ciO-7- ..- ■■■' ,- hVRKl^/OO; '•'■' ".•■ ^iav-i ;*>>:•:*■. • / 3vtvliiv!i{ "'"■•'' ••• tipOSO $^07.--:' ar.tPAr.--'j..-.'/.- 35H»"»V,« ',.";..• BirAr^r.;;;.'. ■• -J. ^EfSS'Avv: '* "'^v&'Crv..; O,-/ ilii,-^".^;.- < ■ SZ-l-'sv.■■■. :•' ••23wa ARMY MEDICAL LIBRARY FOUNDED 1836 WASHINGTON, D.C DOMESTIC MEDICINE; OR, THE FAMILY PHYSICIAN: BEING AN ATTEMPT To render the Medical Art more generally ufeful, by {hewing people what is in their own power both with refpeel to the Prevention and Cure of Difeafes. CHIEFLY Calculated to recommend a proper attention to**'" REGIMEN and SIMPLE MEDICINES. ^..,5^ WILLIAM BUCK AN, MfD. ChasMc Donald * Sed valetudo fuflentatur notitiafui corporis ; et obfrvatione, quae res auf prodefefoleant, *iut obeffe; et continentia in viclu omul atqne cultu, corporis tuendi caufa ; et praetermittendis voluptatibus ; poflre- Tno, arteeorumquorumadfeientiamhaecpertinent. Cic. deOffic. T+„MdL i~ /7;v fs>^ TV .:n IP, -e<>^ PHILADELPHIA: Printed for and fold by R. Aitken, at his Bool;-Store, nearly oppoflte the London-Coffee-Houfei in Frcnt-llro t. ____________________________________o^i___ _____ 'If/ "•* * \ ADVERTISEMENT. IT is aftonifhing, after medicine has been folong cultivated as a liberal art, that philofophers and men of fenfe fhould ftillqueftion whether it be more beneficial or hurtful to mankind. This doubt could never take its rife from the nature of medi- cine, but from the manner in which it has been conduced. All ages and nations have agreed in thinking that the fick ought to be treated in amanner different from thofe in health. Indeed the very appetites of the fick fhew the neceflity of, at leaft, a different regimen. So far medicine is evidently found- ed in nature, and is quite confident with reafon and common fenfe. Had phyftcians been more attentive to regimen, and lefs fol- licitous in hunting after wonderful medicines, and concealing their pretended virtues from the reft of mankind, the medical art would never have become an object of ridicule. The affec- tation of myftery may, for a while, draw the admiration of the multitude, but will never fecure the efteem of men of fenfe ; and it will always occafion fufpicions in the minds of the more enlightened part of mankind. Every attempt therefore to monopolize or conceal any thing that relates to the prefervation of health or the cure of difeafes, muft not only be injurious to the interefts of fociety, but iikewife detrimental to the medical art. If medicine be a rational fcience, and founded in nature, it will never lofe its reputation by being expofed to public view. If it be not able to bear the light, it is high time that it were exploded. Secrecy in any art lays a foundation for impofition. Had phyficians never affected myftery, quacks and quackery cculd never haveexifted. Now that they have over run all Europe, and difgraced both human nature and the medical profeflion, there is no other method of difcrediting them with the peo- ple, but a total reverfe of behaviour in the Faculty. Let us therefore aft with candor, opennefs, and ingenuity, and man- kind will foon learn fodread every thing in medicine that has the fmalleft appearance of fecrzey or difguife. The affedtation of myftery not only renders the medical art more liable to be abufed, but likewiTe retards its progrefs. No art ever arrived at any confiderable degree of improvement fo long as it was kept in the hands of a few who practiced it as a trade. Theinterefted views of a trade will always obflruct the progvefs iv ADVERTISEMENT. progrefs of a fcience. Other arts have been diffufed among the people, have become the objects of general attention, and have "been improven accordingly. Medicine ftill continues a myftery. Even the philofopher is not afliamed to own that he is ignorant of the caufes and cure of difeafes. Hence it is, that while other branches of fcience have arrived at a high degree of perfection, the healing art is ftill involved in doubt and uncertainty. Those who follow the beaten tract of a teacher feldorn make any ufeful difcoveries. Accordingly we find that moft of the real improvements in medicine have either been the ef- fect of chance, or have been made by perfons not bred to phy- fic. Men who think and reafon for themfelves, who are not fettered by theories nor warpt by hypothefes, bid thefaireftfor improving any art. As all men arc liable to difeafe, and equally interefted in every thing relating to health, it is certainly the duty of phy- ficians to fliew them what is in their own power both with re- fped to the cure of the one, and the prefervation of the other. Did men take every method to avoid difeafes, they would fel- dorn need the phyfician ; and would they do what is in their own power when fick, there would be little occafion for medi- cine. It is hard to fay if more lives arc not loft by people trufting to medicine, and neglecting their own endeavours, than all that are faved by the help of phyfic. We do not mean that all men are to be made phyficians. This, according to the prefent acceptation of the word, would be an attempt as ridiculous as it is impoflible. We only mean that they fhould be taught the importance of due care for the prefervation of health, and of a proper regimen in difeafes. Thefe they are certainly capable of underftanding, and all the reft are of fmall account. We are happy to find that fome of the moft eminent phy- ficians now begin to entertain more liberal ideas with regard to phyfic. Van Sweiten*, Rofenf, Tiffot, and fome others, have written with a view of diffufing fome knowledge of medi- cine among tne people. Their performances have met with that applaufe from the public, which it is always ready to be- llow upon works of real utility. Had Tiflbt's plan been more extenfive, the following pages would probably never have been made public. He confines himfelf folely to the acute difeafes. We have likewife treated the chronic ; both becaufe they arq very * Phyfician to their Imperial Majefties. f Fiift phyfician of the kingdom of Sweden. ADVERTISEMENT. v very frequent in this country, and becaufe the cure of them chiefly depends on a proper regimen. Dr Tissot has alfo treated the prophylaxis, or preven- tive part of medicine, lefs minutely than feems neceflary. A very flight inquiry into the caufes of popular maladies is fuffi- cient to fhew that many of them might, by due care, be pre- vented. For this reafona coafiderable number of the follow- ing pages are employed in pointing out the moft common caufes of popular difeafes, and the means of avoiding them. The firftpart of the prophylaxis is calculated to fhew the importance of proper nurfing *. The obfervations were made in a fttuation where the author had the greateft opportunitie* of feeing the effects both of the right and wrong management of children, and of being fully convinced that the latter is the principal caufe of their great mortality. Peculiar attention is paid to the difeafes of mechanics. That ufeful fet of people, upon whom the riches and profpe- rity of Britain depend, can never be too much regarded. Their valuable lives are frequently loft for want of due atten- tion to circumftances which both to themfelves and others may often appear trifling. We have likewife endeavoured to point out the bad effects of luxury, indolence, &c All men acknowledge health to be the chief blefling of life; but few fhew a proper concern for the prefervation of it. There is hardly any pleafure or profit for which people will not hazard their health ; and it is often bartered for the moft fordid enjoyments. Few things howe- ver are more in our own power. Moft men may enjoy health if they will. Even thofe who have had the misfortune to be naturally of a weak conftitution, have often, by proper care, arrived at an extreme old age, and enjoyed good health to the very laft; while fuch as were naturally robuft, by trufting too much to their ftrength of conftitution, and defpifing care, have either died young, or dragged out a life of pain and mi- fery. In the treatment of difeafes we have been chiefly attentive to diet, drink, air, and the other plirts of regimen. Regimen feems to have been the chief, if not the only medicine of the more early ages, and, to fay the truth, it is the moft valuable part of medicine ftill. But regimen and domeftic medicines are dcfpifed, while foreign regions are ranfacked for things of lefs * Moft of the obfervations contained in the firft chapter were made in the Foundling Hofpital at Ackwoith, and communicated to the public feveral years ago, in a pamplet addrefled to the governours of that hof- pital. vi ADVERTISE M FN T. lefs value, and every ore which the earth afFords is tortured to extract poifons, and arm the daring empiric for the deftruction of his fellow men. We have indeed ventured to recommend fome fimple medi- cines in almoft every difeafe ; but even thefe fhould only be adminiftered by people of better underftanding. We would have the ignorant omit them altogether, and attend folely ta the directions relating to diet and the other parts of regimen. The laudable difpofition which fo univerfally prevails a- mong the better fort of people in the country, of aflifting their poor neighbours in diftrefs, fuggefted the firft hint of this at- tempt. It never was, and, in all probability, never will be in the power of one half of mankind to obtain the afliftaiice of phyficians. What rauft they do ? To truft themfelves in the hands of quacks, or blunder on in the track which their rude forefathers pointed out, are perhaps equally dangerous. The ignorant ruftic puts little confidence in any endeavours of his own. All his hopes of a cure are placed in fomething which he does not underftand, fomethingmyfterious and quite above his capacity, as herbs gathered under the influence of fome planet, charms, the noftrums of quacks and conjurers, &c. Such are the ridiculous and deftructive prejudices which prevail among the inhabitants of this country, even in this enlighten- ed age, and fuch is their entire ignorance of medicine, that they become the eafy dupes of every pretender to it. We make no doubt but the ladies, gentlemen, and clergy who refide in the country will readily concur with us, in en- deavouring to root out fuch pernicious and deftructive prejudi- ces. Their example will have great weight with their de- pendents and inferiors ; and their advice will be often liftened to with more attention than that of a phyfician. They will teach the poor the importance of a proper regimen both in health and ficknefs ; the danger of trufting their lives in the hands of quacks and conjurers, and the folly of their own fuperftitious notions. By this means they may prevent much evil, do fome good, and prove re.-.l bleflings to thofe among whom they refide. Nothing is farther from the defign of the following pages, than to induce ignorant perfons ro tamper with dangerous me- dicines, or truft to their own ikill, where better afliftance can be obtained. But where fomething muft be done, and no me- . dical afliftance can be had, it is certainly better to direct peo- ple what they ought to do than to leave them to blunder on in the dark. There ADVERTISEMENT. vii< There is no*doubt but the, more mercenary part of the Fa- culty, whofe ideas of medicine never rife above the fordid views of a trade, will do all intheirpower to difcredit every at- tempt of this kind with the public. With fuch as are able to fee through the difguife, their cenfure will pafs for applaufe; and with the lefs enlightened, it will be very little regarded. With us it can have no weight, fo long as we are confcious that we have the good of mankind at heart; and that, howe- ver imperfect the execution may be, the defign has been appro- ven by many whofe names do honour to the medical profeflion. As people who live in the country cannot always obtain me- dicines, upon any fudden emergency, even though they knew how to ufe them, we have here added a lift of fuch fimple drugs and medicines as ought to be kept, at leaft in every gentleman's family, in order to be in readinefs upon all occaii- Rhubarb Jalap Senna Manna Glaubers falts Cream of tartar Salt of tartar Tamarinds Ipecacuanha Jefuits bark Nitre, or fait petre Sal. prunell Sal. ammoniac Flowers of fulphur Magnefia alba Crabs claws prepared Snake root Liquorice root Seneka root Wild Valerian root Gentian root Gum arabic ----camphor —---■ ammoniac ■----afafcetida Burgundy pitch Agaric of the oak Afh coloured ground Liver- wort Cinnamon water Penny-royal water Pepper mint water Syrup of poppies -----of oranges -----of lemons Spirits of wine -----of nartfhorn Sweet fpirits of nitre -----------of vitriol Liquid laudanum Elixir* qf vitriol Vinegar of fquills Oil of almonds Olive oil Adhefive plafter Bliftering plafter Wax plafter Yellow bafilicon ointmenE White ointment Turner's cerate THE CONTENTS. PART I. Of PREVENTING DISEASES. OF CHILDREN .---. page i Cloathing ■ • * ---- 8 Food <----. ---- 12 Exercife . ■ . ---- 17 Bad effects of unwholefome air *—— 24 Faults of nurfes ---- ----• 26 A fummary view of the directions concerning children 28 General C A U S E S of difeafes ---- 31 Catching cold---- ----■ ib. Unwholefome food <----• ---- 37 Irregularities in diet, fleep, Sec. —— 44 Bad air ---- „----_jp 2$ Negledf. of cleahlinefs « - »■ fx9^K' 52 Intemperance -—« »f^y -......•'^^'x^A 55 Indolence «---• *' &f ---- y' 59 Infe&ion ---- V •----■ > 63 The paflions ----* '■ '■ ■ ■ + /bb Particular CAUSES of difeafes----> ^^"i Laborious employments * 74 Sedentary employments ■---- 81 Intenfe ftudy ----<- —— S5 PART II. Of DISEASES. m Of diftinguifhing difeafes---- <$* Fevers in general ----• ---- $7 Intermitting fevers, or agues ——. iqj An acute continual fever ---- *Go Apleurify ----• •---- 113 A peripneumony or inflammation of the lungs 119 Consumptions ---- ---- i?i A flew or nervous fever —-— * $2 A malignant, putrid, or fpotted fever ^ --*--=- 136 CONTENTS. Of the miliary fever —:— ---- 144 The fmall pox ---- ---- 148 The rmrfles ---- ---- 108 The fcarlct fever —:— ---- 171 The eryfipejas, or St Anthony's fire ---- 172 The inflammation of the brain ---- ■ J 76 The inflammation of the eyes ---- 180 The quinfey, or inflammation of the throat 184 The malignant quinfey, or ulcerous fore throat 189 Colds ---- ---- 192 Coughs ---- ---- 195 The chin-cough ■---- ---- 198 The inflammation of the ftomach ---- 201 The iliac paflion ---- ---- 203 Colics —.— ---- 206 The inflammation of the kidneys---- 2IO The inflammation of the liver ---- 213 The cholera morbus, or vomiting and loofenefs 21 <( A diarrhoea, 01 loofenefs — 217 The dyfentery, or bloody flux —— 220 A diabetes, or exceflive difcharge of urine 226 A fuppreflion of urine ——— 228 Coftivenefs — — 230 Involuntary difcharges of blood ■ 232 bleeding at the nofe ----■ 234 Bleeding and blind piles ■----» 236 Spitcing of blood —■ -— 238 Vomiting of blood — -— 241 Bloodv urine —- —- 242 I'.xceflive vomiting -— — 243 The hcadach ■----• 246 249 252 The toothach The caracli he heart-burn ^^ ---- 2^4 of the fiomacH ——— 25 < ins — — 257 The jaundice ' •---- • 261 Th'.-mopiy — — 264 The 50111 — — 267 The rhcun.p.tifm —- oro / j> The fcurvy — — 276 Thf-fcrophu'a, or king's evil — 280 4 h- lickct: 2S3 Of CONTENTS. Of the itch .---.--- 286 Theafthma — — 288 The apoplexy — ■ 291 The palfy — — 294 The epilepfy, or falling ficknefs ■— 295 Nervous, hyfteric and hypochondriac diforders 299 Melancholy and madnefs ■ ■ » 303 Poifons — — 308 The ftoneand gravel ■ ■■ ■ 318 The hiccup — — 321 The cramp of the ftomacht ——. 322 Want of appetite --- 323 Deafnefs „ ~ • — .. - . —* -' - - - -* 324 The night mare — — 325 Swoonings ~> 326 DISEASES of WOMEN •--- 328 Pregnancy — — 334 Childbirth ---■ — 336 Barrennefs --- ...... « 339 PISEASESof CHILDREN Retention of the meconium >•——• 341 Aphthae pr thrufh ■ ih. Acidities — — 342 Galling and excoriations — 344 Stoppage of the nofe • ib. Eruptions — — 345 Difficult breathing — 347 Teething — — 34^ SURGERY * Of wounds — — 35° Burns — —' 354 Bruifes --- •-*—■ 355 Diflocations — — 356 Broken bones —- — 357 Strains — — 36° Ulcers ■---■ ■---• &. Impofthumes or boils ° ■■ • 3^2 Whitlows --- --- 363 Ruptures •--- «---' 365 " Cafualties ------ . 366 [ * ] PART I. OF PREVENTING DISEASES. CHAP. I. OF CHILDREN. • TO avoid difeafes, it is neceflary we fhould know their caufes. Thefe indeed are numerous; but we fhall endeavour to point out fuch only as have the moft general influence, as too great minute- nefs in this refpeft would tend rather to perplex than in- ftrudt the generality of readers. The better to trace difeafes from their original caufes, we fhall take a view of the common treatment of mankind in the ftate of infancy. In this period of our lives, the foundations of a good or bad conftitution are generally laid j it is therefore of importance, that parents be well ac- quainted with the various caufes which may produce dif- eafes in their offspring. It muft be owing either to the ig- norance or carejeflhefs of parents, that fo many of the hu- man fpecies perifh in infancy. This, we prefume, will appear from the following obfervations. The annual regifters of the dead fliew, that at leaft one half of the children born in Great BjKn die under twelve years of age. To thofe who do not reflect, this appears to be a natural evil, and therefore they think it their duty to fubmit to it. But whoever accurately examines the mat- ter, will find that it is an evil of our own making, and, in a great meafure, owing to mifmanagement. Were the death of infants a natural evil, other animals fhould be as liable to die young as man j but that we fee is ndt the cafe. It may feem ftrange, that man, notwithftanding his fuperior rcafon, fhould fall fo far fhort of other animals A ir\ 2 OFPREVENTING in the management of his young: But our furprife will foon ceafe, if we confider that brutes, guided by inftinft, never err in this refpect:; while man, trufting folely to art, is feldom ri^ht. Were a catalogue of thofe children who perifh annually by art alone, exhibited to public view, it would aftonifli moft people. When parents are above taking care of their children, others muft be employed for that purpofe: Thefe will al- ways endeavour to recommend themfelves by the appear- ance of extraordinary fkill and addrefs. By this means fo many unneceflary and deftruitive articles have been intro- duced into the diet, cloathing, &c. of children, that it is no wonder fo many of them perifh. Nothing can be more prepofterous than for a mother to think it below her to take care of her own child, or to be fo ignorant as not to know what is proper to be done for it. If we fearch nature throughout, we cannot find a parallel to this. Every other creature is the nurfe of its own young, and they thrive accordingly. Were the brutes to bring up their young by proxy, they would fhare the fame fate with thofe of the human fpecies. We mean not to impofe it as a tafk upon every mother to fuckle her own child. This, whatever fpeculative writers may fay to the contrary, is in many cafes imprac- ticable, and would inevitably prove deftruclive both to the mother and child. Women of delicate conftitutions, fub- jcdl to low fpirits, hyfteric fits, or other nervous diforders, make very bad nurfes: But thefe complaints are now fo common, that it is rare to find a woman of fafhion free from them ; for which caufe few women of better ftation, fuppofe them willing, are really able to fuckle their own children. Did mankind live as nature directs, almoft every mother would be in a condyjgn to give fuck: But, whoever con- fiders how far we hfiBrdeviated from her dictates, will not be furprifed to find many of them unable to perform that neceflary office. Mothers, who do not eat enough of foiid food, nor enjoy the benefit of free air and exercife, can neither have wholefome humours themfelves, nor afford proper nourishment to an infant. Children who are fuck- led by delicate women, either die young, or are weak and fickly all their lives. Nor is this at all to be wondered at. If children fuck in nervous difeafes with their mother's milk, What have we to expect ? When DISEASES. 3 When we fay, that every mother is not able to fuckle her own child, we would not be underftood as difcouraging that practice. Every mother who can, ought certainly to perform that tender office. But fuppofe it to be out of her power, fhe mav, nevertheleft, be of great fervice to her child. The bufinefs of nurfing is by no means con- fined to giving fuck. To a woman who abounds with milk, that is the eafieft part of it. Numberlefs other offices are neceflary for a child, which the mother at leaft ought to fee done. A mother, who abandons the fruit of her womb, as foon as it is born, to the fole care of an hireling, hardly deferves that name. A child, by being brought up under the mother's eye, not only fecures her affection, but may reap all the advantages of a mother's care, though it be fuckled by another. How can a mother be better em- ployed, than in fuperintending the nurfery? This is at once the moft delightful and important office ! yet the moft trivial bufinefs or infipid amufements are often preferred to it. A ftrong proof both of the bad tafte and wrong edu- cation of modern females. It is much to be regretted, that more pains is not be- ftdwed in teaching the proper management of children to thofe whom nature has defigned for mothers. This, in- ftead of being made the principal, is feldom confidered as any part of female education. Is it any wonder, when females, fo educated, come to be mothers, that they fhould be quite ignorant of the duties belonging to that ftation ? However ftrange it may feem, it is certainly true, that many mothers, and thofe of fafhion too, are as ignorant, when they have brought a child into the world, of what is proper to be done for it, as the infant itfelf. Indeed, the moft ignorant part of the fex are generally reckoned moft knowing in the bufinefs of nurfing. Hence, fenfible people become the dupes of ignorance and fuperftition; and the nurfing of children, inftead of being conducted by reafon, is the refult of whim and caprice. One great defign of females, no doubt, is to propagate the fpecies. But to bring forth a child, is the leaft part of that important bufinefs. Were the care of a parent to ftop here, the whole human race would foon be extinct. Ma- ture has made it neceflary, that a child fhould depend on its parents during the ftate of infancy; and thofe parents who neglect the proper care of their offspring, not only violate one of the firft and ftrongeft principles of nature, A 2 but 4 OF PREVENTING but actually endeavour to extinguish the human race. An infant may be as certainly murdered by neglect, as by any act of violence whatever; and, for one child that lofes its life by the latter, a thoufand perifh by.the former, without being regarded. Were the time that is generally fpent by females in ac- quiring ufelefs knowledge, employed in learning how to bring up their children ; how to drefs them fo as not to hurt, cramp, or confine their motions; how to feed them with wholefome and nourifhing food ; how to exercife their tender bodies, fo as beft to promote their growth and ftrength: Were thefe the objects of female inftruction, mankind would derive the greateft advantage from it. But, while the education of females implies little more than what relates to drefs and public fhow, we have nothing to ex- pect from them but ignorance, even in the moft important concerns. But ignorance can be no excufe, where people have it in their power to be better informed ; and, if chil- dren perifh by the negligence of mothers, they muft be accountable. Did mothers know their importance, and lay it to heart, they would embrace every opportunity of informing them- felves of the duties which they owe to their infant-offspring. It is theirs, not only to form the body, but alfo to give the mind its moft early caft. They have it very much in their power to make men healthy or valetudinary, ufeful in life, or the bane of fociety. But the mother is not the only perfon concerned in the management of children. The father has an equal intereft in their welfare, and ought to aflift in every thing that re- flects either the improvement of the body or mind. It is pity that men pay fo little regard to this matter. Their neglect is one reafon why females know fo little of it. Women will ever be defirous to excel in fuch accom- plifhments as recommend them to the other fex. But men generally keep at fuch a diftance from even the fmalleft ac- quaintance with the affairs of the nurfery, that many would efteem it an affront, were they fuppofed to know any thing of it. Not (b, however, with the kennel or the ftables: A gentleman of the firft rank is not afhamed to give di- rections concerning the management of his dogs or horfes; but would blufti, were he to be furprized in performing the fame office for that being, who derived its exiftence from himfelf, who is the heir of his fortunes, and the future hope of DISEASES. 5 of his country. Few fathers indeed run any hazard of being furprized in this fituation; yet, certain it is, that man needs culture more than any other creature, and that both his body and,, mind are capable of the greateft im- provement. Nature has left fo much in the power of pa- rents, that children are, in a great meafure, what they pleafe to make them. Physicians themfelves have not been fufficiently atten- tive to the management of children : That has been gene- rally confidered as the fole province of old women, while men of the firft rank in phyfick have even refufed to vifit infants when fick. Such conduct in the faculty has not only caufed this branch of medicine to be neglected, but has alfo encouraged the other fex to affume an abfolute title to prefcribe for children in the moft dangerous difeafes. The confequence is, that a phyfician is feldom called till the good women have exhaufted all their fkill; when his attend- ance can only ferve to divide the blame and appeafe the dif- confolate parents. We would have nurfes do all in their power to prevent difeafes ; but, when a child is taken ill, fome perfon of fkill fhould immediately be confulted. The difeafes of children are generally acute, and the leaft delay is dan- gerous. Were phyficians more attentive to the difeafes of chil- dren, they would not only be better qualified to treat them properly when fick, but likewife to give ufeful directions for their management when well. The difeafes of chil- dren is by no means fuch a difficult ftudy as many imagine. It is true, children cannot tell their complaints; but the caufes of them may be pretty certainly discovered, by put- ting proper queftions to the nurfes and fuch as are about them. Befides, the difeafes of infants, being lef» compli- cated, are eafier cured than thofe of adults. It is really aftonifhing, that fo little attention fhould ia general be paid to the prefervation of infant-lives! What labour and expence are daily beftowed to prop an old rotten carcafe for a few years, while thoufands of thofe, who might be ufeful in life, perifh without being regarded, and prove no better than an untimely birth ! Mankind are apt to value things not according to their future but their pre- fent utility. This is of all others the moft erroneous me- thod of eftimation -, yet, upon no other principle is it pof- fible 6 OF PREVENTING fible to account for the general indifference with refpedt to the death of infants. Of DISEASED PARENTS. Diseased parents cannot beget healthy children. It would be as reafonable to expect a rich crpp from a barren foil, as that ftrong and healthy children fhould be born of delicate parents, worn out with intemperance or difeafe. An ingenious writer obfervcs *, that on the conftitution of mothers depends originally that of their offspring. No one who beljeves this, will be furprifed, on a view of the - female world, to find difeafes and death fo frequent among children. A delicate female, brought up within doors, an utter ftranger to exercife and open air, who lives on tea and other flops, may bring a child into the world, but it will hardly be fit to live. The firft blaft of a difeafe will nip the tender plant in the bud : Or, fhould it ftruggle through a few years exiftence, its feeble frame, fhook with convul-, fions from every trivial caufe, would be unable to fuftain the common functions of life, and prove a burden to fo-f ciety. If to the delicacy of mothers we add the irre*gular lives of fathers, we fhall fee further caufe to believe, that chil- dren are often hurt by the conftitution of their parents. A fickly frame may be originally induced by hardfhips or in- temperance, but chiefly by the latter. It is impoffible that a courfe of vice fhould not fpoil the beft conftitution : And did the evil terminate here, it would be a juft punifhfnent for the folly of the fufferer; but when once a diftemper is contracted and rivetted in the habit, it is entailed on all pofterity. What a dreadful inheritance is the gout, the fcurvy, or the kings-evil, to tranfmit to our offspring ! How happy had it been for the heir of many a great eftate, had he been born a beggar, rather than to inherit his father's fortunes at the expence of likewife inheriting his difeafes ! No perfon who labours under any incurable malady, ought to marry, as he thereby both fhortens his own life, and tranfmits mifery to others : But when both parties are deeply tainted with the fcrophula, the fcurvy, or the like, the effects muft be ftill worfe. Such will either have no iffue at all, or thofe whom they have, muft be miferable in- deed. Want of attention to thefe things, in forming con- nections * Rouueau. DISEASES. y nections for life, has rooted out more families than the plague, famine, or the fword; and while thefe conne&ionj are formed from mercenary views, that muft be the cafe. In our matrimonial Contracts, it is amazing fo little re- gard is had to the health and form of the object. Our fportfmen know, that the generous courfer cannot be bred out of the foundered jade, nor the fagacious fpaniel out of the fnarling cur. This is fettled upon immutable laws. The man who marries a woman of a ftckly conftitution, and defcended of unhealthy parents, whatever his views may be, cannot be faid to act a prudent part. A puny fcrophulous woman may prove fertile j fhould this be the cafe, the family muft become an infirmary. What profpect of happinefs the father of fuch a family has, we fhall leave any one to judge. The Jews, by the pofitive direction of the Almighty, were forbid to have any manner of commerce with the difeafed; and indeed to this all wife legiflators ought to have a fpecial regard. In fome ftates, the marriage of morbid people has actually been prohibited. This is an evil of a complicated kind, a natural deformity, and political mifchiefj and therefore requires a public con- sideration. Such children as have the misfortune to be born of dif- eafed parents, will require to be nurfed with greater care than others. This is the only way to make amends for the defects of conftitution ; and it will often go a great length. A healthy nurfe, wholefome air, and enough of * exercife, will do wonders. But, when thefe are neglect- ed, little is to be expedted from any other quarter. The defe&s of conftitution cannot be fupplied by medicine. Those who inherit any family-difeafe, ought to be very circumfpe& in their manner of living. They fhould con- fider well the nature of fuch difeafe, and guard againft it by a proper regimen. It is certain, that family-difeafes have often, by proper care, been kept off for one genera- tion ; and there is great reafon to believe, that, by perfift- ing in the fame courfe, fuch difeafes might at length be vvholely eradicated. This is a fubject very little regarded, though of the laft importance, i amily-conftitutions are as capable of improvement, as family-eftates; and the li- bertine, who impairs the one, does greater injury to his pofterity, than the prodigal who fquanders away the other. Of 8 OFPREVENTING Of the CLOATHING of CHILDREN. The cloathing of an infant is fo fimple a matter, that it is furprifing, how any perfon fhould err in it; yet many children lofe their lives, and others are deformed, by errors of this kind. Nature knows no other ufe of cloaths to an infant, but to "keep it warm. All that is neceflary for this pur- pofe, is to wrap it in a foft, loofe covering. Were a mo- ther left to the dictates of nature and reafon, this is cer- tainly the method that fhe would follow. But the bufinefs of drefling an infant has long been out of the hands of mo- thers, and has at laft become a fecret, which none but adepts pretend to underftand. From the moft early ages it has been thought neceflary, that a woman in labour fhould have fome perfon to attend her. This in time became a bufinefs; and, like all others, thofe who were employed in it, ftrove to outdo one ano- ther in the different branches of their profeffion. The dreffing of a child came of courfe to be confidered as the midwife's province, who no doubt imagined, that the more dexterity fhe could fhow in this article, the more her fkill would be admired. Her attempts might be feconded by the vanity of parents, who wanting to make a fhow of the in- fant as foon as it was born, were ambitious to have as much finery heaped upon it as poffible. Thus it came to be thought as neceflary for a midwife to excel in bracing and drefling an infant, as for a furgeon to be expert in applying bandages to a broken limb ; and the poor child, as foon as it came into the world, had as many rollers and wrappers applied to its body, as if every bone had been fractured in the birth ; while thefe were often fo tight, as not only to gall and wound its tender frame, but even to obftruct the motion of the heart, lungs, and other organs neceflary for life. In feveral parts of Britain the practice of rolling chil- dren with fo many bandages is now, in fome meafure, laid afide; but it would ftill be a difficult tafk to perfuade the generality of women, that the fhape of a child does not in- tirely depend on the midwife's care. So far, however, are all their endeavours to mend the fhape of children, from being fuccefsful, that they conftantly operate the contrary way, and mankind become deformed juft in proportion to the DISEASES. 9 the means ufed to prevent deformity. How little deformi- ty of body is to be found among uncivilized nations ? So little indeed, that it is vulgarly believed they put all their deformed children to death. The truth is, they hardly know fuch a thing as a deformed child. Neither fhould we, if we followed their example. Savage nations never think of manacling their children. They allow them the full ufe of every organ, carry them abroad in the open air, wafh their bodies daily in cold water, &c. By this ma- nagement their children become fo ftrong and hardy, that, by the time our puny infants get out of the nurfe's arms, theirs are able to ftiift for themfelves. Among brute animals no art is neceflary to procure a fine fhape. Though many of them be extremely delicate, when they come into the world, yet we never find them grow crooked for want of fwaddling-bands. Is nature lefs generous to the human kind ? No : But we take the bufinefs out of nature's hands. Not only the analogy of other animals;, but the very feelings of infants tell us, that they ought to be kept eafy and free from all preffure. They cannot indeed fpeak their complaints; but they can fhew figns of pain j and this they never fail to do, by crying, when pinched by their cloaths. No fooner are they freed from their bracings, than they feem pleafed and happy; yet, ftrange infatuation ! The moment they hold their peace, they are again committed to their chains. If we confider the body of an infant as a bundle of foft pipes, replenifh'd with fluids in continual motion, the dan- ger of preffure will appear in the ftrongeft light. Nature, in order to make way for the growth of children, has form- ed their bodies foft and flexible; and, left they fhould re- ceive any injury from preflure in the womb, has furrounded the fcetus every way with fluids. This (hews the care which nature takes to prevent all unequal preffure on the bodies of infants, and to defend them againft every thing that might in the leaft cramp or confine their motions. Even the bones of an infant are fo foft and cartileginous, that the readily yield to the flighteft preflure, and eafily take on a bad fhape, which can never after be remedied. Hence it is, that fo many people appear with high fhoul- ders, crooked fpines and flat brcafts, who were born with as good a Ihape as others, but had the misfortune to be B fqueezed io OF PREVENTING fqueezed into monfters by the application of ftays and bandages. Pressure, by.obftruaing the circulation, prevents the equal diftrihution of nouriftiment to the different parts of the body, by which means the growth becomes unequal. One part of the body grows too large, while another re- mains too fmall, and thus in time the whole frame becomes difproportioned and misfhapen. To this we muft add, that when a child is cramped in its cloaths, it naturally fhrinks from the parts affeaed, and by putting its body into unna- tural poftures, it becomes deformed by habit. Deformity of body may proceed from weaknefs or difeafes; but, in general, it is the effea of improper cloathing. Nine tenths, at leaft, of the deformity amongft mankind muft be imputed to this caufe. A deformed body is not only difagreeable to the eye, but injurious to the health. By a bad figure both the animal and vital func- tions muft be impeded, and of courfe health impaired. Hence, few people remarkably misfhapen are ftrong or healthy. The new motions which commence at the birth, as the circulation of the blood through the lungs, refpiration, the periftaltic motion, &c. afford another ftrong argument for keeping the body of an infant free from all preflure. Thefe organs, not having been accuftomed to move, are eafily flopped; but when that happens, death muft enfue. Hardly any method could be devifed more effeaually to flop thefe motions than bracing the body too tight with * rol- lers, &c. Were thefe to be applied in the fame manner to the body of an adult, for an equal length of time, they could hardly fail to hurt the digeftion and make him fick. How much more hurtful they muft be to tender infants, we fhall leave anyone to judge. Whoever confiders thefe things, will not be furprifed, that fo many children die of convulfions foon after the birth. Thefe fits are generally attributed to fome inward caufe; but, in faa, they oftener proceed from our own imprudent condua. I have known a child feized with convulfion-fits, foon after the midwife had done fwaddlino- it; but, upon taking off the rollers and bandages, it was im- * This is by no means inveighing againft a thing that does not happen. In many parts of Britain at this day a roller, five or fix feet in length, is applied round the child's body as foon as it is born. DISEASES. u immediately relieved, and never had any convulfion-fits af- terwards. Numerous examples of this fort might be brought, were they neceflary. It would be fafer to fix on the cloaths of an infant with firings than pins, as thefe often gall and irritate their tender (kins, and occafion convulfions. Inftances have been known, where pins were found fticking above half an inch into the body of a child after it had died of con- vulfion-fits, which, in all probability, proceeded from that caufe. Children are not only hurt by the tightnefs of their cloaths, but alfo by the quantity. Every child has fome degree of fever after the birth; and, if it be loaded with too many cloaths, the fever muft be increafed. But that is not all; the .child is generally laid in bed with the mo- ther, who is likewife feverifh ; to which we may add the heat of the lying-in-bed-chamber, and the wines, and other heating things too often given to children immediate- ly after the birth. When all thefe are combined, which does not feldom happen, they muft increafe the fever to fuch a degree as will endanger the life of the infant. The danger of keeping infants too hot, will further ap- pear, if we confider, that, after being for fome time in the fituation mentioned above, they are often fent into the country to be nurfed in a cold houfe *. Is it any wonder, if a child, from fuch a tranfition, catches a mortal cold, or contraas fome other fatal difeafe ? When an infant is kept too hot, its lungs not being fufficiently expanded, are apt to remain weak and flaccid for life; from whence pro- ceed coughs, confumptions, and other difeafes of the breaft. It would anfwer little purpofe to fpecify the particular pieces of drefs proper for an infant. Thefe ever will vary in different places according to cuftom and the humour of parents. The great rule to be obferved is, That a child have no more cloaths than are neceflary to keep it warm, and that they be quite eafy for its body. Stays are the very bane of children. A volume would not fuffice to point out all the ill effeas of this ufelefs piece of drefs. The madnefs in favour of ftays feems, however, to have been at a height; and it is to be hoped the world will, in time, become wife enough to know, that the hu- B 2 man * Cadogan. 12 OF PREVENTING man fhape does not folely depend upon whale-bone and bend leather *. We fhall only add, with refpea to the cloaths of chil- dren, that they ought to be kept very clean. Children , perfpire more than adults; and, if their cloaths be not frequently changed, they become very hurtful. Dirty cloaths not only gall and fret the tender fkins of infants, but likewife occafion ill fmells; and, what is worfe, tend to produce vermin and cutaneous difeafes. Cleanliness is not only agreeable to the eye, but tends greatly to preferve the health of children. It pro- motes the perfpiration; and, by that means, frees the body from fuperfluous humours, which, if retained, could not fail to occafion difeafes. A nurfe can have no excufe for allowing a child to be dirty. Poverty may oblige her to give it coarfe cloaths; but, if fhe does not keep them clean, it muft be her own fault, Of the FOOD of CHILDREN. Nature not only points out the food proper for an in- fant, but aaually prepares it. This, however, is not fuf- ficient to prevent fome who think themfelves wifer than nature, from attempting to bring up their children with- out her provifion. Nothing can fhow the difpofition which mankind have to depart from nature more than their en- deavouring to bring up children without the breaft. The mother's milk, or that of a healthy nurfe, is unqueftion- ably the beft food for an infant. Neither art nor nature can afford a proper fubftitute for it. A child may feem to thrive for a few months without the breaft; but when teething, the fmall-pox, and other difeafes incident to childhood come on, they generally fall a viaim. An evi- dent proof, that their food is unwholefome, and their hu- mours bad. A child foon after the birth fhews an inclination to fuck; and there feems to be no reafon why it fhould not be ^ra- tified. It is true, the mother's milk does not always come immediately after the birth; but is not this the way to bring it ? The firft milk that the child can fqueeze out of the breaft, anfwers the purpofe of cleanfing better than all the drugs in the apothecary's fhop, and at the fame time pre- * Stays made of bend-leather are worn by all the woman of lower ftation in many parts of England. DISEASES. 13 prevents inflammations of the breaft, fevers, and other dif- eafes incident to mothers. It is ftrange how people came to think, that the firft thing given to a child fhould be drugs. This is beginning with medicines by times, and no wonder that they generally end with it. It fometimes happens, that a child does not pafs the meconium fo foon as could be wifhed. This has in- duced phyficians in fuch cafes to give fomething of an open- ing nature to cleanfe the firft paffages. Midwives have im- proved upon this hint, and never fail to give fyruos, oils, &c. whether they be neceflary or not". Cramming an in- fant with fuch indigeftible fluff as foon as it is born, can hardly fail to make it fick, and is more likely to occafion difeafes, than prevent them. Children are feldom long af- ter the birth without having pa'ffage both by ftool and urine; though thefe evacuations may be wanting for fome time without any danger. Were a child permitted to fuck its mother as foon as it fhows an inclination for the breaft, it would need no other phyfic; but if it muft have fomething before it be allowed the breaft, let it be a little fimple water-pap, to which may be added an equal quantity of new milk. If this be given without any wines, fuga'rs, or fpiceries, it will neither heat the blood, load the ftomach, nor occafion gripes. Upon the firft fight of an infant, almoft every perfon is ftruck with the idea of its being weak, feeble, and wanting fupport. This naturally fuggefts the need of cordials. Accordingly we find wines univerfally mixed with the firft food of children. Nothing can be more fallacious than this way of reafoning, or more hurtful to infants than the condua founded upon it. Children need very little food for fome time after the birth ; and what they receive, fhould be thin, weak, light, and of a cooling quality. A very fmall quantity of wine, or even fugar, is fuificient to heat and inflame the blood of an infant; but every per- fon, converfant in thefe matters, muft know, that moft of the difeafes of infants proceed from the heat of their hu- mours, as the thrufh, &c. If the mother or nurfe has enough of milk, the child will need little or no other food before the third or fourth month. It will then be proper to give it, on~e or twice a day, a little of fome food that is eafy of digeftion ; as wa- ter-pap, milk-pottage, weak broth with bread in it, or the like. This will eafe the mother; it will accuftom the child by m. OF PREVENTING by degrees to take food, and render the weaning both lefs difficult and dangerous. All great and fudden tranfitions arc to be avoided in nurfing. For this purpofe the food of chil- dren ought to be fimple, as near as poffible rcfembhng the properties of milk. Indeed milk itfelf fhould make a princi- pal part of their food, not only before they be weaned, but for a long time after. • Next to milk, we would recommend good light bread. Bread may be given to a child as foon as it fhows an in- clination to chew, and it may at all times be allowed as much as'it pleafes. The very chewing of bread will help to cut the teeth and promote the difcharge offaliva, while by mix- ing with the nurfe's milk in the ftomach, it will afford an excellent nouriftiment. Children fhow an early inclination to chew whatever is put into their hands. Parents obferve the inclination, but generally.miftake the objea. Inftead of giving the child fomething which may at once exercife its gums and afford it nouriftiment, they commonly put into its hand a piece of hard metal or impenetrable coral. A cruft of bread is the beft gum-ftick. It not only anfwers the pur- pofe better than any thing elfe, but has the additional pro- perties mentioned above, of nourifhing the child and car- rying the faliva down to the ftomach, which is too valuable a liquor to be loft. Bread, befides being ufeddry, may be many ways pre- pared into food for children. One of the beft methods of preparing it, is to boil it in water, afterwards pouring the water off, and mixing with the bread a proper quantity of new milk unboiled: Milk is both more wholefome and nouiifhing this way than boiled, and is lefs apt to occafion coftivenefs. For a child farther advanced, bread may be mixed in veal or chicken broth, made into puddings or the like. Bread is a proper food for children at all times, pro- vided it be plain, made of wholefome grain, and well fer- mented ; but when enriched with fruits, fugars, or fuch things, it becomes very unwholefome. It is foon enough to allow children animal food when they have got teeth to eat it. They fhould never tafle it till after they are weaned, and even then they ought to ufe it very fparingly. Indeed, when children live wholely on vegetable food, it is apt to four on their ftomachs ; on the other hand, too much flefh heats the blood and occafions fevers and other inflammatory difeafes. This plainly points out a proper mixture of animal and vegetable food as moft fit for children. Vr„, DISEASES. 15 Few things are more hurtful to children, than the com- mon method of fweetening their food. It not only makes them grow fat and bloated, but entices them to take more food than they ought to do. It is pretty certain, if childrens food were quite plain, that they would never take more than enough. Thus the exceffes of children are entirely owing to nurfes. If a child be gorged with food at all hours, and enticed to take it, by making it fweet and agreeable to the palate, is it any wonder if fuch a child comes in time to crave more food than it ought to have ? Children may be hurt by too little as well as too much food. After a child is weaned, it ought to be fed four or five times a-day ;• but fhould never be accuftomed to eat in the night; neither fhould it have too much at one time. Some lay it down as a rule, that no child ought to be fed above three times in twenty-four hours; whereas, moft adults eat four times in the fame fpace. The food of chil- dren is generally lighter than that of adults ; their digeftion is likewife more quickly performed : If to thefe we add the power of habit, we will be inclined to think, that children fhould be fed oftener than up-grown perfons. If a child, who has been accuftomed to fuck its nurfe at all hours, be fuddenly deprived of that, and reftriaed to three meals a-day, bad confequences muft follow. I have often feen the fcheme of bringing children to live on three regular meals a-day tried, but never knew it fucceed. Children thrive much better with fmall quantities of food frequently given. This neither overcharges the ftomach, nor hurts the di- geftion, and is certainly moft agreeable to nature. Writers on nurfing, have inveighed with fuch vehe- mence againft too much food, that one would be apt to imagine two thirds of thofe who die in infancy were aau- ally crammed to death. This has induced many parents to ruin the conftitutions of their children, by running into the other extreme. The error of pinching children in their food, is more hurtful than its oppofite. Nature has many ways of relieving herfelf when overcharged; but a child who is pinched with hunger will never become a ftrong or healthy man. That errors are frequently committed on both fides, we are ready to acknowledge; but where one child is hurt by the quantity of its food, ten fufier from the qua- lity. That is the principle evil, and claims our ftnaeft at- tention. Many people imagine, that food which they love them- felves cannot be bad for their children : But this notion is very 16 OF PREVENTING very abfard. In the more advanced periods of life we often acquire an inclination for food which when children we could not bear to tafte. There are many things that may agree very well with the ftomach of an up-grown perfon, which would be very hurtful to a child ; a* high-feafoned, faked, and fmoke-dried provifions, &c. It would alfo be improper to feed children with fat meat, ftrong broths, rich foups, gravies, or the like. All ftrong liquors are hurtful to children. Some parents teach their children to guzzle ale, and other ftrong liquors' at every meal ; but fuch a praaice cannot fail to do mif- chief. Thefe children feldom efcape the violence of the fmall-pox, meafles, hooping-cough, or fome other feverifh diforder. Milk, water, butter-milk, or whey, make the moft proper drink for children. If they have any thing ftronger, it may be fine fmall bear, or a little wine mixed with water. The ftomachs of children can digeft well enough without the afliftance of warm ftimulants. Young people are naturally hot, and confequently are eafily hurt by every thing of a heating quality : Their blood has acon- ftant tendency to inflammation, which all ftrong liquors muft increafe. Few things are more hurtful to children than unripe fruits. Thefe not only four the ftomach, but relax it and weaken the digeftion; by which means it becomes a pro- per neft for worms of all kinds. Children indeed fhow the greateft inclination for fruit, and I am apt to believe, that if good ripe fruit were allowed them in proper quantity, it would have no bad effeas. We feldom find a natural incli- nation wrong, if direaed to its proper objeas. Fruits are generally of a cooling nature, and correa the heat and acri- mony of the humours. This is what moft children want ; only care fhould be taken left they exceed. Indeed the beft way to prevent children from going to excefs in the ufe of fruit, or eating that which is bad, is to allow them a proper quantity of what is good. Roots which contain a crude vifcid juice fhould be fpa- ringly given to children. They fill the body with grofs hu- mours, and tend to produce eruptive difeafes. This caution is peculiarly neceflary for the poor ; being glad to get what will fill their childrens' bellies for a little money, they ftui" them two or three times a-day with potatoes and the like. Children had better eat a fmall quantity of fuch food as would yield a wholefome nouriftiment, than be crammed wiih whatth^ir digeftive powers are unable properly to aflimulate. Butter DISEASES. 17 Butter ought likewife to be fparingly given to children. It both relaxes the ftomach, and produces grofs humours. Indeed, moft things that are fat or oily, have the fame ef- fedi. Butter, when faked, becomes ftill more hurtful. In- ftead of butter, fo plentifully eat by children in moft parts of Britain, we would recommend honey. Honey is not only more wholefome than butter, but likewife cheaper. It is cooling, cleanfing, and tends to fweeten the humours ; whereas butter isjuft the reverfe. Children who eat honey are feldom troubled with worms. They are alfo lefs fubject to the common cutaneous difeafes, as itch, fcabbed-head, &c. Many people err in thinking the diet of children fhould be always moift. When children live entirely upon flops, it relaxes their folids, renders them weak, and predifpofes them to rickets, fcrophulas, and other glandular diforders. Relaxation is one of the moft general caufes of the difeafes of children. Every thing therefore which tends to unbrace their bodies ought to be carefully avoided. We would not be underftood as confining children to any particular kind of food. Their diet may be frequently varied, provided regard be had to fimplicity. Whatever food we are moft accuftomed to in yeuth, we generally love during life. For this reafon children fhould have a little of any kind of food that is plain and wholefome, left they fhould contraa an averfion for it, and afterwards be under the neceflity of ufing it. Of the EXERCISE of CHILDREN. Of all the caufes which confpire to render the lives of children fhort and miferable, none has greater influence than the want of proper exercife : Healthy parents, whole- fome food, and proper cloathing, will avail little where it is negleaed. Enough of exercife will make up for fevcral other defeas; but nothing can fupply the want of it. It is abfolutely neceflary to the health, the growth, and the ftrength of children. The defire of exercife is almoft co-eval with life itfelf. Were this principle attended to, many difeafes might be prevented. But while indolence and fedentary employ- ments keep two thirds of mankind from either taking ex- ercife themfelves, or giving it to their children, what have we to expea but difeafes and deformity among their oft- fpring ? The rickets, fo deftruaive to children, never ap- C peared 18 OF PREVENTING peared in Britain till manufaaures began to flouriih, and people, altraaed by the love of gain, left the country to follow fedentary employments in great towns. It is amongit thefe people that this difeafe chiefly prevails, and not only deforms, but kills many of their offspring. The analogy of other animals ftiews that children re- quire exercife. Every creature endeavours to make ufe of its organs as foon as it can, and many of them, even when under no neceflity of moving in queft of food, cannot be re- ftrained without force. This is evidently the cafe with the calf, the lamb, and many other young animals. If thefe creatures were not permitted to frifk about, and take ex- ercife, they would foon die. The fame inclination appears very early in the human fpecies; but as they arqnot able to take exercife themfelves, it is the bufinefs of their parents or nurfes to affift them. Children may be exercifed various ways. The beft me- thod, while light, is to carry them about in the nurfe's arms. This gives the nurfe an opportunity of talking to the child, and of pointing out every thing that may pleafe and delight its fancy. It is much fafer than fwinging an infant in a machine, or leaving it to the care of fuch as are not fit to take care of themfelves. Nothing can be more foolifh than to fet one child to keep another; that has proved fatal to many infants, and has rendered others lame for life. When children begin to walk, the fafeft and beft method of leading them about is by the hands. The common way of fwinging children by firings fixed to their backs, has many bad confequences. It makes them throw their bo- dies foreward, and prefs with their whole weight upon the breaft: by that means the breathing is obftruaed, the breaft flattened, and the bowels compreflcd. This hurts the di- geftion, and occafions confumptions of the lungs, and other difeafes. It is a common notion, that if children be fet upon their feet too foon, their legs will become crooked. There is reafon to believe, that the very reverfe of this is true. Eve- ry member acquires ftrength in proportion as it is exercifed. The limbs of children are weak indeed, but their bodies are proportionably light; and had they fkill to direa them- felves, they would foon be able to fupport their own weight. Who ever heard of any other animal that became crooked by ufing its legs too foon ? Indeed if a child be not permit- ted to make ufe of its legs till a confiderable time after the birth, DISEASES. 19 birth, and be then fet upon them with its whole weight at once, there may be fome danger of hurting it; but this proceeds intirely from the child's not having been accuftom- ed to ufe its legs from the beginning. Mothers of the poorer fort think they gain a great deal by making their children lie or fit while they work, in this they are greatly miftaken. By negleaing-to give their chil- dren exercife, they are obliged to keep them a long time before they can do any thing for themfelves, and to fpend more <5n medicine than would have paid for proper care, while it can never fupply its place. To take care of their children, is the moft profitable bufinefs in which even the poor can employ themfelves : But alas ! it is not always in their power. Poverty often obliges them to neglea their offspring, in order to procure the neceflaries of life. When that is the cafe, it becomes the intereft as well as the duty of the public to aflift them. Ten thoufand times more be- nefit would accrue to the ftate, by enabling the poor to bring up their own children, than from all the *hofpitals that ever can be ereaed for that purpofc. Whoever confiders the ftruaure of the human body, will foon be convinced of the neceffity of exercife for the health of children. The body is compofed of an infinite number of veffels, whofe contents cannot be pufhed on with- out the aaion and preffure of the mufcles. But if the fluids remain inaaive, obftruaions muft happen, and the humours will of courfe be vitiated, which\:annot fail to occafion dif- eafes. Nature has furnifhed both the veffels which carry the blood and lymph with numerous valves, in order that the aaion of every mufcle might pufh forward their contents; but without aaion this admirable contrivance can have no effea. The final caufe of this part of the animal ceconomy proves the neceffity of exercife for the prefervation of health. Arguments to fhew the importance of exercife might be drawn from every part of the animal ceconomy : With- C 2 out * If we make it the intereft of the poor to keep their offspring alive, we (hall lofe very few of them. This I have had many oppor- tunities of obferving. A fmall premium given to the poor annually for every child they have alive, would fave more infant-lives than if the whole revenues of the nation were expended on hofpitals for that purpofe. -This would make the poor efteem fertility a blefling ; whereas many of them think it the greateft curie that can betal them ; and in place of withing their children to live, fo far does po- verty get the better of natural attention, that they are very happy when they die. no OF PREVENTING out exercife the circulation of the blood cannot be properly carried on, nor the different fecretions duly performed; without exercife the humours cannot be properly prepared, nor the folids rendered ftrong or firm. The aaion of the heart, the motion of the lungs, and all the vital funaions are greatly afiifted by exercife. But to point out the man- ner in which thefe effeas are produced, would lead us far- ther into the ceconomy of the human body, than moft of thofe for whom this treatife is intended, would be able to follow. We fhall therefore only add, that where exercife is negleaed, none of the animal funaions can be duly per- formed ; and when that is the cafe, the whole conftitution muft go to wreck. Certainly our firft objea in the management of chil- dren ought to be a good conftitution. This lays a founda- tion for their being ufeful and happy in life ; and whoever negleas it, not only fails in his duty to his offspring, but to fociety. One very common error of parents, by which they hurt the conftitutions of their children, is fending them too young to fchool. This is often done folely to prevent trouble. When the child is at fchool, he needs no keeper. Thus the fchoolmafter is made the nurfe; and the poor child is nailed to a feat feven or eight hours a-day, which ought to be fpent in exercife and diverfions. Sitting fo long cannot fail to produce the worft effeas upon the body; nor is the mind lefs injured. E^rly application weakens the fa- culties, and often fixes in the mind fuch an averfion from books as can never be removed. But fuppofe this were the way to make children fcholars, that ought not to be done at the expence of their conftitu- tions. Our anceftors, who feldom went to fchool before they were men, were not lefs learned than we. But we imagine the boy's education will be quite loft unlefs he be carried to fchool in his nurfe's arms. No wonder if fuch hot bed plants feldom become either fcholars or men ! Not only the confinement in public fchools, but the number often proves extremely hurtful. Children are much injured by being kept in crowds within doors; their breath- ing not only renders the place unwholefome; but if any one of them happens to be difeafed, the reft catch the infection. A fingle child has been often known to communicate the bloody-flux, the hooping-cough, the itch, or other difeafes to almoft every individual in a numerous fchool. But DISEASES. 21 But if fafhion will prevail, and infants muft be fent to fchool, wc would earneftly recommend to teachers, as they value the interefts of fociety, not to confine them too long at a time; but to permit them to run about and play at fuch aaive diverfions as may promote their growth and improve their conftitutions. Were boys, inftead of being whipped, for Healing an hour to run, ride, fwim, or the like, encou- raged to employ their time in thefe manly and ufeful ex- ercifes, it would have many excellent effeas. It would likewife be of great fervice to boys, if at a pro- per age, they were all taught the military exercife. This would improve their ftrength, courage, and agility; and, when their countrv called for their afliftance, it would enable them to aa in her defence, without being obliged to under- go a tedious and troublefome courfe of inftruaions, at a time when they are lefs fit to learn new motions, geftures, &c . An effeminate education will infallibly fpoil the beft na- tural conftitution ; and, if boys are brought up in a more delicate manner than even girls ought to.be, they never will be men. But the common education of girls is no lefs hurtful to the conftitution than that of boys,. Mifs is fet down to her frame, before fhe can put on her cloaths ; and is taught to believe, that to excel at the needle is the only thing that can intitle her to general efteem. It is unneceflary here to in- fift upon the dangerous confequences of obliging girls to fit too much. They are pretty well known, and are too often felt at a certain time of life. But fuppofe this critical pe- riod to be got over, greater dangers ftill await them when they come to be mothers. Women who have b*>en early accuftomed to a fedentary life, generally run great hazard in , childbed; while thofe who have been ufed to romp about, and take enough of exercife, are feldom in any danger. One hardly meets with a girl who can, at the fame time, boaft of early performances by the needle, and a good con- ftitution. Clofe and early confinement generally occafions indigeftions, headachs, pale complexions, pain of the fto- mach, \ofs of appetite, coughs, confumptions of the lungs, and deformity of body. The latter indeed is not to be wondered at, confidering the aukward poftures in which girls fit at many kinds of needle-work, and the delicate flexible ftate of their bodies in the early periods of life. Would mothers, inftead of having their daughters in- ftrucled in many ufclefs accompliftimeius, teach them plain wotk 22 OF PREVENTING work and houfewifery, allowing them enough of time to run about, they would both make them better mothers and more ufeful members of fociety. I am no enemy to gen- teel accomplifhments, but would have them only con- fidered as fecondary, and always difregarded when they impair health. Many people imagine it a great advantage for children to be early taught to gain their bread. This opinion is certainly right, provided they be fo employed as not to hurt their health or growth; but, when thefe fuffer, fo- ciety, in place of being gainers, are real lofers by their labour. There are few employments, except fedentary ones, by which children can earn a livelihood; and, if they be fet to thofe too foon, it ruins their conftitutions. Thus, by gaining a few years from childhood, we generally lofe twice as many in the other periods of life, and even render the perfon lefs valuable while he does live. In order to be fatisfied of the truth of this obfervation% one needs only look into the great manufaauring towns, where he will find a puny degenerate race of people, weak and fickly all their lives, feldom exceeding the middle pe- riod of life; or, if they do, being unfit for bufinefs, they become a burden to fociety. Thus, arts and manufactures, though they may increafe the riches of a country, are by no means favourable to the health of its inhabitants. Good policy would therefore require, that fuch people as labour during life, fhould not be fet too early to work. Every perfon converfant in the breeding of horfes, or other work-animals, knows, that, if they be fet to hard labour too foon, they never will turn out to advantage. This is equally true with refpea to the human fpecies. There are neverthelefs various ways of employing young people, without hurting their health. The eafier parts of gardening, hufbandry, or any bufinefs carried on without doors, are moft proper. Thefe are emplo>ments that moft young people are fond of, and fome parts of them may al- ways be adapted to their age, tafte and ftrength. Such parents, however, as are under the neceffity of employing their children within doors, ought to allow them enough of time for aaive diverfions. This would both encourage them to do more work, and prevent their con- fticutions from being hurt. w Some imagine, that exercife within doors is fufficient • but they are greatly rniftaken. One hour fpent in running,' or DISEASES. 23 or any other exercife without doors, is worth ten within. When children cannot go abroad, they ought indeed to be exercifed at home. The beft method of doing this, is to make them run about in a long room, or dance. This laft kind of exercife, if not carried to excefs, is of ex- cellent fervice to young people. It cheers the fpirit, pro- motes perfpiration, ftrengthens the limbs, cifV. An eminent phyfician ufed to fay, that he made his children dance, in- ftead of giving them phyfic. It were well, if more people followed his example. As many of the chronic difeafes of children might be prevented by the prudent ufe of the Cold Bath, we fhall point out fome of thofe miftakes which commonly prevent its having the defired effea. The Cold Bath may be confidered as an aid to exercife. By it the body is braced and ftrengthened, the circulation and fecretions promoted, and, were it conduaed with pru- dence, many difeafes, as the rickets, fcrophula, &c. might thereby be prevented. The antients, who took every me- thod to render children hardy and robuft, were no Arran- gers to the ufe of the cold bath; and, if we may judge from the great number of confecrated wells in this ifland, many of which poffefs no other virtues but thofe of cold water, yet are faid to have been famous for curing the dif- eafes of children, we will fee caufe to believe, that the praaice of immerfing children in cold water muft have been very common amongft our anceftors. So far as I have been able to obferve, the cold bath does as much mifchief as good; but that is owing to the want of due care in ufing it. Children born of delicate parents are not fuddenly to be plunged over the head in cold wa- ter. They muft be gradually brought to it by ufing tepid water at firft, and making it a little cooler every time they are bathed, till by degrees they be able to bear it quite cold. Children affliaed with internal difeafes, as inflam- ' mations or obftruaions of the breaft, bowels, b'c. ought not to be bathed in cold water. No child fhould be put into the cold bath, when its body is hot, nor immediately after a meal. It is next to impoflible to bring nurfes to make a proper ufe of the cold bath: Their prejudices are fo ftrong and deep-rooted, that no reafoning is able to bring them off their own way. I have known fome of them, who would not dry a child's fkin after bathing it, left it fhould deftroy the 24 OF PREVENTING the effea of the water. Others will even put'cloaths dipt in the water upon the child, and either put it to bed, or fuffer it to go about in that-condition. Some nurfes be- lieve, that the whole virtue of the water depends upon its being dedicated to fome particular faint. Thefe will carry a child 40, 50, or 100 miles to have it once dipt in a cer- tain well; and this is to cure it of whatfoever difeafe it la- bours under. Others place their confidence in a certain number of dips, as three, feven, nine, or the like, and the world could not perfuade them, if thefe do not fuc- ceed, to try it a little longer. Thus, by the whims and caprice of nurfes, a valuable medicine is loft, and the phyfician is often difappointed in his hopes by their mifconduct. When the cold bath is ufed as »a medicine, it ought always to be by the advice of a phy- fician, and the nurfe fhould adhere ftriaiy to his direaions. I have feen wonderful cures in the moft obftinate fcrophu- lous cafes performed by the cold bath. The fait water in this cafe is always to be preferred. That will fucceed where all other medicines have failed. Every child, when in health, ought to have its extre- mities at leaft wafhed with cold w|ter daily. This is a partial ufe of the cold bath, and is better than none. In v/inter this may fuffice; but' in the warm feafon, if a child be relaxed, or feem to have a tendency to the rickets or fcrophula, its whole body ought to be daily immerfed in cold water. Care however muft be taken not to do this when the body is hot, or the ftomach full. The child fhould be dipt only once at a time, fhould be taken out immediately, and have its fkin well rubbed with a dry cloth. Of the BAD EFFECTS of UNWHOLESOME AIR upon CHILDREN. Few things are more deftruaive to children than con- fined or unwholefome air. This is one reafon why fo few of thofe infants live who are put into hofpitals, or parifh- workhoufes. Thefe places are generally crowded with old, fick.lv and infirm people. By that means the air is ren- dered fo extremely pernicious, that it becomes a poifon to infants. Want of wholefome air is likewife deftruaive to many ©f the children born in great towns. There the poorer fort of DISEASES. 25 of inhabitants live in low, dirty, confined houfes, where the frefh air has no accefs. Though up-grown people, who are hardy and robuft, may live for a number of years in fuch fituations, yet they generally prove fatal to their off- fpiing, few of whom arrive at maturity, and thofe who do, are weak and deformed. Such people, not being able to •carry their children abroad into the open air, we muft lay our account with lofirig the greater part of their progeny. But the rich have not that excufe. It is their bufinefs to fee that their children be dailv carried abroad, and that they be kept in the open air for a fufficient time. This will fuc- ceed better, if the mother goes along with them. Servants are often negligent in thefe matters, and allow a child to fit or lie on the damp ground, in place of leading or carry- ing it about. The mother furely needs air as well as her children; and how can fhe be better employed than in at- tending them ? Some may think this office below their dignity ; but I know no fituation in which a mother ap- pears to fuch advantage, as when furrounded by a circle of healthy children. A very bad cuftom prevails of making children fleep in fmall apartments, or crowding two or three beds into one chamber. In place of that, the nurfery ought always to be the largeft and beft aired room in the houfe. When children are confined in fmall apartments, the air is not only unwholefome, but fuch places being generally too hot, their bodies are relaxed, and this difpofes them to catch cold when they go abroad, and has many other bad effeas. Children who are kept within doors all day, and fleep all night in warm clofe apartments, may, with great pro- priety, be compared to plants nurfed in a hot-houfe, in place of the open air. Though fuch plants, by extraor- dinary care, may be kept alive for fome time; yet they never will arrive at that degree of ftrength, vigour and magnitude, which they would have done in the open air, nor w|>uld they be able to bear it afterwards, fhould they be expofed to it. Children brought up in the country, who have been accuftomed to frefti open air, "fhould not be too early lent to great towns, where the air is confined and unwhole- fome. This is frequently done with a view to forward their education, but proves very hurtful to health. Thofe who are grown up, do not fuffer near fo much from bad D air 26 OF PREVENTING air as young perfons. All fchools and feminaries of learn- ing ought to be fo fituated as to have frefh, dry, whole- fome air, and fhould never be too much crowded. Without entering into a detail of the particular ad- vantages of wholefome air to children, we fhall only ob- ferve, that when they enjoy that blefling, they generally fleep well, eat well, and thrive accordingly. It braces and ftrengthens their bodies, enlivens their fpirits, and every way promotes their growth and health. Of NURSES. Nurses are guilty of many faults, which prove fatal to infants. It is therefore the duty of parents to watch over their condua with the greateft care, and to be extremely cautious in the choice of them. One of the moft common faults of nurfes is to dofe children with ftupifaaives, or fuch things as lull them afleep. An indolent nurfe, who does not give a child enough of exercife in the open air to make it fleep, and does not chufe to be difturbed by it in the night, will fel- dom fail to procure for it a dofe of .laudanum, diacodium, faffron, or, what anfwers the fame end, a dram of fpirits, or other ftrong liquors. Thefe, though they be certain poifon to children, are every day adminiftered by many who bear the charaaer of very good nurfes. A nurfe who has not enough of milk, is apt to imagine, that fhe can fupply that defect by giving the child wines, cordial waters, or other ftrong liquors. This is an egre- gious miftake. The only thing that has any chance to fupply the place of the nurfe's milk, muft be fomewhat nearly of the fame quality, as cow's milk, afs's milk, or the like, with good bread. It never can be done by the help of ftrong liquors. Thefe, in place of nourifhing an infant, never fail to produce the contrary effect. Children are often hurt by nurfes permitting them to cry long and vehemently. This ftrains their tender bo- dies, and frequently occafions ruptures, inflammations of the throat, lungs, tjfc. The nurfe who can hear an infant cry till it has almoft exhaufted itfelf, without endeavouring to pleafe it, muft be cruel indeed, and is unworthy to be trufted with the care of a human creature. Nurses who deal much in medicine, are always to be fufpeaed. They truft to it, and neglea their duty. I never DISEASES. 27 never knew a good nurfe who had her Godfrey's cordials, Daffy's elixirs, c57. at hand. Such generally imagine, that a dofe of thefe will make up for all defeas in food, air, exercife, cleanlinefs, cifc. A very pernicious cuftom of indolent nurfes is the al- lowing of children to continue long wet. This is not only difagreeable, but it galls and fretsthe infant, and by relaxing the folids, occafions fcrophulas, rickets, and other fatal difeafes. Nature often attempts to free the bodies of children from bad humours, by throwing them out upon the fkin : By that means fevers, and other difeafes are prevented. Nurfes are apt to miftake fuch critical eruptions for an itch, or fome other infeaious diforder. Accordingly they take every method to drive them in. In this way many children lofe their lives; and no wonder, as nature is oppofed in the very method that fhe took to relieve them. It ought to be a rule which every nurfe fhould obferve, never to flop any eruption without proper advice, or being well allured, that it is not of a critical nature. At any rate it is never to be done without previous evacuations. Loose ftools is another method by which nature often prevents the difeafes of infants. If .thefe proceed too far, no doubt they ought to be checked ; but this is never to be done without the greateft caution. Nurfes, upon the firft appearance of loofe ftools, frequently fly to the ufe of aftringents, or fuch things as bind the belly. Thus in- flammations, fevers, and other fatal difeafes are brought on. A dofe of rhubarb, a gentle vomit, or fome other evacua- tion, fhould always precede the ufe of aftringent medicines. One of the greateft faults of nurfes is concealing the difeafes of children from their parents. This 'they are extremely ready to do, efpecially when the difeafe is the effect of their own negligence. Every perfon muft have feen inftances of people who were lame for life, by a fall out of the nurfe's arms, while fhe, through fear, conceal- ed the misfortune till it was paft cure. Every parent who intrufts a nurfe with the care of a child, ought to give her the ftriaeft charge not to conceal the moft trifling dif- order or misfortune that may befal it. Parents* inftead of being angry, when a nurfe informs them of fuch accidents, ought to reward her for her honefty; this would encourage her to do the fame upon other occafions. We can fee no reafon why a nurfe fhould not be punifhed who conceals d 2 any 28 OF PREVENTING any diforder or misfortune that happens to a child under hef care, till it lofes its life. A few examples of this would fave many infant lives ; but as there is little reafon to expea, that it ever will be the cafe, we would earneftly recommend it to all parents to look carefully after their children, and not to truft fo valuable a treafure entirely in the hands of an hireling. These, and many other faults, being daily committed by thofe who have the care of children, it ought furely to roufe the attention of all parents who have airy regard for their offspring, and to make them very circumfpea*in the choice of thofe into whofe hands they commit them, They ought at leaft to take care that a nurfe be fober, cleanly, honeft, healthy, not too young, nor the contrary; that fhe have the neceffaries of life, and a comfortable ha- bitation, &c. Were it praaicable to have all children nurfed and educated in the country, we fhould lofe very feV of them, One feldom fees a country-farmer without a numerous off- fpring, moft of whom arrive at maturity. Many things Confpire to that end. The children of thefe people are generally nurfed by their mothers; they eat plain whole- fome food, enjoy the benefit of frefh air, and have enough of proper exercife ; they have rural fports and paftimes fuited to their age, and as they grow up, find employments adapted to their ftrength, agreeable to their inclinations, and conducive to their health. They learn induftry and fo- briety from their parents, and feldom fail to praaife thefe virtues for life. In fine, we cannot help joining with the learned Mr. Locke *, in recommending the" example of thefe people as a model to all in the management of their children. ; As many people can under/land the meaning of a Jhort rule, who are not able to attend to a chain of reafoning, we fhall reduce the leading principles of nurfing under the following general heads. i. Eve^y mother ought to fuckle her own child, if ftie can do it with fafety. 2. A weak, confumptive, nervous, or hyfteric mother pught not to give fuck, where a healthy nurfe can be had. 3. No * On Education." DISEASES. 29 3. No child fhould be brought up without the breaft, if it be poftible to obtan a proper nurfe. 4. The cloaths of an infant fhould be foft, light, loofe and eafy for its body. They ought to be fattened on with firings rather than pins. 5. The cloths of children ought to be kept very clean. 6. A new born infant fhould not be kept too hot. 7. An infant fhould be permitted to fuck as foon as it fhows an inclination for the breaft. 8. An infant fhould neither be crammed with food nor phyfic as foon as it is born ; but permitted to lie qufet for fome time, ill order to recover the fatigue of the birth, cifV. 9. If an infant muft have food before it fucks, let it be water-pap mixed with new milk, free of all wines, fugars, fpiceries, or the like, 10. While the child fucks, it feldom needs much of -any other food. It will however be right, about the third or fourth month, to begin to give it once or twice a-day a little of fome food that is light and eafy of digeftion. This will make the weaning both lefs troublefome and dangerous. 11. A child fhould not be weaned all at once, but by degrees ; as all fudden changes in the diet of children are dangerous. 12. The food of children ought at all times to be fimple, but nourifhing. It fhould confift of a proper mix- ture of animal and vegetable fubftances. 13. Children fhould not be permitted to eat too much fruit, or roots of any kind; but all forts of green trafh ought to be kept from them with the greateft care. 14. Children ought not to be pinched in their food. They require to eat oftener than adults.—If their food be fimple, and they know that they can have it when hungry, they will feldom or never eat more than enough. 15. As foon as children can take exercife, they ought to be allowed as much as they pleafe; till then it is the bufi- nefs of the nurfe to carry and tofs them about. 16. A nurfe ought not only to carry an infant about, but to divert and amufe it fo as to keep it in good humour. 17. An infant fhould never be fuffered to cry long and vehemently. 18. Eruptions, or loofenefs in children, ought not to be ftopt, but with the greateft caution. 19. Nurses 30 OF PREVENTING 19. Nurses fhould ufe no means to force children to fleep; but they may always be permitted to take as much as they pjeafe. 20. Children ought never to have medicine unlefs they are difeafed. 21. Children fhould neither be too early fet to fchool, nor confined to any mechanical employment within doors. 22. Schoolmasters, and all who have the care of youth, fhould allow them plenty of time for exercife and diverfions. 23'. All children fhould be nurfed and educated in the country, if poffible. When that cannot be done, they ought to be carried abroad every day, and kept for a fuffi- cient time in the open air. 24. The children of delicate and difeafed parents muft be managed with more care than thofe of the hardy and robuft. 25. A mother fhould never abandon her child folely to the care of a mercenary nurfe. Let no one imagine thefe matters unworthy of his at- tention. On the proper management of children depend not only their health and ufefulnefs in life, but likewife the fafety and profperity of the ftate to which they be- long. Effeminacy ever muft prove the ruin of any king- dom ; and when its foundations are laid in infancy, it can never afterwards be wholely eradicated. We would therefore recommend to all who wifh well to their country, to ftudy every method to render their offspring ftrong and healthy. ■-----------'By arts like thefe, Laconia nurs'd of old her hardy fons; And Rome's unconquerM legions urg'd their way, Unhurt, thro' every toil in every clime *. * Armstrong on health. CHAP. DISEASES. 3i CHAP. II. OF ADULTS. HAVING endeavoured to point out fome of the fources from which the difeafes and mortality of in- fants proceed, we fhall next take a view of the more ge- neral caufes of difeafes, or fuch things as endanger the health of mankind in the more advanced periods of life. No man, however careful, can at all times avoid dif- eafes ; yet nothing is more certain than that many of them, and thbfe too of the moft dangerous nature, are often ow- ing to the want, of care'. The fmalleft caufes, when ne- gleaed, generally produce the greateft effeas. This is ftriaiy true with refpea to difeafes. A little care would often prevent what no medicine can cure. The moft common caufe of difeafes in this ifland is an obftruaed perfpiration, or what commonly goes by the name of catching cold. The perfpiration is by far the moft confiderable difcharge from the body; and fo long as it goes on properly, we have feldom any complaints; but when it is obftruaed, the health muft fuffer. Men being lefs fenfible of this than of the other evacuations, are confequently not fo attentive to the various caufes which obftrua it: We fhall therefore point out fome of the moft confiderable of them, in order to put people upon their guard. Common CAUSES of catching COLD. Colds are often occafioned by fudden changes in the atmofphere. There is no country where fuch changes hap- pen more frequently than in Britain. The degrees of heat and cold are not only various in the^different feafons of the year, but often change from the one extreme to the other in a few days, and fometimes even in the courfe of one day. As thefe changes cannot fail to increafe or diminifh the perfpiration, they muft of courfe affea the health. The beft method of fortifying the body againft the changes of the weather, is to be abroad every day. Thofe who keep much within doors, are moft liable to catch cold. Such 32 OF PREVENTING Such people feel even the flighteft changes in the atmof- phere, and by their coughs, pains and oppreflions of the breaft, cffV. become a kind of living barometers. The frequent changes of the weather ought to make us cautious in changing our apparel. All perfons, but efpecially the valetudinary, fhould be careful not to put off their winter-garments too foon, nor to wear their fummer ones too long. The commencement of our warm feafon is fo uncertain, that a few hot days in April or May often make us believe fummer is arrived; when all of a fudden the weather fets in more intenfely cold than atvChriftmas. The like fudden changes frequently happen in September or Oaober ; and where no care is taken to guard againft their influence, the gout, rheumatifms, fluxes and fevers often enfue. Labourers frequently fuffer by not attending to the changes of the weather. They ftrip to work while it is warm, but negtea to put on their cloaths when it grows cold; fome are even thoughtlefs enough to difregard being wet; fuch however, in the end, generally find caufe to re- pent their fool-hardinefs. Nothing more certainly obftruas the perfpiration than wet cloaths. Nor is the moft robuft conftitution proof againft their effeas. The perfpiration is not only ob- ftruaed by wet cloaths, but the moifture is likewife ab- forbed, which greatly encreafes the danger. It is impoflible for people who go abroad, always to avoid being wet. But the danger might generally be lef- fened, if not wholely prevented, by changing their cloaths foon; when that cannot be done, they fhould keep in mo- tion till they dry. So far are many from obferving this rule, that they will fit, or even lie down in the fields with their cloaths wet, and frequently fleep whole nights in that condition. Every perfjn muft have known inftances of fevers, rheumatifms, and even confumptions, brought on in this way. Though thefe happen dail., yet they are not fufficient to deter others from the like condua. Even wet feet often occafion fatal difeafes. Coughs, in- flammations of the breaft, and ulcers in the lungs, frequent- ly proceed from that caufe. The cholic, a fit of the gout, the iliac paffion, and cholera morbus, are likewife often oc- cafioned by wet feet. Habit will, no doubt, render this lefs dangerous; but it oaght, as far as poflibic, to be avoided. The.delicate, and thofe who are net accuftomed to DISEASES. 33 to have their cloaths or feet wet, fhould be peculiarly care- ful in this refpea. The perfpiration is often obftruaed by night-air; the abfence of the fun renders it damp and foggy. Even in fummer the night-air ought to be avoided. The dews which fall plentifully after the hotteft day, make the night more dangerous than when the weather is cool. Hence, in warm countries the dews are more hurtful than where the climate is more temperate. It is very agreeable indeed, after a warm day, to be abroad in the cool evening; but this is a pleafure to be avoided by all who value their health. The effeas of evening dews are gradual and almoft imperceptible; but they are not the lefs to be dreaded : We would therefore advife travellers, labourers, and all who are much heated by day, carefully to avoid them. When the perfpiration has been great, thefe become dangerous in proportion : By not attending to this, in flat marftiy countries, where the exhalations and dews are copious, labourers often catch intermitting fevers, quinfies, and the likej Damp beds feldom fail to obftrua the perfpiration. Beds become damp, either from want of ufe, Handing in damp houfes, or in rooms without fire. Nothing is more to be dreaded by travellers than damp beds, which arc very common in all places where feuel is fcarce. When a tra- veller cold and wet arrives at an inn, he may by means of a good fire, and a dry bed, have the perfpiration reftored ; but if he be put into a cold room, and laid on a damp bed, it will be more obftruaed, and the worft confequences muft enfue. Travellers fhould avoid inns which are noted for damp beds, as they would a houfe infeaed with the plague 5 as no man, however robuft, is proof againft the danger arifing from them. But inns are not the only places where damp beds are to be met with. Beds kept in private families for the re- ception of ftrangers, are no lefs dangerous. All kinds of liAen and bedding, when not frequently ufed, become damp. How then is it poflible, that beds which are not flept in above two or three times a-year, fhould be other- wise ? Nothing is more common than to hear of people having caught cold by changing their bed. The reafon is obvious. Were they careful never to fleep on a bed but what was frequently ufed, they would feldom find any ill confequences from a change. E No- 34 OF PREVENTING Nothing is more to be dreaded by a delicate perfon, when on a vifit, than being laid in the gueft-chamber. That ill-judged piece of complaifance becomes a real in- jury. All the bad confequences from this quarter might be eafily prevented in private families, by caufing their fer- vants to fleep in the ipare beds, and to refign them to ftran- gers when they come. This is the cuftom of many families in London, and we would eameftly recommend it to all who value the health of their friends. In inns where the beds are ufed almoft every night, nothing elfe is neceflary than to keep the rooms well feafoned by frequent fires, and the linen dry. Damp houfes frequently produce the like ill confe- quences. For this reafon thofe who build, fhould be care- ful to chufe a dry fituation. A houfe which ftands on a damp marftiy foil, muft be hurtful tS the health of the in- habitants. Not only a marfhy foil, but being fituated in the neighbourhood of large woods, lakes, or ftanding wa- ter, muft make a houfe damp. Large woods both prevent the free current of air, and fend forth great quantities of moift exhalations, which render all places near them un- wholefome. This is one reafon why new difcovered coun- tries commonly prove unhealthy, till they be cleared of their woods. Even in England, at this day, there is great- ly more planting in feveral parts than is either conducive to the fertility of the foil, or the health of its inhabitants. This tafte, inftead of being any improvement, is the way to reduce the country back to its original ftate, and to render the climate lefs healthy than it otherwife would be. Cold is not near fo hurtful to the health as moifture. Cold, in a moderate degree, braces and ftrengthens the body; but moifture relaxes and pre-difpofes it to difeafes. That is the reafon why intcrmittents and other fevers are fo frequent in low, damp, marfhy countries abounding with woods and ftanding water. This likewife fhews the danger of inhabiting new houfes before they be thoroughly dry. Nothing is more common than for people, merely to avqid fome trifling inconveniency, to hazard their lives, by in- habiting a houfe almoft as foon as the mafons, plaifterers &c. have done with it. Such houfes are not only dangerous from their dampnefs, but likewife from the fmell of lime, paints, &c. The afthma's, confumptions, and other dif- eafes of the lungs, fo common to people who work in thefe articles, are a plain proof of their being unwholefome. Houses DISEASES. 35 Houses are often rendered damp by an unfeafonable piece of cleanlinefs, I mean the ridiculous cuftom of wafhirig rooms immediately before company is put into them. Many people are fure to catch cold, if they fit but a fhort while in a room that has been lately vvafhed. The delicate ought carefully to avoid fuch a fituation, and even the robuft would run lefs hazard by fitting without doors. People who are accuftomed to live in dry houfes, ought, as far as poflible, to fhun damp ones, and by all means not to continue long in rooms that have been lately wafhed. All houfes, unlefs where the ground is extremely dry, mould have the firft floor a little mifed. Such fervants as are obliged to live for the moft j^irt in cellars and funk fto- ries, feldom continue long in health ; and furely mafters ought to pay fome regard to the health of their fervants as well as to their own. Even houfes which are built for the poor, ought to be dry. Thefe people generally live on the ground-floor, and if it be damp, they muft fuffer. This is one caufe of the aches, cramps and rheumatic pains, which poor people are fo fubjea to in the decline of life. But nothing fo frequently obftruas the perfpiration as sudden transitions from heat to cold. Colds are feldom caught, unlefs when people have been too much heated. Heat rarifies the blood, quickens the circulation, and in- creafes the perfpiration; but when thefe are fuddenly checked, the confequences muft be bad. It is indeed im- poflible for labourers not to be too hot upon certain occa- fions ; but it is generally in their power to put on their cloaths when they leave off work, to make choice of a dry place to reft themfelves in, and to avoid falling afleep in the fields. 'Thefe eafy rules, if obferved, would fave many ufeful lives. Nothing is mere common than for people, when hot, to drink freely of cold fmall liquors, lifts condua is ex- 'tremely dangerous. Thirft indeed is hard to bear, and the inclination to gratify that appetite, frequently gets the bet- ter of reafon, and makes us do wh.it our judgment difap- proves. Every peafant knows, if his horfe be permitted to drink his belly full of cold water after violent exercife, and be immediately put into the flable, or fuffered to remain at reft, that it will kill him. This they take the utmoft care to prevent. It were well, if they were equa'ly atten- tive to their own fafety. E an Thirst 36 OF PREVENTING Thirst mav be quenched many ways without (wallow- ing large quant ties of cold liquor. The fields afford variety of acid fruits and plants, the very chewing of which would abate thirft. Water kept in themcuth for fome time, and fpit out again, if frequently repeated,, will have the fame effea. If a bit of bread be eat along with a few mouth- fuls of water, it will both quench thirft more effeaually, and make the danger kfs. When a perfon is extremely hot, a mouthful of brandy, or other fpirits, ought to be preferred to any thing elfe, if it can be obtained. But if any one has been fo foolifh, when hot, as to drink freely of cold liquor, he oughfc to continue fiis exercife at leaft, till what he drank be thoroughly warmed upon his ftoT mach. It would be tedious to enumerate all the bad effeas. which flow from drinking cold thin liquors when the body is hot. Sometimes this has occafioned immediate death. Hoarfenefs, quinfeys, and fevers of various kinds, are its common confequences. Neither is it fafe, when warm, to eat freely of raw fruits, fall ads, or the like. Thefe indeed have not fo fudden an effea on the body as cold liquors, but they are notwithftanding dangerous, and ought to be avoided. Sitting in a warm room, and drinking hot liquors til! the pores are quite open, and immediately going into the cold air, is extremely dangerous. Colds, coughs, and in- flammations of the breaft, are the ufual effeas of this conduct: Yet ho.v common is it? A'iany people, after having drank warm liquors for feveral hours, walk or ride a number of miles in the coideft night; while others fit up at their bottle all night, or rambfe about in the ftreets. Such condua is one caufe why coughs and colds are fo common in the winter-feafon. People are very apt, when a room is hot, to throw open a window, and to fit near it. This is a moft ready way to catch cold. A delicate perfon had better fit with- out doors than in fuch a fituation, as the current of air is. dieted againft one particular part of the body. Inflam- matory fevers and confumptions have often been occafioned by fitting or ftanding thinly cloathed near an open window. Nor is fleeping with open windows lefs to be c'.rc .Jed. That ought never to be done even in the hotteft feaion. I have known mechanics frequently contraa fatal difeafes, by ♦ work- DISEASES. 37 working ftript at an open window, and would advife all of them to beware of fuch a praaice. Nothing expofes people more to catch cold than keep- ing their own houfes too warm ; fuch perfons may be faid to live in a fort of hot-houfes ; they can hardly ftir abroad to vifit a neighbour, but at the hazard of their lives. Were there no other reafon for keeping houfes in a mode- rate degree of warmth, that alone is fuflicient. But no houfe that is too hot, can be wholefome. Heat deftroys the fpring and elafticity of the air, and renders it lefs fit for expanding the lungs, and other purpofes of refpiration. Hence it is, that confumptions and other difeafes of the lungs prove fo fatal to people who work in forges, glafs- houfes, and the like. Some .are even fo fool-hardy, as to bathe themfelves, wken hot, in cold water. Not only fevers, but madnefs itlelf, has frequently been the effea of this condua. In- deed it looks too like the action of a madman to deferve a ferious confederation. We fhall conclude thefe obfervations on the common caufes of catching cold, by recommending it to every one to avoid, with the utmoft attention, all fudden tranfitions from heat to cold, and to keep the body in as uniform a temperature as poflible; or, where that cannot be done, tp take care to cool gradually. It may be thought, that too ftria an attention to thefe things would tend to render people delicate. So far how- ever is this from being our defign, that the firft rule laid down for preventing colds, i? to harden the body, by enur- ing it daily to bear the open air. It is a true faying, that colds kill more than plagues. On examining patients, one finds moft of them impute their dif- eafes either to violent colds, or to flight ones which had been negkaed. This fliows the importance of guarding againft every thing that may obftrua the perfpiration, and likewife of ufing proper means immediately to remove fuch obstruc- tion when it does happen. The want of due attention to thefe cofts Britain annually fome thoufands of. ufeful lives. UNWHOLESOME FOOD. As our bodies confift of what we eat and drink, un- wholefome food muft be dangerous. There is no queftion but the whole conftitution of body may be changed bv diet. 38 OF PREVENTING diet. This is often done more quickly than people would imagine. A diet confiding too much of alkaline fubftanceg will foon render the humours putrid. On the other hand, if acids be ufed too freely, they will receive a taint of an oppofite nature. The folids may be relaxed or weakened by the ufe of oily or watery fubftances, or they may be too much conftriaed by eating fpiceries, auftere vegetables, cifr. It is not eafy to afcertain the exact quantity and quality of food proper for every age, fex and conftitution : But a fcrupulous nicety here is by no means neceflary. The beft rule is to avoid all extremes. Mankind were never intend- ed to weigh and meafure their food. Nature teaches every creature when it has enough of food, and a very fmall de- gree of reafon is fuflicient for the choice of it. Men fel- dom err in this refpea through ignorance, The moft knowing are generally the moft guilty. 4^ Though moderation be the only rule neceflary with re- fpea to the quantity of food, yet the quality of it merits further attention. Many people, if they can fatisfy the appetites of hunger and thirft, are very indifferent what they eat or drink. The following obferyations will fhow the danger of fuch condua. Provisions may be rendered unwholefome various ways. Bad feafons may either prevent the ripening of grain, or damage it afterwards. Wet and cold fummers feldom bring the fruits of the earth to maturity; and if the harveft like- wife prove rainy, they are often fo damaged as to be very hurtful. Thefe indeed are aas of Providence ; it is there- fore our duty to fubmit to them. But furely no punifhment can be too fevere for thofe who fuffer proviiions to be fpoilt, by hoarding them on purpofe to enhance the price. The foundeft grain, if kept too long, muft become unfit for ufe. The poor are generally the firft who fuffer by unfound proviiions: But the lives of the labouring poor are of the greateft importance to the ftate. Befides, difeafes occa- lioned by unwholefome food often prove infeaious, and by that means reach people in every ftation. The poor judoc ill in buying low-priced and coarfe provifions. They had better have a fmaller quantity of what is found and good j as that would both afford more nouriftiment, and be at- tended with left, danger. Animal as well as vegetable food becomes unwholefome wh.n kept too long. All animal fubftances have a conftant tendency to putrefaction, and when that has proceeded too far, DISEASES. 39 far, they not only become offenfive to the fenfes, but hurt- ful to health. Difeafed animals, and fuch as die of them- felves, ought not to be eaten. It is common enough in grafing countries for fervants and poor people to eat fuch animals as die of any difeafe in the fpring or winter, or are killed by accident. I have been frequently told by people who live in places where this is done, that when much flefh of that kind is eaten, it never fails to occafion fevers. The injunaions given to the Jews, not to eat any crea- ture which died of itfelf, feem to have a ftria regard to health, and ought to be obferved by Chriftians as well as Jews. Animals never die of themfelves without fome pre- vious' difeafe; but how a difeafed animal fhould be whole- fome food, is inconceivable. Even thofe which die by ac- cident, muft be hurtful, as their blood is mixed with the flefh, and foon turns putrid. Animals which feed grofs, as tame ducks, fwine, &c. are neither eafily digefted, nor afford wholefome nourifti- ment. No animal can be wholefome food which does not take fuflicient exercife. Moft of our flailed cattle, hogs, csV. are crammed with grofs food, but not allowed exercife nor free air, by which means they indeed grow fat, but their humours not being properly prepared or aflimulated, they muft remain crude. The flefh of an animal which has not properly digefted its own food, can never be eafily digefted by another : Yet fuch are the delicacies of modern luxury, and fuch the animals daily devoured even by the weak and valetudinary. Is it any wonder, that fuch fhould complain of crudities, indigeftions, and oppreflion of the fpirits ? Let them eat the fame quantity of an animal which runs wild, and they will not feel any load on their ftomach, or difficulty of digeflion. We would not have people live on carrion ; but furely the oppofite extreme of eating animals which are gorged with grofs food till they are unfit to live, muft be as pernicious. Animals may likewife be rendered unwholefome by being over-heated. Heat caufes a fever, exhalts the falts of the animal, and mixes the blood fo intimately with the flefh, that it cannot be feperated. For this reafon people ought not to eat freely of fuch animals as are hunted down, their flefh being apt to occafion putrid fevers. But- chers fhould alfo be careful not to over-drive their cattle. No perfon would chufe to eat the flefh of an animal which had died in a high fever; yet that is the cafe with all over- drove 40 OF PREVENTING drove cattle, and the fever is often raifed even to the degree of madnefs. No people in the world eat fuch quantities of animal food as the Englifh. That is one reafoh why they are fo generally tainted with the fcurvy, and its numerous train of confequences, as indigeftion, low fpirits, hypochon- driacifin, cjfc Animal food was furely defigned for man, and with a proper mixture of vegetables, it will be found the moft wholefome; but to gorge beef, mutton, pork^ fifh and fowl twice or thrice a-day, is certainly too much. -.. All who value health, ought to be contented with making : one flefh-meal in the twenty-four hours, and this ought to eonfift of one kind only. The moft obftinate fcurvy has often been cured by a vegetable diet; nay, milk alone will frequently do more in that difeafe than any medicine. From hence it is evi- dent, that if vegetables and milk were more ufed in diet, we fhould have lefs fcurvy, and likewife fewer putrid and inflammatory fevers. Our aliment ought neither to be too moift, nor too dry. Moift aliment relaxes the folids, and renders the body feeble. Thus we fee females who live much on tea and other watery diet, generally become weak, and unable to digeft folid food; from whence proceed hyfterics, and all their dreadful confequences* On the other hand, food that is too dry, renders the folids in a manner rigid, and the humours vifcid, which predifpofes the body to inflamma- tory fevers, fcurvies, and the like. The arts of cookery render many things unwholefome, which are not fo in their own nature. By jumbling to- gether a number of different ingredients, in order to make a poignant fauce, or rich foup, the compofition proves al- moft a poifon. All high-feafoning, pickles, &c. are only incentives to luxury, and never fail to hurt the ftomachv It were well for mankind, if cookery, as an art, were in- tirely prohibited. Plain rofting or boiling is all that nature points out, and all that the ftomach requires. Thefe alone are fuflicient for people in health, and the fick have ftill Ieis need of a cook. The liquid part of our aliment likewife claims our at- tention. Water is not only the bafis of moft liquors, but alio compofes a great part of our folid food. Good water muft therefore be of the greateft importance in diet The beft water is that whic.i is moft pure, and free from any mix- DISEASES. 4* mixture of foreign bodies. Water takes up parts of every body with which it comes in contaa; by which means it is often impregnated with metals and minerals of a hurtful or poifonous nature. The inhabitants of fome hilly countries have peculiar difeafes, which in all probability proceed from the water. Thus the people who live near the Alps in Switzerland, and the inhabitants of the Peak of Derby in England, have large tumours or wains on their necks. This difeafe is generally imputed to the fnow-water; but there is more reafon to believe it is owing to the minerals in the moun- tains through which the waters pafs. Were it owing to the fnow-water, it fhould happen to the inhabitants of all mountainous countries, where fnow lies long ; but there are many parts of Britain where the fnow lies much longer than in the Peak of Derby ; yet the inhabitants have no fuch difeafe. The Peak of Derby is well known to be a bed of minerals of different kinds ; and, as far as what is called the mineral country extends, thefe tumours are com- mon, and generally go by the name of Derbyfhire-necks. When water is impregnated with foreign bodies, it ge- nerally appears by its weight, colour* tafte, fmell, heat, or fome other fenfible quality. Our bufinefs therefore is to chufe fuch water, for common ufe, as is lighted, and without any particular colour, tafte or fmell. In moft places of Britain the inhabitants have it in their power to make choice of their water, and few things would contri- bute more to health than a due attention to this article. But mere indolence often induces people to make ufe of the water that is neareft them, without confidering its qualities. * Before water be brought into great towns, the ftriaeft attention ought to be paid to it's qualities, as epidemic dif- tempers are often occafioned by bad water; and when it has been procured at a great expence, we are unwilling to give it up. The common methods of rendering water clear by fil- tration, or foft by expofing it to the fun and air, &c. are fo generally known, that it is unneceffary to fpend time in explaining them. We fhall only in general advife all to avoid waters which ftagnate long in fmall lakes, ponds, or the like. Such waters often become putrid with infeas and other vermine, which breed and die in them. Even cattle frequently fuffer by drinking, in dry feafons, water which F has 4* OF PREVENTING has flood long in fmall refervoirs, without being fupplied by fprings, or frefhened with fhowers. All wells ought to be kept clean, and to have a free communication with the air. When either animal or vegetable fubftances are fuf- fered to lie at the bottom of wells, they corrupt and taint the water. Even the air itfelf, when confined in wells, becomes poifonous, and muft of courfe render the water unwholefome. Much noife has been made about the ufe of fermented liquors. They notwithftanding ftill continue to be the common drink of almoft every perfon who can afford them. As this is, and in all probability will be the cafe, we fhall rather endeavour to aflift people in their choice of thefe liquors, than pretend to condemn what cuftom has efta- bliihed. It is not the moderate ufe of found fermented liquors which hurts mankind ; it is excefs, or the abufe of them, and ufing fuch as are ill-prepared or vitiated. Fermented liquors which are too ftrong hurt digeftion, inftead of affifting it, by which means their intention is loft, and the body, in place of being strengthened bv them, is weakened and relaxed. Many imagine, that hard labour could not be fupported without drinking ftrong liquors: This, though a common, is a very erroneous notion. Men; who never tafte ftrong liquors, are not only able to endure more fatigue, but alfo live much longer than thofe who ufe them daily. But fuppofe ftrong liquors did enable men to do more work, they muft nevertheless wafte the powers of life, and of courfe occafion premature old age. They keep up a conftant fever, which waftes the fpirits, heats and inflames the blood, and predifpofes the body to number- lefs difeafes. But fermented liquors may be too weak as well as too ftrong: When that is the cafe, they muft either be drank new, or they become four and dead. When fuch liquors are drank new, the fermentation not being over, they ge- nerate air in the bowels, and occafion flatulencies; and when kept till ftale, they four on the ftomach, and greatly hurt digeftion. For this reafon all malt-liquor, cyder, cifr. ought to be of fuch ftrength as will make them keep till they be ripe, and then they fhould be ufed. When fuch liquors are kept too long, though they fhould not become four, yet they generally contract a hardnefs, which renders them unwholefome. Hence it is, that bottled ale hurts the ftomach, occafions the gravel, &c. All DISEASES. 43 All families, who can, ought to prepare their own li- quors. Since preparing and vending of liquors became one of the moft general branches of bufinefs, every me- thod has been tried to adulterate them. The great objea both of the makers and venders of liquor is, to render it intoxicating. But it is well known, that this may be done by other ingredients than thofe which ought to be ufed for that purpofe. It would be imprudent even to name thofe things which are daily made ufe of to render liquors heady. It is fufficient to obferve, that the praaice is very common, and all the ingredients ufed for that purpofe, are of an opiate or ftupifaaive nature. But as all opiates are of a poifonous quality, it is eafy to fee what muft be the confequence of their genera] ufe. Though they do not kill fuddenly, yet they hurt the nerves, relax and weaken the ftomach, and of courfe fpoil the digeftion. Were fermented liquors faithfully prepared, not too ftrong, nor too weak, kept to a proper age, and ufed in moderation, they would prove real "bleflings to mankind. But while they are ill prepared, various ways adulterated, and taken to excefs, they muft have many bad confequences. Thefe however we fhall not mention at prefent, as they will be pointed out under another article. To fpecify the different kinds of alimept, to explain their nature and properties, and to point out their effeas in different conftitutions, would far exceed the limits of our defign. Inftead of a detail of this kind, which in all probability would be very little attended to, and would not be generally underftood, we fhall only mention the follow- ing eafy rules with refpea to the choice of aliment. Those whofe folids are weak and relaxed, ought to avoid all vifcid food, or fuch things as are hard of digeftion; and to take plenty of exercife in a dry open air. Such as abound with blood, fhould be fparing in the ufe of every thing that is highly nourifhing, as fat meat, rich wines, ftrong ale, &c. Their food fhould confift moftly of bread and other vegetable fubftances, and their drink ought to be milk, whey, and the like. Fat people fhould not eat freely of oily nourifhing diet. They ought frequently to ufe raddifh, garlic, fpices, or fuch things as are heating, and promote per- fpiration and urine. Their drink fhould be water, coffee, tea, or the like; and they ought to take much exercife and little fleep. F 2 Those 44 OF PREVENTING Those who are too lean, muft follow an oppofite courfe, Such as abound with acidities, or whofe food is apt to four on their ftomach, fhould live much on flefh-meatsj and thofe who are troubled with alkaline eruaations, or heat of the ftomach, ought to ufe a diet confifting chiefly of acid vegetables. People who are affiled with the gout, low fpirits, hy- pochondriac or hyfteric diforders, ought to avoid all flatu- lent food, every thing that is vifcid or hard of digeftion, all faked or fmoke-dried provifions, and whatever is au- ftere, acid, or apt to four on the ftomach. Their food fhould be light, fpare, cool, and of an opening quality. The diet ought not only to be fuited to the age and con- ftitution, but alfo to the manner of life. A fedentary or ftudious perfon fhould live more fparingly than one who labours hard without doors. Food will nourifh a peafant very well, which would be almoft indigeftible to a citizen; and the latter will live upon a diet on which the former would ftarve. Diet ought not to be too uniform. The conftant ufe of one kind of food might have bad effeas. Nature points out this by the great variety of aliments which fhe has pro- vided for man, and likewife by giving him an appetite for different kinds of food. Those who labour under any particular difeafe, ought to avoid fuch aliments as have a tendency to increafe it. For example, a gouty perfon fhould not ufe rich wines, ftrong foups, or gravies, and fhould avoid all acids. One who is troubled with the gravel, ought to fliun all auftere and aftringent aliments; and thofe who are fcorbutic, Ihould not indulge in animal food, &c. In the firft period of life our food ought to be light, nourifhing, and of a diluting nature, but frequently ufed. Food that is folid, with a fufficient degree of tenacity, is moft proper for the ftate of manhood. The diet fuited to the laft period of life, when nature is upon the decline, approaches near to that of the firft. It fhould be lOhter^ and more diluting than that of vigorous age, and likewife more frequently taken. IRREGULARITIES in DIET, SLEEP, Ufe. It is not only neceflary for health, that our diet be Wholefome, but alfo that it be taken at regular periods. Some DISEASES. 45 Some imagine, that long fafting will atone for excefs; but that, inftead of mending the matter, never fails to make it worfe. When the ftomach and inteftines are over dif- tended with food, they lofe their proper tone, and by long fafting they become weak, and inflated with wind. Thus either gluttony or fafting deftroys the powers of digeftion. The frequent repetition of aliment is not only neceflary for repairing the continual wafte of our bodies, but like- wife to keep the humours found and fweet. Our humours, even in the moft healthy ftate, have a conftant tendency to become putrid, which can only be prevented by frequent fupplies of frefh nouriftiment: When that is wanting too long, the putrefaaion often proceeds fo far, as to occafion very dangerous fevers. From hence we may learn the ne- ceffity of regular meals. No perfon can enjoy a good ftate of health, whofe veffels are either frequently over- charged, or the humours long deprived of frefh fupplies of chyle. Long fafting is extremely hurtful to young people; it vitiates their humours, and prevents their growth and ftrength. Nor is it lefs injurious to the aged. Many in the decline of life are affliaed with wind : That com- plaint is not only increafed, but even rendered dangerous, and often fatal, by long fafting. Old people, when their ftomachs are empty, are frequently feized with giddinefs, headachs and faintnefs. Thefe complaints may .generally be removed by a bit of bread and a glafs of wine, or taking any other folid food; which plainly points out the method of preventing them. It is more than probable, that many of the fudden deaths which happen in the advanced periods of life, are occafioned by fafting too long, as it exhaufts the fpirits, and fills the bowels with wind ; we would therefore advife people, in the decline of life, never to al- low their ftomachs to be too long empty. Many take no- thing but a few cups of tea and a bit of bread, from nine o'clock at night till two or three next afternoon. Such may be faid to fa{\. almoft three fourths of their time. This can hardly fail to ruin the appetite, vitiate the humours, and fill the bowels with wind; all which might be pre- vented by a folid breakfaft. That would tend more to ftrengthen the nerves, and expel wind, than all the cor- dial or carminative medicines which can be adminiftered. The ftrong and healthy do not indeed fuffer fo much from fafting as the weak and delicate j but they run great hazard 46 OF PREVENTING hazard from its oppofite, viz. repletion. Many difeafes, efpecially fevers, are the effea of a plethora, or too great fulnefs of the veffels. Strong people, in high health, have generally a great quantity of blood and other humours. When thefe are fuddenly increafed by an overcharge of rich and nourifhing diet, the veffels become diftendeo!, and being unable to contraa themfelves, obftruaions and in- flammations enfue. Hence fo many people are feized with inflammatory and eruptive fevers, after a feaft or debauch. This ihows the danger of all fudden tranfitions from a fpare to a full and luxurious diet. Excess in diet is not peculiar to the rich and opulent; the poor are often guilty of it, and frequently feel its bad effects. The poor feldom lofe an opportunity of gorging themfelves either with meat or drink, when they can obtain it, and the lefs they are accuftomed to it, the danger is the greater. When we recommend regularity in diet, we would not be underftood as condemning every fmall deviation from it. It is next to impoffible for people at all times to avoid fome degree of excefs, and living too much by rule might make even the fmalleft deviation dangerous. It may therefore be prudent to vary a little, fometimes taking more, fometimes lefs than the ufual quantity of meat and drink, provided al- ways that regard be had to moderation. Sleep as well as diet ought to be duly regulated. Too little fleep exhaufts the fpirits, weakens the nerves, and oc-r cafions difeafes; and too much renders the mind dull, the body grofs, and difpofes it to apoplexies, lethargies, C5V. A medium therefore ought to be obferved ; but that is not eafy to fix. The youug require more fleep than thofe who are grown, the laborious than the idle, and fuch as eat and drink freely than thofe who live abftemioufly. Befides, the real quantity of fleep cannot be meafured by time ; as one per- fon will be more refrefhed by five or fix hours of fleep, than another by eight or ten. The beft way to make fleep found and refrefhing is to rife by times. The indolent cuftom of lolling a-bed for nine or ten hours relaxes the body, un-- braces the nerves, and greatly hurts the conftitution. Children may be allowed as much fleep as they chufe ; but for adults fix or feven hours is certainly enough, and none ought to exceed eight. Thofe who lie more than eight hours a-bed may flumber, but they can hardly be faid to fleep ; fuch generally tofs and dream away the fore-part of the night, fin!; to reft towards morning, and dofe till noon. DISEASES. 47 noon. Inftead of encouraging a habit of this kind, rifing early would make them fall into a found fleep as loon as they went to bed, and they would feldom wake till morn- ing, when they would find themfelves fufficiently refreflied. Nature points out night as the proper time for fleep. Thofe who think it too vulgar to fleep in thatfeafon, feldom enjoy health. Nothing more certainly deftroys the con- ftitution than night-watching. It is great pity that a prac- tice fo deftruaive to health fhould be fo much in fafhion. How quickly the want of reft in due feafon will blafl the moft blooming complexion, or ruin the beft conftitution, is evident from the ghaflly countenances of thofe who, as the phrafe is, turn day into night, and night into day. To make fleep refrefhing, the following things are ne- ceflary. Firft, that we take enough of exercife in the open air, through the day ; next, to eat a light fupper ; and laft- ly, to lie down with a mind chearful and ferene. It is certain, that too much fatigue will prevent fleep, as well as too little. We feldom, however, hear the aaive and laborious complain of reftlefs nights. It is the indolent and flothful who generally have thefe complaints. Is it any wonder, that a bed of down fhould not be refrefhing to a perfon who lolls all day in an eafy chair ? A great part of the pleafure of life confifts in alternate reft and motion ; but they who negka the latter can never relifh the former. The labourer enjoys more true luxury in plain food and found fleep, than is to be found in fumptuous tables and downy pillows, where exercife is wanting. That light fuppers caufe found fleep, is true even to a proverb. Many, if they exceed the leaft at that meal, are fure to have uneafv nights ; and if they drop afleep, the load and oppreflion on their ftomach and fpirits occafion frightful dreams, broken and difturbed repofe, with night- mares, &c. Were the fame perfons to go to bed with a light fupper, or fit up till what they eat were pretty well digefted, they might enjoy found fleep, and rife refiefhed and chearful. Nothing more certainly difturbsour repofe than anxie- ty. When the mind is not at eafe, we feldom enjoy found fleep. That greateft of human blefiings often flies the wretch who needs it moft, and vifits the happy, the chear- ful, and the gay. This is a good reafon why every man Ihould endeavour to be as eafy in his mind as poflibIc,when he goes to reft. Many, by negleaing this rule, and by in- dolying 48 OF PREVENTING dulging grief and anxious thoughts, have banifhed fleep fo long, that they could never afterwards enjoy it. Few things contribute more to health than keeping the belly regular. When the fceces lie too long in the bowels^ they become acrid, and fpoil the humours ; and when they are difcharged too foon, the body is not properly nourifhed. Regular ftools depend greatly upon regularity in eating and drinking, and proper exercife ; people have reafon to fu- fpea a fault in one or other of thefe, whenever the belly is not regular. To prevent coftivenefs, one good rule is, to rife betimes and go abroad in the open air. Not only the pofture in bed is unfavourable to regular ftools, but likewife the warmth. This, by promoting the perfpiration, cannot fail to leffen all the other difcharges. Mr. Lock's advice, to folicit na- ture by going regularly to ftool every morning, is a very good one, and has more effea than moft people would ima- gine. Any habit will in time become natural. It is always more fa/e to keep the belly regular by proper diet, exercife, &c. than by the ufe of drugs. Thofe who have frequent recourfe to medicine for that purpofe, feldom fail to ruin their conftitutions. But if opening medicines muft be ufed, the fafeft is fine rhubarb, which may either be taken in fmall dofes in powder, or a little of it chewed daily. Cuf- tom will render this fufficiently agreeable. Such as are troubled with habitual loofenefs, ought to fuit their food to the nature of their complaint. Loofenefs may often be removed by a change of diet : For example, boiled milk may be ufed in place of raw, wheat bread in- ftead of that which is mixed, red wine, or brandy and wa- ter may be drank in place of malt-liquor, White broths may be eat inftead of flefh, and rice or fago gruels, with light flour puddings, in place of barley or oat meal. An habitual loofenefs is often occafioned by an obftruaed perfpiration. In that cafe a flannel veft and thick fhoes are the beft me- dicines. BAD A-I 41. Bad air is a very common caufe of difeafes. Few are aware of the danger arifing from it; people generally pay fome attention to what they eat and diink, but feldom re- gard what goes into the lungs, though the one often proves fatal as well as the other. Perhaps DISEASES. 49 Perhaps no air is perfeaiy pure ; that, however, which has feweft noxious particles in it, is no doubt the beft. Air as well as water takes up parts of moft bodies with which it comes into conta^l, and is often fo replenifhed with thofe of a noxious quality, as to occafion immediate death. But fuch violent effects feldom happen, as people are generally on their guard againft them. The lefs perceptible influ- ences of bad air prove more hurtful to mankind; we fhall thereforeendeavour^o point out fome of thefe, and to fhow wherein the danger confifts. Air may become noxious many ways. Whatever deftroys its fpring or elafticity, renders it unfit for refpiration : Wherever therefore great numbers of people are crowded into one place, if the air has not a free current, it foon be- comes unwholefome. Hence it is that delicate perfons are fo apt to faint or be fick, in crowded churches, affemblies, or any place where the air is exhaufted by breathing, fires, candles, or the like. In great cities fo many things tend to pollute the air, that it is no wonder it proves fo fatal to the inhabitants. The air irf cities is not only breathed over and over by thou- fands, but is likewife exhaufted by fires, loaded with ful- phfur, finoke, and other exhalations, befides the vapours continually arifing from innumerable putrid fubftances. All poflible care fhould be taken to keep the ftreets of large towns open and wide, that the air may have a free current. They ought likewife to be kept very clean. Nothing tends more to pollute and contaminate the air than dirty ftreets, dunghills, flaughter-houfes, Ufe. It is very common in this country to have church-yards in the middle of populous cities. Whether that be the ef- fect of ancient fuperftition, or owing to the increafeof fuch towns, is a matter of no confequence. Whatever gave rife to the cuftom, it is a bad one. It is habit alone which re- conciles us to thefe things; by means of it, the moft ridi- culous, nay, pernicious cuftoms, often become facred. Cer- tain it is, that thoufands of putrid carcafes, fo near the fur- face of the earth, in a place where the air ftagnates, cannot fail to taint it ; and that fuch air being breathed into the lungs, and mixed with the blood, muft occafion difeafes *. Wherever air ftagnates long, it becomes unwholefome. Hence the unhappy inmates of jails not only contraa ma- G lignant * In moft eaftern countries it is cuftomary to bury the dead at fome diitance from any town. It were to be vvilhed the inhabitants of Europe would follow this example. 50 OFPREVENTING lignant fevers themfelves, but often communicate them to others. Nor are many of the hoLs, for we cannot call them houfes, poffeffed by the poor in great towns, much better than jails. Thefe low dirty habitations are the very lurk- ing places of bad air and contagious difeafes. Such as iive in them feldom enjoy good health ; and their children com- monly die young. In the choice of a houfe, the greateft at- tention ought always to be paid to free air. The various methods which luxury Has invented to make houfes clofe and warm, contribute not a little to render them unwholefome. No houfe can be wholefome unlefs the air has a free paffage through it. For which reafon, houfes ought daily to be ventilated by opening oppofite win- dows, and admitting a current of frefh air into every room. This would expel any noxious vapour, and could not fail to promote the health of the inhabitants. In hoipitals, jails, fliips, Ufe where that cannot be conveniently done, venti- lators fhould be ufed. The method of expelling foul, and introducing frefh air, by means of ventilators, is a moft fa- lutary invention, and is indeed the moft ufeful of all our modern medical improvements. We wifh, for the benefit of mankind, it were more generally regarded. It is capable of univerfal application, and fraught with numerous advan- tages, both to thofe in health and ficknefs. Air not only lofes its fpring, and becomes unwholefome from heat and ftagnation, but likewife from moifture. Thus, in low marfhy countries, the air is generally bad, as alfo in countries over-run with wood, or any thing that fends forth moift exhalations. Air that ftagnates in mines, wells, cellars, Ufe. muft be noxious. That kind of air is to be avoided as the moft deadly poifon. It often kills almoft as quick as lightening. For this reafon, people fhould be very cautious in opening cellars that have been long fhut, or going down into deep wells, efpecially if they have been clofe covered. Many people who have fplendid houfes, chufe to fleep in fmall apartments. This condua is very imprudent. A bed-chamber ought always to'be well aired ; as it is gene- rally occupied in the night only, when all doors and win- dows are fhut. If a fire be kept in it, the danger becomes ftill greater. Many have been ftifled when afleep by afire in a fmall apartment. Some are even fo inconfiderate-as to make fires in bed-chambers which have no chimneys, and imagine by ufing that kind of coal which has little or no fmoke, DISEASES. 51 fmoke, that they are fafe ; whereas the danger becomes thereby the greater, fuch coal generally abounding with fulphur. The moft fatal confequences are always to be dreaded from every attempt of this nature. Those who are obliged, on account of bufinefs, to fpend the day in clofe towns, ought, if poffible, to fleep in the country. Breathing good air in the night will, in fome meafure, make up for the want of it through the day. This praaice would have a greater effea in preferving the health of citizens than is commonly imagined. Care fhould be taken to admit a conftant ftream of frefh air into all crowded places, as churches, aflembly-rooms, colleges, courts of juftice, Ufe. The neglea of this has had fo many fatal confequences, that it is fuflicient only to men- tion it. It was neceflary in former times, for fafety, to furround cities, colleges, and even fingle houfes, with high walls. Thefe, by obftruaing the current of air, never fail to ren- der fuch places damp and unwholefome." As fuch walls are now, generally fpeaking, become ufelefs, they ought to be thrown down, and every method taken to admit a free paf- fage to the air. Were proper attention paid to Air and Cleanliness, it would tend more to preferve the health of the inhabitants of great towns than all the endeavours of the Faculty. If frefh air be neceflary for thofe in health, it is ftill more fo for the fick, who often lofe their lives for the want of it. The notion that fick people muft be kept very hot, is fo common, that one can hardly enter the chamber where a patient lies, without being ready to faint, by reafon of the hot fuffocating fmell. How this muft affect, the fick, any one may judge. No medicine is fo beneficial to the fick* as frefh air. It is the moft reviving: of all cordials, if it be ad- miniftred with prudence. We are not, however, to throw open doors and windows at random upon the fick. Frefh air is to be let into the chamber gradually, and, if poffible, by opening the windows of fome other apartment. The air of a fick perfon's chamber may be greatly frefh- ened, and the patient much revived, bv fprinkling the floor, bed, Ufe. frequently with vinegar, juice of lemon, or any other ftrong vegetable acid. In places where numbers of fick are crowded into the j^me houfe, or, which is often the cafe, into the fame apart- ment, frefh air becomes abfolutely neceflary. Infirmaries, G 2 hofpitals, 52 OF PREVENTING hofpitals, Ufe. often become fo noxious for want of proper ventilation, that the fick run more hazard from them than from the difeafe; this is particularly the cafe when dyfen- teries, putrid fevers, or other infeaious difeafes prevail. Physicians, furgeons, and others who attend hofpitals, ought, for their own fake, to take care that they be proper- ly ventilated. They ate obliged to fpend much of their time amongft the fick, and run great hazard of being them- felves infected when the air is bad. All hofpitals, and places for the fick, ought to have an open fituation, at fome dif- tance from any great town. .Want of CLEANLINESS. The want of cleanlinefs is a fault which admits of no excufe. Where water can be had for nothing, it is furely in the power of every perfon to be clean. The continual dif- charge from our bodies by perfpiration renders frequent changes of apparel neceflary. Change of apparel greatly pro- motes the fecretion from the fkin, fo neceflary for health. When that matter which ought to be carried off by perfpi- ration, is either retained in the body, or re-abforbed from dirty cloaths, it is apt to occafion fevers and other difeafes. Most difeafes of the fkin proceed from want of cleanli- nefs. Thefe indeed may be caught by infeaion ; but they will feldom continue long where cleanlinefs prevails. To the fame caufe muft we impute the various kinds of vermine which infeft the human body, houfes, Ufe. Thefe mav ge- nerally be banifhed by cleanlinefs alone. Perhaps, the in- tention of nature in permitting fuch vermine to annoy man- kind, is to induce them to the praaice of this virtue. One common caufe of putrid and malignant fevers is the want of cleanlinefs. Thefe fevers commonly begin among the inhabitants of clofe, dirty houfes, who breathe bad air, take little exercife, ufe unwholefome food, and wear dirty cloaths. There the infeaion is generally hatched, which often fpreads far and wide, to the deilruaion of many. Hence cleanlinefs may be confidered as an objea of public attention. It is not fuflicient that I be clean myfelf, while the want of it in my neighbour affeas my health as well as his own. If dirty people cannot be removed as a common nuifance, they ought at leaft to be avoided as infeaious. All who regard their health fliould keep at a diftance even from their habitations. In DISEASES. 53 Iw pieces where great numbers of people are colleaed, cleanlinefs becomes of the utmoft importance. It is well known, that infeaious difeafes are communicated bv taint- ed air. Every thing, therefore, which tends to pollute the air, or fpread the infeaion, ought, with the utmoft care, to be avoided. For this reafon, in great towns, no filth of any kind fhould be permitted to lie upon the ftreets. Nothing is more apt to convey infeaion than the excrements of the difeafed. Thefe, in many cafes, are known to be highly in- feaious. The ftreets in many great towns are little better than dunghills, being frequently covered with allies and naftinefs of every kind. How eafily might this be prevented by aaive magiftrates, who have it always in their power to make proper laws relative to things of this nature, and to enforce the obfervance of them ? We are forry to fay, that the importance of general clean- linefs does by no means feem to be fufficiently underftood. It were well if the inhabitants of Britain would imitate their neighbours the Dutch in the cleannefs of their ftreets, houfes, Ufe. Water, indeed, is eafily obtained in Holland ; but the fituation of moft towns in Britain is more favourable to cleanlinefs. Nothing can be more agreeable to the fenfes, more to the honour of the inhabitants, or conducive to their health, than a clean town ; nor does any thing imprefs a Arranger fooner with a difrefpeaful idea of any people than its oppofite. The peafants in moft countries feem to hold cleanlinefs in a fort of contempt. Were it not for the open fituation of their houfes, they would often feel the bad effeas of this difpofition. One feldom fees a farm-houfe without a dung- hill before the door, and frequently the cattle and their maf- ters lodge under fhe fame roof. Peafants are likewife ex- tremely carelefs with refpea to change of apparel, keeping their fkins clean, Ufe. Thefe are merely the effeas of indo- lence and a dirty difpofition. Habit may indeed render them lefs difagreeable; but no habit can ever make it falutary to wear dirty cloaths, or breathe unwholefome air. In camps the ftriaeft regard fhould be paid to cleanlinefs. By negligence in this matter, infeaious difeafes are often fpread amongft a whole army; and frequently more die of thefe than by the fword. The Jews, during their encamp- ments in the wildcrnefs, received particular inftruaions with refpea 54 OF PREVENTING refpea to cleanlinefs *. The rules enjoined them ought to be obferved by all in the like fituation." Indeed the whole fyftem of laws delivered to that people, has a manifell ten- dency to promote cleanlinefs. Whoever confiders the na- ture of their climate, and the difeafes to which they were liable, will fee the propriety of fuch laws. It is remarkable, that in moft eaftern countries clean- linefs makes a great part of their religion. The Maho- metan, as well as the Jewifh religion, enjoins various ba- things, walkings and purifications. No doubt thefe were defigncd to reprefent inward purity; but they are at the fame time calculated for the prefervation of health. How- ever whimfical thefe wafhings may appear to fome, few things would tend more to prevent difeafes than a proper attention to many of them. Were every perfon, for ex- ample, after handling a dead body, vifiting the fick, Ufe. to wafh before he went into company, or fat down to meat, he would run lefs hazard either of catching the infeaion himfelf, or communicating it to others. Frequent wafhing not only removes the filth and fordes which adhere to the fkin, but likewife promotes the per- fpiration, braces the body, and enlivens the fpirits. Even wafhing the feet tends greatly to preferve health. The fweat ana dirt with which thefe parts are frequently co- vered, cannot fail to obftrua the perfpiration. This piece of cleanlinefs would often prevent colds and fevers. Were people careful to bathe their feet and hands in warm water at night, after being expofed to cold or wet through the day, they would feldom experience any of the fatal effeas which often proceed from thefe caufes. A proper attention to cleanlinefs is no where more ne- ceflary than on fhipboard. If epidemical.diftempers break out there, no one can be fdfe. The beft way to prevent them is to take care that the whole company be cleanly in their cloaths, diet, Ufe. When infeaious difeafes do break out, cleanlinefs is the moft likely means to prevent their fpreading. Above all things, the cloaths, bedding, Ufe. of the fick ought to be carefully wafhed, and fumigated with brimftone, or the like. Infeaion will lodge a long time * Thou flialt have a place alfo without the camp, whither thou malt go forth abroad; and thou flnk have a paddle upon thy weapon ; and it (hall be, when thou flialt eafe thyfelf abroad, thou (halt dig therewith, and flialt turn back, and cover that which •ometh from thee, GO. Deuter. chap, xxiii. ver. 12. 13. DISEASES. 55 time in dirty cloaths, and will afterwards break out in the moft terrible manner. In places where great numbers of fick people are kept, cleanlinefs ought moft religioufly to be obferved. The very fmell in fuch places is often fuflicient to make one fick. It is eafy to imagine what effea that is likely to have upon the difeafed. A perfon in perfea health has a greater chance to become fick, than a fick perfon has to get well, in an hofpital or infirmary, where cleanlinefs is negkaed. The brutes themfelves fet us an example of cleanlinefs. Moft of them feem uneafy, and thrive ill, if they be not kept clean. A horfe that is kept thoroughly clean, will thrive better on a fmaller quantity of food, than with a greater, where cleanlinefs is neglected. Even our own feelings are a fuflicient proof of the neceffity ''of cleanli- nefs. How refrefhed, how chearful and agreeable does one feel on being fhaved, waftied and dreffed ; efpecially when thefe offices have been long negkaed ? Moft people efteem cleanlinefs; and even thofe who do not praaife it themfelves, often admire it in others. Superior cleanlinefs fooner attraas our regard than even finery itfelf, and often gains efteem where the other fails. To point out the numerous advantages arifing from cleanlinefs of perfon, houfes, ftreets, Ufe. would be a very ufeful and agreeable talk; but as our plan only permits us to name things, we muft conclude this article by recom- mending the praaice of that virtue to people of all ftations and conditions in life. We do not indeed pretend to rank cleanlinefs amongft the cardinal virtues; but we would re- commend it as neceflary for fupporting the dignity of hu- man natuie, as ufeful and agreeable to fociety, and as highly conducive to health. INTEMPERANCE. A modern author * obferves, that temperance and ex- ercife are the two beft phvficians in the world. He might have added, that if thefe were duk regarded, there would be little occafion for any other. Temperance may juftly be called the parent of health ; but numbers of mankind aa as if they thought difeafes and death too flow in their progrefs, and by intemperance and debauch feem, as it were, to follicit their approach. The * Rouffeau. 56 OF PREVENTING The danger of intemperance appears from the very con- flruaion of the human body. Health depends on that ftate of the folids and fluids which fits them for the due perform- ance of the vital funaions ; and fo long as thefe go regular- ly on, we are found and well; but whatever difturbs them, neceffarily impairs health. Intemperance never fails to dis- order the whole animal ceconomy ; it fpoils the digeftion, relaxes the nerves, renders the different fecretions irregular, vitiates the humours, and of courfe occafions difeafes. The analogy between the nouriftiment of plants and animals affords a ftrong proof of the danger of intemper- ance. Moifture and manure greatly promote vegetation; but an over-quantity of either will entirely prevent it. The beft things become hurtful, nay deftruaive, when carried to excefs. From hence we learn, that the greateft pitch of human wifdom confifts in regulating our appetites and paf- fions fo as to avoid all extremes. 'Tis that alone which en- titles us to the charaaer of rational beings. The flave of appetite will ever be the difgrace of human nature. The Author of nature hath endued us with various paf- fions, for the propagation of the fpecies, the prefervation of the individual, Ufe. intemperance is the abufe of thefe paf- fions; and in the proper regulation of them moderation con- fifts. Men, not content with fatisfying the fimple calls of nature, create artificial wants, and are perpetually in fearch after fomething that may gratify them; but imaginary wants can never be gratified. Nature is content with a little; but luxury knows no bounds. The epicure, the drunkard and the debauchee feldom flop in their career till cafh or con- ftitution fails : Then indeed they generally fee their error, when too late. It is impoffible to lay down determined rules of tem- perance, on account of the different conftitutions of man- kind. The moft ignorant perfon however certaily knows what is meant by excefs; and it is in the power of every man to avoid it, if he ehufes. The great rule in regulat- ing our diet, is to ftudy fimplicity. Nature delights in the moft plain and fimple food, and every animal, except man, follows her diaates. Man alone riots at large, and ranfacks the whole creation in queft of luxuries, to his own deftruc'tion. An elegant writer * of the laft age fpeaks thus of intemperance: " For my part, when I behold a " fafhionable table fet out in all its magnificence, I fancy that * Addifon. DISEASES. 57 which not one particle of frefh air muft be admitted. There ought to be a conftant ftream of frefli air into a fick perfon's chamber, fo as to keep it always in a temperate degree of warmth, which ought never to be greater than is agreeable to one in perfea health. Nothing fpoils the air of a fick perfon's chamber, or hurts the patient more than a number of people breathing in it. When the blood ^inflamed, or the humours in a putrid ftate, air that has been breathed over and over will greatly increafe the difeafe. Such air not only- lofes its fpring, and becomes unfit for the purpofes of refpiration, but acquires a noxious quality, which renders it in a man- ner poifonous to the fick. In fevers, when the patient's fpirits are low and deprefled, he is not onlyto befupported with cordials, but every method fhould be taken to cheer and comfort his mind. Manv, from a miftaken zeal, when they think a perfon in danger,' inftead of folacing his mind with the hopes and confola- tions of religion, fright him with the views of hell and damnation, Ufe. It would be unfuitable here to dwell upon the impropriety and dangerous confequences of this con- dua ; .it often hurts the body, and there is reafon to be- lieve, feldom benefits the foul. Amongst common people, the very name of a fever ge- nerally fuggefts the neceffity of bleeding. This notion feems to have taken its rife from moft fevers having been formerly of an inflammatory nature ; but true inflammatory fevers are now feldom to be met with. Sedentary occupa- tions, and a different manner of living, has fo changed the ftate of difeafes in Britain, that there is now hardly one fe- ver in ten where the lancet is neceflary. In moft low, ner- vous, and putrid fevers, which are now fo common, bleed- ing is really hurtful, as it weakens the patient, and finks his fpirits, Ufe. We would recommend this general rule, never to bleed at the beginning of a fever, unleO there be evident figns of an inflammation. Bleeding is an excellent medi- cine when neceffarv, but fhould never be wantonly per- formed. It is likewife a common notion, th<~t it is always ne- ceflary to raife a fweat in the beginning of a fever. As fe- vess INTERMITTING FEVERS,^. 101 vers often proceed from an obftruaed perfpiration, this no- tion is not ill founded. If the patient only lies in bed, bathes his feet and legs in warm water, and drinks freely of water-gruel, or anv other weak, diluting liquor, he will feldom fail to perfpire freelv. The warmth of the bed, and the diluting drink, will relax the univerfal fpafm, which generally affea the folids at the beginning of a fever ; it will open the pores, and promote the perfpiration, by means of which the fever may often be carried off. But in- ftead of this, the common praaice is to heap cloaths upon the patienr, and to give him things of a hot nature, as fpi- rits, fpiceries, Ufe. which fire his blood, increafe the fpafms, and render the difeafe more dangerous. In all fevers a proper attention fhould be paid to the pa- tient's longings. Thefe are the calls of nature, and often point out what may be of real ufe. Patients are not to be wantonly indulged in every thing that the fickly appetite may crave ; but i: is generally right to let them have a lit- tle of what they eagerly defire, though it may not feem al- together proper. What the patient longs for, his ftomach will generally digeft ; and fuch things have fometimes a very happy eftea. When a patient is recovering from a fever, great care is is neceflary to prevent a relapfe. Many perfons, by too foon imagining themfelves well, have relapfed, orcontraa- ed fome other difeafe of an obftinate nature. As the body after a fever is weak and delicate, it is neceflary to guard againft catching cold. Moderate exercife in the cpen air will be of ufe ; agreeable company will alfo hav, a good effea. The diet muft be light, but nourifning. It fhould be taken frequently but in fmall quantities. It is very dangerous at fuch a time to eat as much as the fto- mach craves. Of Intermitting FEVERS or AGUES. Intermitting fevers afford the beft opportunity both of obferviiig the nature of a fever, and alfo the effeas of medicine. No perfon can be at a lofs to diftinguifh an in- termitting fever from any other difeafe, and the proper me- dicine for it is now almoft univerfally known. The feveral kinds of intermitting fevers, as has been ob- ferved, take their names from the period in which the fit returns, as quotidians, tertianr, quartan:, Wc. CAUSES. 102 INTERMITTING FEVERS CAUSE S.—----Agues are occafioned by moift air. This is evident from their abounding in rainy feafons, and being moft frequent in countries where the foil is marfhy, as in Holland, the fens of Cambridgefhire, the Hundreds of Effex, Ufe. This difeafe is alfo occafioned by eating too much ftone-fruit, a poor watery diet, damp houfes, even- ing dews, lying upon the wet ground, Ufe. When the inhabitants of a high country remove to a low one, they feldom fail to catch an intermitting fever, and to fuch the difeafe is moft apt to prove fatal. In a word, whatever relaxes the folids, diminifhes the perfpiration, or obftruas the circulation in the capillary or fmall veffels, predifpofes the body to agues, SYMPTOM S.------An intermitting fever gene- rally begins with a pain of the head and loins, wearinefs of the limbs, coldnefs of the extremities, ftretching, yawning, with fometimes great ficknefs and vomitting ; to which fucceed fhivering and violent fhaking. Afterwards the fkin becomes moift, and a profufe fweat breaks out, which ge- nerally terminates the fit or paroxyfm. Sometimes, indeed, the difeafe comes on fuddenly, when the perfon thinks him- felf in perfea health ; but it is more commonly preceded by liftleflhefs, lofs of appetite, and the fymptoms mention- ed above. REGIME N______While the fit continues, the patient may drink feely of water-gruel, orange-whey, weak camomile-tea ; or, if his fpirits be low, fmall wine- whey, fharpened with the juice of lemon. His drink ought to be a little warm, as that will affift in bringing on the fweat, and confequently fhorten the paroxyfrn. Between the paroxyfms the patient muft be fupported with food that is nourifhing, but light and e; rup of lemon, cr mixed in a glafs of red wine, a cup of camomile-tea, water-gruel, or the like. In an ague which returns every day, a dofe of the above may be taken every two hours during the interval of the fit. By this method the patient will be able to take five or fix dofes between each paroxyfm. In a tertian, or third-day ague, it will be fufficient to take a dofe every third hour, during the interval, and in a quartan every fourth. If the patient cannot take fo large a dofe of the bark, he may di- vide each of the powders into two parts, and take one every hour. For a young perfon, a fmaller quantity of this me- dicine will be fufficient, and the dofe muft be adapted to the age, conftitution, Ufe. The above will feldom fail to remove an ague ; but the patient ought not to leave off taking the medicine fo foon as the paroxyfms are flopped, but fhould continue to ufe it till fuch time as there is reafon to believe the difeafe is in- tirely overcome. Moft of the failures in the cure of this difeafe are owing to the patients not continuing to ufe the medicine long enough. They are generally direaed to take it till their fits are flopped, then to leave it off, and begin again at fome diftance of time ; by which means the difeafe gathers ftrength, and often returns with as much violence as before. A relapfe may always be prevented by the pa- tient's continuing to take fmall dofes of the medicine for fometime after the fymptoms difappear. This is both the moft fufe and effeaual method of cure. Though the bark alone will generaljv cure intermitting fevers ; yet it may be aftifted by alkaline falts, acid and aft rin gent O R A G U E S. 105 aftringent vegetables, Ufe. Many have been cured of an intermitting fever, after the bark had failed, by taking twice or thrice a-day a dram of the fait of wormwood in water-gruel. Some have flopped an ague by eating a boil- ed lemon, with the rind, immediately before the coming on of the fit. We would rather recommend a medicine which is the refult of thefe two when joined together, than either of them feparately. Thus, a dram of fait of wormwood may be diffolved in an ounce and half of frefh lemon juice, to which may be added three or four ounces of boiling water, and half a glafs of brandy. Thefe will make an agreeable medicine ; a tea cupful of which may be taken three or four times a-day. An ounce of gentian root, calamus aromaticus, and orange-peel of each half an ounce, with three or four handfuls 9f camomile flowers, and an handful of coriander feed, all bruifed together in a mortar, may he ufed inform of infufion or tea. About half an handful of thefe ingre- dients may be put into a tea-pot, and an Englifh pint of boiling water poured on them. A cup of this infufion may be drank three or four times a-day. This ftrengthens the ftomach, reaifies the blood, and greatly promotes the cure. Such patients as cannot drink the watery infufion, may put two handfuls of the fame ingredients into a bottle of white wine, and take a glafs of it twice or thrice a-day. If pa- tients drink freely of the above, or any other proper infu- fion of bitters, a much fmalkr quantity of bark than is ge- nerally ufed, will be fufficient to cure an ague. There is reafon to believe, that fundry of our own plants or'barks, which are \ery bitter and aftringent, would fucceed well enough in the cure of intermitting fe- vers, efpecially when affifted by aromatics. But as the Je- fuits bark has been long approved in the cure of this dif- eafe, and is now to be obtained at a very reafonable rate, it is of lefs importance to fearch after new medicines. We cannot however omit taking notice, that the Jefuits bark is very often adulterated, and that it requires confiderable fkill to diftinguifh between the genuine and the falfe. This ought to make people very cautious of whom they purchafe it. Those who cannot fwallow the bark in fubftance, may take it in decoaion or infufion. An ounce of bark in pow- der may be infufed in a bottle of white wine fOr four or five days, frequently fhaking the bottle, afterwards let the O powder io6 INTERMITTING FEVERS powder fubfide, and pour off the clear liquor. A wine- glafs may be drank three or four times a-day, or oftener, as there is occafion. If a decoaion be more agreeable, an ounce of the bark, and two drams of fnakeroot bruifed, with a dram of fait of wormwood, may be boiled in a pro- per quantity of water, into half an Englifh pint. To the ftrained liquor may be added an equal quantity of red wine, and a glafs of it taken thrice a-day, or oftener, if neceffa- ry- In obftinate agues the bark will be found much more ef- ficacious when affiftcd by warm cordials, than if taken alone. This I have had frequently occafion to obferve in a country where intermitting fevers were endemical. The bark feldom fucceeded unlefs affifted by fnakeroot, ginger, canella alba, or fome other warm aromatic. When the fits are very frequent and violent, in which cafe the fever often approaches towards an inflammatory nature', it will be fafer to leave out the ginger, and to add in its place half an ounce of fait of wormwood. But in obftinate tertians or quartans, in the end of autumn, or beginning of winter, warm and cordial medicines are abfolutely neceflary. As autumnal and winter agues generally prove much more obftinate than thofe which attack the patient* in fpring or fummer ; it will be neceflary to continue the ufe of medicines longer in the former than in the latter. A perfon who is feized with an intermitting fever in the be- ginning of winter, ought frequently, if the feafon proves rainy, to take a little medicine, although the difeafe be cured, to prevent a relapfe, till the return of the warm fea- fon. He ought likewife to take care not to be much abroad in wet weather, efpecially in cold, moift, eafterly winds. When agues are not properly cured, they oftert degene- rate into obftinate chronical difeafes ; as the dropfy, jaun- dice, Ufc.q For this reafon, all poffible care fhould betaken to have them radically cured, before the humours be vitiat- ed, and the conftitution fpoiled. Though nothing is more rational than the method of treating intermitting fevers, yet, by fome ftrange infatua- tion, more charms and whimfical remedies are daily ufed for removing this .than any other difeafe. There is hardly an old woman who is not poffcfled of a noftrum for flopping an ague ; and there is reafon to fear, that many by trufling to them lofe their lives. Thofe in diftrefs eagerly grafp at any thing that promifes fudden relief; but the fhorteft way is O R A G U E S. 107 is not always the fafeft in the treatment of difeafes. The only method to obtain a fafe and lafting cure, is gradually to aflift nature in removing the caufe of the difeafe. Some people try bold, or rather fool-hardy experiments to cure agues, as drinking ftrong liquors, jumping into a river, Ufe. Thefe may fometimes have the defired effea, but muft always be attended with danger. When there is any degree of inflammation, or the leaft tendency to it, fuch experiments may prove fatal. • The only perfon whom I remember to have feen die in an intermitting fever, evidently killed himfelf by drinking ftrong liquor, which fome perfon had perfuaded him would prove an infallible remedy. AIanv out of the way things are extolled for the cure of intermitting fevers, as cobwebs, fnuffings of candles, Ufe Though thefe may fometimes fucceed, yet their very nafti- nefs is fufficient to fet them afide, efpecially when cleanly medicines will anfwer the purpofe better. The only medi- cine that can be depended upon, for thoroughly curing an intermitting fever, is the Jefuits bark. It may always be ufed with fafety : And I can honeftly declare, that in all my praaice I never knew it fail, when properly applied, and duly perfifted in. Where agues are endemical, even children are often affliaed with that difeafe. Such patients are verv difficult to cure, as they can feldom be brought to take the bark, or any other difagreeable medicine. One method of ren- dering this medicine more palatable is, to make it into a mixture with diftilled waters and fyrup, and afterward to give it an agreeable lharpnefs with the elixir of fpirit of vi- triol: This both improves the medicine, and takes off the naufeous tafte. The bark may be adminiftered to children in form #of clyfter when they will not take it by the mouth. Wine whey is a very proper drink for a child in an ague ; to half an Englifh pint of which may be put a tea-fpoonful of the fpirit of hartfhorn. Exercife is likewife of confider- able fervice ; and when the difeafe proves obftinate, the child ought, if poffible, to be removed to a warm dry air. Their food ought to be nourifhing, and they fhould fome- times have a little generous wine. We have been the more full upon this difeafe, becaufe it is very common, and becaufe few patients in an ague apply to phyficians unlefs in extremities. "There are, however, many cafes in which the difeafe is very irregular, being O 2 complicated 108 OF AN ACUTE complicated with other difeafes, or attended with fypmtoms which are both very dangerous, and difficult to underftand. All thefe we have purpofely paffed over, as they would on- ly bewilder the generality of readers. When the difeafe is very irregular, or the fymptoms dangerous, the patient ought immediately to apply to a phyfician, and ftriaiy to follow his advice. To prevent agues, people muft avoid their caufes. Thefe have been already pointed out in the beginning of this (eaion ; we fhall therefore only add one preventive medicine, which may'be of ufe to fuch as are obliged to live in low marfhy countries, or who are liable to fiequent at- tacks of this difeafe. Take an ounce of the b?i\ Jefuits bark, half an ounce of Virginian fnake-root, and half an dunce of orange-peel, bruife them all together, and infufe for five or fix days in a bottle of brandy, Holland-gin, or any good fpirit ; afterwards pour off the clear liquor, and take a wine glafs of it twice or thrice a day. This indeed is recom- mending a dram ; but the bitter in a great meafure takes off the ill effeas of the fpirit. Thofe who do not choofe it in brandy may infufe it in wine ; and fuch as can bring them- felves to Chew the bark, will find that method fucceed very well. Gentian-root, or calamus aromaticus, may alfo be chewed by turns for the fame purpofe. All bitters feem to be antidotes to agues, efpecially thofe that are warm and aftringent. Of an ACUTE CONTINUAL FEVER. This fever is denominated acute, ardent, or inflamma- tory. It moft commonly attacks the young, or thofe about the prime or vigour of life, efpecially fuch as live full, abound with blood, and whofe fibres are ftrong and elaftic. It feizes people at all feafons of the year ; but is moft fre- quent in the fpring and beginning of fummer. CAUSES.—An ardent fever may be occafioned by any thing that overheats the body, as violent exercife, fleeping in the fun, drinking ftrong liquors, eating fpiceries, Ufe It may likewife be occafioned by any thing that obftruas the perfpiration, as lying on the damp ground, drinking cold liquor when the body is hot, night-watching, or fuch like. SYMP- CONTINUAL FEVER. 109 SYMPTOM S.;—-A rigor or chillnefs generally ufhers in this fever, which is foon fucceeded by great heat, a frequent and full pulfe, a pain of the head, dry fkin, rednefs of the eyes, a florid countenance, pains in the back, loins, Use. To thefe fucceed difficulty of breathing, fick- nefs, with an inclination to vomit. The patient complains of great thirft, has no appetite for folid food, is reftlefs, and his tongue generally appears black and rough. A delirium, excelfive reftlefsnefs, great oppreffion of the breaft, with laborious refpiration, ftarting of the tendons, hiccup, cold, clammy fweats^ and an involuntary difcharge of urine, are generally the forerunners of death. As this difeafe is always attended with danger, the befl! medical afliftance ought to be procured as foon as poffible. A phyfician may be of ufe at the beginning, but his fkill is often of no avail afterwards. We cannot here omit, once for all, taking notice of the unaccountable condua o£ thofe who have it in their power, at the beginning of a fever, to procure the beft medical afliftance, yet put off till things come to an extremity. When the difeafe, by delay or wrong treatment, has be- come incurable, and has exhaufted the ftrength of the pa- tient, it is in vain to hope for relief from medicine. Phv- ficians may indeed affift nature ; but their attempts muft ever prove fruitlefs, when fhe is no longer able to co-ope- rate with their endeavours. REGIME N.------From the fymptoms of this dif- eafe, it is evident, that the blood muft be thicK md vifcous, by which its circulation thorough the fmall veflUs is imped- ed ; that the perfpiration, urine, and all the other fecretions, are in too fmall quantity ; that the veffels are too rigid, and the heat of the whole body too great : All thefe clearly point out the neceffity of a regimen, calculated to dilute the blood, allay the exceffive heat, remove the fpafmodic flriaure of the veffels, and promote the fecretions. These important purpofes may be greatly promoted by drinking plentifully of diluting liquors, as thin water-gruel, oat-meal tea, clear whey, barky-water, balm-tea, apple- tea, Ufe Thefe fhould befharpened with juice of orange, jelly of currants, rafpberries, and fuch like : Orange-whey is likewife an excellent cooling drink. It is made by boil- ing a bitter orange, fliced, among milk and water, till the curd feparates. If no orange can be had, a lemon, a little cream of tartar, or a few fpoonfuls of vinegar, will have the no OF AN ACUTE the fame effea. Two or three fpoonfuls of white wine may be occafionally added to the liquor when boiling. If the patient be coftive, an ounce of tamarinds, with two ounces of ftoned raifins of the fun, and a couple of figs, may be boiled in three Englifh pints of water to a quart. This makes a very pleafant drink, and may be ufed at dif- cretion. The common peaoral decoaion is likewife a very proper drink in this difeafe. It is made by boiling barley, ftoned raifins and figs, of each two ounces, with half an ounce of liquorice-root fliced, in two Englifh quarts of water, till one half be confumed. The barley fhould be boiled fome time before the other ingredients are put in. This, with the addition of two or three drams of purified nitre, or fal-prunel, will not only be a proper drink, but prove an exceeding good medicine. A tea-cupful of it may be taken every two hours, or oftener, if the patient's heat and thirft be very great. The above liquors muft all be drank a little warm. They may bp ufed in fmalkr quantities at the beginning of a fe- ver, but more freely afterwards, in order to affift in carry- ing off the morbid matter by the different excretions. We have mentioned a variety of liquors, that the patient may have it in his power to choofe that which is moft agreeable; and that, when tired of one, he may have recourfe to an-' other. The patient's diet muft be very fpare and light. All forts of meat, and even chicken-broths, are to be avoided. He may be allowed groat-gruel, panada, or light bread boil- ed in water, and afterwards ftrained; to which may be add- ed a few grains of common fait, and a little fugar, which will render it more palatable. He may eat roafted apples with fugar, toafted bread with jelly of currants fpread upon it, boiled prunes, Ufe. It will greatly relieve the patient, efpecially in an hot feafon, to have frefh air frequently let into his chamber, This, however, muft always be done in fuch a manner as not to endanger his catching cold. It is a common praaice to load the patient with bed- cloaths, under the pretence of making him fweat, or de- fending him from the cold. This cuftom has many ill ef- feas. It increafes the heat of the body, fatigues the pa- tient, and retards, inftead of promoting, the perfpiration. Sitting upright in bed, if the patient be able to bear it, will often have a good effea. It relieves the head, by re- tarding CONTINUAL FEVER. ut tarding the motion of the blood to the brain. But this pof- ture ought never to be continued too long : And if the pa- tient be inclined to fweat, it will be more fafe to let him lie ftill, only railing his head with pillows, Ufe Sprinkling the chamber with* vinegar, juice of lemon, . or vinegar and rofe-water, with a little nitre diffolved in it, will greatly refrefh the patient. This ought to be done fre- quently, efpecially if the weather be hot. The patient's mouth fhould be often wafhed with warm water, mixed with honey, and a little vinegar ; or a de- coaion of figs in barley-water, Ufe His feet and hands ought likewife frequently to be bathed in lukewarm water ; efpecially if the head be effeaed. The patient fhould be kept as quiet and eafy as poffible. Company, noife, and every thing that difturbs the mind is hurtful. Even too much light, or any thing that affeas the fenfes, is to be avoided. His attendants fhould be as few as poffible, and they ought not to be too often changed. His inclinations ought rather to be foothed than contradiaed; even the promife of what he craves will often fatisfy him as much as its reality. M E D IC I N E.—In this and all other fevers arifing from too great a quantity, and too rapid a motion of the blood, bleeding is of the greateft importance. This opera- tion ought always to be performed as foon as the fymptoms of an inflammatory fever appear. The quantity of blood to be let muft be in proportion to the ftrength of the pa- tient, and the violence of the difeafe. If after the firft bleed- ing the fever feems to rife, and the pulfe feels hard, there will be a neceffity for repeating it a fecond, and perhaps a third time, which may be done at the diftance of twelve, eighteen, or twenty-four hours, as the fymptoms require. If the pulfe continues foft, and the patient is tolerably eafy after the firft bleeding, it ought not to be repeated till ne- ceflary. The cooling febrifuge draught, recommended in the in- termitting fever, page 105, will likewife be very proper here; only the brandy muft be left out, and half a dram of purified nitre added in its ftead. If the above cannot be conveniently obtained, forty or fifty drops of the dulcified or fweet fpirit of vitriol may be made into a draught, with an ounce of rofe-water, two ounces of common water, and half an ounce of fimple fy- rup, or a bit of loaf-fugar. This draught may be given to 112 OFANACUTE \ the patient every three hours while the fever is violent; af- terwards, once in five or fix hours will be fufficient. If the patient be affliaed with reaching or an inclination to vomit, it will be right to aflift nature's attempts, by giving him weak camomile tea or lukewarm water to drink. If the belly be bound, the patient ought daily to receive a clyfter of milk and water with a little fait, and a fpoonful of fweet oil or freih butter. If this has not the defired effea, a tea-fpoonful of magnefia alba, or cream of tartar, may be frequently put into his drink. He may likewife eat tama- rinds, boiled prunes, roafted apples, and the like. If about the ioth, nth, or 12th day, the pulfe becomes more foft, the tongue moifter, and the urine begins to kt fall a reddifh fediment, there is reafon toexpea a favourable iffue to the difeafe. But if, inftead of thofe fymptoms, the patient's fpirits grow languid, his pulfe finks, and his breath- ing becomes difficult; with a ftupor, tremors of the nerves, ftarting of the tendons, Ufe there is reafon to fear that the confequences will be fatal. In this cafe, bliftering plaifters muft be applied to the head, ancles, infide of the thighs, Ufe. and the patient muft be fupported with cordials, as ftrong wine-whey, negas, fago-gruel,^nd fuch like. A proper regimen is not only neceflary during the fever, but likewife after the patient begins tp recover. By ne- gkaing that, many relapfe, or fall into other difeafes, and continue valetudinary for life, Tho' the body be weak after a fever, yet the food for fome time ought to be rather cleanfing than of too nourifhing a nature. The perfon fhould take great care not to exceed in any thing. Too much food, drink, fleep, exercife, company, Ufe. are' care- fully to be avoided,. The mind ought likewife to be kept eafy, and the perfon fhould not attempt to purfue ftudy, or any thing that requires intenfe thinking. If the digeftion be bad, or the perfon be troubled at times with feverifh heats, an infufion of the Jefuits bark in cold water will be of ufe. It will ftrengthen the ftomach, and help to fubdue the remains of the fever. When the patient's ftrength is pretty well recovered, he ought to take fome gentle laxative. An ounce of tamarinds and a dram of fenna, may be boHed for a few minutes in an Englifh pint of water, and an ounce of manna diflblved in the decoaion ; afterwards, it may be ftrained, and a tea- cupful drank every hour till it operates. This dofe may be repeated OF THE PLEURISY. 113 repeated twice 01 thrice, five or fix days intervening be- twixt each dofe. Those who follow laborious employments ought not to return too foon to their labour after a fever, but fhould keep eafy till their ftrength and fpirits be recruited. Of the PLEURISY. The true pleurify is an inflammation of that membrane, called the pleura, which lines the infide of the breaft. It is diftinguifhed into the moift artd the dry. In the former, the patient fpits freely; but in the latter, little or none at all. There is likewife a fpecies of this difeafe, which is called the fpurious or baflard pleurify, in which the pain is more exter- nal, and chiefly affeas the mufcles between the ribs. This difeafe abounds among labouring people, efpecially fuch as work without doors, and are of a fanguine conftitution. It is moft frequent in the fpring-feafon. CAUSE S.----The pleurify is occafioned by whatever obftruasthe perfpiration ; as cold northerly winds, drinking cold liquors when the body is hot, fleeping without doors on the damp ground, wet clpaths, plunging the body into cold water, or expofing it to the cold air when covered with fweat, Ufe It may likewife be occafioned by drinking ftrong liquors ; by the ftoppage of ufual evacuations, as old ulcers, iffues, fweating of the feet or hands, Ufe the fudden ftriking in of any eruption, as the itch, the meafles, or the fmall-pox. Thofe who have been accuftomed to bleed at a certain fea- fon of the year, are apt, if they negka it, to be feized with a.pleurify. Keeping the body too warm by means of fire, cioaths, Ufe. renders it more liable to this difeafe. A pleu- rify may likewife be occafioned by violent exercife, as run- ning, wreftling, leaping, or by fupporting great weights, efpecially on the breaft. The very make of the body fome- times predifpofes perfons to this difeafe, as a narrow cheft, a ftraitnefs of the arteries of the pleura, Ufe SYMPTOM S.----This, like moft other fevers, be- gins with chillnefs and fhivering, which are followed by heat, thirft, and reftleflhefs. To thefe fucceed a violent pricking pain in one of the fides amongft the ribs. Some- times the pain extends towards the backbone, fometimes to- wards the forepart of the breaft, and at other times towards the moulder-blades. The pain is generally moft violent when the patient draws in his breath. p Thb ii4 OF THE PLEURISY. The pulfe in this difeafe is generally bard,the urine high coloured ; and if blood be let, it is covered with a tough cruft, or buffy coat. The patient's fpittle is at firft thin, but afterwards it becomes groffer, and is often ftreaked with blood REGIME N.----Nature endeavours to carry off this difeafe either by a critical difcharge of blood from the nofe, Ufe or by expeaoration, fweat, loofe ftools, thick mine, Ufe. When the violence of the fever is not broken by thefe, or other evacuations, it often ends in an abfcefs or fuppuration ; to which enfues an ulcer, mortification, anJ death. The violence of this difeafe may generally be checked by kffening the force of the circulation, relaxing the yef- ft'ls, diluting the humours, and promoting expeaoration, Ufe For thefe purpofes, the diet, as in the former difeafe, muft be cool, flender, and diluting. The patient muft avoid fuod that is vifcid, hard of digeftion, or that affords much nouriftiment, as flefh, butter, cheefe, eggs, milk, and alfo every thing that is of a heating nature. His drink muft be fweet whey, or decoaions and infufions of the peaoral and balfamic vegetables. Take a table fpoonful of linfeed, a quarter of an ounce of liquorice-root fliced, and half an ounce of the leaves of coltsfoot. Put thefe ingredients in a clofe veffel, pour on them a quart of boiling water, and let them ftand near a fire for eight or ten hours ; afterwardsftrainoff the liquor; of which the patient may take a cupful frequently for his ordinary drink. Barley-water fweetened with honey, or fharpened with the jelly of currants, is likewife a very proper drink in this difeafe. It is made by boiling an ounce of pearl- barley in three Englifh pints of water to two, which muft afterwards be ftrained. The decoaionof figs, raifins, and barley, Ufe recommended in the continual fever, p. no. is here likewife very proper. Thefe, and other diluting li- quors, are not to be drank in large quantities at a time; but the patient ought, in a manner, keep continually fip- ping them, fo as to render his mouth and throat always moift. All his food and drink muft .be taken a little warm. The patient fhould be kept quiet, cool, and every way ea- fy, as direaed under the foregoing difeafe. His feet and hands ought OF THE PLEURISY. 115 ought daily to be bathed in warm water ; and he may fometimes lit up in bed for a fhort fpace, in order to re- lieve his head. M E D I C I N E.------Almoft every perfon knows when a fever is attended with a violent pain of the fide, and a quick, hard pulfe, that bleeding is neceflary. When thefe fymptoms appear, the fooner this operation is per- formed the better ; and the quantity at firft muft be pretty large, provided the patient be able to bear it. A large quantity of blood let at once, in the beginning of a pleuri- iy, has a much greater effea than feveral repeated fmall bleedings. An adult perfon may lofe ten or twelve ounces of blood as focn as it is certainlyknown that he is feizedwith a pleurify. For a younger perfen, or one of a delicate con- ftitution, the quantity muft be lefs. If after the firft bleeding, the flitch, with the other vio- •lent fymptoms, fhould continue, it will be neceflary, at the diftance of twelve or eighteen hours, to let eight or nine ounces more. If the fymptoms do not then abate, and the blood fhows a ftrong buffy coat, a third or even a fourth bleeding may be requifite. If the pain of the fide abates, the pulfe becomes fofter, or the patient begins to fpit free- ly of a brown or reddifti colour, bleeding ought not to be repeated. This operation is feldom neceflary after the third or fourth day of the fever, and ought not then to be performed without the advice of a phyfician, unlefs in the moft urgent circumftances. The blood may be many ways attenuated without let- ting it off. There are likewife many things that may be done to eafe the pain of the fide befides bleeding. Thus, after the firft or fecond bleeding, emollient fomentations may be applied to the part affeaed. Thefe may be made by boiling a handful of the flowers of elder, camomile, and common mallows, or any other foft vegetables, in a proper quantity of water. The herbs may be either put into a bag, and applied warm to the fide, or flannels may be dip- ped in the decoaion, afterwirds wrung out, and applied to the part affeaed, with as much warmth as the patient can eafily bear. As the cloths grow cool, they muft be chan- ged, and great care taken that the patient do not catch cold. An ox's bladder maybe half filled with warm milk and wa- ter, and applied to to the fide, if the above method of fo- menting be found inconvenient. Fomentations not only to P 2 eafe ri6 OF, THE PLEURISY. eafe the pain, but by relaxing the veffels, prevent the flag- nation of the blood and other humours. The fide may likewife be frequently rubbed with a little of the following liniment. Take two table fpoonfuls of the oil of fweet almonds, olives, or any other fweet oil, and two tea fpoonfuls of fpirit of hartfhorn : Shake them well together, and rub about a tea fpoonful upon the fide, with a warm hand, three or four times a-day. Some recommend dry applications to the affeaed fide, as"burnt oats, toafted bread, Ufe But thefe, though they may be ufeful, are not fo proper as moift ones. Could it be properly conduaed, we would recommend putting the patient into a bath of warm milk and water, in which emol- lient vegetables had been boiled ; but as this cannot always be obtained, we fhall recommend what is in every perfon's power, viz. to apply foft poultices, or cataplafms to the part affeaed. Thefe may be made of wheat bread and milk, foftened with oil or ftefh butter. Leaves of various plants might likewifp be applied to the patient's fide with advantage. We have often feen, and even felt, the benefit of young cabbage leaves applied, warm to the fide in a pleurify. Thefe not only relax, but likewife draw offa little moifture, and may prevent the ne- c-'ffity of bliftering plaifters ; which, however, when other things fail, muft be applied. If the flitch continues after repeated bleedings, fomenta- tions, Ufe a blifOring plaifter muft be laid upon the part affeaed, and fjffeted to remain for two days. This not only procures a difcharge from the fide, but aaually thins the blood, and by that means affifts in removing the caufe of the difeafe. To prevent a ftranguary when the bliftering plaifter is on, the patient may drink freely of the following emulfion : take an ounce of fweet almonds blanched, and beat them well in a mortar, with an equal quantity of fine fugar ; then diffolve half an ounce of gum arabic in an Englifh quart of bark/ water warm. Let it ftand till cool, and afterwards pour it by little and little upon the almonds and fugar, continually rubbing them till the liquor becomes uniformly white or milky. Afterwards ftrain it, and let the patient ufe it for ordinary drink. A quart bottle, at leaft, may be drank daily. If the patient be coftive, a clyfter of warm water, or of barley water, in which a handful of mallows, or any other OF THE PLEURISY. 117 other emollient vegetable, has been boiled, may be daily adminiftered. This will not only empty the bowels, but have the effea of a warm fomentation applied to the infe- rior vifcera, which will help to make a derivation from the breaft. The expeaoration, or fpitting, may be promoted by fharp, oily, and mucilaginous medicines. For this purpofe, an ounce of the oxymel or vinegar of fquills may be added to fix ounces of the peaoral decoaion, and two table fpoonfuls of it taken every two hours. Should the fquill difagree with the ftomach, two oun- ces of the oil of fweet almonds, or oil of olives, and two ounces of the fyrup of violets, may be mixed with as much fugar-candy powdered as will make an ekauary of the con- fidence of honey. The patient may take a little of this frequently, when the cough is troublefome. Should oily medicines happen to prove naufeous, which is fometimes the cafe, two drams of gum ammoniac may be diflblved in half an Englifh pint of barley water, in the following manner : The gum muft be well rubbed in a mortar, and the water gfadually poured upon it till it be quite diflblved. Three or four ounces of fimple pennyroy- al water may be added to the above quantity, and two table fpoonfuls of it taken three or four times a-day. If the patient does not perfpire, but has a burning heat upon his fkin ; and paffes very little water, fome fmall do- fes of purified nitre and camphire will be of ufe. Two drams of the former may be rubbed with five or fix grains of the latter in a mortar, and the whole divided into fix do- fes, one of which may be taken every five or fix hours, in a little of the patient's ordinary drink, But the beft medicine, which fome indeed reckon al- moft a fpecific in the pleurify, is the decoaion of the Sene- ca rattlefnake root. Two ounces of the root, grofsly pow- dered, muft be boiled in two Englifh pints and an half of water, till one half the water be confumed. It muft not be boiled quickly, but gradually fimmered over a flow fire. After bleeding, and other evacuations have been premifed, the patient may take two, three, or four table fpoonfuls of this decoaion, according as his ftomach will bear it, three or four times a-day. If it fhould occafion vomiting, two or three ounces of fimple cinnamon water, may be mixed with the quantity of decoaion above mentioned, or it may be taken in fmaller dofes. As this medicine at once pro- motes n8 OF THE PLEURISY. motes perfpiration, urine, and keeps the belly eafy, it bids the faircft of any thing yet known to anfwer all the in- tentions of cure in a pkurifv, or any otlicr inflammation of the breaft. No one will imagine, that thefe medicines are all to be ufed at the fame time. We have mentioned different things, on purpofe that people may have it in their power to choofe ; and, likewife, that when one thing cannot be obtained, thev may make ufe of another. Different medicines are no doubt neceflary in the different periods of a difor- der ; and where one fails of fuccefs, or difagrees with the patient, it will be proper to try another. What is called the crifis, or height of the fever, is fometimes attended with very alarming fymptoms ; as diffi- culty of breathing, an irregular pulfe, convulfive motions, Ufe' Thefe are apt to fright the attendants, and induce them to do improper things, as bleeding the patient, giving him ftrong flimulating medicines, or the like. But they are only the ftruggles of nature to overcome the difeafe, in which fhe ought to be affifted by plenty of diluting drink, which is then peculiarly neceflary, as the febrile matter is now ready to be difcharged. If tthe patient's ftrength, however, be much exhaufted by the difeafe, it may be ne- ceflary, at this time, to fupport him with frequent fmall draughts of wine whey, or the like. When the pain and fever are gone, it will be proper, after the patient has gathered fufficient ftrength, to give him fome gentle purges, as thofe direaed under the acute, conrinual fever, page 112. He ought li'.ccwife to ufe a light diet, of eafy digeftion ; and, his drink fhould be butter-milk, whey, and other things of a cleanfing na- ture. That fpecies of pleurify, which is called the bajlard, or fpurious, generally goes off by keeping warm for a few days, drinking plenty of diluting liquors, and obferviiig a proper regimen. It is known by a dry cough, a quick pulfe, and a dif- ficulty of lying on the affeaed fide, v/7>ich laft does not always happen in the true pleurify. Sometimes, indeed, this difeafe proves obftinate, and requires bleeding, with cupping, and fcarifications of the affeaed fide. Thefe, together with the ufe of nitrous, and other cooling medi- cines, OOJom fail to effea a cure. The OF A PERIPNEUMONY, Ufe 119 The paraphrenitis, or inflammation of the diaphragm, is fo nearly conneaed with the pleurify, and refembles it fo much in the manner of treatment, that it is fcarcc neceflary to confider it as a feparate difeafe. It is attended with a very acute fever, and an extreme pain of the part affeaed, which is generally augmented by coughing, fneezing, drawing in the breath, taking food, going to ftool, making water, Ufe Hence the patient breathes quick, and draws in his bowels to prevent the mo- tion of the diaphragm, is reftlefs, anxious, has a dry cough, a hiccup, and often a delirium. A convulfive laugh, or ra- ther a kind of involuntary grin, is no uncommon fymptom of this difeafe. Every method muft be taken to prevent a fuppuration, as it is impoffibk to fave the patient's life when that hap- pens. The regimen and medicine are in all refpeas the fame as in the pleurify. We fhall only add, that in this difeafe emollient clyfters are peculiarly ufeful, as they relax the bowels, and by that means draw the humours from the part affeaed. Of a PERIPNEUMONY, or INFLAM- MATION of the LUNGS. As this difeafe affeas an organ which is abfolutely necef- fary to life, it muft always be attended with danger. Thofe who abound with thick blood, whofe fibres are tenfe and rigid, who feed upon grofs aliment, and drink ftrong vifcid liquors, are moft liable to this difeafe. It is generally fatal to perfons of a flat breaft, or narrow cheft, and to fuch as are affliaed with an afthma, efpecially in the decline of life. Sometimes the inflammation reaches to one lobe of the lungs only, at other times the whole of that organ is affeaed ; in which cafe the difeafe can hardly fail to prove fatal. When the difeafe proceeds from a vifcid pituitous matter, obftruaing the veffels of the lungs, it is called a fpurious or baflardperipneumony. When it arifes from a thin acrid de- fluaion on the lungs, it is denominated a catarrhal pen'p::su- mony, Sec. CAUSE S.— An inflammation of the lungs is fome- times a primary difeafe, and fometimes it fucceeds to other difeafes, as a quinfy, a pleurify, Ufe It arifes from the fame caufes as a pleurify, viz. an -obftruaed perfpiration from cold 120 OF A PERIPNEUMONY, Ufe cold, wet cloaths, Ufe or from an increafed circulation of the blood by violent exercife, the ufe of fpiceries, ardent fpirits, and fuch like. The pleurify and peripneumony are often complicated ; in which cafe the difeafe is called a pleuro -peripneumony. SYMPTOM S.----Moft of the fymptoms of a pleu- rify, likewife attend an inflammation of the lungs ; only in the latter, the pulfe is more foft, and the pain lefs acute ; but the difficulty of breathing, and oppreffion of the breaft, are generally greater. REGIME N. -As the regimen and medicine are in .all refpeas the fame in the true peripneumony as in the pleurify, we fhall not here repeat them, but refer the reader to the treatment of that difeafe. It may not, however, be improper to add, that the aliment ought to be more flender and thin in this than in any other inflammatory difeafe. The learned Dr. Arbuthnot afferts, that even common whey is fufficient to fupport the patient, and that decoaions of barley, and infufions of fennel-roots in warm water with milk, are the moft proper both for drink and nouriftiment. He likewife recommends the fleam of warm water taken in by the breath, which ferves as a kind of internal fomenta- tion, and helps to attenuate the impaaed humours. If the patient has loofe ftools, but is not weakened by them, they are not to be flopped, but rather promoted by the ufe of emollient clyfters. It has already been obferved, that the fpurious or baflard peripneumony is occafioned by a vifcid pituitous matter ob- ftruaing the veffels of the lungs. It commonly attacks the old, infirm, and phlegmatic, in winter or wet feafons. The patient, at the beginning, is cold and hot by turns, has a fmall quick pulfe, feels a fenfe of weight upon his breaft, breathes with difficulty, and fometimes complains of a pain and giddinefs of his head. His urine is commonly pale, and his colour very little changed. The diet in this, as well as in the true peripneumony, muft be very flender, as weak broths fharpened with the juice of orange or lemon, Ufe His drink may be thin wa- ter-gruel fweetened with honey, or a decoaion of fennel- root, liquorice, and roots of quick grafs. An ounce of each of thefe may be boiled in three Englifh pints of water to a quart, and fharpened with a little currant-jelly, or the like. Bleeding and purging are generally proper at the be- ginning of this difeafe ; but if the patient's fpittle be pretty thick, or well concoaed, neither of them are neceflary. It will OF CONSUMPTIONS'. 121 will be fufficient to affift the expeaoration by fome of the foft balfamic medicines, recommended for that purpofe in the pleurify. Bliflering plaifters have generally a good ef- fea, and ought to be applied pretty early. They may either be applied to the neck or ancles, or both, if neceflary. If the patient does not fpit, he muft be bled, if his ftrength will permit, and have a gentle purge adminiftered. Afterwardj|his belly may be kept open by clyfters, and the expeaoration promoted, by taking every four hours two table fpoonfuls of the folution of gum ammoniac, recom- mended in the pkurifv, page 117. When an inflammation of the breaft does not yield to bleeding, bliflering, and the other means mentioned above, it commonly ends in a fuppuration, which is more or lefs dangerous, according to the part where it is fituate. When this happens in the pleura, it fometimes breaks outwardly, and the matter is difcharged by the wound. Sometimes the fuppuration happens within the fub- ftance or body of the lungs; in which cafe the matter may be difcharged by expeaoration ; but if the matter floats in the cavity of the breaft, between the pleura and the lungs, it can only be difcharged by an incifion made betwixt the ribs. If the patient's ftrength does not return after the inflam- mation is to all appearance removed ; if his pulfe continues quick, tho' foft, his breathing difficult and oppreffed ; if he has cold fhiverings at times, his cheeks flufhed, his lips dry; and if he complains of thirft, and want of appetite ; there is reafon to fear that a fuppuration is going on, and that a phthifis or confumption of the lungs will enfue. We fhall therefore proceed to confider the proper treatment of that difeafe. Of CONSUMPTIONS. A confumption is a wafting or decay of the whole body, from an ulcer, tubercles, or concretion of the lungs ; from an empyema, a nervous atrophy, Ufe Dr. Arbuthnot obferves, that in his time confumptions made up above one tenth part of the bills of mortality about London. There is reafon to believe, they have rather in- creafed fince that time ; and we know for certain, that they are not lefs fatal in feveral other towns in England than in London. O Young 122 OF CONSUMPTIONS. Young perfons betwixt the age of fifteen and thirty, of a flender make, long neck, high fhoulders, and flat breafts, are moft liable to this difeafe. Consumptions prevail more in England than in any other part of the world, owing, perhaps, to the great ufe of animal food, and ftrong liquors, the general application to fedentarv employments, and the great quantity of pit-coal which is there burnt; to which we may add, thjfrpcrpetual changes in the atmofphere, or variabknefs of the weather. CAUSE S.-----ic has already been obferved, that in- flammations of ths breaft often end in an impofthume : Confcquently, whatever predifpofes to thofe difeafes, muft likewife be confidered as a caufe of confumptions. Many other difeafes, by vitiating the humours, may likewife occafion confumptions ; as the fcurvy, the fcro- phula or king's evil, the venereal difeafe, the afthma, fmall- pox, meafks, Ufe As this difeafe is feldom cured, it will be neceflary to point out its caufes more particularly, in order that people may be the better enabled to avoid it. Thefe are : -----Want of exercife. Hence it comes to pafs, that this difeafe is fo common amongft the inhabitants of great towns, who follow fedentary employments, and likewife amongft the rich, who are not under the neceffity of la- bouring for their bread. -----Confined or unwholefome air. Air which ftag- nates, or is impregnated with the fumes of metals or mine- rals, is extremely hurtful to the lungs, and often corrodes the tender veffels of that neceflary organ. -----Violent paffions or afteaions of the mind; as grief, difappointment, anxiety, or clofe application to the ftudy of abftrufe arts or fciences, Ufe. -----Excessive evacuations ; as fweating, diarrhoeas, diabetes, execflive venery, the fluoralbus, an over-difchargc of the menftrual flux, giving fuck too long, Ufe. ■----■ The fudden ftoppage of cuftomary evacuations ; as the bleeding piles, fweating of the feet, bleeding of the nofe, the menfes, iflues, ulcers, or eruptions of any kind. .....Changing fuddenlv from a hot to a very cold cli- mate, or whatever greatly leffens the perfpiration. -----Frequent and execflive debaucheries. Late watch- ing, and drinking of ftrong liquors, which generally o-o to- gether, can hardly fail to deftroy the lungs. Kcncc the ban companion generally falls a facrifice to this difeafe. -----Infection. OF CONSUMPTIONS. 123 ■----Infection. Confumptions are often caught by fleeping with the difeafed ; for which reafon this fhould be carefully avoided. It cannot be of great benefit to the fick, and muft hurt thofe in health. 1---- Occupations in life. Thofe artificers who fit much, and areconftantly leaning forward, or preifing upon their ftomachs and breafts, as cutlers, taylors, fhoemakers, Ufe often die of confumptions. ■----■ Cold. More confumptive patients date their dif- orders from wet feet, damp beds, night air, wet cloaths, and Juch like, than from all other caufes. Sharp, faline, and aromatic aliments, which heat and inflame the blood, arc likewife frequently the caufe of con- fumptions. We fhall only add, that this difeafe is often owing to an hereditary taint; in which cafe, it is generally incurable. SYMPTOMS.---This difeafe generally begins with a dry cough, which often continues for fome months. If a difpofition to vomit after eating be excited by it, there is great reafon to fear an approaching confumption. The patient complains of a more than ufual degree of heat, a pain and oppreffion of the breaft, efpecially after motion ; his fpittle is of a faltifh tafte, and fometimes mixed with blood. ,He is apt to be fad ; his appetite is bad, and his thirft great- There is generally a fenfe of weight on the breaft, with a quick, foft, fmall pulfe; though fometimes the pulfe is pret- ty full, and rather hard. Thefe are the common fymptoms of a beginning confumption. Afterwards the patient begins to fpita greenifh, white, or bloody matter. His body is extenuated by the heaic fever and colliquative fweats, which mutually fucceed one another, viz. the one towards the night, and the other in the morning. A loofenefs, and exceffive difcharge of urine, are often troublefome fymptoms at this time, and greatly weaken the patient. There is a burning heat in the palms of the hands, and the face generally fluihcs after eating ; the fingers become remarkably fmall, the nails are bent invw.ru>, and the hairs fall off. At laft, the fwelling of the feet and legs, the total lofs of ftrength, the finking of the eyes, the difficulty of fwallow- ing, and the coldnefs of the extremities, fhow the immedi- ate approach of death, which, however, the patient feldom believes to be fo near. Such is the ufual progrefs of this » Q_ 2 fatal 124 O F C O N S U M P T I O N S. fatal difeafe, which, if not early checked, commonly fets all medicine at defiance. REGIMEN.-----On the firft appearance of this difeafe, if the patient lives in a large town, or any place where the air is confined, he ought immediately to quit it, and to make choice of a fituation in the country, where the air is pure, tlryiand free. Here he muft not remain inac- tive, but take every day as much exercife as he can bear. The beft method of taking exercife is to ride on horfe- back, as this gives the body a great deal of motion without much fatigue. Such as cannot bear this kind of exercife, muft make ufe of a machine. A long journey, as it amufes the mind by a continual change of objeas, is greatly pre- ferable to riding the fame ground over and over. Care, however, muft be taken to avoid catching cold from wet cloaths, damp beds, or fuch like. At any rate, the patient muft ride ; his life depends upon it; and it is aliru.ii an in- fallible remedy, if begun in time, and duly perfifted in. It is pity thofe who attend the fick feldom recommend riding in this difeafe, till the patient is either unaLie to bear it, or the malady is become incurable. Patients are always apt to trifle with every thing that is in their own power. They cannot fee how one of the common aaions of life fhould prove a remedy in an obftinate difeafe, and therefore they rejea it, while they greedily hunt after relief from me- dicine, merely becaufe it is unknown. Those who have ftrength and courage to undertake a pretty long voyage, may expea great advantage from it. This has frequently cured a confumption after the patient was thought to be in the laft ftage of that difeafe, and where medicine had proved ineffeaual. It is reafonable from hence to conclude, that if a voyage were undertaken in due time, it would feldom fail to perform a cure. Such as try this method of cure, ought to carry as much frefh provifions along with them as will ferve for the whole time they are at fea. As milk is not to be obtained in this fituation, they ought to live upon fruits and the broth of chickens, or other young animals which can be kept alive onboard. It is fcarce n.-celTary to add, that fuch voyages fhould be undertaken, if poffible, in the mildeft feafon, and that they ought to be towards a warmer climate. Those wno have not courage for a long voyage may travel into a more fouthern climate, as the fouth of France, Spain, or Portugal; and if they find the air of thefe countries agree OF CONSUMPTIONS. 125 agree with them, they fhould continue there, at leaft til* their health be confirmed. Next to proper air and exercife, we would recommend a dueattentionto the diet.The patient muft eat nothing that is either heating or hard of digeftion, and his drink muft be of a foft and cooling nature. All the diet muft be calculat- ed to leffen the acrimony of the humours, and abate the rapid motion of the blood. For this purpofe the patient muft keep ftriaiy to the ufe.of vegetables and milk. Milk, alone, is of more value in this difeafe, than the whole ma- teria medica. Asses milk is generally reckoned preferable to any other ; but it cannot always be obtained ; befides, it is generally taken as a medicine, whereas, to produce any confiderable effeas, it ought, in a manner, to make the principal part of the patient's food. It is hardly to be expeaed, that a gill or two of affes milk, drank in the fpace of twenty-four hours, fhould be able to produce any confiderable change in the humours in a fhort time ; but when people do not per- ceive its effeas foon, they lofe hope, and fo leave it off. Hence it comes to pafs, that this medicine, however valua- ble, very feldom performs a cure. The reafon is obvious; it is commonly ufed too late, is taken in too fmall quanti- ties, and is not duly perfifted in. I have known very extraordinary effeas from affes milk in obftinate coughs, which threatened a confumption of the lungs ; and do verily believe, if ufed at this period, that it would feldom fail; but if it be delayed till an ulcer is formed, which is generally the cafe, how can it be expea- ed to fucceed ? Asses milk ought to be drank, if poffible, in its natural warmth, and in the quantity of half an Englifh pint at a time. Inftead of taking this quantity night and morning only, the patient ought to take it four times, or, at leaft, thrice a-day, and to eat a little light bread along with it, fo as to make it a kind of meal. If affes milk fhould happen to purge'the patient, it may be mixed with old conferve of rofes, which is itfelf a valu- able medicine in this difeafe. If that cannot be obtained, the powder of crabs claws may be ufed in its ftead. Affes milk is ufually ordered to be drank warm in bed ; but as it generally throws the patient into a fweat, when taken in this way, it would be proper to give it after he rifes. Some 126 OF CONSUMPTIONS. Some extraordinary cures in confumptive cafes have been performed by breaft milk. Could this be obtained in fufficient quantity, we would recommend it preferable to any other. It is better if the patient can fuck it from the breaft than todrink it afterwards, i knew a man who was reduced to fuch a degree of weaknefs in a confumption, as not to be able to turn himfelf in bed. His wife was that time giving fuck, and the child happening to die, he fucked her breafts, not with a view to reap any advantage from the milk, but to make her eafy. Finding himfelf however greatly bene- fited by it, he continued to fuck her till perfe&ly recovered, and is at prefent a ftrong and healthy "man. Some prefer butter-milk to any other, and it certainly is a very valuable medicine, if the ftomach be able to bear it. It does not agree with every perfon at firft ; and is there- fore often laid afide# without a fufficient trial. It fhould at firft be taken fparingly, and the quantity gradually increaf- ed, until it comes to' be almoft the foie food. I never knew it fucceed, unlefs where the patient almoft entirely lived upon it. Cows milk is moft readily obtained of any ; and tho' it be hot fo eafily digefted as that of afles or mares, it. may be rendered lighter, by adding to it an equal quantity of barley water, or allowing it to "fland for fome hours, and afterwards taking off the cream. If it fhould, notwith- ftanding, lie heavy on the ftomach, a table fpoonful of rum or brandy, and a bit of loaf-fugar, may be put into half an Englifh pint. It is not to be wondered, that milk fhould, for fome time, difagree with a ftomach that has not been accuftomed to digeft any thing but flefh and ftrong liquors, which is the cafe of moft of thofe who fall into confumptions. We do not, however, advife thofe who have been accuftomed to animal food and ftrong liquors, to leave them off all at once. Thismight be dangerous. It will be neceflary for fuch to eat a little once a-day of the flefh of fome young animal, or rather to ufe the broth made of chickens, veal, lamb, or fuch like. I hey ought likewife to drink a little wine made into negas, or diluted with twice or thrice its quan- tity of water, and to make it gradually weaker till they can leave it off altogether. These muft be ufed only as preparatives to a diet con- fifting folely lit milk and vegetables, which the fooner the patient can be brought to bear, the better. Rice and milk, or OF CONSUMPTIONS. 127 or barley and milk boiled, with a little fugar, is very pro- per food. Ripe fruits, roafted, baked, or boiled, are like- wife proper; as goofe or currant-berry tarts, apples roafted, or boiled in milk, Ufe The jellies, conferves, and prc- ferves, Ufe of ripe fubacid fruits, ought to be eat plenti- fully, as the jelly of currants, conferve of rofes, preferved plumbs, cherries, Ufe Wholesome air, proper exercife, and a diet confifting folely of thefe and other vegetables, with milk, is the only ■ courfe that can be depended on in the beginning of a con- fumption. If the patient has ftrength and fufficient refolu- tion to perfift in this courfe, he will feldom be difappointed of a cure. In a populous town in England, where confumptions . are very common, I have frequently feen confumptive pa-' tients, who had been fent to the country with orders to ride, and live upon milk and vegetables, return in a few months quite plump, and free of any complaint. This, in- deed, was not always the cafe, efpecially when the difeafe was hereditary, or far advanced ; but it was the only me- thod in which fuccefs was to be expeaed ; where it failed, I never knew medicine fucceed. If the patient's ftrength and fpirits flag, he muft be fup- ported by rich broths, jellies, Ufe Some recommend fhell-fifh in this diforder, and we are inclined to think with reafon ; they are very nourifhing, at the fame time that they cool the blood, ami blunt the acrimony of the hu- mours. All the food and drink ought to be taken in fmall quantities, left an overcharge of frefh chyle fhould opprefs the lungs, and too much accelerate the circulation of the blood. The patient's mind ought to be kept as e'afy and chear- ful as poffible. Confumptions are often occafioned by a melancholy caft of mind ; for which reafon, rnufic, cheer- ful company, and every thing that infpires mirth, are high- ly beneficial. The patient ought feldom to be left alone, as brooding over his calamities is fure to render them work. M E D I C I N E.-----Though we know no medi- cine that will cure a confirmed confumption ; yet the fol- lowing things may be of krvice, in abating fome of the more violent fymptoms. In the firft ikge of a confumption, the cough may fome- times be appeafcd by blccdmg ; and expeaorauon promoted by 128 OF CONSUMPTIONS. by the following medicines. Take frefh fquills, gum am- moniac, and powdered cardamum feeds, of each a quarter of an ounce ; beat them together in a mortar, and if the mafs proves too hard for pills, a little of any kind of fyrup may be added to it. This may be formed into pills of a moderate fize, and four or five of them taken twice or thrice a-day, according as the patient's ftomach will bear them. The lac ammoniacum, or milk of gum ammoniac, as it is called, is likewife a proper medicine in this ftage of. the dif- eafe. It may be prepared and ufed, as direaedpage 117. A fyrup made of equal parts of lemon juice, fine honey, and fugar-candy, may likewife be ufed. Four ounces of each of thefe may be fimmered together in a fauce-pan, over a flow fire, and a table fpoonful of it taken at any time when the cough is troublefome. It is common, in this ftage of the difeafe, to load the patient's ftomach with balfamic medicines, and at the fame time, to drench him with decoaions, infufions, Ufe of the peaoral vegetables. The former of thefe, inftead of re- moving the caufe of the difeafe, tend rather to increafe it, by heating the blood, while the latter pall the appetite, relax the folids, and prove every way hurtful to the pati- ent. Whatever is ufed for removing the cough, befides, riding, and other proper regimen, ought to be medicines of a fharp and cleanfing nature. For the patient's drink, we would recommend infufions of the bitter plants, as ground-ivy, the leffer centaury, camomile flowers, or water trefoil. Thefe infufions may be drank at pkafure. They ftrengthen the ftomach, pro- mote digeftion, reaify the,blood, and at the fame time an- fwerall the purpofes of dilution, and quench thirft much better than things that are lufcious or fweet. But if the patient fpits blood, he ought to ufe the fol- lowing decoaion for his ordinary drink. Take an ounce of comfrey root, of liquorice and marfh-mallow roots, each half an ounce. Boil them in two Englifh quarts of water to one. If a tea fpoonful of the acid elixir of vitriol be add- ed to this decoaion, when cold, it will be a very proper medicine. A tea cupful of it may be taken at pkafure. There are many other mucilaginous plants and feeds, of a healing and agglutinating nature, from which decoai- ons or infufions may be prepared with the fame intention ; as the orches, the quince feed, coltsfoot, linfeed, farfaparilla, Ufe It is not r.eceffiry to mention the different forms in which OF CONSUMPTIONS. i2<5 which thefe may be ufed. Simple infufion, or boiling, is all that is neceflary, and the dofe may be at difcretion. The conferveof rofes is here peculiarly proper. It may either be put into the decoaion above prefcribed, or eat by itfelf. No benefit is to be expeaed from trifling dofes of this medicine. I never knew it of any fervice, unlefs where three or four ounces at leaft were ufed daily. In this way I have feen it produce very extraordinary effeas, and would recommend it wherever there is a dikharge of blood fioni the lungs. When the fpitting up of grofs matter, oppreffion of the bi'jjft, and the heaic fymptoms fnow that an impofthume is formed in the lungs, we would recommend the Jefuits bark, that being the only drug which has any chance to counteraa the tendency which the humours then have to putrefaaion. An ounce of the bark, in powder, may be divided into eighteen or twenty dofes, of which one may betaken eveiy three hours through the day, in a little fyrup, or %cup of the patient's ordinary drink. If the bark fhould happen to purge, it may be made into an ekauary, with the conferve of rotes : thus ; t:.ke old conferve of rofes, a quarter of a pound ; Jefuits br.rk, in powder, an ounce ; fyrup of orange, or lemon, as much as will make it of the confiftence of honey. This quanti- ty will ferve the patient four or five days, and may be re- peated as there is occafion. Such as cannot take the bark in fubftance, may infufe it in cold water. This feems to be the beft medium for ex- traaing the virtues of that drug. Half an ounce t.f bark, in powder, may be infufed Or twenty-four hours in half an Englifh pint of water. Afterwards let it be palled through a fine ftrainer, and an ordinary tea cupful of it taken three or four times a-day. We would not recommend the bark while there are any fymptoms of an inflammation of the bre.ifi ; but when it is certainly known, that m.-tter is colkaing there, it is the only medicine upon which anyftrels can be laid. Few pa- tients have resolution enough to give the bark a fair trial, at this period of" rhe difeafe • orh-rv.OO, ws have reafon to believe, that great benefit might be reaped from it. When it is evident, that there is an impofthume in the breaft, and the matter can neither be fpit up, nor carried off by abforption, the patient muft endeavour to make it 1 R break 130 OF CONSUMPTIONS. break inwardly, by drawing in the fleams of warm water or vinegar with his breath, coughing, laughing, or* bawl- ing aloud, Ufe. When it happens to burft within the lungs, the matter may be difcharged by the mouth. Sometimes, indeed, the burfting of the vomica, occafions immediate death, by fuffocating the patient. When the quantity of matter is great, and the patient's ftrength exhaufted, this is apt to happen. At any rate, the patient is ready to fall into a fwoon, and fhould have volatile fpirits, or falts, held to the nofe. If the matter difcharged be thick, and the cough, and breathing, become eafier, there may be fome hopes of a cure. The diet, at this time, ought to be light, but re- ftorative ; as, fmall chicken broths, fago gruel, rice-milk, Ufe The drink, butter-milk, or whey, fweetened with honey. This is likewife a proper time for ufing the Jefuits bark, which may be taken as before diredled. If the vomica, or impofthume, fhould Ififcharge itfelf into tbje cavity of the breaft, betwixt the pleura and the lungs, there is no way of getting the matter out, but by an incifion, as has already been obferved. As this opera- tion muft always be performed bv a furgeon, it is not ne- ceflary for us to defcribe it. We fhall only obferve, that it is not fo dreadful as people aie apt to imagine, and that it is the only chance the patient has for his life. It is, indeed, a pity that this operation, like moft others, is ge- nerally delayed till too late. When the whole mafs of hu- mours is tainted, the body wafted, and the ftrength decay- ed, it is in vain to attempt to fave the patient's life by an operation. A N E R V O U S C O N S U M P T I O N, is a wafting, or decay of the whole body, without any confi- derable degree of a fever, cough, or difficulty of breathing. It is attended with indigeflion, weaknefs, and want of ap- petite Ufe Those who are of a fretful temper, who indulge in fpi- rituous liquors, or who breathe an unwholefome air, are moft liable to this difeafe. # We would chiefly recommend, for the cure of a ner- vous confumption, a light and nourifhing diet ; enough of exercife, in a free open air ; and the ufe of fuch bitters, as brace and ftrengthen the ftomach ; as, the jefuits hark, gentian OF CONSUMPTIONS. 131 gentian root, camomile, Ufe Thefe may be infufed in wine, and a glafs of it drank frequently. It will greatly affift the digeftion, and promote the cure of this difeafe, to take, twice a-day, twenty or thirty drops of the elixir of vitriol in a glafs of wine or water. The chalybeate wine is likewife an exfcellent medicine in this cafe. It ftrengthens the folids, and poweifully af- fifts nature in the preparation of good blood. It is made by putting three ounces of the filings offteel, or iron, into a bottle of Rhenifh wine, and allowing it to digeft for three weeks, frequently fhaking the bottle. Afterwards the. wine muft be filtered for ufe. A table fpoonful of it may be taken twice or thrice a-day. Agreeable amufements, cheerful company, and riding about, are, however, preferable to all medicines in this dif- eafe. For this reafon, when the patient can afford it, we would recommend a long journey of pkafure, as the moft likely means to reftore his health. What is called a fymptomatic confumption cannot be cured without firft removing the difeafe by which it is oc- cafioned. Thus, when a confumption proceeds from the fcrophula, or king's evil, from the fcurvy, the afthma, the venereal difeafe, Ufe. a due attention muft be paid to the malady from whence it arifes, and the regimen and medicine directed accordingly. When exceffive evacuations, of any kind, occafion a confumption, they muft not only be reftrained ; but the pa- tient's ftrength muft be reftored by gentle exercife, nou- rifhing diet, and generous cordials, Ufe. Young and de- licate mothers, often fall into confumptions, by giving fuck too long. As foon as they perceive their ftrength and ap- petite begin to fail, they ought immediately to wean the child, or give it to another nurfe, otherwife they cannot ex- pea a cure. Before quitting this fubjea, we would earneftly recom- mend it to all who wifh to avoid confumptions, to take as much exercife without doois as they can ; to avoid un- wholefome air, and to ftudy fobriety. Confumptions owe their prefent increafe not a'littk to the fafhionabk mode of fpending every evening over a punch-bowl, or a bottle of wine. Thefe' liquors not only fpoil the appetite, and hurt the digeftion, but heat and inflame the blood, and fet the whole conftitution on fire. R 2 The, 132 THE NERVOUS FEVER. The SLOW or'.NERVOUS FEVER. Nervous fevers have increafed greatly of late years in this iiland, owing, doubtlefs, to the increafe of luxury and fedentary employments; as this difeafe commonly attacks perfons of a weak relaxed-habit, who negledi exercife, eat littleYolid food, ftudy hard, or indulge in fpirituous liquors. CAUSE S.----Nervous fevers are occafioned by what- ever dcpreffes the fpirits, or impoverifb.es the blood ; as grief, fear and anxiet,, want of fleep, intenfe thought; firing on poor watery diet, as unripe fruits, cucumbers, melons, mufhrooms, Ufe. They are likewife occafioned by damp, confined, or unwholefome air. Hence they are very common in rainy feafons, and prove moft fatal to thofe who live in dirty, low houfes, crowded ftreets, hofpitals, jails, or fuch like places. Persons whofe conftitutions have been broken by ex- ceffive venery, frequent falivations, too free an ufe of pur- gative medicines, or the like, are very liable to this difeafe. Keeping on wet cloaths, fleeping in the fun, lying on the damp ground, exceflive fatigue, and whatever obftruas the perfpiration, or caufes a fpafmodic ftriaure of the fo- lids, may likewife occafion nervous fevers. We fhall only add, frequent and great irregularities in eating and drinking. Too great abftinence, as well as excefs, is hurtful. Nothing tends fo much to preferve the humours in a found ftate as a regular diet ; nor can any thing contribute, more to occa- fion fevers of the worfl kind than its contrary. .SY.MPTOMS.----Low fpirits, want of appetite, weaknefs, wearinefs after motion, watchfulnefs, deep figh- ing, and dejeaion of mind, are generally the forerunners of this difeafe. Thefe are fucceeded by a quick low pulfe, a dry tongue, without any confiderable thirft, chillnefs and flufhing in turns, Ufe After fome time, the patient complains of a giddinefs and pain of his head, has a naufea, with reachino-s and vo- miting ; his pulfe is quick, andt fometimes intermitting ; his urine pale, refernbling dead'fmall bear, and his breath- ing is difficult, with oppreffion of the breaft, and flight alie- nations of mind. If towards the ninth, tenth, or twelfth day, the tongue becomes more moift, with a plentiful fpitting, a ^entlc diarrhoea, or a moifture upon the fkin ; or if a fuppuration happens in' one or both ears, or large piiftulcs break out .about THE NERVOUS FEVER. 133 about the lips and rwfe, there is reafon to hope for a favour- able crifis. But, if there bean exceffive loofenefs, or wafting fweats, with frequent fainting fits ; if the tongue, when put out, trembles exceflively, and the extremities feel cold, with a fluttering or flow creeping pulfe; if there be a ftarting of the tendons, an almoft total tefs of fight and hearing, and an involuntary difcharge by ftool and urine, there is great reafon to fear that death is approaching. REGIME N.----It is highly neceflary in this difeafe to keep the patient eafy and quiet. The leaft motion will fatigue him, and will be apt to occafion wearinefs, and even faintings. His mind likewife ought not only to be kept eafy, but^foothed and comforted with^the hopes of a fpeedy reepvery. Nothing is more hurtful in low fevers of this kind, than prefenting to the patient's mind gloomy or- frightful ideas. Thefe often occafion nervous fevers, and it is not to be doubted but they will likewife increafe the danger. The patient muft not be kept too low. His ftrength and fpirits ought to be fupported by nourifhing diet and ge- nerous cordials. P'or this purpofe, his gruels, panadas, or whatever food he takes, muft be ftrengthened with wine, according as the fymptoms may require. Pretty ftrong wine-whey, or fmall negas fharpened with the juice of orange or lemon, will be proper for his drink. Wine, in this difeafe, if it could be obtained genuine, would be almoft the only medicine that we fhould need. Good wine poffeffes all the virtues of the cordial medicines, while it is free from many of their bad qualities. I fay, good wine ; for, however common that article of luxury is now become, it is rarely to be obtained genuine, efpecially by the poor, or fuch as purchafe it in fmall quantities. I have feen a patient in a low nervous fever, whofe pulfe could hardly be felt, with a conftant delirium, coldnefs of the extremities, and almoft every other mortal fymptom, recover by ufing, in whey, gruel, and negas, a bottle of ftrong wine every day. Good wine is not only, the moft proper cordial, but feems alfo to be an excellent antifpaf- modic medicine ; and confequently it muft be highly pro- per in all difeafes arifini.'; from a poor vapid ftate of the blood, and too great a itriaure of the folids. Mustard whey is a very proper drink in this fever. It is made by tying in a linen r.;g a table ipoo:ftul of common muftani 134 THE NERVOUS FEVER. muftard bruifed, and boiling it a little in half an Englifh pint of water, with an equal quantity of milk. Two or three fpoonfuls of wine may be added to it when boiling, to make the curd feparate more perfeaiy, and to render the whey more cordial. A tea cupful of this may be given fre- quently for the patient's ordinary drink. In a word, the great aim In this difeafe is to fupport the patient's fpirits, by giving him frequently fmall quantities of the above, or other drinks of a warm and cordial nature. He is not, however, to be over-heated either with liquor or cloaths ; and his food ought to be light, and given in fmall quantities. M E D ICIN E.----Where a naufea, load, and fick- nefs at ftomach prevail at the beginning of the feyer, it will be neceflary to give the patient a gentle vomit. Fifteen or twenty grains of ipecacuanha will generally anfwer this purpofe very well. This may be repeated any time before the third or fourth day, if the above fymptoms continue. Vomits not only clean the ftomach, but, by the general (hock which they give, promote the perfpiration, and have many other excellent effeas in flow fevers, where there are no figns of inflammation, and nature wants roufing. Such as dare not venture upon a vomit, may clean the bowels by a fmall dofe of Turkey rhubarb, or an infufion of fenna and manna. » In all fevers, the great point is to regulate the fymptoms, fo as to prevent their going to either extreme. Thus, in fevers of the inflammatory kind, where the force of the cir- culation is too great, or the blood denfe, and the fibres too rigid, bleeding and other evacuations are neceflary. But where nature flags, where the blood is vapid and poor, and and the folids weak and relaxed, there the lancet is to be avoided. Hence, bleeding is never to be permitted in ner- vous fevers unlefs there be evident figns of an inflammation, which very feldoms happens. It is the more neceflary to caution people againft bleed- ing in this difeafe, as there is generally, at the beginning, an univerfal ftriaure upon the veffels, which even to the pa- tient himfelf often gives the idea of a plethora, or too great a quantity of blood. I have known fome of the profeflion deceived by their own feelings in this refpea, fo far as to infill upon being bled, v»hcn it was evident that the opera- tion was improper. I lemember THE NERVOUS FEVER. 135 I remember to have attended an apothecary in a nervous fever, who, at the beginning, was fo fully perfuaded of the exiftcnce of a plethora, and the neceffity of bleeding, that when I objeaed to it, he told me he was fo certain of the neceffity of that operation from his own feelings, that if it was not performed he could not live ; and that if no body elfe would bleed him, he was determined to do it himfelf. He was accordingly bled, but was foon convinced of his error. The blood fhewedno figns of inflammation, and he was fo remarkably worfe after the operation, that he nar- rowly efcaped with his life. His pulfe and fpirits funk ex- ceedingly, fo that he could hardly be fupported by a bottle of ftrong wine in the day, befides other cordial medicines. Tho' bleeding be improper in this difeafe, yet bliflering is highly neceflary. Bliflering plafters may be applied at all times of the fever with great advantage ; we would, how- ever, advife people not to make too free with them at the beginning, left there fhould be more occafion for them after- wards, if the patient be delirious, he ought to be bliftered on the neck, and it will be the fafeft courfe, while the fever continues ; as foon as the difcharge occafioned by one plafter abates, to apply another fome where elfe, and by that means keep up a continual fucceffion of them till the patient be out of danger. I have been more fenfible of the advantage of bliflering in this difeafe, than of any other medicine. It not only pro- motes the circulation by ftimulating tjae folids, but likewife occafions a continual difcharge, which may, in f imc mea- fure, fupply the want of critical evacuations, which feldom happen in this kind of fever. If the patient be coftive through the courfe of the difeafe, |t will be neceflary to procure a.flool, by giving him every other ,day a clyfter of milk and water, wich a little fugar, to which may be added a fpoonful of common fait, if it be ne- ceflary. Should a violent loofenefs come on, it mar be checked, bv giving the patient frequently a fmall quantity of Venice treacle, or any thing that will promote the perfpiration. Tho' bliflering and cordial liquors are the only medi- r ines to be depended on in this kind of fever, yet, for thofe who may choofeto ufe them, we fhall mention one or two of the forms of medicine which are commonly prefcribed in it. Thus, when the patient is low, ten grains of Virginian fnakeroot, and the fame quantity of contrayerva root, with five 136 THE PUTRID OR SPOTTED FEVER. five grains of Ruffian caftor, all in fine powder, may be madeintoa bolus, with a little of the cordial contcifion or lyrup of fa'ffron. One of thefe may be taken every four or five hours. The following powder may be ufed for the fame inten- tion. Take wild Valerian root, in powder, one fcruple ; faffum and caftor, each four grains. Mix thefe by rubbing them together in a mortar, and give it in a cup of wine wney three or four times a-day. . In defperate cafes, where the hiccup and ftarting of the tendons have already come on, we have fometimes feen ex- traordinary effeas from large dofes of mufk frequently ex- hibited. This is doubtlefs a great antifpafmodic, and may be given to the quantity of a fcruple three or four times 2-day. Sometimes, it may be proper to add to the mufk a few grains of camphire, and fait of hartfhorn, as thefe tenJ to promote perfpiration aird urine. Thus, fifteen grains of mufk, with three grains of camphire, and fix grains of fait of hartfhorn, may be made into a dofe and given as above. If the fever fhould happen to intermit, which it frequent- ly does towards .the decline, or if the patient's ftrength fhould bewailed with colliquative fweats, it will be neceffa*- ry to give him an infufion of the Jefuits bark, with fnake- root, in wine or brandy. Half an ounce of the bark, with a dram of Virginian fnakeroot, half a dram of faffron, and half an ounce of orange-peel, ail grofsly powdered, may be infufed in half an Englifh pint of brandy for three or four days. Afterwards ftrain it, and give the patient two tea fpoonfuls in a glafs of water, or fmall wine, three or four times a-day. Such as don't choofe fpirits, may infufe the above ingre- dients in a bottle of Lifbon wine, and take a glafs of it fre- quently ; this will reftore the ftrength, prevent a relapfe, and help to carry off the remains of the fever. It will likewife be proper, at this time, to interpofe now and then a gentle dofe of rhubarb, or fome other mild open- ing medicine, taking care, at the fame time, to fupport the patient's ftrength with chicken-broth, jellies, and fuch like. Or the MALIGNANT, PUTRID, or SPOTTED FEVER. This may be called the fejlilential fever of Europe, as in many of its fymptoms it bears a great refemblance to that dreadful difeafe. Persons THE PUTRID OR SPOTTED FEVER. 137 Persons of a lax habit, a melancholy difpofition, and thofe whofe vigour has been wafted by long fafting, watch- ing, hard labour, exceffive venery, or frequent falivations, Ufe. are moft liable to this difeafe. CAUSES.----This fever is occafioned by an un- wholefome, putrid, or ftagnating air. Hence it prevails in jails, hofpitals and infirmaries, efpecially where fuch places are greatly crowded, and cleanlinefs is negkaed. A clofe conftitution of the air, with long rainy or foggy weather, likewife occafions putrid fevers. Hence they often fucceed great inundations in low and marfhy countries, efpe- cially when thefe are preceded or followed by a hot andful- try feafon. Living too much upon animal food, without a proper mixture of vegetables, or eating fifh or flefh that has been kept too long, are likewife apt to occafion this kind of fe- ver. Hence, failors on long voyages, and the inhabitants of befieged cities, are very often vifited with putrid fevers. Corn that has been greatly damaged by rainy feafons, or long keeping, and water that has become putrid by flagna- tion, will likewife occafion putrid fevers. The exceffive ufe of alkaline falts will alfo have this effea. Dead carcafes tainting the air, efpecially in hot feafons, are very apt to occafion putrid fevers. Hence this kind of fever often prevails in camps, and fuch countries as are the fcenes of war and bloodfhed. This fhews the neceffity of removing church-yards, flaughter-houfes, Ufe at a proper diftance from great towns. Want of cleanlinefs is a very general caufe of putrid fe- vers. Hence they prevail amongft the poor inhabitants of large towns, who breathe a confined, unwholefome air, ne- gka cleanlinefs, and are forced to live upon fpoiled or un- wholefome provifions, Ufe Such mechanics as carry on dirty employments, and are conftantly confined within doors, are likewife very liable to putrid fevers. We fhall only add, that all putrid, malignant, or fpotted fevers, are very infeaious ; and are, therefore, often com- municated in this way. For which reafon, all perfons ought to keep at a diftance from fuch as are affeaed with thefe dif- eafes, unlefs thofe whofe attendance is abfolutcly neceflary. SYMPTOM S.----The malignant fever is generally preceded by a remarkable weaknefs, or lofs of ftrength, without any apparent caufe. This is fometimes fo great, S that 138 THE PUTRID OR SPOTTED FEVER. that the patient can fcarce walk, or even fit upright, with- out being in danger of fainting away. His mind too is greatly dejeaed j he fighs, and is full of dreadful appre- henfions. There is a naufea, and fometimes vomiting of bile j a violent pain of the head, with a ftrong pulfation, or throbbing of the temporal arteries ; the eyes often appear red and inflamed, with a pain at the bottom of the orbit; there is a noife in the ears, the breathing is laborious, and often interrupted with a figh ; the patient complains of a pain about the region of the ftomach, and in his back and loins ; hi tongue is at firft white, but afterwards it appears black and chapped ; and his teeth are covered with a black cruft. He fometimes paffes worms both upwards and downwards, is affeaed with tremors, or fhaking, and often becomes delirious. If blood be let, it appears diflblved, or with a very fmall degree of cohefion, and foon becomes putrid ; the ftools fmell extremely foetid, and are fometimes of a greenifh, black, or reddifh caft. Spots of a pale, purple, tdun, or black colour, often appear upon the fkin, and fometimes violent haemorrhages, or difcharges of blood from the mouth, eyes, riofe, Ufe. happen. Putrid fevers may be diftinguifhed from the inflamma- tory, by the fmallnefs of the pulfe, the dejeaion of mind, the diflblved ftate of the blood, the petechia;, or purple fpots, and the putrid fmell of the excrements. They may likewife be diftinguifhed from the low or nervous fever, by the heat and thirft being greater, the urine of a higher co- lour, and the other fymptoms more violent. It fometimes, however, happens, that the inflamma- tory, nervous, and putrid fymptoms, are fo blended toge- ther, as to render it very difficult to determine to Which clafs the fever belongs. In this cafe, the greateft caution and fkill are requifite. All endeavours muft be ufed to re- lieve the moft urgent fymptoms ; and the efforts of nature are carefully to be watched, in order that we may give her what afliftance we can in expelling the caufe of the difeafe in her own way. Inflammatory and nervous fevers are often converted into malignant and putrid, by too hot a regimen, or im- proper medicines. The period of putrid fevers is extremely uncertain ; fometimes they terminate betwixt the feventh and fourteenth day, THE PUTRID OR SPOTTED FEVER. 139 day, and at other times, they are prolonged for five or fix weeks. Their duration depends greatly upon the conftitution of the patient, and the manner of treating the difeafe. The moft favourable fymptoms are, after the fourth or fifth day, a gentle loofenefs, with a warm, mild fweat. Thefe, when continued for a confiderable time, often carry off the fpver, and fhould never be imprudently flopped. Small miliary puftules appearing between the petechiae, or purple fpots, are likewife favourable ; as alfo, hot fcabby eruptions about the mouth and nofe. It is a good fign when the pulfe rifes upon the ufe of wine, or other cordi- als, and the nervous fymptoms abate ; deafnefs coming on towards the decline of the fever, is likewife a favourable fymptom, and fo are abfceffes in the groin, or parotid glands. Amongst the unfavourable fymptoms may be reckoned an exceffive loofenefs, with a hard fwelled belly. Large black or livid blotches breaking out upon the fkin, are a proof of the putrid diffolution of the blood, and fhew the danger to be very great. Aphthae in the mouth, and cold clammy fweats, are unfavourable figns; as alfo, blindnefs, change of the voice, a wild flaring of the eyes, difficulty of fwallowing, an inability to put out the tongue, and a conftant inclination to uncover the breaft. When the fweat and faliva are tinged with blood, and the urine is black, or depofites a black, footy fedjment, the patient is in great danger. Starting of the tendons, and foetid, ichorous, involuntary ftools, attended with coldnefs of the extremities, are generally the forerunners of death. REGIME N.—----In the management of this difeafe, we are to endeavour, as far as poffible, to counter- aa the putrid tendency of the humours ; to fupport the pa- tient's ftrength and fpirits ; and to affift nature in expelling the morbific matter, by gently promoting perfpiration and the other evacuations. It has been obferved, that putrid fevers are often'occafi- oned by unwholefome air, and, of courfe, they muft be aggravated by it. Care muft, therefore, be taken to prevent the air from ftagnating in the patient's chamber, to keep it cool, and renew it frequently, by opening the doors or windows of fome adjacent apartment. The breath and perfpiration of perfons in perfea health, foon render the air of a fmall apartment noxious ; but this will fooner S 2 happen 140 THE PUTRID OR SPOTTED FEVER. happen from the perfpiration and breath of a perfon whofe whole mafs of humours are in a putrid ftate. Thefe fevers are often fo heightened by the fame infixed air being breathed over and over, that the patient is, in a manner, fuffocated by his own atmofphere. Besides the frequent admiffion of frefh air, we would recommend the ufe of vinegar, verjuice, juice of lemon, Sevil orange, or any kind of vegetable acid that can be moft rea- dily obtained. Thefe ought frequently to be fprinkled up- on the floor, the bed, and every part of the room. They may alfo be evaporated with an hot iron, or by boiling, Ufe. The frefh fkins of lemons or oranges ought likewife to be laid in different parts of the room, and they fhould be fre- quently held to the patient's nofe. The ufe of acids in this manner would not only prove very refrefhing to the patient, but would tend greatly to prevent the infeaion from fpreading among thofe who attend him. Strong fmelled herbs, as rue, tanfy, rofemary, wormwood, Ufe may likewife be laid in different parts of the houfe, and fmelled by thofe who go near the patient. The patient muft not only be kept cool, but likewife quiet and eafy. The leaft noife will affea his head, and the fmalleft fatigue will be apt to make him faint away. Nothing is of fo great importance in this difeafe, as the liberal ufe of acids. Thefe are to be mixed with all the patient's food, as well as drink. Orange, lemon, or vinegar whey, are all very proper, and maybe drank in turns, according to the patient's inclination. Thefe may be ren- dered cordial, by the addition of wine, in fuch quantity as the patient's ftrength feems to require. When he is very low, he may drink negas, with only one half water, and fharpened with the juice of orange or lemon, in fome cafes, a glafs of clear wine may now and then be allowed. The raoft proper wine is Rhenifh ; but if the belly be open, red Port, or claret, is to be p'referred. When the belly is bound, a tea fpoonful of the cream of tartar may be put into a cup of the patient's drink, as there is occafion ; or he may eat a few tamrinds, which will both quench his thirft, and keep his belly eafy. If camomile tea will fit upon the ftomach, it is a very proper drink in this difeafe. It may be fharpened by add- ing to every cup of the tea fifteen or twenty drops of the elixir of vitriol. The THE PUTRID OR SPOTTED FEVER. 141 The food muft be light, as panada, groat-gruel, and fuch like ; to thefe a little wine may be added, if the patient be weak and low, and they ought all to be fharpened with the juice of orange, or the jelly of currants, rafpberries, Ufe. The patient ought likewife to eat freely of ripe fruits, either baked, roafted, or raw, as roafted apples, currant, or goofe- berry tarts, preferved cherries, plumbs, and fuch like. The patient muft never be long without nouriftiment. Taking a little food or drink frequently, not only fupports the fpirits, but counteraas the putrid tendency of the hu- mours ; for which reafon, he ought conftantly to be flipping fmall quantities of fome of the acid liquors mentioned above, or any that may be more agreeable to his palate, or more readily obtained. If the patient be delirious, his feet and hands ought to be frequently fomented with ftrong infufions of camomile floweis. This, or an infufion of the bark, to fuch as can afford it, cannot fail to have a good effea. Fomentations of this kind not only relieve the head, by relaxing the vef- fels in the extremities, but as their contents are abforbed, and taken into the blood, they muft, by their antifeptic qualities, affift in preventing the putrefcency of the humours. If the patient be not able to put his feet and hands into the decoaion, cloths dipt in it may be applied to them. M E DI CIN E.----If a vomit be taken at the very be- ginning of this fever, it will hardly fail to have a good ef- fea ; but if the fever has gone on for fome days, and the fymptoms are violent, vomits muft not be taken without proper advice. Bleeding is feldom neceflary in putrid fevers. If there be figns of an inflammation, it may fometimes be permitted at the firft onfet; but the repetition of it often proves fatal. Blistering plafters are never to be ufed unlefs in the greateft extremities. If the petechiae, or fpots, fhould fud- denly difappear, the patient's pulfe fink remarkably, and a delirium, with other bad fymptoms, come on, bliftering may be permitted. In this cafe, the bliftering plafters are to be applied to the head, and the infides of the legs or thighs. But as they are fometimes apt to occafion a gan- grene, we would rather recommend warm poultices or cata- plafms to be applied to the feet, having recourfe to blifters only in the utmoft extremities. A very ridiculous notion has long prevailed, of expelling the poifonous matter of1 malignant difeafes by ftrong dofes of 142 THE PUTRID OR SPOTTED FEVER. ©f cordial or alexipharmic medicines. In confequence of this notion, the contrayerva root, the cordial confeaion, and the mithridate, Ufe. have been extolled as infallible re- medies. There is reafon to believe, that thefe oftener do harm than good. Where cordials are neceflary, we know none that is fuperior to good wine ; and therefore again re- commend it both as the fafeft and beft. Wine, with other acid and antifeptic medicines, are the only things to be re- lied on in the cure of malignant fevers. We have already recommended acids in various forms, and fhall only add one more, viz. camphorated vinegar. This is made, by rubbing a dram of camphor, with a fmall quantity of fpirits of wine in a mortar, till it becomes foft, then adding half an ounce of loaf-fugar, and rubbing the whole together till perfeaiy united. Afterwards, take an Englifh pint of warm vinegar, and add it by little and little, ftill continuing the trituration, till they be uniformly mix- ed. Let it ftand to cool, and afterwards ftrain it. This may be taken in the dofe of a table fpoonful or two, every two or three hours, according as it agrees with the ftomach. If it fhould heat the patient, or occafion a naufea, it muft be difcontinued. In the moft dangerous fpecies of this difeafe, when it is attended with purple, livid, or black fpots, the Jefuits bark is the only medicine that can be depended upon. I have feen it, when joined with acids, almoft perform wonders, even in cafes where the petechia; had the moft threatening afpea. But, to anfwer this purpofe, it muft not only be given in large dofes, but dulyperfifted in. The beft method for adminiftering the bark is certainly in fubftance. An ounce of it, in powder, may be mixed with half an Englifh pint of water, and the fame quantity of red wine, and fharpened with the elixir of fp*irit of vitriol, which will both make it fit eafier on the ftomach, and ren- der it more beneficial. Two or three ounces of the fyrup of lemon may be added, and two table fpoonfuls of the mix- ture taken every two hours, or oftener, if the ftomach will bear it. Those who cannot take the bark in fubftance may in- fufe it in wine, as recommended in page 136. If there be a violent loofenefs, the bark muft be boiled in red wine, with a little cinnamon, and fharpened with the elixir of vitriol, as above. Nothing can be more beneficial in THE PUTRID OR SPOTTED FEVER. 143 in this kind of loofenefs than plenty of acids, and fuch things as promote the perfpiration. If the patient be troubled with vomiting, a dram of the fait of wormwood diflblved in an ounce and an half of frefh lemon juice, and made into.a draught with an ounce of fimple cinnamon water, or peppermint water, and a bit of fugar, may be given to the patient, and repeated as often as it is neceflary. If fwellingsof the glands appear, there fuppuration is to be promoted by the Application of poultices, ripening cata- plafms, Ufe And as foon as there is any appearance of mat- ter in them, they ought to be laid open, and the poultices Continued. I have known patients, in the decline of this fever, have large ulcerous fores break out in various parts of the body, of a livid gangrenous appearance, and a moft putrid cada- verous fmell. Thefe gradually healed, and the patient re- covered by the plentiful ufe of Jefuits bark mixed in wine, and fharpened with the fpirits of vitriol. All who would avoid this dreadful difeafe, fhould ftudy univerfal cleanlinefs, and fhould live regularly, avoiding the extremes of too high or too low a diet with equal care. Infection, above all things, is to be avoided. No con- ftitution is proof againft it. I have known perfons feized with a putrid fever, by only making a fingle vifit to a pa- tient in it; others, have caught it by going through a town where it prevailed j and fome by attending the funerals of fuch as died of it. Any one who is apprehenfive of having caught the in- feaion, ought immediately to take a vomit, and to work it off by drinking plentifully of camomile tea. This may be repeated in a day or two, if the apprehenfions ftill continue, I or any unfavourable fymptoms appear. The perfon ought likewife to take an infufion of the bark and camomile flowers for his ordinary drink ; and, be- fore he goes, to bed, he may drink an Englifh pint of pretty ftrong negas, or a few glafles of generous wine. I have been frequently obliged to follow this courfe when malig- nant fevers prevailed, and have likewife recommended it to others with conftant fuccefs. People generally fly to bleeding and purging as antidotes. againft infeaion ; but thefe are fo far from fecuring them, that they often increafe the danger. PHYSICIANS, 144 OF THE MILIARY FEVER. Physicians, and fuch as attend the fick in putrid fevers, ought always to have a piece of fpunge, or a handkerchief dipt in vinegar, or juice of lemon, to hold at their nofe. They ought likewife to wafh their hands, and, if poffible, to change their cloaths, before they vifit any other patient. Of the MILIARY FEVER. This fever takes its name from the fmall puftules or bladders which appear on the fkin, refembling, in fhape and fize, the feeds of millet. The puftules are either red or white, and fometimes both are mixed together. Sometimes the whole body is covered with puftules ; but they are generally more numerous where the fweat is moft abundant, as on the breaft, the back, Ufe. A gentle fweat, or moifture on the fkin, greatly promotes the erup- tion ; but where the fkin is dry, the eruption is both more painful and dangerous. Sometimes this is a primary difeafe ; but it is much of- tener only a fymptom of fome other malady, as the fmall- pox, meafles, ardent, putrid, or nervous fever, Ufe. In all thefe cafes it is generally the effea of too hot a regimen or medicines. The miliary fever chiefly attacks the idle and the phleg- matic, or perfons of a relaxed habit. The young and the aged are more liable to it than thofe in the vigour and prime of life. It is likewife more incident to women than men, efpecially the delicate, and the indolent, who, negkaing ex- ercife, keep continually within doors, and live upon weak, watery diet. Such females are extremely liable to be feiz- ed with this difeafe in child-bed, and often lofe their lives by it. CAUSE S.------The miliary fever is often occafi- oned by violent paffions or affeaions of the mind ; as ex- ceffive grief, anxietv, thoughtfulnefs, Ufe. It may like- wife be occafioned by exceffive watching, great eyacuations, a weak, watery diet, rainy feafons, eating too freely of cold, watery, unripe fruits, as plumbs, cherries, cucum- bers, melons, Ufe Impure waters, or provifions which have been fpoiled by rainy feafons, long keeping, Ufe may likewife caufe miliary fevers. They may alfo be occafion- ed by the ftoppage of any cuftomary evacuation, as iffues, fetons, ulcers, the bleeding piles in men, or the menftrual flux in women, Ufe. * This OF THE MILIARY FEVER. 145 This difeafe in childbed women is fometimes the effea of great coftivenefs during pregnancy ; fometimes it is oc- cafioned by their exceffive ufe of green, unripe fruits, and other unwholefome things, in which pregnant women are too apt to indulge. But its moft general caufe is in- dolence. Such women as indulge an eafy, fedentary life, during- pregnancy, and, at the fame time, live grofs and full, can hardly efcape this difeafe in childbed. Hence it proves extremely fatal to women of fafhion, and likewife to thofe women in manufaauring towns, who, in order to affift their hufbands, fit clofe, within doors, for almoft the whole of their time. But, among women who are aaive and laborious, who live in the country, and take enough of exercife without doors, this difeafe is very little known. SYMPTOM S.-----When this is a primary dif- eafe, it makes its attack, like moft other eruptive fevers, with a flight fhivering, which is fucceeded by heat, lofs of ftrength, faintifhnefs, fighing, a low quick pulfe, difficul- ty of breathing, with great anxiety and oppreffion of the breaft. The patient is reftlefs, and fometimes delirious ; the tongue appears white, and the hands fhake, with often a burning heat in the palms ; and, in childbed wo- men, the milk generally goes away, and the other difchar- ges flop. The patient feels an itching or pricking pain under the fkin, after which innumerable fmall puftules of a red or white colour begin to appear. Upon this the fymptoms generally abate, the pulfe becomes more full and foft, the fkin grows moifter, and the fweat, as the difeafe advances, begins to have a peculiar foetid fmell; the great load on the breaft, and oppreffion of the fpirits, generally go off, and the cuftomary evacuations gradually return. About the fixth or feventh day from the eruption, the puftules be- gin to dry, and fall off, which occafions a very difagree- able itching in the fkin. It is impoffible to afcertain the exaa time when the pu- ftules will either appear or go off. They generally come out on the third or fourth day, when the eruption is criti- cal ; but, when f)inptomatical, they may appear at any lime of the difeafe. Sometimes the puftules appear, and vanifh, by turns. When that is the cafe, there is always danger ; but when they ftrike in, all of a fudden, and do not appear again, the danger is very great. « i46 0 F T H E M I L I A R Y F E V E R. In childbed women, the puftules are commonly at firft filled with clear water, afterwards they grow yellowifh. Sometimes they are intcrfperfed with puftules of a red co- lour. When thefe only appear, the difeafe goes by the name of a rafh. REGIME N.------In all eruptive fevers, of what- ever kind, the chief point is to prevent the fudden ftriking in of the puftules. For this purpofe, the patient muft be kept in fuch a temperature, as neither to pufh out the eruption too faft, nor caufe it to retreat prematurely. The diet and drink ought therefore to be in a moderate degree, nourifhing and cordial ; but neither ftrong nor heating. The patient's chamber ought neither to be kept too hot nor too cold ; and he fhould not be too much covered with cloaths. Above all, the mind is to be kept eafy and cheer- ful. Nothing fo certainly makes an eruption flrike in, as fear, or the apprehenfion of danger. The food muft be weak chicken broth, with bread, wa- ter pap, withfago, and groat gruel, Ufe to a gill of which may be added a fpoonful or two of wine, as the patient's ftrength requires, with a few grains of fait and a little fu- gar. Good apples, roafted or boiled, with other ripe fruits, of an opening, cooling nature, may be eat. The drink muft be fuited to the ftate of the patient's ftrength and fpirits. If thefe be pretty high, the drink ought to be weak ; as water gruel, balm tea, or the fol- lowing decoaion : Take two ounces of the fhavings of hartfhorn, and the fame quantity of farfaparilla,boil them in two Englifh quarts of water. To the flrained decoaion add a little white fugar, and let the patient take it for his ordinary drink. When the patient's fpirits are low, and the eruption does not rife fufficiently, his drink muft be a little more ge- nerous ; as wine whey, or fmall negas, fharpened with the juice of orange or lemon, and made ftronger or weaker, as the circumftances may require. Sometimes the miliary fever approaches towards a pu- trid nature ; in which cafe the patient's ftrength muft be fupported with generous cordials, joined with acids ; and if the degree of putrcfcency be great, the Jefuits bark muft be adminiftered. If the head be much affeaed, the belly muft be kept open by emollient clyfters. In the Commercium Literarium for the year 1735, we have the the hiftory of an epidemical miliary fever, which raged at OF THE MILIARY FEVER. 147 at Strafburg in the months of November, December, and January; from which we learn the neceffity of a temperate regimen in this difeafe, and likewife that phyficians are not always the firft who difcover the proper treatment of dif- eafes. " This fever made terrible havoc among men of robuft conftitutions, and all medicine proved in vain. They were feized in an inftant with fhivering, yawning, ftretch- ing, and pains in the back, fucceeded by a moft intenfe heat; at the fame time, there was a great lofs of ftrength and appetite. On the feventh or ninth day the miliary eruptions appeared, or fpots like flea-bites, with great anxie- ty, a delirium, reftleffnefs, and toffing in bed. Bleeding was fatal. While matters were in this unhappy fituation, a midwife, of her own accord, gave to a patient, in the height of the difeafe, a clyfter of rain-water and butter, without fait, and for his ordinary drink a quart of fpring- water, half a pint of generous wine, the juice of one lemon, and fix ounces of the- whiteft fugar, gently boiled till a fcum arofe, and this with great fuccefs ; for the belly was foon loofened, the grievous fymptoms vanifhed, and the patient was reftored to his fenfes, and fnatched from the jaws of death." This praaice was imitated by others with the like happy effeas. M £ DI C IN E.—-If the food and drink be properly regulated, there will be little occafion for medicine in this difeafe. Should the eruption, however, not rife, or the- fpirits flag, it will be neceflary to fupport the patient with" cordials, and to apply blifters. The moft proper cordial, in this cafe, is good wine, which may either be taken in the patient's food or drink; and if there be any figns of putref- cency, which frequently happens, the bark and acids may be mixed with wine, as directed in the putrid fever. Some recommend blifters through the whole courfe of the difeafe; and where nature flags, and the eruption comes and goes, it may be neceflary to keep up a ftimulus, by a continual fucceffion of fmall blifters ; but we would not re- commend above one at a time. If, however, the pulfe fhould fink remarkably, the puftules ftrike in, and the head be af- feaed, it will be neceflary to apply feverai bliftering plafters to the moft fenfible parts, as the infide of the legs and thighs, Ufe. Bleeding is feldom neceflary in this difeafe, and fome- times it does much hurt, as it weakens the patient, and de- preffes his fpirits. It is, therefore, never to be attempted T 2 unlefs i4& OF THE SMALL-POX. unlefs by the advice of a phyfician. We mention this, be- caufe it has been cuftomary to treat this difeafe in childbed women by bleeding, and other evacuations, as if it wej£. highly inflammatory. But this praaice is generally very unfafe. Patients, in this fituation, bear evacuations very ill. And, indeed, the difeafe feems often to be more of a putrid than an inflammatory nature. Though this fever be often occafioned in childbed women by too hot a regimen, yet it would be dangerous to leave that off all of a fudden, and have recourfe to a very cool regimen, and large evacuations. We have reafon to believe, that fupporting the patient's fpirits, and promoting the natural evacuations, is here much fafer than to have re- courfe to artificial ones, as every thing that tends to deprefs the patient's fpirits conftantly increafes the danger. If this difeafe proves tedious, or the recovery flow, we would recommend the Jefuits bark, which may either be taken in fubftance, or infufed in wine or water, as the pa- tient inclines. The miliary fever, like other eruptive difeafes, after it is gone, requires purging, which fhould not be negkaed as foon as the patient's ftrength will permit. To avoid this difeafe, a pure dry air, plenty of exercife and wholefome food, are neceflary. Pregnant women fhould £yiffd againft coftivenefs, and take daily as much exercife as- they can bear, avoiding all green trafhy fruits, and other / unwholefome things ; and when in childbed, they ought ftriaiy to obferve a cool regimen. Of the SMALL-POX. This difeafe is fo general, that very few efcape it at one time of life or another. It is the moft contagious malady in thefe parts; and has, for upwards of a thoiifarid years, proved the fcourge of Europe. The fmall-pox generally appear towards the fpring. They are very frequent in fummer, lefs fo in autumn, and leaft of all in winter. Children are moft liable to this dif- eafe ; and thofe whofe food is unwholefome, who want pro- per exercife, and abound with grofs humours, run the greateft hazard from it. The difeafe is diftinguifhed into the diftina arid conflu- ent kind ; the latter of which is always attended With dan- ger. OF THE SMALL-POX. 149 ger. There are likewife other diftinaions of the fmall- pox ; as the lymphatic, the cryftalline, the bloody, Ufe CAUSE S.------The fmall-pox are commonly caught by infeaion. Since the difeafe was brought into Europe, the ihfeaion has never been wholely extinguished; nor have any proper methods, fo far as we know, ever been taken for that purpofe ; fo that now it has become in a manner con- ftitutional. Children who have over-heated themfelves by running, wreftling, Ufe or adults after a debauch, are very - apt to be feized with this difeafe. SYMPTOM S.----This difeafe is fo generally known, that a minute defcription of it is unnecefiary. Children commonly look a little dull, feem liftkfs and drowfy for a few days before the more violent fymptoms of the fmall-pox appear. They are likewife more inclined todrink than ufual, have little appetite for folid food, complain of weari- nefs, and, upon taking exercife, are apt to fweat. Thefe are fucceeded by flight fits of cold and heat in turns, which, as the time of the eruption approaches, become more vio- lent, and are accompanied with pains of the head and Joins, vomiting, Ufe The pulfe is quick, with a great heat of the fkin, and reftkffnefs. When the patient drops afleep, he wakes in a kind of horror, with a fudden ftart, which is a very Common fymptom of the approaching eruption; as are alfo convulfion fits in very young children. About the third or fourth day from the time of ficken* ing, the fmall-pox generally begin to appear; fometimes, indeed, they appear fooner, but that is no advantage. At firft they very nearly refemble flea-bites, and are moft early difcovered on the face, arms and breaft. The moft favourable fymptoms are a flow eruption, and an abatement of the fever as foon as the puftules appear. In a mild drftina kind of fmall-pox, the puftules feldom ap- pear before the fourth day from the time of fickening, and they generally keep coming out gradually for fcveral days after. Puftules,, which are"diftina, with a florid red bafis, and which fill with thick purulent matter, firft of a whitifh, and afterwards of a yellowifh colour, are the beft. A livid brown colour of the puftules is an unfavourable fymptom ; as alfo, when they are fmall and flat, with black fpecks in the middle. Puftules which contain a thin wa- tery ichor are very bad. A great number 'of pox on the face is always a bad fign, efpecially if they be confluent, or run into one another. But 150 OF THE SMALL-POX. But the moft unfavourable fymptom is the petechia;, or purple, brown and black fpots interfperfed among the puftules. Thefe are figns of a putrid diffolution of the blood, and fhow the danger to be very great. Bloody ftools or urine, with a fwelled belly, are bad fymptoms ; as is alfo, a continual ftrangury, When the urine is very pale, and there is a violent throbbing of the arteries of the neck, it portends a delirium or convulfion fits. When the face does not fwell, or falls before the pox come to maturity, it is a very bad fign. If the face begins to fall about the eleventh or twelfth day, and the hands begin to fwell, and afterwards the feet, the patient generally does well; but when thefe do not fucceed, there is reafon to apprehend danger. When the tongue is covered with a brown cruft, it is an unfavourable fymptom. Cold fhivering fits coming on at the height of the difeafe, are likewife unfavourable. Grinding of the teeth, when it proceeds from an affeaion of the nervous fyftem, is a bad fign ; but, fometimes, it is oc-^ cafioned by worms, or a difordered ftomach. REGIME N.----When the firft fymptoms of the fmall-pox appear, people are ready to be alarmed, and often fl/ to the ufe of medicine, to the great danger of the pa- tient's life. I have known children, to appeafe the anxiety of their parents, bkd,bliftered, purged, and vomited, during the fever which preceded the eruption of the fmall-pox, to fuch a degree, that nature was not only difturb.ed in her operation, but rendered unable to fupport the puftules after they were out; fo that the patient, exhaufted by mere eva-r cuations, funk under the difeafe. When convulfions appear, they give a dreadful alarm. Immediately fome noftrum is applied, as if this were a pri- mary difeafe ; whereas, it is only a fymptom, and far from being an unfavourable one, of the approaching eruption. As the fits generally go off before the aaual appearance of the fmall-pox, it is attributed to the medicine, which, by this means, acquires a reputation without any merit. All that is, generally fpeaking, neceflary during the eruptive fever, is to keep the patient within doors, and to allow him to drink freely of fome weak diluting liquors; as balm tea, barley water, clear whey, gruels, Ufe He fhould neither be kept in too warm a room, nor confined to bed; but fhould fit up as much as he is able, and fhould have his feet and legs frequently bathed in lukewarm water. OT THE SMALL-POX, 151 His food, if he takes any, ought to be very light ; and he fhould be as little difturbed with noife and company as poffible. Much mifchief is done at this period by confining the patient too foon to his bed, and plying him with warm cordials, or fudorific medicines. Evety thing that heats and inflames the blood, increafes the fever, and pufhes out the puftules too faft. This has numberlefs ill effeas. It not only increafes the number of puftules, but likewife tends to make them run into one another ; and when they have been pufhed out with too great violence, they gene- rally fall in before they come to maturity. The good women, as foon as they fee the fmall-pox begin to appear, commonly ply their tender charge with cordials, faffron or marygold teas, wines, punch, and even brandy itfelf. All thefe are given with a view to throw out the eruption, as they pretend, from the heart. This, like moft other popular miftakes, is the abufe of a very juft obfervation, That when there is a moiflure on the fkin, the pox rife better, and the patient is eafler than when it continues dry and parched. But that is no reafon for forcing the patient into a fweat. Sweating never relieves, unlefs where it 1 comes fpontaneoufly, or is the effea of drinking weak di- luting liquors. 1 The patient ought to have no more covering in bed than is neceflary to prevent his catching cold, and he fhould be frequently taken up, if it were only for a few minutes ; this will both keep him cool, and prevent too great a flux of blood towards the head. Children are often fo peevifh that they will not lie a-bed without a nurfe conftantly by them. This, we have reafon to believe, has many bad effeas. Even the natural heat of the nurfe cannot fail to augment the fever of the child ; but if fhe too proves feverifh, the danger muft be increafed. I have rtlown a nurfe contraa a malignant fe- ver, by lying in bed with a child the whole time of its be- ing ill of a bad kind of fmall-pox. Laying fcveral children who have the fmall-pox in the fame bed, has manv ill confequences. They ought, if pof- fible, never to be in the fame chamber, as the perfpiration, the heat, and the i'mtii, Ufe all tend to augment the fever, and to heighten the difeafe. it is common, among the vo§t, to fee two or three children lying in the fame bed, with fuch a load of puftules, that'their very fkins flick to- gether. 152 OF THE SMALL-P OX. gether. One can hardly view a fcene of this kind without being fickened by the fight and fmejl. How much more muft thefe affea the poor patients, many of whom perifh by this ufage ? This obfervation is likewife applicable to hofpitals, workhoufes, Ufe where numbers of children happen tq have the fmall-pox at the fame time. I have feen above forty children cooped up in one apartment all the while they had this difeafe, without any of them being admitted to breathe the frefh air. No one can be at a lofs to fee the impropriety of fuch condua, which generally proceeds from a piece of ill-judged ceconomy, to favethe trifling ex- pence of a few nurfes.lt ought to be a rule, not only in hofpi- tals for the fmall-pox, but likewife for other difeafes, that no patient fhould be within fight or hearing of another. This is a matter to which too little regard is paid in moft hofpitals and infirmaries, where the fick, the dying, and the dead are often to be feen in the fame apartment. A very dirty cuftom prevails amongft the lower fort of people, of allowing children in the fmalj-pox to keep on the fame linen during the \whole period of that loathfome difeafe. This is done left they fhould catch cold, but it has many ill confequences. The linen becomes hard, by • the moifture which it abforbs, and frets the tender fkin. It likewife occafions a bad fmell, which is very pernicious both to the patient, and thofe about him ; befides the filth and fordes, which adhere to the linen, being abforbed, ortaken up again into the body, greatly augment the difeafe. A patient fhould not be kept dirty in any difeafe, efpe- cially in the fmall-pox. Cutaneous diforders are often oc- cafioned by naftinefs alone, and are always increafed by it. Were the patient's linen to be changed every day, it would greatly refreih him. Care, indeed, is to be taken that the linen be thoroughly dry. It ought, likewife, to be warm- ed, and put on when the patient is motl cool. So ftrong is the vulgar prejudicein this country, nbtwith- ftanding all that has been faid againft keeping children too warm in the fmall-pox, that numbers ftill fall a facrifice to that error. I have feen poor women travelling in the depth of winter, and carrying their children along with them in the fmall-pox ; and have frequentlv obferved others begging by the way-fide, with infants in their arms, covered with the puftules ; yet 1 could never learn that one of thefe j#il- drendied by this fort of treatment. We would not, however, propofe OF THE SMALL-POX. 153 propofe this as an example worthy of imitation ; we only mention it to fhew, that the danger of expofing children to the open air in this difeafe is not fo great as people are apt to imagine. Strong prejudices, when got over, often produce the oppofite extreme. We would, therefore, advife people, when they avoid one error, not to run into another. Some celebrated inoculators order their patients to walk about all the\vhik they are under the difeafe, as if no.thing were the matter. We fhould think it advifable, however, to keep within doors, at leaft during the eruption, as cold air is apt to check the perfpiration, and to prevent the pox from rifing, or filling with matter. 1 do not remember ever to have feen large, well-filled puftules where the patient wasexpofedto the external air. In winter the air ofthiscoun- try is abundantly cool within doors, and in fummera patient may be kept more uniformly cool in the houfe than he can be out of it. For thefe, and other reafons, we ftiould think it right to confine the patient to the houfe while the eruption is out; but never to allow the heat of his chamber to be greater than is agreeable to a perfon in perfea health. The food in this difeafe ought to be very light, and of a cooling nature, as water pap, rice, or bread, boiled with milk, good apples, roafted, or boiled with milk, and fweetened with a little fugar, or fuch like. The drink may bee,qual parts of milk and water, clear fweet whey, barley water, or thin gruel, Ufe After the pox are full, butter-milk is an excellent drink, -it being of an opening and cleanfing nature. M E D I C I N E.------This difeafe is generally divi- ded into four different periods, viz. the fever whch pre- cedes the eruption, the eruption itfelf, the fuppuration, or maturation of the puftules, and the fecondary fever. It has already been obferved, that little more is neceflary during the primary fever, than to keep the patient cool and quiet, allowing him to drink diluting liquors, and bathing his feet frequently in warm water. Though this be gene- rally the fafeft courfe that can be taken with infants, yet adults of a ftrong conftitution and plethoric habit fome- times require bleeding. When a pulfe, a dry fkin, and other fymptoms of inflammation, render this operation ne- ceflary, it ought to be performed. But, unlefs thefe fymptoms are urgent, it is fafer to truft to fomentations ; U and, 154 OF THE S M A L L - P O X. and, ifthe belly be bound, emollient clyfters maybe thrown in. If there be a great naufea or vomiting, weak camomile tea, or lukewarm water, may be drank, in order to clean the ftomach. At the beginning of a fever, nature general- ly attempts a difcharge, either upwards or downwards ; which, if promoted by gentle means, would tend greatly to abate the force or violence of the difeafe. Though every method is to be taken during the prima- ry fever, by a cool regimen, Ufe to prevent too great an eruption ; yet, after the puftules have made their appear- ance, our bufinefs is to promote the fuppuration, by gen- tle warmth, diluting drink, light food, and, if nature feems to flag, by generous cordials ; but the latter ought never to be given unlefs where there is an abfolute neceffi- ty. When a low, creeping pulfe, faintifhnefs, and great lofs gf ftrength, render cordials neceflary, we would re- commend good wine, which may be made into negas, with an equal quantity of water, and fharpened with the juice of orange, the jelly of currants, or the like. Wine whey, fharpened as above, is likewife a proper drink in this cafe ; great care, howevt-r, muft be taken not to overheat the pa- tient by any of thefe things. This would retard inftead of promoting the eruption. Sometimes the rifing of the fmall-pox is prevented by the violence of the fever ; in which cafe, the cool regimen is ftriaiy to be obferved. For example, the patient's chamber muft be kept cool ; he ought likewife frequently to be taken out of bed, and to be lightly covered with cloaths while in it. Excessive reftleflhefs often prevents the rifing and fill- ing of the fmall-pox. When that happens, gentle opiates are neceflary. Thefe, however, ought always to be ad- miniftered with the greateft caution. To an infant, a tea fpoonful of the fyrup of poppies may be given every five or fix hours, till it has the defired effea. An adult perfon will require a table fpoonful in order to anfwer the fame pur- pofe ; and to others, the dofe muft be proportioned to their age, and the violence of the fymptoms. If the patient be troubled with a ftrangury, or fuppref- fion of urine, which often happens in the fmall-pox, he fhould be frequently taken out of bed, and, if he be able, fhould walk acrofs the room with his feet bare. When he cannot do this, he may be frequently fet on his knees in bed, OF THE SMALL-PfJX, 155 bed, and fhould endeavour to pafs his urine as often as he can. When thefe do not fucceed, a tea fpoonful of the fweet fpirits of nitre may be occafionally mixed in his drink. Nothing more certainly relieves the patient, or is more be- neficial in the fmall-pox, than a plentiful difcharge of urine. If the mouth be foul, and the tongue dry and chapped, it ought to be frequently wafhed, and the throat gargled with warm water and honey, fharpened with a little vinegar or currantjelly. During the rifing of the fmall-pox, it frequently hap- pens that the patient is eight or ten days without a ftool. This not only tends to heat and inflame the blood, but the fceces, by lodging fo long in the body, become acrid and even putrid, from whence bad confequences muft enfue. It will therefore be proper, when the belly is bound, to throw in an emollient clyfter every fecond or third day, through the whole courfe of the difeafe. This will greatly cool and relieve the patient. When petechia;, or purple, black, or livid fpots appear ■among the fmall-pox, the Jefuits bark muft immediately be adminiftered in as large dofes as the patient's ftomach can bear. For a child, two drams of the bark in powder may be mixed in three ounces of common water, one ounce of fimple cinnamon-water, and two ounces of the fyrup of orange or lemon. This may be fharpened with the fpirits of vitriol, and a table fpoonful of it given every hour. If it be given to an adult in the fame form, he may take at leaft three or four fpoonfuls every hour. This medicine ought not to be trifled with, but muft be thrown in as faft as the ftomach can bear ; in which cafe it will often produce very happy effeas. I have frequently feen the petechia; difap- pear, and fmall-pox, which had a very threatening afpeil, rife and fill with laudable matter, by the ufe of the Jefuits bark and acids. The patient's drink ought likewife, in this cafe, to be acidulated with the fpirits of vitriol, vinegar, juice of k-. mon, jelly of currants, or fuch like. His food muft confift of apples, roafted or boiled, preferved cherries, plumbs, and other fharp fruits. Camomile tea, ifthe patient's ftomach will bear it, is likewife a very proper drink in this cafe. It may be fharpen- ed v/ith any of the acids mentioned above, and drank at pkafure. When the pulfe and fpirits are low, red wine U 2 negas, 156 OF THE S M A L L - P O X. negas, or pretty ftrong wine whey, fharpened with the juice of lemon, muft be given for the patient's ordinary drink. The bark and acids are not only neceflary when the pe- techia or putrid fymptoms appear, but likewife in the lym- phatic or cryftalline fmall-pox, where the matter is thin, and not duly prepared. The Jefuits bark feems poffeffed of a Angular power to affift nature in preparing laudable pus, or what is called good matter ; confequently it muft be very beneficial, both in this and other difeafes whofe crifis depends on a fuppuration. I have often obferved, where the fmall-pox were flat, and the matter contained in them quite clear and tranfparent, and where they had the appearance of running into one another, that the ufe of a few drams of the Jefuits bark, acidulated as above, not only promoted the fuppuration, but changed the colour and confiftence of the matter, and produced the moft happy effeas. When the eruption fubfides fuddenly, or, as the good women term it, when the fmall-pox ftrike in, before they have arrived at maturity, the danger is very great. This is* often the effea of adiot regimen, or medicines which at the beginning pufh out the matter before it has been properly prepared. When this happens, bliftering plafters muft be immediately applied to the wrifts and ancles, and the pa- tient's fpirits fupported with cordials. Sometimes bleeding has a furprifing effea in raifing the puftules after they have fubfided ; but it requires fkill to know when this is proper, or to what length the patient can bear it. Sharp cataplafms, however, may be applied to the feet and hands, as they tend to promote the fwelling of thefe parts, and by that means to draw the humour towards the extremities. The moft dangerous period of the difeafe is what we call the fecondary fever. This generally comes on when the fmall-pox begin to turn on the face; and moft of thofe who die of the fmall-pox are carried offby this fever. Nature generally attempts, at the turn of the fmall- pox, to relieve the patient by loofe ftools. Her endeavours this way, are by no means to be counteraaed, but promoted, and the patient at the fame time fupported by things of a light but nourifhing nature. Patients have often been re- markably relieved at this time by a few loofe ftools, either brought on by nature or procured by art. That fhould encourage OF THE SMALL-POX, 157 encourage us to endeavour to affift nature in this way, efpe- cially if the fymptoms be threatening, and the belly con- tinues bound. If at the approach of the fecondary fever, the pulfe be very quick, hard, and ftrong, the heat intenfe, and the breathing laborious, with other fymptoms of an inflamma- tion of the breaft, the* patient muft immediately be bled, otherwife a fatal peripneumony will enfue. The quantity of blood to be let muft be regulated by the patient's ftrength, age, and the urgency of the fymptoms. But, in the fecondary fever, ifthe patient be faintifh, the puftules become pale and fhrink, and if there be great coldnefs of the extremities, bliftering plafters muft be ap- plied, and the patient muft be fupported with generous wine. Wine, and even fpirits have fometimes been given in fuch defperate cafes with amazing fuccefs. As the fecondary fever is in great meafure, if not whole- ly, owing to the abforption of the matter, it would feem highly confonant to reafon, that the puftules, as foon as they come to maturity, fhould be opened. That is every day praaifed in other phlegmons which tend to fuppura- tion ; and there feems to be no reafon why it fhould be lefs proper here. On the contrary, we have reafon to believe, that by this means the fecondary fever might always be leflened, and often wholely prevented. The puftules fhould be opened when they begin to turn of a yellow colour. Very little art is neceflary for this operation. They may either be opened with a pair of fcif- fors, or a needle, and the matter abforbed by.a wet fpunge, or a little lint. As the puftules are generally firft ripe on the face, it will be proper to begin with opening thefe, and the others in courfe as they become ripe. The puftules generally fill again, a fecond, or even a third time, Ufe for which caufe the operation muft be repeated, or rather continued fo long as there is any confiderable appearance of matter in the puftules. We have reafon to believe, that this operation, rational as it is, has been negkaed from a piece of miftaken tender- nefs in patents. They Believe, that it muft be great pain to the poor child ; and therefore would rather fee it die than have it thus tortured. This notion, however, is en- tirely without foundation. It is only the fcarf-fkin that is cut, which, upon the top of the puftules, by the time they are ripe, becomes quite infenfible. 1 have frequently open- 158 OF THE SMALL -POX. ed the puftules when the patients did not fee me, without their being in the leaft fenfible of it ; but fuppofe it were attended with a little pain, that is nothing in comparifon to the advantages which arife from it. Opening the puftules not only prevents the abforption of the matter into the blood, but likewife takes off tenfion of the fkin, and by that means greatly relieves the patient. It likewife prevents the pitting, which is a matter of no fmall importance. Acrid matter, by lodging long in the puftules, cannot fail to corrode the tender fkin ; by which many a handibme face becomes fo deformed as hardly to bear a refemblance to the human figure. It is always neceflary, after the fmall-pox are gone off, to purge the patient. If, however, the belly has been open through the whole courfe of the difeafe, or, if butter- mi Ik, and other things of an opening nature, have been given, after the height of the fmall-pox, purging becomes lefs neceflary ; but it ought never wholely to be negkaed. For very young children, an infufion of fenna and prunes, with a little rhubarb, may be fweetened with manna or coarfe fugar, and given in fmall quantities till it operates. Thofe who are farther advanced muft take me- dicines of a fharper nature. For example, a child of four or five years of age, may take ten grains of fine rhubarb in powder over night, and the fame quantity of jalap in powder next morning, with two or three grains of calomel, mixed in currant jelly, or made into a bolus with a little honey. He ought to keep the houfe all day, and to drink nothing that is cold. The dofe mav be repeated three or four times, five or fix days intervening betwixt each dofe. For children further advanced, and adults, the dofe muft be increafed in proportion to the age and conftitution. When impofthumes happen after the fmall-pox, which is not feldom the cafe, they are to be brought to fuppurati- on as foon as poffible, by means of ripening poultices ; and, when they have been opened, or break of their own accord, the patient muft be purged. When a cough, a difficulty of breathing," or other fym- toms of a confumption, fucceed t* the fmall-pox, the pa- tient muft be fent to a well aired place, and put upon a courfe of affes milk, with fuch exercife as he can bear. For further dire&ions in this cafe, fee the article Confump- tions. Though no difeafe, after it is formed, baffles the pow- ers of medicine more than the fmall-pox, yet more may be done OF THE S M A L L - P O X. 159 done before hand to render this difeafe favourable than any one we know, as almoft all the danger from it may be pre- vented by inoculation. This falutary invention has been known in Europe about half a century ; but, like moft other ufeful difcoveries, it has met with great oppofition. It muft, however, be acknowledged, to the honour of this country, that inoculation has met with a more favourable reception here than by any of our neighbours. It is ftill, however, far from being general, which we have reafon to fear will ever be the cafe, fo long as the praaice continues in the hands of the faculty. No difcovery can ever be of general utillity while the praaice of it is kept in the hands of a few. Had the inocu- lation of the fmall-pox been introduced as a fafhion, and not as a medical difcovery, and had it been praaifed by the fame kind of operators here as it is in thofe countries from whence we had it, it had long ago been univerfal. The fears, the jealoufies, the prejudices, and the oppofite inte- refts of the faculty ,t are, and ever will be, the moft effeaual obftacks to the progrefs of any falutary difcovery. Hence it is, that the praaice of inoculation never became, in any meafure, general, even in England, till taken up by men not bred to phyfic. Thefe have not only rendered the praaice more extenfive, but likewife more hfe, and, by aaing under lefs reftraint than the regular praaitioners, have taught them that the patient's greateft danger arofe, not from the want of care, but from the excefs of it. They know very little of the matter, who impute the fuccefs of modern inoculators to any fuperior fkill, either in preparing the patient or communicating the difeafe. Some operators indeed, from a fordid defire of ingroffing the whole praaice to themfelves, pretend to have extraordi- nary fecrets or noftrums in preparing per fons for inoculation, which never fail of fuccefs. But this is only a pretence calculated to blind the ignorant and inatr-mtive. Com- mon fenfe and prudence alone are fufficient both in the choice of the fubjea, and management of the operation. Whoever is poffeffed of thefe may perform this office for his children whenever he finds it convenient, provided they be in a proper ftate of health ; and may reft affured, that he will fucceed a3 well as the moft celebrated inoculator. 'This fentiment is not the refult of theory,but of obferva- tion. Though few phyficians have had more opportuni- ties of trying inoculation in all its different forms, fo little appear 160 OF THE SMALL-POX. appears to me to depend on thefe, generally reckoned im- portant circumftances, of preparing the body, communi- cating the infeaion by this or the other method, Ufe. that for feveral years paft I have caufed the parents or nurfes perform the whole themfelves, and have found that method followed with equal fuccefs, while it is free from many in- conveniencies that attend the other. A critical fituation, too often to be met.with, firft put me upon trying this method. A gentleman who had loft all his children, except one fon, by the natural fmall-pox, was determined to have him inoculated. He told me his intention, and defired I would perfuade the mother and grandmother, Ufe of its propriety. But that was impofli- ble. They were not to be perfuaded, and either could not get the better of their fears, or"were determined againft con- viaion. It was always a point with me not to perform the operation without the confent of parties concerned. I therefore advifed the father, after giving his fon a dofe or two of rhubarb, to go to a patient wh# had the fmall-pox of a good kind, to open two or three of the puftules, taking up the matter with a little cotton, and as foon as he came home to take his fon into a private room, and give his arm a flight fcratch with a pin, as if it had been by accident, afterwards to rub the place well with the cotton, and take no farther notice of it. All this he punaually performed ; and, at the ufual period, the fmall-pox made their appear- ance, which were of an exceeding good kind, and fo mild as not to confine the boy an hour to his bed. Npne of the other relations knew but the difeafe had come in the natural way till the patient was well. We do not propofe this as the only method in which the fmall-pox can be communicated. It appears from experience, that this may be done various ways with equal fuccefs. In Tur- key, from whence welearned the praaice, the women commu- nicate thedifeafetochildren,byopeninga bit of thefkin witha needle, and putting into the wound a little matter taken from, a ripe puftule. On the coaft of Barbary, tliey pafs a thread wet v/ith the matter through the fkin, between the thumb and fore-finger ; .and in Europe inoculation is generally performed by making a fmall incifion through the cuticle of the arm or kg with a lancet, and laying a°bit of thread wet with the matter upon the wound, which is co- vered with a piece of fticking plafter, and kept on for two or three days. Some OF THE SMALL-POX. 161 Some of the people in England, who make a trade of inoculation, only open one of the ripe puftules with a lan- cet, and while it is wet with the matter, make a flight in- cifion in the arm of the perfon to whom they want to com- municate the difeafe ; afterwards they clofe up the wound, and leave it without any other dreffing. This feems to be no real improvement. It frequently fails to communicate the difeafe, and is far lefs certain than when afcratch with a pin or needle is made, and a bit of thread wet with the matter kept on the wound for fome days by a fticking pla- fter. Indeed, if the matter be applied long enough to the fkin, theie is no occafion for any wound at all. Let a bit of thread, about half an inch long, wet with the matter, be applied to the arm, midway between the fhoulder and elbow, and covered with a piece of the common black fticking plafter, and kept on for eight or ten days. This will feldom fail to communicate the difeafe. We mention this method, becaufe many people are afraid of a wound ; and, doubtlefs, the more eafily the operation can be per- formed, it has the greater chance to become general. Some people imagine, that the difcharge from a wound leflens the eruption ; but there is not much ftrefs to be laid upon this notion : Befides, deep wounds often ulcerate, and be- come troublefome. We do not find that inoculation is at all confidered as a medical operation in tho/e countries from whence we learn- ed it. In Turkey it is performed by the women, and in the Eaft-lndies by the Brachminsor priefts. In this coun- try the cuftom is ftill in its infancy ; we make no doubt, however, but it will become fo familiar, that parents will think no more of inoculating their own children than at prefent they do of giving them a dofe of phyfic. No fet of men have it fo much in their power to render the praaice of inoculation general as the clergy ; the great- eft oppofition to it ftill arifing from fome fcruples of con- fcience, which they alone can remove. We would recom- mend it to them, not only to endeavour to remove the re- ligious objeaions which weak minds may have to this falu- tary praaice, but to enjoin it as a duty, and to point out the danger of neglecting to make ufe of a mean which Pro- vidence has put in our power for faving the lives of our offspring. Surely fuch parents as wilfully negka the means of faving their children alive, are as guilty as thofe who X put 162 OF THE S M 'A L L - P O X. put them to death. We wifh this matter were duly weigh- ed. No one is more ready to make allowance for human weaknefs and religious prejudices, yet I cannot help recom- mending it, in the warmeft manner, to parents to confider how great an injury they do their children, by negkaing to give them this difeafe in the early period of life. The numerous advantages attending inoculation of the fmall-pox, have been pretty fully pointed out by the learn- ed Dr. M'Kenzie in his Hiftory of Health : «« Many and great, fays this humane author, are the dangers attending the natural infeaion, from all which the inoculation is quite fecure. The natural infeaion may invade weak or diftempered- bodies, by no means difpofed for its kindly reception. It may attack them at a feafon of the year either violently hot, or intenfely cold. It may be commu- nicated from a fort of fmall-pox impregnated with the ut- moft virulence. It may lay hold upon people unexpect- edly, when a dangerous fort is imprudently imported into a maritime place. It may furprize us foon after exceffes committed in luxury, intemperance, or lewdnefs. It may likewife feize on the innocent, after indifpenfible watch- ings, hard labour, or neceflary journies. And is it a tri- vial advantage, that all thefe unhappy circurhftances can be prevented by inoculation ? By inoculation "numbers are faved from deformity as well as from death. In the na- tural fmall-pox, how often are the fineft features, and the moft beautiful complexions, miferahly disfigured ? Where- as inoculation rarely leaves any ugly marks or fears, even where the number of puftules on the face have been very confiderable, and the fymptoms by no means favourable. And many other grievous complaints, that are frequently fubfequent to the natural fort, feldom follow the artificial. Does not inoculation alfo prevent thofe inexpreffible ter- rors that perpetually harrafs perfons who never had this dif- eafe, infomuch, that when the fmall-pox is epidemical, in- tire villages are depopulated, markets ruined, and the face of diftrefs fpread over the whole country ? From this terror it arifes, that juftice is frequently poftponed, or dif- couraged, at feffions or affizes, where the fmall-pox ra- ges. Witnefles and juries dare not appear ; and, by rea- fon of the neceflary abfence of fome gentlemen, our ho- nourable and ufeful judges are not attended with that reve- rence and fplendor due to their office and merit. Does not inoculation, in like manner, prevent our brave failors frorn being OF THE SMALL-POX. 163 being feized with this diftemper on fhipboard, where they muft quickly fpread the infeaion among fuch of the crew who never had it before, and where they have fcarce any chance to efcape, being half-ftifled with the clofenefs of their cabbins, and but very indifferently nurfed ? Laftly, with regard to the foldiery, the miferies attending thefe poor creatures, when attacked by the fmall-pox on a march, is inconceivable, without attendance, without lodgings, without any accommodations j fo that one of three commonly perifhes." We fhall only add, that fuch as have not had the fmall- pox in the early period of life, are not only rendered un- happy, but likewife, in a great meafure, unfit for fuftain- ing many of the moft ufeful and important offices. Few people would choofe even to hire a fervant who have not had the fmall-pox, far lefs to purchafe a flave who had the chance of dying with this difeafe; How could a phyfician, or a furgeon, who had never had the fmall-pox himfelf, attend others under that malady ? Thus, befides, the continual fears and anxiety which haunt thofe perfons who have not had the fmall-pox, we might fhew numberlefs in- conveniencies which arife from it. For example, How deplorable is the fituation of females, who arrive at mature age without having had the fmall-pox ! A wo- man with child feldom furvives this difeafe : And, if an infant happens to be feized with the fmall-pox upon the mother's breaft, who has not had the difeafe herfelf, the fcene muft be diftreffing ! If fhe continues to fuckle the child, it is at the peril of her own life ; and, if fhe weans it, in all probability, it will perifh. How often is the af- feaionate mother forced to leave her houfe, and abandon her children, at the very time when her care is moft necef- fary ? But fhould parental affeaion get the better of her fears, the confequences will often prove fatal. I have known the tender mother and her infant child laid in the fame grave, both untimely viaims to this dreadful malady. But thefe are fcenes too fhocking even to mention. Let parents who run away with their children to avoid the fmall-pox, or who refufe to inoculate them in their infan- cy, confider to what deplorable fituations they may be re- duced by this miftaken tendernefs. As the fmall-pox has now become a conftitutional dif- eafe in moft parts of the known world, no other choice re- mains, but to render the malady as mild as poffible ; that X 2 is 164 OF THE S M A L L - P O X. is the only manner of extirpation now left in our power ; and, though it may feem paradoxical, this artificial method of planting tf^e difeafe, could it be rendered tiniverfal, would amount to nearly the fame thing as rooting it out'. It is a matter of fmall confequence, whether a difeafe be entirely extirpated, or rendered fb mild, as neither to de- ftroy life, nor hurt the conftitution ; but thac this may be done by inoculation, does not now admit of a doubt. The numbers who die under inoculation, hardly deferve to be named. In the natural way, one in four or five generally die ; but by inoculation, not one of a thoufand. Nay, fome can boaft of having inoculated ten thoufand without the lofs of a fingle patient. I have often wifhed. to fee fome plan eftablifhed for ren- dering this falutary praaice univerfal ; but am afraid I fhall never be fo happy. The difficulties indeed are many ; yet the .thing is by no means impraaicable. The aim is great ; no lefs than faving the lives of one fourth of man- kind. What ought not to be attempted in order to accom- plifh fuch an end ? The firft flep towards rendering the praaice univerfal, muft be to remove the religious prejudices againft it. This, as.already obferved, can only be done by the clergy. They muft not only recommend it as a duty to. others, but likewife praaife it on their own children. Example will ever have more influence than precept. The next thing requifite is to put it in the power of all. For this purpofe we would recommend it to the Faculty to inoculate the children of the poor gratis. It is hard that thofe who are certainly the moft ufeful part of mankind, fhould, by their poverty, be excluded from fuch a bene- fit. Should this fail, it is furely in the power of any ftate to render the praaice general, at leaft, as far as their do- minion extends. We do not mean, that it ought to be in- forced by a law : That, there is reafon to believe, would rather tend to obftrua its progrefs. The way to promote it, would be to employ a fufficient number of operators at the public expence to inoculate the children of the poor. This would only be neceffary, till the praaice became general ; afterwards cuftom, the flrongeft of all laws, would oblige every one to inoculate their children, to prevent refieai- ons. It OF THE SMALL-POX. 165 It may be objeaed to this fcheme, that the poor would refufe to employ the inoculators : That is eafily removed. A fmall premium to enable mothers to attend their ch'il-. dren while under the difeafe, would be a fufficient induce- ment ; befides, the fuccefs attending the operation, would foon banifh all objeaions to it. Even confiderations of profit, would induce the poor to embrace this plan. They often bring up their children to the age of ten or twelve, and when they come to be ufeful, they are fnatched away by this malady, to the great lofs of their parents, and de- triment of the public. The Britifh legiflature has, of late years, fhown great attention to the prefervation of infant lives, by fupporting the foundling hofpital, Ufe But we will venture to fay, if one tenth part of the fums laid out in fupporting that in- ftitution, had been beftowed towards promoting the prac- tice of inoculation of the fmall-pox among the poor, that not only more ufeful lives had been faved, but the praaice, before now, rendered quite univerfal in this ifland. It is not to be imagined, what effea example, and a little mo- ney, will have upon the poor ; yet, if left to themfelves, they will go on for ever in the old way, without thinking of any improvement. We only mean this as a hint to the humane and public fpirited. Should fuch a fcheme be ever put in praaice, a proper plan might eafily be laid down for the execution of it. As all public plans are very difficult to bring about, and, often, by the felfifh views, or mifcondua, of thofe intruft- ed with the execution of them, fail of anfwering the noble purpofes for which they were dcfigned : We fhall, there- fore, point out fome other methods by which the benefits of inoculation may be extended to the poor. There is no doubt but inoculators will be daily more numerous. We would, therefore,, have every parifh in Britain, to allow one of them a fmall annual falary for inoculating all the children of the parifh at a proper age. Though fome refraaory perfons might for a while objea to this method, they would foon be obliged to comply with it, or run the hazard of being reckoned the murder- ers of their own children. Two things chiefly operate to prevent the progrefs of inoculation. The one is a wifh to put the evil day as far off as poffible. This is a principle in our nature ; and as inoculation feems rather to be anticipating a future evil, at 166 OF THE S M A L L - P O X. it is no wonder mankind are fo averfe from it. But this objeaion is fufficiently anfwered by the fuccefs. Who, in his fenfes, would not prefer a leffer evil to-day, to a greater to-morrow, provided it were equally certain ? The other obftacle is the fear of refleaions. This has very great weight with the bulk of mankind. Should the child die, they think the~ world would look down upon them. This they cannot bear. Here lies the difficulty which pinches, and till that be removed, inoculation will make but fmall progrefs. Nothing can remove it but cuftom. Make the praaice fafhionable, and all the ob- jeaions at once vanifh. It is fafhion alone that has led the multitude fince the beginning of the world, and will lead them to the end. We muft, therefore, call upon the more enlightened part of mankind, to fet a pattern to the reft. Their example, though it may, for fome time, meet with oppofition, muft, at length, infallibly prevail. I am aware of an objeaion to this praaice, from the expence with which it may be attended ; this is eafily ob- viated. We do not mean that every parifh ought to employ a Sutton, or a Dimfdale, as inoculators. Thefe have, by their fuccefs, already recommended themfelves to crowned heads, and are beyond the vulgar reach ; but have not others an equal chance to fucceed ? They certain- ly have. Let them make the fame trial, and the difficulties will foon vanifh. There is not a parifti, and hardly a vil- lage in Britain, deftitute of fome perfon who can bleed. But this is a far more difficult operation, and requires both more fkill and time than inoculation. The perfons to whom we would chiefly recommend the performance of this operation are the clergy. Moft of them know fomething of medicine. Almoft all of them bleed, and can order a purge ; which are all the qualifica- tions neceflary for the praaice of inoculation. The priefls among the lefs enlightened Indians perform this office ; and why fhould a Chriftian teacher think himfelf above it ? Surely the bodies of men, as well as their fouls, merit a part of the pallor's care; at leaft, the greateft Teacher who ever appeared among men feems to have thought fo. Should all other methods fail, we would recommend it to parents to perform the operation themfelves. Let them take any method of communicating the difeafe they pleafe, provided the fubjea be healthy, and of a proper age ; and we may venture to warrant their fuccefs. I have known many OF THE SMALL-POX. 167 many inftances of parents performing the operation, and never fomuch as heard of one bad confequence. A plant- er in one of the Weft-India iflands is faid to have inocula- ted, with his own hand, in one year, three hundred of his flaves, who, notwithstanding the warmth of the climate, and other unfavourable circumftances, all did well. Common mechanics have often, to my knowledge, performed the ope- ration with as good fuccefs as phyficians. We do not, how- ever, mean to difcourage thofe, who have it in their power, from employing people of fkill to inoculate their children, and attend them while under the difeafe, but only to fhew, that where fuch cannot be had, the operation ought not, upon that account, to be negkaed. Instead of multiplying arguments to this effea, I fhall juft beg lelve to mention the method I took with my own child, an only fon. After giving him two gentle purges, I ordered the nurfe to take a bit of thread, which had been previoufly wet with frefh matter from a pock, and to lay it upon his arm, covering it with a piece of fticking plafter. This flaid on fix or feven days, till it was rubbed off by accident. At the ufual time, the fmall-pox made their ap- pearance, and were exceedingly favourable. Sure this, which is all that is neceflary, may be done without any fkill in medicine. The beft feafon of the year for inoculation, is towards the end of the fpring, and in the beginning of fummer. It may, however, be done at any time of the year, if circum- ftances render it neceflary. The moft proper age for inoculation is betwixt two and five. Many difagreeable circumftances attend inoculating children upon the breaft, which we have not time to enu- merate. Neither fhould the operation be too long delayed. When the fibres begin to grow rigid, and children make ufe of groffer food, the fmall-pox become more danger- ous. Children, who have conftitutional difeafes, muft, ne- verthekfs, be inoculated. It will often mend the habit of body ; but ought to be performed at a time when they are moft healthy. Accidental difeafes fhould always be re- moved before inoculation. The moft healthy ftate is always to be chofen, as that muft be the beftpreparation.The next ftep is to regulate thediet for fome time before the difeafe is communicated. In children great alteration in diet is feldom neceflary, their food being commonly 168 OF THE MEASLES. commonly of the the moft fimple and wholefome kind ; as milk, water pap, fmall broths, bread, light pudding, mild roots, and white meats. Children, however, who have been accuftomed to a hotter diet, wno are of a grofs habit* or abound with bad humours, ought to be put upon a fpare diet, before they be inoculated. Their food fhould be of a light cooling nature ; and, their drink, whey, butter-milk, and fuch like. We would recommend no other medicinal preparation, but two or three mild purges, which ought to be fuited to the age and ftrength of the patient. It is, no doubt, poffi- ble, by purgative and mercurial medicines, to leffen the eruption ; but it very feldom happens, that the eruption, in this way, proves too "great, and, we have always obferved, that thofe children who had a pretty free eruption, and where the pox filled well, enjoyed the beft health after- wards. The regimen, during the difeafe, muft be the fame as under the natural fmall-pox. The patient muft be kept cool, his diet muft be light, and his drink weak and dilu- ting, Ufe Should any bad fymptoms appear, which feldom happens, they muft be treated in the fame way as direaed in the natural fmall-pox. Purging is not lefs neceflary, after the fmall-pox by inoculation, than in the natural way, and ought, by no means, to be negkaed. Of the MEASLES. The meafles appeared about the fame time with the fmall-pox, and are nearly related to that difeafe. They both came from the Eaft, are both infeaious, and feldom attack people more than once. The meafles are moft com- mon in the fpring feafon, and generally difappear in the fummer. The difeafe itfelf, when properly managed, is feldom dangerous ; but its confequences arie often fatal. C A U S E.------This difeafe, like the fmall-pox, proceeds from infeaion, and is more or lefs dangerous, ac- cording to the conftitution of the patient, the feafon of the year, the climate, Ufe. SYMPTOM S.-----The meafles, like other fevers, are preceded by alternate fits of heat and cold, fick- nefs, and lofs of appetite. The tongue is white, but ge- nerally moift. There is a fhort cough, a heavinefs of the head OF THE MEASLES. 169 head and eyes, drowfinefs, and running of the nofe. Sometimes, indeed, the cough does not come before the eruption. The eye-lids frequently fwell fo as to occafion blindnefs. The patient generally complains of his throat ; and vomiting or loofenefs often precedes the eruption. The ftools in'children are commonly greenifh ; they complain of an itching of the fkin, and are remarkably peevifh. Bleeding at the nofe is common, both before and in the progrefs of the difeafe. About the fourth day, fmall fpots, refembling flea- bites, appear, firft upon the face, then upon the breaft, and, afterwards, on the extremities : Thefe may be diftin- guifhed from the fmall-pox, by their fcarcely rifing above the fkin. The fever, cough, and difficulty of breathing, inftead of being removed by the eruption, as in the fmall- pox, are rather increafed j but the vomiting generally ceafes. About the fixth day, the meafles begin to grow dry on the face, and, afterwards, upon the body ; fo that by the ninth day they entirely difappear. The fever, however, and difficulty of breathing, often continue, efpecially ifthe patient has been kept upon too hot a regimen. Petechia?, or purple fpots, may likewife be occafioned by this error. A violent loofenefs fometimes fucceeds the meafles, in which cafe the patient's life is in imminent danger. Such as die of the meafles generally expire about the ninth day, and are evidently carried off by a peripneumony, or inflammation of the lungs. The moft favourable fymptoms are, a moderate loofenefs, gentle fweats, and a plentiful difcharge of urine. When the eruption fuddenly falls in, and the patient is feized with a delirium, he is in the greateft danger. Ifthe meafles turn of a pale colour, it is an unfavourable fymp- tom, as are alfo, great weaknefs, vomiting, reftleffnefs, and difficulty of fwallowing. Purple, or black fpots, ap- pearing among the meafles, are very unfavourable. When a continual cough, with hoarfenefs, fucceeds the difeafe, there is reafon to fufpea an approaching confumption of the lungs. Our bufinefs in this difeafe is to affift nature, if her ef- forts be too languid, in throwing out the morbid matter, by proper cordials ; but when they are too violent, they muft be reftrained by evacuations, and cool diluting liquors, CSV. We ought, likewife, to endeavour to appeafe the Y moft 170 O F T H E M E A S L E S. moft urgent fymptoms, as the cough, reflkffnefs, and dif- ficulty of breathing. REGIME N.----— The regimen in this difeafe fhould be of the fame kind with that recommended in the fmall-pox, viz. cooling and diluting. Acids, however, do not anfwer fo well here as in the fmall-pox, as they tend to exafperate the cough. Small beer, likewife, though a good drink in the fmall-pox, is here improper. The moft fuitable liquors are decoaions of liquorice, with marfh-mallow roots, and farfaparilla; infufions of linfeed, or of the flowers of eider with milk, clarified whey, barley water, and fuch like. Thefe, if the belly be bound, may be fweetened with honey ; or, if that fhould difagree with the ftomach, a little manna may oceafionally be added to them. MEDICIN E.-----The meafles- being an in- flammatory difeafe, without any critical difcharge of mat- ter, as in the fmall-pox, bleeding is commonly neceflary, efpecially when the fever runs high, with difficulty of breathing, and great oppreffion of the breaft. But ifthe difeafe be of a mild kind, bleeding may be omitted. Bathing the feet and legs in lukewarm water, both tends to abate the violence of the fever, and to promote the eruption. The patient is often greatly relieved by vomiting. When there is a tendency this way, it ought not to be Hop- ped, but encouraged, by drinking lukewarm water, or weak camomile tea. When the cough is very troublefome, with drynefs of the throat, and difficulty of breathing, it will greatly re- lieve the patient; if he holds his head over the fleam of warm water, and draws the fleam into his lungs. He may likewife lick a little fpermaceti and fugar-can- dy pOunded together ; or take now and then a fpoonful of the oil of fweet-almonds, with fugar-candy diflblved in it. Tfiefe will foftcn the throat, and relieve the tickling cough. In cafe the meafles fhould fuddenly difappear, it will be neceflary to purfue the fame method which we have recom- mended when the fmall-pox fall in. The patient muft be fupported with wine and cordials. Bliftering plafters muft be applied to the extremities, and the body rubbed all over with warm flannels. Warm poultices may, likewife, be applied to the feet, and palms of the hands. When OF THE SCARLET FEVER. 171 When purple, or black fpots appear, the patient's drjnk fhould be fharpened with fpirits of vitriol r and, if the putrid fymptoms run high, the Jefuits bark muft be adminiftered in the fame manner as direaed in the fmall- pox. Opiates are "fometimes neceffary, but fhould never be given except in cafe of extreme reftleffnefs, a violent loofe- nefs, or when the cough is very troublefome. For chil- dren, the fyrup of poppies is fufficient. A tea fpoonful or two may be occafionally given, according to the patient's age, or the violence of the fymptoms. After the meafles are gone off, purging is abfolutely ne- ceffary. This may be conduaed in the fame manner as direaed in the fmall-pox. If a violent loofenefs fucceeds the meafles, it may be checked by taking, for fome days, a gentle dofe of rhubarb in the morning, and an opiate over night ; but, if thefe do not remove it, bleeding will feldom fail to have that effea. Patients recovering after the meafles, fhould be very careful what they eat or drink. Their food, for fome time, fhould be light, and in fmall quantities, and their drink diluting, and rather of an opening nature; as butter- milk, whey, and fuch like. They ought, alfo, to be- ware of expofing themfelves to the cold air, left a fuffoca- ting catarrh, an afthma, or a confumption of the lungs fhould enfue. Should a cough, with difficulty of breathing, and other fymptoms of a confumption, remain after the meafles, we would recommend fmall quantities of blood to be fre- quently let at proper intervals, as the patient's ftrength and conftitution will bear. He ought, likewife, to drink affes milk, to remove to a free air, if neceffary, and to ride daily on horfeback. He muft keep clofe to a diet, con- fifting of milk and vegetables ; and, laftly, if thefe do not fucceed, let him remove to a warmer climate. OftheSCARLET FEVER. The fcarlet fever is fo called from the colour of the pa- tient's fkin, which appears as if it were tinged with red wine. It happens at any feafon of the year, but is moft common in the latter end of fummer ; at which time it of- ten feizes whole families, efpecially children. Y 2 It x72 OF THE ERYSIPELAS, It begins with coldnefs and fhivering, as in other fevers, without any violent ficknefs. Afterwards the fkin is covered with red fpots, which are broader, more florid, and lefs uni- form than the meafles. They continue two or three days, and then difappear j after which the cuticle, or fcarf-fkin, fails off. There is feldom any occafion for medicine in this dif- eafe. The patient ought, however, to keep within doors, to abftain from flefh, ftrong liquors, and cordials, and to take plenty of cool diluting drink. If the fever be high, the bellv muft be kept gently open by emollient clyfters, or fmall dofes of nitre and rhubarb. A fcruple of the for- mer, with five grains of the latter, may be taken thrice a-day, or oftener, if neceffary. Children, and young perfons, are fometimes feized, at the beginning of this difeafe, with a kind of ftupor, and epileptic fits. In this cafe, the feet and legs fhould be bathed with warm water, a large bliftering plafter applied to the neck, and a dofe of the fyrup of poppies given every night till the patient recovers. After the fever is gone off, the patient ought to be purged once or twice. Of the ERYSIPELAS, or St. ANTHONY's FIRE. This difeafe, which in many parts of Britain is called the rofe, attack perfons at all periods of life, but is moft common between the age of thirty and forty. Perfons of a fanguine or plethoric habit, are moft liable to it. It often attacks young people, and pregnant women ; and fuch as have once been affliaed with it, are very liable to have it again. Sometimes it is a primary difeafe, and, at other times only a fymptom of fome other malady. Every part of the body is liable to be attacked by an eryfipelas, but it moft frequently feizes the legs or face, efpecially the latter. It prevails moft in autumn, or when hot weather is fucceed- ' ed by cold and wet. CAUSE S.------The erifipelas is frequently occa- fioned by violent paflions or affeclions of the mind ; as, fear, anger, Ufe. It is likewife occafioned by cold. When the bod/ has been heated to a great degree, and is immediately expofed to the cold air, fo that the perfpiration is fuddv.nly checked, an eryfipelas will often enfue. It may OR ST. ANTHONY'S FIRE. 173 may alfo be occafioned by excefs of ftrong liquor, by con- tinuing too long in a warm bath, or by any thing that over- heats the blood. If any of the natural evacuations be ob- ftruaed, or in too fmall a quantity, it may caufe an ery- fipelas. The fame effea will follow from a ftoppage of ar- tificial evacuations ; as, iffues, fetons, or the like. SYMPTOM S.----The eryfipelas attacks with a violent fhaking, heat, thirft, lofs of ftrength, pain in the head and back, reftleffnefs, and a quick pulfe ; to which may be added, vomiting, and fometimes a delirium. On the fecond, third, or fourth day, the part fwells, be- comes red, and fmall puftules appear ; at which time the fever generally abates. When the eryfipelas feizes the foot, the parts contigaous fwell, the fkinfhines ; and, ifthe pain be violent, it will afcend to the leg, and will not bear to be touched. When it attacks the face, it fwells, appears red, and the fkin is covered with fmall puftules, filled with clear water. One or both eyes are generally clofed with the fwelling ; and there is a difficulty of breathing. If the mouth or noftrils be very diy, and the patient drowfy, there is reafon to expea an inflammation of the brain. If the eryfipelas effeas the breaft, it fwells, and becomes exceedingly hard, with great pain, and is apt to fuppurate. There is a violent pain in the armpit on the fide affeaed, where an abfcefs is often formed. There is a kind of eryfipelas, which in fome parts of Britain goes by the name of the ring worm. It frequently attacks children about the region of the nav^l, where it furrounds the body like a girdle, and is not wi.h~ut dan- ger. The event of this difeafe depends greatly upon the con- ftitution of the patiegt.lt is feldom dangerous; yet I have known it prove fatal to people in the decline of life, who were of a fcorbutic habit, or whofe humours were vitiated bv irregular living, or unwholefome diet. ' If, in a day or two, the fwelling fubfides, the heat and pain ceafe, the rofy colour turns yellow, and the cuticle breaks and falls off in fcales, the danger is over. When the eryfipelas is large, deep, and afteas a very fenfible part of the body, the danger is great. If the red colour changes into black or blue, it will end in a mortifi- cation. Sometimes the inflammation cannot be difcuffed, but comes to fuppuration ; in which cafc, fiftulas, a gan- grene, 174- OF THE ERYSIPELAS, grene, or mortification, generally enfue. Where the con- ftitution was bad, I have frequently feen the kg fwell to ^prodigious ftze, and the cure prove extremely difficult. SUCH as die of this difeafe, are moftly carried off by the fever, which is attended with difficulty of breathing, fome- times with a delirium, and great drowfinefs. They gene- rally die about the feventh or eighth day. REGIME N.------In this difeafe the patient muft neither be kept too hot nor cold, as either of thefe extremes will tend to make the difeafe retreat, which is always to be guarded againft. When the difeafe is mild, it will be fufli- cient to keep the patient within doors, without confining him to his bed, and to promote the perfpiration by diluting liquors, Ufe The diet ought to be veryfpare,andofa moderately cool- ing and moiftening quality ; as groat gruel, panada, fmall chicken or barley broth, with cooling herbs and fruits,Ufe. arvoiding flefh, fifh, ftrong drink, fpices, pickles, and all other things that may heat and inflame the blood ; the drink may be barley water, an infufion of elder flowers, common whey, and fuch like. But if the pulfe be low, and the fpirits funk, the patient rnuft be fupported with fmall negas and other thingsof a cor- dial nature. His food may be fago gruel with a little wine, and nourifhing broths, taken in fmall quantities, and often re- peated. Great care, however, muft be had not to over- heat him. M E D I C I N E.----In this difeafe much mifchief is often done by medicine, efpecially external applications. People, when they fee an inflammation, immediately think of fome external applications. Thefe, indeed, are neceffa- ry in large phlegmons ; but, in an eryfipelas, the fafer courfe is to apply nothing. Almoftfcll ointments, falves and plafters, are of a greafy nature, and tend rather to ob- ftrua and repel, than promote any difcharge from the part. At the beginning of this difeafe, it is neither fafe to pro- mote a fuppuration, nor to repel the matter too quickly. The eryfipelas, in many refpeas, refembks the gout, and is to be treated with the greateft caution. Fine wool, or very foft flannel;, are the fafeft applications to the part. Thefe not only defend it from the external air, but likewife promrte the perfpiration, which has a great tendency to carry off the difeafe. It OR ST. ANTHONY'S FIRE. 175 It is a common thing to bleed in the eryfipelas ; but this likewife requires caution. If, however, the fever be high, the pulfe hard and ftrong, and the patient vigorous, it will, be proper to bleed ; but the quantity muft be regulated by thefe circumftances, and the operation repeated or not, as the fymptoms may require. If the patient has been accu- ftomed to ftrong liquors,. and the difeafe attacks his head, bleeding is abfolutely neceffary. Bathing the feet and legs frequently in lukewarm water, when the difeafe attacks the face or brainr, has an excellent effea. It tends to draw the humours of the head towards the inferior extremities, and feldom fails, to relieve the pati- ent. When bathing proves ineffeaual, poultices, or fharp finapifms, may be applied to the foles of the feet for the fame purpofe. In cafes where bleeding is requifite, it is likewife necefla- ry to keep the belly gently open. This may be effeaed by emollient'clyfters, or fmall dofes of nitre and rhubarb, fuch as are prefcribed in the foregoing difeafe. Some, in- deed, recommend very large dofes of nitre in this cafe; but nitre feldom'fits eafy on the ftomach when taken in large quantities. It is, however, one of the beft medicines in this cafe; and, when the fever and inflammation run high, half a dram of it may be taken in the patient's ordinary drink, three or four times a-day. The faline julep, as itis calltd, is likewife a very proper medicine in the eryfipelatous fever. It may be made by diffolving two drams of fait of wormwood, or fait of tartar, in three ounces of frefh lemon juice, to which may be add- ed, two ounces of common water, and an ounce or two of peppermint water, with as much white fugar as will render it agreeable. Of this two table fpoonfuls may be taken every two or three hours. When the eryfipelas leaves the extremities, and feizes the head, fo as to occafion a delirium, or ftupor, it is ab- folutely neceffary to open the belly. If clyfters and mild purgatives fail to have that effea, ftronger ones muft be given. Bliftering plafters muft, likewife, be applied to the neck, or behind the ears, and fharp cataplafms laid to the foles of the feet. When the eryfipelas cannot be difcuffed, and the pain lies deep, and feems to reach to the membrane, which co- vers the bones, and the part has a, tendency to ulcerate, it will then be proper to promote fuppuratipn,. which mav be 176 INFLAMMATION OF THE BRAIN. be done by the application of ripening poultices, with faf- fron, warm fomentations, and fuch like. When the black, livid, or blue colour of the part, fhews a tendency to mortification, the Jefuits bark muft be adminiftered. It may be taken along with acids, as re- commended in the fmall-pox, or in any other form more agreeable to the patient. • It muft not, however, be trifled with, as the patient's life is at flake. Haifa dram maybe taken every two hours, or oftener, if the fymptoms be threatening, and cloths dipped in warm camphorated fpi- rits of wine, or the tinaure of myrrh and aloes, may be applied to the part, and frequently renewed. In what is commonly the fcorbutic eryfipelas, which continues for a confiderable time, it will only be neceffary to give gentle laxatives, and fuch things as purify the blood. Medicines which promote the perfpiration are likewife proper. Thus, after the inflammation has been checked by opening medicines, a decoaion of the fudorific woods,as faffafras and guaiacum, with liquorice root, may be drank, and afterwards a courfe of bitters, which will both ftrengthen the ftomach, and purify the blood. Such as are liable to frequent attacks of the eryfipelas, ought carefully to guard againft all violent, paffions ; to ab- flain from ftrong liquors, and all fat, vifcid, and highly nourifhing food. They fhould take abundance of exercife, carefully avoiding the extremes of heat or cold. Their food fhould confift chiefly of milk, and fuch fruits, herbs, and roots, as are of a cooling quality ; and their drink ought to be fmall beer, whey, butter-milk, and fuch like. They fhould never fuffer themfelves to be too Ion* coftive. If that cannot be prevented by diet alone, it will be proper to take frequently a gentle dofe of rhubarb and cream of tartar, the lenitive ekauary, or fome other mild purga- tive. Of the INFLAMMATION of the BRAIN. This is fometimes a primary difeafe, but oftener only a fymptom of fome other malady j as the inflammatory, eruptive, or fpotted fever, Ufe It is very common, how- ever, as a primary difeafe in warm climates, and is moft incident to perfons about the prime and vigour of life. The paffionate, the ftudious, and thofe whofe nervous fyftem is weak, are very liable to it. CAUSES. INFLAMMATION OF THE BRAIN. 177 CAUSE $.•----■ This difeafe is often occafioned by night-watching, efpecially when joined with hard ftudy : It, likewife, proceeds from hard drinking, from anger, grief, or anxiety. It may, alfo, be occafioned by a feden- tary lift-, or the ftoppage of ufual evacuations ; as the bleeding piles in men, the cuftomary difcharges of women, Ufe Such as imprudently expofe themfelves to the heat of the fun, efpecially by fleeping without doors, in a hot feafon, with their hemds uncovered, are often fuddenly feiz- ed with an inflammation of the brain, fo as to awake quite delirious. When repellents are imprudently ufed in an eryfipelas, an inflammation of the brain is often the confe- quence. It may, likewife, be occafioned by external in- juries, as blows, or bruifes upon the head, Ufe SYMPTOM S.----The fymptoms which precede a true inflammation of the brain are, pain of the head, rednefs of the eyes, a violent flufhing of the face, difturb- ed fleep, or a total want of it, great drynefs of the fkin, coftivenefs, a retention of urine, a fmall dropping of blood from the nofe, finging of the ears, and extreme fenfibility of the nervous fyftem. When the inflammation is formed, the fymptoms, in gejyffal are fimilar to thofe of the inflammatory fever. The pjfl£, indeed, is often weak, irregular, and trembling ; but, fometimes, it is hard and contracted. When the brain itfelf is inflamed, the pulfe is always foft and low ; but when the inflammation only affeas the integuments of the brain, it is hard. A remarkable quicknefs of hearing, is a com- mon fymptom of this difeafe ; but that feldom continues long. Another ufual fymptom is, a great throbbing or pul- fation in the arteries of the neck and temples. The tongue is often black and dry ; yet the patient feldom complains of thirft, and even refufes drink. The mind chiefly runs after fuch objeas as have before made a deep impreffion upon it ; and, fometimes, from a fullen fiknce, the patient be- comes all of a fudden quite outrageous. A conftant trembling and ftarting of the tendons, is an unfavourable fymptom, as alfo, a fuppreffion ©f the urine; a total want of fleep ; a conftant fpitting ; a grinding of the teeth, which muft be confidered as a kind of convulfi- on. When this difeafe fucceeds an inflammation of the lungs, of the inteftines, or of the throat, Ufe it is owing to a tranflation of the morbific matter from thefe parts to the brain, and generally proves fatal. Hence we learn the neceffity of proper evacuations, and the danger of repellents in all inflammatory difeafes. ^ The r;8 INFLMMATION OF THE BRAIN. The favourable fymptoms are, a free perfpiration or fweating, a copiousJdifcharge of blood from the nofe, the bleeding piles, a plentiful difcharge of urine, which lets fall a copious fediment. Sometimes the difeafe is carried off by a loofenefs, and in women by an exceffive flow of the tnenfes. As this difeafe often proves fatal in a few days., it re- quires the moft fpeedy applications. When it is prolong- ed, or improperly treated, it fometim«s ends in madnefs, or a kind of ftupidity, which continues for life. • In the cure, two things are chiefly to be attended to, 'viz. to leffen the quantity of blood in the brain, and to re- tard the circulation towards the head. REGIME N—- The patient ought to be kept very quiet. Company, noife, and every thing that affeas the fenfes, or difturbs the imagination, increafes the difeafe. Even too much light is hurtful ; for which reafon, the pa- tient's chamber ought to be a little daikened,and he fhould neither be kept too hot nor cold. It is not, however, neceflary to exclude the company of an agreeable friend, as this has a tendency to footh and quiet the mind. Nei- ther lhould the patient be kept too much in the dark, left it fhould occafion a glqomy melancholy, which is too ofen the confequence of this difeafe. iP- The patient muft, as far as poffible, be foothed and hu- moured in every thing. Contradiaion will ruffle his mind, and increafe his malady. Even when he calls for things which are not to be obtained, or which might prove hurtful, he is not to be pofitively denied them, but rather put off with the promife of having them as foon as they can be obtained, or by fome otherexcufe. A little of any thing that the mind is fet upon, though not quite proper, will hurt the patient lefs than a pofitive refufal. Jn a word, whatever the patient is fond of, or ufed to be delighted with when in health, may here be tried, as plea- fing flories, foft mufic, or whatever has a tendency to footh the paffions, and compofe the mind. Boerhaave pro- pofes feveral .mechanical experiments for this purpofe ; as the foft noife of water diftilling by drops into a bafon, and the patient trying to reckon them, Ufe Any uniform found, if low and continued, has a tendency to procure fleep, and, confequently, may be of fervice. The aliment ought to be light, of farinaceous fubftances; as panado, and water gruel, fharpened with jelly of cur- rants INFLAMMATION OF THE BRAIN. 179 rants, or juice of lemons, ripe fruits roafted or boiled, jellies, preferves, Ufe The drink fmall, diluting, and cooling, as whey, barley water, or decoaions of barley and tamarinds ; which latter, not only renders the liquor more palatable, but likewife more beneficial, as they are of an opening cooling nature. MEDICINE S.—— In an inflammation of the brain, "'nothing more certainly relieves the patient than a free difcharge of blood from the nofe. When this comes of its own accord, it is by no means to be flopped, but promoted, by applying cloths dipped in warm water to the part. When bleeding at the nofe does not happen fponta- neoufly, it may be provoked by putting a ftraw, or any other fharp body up the noftril. Bleeding in the temporal arteries greatly relieves the head ; but as this operation cannot be generally performed, we would recommend in its ftead bleeding in the jugular veins. When the patient's pulfe and fpirits are fo low, that he cannot bear bleeding with the lancet, leeches may be applied to the temples. Thefe not only draw off the blood more gradually, but by being applied nearer to the part affeaed, generally give more immediate relief. A difcharge of blood from the hemorrhoidal veins is like- Wife of great fervice, and ought, by all means, to be pro- moted. If the patient has been fubjea to the bleeding piles, and that difcharge has been flopped, every method muft be tried to reftorc it j as the application of leeches to the parts, fitting over the fleams of warm water, fharp cly- fters, or fuppofitories made of honey, aloes, and rock fait. If the inflammation of the brain be occafioned by the ftoppage of any evacuation, either natural or artificial, as themenfes, iffues, fetons, or fuch like, all means muft be ufed to reflore it as foon as poffible, or to fubftitute fome other in its ftead. If the patient be coftive, his belly muft be kept open by emollient clyfters, or gentle purgatives; as manna, rhu- barb, cream of tartar, or fuch like. Thefe may either be given feparately or together in fmall dofes, and repeated as there may be occafion. Small quantities of nitre ought frequently to be mixed ' with the patient's drink. Two drams, or more, if the cafe be dangerous, may be ufed every twenty-four hours. The head fhould be fhaven, and frequently rubbed with vinegar and rofe water a little warm. Cloths dipped in it may likewife be applied to the temples. Z 2 If 180 INFLAMMATION OF THE EYES. If the difeafe proves obftinate, and does not yield to thefe medicines, it will be neceffary to apply a bliftering plafter to the whole head. Of the INFLAMMATION of the EYES. This difeafe may be occafioned by external injuries ; as ftrokes, dull thrown into the eyes, Ufe. It is often caufed by the ftoppage of cuftomary evacuations ; as the healing of old fores, drying up of iffues, or the like. Nothing more certainly brings on an inflammation of the eyes, than the fuppreffion of gentle morning fweats, or the fweating of the feet. Long expofure to the night air, efpecially in cold northerly winds, or whatever fuddenly checks the perfpiration, efpecially after the body has been much heat- ed, is very apt to caufe an inflammation of the eyes. View- ing fnow or other white bodies for a long time, or looking ftedfaftly at the fun, a clear fire, or any bright objea, will likewife occafion this malady. A fudden transition from darknefs to very bright light, will often have the fame effea. Nothing more certainly occafions an inflammation of the eyes than night watching, efpecially reading or writing by candle light. Drinking fpiritous liquors, and excefs of venery, are very hurtful to the eyes. The acrid fumes of metals, and of feveral kinds of fuel", are likewife very perni- cious. Sometimes an inflammation of the eyes proceeds from a venereal taint, and often from a fcrophulous or gouty habit. It may likewife be occafioned by hairs in the eye-lids turning inwards, and hurting the eyes. Sometimes the difeafe is epidemic, efpecially after wet feafons ; and I have frequently known it prove infeaious, particularly to thofe who lived in the fame houfe with the patient. It may be occafioned by moift air, or living in low, damp houfes, efpecially where people are not accuftomed to fuch fituations. In children, it often proceeds from imprudent- ly drying up of fcabbed heads, a running behind the ears, or any other difcharge of the fame nature. Inflammations of the eyes often fucceed the fmall-pox, or meafles, efpe- cially in children of a fcrophulous habit. SYMPTOM S.----An inflammation of the eyes is attended with acute pain, heat, rednefs, and fwelling. The patient is not able to bear the light, and fometimes he feels a pricking pain, as if his eyes were pierced with a thorn. INFLAMMATION OF THE EYES, i8r thorn. Sometimes he imagines his eyes are full of motes, or thinks he fees flies dancing before him, the eyes are fill- ed with a fcalding rheum, which rufhes forth in great quantities, whenever the patient attempts to look up. The pulfe is generally quick and hard, with fome degree of fever. When the difeafe is violent, the neighbouring parts fwell, and there is a throbbing or pulfation in the temporal arteries, Ufe A flight inflammation of the eyes, efpecially from an ex- ternal caufe, is eafily cured ; but when the difeafe is vio- lent, and continues long, it leaves fpecks upon the eyes, or dimnefs of fight, and fometimes total blindnefs. If the patient be feized with a loofenefs, it has a good effea ; and when the inflammation paffes from one eye to another, as it were by infeaion, it is no unfavourable fymptom. When the difeafe is accompanied with a vio- lent pain of the head, and continues long, the patient is in great danger of lofing his fi^ht. REGIME N.---- The diet, unlefs in fcrophulous cafes, can hardly be too fpare, efpecially at the beginning. The patient muft abftain from every thing of a heating na- ture. His food muft confift chiefly of mild vegetables, Weak broths, and gruels. His drink may be barley water, balm fea, common whey, and fuch like. The patient's chamber muft be darkened, or his eyes fhaded by a green cover, fo as to exclude the light, but not to prefs upon the eyes. He fhould not look at a candle, the fire, or any luminous objea ; and ought fo avoid all fmoke, as the fumes of tobacco, orany thing r:r„t may caufe cough- ing, fneezing, or vomiting. He fhould Ke kept quiet, avoid- ing all violent efforts, either of body or mind, and encou- raging fleep, as much as poffible. ME D i C I N E.«---- This is one of thofe difeafes wherein great hurt is done by external applications. Al- moft every perfon pretends to be poffefled of a remedy for the cure of fore eyes. Thefe remedies generally confift of eye- waters and ointments, with other external applications. All which do mifchief twenty times for once they do good. People ought, therefore, to be very cautious how they ufe fuch things, as the very preffure upon the eyes often Lncrea- fes the malady. Bleeding, in a violent inflammation of the eyes, is al- ways neceffary. This fhculd be performed as near the part affeaed as poffible. An adult may lofe ten or twelve ouoces of m INFLAMMATION OF THE EYES. of blood from the jugular vein, and the operation may be re- peated according to the urgency of the fymptoms. If it be not, however, convenient to bleed in the neck, the fame quan- tity may be let from the arm, or any other part of the body. Leeches are often applied to the temples, or under the eyes with good effea. The wounds muft be fuffered to bleed for fome hours, and if the bleeding flop foon, it may be promoted by the application of cloths dipt in warm water. In obftinate cafes, it will be neceffary to repeat this opera- tion feveral times. Opening and diluting medicines are by no means to be negkaed. The patient may take a fmall dofe of Glaiw ber's falts and cream of tartar, every fecond or third day, or a decoaion of tamarinds with fenna. If thefe be not agreeable, gentle dofes of rhubarb and nitre, a little of the lenitive electuary, or any other mild purgative, will anfwer the fame end. The patient, at the fame time, muft drink freely of water gruel, tea, or any other weak diluting li- quor. He Ought likewife to take, at bed-time, a large draught of very weak wine whey, in order to promote per- fpiration. His feet and legs muft frequently be bathed in lukewarm water, and his head fhaved twice or thrice 2-week, and afterwards wafhed in cold water. This has a remarkable good effea. After thefe evacuations have been continued for fome time, ifthe inflammation does not yield to them, bliftering plafters muft be applied behind the ears, to the temples, or upon the neck, and kept open for fome time by the mild bliftering ointment. I never knew thefe, if long enough kept open, fail to remove the moft obftinate inflammation of the eyes ; but, for this purpofe it is often neceffary to con- tinue the difcharge for feveral weeks. When the difeafe has been of long ftanding, I have feen very extraordinary effeas from a feton in the neck, or be- twixt the fhoulders, efpecially the latter. It fhould be put upwards and downwards, Or in the direaion of the fpine, and in the middle between the fhoulder-blades. It may be dreffed twice a-day with yellow bafilicon. I have known patients, 'who had been blind for feveral months, recover light by means of a feton betwixt the fhoulders. When the feton is put a-crofs the neck, it foon wears out, and is both more painful and troublefome than between the fhoulders ; befides, it leaves a difagreeable mark, and does not difcharge fo freely. When INFLAMMATION OF TH^E EYES. 183 When the heat and pain of the eyes is very great, a foft poultice of bread and milk, with plenty of fweet oil or frefh butter, may be applied to them, at leaft all night; and they may be bathed with lukewarm milk and water every mornr ing. If the patient cannot fleep, which is fometimes the cafe, he muft take ten or tweiye drops of laudanum, or two fpoon- fuls of the fyrup of poppies, over night, more or lefs ac- cording to his age, or the violence of the fymptoms. After the inflammation is gone off, if the eyes ftill re- main weak and tender, they maybe bathed every night and morning with cold water and a little brandy, fix parts of the former to one of the latter. A method fhould be con- trived by which the eyes can be quite immerfed in the bran- dy and water, where they fhould be kept for fome minutes. J have generally found this as good a ftrengthener of the eyes as any of the moft celebrated collyriums. When an inflammation of the eyes proceeds from a fcro- phulous habit, it generally proves very obftinate. Jn this cafe the patient's diet muft not be too low, and he may be allowed to drink fmall negas, or now and then a glafs of wine. The moft proper medicine is the Jefuits bark, which may either be given in fubftance, or prepared in the following manner : Take an ounce of Jefuits bark in powder, with two drams of Winter's bark, and boil them in an Englifh quart of water to a pint; when it has boiled nearly long enough, add half an ounce of liquorice root fliced. Let the liquor be ftrained. Two, three, or four table fpoonfuls, according to the age of the patient, may be taken three or four times a-day. It is impoffible to fay how long this mer dicine fhould be continued, as the cure is fooner performed in fome than others ; but, in geneial, it requires a confir derable time to produce any lafting effeas. Dr. Cheyne fays, " That asthiops mineral never fails in inflammations of the eyes, even fcrophulous ones, if given in a fufficient dofe, and periifted in for a fufficient time." Both this and other mercurial preparations, are no doubt proper when the difeafe proves obftinate; more efpecially, when there is reafon to fufpea that it may proceed from a venereal taint ; but as thefe medicines can never be fafely adminiftered unlefs under the direaion of a phyfician, we (hall omit fpecifying their particular dofes, Ufe." 184 O F T H E CLU I N S E Y. It will be proper frequently to look into the eyes, to fee if any hairs be turned inwards, or prefling upon them, in order that they may be cut off without delay. Such as are liable to frequent returns of this difeafe, ought conftantly to have an iffue in one or both arms. Bleeding or purging in the fpring and autumn, will be very beneficial to fuch perfons. They ought likewife to live re- gularly, avoiding ftrong liquor, and every thing of a heat- ing quality. Above all, let them avoid the night air and late ftudies. Of the QtriNSEY, or INFLAMMATION of the THROAT. This difeafe is very common in Britain, and is fre- quently attended with great danger, it prevails in the win- ter and fpring, and is moft fatal to young people of a fan- guine or plethoric habit. CAUSE S.------In general, it proceeds from the fame caufes as other inflammatory fevers, viz. an obftruaed per- fpiration, or whatever heats or inflames the blood. An in- flammation of the throat is often occafioned by omitting fome part of the covering ufually worn about the neck, by drinking cold liquor when the body is warm, by riding or walking againft a cold northerly wind, or any thing that greatly cools the throat, and parts adjacent. It may like- wife procecJ from the negka of bleeding, purging, or any cuftomary evacuation. Singing, fptaking loud and long, or whatever ftrains the throat, may likewife caufe an inflammation of that or- gan. I ha^e often known the quinfey prove fatal to jovial companions, after fitting long in a warm room, ^drinking hot liquors and finging with vehemence ; efpecially, when they were fo imprudent as afterwards to go abroad in the cold night air. Sitting with wet feet, or keeping on wet cloaths, are very apt to occafion this malady. It is likewife frequently occafioned by continuing long in a moift place, fleeping in a damp bed, fitting in a room that has been newly plaftered, Ufe I know people who never fail to com- plain of their throat after fitting but a very fhort while in a room that h.-is been lately wafhed. Acrid or irritating food may likewife inflame the throat, and occafion a quinfey. It may alfo proceed from bones, pins, or other lhap fubftances fticking in the throat, or from OF THE Q_UINSEY. 185 from the cauftic fumes of metals or minerals, as arfenic, an- timony, Ufe taken in by the breath. This difeafe is fome- times epidemic and infeaious. SYMPTOM S.----The inflammation of the throat is evident from infpeaion, the parts appearing red and fwelled ; befides, the patient complains of pain in fwallow- ing any thing. His pulfe is quick and hard, with other fymptoms of a fever. If blood be let, it is generally covered with a tough coat of a whitifh colour, and the patient fpits a tough phlegm. As the fwelling and inflammation increafe, the breathing and fwallowing become the more difficult, the pain aftbas the ears; the eyes generally appear red, and the face fwells. The patient is often obliged to keep himfelf in an erea pofture, being in danger of fuffocation ; there is a conftant naufea, or inclination to vomit, and the drink, in- ftead of paffing into the ftomach, is often returned by the nofe. The patient is frequently ftarved at laft, merely from an inability of fwallowing any kind of nouriftiment. When the breathing is performed with a hiffing noife, and the pulfe begins to intermit, death is at hand. As feveral of the organs neceffary for life are affeaed by this difeafe, it can never be without danger j no time there- fore fhould be loft in attempting to remove it, as a little de- lay often renders it incurable. When the breathing is laborious, with ftraitnefs of the breaft and anxiety, the danger is great. Though the pain of fwallowing be very great, yet while the patient breathes eafy, there is not fo much danger. An externa) fwelling is no unfavourable fymptom ; but if it fuddenly falls, and the morbific matter is thrown upon the breaft, the danger is very great. When a quinfey is the confequence of fome other difeafe, which has already weakened the patient, his fituation is dangerous. A frothing at the mouth, with a fwelled tongue, a pale ghaftly countenance, and coldnefs of the extremities, are fatal fymptoms. REGIME N.-----The regfmen in this difeafe is in all refpeas the fame as in the pleurify or peripneumony. The food muft be light, and in fmall quantity, and the drink plentiful, weak, and diluting, mixed with acids. It is highly neceffary, in this difeafe, that the patient be kept eafy and quiet. Violent paffions of the mind, or great efforts of the body, may prove fatal. He fhould not even attempt to fpeak but in a low voice. Such a degree of warmth as to promote a conftant gentle fweat is proper. When the A a patient 185 OF THE Q_U I N S E Y. patient is in bed, his head ought to be raifed a little higher than ufual. It is peculiarly neceffary that the throat be kept warm ; for which purpofe feveral folds of foft flannel maybe wrapt round the neck : That alone will often remove a flight complaint of the throat, efpecially if applied in due time. We cannot here omit obferving the propriety of a cuftom which prevails amongft the peafants of this country ; when they feel any uneafinefs of the throat, they wrap a flocking about it all night. So effeaual is this remedy, that, in many places, it paffes for a charm, and the flock- ing is applied with particular ceremonies : The cuftom, however, is undoubtedly 2 good one, and fhould never be negkaed. When the throat has been thus wrapt up all night, it muft not be expofed to the cold air through the day, but a handkerchief, or a piece of flannel, kept about it, till the inflammation be gone. The jelly of black currants is a medicine very much in efteem for complaints of the throat; and indeed the whole materia medica cannot afford a better. It fhould be almoft conftantly kept in the mouth, and fwallowed down leifure- ly. It may likewife be mixed in the patient's drink, or taken any other way. When it cannot be obtained, the red currant jelly, or the mulberry, may be ufed in its ftead. Gargles for the throat are likewife very beneficial. They may be made by adding to half an Englifh pint of the peacral decoaion mentioned in page no, two or three fpoonfuls of honey, and the fame quantity of currant jelly. This may be ufed three or four times a-day ; and, if the patient be troubled with tough vifcid phlegm, the gargle may be made more fharp and cleanfing, by adding to it a tea fpoonfui of the fpirits of fal ammoniac. Some recom- mend gargles made of a decoclion of the leaves or bark of the blackberry bufh ; but where the jelly can be had, thefe are unneceffary. There is no difeafe wherein the benefits of bathing the feet and legs in lukewarm water are more apparent. That practice ought, therefore, never to be neglected. If people were careful to keep warm, to wrap up their throats with flannel, to bathe their feet and legs in warm water, and to ufe a fpare diet, with diluting liquors, at the beginning of this difeafe, it would feldom proceed to any great height, or be attended with any danger j but when thefe precauti- ons O F T H E Q,U I N S E Y. 187 ons are negkaed, and the difeafe becomes violent, more powerful medicines are neceffary. M E D I C I N E.----An inflammation of the throat being one of the moft acute and dangerous diftempers, which fometimes takes off the patient in a few hours, the moft early remedies are, with the greateft care and di- ligence to be adminiftered. In the very firft attack, there- fore, when it is violent, it will be proper to bleed in the arm, or rather in the jugular vein, and to repeat the ope- ration if the fymptoms require. The belly fhould likewife be gently opened. This may either be done by giving the patient for his ordinary drink a decoaion of figs and tamarinds, or fmall dofes of rhu- barb and nitre, as recommended in page 172.. Thefe may be increafed according to the age of the patient, and repeat- ed till they have the defired effea. I have often known very good effeas from a bit offal prunel, or purified nitre, held in the mouth, and fwllowed down as it melted. This promotes the difcharge of faliva, by which means it anfwers the end of a gargle, while, at the fame time, it cools the blood, by promoting the dif- charge of urine, Ufe The throat ought, likewife, to be rubbed twice or thrice a-day with a little of the volatile liniment. This may be made by taking an ounce of oil of fweet almonds, and half an ounce of fpirit of hartfhorn, and fhaking them together in a vial till they be united. I do not remember ever to have feen this fail to produce fome good effeas. The throat fhould be carefully covered with wool or flannel, to prevent the cold from penetrating the fkin, as this application ren- ders it, very tender. Many other external applications are recommended in this difeafe, as a fwallow's neft, poultices made of the funges called Jews-ears, Ufe But as we do not look upon any of thefe to be preferable to a common poultice of bread and milk, we fhall take no farther notice of them. Blistering upon the neck, or behind the ears, in vio- lent inflammations of the throat, is very beneficial. After the plafters are taken off, the part ought to be kept running by the application of fharp ointment, till the inflammation is gone ; otherwife, upon their drying up, the patient will be in danger of a relapfe. When the patient has been treated as above, a fuppura- tion feldomhappens. This, however, in fometimes the cafe, in A a 2 fpite 188 O F T H E Q^U I N S E Y. fpite of all our endeavours to prevent it. When the inflam- mation and fwelling continue, and it is evident that a fup- puration will enfue, it ought to be promoted by drawing the fleam of warm water into the throat through a tunnel, or the like. Soft poultices ought, likewife, to be applied outwardly, and the patient may keep a roafted fig conitant- ly in his mouth. It fometimes happens, before the tumour breaks, that the fwelling is fogreat, as entirely to prevent any thing from getting down into the ftomach. Jn this cafe, the patient inuft inevitably perifh, unlefs he can be fupported in fome ether way. This can only be done by nourifhing clyfters of broth, or gruel with milk, Ufe Patients have often been fupported by thefe for feveral days, till the tumour has broke ; and afterwards they have recovered. Not only the paffage of the food, but the breathing is often prevented by the tumour. In this cafe, nothing can fave the pa.knt's life, but opening the trachea or windpipe, That has been fo often done with fuccefs, that no perfon, in fuch defperate circumftances, ought to hefitate a mo- ment about the operation ; but as it can only be performed by a furgeon, it is not neceffary here to give any direaions about it. ,. When a difficulty of fwallowing is not attended with an acute pain or inflammation, it is generally owing to an ob- ftruaion of the glands about the throat, and only requires that the part be kept warm, and the throat frequently gar- gled with fomewhat that may gently flimulate the glands, as a decoaion of figs with vinegar and honey ; to which may be added a little muftard, or a fmall quantity of fpirits. But this kind of gargle is never to be ufed where there are figns of an inflammation. This fpecies of angina has various names among the common people, as the pap of the throat, the falling down of the almonds of the ears, Ufe Ac- cordingly, to remove it, they pull the patient up by the hair of the head, and thruft their fingers under his jaws, Ufe all which praaices are, at beft, ufelefs, and often hurtful. Those who are fubjea to inflammations of the throat, in order to prevent too great a fulnefs of blood and hu- mours, ought to live temperately. Such as do not choofe to obferve this rule, muft have frequent recourfe to purging and other evacuations, to difcharge the fuperfluous hu- mours. They ought likewife to beware of catching cold, OF THE MALIGNANT QUINSEY. 189 and fhould abftain from aliment and medicines of an aftrin- gent or ftimulating nature. Violent exercife, by increafing the motion and force of the blood, is apt to occafion an inflammation of the throat, efpecially if cold liquor be drank immediately after it, or the body fuffered fuddenly to cool. Thofe who would avoid this difeafe, ought, therefore, after fpeaking aloud, finging, running, drinking warm liquor, or doing any thing that may ftrain the throat, or increafe the circu- lation of the blood towards it, to take care to cool gradu- ally, and to wrap plenty of coverings about their necks, Ufe. I have often known perfons who had been fubjea to fore throats, kept intirely free from that complaint by only wearing a ribband, or a bit of flannel, conftantly about their necks, or by wearing a pair of thicker (hoes, Ufe Thefe may feem trifling, but they have great effed. There is danger indeed in leaving them off, after perfons have been accu- ftomed to them ; but furely the inconveniency of ufing fuch things for life, is not to be compared with the danger which may attend the negle& of them. Of the MALIGNANT QUINSEY, OR PUTRID, ULCEROUS SORE THROAT. This kind of quinfey is but little known in the northern parts of Britain, though, for fome time paft, it has been very fatal in the more fouthern counties. Children are more fubjea to it than adults, females than males, and the delicate than thofe who are hardy and robuft. It prevails moft in autumn, or after a long courfe of damp, or fultry weather. C A U S E.----This is evidently a contageous diftem- per, and is generally communicated by infeaion. Whole families, and even entire villages often receive the infeaion from one perfon. This ought to put people upon their %uard againft going near fucn patients as labour under the diforder ; as by that means they endanger not only their own lives, but likewife thofe of their friends and connecti- ons. SYMPTOM S.-----It begins with alternate fits of fhivering and heat.The pulfe is quick, but low and une- qual, and generally continues fo through the whole courfe of the difeafe. The patient complains greatly of weaknefs and j90 OF THE MALIGNANT QUINSEY. and oppreffion of the breaft ; his fpirits are low, and he is apt to faint away when fet upright ; he is troubled with a naufea, and often with a vomiting or purging, The two latter are moft common in children. The eyes appear red and watery, and the face fwells. The urine is at firft pale and crude ; but, as the difeafe advances, it turns more of a yellowifh colour. The tongue is white, and generally moift, which diftinguifhes this from an in- flammatory difeafe. Upon looking into the throat it ap- pears fwelled, and of a florid red colour. Pale, or afh- coloured fpots, however, are here and there interfperfed, and fometimes one broad patch or fpot, of an irregular fi- gure, and pale white colour, furrounded with florid red only appears. Thefe whitifh fpots, or floughs, cover fo many ulcers underneath. A n efflorefcence, or eruption upon the neck, arms, breaft, and fingers, about the fecond or third day, is a common fymptom of this difeafe. When it appears, the purging and vomiting generally ceafe. There is often a flight degree of delirium, and the face frequently appears blotted, and the infide of the noftrils red and inflamed. The patient complains of a difagreeable, 1 putrid fmell, and his breath is very offenfive. The putrid, ulcerous fore throat, may be diftinguifhed from the inflammatory, by the vomiting and loofenefs, with which it is generally ufhered in ; by the foul ulcers in the throat, covered with a white or livid coat; and, by the exceffive weafeiefs of the patient ; with other fymptoms of a putrid fever. Unfavourable fymptoms arc, an obftinate purging, extreme weaknefs, dimnefs of the fight, a livid or black colour of the fpots, and frequent fhiverings, with a weak, fluttering pulfe. If the eruption upon the fkin fuddenly difappears, or becomes of a livid colour, with a dif- charge of blood from the nofc or mouth, the danger is very great. If a gentle fweat breaks out about the third or fourth day, and continues with a flow, firm, and equal pulfe ; if the floughs caft off in a kindly manner, and appear clean and florid at the bottom ; and if the breathing be foft and free, with a lively colour of the eyes, there is reafon to hope for a falutary crifis. REGIME N.----The patient muft be kept quiet,. and, for the moft part, in bed, as he will be apt to faint when taken out of it. His food muft be nourifhing and reftorative ; OF THE MALIGNANT QUINSEY. 19* reftorative ; as fago gruel with red wine, jellies, broths, Ufe. His drink ought to be generous, and of an antifep- tic quality ; as red wine negas, white wine whey, and fuch like. M E D I C I N E.----The medicine in this kind of quinfey is entirely different from that which is proper in the inflammatory. All evacuations, as bleeding, purging, Ufe. which weaken the patient, muft be avoided. Cooling medicines, as nitre, and cream of tartar, are, likewife, hurtful. Strengthening cordials alone can be ufed with fafety ; and thefe ought never to be negkaed. If, at the beginning, there be a great naufea, or incli- nation to vomit, the patient muft .drink an infufion of green tea, camomile flowers, or carduus benediclus, in order to clean the ftomach. If thefe be not fufficient, he may take a few grains of the powder of ipecacuanha, or any other gentle vomit. Jf the difeafe be mild, the throat may be gargled with an infufion of fage and rofe leaves, to a gill of which may be added a fpoonful or two of honey, and as much vinegar as will make it agreeably fharp ; but, when the fymptoms are urgent, the floughs large and thick, and the breath ve- ry offenfive, the following gargle may be ufed. To fix or feven ounces of the pedtoral decoaion, when boiling, add half an ounce of con tray erva root ; let it boil for fome time, and afterwards ftrain the liquor ; to which add two ounces of white wine vinegar, an ounce of fine honey, and an ounce of the tinaure of myrrh. This ought not only to be ufed as a gargle, but a little of it fhould frequently be injeaed with a fyringe to clean the mouth, be- fore the patient takes any meat or drink. This method is pe- culiarly neceflary for children, who cannot ufe a gargle. It will be of great benefit if the patient frequently re- ceives into his mouth, through an inverted funnel, the fleams of warm vinegar, myrrh, and honey. When the putrid fymptoms run high, and the difeafe is attended with danger, the only medicine that can be de- pended upon is the Jefuits bark. It may be taken in fub- ftance, if the patient's ftomach will bear it. If not, an ounce of bark grofsly powdered, with two drams of Virgi- nian fnakeroot, may be boiled in an Englifh pint and an half of water, to half a pint ; to which a tea fpoonful of the elixir of vitriol may be added, and an ordinary tea cupful of it taken every three or four hours. Bliftering plafters are 192 O F C O L D S. are very beneficial in this difeafe, efpecially when the pati- ent's pulfe and fpirits are low. They may be applied to the throat, behind the ears, or upon the back-part of the neck. Should the vomiting prove troublefome, it will be pro- per to give the patient two table fpoonfuls of the faline ju- lep, recommended in page 175, every two hours, or oftener, if neceffary. Tea made of mint and a little cinnamon, will likewife be a proper drink, efpecially if an equal quantity of red wine be mixed with it. In cafe of a violent loofenefs, the fize of a nutmeg of diafcordium, or the Japonic confeaion, may be taken two or three times a-day, or oftener, if neceffary ; and the pa- tient's drink muft be red wine negas. If a difcharge of blood from the nofe happens, the fleams of warm vinegar may be received up the noftrils fre- quently ; and the drink may be fharpened with fpirits of vitriol, or tinaure of rofes. In cafe of a ftrangury, the belly muft be fomented with warm water, and emollient clyfters given three or four times a-day. After the violence of the difeafe is over, the belly fhould be opened with mild purgatives ; as manna, fenna, rhubarb, or the like. If great weaknefs and dejeaion of fpirits, or night fweats, with other fymptoms of a confumption, fhould re- main after this difeafe, we would recommend it to the pati- ent to continue the ufe of the Jefuits bark, with the elixir of vitriol, and to take frequently a glafs of generous wine. Thefe, together with a milk diet, and riding on horfeback, are the moft likely means for recovering his ftrength. Of COLDS. It has already been obferved, that colds are the effea of an obftruaed perfpiration ; the common caufes of which we have likewife endeavoured to point out, and fhall not here repeat them. Neither fhall we fpend time in enumerating all the various fymptoms of colds, as they are pretty generally known. It may not, however, be a.nifs to obferve, that almoft every cold is a kind of fever, and only differs in degree from fome of thofe which have already been treated of. No O F C O L D S. 193 No age, fex, nor conftitution, are exempted from this difeafe ; neither is it in the power of medicine to prevent it. The inhabitants of every climate are liable to catch cold, nor can even the greateft circumfpeaion defend them againft its attacks. Indeed, if the human body could be kept conftantly in an uniform degree of warmth, fuch a thing as catching cold would be impoffible : But as that cannot be effeaed by any means, the perfpiration muft be liable to many changes. Such changes, however, when fmall, do not affea the health ; but, when exceffive, they muft prove hurtful. Hence the great fecret of preventing colds, lies in avoiding, as far as poffible, all extremes ei- ther of heat or cold. When oppreffion of the breaft, a fluffing of the nofe, uniifual wearinefs, or a pain of the head, Ufe give ground to believe that the perfpiration is obftruaed, or, in other words, that the perfon has caught cold, he ought imme- diately to leffen his diet, at leaft, the ufual quantity of his folid food, and to abftain from all ftrong liquors. Inftead of flefh, fifh, eggs, milk, and* other nourifhing diet, he may eat light bread pudding, veal, or chicken broth, paps, or gruels, and fuch like. His drink mav be water gruel, fweetened with a little honey; an infufion of balm, or linked, fharpened with the juice of orange or lemon ; a decoaion of barley and liquorice, with tamarinds, or any other cool, diluting acid liquor. Above all, his fupper fhould be light ; as fmall poller, or water gruel, fweetened with honey, and a little toafted bread in it. If honey fhould difagree with the ftomach, the gruel may be fweetened with treacle, or coarfe fugar, and fharpened with the jelly of currants. Thofe who have been accuftomed to generous liquors, may take white wine whey inftead of gruel, which may be fweetened as above. The patient ought to lie longer than ufual in bed, ana1 to encourage a gentle, fweat, which is eafily brought on towards morning, by drinking tea, or any kind of warm diluting liquor. I have often known this praaice, in a day or two, carry off a cold, which, in all probability, hid it been negkaed, would have cofl the patient His life, or have confined him for fome months to his bed. Would people facrifice a little time to eafe and warmth, and prac- tice a moderate degree of abftinence when the firft fymptoms of a cold appear, we have reafon to believe, that moft of the bad effeas which flow from an obftruaed perfpiration, B b might r94 O F C O L D S. might be-prevented. But, after the difeafe has gathered ftrength by delay, all attempts to remove it, often prove in vain. A pleurify, a peripneumony, or a fatal confumption of the lungs, are the common effeas of colds that have ei- ther been totally negkaed, or treated improperly. Many attempt to cure a cold, by getting drunk. But this, to fay no worfe of it, is a very hazardous and fool- hardy experiment. No doubt it may fometimes fucceed, by fuddenly reftoring the perfpiration ; but when there is any degree of inflammation, which is frequently the cafe, ftrong liquors, inftead of removing the malady, wil^in- creafe it. By this means a common cold is often convert- ed into an inflammatory fever. When thofe who labour for their daily bread have tkt misfortune to catch cold, they grudge to lofe a day or two, in order to keep themfelves warm, and take a little medi- cine, by which means the diforder is often fo aggravated, as to confine them for a long while, or even to render them ever after unable to fuflain hard labour. Such of the labouring poor as can afford to take care of themfelves, are often too hardy to do it ; they affea to defpife colds, and as long as they can crawl about, fcorn to be confined by what they call a common cold. Hence it comes to pafs, that colds deftroy fuch numbers of mankind. Like an enemy defpifed, they gather ftrength from delay, till, at length, they become invincible. We often fee this verifi- ed in travellers, who, rather than lofe a day in the profe- cution of their bufinefs, throw away their lives, by purfu- ing their journey with this difeafe upon them, even in the coldeft feafon. But colds may be too much as well as too little indulged. When a perfon, for a flight cold, fhuts himfelf up in a warm room, and drinks great quantities of warm liquor, it may bring on fuch a general relaxation of the folids as will not be eafily removed. It will, therefore, be proper, when the difeafe will permit, and the weather is mild, to join to the regimen mentioned above, gentle exercife ; as walking, riding on horfeback, or in a machine, Ufe. An obftinate cold, which no medicine can remove, will yield to a pro- per courfe of exercife when duly perfifted in. Bathing the feet and legs every night in warm water, has a great tendency to reftore the perfpiration. But care muft be taken that the water be not too warm, otherwife it will do hurt. It fhould never be warmer than new milk, and O F C O U G H S. Jp and the patient fhould go immediately to bed after ufingit. Bathing the feet in warm water, lying in bed, and drfflk- ing warm water gruel, or other weak liquors, will fooner take off a fpafm, and reftore the perfpiration, than all the hot fudorific medicines in the world. This is all that is neceffary for removing a common cold ; and if this courfe be taken at the beginning, and purfued for a few days, it will feldom fail. But when the fymptoms do not yield to abftinence, warmth, and diluting liquors, there is reafon to fear the approach of fome other difeafe, as an inflammation of the breaft, an ardent fever, Ufe If the pulfe, therefoie, be haAl and frequent, the fkin hot and dry, and the patient Complains of his head and breaft, Ufe. it will be neceffary t^ bleed, andl|o give the cooling opening powders menti- oned in page 172, every three or four hours, till they give a ftool. It will likewife be proper to put a bliftering plafter on the back, to give two table fpoonfuls of the faline mixture ordered in page 175, every three hours, and, in fhort, to treat the patient, in all refpeas, as for a flight fever. I have often feen this courfe, when obferved at the begin- ming, remove the complaint in two or three days, when the patient Jiad all the fymptoms of an approaching ardent fever, or an inflammation of the breaft. Of COUGHS. •A cough is generally the effea of a cold, which has ei- ther been improperly treated, or intirely negkaed. When it proves obftinate, there is always reafon to fear the confe- quences, as this fhews a weak ftate of the lungs, and is often the forerunner of a confumption. If the cough be violent, and the patient young and ftrong, with a hard quick pulfe, bleeding will be neceffary, to leffen the quantity of the humours, and prevent a rup- ture of the blood-veffels of the lungs, Ufe. but in weak and relaxed habits, bleeding rather prolongs the difeafe. When the patient fpits freely, bleeding is unneceffary, and fome- times hurtful, as it tends to leffen that difcharge. When thecough is notattended with a fever, and the fpittle is vifcid and tough, fharp peaoral medicines are to be ad- miniftered ; as gum ammoniac, fquills, Ufe 1 he lolution of gum ammoniac may be prepared as direaed in page 117, B b 2 and ioS OF COUGHS. ami two table fpoonfuls of it taken three or four times a-day, more or lefs, according to the age and conftitution of the patient. Squills may be given various ways ; two ounces of the vinegar, the oxymel, or the fyrup, may be mixed with the fame quantity of fpirituous cinnamon water, to which may be added, an ounce of common water, and an ounce of balfamic fyrup. Two table fpoonfuls of this mix- ture may be taken three or four times a-day. A fyrup made of equal parts of lemon juice, honey and fugar-candy, is likewife very proper in this kind of cough. A table fpoonful of it may be taken at pl^rfure. When the defluxion is fharp and thin, thefe medicines rather do hurt. In this cafe, gentle opiates, oils, and*mu- cilages are proper. A cup of the infufion of* wild^popfty leaves, with marfh mallow roots, or the flo\#rs of coftsfajfc- may be taken frequently ; or a tea fpoonful of the pareg^ ric elixir may be put into the patient's drink twice a-day. He may likewife take an emulfion made of an ounce and an half of olive oil, fix ounces of water, one ounce of pec- toral fyrup, and a tea fpoonful of fpirits of hartfhorn. Thefe muft be well fliaken together, and two table fpoonfuJs^>f the mixture taken every three or four hours. Fuller's SparUffi infufion is alfo a very proper medicine in this cafe, and mjp be taken, if the above fhould difagree with the patient's.flp- mach. It is made, by infufing in an Englifh quart of boil- ing water, two drams of fait of tartar, half a dram of faffrijifc cut into fmall pieces, and an ounce of Spanifh juice like- wife cut fmall. Thefe muft Hand in a clofe veffel for tWen- ty-four hours, in a gentle degree of warmth. Afk#war*fs, let the infufion be flrained, and a tea cupful of it taken three or four times a-day. When a cough isoccafioned by acrid humours tickling the throat and fauces, the patient lhould keep fome foft peaoral lozenges almoft conllantly in his mouth ; as the Pontefraa liquorice cakes, barley fugar, the Spanifh juice, Ufe Thefe blunt the acrimony of the humours, aaid by taking off their ftimulatingquality,help to appeafe thecough. In obftinate coughs, proceeding from a flux of humours upon the lungs, it will often be neceffary, befides expec- torating medicines, to have recourfe to iffues, fetons, or fome other drain. In this cafe, I have akvays obferved the moft happy effeas from a Burgundy pitch plafter applied between the fhoulders. I have ordered this fimple remedy in the moft obftinate coughs, in a great number of cafes, and in many different conftitutions, without ever knowing OF COUGHS., 197 it fail, unlefs where there were evident figns of an ulcer in the lungs. About the bulk of a nutmeg of Burgundy pitch may be fpread thin upon a piece of foft leather, about the fize of the hand, and laid between the fhouVkr-blades. It may be taken off and wiped every three or four days, and ought to be renewed once a fortnight or three weeks. This is indeed I. cheap and fimple medicine, and confequently apt to be defpifed ; but we will venture to affirm, that the whole materia medica does not afford an application more ef- ficacious in almoft every kind of cough. It^has not, indeed, an immediate effe# ; but, if continued long enough, it will fuc^Sa where moft other medicines fail. WtE only incQnveniency attending this plafter is the itch- ing, which'it occafions in the part to which it is applied ; Jbui fuffely this^pay be difpenfed with, confidering the ad- vintage which.'the patient may expea to reap from the ap- plication ; befides, when the itching becomes very uneafy, the plafter may be taken off, and the part rubbed with a dry cloth, or wafhed with a little warm milk and water. JSome saution/indeed, is neceffary in difcontinuing the ufe "of .fuch a plafter; this, hov/ever, maybe fafely done by making it fifralldPly degrees, and at length quitting it al- together in a warm feafon. But coughs proceed from many other saufes befides de- fluxions upon the lungs. In thefe cafes the cure is not to be attempted by peaoral medicines. Thus, in a ccugh pro- ceeding from a foulnefs and debility of the ftomach, fyrups, oils, mucilages, and all kind of balfamic medicines, do hurt. Th"is cough may be known from one that is owing to a fault in the lungs by this mark, that in the latter the patient coughs whenever he infpires, or draws in his breath fully ; but in the former that does not happen. The cure of this'tough depends chiefly upon cleanfing and ftrength«ning the ftogtach ; for which purpofe gentle vomits and bitter purgatives are moft proper. Thus, after a vomit or two, theYacred tinaure, as it is called, may be uken for a confiderable time, in the dofe of a table fpoonful or two twice a-day, or as often as it is found neceffary to keep the belly gently open. People may make this tinaure themfelves, by infufing an ounce of hiera pi era in an Englifh pint of white wine, letting it Hand a few days, and then ftraining it oft far ufe. In coughs, which proceed from a debility of the ftomach, the Jefuits bark is, likewife, of confiderable ufe. It may either v$ OF. TI^E CHIN-"CO UGH. cither be chewed, taken* in powder, or made into atipaure along with other fto«iachic bitters. A nervous cough can only be removed by change of air, and proper ei^rcife ; to which may be added the ufe of gentle opiates. A tea fpoonuft of the paregoric elixir, or two of the faponaceous pills may be taken twice a-day. If thefe prove too weak, ten, fifteen, or tw«enty*lrops of li- quid laudanum, more or lefs, as circumftances require, may be taken at bed-time, or when the cough.js, moft troublefome. Putting the feet and hands in warm wa- ter,, will often a'ppeaie the viole^CjOf a nervous cough. When a cough is only the fymptom pf fome oth^Una- lad'y, it is in vain to attempt to remove k without H^J:u- ring the difeafe from which it proceods7- l^jfr when a cough is occafioned by the cutting'of J^th^J«epjng the belly open, fcarifying the gums, or wflatever facilitates the teething, likewife appeafes the cough. In ftke manner, when worms occafion a cough, fuch medicines as remove thefe, will generally cure the cough ; as bitter purgatives, oily clyfters, and fuch like. * ^ Women, during the laft months of pregnapcy, are often greatly affliaed with a cough, which is^jenarally relieved by bleeding, and keeping the belly open. They ought to avoid all flatulent foocfj and to wear a look eafy drefs. A cough is not only a fymptom, but is often, likewife, the forerunner of difeafes. Thus, the gout is "frequently ufhered in by a very troublefome cough, which affects the patientfor fome days before the coming on of the fit. A pa- roxyfm of the gout generally removes this'cough, which fhould, therefore, be promoted, by keeping trrc extremities warm, drinking warm liquors, and bathing the feet and legs frequently in lukewarm water. . . « Of the C H IN,- C O U G H. This cough feldom affea adults, but is often epidemical among children. Such children as live upon thin watery diet, who breathe unwholefome air, and have too little ex- ercife, are moft liable to this difeafe, and generally fufter moft from it. The chin-cough is fo well known, eveft to nurfes, that no defcription of it is neceffary. Whatever hurts the digeft- ion, obftruas the perfpiration, or relaxes the folids, pre- difpofes OF THE CHIN-fOUGH. 199 difrJbfes to this difeafe ; confequently its cure muft depend upon cleaning and ftrengthening the ftomach, bracing the folids, and, at the fame time, prornpting perfpiration, and the different fecretions. '. The diet in this difeafe muft be light, and of ^fy digeft- ion ; for ofcildrffc, good bread made into pap or pudding, chicken broth, with other light fpoon meats^ are proper a but thofe who are farther advanced, may be avowed fag® gruel, and, if the fever be not high, a little^oikd chick- en, or other white meats. The drink may be pennyroyal tea, Jj|eetened with honey or fugar-candy, fmall wine wh^^" Or, if the patient be weak, he may foretimes be allowed a Httle negas. J^HElmoft elj^tual remedy in this difeafe is change^of air. This often removes the malady, even when the change feems to be from a purer to a lefs wholefome air. This may, in fome ^pieafure, depend on the patient's being re- moved from the place where the infeaidn prevai^. Moft of the djfeafes of children are infeaious ; nor is it at all uncommon to find the chin-cOugh prevailing in one town or village^ When^pother, at a very fmall diftance, is quite free fgfl^i it. But,» whatever be the caufe, we are Aire of the faft. Nolime ough^ theref#e, to be loft in removing the patient;at feldom be neceffary to repeat the operation; yet, if Hhere be fymptoms of an inflammation of the lungs^a fecond, oriven a third bleeding may be re- quifite. It is a favourable fymptom when the patient vomits after the fit. This cleans the ftomach, and greatly relieves the cough. It will, therefore, be proper to promote the dif- charge, either by camomile tea, or lukewarm water ; and, when thefe are not fufficient, fmall dofes of ipecacuanha may be given. A child of three or four years of age may take five or fix grains ; and to others, lefs or more muft be given, according to their age and ftrength. It is very difficult to make children drink after a vomit, I have often feen them happily deceived, by infufing a fcru- ple 200 OF THEICHIN-COUGH. pie, or half a dram, of the powder of ipecacuanha in a tea- pot, with half an Englifh pint of boiling water. If this be difguifed with a/ew drops of milk, and a Jittle fugar, they will imagine it tea, and drink it very greedily. A final I tea cupful of this may be given every quarter of an hour, or rather every ten minutes, till it operate*. When they becr'in to puke, there will be no occafion for drinking any more, as trW water already on their ftomach will be fuffi- cient. Vomits not only clean the ftomach, which, in this dif- eafe is generally loaded with vifcid phlegm, but thejJKke- wife promote the perfpiration and other fecretions jB^nd ought, therefore, to be repeated, according to the obftina- cy gf the difeafe. They fhould not, bikrcver, be too ftrong ; gentle vomits, frequently repeated, are both lefs dangerous, and more beneficial than ftrong ones. As the patient is generally coftive, it will be proper to keep his belly gently open. The beft medicines for this purpofe are rhubarb and its preparations, or the facre^ tinc- ture, if the patient can be brought to tdce it.' Of this a tea fpoonful or two may be given to a yo^g child, twice or thrice a-day, as there is occafion. Torfuch as are-^rther advanced, the dofe muft*be proportionally increafed* and repeated till it has the defired effea. Thofe'who cannot he brought to take the bitter tinaure, may have an llfufion of fenna and prunes, fweetened with manna, coarfe fugar, or honey ; or a few grains of rhubarb, mixed with a fpoon- ful or two of fyrup, or currant jelly, fo as"to difguife the tafte. Moft children are fond of fyrups and^jellies, and feldom refufe even a bitter medicine^ when mixed with them. , \% Many people believe that oily, peftoral, and balfamic medicines, poffefs wonderful virtues for the cure of the chin-cough, and accordingly exhibit them plentifully to patients of every age and conftitution, without confiderijig that every thing of this nature muft load the ftomach, hurt the digeftion, and, of courfe, aggravate the diforder. The millepedes, or woodlice, are greatly recommended for the cure of a chin-cough. Thofe who choofe to make ufe of thefe inkas, may infufe two ounces of them bruifed in an Englifh pint of fmall white wine for one night. Af- terwards the liquor may be ftrained through a cloth, and a table fpoonful of it given to the patient three or four times a-day. Otiates INFLAMMATION OF THE STOMACH. 201 Opiates are fometimes neceffary to allay the violence of the cough. For this purpofe, a little of the fyrup of poppies, or ten, fifteen, or twenty drops, according to the age of the patient, of the paregoric elixir, may be taken in a cup of hyffop, or pennyroyal tea, three or four times a-day. An aSult may take a table fpoonful of the fyrup, or a tea fpoonful of the elixir. The garlic ointment is a well known remedy in North- Britain fot the chin-cough. It is made by beating in a mortar garlic with an equal quantity of hogs lard, but- ter, or oil. With this the foles of the feet may be rubbed twice or thrice a-day, or it may be fpread thin upon a rag, and applied as a plafter. It fhould be renewed every night and morningjfrat leaft, as the garlic foon lofes its virtue. This is an exceeding good medicine, both in the chin- cough, and in, moft other coughs of an obftinate nature. It ought not, however, to be ufed when the patient is very hot, or feverifh, left it increafe thefe fymptoms. The feet fhould be bathed once every two or three days in warm water : and the Burgundy pitch plafter, mention- ed in page I96,*may be applied betwixt the fhoulders. But when the difeafe proves very violent, it will be neceffary, inftead of it, to apply a bliftering plafter, and to keep the part open for fome time with iffue ointment. When the difeafe is prolonged, and the patient is free of a fever, the Jefuits bark, and other bitters, are the moft proper medicines. The bark may either be taken in fub- ftance, or in a decoaion or infufion, as is moft agreeable to the patient. For a child, ten, fifteen, or twenty grains may be given for a dofe, according to the age of the patient. For an adult, half a dram, or two fcruples, will be proper. Some give the extraa of the bark with cantharides ; but to manage this, requires fome fkill and attention. It is more fafe to give a few grains of caftor along with the bark. A child of fix or feven years of age may take feven or eight grains of caftor, with fifteen grains of powdered bark, for a dofe. This may be made into a mixture, with two or three ounces of any fimple diftilled water, and a little fyrup, and taken three or four times a-day. INFLAMMATION of the STOMACH. This is a dangerous difeafe, and requires the moft fpeedy afliftance, as it frequently ends in a fuppuration ; and fometimes in a mortification, which is certain death. Cc CAUSES. 202 INFLAMMATION OF THE STOMACH. CAUSE S.—— It may proceed from any of the caufes which produce an inflammatory fever ; as cold li- quor drank while the body is warm, an obftruaed perfpi- ration, the fudden ftriking in of any eruption, Ufe It may likewife proceed from the acrimony pof the bile, or from acrid and flimulating fubftances taken into the fto- mach ; as ftrong vomits or purges, corrofive poifons, and fuch like. When the gout has been repelled from the ex- tremities, either by cold or improper applications, it often occafions an inflammation of the ftomach. Hard or indi- geftable fubftances taken into the ftomach, as bones, 4he fhells of nuts, Ufe have likewife that effea. SYMPTOM S.----» It is attended^with a fixed pain and burning heat in the ftomach ; great reftleffnefs and anxiety ; a fmall, quick, hard pulfe ; vomiting, or, at leaft, a naufea and ficknefs ; exceffive thirft ; coldnefs of the extremities ; difficulty of breathing ; cold clammy fweats ;' and fometimes convulfions and fainting fits. The ftomach is fwelled, and often feels hard to the touch. One of the moft certain figns of this difeafe is the fenfe of pain, which the patient feels upon taking any kind of food or drink, efpecially if too hot or cold, into his ftomach. When the patient vomits every thing he eats or drinks, is extremely reflkfs, has a hiccup, with an intermit- ting pulfe, and frequent fainting fits, the danger is very great. REGIME N.---- The patient muft, with the greateft care, avoid all acrimonious, heating, and irrita- ting food and drink. His weaknefs may deceive the by- flanders, and induce them to give him wines, fpirits, or other cordials ; but all thefe increafe the difeafe, and of- ten occafion fudden death. The inclination to vomit, may likewife impofe on the attendants, and make them think a vomit neceffary j but that too is almoft certain death. The food muft be light, thin, tool, and eafy of digeft- ion. It muft be given in fmall quantities, and fhould nei- ther be quite cold nor too hot. Thin gruel made of bar- ley or oatmeal, light toafted bread, diffolved in boiling water, or very weak chicken broth, are the moft proper. The drink fhould be clear whey, barky water, or decoai- ons of emollient vegetables; or liquorice and marfti mal- low roots, Uff. . MEDICINE. OF THE ILIAC PASSION. 203 M E D I C I N E.----Bleeding in this difeafe is ab- folutely neceflary, and is almoft the only medicine that can be depended on. When the difeafe proves obftinate, it will often be neceffary to repeat this operation feveral times, nor muft the low ftate' of the pulfe deter us from doing fo. The pulfe in this difeafe genoi ally rifcs upon bleeding, and fo long as that is the cafe, the operation is fafe. Frequent fomentations with warm water, or a decoc- tion of emollient vegetables, are likewife beneficial. Flan- nel cloths dipped in thefe, muft be applied to the region of the ftomach, and removed as they turn cool. They muft neither be applied too warm, nor fuffered to continue till they become quite cold, as either of thefe extremes would aggravate the difeafe. The feet and legs ought, likewife, to be frequently bathed in lukewarm water, and warm bricks, or poultices, may be applied to the foles of the fret. The only internal medicines which we fhall venture to recommend in this difeafe, are mild clyfters. Thefe may be made of warm water, or thin water gruel, and, if the patient be coftive, a little fweet oil, honey or manna, may be added. Clyfters anfwer the purpofe of an internal fo- mentation, while they keep the belly open, and, at the fame time, hourifh the patient, who is often, in this dif- eafe, unable to retain any thing upon his ftomach. For thefe reafons they muft not be negkaed, as the patient's life may depend on the application of them. Of the ILIAC PASSION. This is one of the moft painful and dangerous difeafes that mankind are liable to. It proceeds from the fame caufes as the inflammation of the ftomach ; to which may be added coftivenefs, worms, eating unripe fruits, or great quantities of nuts, drinking hard windy malt liquors, as ftale beer, bottled ale, or four wine, cider, Ufe. It may, likewife, be occafioned by a rupture, fcirrhous tumours of the interlines, or by their oppofite fides growing together. The fymptoms here are nearly the fame as in the forego- ing difeafe ; only the pain, if poffible, is more acute, and is fituate lower down about the region of the navel., The vomiting is likewife more violent, and fometimes even the excrements, together with the clyfters and fuppofitaries, C c 2 are 204 OF THE ILIAC PASSION. are difcharged by the mouth. The patient is continually belching up wind, and has often an obftruaion of his urine. While the pain fhifts,and the vomiting only returns at certain intervals, and while the clyfters pafs downwards, there is ground to hope; but when the clyfters and faeces ate vo- mited, and the patient is exceeding weak, with a "low fluttering pulfe, a pale countenance, and a difagreeable, or ftinking breath, there is great reafon to fear, that the confequences will prove fatal. Clammy fweats, black fcetid ftools, with a fmall intermitting pulfe, and a total ceffation of pain, are the figns of a gangrene, and approaching death. REGIME N.----The regimen in this difeafe is in general the fame as in an inflammation of the ftomach, The patient muft be kept quiet, avoiding cold, and all vi- olent paffions of the mind. His food muft be thin, weak, and given in fmall quantities ; his drink weak and diluting j as clear whey, barley water, and fuch like, M E D I C I N E.----Bleeding in this, as well as in the inflammation of the ftomach, is the remedy moft to be depended on. It fhould be performed as foon as the fymp- toms appear, and muft be repeated according to the ftrength of the patient, and the violence of the fymptoms. A bliftering plafter applied immediately over the part where the moft violent pain is, has often a very good effea. Even clyfters, which before had no effea, will operate when the blifter begins to rife, Fomentations and laxative clyfters are by no means to be omitted. The patient's feet and legs fhould fre- quently be bathed in warm water ; and cloths dipped in it applied to his belly. Bladders, filled with warm water, may likewife be applied to the region of the navel, and warm bricks, or bottles filled with warm water, to the foles of the feet. The clyfters may be made of barley wa- ter or thin gruel, and foftened with plenty of fweet oil, or frefh butter. Thefe may be adminiftered every two or three hours, or oftener, if the patient continues coftive. If common clyfters have not the defired effea, we would recommend the fmoke of tobacco. It may be blown into the bowels through an inverted pipe. This may berepeatr ed after fome time, unlefs the effea of the firft renders it un neceffajy. If the difeafe does not yield to clyfters and fomentations, recourfe muft be had to pretty ftrong purgatives j but" as thefe OF THE ILIAC PASSION 205 thefe, by irritating the bowels, often increafe their contrac- tion, and, by that means, fruftrate their own intention, it will be neceffary to join them with opiates ; thefe, by al- laying the pain, and relaxing the fpafmodic contractions of the guts, greatly affift the operation of purgatives in this cafe. What often anfwers the purpofe of purging very well, is a folution of the bitter purging falts. Two ounces of thefe may be diffolved in an Englifh pint of warm water, or thin gruel, and two or three table fpoonfuls given every half hour till it operates. At the fame time, fifteen, twen- ty, or twenty-five drops of laudanum may be given in a glafs of pepper mint, or fimple cinnamon water, to appeafe the irritation, and prevent the vomiting, Ufe Acids have often a very happy effea in flaying the vo- miting, and appeafing the other violent fymptoms of this difeafe. It will, therefore, be of ufe to fharpen the pati- ent's drink with cream of tartar, juice of lemon ; or, wqen thefe cannot be obtained, a little vinegar may be add- ed to it. But it often happens, that no liquid whatever will flay on the ftomach. In this cafe the patient muft take pur- gative pills. I have generally found the following anfwer .very well. Take jalep in powder, and vitriolated tartar, each half a dram, opium, one grain, Caftile foap, as much as will make the mafs fit for pills. Thefe muft be taken at one dofe, and if they do not operate in fix or feven hours, the dofe may be repeated. If a ftool cannot be procured by any of the above means, it will be neceffary to immerfe the patient in warm water up to the breaft, I have often feen this fucceed, when other means proved in vain. The patient muft continue in the water as long as he can eafily bear it without faint- ing, and, if one emerfion does not fucceed, it may be re- peated after fome time, when the patient's ftrength and fpirits are recruited. It is more fafe for him to go fre- quently into the bath, than continue too long at a time ; and, it is often neceffary, to repeat it feveral times before it has the defired effea. It has fometimes happened, after all other means of procuring a ftool had been tried in vain, that this was brought about by immerfing the patient's lower extremities in cold water,making him walk upon a wet pavement, and dafhing his legs and thighs with the cold water, Ufe This method, 206 OF THE COLIC. method, when others fail, at leaft merits a trial. It is, indeed, attended with fome danger ; but a doubtful reme- dy is better.than none. In defperate cafes it is common to give quickfilver. This may be taken to the quantity of feveral ounces, or even a pound, but fhould not exceed that. When there are evident marks of an inflammation, or any reafon to fufpea a mortification of the guts, this medicine ought not to be tried. In that cafe, it will only haften the patient's death. But when the obftruaion is occafioned by any caufe that can be removed by force, quickfilver is not only a proper medicine, but the beft that can be applied, as it is the fitteft body we know for making its Way through the inteftinal canal. If the difeafe proceeds from a rupture, the patient muft be laid with his head very low, and the interlines returned by gentle preffure with the hand. If this, with fomenta- tions and clyfters, fhould not fucceed, recourfe muft be had to a furgical operation, which may give the patient re- lief. Such as would avoid this excruciating and dangerous difeafe, muft take care never to be too long without a ftool. Some who have died of it, have had feveral pounds of hard, dry foeces taken out of their guts. They fhould, likewife, beware of eating too freely of four or unripe fruits, or drinking flak windy liquors, pricked wines, or the like. I have of- ten known it brought on by living too much on baked fruits, which are feldom good. It likewife proceeds fre- quently from cold caught by wet cloaths,Ufe. but efpecial- ly from wet feet. Ofthe COLIC. The colic has great affinity, both in its fymptoms and method of cure, with the two preceding difeafes. It is generally attended with coftivenefs and acute pain of the bowels ; and requires diluting diet, evacuations, fomenta- tions, Ufe. Colics are varioufly denominated according to their caufes, as the flatulent, the bilious, the hyjieric, the nervous, Ufe As each of thefe requires a particular treatment, we fhall point out their moft general fymptoms, and the means to be ufed for their relief. The OF THE COLIC. 207 The flatulent, or wind colic, is generally occafioned by an indifcreet ufe of unripe fruits, meats of hard digeftion, windy vegetables, fermented liquors, and fuch like. It may likewife proceed from an obftruaed perfpiration, or catching cold. Delicate people, whofe digeftive powers are weak and debilitated, are moft liable to this kind of colic. The flatulent colic may either affea the ftomach or in- terlines. It is attended with a painful ftretching of the ftomach, or that part of the bowels where it is lodged. The patient feels a rumbling in his guts, and is generally relieved by a difcharge of wind either upwards or down- wards. The pain is feldom confined to any particular part, as the vapour wanders from one divifion of the bowels to an other, till fuch time as it finds a vent. When the difeafe proceeds from windy liquor, eating green fruit, four herbs, or the like, the beft medicine is to take immediately a dram of brandy, gin, or any good fpi- rits, and to apply warm cloths to the ftomach and bowels. * The patient fhould likewife fit with his feet upon a warm hearth ftone, or apply warm bricks to them ; and he may drink camomile tea, or water gruel, with as much pepper in it as to render it moderately warm. This is the only colic wherein ardent fpi/its, fpiceries, or any thing of a hot nature, may be ventured upon. Nor, indeed, are they to be ufed here, unlefs at the beginning, before there be any fymptoms of inflammation. We have reafon to believe, that a colic occafioned by wind or fla- tuleqt food, might always be cured by fpirits and warm li- quors, if they were taken immediately upon perceiving the firft uneafinefs ; but when the pain has continued for a con- fiderable time, and there is reafon to fear an inflammation of the bowels is already begun, all hot things are to be avoid- ed, and the patient is to be treated in the fame manner as for the iliac paffion. Several kinds of food, as honey, eggs, Ufe occafion colics in fome particular conftitutions. I have generally found the beft cure for thefe colics was to drink plentifully of fmall diluting liquors, as water gruel, fmall pofiet, toaft and water, Ufe. Colics which proceed from excefs and indigeftions, ge- nerally cure themfelves, by occafioning vomiting or pur- ging. Thefe difcharges are by no means to be flopped, but promoted, by drinking plenty of warm water, or weak pofkt. 208 OFTHECOLTC. poffet. When their violence is over, the patient may take a dofe of rhubarb, or any other gentle purge, to carry off the dregs of his debauch. Colics which are occafioned by wet feet, or catching cold, may generally be removed ait the beginning, by bathing the feet and legs in warm water, and drinking fuch warm diluting liquors as will promote the perfpiration, as weak wine whey, or water gruel, with a fmall quantity of fpirits in it. These flatulent colics, which prevail fo much in the country, might generally be prevented, if people were careful to change their cloaths when they get wet. They ought, likewife, to take a dram,or to drink fame warm li- quor after eating any kind of green trafh. We do not mean to recommend the praaice of dram drinking, but, in this cafe, ardent liquors prove a real medicine, and, in- deed, the beft tftat can be applied. The bilious colic is attended with very acute pain about the region of the navel. The patient complains of great thirft, and is generally coftive. He vomits a hot, bitter, yellow coloured bile, which being difcharged, feems to afford fome relief, but is quickly followed by the fame vi- olent pain as before. As the diftemper advances, thepro- penfity to vomit increafes, in fo much, that fometimes it becomes almoft continual, and the proper motion of the interlines is fo far perverted, that there are all the fymptoms of an impending iliac paffion. If the patient be young and ftrong, and the pulfe full and frequent, it will be proper to bleed, after which cly- fters may be adminiftered. Clear whey, or gruel, fharp- ened with the juice of lemon, or cream of tartar, muft bs drank freely. Small chicken broth, with a littk^nanna diffolved in it, or a flight decoaion of tamarinds, are, like- wife, very proper, or any other thin, acid, opening li- quor. Besides bleeding, and plentiful dilution, it will be ne- ceffary to foment the belly with cloths dipped in warm water, and if this fhould not fucceed, the patient muft be fet in a warm bath up to the middle. Mild purgatives are here likewife neceffary, as the leni- tive ekauary, manna, cream of tartar, or, what will an- fwer very well, the bitter purging falts. Thefe may be diffolved in water, and given in the fame manner as direa- ed in page 205. If thefe medicines will not flay on the ftomach, OF-THE COLIC. 209 ftomach, it will be neceflary to join an opiate with them. Such as are liable to frequent returns of the bilious colic fhould ufe flefh fparingly, and live chiefly upon a light ve- getable diet. They lhould, likewife, take frequently a dofe of cream of tartar with tamarinds, or any other cool, acid purge. The hyfleric colic bears a great refemblance to the bilious. It is attended with acute pains about the region of the fto- mach, vomiting, Ufe But what the patient vomits in this cafe is commonly of a greenifh colour. There is a great finking of the fpirits, with dejeaion of mind, and difficul- ty of breathing, which are the charaaeriftic fymptoms of this diforder. Sometimes it is accompanied with the jaun- dice, but this generally goes off of its own accord in a few days. ^ In this colic all evacuations, as bleeding, purging, vo- miting, Ufe do hurt. Every thing that weakens the pati- ent, or finks the fpirits, is to be avoided. If, however, the vomiting fhould prove violent, weak camomile tea, or fmall poffet, may be drank to cleanfe the ftomach. After- wards the patient may take fifteen, twenty, or twenty-five drops of liquid laudanum in a glafs of cinnamon water. This may be repeated every ten or twelve hours till the fymptoms abate. The patient may likewife take four or five of the foetid pills, three times a-day, and drink a cup of pennyroyal tea after them. If afafostida fhould difagree with the ftomach, which is fometimes the cafe, a tea fpoonful of the tinaure of caftor in a cup of pennyroyal tea, or thirty or forty drops of the balfam of Peru dropped upon a bit of loaf fugar, may be taken in its ftead. The anti-hyfteric plafter may alfo be applied to the region of the navel, which has often a good effect.- The nervous colic prevails moft among miners, fmelters oFlead, plumbers, the makers of white lead, Ufe. It is very difficult to cure, and often ends in a palfy. No difeafe of the bowels is attended with more excru- ciating pain than this. Nor is it foon at an end. I have known it continue eight or ten days with very little inter- miffion, the belly all the while continuing bound in fpite of medicine, yet at length yield, and the patient recover. The general treatment of this difeafe is fo nearly the fame with that of the iliac paffion, or inflammation of the guts, that we fhall not infift upon it. • The belly is to be D d opened 210 INFLAMMATION OF THE KIDNEYS. opened by mild purgatives, given in fmall dofes, and fre- quently repeated, and their opeiati^i". muft Ic affilted by foft oily clyfters, fomentations, Ufe The Barbados tar is faid to be a proper medicine in this difeafe. It may be taken to the quantity of two drams thrcetimes a-day, or oftener if the ftomach will bear it. This tar, mixed with an equal quantity of ftrong rum, is likewife proper for rubbing the fpine, in cafe any tingling, or other fymptoms of a pally are felt. When this tar cannot be ob- tained, the back m~y be rubbed with ftrong fpirits, or a little of the oil of nutmegs or rofemary. If the patient remains weak and languid after this difeafe, he muft take exercife on horfeback, and ufe an infufion of the Jefuits bark in wine. When the difeafe ends in a palfy, the Bath waters are found ^o be extremely proper. To avoid this colic, people muft fhun all four fruits, acid and auftere liquors, Ufe Thofe who work in lead ought never to go to their bufinefs fafting, and their food fhould be oily or fat. They may take a glafs of fallad oil, with a little brandy or rum every morning, but fhould ne- ver take fpirits alone. Liquid aliment is beft for them ; as fat broths, Ufe but low living is bad. They fhould now and then go a little out of the tainted air; and fhould, at leaft, take phyfic every fpring and fall. Sundry other kinds of this difeafe might be mentioned, but too many diftinaions would tend only to perplex and bewilder the reader. Thefe already mentioned are the moft material, and fhould indeed be attended to, as their treat- ment is very different. But even thofe who are not in a condition to diftinguifh very accurately in thefe matters, may neverthelefs be of great fervice to patients in colics, by only obferving the following general rules : Firft, To bathe the patient's feet and legs in warm water ; and next, To apply bladders filled with warm waiter, or cloths dipped jn it, to his ftomach and bowels. Afterwards, To make him drhik freely of weak, diluting, warm liquors. And, laftly, To give him an emollient clyfter every two or three hours. INFLAMMATION of the KIDNEYS. CAUSE S.——This difeafe may proceed from any of thofe caufes which produce an inflammatory fever. It is likewife occafioned by wounds, or bruifes of the kidneys, r.n3 by fmall ftones or gravel lodging within them. It may alfo proceed from ftrong diuretic medicines; as fpirits of turpentine, INFLAMMATION OF THE KIDNEYS. 211 turpentine, tinaure of cantharides, Ufe Violent motion, as hard riding or walking, efpecially in hot weather, or whatever drives the blood forcibly into the kidneys, may occafion this malady. It may likewife proceed from lying too foft, or too much on the bade, or from involuntary contraaions, or fpalms in the urinary veffels, Ufe. S Y M PTOM S.----There is a (harp pain about the region of the kidneys, with fome degree of fever, and a ftu- por, or dull pain in the thigh of the affeaed fide. The urine is at firft.ciear, and afterwards of a redifti colour ; but in the word kind of the difeafe it generally continues pale, is paffed with difficulty, and commonly fmall quantities at a time. The patient feels great uneafinefs when he endea- vours to walk or fit upright, fie lies with more eafe on the affeaed fide than on the found ; and has generally a naufea or vomiting, refembiing that which happens in the colic. This difeafe, however, may be diftinguifhed from the colic by the pain being feated farther back, and by the dif- ficulty of paffing urine, which is a conftant fymptom of this difeafe, but does nor always happen in the other. R E ii 1 MEN.—----Every thing of a heating or fti- mutating nature is to be avoided. The food muft be thin and light; as water pap, fmall broths, with mild vegetables, and the like. Emollient and foft liquors muft be plentifully drank ; as clear whey, or balm tea fweetened with honey, decoaions of marfh mallow roots, with barley and liquo- rice, Ufe. The patient, notwithftanding the vomiting, muft conftantly keep fipping fmall quantities of thefe or other diluting liquors. Nothing fo fafely and certainly abates the inflammation, and expels the obftructiiig caufe, as co- pious dilution. The patient muft be kept eafy, quiet, and free from cold, fo long as any fymptoms of inflammation appear. MEDICINE.----Bleeding is here very neceffary, efpecially at the beginning. Ten or twelve ounces may be let from the arm or foot with a. lancet, and ifthe pain and inflammation continue, The operation m?y be repeated in twenty-four hours, efpecially if the patient be of a full ha- bit. Leeches may likewife be applied to the hoenorrhoidal veins, as a difcharge from thefe will greatly relieve tiie pa- tient. • Cloths dipped in warm water, or bladders filled with it, muft be applied to the part affeaed, and renewed as they grow cool. If the bladders be filled with a to 288 O F T H.E I T C H to w'afh the parts affeaed with a ftrong folution of the cof- rofive fublimate, which had almoft proved fatal. Others ufe the mercurial ointment without taking the leaft care either to avoid cold or obfervea proper regimen. The confequences of fuch condua may be eafily gueffed. I have known even the mercurial girdles produce tragical effeas, and would advife every perfon, as he values his health, to beware how he ufes them. Mercury ought never to be ufed as a medicine without the greateft care. Ignorant people look upon thefe girdles as a kind of charm, without confidering that the mercury enters the blood. As fulphur is both the moft fafe and efficacious medicine for the itch, we fhall not recommend any other. Other medicines may be ufed by perfons of fkill, but are not ta be ventured upon by the ignorant. Thofe who would avoid this deteftable difeafe ought to beware of infeaed perfons, to ufe wholefome food, and to ftudy univerfal cleanlinefs. Of the ASTHMA* The afthma is a difeafe of the lungs, which feldom admits of a cure. Perfons in the decline of life are moft liable to this difeafe. It is divided into the moift and dry, or hu- moural and nervous. The former is attended with expec- toration or fpitting; but in the latter the patient feldom fpits, unlefs fometimes a little tough phlegm by the mere force of coughing. CAUSE S.----The afthma is fometimes hereditary. It may likewife proceed from a bad formation of the breaft ; the fumes of metals or minerals taken into the lungs* ; vi- olent exercife, efpecially running ; the obftruaions of cu- ftomary evacuations, as the menfes, haemorrhoids, &c ; the fudden retroceffion of the gout, or ftriking in of eruptions, as the fmall-pox, meafles, &c. ; violent paffions of the mind, as fudden fear, or furprife. In a word, the difeafe may proceed from any caufe that either impedes the circu- lation of the blood through the lungs, or prevents their be- in? duly expanded by the air. G 7 ) SY*MP- * I knew a perfon whofe lungs were fet in a manner ftock-ftill, by the fumes of antimony. It happened in the night, after he had been preparing a great quantity of the regulus of antimony through die day* He was relieved by clyfters, fomentations and oily emuliions, OFTHEASTHMA. a8o. SYMPTOM S.----An afthma is known by a quick laborious %refpiration, which is generally performed with a kind of wheezing noife. Sometimes the difficulty of breath- ing is fo great that the patient is obliged to keep an erea pofture, otherwife he is in danger of being fuffocated. A fit or paroxifm of the afthma is very apt to happen after a perfon has been expofed to cold ea;'ccrly winds, or has been abroad in thick foggy weather, or has got wet, or continu- ed long in a damp place underground, or the like. A fit of the afthma is generally ufheredin with great lift- lefihefs, want of fleep, hoarfenefs, cough, belching of wind, a fenfe of heavinefs about the breaft; and difficulty of breathing. To thefe fucceed heat, fever, pain of the head, ficknefs and naufea, great oppreffion of the breaft, palpitation of the heart, a weak and fometimes intermitting pulfe, an involuntary flow of tears, bilious vomitings, Szc. All the fymptoms grow worfe towards night; the patient is eafier when up than in bed, and is very defirous of cool air. REGIME N.----The food, ought to be light, and of eafy digeftion. Boiled meats are generally preferred to roafted, and the flefh of young animals to that of old. All windy food, and whatever is apt to fwell upon the ftomach, is to be avoided. Light puddings, white broths, and ripe fruits baked, boiled or roafted, are proper. Strong liquor of all kinds, efpecially malt-liquor, is hurtful. Thepati- ent fhould eat a very light fupper, or rather none at all. His cloathing fhould be warm, efpecially in the winter- feafon. A flannel lhirt or waiftcoat, and thick fhoes, are of great fervice ; as all diforders of the breaft are much re- lieved by keeping the feet warm, and promoting the perfpi- ration. But nothing is of fo great importance in the afthma zs pure and moderately warm air. Afthmatic people can fel- dom bear either the clofe heavy air of a large town, or the Iharp, keen atmofphcre of a bleak hilly country ; a medium between thefe is therefore to be chofen. The air near a large town is often better than at a diftance, provided the patient be removed fo far as not to be affeaed by the fmok?. Some afthmatic patients indeed breathe eafier in town than in the country ; but this is feldom the cafe, efpecially in towns where much coal is burnt. Afthmatic perfons who are obliged to be in town all day, ought, at leaft, to fleep out of it. Even this will often prove of great fervice. Thofe O o .. vh 290 OFTHEASTHMA. who can afford it ought to travel into a warmer climate. Many afthmatic perfons who cannot live in Britain enjoy very good health in the fouth of France, or in Spain or Italy. Exercise is likewife of very great importance in the afthma, as it promotes the digeftion, and greatly affifts in the preparation of the blood. The blood of afthmatic per- fons is feldom duly prepared, owing to the proper aaion cf the lungs being impeded. For this reafon fuch people ought daily to take as much exercife, either on foot, horfe- back, or in a machine, as they can bear. MEDICIN E.t---Almoft all that can be done by medicine in this difeafe, is to relieve thepatient when feiz- ed with a violent fit. This indeed requires the greateft ex- pedition, as the difeafe often proves fuddenly fatal. In the paroxifm or fit, the body is generally bound, a clyfter ought therefore to be adminiftred, and if there be occafion, it may be repeated two or three times. The patient's feet ought tc be put into warm water, and afterwards rubbed with a warm hand, or dry cloth. If there be a violent fpafm about the breaft or ftomach, warm fomentations, or, bladders filled with warm milk and water, may be applied to the part affeaed, and warm cataplafms to the foles of the feet. The patient muft drink freely of diluting li- quors, and may take a tea-fpoonful of the tinaure of caftor and faffron, mixed together in a cup of valerian-tea, twice or thrice a-day. Sometimes a vomit has a very good effea, and fnatches the patient, as it were, from the jaws of death. This will be more faf* after other evacuations have been premifed. Out of the fit. In the moift afthma, fuch things as promote expeaon tion or fpitting, ought to be ufed ; as the fyrup of fquills, gum-ammoniac, and fuch like. A common fpoonful of the fyrup or oxomell of fquills, mixed with an equal quantity of cinnamon-water, may be taken three or four times a-day. Any quantity of gum-ammo- niac, with an equal quantity,of afafcetida, may be made into pills, and four or five of them taken every night at bed-time. In the convulfive or nervous afthma, antifpafmodics and bracers are the moft proper medicines. The patient may take a tea-fpoonful of the paregoric elixir twice a-day. The jefuits bark is likewife proper in this cafe. It may be taken in fubftance, or infufed in wine. In fhort, every thing OF THE APOPLEXY, .201 that braces the nerves, or takes off fpafm, may be of ufe in a nervous afthma. It is often relieved by the ufeof affes milk ; I have likewife known cows milk drank warm of a morning, have a very good effea in this cafe. In every fpecies of afthma iffues have a good effea ; they may either be made in the back or fide, and fhould never be allowed to dry up. We fhall here, once for all, obferve, that in moft chronic difeafes, iffues are extremely proper. They are both a fafe and efficacious remedy; and and tho' they do not always cure the difeafe, yet they will often prolong the patient's life. Of the APOPLEXY. The apoplexy is a fudden lofs of fenfe and motion, wherein the patient is to all appearance dead, only the heart and lungs ftill continue to move. This difeafe, by a little care, might often be prevented, but can feldom be cured. It chiefly attacks fedentary perfons of a grofs ha- bit, who ufe a rich and plentiful diet, and indulge in ftrong liquors. People in the decline of life are moft fubjea to the apoplexy. It prevails moft in winter, efpecially in long rainy feafons, and very low ftates of the barometer. CAUSES.-----The immediate caufe of an'apoplexy is a compreffion of the brain, occafioned by an effufion of blood, or of watery humours on that part. The former is called a fanguine, and the latter a ferous apoplexy. It may be produced by any caufe that increafes the circulation to- wards the brain, or prevents the return of the blood from the head ; as intenfe ftudy ; violent paffions* ; viewing ob- jeas for a long time obliquely ; wearing any thing too tight about the neck ; a rich and luxurious diet; fuppreffi- on of urine; fuffering the* body to cool fuddenly after having been very hot; continuing long in a warm bath ; {he exceffive ufe of fpiceries, or high-feafoned food ; excefs O o 2 of * I knew a woman who in a violent fit of anger was feized with a fanguine apoplexy. She at firft complained of extreme pain, astfdag- ger? had been tbruft thro* her head, as fhe expreffedit. Afterwards fhe be- came comatofe and dull, her pulfe funk very low, and was exceeding flow. By the help of bleeding, bliftering, and other evacuations, fhe was kept alive for about a fortnight. When her head was opened, a large quantity of extravafated blood was found in the left ventricle of the brain. 292 OF THE APOPLEXY. of venery ; the fudden flriking in of any eruption ; fuf- fering iffues, featons, &c. fuddenly to dry up, or the ftop- page of any cuftomary evacuation ; a mercurial falivation fuddenly checked bv cold; wounds or bruifes on the head ; long expofure to exceffive cold ; poifonous exhalations; ke. SYMPTOMS, and method of cure.----The ufu- al forerunners of an apoplexy are giddinefs, pain, and fwimming of the head ; lofs of memory ; drowfinefs ; noife in the ears; the night mare; afpontaneous flux of tears, and laborious refpiration. When perfons of an apopkaic make obferve thefe fymptoms, they have reafon to fear the approach of a fit, and fhould endeavour to prevent it by plentiful bleeding, low diet, and opening medicines. In the fanguine apoplexy, if the patient dtoes not die fuddenly, the countenance appears florid, the face is fwell- ed or puffed up, and the blood-veffels, efpecially about the neck and temples, are turged; the pulfe beats ftrong; the eyes are prominent and fixed, and the breathing is difficult, and performed with a fnorting noife. The excrements and urine are often voided fpontaneoufly, and the patient is fometimes feized with a vomiting. In this cafe every method muft be taken to leffen the force of the blood towards the head. The patient fhould be kept perfeaiy eafy and cool. His head fhould be raifed pret-, ty high, and his feet fuffered to hang down. His cloaths ought to be loofened, efpecially about the neck, and frefh air admitted into his chamber. His garters fhould be tied pretty tight, by which means the motion of the blood from the lower extremities will be retarded. As foon as the patient is placed in a proper pcfture, he fhould be bled pret- ty freely in the neck or arm, and, if there be occafion, the operation may be repeated in two or three hours. A laxa- tive clyfter with plenty of fweet oil, or frefh butter and a large fpoonful of common fait in it, may be adminiftred eve- ry two hours; and bliftering plafters applied betwixt the fhoulders, and to the calves of the legs. As foon as the fymptoms are a little abated, and the pa- tient is able to fwallow, he ought todrink freely of fome di- luting opening liquor, as a decoaion of tamarinds and li- quorice, cream-tartar-whey, or common whey with cream of tartar diffolved in it. Or he may take any cooling purge, as Glauber's falts, or manna diffolved in an infufion of fenna, or the like. All fpirits and other ftrong liquors are to be avoided, OF THE APOPLEXY. 293 avoided. Even volatile falts held to the nofe do mifchief. Vomits," for the fame reafon, ought not be given, nor any thing that may increafe the motion of the blood towards the head. In the ferous apoplexy, the fymptoms are nearly fimilar, only the pulfe is not fo ftrong, the countenance is lefs flo- rid, and the breathing lefs difficult. Bleeding is not fo ne- ceffary here, as in the former cafe. It may however ge- nerally be performed once with fafety and advantage ; but fliould not be repeated. The patient fhould be placed in the fame pofture as direaed above, and fhould have blifter- ing plafters applied, and receive opening clyfters in the fame manner. Purges are here likewife neceffary, and the pati- ent may drink ftrong balm tea. If he be inclined to fweat, it ought to be promoted by drinking fmall wine whey, or an infufion of carduus benediaus. A plentiful fweat kept up for a confiderable time, has often carried off a ferous a- poplexy. When apopleaic fymptoms proceed from opium, or o- ther narcotic fubftances taken into the ftomach, vomits are neceffary. The patient is generally relieved, as foon as he has difcharged the poifon in this way. Persons of an apopkaie make, or thofe who have been attacked by it, ought to ufe a very fpare and flender diet, a- voiding all ftrong liquors, fpiceries, and high feafoned food. They ought likewife to guard againft all violentpaffi- ons, and to avoid the extremes of heat and cold. The head fhould be fhaved, and daily wafhed with cold water. The feet ought to be kept warm, and never fuffered to con- tinue long wet. The belly muft, by all means, be kept open, either by food or medicine, and blood ought to be let every fpring and fall. Moderate exercife fhould likewife be taken ; but it ought never to be continued too long. No- thing has a greater effea in preventing an apoplexy than if- fues or perpetual blifters ; but great care muft be taken ne- ver to fuffer them to dry up, without opening others in their ftead. Apopkaie perfons ought never to go to fleep with a full ftomach, nor to lie with their heads too low, or wear any thing tight about their necks. Of 29+ OF THE PALSY. Of the PALSY. The palfy is a lofs or diminution of fenfe, or motion, or of both, in one or more parts of the body. It is more or lefs dangerous, according to the importance of the part af- feaed. A palfy of the heart, lungs, or any part neceffary for life, is mortal. When it affeas the ftomach, the intef- tines, or the bladder, it is highly dangerous. If the face be affeaed, the cafe is bad, as this fhews, that the difeafe proceeds from the brain. If the part affeaed feels cold, is infenfible, or waites away, there is fmall hopes of a cure, efpecially, if the judgement and memory begin to fail. CAUSE S.----The immediate caufe of the palfy is whatever prevents the regular exertion of the nervous pow- er upon any particular mufcle or part of the body. The occafionalandpredifpofingcaufesarevarious,asdrunkennefs j wounds of the brain, or fpinal marrow; preflure upon the brain or nerves ; very cold or damp air ; the fuppreffion of cuftomary evacuations ; fudden fear ; want of exercife ; or or whatever greatly relaxes the fyftem, as drinking much tea, * or coffee, &c. Wounds of the nerves themfelves, or any thing that obftruas the regular aaion of that, vital pow- er contained in them, will occafion a palfy. It may like- wife proceed from the poifonous fumes of metals or minerals, as mercury, lead, arfenick, &c. In young perfons of a full, habit, where there are fymp- toms of inflammation, the palfy muft be treated in the fame manner as the fanguine apoplexy. The patient muft be bled, bliftered, and have his belly kept open by fharp cly- fters or pugative medicines. But, in old age, or when the difeafe proceeds from relaxation or debility, which is gene- rally the cafe, a quite contrary courfe muft be purfued. The diet muft be warm and attenuating, confifting chiefly of fpicy and aromatic vegetables, as muftard, horfe-radifh, &c. The drink may be generous wine, muftard-whey, or brandy and water. Friaion with the flefh brufh, or a warm hand, is extremely proper, efpecially on the parts affeaed * Many people imagine, that tea has no tendency to hurt the nerves, and that drinking the fame quanuty of warm water would be equally pernicious. This howeverfeems to be a miftake. I know many per- fons who daily drink three or four cups of warm milk and water with- out feeling any bad confequences; yet the fame quantity of tea will make their hands fliake for twenty-four hours. OF THE EPILEPSY,^ 195 affeaed. Bliftering-platters may likewife be applied to the affeaed parts with advantage. When this cannot be done, i they may be rubbed with the volatile liniment, or the nerve-ointment of the Edinburgh difpenfatory. But the beft external application is ekaricity. The fliocks fliould be received on the part affected ; and they ought daily to be repeated for feveral weeks. This is not only proper for •curing, but alfo for preventing a palfy. Vomits are very beneficial in this kind of palfy, and ought to be frequently adminiftred. Cephalic fnuff, or any thing that makes the patient fneeze, is likewife ufeful. Some pretend to have found great benefit from rubbing the parts affeaed with nettles ; but this does not feem to be any ways preferable to bliftering. Ifthe tongue be affeaed, the patient may gargle his mouth frequently with brandy and muftard ; or he may hold a bit of fugar in his mouth wet with the palfy-drops or compound fpirits of lavender. The wild valerian root is a very proper medicine in this E>a cafe. It may either be taken in an infufion with fage- , leaves, or half a dram of it in powder may be given in a glafs of wine three times a day. If the patient cannot ufe l the valerian, he may take offal volatile oleofum, compound fpirits of lavender, and tinaure of caftor, each half an ounce ; mix thefe together, and*take forty or fifty drops in a glafs of wine, three or four times a day. A table fpoon- ful of muftard-feed taken frequently is a very good medi- cine. The patient ought likewife to chew cinnamon bark, \ ginger» or otber warm fpiceries. Exercise is of the utmoft importance in the palfy; but thepatient muft beware of cold, damp, and moift air. He iV -ought to wear flannel next his fkin 5 and, if poffible, fhould remove into a warmer climate. i Of the EPILEPSY, or FALLING SICKNESS. The epilepfy is a fudden deprivation of all the fenfes, wherein the patient falls fuddenly down, and is affeaed ['. with violent convulfive motions. Children, efpecially thofe that are delicately brought up, are moft fubjea to it. It jf more frequently attacks men than women, and is very drffi- ' cult to cure. When the epilepfy attacks children, there is reafon to hope it may go °ff about tb* ijHie of puberty. When 296 OF THE EPILEPSY, When it attacks any perfon after twenty years of age, the cure is difficult ; but when after forty, a cure is hardly to be ex- peaed. Ifthe fit continues only for a fhort fpace, and re- turns feldom, there is reafon to hope; but if it continues long and returns frequently, the profpea is bad. It is a very unfavourable fymptom, when the patient is feized with the fits in his fleep. CAUSE S.----Sometimes the epilepfy is a hereditary difeafe. It may likewife proceed from a fudden fright of the mother when with child of the patient ; from blows, bruifes, or wounds on the head ; a colkaion of water, blood, or ferous humours in the brain ; a polypus ; tumours or concretions within the fkull; exceffive drinking ; intenfe ftudy; excefs of venery; worms; teething; fuppreffion of cuftomary evacuations ; too great emptinefs or repletion ; violent paffions or affeaions of the mind, as fear, joy, Ufe. hyfteric affeaions ; contagion received into the body, as the infeaion of the fmall-pox. meafles, Ufe SYMPTOM S.---An epileptic fit is generally pre- ceded by an unufual wearinefs; pain of the head ; dulnefs; giddinefs ; noife in the ears ; dimnefs of fight; palpitation oftheheart; difturbed fle-p ; difficult breathing; the bow- els are. inflated with wind ; the urine is in great quantity, but thin ; the complexion's pale ; the extremities are cold, and the patient feels as it were a ftream of cold air afcend- ing towards his head. In the fit, the patient generally makes an unufual noife; his thumbs are drawn in towards "the palms of the hands ; his eyes are diftorted ; he Marts, and foams at the mouth * his extremities are bent or twifted various ways; he often difcharges his feed, urine, and foeces involuntarily ; and is • quite deftitute of all fenfe and reafon. After the fit is over, his fenfes gradually return, and he complains of a kind of ftupor, wearinefs, and painof his head; but has no remem- brance of what happened to him during the fit. Sometimes the fits return at flared periods, as at the - full or change of the moon : at other times they are excited by violent affeaions of the mind, a debauch of liquor, ex- ceffive heat, cold, or the like. This difeafe, from the difficulty of inveftigating its caufes, and itsftrange fymptoms, was formerly attributed to the wrath of the gods, or the agency of evil fpirits. In modern times it has often, by the vulgar, been imputed to witchcraft; OR FALLING SICKNESS. 297 witchcraft or fafcination. It depends however as much up- on natural caufes as any other malady; and its cure can only be effeaed by perfifting in the ufe of proper means. REGIME N..-----Epileptic patients ought, if poffible,, to breathe a pure and free air. Their diet fhould be nourifh- ing, but of eafy>digeftion. They ought to chink nothing ftrong, to avoid fvvines flefh, water-fowl, and likewife all windy and oiiy vegetables, as cabbage, nuts, &c. They ought to keep themfelves cheerful, carefully avoiding all occafions of violent paffions, as anger, fear, &c"0 Exercise is likewife of great ufe ; but the patient muft be careful to avoid all extremes either cf heat or cold, all dangerous fituations, as ftanding upon precipices, riding deep waters, &c. Any thing that makes him giddy, is apt to occafion a fit, as turning round, looking into a deep pit, or the like ; all thefe ou^ht therefore to be avoided with the utmoft care. M E D I C IN E^----The intentions of cure muft vary according to the caufe of the difeafe. If the patient be of a fanguine temperament, and there be reafon to fear an inflammation in the brain, bleeding and other evacuations will be neceflary. When the difeafe is occafioned by the ftoppage of cuftomary evacuations, thefe, if poffible, muft be reftored j if this cannot be done, others may be fubfti- tuted in their place. Iffues or fetons, in this cafe, have often a very good effea* When there is reafon to believe that the difeafe proceeds from worms, proper medicines muft be ufed to kill or carry off thefe vermin. When the difeafe proceeds from teething, the belly fhould be kept open by eh.O'iLv.t; clyfters, the feet frequently bathed in warm wa- t- r, and, if tiie fits prove obftinate, abliftvring plafter may be put betwixt the fhoukkrs. The fame method is to be followed, when epileptic fits prec-d_ the eruption of the fmall-pox, or meail.s, c:c. When the difeafe is hereditary, or proceeds from a wrong formation of the brain a cuic is not to be expeaed. When it is owing to feme fault in the-nervous fyftem fuch P n medicines • * It has already been obferved that epileptic fits are often the effect of fear, and aie accalioncd by that idle cuftom amon:- young people of frightening one another. Thou-h this be generally done out of mere frolic, it has many dreadful cor.iOmcnces, r iO cv,ght byall means to be difcouraged. It is Orciy a OiaOr crime to take away a peifon's life, than to render him z.i once iniltrabU. is himfelf, and a burden to fociety. i98 • O F T H E E P I L E P S Y, &c. medicines as tend to brace and ftrengthen the nerves may be ufed, as the Jefuits bark, Valerian root, mifletoe of the oak, fnake-root, &c. Fuller recommends the following ekauary as a moft excellent anti-epileptie Take Jefuits bark in powder three ounces, Virginian fnake-root powdered *one ounce, as much fyrup of paeony or cloves as is fufficient to form it in- to a foft ekauary. The dofe to an adult is a dram, or a- bout the fize of a nutmeg, morning and evening. It muft be continued for three or four months, and after- ■ wards repeated, three or four days before the new and full moon, for fome time. Mead recommends an ekauary againft the epikpfy much of the fame nature, only he ufes Valerian-root in place of the fnake-root. It muft be taken in the fame manner as the above. The patient ought always to be bled, and to 9 take a purge or two before he begins to ufe thefe medicines. They will likewife have a better effea if the patient drinks a tea-cupful of the decoaion of guaiacum after each dofe. It may be made by boiling two ounces of guaiacum fhavings, and one ounce of raifins of the fun ftoned, in tv/o Englifh quarts of water to one. Strain the liquor, and afterwards let it ftand to fettle, then pour off the clear from the feces. Colebatch fays, that the mifhtoe cures an epilepfy as certainly as the Jefuits bark does an intermittent fever. The dofe to an adult is half a dram of the powder, four times a- day, drinking after it a draught of a ftrong infufion of the fame plant. Though this medicine has not been found to anfwer the high encomiums which have been paffed upon it, yet in obftinate epileptic cafes it deferves a trial. It muft be ufed for a confiderable time, in order to produce any fa- lutary effeas. Musk has fometimes been found to anfwer very well in the epilepfy. Ten or twelve grains of it, v/ith the fkrr.e quantity of feaitious cinnabar, may be made up into a bo- lus and taken every night and'morning. Sometimes the epilepfy has been cured by ekaricity. Convulsion fits proceed from the fame caufes, and muft be treated in the fame manner rs the epilepfy. There is one particular fpecies of convulfions, which commonly goes by the name of St. Vitus's dance, wherein the patient is agitated with Arrange motions and gef iculati- o:is, which by the common people are generally believed to OF NERVOUS DISORDERS. acg to be the effeas of witchcraft. This difeafe may be cured by repeated bleedings and purges ; and afterwards ufing the medicines prefcribed above for the epilepfy, viz. thejefuits- bark, and fnake-root, Sec. Chalybeate waters, are found to be beneficial in this caO. The cold bath is likewife of lingular fervice, and ought never to be negkaed when the patient can bear it. Of NERVOUS, HYSTERIC, and HYPOCHONDRIAC Disorders. Of all difeafes incident to mankind, thofe of the ner- vous kind are the moft complicated and difficult to cure. A volume would not be fufficient to point out the various fymptoms. They imitate almoft every difeafe; and are fel- dom alike in two different per/ons, or even in the fame perfon at different times. Like Proteus, they are continual- ly changing fhape; and upon every frefh attack, the pati- ent thinks he feels fymptoms which he never experienced before. Nor do they only effea the body, the mind like- wife fuffers, and is often thereby rendered extremely weak and peevifh. The low fpirits, timoroufnefs, melancho- ly, and ficklenefs of temper which generally attend ner- vous diforders, induce many people to believe, that they are entirely difeafes of the mind ; but this change of temper is rather a confequence, than the caufe of nervous difeafes. CAUSE S.----Every thing that tends to relax or weaken the body, predifpofes it to nervous difeafes, as in- dolence, exceffive venery, drinking great quantities of tea, or other weak watery liquors, frequent bleeding, purging, vomiting, &c. Whatever hurts the digeftion, or prevents the proper affimilation of the aliment, has likewife this ef- fea, as long fafting, excefs in eating or drinking, the ufe of windy, crude, or unwholefome aliments, a bending pofture of the body, &c. Nervous diforders often proceed from affeaions of the mind, as grief, difappointments, anxiety, intenfe ftudy, &c. ,Few ftudious perfons are free from nervous difeafes. Nor is this at all to be wondered at; intenfe thinking not only preys upon the fpirits, but prevents the perfon from taking proper exercife, by which means the digeftion is im- paired, the nouriftiment prevented, the folids relaxed, and thewhole mafs of humours vitiated. Grief and difappoint- P P"2 meat I 300 OF NERVOUS DISORDERS. ment likewife produce the fame effeas. I have known more hyfteric and hypochondriac patients, who dated the commencement of their diforders from the lofs of a hufband, a favourite child, or from fome difappointhient in life, than from any other caufe. In a word, whatever weakens the body, or depreffes the fpirits, may occafion nervous dif- orders, as unwholefome air, want of fleep, great fatigue, &c. SYMPTOM S.-----We fhall only mention fome of the moft general fymptoms of thefe diforders, as it would be both an ufelefs and impraaicable talk to point out the whole. They generally begin with windy inflations ordi- ftenfions of the ftomach and inteftines, efpecially under the falfe ribs of the left fide, where a hard tumour may fome- times be perceived. The appetite and digeftion are general- ly bad ; yet fometimes there is an uncommon craving for food, and a quick digeftion. The food often turns four on the ftomach ; and the patient is troubled with vomiting of clear water, tough phlegm, or a blackifh coloured liquor refembling the grounds of coffee. Excruciating pains are often felt about the navel, attended with a rumbling or murmuring noife in the bowels. The belly is fometimes loofe, but more commonly bound, which occafions a reten- tion of wind and great uneafinefs. The urine isfometimct, in fmall quantity, at other times very copious and quite clear. There is a great ftraitnefs of the breaft with difficulty of breathing ; violent palpitations of the heart ; fudden flufhings of heat in various parts of the body ; at other times a fenfe of cold, as if water were pour- ed on them ; flying pains in the arms and limbs ; pains in the back and belly, refembling thofe occafioned by gravel 5 the pulfe very variable, fometimes uncommonly flow, and at other times very quick ; yawning, the hiccup, frequent fighings and a fenfe of fuffocation, as if from a ball or lump in the throat; alternate fits of crying and convulfive laugh- _ ing ; the fleep is unfound, and feldom refrefhing ; and the patient is often troubled with the night-mare. As the difeafe increafes, the patient is molefted with headachs, cramps, and fixt pains in various parts of the body; the eyes are clouded, and often affeaed with pain and drynefs ; there is a noife in the ears, and often a dull=- nefs of hearing; in fhort, the whole animal funaions are impaired. The mind is difturbed on the moft trivial occa- fions, OF NERVOUS DISORDERS. 301 fions, and is hurried into the moft perverfe commotions, in- quietudes, terror, fadnefs, anger, diffidence, Sec. The pa-' tient is apt to entertain vOld imaginations, and extravagant fancies ; the memory becomes weak, and the reafon failsj Nothing is more charaaeriftic of this difeafe than a conftant dread of death. This renders the patients peevifh, fickle, impatient, and apt to run from one phyfician to another; which is one reafon why they feldom reap any benefit from medicine, as they have not fufficient refolution to perfift in any one courfe till it has time to produce its proper effeas. They are likewife apt to imagine that they labour under dif- eafes from which they are quite free, and are very angry if any one attempts to laugh them out of their ridiculous no- tions. REGI'ME^----Hyfteric and hypochondriac per- fons ought never to fa ft long. Their food fhould be folid and nourifhing, but of eafy digeftion. Fat meats, and heavy fauces, are hurtful. All excefs lhould bt carefully avoided. They ought n#ver to eat more at a time than they can eafily digeft. Heavy fuppers are to be avoided. Ifthe patient feels himfelf weak and faint between meals, he ought to eat a bit of bread, and drink a glafs of wine. Tho' wine in excefs enfeebles the body, and impairs the faculties of the mind, yet taken in moderation, it ftrengthens the ftomach, and promotes digeftion. Wine and water is a very proper drink at meals. If wine fours on the ftomach, or the patient is much troubled with wind, brandy and wa- ter will anfwer better. Every thing that is windy, or hard of digeftion, muft be avoided. All weak and warm liquors arc hurtful, as tea, coffee, punch, &c. People may_ find a temporary relief from thefe, but they always increafe the malady, as they weaken the ftomach, and hurt digeftion. Above all things, drams are to be avoided. Whatever im- mediate eafe the patient may feel from the ufe of ardent fpi- rits, they are fure to aggravate the malady, and prove cer- tain poifons at laft. Thefe cautions are the more neceffa- ry here, as all hyfteric and hypochondriac perfons are pe- culiarly fond of tea and ardent fpirits; tothe ufeof which many of them fall a viaim. Exercise is of fuch importance in nervous diforders, that it is worth all other medicines. Riding on horfeback is generally efteemed the beft, as it gives motion to the whole body, without fatiguing it. I have known fome patients, however, 302 OF NERVOUS DISORDERS. however, with whom walking agreed better, and others who were moft benefited by riding in a machine. Every one ought to ufe that which he finds«moft beneficial. Long fea-voyages have an excellent effea ; and to thofe who can afford to take them, and have fufficient refolution, we would by all means recommend this courfe. Even change of place, and the fight of new objeas, by diverting the mind, have a great tendency to remove thefe complaints. For this reafon a long journey, or a voyage, is of much more advantage than riding fhort journeys near home. A cool and dry air is the beft, as it braces and imparts vigouf to the whole body. Nothing tends more to relax and enervate than hot air, efpecially that which is render- ed fo by great fires, or ftoves in fmall apartments. Hut when the ftomach or bowels are weak, the body ought to be well guarded againft cold, efpecially in winter, by wear- ing a thin flannel waiftcoat next the fkin. This will keep up an equ%l perfpiration, and defend the alimentary canal from many impreffions, to whioji it would otherwife be fubjea, upon every fudden change from warm to cold wea- ther. Rubbing the body frequently with a flefh-brufh, or a coarfe linen cloth, is likewife beneficial, as it promotes the circulation, perfpiration, &c. Perfons who have weak nerves ought to rife early, and take exercife before break- faft, as /ying too long a-bed cannot fail to relax the folids. They ought likewife to be diverted, and to be kept aseafy and cheerful as poffible. Nothing hurts the nervous fyftem, or weakens the digeftive powers more than fear, grief, or anx- iety. MEDICINES.----Tho' nervous difeafes are fel- dom radically cured, yet their fymptoms may fometimes be alleviated, and the patient's life rendered, at leaft, more comfortable, by proper medicines. When the patient is coftive, he ought to take a little rhubarb, or fome other mild'purgative, and fhould never fuffer hisbellv to be long bound. All ftrong and violent purga- tives are however to be ^voided, as aloes, jalap, ore. I have generally feen an infufion of fenna and rhubarb in brandy anfwer very well. This may be made of any ftrength, and taken in fuch quantity as the patient finds neceffary. When the digeftion is bad, and the ftomach relaxed and weak, bitters will be of fervice. The beft of thefe are the jefuits bark and gentian root, which may be prepared and ufed OF MELANCHOLY AND MADNESS. 303 ufed in the following manner. Take jefuits bark in pow- der, an ounce and a half, gentian-root and orange peel bruifed, of each half an ounce. Infufe thefe ingredients in a bottle of brandy or whifky, for five or fix days, then ftrain thciiqucr, and take a table fpoonful in half a glafs of water an hcue before breakfaft, dinner, and fupper. Nothing tends more to ffrcngthen the nervous fyftem than coll Lathing. This practice, if duly perfifted in, will produce very extraordinary .effects ; but when the liver or other "ji far a are obftruaed, or otherwife unfound,' the cold bath is improper. The moft proper ftafor.s for it are fummer and autumn. It will be kOiOor,t, efpecially for perfons of a fpare habit, to go into the cold bath three or four times a week, if the patient be weakened by it, or feels chilly for a long time after coming out, it is improper. In patients affliaed with wind, I have always cb-erved the greateft bene .it from the acid elixir of vitriol. It may betaken in the quantity cf fifteen, twenty, or thirty drops, twice or thrice a-cOy, in a glais of water. This bath ex- pels wind, ftrjnguicns the itonach, and promotes digefti- on. Opiates are greatlv extolled in thefe maladies ; but as they only palliate the fymptdrne, and generally afterwards increafe the difeafe, we would advife people to be extreme- ly cautious in th^ife of them, left habit render them at laft abfolutcly neceffl^. It would be an eafy matter to enumerate many medicines which have bean extolled for relieving nervous diforders; but whoever wiikee for a thorough cure muftexpea it from re^ra.ea alcne ; we fhall therefore omit mentioning more ir. iieines, and aa;ain recommend the ftriaeft attention to diet, air, exercise, and amusements. Of MELANCHOLY and M A D N E S S. Melancholy and madnefs arc nearly allied. They both proceed from the fame origin, and may be confidered as only different degrees of the fame Ok aie. A delirium without a fever is the common definition of m;>dnefs : Indeed it is rot a very accurate one; but mere is 110 great occafi- on to be folicitous about the definition .of a difeafe which every body'knows. It is cf far g-eater importance to know how i" is cccafiQiy-'J, ana by who means it may be cured. C A USES.---■ 304 OF MELANCHOLY AND MADNESS. CAUSE S.----It may proceed from a hereditary dif- pofition ; intenfe thinking, efpecially where the mind is long occupied about one objea; violent paffions or affeai- ons of the mind, as love, fear, joy, grief, over-wtcning pride, and fuch like. It may alfo be occafioned by excef- five venery ; narcotic or ftupifaaive poifons ; a fedentary life; folitude ; the fuppreffion of cuftomary evacuations; accute fevers, or other difeafes. Violent anger will change melancholy into nvaunefs ; and exceffive cold, efpecially of the lower extremities, will force the blood in- to the brain, and produce all the fymptoms of madnefs. It may likewife proceed from the ufe of aliment that is hard of digeftion, or which cannot be eafily affimilated ; from a callous ftate of the integuments of the brain, or a dryncfs of the brain itfelf. To all which we may add gloomy or miftaken notions of religion*. SYMPTOM S.---When perfons begin to be me- lancholy, they are dull ; dejeaed ; timorous ; watchful ; fond of folitude ; fretful; fickle; captious and inquifitive; folicitous about trifles ; fometimes niggardly, and at other times prodigal. The belly is generally bound; the urine thin, and in fmall quantity; the ftomach and bowels in- flated with wind ; the complexion pale ; the pulfe ilow and weak. The funaions of the mind are alfo greatly pervert- ed, in fo much that the patient often imagines himfelf dead, or changed into fome other animal. ^Bome have ima- gined, their bodies were made of glaO, or other brittle fub- ftances, and were afraid to move left they fhould be broken in pieces. The unhappy patient, in this cafe, unlefs care- fully watched, is apt to put an end to his own miferable life. * The figns of approaching madnefs are : Rednefs of the eyes, with a tremulous and conftant vibration of the eye- lids ; a change of difpofition and behaviour; fupercilious looks ; a haughty carriage ; grinding of the teeth ; unac- countable malice to particular perfons ; exceffive watchful- nefs ; violent headachs ; quicknefs of hearing; noife in the ears, &c. Persons * The mind by dwelling too long upon the dark fide of religion, is often, at length, overwhelmed with the deepeft melancholy, which ends in madnefs. What a pity that religion, which was intended to al- leviate the calamities of life, to keep the mind cheerful, and to raife it above difappointments, lhould ever be perverted into the means of producing thefe very evils it was defigntd to cure ? OF MELANCHOLY AND MADNESS. 305 Persons aaually mad are in an exceffive rage when pro- voked to anger. Some wander about, others make a hide- ous noife. Some fhun the fight of men; others, if permit- ted, would tear themfelves, or thofe whom they meet, to pieces. Some in the higheft degree of the diforder fee ima- ges before their eyes, and fancy themfelves ftruck with lightening. To thefe we may add incredible ftrength, and great infenfibility to hunger and cold. When the difeafe is owing to an obftruaion of cuftom- ary evacuations, or any bodily diforder, it is eafier cured than when it proceeds from the mind. Madnefs attended with mirth is not fo dangerous as that which is accompani- ed with fadnefs. A difcharge of blood from the nofe, a vi- olent loofenefs, fcabby eruptions, the bleeding piles, or the menfes, fometimes carry off this difeafe. Diseases of the mind often intermit for feveral years, and return again. In fome they return annually at the fol- flics ; in others about the time of the equinoxes. Some- times the raving fits obferve the lunar periods; in which cafe the difeafe is thought to have fome affinity with the e- pilepfy. REGIME N.---The diet ought to confift chiefly of vegetables of a cooling and opening quality. Animal food, efpecially faked or fmoke-dried fifh or flefh, ought to be avoided. All kinds of fhell-fifh are bad. Aliments pre- pared with onions, garlic, or any thing that generates thick blood, are likewife improper. All kinds of fruits that are wholefome may be eat with advantage. Boerhaave gives an inftance of a patient who by a long ufe of whey, ' water, and garden-fruits, evacuated a great quantity of black matter, and recovered his fenfes. This feems to have been the method of cure praaiced at the Affyrian court; where wefind the monarch himfelf, when feized with mad- nefs, was turned out to graze. Strong liquors of every kind ought to be avoided as poifon. The moft proper drink is water, whey, or very fmall beer. Tea and coffee are improper. If honey agrees with the patient, it may be eat freely, or his drink fweet- ened with it. Infufions of balm-leaves, penny-royal, the roots of wild valerian, or the flowers of the lime-tree, may be drank freely, either by themfelves, or fweetened with honey, as the patient fhall chufe. 7 Q^q The 3o6 OF MELANCHOLY AND MADNESS. The patient ought to take as much exercife in the open air as he can bear. This helps to diffolve the vifcid humours, it removes obftruaions, promotes the perfpiration, and all the other fecretions. Every kind of madnefs is attended with a diminifhed perfpiration ; all means ought therefore to be ufed to promote that neceffary and falutary difcharge. Nothing can have a more direa tendency to increafe the difeafe than the common method cf confining the patient to a clofe apartment. Were a proper fpace allotted for him to run about in, where he could neither hurt himfelf nor others, it would contribute much to promote a cure. It would have ftill a better effea, if he were obliged to labour a piece of ground. By digging, hoeing, planting, low- ing, &c. both the body and mind would be exercifed. A plan ©f this kind, with a ftria vegetable aiet, would be a more rational method of cure than confining the patient in Bedlam, or fending him to a private mad-houfe. Thefe inftitutions, as they are generally managed, are far more likely to make a wife man mad than to reftore a madman to his fenfes. Even running about at large, tho' it may be attended with fome bad confequences, is more likely to re- ftore the patient than confining h:m in a mad-houfe. I have known feveral inftances of peiaons cured by exercife, amufements, and a vegetable diet, who, in all probability, had they been confined, would have continued lunatic for life. A long journey, or a voyage, efpecially into a warm- er climate, with agreeable companions, has often very hap- py effeas. M E D I C IN E.----In the cure of madnefs, great re- gard muft be paid to the mind. When the patient is in a low melancholy ftate, his mind ought to be foothed and di- verted with variety of amufements, as entertaining flories, paftimes, mufic, Sic. This feems to have been the method of curing melancholy among the Jews, as we learn from the ftory of King Saul; and indeed it is a very rational one. Nothing can remove difeafes of the mind fo effeaually as applications to the mind itfelf, the moft efficacious of which is mufic. The patient's company ought likewife to con- fift of fuch perfons as are agreeable to him. People in this ftate are apt to conceive unaccountable averfions againft particular perfons; and' the very fight of fuch perfons is fufficient to diffract their minds, and throw them into the utmoft; OF MELANCHOLY AND MADNESS. 307 utmoft perturbation. In all kinds of madnefs, it is better to footh and calm the mind than to ruffle it by contradiai- on. When the patient is high, evacuations are neceffary. In this cafe he muft be bled, and have his belly kept open by purging medicines, as manna, rhubarb, cream of tartar, or the folube tartar. I l>ive feen the laft have very good ef- feas. It may be taken in the dofe of half an ounce, dif- folved, in water gruel every day, for fundry weeks, or even for months, if neceffary. More or lefs may be given according as it operates. Vomits have likewife a good ef- fea ; but they muft be pretty ftrong, otherwife they will not operate. Madness has fometimes been cured by camphire. Ten or twelve grains of it may be rubbed in a mortar with half a dram of nitre, and taken twice a day, or oftner if the ftomach will bear it. If it will not fit upon the ftomach in this form, it may be made into pills with gum Vafaetida and Ruffian caftor, and taken in the quantity above direa- ed. Mufk has likewife been found efficacious in this cafe ; but to have any effea, it muft be given in large dofes, A fcruple or twenty five grains may be made into abolus with a little honey or fyrup, and taken twice or thrice a day. The antimonial wine is by fome extolled for the cure of madnefs. It may be taken in the dofe of forty or fifty drops, twice or thrice a day, in a cup of tea. The tinaure of hellebore has likewife been in great efteem ; -but I never faw any con- fiderable effeas from it. Each of the above medicines may be of fervice in fome particular cafe, provided it be duly petfifted in, and where one fails, it may not be amifs to try another. Ag it is very difficult to induce patients in this difeafe to take medicines, we fhall mention fome outward appli- cations which fometimes do good; the principal of thefe are iffues, fetons, and cold bathing. Iffues may be made in any part of the body, but they generally have the beft ef- fect near the fpine of the back. The difcharge from thefe may be greatly promoted by dreffing them with the mild bliftering ointment, and keeping what are commonly called the orrice peas in them. The fait water is moft proper for bathing in ; but when that cannot be obtained, the patient may be daily immerfed in frefh water. Some recommend Q.q * 30S O F P O I S O N S. recommend bathing the body in warm water, and at the fame time pouring cold water upon the head. That kind of madnefs or delirium which proceeds from mere weaknefs, requires a quite different method of treat- ment. It is often the effea of fevers injudicioufly treated, wherein the patient's ftrength has been exhaufted by frequent bleedings and purgings. This muft be removed by nourifh- ing diet, exercife proportioned to the patient's ftrength, and cordial medicines. All evacuations are here carefully to be avoided. The patient may take frequently a glafs of good wine, in which a little jefuits bark has been infufed. OF POISONS. Every perfon ought, in fome meafure, to be acquaint- ed with the nature and cure of poifons. They are general- ly taken unawares, and their effeas are often fo fudden and violent, as not to admit of delay, or allow time to procure the afliftance of phyficians. Indeed no great degree of me- dical knowledge is here neceffary, the remedies for moft poifons being generally at hand, or eafily obtained, and nothing but common prudence needful in the application of them. The vulgar notion that every poifon is cured by fome counter poifon, as a fpecific, has done much hurt. People believe they can do nothing for the patient, unlefs they know the particular antidote to that kind of poifon which he has taken. Whereas the cure of all poifons taken into the ftomach, without exception, depends on difcharging them as foon as poffible. There is no cafe wherein nature points out the method of cure more clearly than in this. Poifon is feldom lqng in the ftomach before it occafions ficknefs with an inclination to vomit. This fhews plainly what ought to be done. In- deed common fenfe diaates to every man, that, if any thing has been taken into the ftomach which endangers life, it ought immediately to be difcharged. Were this duly re- garded, moft of the mifchief occafioned by poifon might be prevented. The method of cure is obvious, and the means of performing it are in the hands of every man. Poisons, either belong to the animal, vegetable, or mi- neral kingdom. Mineral OF POISONS- 3°9 Mineral poifons are commonly of an acrid or corrofive quality, as arfenic, the corrofive fublimate of mercury, &c. Those of the vegetable kind are generally of a narcotic or ftupifaaive quality, as poppy, hemlock, henbane, ber- ries of the deadly night-fhade, &c. Poisonous animals communicate their infeaion, either by the bite or fling. This poifon is very different from the former, both in its fymptoms and cure. MINERAL POISON S.---Arfenic is the moft common of this clafs ; and, as the whole of them are pret- ty fimilar both in their effects and method of cure, what is faid with refpea to it will be applicable to every other fpe- cies of corrofive poifon. When a perfon has taken arfenic, he foon percieves a burning heat, and violent pricking pain in his ftomach and bowels, with vomiting and intolerable thirft. The tongue and throat feel rough and dry; and, if proper help be not foon adminiftred, the patient is feized with great anxiety, hiccupping, faintings, and coldnefs of the extremeties. To thefe fucceed black vomits, foetid ftools, with a mortifica- tion of the ftomach and inteftines, which are the immedi- ate forerunners of death. On the firft appearance of thefe fymptoms, thepatient mould drink large quantities of new milk and falad oil till he vomits ; or he may drink warm water mixed with oil. Fat broths are alfo proper, provided they can be got ready in time. Where no oil is to be had, frefli butter may be melted and mixed with the milk or water. Thefe things are to be drank as long as the inclination to vomit conti- nues. Some have drank eight or ten Englifh quarts before the vomiting ceafed ; and it is never fafe to leave off drink- ing while one particle of the poifon remains in the ftomach. These oily" or fat fubftances not only provoke vomiting, but likewife blunt the acrimony of the poifon, and prevent its wounding the bowels ; but if they lhould not make the perfon vomit, half a dram or two fcruples of the powder or ipecacoanha muft be given, or a few fpoonfuls of the oxy- mel of fquills mixed with the water which he drinks. Vo- miting may likewife be excited by tickling the infideof the throat with a feather. If the tormenting pains are felt in the lower belly, and there is reafon to fear, that the inteftines are attacked, clyf- ters of milk and oil muft be very frequently thrown up* • and 3io O F P O I S O N S. and the patient muft drink emollient decoaions of bar- ley, oatmeal, marfhmallows, and fuch like. After the poifon has been evacuated, the patient oughti for fome time, to live upon fuch things as are of a healing and cooling quality. To abftain from flefh and all ftrong liquors, and to live upon milk, broth, gruel, light pud- dings, and other fpoon meats of eafy digeftion. His drink fhould be barley-water, linfeed-tea, or infufions of any of the mild mucilaginous vegetables. VEGETABLE POISONS, befides heat and pain of the ftomach, commonly occafion fome degree of giddinefs, and often a kind of ftupidity or folly. Perfons who have taken thefe muft be treated in the fame manner as for the mineral or corrofive. Though the vegetable poifons, when allowed to remain in the ftomach, often prove fatal ; yet the danger is gene- rally over as foon as they are difcharged. Not being of fuch a cauftic or corrofive nature, they are lefs apt to wound and inflame the bowels than mineral fubftances, no time however ought to be loft in having them expelled the fto- mach. Opium, being frequently taken by miftake, merits par- ticular attention. It is ufed as a medicine both in a folid and liquid form, which latter commonly goes by the name of laudanum. It is indeed a valuable medicine when taken in proper quantity ; but as an over-dofe proves a ftrong poifon, we fhall point out its common effeas, to- gether with the method of cure. Too great a quantity of opium generally occafions great drowfinefs, with ftupor and other apopkaie fymptoms. Sometimes the perfon has fo great an inclination to fleep, that it is almoft impoffible to keep him awake. Every me- thod muft however be tried for this purpofe. He fhould be toffed, fhaked, and moved about. Sharp bliftering plafters fhould be applied to his legs or arms, and flimulating me- dicines, as falts of hartfhorn, &c. held under his nofe. It will alfo be proper to let blood. At the fame time every method muft be taken to make him difcharge the poifon. This may be done in the manner direaed above, viz. by the ufe of ftrong vomits, drinking plenty of warm water with oil, &c. Mead, befides vomits, in this cafe, recommends acid medicines with lixivial falts. He fays, that he has often given O F P O I S O N S. 31* given fait of wormwood mixed with juice of lemon in re- peated dofes with great fuccefs. If the body fhould remain weak and languid after the poifon has been difcharged, nourifhing diet and cordials will be neceffary ; but when there is reafon to fear that the fto- mach or bowels are inflamed, the greateft circumfpeaion is neceffary both with regard to food and medicine. ANIMAL POISON S.---We fhall begin with the bite of a mad dog, as it is both the moft common and dangerous animal poifon in this country. The creatures naturally liable tocontraa the hydropho- bia are, fo far as we yet know, all of the dog-kind, viz. dogs, foxes, and wolves. Ofthelaftwe have none in this ifland ; and it fo feldom happens that any perfon is bit by the fecond, that they fcarce deferve to be taken notice of. If fuch a thing fhould happen, the method of treatment is precifely the fame as for the bite of a mad dog. The fymptoms of madnefs in a dog are as follow. At firft he looks dulL, fhews an averfion to food and company : He does not bark as ufual, but feems to murmur, is peevifh, and apt to bite ftrangers : His ears and tail droop more than ufual, and he appears drowfy. Afterwards he begins to loll out his tongue, and froth at the mouth, his eyes feeming heavy and watery. He now, if not confined, takes off, runs panting along with a kind of dejeaed air, and endea- vours to bite every one he meets. Other dogs are faid to fly from him. Some think this a certain fign of madnefs fup- pofing that they know him by the fmell; but it is not to be depended on. * If he efcapes being killed, he feldom runs - above two or three days, till he dies exhaufted with heat, hunger, and fatigue. » This difeafe is moft frequent after long dry hot feafons ; and fuch dogs as live upon putrid ftinking carrion, without having enough of frefh water, are moft liable to it. WrHEN any perfon is bit by a dog, the ftriaeft enquiry ought to be made, whether the animal be really mad. Many difagreeable confequences arife from negkaing to af- certain this point. Some people have lived in continual anxiety for many years, becaufe they had been bit by a dog which they believed to be mad ; but, as he had been killed on the fpot, it was impoffible to afcertain the faa. This fhould induce us, inftead of killing a dog the moment he 3i2 O F P O I S O N S. has bit any perfon, to do all in our power to keep him alive, at leaft till we can be certain whether he bemad or not. Many circumftances may contribute to make people imagine a dog mad. He lofes his mafter, runs about in quell of him, is fet upon by other dogs, and perhaps by men. 'Fhe creature thus frightened, beat, and abufed, looks wild, and lolls out his tongue as he runs along. Immediately a crowd is after him ; while he, finding himfelf clofely pur- fued, and taking every one he meets for an enemy, natu- rally attempts to bite in felf-defence. He foon gets knock- ed on the head, and paffes currently for a mad dog, as it is then impoffible to prove the contrary. This being the true hiftory of, by far, the greater part of thofe dogs which pafs for mad, is it any wonder that rmmberlefs whimfical medicines have been extolled for pre- venting the effeas of their bite ? This readily accounts for the great variety of infallabk remedies for the bite of a mad dog, which are to be met with in almoft every family. Though not one in a thoufand has any claim to merit, yet they are all fupported by numberlefs vouchers. No wonder that imaginary difeafes fhould be cured by imaginary reme- dies. In this way credulous people firft impofe upon them- felves, and then deceive others. The fame medicine that was fuppofed to prevent the effeas of the bite, when the dog was not mad, is recommended to a perfon who has had the misfortune to be bit by a dog that was really mad. He' takes it, trufts to it, and is undone. To thefe miftakes we muft impute #the frequent ill fuc- cefs in preventing the effeas of the bite of a mad dog. It is not owing fo much to a defea in medicine, as to wrong applications. I am perfuaded if proper medicines were taken immediately after the bite is received, and continued for a fufficient length of time, we fhould not lefe one in a thoufand of thofe who have the misfortune to be bit by a mad dog. This poifon is generally communicated by a wound, which, neverthelefs, heals as foon as a common wound : But afterwards it begins to feel painful, and as the pain fpreads towards the neighbouring parts, the perfon becomes heavy and liftlefs. His fleep is unquiet with frightful dreams; he fighs, looks dull, and loves folitude. Thefe are the forerunners, or rather the firft fymptoms, of that dreadful difeafe occafioned by the bite of a mad dog. But as O F P O I S O N S. 313 as we do not propofe to treat the difeafe itfelf, but to point out the method of preventing it, we fhall not take up time in fhcwing its progrefs from the firft invafion to its com- monly fatal end. The common notion, that this poifon may lie in the body for many years, and afterwards prove fatal, feems not to be well founded. It muft render fuch perfons as have had the misfortune to be bit very unhappy, and can have no good effeas. If the perfon takes proper medicines for for- ty days after being bit, and feels no fymptoms of the dif- eafe, there is reafon to believe him out of danger. Some indeed have gone mad twelve months after being bit; but I never knew it happen later ; and of this I only remember to have feen one inftance. The medicines recommended for preventing the effeas of the bite of a mad dog, are chiefly fuch as promote urine and perfpiration ; to which may be added antifpafmodics. Dr Mead recommends a preventive medicine, which he fays he never knew fail, though in the fpace of thirty years he had ufed it a thoufand times. The medicine is as follows: " Take afh-coloured ground liver-wort, cleaned, dried, and powdered, half an ounce ; of black pepper powdered, a quarter of an ounce. Mix thefe well together, and divide the powder into four dofes ; one of which muft be taken every morning fafting, for four mornings fucceffively, in half an Englifh pint of cows milk warm. After thefe four dofes are taken, the patient muft go into the cold bath, or a cold fpring or river, every morning fafting, for a month ; he muft be dipped all over, but not flay in (with his head above water) longer than half a mi- nute, ifthe water be very cold. After this he muft go in three times a-week for a fortnight longer. The perfon muft be bled before he begins to ufe the me- dicine*." R r We * I was, fome time ago, favoured with the following prefcription for the bite of a mad dog, which had been long kept a fecret in a gentleman's family in the north of England, and is faid never to have failed, when given as a preventive either to man or beaft.—" Take fix ounces of Rue clean picked and bruifed, four ounces of garlic pealed and bruifed, four ounces of Venice treacle, four ounces of fcraped tin or pewter. B01 'all thefe ingredients in two Englifli quarts of the beft ale, in aveHel cloic > 3r4 O F P O I S O N S. We fhall next mention the famous Eaft India fpecific, as it is called. This medicine is compofed of cinnabar and mufk. It is efteemed a great antifpafmodic, and by many, thought to be an infallible remedy for preventing the effeas of the bite of a mad dog. " Take native and faaiticfhs cinnabar, of each twenty- four grains, mufk fixteen grains. Let thefe be made into a fine powder, and taken in a glafs of arrack or brandy." This fingle dofe is faid to fecure the perfon for thirty days, at the end of which it muft be repeated; but if he has any fymptoms of the difeafe, it muft be repeated in three hours. The following is likewife a good antifpafmodic medicine. Take of Virginian fnake-root in powder, half a dram, gum afafcetida twelve grains, gum Camphire feven grains ; make thefe into a bolus with a little fyrup of faffron. Camphire may alfo be given in the following manner : Take purified nitre half an ounce, Virginian fnake-root in powder two drams, camphire one dram ; rub them toge- ther in a mortar, and divide the whole into ten dofes. Mercur.y is another medicine of great efficacy, both in the prevention and cure of this kind of madnefs. When ufed as a preventive, it will be fufficient to rub daily a dram of the ointment into the parts about the wound. Vinegar is likewife of confiderable fervice, and fhould be taken freely, either in the patient's food or drink. These are the principal medicines recommended for preventing the effeas of the bite of a mad dog. We would not however advife people to truft to any one of them ; but from a proper combination of their different powers, there is the greateft reafon to hope for fuccefs. The great error in the ufe of thefe medicines lies in not taking them for a fufficient length of time. They are ufed more like charms than medicines intended to produce any change in the body. To this, and not to the infufficiency of clofe covered, over a flow fire, for the fpace of an hour; then ftrain th; liquor, and giye eight or nine fpoonfuls of it warm to an adult per- fon every morning fafting, for three or four mornings running. Left may be given to a young perfon, or one of a weak conftitution. Some of the ingredients may be bound upon the wound, if it can be conveni- ently done." This is ordered to be given within nine days after the bite. No doubt the fooner it is given thebetter.---The dofe ordered for ahorfe is twelve fpoonfuls, the fame quantity for a bullcck ; and for a flieep, hog, or do~, four or five. OF POISONS. 315 <*-l the medicines, muft we impute their frequent want of fuccefs. Dr. Mead fays, that the virtue of his medicine con- fifts in promoting urine. But how a poifon fhould be ex- pelled by urine, with only three or four dofes of any medi- cine, however powerful, is not eafy to conceive. More time is certainly neceflary ; and here the defea of the Doc- tor's prefcription feems to lie. The Eaff-India fpecific is ftill more exceptionable on this account. As thefe and moft other medicines, taken fmgly, have frequently been found to fail, we fhall recommend the fol- lowing courfe. If a perfon be bit in a flefhly part, where there is no hazard of hurting any large blood-vclfel, the parts adjacent to the wound may be cut away. But if this be not done foon after receiving the bite, it will be better to omit it. The wound may be wafhcd with fait and water, or a pickle made of vinegar and fait, and afterwards dreffed twice a-day with yellow bafiiicon mixed with fome red pre- cipitate. The patient fhould begin to ufe either Dr Mead's me- dicine, or fome of the others mentioned above. If he takes Mead's medicine he may ufe it as the Doaor direas for four days fucceffively. Let him then omit it for two or three days, and again repeat the fame number of dofes as before. During this courfe, he muft rub into the parts about the wound, daily, one dram of the mercurial or blue oint- ment, as it is called. This may be done for ten or twelve days at leaft. When this courfe is over, he may take a purge or two, and then begin to ufe the cold bath. This muft be ufed every morning for five or fix weeks ; but if the patient fhould feel cold and chilly for a long time after coming out of the cold bath, it will be better to ufe a tepid one, or to have the water a little warmed. In the mean time, we would advife him not to leave off all internal medicines, but to take either one of the bolufes of fnake-root, afafcetida and camphire ; or one of the pow- ders of nitre, camphire, and fnake-root, twice a-day. Thefe may be continued fqr a fortnight or three weeks 316 O F P O I S O N S. If the perfon has gone through the above courfe of me- dicine, and no fymptoms of madnefs appear, he may be reckoned out of danger. It will neverthelefs be advifeable, for the greater fafety, to take a dofe or two of Dr Mead's medicine, at every full or change of the moon, for thethree or four fucceeding months. During the ufe of the mercurial ointment, the patient muft keep within doors, and take nothing cold. A proper regimen muft be obferved during the whole courfe. The patient fhould abftain from flefh, and all fak- ed and high-feafoned provifions. He muft avoid ftrong li- quors, and live moftly upon a light and rather fpare diet. His mind fhould be kept as eafy and chcerfu} as poffible, and all exceffive heat and violent paffions avoided with the utmoft care. I have never feen this courfe of medicine, with proper regimen, fail to prevent the hydrophobia, and cannot help again obferving, that the want of fuccefs muft generally be owing either to the application of improper medicines, or not ufing proper ones for a fufficient length of time. Mankind are extremely fond of every thing that promi- fes a fudden or miraculous cure. By trufting to thefe they often lofe their lives, when a regular courfe of medicine would have rendered them abfolutely fafe. This holds re- markably in the prefent cafe: Numbers of people, for ex- ample, believe if they or their cattle be once dipped in the fea, it is fufficient: as if the fait water were a charm againft the effeas of the bite. This and fuch like whims have proved fatal to many. Some people believe, if a perfon be bit by a dog that is not mid, if he fhould go mad afterwards, that the perfon will be feized with the diforder at the fame time. This no- tion is too ridiculous to deferve a ferious confutation*. The next poifonous animal that we fhall mention is the VIPER. The greafe of this animal rubbed into the wound is generally reckoned a cure for the bite. Though this is all that the viper-catchers commonly do when they are bit, * It i«s furprifin?; that no proper inquiry has ever been made into the truth of the common opinion, that a dog which has been wormed can- not bite after he goes mad. This circumftance not only merits the at- tention of phyficians, but of the legislature. If the faft could be afcer- tained, and the practice rendered gerieral, it would fave both the lives and pivpertks oi'ir. my. f O F P O I S O N S. 317 bit, I fliould hardly think it fufficient for the bite of an enraged viper. It would furely be more fafe to have the wound well fucked,\ and afterwards rubbed with warm fa- lad oil. A poultice of bread and milk, with plenty of falad oil in it, fhould likewife be applied to the wound, and the patient ought to drink freely of wine whey with fome fpirits ofhartfhhorn ; or, if that be not at hand, of water gruel with vinegar in it, to make him fweat. Ifthe. patient be fick, he may take a vomit. This courfe will be fufficient for the bite of any of the poifonous animals of this country. With regard to poifonous infeas, as the bee, wafp, hornet, &c. their flings are feldom attended with great dan- ger, unlefs where a perfon happens to be flung by a num- ber of them at once. In this cafe fomething fhould be done to abate the pain and inflammation. Some, for this pur- pofe, apply honey, others lay pounded parfley to the part. Some recommend a mixture of vinegar and Venice-treacle; but I have always found rubbing the part with warm falad- oil fucceed very well. Indeed, ifthe flings be fo numerous as to endanger the patient's life, which is fometimes the cafe, he muft not only have oily poultices applied to the part, but muft likewife be bled and take fome cooling me- dicines, as nitre, cream of tartar, &c. with plenty of dilu- ting liquor?. It is the happinefs of this ifland to have very few poifon- / ous animals, and even thefe are not of the moft virulent kind. Nine tenths of the effeas ufually attributed to poi- fon or venom are really other difeafes, and depend upon quite different caufes. We cannot however make the fame obfervation with re- gard to poifonous vegetables. Thefe abound every where, and prove often fatal to the ignorant and unwary*, v This x indeed f The practice of fucking out poifons is very anc;ent ; and indeed nothing can be more rational. It is the moft likely method of extract- ing the poifon where the bite cannot be cut out. There is no danger in performing this office ; as the poifon does no harm unlefs it be taken mto the body by a wound. The perfon who fucks the wound ought however to wafh his mouth frequently with falad-oil, which will fecure him from even the leaft inconveniency. The ancient Pfylli in Africa, and the Marfi in Italy were famed tor curing the bites of poifonous ani- mals bv fucking the wound ; and we are told, that the Indians in North America practice the fame at this day. * The principal of thefe are, hemlock, henbane, monkfliood, co- lumbine, hellebore, berries of the deadly night-fliade, thorn-apple, all the (purges, and moft mufhrooms, &c. 3i$ OF THE STONE AND GRAVEL. indeed is, in a great meafure, owing to careleffnefs. Chil- dren ought early tobe cautioned againft eating any fort of roots or berries which they do not know. We would like- wife advife parents to deftroy all pr)ifonous plants in their gardens, &c. or elfe to keep them in places where their children can have no accefs. But it is not children alone who fuffer by eating poifo- nous plants : We have every year accounts of adults poifon- ed by eating hemlock-roots inftead of parfnips, or fome fungus which they gather for muftirooms, &c. Thefe ex- amples ought to put people upon their guard with refpea to the former, and put the latter entirely out of ufe. Of the STONE and GRAVEL. When fmall ftones are lodged in the kidneys, or dif- charged along with the urine, the patient is faid to be afflic- ted with gravel. If one of thefe ftones happens to make a lodgment in the bladdar for fome time, it accumulates frefh matter, and at length becomes too large to pafs off with the urine. In this cafe the patient is faid to have the ftone. CAUSE S.----This difeafe may be occafioned by high living ; the ufe of ftrong aftringent wines* ; a feden- tary life ; lying too hot, foft, or too much on the back j the conftant ufe of water which is impregnated with earthy orftony particles, aliments of an aftringent or windy na- ture, &c. It may likewife proceed from an hereditary dif- pofition. Perfons in the decline of life, and thofe who have been much afflicted with the gout or rheumatifm are moft fubjea to it. SYMPTOMS.---Small ftones or gravel in the kidneys occafion pain in the loins; ficknefs ; vomiting ; and fometimes bloody urine. When the ftone defcends into the ureter, and is too large to pafs along with eafe, all the above fymptoms are increafed ; the pain extends to- wards the bladder; the thigh and leg of the affeaed fide feel benumbed ; the tefticles are drawn upwards, and the urine is obftruaed. A STONE * It is a common notion that the tartar in wine generates the ftone : but there is more reafon to believe that its aftringency, together with the fixed air contained in it, produce this effea. I know many perfons who never fail to pafs lefs urine, and to complain of a pain in their kid- neys for feveral days after drinking freely of red wine. OF THE STONE AND GRAVEL. 319 A stone in the bladder is known from a pain at the time, as well as before and after making water; from the urine coming away by drops, or ftopping fuddenly when in a full itream ; by a violent pain in the neck of the blad- der upon motion, efpecially on horfeback or in a coach on rough road ; from a white, thick, copious, flunking, mu- cous fediment in the urine ; from an itching in the top of the penis ; from an inclination to go to ftool while the urine is difcharged ; from the patient's paffing his urine more ea- fily when lying than in an erea pofture ; and from a kind of convulfive motion occafioned by the fharp pain in dif- charging the laft drops of the urine. REGIME N.----Perfons affliaed with the gravel or ftone lhould avoid aliments of a windy or heating nature, as falt-meats, four fruits, &c. Their diet ought chiefly to confift of fuch things as tend to promote the fecretion of u- * rine, and to keep the belly open. Artichoaks, afparagus, fpinnage, lettuces, fuccory, parfley, purflane, turnips, po- tatoes, carrots, and radifhes may be fafely eat. Onions, leeks, and cellery are, in this cafe, reckoned medicinal. The moft proper drink is whey, butter-milk, milk and wa- ter, barley-water; decoaions of the roots of marfhmallows, parfley, liquorice; or of other mild mucilaginous vegetables, as linfeed, &c. If the patient has been accuftomed to gene- rous liquors, he may drink fmall gin-punch without acid. But fpirits muft be ufed very fparingly, as every thing that heats is hurtful. Gentle exercife is proper; but if violent, it is apt to occcafion bloody urine. We would therefore advife that it fhould be taken in moderation. Perfons affliaed with gra- vel often pafs a great number of ftones after riding on horfe- back, or in a machine ; but thofe who have a ftone in the bladder are feldom able to bear thefe kinds of exercife. Where there is a hereditary tendency to this difeafe, a fe- dentary life ought never to be indulged. Were people care- ful, upon the firft fymptoms of gravel, to obferve a pro- per regimen of diet, and to take fufficient exercife, it might often be carried off, or, at leaft, prevented from in- creafino- ; but if the fame courfe which occafioned the dif- eafe be°perfifted in, it cannot fail to become worfe. M E D I C I N E.----In what is called a fit of the gra- vel which is commonly occafioned by a ftone fticking in the yreter or fome part of the urinary paffages, thepatient mufl bo 320 OF THE STONE AND GRAVEL. be bled, warm fomentations applied to the parts, emolierit clyfters adminiftered, and diluting mucilaginous liquors drank, Ufe. The treatment of this cafe has been fully pointed out under the articles, inflammation of the kidneys and bladder, to which we refer the reader. Dr Whytt advifes patients who are fubjea to fre- quent fits of g?avel in the kidneys, but have no ftone in the bladder, to drink every morning, two or three hours before breakfaft, an Englifh pint of oyfter or cockk-fhell lime- water. The Dodter very juftly obferves, that though this quantity might be too fmall to have any fenfible effea in diffolving a ftone in the bladder 5 yet it may very probably prevent its growth. When a ftone is formed in the bladder, the Doaor re- commends Alicant foap, and oyfter or cockk-fhell lime- water* to be taken in the following manner. The patient muft fwallow everyday, in any form that is leaft difagreea- ble, an ounce of the internal part of Alicant foap, and drink three or four Englifh pints of oyfter or cockk-fhell lime-water. The foap is to be divided into three dofes ; the largeft to be taken fafting in the morning early ; the fe- cond at noon; and the third at feven in the evening, drinking above each dofe a large draught of the lime-water; the remainder of which he may take any time betwixt din- ner and fupper, inftead of other liquors. The patient fhould begin with a fmaller quantity of the lime-water and foap than what is mentioned above ; at firft an Englifh pint of the former and three drams of the latter, taken daily, may be enough. This quantity, however, he may increafe by degrees, and ought to perfevere in the ufe of thefe medicines, efpecially if he finds any abatement of his complaints, for feveral months ; nay, if the ftone be very large, for years. It may likewife be proper for fhe patient, if he be feverely pained, not only to begin with the foap and lime-water in fmall quantities, but to take the fecond or third lime-water inftead of the firft. However, after he has been for fome time accuftomed to thefe medi- cines * Oyfter-fhell lime-water is prepared by pouring an Englifh gallon and a half of boiling water upon a pound of oyfter-fhells reduced to quick-lime by being burnt. Where oyft«r or cockle-fhells cannot be had, common quick lime maybe ufed in their ftead, After the clear liquor has been poured off, the fame quantity of lime will make a fe- cond or third quantity of water of nearly the fame ftrength as the firft. t OF THE HICCUP. 321 cines, he may not only take the firft water, but, if he finds he can eafily bear it, heighten its diffolving power ftill more by pouring it a fecond time on frefh calcined fliells. ' The only other medicine which we fhall mention is the uva urfl. It has been greatly extolled of late years both for the gravel and ftone. It feems, however, to be, in all refpecTcs, inferior to the foap and lime-watt* ; but as it is lefs difagreeable, and has frequently, to my knowledge, re- lieved gravelly complaints, it deferves a trial. It is general- ly taken in powder from half a dram to a whole dram, two or three times a-day. It may be mixed in a ciip of tea or gruel, or taken in any way that is moft agreeable to the pa- tient. Of the HICCUP. -. The hiccup is a fpafmodic or convulfive affeaion of the ftomach and midriff, arifing from any caufe that irritates their nervous fibres. It may proceed from excefs in eating or drinking ; from a hurt of the ftomach ; poifons -}/ inflammations of the fto- mach, inteftines, bladder, midriff, or the reft of the vifcera. In gangrenes, acute and malignant fevers, a hiccup is often the forerunner of death. I have known an obftinate hic- cup proceed from a fchirsous tumour of the' pylorus, or right orifice of the ftomach. When the hiccup proceeds from excefs, efpecially from aliment that is flatulent, or hard of digeftion, a draught of generous wine, or a dram of any fpiritous liquor, will ge- nerally remove it. If poifon be the caufe, plenty of milk and oil muft be drank, as has been formerly recommended. When it proceeds from an inflammation of the ftomach, Sec. it is very dangerous. In this cafe the cooling regimen muft be obferved. The patient muft be bled, and take frequent- ly a few drops of the fweet fpirits of nitre in a cup of wine- whey. His ftomach muft likewife be fomented with cloths dipped in warm water ; or bladders filled with warm milk and water applied to it. A hiccup proceeding from a gangrene, or mortificati- on, is generally incurable. In this cafe the Peruvian bark, with other antifeptic medicines, aremoft likely to fucceed. If the hiccup be a primary difeafe, and proceeds from a foul ftomach, loaded either with a pituitous or a bilious hu- S f mour, 322 CRAMP OF THE STOMACH. mour, a gentle vomit and purge, if the patient be able to bear them, will be of fervice. If it arifes from flatulencies, the carminatives direaed for the heart-burn, page 255. muft be ufed. When the hiccup proves very obftinate, recourfe muft be had to the moft powerful aromatic and antifpafmodic medicines. The principal of thefe is mufk; fifteen or twenty grains of which may be made into a bolus, and re- peated occafionally. Opiates are likewife of fervice j but they muft be ufed with caution. A bit of fugar dipped in compound fpirits of lavender, or the volatile aromatic tinc- ture, may be taken frequently. The Peruvian bark is like- wife of ufe. External applications are fometimes alfo be- neficial ; as the ftomech plafter, or a cataplafm of the Ve- nice treacle of t\w Edinburgh or London difpenfatory, ap- plied to the ftomach. I lately attended a patient who had almoft a conftant hiccup for above nine weeks. It-was frequently ftopped by the ufe of mufk, opium, wine, and other cordial and anti- fpafmodic medicines, but always returned. Nothing in- deed gave the patienjjfo much eafe as brifk fmall beer. By drinking fredy of this, the hiccup was often kept oft" for feveral days, which was more than could be done by the meft powerful medicines. He was at length feized with a von.iting of blood, which foon.put an end to his life. Up- on opening his body, a large fchirrous tumour was found near the pylorus or right orifice of the ftomach. CRAMP of the STOMACH. Tho' this, for the moft part, is only a fymptom of ner- vous or hyfteric diforders, we thought proper to treat it fe- parately ; as it often feizes people fuddenly, is very dange- rous, and requires immediate afliftance. If the patient has any inclination to vomit, he ought to take fome draughts of warm water, or weak camomile tea, to clean his ftomach. After this, if he has been coftive, a laxative clyfter muft be given. He ought then to take fome dofes of laudanum. The beft way of adminiftering it is in a clyfter. Sixty or feventy drops of liquid laudanum may be given in a clyfter of warm water. This is much more certain than laudanum ^iven by the mouth, which is often vomited, WANT OF APPETITE. 323 Vomited, and in fome cafes increafes the pain and fpafms in the ftomach. If the pain and cramps return with great violence, after the effeas of the anodyne clyfter are over, another with an equal or larger quantity of opium, may be given ; and e- very four or five hours a bolus with ten or twelve grains of mufk, and half a dram of the Venice treacle. In the mean time, the ftomach ought to be fomented with cloths dipped in warm water ; or bladders filled with warm milk and wa- ter, fhould be conftantly applied to it. I have often feen thefe produce the moft happy effeas. The anodyne balfam may alfo be rubbed into the ftomach ; and an antihyfteric plafter worn upon it for fome time after the cramps are re- moved, to prevent their return. In very violent and lafting pains of the ftomach, fome blood ought to be 1:", unlefs the weaknefs of the patient makes it improper^ When the pain or cramps of the fto- mach proceed from a fuppreffion of the menfes, bleeding is of great ufe. If they be owing to the gout, fome of the warm cordial waters, or a large dram of good brandy or rum, will be neceffary. Bliftering plafters ought likewife, in this cafe, to be applied to the ancles. WANT of APPETITE. This may proceed from a foul ftomach ; indigeftable food ; the want of free air and exercife ; grief; fear ; anx- iety; or any of the depreffing paffions ; exceffive heat; living much upon ftrong broths, or fat meats; the immo- derate ufe of ftrong liquors, tea, tabacco, opium, &c. The patient ought, if poffible, to make choice of an o- pen dry air ; to take exercife daily on horfeback, or in a machine ; to rife betimes ; and to avoid all intenfe thought. He fhould ufe a diet of eafy digeftion, avoiding every thing that is fat andjoijy ; he ought to chufe agreeable company ; and fliould avoid intenfe heat and greai; fatigu■-.:. If want of appetite proceeds fecrr. errors in diet, or any other part of the patient's regimen, it ought to be changed. If naufea and reachings to vomit, fhew that the ftomach is loaded with crudities, a vomit will be cf fervice. After this a gentle purge or two of rhubarb, of any of the bitter purging fairs, may be taken. The patient ought next to ufe an infufion in wine of a: -f: ihe ftomacliic bitters ; as S t 2 Gentian 324 OF DEAFNESS. Gentian root, jefuits bark, orange peel, &c. He may alfo eat orange peel or ginger candied. Though gentle evacuations be neceffary, all ftrong pur- ges and vomits are to be avoided, as they tend to weaken the ftomach and hurt digeftion. After proper evacuations, bitter elixirs and tinaures with aromatics may be ufed. The patient may take, twice a-day, a common fpoonful of the ftomachic tinaure ; or, if he be coftive, the fame quantity of the bitter tinaure of rhubarb. Elixir of vitriol is an excellent medicine in moft cafes of indigeftion, weak- nefs of the ftomach, or want of appetite. Twenty or thirty drops of it may be taken twice or thrice a-day in a glafs of wine or water. It may likewife be mixed with the tinaure cf fhe bark, two drams of the former to an ounce of the.latter, and a tea-fpoonful of it taken in wine or water, as above. The chalybeate waters are of great fervice in this cafe. I never knew thefe fail to lharpen the appetite, if drank in moderation. The fait water has likewife this effea; but it muft not be ufed too freely. The waters of Harrowgate, Scarfborough, Moffr.t, and moft other fpaws in Britain, may be ufed with the feme intention. We would advife all who are affliaed with indigeftion and want cf appetite, to repair to thefe places of public rendezvous. The very change of air, and the cheerful company will be of fervice ; not to mention the exercife, dk.ipation, amufements, &c. Of DEAFNESS. Deafness is fometimes owing to an original fault, or v. rop.g formation of the ear itfelf. It may likewife be occa- fioned by wounds, ulcers, or any thing that deftroys the fa- bric of the ear. It is often the effea of old age ; of violent colds in the head ; of fevers; of exceffive noife; of hard wax in the ear ; of too g^eat moifture or drynefs of the ear, Sec. Persons who are born deaf are feldom cured. When deafnefs is the effea of wounds or ulcers in the ear, or of old age, it is not eafily removed. If it proceeds from cold of the head, the patient muft be careful to keep his head warm, efpecially in the night; he fhould likewife take a purge or two, and fhould keep his feet warm, and bathe them frequently in warm water. When deafnefs is the ef- fect OF THE NIGH T-M ARE. 325 fea of fevers, it generally ceafes of itfelf, after the patient recovers ftrength. If it proceeds from dry wax fticking in the ears, it miffl be foftened by dropping oil into them for a few nights, at bedtime ; afterwards trfey muft be fyringed with warm milk^and water, or milk and oil. If deafnefs proceeds from drynefs of the ears, which may be known by looking into them, half an ounce of the oil of almonds, and the fame quantity of liquid opodeldoch, or tinaure of afafcetida, may be mixed together, and a few drops of it put into the ear every night at bed-time, ftopping them afterwards with a little wool or cotton. I have often known this have good effeas. When the ears abound with moifture, it may be drained off by an iffue or feton, which muft be made as near the parts affeaed as nr.fnble. Many medicines are recommended for the cure of deaf- nefs, fome of which, in obftinate cafes, at leaft, deferve a trial. Some recommend the gall of an eel mixed w^th fpirit of wine, to be dropped into the ear ; others equal parts of Hungary water and fpirits of lavender. Etmuler recom- mends amber and mufk ; and Brookes fays he has often known hardnefs of hearing cured by putting a grain or two of muft: into the ear with cotton-wool. But thefe and o- ther applications muft be varied according to the caufe. We cannot conclude this article wi#iout recommending the greait ft attention to warmth. From whatever caufe deaf- nefs proceeds, the patient ought to keep his head warm. I have known more benefit from this alone, in the moft obfti- nate cafes of deafnefs, than from all the medicines I ever law ufed. Of the NIGH T-M ARE. In this difeafe thepatient, in time of fleep, Imagines he feels an uncommon oppreffion or weight about his breaft or ftomach, which he can by no means make off. He groans, and fometimes cries out, tho' oftener he attempts to fpeak in vain. Sometimes he imagines himfelf engaged with an enemy, and, in danger of being killed, attempts to run a- way, but finds he cannot. Sometimes he fancies himfelf in a houfe that is on fire, or that he is in danger of being drowned in a river. He often thinks he is falling over a pre- cioice, and the dread of being dafhed to A.;..ct'i fuddenly a- v/akes him. This 326 OFSWOONINGS. This diforder has been fuppofed to proceed from to© much blood ; from a ftagnation of blood in the brain, lungs, &c. But its general caufe is indigeftion. FoOons of weak nerves, who lead A fedentary life, and live full, are moft commonly affliaed with the night-mare. Nothing tends more to produce it than heavy fuppers, efpecially if eat late, or the patient goes to bed foon after. Wind is like- wife a very frequent caufe of this difeafe ; for which reafon thofe who are affliaed with it ought to avoid all flatulent food. Deep thought, anxiety, or any thing that oppreffes the mind, ought alfo to be avoided. Persons affliaed with the night-mare ought to eat very light fuppers. They fhou4d never go to bed immediately after eating, nor lie upon their back with the head low. As they generally moan, or make fome noife in the fit, they fhould be waked, or fpoken toby luch as.hear them, as the uneafinefs generally goes off as foon as the patient is awake. Dr Whytt fays he generally found a dram of brandy, taken at bed-time, prevent this difeafe. That, however, is a bad cuftom, and, in time, lofes its effea. We would rather have the patient depend upon cheerfulnefs, and exercife through the day, alight fupper taken early, and the ufe of food of eafy digeftion,&c. than to accuftom himfelf to drams. A draught of cold wat«r wijl often promote digeftion as much as a glafs of brandy, and is muck later. After a per-" fon of weak digeftion however has eat flatulent food, a dram may be neceffary; in this cafe we would recommend it as the moft proper medicine. Persons who are young, and full of blood, if troubled with tiie night-mare, ought to purge, bleed, and ufe a fparc diet. Of S W O O N I N G S. The principal caufes of fwooning are, fudden tranfiti- ons from cold to heat ; breathing air that is deprived of its proper fpring or elafticity ; great fatigue ; exceffive weak- nefs ; lofs of blood ; long fefting ; fear, grief; and other vi- olent pafeons or affeaions of the mind. It is well known, that perfons who have been long ex- pofed to cold, often faint or fall into a fwoon, upon coming into the houfe, efpecially if they drink hot liquor, or fit near a large fire. This might eafily be prevented by peo-' pie OF SWOONING S. 327 pic taking care not to go into a warm room immediately after having been expofed to the cold air, to approach the fire gradually, and not to eat or drink any thing hot, till the body has been gradually brought into a warm tempera- ture. When any one, in confequence of negkaing thefe pre- cautions, falls into fwoon, he ought immediately to be re- moved to a cooler apartment, to have ligatures applied above his knees and elbows, and to have his hands and face fpriflkled with vinegar. He fliould likewife be made to fmell to vinegar, and fhould have a fpoonful or two of .wa- ter, if he can lwallow, with about a third part of vinegar mixed with it, poured into his mouth. If the fainting fits prove obftinate, it will be neceffary to bleed the patient, and afterwards to give him a clyfter, As air that is breathed over and over lofes its elafticity \ or fpring, it is no wonder if perfons who refpire in it often fall into.fwooning or fainting fits. They are, in this cafe, deprived of the very principle of life. Hence it is that fainting fits are fo frequent in all crowded afiembHes, efpe- cially in hot feafons. Such fits however muft be confider- ed as a kind of temporary death ; -and, to the weak and de- licate, they fometimes prove fatal in reality. They ought therefore to be avoided with the utmoft care. The method of doing this is obvious. Let affembly rooms, and all o- ther places of public refort, be well ventilated ; and let the weak and delicate avoid-fuch places, particularly in warm feafons. A person who faints, in fuch a fituation, ought im- mediately to be carried into the open air ; his temples fhould be rubbed with ftrong vinegar or brandy, and volatile fpi- rits or falts held to his nofe. He fhould be laid upon his back with his head low, and have a little wine, or fome o- ther cordial, poured into his mouth, as foon as he is able to fwallow it. If the perfon has been fubjea to hykeric fits, caftor or afafcetida fhould be applied to the nofe, or burnt feathers, horn, or leather, &c. When fainting fits proceed from mere weaknefs or ex- hauftion, which is often the cafe after great fatigue, long fafting, lofs of blood, or the like, the patient muft be fup- ported wkh generous cordials, as jellies, wines, fpirituous liquors, &c. Thefe howevervmuft be given at firft in very fmall quantities, and increafed gradually as the patient is able 328 DISEASES OF WOMEN. able to bear them. He ought to be allowed to lie quite ftill and eafy upon his back, with his head low, and fhould have frefh air admitted into his chamber. His food fhould confift of nourifhing broths, fago-gruel with wine, new milk, and other things of a light and cordial nature. Thefe things are to be given out of the fit. All that can be done while the perfon continues in the fit is, to let him fmell to a bottle of Hungary water, eau de luce, or fpirits of hartf- horn, and to rub his temples with warm brandy, or to lay a comprefs dipped in it to the pit of his ftomach. * In fainting fits that proceed from fear, grief, br other vi- olent paffions ro affeaions of the mind, the patient muft be very cautioufly managed. He fhould be fuffered to remain at reft, and only made to fmell to fome vinegar. After he has come to himfelf he may drink freely of warm lemoriade, or balm tea, with fome orange or lemon peel in it. It will likewife be proper, ifthe fainting fits have been long and fevere, to clean the bowels by throwing in an emolient clyfter or two. DISEASES of WOMEN. The difeafes peculiar to women arife chiefly from their monthly evacuations, pregnancy, and child-birth. Fe- males generally begin to menftruate about the age of fif- teen, and leave it off about fifty, which renders thefe two periods the moft critical of their lives. About the firft ap- pearance of this difcharge the conftitution undergoes a very confiderable change, generally indeed for the better, but fometimes for the worfe. The greateft care is now neceffa- ry, as the future health and happinefs of the female depends, in a great meafure, upon her condua at this period. If a girl about this time of life be confined to the houfe, kept conftantly fitting, and neither allowed to romp about, nor employed in fome aaive bufinefs, which gives exercife to the whole body, fhe becomes weak, relaxed and puny ; her blood not being duly prepared, fhe looks pale and wan j her health, fpirits, and vigor decline, and fhe finks into a valetudinary for life. Such is the fate of numbers of thofe unhappy females who either from the indulgence of mo- thers, or their own narrow circumftances, are, at this cri- tical period of life, denied the benefit of exercife and free air. A lazy DISEASES OF WOMEN. 329 A lazy indolent difpofition proves very hurtful to girls &t this period. One feldom meets with complaints from obftruaions amongft the more aaive and laborious part of the fex ; whereas the indolent and lazy are feldom free . from them. Thefe are, in a manner, eat up by the chlorofis, or green ncknefs, and other difeafes of this nature. We would therefore recommend it to all who wifti to efcape thefe calamities, to avoid indolence and inaai.vity, as their greateft enemies, and to take as much exercife, efpecially in the open air, as poffible. Another thing that proves very hurtful to girls about this period of life, is unwholefome food. Fond of all man- ner of trafh, they often eat every out-of-the-way thing they can get, till their blood and humours are quite vitiate J. Hence enfue indigeftiens, want of appetite, and a whole train of evils. If the fluids be not culy prepared, it is ut- terly impofiibfe that the fecretions fhoukl be properly per- formed : Accordingly we find that fuch girls as lead an in- dolent life, and eat great quantities of trafh, are not only ^ fubjea to obftruaions of the tr.enfcs, but likewife to glan- dular obftruaions ; as the fcrophula or King's evil, Sic. g A dull difpofition is likewife very hurtful to girls at Tnis period. It is a rare thing to fee a fprightly girl who does not enjoy good health, while the'grave, moping, me- lancholy creature proves' the very prey of vapours and hy- ftericks. Youth is the fe_fon for mirth and cheerfulnefs. Let it therefore be indulged. It is an abfolute duty. To lay in a flock of health "in time of youth is as neceffary a piece of prudence as to make provifion againft the decays of old age. While therefore wife Nature prompts the hap- py youth to join in fprightly amufements, let not the fevere dilates of hoar/ age forbid the ufelul impulfe, nor damp with ferious gloom the feafons ckffined to mirth and inno- cent feftivity. Another tlvngvery hurtful to females about tnis peri- od of life is ftrai? cloaths. They are fond of a fine fhape, and foolifhly imagine, that this can be acquired by ftrait cloaths. Hence by fqueezing their ftomach and bowels they hurt the digefticR, and occafion many incurable ma- ladies. This error is not indeed fo common as it has been; but, as fafhions change, it may come in again, we there- fore think it not improper to mention it. I know many fe- mafes who, to this day, feel the direful dre.b of that T t wretched 33o DISEASES OF WOMEN. wretched cuftom which prevailed fome time ago, of fqueez- ing every girl into as fmall a fize in the middle as poffible. Human invention could not poffibly have devifed a praaice more deftruaive to health. After a female has arrived at that period of life whqn the menfes ufually begin to flow, and they do not appear, but, on the contrary, her health and fpirits begin to de- cline, we would advife, inftead of fhutting the poor girl up in the houfe, and dofing her with fteel, afafcetida, and o- ther naufeous drugs, to place her in a fituation where fhe can enjoy the benefit of free air and agreeable company. There let her eat wholefome food, take plenty of exercife and amufements, and we have little reafon to fear but Na- ture, thus affifted, will do her proper work. She feldom fails unlefs where the fault is on our fide. When the menfes have once begun to flow, the greateft care fhould be taken to avoid every thing that may tend to obftrua them. Females ought to be exceeding careful of what they eat or drink at the time they are out of order. Every thing that is cold, or apt to four on the ftomach, ought to be avoided ; as fruit, butter milk, and fuch like. Fifh, and all kinds of food that are hard of digeftion, are alfo to be avoided. As it is impoffible to mention every"* thing that may difagree with individuals at this time, we would recommend it to every female to be very attentive to what difagrees with her own ftomach, and carefully to a- void it. Cold is extremely hurtful to females at this particular period. More of the fex date their diforders from colck, caught while they were out of order, than from all other cauies. This ought furely to put them upon their guard, and to make them very circumfpea in their condua at fuch times. A degree of cold that will not in the leaft hurt them at another time, will, at this period, be fufficient to ruin their health and conftitution altogether. The greateft attention ought at thio trine to be paid to the mind, which fhould be kept as eafy and cheerful as poffible. Every pare of the animal ceconomy is influenced by the paffions, but none more fo than this. Anger, fear, grief, and other affeaions of the mind, often occafion ob- ftruaions of the menftrual flux, which prove abfolutely in- curable. Frcm DISEASES OF WOMEN. 331 From whatever caufe this flux is obftruaed, unlefs the female be pregnant, proper means fhould be ufed to reftore it. For this purpofe we would rcommend plenty of exercife, in a dry, open, and rather cool air ; wholefome diet, and, ifthe body be weak and languid, generous liquors*, alfo cheerful company, and all manner of amufements. If thefe fail, the following medicines may be tried. If the obftrudlions proceed from a weak relaxed ftate of the folids, fuch medicines as tend to promote digeftion, to brace the folids, and affift the body in preparing good blood, ought tobe ufed. The principal of thefe are iron, the je- fuits bark, and other bitter and aftringent medicines. Fi- lings of iron may be infufed in wine or ale, two ounces to an Englifh quart, and after it has flood in a warm place twenty four hours, it may be ftrained, and a fmall cupful drank three or four times a-day ; or they may be reduced to a fine powder, and taken in the dofe of half a dram, mixed with a little honey or treacle, three or four times a-day. The bark and other bitters may either be taken in fubftance or infufion, as is moft agreeable to the patient. When obftruaions proceed from a vifcid ftate of the blood, and the patient is of a grofs full habit, evacuations, and fuch medicines as attenuate the humours, are neceffa- ry. The patient, in this cafe ought to be bled, to bathe her feet frequently in warm water, to take now and then a dofe of cooling phyfic, and to live upon a fpare thin diet. Her drink fhould be whey, water, or fmall beer, and fhe ought to take plenty of exercife. When obftruaions proceed from affeaions of the mind, every method fhould be taken to amufe and divert the pati- ent. And that fhe may the more readily forget the caufe of her affiiaion, fhe ought, if poffible, to be removed from the place where it happened. A change of place, by pre- fenting the mind with a variety of new objeas, has often a very happy influence in relieving it from the deepeit dif- trefs. A foothing, kind, and affable behaviour to perfons in this fituation is alfo of the laft importance. This would often prevent the fatal confequences which proceed from a harfh treatment of females, who are fo unfortunate as to be crofted in their inclinations; or who meet with difappoint- ments in love, &c. Tho' many difeafes proceed from obftruaion, it is not always to be confidered as the caufe, but eften as the ef- T t 2 *e<-* 332 DISEASES OF WOMEN. fea of other maladies. When that is the cafe, inftead of giving medicines to force down the menfes, which might be dangerous, we ought, by all means, to endeavour to reftore the patient's health and ftrength. When that is effected the other will return of courfe. But the menftrual flux may be too great as well as too fmall. When that is the cafe, the patient becomes weak, the colour pale, the appetite and digeftion are bad, and cedematous fwellings of .the feet, dropfies and confumpti- ons often enfue. This frequently happens to women about the age of forty five or fifty, and is very difficult to cure. It may proceed from a fedentary life ; a full diet, confift- ing chiefly of faked, high-feafoned, or acrid food; the ex- ceffive ufe of fpiritous liquors; too much exercife; violent paffions of the mind, &c. To reftrain this flux, the patient ought to be kept quiet and eafy both in body and mind. If it be very violent, fhe ought to He in bed with her head low ; to live upon a cool and flender diet, as veal or chicken-broths with bread ; and to drink decoaions of nettle-roots, or the greater comfrey. If thefe be not fufficient to ftop the flux, ftronger aftringents may be ufed, as allum, dragons blaod, &c. As much powdered allum as will lie upon a fixpence may be taken in a glafs of red wine twice or thrice a-day, or oftener if the patient's ftomach can bear it. Such as cannot take allum in fubftance may ufe the allum-whey. Females who have frequent returns of this complaint, ought to ufe the jefuits bark for a confiderable time. Half a dram of bark may be mixed in a glafs of red wine three or four times a-day, of it may be taken in common water, and fharpened with fpi- rits of vitriol. But the uterine flux may offend in quality as well as in quantity. Wh&t is ufually called the fluor albus or whites, is a very common difeafe, and proves extremely hurtful to delicate women. This difcharge is not always white, but fometimes pale, yellow, green, or of a blackifh colour; fometimes it is fharp and corrofive ; fometimes foul and foe- tid, Sec. It is attended with a pale complexion, pain in the fpine of the back, lofs of appetite, fwelling of the feet, &c. It generally proceeds from a relaxed and debilitated ftate of the body, arifing from indolence, the exceffive ufe of tea, coffee, or other weak and watery diet. T9 DISEASES OF WOMEN. 333 To remove this difeafe, the patient muft take as much exercife as fhe can bear without fatigue. Her food muft be folid and nourifhing, but of eafy digeftion ; and her drink pretty generous, as red port or claret wine. Thefe may be drank pure or mixed with water, as the patient inclines. Tea and coffee are to be avoided. I have often known ftrong broths have an exceeding good effea in this cafe. The patient ought not to lie too long a.bed. When medi- cine is wanted, we know none preferable to the jefuits bark, which, in this cafe, ought always to be taken in fubftance. That period of life at which i:he menfes ceafe to flow is likewife very critical to the fex. The ftoppage of any cuftomary evacuation, however fmall, is fufficient to dif- order the whole frame, and often to deftroy life itfelf. Hence it comes to pafs that fo many women either fall into chronic diforders, or die about this time : Such of them however as furvive it, without contraaing any chronic dif- eafe, often become more healthy and hardy than they were before, and enjoy ftrength and vigour to a very great age. If the menfes ceafe all of a fudden, in women of a full ha- bit, they ought to abate fomewhat of their ufual quantity of food, efpecially of the more nourifhing kind, as flefh, eggs, &c. They ought likewife,to take plenty of exercife, and to keep the belly open. This may be done by taking, once or twice a-week, a little rhubarb, or an infufion of hiera picra in wine or brandy. It often happens that women of a grofs habit, at this pe- riod of life, have ulcerous fores break out about their an- cles, or in other parts of the body. Such ulcers ought to be confidered as critical, and fhould either be fuffered to continue open, or artificial drains fhould be opened in their ftead. Women who will needs have fuch fores dried up, are often foon after feized with acute or chronic difeafes, of which they die. Persons of either fex ought to be very cautious in drying up fores which break out towards the decline of life. We would lay it down as a rule, where ever fuch fores appear, that before any attempts be made to heal them, an iffue or feton fhould be fet in fome part of the body. Few things bid fairer for preferving health, or prolonging life, efpeci- ally in perfons who live full, than an iffue, or fome other drain conftantly kept open in the decline of life. This is imitating 334 OF PREGNANCY. imitating Nature, who often, at this period, endeavours to relieve herfelf by a fiftula, the hemorrhoidal flux, &c. Of PREGNANCY. Pregnancy is not a difeafe, but as it fubjeas women to feveral ailments, it may not be improper to point out the methods of preventing or relieving them. Pe.egnant women are often affliaed with the heart- burn. The method of treating this complaint has already been pointed out in page 254. and the one following. rFhey are likewife, in the more early periods of pregnancy, often harraffed with fickneiS and vomiting, efpecially in the morn- ing. Thefe complaints may generally be relieved by care- fullyobfervingthedireaionscontainedinpages 244.and 245. Thehead-ach and tooth-ach are alfo very troublefome fymp- toms of pregnancy. The former may generally be removed by keeping the belly gently open, by the ufe of prunes, figs, roafted apples, and fuch like. When the pain is very vio- lent, bleeding may be neceffary. For the treatment of the latter, we muft refer the reader to that article page. 249. Every pregnant woman is more or lefs in danger of a- bortion. This fhould be guarded againft with the greateft care, as it not only weakens the conftitution, but renders the woman liable to the fame misfortune afterwards. Abor- tion may happen at any period of pregnancy, but it is moft common in the fecond or third month. Sometimes howe- ver it happens in the fourth or fifth. If it happens within the firft month, it is ufually called a falfe conception ; if after the feventh month, the child may often be kept alive by proper care. The common caufes of abortion are, the death of the child ; weaknefs or relaxation of the mother ; great evacua- ations ; violent motion ; raifing great weights ; reaching too high ; vomiting ; coughing ; convulfion-fits; ftrokes on the belly ; falls; fevers ; difagreeable fmells ; excefs of blood ; indolence ; high living ; or the contrary ; violent paffions or affeaions of the mind, as fear, grief, &c. The figns of approaching abortion are, a pain in the loins, or about the bottom of the belly ; a dull heavy pain in the infide of the thighs; a flight degree of coldnefs or fhivering i ficknefs ; palpitation of the heart j the breafls become OF PREGNANCY. 335 become flat and foft; the belly falls ; and there is a dif- charge of blood or watery humours from the womb. To prevent abortion, we would advife women of a weak or relaxed habit to ufe folid food, avoiding great quantities- of tea, and other weak and watery liquors; to rife early, and go foon to bed ; to fhun damp houfes; to take frequent exercife in the open air, but to avoid fatigue ; and never to go abroad in damp foggy weather, if they can fhun it. Women of a full habit ought to ufe a fpaie diet, avoiding ftrong liquors, and every thing that may tend to heat the body, or increafe the quantity of blood. Their diet fhould be of an opening nature, confifting principally of vegeta- ble fubftances. Every woman with child ought to be kept cheerful and eafy in her mind. All violent paffions hurt the foetus, and endanger an abortion. When any figns of abortion appear, the woman ought to be laid in bed on a mattrefs, with her head low. She fhould be kept quiet, and her mind foothed and comforted. She ought not to be kept too warm, nor to take any thing of a heating nature. Her food fliould confift of broths, rice and milk, jellies, or gruels with a very little wine in them. If fhe be able to bear it, fhe fliould lofe, at leaft, half a pound of blood from the arm. Her drink ought to be bar- ley-water fharpened with cream of tartar ; or fhe may take half a dram of powdered nitre in a cup of water-gruel, eve- ry five or fix hours. If the woman be feized with a violent loofenefs, fLe ought to drink the decoaion of calcined hartfhorn prewar.J. If fhe be affeaed with vomiting, let her take frequently one of the feline draughts recommenc- ed page 143. Sanguine robuft women, who are liable to mifcarry at a certain time of pregnancy, ought always to be bled a few days before that period arrives. By this means, and obfer- ving the regimen above prefcribed, they may often efcape that misfortune. Tho' we recommend due care for preventing abortion, we would not be underftood as reftraining pregnant women from their ufual exercifes. This would operate the quite contrary way. Want of exercife not only relaxes the body, but induces a plethora, or too great a fulnefs of the veffels, which are the two principal caufes of abortion. 336 O F C H I L D-B I R T H. Of* CHILDBIRTH. Many difeafes proceed from the want of due care in child- bed. The more hardy part of the fex are apt to defpife the neceflary precautions after delivery. They think, when the labour-pains are ended, the danger is over; but in truth it may only then be faid to be begun. Nature if left to herfelf, will feldom fail to expel the foetus; but proper care and management are certainly neceffary for the recove- ry of the mother. No doubt, mifchief may be done by too much as well as by too little care. Hence it is that females who have the greateft number of attendants in child-bed, generally recover worft. But this is not peculiar to the ftate of child-bed. Exceffive care always defeats its own intention, and is generally more dangerous than none at all. During aaual labour, nothing of a heating nature muft be given. The woman may, now and then, take a little panada, and her drink ought to be toaft and water, or thin groat-gruel. Spirits, wines, cordial-waters, and other things, which are given with a view to ftrengthen the mo- ther, and promote the If.irth, for the moft part tend only to increafe the fever, inflame the womb, and retard the la- bour. Befides, they endanger the woman afterwards, as they often occafion violent and mental haemorrhages, or predifpofe her to eruptive and other fevers. When the labour proves tedious and difficult, to pre- vent inflammations, it will be proper to bleed. An emoli- ent clyfter ough^ likewife frequently tobe adminiftered ; and the patient fhould fit over the fleams of warm water. The paflage ought to be gently rubbed with a little foft pomatum or frefh butter, and cloths wrung out of warm water ap- plied over the belly. Tf Nature feems to fink, and the wo- man be greatly exhaufted with fatigue, a draught of gene- rous wine, or fome other cordial, may be given, but not otherwife. Thefe direaions are fufficient in natural la- bours, and in all preternatural cafes, afkillful furgeon, or man-midwife, ought to be called as foon as poffible. We cannot help taking notice of that ridiculous cuftom which ftill prevails in fome country-places, of colkaing a number of women together upon fuch occafions. Thefe, inftead of being ufeful, ferve only to crowd the houfe, and ©bftrua the neceffary attendants. Befides, they hurt the patient OF CHIL D-B I R T H. 337 patient with their noife ; and often by their untimely and impertinent advice, do much mifchief. After delivery, the woman ought to be,kept as quiet and eafy as poffible. Her food fhould be light and thin ; as gruel, panada, &c. and her drink weak and diluting. To this rule however there are fome exceptions. I have known feveral hyfteric women, whofe fpirits could not be fupported in child-bed without folid food and generdus li- quors ; to fuch a^lafs of wine and a bit of chicken muft be allowed. Sometimes an exceffive haemorrhage or flooding hap- pens after delivery. In thus cafe, the patient fhould be laid with her head low, have ligatures applied above her knees and elbows, and be in ail refpeas treated as for an exceffive flux of the menfes. If the flooding proves violent, linen cloths, which have been wrung out of a mixture of equal parts of vinegar and water, fliould be applied to the belly, the loins, and the thighs: Thefe muft be changed as they grow dry ; and may be difeontinued as foon as the flooding abates. If there be violent pains after delivery, the patient ought to drink plentifully of warm diluting liquors, as tea with a little faffron ; or an infufion of camomile flowers ; and to take fmall broths, with carroway feeds or a bit of orange- peel in them ; an ounce of the oil of fweet almonds may likewife be frequently taken in a cup of any of the above li- quors ; and if the patient be reftlefs, a fpoonful of the fy- rup of poppies may now and then be. mixed with a cup of her drink. If fhe be hot or feverifh, one of the following powders may be taken in a cup of her ufual drink, every five or fix hours. Take of crabs claws prepared half an ounce, purified nitre two drams, faffron powdered half a dram ; rub them together in a mortar, and divide the whole into eight or nine dofes. When the patient is low fpirit- ed, or troubled with hyfkrical complaints, fhe ought to take frequently twelve'or i'Oteen drops of the tiifelure of afafcetida in a cup of penny-royal tea. An inflammation of the womb is a dangerous and net un- frequent difeafe after delivery. It is known by pains in the lower part of the belly, which are greatly incixOed upon touchino- j by thetenlion or tightnefs of the parts ; great weaknefs-; change of countenance ; a conftant fever, with a weak and hard^ pulfe ; a flight delirium or raving ; forne- U u times X 338 O F C H I L D-B I R T H. times inceffant vomiting ; a hiccup ; a difcharge of redifh ftinking fharp water from the womb ; an inclination to go to ftool ; a heat, and fometimes total fuppreffion of urine. This muft be treated like other inflammatory diforders, by bleeding and plentiful dilution. The drink may be thin gruel or barley water; in a cup of which half a dram of nitre may be diffolved, and taken three or four times a day. Clyfters of warm water muft be frequently adminiftred ; and the belly fhould be fomented by cloths wrung out of warm water, or by applying bladders filled with warm milk and water to it. A suppression of the lochia, or ufual difcharges after de- livery, and the milk-fever, muft be treated nearly in the fame manner as an inflammation of the womb. In all thefe cafes the fafeft courfe is plentiful dilution, gentle evacuati- ons, and fomentations of the parts affeaed. In the milk- fever, the breafts may be embrocated with a little warm lin- ked oil, or the leaves of red cabbage may be applied to them. The child fhould be often put to the breaft, or it fhould be drawn by fome other perfon. Nothing would tend moreto prevent the milk-fever than putting the child early to the breaft. The cuftom of not allowing children to fuck for the firft two or three days, is contrary to Nature and common fenfe, and is very hurtful both to the mother and child. Every mother who has milk in her breafts, ought either to fuckle her own child, or to have her breafts frequently drawn, at leaft for the firft month. This would prevent many of the difeafes which prove fatal to women in child-bed. When an inflammation happens in thebreaft,attended with rednefs, hardnefs, and other fymptoms of fuppuration, the fafeft application is a poultice of bread and milk, foftened with oil or frefh butter. This may be renewed twice a day till the tumour be either difcuffed or brought to fuppuration. Afterwards it may be dreffed with yellow bafilicon, or any other digeftive ointment. The ufe of repeilants, in this cafe, is very dangerous; they often occafion fevers, and fometimes cancers: Whereas a fuppuration is feldom attend- ed with any danger, and has often the moft falutary effeas. When the nipples are fretted or chapt, they may be a- nointed with ?. mixture of oil and bees-wax, or a little gum arabic may be fprinkkd on them. I have feen Hungary- water applied to the nipples have a very good effea. should OF BARRENNESS. 339 the complaint prove obftinate, the nurfe ought to be purg- ed, which generally removes it. The miliary fever is a difeafe very incident to women in child-bed. But as it has been treated of already, we fhall take no farther notice of it here than only, with the celebrat- ed Hoffman, to obferve, that this fever of child-bed women might generally be prevented, if they, during their preg- nancy, were regular in their diet, ufed moderate exercife, took now and then a gentle laxative of manna, rhubarb, or cream of tartar ; not forgetting to bleed in the firft months, and avoid all fharp air. When the labour is coming on, it is not to be haftened with forcing medicines, which inflame the blood and humours, or put them into unnatural com- motions. Care fhould be taken, after the birth, that the natural excretions proceed regularly ; and if the pulfe be quick, a little nitrous powder lhould be given, &C We fhall conclude our obfervations on child-bed women by recommending it to them, above all things, to beware of cold. Poor women, whofe circumftances oblige them to quit their bed too foon, often contraa difeafes from cold, of which they never recover. It is pity the poor are not better taken care of in this fituation. But the better fort of women run the greateft hazard from being kept too hot. They are generally kept in a fort of bagnio for the firft eight or ten days, and then dreffed out to fee company. The danger of this condua muft be obvious to every one. The fuperftitious cuftom of obliging women to keep the houfe till they go to church, is likewife a very common caufe of catching cold. All churches are damp, and moft of them cold ; confequently they are the very worft places to which a woman can go to make her firft vifit, after being confined in a warm room for a month. We make this obfervation from experience, having often had occafion to attend wo- men whofe diforders were the effea of cold caught in this way. Of BARRENNESS. Barrenness may be very properly reckoned among the difeafes of females, as few married women who have not children enjoy a good ftate of health. It may proceed from various caufes ; but we fhall only take notice of two, viz. hieh living and relaxation. It is very certain that high 5 & U u 2 living 340 OF BARRENNESS. living vitiates the humours, and prevents fecundity. We feldom find a barren woman among the labouring poor, while nothing is more common amongft the rich and afflu- ent. The inhabitants of every country are prolific in pro- portion to their poverty, and it would be an eafy matter to adduce many inftances of women who, by being reduced to live entirely upon a milk and vegetable diet, have con- ceived and brought forth children, though they never had any before. Would the rich ufe the fame fort of food and exercife as the better fort of peafants, they would feldom have caufe to envy their poor vaffals and dependents the blefling of a numerous and healthy offspring, while they, pine in forrow for the want of even a fingle heir to their ex- tenfive dominions. Affluence begets indolence, which not only vitiates the humours, but induces a general relaxation of the folids; a ftate highly unfavourable to procreation. As we have the greateft reafon to believe, that relaxation is one of the moft common caufes of barrennefs, we would recommend the following courfe for removing it. Firft, plenty of exer- cife in the open air ; fecondly, the ufe of the cold bath ; and laftly, aftringent medicines. It is well known, that many women who had been long barren, have, by the ufe of the cold bath not only become mothers, but have after-' wards enjoyed a much better ftate of health. This fhould induce all barren women not only to try the cold bath, but to perfift in the ufe of it for a long time, otherwife it cannot be expeaed to produce any confiderable effeas. Tho' a vegetable diet, plenty of exercife, and the cold bath, are the medicines rnoft to be relied upon, we fhall mention one more, which has fometimes proved effeaual, viz. common allum. About the third or fourth day of the menftrual flux the woman muft take as much powdered al- lum at bed-time, in a cup of wine or negas, as will lie up- on fixpence. This muft be repeated for three or four nights running. If it has not thedefired effea, it may be taken in the fame manner next time the menfes return. I have known feveral women who always conceived after taking this medicine, and never without it. The above obfervations on diet, air, and exercife, are applicable to men as well as to women. Dr Chyne avers, that want of children is oftener the fault of the male than of the female, and ftrongly recommends a milk and veget- able DISEASES OF CHILDREN. 341 able diet to the former as well as the latter ; adding, that his friend Dr Taylor, whom he calls the milk Doaor of Croyden, had brought fundry opulent families in his neigh- bourhood, who had continued fome years after marriage without progeny, to have feveral fine children, by keeping both parents, for a confiderable time, to a milk and veget- able diet. DISEASES of CHILDREN. The nurfing and management of children having been pretty fully treated of in the firft part of this book, we fhall only here take notice of fuch of their difeafes as have not been already mentioned. RETENTION of the MECONIUM. The ftomach and bowels of a new-born infant are filled with a blackifh coloured matter of the confiftence of fyrup, commonly called the meconium. This is generally paffed foon after the birth by the mere effort of nature, in which cafe it is not neceffary to give the infant any kind of medi- cine. But if it fhould be retained, or not fufficiently carri- ed off, it may occafion wind, gripes, jaundice, reftleffnefs, convulfions, &c. Tjie moft proper medicine for expelling the meconium is the mother's milk, which is always, at firft, of a purga- tive quality. But, if the the mother does not gives luck, or, if her milk happens not to be fufficiently purgative, a little of the fyrup of pale rofes may be given, or a fmall quantity of the fyrup of rhubarb diluted with water, and fweetened with honey or coarfe fugar. If thefe are not at hand, a common fpoonful of whey fweetened with a tea- fpoonful of honey may be given. All kind of oils are tobe avoided ; they are quite indi- geftible by infants, and tend only to load their ftomachs and makes them fick. The APHTHA or THRUSH. The aphthae are little whitifh ulcers affeaingthe whole infide of the mouth, tongue, throat, and ftomach of in- fants. Sometimes they reach through the whole inteftinal canal -t 342 DISEASES OF CHILDREN. canal ; in which cafe they are very dangerous, and often put an end to the infant's life. If the aphthae are of a pale colour, pellucid, few in number, foft, fuperficial, and fall eafily off, they are not dangerous ; but if opake, yellow, brown, black, thick, or running together, they are bad. It is generally thought that the aphthae owe their origin to acid humours ; but we have reafon to believe that thefe, and feveral oifeer eruptive difeafes of infants, are, in a great meafure, owing to too hot a regimen both of the mother and child. It is a rare thing to find a child who is not dofed with wine, punch, cinnamon waters, or fome other hot and inflaming liquors, almoft as foon as it is born. It is well known that thefeh will occafion inflammatory diforders even in adults; is it any wonder then that they fhould heat , and inflame the tentler bodies of infants, and fet, as it "* were, the whole conftitution on a blaze ? » The moft proper medicines for the aphthae are thofe of a cooling and gentle opening nature. Five grains of rhu- barb and a dram of magnefia alba may be rubbed together, and divided into fix dofes, one of which may be given to the child every five or fix hours. Thefe powders may ei- ther be given in the child's food or a little of the fyrup of pale rofes, and may be repeated as often as is found neceffa- ry to keep the belly open. Many things have been recommended for gargling the mouth and throat in this difeafe ; but it is not eafy to apply thefe in very young infants; we would therefore recommend it to the nurfe to rub the child's mouth frequently with a little borax and honey ; or with the following mixture. Take fine honey an ounce, borax a dram, burnt allum half a dram, rofe-water two drams ; mix them together. Thefe may be applied with the finger, or by means of a bit of foft rag tied to the end of a probe. Of ACIDITIES. The food of children being, for the moft part, of an acefcent nature, it readily turns four upon the ftomach, e- fpecially if the body be any how difordered. Hence it comes to pafs, that moft difeafes of children are accompa- nied with evident figns of acidity, as green ftools, gripes, &c. Thefe appearances have induced many to believe, DISEASES OF CHILDREN. 343 that all the difeafes of children were owing to an acid a- bounding in the ftomach and bowels; but whoeverconfiders the matter attentively, will find, that thefe fymptoms of a- cidity are oftener the effea than the caufe of difeafes. Nature evidently intended, that the food of children fhould be acefcent; and until the body be difordered, or the digeftion hurt, from fome other caufe, we will venture to fay, that the acefcent quality of their foodfljs feldom in- jurious to them. Acidity however is often a fymptom of infantile diforders, and, as it is a very troublefome one, we fhall point out the method of relieving it. When green ftools, gripes, purgings, &c. fhew, that the bowels abound with an acid, the child fhould have a little fmall broth im'tead of milk, with light white bread in it; and fhould have plenty of exercife in order to promote the digeftion. It has been cuftomary in this cafe to give the pearl-julep, chalk- crabs eyes, and other teftaceous pow- ders. Thefe indUd, by their abforbent quality, may cor- rea the acidity ; but they are attended with this inconve- niency, that they are apt to lodge in the bowels, and occa- fion a coftivenefs, which may prove very hurtful to the in- fant. For this reafon they fhould never be given unlefs mixed with purgative medicines; as rhubarb, manna, or fuch like. The beft medicine which we know, in all cafes of aci- dity, is that fine infipid powder called magnefia alba. It purges, and, at the fame time, correas the acidity ; by which means it not only removes the difeafe, but carries off" its caufe. It may be given in any kind of food, from ten grains to a teafpoonful, according to the age of the pa- tient. I have often known it have good effeas when given in the following manner. Take of magnefia alba two drams, fine rhubarb in powder half a dram, pepper-mint water and common water, of each two ounces, as much fyrup of fu^ar as will make it agreeable. Shake the bottle, and give The child a table-fpoonful three or four times a- day. When an infant is troubled with gripes, it ought not to be dofed with brandy, fpiceries, and other hot things, but fhould have its belly opened with an emolient clyfter, or the medicine mentioned above ; and at the fame time a little brandy may be rubbed on its belly with a warm hand before the fire. I have feldom feen this fail to eafe the gripes 344 DISEASES OF CHILDREN. gripes of infants. It is often more effeaual, and always more fafe than brandy taken inwardly. GALLING and EXCORIATION. These are very troublefome to children. They happen chiefly about the groin and wrinkles of the neck, under the arms, behind tjjhie ears, and in other parts that are moiften- ed by the fweat or urine. As thefe complaints are, in a great meafure, owing to want of cleanlinefs, the moft effeaual means of prevent- ing them are, to wafh the parts frequently with water, to change the linen often, and in a word, to keep the child, in all refpeas, thoroughly clean. When this is not fuffi- cient, the excoriated parts may be fprinkled with abforbent or drying powders ; fuch as burnt hartfhorn, tutty, chalk, crabs claws prepared, &c. Any of thefe may be tied in a rag, and the powder fhook out on the di»rdered places. When the parts affeaed are very fore, and tend to a real ulceration, it will be proper to add a little fugar of lead to the powders ; or to anoint the place with a little cam- phorated ointment. If the parts be wafhed with fpring wa- ter, in which a little white vitriol has been diffolved, it will dry and heal them very powerfully. STOPPAGE of the NOSE. The noftrils of infants are often plugged up with a grofs mucus, which prevents their breathing freely, and likewife renders it difficult for them to fuck or fwallow. Some, in this cafe, order, after a fuitable purge, two or three grains of white vitriol diflblved in half an ounce of marjoram water and filtered, to be applied now and then to the noftrils with a linen rag. Wedelius fays, If two grains of white vitriol, and the fame quantity of elaterium, be dif- folved in half an ounce of marjoram water, and applied to the nofe, as above direaed, that it brings away the mucus without fneezing. In obftinate cafes thefe things may be tried ; but we have never found any thing elfe neceffary, than to rub the. nofe at bed-time with a little oil of fweet almonds, or a bit of frefh butter. This refolves the filth, and renders the breathing more free. DISEASES OF CHILDREN. 345 Of ERUPTIONS. Children, while on the breaft, are feldom free from e- ruptions of one kind or other. Thefe however are not often dangerous, and ought never to be ftopped but with the greateft caution. They tend to free the bodies of infants from hot and acrid humours, which, if retained, might produce fatal diforders. The eruptions of children are chiefly owing to the fol- lowing caufes, viz. improper food, and neglect of cleanli- nefs. If a child be fluffed at all hours with food that his ftomach is not able to digeft, fuch food, not being proper- ly affimilated, inftead of nourifhing the body, fills it with grofs humours. Thefe muft either break out in form of e- ruptions upon the fkin, or remain in the body, and occafi- on fevers and other internal diforders. That negka of cleanlinefs is a very general caufe of eruptive diforders, muft be obvious to every one. The children of the poor, and of all who defpife cleanlinefs, are almoft conftantly found to fwarm with vermin, and are generally covered over with the fcab, itch, and other eruptions. When eruptions are the effea of improper food, or want of cleanlinefs, a proper attention to thefe alone will generally be fufficient to remove them. If this fhould not be the cafe, fome drying medicines will be neceffary; but they fhould never be applied without the greateft caution. If drying medicines are applied, the belly ought at the fame time to be kept open, and cold is carefully to be avoided. We know no medicine that is more fafe for dry- ing up cutaneous eruptions than fulphur, provided it be fparingly ufed. A little of the flowers of fulphur may be mixed°with the white ointment or hog's lard, and the parts affeaed frequently touched with it. The moft obftinate of all the eruptions incident to chil- dren are, the tinea capitis, or fcabbed head, and chilblains. The fcabbed head is often exceeding difficult to cure, and fometimes iqdeed the cure proves worfe than the difeafe. I have frequently known children feized with internal difor- ders, of which they died foon after their fcabbed heads had been healed by the application of drying medicines*. The X x cure * I some time ago faw a very ftriking inftance of the dsngeroffubfti- tuting drying medicines in the pla«e of univerfally known ; we fhall therefore proceed to point out the method of treating it. ^ In flight bruifes it will be fufficient to bathe the part with a mixture of equal quantities of vinegar and water, and to keep cloths wet with this mixture conftantly applied to it. This is far more proper than rubbing it with brandy, fpirits of wine, or other ardent fpirits, which are commonly ufed in fuch caOs. In fome parts of the country the peafants apply to a re- cent bruife a poultice of frefh cow's duns;, with very happy effeas. When a bruife is very violent, the patient ought imme- diately to be bled, and put upon a proper regimen. His food mould be light and cool, and his drink weak, and of an opening nature ; as whey fweetened with honey, decoc- tions of tamarinds, barley, cream-tartar-whey, and fuch like. The bruifed part muft be bathed with vinegar and water, as direaed above ; and a poultice made by boiling crumbs of bread, elder flowers, and camomile flowers, in equal quantities of vinegar and water, applied to it. This poultice is peculiarly proper when a wound is joined to the bruife. It may be renewed two or three times a-day. 356 OF DISLOCATIONS. As the ftrua-ure of the veffels is totally deftroyed by a violent bruife, there often enfues a great lofs of fubftance, which produces an ulcerous fore very difficult to cure. Ir the bone be affeaed, the fore will not heal before an exfo- liation takes place, that is, before the difeafed part of the bone fepaAtes, and comes out through the wound. This is often a very flow operation, and may even require feveral years to be compkated. Hence it happens, that thefe fores are frequently miftaken for the King's evil, and treated as fuch, though, in faa, they proceed folely from the injury which the folid parts received from the blow. Patients in this fituation are pcftered with different ad- vices. Every perfon who fees them propofes a new remedy, till the fore is in a manner, poifoned with various and oppo- fite applications, and, is often at length rendered abfo- lutely incurable. The beft method of managing fuch fores is, to take care that the patient's conftitution does not fuffer by confinement, or improper medicine, and to apply nothing to them but fome fimple ointment fpread upon foft lint, over which a poultice of bread and milk, with boiled camomile flowers, or the like, may be put to nourifh the part, and keep it foft and v/arm. Nature, thus affifted, will generally in time operate a cure, by throwing off the difeafed parts of the bone, after which the fore foon heals. Of DISLOCATIONS. Dislocations are generally occafioned by falls, blows, or the like. Tr.ey are always dangerous, and fometimes, unlefs immediately reduced, they prove fatal. A perfon who has the misfortune, by a fall from his horfe, or the like, to diflocatc his neck, is often left to perifh, while it is in the power of every perfon prefent to do all that is necef- fary for his recovery. But people are feized with a kind of panic upon thefe occafions, and are often fo much afraid of doing wrong, that they do nothing at all. This is, in face, allowing a perfon to die for fear of hurting him. When the neck is di(located, or put out of joint, th- patient is immediately deprive J of all fenfe and motion; his countenance foon turns bloated and blackifh; his neck fwclk •, and his face is generally turned towards one fhoul- ckr. He fliould immediately he laid upon his back on the ground, and the oo.-iruur muft place himfelf brhind him :>\ OF BROKEN BON E S. 357 fuch a manner, as to be able to lay hold of, hi§ head with both his hands, while he makes a refiftanCe by placing his knees againft the patient's fhoulders. In this pofition, with one hand under the chin, and the other under the hinder part of the head, he muft pull with confiderable force, gently twill- ing it at the fame time, if the face be turned to one fide, till he perceives that the joint is replaced. This is eafily known from the noifewhich the bones generally make upononeano- ther in the very aa of reduaion, from thepaticnt'sbeginning foon after to breathe, and from the head continuing in its proper pofition, &c. This operation, like many others, is eafier performed than defcribed, and requires only common prudence and fufficient refolution in the operator. I have known inftances of its being happily performed even by women, and frequently by men of no medical education. Tho' diflocations of the limbs are lefs dangerous, they ou"-ht neverthelefs to be reduced as foon as poffible. When the operation is long delayed it becomes very difficult, and fometimes even impraaible. Befides, when a bone has been diflocated for a confiderable time, it can feldom be kept in its place after it has been reduced. A mechanical genius, with a very flight notion of the ftruaure of the human body, will enable any perfon to reduce a diflocated- bone. All that is neceffary is to make a proper exftenfion and at the fame time, to pufh the head of the bone towards the focket *. After the bone has been reduced, a roller wet with equal parts of vinegar and water may be applied round the joint. The member ought to be placed in the moft natu- ral and eafy pofture, and kept fo for fome time, till the parts recover their wonted ftrength and tone. Of BROKEN BONES. There are in moft country villages feme perfeti who pretends to the art of reducing figures. Tho' in general fuch perfons are very ignorant, yet fome of them are very fuccefsful ; which evidently proves, that a fmall degree of lcarnin-v, with a fufficient fhare of common fenfe, will en- ^ ' able * We intended here to have tnnte.1 of the vr.riou; kinds of difloca- rlonsandtoluvcfliwnthe method cf redudr.g d.un; but this the limits of our . rfer ;.mce will not pomit. 2S8 OF BROKEN BONES, able a man to be ufeful in this way. We would however advife people never to truft fuch operators when an expert and fkilful furgeon can be had ; but when that is imprac- ticable, they muft be employed ; we fhall therefore recom- mend the following hints to their confideration. When a large bone is broken, the pntient's diqt ought, in all refpeas to be the fame as that of a perfon in a fever. He fhould likewife be kept quiet and cool, and his belly fliould be kept gently open either by emollient clyfters, or, if thefe cannot be conveniently adminiftered, by food that is of an opening quality; as ftewed prunes, applesboiledinmilk, boiled fpinnage, Sec. It ought however to be here remarked, thatperfons who have been accuftomed tolivehigh,arenot all of a fudden to be reduced to a very low diet. This might have fatal confequences. There is often a neceffity of indulging bad habits, in fome meafure, even where the nature of the difeafe might require a different ireatment. It will generally be neevffary to bleed the patient after a fraaure, efpecially if he be young, of a full habit, or has, at the fame time, received any bruife or contufion. This operation fhould be performed as foon after the accident happens as poffible, and if the patient be very feverifh, it may be repeated next day. When feveral of the ribs are broken, bleeding, is peculiarly neceffary. If any of the large bones which fuppoir the weight of the body be broken, the patient muft keep his bed for feveral weeks. It is by no means however neceffarv that he fhould lie all this while, as is cuftomary, upon his back. This fituation finks the fpiritc, galls and frets the patients fkin, and renders him very uueafy. After the fecond week he may be gently raifed up, and may fit feveral hours, fupport- ed by a bed chair, or the like, which will greatly relieve him. Great care however muft be taken in raifinghim up, and laying him down, that he exert no ftrength of his own, otherwife the aaion of the mufeles may pull the bone out of its place. It is of gre.it importance to keep the patient dry and clean while in this.fkuatioti. By negkaing this he is of- ten fo oral led and e.cccriated, that he is forced to keep fhift- ing places for cafe. I have fometimes known a fraaurcd thigh bone, after it had lain flrait for above a fortnight, mifplaced by this means, a:ri continue bent for life, in Ipitc "* of all that could be done. Bonj OF BROKEN BONES. 359 Bone-setters ought carefully to examine whether the bone be not fhattered, or broken into a great many pieces. In this cafe it will generally be neceffary to have the limb taken off, otherwife a gangrene or mortification may enfue. The horror which attends the very idea of an amputation often occafions its being delayed in fuch cafe* till too late. I, fome time ago, faw a fhocking inftance of this in a mafon, who had the misfortune to fall from the third ftory of a houfe. In one of his legs, which had ftruck a beam, the bones were fo fhattered and fplit near the ancle, that they felt almoft like a bag of fmall ftones. Some of their fharp points had likewife penetrated the ikin. It was advifed that the leg fhould immediately be taken off; but to this the patient's friends would not confent. After tak- ing three or four days to confider of it, the operation was at laft determined upon, and was accordingly performed ; but alas, it was in vain ! The mortification had already proceeded too far to be ftopped, and the miferable patient died in two days. When a fraaure is accompanied with a wound, it muft be dreffed in all refpeas as a common wound. All that art can do towards the cure of a broken bone, is to lay it perfeaiy ftraight, and to keep it quite eafy. All tight bandages do hurt. They had much better be wanting altogether. A great many of the bad confequences which proceed from fraaured bones are owing to tight bandages. This is one of the ways in which the excefs of art, or rather the abufe of art, does more mifchief than would be occafi- oned by the want of it. Some cf the moft fudden cures of broken bones which were ever known, happened when no bandages were applied at all. Some method however muft be taken to keep the member fleady; but this may be done many ways without bracing it with a tight bandage. We are not however againft the ufe of bandages altogether. It is only the wrong application of them which we find fault with. In fraaures of the ribs, where a bandage cannot be pro- perly ufed, an adhefive plafter may be applied over the part. The patient in this cafe ought to keep himfelf quite eafy, avoiding every thing that may occafion fneezing, laughing, coughing or the like. He ought to keep his body in a ftraight pofture, and fhould take care that his ftomach be conftantly 360 O F S T R A I N S. conftantly diftended, by taking frequently fome light food, and drinking freely of weak watery liquors. The moft proper external application for a fraaure is nxycrate, or a mixture of vinegar and water. The banda- ges fhould be wet with this at every dreffing before they be applied, and the part may be frequently fprinkled with it. Of STRAINS. Strains are often attended with worfe confequences than broken bones. The reafon is obvious ; they are generally negkaed. When a bone is broken, the patient is under a neceffity of keeping it eafy, becaufe he cannot make ufe of it; but when a joint is only ftrained, the perfon finding he can ftill make a fhift to move it, is forry to lofe his time for fo trifling an ailment. In this way he deceives himfelf, and converts into an incurable malady what might have been removed by only keeping the part eafy for a few days. Country people generally immerfe a ftrained limb in cold water. This is very proper, provided it be done im- mediately, and not kept in too long. But the cuftom of keeping the part immerfed in cold water for many hours together, is certainly dangerous. This relaxes inftead of bracing the part, and is more likely to produce a difeafe than remove one. Wrapping a garter, or fome other bandage, pretty tight about the ftrained part, is likewife of ufe. It helps to reftore the proper tone of the veffels, and prevents the ac- tion of the parts from encreafing the difeafe. It fhould not however be applied too tight. I have frequently known bleeding near the affeaed part, in violent ftrains, have a ve- ry good effea. But what we would recommend above all things for a ftrain is eafe. It is more to be depended upon than any medicine, and feldom fails to remove the complaint. Of ULCERS. Ulcers may be the confequence of wounds, bruifes, or tumours, improperly treated ; but they generally proceed from an ill ftate of the humours, or what may be called a bad habit of body. When O F U L C E R S. 361 When this is the cafe they ought not to be haftily dried Up, otherwife it may prove fatal to the patient. Ulcers happen moft commonly in the decline of life ; and perfons who negka exercife and live full, are meft liable to them. They might often be prevented by retrenching fome part of the folid food, or by opening artificial drains, as iffues, fetons, or the like. An ulcer may be known from a wound by its difcharg- ing a thin watu-y humour, which is often fo acrid as to in- flame and corrode the fkin ; by the hardnefs and perpen- dicular fituation of its fides or edges, and by the time of its duration, Sec. It requires confiderable fkill to be able to judge when an ulcer ought to be healed, and when not. In gener;-), all ulcers which proceed from a bad habit of body fliould be fuffered to continue open at leaft till the conftitution be fo far changed by proper regimen, or the ufe of medicine, that they feem difpofed to heal of their own accord. Ul- cers which are the effea of malignant fever?, or acute dif- eafes, may'generally be healed with fafety after the health has been reftored for fome time. The cure ought not however tobe attempted too foon, nor at any time without the ufe of purging medicines and a proper regimen. When wounds or bruifes have by wrong treatment, degenerated into ulcers, if the conftitution be good, they may generally be healed with fafety. W hen ulcers either accom pa:i\ chro- nical difeafes, or come in their ftead, they muft be caurioufly healed. If an ulcer conduces to the patient's health, it ought never to be healed ; but if, on the contrary, it waftes the ftrength, and confumes the patient by a flow fever, it fhould be healed as foon as poffible. We would earnOlly recommend a ftria attention to thefe particulars, to all who have the misfortuue to labour under this diforder, as we have frequently known people throw away their lives by the want of it, while they were extolling and generoufly rewarding thofe whom they ought to have looked upon as their murderers. The moft proper regimen for promoting the cure of ulcers, is to avoid all fpices, all faked and high feafoned food, all ftrong liquors, and to leffen the ufual quantity of flefh meat. The belly ought to be kept gently open by a diet confifting chiefly of cooling laxative vegetables and by drinking butter-milk, or whey iucevned with honey or the like. The patient ought to be conitanriy cheerful, and Z a fhould 362 Of U L C E R S. fhbuld take as much exercife as he can eafily bear. When the bottom and fides of an ulcer feem hard and callous, they may be fprinkled twice a day with a little red precipitate of mercury, and afterwards dreffed with the yellow bafilieon ointment. Some chufe to have the edges of the ulcer fcarified with a lancet; but this operation ought to be performed by a furgeon. Lime-water has frequently been known to have very happy effeas in the cure of obftinate ulcers. It may be ufed in the fame manner as direaed for the ftone and gravel. My late learned and ingenious friend, Dr Whytt, ftrongly recommends the ufe of a folution of the corrofive fublimate of mercury in brandy, for the cure of obftinate ill conditioned ulcers. I have frequently found this medi- cine, when given according to the Doaor's direaion:, prove very fuccefsful ; but it fhould never be adminiftred without the greateft care. It is made by diflolving four grains of the corrofive fublimate of mercury in eight ounces of the beft French brandy. The dofe is a tabk-fpoonful night and morning ; at the fame time wafhing the fore twice or thri'ce a-day with it. In a letter which I had from the Doaor a little before his death, he informs me, " That he obferved wafhing the fore thrice a-day with a folution of trible ftrength was very ufeful." This me- dicine ought always to be prepared with the greateft care, and ought never to be adminiftred but under the eye of fome perfon of fkill in phyfic. « Of IMPOSTHUMES, or BOILS. Boils are generally the efforts of Nature to expel noxi- ous humours out of the body. Their fuppuration ought therefore by all means to be promoted. I do not remember ever to have feen one inftance of the conftitution being hurt by them, but have often known it greatly mended, efieecially when care was taken to promote a full and free fuppuration. Imposthumes may proceed from the ufe of traihy fruits, or any other unwholefome food, from hunger, exceffive labour, or the like. They are attended with acute pain, hardnefs, rednefs of the part, and all the fymptoms of in- flammation. Bleeding and purging will fometimes difcufs thefe tu- mours at the beginning ; but as foon as it is evident that matter O F W H I T L O W S. 363 matter is colkaing, it will be proper to apply a poultice of bread and milk, with a little oil or frefli butter. This may be renewed twice a-day ; and if the fuppuration goes flow- ly on, a raw onion may be cut into fmall pieces, or bruifed in a mortar, and fpread upon the top of the poultice. This will promote the fuppuration more in one day than a fimple poultice will do in three or four. When the boil turns foft, appears of a white or yel- 'owifh colour, and is quite full of matter, if it does not break of itfelf, it fhould be opened with a lancet. This operation is no ways dangerotis, and is very little painful, as the fkin is very thin and greatly diftended. If no other inflrument be at hand, it may be opened with a large needle; but it is always better to make ufe of a lancet or fome inflrument that will make a pretty large wound, in order that thf matter may be difcharged freely. After the impofthume has broke, or been opened, it maybe dreffed twice a-day with yellow bafilicon ointment, fpread upon lint, or a bit of foft rag. It will ftill however be proper to keep the poultice applied to it, till fuch time as the matter be entirely difcharged. After the matter has been difcharged, thepatient ought to be purged. When boils return frequently, it fhews a bad ftate of the humours, and merits particular attention. The patient ought to be peculiarly attentive to his diet, .and, if the dif- eafe proceeds from any error in it, it fhould be changed as foon as poffible. Repeated purges are generally neceffary in this cafe ; and infufions of the bitter plants, as water- trefoil, camornile-flowers, &c. ought to be drank freely. Thofe who are able to afford it, fhould take a courfe of the purging mineral waters. Of WHITLOWS. A whitlow is a painful tumour appearing near the end of a finger, the humour of which is often fo fharp as to corrode the tendons and nerves, and fometimes even the bone itfelf. These tumours fometimes proceed from the punaureof a fharp body, as a thorn, a pin, a fplinter, or the like. But their moft general caufes, as was formerly obferved, are fudden changes from cold to heat, or the contrary. Hence the difeafe is very common among milk-maids, efpecially at that feafon of the year when they go a milking in a cold £ z 2 nipping 364 O F W H I T L O W S. Hipping frofty morning, and, as foon as they get home, plunge their hands into warm water, or hold them near the fire. The pain of a whitlow is commonly fo great, as to render the patient exceeding reftlefs. It is attended with an inflammation and often with an evident pulfation. When the humour lies deep, the inflammation fpreads over the whole hanci, and fometimes it extends up the arm even to the fhouldtr. The pain, inflammation, and fever have fometimes been fo violent, in this cafe, as to prove mortal. Many things are recommended for difcuffing the in- flammation; as bleeding, bliftering, thepatient, the hold- ing the part in diftilkd vinegar, dipping it frequently in feakling-hot water, and fuch like. Thefe may fometimes fucceed at the beginning, but they do no good afterwards. The fafeft courfe is to promote the fuppuration, by apply- ing cataplafms, or poultices of bread and milk,* with boiled camomile flowers. Or, if a more aafVe and ripening poul- tice be neceffary, the white lilly-root, or a little honey may be added ; but thefe fhould not be applied till there be evi- dent figns of a fuppuration. When the inflamation and fever run very high, it will be neceffary to bleed the patient, and to keep him upon a low diet, allowing him to drink freely of diluting liquors. • When the matter is lodged deep, it is not fafe to wait ' till the tumour breaks and difcharges itfelf. In this cafe the matter muft be let out by making a deep incifion, otherwife it will corrode and deftroy the bone. This o- Deration fhoul.1 always be performed by a furgeon if one can be had. I have frequently feen one bone of the finger loft by the matter remaining too long in contaa with it. Indeed whenever the inflammation begins very deep, it is hardly poffible to fave the bone. After the tumor has burft, or been laid open, it may be dreffed with die yellow bafilicon ointment, or fome other jdigeftive, and a poultice applied over it. If proud flefh ap- pears, it may be kept down by fprinkling a little burnt al- lum over it. If any fymptoms of a gangrene or mortification appear, as a black, pale or lived colour of the parts, Sec. the patient muft have immediate recourfe to the bark, a dram of which muft be taken every two or three hours. The part muft alfo be fcarified, and fomented with a ftrong decoaion of the bark, or camomile flowers ; to which fome fpirit of fea-falt pr ftrong vinegar, may be added. A3 O F R U P T U R E S. 365 As whitlows and mortifications of the extremities are often the effeas of violent cold, we would advife people who have been expofed to an exceffive degree of it, if their hands or feet aregreatly benumbed, to wafhthem in cold water,or rub them, for fome time with fnow, and to keep at a diftance from the fire. This would not only prevent whitlows, but is the only method of reftoring frozen limbs, and of pre- venting a mortification from extreme cold. Of RUPTURES. This difeafe happens moft frequently to children and old people. Men are greatly .more liable to it than wo- men, efpecially thofe who are naturally of a weak and relaxed habit. In infants it is generally occafioned by ex- ceffive crying, violent coughing, repeated efforts to vomit, &c. In adults it is commonly the effea of blows, violent exertions of the ftrength, as leaping, carrying great weights, &c. An oily or very moift diet, by inducing a general fe- laxation of the folids, is commonly thought to predifpofe the body to ruptures. On the firft appearance of a rupture in an infant it ought to be laid upon its back,#*ith itsjjead very low. While in this pofture, if the gut does not return of itfelf, it may ea- fily be put up by gentle preffure. After it is returned, a piece of flicking plafter may be applied over the part, and a proper trufs or bandage muft be conftantly worn for a con- fiderable time. The method of making and applying thefe rupture-bandages for children is pretty well known. The child muft, as far as poffible, be kept from crying, and from all violent motion, till the rupture is quite healed. In adults, when the gut has been forced down with great violence, or happens, from any caufe, tobe inflamed, it is often very difficult to return it, and fometimes quite i-mpraaicable without an operation which it is not our bu- finefs to defcribe. As I have been fortunate enough how- ever always to fucceed in my attempts to return the gut, without having recourfe to any other means than what are in the power of every man, I fhall very briefly mention the method which I generally purfue. After thepatient has been bled, he muft be laid upon his back, with his head very low, and his breech raifed high with pillows. In this fituation flannel-cloths wrung out of a decoaion of mallows and camomile-flowers, or, if thefe are not at hand, of 366 OF CASUALTIES. of warm water, muft be applied for a confiderable time. A clyfter made of this decoaion, with a large fpoonful of but- ter and a little fait, may be afterwards thrown up. If thefe fhould not prove fuccefsful, recourfe muft be had to pref- fure. If the tumour be very hard, confiderable force will be neceffary; but it is not force alone which fucceeds here. The operator, at the fame time that he makes a preflure with the palms of his hand, muft with his fingers condua the gut in by the fame aperture thro' which it came out. The manner of doing this can be much eafier conceived than defcribed. Should all thefe endeavours prove ineffec- tual, clyfters of the fmoke of tobacco muft be tried. Thefe have been often known to fucceed where every other me- thod failed. An adult, after the gut has been returned, muft wear a fleel-bandage. It is needlefs to defcribe thefe, as they are only to be had from the artifts who make them. They are generally uneafy to the wearer for fome time, but by cuftom th^y become quite eafy. No perfon who has had a rupture after he arrived at man's eftate, fhould ever be without one of thefe bandages. Persons who have a rupture ought carefully to avoid all violent exercife, carryingjgfeat v*Arhts, leaping, running, and the like. They fho^Hd likewife avoid windy aliment and ftrong liquors; and fhould carefully guard againft catching cold. Of CASUALTIES. As it is often impraaicable to obtain even the fmalleft degree of medical afliftance in many of thofe accidents which endanger life, we fhall conclude with a few obfer- vations upon fome of the moft common and hazardous of them. The firft we fhall name is the floppage of fubflances be- tween the mouth andthejlomach. Though accidents of this kind are unavoidable, yet, generally fpeaking, they are the effea of careleffhefs. Children have a ftrong inclination to put every thing in their mouths which they get hold of. This ought to make nurfes careful in keeping every thing from them that they can fwallow, which would be hurtful. Even adults are far lefs careful in this refpea than they ought to be. Nothing fhould ever be held in the mouth which it would be dangerous to fwallow, as a fit of cough- ing* OF CASUALTIES. 367 ing, or fome other accident, may force it over. Notwith- ftanding the numberlefs accidents which are daily occafion- ed by holding pins in the mouth, many women have their mouths, for the moft part, full of them through the day ; and fome of them even fleep with them there all night. When a pin, or any other fharp body is fwallowed, it will generally defcend into the ftomach, if its head, or blunt end goes foremoft; but if the point goes foremoft, it. is apt to ftop, and wherf'that happens, every effort to force it down will only ferve to fix it fafter in. In this cafe the beft way is to make the patient vomit, either by tickling his throat with a feather, or giving him a vomit. I have fre- quently known pins which had ftuck in the gullet for feve- ral days, brought up by fwallowing a bit of tough meat ti- ed to a ftrong thread, and drawing it'quickly up again. All hard or fharp fubftances, which mighthurt or wound the bowels, ought, if poffible, to be difcharged upwards. Subftances that will diffolve in the ftomach, if they cannot be brought up, may be pufhed down. When a mouthful of folid food flops in the gullet, it may often be forced up by giving the perfon a blew on the back betwixt the fhoul- ders. If this fhould not fucceed, the throat may be tickled with the finger or a feather. I lately faw a halfpenny, which had ftuck fall in the gullet'of a boy about eight years old, thrown up by only thrufting a finger down his throat. Persons who have the misfortune to fall into the water are often given up for dead, when it is certain they might, by proper care, be recovered. The great intention which fhould be kept in view is to reftore the natural warmth and renew the circulation and breathing. Tho' cold is by no means the caufe of the perfon's death, yet it will prove an effeaual obftacle to his recovery. For this reafon, after ftripping him of his wet cloaths, if he had any on when the accident happened, his body muft be ftrongly rubbed for a confiderable time with coarfe linen cloths as warm as they can be made. As foon as a bed can be got ready, and well heated, he may be laid in it, and the rubbing ftill conti- nued. Warm cloths fhould be laid to his ftomach and bowek, and hot bricks, or bottles filled wirh warm water, to the fedes of his feet. He fhould likewife be bled. The moft omper part for this operation is in the jugular vein, hofh beeaufe it is moft likely ty hle^i, and af.^rds the moft fudden reiiefto the head. hi 368 OF CASUALTlE S. In order to renew the breathing, a ftrong perfon rtiay blow his own breath into the patient's mouth with all the force he can; or, what will fucceed better, the fmoke of tobacco may be blown into the lungs, by means of a pipe or funnel. I have known a pig drowned and reftored to life, two or three different times fucceffively, by blowing air into its moulh with a pair of bellows. It will likewife be proper to throw up the fmokc of tobacco into the intef- tines, in form of a clyfter, by means of a proper pipe. Strong volatile falts ought alfo to be applied to the nofe, or fpirits of hartfhorn, burnt feathers, &c. The' nofe ought likewife to be tickled with a feather dipped In volatile fpi- rits, and warm fpirits of wine fhotikl be rubbed upon the temples, pit of the ftomach, &c. If thefe do not fucceed, the perfon may be put into a warm bath, or laid among warm afhes. Dr Tiflbt menti- ons an inftance of a girl who was reftored to life, after be- ing taken out of the water to all appearance dead, by lay- ing Ikt naked body upon hot or warm afhes ; by covering her with others equally hot; by putting a bonnet round her head, with a flecking round her neck fluffed with the fame, and heaping coverings over all. The fame method muft be purfued for the recovery of perfons ftrangkd as for thofe who are drowned.----Such as have the misfortune to be ftunned by a fall,- a blow, or the like, muft a'fo be treated nearly upon the fame princi- ples. Every method muft be taken to keep up the genial warmth, and to reftore the vital funaions. Nor ought we to defpair too foon of fuccefs. I have been happy enough to recover a perfon who was taken up for dead by a fall from a horfe, after fix hours endeavours, during the great- er paiT; of which time he hardly fhe wed any figns of life. Nothing is more certa>n than that life, when feeming- ly loft, might often be reftored by perfifting for a fufficient time in the ufe of proper means ; and that many of thofe unhappy perfons who perifh by "accidents, are really loft for want of due care. Surely all the laws of religion and hu- manity call upon us to do every thing in our power to fave th■" liver, of our fellow-men. Who would not chufe to be ths happy inflrument of preferving an ufeful member of focfetv, and perhaps of nre^jiting the ruin of an innocent family? V^"^^^ >Sl\ F I 'N I -S. ^^S ★ * ARMY * ★ MEDICAL LIBRARY Ctenplfind RrnErl Med. Hist' W Z 7.qo B9I8<1 f?, -ill \T-A • >.o%*v :h"7":^-, .ia-ivr* .....•* ■;<* >■ 'r»i *■ k ♦d»i'V' ■■•'. ■-■■;'?>■■■'«r»^wi-i:' ' -o;; v#J$£v. .-'■■•''Oaw,' hOO0yM.'ffi>££r h'-7;-iv'4;HK' ::':o'^i:ii:: , *JV ■ I. .,'ds'^.J!K';' .....s<*m,,. ■ 7 ; - "tii-iv.:: ■.'_.'. •.". wit,.. ■■ ■■•■ :—U-iJi^lM '•' •'• :':■, -O.iOii'1'' ' - • ,...„,'-5rvHO •'•■■»iL