&♦£. ■'"■ -dak:;.«/.-'■••■-* ^tib*? y" :^*:#^&.; 1 :"•• -*/$fj^ \ ., -2-.:-* K ■v . "'">«♦£?' Ms i ARMY MEDICAL LIBRARY " WASHINGTON Founrtcrt 1836 Section 2..JL3./-A.2- . p . 3—10543 F„B„113c W.D SCO (Revised June 13, liMOJ *f* DOMESTIC MEDICINE: OR, A TREATISE ON THE PREVEN1I0N and CURE OF DISEASES, BY REGIMEN AND SIMPLE MEDICINES. WITH , m . AN APPENDIX, ys" CONTAINING A DISPENSATORY FOR THE USE OF PRIVATE PRACTITIONERS. TO WHICH ARE ADDED, OBSERVATIONS ON DIET ; RECOMMENDING ^ A METHOD OF LIVING LESS EXPENSIVE, AND MORE CONDUCIVE .•} TO HEALTH, THAN THE PRESENT. ALSO, ADVICE TO MOTHERS, On the Subjecl of their own Health i Ana of the Means of Promoting The Health, Strength, and Beauty Of their Offspring, by WILLIAM BUCHAN, m. d. Fellow of the Royal College o/Phyficians, Edinburgh. New, CorreB Edition, Enlarged—From the Author's lad Rcvifal. BOSTON: PRINTED FOR JOSEPH BUMSTEAD, (Printer and Bookfel'er.) rOR SALE AT HIS BOOKSTORE NO. 77, STATE-STREET, AND BY BOOK- SELLERS IN VARICU3 PART3 OF THE VNITED fiTATBS. *& • • • ^p * ADVERTISEMENTS. THE prtfent edition of the " DOMESTIC MEDICINE," claims no other pre-eminence over former imprefjions, than that it is a copy of. the Author's laft revifal. From an examination of the feveral revifed editions of this Work, which have been publifhed in the Union, it appears, a particular deference has beenfhewn to the Author's opinion, and the improvements to be chiefly in ADDITION—'From this conftderation, which no doubt originated, not Only from the correclnefs of the Author's principles and praBice, but from the defervedly high eflimation the public entertain for the Original Work, the Publifher of the prejent Impreffton was induced not to admit of any alterations.—The articles which have been added to this edition, from the fources whence they have been derived, whether original or /elected, will no doubt enhance its value. The new matter in the body of the work, is marked with a SECTION, and that of the Notes will readily be diflinguifhed by the letters, A. E. Advertifement by Dr. BUCHAN. THE Author, having been in conftant practice fince the firft appear- ance of this Bdok, has taken occafion in the later Editions through which it ha: parted, to improve many articles which were inferted with lefs accuracy 'in the more early impreflions. To the preceding Edition was added a Chap- ter on Dier, recommending a method of living lefs expenlive, and more con- ducive to health, t.han the prefent. Several other improvements have been |p alfo made in the form of notes to illuftrate the text, or put people on their gu*rd in dangerous fituations, and prevent fatal miftakes in the practice of ir.edicine, which, it is to be regretted, are but too common. Although the Domeftic Medicine w s never intended tb fuperfede the ufe of a Thyfician, but to fupply his place in fituation« where medical affifl- aice cou.d not eafily be obtained ; the Author is forry to obferve, that the jealoufies and fears of fomeof the Faculty have prompted them to treat th« Work in a manner very unbecoming the Profeffors of a liberal fcience ; nor- withftanding this injurious treatment, convinced of the utility of his plan, he (hall (pare no pains to make it more ufeful ; desermined that neither in- tereft nor prejudice (hall ever deter him from exerting his bed end«avouis i» render the Meaital Art more extenji'vely bev-ficial !o Mankind. NeiV'Store Street, Bedford Square, \ June 4, 1798. \ CONTENTS. PART I. Of the general Caufes of Difeafes. CHAP. I. Of Children Page 31 — Difeqfed Parents 34 — Clothing of Children 37 — Food of ditto 39 -— Exercife of ditto 43 — Bad Effects of unwholefome Air upon ditto 48 — Nurfes 50 CHAP. II. Of the Laborious, f*fc. 54. — the Sedentary e, 8 — the Studious <5>2 CHAP. Ill, Of Aliment 6j CHAP- IV. Of Air * ' 81 chap, v." Of Exercife 84 CHAP. VI. 0/ Sleep 88 — Clothing 89 CHAP. VII. Of Intemperance pi CHAP. VIII, Of Cleanlinefs 95 CHAP. IX. Of Infetlion 98 CHAP. X. Of the Pafjions 101 — Anger ib. — Fear 102 — Grief 104 — Love I ©5 — Religious Melancholy 196 CHAP. XI. Of the Common Evacuations. ib. ■— Stool i»7 — Urine I«8 Of Perfpirettion " Page is>f. —- being affecled by Changes in the Atmojphere ib. __Wet Clothes 11 o — Wet Feet ib. — Night Air ib. — Damp Beds 110 — Damp Houfes 14 1 — Sudden Tranfttionsfrom Heat to Cold he PART II. Of Difeafes. CHAP. XXI. Of the Knowledge and Cure of Difeafes 114 chap, xm. Fevers in general 117 chap. xiv. Of intermitting Fevers or Agues 121 CHAP. XV. Of an acute continual fever 127 CHAP. XVI. Of the Pleurify jo0 ——— Bajlard ditto 124 ------Paraphrenitis ib, CHAP. XVII. Inflammation of the Lungs 134 CHAP. XVIII. Of Confumptions j?6 CHAP. XIX. Of the Slow or Nervous Fever 144 CHAP, xx. Malignant, Putrid or Spotted Fever JAg CHAP. XXI. Miliary Fever jr^ CHAP. XXII. Remitting Fever ir<> CHAP. XXIII. Of the Tellow Fever r £ 8 CHAP. XXIV. The Small-pox Fage Inoculation CHAP. XXV. Of the Ccw-pox, and iis Inoc- ulation CHAP. XXVI. The Meafes • Scarlet Fever —— Bilious Fever CHAP. XX VI I. St. Anthony s Fire CHAP. xxvm. Inflammation of the Brain CHAP. XXIX. Inflammation of the Eyes chap, xxx. The Quinfey — Malignant ditto CHAP. XXI. Colds and Coughs A common Cough Hooping Cough chap. , XXXII. Inflammation of the Stomach --------■— 'of the lnteflines Of the Chdic , lnfammatidn of the Kidnies —■----------of the Bladder — of the Liver Chop. XXXIII. Of the Cholera Morbus and other exceffive difcharges from the Stomach and Bowels — a Diarrhoea, or Loofenefs — Vomiting Chap. XXXIV. Diforders of the Kidnies and Bladder Of the Diabetes, or exceffive Difcharge /f Urine — Suppreffion of ditto — the Gravel and Stone Chap. XXXV. Involuntary Difcharges of Bleeding at the Nofe Bleeding and Blind Piles Spitting of Blood Vom'it'■■>; 248 250 25S 25.4 255. 25y 26l 264 268 27I 274 276 27I 28-0 282 284 tb* 286 289 291 293 295 296 ib-. 297 299 30c 3C* 30;-: 3OV ib. 3°8 ib. ib. ib. 310 ib. 310 3" 3X3 Short Stghtednefs Page 309 Seeing only at too great a Dis- tance Squinting Spots or Specks Blood/hot Eye Watery or Weeping Eye Of the Ear ----Tajle and Smell ----Touch Chap. XLVII. Of a Scirrhous and Cancer*, Chap. XLV1II. Of Poifons ~— Mineral Poifons — Vegetable ditto Bites ofpoifonous animals ----of the Mad Dog '---of the Viper ——of Poifonous In feels '.—— of the Rattle-fnake Kettering's fpecificfor the Hydrophobia Chap. XLIX. Of the Venereal Difeafe ----Virulent Gonorrhoea Of Gleets — Swelled Teficle — Buboet __ Chancres __A Confirmed Lues or Pox General Obfervations Chap. L. Difeafes of Women Qf the Menjlrual Difcharge __Pregnancy __ Child-birth — Barren nefs Chap. LI. Difeafes of Children Of the Meconium — The Aptha or Thru/h '— Acidities — Galling and Excoriation — Stoppage of the Nofe — Vomiting — A Loofenifs — Eruptions -— The^ Croup or Hiva ym~ Teething ~-Tfo Rickets CONTENTS. — Convulftons Fage 368 -^ Water in the Head 369 Chap. LII. Of Surgery 37» — Bleeding 371 3*3" 3n ib. 3'8 3*9 ib. 324 ib. ib. 326 327 328 333 334 335 336 338 34i 344 345 349 35 emf! C0NTEN7S. more conducive to Health than the prefent General obfervations on Alt' ment Of Bread .— Boiled Grain — Butter — Fruits and Roots — Broths and Soups Conclufion APPENDIX., Introduction Lifl of .imples MEDICAL PRBPARATIONS. Balfams Bolufes Cataplafms and Sinapifms Clyfiers Colly ria? or Eye-waters Confetlions Conferves and Prejervn DececJions Draughts Fage 413 Eletluarits Emulfions 414 Extracls 416 Fomentations 419 Gargles 422 Infuftons 424 Juleps 429 Mixtures 431 Ointments, Liniments and Ce' rates 434 Pills ib. Plaflers Powders 440 Syrups ib. Tinclures, Elixirs, t&e, 441 Vinegars\ 442 Waters by infufton, l*?c. 443 dimple diflilled Waters 444 Spirituous diflilled Water: ib. Wheys 445 Wines 440 ib. 449 450 ib. 451 ib. 453 454 455 457 45 9 461 4^3 ib. 466 467 468 469 ib. ib. GLOSSARY W INDEX 474 .V )«0oOW0«0««00«=eO«CC3OCMOOCSOCCKB0.8<*..f* PREFACE. \\f HEN I firil fignified my intention of publifhing the follovir- ingfheets, I was told by my friends it would draw on me^the r^enN ment of the Faculty. As I never could entertain fuch an ^l™™™ ,dea, I was refolvei to make the experiment, which indeed came out pretty much as might have been expeded. . Many whofe= learning and liberality of fentiments do honour to medicine, t^'**'™^ rnanne/which at once fhewed their indulgence, ^.^.j^VjSS. opinion that every phyjician ;Mr«i were chiefly fugeefted by an extenfive praftice among in- £n« n'al e5h of the Foundling Hofpital, where I had an op; ^,'nitv not onlv of treating the difeafes incident to childhood, but ^CiTeof trying diff-en? plLof nurfing and obferving their effect. ^ henever I LI it in my power to place the children under thecareof irope" n" f«, to mltruS thefe nurfes in their duty, and tp be fatisfied barney performed it, very few of them died ; but when from diftance of obce; and other unavoidable circumftances, the children were left to ^/fclecare of mercenary nurfes, without any perfon to inftruft and Wrintemi them, fcarce any of them lived. This was fo apparent, as with me to amount to a proof of the Allowing melancholy faft : That almofi one half of the human fpeeiespenfj ^infancy, by improper management or negletl : This refi^on has made me often wifh to be the happy inftrument of alleviating the miferies of ihofe fuffering innocents, or of refcuing them from an untimely grave. \o one, who has not had an opportunity of obf-rving them, can im- •Mrine what abfurd and ridiculous pra&ices ftill prevail in the nurfing md management of infants, and what numbers of lives are by that means loft to fociety. As thefe praftices are chiefly owing to igno- rance, it is to be hoped, that when nurfos it* better informed, their -ondua will b.» mor- proper. PREPACK. $ The application of medicine to the various occupations of life •has been in general the refuk of obfervation. An extenfive prattle for ftveral years, in one of the largeft manufacturing towns in Eng-" land, afforded me fufEcient opportunities of obferving the injuries which thofe ufeful people fuftain from their particular employments> and like wife of trying various methods pf obviating fuch injuries.! The fuccefs which attended thefe trials was fufEcient to encourage. this attempt, which I hope will be of ufe to thofe who are under the neceifity of eating their bread by fuch employments as are unfavora- ble to health. I do not mean to intimidate men, far lefs to infinuate that even thofe arts, the practice of which is attended with fome degree of danger, fliould not be carried on; but to guard the lefs cautious and unwary againft thofe dangers which they have it in their power to avoid, and which they often, through mere ignorance, incur. As every occupation in life difpofes thofe who follow it to fome partic- ular difeafes .more than to others, it is certainly of importance to know thefe, in order that people may be upon their guard againft them. It. is always better co be warned of the approach of an ene- my, than to be furprifed by him, efpecially when there is a poffibiUV ty of avoiding the danger. The obfervations concerning, Diet, Air, Exercife, &c. are of 3 more general nature, and have not efqaped the attention of phyfi- cians in any age. They are fubjects of too great importance, how~ ever, to be pafled over in an attempt of this kind, and can never be fuflkiently recommended. The man who pays a proper attention to thefe, will feldom need the phyfician ; and he who does not, will feldom enjoy health, let him employ as many phyficians as Xic pleafes. Though we have endeavored to point out the caufes of difeaf,. es,.and to put people upon their guard againft them, yet it muft be acknowledged that they are often of fuch a nature as to admit of being removed only by the diligence and activity of the pub ic magiftrate. We are forry, indeed, to obferve, that the power of the magiftrate -is feldom exerted in this country for the preservation of health. The importance of a proper medical police is either not underftood, or lktle regarded. Many things highly injurious to the public health are daily pra&ifed with impunity, while others absolutely neceflary for its prefervation, are entirely neglected. Some of the public means of preferving health are mentioned in the general prophylaxis, as the infpeclion of provifions, widening the ftreets of great towns, keeping them clean, Supplying the inhabi- tants with whole fome water, &c ; but they are paffed over in a very curfory manner. A proper attention to thefe would have fweKed this volume to too large a fize; I have therefore referved them for the fubjecr, of a future publication. In the treatment of difeafes, I have been peculiarly attentive to regimen. The generality of people lay too much ftrefs upon Med- icine, and truft too little to their own endeavors. It is always in t|ie power of the patient or of thofe about him, to do as much towards his recovery as can be erTeded by the phyfuian. By not attending to this, the defigns of medicine are often frunrated ; and the patient, by purfuing a wrong plan of regime.:, not only defeats the Doctors fedeavors, but renders tjiem dangerous. IhaVc often l^own pV- ip • PREFACE. tients killed byan error in regimen, when they were ufing veiy prob- er medicines. It w 11 be faid, the phyfician always orders the regi- men when he prefcribes a medicine I wifh it were fo, both for the honour of the faculty and the fafety of their patients : but phy- ficians, as well as other people, are too little attentive to this matter. Though many reckon it doubtful whether phyfic is benefi- cial or hurtful to mankind, yet all allow the neceflity and importance of a proper regimen in difeafes. Indeed the very appetites of the fick prove its propriety. No man in his fenfes, ever imagined that a perfon in a fever, for example, could eat, drink, or condudt himfelf in the fame manner as one in perfect health. This part of medicine, therefore, is evidently founded in Nature, and is every way confif- tent with reafon and common fenfe. Had men been more attentive to it, and lefs folicitous in hunting after fecret remedies, medicine had never become an object of ridicule. This feems to have been the firft idea of Medicine The an- cient phyficians a&ed chiefly in the capacity of nurfes. They went very little beyond aliment in their prefcriptions ; and even thi* they generally adminiftered themfelves, attending the lick for that pur- pofe through the whole courfe of the difeafe; which gave them an opportunity not only of marking the. changes of difeafes with great accuracy, but likewife of obferving the effects of'their different ap- plications, and adapting them to the fymptoms. The learned Dr. Arbuthnot afferts, that by a proper attention to thofe things which are almofi within the reach of every body, more good and lefs mifchief will be done in acute difeafes, than by- medicines improperly and unfeafonably adminiftered ; and that great cures may be effected in chronic diftempers, by a proper regimen of the diet only. So entirely do the Dottor'e fentiment6 and mine agree, that I would advife every perfon, ignorant of phyfic, to con- fine his practice folely to diet, and the other parts of regimen ; by ■which means he may often do much good, and can feldom do any hurt, This feems alfo to have been the opinion of the ingenious Doc- tor Huxham, who obferves, that we often feek from Art what all- bountiful Nature moft readily, and as effeftually, offers us, had we diligence and fagacity enough to obferve and make ufe of them ; that the dietetic part of Medicine is not fo much ftudied as it ought to be; and that though lefs pompous, yet it is the moft natural meth- od of curiug difeafes. To render this book more generally ufeful, however, as well as more acceptabl to the intelligent part of mankind, 1 have in moft difeafes, beGdes regimen, recommended fome of the moft fimple and approved forms of medicine, and added fuch cautions and di- rections asfeemed neceflary for their fafe adminiftration. It would no doubt have been more acceptable to many, had it abounded with pompous prefcriptions, and p-omifed great cures in confequence of their ufe ; but this wjs not my plan; I think the adminiftration of medicines always doubtful, and often dangerous, and would much rather teach men how to avoid the neceflity of ufing them, than how they lhould be.ufed. Several medicines, and thofe of confiderable efficacy, may be adminiftered with great freedom and fafety. Phyficians generally tftfle a long typ? w$* medicines hefoe ftey learn their proper ufci PREFACE. ij Many peafants at prefent know better how to ufe fomfc of the moft important articles in the materia medi^a, than phyfi ians did a century ago; and doubtlefs the fame obfervations will hold with regard to others fome time hence. Wherever I was convinced that medicine might be uftd with fafety, or where the cure depended chiefly upon it, I have taken care to recommend it; but where it was either highly dangerous, or not very neceflary, it is omitted. 1 hav" not troubled the reader with an ufelefs parade of quota* tions from different authors, but have in general adopted their obi* fervations where my own were either defective, or totally wanting. Thofe to whom I am moft obliged, are Ramizina, Arbuthnot, and Tiflbt; the laft of which, in his At only confiderably enlarged my treatife, but by his very ingenious and ufeful notes, has rendered it fo popular on the Continent, as to ©ccafion its being tranflated into all the languages of modern Europe. I have only to add, that the book has not more exceeded my (expectations in its fuccefs, than in the effects it has produced. Some of the moft pernicious practices, with *egard to the treatment of the tick, have already given place to a more rational conduct ; and many of the moft hurtful prejudices, which feemed to be quite in- surmountable, have in a great meafure yielded to better information. Of this a ftronger inftance cannot be given than the inoculation of the fmall pox. Few mothers, fome years ago, would fubmit to have their children inoculated even by the hand of a phyfician ; yet nothing is more certain, than that of late many of them have per- dfbrmed this operation with their own hands ; and as their fuccefs has been equal to that of the moft dignified inoculators, there is little jreafon to doubt that the practice will beqome general. Whenever •tfiis fhall be the cife, more lives will be faved by inoculation alone, %*n- are aj prfifcnt by aU the endeavors of the Faculty. --—^6iHD5aaj22!Oirs!£^B*«M«.. - INTRODUCTION. nr 1 HE improvements in Medicine, fince the revival oflearnifi£ have by no means kept pace with thofe of the other arts. The reafoa is obvious. Medicine has been ftudied by few, except thofe who intended to live by it as a bufinefe. Such, either from a miftakea ieal for the honor of Medicine, or to raife their own importance have endeavored to difguife and conceal the art. Medical author? have generally written in a foreign language; and thofe who werei uncqua to this talk, have even valued themfelvesupon couching, at leait, their prefcriptions, in terms and characters unintelligible to the reft of mankind. * The contentions of the clergy, which foon happened after the teltoration of learning, engaged the attention of mankind, and paved the way for that freedom ©f thought and inquiry, which has fince prevailed m moft parts of Europe with regard to religious matters; Every man took a fide in thofe bloody difputes ; and every gentle- man, that he might diftinguimhimfelf on one fide or other was in- ltructed in Divinity. This taught people to think and reafon for tnemfelves in matters of religion, and at laft totally deftroyed that complete and abfolute dominion which the clergy had obtained* over the minds of men. • at TJie ftu(?y of Law has Iikewife> « ™oft civilized nations, beer* jultly deemed a neceflary part of the education of a gentlefnan. Ev- ery gentleman ought certainly to know at leaft the laws of his own country; and if he were alfo acquainted with thofe of others it might be more than barely an ornament to him. ' • ^ d'fcrcm benches of Philofophy have alfo of late Wen venr umverfally ftudied by all who pretended to a liberal education. The advantages of this are manifeft. It frees the mind from prejudice and fuperftition, fits it for the inveftigation of truth ; indue? i-*Wits of reafoning and judging properly j opens an inexhauftible fource of entertainment; paves the way to the improvement of arts and agri- culture j and qualifies men for ading with propriety in the moft im- portant ftations of life. _ Natural Hiltory is likewife become an objea of general attend tion; and it well deferves to be fo. It leads to difcoveries of the greateft importance. Indeed agriculture, the moft ufeful of all arts is only a branch of Natural Hiitory, and can never arrive at a high degree of improvement where the itudy of that fcience is neglefted Medicine however, has not, as far as I know, in any country- been reckoned a neceffiry part of the education of a gentleman But furely no Efficient reafon can be afligned for this omiflion. No fci ence lays open a more extenfive field of uictui knowledge, or affords more ample entertainment to an inquifitive mind. Anatomy Bota By, Chymiftry, and the Materia Medica, are all branches of Natural Hiltory, and are fraught with fuch amufement and utility, that the 14 *tNTRODUCTION. man who'entirely neglects them has but a forry claim either to tafte or learning. I> a gentleman has a turn for obfervation, fays an ex- cellent and fenfible writer,* furely the natural hiftory of his own fpe- cies is a more interefting fubject, and prefents a more ample field fot the exertion of genius, than the natural hiftory of fpiders and cockle-fhells. We do not mean that every man fhould become a phyfician.. This would be an attempt as ridiculous as it is impoflible. All we plead for is, that the men of fenfe and learning fhould be fo far acquain- ted with the general principles of Medicine, as to be in a condition to derive from it form of thofe advantages with which it is fraught ; and at the fame time to guard themfeives againft the deftructive in- fluences of ignorance, fuperltition and quackery. As matters ftand at pre.fent, it is eafier to cheat a man out of his life than of a fhilling, and almoft impoflible either to detect or punifh the offender. Notwithftanding this, people ftill fhut their eyes, and take every thing upon truft that is adminiftered by any Pretender to medicine, without daringto afk him a reafon for any part of his conduct. Implicit faith, every where elfe the object of ridi- cule, is ftill facred here. Many of the faculty are no doubt worthy of all the confidence that can be repofed in them; but as this can never be the character of every individual in any profeffion, it would certainly be for the fafety, as well as the honor of mankind to have fome check upon the conduct of thofe to whom they entruft fo val^ liable a treafure as health. The veil of myftery, which ftill hangs over medicine, renders it not only a conjectural, but even a fufpicious art. This has been long ago removed from the other fciences, which induces many to bel.-eve that medicine is a mere trick, and that it will not bear a fair and candid examination. Medicine, however, needs only to be bet- ter known, in order to fecure the general efteem of mankind. Its precepts are fuch as every wife man would chufe to obferve, and it forbids nothing but what is incompatible with true happinefs. Difguifing Medicine not only retards its improvement as a fci- ence, but expofes the profeffion to ridicule, and is injurious to the true interefts of fociety. An art founded an obfervation never can arrive at any high degree of improvement, while it is confined to a few who make a trade of it. The united obfervations of all the in- genious and fenfible part of mank'n I, would do more in a few years towards the improvement of Medicine, than thofe of the Faculty alone in a great many. Any man can tell when a medicine gives him eafe as well as a phyfician ; and if he only knows the name and dofe of the medicine,and the nameof thedifeafe, it is fufficient to perpetu- ate the fact. Yet the man who adds one fingle fact to the ftock of medical obfervations does more real fervice to the art, than he who writes a volume in fupport of fome favourite hypothefis. Very few of the valuable difcoveries in medicine have been made by phyficians. They have in general either been the effect of chance or of nereflity, and have been ufually oppofed by the Faculty ; till every one elfe was convinced of their importance. An implicit faith in the opinions of teachers, an attachment to fyftems and ef- tablifhed forms, and the dread of reflections, will always operate ur> 013 thofe who follow medicine as a trade. Few improvements are * Obftiyations on $e Duties and Offices of a Fhyfitj^, INTRODUCTION. f£ to be expected from a man who might ruin his charafter and family by the fmalleft deviation from an eftablifhed rule. If men of letters, fays the author of the performance quoted above, were to claim their right of inquiry into a matter that fo near- ly concerns them, the good effects on medicine would foon appear. Such men would have no feparate intereft from that of the art. They would detect and expofe afluming Ignorance under the mafk of Gravity and Importance, and would be the judges and patrons o£ modeft merit. Not having their underftandings perverted in their youth by falfe theories, una wed by authority, and unbiafled by inter* eft, they would canvafs with freedom the moft univerfally received principles in medicine, and expofe the uncertainty of many of thofe doctrines, of which a phyfician dares not fo much as feem to doubt. No argument, continues he, can be brought againft laying open medicine, which does not apply with equal, if not greater, force to religion ; yet experience has fhewn, that fince the laity have aflerted their right of inquiry into thefe fubjects, Theology, confidered as a fcience, has been improved, the interefts of real religion have been promoted, and the clergy h«.ve become a more learned, a more ufe- ful, and a more refpectable body of men, than they evef were in the days of their greateft power and fplendor. Had other medical writers been as honeft as this gentleman, the art had been upon a very different footing at this day. Moft of them extol, the merit of thofe men who brought Philofophy out of the fchools, and fubjected it to the rules of common fenfe. But they never confider that medicine, at prefent, is in nearly the fame fitua- tion as philofophy was at that time, and that it might be as much improved by being treated in the fame manner. Indeed no fcience can either be rendered rational or ufeful, without being fubmitted to the common fenfe and reafon of mankind. Thefe aldhe ftamp a value upon fcience ; and what will not bear the teft of thefe ought to be rejected. I know it will be faid, that diffufing medical knowledge among the people might induce them to tamper with medicine, and to trufl: to their own ikill inftead of calling a phyfician. The r-everfe of this however is true. Perfons who have the moft knowledge in thefe matters, are commonly moft ready both to afk and to follow advice, when it is neceflary. The ignorant are always moft apt to tamper with medicine, and have the leaft confidence in Phyficians. lnftan- ces of this are daily to be met with among the ignorant peafants, who, while they absolutely ref ufe to take a medicine which has been prefcribed by a phyfician, will fwallow with greedinefs any thing that is recommended to them by their credulous neighbors. Where men will act even without knowledge, it is certainly more rational to afford them all the light we can, than to leave them entirely in the dark. It may alfo be alledged, that laying medicine more open to man- kind would leflen their faith in it. This would indeed be the cafe with regard to fome ; but it would have a quite contrary effect upon others. I know many people who have the utmoft dread and horror of every thing prefcribed by a phyfician, but who will nevertheless very readily take a medicine which they know, and whofe qualities they arc in fome meafure acquainted with. Hence it is evident.. *+at the dread arifes from the doctor, not from the drug. Nothing eysf jK JWrVDUcTiGN: dan or will irifpire*mankind with an abfolute confidence in phyficians but an open, frank, and undifguifed behavior. While the iealt madoW of myftery remains in the conduct of the Faculty, doubts^ j'ealoufies and fufpicions, will arife in the minds of men. No doubt cafes will fometimes occur, where a prudent phyfician may find it expedient to difguife a medicine. The whims and hu- mours of men muft he regarded by thofe who mean to do them fer- Vice ; but this can never affect the general argument in favor of can- dour and opennefs. A man might as well alledge, bccaufe there are k i ives and fools in the world, that he ought to take every one he meets fo»- fuch, and to treat him accordingly. A fenfible phyfician will always know where difguife is neceflary ; but it ought never to appear on the face of his general conduct. The appearance of myftery in the conduct of phyficians not &c\\y renders their art fufpicious, but iays the foundations of Quack- ery, which is the difgrace of Medicine. No two characters can be more different than that of the honeft phyfician and the quack ; yet they have generally been very much confounded. The line between them is not fufficiently apparent; at leaft is too fine for the general eye. Few perfons are able to diftinguifh fufficiently between the conduct of that man who adminifters a fecret medicine, and him who writes a prefcription in myftical characters and an unknown tongue. Thus the conduct of the honeft phyfician, which needs no difguife, gives a fanction to that of the villain, whofe fole confequence de- pends upon fecrecy. No laws will ever be able to prevent quackery, while people believe that the quack is as honeft a man, and as well qualified as the phyfician. A very fmall degree of medical knowledge, however* ^vould be fufEcient to break the fpell ; and nothing elfe can effectu- ally undeceive them. It is the ignorance and credulity of the multi- tude, with regard to medicine, which renders them fuch an eafy prey fo every one who has the hardinefs to attack them on this quarter. ftbr can the evil be remedied by any other means but by making them wifer. The moft effectual way to deftroy quackery in any art or fci- ence, is to diffufe the knowledge of it among mankind. Did phy- ficians write their prefcriptions in the common language of the coun- try, and explain their intentions to the patient, as far as he could un- derftand them, it would enable him to know when the medicine had the defired effect ; would inspire him with abfolute confidence in the phyfician ; and would make him dread and deteft evdry man who pretended to cram a fecret medicine down his throat. Mert in the different ftates of fociety, have very different views of the fame object. Sometime ago it was the practice of this coun- try for every perfon to fay his prayers in Latin, whether he knew any thing of that language or not. This conduct, though facred in the eyes :>f our anceftors, appears ridiculous enough to us; and doubtlefs fome parts of ours will feem as ftrange to pofterity* Among thefe we may reckon the prefent mode of medical prefcrip- tion, which, we venture to affirm, will fome time hence appear to have been completely ridiculous, and a very high burlefque upon the common fenfe of mankind. But this practice is not only ridiculous^ it is likewife dangerous. ijbwevtr capable phyficians may l>e of writing liatin, I arn e^rtajn INTRODUCTION. 1? apothecaries are not always in a condition to read it, and that dan- gerous miftakes, in confequence of this, often happen. But fuppofc the apothecary ever fo able to read the phyfician's prefcription, he is* generallyotherwife employed, and the bufinels of making up prefcrip- tions is left entirely to the apprentice. By this means the greateft:- man in the kingdom, even when he employs a firft-rate phyfician, in reality trufts his life in the hands of an idle boy, who has not only the chance of being very ignorant, but likewife giddy and carelefs. Miftakes will fometimes happen in fpke of the greateft care ; but, where human lives are concerned, all poffible methods ought cer- tainly to be taken to prevent them. For this realon, the prefcriptions1 of phyficians, inltead of being couched in myftical characters and a dead language, ought, in my humble opinion, to be conceived in the moft plain and obvious terms imaginable. Diffufing medical knowledge among the people would not on- ly tend to improve the art and to banifh quackery, but likewife to render Medicine more univerfaliy ufeful, by extending its benefits to fociety. However long Medicine may have been known as a' fcience, we will venture to fay, that many of its molt important purpofes to fociety have either been overlooked, or very little atten- ded to. The cure of difeafes is doubtlefs a matter of great impor- tance ; but the prefervation of health is of ftill greater. This is the concern of every man, and furely what relates to it ought to be ren- dered as plain and obvious to all as poflible. It is not to be fuppef- ed, that men can be fufficiently upon their guard againft difeafes, who are totally ignorant of their caufes. Neither can the Legifla- ture, in whofe power it is to do much more for •preferving the public health than can ever be done by the Faculty, exert that power with propriety, and to the greateft advantage, without fome degree of medical knowledge. Men of every occupation and condition in life might avail them- felves of a degree of medical knowledge ; as it would teach them to avoid the dangers peculiar to their respective ftations; which is al- ways eafier than to remove their effects. Medical knowledge, in- ftead of being a check upon the enjoyments of life, only teaches men how to make the moftof them. It'hasindeedbeenfaid,that/o<.v» medically, it to live mijerabh ; but it might with equal propriety be faid, that to live rationally, is to live miferably. If phyficians ob- trude their own ridiculous whims upon mankind, or lay down rules inconfiftent. with reafon or common fenfe, no doubt they will be defpifed. But this is not the fault of medicine. It propofes no rules that I know, but fuch as are perfectly confident with the true enjoyment of life, and every way conducive to the real happinefs of mankind. We are forry indeed to obferve, that Medicine has hitherto hard- ly been confidered as a popular fcience, but as a branch of knowledge folely confined to a particular fet of men, while all the reft have been taught not only to neglect, but even to dread and defpife it. It will however appear, upon a more ftrict examination, that no fcience better deferves the attention, or is more capable of being rendered generally ufeful. People are told, that if they dip the leaft into medical knowledge, it will render them fanciful, and make them believe they have every difeafe of which they read. T,his I am fatisfied will feldom fee the *S INTRODUCTION: ©afc with fenfible people ; a'nd fuppofe it were, they muft foon be undeceive;;. A fhort time will fhew them their error, and a little more fading will infallibly correct it. A fingle inftance will fhew the aciu*duy of this notion. A fenfible lady, rather than read a medical performance, which would inftruct her in the management of her children, generally leaves them entirely to the care and con- duct of the moft ignorant, credulous, and fuperftitious part of the human fpecies. No part of medicine is of more general importance than that which relates to the nurfing and management of children. Yet few parents pay a proper attention to it. They leave the fole care of their tender offspring, at the very time when care and attention are moft neceflary, to hirelings, who are either too negligent to do their duty or too ignorant to know it. We will venture to affirm, that more human lives are loft ry the careleflhefs and inattention of parents and nurfes, thm are faved by the Faculty; and that the joint and well- conducted endeavors, both of private perfons and the public, for the prefervation of infant livss, would be of more advantage to fociety than the whole art of medicine, upon its prefent footing. The benefits of medicine, as a trade, will ever be confined to thofe ■who are able to pay for them ; and of courfe, the far greater part of mankind will be every where deprived of them. Phyfit ians,like other people, muft live by their employment, and the poor muft either want advice altogether, or take up with that which is worfe than none. There are not however any where wanting wcll-difpofed people, o£ tetter fenfe, who are willing to fupply the defect of medical advice to the poor, did not rheir fear of doing ill often fupprefs their incli- nation to do good. Such people are often deterred from the moil: noble and praife-worthy actions, by the/ foolifh alarms founded in their ears by a fet of men who, to raife#ieir own importance, mag- nify the difficulties ot doing good, "find fault with what is truly com- mendable, and fleer at every attempt to relieve the fick which is not conduced by the precife rules of medicine. Thefe gentlemen muft howe er excufe me for faying, that I have often known fuch well- difpofed perfons do much good ; and that their practice, which is generally the refult of good fenfe and obfervation, affiiled by a little medical leading, is frequently more rational than that of the ignorant retailer of phyfic, who defpifes both reafon and obfervation, that he mcy he -turon^ by rule. and who, while he is doling his patient with medicines, often neglects other things of far greater importance. Many things are neceflary tor the fick befides medicine. Nor s the perfon who takes care to procure thefe for them, of lefs im- portance than a phyfician- The poor oftener perifh in difeafes for want of proper nurfing than of medicine. They are frequently in wnnt of even the necefiaries of life, and ftill more fo of whru is proper for a fick bed. No one can imagine, who has not been a witnefs of thefe fituations, how much good a well-difpofed perfon may do, by only taking care to h ve fuch wants fupplied. There certainly cannot be a more neceflary, a more noble, or a more God- like action, than to adminifter to the wants of our fellow-creatures in diftrefs- While virtue or religion are known among mankind, this conduct will be approved ; and while Heaven is juft it muft be rewarded. Perfons who do not choofe to adminifter medicine to the frck, INTRODUCTION. X* may neverthelefe direct their regimen. An eminent medical author has faid, That by diet alone all the intentions of medicine may be anfwered.* No doubt a great many of them may ; but there are other things befidesdiet, which ought by no means to be neglected. Many hurtful and deftructive prejudices, with regard to the treat- ment of the fick, ftill prevail among the people, which perfons of better fenfe and learning alone can eradicate. To guard the poor ' againft the influence of thefe prejudices, and to mftill into their minds fome juft ideas of the importance of proper food, frefh air, cleanli- nefs, .nd other pieces of regimen neceflary in difeafes, would be a work of great merit, and productive of many happy confequences. A proper regimen, in moft difeafes, is at leaft equal to medicuie, and in many of them it is greatly fuperior. To afuft the well-meant endeavors of the humane and benevo- lent in relieving diftrefs; to eradicate dangerous and hurtful preju- dices ; to guard the ignorant and credulous againft the frauds and impofitions of quacks and impoftors ; and to fhew men what is in their own power, both with regard to the prevention and cure of dif- eafes, are certainly objects worthy of the phyfician's attention. Thefe were the leading views in compofing and publifhing the fol- lowing fheetc. They were fuggefted by an attention to the conduct of mankind with tegard to medicine, in the courfe of a pretty long practice in different parts of this ifland, during which the auther haa often had occafion to with that his patients, or thofe about them, had been poffefled of fome fuch plain directory for regulating their conduct. How far he has fucceeded in his endeavors to fupply this deficiency, muft be left to others to determine : but if they be found to contribute in any meafure towards alleviating the calamities of mankind, he will rhink his labor very well beftowed. § " Before wc enter upon the prevention or cure of difeafes, it may not be improper to take a curfory view of the human body, ref- pecting the functions immediately connected with life. So wonder- ful is the (tructure of our frame, as difplayed by anatomy, that athe- iftical perfons, obdurate to every other evidence of the exiftence of a God, who created the univerfe, have on witnefling a diflection, been inftantly convinced of their miftake, and have acknowledged with equal aftonifhment and lname, that nothing lefs than a Being of infinite wifdom and power could have contrived and executed fuch a wonderful piece of mechanifm as that of the human body. " The primary agent in the circulation of the blood is the heart, a large mufcle fituated in the left fide of the breaft (thorax, or cheft) and endowed with great irritability. In the firft rudiments of animal life, even before the brain is formed, the puntlumj'uitns, as it is called, points out the embryo heart in miniature, and marks its primaeval ir- ritability as a fure prefage of its future importance in fupporting the vital motions. As this lingular organ exhibits irritability the firft, fo it never relinquifhes it till the laft; whence it has been called the pnmum mobiL, and u.ttmum montn<, that is, " the firft part that moves, and the laft that dies," of the animal machine. It is obfervable, that the motion of the heart not only furvives that of the organs of \o\~ untaTy mofon, but continues a confiderable time even after it is fe- Mtated from the body of fnany animals. Hence in drowning, or, fuffc:*- * Arbutiuioti ia INTRODUCTION tion, though the pulfe be imperceptible, and apparently extmgtii/h' ed, yet the heart ftill preferves this latent power or fufceptibihty of motion, and wants only to be gently excited by fuitable means to re- new its, action. This organ is furrounded by the pericardium, or heart-pur fe, an exceeding ftrong membrane, which covers the heart, even to its ba- fis. Its ufes are to keep the heart from having any friction with the lungs, and to contain a fluid to lubricate ormoiften its furface. "From the right ventricle or cavity of the heart, the irratibili- ty of which is excited into action by the circulating fluid, the blood is propelled through the lungs, which are fifuated on the right and left fide of the heart, from which they differ on appearing to be void of irritability. They are divided into two lobes, and thefe into more divifions, three on the right fide, and two on the left. The trachre, or wind-pipe, defcends into the lungs, and forms innumerable cells, which have a communication with each other, and give the whole the appearance of a honey-comb or fponge. " The blood, after paffing through the lungs, arrives again at the heart, and from the left ventricle is expelled into the aorta, or great artery ; which dividing into two branches, one upwards, and the other downwards, diftributes the blood through the whole body ; from the extremities of which it returns, by various veins, through She afcending and defcending cava,* and is tranimitted again to the heart. " The heart is the grand organ which actuates the vital^ func- tions ; and to this purpofe it is admirably fitted by its own irritabili- ty ; but it is neceffarily fupported in its action by the powerful in- fluence of the nerves, which are the ultimate inftruments both of motion and fenfation, and have their origin in the brain. " The diaphragm or midriff is a large broad mufcle, which di- vides the thorax from the abdomen,f or belly. In its natural ftate, it is concave or vaulted towards the abdomen, and convex towards the thorax.I Haller calls it " the moft noble bowel next to the heart;" and, like the latter, it is in conftant action. At the time of inspiration it approaches towards a plane. Befides being a muf- cle of infpiration, it nffifts in vomiting, and the expulfion of the feces.j| From the exertion of this mufcle likewife proceed fighing, yawning, coughing, and laughing. It is effected by fpafms, as in the hickup, &c. It is both a mufcle of voluntary and involuntary action. We may obferve in this mufcle ftrong characters of admir- able contrivance. It feparates pofteriorly into two flips, between which the defcending aorto pafles. A little above this, and towards the left fide, in the nvft flefhy part of the midriff, there is a direct opening for the paflage of the afpbagus or gullet. There is alfo on the right fide a large triangular hole for the paflage of the afcend- ing <-«7,\1. " The gullet is compofed both of longitudinal and circular fibres, but chiefly circular, much more fo than the inteftines ; becaufe this has no foreign power to aflift it, and becaufe it is neceflary that the food fhould make a fhorter ftay in the throat than in the bowels;! * Cava is the large vein which conveys the refluent b'ood to the heart. ■f Abdomen, from abrio to hide, as its contents lie hidden. $ Derived from the Greek, fignifying the bread. || This word with chymifti is ufed toexprefs the ingredients and fettling after diftil*- Iftioa and infafion ; here it means excrement* INTRODUCTION. *j The inner Tutface is a fmooth membrane, well fupplied with mu- cilage, to fheath the organ, and render the paffage of the aliment or food eafy. " The ftomach lies acrofs the upper part of the abdomen, and is covered by the liver ; when diftended it prefles on the fpleen. It nearly refembles in figure the pouch of a bag- pipe, its upper fide be- ing concave, and the lower convex. Its left end is the moft capa- cious. On the left fide is the entrance from the gullet; on the right is the opening, called pylorus, by .which the chyle pafles into the inteftines. Here is a circular valve, or fphincter-mufcle, which prevents a regurgitation of the aliment. The ftomach has circular and longitudinal fibres, and its inner membrane is covered with a ftrong vifcid mucus. «' The liver, the largeft gland in the body, is fituared immediate- ly under the vaulted cavity of the midriff, chiefly on the right fide, and fomewhat on the left over the ftomach. Exteriorly, or anteri- orly, it is convex, inwardly it is concave ; very thick in its fuperior part, and thin in its inferior. The upper fide adheres to the midriff; and fb is fixed to this, and ihefernum, or breaft-bone, by a broad lig- ament. It is alfo tied to the navel by a ligamentous band, which is the umbilical vein of the unborn infant, degenerated into a ligament. Both thefe bands ferve to fufpend it, while laying on the back, from bearing too much on the fubjacent cava ; otherwife it might prefs on this important returning veffel, ftop the circulation, and put a period to life. Dog's, cats, and other animals who are defigned for leap- ing, have their liver divided into many diftinct lobules, to prevent too great a concuffion of the organ. The liver is the vifcus or bow?- el which performs the fecretionof the bile. " The gall-bladder is fituated under the great lobe of the liver; a little to the right. In a ftanding pofture it lies forwards and down- wards. Its bottom is raifed by a fulnefs, and deprefied by the emp. tying of the ftomach. The uie of the gall-bladder is to ferve as a receptacle for the bile. " The inteftines are deftined to receive the food from the fto- mach, and after expofing the ufeful part of it to the lacleals, a fet of extremely fmall veflels, to convey the remainder out of the body. The inteftinal canal is ufually five times the length of the individual; it is curioufly convoluted in the abdomen, and is extremely irritable- Anatomifts have divided this canal, although one continued pipe, into fix portions, three of which are termed the/maJl inteftines,* and the three, laft, the great. In the fmall inteftines there are numerous- plaits to detain the food, and allow a larger furface for its abforp- tion. Thefe are larger, and far more numerous near the ftomach, where the food is thinner, than they are towards the other extremi- ty. At the entrance of the illium into the coloti, there are two very large valves, which prevent the regrefs of the faces into the illium. The cacum and coion, two of the inteftines towards the lower ex- tremity, befides having ftronger mufcular coats than the fmall intef- tines, are furniihed with three^ ligamentous bands, running length- • The three (mailer are, the duodenum, (from its length being about that of th; bread '\ of twelve fiaf,trs)j.j unum, andiHium, from the Greek fignifying to turn about^ Lccauie it makes many convolutions. The thrrejargei are, the cacum, or blind gut (fo called from its being perforated"a1: one end jmy) the colcr^ figntfying-hollow; a won! liqm tr:e Greek, and tlhe rtSuri s>-" foaightgut. *2 INTRODUCTION wife on their outfide, dividing their furfaces into three poriiotte nearly equal. Though appearing externally like ligaments, they are compofed, in their inner ftructure, of true mufcular fibres. The ligament-like bandp, which in the caecum andcolon are collected into three portions, are fpread equally over the furface of the rectum, or or lower extremity of the inteftines. This is a wife precaution of Nature, that no part of it may be weaker than another, left it fhould give way in the effort* for expelling thefeces. The plaits are con- siderably fewer in the great inteftines. They have all an inner mem- brane, covered with an infinite number of arteries or glands, which difcharge a lubricating fluid. They are furnifhed with mufcular fi- bres, both circular and longitudinal. " The fpleen, or milt, is fituated immediately under the edge of the midriff, above the left kidney, and between the ftomach and ribs. In figure, it refembles a deprefied oval, near twice as long as broad, and almoft twice as broad as thick. Chefelden informs us, that it has been taken from dogs without any obfervable inconven- ience to them. Its ufe is ftill problematical. " The pancreas, or fweet-bread, is fituated tranfverfly under the ftomach. Its fhape refembles a dog's tongue. Along the whole length of it there is a duct, which terminates in the upper part of the inteftines near the ftomach. The pancreatic juice refembles the faliva, but is lefs vifcid or flimy, and contains a larger proportion of the falts of the blood. It is probably intended for the folution o£ our aliment. The kidneys are two oval bodies, fituated in the lines, contiguous to the two laft fhort ribs ; the Tight under the liver, and the left un- der the fpleen. The ftructure of the kidneys is curioufly fitted for fecuring the urine, which is earned from each of them by canals termed the ureters, into the bladder, the refervoir of that fluid, fitu- ated in the lower part of the belly. They enter the bladder near its neck, running for the fpace of an inch obliquely between its coats, and forming, as it were, to themfelves, two valves; fo that, upon the contraction of the bladder, the urine is directed along the ure-* thra, which is its proper paffage out of the body. Over the upper part of the abdomen is* fpread the omentum, of' caul, confifting of two broad, thin, and tranfparent membranes^ joined together by cellular texture, in the cells of which a quantity of fat is depofited. The ufes of it are to interpofe between the peruo/tcum,* or lining the inteftines, and the ftomach, to keep all thefe parts moift, warm, flippery, and to prevent their adhefion. Laft of all comes the peritonaeum, a ftrong membrane, which confines, as in an enclofure, the inteftines and contents of the ab- domen. Such, in a general view, are the contents of the cavities of the breaft and belly, which perform, reflectively, the vital motions, and thofe natural functions that are fubfervient to the fupport of our frame. But there remains to be mentioned another effential cavity, with its dependent fyftem, to the prmary influence of which all the other parts of the body are indebted*" for their action and energy. The cavity to which I allude is the fkull, the receptacle of the brain. The brain is divided into two portions, namely,- the cerebrum * Signifying near to, ftretcliing iound,or about, as/wofteurn./w'carpiunj, neart'o the bone, heart, &c, * Introduction. 2% and cerebellum if the-former fituated in the upper paTt of the fkutf, and the latter under it, in the hind part. The bran, is a ioft pulpy fubftance, furrounded by two membranes; one called <-.u.~*, and the other pia, matter. It has alfo a third, called aracknow, from its fine- nefs, as being firnilar to a fpider's web. It contains fome jtutjus, which are nothing more thnn large veins or receptacles for blood, and fourcavitiescalledi/*»/r»W^, moiltened,in a healthful ttate, with a fine vapour, which increafing gives rift to difeafes. Like other parts of the body, it has a variety of arterial branches from the heart, which dirfufes through its fubftance, and on the membranes. The brain is the great elaboratory, where the animal fpirits, or nervous influences which actuate our frame, are fuppofed to receive their exiftence. The nature of this fluid,.if really a fluid, has not yet been fufficiently inveftigated. It is certain, however, that from this fouice tf^ nerves derive their origin. Thefe are white, firm folid cords, which arife from the brain and fpinal marrow, which is only an elongation of the" brain, and are tpread over every part of the body endowed with ftn- fibility, by innumerable filaments. Ten pair of nerves iffuc from the brain itfelf, and thirty from the fpinal marrow. Thofe that go- to the organs of fenfe are considerably larger than the reft, and are in part diverted of their outer covering. Whether an immaterial and invifible Being can positively be faid to exift in any place, it might appear prefumptuous to deter- mine ; but it is a prevailing opinion in phyfiology, that the brain is the feat of the foul; and the pineal gland, in the peneiratia of the brain, has been affigned as the facred manfion of this immortal in- habitant. Human vifion can difcover no figns to confirm this opin- ion ; but the man would be blind, and utterly void of under Handing, who could not trace through the whole of the animal fyftrtn the moft evident marks of Divine Intelligence and wifdom ; of intelli- gence which excites admiration, and of wifdom beyond concept on. The wonderful contrivance exhibited in the human frame is, if poflible, ftill more manifeft from the curious formation of the eye and ear ; of which only a very imperfect idea could be conveyed by verbal defcription. I fhall therefore not attempt to delineate rhofe admirable organs: nor need I mention the conftruction of the limbs; of the arms and legs; of the hands and feet; fo nicely united with joints, and fo happily fupplied with mufcles and tendons, with ligaments and nerves, that they are adapted to all the various pur- poses of convenience and utility in motion. I fhall conclude this imperfect fketch of the human body with a brief account of digeftion, that important prccefs in the animal economy, by means of which the continual and unavoidable wafte of the conftitution is regularly fupplied. The aliment being received into the mouth, the firft operation it undergoes is vo be mafticated by die action of the teeth and fev- eral mufcles. This maftication is of greater moment than is gen- erally imagined ; and the good effects of it are further promoted by mixing with the food a quantity of faliva, difchnrged from the glands of the mouth, and which is greatly conducive to digeftion. When the food is carried down the gullet into the ftomach, it there meets with an additional fupply of juices, called the gaftric juices, of a nature yet more efficacious than the former, befides a fmall por- f CerdcHum, the little braia a* i( wefe j toft are often. catHd thus, when the brain iffpoten of in taall animal s. *4 INTRODUCTION. tion of bile. During its continuance in the ftomach) it experiences the effects of heit and mufcular action, from the coats of that organ, and the motion and warmth of the furrounding parts. It thence pafles out gradually by the right orifice of the ftomach, and there meets with an additional quantity of bile from the gall-bladder and liver, befides thepancreatic juice, or that of the fweet-bread, of a nature fimilar to the faliva, but rather more thick, and the fluids fe- parated by the inteftines. It now receives the action of the bowels, or the p.niftaltic motion, by which they churn, as it were, the whole mafs, minutely mixing together the food, and the different juices, collected in the paffage from the mouth. A fluid is now produced called chyle, which is feparated from the grofler materials, and taken up by a fet of extremely fmall abforbent veflels called lacteals. Thefe have their origin in the inner coat of the inteftines, and, paf- fing thence, difcharge themfelves into a duct named the recep- tacle of the chyle,whence this fluid proceeds along the thoracic * duel, which terminates in the left fubclavian f vein. In the paffage from the inteftines to the receptacle, there is a number of glands, which feparate a watery liquid, for the purpofe of giving the chyle a thin- ner confiftence. To-prevent the chyle from falling back in its pro- grefs through the lacteals, the construction of thefe veflels is admira- bly contrived. They are furnifhed with a number of valves, which open only forwards, and are fhut by any fluid prefling backwards. From the fubclavian vein, the chyle is poured into the blood, and thence immediately thrown into the right auricle and ventricle % of the heart; from which, now mixed with the blood, it pafles into the lungs. It undergoes in that organ a considerable change from the act of refpiration. From the lungs it proceeds through the pulmona- ry vein to the left auricle of the heart, and then into the left ventri- cle ; whence, at laft endowed with all the qualities of blood, it paf- fes into the aorta, and is diffufed univerfally through the frame; the wants of which it is fitted to fupply by the addition of nourifhing particles. Is it pofiible to contemplate this admirable mechanifm without breaking forth in the exclamation of the Pfalmift, that " we are wonderfully made ?" I may juftly add, that considering the great variety of ways in which the human body may be affected, both from without and within, with the neceflity for the perpetual motion of the vital powers, and the millions of veflels, invisible to the naked eye, through which the fluids ought to pafs, it is a matter of real af- tonifhment that we fhould fubfift a fingle day. And doubtlefs it would be impoflible, were not the machine conftantly fuftained by the fame Almighty and Beneficent Being who formed it. * From thorax the breaft. A term applied to any thing under the arm-pit or moulder. Two mufcular bag*, one on each fide, are termed its. ayricjes, fro^n thy Latin, fig- nrfji'ig ears: MEDICINES USED IN PRACTICE. MANY who perufe the Domeflic Medicivp, have exprefled a with* that the catalogueof Medicinescontained in that book fhould be more extenGvef and likewife that the dofe of each article lhould be ascer- tained, as they are often at a lofs to know how to adminifter even thofe medicines, the names of which they meet with in almoft ev- ery medical author. To obviate this objection, and furnifli a greater fcope to thofe who may wifh to employ more articles thafc are con- tained in the Difpenfatory annexed to the above work, the following Lift of Simples and Compounds, taken from the moft improved Dit- penfatories, is now inferted. To prevent miftakes, the Englifh name of every medicine is not only ufed, but the different articles are arranged according to the or- der of the Englifh alphabet, and the fmalleft and largest dofe pla- ced oppofite to each article. The dofes indeed refer to adults, but may be adapted to different ages by attending to the rules laid down in the Introduction to the Appcndx. Short cautions are occafionally inferted under fuch articles as require to be ufed with care. Though a greater variety of medicines is contained in this than in any former edition of the Domestic Medicine, yet the Author would advife thofe who perufe it, as far as poflible, to adhere to sim- plicity in practice. Difeafes are not cured by the multiplicity of medicines, but by their proper application. A few fimples, judi- cioufly adminifteied,and accompanied with a proper regimen, will do more good, than a farrago of medicines employed at random. A LIST OF THE MEDICINES COMMONLY USED IN PRACTICE, WITH THEIR ACACIA, the expreffed juice, Acid, the acetous -, muriatic, ----, nitrous, diluted - ----, vitriolic, diluted ^Ether, vitriolic JEthiops, mineral Aloes - Alum - ----, burned PROPER DOSES. from i i 10 »s - 3° 10 5 . - 6 Amber, prepared Ammoniac, gum -. ——------, milk of Angelica, the root powdered Anife, the feeds Antimony - ——----, calcined -■■ ---—, glafs of Afafoetida - ■' —, milk of Afarum, to provoke fneezing ^ Balfam of capivi ------, Canadian ------, of Peru, • „■• '■■, of Tolu, IO IO I I 6 i 3 20 fcruple fcrupfe drops drops drops drops grains grains grains grains drachm grains ounce drachm grains grains fcruple grain grains ounce grains drops i drachm i drachm 40 drops 40 drops 40 drops 2 drachms 30 grains 30 grains 20 grains ! 2 grains 1 drachm 30 grains 1 ounce if drachm 1 drachm 1 drachm 1 drachm 2 grains j drachm 1 ounce 5 grains 60 drops (3) 26 MEDICINES USED IN PRACTICE. Bark, Peruvian, powder Bears foot, powder - Benzoin, refin of • - , flowers of Bidort, powder of the root Bieffed thiftle ------ ■ , expreffed juice of Bole Armenian ----, French Borax - Broom, afhes of the tops Burdock, powder of the root Calomel - • * Camphor - * Canella alba, powder of Cantharides • - . • Cardamoms * Caraway feed - Cafcarilla bark Caflia, the pulp Caftor ... Catechu - Camomile^ in powder » Chalk Cinnamon * Colocynth - Columbo ... Confection, aromatic -....., opiate • Crabs claws, prepared Conferve of rofes , * , of fquills *- ————, of arum Cantrayerva - - Coriander feed Cowhage, the fpicula? of one pod mix- ed with honey or molafles. Dandelion, expreffed juice Decoction of hartfhorn, half a pint re- peated as often as neceflary. ■ ■ ■■■ , of broom, i ounce to a pint of water, to be taken by tea-cupsful. . ■ ■——, of Peruvian bark ---------, of the inner bark of the elm ....., of farfaparilla —, compound { ■»»" ■ ■ ■ of guaiacum, 3 drachms to a pint of water. A pint daily. Electuary of caflia ■ — of fcammony <■■ — lenitive, or of fenna Elixir of vitriol Elecampane, powder of the root 1 2 fcruples to * drachms 10 grains 20 grains 4 grains 20 grains 10 grains 20 grains 1 fcruple 1 drachm 10 grains 1 drachm 2 drachms 2 ounces 10 grains 2 drachms 10 grains 40 grains 1 fcruple 1 drachm 10 grains C drachm 1 gr. to 3 gr. . alterative 3 do. to 12 do purgative 2 grains j drachm 1 fcruple 2 drachms I grain 4 grains 5 gralns 20 grains 10 grains 40 grains io grains 40 grains 2 drachms 1 ounce 8 grains 1 drachm 13 grains 30 grains 2o grains 1 drachm 2o grains 2 fcruples 1 drachm 5 grains io grains 1 drachm 10 grains I drachm 10 grains 2 fcruples 10 grains 2 fcruples 10 grains 1 drachm 1 drachm 1 ounce 20 grains 30 grains 20 grains i drachm 20 grains 2 fcruples 15 grains 1 drachm 1 ounce 3 ounces 1 ounce 4 ounces 4 ounces 4 ounces 16 oz. daily x6 oz. daily 1 drachm 2o grains 30 grains 15 drops 20 grains 1 ounce 1 drachm 6 drachms 50 drops z drachm MEDICINES USED IN PRACTICE. from | drachm to Extract of broom tops Extract of Peruvian bark —' • cafcarilla — camomile ---------colocynth --------gentian ----—— liquorice --------logwood ---------black hellebore ---------jalap ---------guaiacum •--------white poppies ---------rue favin — fen? of Fern, powder of the root Fennel feed Fox glove, powder of the leaves or a drachm infufed in a pint of boiling water, of which a dofe is Should be adminiftered with caution. Galbanum Galls Garlic, clove Gentian Germander * Ginger - . Ginfeng - . Guaiacum,, gum-refin Gum arabic ----gamboge Hartfhorn, prepared ---------, fpirits of --------, caustic, in fome muci laginous vehicle ■ —, fait of io grains io grains 20 grains 5 grains 10 grains 1 drachm 10 grains 3 grains 10 grains 10 grains 1 grain 10 grains 10 grains 10 grains j drachm 20 grains } Hellebore, white ---------, black Hemlock, fhould always be begun in very fmall dofes, of one grain or lefs, and gradually increafed as the constitution will bear. Hiera picra Honey of fquills 1------ofrofes Hoffman's anodyne liquor Jalap, powder Infufion of Gentian, powder -------of rofes • ■■•■■■ ■■ of fenna Ipecacuanha Iron,ruft of - Iron ammoniated Iron tartarifed 1 ounce 1 o grains i* grains No. 1. 10 grains 15 grains 5 grains 20 grains 10 grains 15 grains 2 grains 2e grains 10 drops 5 drops 2 grains i grain 5 grains 10 grains 10 grains 1 drachm 20 drops 10 grains 1 ounce 2 ounces vounce 10 grains 5 grains 2 grains 2 grains *7 x drachm | drachm £ drachm 1 drachm 25 grains | drachm | ounce § drachm 10 grains 20 grains 20 grains 5 grains 20 grains 30 grains 30 grains | ounce 1 drachm 3 grains 30 grains 20 grains No. 6. 40 grains 1 drachm 20 grains 3 Manna • - - Maftich, gum - Mercury, crude - * ■ — calcined ------with chalk - ------corrpfive fublimate ——— cinnabar of ------yellow emetic, as fternutory IWezereon, decoct, to a pint of water Millepedes * Mufk - r Mustard feed • Myrrh, gum - Nitre, purified • Nutmeg - Oil of Almonds } ----Linfeed .----Caftor Olibanum Onion, expreffed juice of a powerful diuretic Opium Opopanax - Oxymel of colchicum ------of fquills - Petoleum - Pills, aloetic - ----of the gums - ----mercurial - Pomegranate, powder of Powder antimonial May be taken according to the directions for James' Powder, with which it nearly coincides. ------of Contrayerva, compound «-,-----of Chalk compound „-----of Chalk compound, with opium . w—-— of Ipecacuanha compound, 1 or Dover's powder J 5 g™n 20 grains 10 grains i drachm 3 grains i ounce 4 ounces 15 drops to ~ drachm 10 grains | drachm f ounce io grains i ounce £ grain 10 grains £ grain 10 grains 1 grain 2o grains 5 grains 1 drachm lo grains 10 grains 6 grains | ounce 2 drachms 5 grains I ounce k grain lo grains | drachm \ drachm 10 drops 10 grains io grains io grains 2o grains 3 grains 15 grains 20 grains 10 grains 10 grains MEDICINES USED IN PRACTICE* Qua ma ... from 5 grains to Two drachms to a pint of water for a decoction. Quince feeds, mucilage of, at pleaf- ure, to obtund acrimony. Rheubarb, powder - Refin, yellow - - Rue powder St. John's-wort Saffron - Sagapenum - Sal ammoniac Salt, Epfom - ----Glauber - ----Polychreft - ----of Tartar Sarfaparilla, powder of • Scammony - , * Seneca ... Senna ... Soap «... Scurvy-grafs, expreffed juice Snake root - Sorrel, juice of, depurated Spirit of Mindererus - - •■ ■ fweet, of vitriol »■■ ----of nitre - - •—— of fal ammoniac • '■ ■ ——— compound ' ----------foetid Spirits, diflilled Spermaceti - Sponge, burned Sulphur, flowers of - ■ " ■ precipitated, of antimony Squill, dried powder -----frefh Syrup of poppies - - ------of buckthorn - - —■——•of ginger - - Syrups in general Tar water. A pint daily. Tartar, cream of - - ------regenerated - - ■■■ foluble - -———•emetic, alterative ------— —— as emetic - Terra japonica - - - Tobacco, an infufion of, 1 drachm to a pint of water ; fhould be adminis- tered by table fpoonsfull—ftrongly diuretic. Tin, powder of - » to grains 3 grains 20 grains 20 grains 5 grains 10 grains 10 grains 2 drachms 4 drachms 20 grains 10 grains 20 grains 5 grains 2o grains 20 grains 20 grains /10 drops 1 ounce 20 grains 4 ounces 1 drachm 15 drops 15 drops 15 drops \ drachm 20 grains 20 grains 20 grains 1 grain 1 grain C grain? £ drachm 1 drachm 1 drachm z drachm 2 drachma 20 grains 2 drachms $ grain 1 grain 20 grains 20 grains 29 30 grains 40 grams 20 grains 40 grains 1 drachm 20 grains 30 grains 30 grains i| ounces 2 ounces I ounce 30 grains 40 grains ro grains 40 grains 40 grains | ounce 30 drops 4 ounces 40 grains 8 ounces t ounce 40 drops 40 drops 40 drops* f ounce 1 drachm 1 drachm 1 drachm 4 grains 3 grains 15 grains § ounce 2 drachms f ounce 2 drachms 1 ounce 1 drachm 1 ounce f grain 3 g^ins 40 grains r drachrja # MEDICINES USED IN PRACTICE. 3° Turmeric Turpentine, fpirits of *- Tincture of aloes - ---- —----compound ----of afafcetida - —- Benzoin, compound ----of cantharideis ----of cardamoms ----■ of caftor - —— of catechu - ----of Peruvian bark ----of iron, muriated, - —— of Columbo - —— of Gentian, compound —— guaiacum volatile - ----of black hellebore -. of jalap - —— of lavender, compound ----of myrrh - ----of opium - - —— ——— camphorated, or paregoric elixir -»----of rheubarb ■ ■' ■ offenna - —— of fnake-root — ■ of valerian — -----------volatile - Tormentil, powder of - Valerian, powder of - Vinegar, diflilled - —. i of fquills - —.--------;----as emetic Verdigreafe, violent emetic Vitriol, white, as a tonic ——-------as a quickly operating emetic ------blue emetic from } } Uva urfi, in powder Water-crefs, expreffed juice of Water, the simple diflilled, may generally be given Wormwood, expreffed juice White lead Wine, alcetic —— ant.monial ----Ipecacuanha - ■*•— Rhubarb * * } 20 grains 10 drops i ounce | drachm \ drachm 10 drops 10 drops 1 drachm 1 drachm 1 drachm 1 drachm 10 drops 1 drachm 1 drachm 1 drachm 1 fcruple 1 drachm 20 drops 1 fcruple 1® drops 1 drachm | ounce 2 drachms 1 drachm I drachm I drachm 10 grains 20 grains 2 drachms 10 drops | ounce 1 grain 2 grains 20 grains 1 grain 20 grains | ounce | ounce | ounce 1 grain £ ounce 20 drops 1 drachm lounce to 1 drachni 30 drops 1 ounce 2 drachms 2 drachms 40 drops 40 drops \ ounce 1 {drachms 2 drachms | ounce 60 drops 3 drachms 1 drachm 3 drachms 3 drachms | ounce 2 drachms 1 drachm 40 drops 3 drachms 2 ounces 1 ounce 2 drachms 3 drachms 2 drachms 1 drachm 2 drachms 1 ounce 50 drops 1 ounce 2 grains 5 grains 1 drachm 3 grains 1 drachm 2 ounces 3 or 4 oz. 2 ounces 3 grains 1 ounce 2 drachms 1 f- ounce 2 ounces PART I. ■ OF THE GENERAL CAUSES OF DISEASES; CHAPTER I. Of Children. X HE better to trace difeafes from their original caufes, we fhall take a vbw of the common treatment of mankind in the Hate of infancy. In this period of our lives, the foundations 6F a good or bad constitution are laid; it is therefore of importance, that parents be well acquainted with the various caufes which may injure the health of their offspring. It appears ftvm the annual registers of the dead, that almofr. one half of the children born in Great-Britain die under fwelye years of age. To many, indeed, this may appear a natural evil; but on due examination, it will be found to be one of our own creating. Were the death of infants a natural evil, ot-er ani- mils would be as liable to die young as man; but this we find is by no means he cafe. It may feera ftrange that man, notwithstanding his fuperior realon, fh uld fall fo far fhort of other animals in the manage- ment of his young; but our furprife will foon ceafe, if we confid- er that brutes, guided by inftinct, never err in this refpcct ; while man, trufting folely to art, is feldom right. Were a cata- logue of tncfe infants who perifli annually by art alcne exhibited to public view, it would aftoniifi moft people. If parents are above taking cars of their children, others muft be employed for that purpofe : thefe will always endeavor tore- commend themfelves by the appearance of extraordinary ikiU and addrefs. By this means I'uch a number cf unnecelTary aid deftructive articles have been introduced into the diet, cloth- ing, &c. of infants, that it is no wonder fo many of them perifh. Nothing can be mere preposterous than a mo. her who thicks it below her to take care of her own child, or wno u foigoorant as not to know what is prop :r to be done for it. If we fearch Nature throughout, we cannot find a parallel to this. Ev.-ry other animal is the nurfe of its own offspring, and they thrive accordingly. Were the brutes to bring up their young by proxy, they would fture the fame fate wi'.h thole of the human ipecits. We mean not, however, to impoie it as a talk upon every mother to i'uckle her own child. This, whatever fpeculative wri- ters may a^ec'go, is in fome cafes impracticable, and would inevit* ably nr:v3 deitruftive both to :he mother and child. Women 32 OF CHILDREN. " . of delicate conflitutions, fubject to hyfteric fits, or other nervous affections, make very bad nurfes :* and thefe complaints are now fo common, that it is rare to find a woinan of fafnion free from them; ftun women therefore, iuppoiing them willing, are often unable to fuckle their own children. Almoft eyery motner would be in a condition to give fuck, did mankind live agreeably to Nature ; but whoever confiders how far many mothers deviate from her dictates, will not be i'ur- priied to find fome of them unable to perform 'hat m-c, fiary of- fice. M thers who do n~t eat a fufficieot quantity of folio food, nor enjoy the benefit of rrefh air and exercife, can neither have wooleiv me juices themlelves, liv.r afford proper nourishment to an infant. Hence children who are fuckl<:d by delicate women, either die young, or continue weak and fi kly all their lives. When we lay that mothers are not aiwaysin a condition to fuckl the'r own children, we would not be understood as dif- couraging that practice- Every m;fher who ca; , ought c rtain- ly to perform lb tender and agreeable an office, t Butluppofe ir to be out of her power, (he may, neverthelefs, be of gr at Itrvice to ih'er child. The oufmefs of nurfing is by no means confined to giving-fuck. To a woman who abounds with milk, this is the eafiefl part of it. Numberlels other offices are neceflary for a a child, which the mother ought at leait 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 delerves 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 pareoi's care, though it be fuckled by another. How can a moth- er be better empl yed t an in fuperintending the nurfery ? This is at once the moft delightful and important office; vet the moft trivial bu-inefs or infipid amufements are often preferred to it! A ftrong proof both of the bad tafte and wrong education ot picdern females. It is indeed to be regretted, that more care is not beftowed in teaching the proper management of children to thofe whom Nature h.is ^iefigned for mothers. This, inftead of behog made the principal, is fel fociety. But the T.other is not the only perfon concerned in the man- agement of children. The fatr.er has an equal intereft in their welfire, ard ought to aflift in every thing that refpects either the impr vement of the bo ly or mind. It is a pity that the men fhould be fo inattentive to this mat- ter. Their negligence is one reafon why females know fo little of it. Women will ever be defirous to excel in fuch accomplilh- ments as recommend them to the o her fex. But men generally keep at fuch a distance from even the fmalleft acquaintance with the affairs of the nurfery, that many would reckon it an affront, were they fuppofed to know any thing of them. Not fo, how- ever, with the kennel or the {tables: a gentleman of the firft rank is n^t alhamed to give directions concerning the manage- ment of his dogs or hories, yet would blufh were he furprifed in performing the fame office for that being who derived its exigence from himfelf, who is the heir of his fortunes, and the future hope of his country." Nor have phyficians themfelves been fufUciently attentive to the management of children : this has been generally confidered a^ the fole province of old women, while men of the ffrft charac- ter in phyfic, have refufed to vifit infants even when fick. Such conduct in the faculty has not only caufed this branch of medi- v * Tacitus, the celebrated Roman^Tiiftorian, comp'ans greatly of the degeneracy of the Roman laaies in his time, with regard to the ca:i of their offtpring. He fays that, in firmer times, the greateft women in Rome uM to account it their chief glory to keep the houfe and attend their children j but that now the young infant was committed to the fole care of loms poor Grecian wench, or other menial fervant.—We are afra;e, wherever luxury and effeminacy creyail, there will be t»9 aiu«h ground for ;hii complaint. ■34 OF CHILDREN. die to be neglected, but has alfo encouraged the other fex to af- fu oe an abfolute title to prefcribe for children in the moft dan- gjv us difeafes. The confequence is, that a phyfician is feldom cTl. d all the good women have exhaufted all their fkill; when hi attendance can only ferve to divide the blame, and appeafe the - 'ifconfolate parents. Nurfes fhould do all in their power to prevent difeafes; but when a child is taken ill, fome perfon of fkill ought immediately to be confulted. The difeafes of children are generally acute, and the leaft delay is dangerous. Were phvfidans more attentive to the difeafes of infants- they would not only be better qualified to treat 'hem properly when fick, bu* likewife to give ufeful directions for their man- age vent wh'.n well. The difeafes of children are by no means fo liffic"" t to be understood as many imagine. It is true, children cannot tell their complaints; but the caufes of them may be pretty certainly difcovered by obferving the fymptoms, and putting prop, r queftions to the nurfes. Betides, the difeafes of infants being lefs c mplicnted, are moreeafily cured than thofe of adults.* It is really aftonifhing, that fo little attention fhould in gm- eral be paid to the p' efervation of infants. What labour and ex- pe :fe are daily beftowed to prop an old tottering carcafe for a few y.ars, while thoufands of thofe who might be ufeful in life, pe"ifh w'thout being regarded I Mankind are too apt to value things according to their prefent, not their ftrure ufefulnefs. Though this is of all others the moft erroneous method of efti- matr n ; yet upon no other principle is it poflible to account for the general indifference with refpect to the death of infants. Of Difeafed Parents. One great fource of the difeafes of children is, the Unhealthy inefs of Parents. It would be as reafonable to expect a rich crop fi- m. a barren foil, as that ftrong and healthy children fhould be t>orn of parents whofe conftitutions have been worn out with in- tempero ce and difeafe. Aningemous writer t obferves, tlr>t on the constitution of mother.: depends originally that of their offspring. No one who believes this, will be furprized, on a view of the female world, to fii;d difeafes and'death fo frequent among ch'ldren. A delicate fvrrale, brought up within doors, an utter stranger to exercife and open a;r, wio lives on eta and other flops, may bring a c ild in- to the world, but it will be hardly fit to live. The firft blaft of difeafe wijl nip the te^derplant in the bud : or fhould it ftiug: le through a few years of exiftence,its feeble frame.fhoken with con- vulfions from ev?ry trivial caufe, will be unable to perforin the common functions cf life, and prove a burden to fociety. * The common opinion, that the difeafes of infants are hard to difcover and d'ffcult to cure, has deterred many phyficians from paving that attention to them which the de- Orve. 1 can, however, from experience declare, that this opinion is without founda- tion ; and that the difeafes of infants arc neither fo difficult to djfeover, nor fo iJl t» cure, as thofe of adults. f Rcfleau, OF CHILDREN. 35 If to the delicacy of mothers, we add the irregular lives of fathers, we fhall fee further caufe to believe that children are of- ten hurt by the ccn" itution of t^eir parer.ts. A fickly frame may be originally induced by hardfhips and intemperance, but chiefly by the latter. It is impoflible that a courfe of vice fhould not fpoil the beft constitution: and did the evil terminate here, it would be a juft punifhment for the folly of the lufferers; but when once a difeafe is contracted and riveted in the habit, it is entaibd on posterity. What a dreadful inheritance is the gout, the fcurvy, or the king's evil, to tranfmit to our offspring ! how happy had it been for the heir of many a great elate, had he been born a beggar, rather than to inherit his father's fortunes at the expenfe of inheriting his difeafes! A pr.rfon laboring under any incurable malady, ought not to marry. He thrreby not only fhortens his own life, but rrrirf- mits mifery to oth -rs; but when both parties are deeply tainted with the fcrophula, the fcurvy, or the like, the effects muft be ftiil worfe. If fuch have any iflue, they muft be miferable indeed. Want of attention to thefe things, in forming connections for life, has rooted out more families than plague, famine, or the fword; and as long as thefe connections are formed from mer- cenary views, the evil will be continued.* . In our matrimonial contracts, it s amazing fo little regard is had to the health and form of the object. Our fportfmen know that the generous courier cannot be bred out of t:e foundered jade, nor the fagacious fpaniel out of the fnarling cur. This is fettled upon immutable laws. The man who marries a woman cf a fickly conftitution, and defcended of unhealthy parents, whatev- er his views may be, cannot be faid to act a prudent part. A difeafed woman may prove fertile; fhould this be the cafe, the family muft became an infirmary: what profpect of happinefs the father of fuch a family has, we fhall leave any one to judge, t Such children as have the misfortune to be borne of difeaf- ed parents, will require to be nurfed wiih greater care than oth- ers. This is the only way to make amends for the defects of conftitution; and it will often go a great length. A heait'y nurfe, wholefome air, and fufficient exercife, wilfdo wonders. But when thefe are neglected, little is to be expected from any other quarter. The defects of conftitution cannot be fupplied by medicine. Thofe who inherit any family difeafe ought to be very rir- cumfpect in their manner cf living. They fhould confiJer well the nature of fuch difeafes, and guard againft it by a proper reg- imen. It is certain, that family difeafes have often, by proper care, been kept off for one generation ; and there is reafon to * The Lacedemonians condemned their kinglKrchidamus for having married a weak puny woman; becaufe, faid they, rnftead ef propagating a ti.ee of heioes, )ou will fill the throne with a progeny of changelings. f The Jews, by their laws, were, in certain cafes, forbid to h.ve any manner of com- merce with the difealed ; and indeed to this all wile legislatorsouyht to have a Ipecial re- gard. In fome countr.es, difeafed perfons have actually been forbid to marry. This is an evil of a complicated kind, a natural .Jsfoimityi rnJ poiltkil u:i;chU:~: and. tkeiefou-e. r-quizet \ public consideration. 36 OF CHILDREN. believe, that, bv perfifting in the fame courfe, fuch difeafes might at length be wholly eradicated. This is a fubject very little re- garded, 'hough of the greateft importance. Family conftitution* areas capable of improvement as family eftates, and the libertine who impairs the one, does greater injury to his pofterity, than the prodigal who fquanders away the other. Of the Clothing of Children. The clothing of an infant is fo fimple a matter, thnt ;t ;s furprifing h w any perfon fhbuld err in it; yet many children bfe their lives, and others are deformed, by inattention to this article. Nature knows no ufe of clothes to an infant, but to keep it warm. All that is neceflary for this purpofe, is to wrip it in a foft loofe covering. Were a mother left to the dictates of Na- ture alone, fhe would certainly purfue this courfe. But the bu- finefs of dreffmg an infest has long been out cf the hands of mothers, and has at laft become a fecret which none but adepts pretend to underfrand. From the moft early ages it has been thought neceflpry, that a woman in labor fhould have fome perfon to attend her. this in time became a bufiuefs; and, as in all others, thofe who were employe J in it ftrove tooutdo one another in the different branch- es of ther profeffion. The drefling of a child came of courfe to beconfideredas the midwife's province, who no doubt imagined, that t:.e more dexterity fhe could fhew in this article, the more her fkill would be admired. Her attempts were leconded by the vanity of parents, who, too often defirous of making a fhew of the infant as fbon as it was born, were ambitious to hove as much finery heaped upon it as poflible. Thus it came to be thought as neceflary for a midwife to excel in bracing and drefling an in- fant, 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 wr-und its tender frcme, but even*to obftruct the motion of the heart, lungs, and other organs neceflary for life. In the moft parts of Britain, the practice of rolling children with fo many bandages is now, in fome meafure, laid afide; but it would ftiil be a difficult talk to perfuade the generality of man- kind, that the fhape of an infant does not entirely depend on the care of the midwife. So far, however, are all her endeavors to mend the fhape from being fuccefsful, that they conftantly oper- ate the contrary way, and mankind become deformed in propor- tion to the means ufed to pj^vent it. How little deformity of body is to be found among uncivil-'zed nations ? So little indeed that it is vulgarly believed they pu< ail their deformed children to death. The truth is, they hardly know fuch a thing as a de- formed child. Neither fhould we, if we followed their example. Savage nations never thick of manacling their children. They OF CHILDREN. 39 allow them the full ufe of every organ, carry them abroad in the open air, wafh their bodies daily in cold water, &c. Bv this management, thi ir children become fo ftrong and h-rdy, that by the time our puny infants get out of the nurfe's arms, theirs are able to fhift for themfelves.* Among brute animals no art is neceflary to procure a fine fhape. Though many of them are extremely delicr.te 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 bufmefs out of Nature*s hands. Not only the analogy of other animals, but the very feelings of infants tell us, they ought to be kept eai'y and free from all preflure. They cannot indeed tell their complaints; but they can fhew flgns of pain: and this they never fail to do, by crying . when hurt by th--ir clothes. No fooner are they freed from their bracings, than they feem pleafed and happy: yet, ftrange infatu- ation! te moment they hold their peace, they are again commit- ted to th ir chains. If we confider the body of an infant as a bundle of Toft pipes, replenifhed with fluids in continual motion, the danger of pr°ffure wll appear in the ftrongeft light. Natu-e, in order to make way for the growth of children, has formed their bodies loft and flexible j and left they fhould receive any injury from preflure in the w->mb, has furrounded the foetus everv where v i'h fluids. This fhews the care which Nature take? to prevent all un^qu^l preflure on the bodies of infants, and to defend thena againft every thing that might in the leaft cramp or confine their mot;ons. Even the bones of an infant are fo foft and cartilaginous, that they readily yield to the flighteft preflure, and eafily aflume a bad fhape, which can never after be remedied. Hence it is, that fo m..ny people appear with high fhonlders, crooked fpines, and flat breafts, who were as well proportioned at their births as others, but had the misfortune to be fqueezed out cf fhape by th? application of fhys and bandages. Preflure, by brtructhg the circulation, likewife prevents th ■ equd distribution of nourifhment to the different parts of the body, by which means the growth becomes unequal. One part grows too large, while another remains too fmaH ; and thus in time the whole frame becomes difproportionate and mifhapen. To this we muft add, that when a child is cramped io its clothes, it naturaily fhrinks from the part that is hurt; and by putting its body int~> unnatural poftures, it becomes def ,rmed by habit. Deformity of body may indeed proceed from weaknefs or difeafe; but in general, it is the effect of improper clothing. Nine- fn h% at leaft, of the deformity among mankind, muft be im- puted to this caufe. A deformed body is not only dif?greeable to the eye, but by a bad figure both the animal and vital func- • A friend of mine, who was fereral >e*rs on the coaft of Africa, te'lt me, that the nativei neither put any clothes upon their children, nor apply t" their bodies baniagesot" anv kind, but lay them on a pallet, and fuft'er them ts tumble about atpleafure, yet they v- lood through the lungs, refpira- tion, the periftalic 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 this happens, deoth muft enfue. Hardly any met od could be devifed mora effectually to jt~p thefe motions, than bra- cing the body too tight with rollers "* and bandages. Were thefe to be applied in the fame manner to the body of an adult for an equal length of time, they would hardly fail to hurt the digeftion and make him fi^k : how much more hurtful they muft pr:ve to the tender bodies of infants, we fhall leave any one to judge. Whoever confiders thefe things will not be furprifcd, thot fo many children die of convulsions foon after the birth. Thefe fits are generally attributed to fome inward caufe; but in fa«£t they oftener proceed from our own imprudent conduct. I have known a child feized with convulfion fits foon after the midwife had done Twaddling it, who, upon taking off the rollers and banda- ges, was immediately relieved, and never had the difeafe after- wards. Numerous examples of this might be given, were they neceflary. It would be fafer to fatten the clothes of an infant with 'firings than pins, as thefe often gall and irritate their ten 'er ikins, and occafion diforders. Pins have been found fticking above half an inch into the body of a child, after it had died of a>nvul- lion fits, which in all probability proceeded from that caufe. Children are not only hurt by the tightnefs of their clothes, but alfo by the quantity. Every child has fome degree of fever after the birth; and if it be loaded with too many clothes, the fever muft be increafed. But this is not all; the child is gener- ally laid in bed with the mother, who is often likewife feverifh; to which we may add the heat of the bed-chamber, the wines, and other heating things, too frequently given to children in^m - diately after the birth. When all thefe are c mbined, w* ich 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 appear^ if we confider thit,aftertheyhave reenforfome time in thefitu- ation bef ore-men tioned,they are often lent into the country to be nurfed in a cold hcufe. Is it any wonder, if a child, from fuch a tranfition, catches a mortal cold, or contracts fome other fatal difeafe ? Wnen an infant is kept too hot, its lungs, not being fnfliciently expanded, are apt to remain weak and flaccid for life * hence proceed coughs, confumptions and other difeafes of the breaft. It would anfwer little purpofe to fpecify the particular fpe- cies of drefs proper for all infants. Thefe will always vary in * This is by no means inveighing againft a thing that does not happ?n. In many parts of Britain at this day, a roller eight or ten feet in length, is applied tightly round fhe child's body as foon as it is born. OF CHILDREN. 59 different countries, according to custom and the humour of pa- reT °. The great rue to be r,bf< rved i?, That a chdd have no more clothes than are necejfary to keep it lyarm, and that they be quite eafy for its body. Stays are the very bane of infants. A volume would not fuTice to point out all the bad effects of this ridiculous piece of drefs both on children and adults. The madnefs in favour of ftays feems however, to be fomewhat abated; and it is to be hon-^d tne world will, in time, become wife enough to know, that t .e human fhape does not folely depend upon whale-bcne and beod leather.* I fhall only add with refpedt to the clothes of children, that they m ht to be kept thoroughly clean. Children perfpire more than adults ; and if their clothes be not frequently changed, they become very hurtful. Dirty clothes not only g :ll and fret the tender fkins of infants, but likewife occafion ill fmells; ond what is worfe, tend to produce vermin and cutaneous dife-fes. Cleaolinefs is not only agreeable to the eye, but tends great- ly to preferve the health of children. It promotes the peripira- tion, and, by that means, frees the body from superfluous hu- mours, which, if retained, could not fail to occafion dife fes. No mother or nurfe can have any excufe for allowing a child to be dirty. Poverty may oblige here to give it coarfe clothes; but if fhe dees not keep them clean, it muft be her own fault. Of the Food of Children. Nature not only points out the fopd proper for an infant, but actually prepares it. This however, is not fufficient to prevent fome who think themfelves wifer than Naturr, from attempiing to bring up their children without her provifion. Nothing can fhew the c'ifpofition whichmankind have to depart from Nature more than their endeavoring to bring up children without the breaft. The mother's milk, or that of a healthy nurfe, is un- queftionably the beft food for an infant. Neither art nor nature can afford a proper fubftitute for it. Children may feem to thri. e for a few months without the breaft ; but when teething, the fmall-pox, and other difeafes incident to childhood, come on, they generally p?rifh. A child, foon after the birth, fhews an inclination to fuck ; and there is no reafon why it fhould not be gratified. It is true, the mother's milk does not always come immediately after the birth: but this is the way to bring it: befides, the firft milk that the child can fqueeze out of the breaft anfwers 'he purmfe of cleanfing, better than all the drugs in the apothecary's fh:p, and at the fame time prevents inflammations of the breaft, fev- ers, and other difeafes incident to mothers. * Stavs made of bend leather are worn by all the women of lower Station in many parts of England. ' I am forry to underftand, that there are ftill mothers mad enough to lace their daugh- ters very tight in order to improve their fhape. As reafoning wou.d be totally loft uo. on fuch people, I fhall beg leave juft n afk them, Why the e are ten deformed women for one man ? and Jikewife to recommend to their perulil a fhort moKl precept, which to:. bids us to psroRM the kvmap socyi ... *« OF CHILDREN. It is ftrange how people came to think that the firft thing given to a child fhould be drugs. This is beginning with medi- cine by times, and no wonder if they generally endwith it. It fome- rimes happens, indeed, that achiVd does not difcharge the meconium f foon as could be wiftied ; this has induced phyficians, in fuch cafes, to give fomething of an opening nature to cleanfe the firft paflkges. Mid wives have improved upon this hint, and never foil to give fyrups, oils, &c. whether they be neceflary or not. Cramming an infant with fuch indigeftible ftuff as foon as it is born, can hardly fail to make it fick, and is more likely to occa- fion difeafes than to prevent them. Children are feldom long af- ter the birth without having a paffage both by ftool and urine ; though th fe evacuations may be wanting for fome tune without any da g-r- But if children muft have fomething before they be allowed the breaft, let it be a little thin water pap, to which may be added an equal quantity of new milk ; or rather water alone, with the addition of a little raw fugar. If this be given without any wines 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 fup- port. This naturally fuggefts the need of cordials. According- ly wines are 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 conduct founded upon it. Children require very little food for fome time after the birt ; and whit they receive fhould be thin, weak, light,and of a cooling quality. A very fmall quantity of wine is fufficient to heat and inflame the blood of an infant; but every perfon converfaut in thefe matters muft know, that moft of the difeafes of infants proceed from the heat of their humours. If the motrer or nurfe has enough of milk, the child will need little or no food before the third or fourth month. It will then be proper to give it, once or twice a day, a little of fome food that is eafy of digeftion, as water-pap, milk-pottage, weak broth with bread in it, and fuch like. This will eafe the mother, will accuftom the child by degrees to take food, and will render the weaning both lefs difficult and lefs dangerous. All great ard fudden tranfitions are to be avoided in nurfing. For this pur- pofe, the food of children ought not only to be Ample, but to refemble, as nearly as poflible, the properties of milk. Indeed milk itfelf fhould make a principal part of their food, not only before they are weaned, but for fome time after. Next to milk, we would recommend good light bread. Bread' may be given to a child as foon as it fhews an inclination to chew; and it may at all times be allowed as much plain bread as it will eat. The very ch. wing of bread will promote the cutting of the teeth, and the difcharge of faliva, while by mixing with the nurfe's milk in the ftomach, it will afford an excellent aeurifhment. Chil- dren difcov r an early inclination to chew whatever is put into their hands. Parents obferye the inclination, but generally mif- t)F CHILDREN. & take the object. m Inftead of giving the child fome*hing which may at once exercife its gums and afford it nourifhment, they com- monly put into its havds a p;ece of hard me*al, or impenetrable coral. A cruft of bread is the beft gum-ftick. It not only an- fwers the purpofe better than any thirg elfe, but has the addi- tional properties of nouriihing the child and carrvi'g the faiiva down to the ftomoch, which is too valuable a liquor to be loft. Bread, befides bring ufed dry, mav b$* many ways pre- pared into food for children. One of the bef^ methods is to boil it in w-ter, afterwards pouring the water off, and mixing with the bread a proper quantity or new milk unboiled. Miik is both more wholefome and nourifhing this way than boiled, and is lefs apt to occafion coftivenefs. For a child further 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 fermented j but when enriched with fruits, fugars, or fuch things, it becomes very unwholefome. It is foon enough to allow children animal food when they h • ve got teeth to eat it. They fhoul'' nev#r tafte it till after they are weaned, and even then they ought to ufe it fparingly. In- deed, when children live wholly on vegetable food, it is apt to four on their ftomachs; but, on the other hand, too much flefhi heats the body, and occafions fevers and other inflammatory dif- eafes. This plainly points out a due mixture of animal and veg- etable food as moft proper for children. Few things prove more hurtful to infants than the ' ommoa method of fweeiening their food. It entices them to take m. re than they ought to do, which makes them grow fat and bloated. It is pretty certain, if the food of children were quite plain, th:*t they would never take more than enough. Their exercifes are entirely owing to nurfes. If a child be gorged with food at all hours, and enticed to take it, by making it tweet and agreeable to the palate, is it any wonder *h".t fuch a child fhould in time be induced to crave more food than it our ht to have ? Children may be hurt by too little as w 11 as too murh food. After a child is weaned, it ought to be fed four or five times a day; but fhould never be accuitomed to eat in th - night; neither fhould it have too much at a time. Children thrive beft with fmall quantities of food frequently given. This neither over,* loads the ftomach nor hurts the digefiioi:, and is certainly moft, agreeable to nature. Writers on nurfing have inveighed with fuch vehemence againft giving children too much fi od, that mauy parents, by eiv deavcuring to fhun that error, have run into the oppofite extreme, and ruined the confutations of their children. But the error d pinching children in their food is more hurtful than the other ex- treme. Nature has many ways ot relieving herfelf when over- charged ; but a child, who is pincheo wi'h hunger, will never become a ftrong or tieajthy man. That errors are .frequently (4) 42 OF CHILDREN. committed on both fides, we are ready to acknowledge; but where one child is hurt by the quantity of its food, ten fuller from the quality. This is the principal evil, and claims our ftricteft attention. Many people imagine, that the food which they themfelves love, cannot be bad for their children : but this notion is very abfurd. In the more advanced periods of life we often acquire an inclination for food, w ich when c ildren we could n t en- dure. Befides, there are many things that by haSt may agree very well with the ftomach of a grown perfon, wKich would be hurtful to a child ; as high-feafoned, fait, and fmoke-dried pro- vifions, &c. It would alfo be impr-per to feed children with fat meat, ftrong broths, rich foups, or the like. AH ftronjg liquors are hurtful L> children. Some parents teach their children to guzzle ale, and others fermented liquors, at every meal. Such a practice cannot fail to do mifchief. Thefe children feldom efcnpe the violence of the fmall-p x, me fles, hooping-cough, or fome inflammatory dif rder. Milk, waer, butter-milk, or whey, are the moft proper for children to chrink. If they have any thing ftronger, it may be fine fmall beer, or a little wine mixed with water. The ftoma-h of children can di- geft well enough without the afliftance of warm ftimu'.ants, be- fides, being naturally hot, they are eafily hurt by every thing of a heating quality. Few things are more hurtful to children than unripe fruits. They weaken the powers of digeftion, and four and relax the ftomach, by which means it becomes a proper neft for infects. Children indeed fhew a'great inclination fc r fruit, and I am apt to believe, that if good ripe fruit were allowed them in proper quantity, it would have no bad effects. W e never find a nat- ural inclination wrong, if properly regulated. Fruits are gener- ally of a cooling naiure, and correct the heat and acrimony of the humours. This is what moft children require ; only care fhould be taken left they exceed. Indeed [he beft way to pre- vent children from going to excefs in the ufe of fru't, or eating that which is bad, is to allow them a proper quantity of what is good.* Roots which contain a crude vifcid jure fhould be fparingly given to children. They fill the body with grofs humours, and tend to produce eruptive difeafes. This caution is peculiarly neceflary for the poor; glad to obtain at a fmall price what will' fill the bellies of their childr n, they fluff them twoorthre° times a day with crude v- getaMes. Children had better eat a fmaller quantity of food which yields a wholefome nonrifhment. than be crammed with what their digeftive powers are unable properly to aflimilate. Butter ought likewife to be fparinply given to children. It * Children are alway* fickly in the f-nit feafon, which may be thus accounted for : Two thirds of the fruit which comes to market in this country is really unripe, ;a^ 0f butter, fo libeHlv given to <-h;h'rer ir moft parts of BrHi \ we woHd recommend! h o v. H ney is nnt only wholefom°. nut coolh g, cleoo'jng, and tends to fw.:\ teo the humours. Children wh^ e?t honey are feldom tr^uMed with w >rms: thev are alfo lefs fubject to cuta- neous dif afes. as itch, f^.bSed he;».d, &rc. Many oe. at the diet of chMdren ought to h? altoget er moift. When children live entirely upon flops, it rehx-°s their folios, renders them weak, and difpofes them to the rickets, f-r p' uh, aod tirr glandular diforders. Relaxavoa is one of the nrA gene-al caufes of the difeafes of children. Ev- ery thina; therefore which tends to unbrace their folids, ought to be carefully avoided. We won! * not b-* undetftood by thefe obfervations as con- fining children to any particular kind ' f food. Their diet may befr*qu ntiy varied, provided always that fufficient regard be had t fimplicity. Of the Exerci/e of Children. Of all the caufes which confp:re to render the life of man fhort and niferable, none havo greater influence than the want of prop- r Ex Hie : Heohhy parents, wholefome food, and proper "1 rthhg, will avoil little, where exercife is neglected. Suf- .ficie t exerci^ will make up for feveral defects in nurfing; but U thing c\n fupoly tho wmt of it. Ir is abfolutely neceffary to the heolth, th* growth, aoi the ftrength of children. The d fir ^f exercife rs coeval with life itfelf. Were this principle attended to, many difeafes might be prevented. But, vvf.ile iodoienos and fedentary employments prevent two thirds or mink nd from e;ther tak;ng fufficient exercife themfelves,-or giv- ing it to their children, what hive we to expect bu difeafes and deformity among their offspring ? The rickets, f > destructive to ch;l h n, nev^r appear d in Britain until manufactures began to flourifh, and people, attracted by t;,e love of gain, left the coun- try to tMlow fedentary employments in great tows. It is among" thefe people that this difeafe chiefly prevails, and not only deforms but kills many of th^ir offspring. Tie con luft of other young animals fhew? the propriety of giving exercife to c 41 Iren. Every other animal makes ufe ef its organs of motion as foon as it c n, a id nnny of them, even when unier no neceflity of moving in queft of food, cannot be retrain- ed without force. This is evidently the cafe wit the calf, the laino, and moft other ycu^g animals. If 'htfe creatures were not permitted to frik about and toke exercife, they would f on die or become dife fed. .The fame inclination appears very earlv in the hnoian hVries; but as they ore not able to fcike ex?rc;f^ th* nfeives, it is the bufinefs of their parents and nurfes toaflift 'hem. C ildren may be exercifed various ways. The beft methi od, while they are light, is to carry them about in the nurle's ft OF CHILDREN. 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. Befides, it is much fafer than twinging an infant m a machine, or leaving it to the care of fuch as are not fit to take care of themfelves. Nothing can be more abfurd than to let one child to keep another; this conduct has proved fatal to many in- fants, and has rendered others miftrable for life. When children begin to walk, the fcfeft and beft method of leading them about is bv the hands. The common way, of fwinging them in leading firings, fixed to their backs, has feveral bad confluences. It makes them throw their bodies forward, and prefs with their whole weight upon the ftomach and breaft; by this n eans the breathing is obftructed, the breaft flattened. and the bowels comprefled; which muft hurt the d:geftion, and occafion confumptions of the lungs, and other difeafes. It is a common notion, that if children are fet upon their feet too foon, their legs will become crooked. There is reafon ts believe, that the very reverfe of this is true. Evervmember ac- quires 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 direct themfelves, 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 ? In- deed, if a child is not permitted to make any ufe of its legs till a confiderable time after the birth, and be then fet upon them wirfe its whole weight at once, there may be fome danger ; but this proceeds entirely from the child's not having been accuftomed to vie its legs from the beginning. Mothers of the poorer fort think they are great gainers by snaking their children lie or fit while they themfelves work, hi this they greatly miftake. By neglecting to give their chil- dren exercife, they are obliged to keep them a long time before they can do any th:ng for themfelves, and to fpend more ©n medicine than would have paid for proper care. To take care of their children, is the moft ufeful bufinefs in which even the poor can be employed ; but alas ! it is not always in their power. Poverty often obliges them to neglect their off- spring in order to procure the neceflaries of life. When this is the cafe, it becomes the interest as well as the duty of the public to aflift them. Ten thoufand times more benefit would accrue to the ftate, by enabling the poor to bring up their own children, than from all the hoipitals t that ever can be erected for that purpofe. * The nurfe oughtto be careful to keep the child in a proper pofition ; as deformity is often the conle neglected, none of the animal functions can be duly p rformed 5 and when that is the cafe, the whole conftitution muft go to wreck* A good conftitution ought certainly to be our firft ooj ct in the management of children. It lays a foundation for their be- ing ufeful and happy in life: and whoever neglects it, not only fails in his duty to his offspring, but to f ciety. One very common error of parents, by which they hurt the conftitutions of their children, is the fending them too young to fchool. This is often done folely to prevent trouble. Wnen the child is at fchool, he needs no keeper. Thus the fchool-maf- ter is made the nurfe; and the poor child is fixed to a feat fevea or eight hours a-day, which time ought to be fpent in exercife and diverfions. Sitting fo long cannot fail to produce the worft effects upon the body: nor is the mind lefs injured; Early ap- plication weakens* the faculties, and often fixes in the mind an averfion to books, which continues for life.* But fuppofe this were the way to make children fcholars, it certainly ought not to be done at the expence of their conftitu- tions. Our anceftors, who feldom went to lchool very young, were not lefs learned than we. But we imagine the boy s edu- cation will be quite marred, 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 of children in public fchoots, but their number, often proves hurtful. Children are much injured * It Is undoubtedly the duty of parents to inflru£r. their children, at leaft till they are of an age proper to take fome care of themfelves. This would tend much to confirm the tiet of parental cenae/nels and filial affecYion, of the want of which there are at prefent fo many deplorable instances. Though fj w fathers have time to inftruft their children, yc*i -noft mothers hate, and furely they cannot be, better, cmployd.-, 4d OF CHILDREN: by being kept in crouds witmn jo^rs; their breathm? not only renders tne place unwnoleiome, but if any one of tnem hap- pens to be diiealid, t ,e reit citch t..c intectioo. A fingle child has >eea often known t.; co nmuaicate tne bloody flux, tne •ivp- ing cough, the itch, or jther difeafe, to alaioft every individual in a aumer.)us fch ol. But, if faimou muft prevail, and infants are to be feut to fchool, we would recommend it to teachers, as they value the in- terests of l ciety, not to confine them too long at a time, but al- low them to run a >out ani play at fuch active dive.rfwns as may promote their growl.;, and strengthen their constitutions. Were boys, instead of bei g wmpped t. r fteal ng an nour to run, ride, fwi.n, or tne hke, encouraged to employ a proper part ot li.eir time in thefe manly and liietul exercihrs, it Would have many ex- cellent eff cts. It would be a great fervice to boys, if, at a proper age, they were taug t the military exerciie. Tuis would increale iheir ftrength, infpire them with courage, and when tneir country calk ed for tneir aififtance, would enable them to act ui i.er d fence, Without being obliged to undergo a tedious and troubittorne Courfe of iultructicns, at a time wheu they are lets fit to learn new motions, geftures, &c* An effeminate education will infallibly fpoil he belt natural constitution -, and if boys are orougnt up in a more delicate man- ner than even girls ought to be, they will never oe men. in or is the common education «"f girl> his hurtful to the conftitution than that of boys. Mils is let down to her frame. before fhe can put on her clotnes; and is taugm to believe, that to ex el at the needle is-the only thing that c.:.. entitle her to gen*, eral efteem. it is unneceflary here to infift upon tne dangerous" conf*que, .ces of obliging girls to fit to> much. 1 hey are pretty well known, and are too often felt at a certain time ot life, ilut fuppofing tnis critical period to be got o\er, greater dangers ftill await them when they-come to be mothers. Women who have been early accuftomed to a fedentary life, generally run great hazard in child- >td ; while tnofe wno have been ufed to romp about, and take fuhicieut exercife, are feldom in any danger. One hardly meets with a girl who can at the fame time boaft of early performances by Lie needle, and a good conftitu- tion. Clofe and early confinement generally occafions indigent ions, head-achs, pale complexions, pain of the ftomach, lofs of appetite, coughs, confumptions of the lungs, and deformity of body. The laft of tnefe indeed is not to be wondered at, confid- ering the awkward 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. W ould mob ers, inftead of having their daughters inftructed in many trifling accomplifhments, employ them in plain work and * 1 am happy to find that the mafters of academies now begin to put in practice this advice. Each of them ought to keep a diiU fergeant for teaching the boys the military e^ierc.ie. This, befidea contributing ft their health and vigour of body, would have mzi tff other happy sffs^j* < *•" OF CHILDREN. 47 boufewifery, and allow them fufficient exercife in the open air, thev -v'isulJ b tn miketnera more healthy mothers, and more ufeful members of fociety. I am no enemy to genteel accom- pliitments, but would have then only confidered as fecondary, and always difregarded when they impair the health. IVIaav people imagine it a great advantage for children to be early taught to earn their bread. This opinion is certainly right, prov ded they were fo erapl yed as not to hurt their health or gr w'h; but, wnen thefe fuffer, fociety, instead of being ben- efited, ifi a real lofr by tneir labor. There are few employments, except fedeatary on°s, by which children can earn a livelihood j and if they be let to thefe too foon, it ruins their conftitutions. Thus, by gaining a few years from childhood, we generally lofe twice as many in the la'ter period of life, and even render the perfon lefs ufeful wnile he does l;ve. In order to be fatisfied of the truth of this obervation, we need only look into tie great manufacturing towns, where we _ fhall find a puny degenerate race of people, weak and fickly all the;r lives, feldom exceeding the middle periodof life; or if they do, being unfit for bufinefs, they become a burden to fociety. Thus arts and maiufactures, though they may increafe the rich- es of a country, are by no means favourable to the health of its inhabitants. Good policy would therefore require, that fuch people as labor during life, fhould not be fet too early to work. E v/ery perfon converfant in the oreed of horfes, or other working an rials, knows, that if thev be fet to hard labor too foon, they never will : urn out to a 'vantage. This is equally true w'nh rei- pe^t to th.? human fpecies. Weakly children ihould always ba pur apprentices to trades whicn require their being moftry out of doors. There are neverthelefs various wavs of employing young people, without hurting their health. The eafier parts of gard- ening, huibandry, or any bu'inefs carried on without doors, are moft pron?r. Thefe are employ:nents which moft young peoole are fond of, and fome pirts of them may always be adapted to their age, tafte, and ftreng' h.* Such parents, however, as are under the neceflity of em- ploying tieir children w; hin doors, ought to allow them fuffi- cient time for active diverfions without. This would both en- courage tnem to do more work, and prevent th*ir conftitutions from being hurt. Some imagine, that exercife within doors is fufficient; but they are greatly miftakea. One hour fpent in running, or any other exercife without doors, is worth ten within. When chil- dren cannot goaoroad, they may indeed be exercifed at home. The bet method of doing this, is to make them run about in a large roou, or dance, this hit kind of exercife, if not carried to excefs, is of excellent fervice to young people. It cheers the fpirits, promotes perfpiration, ftrengthens the limbs, &c. I know an eminent phyfician who ufed to fay, that he made his children * I have been told that in China, where the police is the beft in the world, all the children are employed in the eafier part of £»rme of them who would not dry a child's fkin af- ter oarhing it, left it fhould deftroy the effects of the water. Oth- ers will even put clothes dipt in water up n the chil', and either put it to bed, or fuffer it to go about in that condition. Some believe that the whole virtue of the water depends upon its be- ing dedicated to a particular faint; while others place their con- fidence 5n a certain number of dips, as three, feven, nine, or the lik*-; and the world could not perfua«de them, if thefe do not fuo ceed, to try it a little logger. Thus, by the whims of nurfes, children lofe the benefit of the cold bath, and the hopes of the phyfician from that medicine are often fruf rated, We ought not, however, entirely to fet afide the cold bath j Ibecaufe fome nurfes make a wrong ufe of i, Every child when in health, fhould at leaft have i- s extremities daily wafhed in cold w^ter. This is a partial ufe of the cold bath, and is better than none. In winter this may fuffice; but, in the warm feafon, if a Child be relaxed, or feem to have a tendency to ihe rickets or fcro- phula, its whole body ought to be frequently 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 dipped only once at a time, fhould be taken out immediately, and have its ikin well rubbed with a dry cloth. The bad Effebls gfunwholefome Air upon Children. Few things prove more destructive to chddren than confined 6r unwholefome air. This is one reafon why fo few of thofe in* fants who are put into hofpitals, or parifh workhoufes, live, Thefe places are generally crouded with old, fickly, and infirm people; by which means the air is rendered fo extremely perni- cious, that it becomes a poifon to infants. Want of vvhMefbrne air is likewife deftructive to many of the children born in great towns. There the poorer fort of inhab- itants I've in low, dirty, confined houfes, to which the frefh air has hardly a y accefs. Though tfrown people, who are hnrdy and robuft, may l:ve in fuch fituations, yet they generally prove fatal to their offspring, few of whom arrive at maturity, and th^fe w ^ do .ire weak and deformed, ^s fuch people are not in a fondiiioQ to carry their children abrgad into tbe open air, w? OF CHILDREN. j& muft ray our account with lofing the greater partof them. But the ri h have not this xcufe. It is their bufinefs to fee that their children be daily carried a >road, and that 'hey be kept in t ;e open air for a fuffbent time. This will always fucceed bet er if the mother goes along with them. Servants are often neg.igent in thefe matt rs, :md allow a child to fit or lie on the damp gr und, instead of leading or carrying it about. The mother furely needs air as well as ner children; and how can fhe be better employed than in attending them ? A very -ad cuftom prevails, of making children fleep ia fmall apartments, or crowding two or three beds in one chamber, Inftead of this, the nurfery ought always to be the largeft and belt aired rx>m in the houfe. When children are confined in fmall apartments, the air not only becomes unwnolelorae, but the heat relaxes their folids, renders them delicate, and difpofes them to colds and many other diforders. Nor is the cuftom of wrap- ping them up too clofe in cradles lefs pernicious. One would think that nurfes were afraid left children fhould fuffer by breath- ing free air, as many of them actually cover the child's face while afleep, and others wrap a covering over the whole cradle, by which means the child is forced t j bfeathe he fame air over and over all the tune it fleeps. Cradles indeed are on many accounts hurtful to children, and it would be better if the ufe of them were totally laid afide.* A child is generally laid to lleep with all its clothes on; an A if a number of others are heaped above them, it muft be over- heated ; by wlvch means it cannot fail to eaten cold on being tak- en out of the cradle, and expofed to the open air with only its ufual clothing, which is too frequently the cafe. Children who are kept w thin doors all day, and lleep all night in warm clofe apartments, may, with great propriety, be compared to plants, nurfed in a hot-houfe, inftead of the open air. Though fuch plants may by this means be kept alive for fome time, they will never arrive at that degree of strength, vig- our, and magnitude, which they would h ve a quired in the open air, nor would they be able to bear it afterwards, fhould they be expofed to it. Children brought up in the country, who have been accuf- tomed to the open air, fhould not be too early fent to great towns, where it is confined and unwholefome. This is frequently done with a view to forward their education, but proves very hurtful to their health. All fchools and feminaries of learning ought, if poflible, to be fo fituated as to have frefh, dry, wholefome air, and fhould never be too much crowded. * It it amazing how children efcape fufFocation, confideting the manner in which they are often rolled up in flanne't, &c. I lately attended an infant, whom 1 found muf- fled up over he d and ears >n many folds of flannel, though it was in the middle of June. 3 begged for a little free air to the ooor babe j but though this indulgence was granted dur- ing my ftay, I f iund it always on my return in the fame Situation. Death, as might be expected, foon freed the infant from all its miferies: but it was not in my power to fret the minds of its parents from thofe prejudices which proved fatal to the child. 1 was very >atelv called to fee a.- infant which was laid to be expiring in convul- fion fits. I deCred the mother to ftrio.thfi <&Dd4 vA W»P, it in a loofe coverings It had no more conrtUfton fits, /^Iw^ **k - c ^ t , V» 3 (q 9 i n rj ■\ 'So OF CHILDREN. Wthout entering into a detail of rhe particular advantage* ©F wh ilefomeair to children, or of th3 bad confequences which proceel frou the wmc ^f it, 1 (hall only obferve, that of feveral th.Tufaiis of cnildr-n which have been under ray care, I do not renenoer one intaace of a fingle chili who continued healthy in a clofe confined aation; but hive often knowi the moft oh. ftinate difeafes cured by removing them from fuch a fituation td ourfe, is a healthy child up ^n her br-aft. Bu*, as the mifconduct f nurfes ofren proves fatal to children, it will be of importance to point out a few of their moft baneful errors, in order to roufe the atten- tion of parents, and to make them look more strictly into the conduct of thofe to whom they commit the care of their infant offspri \g. Though it admits of fome exceptions, yet we may lay it,, down as a general rule, That every woman who nurfes for hire fhould he carefully looked after, otherwrfe fhe will not do her duty. For this rea- fon parents ought always to have their children nurfed under their own eye, if poflible; and where this cannot be 'one, they fhould be ex»ramely circumfpedt in the choice of thofe perfons to whom they intruft them. It is folly to imagine that any woman* who abandons her own child to fuckle another for the fake of jgain, fhould feel all the affections of a parent towards her nurf- ling; yet fo neceflary aie the affections in a nurfe, that, but for them, the human rice would foon be ext:nct. One of the moft common faults of thofe who nurfe for hire, is dofing children with ftupefactives, or fuch things as lull them afleep. An indolent nurfe, who do s not give a child fuffi- cient exercife in the open air to make it deep, and does not chufe to be disturbed by it in the night, will feldom fail to procure for it a dofe of laudanum, diacodium, faff on, or what at fwers the fame purpofe, a dofe of fpirits, or other ftrong liquors. Thefe,. ;y though they be certain poifon to infants, are every day adminif- " tered by many who bear the character of very good nurfes.J * I have often known people fo impofed upon, as to give an infant to a nurfe to be fuck ed who had not one drop of milk in her breaft. t Next of importance to a healthy, cleanly, and good natured nurfe, is her diet. On ed upon the milk of nurfes living entirely upon vegetable aliments ; and 1 have known many mftaices of children breaming difeafed.by their being fed by the milk o/nurfes who had chained tteir diet from entirely vegetable, to their taking in a quantity of animal food. Nay, I have known mftances of children becoming difordered from a nurfe's inakiag a fingle meal of an unufually large portion of animal food." f If a mother, on vifiting her child at nurfe, finds it always afleeo.I would adv'ifrLr to remove it immediately j otherwife it will foon fleep iti laft, P* »««*« OF CHILDREN. 5* A nurfe who has not mile enougn is apt to 'maglne" that this 3efect may be fupiplied oy giving theenhd wines, cardial waters, or otner ftrong liquors. 101s is an egregious miftake. The only thing that has any chance to fupply the place of the nurfe's milk, muft be fomewhit neany of tne fame quality, as cow's milk, afs's milk, or beef tea, with a little bread, it never can oe done by the help of ftr.mg liquors. Tnefe, inftead of nourifhing an infant, never fail to produce the contrary effect. Chil iren are often hurt by nurfes iuffcring them to cry long and vehemently. This ftrains their tender ood»es, and frequently occafions ruptiares, inflammations f h throat, lung?, &c. A child never continues to cry long without fome came, which might always be diicovered by pr :>per attention; and the nurfe who can hear an infant cry till-it has almoft fpent itlelf, without endeavoring to pleafe it, muft oe cruel indeed, and is unworthy to be intruited wita the care ot an human creature. . Nurfes who deal much in medicine are always to be fufpect- ed. They truft to i, and neglect their duty. I never knew a good nurfe who had her Godfrey's cordial, Daffy's ehxirs, Dal- by's carminative, &c, at hand. Such generally imagine, that a dole . ;f medicine will make up for all defects in food, air, exercile, and cleanlinefs. By errors of this kiud, 1 will venture to fay, that one half the children who die annually in L ndon lofe their lives. Allowing children to continue long wet, is another very per- nicious cuftom of indolent nuries. This is n t only dif agreeable*, but galls and frets the infant, and by relaxing the folios, occa- fions icrophulas, rickets, and other difeaies. A dirty nurie is always to be fufpect d. Nature often attempts to free the bodies of chil iren from bad humours, by throwing them upon the ikin: by this means fevers and other difeafes are prevented. urfes are apt to mif- take fuch critical eruptions for an itch, or fome other infectious diibrder. 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 fhe takes 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 allur- ed tnat it is not of a critical nature. At any rate, it is never to be done without previous evacuations, Loofe ftools is another method by which Nature often pre- vents or carries off the difeafes of infants. If thefe proceed too far, no doubt they ought to be checked; but this is nev=rr to be done without the greateft caution. Nurfes, upon the firft ap- • pearance of loofe ftools, frequently fly to the ufe of astringents, or fuch things as bind the body. Hence inflammatory fevers, and other fatal difeafes, are occafioned. A dofe of rheubarb, a gentle vomit, or fome other evacuations, fhould always precede tne ufe of aftringent medicines. One of the greateft faults of nurfes is, concealing the dif- eafes of children, from tbeir parents. This they are extremely ips THE LABORIOUS, THE SEDENTARr, ready to do, efpecialry when the difeafe is the effect of their own negligence. Many inftances might be given of perfons who have been rendered lame for life oy a fall from the nurlVs arms^ which fhe, through fear, concealed till the misfortune was paft cure. Every parent who intrufts a nurfe with the care of a child, ought to give her the ftricteft charge not to conceal the moft trifling diforder or misfortune that may befal it. We can fee no reaf >n why a nurfe, who conceals any mif- fortune which happens to a child under her care, till it lofes its life or limbs, fhould not be punifhed. A few examples of this would fave the lives of many infants ; but as there is little reafon to -jxpect tha' it ever will be the cafe, we would earneftly recom- mend it to all parents to look carefully after their children, and not to trust fo valuable a treafure entirely in the hands of a hireling. No perfon ought to imagine thefe things unworthy of his attention. On t.e 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 belong. Effeminacy cv r will prove the ruin of any ftate where it prevails; and when its foundations are laid in infancy, it can never afterwards be wholly eradicated. Parents who love their offspring, and wift well to their country, ougnt therefore, in the management of their children, to avoid every thing that may have a tendency to make them weak or effeminate, and to take every method in their power to render their constitutions ftrong and nardy. " By arts like thefe tl Laconia nurs'd ot old her hardy foil* ; *' And Rome's unccnquer'd legions urg'd their way, " Unhurt, through every toil ia every clime." A*i|stron(;» CHAP. IL OF THE LABORIOUS, THE SEDENTARr, AND THE STUDIOUS. JL HAT men are expofed to particular difeafes from the occupations which they follow, is a fact well known ; but to remedy this evil is a matter of fome difficulty. Moft people are under the neceflity of following thofe employments to which they have been bred, whether they be favorable to heal h or not. For this reafon, inftead of inveighing, in a general way, as fome au- thors have done, againft thofe occupations which are hurtful to health, we fhall endeavor to point out the drcumftances in each of them from which the danger chiefly arifes, and to propofe the moft rational methods of preventing it. Chymifts, founders, forgers, gbfs-makers, and feveral other mtifts, are hurt by the unwholefome air which they are obliged to breathe. This air is not only 1 :>aded with the noxious exhala? tions arifing from metals and minerals, but is fo charged witli phiogi&oji ^ t« tje rendered uafit for expanding the lungs ftrr> AND THE STUDIOUS. £f< ficiently, and anfwering the other important pnrpofes of res- piration. Hence proceed althmas, coughs, and confumptions of Che lungs, Co incident to perfons who follow thefe employments To prevent fuch confequences, as far as poffible, the places where thefe occupations are carried or, ought to be conftructed iu fuch a manner as to difcharge the fmoke and other exhala- tions, and admit a free current of frefh air. Such artifts ought never to continue too long at work; and when they give over* they fhould fuffer themfelves to cool gradually, and put on their clothes before they go into the open air. They ought never to drink large quantities of cold, weak, or watery liquors, while their bodies are hot, nor to indulge in raw fruits, fallads, or any thing that is cold on the ftomach.* Miners, and all who work under ground, are likesihTe hurt by unwholefome air. The air, bv its ftagnation in deep mires, not orly lofes its proper fpring and other qualities neceffary for refpiration, but is often loaded with fuch noxious exhalations as to become a moft deadly poifon. The two kinds of air which prove moft deftructive to mi- ners, are what they call the fire damp, and the choke damp. In both cafes the air becomes a poifon by its b-ing loaded with pHo- gifton. The danger from the former may be obviated by mak- ing it explode before it accumulates in too great quantities; and tue latter may be generally carried off by promoting a free circu* lation of air in f e mine. Miners, are not only hurt by unwholefome air, but likewife hv the particles of metal which adhere to their fkin. clothes, &c. Thefe are abforbed, or taken up into the body, and occafion pal- fi°s, vertigoes, and other nervous affections, which often prove f - tnl. FailopiuR obferves, that thofe who work ia mines of mer- cury feldom live above three or four years. Lead, and feveral other metals, are likewife very pernicious to the he Ith. Miners oug^t nver to go to work fading, nor to continue too long a< work. Their food ought to be nourifhing, and their liquor generous: nothing more certainly hurts them than living too low. They fhould by all means avoid coftivenefs. This may either be done by chewi. g a little rheubarb, or taking a fuf- fiVlent quantity of fallad oil. Oil not only opens the body, but fheathes a»-d defends the inteftines from the ill effects of the met- als. All who work ;n mines or metals ought to walh carefully, and to change the^r clothes as foon as they give over working. Nothing would tend more to preferve the health of fuch people, than » strict, and ?lmoft relig;ous regard to cleanlinefs. Plumbers, painters, gilders, fmelters, makers of white lead, and many o'hers who work in metals, are liable to the fame dif- eafes as miners; and ought to obferve the fame directions for avoiding them. Tallow-chandlers, boilers of oil, and all who work in putrid animal fubftances, are likewife liable to fufter from the unwhole ■ • When perfons heated witr> l.fbpjr hare dtaftlt cpjd water, t>*y ovfh\ to epfttinue a5 *°{.k fal fs3& 'to? *f«*» 54 THE LABORIOUS, THE SEDENTARY, fome fmells or effluvia of thefe bo lies. They ought to p?r the fame regard to cle Hmefs ?s miners ; and when thev are affect- ed with nanfea, fieknefs, or mdigeftion, we would advife them to take a vomit or gentle purgp. Such fubftanees ought alwavs to be manufactured' as foon as poffible. When long kept, they not only become u^w?^olefome to thofe who manufacture them, but likewife to people who live in the neighborhood. It would greatly exceed the limits of this part of our fubject, to fpecify the difeafes peculiar to perfons of every occupation; we fhall therefore confider mankmd under the general claffes of the Laborious, Sedentary, and Studious. The Laborious* Though thofe who f How laborious employments are in general tne moft healthy of mank;nd, yet the nature of their oc- cupations, an^ the places wh-re they are carried on,expofe thera more partjcul \rly to fome difeafes. Hufbandmen, for example^ are expofed to ail the viciflitudes of the weather, which, in this country, are often very great and fudden, and occafion coldfi, coughs, quinfies, rheumatifms, fevers, and other acute diforden; Thjy are likewife forced to work hard, and often to carry burdens abov • their ftren*ih, which, bv overuraining the veflels, occafion afthrras, ruptures, pleurifies, &c. Thofe who labor wit1 out doors are often afflicted^ with in- termitting fevers or agu s, occafioned by the frequent yiciflitude* of eat ad cold, poor living, bad water, fitting or lying on the damp ground, evening dews, night air, &e. to which they are frequently expofed. Such as bear heavy burdens, as porters, laborers, &c. are obliged to draw in the air with much greater force, and alfo to keep their lungs dPe'-de • with more violence than neceflary for common refp;r°tion: bv th-s means the tender veflels of the lungs are overstretched, and often burft, infomuch that a fpitting of ^bod r-r fever eofues. Hippon-ares mentions an inftance to this purpofe, of a man who, up-^n a wager, carried an afs, but was foon aft^r feized with a fever, a vomiting of blood and a rupmre. Carrymtr. heavy burdens is generally the effect of mere lazi- nefs, which prompts people to do at once what fhould be d~ne at twice. SomeuVes it proceeds from vanity rr emulation. Pence it is. that the ftr^ngeP m?n are moft commonly hurt by heavy bur lens, haH frMr, or feais of activity. It is r»re to find one who boafts of "re-gth whhout a ruptur°, a fining of blood, or fome other, difeafe, which he reaps as the fnrt of his folly. One would imagine the daily inflates we have of the fatal effects of carrying great weight?, running, wreftling, and the like, would be fuffirient to prevent fuch pra£ia>es. There are indeed fome employments which nereflarily re- quire a great exertion of ftrength, as porters, blarkfrn-rhs, car- penters, &c. No-p rng^t to follow thefe but men of ftrong body j and they fhould never eafcrt their ftrength to the utmoft, AND THE STUDIOUS. & »or work too long. When the mufcles are violently ftrained, frequent reft is neceffarv, in order that they may recover their ton.*; withou* this, *he ftrength and conftitntion will foon be worn out, and a prem tureold age be induced. The eryr,pelas, or St. Anthony's fire, is a difeafe very inci- dent to t e laborious. It is oc^afio ed by whatever gives a fud- den check to the perfpiration, as drinking cold water when the body is warm, wet feet, keeping on wet clothes, fitting or lying on the damp ground, &c. It is impoflible for thofe who labor without doors always to guard againft thefe inconveniences; but it is known from experience, that their jjl confequences might often be prevented by proper care. The iliac paflion, thecholic, and other complaints of the bowels, are often occafioned by the fame caufes as the eryfipelas ; but they may likewife proceed from flatulent and indigestible food. La' orers generally eat unfermented bread, made of peas, beans, rye, an d other windv ingredients. They alio devour great quantities of unripe fruit?, baked, fiVwed, or raw, with various kinds of rx>ts and herbs, upon which they often drink four milk, ftale fmall beer, or the like. Such a nvxmre cannot fail to fill the boweis with wind, and occafion difeafes in thofe parts. Inflammation, w' itkx s, and other difeafes of the extremities, are likewife common among thofe who labor without doors- Thefe difeafes ar* often attributed to ven >m, or fome kind of poifon ; but they generally proceed either from fudden heat after cold, or thecontr-ry. When laborers, milk-maids, &c. come from the fiel', cold or wet, they run to the fire, and often plunge their hands in warm water, Ny which means the blood and other humiurs in thofe parts a-e fuddenly expanded, and, the veflels not yielding fo quickly, a strangulation happens, and an inflam- mation or a mortification eofues. Wren fuch perfons come home cold, they ought to keep at a diftance from the fire far fome time, to wafti their hands in c -Id water, and rub V em well with a dry clot-. It fomefimes hap- pens, that people are fo benumbed with cold, as to be quite de- prived )f the ufe of their limbs. In this cafe the only remedy is to rub the parts affected with fnow, or where it cannot be had, with cold water. If thev be held near the fire, or plunged into warm water, a mortification will generally eniue. Laborers in the hot feafon are apt to lie down and lleep m the fun. This praftice is fo dangerous, that they of ten awake in a burning fever. Thefe ardent fevers, which prove lo fatal about the end of the fummer and the beginning of autumn, are frequently occafioned bv this means. Whev laborers leave oi work, whic!1 th-v ought always to do during the heat ot the day, they mould go home, or at leaft get under fome cover where thev may repofe themrelves in £>t>»v. . r Mmvpeonle fallow th-ir employments m the fields.from morning rll ugh<, without eating ary fai^g. ims cannot tail to hurt 'heir health. However homely fh-ir fare be, nev ougnt to have it at regular times; and die harder they work, the more 5: drank even in form of wort, is very wholefome, and is found to; be an antidote againft the fcurvy. Small wines and cider might likewife be plentifully laid in ; and fhould they turn four, they would ftill be ufeful as vinegar. Vinegar is a great antidote againft difeafes, and fhould be ufed by all travellers, efpecially at fea. It may either be mixed with the water they drink, or taken in their food. Such animals as can be kept alive, ought likewife to be car- ried on board, as hens, ducks, pigs, &c. Frefh broths made of portable foup, and puddings made of peas or other vegetables, ough«: to be ufed plentifully. Many other things will readily oc- cur to people converfant in thefe matters, which would tend to preferve the health of that brave and ufeful fet of men.*^ We have reafon to believe if due attention were paid to the diet, air, cloathin?, and above all things to the cleanlinefsf of fea- faring people, rhey would be the moft healthy fet of men in the world; but when thefe are neglected, the very reverfe will happen. The beft medical antidote that we can recommend to failors or fahiiers on foreign coafts, efpecially whtre dampnefs prevails, is the Peruvian b^rk. This will often prevent fevers, and other fatal difeafes. About a drachm of it may be c-ewed every dvy; or if this fh uld prove difagreeable, an ounce of bark, with hair an ounce of ormge pe~l, ar.d *wo drachms of fnake-root coirfely powdered, may be infufed for two or three days in an Englifh quart of brandy, and half a wine glafs of it may I e taken twice or thrice a-day, when the ftomach is empty. This has been f uni to be an excellent antidote againft fluxes, putrid, intermitting, and other fevers, In unhealthy climates. It is not material in what form this medicine is taken. It may either be infufed in water, wine, or fpirits, as recommended above, or made into an electuary with fyrups of lemons, oranges, or the like. The Sedentary. Though nothing can be more contrary to the nature of man than a fedentary life, yet this clafs comprehends by far the great- er part of the fpecies. Almoft the whole female world, and in manufacturing countries, the major part of the males, may be reckoned fedentary4 „, * Tj>c celebrated Capta'-n Cook has fliewn how far, by proper care and attention, the difeafes formerly fo fatal to feamen may be prevented. In a voyage of three years an* eighteen days, during which he was expofed to every climate, from the <3 deg. north, to the 71 deg. of fouth latitude, of one hundred and eighteen men, compofine the (hip's company, he loft only one, who died of a Phthifis Pulmonalis. The principal means he once a wee* to waih their feet clean, is worthy of general attention, as a means' of pre- ierving health. * rKg 1 Toe appellation of fedentary hasgenerally been given only to the ftudious : we can fee no -eafon, however, tor reftn.St.ue it to them alone. Many artificers may, with « much propriety, be denominated fedentary as the ftudious, with this particular diiadvan- AND THE STUDIOUS* 5$ Agriculture, the firft and moft healthful of all employments, is now folk wed by few who are able to crry on anv other ' u- linefs. But thofe who imagine that the culture of the e-rth is not fufficient to employ all its inhabitants, are erectly miftaken. An ancient Roman, we are told, could mainta;n his family from the produce of one acre of ground. So might a modern Briton, if he would be contented to live like a Roman. This fhews what an immenfe increafe of inhabitants Britain might admit of, and all of them live by the" culture of the ground. Agriculture is the great fource of domeftic riches. Where •it is negle&V., whatevar wealth may be imported from abrcad, poverty and rnifery will abound at home. Such is, and ever will be, the fluctuating ftate of trade and manufactures, that thoufands of people may be in full employment to-day and in beggary tomorrow. This can never happen to thofe who culti- vate the ground. They can eat the fruit of their labor, and ata ways by industry obtain, at leaft, the neceflaries of life. Though fedentary employments are neceflary, yet there feems to be no reafon why any perfon fhould be confined for life to thefe alone. "Were fuch employments intermixed with the more active and laborious, they would never do hurt. It is con- ftant confinement that ruins the health. A man may not be hurt by fitting five or fix hours a-day ; but if he is obliged to fit ten or twelve, he will foon become difeafed. But it is not want of exercife alcne which hurts fedentary people ; they likewife fuffer from the confined air which they breathe. It is very common to fee ten or a dozen taylors,* or ftiy-m \kers, for example, crowded into one fmall apartment,, where there is hardly room for one perfon to breathe freely. In? this fituation they generally continue for many hours at a time, often with the addition of feveral candles, w ich tend likewife to wafte the air, and render it lefs fit for refpiraton. Air that is breathed repeatedly becomes unfit for expanding the lungs. This is one caufe of the phthifical coughs, and other complaints of the breaft, fo incident to fedentary artificers, Even the perfpiration from a great number of perfons pent up together, renders the air unwholefome. The danger from, this quarter will be greatly iccreafed, if any one of them happens. to have bad lungs, or to be other wife difeafed, Thofe wno fit. near him, being forced to breathe the fame air, can hardly fail to be infected. It would be a rare thing, however, to find a dozen of fedentary people all in good health. The danger of crowding them together muft therefore be evident to every one. Many of thofe who follow fedentary employments are con- stantly in a bending pofture, as fhoamakers, taylors, cutlers, &c. Such a fituation is extremely hurtful. A bending pasture ob- * A perfon of obfervation in that line of life told me, that moft taylors die of con- fumptions'} which he attributed chiefly to the unfavorable poftures in which they fit, and the unwholefomenefs of thofe places where their bufinefs is carried on. If more attention was not paid to profit than to the preservation of human live,, this evil might he eahjy e-nedied : but while makers only mind ttittr own tntereft, iioqunf will H •«* tot *« ..\:;'yiof thsir fcrvar.:». So THE LABORIOUS, THE SEDENTART, ftructs all the vital motions, and of courfe muft deftroy the health. Accordingly we find fuch artificers generally complaining of in- digeftions, flatulencies, head-achs, pains of the breaft, &c. The aliment in fedentary people, inftead of being pufhed forwards by an erect pofture, and the action of the mufcles, is in a manner confined in the bowels. Hence indigeftion, coftivenefs, wind, and other hypochondrical affections, the conftant compan- ions of the fedentary. Indeed none of the excretions can be du- ly performed where exercife is wanting; and when the matter which ought to be difcharged in this way is retained too long in the body, it muft have bad effects, as it is again taken up into the Siafs of humours. A bending pofture is likewife hurtful to the lungs. When this organ is comprefled, the 3ir cannot have free accefs in all its parts, fo as to expand them properly. Hence tubercles, adhe- fions, &c. are formed, which often end in confumptions. Befides, the proper action of the lungs being abfolutely neceflary for making go-.-d blood, when the organ fails, the humours foon become univerfally depraved, and the whole conftitution goes to wreck. Sedentary artificers are not only hurt by preflure on the bowels, but alfo on- the inferior extremities, which obstructs the circulation in thefe par'. s,and renders them weak and feeble. Thus taylors, fhoemakers, &c. frequently lofe the ufe of their Jegs al- together ; befides the blood and humours are, by ftagnatiflb, vi- tiated, and the perfpiration is obstructed; from whence proceed the fcab, ulcerous fores, foul blotches, and other cutaneous dif- eafes fo common among fedentary artificers. A bad figure of body is a very common confequence of dofe application to fedentary employments. The fpine, for example, by being continually bent, puts on a crooked fhape, and gener- ally remains fo ever after. But a bad figure of body has already been obferved to be hurtful to health, as the vital functions are thereby impeded. A fedentary life feldom fails to occafion an univerfal relaxa- tion of the folids. This is the great fource from whence melt of the difeafes of fedentary people flow. The fcrophula, conlump- tion,hyfterics, and nervous difeafes, nowfocommon, were very lh- -tleknown in this country before fedentary artificersbecamefonu- merous ; and they are very little known ftill among fuch of our people as follow active employments without doors, though in great towns at leaft two thirds of the inhabitants are afflicted. with them. ■ It is very difficult to remedy thofe evil?, becaufe many who have been accuftomed to a fedentary Ife, like ricketty children, lofe all inclination for exercife ; we fhall, however, throw out a few hints with refpect to the moft likely means for prefcrving the health of this ufeful fet of people, which fome of them, we hope, will be wife enough to take. It has been already obferved, that fedentary artificers are of- ten hurt by their bending pofbre. They ought therefore to AND THE STUDIOUS. * 6% ftand or fit as erect as the nature of their employments will per- mit. They fhould likewife change their pofture frequently, and ftiould never fit too long at a time, but leave off w Tk, and walk, ride, run, or do any thing that will promote t e vital functions. Sedentary artificers are generally allowed too little time for exercife; yet fhort as it is, thev feldom employ it properly. A journeyman taylor or weaver, for example, inftead of walking abroad for exercife and frefh air, at his hours of leifure, chufes often to fpend them in a public houfe, or in playing at fome fed- entary game, by which he generally lofes both his time and his money. The awkward poftures in which many fedentary artificers work, feem rather to be the effect of cuftom than neceflity. For example, a table might furely be contrived for ten or a dozen tay: lors to i\t round with liberty for their legs either to hang down, or reft upon a foot-board, as they fhould chufe. A place might likewife be cut out for each perfon, in fuch a manner that he might fit as conveniently for working as in the prefent mode of fitting crofs-legged. All fedentary artificers ougM to pay the moft religious regard to cleanlinefs. Both their fituation and occupations render this highly neceflary. Nothing would contribute more to preferve their health, than a strict attention to it; and fuch of them as neglect it, not only run the hazard of lofing health, but of becom- ing a nuifance to their neighbors. Sedentary people ought to avoid food that is windy or hard of digeftion, and fhould pay the ftricteft regard to fobriety. A perfon who works hard without doors will foon throw off a de- bauch; but one who fits has by no means ?.n equal chance Hence it often happens, that fedentary people are feized with fe- vers after hard drinking. When fuch perfons feel their fpirits low, inftead of running to the tavern for relief, theyfbruld ride or walk in the fi-dd. This would remove the complaint more effctually than ftrong liquor, and would never hurt the confti- tution. Iiftead of multiplying rules for preferving the health of the fedentary, we (hall recommend to them the fallowing general plan, viz. That every perfon who follows a fedent-ry employ- ment fhould cultivate a p;ece of ground with his own hands. This he might dig, plant, fow, and weed at leifure hours, fo as to make it both an exercife and nmuiement, while it produced many of the neceffaries of life. After working an hour in a gar- den, a man will return with more keennefs to his employment v'/.thin door?, than if he had been oil the while idle. Laboring the ground is every way conducive to health. It not only gives exercife to every part of the body, but the very fmell ot the earth and frefh herbs revives and cheers the fpirits, whilft the perpetual profpect of fomething coming to maturity, delights and entertains the mind. We are lb formed as to be always pleafed with fomething in profpect, however diftant or however trivial.r Hence the happiaefs that moft men feel in r52 * THE LABORIOUS, THE SEDENTART, planting, fowing, building, &c. Thefe feem to have been the chief employments of the more e?rly ges ; and, when kings and conquerors cultivated the ground, there is reafon to believe that they knew, as well wherein true happinefs confined as we do. It may feem romantic to recooime-:d %. rdening to manufac- turers in gre,it towns i but obfervation proves that the plan is very practicable. In t e town of Sheffield, in Y rkfhire, where the great iron manufacture is carred on, there is hardly a journ- eyman cutler who ^oes not p flHs a piece of ground, which, he cultivates as a garden. Tins practice has many falutory effects. It not only induces thefe pe pie to take exercife without doors, but alfo to ear many greens, roots, &c. of their own growth, which they would never think of purch.fipg. There can be no reafon why manufacturers in any ther town in Great-Britain fhould not follow the fame plan. It is indeed to be regretted, that in fuch a place as Lo* don a pi n of this kind is not practica- ble ; yet even there, fedentary artificers may find opportunities of taking air and exercife, if they c ufe to embrace them. Mechanics are too much inclined to croud into great towns. The fituation may have fome advantages, but it has likewife ma- ny difadvantages. All mechanics who live in the country have it in their power to cultivate a piece of ground ; which indted moft of them do- This not only gives them exercife, but enables them to live more comfortably. So far at leaft as my obferva- tion extends, mechanics who live in the country are far more happy than thofe in great towns. They enjoy better health, live in greater affluence, and feldom fail to rear a healthy and numer- ous offspring. In a word, exercife without doors, in one fhape or another, is abfolutely neceflary to health. Thofe w^o neglect it, though they may for a while drag out life, can hardly be laid to enjoy it. Weak and effeminate, they languifh for a few years, and foon drop into an untimely grave. The Studious. Intenfe thinking is fo destructive to health, that few inftan- ces can be produced of ftudious perfons who are ftrong and heal- thy. Hard ftudy always implies a fedentary life; and when in- tenfe thinking is joined to the want of exercife, the confSequences. muft be bad. ,We have frequently known even a few months of clofe application to ftudy ruin an excellent conftitution, by in- ducing a train of nervous complaints, which could never be re- moved. Man is evidently not forned for continual thought more than for perpetual action, and would be as foon worn out by the one as the other. t So great is the power of the mind over the body, that, by its influence, the whole vital motions may be accelerated or re- tarded, to almoft any degree. Thus cheerfulnefs and mirth quicken the circulation, and promote all the fecretions ; whereas .fadnefs and profound thought n§ver fail to retard them. Hence it would appear, that era a degree of thoughOdiiefs, is neceijji- AND THE STUDIOUS. €3 ry to health. Indeed the perpstual thinker feldom enjoys either health or fpirits; while the perfon who can hardly be fajd to think at all, generally enjoys both. Perpetual thinkers, as they are called, feldom think long. In a few years they generally become qute ftupid, and exhibit a m?lanch.-jy proof how readily the greateft hlefliogs maybe abu^ fed. fhinkirg, like every thing elfe, when carried to extreme, becomes a vice; nor can any thing aff rd a greater proof of wif- dom, than for a man frequency and feafonably to unbend his mind.. This may genen lly be done by mixing in cheerful con> pany, active diverfions, or the like- Inftead of attempting to investigate the nature of that con- nection which fubGfts between the mind and body, or to inquire int-i the manner in which thev mutually affect each other, we fhall orly mention thofe difeifes to which tne learned are more peculiarly liable, and endeavor to point out the means of avoid- ing them. Srudious perf ns are very fubject to the gout. This pain- ful difeafe in a great meafure proceeds from indigeftion, and an obftiuctel perfpiration. It is impoflible that the man who fits from morning till night fhould either digest his food, or have any of the fecretions in due quantity. But when that matter whicit fhould be thrown off by the fkin, is retained in the body, and the humours are n t duly prepared, difeafes muft enfue. The ftudious are likewife very liable to the flone and gravel. Exercife greatly promotes both the fecretion and difcharge of the urine ; consequently a fedentary life muft have the contrary effect. Any one may be fatisfied of this by obferving that he pafles much more urine by day than in the night, and alfo when he walks or rides, than when he fits. The circulation in the liver being flow, ob'ftmctions in that organ can hardly fail to be the confequence of inactivity. Hence fedentary people are frequently afflicted with fchirrous livers. But the* proper fecretion and difcharge of the bile is fo neceflary a part of the animal economy, that were thefe are not duly per- formed, the health muft foon be impaired. Jaundice, indigeftion, lofs of appetite, and a wafting of the whole body, feldom fail to be the confequences of a vitiated ftate of the liver or obftructions of the bile. Few difeafes prove more fatal to the ftudious than confump- tions of the lungs. It has already been obferved, that this organ cannot be duly expanded in thofe who do not take proper exer- cife; and where this is the cafe, obftructions and adhefions will enfue. Not only want of exercife, but the pofture in which ftudious perfons generally fit, is very hurtful to the lungs. Thofe who read or write much are ready to contract a habit of bend- ing forwards, and often prefs with their breaft upon a table or bench. This pofture cannot fail to hurt the lungs. The functions of the heart may likewife by this means be injured. I remember to have feen a man opened, whofe peri-, -ardiura adhered to the breaft-bene in fuch a manner as to ob- 64 THE LABORIOUS, THE SEDENTART, ftru£t the motion of the heart, and occa'.ion nis death. The on- ly pr -jon'decaufe that could be afligned for this lingular fyniptom was, that the man, whofe bufinefs was writing, ufed constantly to fit in a bending pofture, with his breaft preiling upon the edge of a plain table. No perfon can enjoy health who does not properly digeft his f xxl. But intenfe thinking and iuactivi' y never fail to weak, en the powers of digeftion. Hence the hum urs become crude and vitiated, the folids weak and relaxed, and the whole confu- tation goes to ruin. Long and intenfe thinking often occafions grievous head- achs, which bring on virtigoes, apoplexies, palfies, and other fatal diforders. The beft way to prevent thefe is, never to ftudy too long at one time, and to keep the body regular, either by proper food, or taking frequently a little of fome opening raecU icine. Thofe who read or write much are often afflicted with fore eyes. Studying by candle-light is peculiarly hunful to the fight, T iis ought to be practifed as feldom as poflible. When i: is un- av liable, the eyes fhould be fhaded, and the ead fhould oot be held too low. When the eyes are weak or painful, th y fhould h? bathed every nigrit and morning in cold water, to which a lit* tie brandy may be added. It has already been obferved, that the excre'ions are very defective in the ftudious. The dropfv is oftet occafioned by the retenti- n of thofe humours which ought to be carried off in this wav. Any perfon may obferve, that fitting makes his i^gs fwell, and that this goes off by exercife; which clearly points out the method of prevention. Fevers, efpecially of the nervous kind, are often the effect of ftudy. Nothing affects the nerves fo much as intenfi thought. It in a manner unhinges the whole human frame, and not r nly hurts the vital motions, but diforders the mind itfelf. Hence a deliriu , melancholy, and even madnefs, are often the effect of clofe application to ftudy. In fine, there is no difeafe which can proceed either from a bad ftate of the humours, a defect of the ufual fecretions, or a debility of the nervous fyftem, which may not be induced by intenfe thinking. But the moft afflicting of all the difeafes which attack the ftudious is the hypocoudriuc. This difeafe feldom fails to be the companion of deep thought. It may rather be called a complica- tion of maladies than a fingle one. To what a wretched condi- tion are the beft of men often reduced by it! Their ftrength and appetite fail; a perpetual gloom hangs over their minds; they live in the constant dread of death, and are continually in fearch of relief from medicine ; where, alas! it is not to be found. Thofe who labor under this diforder, though they are often made the fubject of ridicule, juftly claim our higheft fympathy and companion. Hardly any thing can be more preposterous than for a per- gp to make ftudy his fole feufofiffr fr mere, ftudent is fejojonj AND THE STUDIOUS. 65 An ufeful member of fociety. He often neglects the moft im- portant duties of life, in order to purfue ftudies of a very trifling nature. Indeed it rarely happens that any ufeful invention is the effect of mere ftudy. The farther men dive into profound researches, they generally deviate the more from common fenf?, a-".d too often 1 Me fight of it altogether. Profound {peculations, inftead of making men wifer or better, generally render them abfolute fceptics, > and overwhelm them with doubt and uncer- tainty. All that is neceflary for a man to know, in order to be happv, is eafily obtained; and the reft, like the forbidden fruit, ferves only to increafe his mifery. Studious perfons, in order to relieve their minds, muft not only difcontinue to read and write, but engage in fome employ- ment or diverfion that will not fo far occupy the thought as to make them forget the bufinefs of the clofet. A folitary ride or walk are fo far from relaxing the mind, that they rather encour- age thought. Nothing can divert the mind when it gets into a train of ■erious thinking, but attention tofubjects of a more triv- ial nature. Thefe prove a kind of piay to the mind, and confe- queatly relieve it. Learned men often contract a contempt for what they call trifling comoany. They are afharned to be feen with any but philosophers. This however is no proof of their beirg phiiofo- phers themfelves. No man deferves that name who is afhamed to unbend his mind, by aflbeiating with the cheerful and gay. Even the fociety of children will relieve the mind, and expel the gloom which application to ftudy is too apt to occafion. As ftudious people are neceflarily much within doors, they fliould make choice of a large and well aired place for ftudy. This woul I not only prevent the bad effects which attend confin- ed air, but would cheer the fpirits, and have a moft happy influ- ence both on the body and mind. It is laid of Euripides the tra- gedian, that he ufed to retire to a dark cave to compofe his trag- edies, and of Demofthenes the Grecian orator, that he chofe a place for a ftudy where nothing could be either heard or feen. With all deference to fuch venerable names, we cannot help con- demning their tafte. A man may furely think to as good pur- pofe in an elegant apartment as in a cave; and may have as hap- py conceptions where the all-cheering rays of the fun render the air wholefome, as in places where they never enter. Tnofe who read or write much ihould be very attentive to their pofture. They ought to fit and ftand by turns, always keeping as nearly in an erect pofture as poflible. Thofe who dictate, may do it walking. It has an excellent effect frequently to read or fpeak aloud. This not only exeroifes the lungs, but almoft the whole body. Hence ftudious people are greatly ben- efited by delivering difcourfes in public. Public fpeakers, indeed, fometimes hurt themfelves, by overacting their part; but that is their own fault. The martyr to mere vociferation merits not our fympathy. The morning has, by all medical writers, been reckoned the 66 THE LABORIOUS, THE SEDENTART, he. belt time for ftudy. It is fo. But v is alfo t e moft proper feafon for exercife, while the ftomaca is empty, and ths fpirits ;refrefhed witn fleep. Studious people fhould therefore fome- times fpend the morning in waikr g, riding, or fome manly diver- sions without doors. This would make them return to ftudy with greater alacrity, and would be of more fervce than twice the time after their fpirits are worn out with fatigue. It is not fufficirnt to take diverfion only when we can think no longer. Every ftudious perfon fhould make it a part of his bufinefs, md fliould let nothing interrupt his hours of recreation more than thofe of ftudy. Mufic has a very happy effect in relieving the mind when fatigued with ftudy. It would be well if every ftudious perfon were fo far acquainted with that fcience as toamufe him felf after fevere thought, by playing fuch airs as have a tendency to raife the fpirits, and infpire cheerfulnefs and good humour. It is a reproach to learning, that any of her votaries, to re- lieve the mind after ftu \y, fhould betake themfelves to the ufe of ftrong liqu rs.* This indeed is a remedy ; but it is a deiper- ate one, and always proves destructive. Would fuch perfons, when their fpirits are low, get on horfeback, and ri 'e ten or a dozen miles, they would find it a more effectual remedy than any cordial medicine in the apothecary's fhop, or all the ftrong liqu rs In the world. The following is ray plan, and I cannot recommend a better to others. When my mind is fatigued with ftudy, or other feri- ous bufinefs, I mount my horfe, and ride ten or twelve miles in- to the country, where I fpend a day, and fometimes, two with a cheerful friend; after which I never fail to return to town with new vigor, and to purfue my ftudies or bufinefs with frtfn alacrity. It' is much to be regretted, that learned men, while in ;-ealtn, pay fo little regard to thefe things 1 There is not any thing more common than to fee a miferable object over-run with nervous dif- eafes, bathing, walking, riding, and, in a word, doing every thing for health after it is gone; yet, if any one had recommended thefe t angs to him by way of proventi o, the advice would, in all probability, have been treated with contempt, or, at leaft, with neglect. Such is the weaknefs and folly cf mankind, and fuch the waot of forefig t, even in thofe who ought to be wifer than others! With regard to the ^'et of the ftudious, we fee no re:fon why they should abstain from any kind of food that is whole* fome,provided they ufi- it in moderation. They ought, however, to be fp?ring in the ufr of every thin\\ that is windy, rancid, or hard of digeftion. Their fuppers fhould always be light, or taken foon in the evening. Their drink may be water fine malt '"To fuch perfons," fays Dr. Rufh, " it mav be a difcovery to know, that tea is a much better remedy for that purpofe. By its grateful and gentle ftimulus, it removei fa- tigue, reftores the eictement of the mind, and invigorates the whole fyftem. I am no advocate for the exceffive ufe of tea. When taken too ftrong, it h hurtful efpecially to the female conftitution ; but, when taken of a moderate degree of ftrength a'nd in moder- ate Quantities, with fugar and cream, or milk, 1 believe it is, in general, innoxious.and at all times, tc be preferred to ardeat fpirits, as a cordial for ftudious men," a * ' OF ALIMENT. s 6*7 liquor, not too ftrong, good cyder, wine and watet, or, if troub- led with acidities, water mixed with a little brandy, rum, or any other genuine fpirit. We fhall only obferve, with regard to thofe kinds of exer- cife which are moft proper for the ftudious; that they fhould not be too violent, nor ever carried to the degree of exceffive fa- tigue. They ought likewife to be frequently varied lb as to give action to all the different parts of the body; and fhould, as often as poflibl?, be taken in the open air. In ge eral, riding on horfe- back, walking, working in a garden, or playing at fome active diverfions, are the beft. We would likewife recommend the ufe of the cold bath to the ftudious. It will, in fome menfure, lupply the place of exer- cife, and fhould not be neglected by perfons of a relaxed habit, efpecially io th? warm feafon. No perfon oug; t either to take violent exercife or to ftudy immediately after a full meal. CHAP. III. OF ALIMENT. U N WHOLESOME food, and irregularities of diet, 00 cafion many difeafes. There is'no doubt but the whole confti- tution of body may be changed hy diet alone. The fluids may be thereby atrenuated or condenfed, rendered mild or acrimoni- ous, coagulated or diluted, to almofi any degree. Ner are its effects upon the folids lefs confiderable. They may be braced or relaxed, have their fenfibility, motions* &c. greatly increafed or diminifhed, by different kinds of aliment. A very fmall atten- tion to taefe things will be fufficient to fhew, h. w much the pre- fervation of health depends upon a proper regimen of the diet. Nor is an attention to diet neceflary for the prefervation of health only; it is likewife of importance in the cure of difeaf- es. Every intention in the cure of many difeafes, may be anf- wered by diet alone. Its effects, indeed, are nor always fo quick as thofe of medicine, but they are generally more lasting ; beiides, it is neither fo difagreeable to the patient, nor fo dangerous as medicine, and is always more eafily obtained. Our intention here is not to inquire minutely into the nature and properties of the various kinds of aliment in ufe among mankind; nor to fhew their effects upon the different constitu- tions of the human body ; but to mark f. me of ihe moft perni- cious errors which people are apt to fall into, with refpect both to tne quaotity and quality of their food, and to point out their influence upon health. It is not indeed an eafy matter toafcertain the exact quanti- ty of food proper for every age, fex, and conftitution ; but a fcru- pulous nicety here is bv no means neceffarv. The beft rule is to avoid all extreme^, lYUndaad \yere never intended to weigh and •<58 .OF ALIMENT. mesfure t^e'r food. Nature teaches every creiture when it has enough ; and the calls of thirft and hunger are fufficieHt to inform them when more is neceffarv. Though moderation-is the chief rule with regard to thequan- thy, yet the quality of food merits a farther confideration. There are many ways by which provifions may be rendered unwhole- fome. Bad feafons may either prevent the ripening of grain, or damage it afterwards. Tlvfe, indeed, are acts of Providence, and we muft fubmit to them; but furely no punifhmenr can be too fevere for thofe who fuffer provifions to fpoil by hoarding them, on purpofe to raife the price, or who promote their own intereft by adulterating' the neceflbries of life.* Animal, as well as vegetable food, may be rendered un- \i holefome, by being kept too long. All animal fubftana-s have a conftant tendency to putrefaction ; and, when that has pro- ceeded too far, they not only become offenfive to the fenfes, but hurtful to health. Difeafed animals, and fuch as die of them- felves, ought never to be eaten. It is a common practice, how- ever, in fome grazing countries, for fervants and poor people to eat fuch animals as die of any difeafe, or are killed by accident. Poverty, indeed, may oblige people to do this; but they had bet- ter eat a fmaller quantity of what is found and wholefome: it would both afford a better nourifhment, and be attended' with lefs danger. The injunctions given to the Jews, not toct any creature which died of itfelf, feemed to have a strict regard to health ; and ought to be obferved by Christians as wdl as Jews. Animals never die themfelves without fome previous difeafe ; but how a difeafed animal fhould be wholef me food, is inconceivable : even thofe which die by accident muft be hur ful, as their blood is mixed with the flefh, and foon turns putrid. Animals which feed grofsly, as tame ducks, hogs, .&c. are neither fo eafily digested, nor afford fuch wholefome nourifhment as others. No animal can be wholefome which does not take fufficient exercife. Moft of our flailed cattle are crammed with grofs food, but not allowed exercife nor free air; by which means they indeed grow fat, but their juices not being properly prepared or aflimilated, remain crude, and occafion indigestions, grofs humours, and oppreflion of the fpirits, in thofe who feed upon them. Animals are often rendered unwholefome by being over- heated. Exceffive heat caufes a fever, exalts the animal falts, and mixes the blood fo intimately with the flefh, that it cannot be feparated. For this reafon, butchers fhould be feverely pun- ched who over-drive their cattle. No perfon would chufe to eat the flefh of an animal which had died in a high fever; yet this is the cafe with all over-drove cattle; and the fever is often raifed even to the degree of madnefs. .. * J1^ p,°?r' .indeed> are generally the firft who fuffer by unfound provifions; but the lives of the laboring poor are of great importance to the ftate : befides, dileafr- occafioned by unwholefome food often prove infeftious, bv which mtans they reach people in everv . ftation. It is therefore the intereft of all to take care that no fpoilt provifions of anv kind Y\r> pvnAUrl fn frt'.m. * «m*j fequence of their general ufe. Though they do not kill fudden- ty, yet they hurt the nerves, relax and weaken the ftomach, and fpoj th? digeftion* 7* OF ALIMENT. ' Were fermented liquors faithfully prepared, kept to a props' er aee. ^od ufed in moderation, they would prove real bleffings' to mankind. But, while they are ill prepared, various ways adulterated, and taken to excefs, they muft have many pernicious effects. We would recommend it to families, not only to prepare the'r ~wn liquors, but likewife their bread. Bread is fo neceflary a part of diet, that too much care cannot be beftowed in order to have it found and wholefome. For this purpofe, it is not on- ly neceflary that it be made of good grain, but likewife properly prepared, and kept free from all unwholefome ingredients. This, however, we have reafon to believe is not always the cafe with bread prepared by thofe who make a trade of vending it. Their objeft is rather to pleafe the eye, than to confult the health. The beft bread is that which is neither too coarfe nor too fine ; well fermented, and made of wheat flower, or rather of wheat and rye nvxed 'o.^ethsr. 7 o fpecify the different kinds of aliment, to explain their na- ture and properties, and to point out their effects in different enftitutions, would far exceed the limits of our defign. Inftead of a detail of this kind, which would not be generally underft ~odv and of courfe little attended to, we fhall only mention the fol- lowing eafv rules with refpect to the choice of aliment. Perfons whofe folids are weak and relaxed, ought to avoid all yifcid food, or fuch things as are hard of digeftion. Their di- et, • owev r, ought to be nourifhing; and they fhould take fuffi- cient exercife in the open air. Such as abound with blood fhould be fparing in the ufe of everv thing that i? highly nourifhing, as fat meat, rich wines, • ftrong ale, and fuch like. Their food fhould confift chiefly of bread and other vegetable fubftances; and their drink ought to be water, whey or fmall beer. Fat people fhould not eat freely of oily nourifhing diet. They ougrt frequently to ufe horfe-raddifh, garlic, fpices, or fuch things s are heating and promote perfpiration and urine. Their drink fhould be water, coffee, tea, or the like; and they ought to take much exercife and little fleep. Thof ? who are too lean muft follow an oppofite courfe. Such as are troubled with acidities, or whofe food is apt to four on fhe ftomach, fhould live much on animal food ; and thofe who are afflrctod with hot billious eructations,ought to ufe a diet confiftinpr chiefly of acid vegetables. . i People who are afflicted With the g^ut, low fpirits, hypo- chondriac or hvfteric diforders, ought to avoid all flatulent food, every tiin that isvifcid,orhard of digeftion, all falted or fmc.ke-: dried provifions, and whatever is au! ere, acid, or apt to turn four on the ftomach. Their food fhould be light, fpare, cool, and of an opening nature. The diet ought not only to be fuited to the age and conftitu- tion, out alfo t<> the manner of life ; a fedentary or ftudicus per- • fbn fhould live more fparingly than one who labors hard without OF ALIMENT. 73 doofs. Many kinds of food will nourifti 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 fome bad effects. Nature teaches us this, by the great variety of aliment which fhe has provided for man, and likewife by giving him an appetite for different kinds of food. Thofe who labor under any particular difeafe, ought to avoid fuch aliments as have a tendency to increafe it; for exam- ple, a gouty perfon fhould not indulge in rich wines, ftrcng foups, or gravies, and fhould avoid all acids. One who is troubled with the gravel ought to shun all auftere and astringent aliments; and thofe who are fcorbutic fhould be fparirg in the ufe of falted provifions, &c. In the firft period of life, our food ought to be light, but nourifhing, and frequently taken. Food that is folid, with a fuf- firient 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 nearly to tjiat of the firft. It fhould be lighter and more fucculent^than that of vigorous age, and like- wife more frequently taken. It is not only neceflary for health that our diet be wholefome, but alfo that it be taken at regular periods. Some imagine that long faffing will atone for excefs ; but this, inftead of mending the matter, generally makes it worfe. When the ftomach and inteftines are over diftended with food, they lofe their proper tone, and, by long farting, they become weak, and inflated with wind. Thus, either gluttony or falling deftroys the powers of digeftion. The frequent repetition of aliment is not only neceflary for repairing thfe continual wafte of our bodies, but likewife to keep the fluids found and fweet. Our humours, even in tie moft healthy ftate, have a conftant tendency to putrefaction, which can only be prevented by frequent fupplies of frefh nourifhment: when that is wanting too long, the putrefaction often proceeds fo far as to occafion very dangerous fevers. From hence we may learn the neceflity of regular meals. No perfon can enjoy a good ftate of health, whofe veffeh are either frequently overcharg- ed, or the humours long deprived of frefh fupplies of chyle. Long faffing is extremely hurtful to young people ; it not only vitiates their humours, but prevents their grown. Nor is it lefs injurious to the aged. Moft perfons, in the decline of life, are afflicted with wind: this complaint is.not only increafed, but even rendered dangerous, and often fatal, by long rafting. Old people, when their stomachs are empty, are frequently feiz -d with giddinefs, head-achs, and faintnefs. 1 hefe complaint; may gen- erally be removed by a piece of bread and a glafs of wine, or tafe« ing any other folid food : which plainly points out the method of preventing them. j^L. It is more than probable, that many of the lu^den-OTtlft* W OF ALIMENT. which happen in the advanced periods of life, are occafioned by faffing 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 allow their ftomachs to be too long empty. Many people take nothing but a few cups of tea and a little bread, from nine o'clock at night till two or three next afternoon. Such may be faid to fait almoft three fourths of their time. This can hard- ly fail to ruin the appetite, vitiate the humours, and fill the bow- els with wind ; all which might be prevented by a folid breakfaft. It is a very common practice to eat a light breakfaft and a heavy fupper. This cuftom ought to be reverfed. When peo- ple flip late, .their fupper fhould be very light; but the breakfaft ought always to be folid. If any one eats a light fupper, goes foon to bed, and rifes betimes in the morning, he will be fure to find an appetite for his breakfaft, and he may freely indulge it. T1 e Prong and her.lthy do not indeed fuffer fo much from faft'n?; as the weak and delicate; but they run great hazard from its oppofite, viz. repletion. Many difeafes, efpecially fevers, are the effect of a plethora, or too great fullnefs of the veflels. Strong people, in high health, have generally a great quantity of blood and other humours. When thefe are fuddenly increased, by an overcharge of rich and nourifhing diet, the veflels become too much diftended, and obftructions and inflammations enfue. Hence fo many people are feized with inflammatory and eruptive fevers, apoplexies, &c. after a feaft or debauch. All great and fudden changes in diet are dangerous. Whnt the ftomach has been long accuftomed to digeft, though lefs wholefome, will agree better with it than food of a more faluta- rv nature to which it has not been ufed. When therefore a change becomes neceflary, it ought always to be made gradually; a fudden tranfition from a poor and low, to a rich and luxurious diet, or the contrary, might fo difturb the functions of the body as to endanger health, or even to occafion death itfelf. When we recommend regularity in diet, we would not be underftood as condemning every fmall deviation from it. It is n^xt to imnoffible 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 lit- tle, fometimes taking more, fometimes lefs, than the ufual quan- tity of meat and drink, provided always that a due regard be had to moderation. § Notwithstanding our author's omhTion of a general account of the qualities of the different kinds of animal and vegetable food roft commonly ufed in diet, we think the following not un- worthy attention. " Beef.—When this is the- flefh of a bullock of middle age, it affords good and ftrong nourifhment, and is peculiarly well adap- ted to thofe who labor, or take much exercife. It will often fit eafy upon the ftomachs that can digeft no other kind of food; aud its fat is almoft as eafiiy digeited as that of vcaL. OF ALIMENT. 75 " Veal is a proper food for perfons recovering from an indif- pofition, and may even be given, to febrile paints ;n a very w.-ak ftate, but it affords lefs nourifhment than the flefh of the fame animal in a ftate of maturity. The fat of it.is lighter than ttrt of any other animal, and mows the leaft dfpciiriM to purref- cency. Veal is a very fuitable food in coftive habits; but of all meat it is the leaft calculated for removing an acid from the ftomach. " Mutton, from the age of four to fix vears, and fed on r*ry pasture,, is an excellent meat. It,is of a middle kind between the hrmnefs of beef and the tendernefs of veal. Th • lean part of mut- ton, h ,w>ver, is the moft nourifhing, and conducivfe to health; the fat bei-g hard of digeftion* The h rd of thf fheeo, erpecially when diverted of the fkin, is very tender; and the feet* on account of the jelly they contain, highly nutritive. " Lamb is not fo nourishing as mutton; but it is light, and ex- tremely fuitable to delicate ftomarhs. " Houfe-lamb, though much esteemed by many, poffeffes the bad qualities common to the flefh of all animals reared in an unnat- ural way. " Pork affords rich and fubftantial nourifhment; and its juices are wholefome when properly fed, and when the animal enjoys pure air and exercife. But the flefh of ho*s reared in towns is both hard ot digeftion and unwholefome. Pork is particularly improper for thofe who are liable to any foulnefs of the fkin. It is almoft proverbial, that a dram is good for promoting its digeftion: but this is an erroneous notion : for, though a dram may give a mo-nen- tary ltimulus to the coats of the ftomach,it tends to harden the flefh, and ot courfe, to make it more indigeftible. •n. 1" *f^'ww are a ftron& kind of me*U and rather fit for a rel- lfh than for diet. It is the quality - fall falted meat that the fibres become riaid, and therefore more difficult of digeftion: and w en fo this is added fmoaking, the heat of the chimney occafions the fait to concentrate, and the fat between »he mufcles to be-ome rancid. • 1 nacor\ lsn air° of an ^'geftible quality, and is apt to turn ran- cid on weak ftomachs. " The flefh of goats is hard and indigeftible; but t^at of kids ia tender, as well as d-licnus, ond affords good -ourifhonent. Vfnifm, or the fl*fh of deer, and that of hares, is of a nourifh- ing quahty but is liable to one inconvenience; w ich is, that th wh much difprfed to putrefcency of itfelf, it muft be kept for a little time before it be omes tender. " The blood of animals is ufed ^s aliment by the common peo- ple: but they could riot 1 >ng fubfift upon ir unlefs mixedwith'-^t- meal, &c. for it is not foluble alone by the dig-ft've powers of thehu- mau ttomach, and therefore cannot be nourifTrne. Milk -s of very different confiftence in different animals: but that of cows being the kind ufed in diet, i* at prefent the object of our attention Milk where it agrees with the ftomac\ affords ex- cellent nourifhment for tiofe who are weak, and cannot digeft other aliments. I hough an animal production, it does not readilv be> 76 OF ALIMENT. come putrid, as being pofleffed of the properties of vegetable aii- ment; but it is apt to become four on the ftomach, and thence to produce flatulence, the heart-burn, or gripes, and, in fome conftitu- tions, a loofenefs. The beft milk is from a cow at three or four years of ^e, about two months after producing a calf. It is lighter, but more watery, than the milk of fheep and goats; while, on the other hand, it is more thick and heavy than the milk of afles and mares, which are the next in confiftence to human milk. " On account of the acid which is generated after digeftion, milk coagulates in all ftomachs; but the cafeous or cheefy part is again diffolved by the digestive juices, and rendered fit for the pur- pofe of nutrition. It is however, improper to eat acffl fubftances with milk, as thefe would tend to prevent the due digeftion of it. " Cream is very nourifhing, but on account of its fatUefs is dif- ficult to be digefted in weak ftomachs. Violent exercife, after eat- ing it, will in a little time convert it into butter. " Some writers inveigh againft the ufe of Butter as univerfally pernicious; but they might with equal reafon condemn all vegeta- ble oils, which form a confiderable part of diet in the fouthern cli- mates, and feem to have been beneficently intended by nature for that purpofe. Bwtter,like every other oily fubftance, h2s doubtlefs a relaxing quality, and, if long retained in the ftomach, is liable to be- come rancid ; but, if eaten in moderation, it will not produce thofe effects in any hurtful degree. It is, however, improper in bilious constitutions. The worft confequence produced by butter, when eaten with bread, is, that h obstructs the difcharge of the faliva in the act of maftication or chewing; by which means the food is not fo readily digefted. To obviate this effect, it would be a commen- dable practice at breakfaft, firft to eat fome dry bread, and chew it well, till the falivary glands were exhausted, and afterwards to eat it with butter. By thefe means fuch a quantity of faliva might be carried into the ftomach as would be fufficient for the purpofe of digeftion. " Cheefe is likewife reprobated by many as extremely unwhole- fome. It is doubtlefs not eafy of digeftion ; and, when eaten in a great quantity, may load the ftomach; but, if taken fparingly, its tenacity may be diffolved by the digeftive juices, and it may yield a wholefome, though not a very nourifhing chyle. Toafted cheefe is agreeable to moft palates, but is rendered more indigeftible by that procefs. " The flefh of Birds differs in quality according to the food on which they live. Such as feed on grain and berries afford, in gen- eral, good nourifhment, if we except geeftand ducks, which are hard of digeftion. A young hen or chicken is tender arfd delicate food, and extremely well adapted when the digeftive powers are weak. But of all tame fowls the capon is the moft nutritious. " Turkies, as well as Guinea or India fowls, afford a fubftantial aliment, but are not fo eafy of digeftion as the common domeftic fowls. In all birds thofe parts are the moft firm which are moft ex* ercifed : in the fmall birds, therefore, the wings, and in the larger kinds, the legs j are cwuaoply t lie. moft difficult of digeftion. OF ALIMENT. 77 " The flefh of -wild birds, in general, though moreeafily digeft- ed, is lefs nourifhing than that ot quadrupeds, as being more dry, on account of their almoft conftant exercife. Thefe birds are not wholefome which fubfift upon worms, infects, and fifties, " Eggs. In the laft clafs of terreftrial animal focd we.raay rank the eggs of birds, which are a Ample and a wholefome aliment, Thofe of the turkey are fuperior in all the qualifications of food. The white of eggs is diffolved in a warm temperature, but by much heat it is rendered tough and hard. The yolk contains much oil, and is highly nourifhing, but has a ftrong tendency to putrefaction ; on which account eggs are improper for people of weak ftomachs. efpecially when thev are not quite frefh. Eggs hard boiled or fried are difficult of digeftion, and are rendered ftill more indigeftible by the addition of butter. All eggs require a fufficient quantity of fait, to promote their folution in the ftomach. " F-Jh, though fome of them be light, and eafy of digeftion, af- ford lefs nourifhment than vegetables, or the flefh of quadrupeds, and are of all animal tribes the moft difpofed to putrefaction. Salt- water fifh are, in general, the beft; but when falted, though lefs difpofed to putrefcency, they become more difficult of digeftion. Whitings and flounders are the moft eafily digefted. Acid fauces and pickles, by refifting putrefaction, are a proper addition to fifh, both as they retard putrefcency, and correct the relaxing tendency of butter, fo generally ufed with this kind of aliment. " Oyficrs are eaten both raw and dreffed; but in the former ftate they are preferable; becaufe heat diifipates confiderably their nutritious parts, as well as the falt-water, which promotes their di- geftion in the ftomach ; if not eaten very fparingly, they generally prove laxative. 48 Mufcles are far Inferior to oyfters, both in point of digeftion and nutriment. Sea mufcles are by fome fuppofed to be of a poi- fonous nature; but though this opinion is not much countenanced by experience, the fafeft way is to eat them with vinegar, or fome other vegetable acid. " Bread. At the head of the vegetable clafs stands bread, that article of diet, which, from general ufe, has received the name of thejlaf of life* Wheat is the .grain chiefly ufed for the purpofe in this country, and is among the moft nutritive of all the farinaceous kinds, as it contains a great deal of mucilage. Bread is very properly eat- en with animal food, to correct the difpofttion to pu'refcency ; but is moft expedient with fuch articles in diet as contain much nourifh- ment in a fmall bulk, becaufe it then ferves to give the ftomach a proper degree of exparrfian. But as it produces a flimy chyle, and difpofes to coftivenels, it ought not to be eaten in a large quantity. To render bread eafy of digeftion, it ought to be well fermented and baked; and it never fhould be ufed till it has flood twenty-four hours after being taken out of the oven, otherwife it is apt to occa- fion various complaints in thofe who have weak bowels ; fach as flatulence, the heart-burn, watchfulnefs, and the like. The cuftom of eating butter with bread hot from the oven is -compatible #nty Trith ftrong digeftive powers. 78 ^ OF ALIMENT. " Pafiry, efpecially when hot, has all the difadvantages of hot bread and butter; and ever, buttered toaft, though the bread is ftale, is f arcely inferior in its effects on a weak ftomac'\ Dry toaft without butter is by far the wholelomeft breakfaft. " Bread made of Rye is apt to four on the tbmach, and to ex. cite heart-hurn in certain conttitutions—is of a laxative nature, and, therefore, better luted to coftive habits, ei'.her alone, ■ r mix- ed with wheat: But on account of its difpofition to acefcer cy, f r- mentation, on.* flatulency, may not oe lo well adapted for perfons of choleric teirperaments, and thofe afflh ed wit. dyfpeptic, hypo- ch. ndriar, and hyfteric fymptoms: yet, it is the beft to prevent or cure the fcurvy. " Tnat made of Indian Corn appears to agree well with moft pe pie who like it; and when mixed with wheat or rye, or both, it makes them palatable, and keeps moift a o miiderable time. " Buck wheat being fomewhat li?.ole toanacefcent fermentation in the ftomach, does not agree well with all conititu*ions. The grain fhould, previous to being groun :, be freed from theduft and gnt. It is fuppofsd that its ufe occafions itchings and cutaneous eriiptionsr--and conftantly ufed, is not thought fo wholefome as other bread. " Oats, when deprived of the hulk, and particularly barley, when properly prepared, are each of them fbftening, and afford waolefome and coohng nourifhment. Rice likewife coo tains a nu- friti us mucilage, and is lefs ufed in this country than it deferves, both on account of its wholelomenefs and economical utility. The notion of its bemg hurtful to the l gnt is a vulgar error. In fome cbhftitutioos it tends to makethem coftive; but this fesms to be owii-g chufly to flatulence, and may be corrected by the addition of feme fpice, fuch as caraway, anife feed, and the like. " Potatoes are an agreeable and wh. lefome food, and yield as much nour fhment as any of th. roots ufed in diet. I he farina- ce us or imaly kind is in general the molt eafy of dig .ftion; and they are much improved by pei. g r afted. "Green peafe and Turkey beans, b iled in their fr fh ftate, are both agreeable to the tafte, an 1 wholefome; being neither near fo flatulent, nor difficult of digef lion, as in their ripe ftate; in which they referable the other jeuummous vegetables. French beans pof- fefs much, fhe f me qualities, but yield a more watery juice, and have a greater difp iition to prod ce fbtulence. The leguminous veg tables in gener 1 opghr to be at en with fome fpice. " ballads, being eaten rrw, require good digeftive powers, ef- pecially thofe rf 'he pooling kind j and the addit: n cf oil and vin- egar, though qualified with"muft rd, hardly renders the free ufe of tuem cbufiftent wit: the we^ ft- n.ach. " Stinage affords a fqft lubricating aliment, hut contains little ncur;fhme"-t." In weak fhomachs. it is apt to produce acidm, and frequently a loofenefs. ' To obyiate thefe eff &, it ought always to be well beaten, and but little 1 utter mixed with' it. "' Afparagus is a 'nourifhing aricle in diet, and promote* urine; hut, in common with the vegetable clafs, difpofes a little to flatulence. OF ALIMENT. 79 " Artichokes referable afparagus in their qualities, but feem to be more nutritive and lefs diuretic. " White cabbage is one of the moft confpicuous plants in the garden. It does not afford much nourifhment, but is an agreeable addition to animal food, and not quite fo flatulent as the common greens. It is likewife diuretic, and fomewhat laxative. Cabbage has a ftronger tendency to putrefaction than moft other vegetable fubftances; and, during their putrefying ftate, fends fcrh anoffen- five fmell, much refembiing that of putrefying animal bodies. So far, however, from promoting a putrid difpofition in the human body, it is, on the contrary, a wholefome aliment in the true pu- trid fcurvy. *4 Turnips are a nutritious article of vegetable food, but nr t very eafy of digeftion, and are flatulent. This effect is, in a great mea- fure, obviated by prefling the water out of them before they are eaten. " Carrotscontain a confiderable quantity of nutritious juice, but are am ng the moft flatulent of vegetable productions. " Parfnips are more nourifhing and lefs flatulent than carrots, which they alfo exceed in the fweetnefs of their mucilage. By boil- ing them in two different waters, they are rendered lefs flatulent, but their other qualities are thereby diminifhed in proportion. " Parjley is of a stimulating and aromatic nature, well calcula- ted to make agreeable fauces. It is alfo a gentle diuretic, but pre- ferable in all its qualities when boiled. " Celery affords a root both wholefome and fragrant, but is dif- ficult of digeftion in its raw ftate. It gives an agreeable taite to ibupe, as well as renders them diuretic. " Onions, garlic, and fhallots, are all of a ftimulating nature, by which they aflift digeftion, diffolve flimy humours, and expel flatu- lency. They are, however, moft fuitable to perfons of a cold and phlegmatic conftitution. " Radifhes of all kinds, particularly the horfe-radifh, agree with the three preceding articles in powerfully diffolving flimy humours. They excite the difcharge of air lodged in the inteftines; but this proceeds from the expulfion of air contained in themfelves. " Apples are a wholefome vegetable aliment, and in m?ny cafes medicinal, particularly in difeafes of the breaft and c< mplaints ari- fing from phlegm. But, in general, they agree beft with the ftom- ach when eatea either roafted or boiled. The more aromatic kinds of apples are the: fitteft for eating raw. . " Pears n femtle much in their effects the fweet kind of apples, but have mere of a laxative quality, and a greater tendency to flat- ulence. " Cherries are, in general, a wholefome fruit, when they agree with the ftomach, and they are beneficial in many difeafes, efpecially thofe of the putrid kind. " Plumbs are nourifhing, and have befides an attenuating, as well as a laxative quality; but are apt to produce flatulence. If eaten frefh, and before tney are quite ripe, efpecially in large quantities, rhey occafion cholics and other complaints of the bowels. 8j> ' OF ALIMENT. " Peaches are not of avery nourifhing quality, but they abound in juice, and are ferviceable in billious complaints. " Apricots are more pulpy than peaches, but are apt to ferment and produce acidities in weak ftomachs. Where they do not difa- gree they are cooling, and tend likewife to correct a tendency to putrefcency* "■ Goofeberries, as well as currants, when ripe, are fimilar in their qualities to cherries, anu, when ufed in a green ftate, they are agree- ably cooling. " Strawberries are an agreeable, cooling aliment, and are ac- counted good againft the gravel. " Cucumbers are cooling, and agreeable to the palate in hot weather; but to prevent them from proving nurtful to the ftom- &ch the juice ought to be fqueezed out atier they are fliced, and vinegar, pepper, and fait, afterwards added. " lea. By fome the ufe of tins exotic is condemned in terms the moft vehement and unqualified, while others have either afferted its innocence, or gone fo far as to afcribe to it falubrious and even extraordinary virtues. The truth feems to lie between thefe ex- tremes : there is however an eflential difference in the effects of green tea and of black, or bohea ; the former of which is much more apt to affect the nerves of the ftomach then the latter, efpec- ially when drunk without cream and likewife without bread and butter. That when taken in alarge quantity, or at a later hour than ufual, it often produces watchfulnefs, is a point which cannot be de- nie '; but if ufed in moderation, and accompanied with the addi- tion juft now mentioned, it does not feDfibly difcover any hurtful effects, but greatly relieves an oppreflion of the ftomach, and abates a pain of the head. It ought always to be made of a moderate de- gree of ftrength; for, if too weak it certainly relaxes the ftomach. As it has an aftringent taffe, which feems not very confiftent with, a relaxing power, there is ground for afcribing this effect not fo much to the herb itfelf, as to the hot water, whic ? not being in> pregnated with a fufficient quantity of tea to correct its own emol- ient tendency, produces a relaxation unjuftly imputed to fome nox- ious quality of the plant. But tea, like every other commodity, is liable to damage, and when this happens, it may produce effects not neceffarily connected with its original qualities. *' Coffee. It is allowed that coffee promotes digeftion, and ex- hilarates the animal fpirits; befides which, various other qualities are afcribed to it, fuch as difpeiling flatulency, removing dizzinefs tif tie head, attenuating vifcid humours, increafing the circulation pf the blood, and confequently perfpiration; but if drank too ftrong it affects the nerves, occafions watchfulnefs, and tremor of the hands, though in fome p legmatic confutations it is apt to produce fleep. Indeed it is to perfons of that Iwbit that coffee is well arcommoda- ted; for to people of a thin and dry habit f body it feems to be injurious. Turkey coffee is greatly preferable in flavor to that of the Weft-Indies. Drunk only in the quantity of cne difh after dinner to promote digeftion, it anfwers beft without tither fugar or milk; but if taken at other times it fhould have, froth, or in place o( OF AIR. 81 the latter rather cream, which not only improves the bevgage but tends to mitigate the effect of coffee upon the nerves. # " Chocolate is a nutritive and wholefome compofition if taken in fmall quantity, and not repeated too often; but is generally hurtful to the ftomach of thofe with whom a vegetable diet difa- grees. By the addition of vanilla and other ingredients it is made too heating, and fo much affects particular cocnitutions as to ex* cite nervous fymptoms, efpecially complaints of ths head. CHAP. IV. OF AIR. U NWHOLESOME air is a very common caufe of dif- eafes. Few are aware of the danger arifing from it. People gen- erally pay fome attention to what they eat or drink, but feldom re- gard what goes into the lungs, though the latter proves often more fuddenly fatal than the former. Air, as well as water, takes up parts of moft bodies with which it comes in contact, and is often fo replenifhed with thofe of a noxious quality* as to occafion immediate death. But fuch viol- ent effects feldom happen, as people are generally on their guard againft them. The lefs perceptible influences of bad air prove more generally hurtful to mankind; we fhall therefore endeavor to point out fome of thefe, and to shew whence the danger chiefly arifes. Air may become noxious many ways. Whatever greatly al- ters its degree of heat, cold, moifture,&c. renders it,unwholefome: for example, that which is too hot diflrpates the watery parts ot the blood-, exalts the bile, and renders the whole humors aduft and thick. Hence proceed billious and inflammatory fevers, cholera morbus, &c. Very cold air obftructs the perfpiration, conftringes the folids, and condenfes the fluids. It occafions rheumatifms, coughs, a' d catarrhs, with other difeafes of the throat and breaft. Air that is too moift deftroys the elafticity or fpring of the folid?, induces phlegmatic or lax constitutions, and difpofes the body to agues, or intermitting fevers, dropfies, &c. Wherever great numbers of people are crowded into one place, if the 2ir has not a free circulation, it foon becomes unwhole- fome. Hence it is that delicate perfons are fo apt to turn fick or faint in crowded churches, alTemblies, or any place where the air is injured by breathing, ores, candles, or t e like. In great cities fo many toings tend to contaminate the air, tha* it is no wonder it proves to fatal to the inhabitants. The air :i. cities is not only breathed repeatedly over, but is like-wife loaded with fulphur/fmoke, and other exhalations,' elides the vapars con- tinually arifing from innumerable putrid fubftances, as dunghills, flaughter houfes, &c. All poflible care fhould be taken to keep the ftreets of large towns open and wide, that the air may have a free current through them. They ought likewile to be kept very clean. Nothing tends more to pollute and contaminate the air cf a city than dirty streets. 82 OF A IE. His very common in this country to have church-yards in the middle, of populous cities. Whether this be the effect of ancient fuperftitioh, or owing to the increafe of fuch towns, is a matter of no confequence. Whatever gave rile to this cuftom, it is a bad one. It is habit alone which reconciles us to thefe things; by means of which the moft ridiculous, nay pernicious cuftoms, often become facred. Certain it is, that thoufands of putrid carcaffes, fo near the furf >ce of the eaith, in a place where the air is confin- ed, cannot fail to taint it; and that fuch air, when breathed into the lungs, muft occafion difeafes.* Burying within churches is a practice ftill more detestable. The air in churches is feldom good, and the effluvia from putrid carcai- es muft render it ftill worle. Churches are commonly old build- ings with arched r.',ofs. They are feldom open above once a wcek, are never ventilated by fires nor open windows, and rarely kept clean. This occafions that damp, mufty, unwholefome fmell which one feels upon entering a church, and renders it a very u:ffafe place for the weak and valetudinary. Thefe inconveniences might, in a great meafure, l>e obviated, by prohibiting all perfons from burying within churches, by keeping them clean, and permitting a ftream of frefh air to pafs frequently through them, by opening oppofite doors and windows.f Wherever air stagnates long, it becomes unwholefome. Jtentie the unhappy perfons confined in jails not only contract malignant fevers themfelves, but often communicate them to others. Nor are many of the holes, for we cannot call them houfes, poff-ffed by the poor in great towns, much better than j.o.ls. Thefe low dirty habi- tations are the very lurking places of bad air and contagious dif- eafes. Sue i as live in them feldom enjoy good health; and their children commonly die young, in the choice of a houfe, taofe who have it in their power ought always to pay the greateft attention to open free air. The various methods which luxury has invented to make houfes clofe and warm, contribute not a little to render tnem unwholefome. No houfe caa be wholefome unlets the air has a free paffage through it. F;-r which roaf n houfes ought Ja ly to be ventilatod by open- ing oppofite windows, aod admitting a current of frefh air into ev- ery room. Beds, inftead of being made up rs foon as people rife out of them, ought to be turned down, and expofed to the frefh air from the open windows through the day. This would expel any noxious vapour, and could not fail to promote the health of the inhabitants. In hofpitals, jails, fhips, See. where that cannot be conveniently done, ventilators fhould be ufed. The method of expelling foul and introducing frefh air, by means of ventilators, is a moft faluta- ry invention, and is indeed the moft ufeful of all our modern medi- cal improvements. It is capable of univerfal application, and is * In mofteaftern countries it was cuftomaryto bury the dead at fome diftance from »ny town. As this pradice obtained among the Jews, the Creeks and alfo the Romans, it ii grange that this country ifcould not have followed their example in a cuftom fo truly laudable. f One cannot pifs through a lar6e church or cathedral, even io lummer, -without reel- ing quite chilly. ' OF AIR. 8$ fraught with numerous advantages, both to thofe in health and fick- nefs. In all places, where numbers of people are crowded togeth- er, ventilation becomes abfolutcly neceflary. Air which stagnates in mines, wells, cellars, &c. is extremely noxious. That kind of air is to be avoided as the moft deadly poi- fon. It often kills almoft as quickly as lightning. For this reafon, peopie fhould be very cautious in ope; ing cellars that have been long fhut, or going down into deep wells or pits, efpecially if they have been kept clofe covered.* Many people who have fplendid houfes, chufe to fleep in fmall apartments. This conduct is very imprudent. A bed-chamber ought always to be well aired; as it is generally occup;ed in the night only, when all doors and windows are fhut. If a fire be kept in it, the danger fr^m a fmall room becomes ftill greater. Numbers have been ftifled when afleep by a fire in a fmall apartment, which is al- ways hurtful. Thofe who are obliged, on account of bufinefs, to fpend the day in clofe towns, ought if poflible, to fleep in the country, breath- ing free air in the n'ght will, in fome meafure, make up for the want of it through the day. This practice would have a greater ef- fect in preferving the health of citizens than is commonly imagined. Delicate p rf ns ought, as much as poflible, to avoid the air of great towns. It is peculiarly hurtful to the afthmatic and cohfump- tive. Such perfons fhould avoid cities as they would the plague. The hypochondriac are likewife much hurt by it. 1 have often feen perfons fo much afflicted with this malady while in town, that it teemed impoflible for them to live, who, upon being removed to the country, were immediately relieved. The fame obfervation holds with regard to nervous and hyfteric women. Many people, ind :ed, have it not in their power to change their fituation in quell: of beber air. AH we can fay to fuch perfons is, that they fhould go as often abroad i o the cp°n air as they can, that they fhould admit frefh air frequently into the.r houfes, and take care to keep them very clem. It was neceflary in former tim°s, for fafety, to furrouhd cifies, colleges, aud ev ;n fingle h >ufes, with high walls. Thefe, by ob- structing the free current of :iir, never fat to render fuch places damp and unwholefome. As fuch walls are n;w, in moft parts of isms country, become ufelefs, they oug^t to be puHed down, and ev- ery method 'aken to admit a free paffage to tire air. Proper at-ca- tion to Air and Cleanlhefc would tend more topr.-frrve the health of mankind, than all the prefcriptions of the f coltv. .Surrounding houfes t o clofely .vrh plantio.g or thick woods,like- wife tends to render «he air mw \oiefo no. Wood not only ob- structs the free currem of tne or, but lends fonh great quantities of anit exhalations, which render it cooftantly damp. Wood ^ very agreeable at a p«-~>p-r diftance ro'.i a hoir'e, bu fhould n^v.-r be pl'nted too near it, efpecially in a flat cou airy. Many of fhe • VVe have dai y accounts of perfons who lots tl<*ir lives by -'0 rig down info drop wells and o'.her places when* the air flagnares ; all thefe accidents might be prevented by only let- ting down a lighted candle Wore them, and ftoppirs when they perceive it go out; yet thii psecaution, fimple as it is, is felom ufed, ,84 OF EXERCIS3. gendemen's feats in England are rendered very unwholefome from the great quantity of wood which furrounds them. Houfes fituated in low marfhy countries, or near large lakes of Stagnating water are likewife unwholefome. Waters which ftagnate not only render the air damp but load it with putrid exhalations, which produce the moft dangerous and fatal difeafes. Thofe who are obliged to inhabit marfhy countries, ought to make choice of the dryeft fituations they can find, to live generoufly, and to pay the ftricteft rejgard to cleanlinefs. If frefh air be neceflary for thofe in health, it is ftill more fo for the fick, who often lofe their lives for want of it. The notion that fick people muft be kept very hot, is fo common, that one can hard- ly enter a 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 frefli air. It is the moft reviving of all cordials, if it be admini- stered with prudence. We are not however, to throw open doors and windows at random upon the fide. Frefh air is to be let into the chamber gradually, and, if poffible, by opening the windows of fome other apartment. y The air of a fick perfon's chamber may be eready frefhenedV' and the patient much revived, by fprinkling the floor, bed, &c. fre- qu-ntly with vinegar, juice of lemon, or any other ftrong vegeta» ble acid. * In places where numbers of fick are crowded into the fame houfe, or, which is often the cafe, into the fame partraent, the frequeat admiflion of frefh air becomes abfolutely neceflary. Infirmaries, hofpitals* &c. are often rendered 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 putrid fevers, dyfenta* ries, and other infectious difeafes prevail. Phyficians, furgeons, and others who attend hofpitals, ought, for their own fafety, to take care that they be properly ventilated. Such perfons as are obliged to fpend the moft of their time amongft the fick, run great hazard of being themfeives infected when the air is bad. All hofpitals, and places of re. eption for the fick, ought to have an open fituation, at fome diftaoce from any great town, and fuch patients as labour under any infectious difeafe ought nev- er to be fuffer^d to come near the reft.* CHAP. V. OF EXERCISE. JVJlANY people look upon the neceflity man is under of earning his bread by labor, as a curfe. Be this as it may, it is evi- dent from the ftructure of the body, that exercife is not lefs necef- fary than food for the prefervation of health: thofe whom poverty * A year feldom paflc» that we do not hear of fome hofpital phyfician or furgeon having loft his life by an hofpital fever, caught from his patients. For this they have themfelves *lone to blame. Their patients ate either in an improper fituation, «r (he* are Coo carelefs w:th regard to their own conduct. OF EXERCISE. % obliges to labor for daily bread, are not only the moft healthy, but generally the moft happy patt of mankind. Induftry feldom fails to place them above want, and activity ferves them inftead of phy- fic. This is peculiarly the cafe with thofe who live by the culture of the ground. The great increafe of inhabitants in infant colonies, and the longevity of fuch as follow agriculture, every where evi- dently prove it to be the moft healthy as well as the moft ufeful employment. The love of activity (hews itfelf very early in man. So ftrong is this principle, that a healthy youth cannot be restrained from ex- ercife. even by the fear of punilhment. Our love of motion is fure- ly a ftrong proof of its utility. Nature implants no difpcfition in vain. It Teems to be a catholic law throughout the whole animal! creation, that no creature, without exercile, mould enjoy health,. or be able to find fubfiftence. Every creature, except man, takes as much of it as is neceffary. He alone, and fuch animals as are under his direction, deviate from this original law, and they fuffer accordingly. Inactivity never fails to induce an univerfal relaxation of the folids, which difpofes the body to innumerable difeafes. When the folids are relaxed, neither the digeftion nor any of the fecretions can be duly performed. In this cafe the worft confequences muft enfue. How can perfons who loll all day in eafy chairs, and fleep all night on beds of down, fail to be relaxed ? Nor do fuch great- ly mend the matter, who never ftir abroad but in a coach, fedan, or iuch like. Thefe elegant pieces of luxury are become fo common, that the inhabitants of great towns feem to be in fome danger of lofing the ufe of their limbs altogether. It is now below any one^ to walk, who can afford to be carried. How ridiculous would it feem, to a perfon unacquainted with modern luxury, to behold the young and healthy fwinging alongonthefhouldersof their fellow-creatures! or to fee a fat carcafe, over-run with difeafes occafioned by inactiv- ity, dragged through the ftreets by half a dozen horfes.* Glandular obstructions, now f3 common, generally proceed from inactivity. Thefe are the molt obf'tinate maladies. So long as the liver, kidnies, and other glands, duly perform their functions, health is feldom impaired ; but when they fail, nothing can reftore it. Exercife is almoft the only cure we know for glandular ob- ftructions; indeed it does not always fucceed as a remedy: but there is reafon to believe that it would feldom fail to prevent thefe complaints, were it ufed in due time. One thing is certain, that amongft thofe who take fufficient exercife, glandular difeafes are v -ry lii tie known; whereas the indolent and inactive are feldom tree from them. Weak nerves are the conftant companions of inactivity. Noth- ing but exercife and open air can brace and ftrengthen the nerves, • It Is not necrffity, but falhion, which makes the ufe of carriages fe common. Ther« are many people who hire not exercife enough to keep their humours wholefome, who yet dare not venture to make a vifit to their next neighbors, but in a coach or feda.i, left ther mould be looked down upon. Strange, that men fliould be fuch fools as to bela> ihedout or' the wfe of their limbs, or to throw awiy thrir health, in »rder to gratify t p"«5 of ranity, c? to wrnplj with a rid:««h>vt fs(h:or>. 86 OF EXERCISE. or prevent the endlefs train of difeafes which proceed from a relaxed ftate of thefe organs. We feldom hear the active or laborious com- plain of nervous difeafes ; thefe are refervedfor the fons of eafe and affluence. Many have been completely cured of thefe diforders by being reduced, from a ftate of opulence, to labor for their daily bread. This plainly points out the fources from whence nervous difeafes flow, and the means by which they may be prevented. It is abfolutely impoflible to enjoy health, where the perfpira- tion is not duly carried on: but that can never be the cafe where exercife is neglected. When the matter which ought to be thrown off by perfpiration is retained in the body, it vitiates the humours, and occafions the g ut, fevers, rheumatifm, &c. Exercife alone would prevent many of thofe difeafes which cannot be cured, and would remove others where medicine proves ineffectual. A late author,* in his excellert treatife on health, fays that the weak and valetudinary outfit to make exercife a part of their reli- gion. We would recommend this, not only to the weak and vale- tudinary, but to all whom tufi efs does not oblige to take fufficnt exercife, as fedentary artificers,t~fhcpkeepers, ftudious per- fons, &c. Such ought to ufe exercife as regularly as rhey take food. This might generally be done without any interruption to bufinefs or real lofs of time. No piece of indolence hurts the health more than the modern cuftom of lying a-bed too long in a morning. This is the general practice in great towns. The inhabitants of cities feldom rife be- fore eight or nine o'clock ; but the morning is undoubtedly the beft time for exercife, while the ftomach is emptv, and the body re- rrefhed with fleep. Befides the morning air braces and Strength- ens the nerves, and in fome meafure anfwers the purpofe of a cold bath. Let any one who has been accuftomed to lie a-bed till eight or nine o'clock, rife by fix or feven, fpend a couple of hours in walking, riding, or any active diverfion without doors, and he will find his fpirits cheerful and terene thrruyh the day, his appetite keen, and his body braced and strengthened. Cuftom foon renders early rifing agreeable, and nothing contributes more'to the preferv- ation of health. The inactive are continually complaining of pairs of the fto- mach, flatulencies, indigeftions, &c. Thefe complaints, whirh pave the way to many others, are nor to be removed by medicines. They can only be cured by a vigorous courfe of exercife, to which indeed they feldom fail to yield. Exercife, if poflible, ought always to be taken in the open air. • Cheyne. f Sedentarv occupations ought chiefly to be followed by women. Thev bear confine- ment much better than men, and are fitter for every kind of bufinefs which does not require much ftrength. It is ndiculousenoueh to fe«> a lufty fellow making pint, needles, or watch wheels, while many of the laborious parts of hufbandry are carried on by the other fex The laft is, wewant men for laborious employments, while one ha'f of the other fex are rendered ufclefsfor want of occupations luited to their ftrength,' 4c. Were pirls bred to mechanical employments, we hould not fee fuch numbers of them proftitute themfelves for bread, nor find Iuch a want ot men for the important purpofes of navigation agrculture &c An em- inent filk manufacturer told me, that he found women anfwer better for tha' bufinefs than men : and that he had lately taken a *reat many girls apprentice} aa filk weavers. I Lore hrs example will be followed by many others. •«. . OF EXERCISE. 8? When that cannot be done, various methods may be contrived for exercifing the body within doors, as the dumb bell, dancing, fenc- ing, &c. It is riot neceffary to adhere ftrictly to any particular kind of exercife. The beft way is to take them by turns, and to ufe that longeft which is moft fuitable to the ftrength and the con- ftitution. Thofe kinds of exercife which give action to moft of the bodily organs, are always to be preferred, as walking, running, riding, digging, rubbing furniture, and fuch like. It is much to be regretted, that manly and active diverfions are now fo little practifed. Diverfions make people take more exercife than they otherwife would d<~>, and are of the greateft fervice to (iich as are not under the neceflity of laboring for their bread, .As active diverfions lofe ground, thofe of a fedentary kind feem to pre? vail. Sedentary diverfions are of no other ufe but to confume time. Inftead of relieving the mind, they often require more thought than either ftudy or bufinefs. Every thing that induces people to fit ftill, unlefs it be fome neceflary employment, ought to be avoided. The diverfions which afford the beft exercife are, hunt ing, fhoot* ing, playing at cricket, hand-ball, golff,* &c. Thefe exercife the limbs, promote perfpiration and the other fecretions. They likewife ftiengthen the lungs, and give firmnefs and agility to the whole body. Such as can, ought to fpend two or three hours.a day on horle- back; thofe who cannot ride, fhould employ the fame time in walk- ing. Exercife fhould never be continued too bug. Over-fatigue prevents the benefit of exercife, and inftead of itrengthening the body tends to weaken it. Every man fhould lay himfelf under fome fort of neceflity to take exercife. Indolence, like other vices when indulged, gains ground, and at length becomes agreeable. Hence many who were fond of exercife in the early part of life, become quite averfe to it afterwards. This is the cafe of moft hypochondriac and gouty peo- ple, wh'rh renders their difeafes in a great meafure incurable. In fome countries laws have been made, obliging every man, of whatever rank, to learn fome mechanical employment. Wheth- er fuch laws were defigned for the prefervation of health, or the en- couragement of manufacture, is a quefticn of no importance. Cer- tain it is, that if gentlemen were frequently to amufe and exercife themfelves in this way, it might have many good effects. They would at I aft derive as much honor from a tew mafterly fpecimens of their own workmanfhip, as from the character of having ruined moft of their companions by gaming or drinking. Befides men of leifure, by applying themfelves to the mechanical arts, might im- prove them, to the great benefit of fociety, Indolence not only occafions difeafes, and renders men ufclefs to fociety, but promotes all manner of vice. To fav a man is idle, is little better than to call him vicious. The mind, if net engaged in fome ufeful purfuit, is conftantly in quest of idle pleafcres cr impreffed with the apprehenfjon of fome imaginary evil. From * GollFis adiverAon very common in North Britain. " It is well calculated for, exe-r^ifnv; the body, and may always.be taken in fqoh moderation, as neiebejjto over-heat nor f.ir-jz'!?. lt his greatly the preference over crlcktt, tennis, or any «f tV'iVga-r.-s vy-hi-th -.run-? it phvjcd without tiolenie. ■- ' • 8g OF SLEEP AND CLOTHING. thefe fources proceed moft of the miferies of mankind. Certainly man was never intended to be idle. Inactivity fruftrates the very defign of his creation; whereas an active life is the beft guardian of virtue, and the greateft prefervative of health. CHAP. VI. OF SLEEP AND CLOTHING. l^LEEP, as well as diet, ought to be duly regulated. Too little fleep weakens the nerves, exhaufts the fpirits, and occafions difeafes; and too much renders the mind dull, the body grofs, and difpofes to apoplexies, lethargies, and other complaints of a fiaiilar nature. A medium ought therefore is, turn day into night, and night into day. To make fleep refrefhicg, the followmg things are requillte: Firft, to take fufficient exercife in the open air; to avoid ftrong tea or coffee: next, to eat a light fupper; and laftly, fo lie down with a mind as cheerful and ferene as p' flible. It is certain that too much exercife will prevent fleep, as well as too little. We feldom however hear the active and laborious complain of reftlefs nights. It is the indolent and flothfhl who gen« erallv have thefe complaints. Is it aov wonder that a bed of down should not be refrefhing to a perfon who fit? all day in an eafy chair ? A great part of the pleafure of life confifts in alternate reft and motion; but they who neglect the latter can never relifh the former. The laborer enjovs more true luxurv in plain food and found fleep, than is to be found in fumptuous tables and downy pillows, where exercife is wanting. That light flippers caufe found fleep, is true even to a proverb, Many perfons, if they exceed the leaft at that meal, are fure to OF SLEEP AND CLOTHING. *0 have uneafy nights; and, if they fall afleep. the load and oppreffion on their 'lomach and fpirits occafion frightful dreams, broken and difturbed repofe, the night-mare, &c. Were the fame perfons to §o to bed with a light fupper, or fit up till that meal was pretty well igefted, they would enjoy found fleep, and rife refreshed and c eer- fuf. There are indeed fome people who cannot fleep, unlefs they have taken fome folid food at night, but this does not imply the ne- ceffity of a heavy fupper; befides, thefe are generally perfons who have accuftomed themfelves to this method, and who do not take a fufficient quantity of foli d food and exercfe. Nothing more certainly difturbs our rep fe than ?nxiety. When the mind is not at eale, one feldom enjoys found fleep. Th;s greateft of human bleflings flies the wretched, and vifits the hnp- py, the cheerful and the gay. This is a fufficient reafon why every man fhould endeavor to be as eafy in mind as poflible when he goes to reft. Many, by indulging grief and anxious thought, have ban- ifhed found fleep fo long, that they could never afterwards en'y.y it. Sleep, when taken in the fore-part of the night, is generally reckoned moft refrefhing. Whether this be the effect of habit or not, is hard to fay; but as moft people are accuftomed fo go early to bed when young, it may be prefumed that fleer}, at this fe-»frn, wU prove moft refrefhing to them ever after. Whether the fore-part of the night be beft for lleep or not, fuHy the fore- part of the day is fitteft both for bufinefs and amufement. I hard- ly ever knew an early rifer, who did not enjoy a good ftate of health.* Of Clothing. The clothing ought to be fuited to the climate, Cuftom has no doubt a very great influence in this article; but no cuftom can ever change the nature of things fo far, as to render the fame cloth- ing fit for an inhabitant of Nova Zembla and the Illand of Jamai- ca. It is not indeed neceflary to obferve an exact.proportion be- tween the quantity of clothes we wear, and the degree of latitude wlvch we inhabit; but, at the fame time, proper attention ought to be paid to it, as well as to the cpennefs of the country, the fre- quency and violence of ftbrms, &c. In youth, while the blood is hot and the perfpiration free, it is lefs neceflary to cover the body with a great quantity of clothes ; but in the decline of life, when the fkin becomes rigid and the hu- mours more cool, the clothing fhould be increafed. Many difeafes in the latter period of life proceed from a defect of perforation : thefe may, in fome meafure, be prevented by a fukable addition to the clothing, or by wearing fuch as are better calculated for pro- moting the difcharge from the fkin, as clothes made of cotton, flannel, &c. The clothing ought likewife to be fuited to the feafon of the year. Clothing may be warm enough for fumraer, which is by no means fufficient for winter. The greateft caution, however, is ne- ceffary in making thefe changes, we ought, neither to put off our * Men of every occupation, and, fv«ry fituation of l;fev ha»e lived to a jrcod old age ; nay fome have enjoyed this b'lefling whofe pl.-n r.i livin* rrzj by no means regular : but it con- Jifts with observation, that all very old me-, have beta early lifer*. TH» rs tfev -nly c">rc*«r.- :•*.-. ;i attending longevity :? which 1 never knr-v aa exception, fn) oa OF SLEEP AND CLOTHING. winter clothes too foon, nor to wear our fummer ones too long. In this country, the winter often fets in very early with great rigour, and we have frequently cold weather even after the commencement of the fummer months. It would likewife be prudent not to make the change all at once, but do it gradually; and indeed the changes of apparel in this climate ought to be very inconfiderable, efpecially among thofe who have palled the meridian of life.* Clothes often become hurtful by their being made fubfervient to the purpofes of pride or vanity. Mankind in all ages feem to have confidered clothes in this view; accordingly their fafhion and figure have been continually varying, with very little regard either to health, the climata, or conveniency; a farthingale, for example, may be very neceffary in hot fou'hern climates, but furely nothing can be more ridiculous in the cold regions of ti.e north. Even the human fhape is often attempted to be mended >by drefs, and thofe who know no better believe that mankind would be monftrous without its afliftance. All attempts of this nature are highly pernicious. The moft deftructive of them in this country is that of fqueezing the ftomach and bowels into as narrow a compafs aspoflible, to procure, whatisfalfelycalledafineihape.t By this prac- tice the action of the ftomach and bowels, the motion of the heart and lungs, and almoft all the vital functions, are obftructed. Hence proceed indigestions, fyncopes or fainting fits, coughs, confurajv. tions of the lungs, and other complaints fo common amon^ females. The feet likewife often fuffer by preflure. How a fmall foot came to be reckoned genteel, I will not pretend to fay; but certain it is, that this notion has made many perfons lame. Almoft nine- tenths of mankind are troubled with corns: a difeafe that is feldom or never occafioned but by straight fhoes. Corns are not only ve- ry troublefome, but by rendering people unable to walk, they may likewife be confidered as the remote caufe of other difeafes.% The fize and figure of the fhoe ought certainly to be adapted to the foot. In children the feet are as well fhaped as the hands, and the motion of .the toes as free and eafy as that of the fingers; yet few perfons in the advanced period of life are able to make any ufe of their toes. They are generally by narrow fhoes, fqueezea all of a heap, and often laid over one another in fuch a manner as to be rendered altogether incapable of motion. Nor is the high heel lefs hurtful than the narrow toe. A lady may feem taller for walk- ing on her tiptoes, but fhe will never walk well in this manner. It {trains her joints, diftorts her limbs, makes her ftoop, and utterly ijeftroys all her eafe and gracefulnefs of motion : it is entirely ow- * That coips kill more than tlagues, is an old obfervation : and, with re- gard to tliis country, it holds ftricUy true. Every perfon of difcemment, however, will per- ceive, that moft of the cilds which prove fo deftructive to the inhabitants of Britain, are owing to their imprudence in changing clothes. A few warm days in March or April induce them to throw off their winter garments, without considering that our moft penetrating colds generally happen in the fpring. f Thi. madnefs feems to have pervadedthe minds of mothers in every age and country. Terence, in hif Comedy of the Eunuch, ridicules the Roman matrons for attempting t# aaend the fhape of their daughters. t We often fee perfons, who are rendered quite lame by the nailt of their to-« having grown into the flefh, and frequently hear of mortifications proceeding from this caufe. All theie, and many other inconveniences attending thefect, rnuftbeimpmed folely to the u(s 9! ftortandftraightln«e«.. OF INTEMPERANCE. • $i Ing to fhoes with high heels and narrow toeSj that not one female in ten can be faid to walk well. In fixing on the clothes, due care fhould ce taken to avoid all tight bandag-s. Garters, buckles, &c* when drawn too tight, not only prevent the free motion and ufe of the parts about wMch they are bound, but likewifc obftruct the circulation of t e blood, which pre- vents the equal nourifhment nndgrowth of ihef • parts,and occafions . various difeafes. Tight bandages about the neck, as ftocks, cravats, neckhces, &c. are extremely dangerous. They obftruct the blood in its courfe from the brain, by which means head-achs, vertig- es, apoplexies, znd other fatal difeafes are often occafioned. The perfection of drefs is to be eafy and cleao. Nothing can be nrr° ridiculous, than for any one to make hvr.ielf a flave to fine clothes. Such a on*, and many fuch there are, would rather remain as fixt as a ftarue from morning till night, than difcompofe a fingle hair or altar the pofition of a pin. Were we to recommend any particular pattern for drefs, it would be that wh'ch is worn by the people called Quakers. They are always neat, clean, and often elegant, without any thing fuperfluous. What others lay out. upon tawdry laces, ruffles, and ribands, they beftow upon fuperior clean- linefs. Finery is only the affectation of drefs, and very often cov- ers a great deal of dirt. We fhall only add, with regard to clothing, that it ought not only to be luited to the climate, the feafon of the year, and the pe- riod of life; but likewife to the. temperature and conftitution. Ro> buft perfons are able to endure either .cold or heat better than the delicate; confequently may be lefs attentive to their clothing. But the precife quantity of clothes neceffary for any perfon cannot be determined by reafonkg. It is entirely a ma' ter of experience, and every man is the beft judge for himfelf what quantity of clothes is Eeceffary to keep him warm.* CHAP. VII. OF INTEMPERANCE. Jr\_MODERN author f obferves, that temperance and exer- cife are the two beft phyficians in the world. He might have added, that if thefe wre duly regarded, there would belittle occafion for any other. Temperance may justly be called the parent of health; yet numbers of mankind act as if they thought difeafes and death too flow in t: eir progrefs, and by intemperance and debauch feem as it were to folicit their approach. The danger of intemperance appears from the very construc- tion of the human body. Health depends On that ftate of the fo- * The celebrated Boerhaave ufed to fay, that nobodv fuffered by cold fave fools and beggars ; the latter not being able to procure clothes, a. d the former not having fenfe to wear them. Be this as it may, 1 can with the ftriael truth dec are, that in many cafes where the powers of medicine have beenTri*d in vain, 1 have cured the patient by recommending thick fhoes, a flannel waiftcoat, and drawers, a pair of under ftotttngs, or a ft-nnel petticoat, to be worn during the cold fealon at leaft. Where WR:mer clothing is wanted. I would rrcommejwi •.be rleecy hofiery to b« wcra r:ext the fk;n, * RottlTeau. 9* OF INTEMPERANCE. lids and fluids which fits them for the due performance of the vital functions; and while thefe go regularly on, we are found and well; but whatever dr.urbs them neceffarily impairs health. Intemper- ance never fails to diforder the whole animal economy; it hurts the digeftion, relaxes the nerves, renders the different fecretions irregu- lar, vit;ates the humors, and occafions numberlefs difeafes. The analogy between the nourifhment of plants and animals affor s a flriking proof of the danger of intemperance. Moifture and manure greatly promote vegetation ; yet an over-quantity of either will entirely destroy it. The belt things become hurtful, nay destructive, when carried to excefs. Hence we learn, that the hig-heft degree of human wifdom conlifts in regulating our appe- tites and poflions fo as to avoid all extremes. It is that chiefly which entitles us to the character of rational beings. The flave of appetite will ever be the difgrace of human nature. The Author of Nature hath endued us with various paflions, for the propagation of the fpecies, the prefervation of the indivU dual, &c. Intemperance is the abufe of thefe paflions; and mode- ration confifls in the proper regulation of them. Men, not content- ed with fatisfying the fimple calls of Nature, create artificial wants, and are perpetually in fearch after fomething that may gratify tkem; but imaginary wants never can be gratified. Nature iscontent with little: but luxury knows no bounds. Hence the epicure, the drunkard, and the debauchee feldom flop in their career till their money or their conftitution fails: then indeed they generally fee their error when too late. It is impoflible to lay down fixed rules with regard to diet, on account of the different conftitutions of mankind. The moft igno- rant perfon, however, certainly knows what is meant, by excefs; and it is in the p^wer of every man, if he choofes, to avoid it. The great rule of diet is to ftudy fimplicity. Nature delights in the molt plain and fimple food, and every animal, except man, follows hsr dictates. Man alone riots at large, and ranfacksthe whole creation in queft of luxuries, to his own destruction. An ele- gant writer * of the laft age, fpeaks thus of intemperance in diet: 4< For my part, when I behold a fafhionable table fet out in all its magnificence, 1 fancy that I fee gouts and dropfies, fevers and le- thargies, wit" other innumerable cTiftempers, lying in ambufcade among the difhes." Nor is intemperance in other things lefs deftructive than in diet. H. w quickly does the immoderate purfuit of carnal nlcfe' furcs, or the abufe of intoxicating liquors, ruin the beft conftitUr > tion ! Indeed thefe vices generally go hand in hand. Hence it is that we fo often behold the votaries of Bacchus and Venus, evn before they have arrived at the prime of life, worn out with dif- eafes, and flattening with fwift pace to an untimely grave. Did men reflect on the painful difeafes and premature deaths, which are daily occafioned by intemperance, it would be fufficient to make them fhrink back with horror from the indulgence even of their darling pleafures. * Addifon. OF INTEMPERANCE. 93 Intemperance does not hurt its votaries atone ; the innocent too often feel the direful effects of it IT iw many wretched or- phans are to be feen embracing dung-hills, w cfe parents, regard- lefs of the future, fpent in riot and debauch what might have ferv- ed to bring up their oi&pring in a decent manner ! H w often do we behold the miferable mother, with her helpMs infants, 'pining in want, while the cruel father is indulging his infatiate appetites! Families are not only reduced to mifery, but even extirpated, by intemperance. Nothing tends fo much to prevent propagation, and fliorten the lives of children as the intemperance of parents. The poor man who labors all day, and at night lies down contented with his humble fare, can boait a nurcer us offspring, while his pampered lord, fur.k m eafe and luxury, often languishes without an heir to his ample fortunes. Even ftates imd empires feel the influ- ence of intemperance, and rife or fall as it prevails. Inftead of mentioning the different kinds of intemperance, and pointing out their influence upon health, we fh.dl only, by way of example, make a few obfervations on one particular fpecies of that vice, viz. the abufe of intoxicating liquors. Every act of intoxication puts nature to the expenfe of a fever, in order to difcharge the poifonous draught. When this is repeat- ed almoft every day, it is eafy to forefee the confequences. That conftitution muft be ftrong, indeed, which is able long to hold out under a daily fever ! but fevers occafioned by drinking do not al- ways gooff in a day; they frequently end in an inflammation of the breaft, liver, or brain, and produce fatal eff cts. Though the drunkard fhould not fall by an acute difeafe, he feldom efcapes thofe of a chronic kind. Intoxicating liquors, when ufed to an excefc, weaken the bowels and fpoil the digeftion ; they deftroy the power of the nerves* and occafion paralytic and convul- five diforders; they likewife heat and inflame the blood, deftrov its balfamic quality, render it unfit for circulation, and the nr.urifh- meut of the body. Hence obstructions, atrophies, dropf es, and confumptions of the lungs. Thefe are the common ways in which drunkards make their exit. Difeafes of this kird, when brought on by hard drinking, feldom admit of a cure. Many people injure their health bv drink:ng, v/ho feldom get drunk. The continual habit of foaking, as it is called, though its effects be not fo violent, is not lefs pernicious. W en the veffels are kept constantly full and upon the ftretch, the different digeftions can neither be duly performed, nor the humors properly prepared. Hence moft people of this character are afflicted with the gou:, t e gravel, ulcerous fores in the legs, &c. If thefe diforders do not appear, they are feized with low fpirits, hypochondriacal affections, and other fymptoms of indigeftion. Confumptions are now fo common, that it is thought one-tenth of the inhabitants of great towns die of thaf difeafe. Hard ^ri k- ing is no doubt one of the caufes to which we muft impute the in- creafe of confumptions. The great quantities of vifcid malt 1 quor drank by the common people of England, cannot fail to render the blood fizy and unfit for circulation j from whence proceed obrftuc- 94 OF INTEMPERANCE. tions, and inflammations of the lungs. There are few great ale drinkers who are not pnthifral: nor is that to be wondered at, confidering the glutinous and almoft indigeftible nature of ftro' g ale. Thofe who drink ardent fpirits or ftrong wines, run ftill great- er hazard ; thefe liquors heat and inflame the blood, and tear the tender veflels of the lungs to pieces; vet fo great is the confumption of them in this country, that one would almoft be induced to think that ihe inhabitants liv d upon them.* The haoit of drinking proceeds frequently from misfortunes in life. The miferable fly to it forreli-f. It affords th?m indeed a temporary eafe. But, alas ! ibisfoloce is fhort-lived ; and when it is over, the fpirits fink as much below their ufual tone as they had bffore been raifed above i'. Hence a r.petition of the dofe be- comes neceff'ry.and every frefh dofe makes w3y for another, till the unhappy wretch becomes a flave to the bottle, and at length falls a fa-rifice fo what at firft perhaps was tak^n only'as a medicine. No man is fo dejected as the drunkard when his debauch is gone off. Hence it is, that thofe who have the gr?ateft flow of fpirits while the glafs circulates freely, are of all others the mcft melancho- ly when fober, and often put an end to their L.wn miferable exist- ence in a fit of fple jn or ill humour. Dru.'ikennels not only proves destructive to he~dth, bur like- tvi io the faculties of the mind. It is ftrange that creatures who v^. ut t.hrmfelves on account of a fuperior <;egree of reafon to tliat ©f utes, fhould take pleafure in finking io far below them. Were fuch as vluntarly deprive themfelves cf the ufe of reafon, to con- tinue ever after in that condition, it would feem but a juft punifh- ment. Though this be not the confequence of one act of intoxica- tion, it feldom fails to fucceed a courfe of it. By a habit of drink- ing, the greateft genius is often reduced to a mere idiot.f Intoxication is peculiarly hurtful to y ung perfens. It heats their blood, impairs 'heir strength, and obstructs their growth; be- fides the frequent ufe of ftrorg liquors in the early part of life def- troys any benefit that might ?rife from tem afterwards. Thofe who make a practice of drinking generous liquors when young, can- not expect to leap any benefit from them as a cordial in the decline of life. Drunkenn°fs is not only in itfelf a moft abominable vice; but is an inducement to many others. There is hardly any * We may form fome notion of the mm»nfe quantity of ardent fpirits confumed in Great Britain fr,om this circumrtance, that in the city of Edinburgh and its environs, befides the great Juant'ty <>f rore;gn fpipts du y entered, and the ftill g: eater quantity which isfuppofed to be inuggle«i, it is computed that above two rhiufand pr vate ftiils are conftantly employed in preparing a poifonous liquor callec Mol ass its The common people have got fo univerfally into the habit or drinking th s bale fpirit, that when a porter or laborer is feen reeling along the ftreets, they fay, h* has got moiassfi. f It ts amazing that ou. improvements in arts, learning and politenefs have not put the barbarous cuftom of drinking to excels out of f^fhion. Itisindee- lefs common in South Britain than it was formerly j but it ftill prevails very murh in the North, where this relic of Baroaiity is rmftaken for hofpitality. There no man is fuppofed to entertain his guefts well, who doe? no! make them drunk. Forcing people to drink is certainly the greateft piece of rudenefs that any man can be guilty of. Manlin< fs, complaifance, or mere good-nature, may n iuce a man to take his glafs, if urged to it, at a time when he might as well take poi- ,. ion. The cuftom of drinking to excels has long been out of fafhion in France; and, as it begins to loff ground among the politer part of the Englifli, WC hope it will foon be banifhed ftoai every part of (his iilandf OF CLEANLINESS. 95 crime fo horrid that the drunkard will not perpetrate for the love of liquor. We have known mothers fell their children's clothes, the food that they fhould have eat, and afterwards even the infants themfelves, in order to purchafe the accurfed draught. CHAP. VIII. OF CLEANLINESS. X HE want of cleanlinefs is a fault which admits of no ex- cufe. Where water can be had for nothing, it is furely in the pow- er of every perfon to be clean. The continual difcharge from our bodies by perfpiration. renders frequent change of apparel neceffa- ry. Changing apparel greatly promotes the fecretion from the Jkio, fo neceflary for health. When that matter which ought to be car- ried off by perfpiration is either retained in the body, or reabforbed froi-n dirty clothes, it muft occafion difeafes. Difeafes of the fkin are chiefly owing to want of cleanlinefs.* They may indeed be caught by infection, or brought on by poor living, unwholefome food, &c. but they will feldom continue long where cleanlinefs prevails. To the fame caufe muft we impute the various kinds of vermin which infeft the human body, houses, &c. Thefe may always be banifhed by cleanlinefs alone, and wherever they abound, we have reafon to believe it is neglected. One common caufe of putrid and malignant fevers is the want of cleanlinefs. Thefe fevers commonly begin among the inhabi- tants of clofe, dirty houfes, who breathe unwholefome air, take lit- tle exercife, and wear dirty clothes. There the infection is generally hatched, which of ten fpreads far and wide, to the deftruction of many. Hence cleanliaefs may be confidered as an object of public attention. It is not fufficient that I be clean myfelf, while the want of it iu my neighbour affects my health as well as his. If dirty peo- ple cannot be removed as a common nuifance, they ought at leoft to be avoided as infectious. All who regard their health fhould keep at a diftance even from their habitations. In places whero great numbers of people are collected, cleanli- nefs becomes of the utmost importance. It is well known that in- fectious difeafes are.communicated by tainted air. Every thins* therefore which tends to pollute the air, or fpread the infection, ought with the utraoft care to be guarded againft. For this realon, in great towns, no filth, o'f any kind, fhould be permitted to lie upon the ftreets. Nothing is mere apt to convey infection than the ex- crements of the difeafed. In many great towns the ftreets are little better than dunghills, being frequently covered with afhes, dung, and naftinefs of every kind. Even ftaughter-h ufes, or killing fhambles, are often to be • Mr. Pot, in his furgical obfervations mentions a difeafe which he calls the chimney fweeper's cancer, as it is almoft peculiar to that u^.happy fet of people. This he attribu es to negleft of cleanlinefs, and with great iuftnefs, 1 am Convinced, that if that pait of the body which is the feat of this cruel mfeafs was kept clean by frequent wa'hing, it wou'd never happen. The ctfrnbing boys, as they are called, are certainly the moft miferable w.ctches oa the face of the earth ; jet, for cleaning chitijiies, ao fuch perfons are n9;:2*ary, 96 OF CLEANLINESS. leen in the very centre of great towns. The putrid blood, excre- ments, &c. with which thefe places are generally covered, cannot fail to taint the air, and render it unwholefome. How eafily might this be prev-.nte i by active magistrates who have it always in their power to make proper laws relative to things of ths nature, and to enforc • the obfervance of them. We are lorry to fay, that the importance of general cleanlinefs does not feem to be luffic.ently understood by the magiftrates of moll great towns in Britain ; though hsalto, pleafure, and delicacy, all confpire to recommend an attention to it. Nothing can be more agreeable to the fenfes, more to the honor of the inhabitants, or more conducive to their health, than a clean town ; nor can any thing imprefs a ftranger with a more difrefpectful idea of any peo- ple toan its oppvote. Wnatever pretenfnns people may raake^o learning, polite -•efs, or civilization, we wiil venture to affirm, that while they m gleet cleanlinefs, they are in a ftate of barbarity * T; e p. afems n moft countries feem to hold cleanlinefs in a fort of contempt* Were it not for the < pen ttuation ofthdr houfes, tl ey w.'uld often feel the bad effects of tl is difpofition. One fel- do-n fees a farm-h^ufe without a dunghill before the door, andfre- .. qucn ly the cattle and ther matters lodge under the fame roof. * Peafat ts :t likewife extremely carelefs with refpect to change of" apparel, keeping their houfes, &c. clean. This is merely the effect cf indolence and a dirty diipofiti n. Habit may indeed render it lefs difagreeable to them, bu no habit can ever make it falutary to wear oirty clothes or breathe unwholefome air. As many articles ot diet come t rough the hands of peafants, every meth d fhould be taken io encourage and promote habits of cleanlinefs among them. This, for example, rnigJ.t be done by. giv- ing a fmall premium to the perfon who brings the cleaneft and beft article 'T any kind to market,as butter, cheefe, &c. and.by punifh- ing feverely th-.fe who l>ring it dirty. The fame method mould be taken with butchers, brokers, brewers, and all who are employed in prepar: g t: eneceffarfes .,f life. In camps hc ftrifteft regard fhould be paid to cleanlinefs. By negligence in this matter, infectious difeafes are often fpread amongft a whrle army ; and frequently more die of thefe than by the fword. The Jews, during their enca •-.pments in the wildernefs, received particular inftructions with refpect to cleanlinefs.f J he rules en- joined them ought to be obferved by oil in be like fituation. In- deed the whole fyftem f 1. ws delivered to that people has a mani- feft >eud ncy to promote cleanlinefs. Whoever confiders thena- * In ancient Rome the greateft*men did not think cleanlinefs anobjedt unworthy of their attention. Pi:ny fays, the Cloacae, or common fewers for the conveyance of ft1 th and uafti eli from h^ city, were the tfieatrft rf all the pubiic works j and beftows higher enco- miums upon rarquinius, Agrppa, and others who made and improved them, than on thofe who achieved the greateft conquefts. Howtru'v great does the emperor Trajan appear, when given cire£tions to Pliny hii pro- contu1, concerning the making of a common fewer for the health and convenience of a con- quered c'.ty * •f Thou fha'thavea place alfo without the camp, whither thou fhalt go forth abroad ; and thou fhalt have a paddle upon thy weapon : and itfhalt he when thou malt eafe tnyfelf abroad, thou fhah dig therewith, an fl»*ll turn back, and cover that which cometh from thee, &e. Peuter. chap. xxii. ver. x», ij. OF CLEANLINESS. 97 ture of the'r climate, the difeafes to which they were liable, and their dirty difpofiticn, will fee the propriety of fuch laws» It is remarkable that, in moft eastern countries, cleanlinefs makes a great part of their religion* the Mahometan, as well as the Jewifh religion enjoins various bathings, wafhings, and purific- ations—No doubt theii? mig; t be defigned to reprefent inward puri- ty ; but they were at the fame time calculated for the preservation of oealth. However whimfical thefe wafhings may appear to fome, few things would ten J more to prevent difeafes than a proper at- tertion to many of them. Were every perfon, for example, after vifiting the lick, handling a dead body, or touching aoy thing that mig. t convey infection, to wafh before he went into company, or fa: down to meat, he would run lefs hazard either of catching the in- fecti. n h mfelf, or of communicating it to others. Frequent wafhing not only removes the filth and fores which adhere to re fkin, but likewife promotes the perfpiration, braces the body and enlivens the fpirits. How refrcfhed, how cl eerful, and agreeable docs one feel on being fliaved, walhed, and fhifted : •efpecially wi eo thefe vfti es have been neglected longer than-ufual! Tne eaftern cuftom of wafhing the feet, though lefs neceflary in this country, is neverthelefs a very agreeable piece of cleanlinefs, ar.d contributes greatly to the prefervation of health. Thefweat and dirt with which thefe parts are frequently covered, cannot fail to obfruct the perfpiration. This piece of cleanlinefs would often prevent c Ids and fevers. Were people careful to bathe their feet and legs in Iuke-warm water at night, after being expofed to cold or wet through the day, they would feldomexperiencetheill effects which often pvocted from thefe caufes. A proper attention to cleanlinefs is no where more neceflary than on ihip-bonrd. If epidemical distempers break out there, no ce car >e fafe. 1 he befl way to prevent them, is to take care that the whole company be cleanly in ti eir clothes, bedding &c. When infectious difeafes do break out, cleanlinefs is the moft likely means to prevent t' "ir fpreading: it is likewife neceffary to prevent their retur ing ~fterw:'rds,or being conveyed to otner places. Fcrthispur- pofe theclothes, oedding, &c, of the flckought to be carefully wafhed, an fumigated with brimftone. Infection will lodge a long time iu dirtv cl* tiro,and afterwards break out in the moft terrible manner. In places where great numbers of fick^people are collected toge- ther, cleanlinefs ought to be moft religioufly obferved. The very fmell in fuch places is often fufficient to make one fick. It is eafy tq irnagi e what -effect that is likely to have upon the difeafed. In ah hofpital or infirmary, where cleanlinefs is neglected, a perfon in p-.rfect health has a greater chance to become fick, than a fick per- ibn has to get well. Few t in?s aro more unaccountable than that neglect,'or rather dread of cleanlinefs, which appears among thofe who have the care of the fick ; they think it almoft criminal to fuffer any thing- that is clean to come near a perfon in a fever; for example they would ra- ther alhw him to wallow m all manner of fiMi, than change the leaft bit of his linen. If cleanlinefs be neafliiry for perfons in health, it 9s of infection. is certainly more fo for the fick. Many difeafes may be cured bt cleanlinefs alone ; moft of them might be mitigated by it; and> where it is neglected, the flighteft diforders are often changed in- to the moft malignant. The fame miftaken care which prompted people to prevent the leaft aJmillion of frefh air to the fick, feems to have induce^them to keep them dirty. Both thefe destructive prejudices will, we hope, be foon eradicated. Cleanlinefs is certainly agreeable to our nature. We cannot help approving it in others, even though we fhould not practice it ourfelves. It fooner attracts our regard than even finery itfelf, and often gains efteem where that fails. It is an ornament to the high- eft as well as to the lowest ftation, and cannot be difpenfed with in either. Few virtues are of more importance to fociety than gen- eral cleanlinefs. It ought to be carefully cultivated every where; but in populous cities it fhould be almoft revered.* ■ ■ ■ ■' ■ . ' i'-1'. * CHAP. IX. OF INFECTION. jVXANY difeafes are infectious. Every perfon oughfc therefore, as far as he can, to avoid all communication with the dif- eafed. The common practice of viiitiog the fick, though often well meant; has many ill confequences. Far be it from me to difcoir* rage any act of charity or benevolence, efpecially towards thofe in diftrefs ; but I cannot help blaming fuch as endanger their own or their neighbours' lives by a miftaken frieadfhip, or an impertinent curiofity. The houfes of the fick, efpecially in the country, are generally crowded from morning till night with idle vifitors. It is customary in fuch places, for fervants and young people to wait upon the fick by turns> and even to fit up with them all night. It would be a miracle indeed fhould fuch always efcape. Experience teaches us the danger of this conduct. People often Catch fevers in this way, and communicate them toothers, till at length they become epidemic. It would be thought highly improper for one who had not had the fmall-pox, to wait upon a patient ;u that difeafe ; yet many other fevers are almoft as infectious as the fmall-pox, and not lefs fatal. Some imagine that fevers prove mere f tal in villages than in great towns for want of proper medical afliftance. This may fometimes be the cafe ; but I am inclined to think it oftener pro- ceeds from the caufe above-mentionefJ. Wereaplantobe laid down for communicating infection,it could not be done more effectually than by the common method of vifit- ing the fick. Such vifitors not only endanger themfelves and their * As it is impoflible to be thoroughly clean without a fufficient quantity of water, we would earneftly recommend it to the ma§iftrates of great towns to be particularly attentive to this article. Moft great towns in Britain are fo fituated as to be eafily fupplied with water j and thofe perfons who will not make a proper ufe of it, after it is brought to their hand, certainly deierve to be feverely punifhed. The ftreets of great towns, where water can be had, ought to be wafned every day. This is the only effe&ual method for keeping then thoroughly dean ; and, upon trial, we are perfuaded it will be found the cheapeft. . Some of the moft dreadful difeafes incident to human nature, might in my opinion} M entirely eradicated by cleanlinefs. OF INFECTION. 00; connections, but likewife hurt the fick. By crowding the houfe they render the air nnw olefome, and by their private whifpers and difmal countenances difturb the imagination of the patient, and de- prefs his fpirits. Perfons who are ill, efpecially in fevers, ought to be kept as quiet as poffible. The fight of ftrange faces, and every thing that difturbs the mind, hurts them. The common practice in country places of inviting great num- bers of people to funerals, and crowding them into the fame apart- ment where the corpfe lies, is another way of fpreading infection. The infection d- es not always die with the patient. Every thing that comes into contact with his body while alive, receives the con- tagion, and fome of them, as clothes, blankets, &o* will retain it for a long time. Perfons who die of infectious diforders ought not to lie long unburied ; and people fhould keep as much as polfible at a diftance from them. It would tend greatly to prevent the fpreading of infectious difeafes, if thofe in heal h were kept at a proper diftance from the fick. The* Jewifh Legiflator, among many other wife inftitutions for prefervng health, has been peculiarly attentive to the means of preventing infection, or defilement as it is called, either from a dif- eafed perfon or a dead body. In many cafes the difeafed were to be feparated from thofe in health ; and it was deemed a crime even to approach their habitations. If a perfon only touched a difeafed or dead body, he was appointed to wafh himlelf in water, and to keep for fome time at a diftance from fociety. Infectious difeafes are often communicated by clothes. It is extremely dangerous to wear apparel which has been worn by the difeafed, unlefs it has bee;: well wafhed and fumigated, as infect;on may lodge a long time in it, and afterwards produce very tragical eff cts. This ihews the danger of buying at random the clothes which have been worn by other people. Inf cti us d forders are frequently imported. Commerce, to*- get er with the riches of foreign climes, bring us alfo their difeafes, Thefe do often more fhan counterbalance all the advantages of that trade by mans of whrh they are introduced. It is to be regret ted, that fo li tie care is commonly beftowed, either to prevent tho introduction or fpreading of infectious maladies. Some attention indeed is generally paid to the plague ; but other _difeafes pal's un- regarded.* Infection is often fpread through ciiies, by jails, hofpital?, he Thefe are frequently fituated in the very middle of populous towns; and when iofectious difeafes break out in them, it is impoflible for the inhabitants to efcape. Did magistrates pay any regard to the health of the people, this evil might be eafily remedied. * Were the tenth part of the care taken to prevent the importation of difeafes, that the-. is to prevent fmugelinif, it woud be attended with many happy confequences. This mighr eafily be done by appointing a phyfician at every confiscable fca-port, to infpeel the (hip's company, piflengers,&c ocfore they came afhore, and, if any tVver or other infectious oil'- orders prevailed, to order the fhip. to perform a fhoit quarantine, and to fend the lick to fome hofpital or proper place to be cured. He might likewife order all the clothes, bedd- ing. Set. wh;ch had been ufed by t^e fick duiing the voyage, tobee'rtherd rroyed, or tho- roughly cleanfed by fumigation, Sec. before any of it was fent afhore. A fcheme ot this kind, if properly conducted, wmld ptevent many fevers, and other infectious difeafes, from being brought by failots into fea-port towns, and by this means diffufed all over the country. ioo a OF INFECTION. Many are the caufes which tend to diflufe infecYiott, through popular cities. The whole atraofphere of a large town is one con. taminated mafs, abounding with various kinds of infection, and muft be pernicious to health. The beft advice that we can give to fuch as are obliged to live in large cities, is to chufe an open fituation; to avoid narrow, dirty, ftreets; to keep their own houfes and offices clean ; and to be as much abroad in the open air as their time will permit. It would tend greatly to prevent the fpreading of infectious difeafes, were proper nurfes every where employed to take care of the fick. This, might often fave a family, or even a whole town, from being infected by one perfon. We do not mean that people fhould abandon their friends or relations in diftrefs, but only to put them on their guard againft being too much in company with thofe who are afflicted with difeafes of an infectious nature. Such as wait upon the fick in infectious difeafes run very great hazard. They fhould ftuff their nofes with tobacco, or fome other ftrong fraelling herb, as rue, tanfy, or the like. They ought like- wife to keep the patient very clean, to fpriokle the room where he lies with vinegar, or other ftrong acids, frequently to admit a ftream of frefh air into it, and to avoid the fmell of his breath as much as they can. They ought never to go into company without having changed their clothes and wafhed their hrnds; otherwife, if the difeafe be infectious, they will in all probability carry the contagion' along with them.* However trifling it may appear to incor.fi lerate perfons, we will venture to affirm, that a due attention to thofe things which tend to diffufe infection woull be of great importance in preventing difeaf- es. As moft difeafes are in fome degree infectious, no one fhould continue lone with the fick, except the neceffary attendance. 1 mean not, however, by this caution, to deter thofe whofe duty or office leads them to wait upon the fick, from fuch a laudable and neceffa- ry employment. Many things are in the power of the magiftrate which would tend to prevent the fpreading of infection; as the promoting of pub- iioacleanlinefs; removing jails, hofpitals, burving-grounds, and other places where infection may be generated .^t a proper diftance from great towns ;t widening the ftreets; pulling down ufelefs walls, and taking all methods to promote a free circulation of air through eve- ry part of the town, &c. Public hofpitals, or proper places of re- ception for the fick, provided they werekep* clean, well ventilated, and placed in an open fituation, would likewife tend to prevent the fpreading of infection. Such places of reception would prevent the * There is ffeafon to believe that infeftion is often convened from one place to another fay the carelefsnefsof the faculty themfelves. Many ohyficians affeft a familiar way of fif- ing upon the patient** bed-fide, and holding his arm tor a confiderable time, if the patient has the fmall-pox, or any other infeaious difeafe, there is no doubt but the doctor's hands, clothes, &c. will carry away fome of the infection s and, if he goes directly to vifir another patient without wafhing his hands, changing his clothes, or being expofed to the o.en air, which is not Seldom the cafe, is it any wonder that he fhould carry the difeafe alone with him * Phyficiansnot only endanger others, but alfo themfelves by this practice. And indeed the* Sometimes fufter for their want of care. f The ancients would not fuffer even the temple* of their gods, where the fick reforteA i be built within the Walls of a city, ■ * QF THE PASSIONS. iqr the poor, when fick* from being yifited by their idle or ofheioual neighbours. They would likewife render it unneceffary for fick fer- vants to be kept in their mafters' houfes. Mafters had better pay for having their fervants taken care of in an hofpital, than run the hazard ot having an infectious difeafe diffufed among a numerous family. Sick fervants and poor people, when placed in hofpitals, are not only lefs apt to diffufe infection among their neighbots, but have likewife the advantage of being well attended. We are not, however, to learn that the hofpitals, inftead of preventing infection, may become the means of diffufing it. When they are placed in the middle of great towns; when numbers of pa- tients are crowded together in fmall apartments; when there is a conftant communication kept up between the citizens and the pati- ents; and when cleanlinefs and ventilation are neglected, they be- come nefts for hatching difeafes, and every one who gones into them not only runs a rifk of receiving infection himfelf, but likewife of communicaring it to others. This however is not the fault of the , hofpitals, but of thofe who have the management of them. It were to be wifhed, that they were both more numerous, and upon a more refpectable footing, as that would induce pec pie to go into them with lefs reluctance. This is the more to be defired, becaufe moft of the putrid fevers and other infectious diforders break out among the poor, and are by them communicated to the more cleanly, and the wealthy. Were proper attention paid to the firft appearances ©f Inch diforders, and the patients early conveyance to an hofpital, we fhould feldom fee a putrid fever, which is almoft as infectious as the plague, become epidemic. CHAP. X. OF THE PASSIONS. X HE paflions have great influence both in the caufe and cure of difeafes. How the mind affects the body, will in all pro- bability ever remain a fecret. It is fufficient for us to know, that there is eftablifhed a reciprocal influence between the mental and corporeal parts, and that whatever injures the one diforders the other. Of Anger. The paflion of anger ruffles the mind, diftorts the countenance, hurries on the circulation of the blood, and diforders the whole vi- tal and animal functions. It often occafions fevers, and other acute difeafes ^ and foraetimes even fudden death. This paflion is peculi- arly hurtful to the del'cate, and thofe of weak nerves. I have known fuch perfo-s frequently lofe their lives by a violent fit> of anger, and would at rife Mem to guard againft the excefs of this paflion with the utmost care. It :s not indeed always in our power to prevent being angry; but w? max- furely avoid harboring refrntment in our breaft. Re- sentment preys upcn the mind, and occafions ths rrvrft obfnnate i'oz OF THE PASSIONS. chronical diforders, which gradually wafte the conftitution. Nothing fhews true greatnefs of mind more than to forgive injuries; it pro- motes the peace of fociety, and greatly conduces to our own eale, health, and felicity. ., . , or Such as value health fhould avoid violent gufts of anger, as, they would the moft deadly poifon. Neither ought they to indulge refentment, but to endeavor at all times to keep their minds calm and ferene. Nothing tends fo much to the health of the body as a conftant tranquility of mind. Of Fear. The influence of fear, both in occafioning and aggravating dif- eafes, is very great. No man ought to be blamed for a decent con- cern about life; but too great a defire to preferve it is often the caufe of lofing it. Fear and anxiety, by deprefling the fpirits, not only difpofe us to difeafes, but often render thofe difeafes fatal which an undaunted mind would overcome. *-..,.£ j Sudden fear has generally violent effects. Epileptic fits, and other convulfive diforderr, are often occafioned by it. Hence the danger of that practice, fo common among young people of fright- ening one another. Many have loft their lives, and others have bee* rendered miferable, by frolics of this kind. It is dangerous to tarn- per with the human paflions. The mind may eafily be thrown in. to fuch diforder as never again to aft with regularity. But the gradual effects of fear prove moft hurtful. 1 he con- ftant dread of fome future evil, by dwelling upon the mind, often occafions the very evil itfelf. Hence it comes to pafs; that fo many die of thofe very difeafes of which they long had a dreai, or which had been impreffed on their minds by fome accident, or fooilih pre- diction. This, for example, is often the cafe with women.m child- bed. Many of thofe who die in that fituation are imprefled with a notion of their death a long time before it happens; and there is reafon to believe that this impreffion is often the caufe of it. The methods taken to imprwfs the minds of women with the apprehenfion of the great pain and peril of child-birth, are very hurt- ful. Few women die in labor, though many lofe their lives af er it; which may be thus accounted for: A woman after delivery, find- ing herfelf weak and exhausted, immediaely apprehends fhe is m danger; but this fear feldom fails to obstruct the neceffarv evacua- tions, upon which her recovery depends.. Thus the fex often fall a facrifice to their own imaginations, when there would be no dan- ger, did they apprehend none. It feldom happens 'hat two or three women in a great town die in child-bed, but their death is followed by many others. Every woman of their acquaintance who is with child dreads the fame fate, and the difeafe becomes epidemical by the mere force of imagina- tion. This fhould induce pregnant women to defpife fear, and by all means to avoid thofe tattling goffips who are continually buzzing in their ears the misfortunes of others. Every thing t1 at may m the leaft alarm a pregnant or child-bed woman, ought with the greatelt care to be guarded againft. OF THE PASSIONS. 103 Many women have loft their .lives in child-bed by the old fu- p^rftkious cuftom, ftill kept up in moft parts of Britain of tolling the parifh bell for every perfon who dies. People who think them- felves in dangerare very inquifitive; and if they come to know that the bell tolls for one who died in the fame fituation with themfelves, what muft be the coniequence ? At any rate they are apt to fup* pofe that this is the cafe, and it will often be found a very difficult matter to perfuade them of the contrary. Bht this cuftom is not pernicious to child-bed women only. It is hurtful to many other cafes. When low fevers in which it is dif- ficult to fupport the patient's fpirits, prevail, what muft be the ef- fect of a funeral peal founding five or fix times a day in his ears: No doubt his imagination will fuggeft that others died of the fame difeafe under which he labors. This apprehenfion^vill have a great- er tendency to deprefs his fpirits, than all the cordials of which me- dicine can boaft, will have to raife them. If this ufelefs piece of ceremony cannot be abclifhed, we ought to keep the fick as much from hearing it as poffible, and from every other thing that may tend to alarm them. So far however is this from beipg generally attended to, that many make it their bufinefs to vifitth^fick,on purpofe to whifper difmal ftories in their ears. Such may pafs for fympathizing friends, but they ought rather to be con- fidered as enemies. All who wifh well to the fick ought to keep fuch perfons at the greatest diftance from theim A cuftom has long prevailed among phyficians of prognostica- ting, as they call it, the patient's fate, or foretelling the iffue of the difeafe. Vanity no doubt introduced this practice, and ftill fup- ports it, in fpite of common fenfe and the fafetylof mankind* I have known a phyfician barbarous enough to boaft, that he pronounced more fentences than all his majefty's judges. Would to God that fuch fentences v/ere not often equally fatal! it may indeed be aHedg- ed, that the doctor does not declare his opinion before the patient. So much the worfe. A fenfible patient had better hear what the the doctor fays, than learn it from the difconfolate looks, the wate- ry eyes, and the broken whifpers of thofe about him. It feldom happens, when the doctor gives an unfavorable opinion, that it can be concealed from the patient. The very embarrafiment which the friends and attendants fhew in difguifing what he has faid, is gene- rally fufficient to difcover the truth. Kind heaven has, for the wifeft ends, concealed from mortals their fate; and we do not fee what right any man has to announce the death of another, efpecially if fuch a declaration has a chance to kill him. Mankind are indeed very fond of prying into future events, and feldom fail to folicit the phyfician for his opinion. A doubtful anfw°r, however, or ore that may tend rather to encou- rage the hopes of the fick, is furely the moft proper. This conduct could neither hurt the patient nor the phyfician. Nothing tends, more to destroy the credit of phyfic than thofe bold prognofticator?a who, by the bye, are generally the moft ignorant of the faculty.—*. The mistakes which daily happen in this way arefo many fhn.-lmg proofs of human varrlv, and the weaknef* of faience 104 OF THE PASSIONS. We readily admit, that there are cafes where the phyfician ought to give intimation of the patient's danger to fome of his near connections; though even this ought always to be don - with the greateft caution: but it never ^an be neceffary in any cafe that the whole town and country fhould know, immediately after the doc- tor has made his firft V'fit, that I>e has no hpes of his patient's recovery. Perfons whofe impertinent curiofity leads them *o question the phy. fician, with regard to the fate of his patient, certainly deferves no other than an evafive anfwer. The vanity of foretelling the fate of the fick is not peculiar to the faculty. Others f llow their example, and thofe who thmk them- felves wifer than their neighbors, often do much hurt in this way. Humanity furely calls upon every one to comfort the fick, and not to add to their affliction by alarming their fears. A friend, or even a phyfician, may often do more good by a mild and fympatfrzing behaviour than by medicine, and fhould never neglect to adminifter that greateft of all cordials, Hope. • Of Grief. Grief is the moft destructive of all the paflions. Its effects are permanent; and when it finks deep into the mind, it generally proves fatal. Aiger an*? fear being of a more violent nature, feldom laft long ; but grief often changes into a fixed melancholy, which preys upon the fpirits, and wattes the conftitution. This paflion ought not to be indulged. It may generally be conquered at the begin- ning ; but when it has gained ftrength, all attempts to remove it are vain. No perfon can prevenf misfortunes in life: but it fhews true greatnefs of mind to * eor them with ferenity. Many perfons make a merit of indulging grief, and when misfortunes happen, they ob- stinately refufe all ronf btion, till the mind, overwhelmed with me- lancholy, finks under the load. Such conduct is not only deT mo- tive to health, but inconfiftent with reafon, religion, and common 1 fenfe. Change of ideas is as neceffary for heahh as dhange of pofture* When the mind dwells long upon one fubject, efpecially of a difa- greeable nature, it hurts the whole functions of the body. Herce grief indulged fiV>ils the disreftion and destroys the appetite; by which means the fpirits are deprefied, the nerves relaxed, thp bow- els inflated with wind, and the humours, for want of frefh fupplies of chyle, vitiated. Thus many an excellent conftitution has been ruined by a family misfortune, or any thing that occafions exceffive grief- It is utterly impoflible t^at any perfon of a dejected mind fhould enjoy health. Life indeed may be dragged out for a few years; but whoever would live to a good old age, muft be good humoured and cheerful. This indeed is not altogether in our own poweri yet our temper of rmvd, as well as our actions, depend greatly upon ourfelves. We can either affociate with cheerful or melancholy companions, mingle in the amufemenr s and offices in life, or fit ftiil and brood over our calamities as we choofe. Thefe, and many fuch OF THE PASSIONS. 105 things, are certainly in our power, and from thefe the mind gene- rally takes it caft. The variety of fcenes which prefent themfelves to the fenfes, were certainly defigned to prevent our attention from being too long fixed upon any one object. Nature ab< am !s with variety, and the mind, unlefs fixed down by habit, delights in contemplating new objects. This at once points out the method of relieving the mind in diftrefs. Turn the attention frequency to new objects. Exa- mine them for fome time. When tne mind begins to recoil, fhift the fcene. By this means a conftant fucceflion of new ideas may be kept up, t/11 the difagreeable ones entirely difappear. Thus travel- ling, the ftudy of any art or fcience, reading, or writing on ftrh fub- jects as deeply engage the attention, will fooner expel grief than the moft fprightly amufements. It has alre-dy be- n obferved, that the body cannot be healthy unlefs it be exercifed; neither c m the mind, indolence nouriflies grief. When the mind has nothing elfe to think of but calamities, no wondar that it dwells there. Few people who purftie bufinefs with a'tention are hurt by grief. InfteaJ therefore of abstracting ourlelves from the world or bufinefs v/hen misfortunes happen, we ought to engage in it with more than ufual attention, to difcharge with double diligence th* functions of our station, and to mix with friends of a cheerful and fecial temper. Innocent amufements are by no means to be neglected. Thefe, by leading the mind infenfibly to the contemplation of agreeable ob- jects, help to difpel the gloom which misfortunes caft over it. They make time feem lefs tedious, and have many other happy effects. Some perfons, when overwhelmed with grief, berake them- felves to drinking. This is making the cure worfe than the difeafe. It feldem fails to end in theruin of fortune, character, and conftitution. Of Love. Love is perhaps the ftrongeft of all the paflions; at leaft, when it becomes violent, it is lefs fubject to the contrail either of the un- derftanding or will, than any of the reft. Fear, anger, and fev-ral other paflions, are neceflary for the prefervation of the individual, but love is neceffary for the continuation of the fp^cies itfelf: it was therefore proper taat this paflion fhould be deeply rooted in the human breaft. Though I we be a ftrong piflion, it is fel Jo-n fo rapid in its pro- gr-:fs as feveral of the others. Few perfons tail defperately in love all at once. We wouLl therefore advife every one, before he tam- pers with this ptfli n, to confider well th? probabili y of his b^ing able to obtain the obj-ct of his wishes. When that is not likely, he ftnuld avrid everv occafnn of increafiig it. Ho outfit imme- diately to ileo th- company of the bel wed object; to apply his mind attentively to bufin-Tsor ftudv; to take everv kind of amufement; and above all, to endeavor, if pDuTJe, fo fin i an .«ther object which. may engage his affecti ~ns,and which it may be in his p nvertoobtain. There is no prvnion with which p°ople are fo ready to tamper as lov?. although noo- is more dangerous. Some men make love rbr amo(ement, oth«r* from nv^re v?.sitv, or: on purnMe ttflfteA- (8) .' . io6 OF THE COMMON EVACUATIONS. their confequence with the fair.' This is perhaps the greateft piece of cruelty which any one can be guilty of. What we eagerly wifh for we eafily credit. Hence the too credulous fair are often be- trayed into a fituation which is truly deplorable, before they* are able to difcover that the pretended lover was only in jeft. But there is no jefting with this paflion. When love has got to a certain height, it admits of no other cure butane poffeflion of its object, which in this cafe ought always, if poilible, to be obtained.* Of Religious Melancholy. Many perfons of a religious turn of mind behave as if they thought it a crime to be cheerful. They imagine the whole of re- ligion confifts in certain mortifications, or denying themfelves the fnalleft indulgence, even of the moft innocent amufements. A per- petual gloom hangs over their countenances, while the deepest me- lancholy preys upon their minds. At length the faireft profpects * \anifh, every thing puts on a difmai appearance, and thofe very ^ cbj t£t$ which ought to give delight, afford nothing but difguft.— Life itfelf becomes a burthen, and the unhappy wretch, perfuaded that no evil can equal what he feels, often puts an end to his mife- rable e;:iittnce. It is great pity that ever religion fhould be fo far perverted, as to become the caufe of thofe very evils which it was defigned to cure. Nothing can be better calculated than True Religion, to raife and fupport the mind of its votaries under every affliction that can befal them. It teaches men that even the fufferings of this life are preparatory to the happinefs of the next; and that all who perfift in a courts of virtue fhall at length arrive at complete felicity. Perfons whofe bufinefs it is to recommend religion to others, fhould beware oftlwelling too much on gloomy fubjects. That peace and tranquility of mind, which true religion is calculated to infpire, is a more powerful argument in its favor than all the terrors that can be uttered. Terror may indeed deter men from outward acts of wickednefs, but can never infpire them with that love of God, and real goodnefs of heart, in which alone true religion confifts. lb conclude; the belt way to ccuuteract the violence of any paflion,- is to keep the mind clofely engaged in fome ufeful purfuit. CHAP. XI. OF THE COMMON EVACUATIONS. r-rr J, HE principal evacuations from the human body are thofe by fool, urine, and infenfible perfpiration. None of thefe can be long obftructed without impairing the health. When that which ought to be thrown off the body is long retained, it not only occafions a * The conduct of parents with regard to the difpofal of their children in marriage is often very blamea.bte. An advantageous match is the conftant aim of parents; while their children often fufTer a real martyrdom betwixt their inclinations and duty. The firft thing which pa- >ents ought to canfult in difpofing of their children in mairiage/iscertainly their inclination!* Were due regard always paid to thefe, there would be fewer unhappy couples, ahd parent! would not have fo often caufe to repent the feverity of their conduct, after a ruined conftiw- tion, a loft charter, or a diftratted mind, has fhewn them their miftake. OF THE COMMON EVACUATIONS. 107 plethora, or too great fuUnefs of the veffels, but acquires qualities which are hurtful to the health, as acrimony, putrefcence, &c. Of the Evacuation by StGol. ' Few things conduce more to health than keeping the body reg- ular. When the faces lie too long in the bowels, they vitiate the humors; and when they are too foon difcharged, the body is not. fufficiently nourifhed. A medium is therefore to be defired, which can only be obtained by regularity in diet, fleep, and exercife.— Whenever the body is not regular, there is reafon to fufpect a fault in one or other of tnefe. Perfons who eat and drink at irregular hours, and w ho eat va- rious kinds of food, and driok of feveral different liquors at every meal, have no reafon to expect either th?t their digeftion will be good, or their difcnarges regular. Irregularity in eating and drink- ing difturbs every pirt of the animal economy, and never fails tc* occa ion difeafes. £hher too much or too little food will have this effect. The former indeed generally occafions loofenefs, and the. latter coftivenefs; but both have a tendency to hurt the health. It woul ] be difficult to afcertain the ex.'.ct number of ftools: which may be confiftent with health, as thefe differ in the diiter-nt periods of life, in different confatutions, and evtn in the fame confti- tution und jr a different reginen of diet, exercife, &c. It is h we- vor generally allowed, that one ftool a day is fufficient for an adult, and that lefs is hurtful. But this, like moft general rules, admits: of many exceptions. I have known perfons io. perfect healtn who did n-)t g ) to ftool above once a-week.# Such a degree of coftive- nefs however is not fafe; though the perfon who labors under it may for fome time enjoy tolerable healtn, yet at length it may oc- cafion dif.afes. One method of procuring a ftool every day is to rife be- times, and go abroad in the open air. Not only the pofture in bed is unfavorable to regular ftools, but alfo the warmth. This, oy pro- moting the perfpiration, leffens all the other difcharges. The method recommended for this purpofe by Mr. Locke is likewife very proper, viz. to folicit nature, by going regularly to ftool every morning whether one has a call or not. Habits of this kind may be acquired, wnich will in time become natural. Perfons who have a frequetit recourfe to medicines for pre- venting coftivenefs, feldom fail to ruin their conftitution. Purging medicines frequently repeated, weaken the bowels, hurt rhe digef- tion, and every dofe makes way for another, till at length they be- come as neceflary as daily br^ad. Tnofe who are trouoled with coftivenefs ought rather, if pofli le, to remove it by diet than drugs- They fhould likewife go thinly cloathed, and avoid every thing qf an aftringent or of an heatins; nature. The diet and other regimen neceffary in this cafe will be found under the article Cofiivenefs,wheie this itate cf the bowels i* treated as a difeafe. Such perfons as are troubled with an habitual loofenefs ought likewife to fuit their diet to the nature of their complaiut. They ' S * ac rvrfoas havt :o!d rrt? 'h?.* tbey did net £0 to ftool above oace a mO"/.h; io$. OF THE COMMON EVACUATIONS. fhouH ufe food which braces and ftrengthens the bowels, and which is rather of a astringent quality, as wheat-bread made of the fineft flour, cheefe, eggs, rice boiled in milk, &c. Their drink fhould be red port, claret, brandy and water, in which toafted bread has been boiled, and fuch like. As an habitual loofenefs is often owing to an obstructed per- fpiration, perfons affected with it ought to keep their feet warm, to wear flannel next tneir fkin, and take every other method to pro- mote the perfpiration. Further directions with regard to the treat- ment of this complaint will be found under the article Loofenefs. Of Urine. So many things tend to change both the quantity and appearan- ces of the urine, that it is very difficult to lay down any determined ^ rules for judging of either.* Dr. Cheyne fays, the urine ought to 1 be equal to three-fourths of the liquid part of our aliment. But fup- pofeany one were to take the trouble of meafuring both, he would find that every thing which altered the degree of perfpiration, would alter this proportion,and likewife that different kinds of aliment would af- ford very different quantities of urine. Though for thefe, and other reafons, no rule can be given for judging of the precife quantity of urine which ought to be difcharged, yet a perfon of common fenfe will feldom be at a lofs to know when it is in either extreme. As a free difcharge of urine not only prevents but actually cures many difeafes, it ought by all means to be promoted; and every thing that may obstruct^ it fhould be carefully avoided. Both the fecretion and difcharge of urine are leffened by a fedentary life, fleeping on ^-eds that are too foft and warm, food of a dry and heat- ing quali y, liquors which are astringent and heating, as red port, claret, and fuch like. Thofe who have reafon to iufpect that then- urine is in too fmall quantity, or who have any fymptoms of the gravel, ought not only to avoid thefe things, but whatever elfe they find has a tendency to leffen the quantity of their urine. Wnen the urine is too long retained, it is not only reabforbed, or taken up again into the mafs of fluids, but by ftagnating in the bladder it becomes thicker, the more watery parts flying off firft, and the more grofs and earthly remaining behind. By the conftant tendency which thefe have to concrete, the formation of ftones and gravel in the bladder is promoted. Hence k comes to pafs that in- dolent and fedentary people are much more liable to thefe difeafes, than perfons of a more active life. Many perfons have loft their lives, and others have brought on * It has long been an observation among phyficians, that the appearances of the utine, are very uncertain, and very little to be depende. on. No one will be furprized at this who confiders how many ways it may be affected, and confequently have its appearance altered.— The paflions, the ftate of the atmofphere, the quantity and quality of the food, the exercife, the clothing, the ftaw of the other evacuations, and mimberieft other caufes, are fufneient to' induce a change either in the quantity or the appearance of the urine. Any one who attends to this will be aftonifhed at the impudence of thofe daring quarks, who pretend to find out difeafes, and prefcribe to patients, from the bare infpeclion of their urine. Thefe impofro s, however, are very common all over Britain, and, by the amazing credulity of the populace, many of them amafs confiderable fortunes. Of all the medical prrjudices which prevail in this country, that in favor of urine doctors it the ftrongeft. The common people ha« ftill an unlimited faith in their fkill, although it hat been demon'"hated that no one of then>. is able to diftir.taiih the urine of a horfe or any other animal, from that of a man. OF THE COMMON EVACUATIONS. 109 very tedious, and even incurable diforders by retaining their urine too long, from a falfe delicacy. When the bladder has been over- diftended, it often lofes its power of action altogether, or becomes paralytic, by which means it is rendered unable either to retain te urine, or expel it properly. The calls of nature ought never to be postponed. Delicacy is doubtlefs a virtue, but that can never be reckoned true delicacy, which induces any one to rifle his health or hazard his life. But the urine may be in too great as well as too fmall a quan- tity. This may be occafioned by drinking large quantities of weak watery liquors, by the exceffive ufe of alkaline falts, or any thing that ftimulates the kidnies, dilutes the blood, &c. This diforder very foon weakens the body, and induces a confumption. It is dif- ficult to cure, but may be mitigated by ftrengthening diet and af- trin:nc thefe n.ites. Thii m< rning. Auguil 14 1783, the thermometer in the ihade was down at fifty-three degrees, and a v.-- few rs.i iute: a_.> ic flood above eighty. No one who reflecls on fuch great and fudden changes in the atmolphcrr, will befuiprized to find colds, coughs, rheums, with other affeclions of the breaft an-i tr.w '!», fo common in this country. iia OF THE COMMON EVACUATIONS. The beft method of fortifying the body againft the changes of the weather, is to be abroad every day. Thofe who keep moft withm doors are m ft liable to catch colds. Such perfons generally render «he!r.felves fo d -licate as to feel even the flighteft changes in the atmofp ere, and by their pains, coughs, and oppreffions of the breaft, &c they become a kind of living barometers. Wet Clothes. ■ Wet clothes not only by their coldnefs obstruct the perfpira- tion,but t eir moifture by being absorbed, or taken up into the bo- dy, greatly increafps the danger. The moft robuft conftitution is not proof agai'rft the danger arifing from wet clothes; they daily occafion fevers, rheumatifms, and other fatal diforders, even in the young and hed hy. It is imp..flHe for people who frequently go abroad to avoid .j fometimes beiog wet. But the danger mighr generally be Ieffened, « of not wholly preventel, by changing their clothes loon; when this ' cannot be don*, they ftVuld keep in motion till they dry. So tar are many from taking this precaution,that they often ii; or lie down in the fieHs with their clothes wet, and frequently fle-ep even wlnle nights in this condh'on. The frequent inftances which we h?veof the fatal effects of this conduct, ought certainly to deter all from-- being guilty of it. Wet Feet. Even wet feet often occafion fatal difeafes._ The cholic, inflam- mations of the breaft and of the bowels, the iliac paflion, cholera morbus-, Sec. are often occafioned by wet feet. Habit will, no doubt, render tois lefs dangerous; but it oug^t, as far as poffible, to be avoided. The delicate, and thofe who are not accustomed to have their clothes or feet wet, fhould be peculiarly careful in this refpect. Night Air. The perforation is often obftructed by night air; even in fum- mer, this ought to be avoided. The dews which fall plentifully af- ter the hottest day, make the night more dangerous than when t'pe weather is cool. Hence, in warm countries, the evening dews are more hurtful than where the climate is more temperate. It is very agreeable after a w^rra day to be abroad in a cool evening ; but this is a pleafure to be avoided by all who v.lue their health.' The effects of evening dews are gradual indeed, and almoft imperceptible; but they are not the lefs to be dreaded: we would therefore advile tr veltos, labourers, and all who are much heated by day, carefully to'avoid them. When the perfpiration has been great, thefe beet me dangerous in proportion. By not attending to this, in flat marfhy countries, where the exhalations and dews are copious, labourers are often feized with intermitting fevers, quin* feys, and other dangerous difeafes. Damp Beds. Beds become damp, either from their not being ufed, ftanding :n damp houfes, or ia rooms without fire, or from the linen not.be- OF THE COMMON EVACUATIONS. in jng dry when laid on the bed. Nothing is more to be dreaded by travellers than damp beds, which are very common in all places where fu 1 is fcarce. When a traveller, cold and wet, arrives at an inn, he may by means of a good fire, warm diluting liquor, and a dry bed, have the perfpiration reftored ; but if he be put into a cold room, and laid in a damp bed, it will be more obstructed, and the worst confequences will enfue. Travellers fhould avoid inns which are noted for damp beds, as they would a houfe infected with the plague, as no man, however robuft, is proof againft the danger ari- fing from them. But inns are not the only places where damp beds are to be met with. Beds kept in private families for the reception of ftran- gers are often equally dangerous. All kinds of liuen and bedding, when not frequently ufed, become damp. How then is it poflible that beds, wh'ch are not flept in above two or three times a year, fhould befafe? Nothing is more common than to hear people com- plain of having caught cold by changing their bed. The reafon is obvious: were they careful never to fleep in a bed but what was frequently ufed, they would feldom find any ill confequences from a change. Nothing is more to be dreaded by a delicate perlon when on a vifit, than being laid in a bed which is kept on purpofe for ftran- gers. That ill-judged piece of complaifance becomes a real injury. All the bad confequences from this quarter might eafily be prevent- ed in private families, by cauflng their fervants to fleep in the fpare beds, and refign them to ftrangers when they com?. In io-^s, where the beds are ufed almoft everv night, nothing elfe is neceffery thaa to keep the rooms well feafoned by frequent fire5;, and the linen dry. That baneful cuftom laid to b.° practifed in many inns, of damp. \nz thefts, an I prefling them in order to fave wifhinsr, and after- wards laving them on the beds, ought, when difoovered, to be pun- ifh 'i with the unnoft fev*rity. It is really a fpecies of mur *er, aid w 11 often prove as fatal as poifon or em-irnt. Indeed linen, efpe- cially if it has been warned in winder, ou^ht not to bs ufed till it has been expofed for fome time to the fire ; nor is this op°rntion. lefs neceffary for linen wafhed in fummer, provided it has lain by for any length of time. This camion is the more needful, as gen- tlemen are often exceedingly attentive to what they eat or drink at an inn, y;t pay no regard to a circumftance of much more impor- tance." Damp Houfes. Damp honfes frequently produce the like ill confequences; for this reafon thofe who build fhould be careful to chufe a dry fitua- tion. A houfe which ftands on a damn marfhv foil or deen clay, will never be thoroughly dry. All houfes, unlefs where the ground is exceedingly dry, fhould have the firft floor a little raifed. Ser- vants and others who are obliged to five in cellars and funk ftories, * If a perfon fufpedh that h"s bed is damp, the fimple precaution of taking -id fuch a fituation, and even the robuft are not always proof againft its influence.* Sudden Tranfitions from Heat to Cold. The perfpiration is commonly obstructed by sudden tran« sitions from heat to cold. Colds are feldom caught, unlefs when people have been too much heated. Heat r urifies the blood, quickens the circulation, and increafes the perfpiration ; but wh<;n thefe are fuddenly checked, the confequences muft be bad. It is indeed im- poflible for labourers not to be hot upon fome occafions: but it is generally in their power to let themfelves cool gradually, to put on their clothes when they leave off work, to make choice of a dry place to reft themfelves in, and to avoid sleeping in the open fields. Thefe e :fy rules> if obferved, would often prevent fevers, and other fatal diforders. It is very common f :>r people when hot, to drink freely of cold water, or fm ill lquors. This conduct is extremely dangerous.— ThVt indeed is nard to bear, and the inclination to gratify that ap. petite frequently gets the better of reafon, and makes us do what our judgoaent difapproves. Every peafant, however, koows, if his horfe be permvted to driok his belly full of cold water after violent exercife, and be immediately put into the ftable, or fuffered to re- main at reft, that it will kill him. This they take the utmoftxare to prevent. It were well if they were equally attentive to their own fafety. Thirft may be quenched many ways without fwallowing large.' quantities of cold liquor. The fields afford variety of acid fruits and plants, tne very ohewing of which would abate thirft. Water kept in the mouth for feme time, and fpit rut again, if frequently repeated, will have the fame effect. If a bit of bread be eaten along with a few mouthfuls of wat«r, it will both quench thirft more ef- fectually, and make'the danger lefs. When a perfon is extremely hot, a mout. ful of brandy, or other fpirits, if it can be obtained, ought to be preferred to any thing elfe. But if any one has been fo fooliib, when hot, as to drink freely of cold liquor, he ought to * People imagine if a good fire is made in aroom after it has been wafhed, that there ii »o danger from fitting in it j but they muft give me leave to fay that this increafes the dan- ger. The evaporation excited fcy the fire generates cold, and renders the d.;^^ more attiw« GF THE COMMON EVACUATIONS. 113 oontinue his exercife at leaft till what he drank be thoroughly warmed upon his ftomach. It would be tedious to enumerate all the bad effects which flow from drinking cold liquors when the body is hot. Someti mes 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, fallads, or the like. Thefe iideed have not fo fudden an effect on the body as cold liquors, but they are notwi'hftandmg dangerous, and ought to be avoided. Sit'ing in a warm room, and drinking hot liquors till the pores are quite Open, and immediately going into the cold air, is extreme- ly dangerous. Colds, coughs, and inflammations of the breaft, are the ufual eff-cts of this conduct; yet nothing is more common than for people, after they have drank warm liquors for fev ral hours, to walk or ride a number of miles in the coldeft night, or to ramble about in the ftreets.* Peop'e are very apt, when a room is hot, to throw open a win- dow, and to fit near it. This is the moft dangerous practice. Any perfon had better fit w thout doors than in fuch a fituation, as the current of air is directed'againft one particular p ■" •■ • ••___!■....... f-.1 n=es PART II. OF DISEASES. CHAPTER XII. OF THE KNOWLEDGE AND CURE OF DISEASES. rp X HE cure of difeares does not depend fo mu^h upon fcr- entific principles as many imagine. It is chiefly the raful«- of expe- rience and obfervation. By attending the fick, and crefu'ly oh- ferving the various occurrences in dTeafes, a (treat- degree >~>f ac- curacy may be acquired, both in diftm^uifhing their fv^aptmns, a^.3 in the application of medicines. Hence fenfible nurfes, and other perfons who wait upon the fick, often forefee the parent's fate lboner than thofe who have been bred to phyfic. We do not how- ever mean to infinuate that a medical education is of no ufe: It is doubtlefs of the greateft imDortance ; but it never can fupply the place of obfervnion and experience. Every difeafe may be confidered as an affemblage of fymotoms, and muft be diftinguiihed by thofe which atv» moft obvioui and per- manent. Inftead therefore of giving a claflicil arrangement of dif- eafes, according to the fyftematic method, it will be more fuitable, in a performance of this nature, to give a full and accurate defcrip- uon of each particular difeafe as it occursj and, where any of the OF THE KNOWLEDGE 115 fymptoms of one difeafe have a near refemblance to thofe of ano- ther, to take notice of that circumftance, and at the fame time to p ?int ^ut the peculiar or characteristic fyraptoms by which it may_ be diltinguifhed. Bv a due attention to thefe, the investigation of difeafas will be found to be a lefs difficult matter than moft people would at fir.t be ready to imagine. A proper attention to the patient's age, fex, temper of mind, conftitntion, and manner of life, will likewife greatly aflift, both in the inveft'gntion and treatment of difeafes. In childhood the fibres are lax and foft, the nerves extremely ir- ritable, ^nd the fluids thin; v/hereas in old age the fibres are rigid, tie nervas become almoft infenfible, and many of the veffels imper- viable. Thefe an 1 other peculiarities render the difeafes of the young and aged very diff rent, and of courfe they muft require a diftVeot :n i^od of tr atme t. F-nrles are liable to manv difeafes which do not afflict the other fex: befides. the nervous fyftem being more irritable in them than in men, their difeafes require to be treated with greater caution.— They are lefs able to bear large evacuations; and all stimulating me- dicines ought- to be adminiftered to them with a fparing hand. Particular constitutions not only difpofe perfons to peculiar dif- eafes, but likewife render it neceffary to treat thefe difeafes in a p culiar manner. A delicate perfon, for example, with weak nerves, who lives m.^ftlv within doors, muft not be treated, under any dif- eafe, p'-ecifety in the fame manner as one who is hardy and robuft, and who is niuch expofed to the open air. The temper of mind ought to be carefully attended to in dif- eafes. Fear, anxiety, and a fretful temper, both occafions and ag- gravate difeifes. In vain do we apply medicines to the body tore- move maladi =s which proceed from the mind. When it is affected, the beft medicine is to foothe the paflions, to divert the mind from anxious thought, and to keep the patient as eafy and cheerful as pof- fible. Attention ought likewife to be paid to the climate, or place wh-»r inquire in'o the patient's occupation, manner of life, &c. This will not only aflift us in finding out the difeafe, but will like- wife direct us in the treatment of it. It would be very imprudent to treat trr laborious and the fedentary precifely in the fame man- ner, ewn fuppofing them to labour under the fame difeafe. It will l'ke vife be proper to inquire, whether the difeafe be con- ftitutional ^r accidental; whether it has been of long or fhort du- ration ; whether it proceeds from any great and fudden alteration ttd AND CURE OF DISEASES. in the diet, manner of life, &c. The ftate of the patient's body. and of the other evacuations, ought alfo to be inquired into; and likewife whether he can with eafe perform all the vital and animal functions, as breathing, digeftion, &c. Lastly, it will be proper to inquire what difeafes the patient has formerly been liable to, and what medicines were moft benefi. rial to him; if he has a ftrong averfion to any particular drug, && As many of the indications of cure may be anfwered by diet alone, it is always the firft thing to be attended to in the treatment of difeafes. Thofe who know no better, imagine that every thing which goes by the name of a medicine poffeffes fome wonderful power or fecret charm, and think, if the patient fwallows enough of drugs, that he muft do well. This miftake has many ill confequen- ces ; it makes people trust to drugs, and neglect their own endea- vours; befides it difcourages all attempts to relieve the fick where medicines cannot be obtained. Medicines are no doubt ufeful in their places; and when ad- miniftered with prudence, they may do much g od; but when they are put in place of every thing elfe, or adminiftered at random, which is not feldom the cafe, they muft do mifchief. We woujd therefore wifh to call the attention of mankind from the purfuit of fecret medicines, to fuch things as they are acquainted with. The proper regulation of thefe may often do much good, and there is little danger of their ever doing hurt. Every difeafe weakens the digeftive powers. The diet ought therefore, in all cafes, to be light and of eafy digeftion. It would be as prudent for a perfon with a broken leg to attempt to walk, as for one in a fever to eat the fame kind of food, and in the fame quan- tity, as when he was in perfect health. Ev^n abftinence alone will often cure a fever, efpecially when it has been occafioned by ex- cefs in eating or drinking. In all fevers attended With inflammation, as pleurifies, peripneu- monies, &c. thin gruels, wheys, watery infufion*? of muOlaeinous plants, roots, Sec are not only proper for the patent's food, but they are likewife the beft medicines which can be adminiftered. In fevers, of a flow, nervous, or put ni kind, where there are nofymptoms of inflammation, and where the patient muft be fup- ported with cordials, "that intention can always be more effectually anfwered by nourifhing diet and generous wines, than by any me- dicines yet known. Nor is a proper attention to the diet of lefs importance in chro- nic than in acute difeafes. Perfons afflicted with low fpirits, wind, weak nerves, and other hypochondriacal affections, generally find more benefit from the ufe of folid food and generous liquors, than from all the cordial and carminative medicines, which can be admi- niftered to them. The fcurvy, that moft obstinate malady, will fooner yield to a proper vegetable diet, than to all the boafted antifcorbutic remedies of the fh ps. In confumptions, when the humours are vitiated, and the fto- mach fo much weakened as to be unaole to uigeft the folid fibres of OF FEVERS IN GENERAL. nj animals, or even to afjamilate the juices of vegetables, a diet confifl-. ing chiefly of milk, will not only fupport the patient, but will often eure the difeafe after every other medicine has failed. Nor is an attention to Other things of lefs importance than to diet. The ftrange infatuation which has long induced people to fhut up the fick from all communication with the external air has done great mifchief. Not only in fevers, but many other difeafes, the patient will receive more benefit from having the frefh air pru- dently admitted into nis chamber, than from all tie medicines which can be given him. Exercife may likewife in many cafes be confidered as a medi- cine- S iliog, or riding on horfeback, for example, will be of more fervice in the cure of confumptions, glandular obstructions, &c. than any medicine yet known. In difeafes which proceed from a relax- ed ftate of the folids, the cold bath, and other parts of the gymnaf tic regimen, will be found equally beneficial. Few things are of greater importance in the cure of difeafes than cleanlinefs. When a patient is fuffcred to lie in dirty clothes, whatever perfpires from his body is again reabforbed,or taken up in- to it, which ferves to nourifti the difeafe and increafe the danger. Many difeafes may be cured by cleanlinefs alone; moft of them may be mitigated by it, and in all of them it is highly*tieceffary both for the patient and thofe who attend him. Many other obfervations, were it neceflary, might be adduced to prove the importance of a proper regimen in difeafes. Regimen will often cure difeafes without medicine, but medicine will feldom fuceeed where a proper regimen is neglected. For this reafon, is the treatment of difeafes, we have always- given the firft place to regimen. Thofe who are ignorant of medicine may confine them felves to it only. For others who have more knowledge, we have recommended fome of the moft fimple but approved forms of medi- cine in every difeafe. Thefe however are never to be adminiftered but by people of better understanding; nor eve.i by them without the greateft precaution. CHAP. XIIL OF FEVERS IN GENERAL. JLjLS more than one half of mankind is find to perifli by fe- vci% it is of importance to be acquainted with their caufes. The moft general caufes of fevers are, infetlion, errors in diet. unvjfyJc- fme air, violent emotions of the mind, excefs or fupprefficn of ifuai evacua- tions, external or internal injuries, and extreme degrees cf h:ci or cold. A*. moft of th-fe have already been treated of at''confiderable "length, and their effects fhewn, we fhall not now relume the epefideratior. of them, but fhall only recommend it to all, as they would wifh to avoid fever? and other fatal difeafes, to pay the moft punctual at- tention to thefe artiJco. Fevers ar» not only the meft freo^oo of x\ difeafes, but they are lUewife the moft rome'ex. In too arcft '"T-e fpe::es efftve-. n8 OF FEVERS IN GENERAL. there is always a combination of feveral different fymptoms. The diftinguifhing fymptoms of fever are, increafed heat, frequency ofpulfe,' lofs of appetite, general debility, pain in the head, and a difficulty in per forming fome of the vital or animalfwitlions. The fymptoms umally at- tendant on fevers are, naufea, thirft, anxiety, delirium, wearinefs, wafting of the flefh, want of fleep, or the fleep difturoed aad not refrefhing. When the fever comes on gradually, the patient gener?lly com- plains firft of langour or liftleffnefs, forenefs of the flefh, or the bones, as the country people exprefs it, heavinefs of the head, lofs of appetite, ficknefs, with clamminefs of the mouth; after fome time come on exceffive heat, violent thirft, reftleffnefs, &c. When the fever attacks fuddenly, it always begins with an un- eafy fenfation of exceffive cold, accompanied whh debility and lofs of appetite; frequently the cold is attended with fhivering, oppref- fion about the heart, and ficknefs at ftomach, or vomiting. Fevers are divided into continual, remitting, intennitti g, and fuch as are attended with cutaneous eruption or topical inflamma- tion as the fmall pox, erysipelas, &c. By a continual fever is memt that which never leaves the patient during the whole courfe of the difeafe, or which fhews no remarkable increafe orabatem nt in the fymptoms. This kind of fever is likewife divided into acute, flow, and malignant. The fever is called acute wh> n its p^ogrefs is quick, and the fymptoms violent; but when thefe are m ^re gentle, it is generally denominated flow. W.en livid or petechial fpots fnew a putrid ftate of the humours, the fever is called malignant, putrid, or petechial. * A remitting fever differs from a continual only in a degree. It has frequent increafes and decreafes, or exacerbations and remif- fions, but never wholly leaves the patient during'the courfe of the difeafe. Intermitting fevers or agues are rhofe wnich, during the- time that the patient may be faid to be ill, have evident intervals or reaiiflions. of the fymptoms. As a fever is only an effort of Nature to free herfelf fro n an offending caufe, it is the bufinefs of thofe who have the care of the fick to obferve with diligence which way Nature p ants, and to en- deavour to aflift her operations. Our bodies are fo fra ned, as to have a conft int tendency to expel or throw off whatever is injuri- ous to health. This is generally done by urine, fweat, ftooi, ex- pectoration, Vomit, or fome other evacuation. There is reafon to believe, if the efforts of Nature, at the be- ginning of a fever, were duly attended to and promoted, it would leldom continue long; but when her attempts are neglected or coun- teracted, it is no wonder if the difeale proves fatal. There are daily inftances of p?rfons who, after catching cold, have all the fymp- toms of a beginning fever; but by keeping warm, drinking dilut- ing liquors, bathing their feet in warm water, &c. the fympto ns in a few hours difappear, and the danger is preve :ted. When fevers of a putrid kind threaten, the beft method of obviating ti.eir effects is by repeated vomits. Our defign is not to enter into a critical inquiry into the n* OF FEVERS IN GENERAL. ng ture and immediate caufes of fevers, but to mark their moft obvi- ous fymptoms, and to point out the proper treatment of the patient with refpedt to his diet, drink, air, &c. in the different stages of the difeafe. In thefe articles the inclination of the patient will In a great meafure direct our conduct. Almoft every perfon in a fever complains of great thirft, and calls out for drink, efpecially of a cooling nature. This at once points out the ufe of water, and other cooling liquors. What is fo likely to abate the heat, attenuate the humours, remove fpafms and obftructions, promote perfpiration, increafe the quantity of urine, and in fhort produce every falutary. effect in an ardent or inflamma- tory fever, as drinking plentifully of water, thin gruel, or any other weak liquor, of which water is the bafis? The neceflity of diluting liquors is pointed out by the dry tongue, the parched Ikin, and tne burning heat, as well as by the unquenchable thirft of the patient. Many cooling liquors, which are extremely grateful to patients in a fever, may be prepared from fruits, as decoctions of tamarinds, apple tea, orange wiiey, and tne like. Mucilaginous liquors might alfo be prepared from marih-mallow roots, linfeed, limetree buds, and other mild vegetables. Thefe liquors, efpecially when acidulated, are highly agreeable to the patient, and fhould uever be denied him. At the beginning of a fever the patient generally complains of great laflitude or wearinefs, and has no inclination to move. This evidently thews the propriety of keeping him eafy, and if poffible in bed. Lying in bed relaxes the fpafms, abateathe violence of the circulation, and gives nature an opportunity of exerting all her force to overcome the difeafe. The bed alone would often remove a fe- ver at the beginning; but when the patient ftruggles with the dif- eafe, inftead of driving it off, he only fixes it the deeper, and ren- ders it more dangerous. This oblervation is too often verified in travellers, who happen when on a journey to be feized with a fe- ver. Their anxiety to get home induces them to travel with the fe- ver upon them, which conduct feldom fails to render it fatal. la fevers the mind as well as the body fhould be kept eafy. Company is feldom agreeable to the fick. Indeed every thing that disturbs the imagination, increafes the difeafe; for which realon every perfon in a fever ought to be kept perfectly quiet, and neither- allowed to fee nor hear any thing that may in the leaft affect or dif- compofe his mind. Though the patient in a fever has the greateft inclination for drink, yet he feldom has any appetite for folid food: hence the im - propriety of urging him to take victuals is evident. Much folid food in a fever is every way hurtful. It oppreffes nature, and in- ftead of nourifhing the patient, ferves only to feed the difeafe.-- What food the patient takes fhould be in fmall quantity, light, and of eafy digeftion. It ought to be chiefly of the vegetable kind, a& panada, roasted apples, gruels and f ;ch like. Poor people, wh*m any of their family are taken ill, run direct- ly to their rich neigt:b urs for c >rdials, and pour wine, fpirits, Sre. into the patient, who perhaps never had been accuftomed to taite fuch liquors when in health. If there be any degree of fev^r.. tlr ••• 120 OF FEVERS IN GENERAL. conduct muft increafe it, and if there be none, this is the ready way to raife one. Stuffing the patient with fweetmeats and other deli- cacies is likewife very pernicious. Thefe are always harder to di- gest than common food, and cannot fail to hurt. Nothing is more defied by a patient in a fever than frefh air. It not only removes his anxiety, but cools the blood, revives the ipirits, and proves every way beneficial. Many patients are in a manner ftifled to death in fevers for want of frefh air; yet fuch is the unaccountable infatuation of moft people, that the moment they think a perfon in a fever, they imagine he fhould be kept in a clofe chamber, into which not one particle of frefh air mua be admitted.. Inftead of this, there ought to be a conftant ftream of frefh air into. a fick perfon's chamber, fo as to keep it moderately cool. Inde d its degree of warmth ought never to be greater than is agreeable to one in perfect 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 bbod is inflamed, or the humours in a putrid ftate, air that has been breathed repeatedly will greatly increafe the difeafe. Such air not only lofes its fpring, and becomes unfit for the purpofe of refpirat,1' tion, but acquires a noxious quality, which renders it in a manner poifonous to the fick. In fevers, when the patient's fpirits are low and depreffod, he is not only to be fupported with cordials, but every method fhould be taken to cheer and comfort his mind. Many, from a miftakea zeal, when they think a perfon in danger, inftead of Solacing his mind wifh the hopes and confolatinns of religion, fright him with the views of hell and damnation. It would be unfuitable here to dwell upon the impropriety and dangerous confequences of this conduct; it often hurts the body, and there is reafon to believe fel- dom benefits the foul. Among common people, the very name of a fever generally fuggefts the neceffity of bleeding. This notion feems to have taken its rife from moft fevers in this country having been formerly of aa inflammatory nature ; but true inflammatory fevers are now fel- dom to be met with. Sedentary occupations, and a different man- ner of living, have fo changed the ftate of difeafes in Britain, that there is now hardly one fever in ten where the lancet is neceflary. In moft low, nervous, and putrid fevers, which are now fo com- mon, bleeding is really hurtful, as it weakens the patient, finks his fpirits, &c We would recommend this general rule, never to bleed at the beginning of a fever, unlefs there be evident figns of inflim- raation. Bleeding is an excellent medicine when neceffary, but fh ould never be wantonly performed. It is likewife a common notion, that fweating is always necef- fary in the beginning of a fever. When the fever proceeds from an obitructed perfpiration, this notion is not ill-founded. If the pa- tient only lies in bed,.bathes his feet and legs in warm water, and drinks freely^ of warm water-gruel, or any other weak diluting li- quor, he will feldom fail to perfpire freely. The warmth of the bed, and the diluting drink, will relax the univerfal fnafm, whic> OF INTERMTTTING FEVERS, OR AGUES. t'i\ generally affects the fkin at the beginning of a fever; it will open the pores, and promote the perfpiration, by means of which the fe- ver may often be carried off. But inftead of this, the common prac- tice is to heap clothes upon the patient, and to give him things of a hot nature, as fpirits, fpiceries, &c. which fire his blood, increafe the fpafrns, and render the difeafe more dangerous. In all fevers a proper attention fhould be paid to the p tient's longings. Theft are the calls of Nature, and ofte^ point out what may be of real ufe. Patients are not indeed to be indulged in every thing that the fickly appetite may crave; but ir is generally right to let them have a little of what they eagerly defire, though it may not feem altogether proper. What the patient longs for, his ftom- ach will generally digeft; and fuch things have fometimes a very happy effect. When a patient is recovering from a fever, great care is necef- fary to prevent a relapfe. Many perfons, by to foon im?ginin& themfelves well, have loft their lives, or contracted other difeafes of an obstinate nature. As the body after a fever is weak and delicate, it is neceffary to guard agaii ft catching cold. Moderate ex* rcife in the open air will be of ufe, but great fatigue is by all means to be avoided; agreeable company will alfo have a good effect. The diet muft be light but nourifhing. It fhould be taken frequently, but in fmall quantities?. It is dangerous, at fuch a time, to eat as much as the ftomach may crave. CHAP. XIV. OF INTERMITTING FEVERS, OR AGUES. INTERMITTING fevers afford the beft opportunity both of obferving the nature of a fever, and alfo the effects of medicine. No perfon can be at a lofs to diftinguifh an intermitting fever from any other, and the proper medicine for it is now almoft univerfally known. The feveral kinds of intermitting fevers take their names from the period in which the fit returns, as quotidian, tertian, quartsn,&r. CAUSES.—Agues are occafioned by effluvia from putrid stag- nating water. This is evident from their abounding in r?iny fea- fons, and being moft frequent in countries where the foil is mrrfriy, as in Holland, the fens of Cambridgefhire, the Hundreds of Effex, &c. This difeafe may alfo be occafioned by eating too much ftrne fruit, by a poor watery diet, damp houfes, evening dews, lyirg up- on the damp ground, watching, fatigue, deprefling pafliens, and the like. When the inhabitants of a high country remove to a low one,' they are generally feized with intermitting fevers, and to fuch the difeafe is moft apt to prove fatal. In a word, whatever relaxes the folids, diminifhes the perfpiration, or obftructs.ihe circulation in the capillary or fmall veflels, difpofes the body to agues. 'SYMPTOMS.—An intermitting fever generally begins with a pain of rhe head and loins, wearinefs of the limbs, ecldxef: cf the (9) 122 OF INTERMITTING FEVERS, UK AUUH.H. extremities, ftretching, yawning with fometimes great ficknefs and vomitting ; to which fucceed ihitfering and violent fhaking. After- Wards the fkin becomes moift, and a profuie fweat breaks out, which generally terminates the fit or paroxyfm. Sometimes indeed the difeafe conies on fuddenly, when the perfon riiaks himfelf in per- fect health ; but it is more commonly preceded by liftleflnefs, lofs of appetite, and the fymptoms mentioned above. REGIMEN.—While the fit continues, the patient ought to drink freely of water-gruel, orange-whey, weak camomile tea; cr, if is fpirits be low, fmall wine-whey, fharpened with the juice of lemon. All his drink fhould be warm, as that will aflift in bring- ing on the fweat, and consequently fhorten the paroxyfm.* Between the paroxyfms the patient muft be fupported with food that is nourifhing, but light and eafy of digeftion, as veal or chicken broths, fago, gruel witn a little wine, light puddings, and fuch like. His drink may be fmall negus, acidulated with the juice of lemons or oranges, and fometimes a little weak punch. He may , likewife drink infufions of bitter herbs, as camomile, wormwood, or water-trefoil, and may now and the^ take a glafs of fmall wine, in which gentian root, centuary,or fome other bitter, has been infufed* As the chief intentions of cure in an ague are to brace- the fol- ids, and promote perfpiration, the patient ought to take as much exercife between the fits as he can bear. If he be able to go abroad, riding on horfeback, or in a carriage, will be of great fervice. But if he cannot bear that k:nd of exercife, he ought to take fuch as his ftrength will permit. Nothing tends mere to prolong an intermit- ting fever, than indulging a lazy indolent difpofition. Intermitting fevers, under a proper regiiren, will often go off without medicine: and when the difeafe is mild, in an open and dry country, there is feldom any danger from allowing it to take its » couife; but when the patient's ftrength feems to decline, cr the paroxyfms are fo violent that his life is in danger, medicine cught immediately to be adminiftered.. This however fhould never be done till the difeafe be properly formed, that is to fay, till the pa- tient has had fev-rai fits of fhaking and fweatirg. MEDICINE.—fhe firft thing to be done in the cure of an in- termitting fever, is to cleanfe the ftomach and bowels. This not only renders the application of other medicines more fafe,but like- wile more efficacious. In this difeafe, the ftomach is generally load- ed with cold vifcid phlegm, and frequently great quantities of bile are difcharged by vomit; woich plainly points out the neceflity of evaluations. Vomits are therefore to be adminiftered before the patient takes any other medicine. A dofe of ipecacuanha will gene- rally ani wer this purpofe very well. A fcruple or half a dram of the powder will be fufficent for an adult, and for a younger per- fon the dole muft be lefs in proportion. After the vomit begins to operate, the pitient ought to drink plentifully of weak camomile tea. The vomit fhould be taken two or three hours before the re- * Dr. Lina fay;, that twenty or twenty-five dropi of laudanum pat into a cup of the pa- tie»t'» drink, and given about half an hour after the commencement of the hot fit, pro- mgtes the fweat, fljortens the fit, rdieves the head, and tends greatly te remove the difeafe OF INTERMITTING FEVERS, OR AGUES. i*3 turn of the fit, and may be repeated at the diftance of two or three days. Vomits not only cleanfe the'ftomach, but increafe the perfpi- ration, and all the other fecretions, which render them of fuch im* portance, that they often cure intermitting fevers, without .the af- fiftance of any other medicine. Purging medicines are likewife ufeful and often neceffary hi intermitting fevers. A fmart purge has been ku^wn to cure ari obk ftinate ague, after the Peruvi n bark and other med:< ines had be?n ufed in vain. Vomits how ver are more fuitabh in this difeaie, and render purging lefs neceflary ; but if the pa'ient be afraid to take a vomit, ! e ought in this cafe to cleanfe the bowels by a dofe cr" two of Glauber's fait, jalap, or rhubarb* Bleeding may fometim s be proper at thebegi ninjr of an inter- cutting fever, when exceffive heat, a delirium, &c» give reafon to fufpect an inflammation; but as the blood is feldom in an inflam- matory ftate in intermitting fevers, this operation is rarely neceffa- ry. When frequently repeated, it tends to prolong this difeafe. After proper evacuations the patient may fafely ufe the Pi ru- vian bark, wnich may be taken in any way that is moft agreeable to him. No preparation of the bark teems to anfwer be ter than the moft fimple form in which it can be given* viz. in powder. Two ounces of the beft Peruvian bark, finely powdered, may be divided into twenty-four doles. Thefe may either be made into boluffes as they are ufed, with a little fyrup of lemon, or mixed in a glafs of red wine, a cup of camomile tea, water grue}, cr any oth- er drink that is more agreeable to the patient.* In an ague which returns every day, one of the above dofes may be taken every two hours during the interval of the fits. 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 '?k2 a dofe every third h> ur during the interval, and in a quar- tan every fourth. If the patient cannot take fo large a dofe of the b.rk, he may divide each of the powders into two parts, and take one every hour, &c. For a yoUng perfon a (mailer quantity of ' his medicine will be fufficient, and the dofe muft be adapted to the age^ constitution and violence of the fymptoms.f Fhe abov= quantity of bark will frequently cure an ague; the patient, however, ought not to leave off taking the medicine as foon as the paroxyfms are flopped, but fhould continue to ufe it till th- re is reafon to believe the difeafe is entirely overcome. Moft of the failures in the cure of this difeafe are owing to patients not contin* uing to ufe the medicine long enough. Thev are generally direct- ed to take it till the fits are flopped, then to leave it off, and begin * It has lately been obferved, that the red bark is more powerful than tha* which has fof fome time been in common ufe. Its fuperior tfficacy feems to arife from its bein<.of a more perfect growth! than the quill bark, and confequently more fully impregnated with the me- dical properties of the plant. f fa intermitting fevers of an obftinate nature, 1 have found it neeeiTary to throw in th* bark much fafter. Indeed the benefits arifing from this medicine deoend chiefly upon a large quantity of it being adminiftered in a mort time—Several ounces of bark *iven In * few days will do more than as many pounds taken -n the courfe of fome weeks. When this medicine i* intended either to flop a mortification, or cure an obftinate ague, it ovt^hc to be thrown in as fail as the ftomach can poflibly be«r it. Inattention to this circumlUnce hw kurt the reputatioa of one of the beft medicine* cf which we »r« in pofleffioa. ,24 OF INTERMITTING FEVERS, UK Jiuujao. again at fome diftance of time; by which means the difeafe gath- ers ftrength and often returns with as much violence as before. A relapfe may always be prevented by the patient's continuing to take dofes of the medicine for fome time after the fymptoms difappear. This is both the moft fafe and effectual method of cure. An ounce of gentian root, calamus aromaticus, and orange- peel, of each half an ounce, with three or four handsful of camo- mile-fl wers, and an handful of coriander-feed, all bruited together iii a mortar, may be ufed in form of infufion or tea. About half an handful of thefe ingredients may be put into a tea-pot, and an Englifh pint of boiling water poured on them. A cup of this infu- fion drank three or four times a day will greatly promote the cure. Such parents as cannot drink the watery infufion, may put two handsful of the fame ingredients into a bottle of white wine, acd take a glafs of it twice or thrice a day. If patients drink freely. of the above, or any other proper infufion of bitters, a fmaller quan- tity of baric than is generally ufed will be fufficient to cure an ague.* * Thofe who cannot fwallow the bark in fubftance, may take it in decoction or infufion. An ounce of bark in powder may be in- fufed in a bottle of white wine for four or five days, frequently fliaking the bottle, afterwards let the powder fubfide, and pour oft the clear liquor. A wine glafs may be drank three or four times 3 day, or oftener, as there is occafion. If a decoction be more agree- able; an ounce of the bark, and two drams of fnake-root bruifed, with an equal quantity of fait of wormwood, may be boiled in a quart of water, to an Englifh pint. To the {trained liquors m.iy be added an equal quantity of red wine, and a glafs of it taken fre- quently. In obftinate agues, the bark will be found much more efficaci- ous when affifted by brandy, or other warm cordials, than taken alone. This I have had frequently occafion to obferve in a country where intermittent fevers were endemical. The bark feldom suc- ceeded unlefs affifted by fnake-root, ginger, canella alba, or fome other warm aromatic. When the fits are frequent and violent, in which cafe the fever often approaches towards an inflammatory na- ture, it will be fafer to keep out the aromatics, and to add fait of tartar in their ftead. But in an obftinate tertian or quartan, in the end of autumn or beginning of winter, warm and cordial medicines are abfolutely neceflary.f As autumnal and winter agues generally prove much more ob- ftinate than thofe which attack the patient in fpring or fummer, it will be neceffary to continue the ufe of medicines longer in the for- * There is reafon to believe, that fundry of our own plants or barks,which are very bitter and aftringent, would fucceed irr the Cure of intermittent fevera, efpecially when affifted bv aromatic . But as tne le uvian bark has been long approved in the cure of this difeafe, 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 Peruvian bark it very often adultetated, an' that it requires confiderable (kill to diftinguifh between the genuine and the falfe. This ought to make people very cautious of whom noife, and every thing that disturbs the mind, is hurtful.— * See ApperjdiX} Peftoral decoffion. OF AN ACUTE CONTINUAL FEVER. u? Even too much light, or any thing that effects the fenfes, .ought to be avoided. His attendants fhoUld be few as poffible, and they ought not to be too often changed. His inclinations ought rather to be foothed than contradicted; even the promife of what he craves will often fatisfy him as much as its reality. MEDICINE.—In this and all other fevers, attended with a hard, full, quick pulfe, bleeding is of the greateft importance. This operation ought always to be perfor'ned as foon as the fymptoms of an inflammatory fever .appear. The quantity of blood to be taken away, however, muft be in proportiwn to the ftrength of the pati- ent and t'e violence of the difeafe. If after the firft bleeding ths fever fhould increafe, and the pulfe become more frequent and hard, there will be a neceflity for repeating it a fecond, and perhaps, a third, or even a fourth time, which may be done at the diftance of twelve, eighteen, or twenty-four hours from each other, as the fymptoms require. If the pulfe continues foft, and the patient is tolerably eafy after the firft bleeding, it ought not to be r-peated. If the heat and fever be very great, forty or fifty drops of tfoe dulcified or fw°et fpirit of nitre may be made i to a draught, with an ounce of rofe water, two ounces of common water, and half an ounce of fimple fyrup, or a bit of loaf-fugar. This draught may be given to the patient every three or four hours while the fever is vi- olent i afterwards once in five or fix hours will be fufficient. If the patient be afflicted with reaching, or an inclination to vomit, it will be right to affilt Nature's attempts, by giving him weak camomile-tea, or luke-warm water to drink. If the body is bound, a clyfter of milk and water, with a little fait, and a fpoonful of fweet oil or frefh butter in it, ought .daily to b?. adminiftered. Should this not have the defired effect, a tea- fpoonful of magnefia alba, or cr^am of tartar, may be frequently put into his drink. He may likewife eat tamarinds, boiled prunes, roafted apples, and the like. If about the tenth, eleventh, or twelfth day, the pulfe becomes , more foft, the tongue moifter, and the urine begins to let fall a red- diih fediment, there is reafon to expect a favorable iffue to the dif- eafe. But if, inftead of thefe fymptoms, the patient's fpirits grow languid, his pulfe fi >ks, and his breathing becomes difficult; with a ftupor, trembling of the nerves, ftarting of the tendons, &c. there is reafon to fear that the confequences will be fatal. In this cafe bliftering platters muft be applied to the head, ancles, inflde of the legs or thighs, as there may be occafion; poultices of wheat-bread, muftard, and vinegar, may likewife be applied to the foles of the feet, and the patient muft be fupported with cordials, as ftrong wine- whey, negus, fago-gruel, with wine in it, and fuch like. A proper regimen isnot only neceffary during the fever, but like- wife after the patient begins to recover. By neglecting this, many relapfe, or fall into other difeafes, and continue valetudinary for life. Though the body is weak after a fever, yet the diet for fome time ought to be rather light than of two nourifhing a nature. Too much food? drink, exercife, company, &c. are carefully to be avoid- ed. The mind ought likewife to be kept eafy, and the patient fhould :3e OF THE PLEURISY. not attempt to purfue ftudy, or any bufinefs that requires intenff thinking. If the digeftion is bad, or the patient is feized at times with feverifh heats, an infufion of Peruvian bark in cold water will be of ufe. It will strengthen 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 fena may be boiled for a few miautes in an Englifh pint of wa- ter, and an ounce of manna diff -lved in the decoction; afterwards it may be ftrained, and a tea-cupfull drank every hour till it ope- rates. This dofe may be repeated twice or thrice, five or fix days intervening. Thofe 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 are fufficiently recruited. CHAP. XVI. OF THE PLEURIST. X HE true pleurify is an inflammation of that membrane called tne pleura, which lines the infide of the breaft. It is diftin- guifh^d into he moift and dry. In the former, the patient fpits free- ly ; in the latter, little or none at all. There is likewife a fpecies of this difeafe, which is called the fpurious, or bnftard pleurify, in which the pain is more external, ?nd chiefly aff cts the mufcles between tte ribs. The plunfy prevails amon? labouring people, efpecially fuch as work without doors, and are of a fanguine conftitution. It is moft frequent in the fpring feafon. CAUSES.—The pleurify maybe occTioned by whatever obstructs the perfpiration ; as coldn rtherly w nos ; drinking cold liquors when the b dy is hot; fleeping without doors on the damp ground; wet cl the s; plur.t hg tne body into cold water or exp:t ing it to the cold air, when covered with fw-at, &c. It may like- wife be occafioned by drinking ftrong liquors, by the stoppage of the ufu;il evacuations; as old ulcers, iffues, fweating of the feet or hand?, &c. the fudden striking in of an eruptbn, as the itch, the meafles, or t e fmall-p->x. Thofe who hav■; b en accuftomed to ble.-d at a certain feafon of the year are apt, if they neglect it, to be feized with a pleurify. Keeping the body too warm by means of fire, clothes, &c. renders it more liaole to this difeafe. A pleurify may likewife be occafioned by violent exercife, as running, wrdftling, leaping, or by fupporting great weight, blows on the breaft, Sec. A bad conformation of the body renders perfons more liable to this difeafe, as a narrow cheft, a ftraitnefs of the arteria of the pleurn, &c. SYMPTOMS___This, like moft ofoer fevers, generally begins with chillinefs and fhivering, which are followed by heat, thirft, and reftlefsnefs. To thefig fucceeds a violent pricking pain in one OF THE PLEURlSr. i3i of the fides among the ribs. Sometimes the pain extends toward* the back-bone, fometimes towards the forepart of the breaft, and at other fmes towards the fhoulder blades. The pain is generally moft violent when the patient draws his breash. The pulfe in this difeafe is commonly quick and hard, the urine high c loured ; and if blood be let, it is covered with atowgh craft, or buffy coat. The patient's fpittle is at firft thin, but after- wards it becomes groffcr, and is often ftreaked with blood. REGIMEN.—Nature generally endeavors to carry off this difeafe by a critical difcharge of blood from fome part of the body, by expectoration, fweat, loofe ftools, thick urinie, or the like. We ought, therefore, to fecond her intentions by leflening the force ot th? circulation, relaxing the vHTels, diluting the humors, and pro- moting expectoration. For thefe purpofes the diet, as in the former difeafe, ought to be cool, flender, and diluting. The patient muft avoid all food that is vifcid, hard of digeftion, or that affords much nourifhment: as flefh, butter, cleefe, eggs, milk, and alfo every thing that is of a heating nature. His drink may be whey, or an infufion of pectoral and balf imic vegetables.* Barley-wat r, with a little honey or jelly of currants mixed with it, is likewife a very proper drink in this difeafe. It is made by boiling an ounce of pearl-oarley in three pints of water to two, which muft afterwards be ftrained. The decoction of figs, raifins, and barky, recommended in the preceding difeafe, is here fikewife very pr pr. Thefe aid other diluting liquors are not to be drank in large qjantiies at a time; but the patient ought to keep contin- ually fipping them, fo as to render his mouth and throat always moift. All his food and drink fhould be taken a little warm. Ths patien: fhould be kept quiet, cool, and every way eafy, as directed under the foregoing difeafe. His foet and hands ought daily to be bathed in lukewarm water; and he may fometimes fit up in bed for a fhort fpace, in order to relieve his head. MEDICINE.—.Almoft every perfon knows, when a fever is attended with a violent pain of the fide, and a quick hard pulfe, that blee ling is neceffary. When thefe fymptoms come on, the fooner'this operation is performed the better ; and the quantity at firft muft be pretty large, provided the patient is able to bear it. A large quantity of blood let at once, in the beginning of a pleuri- fy, has a much better effect than repeated fmall bleedings. A man may lofe twelve or fourteen ounces of blood as foon as it is certain- ly known that he is feized with a pleurify. For a younger perfon, or one of a delicate conftitution, the quantity muft be lefo If, after the firft bleeding, the ftitch with the other violent fymptoms, fhould ftill 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 fhews a ftrong buf- fy coat, a third or even a fourth bleeding may be requ fite. If the pain of the fide abates, the pulfe becomes foft *r, or the patient be- gins to fpit freely, Weeding ought not to be repeated. This operi- •Ses Appendix. Petfc-al.irfujlcn. 132 OF THE PLEURIST. tion is feldom neceflary after the third or fourth day of the fievfr, and ought not then to be performed, unlefs in the moft urgent cir. cumftances. The blood may be many ways attenuated without bleeding.— There are likewife many things that may be done to eafe the pain of the fide without this operation, as fomenting, bliftering, &c. Fo. mentations may be made by boiling a handful of the flowers of el. der, camomile, and common mallows, or any other foft vej;etabl« in a proper quantity of water. The herbs may be either put into a flannel bag, and applied warm to the fide, or funnels may be dip. ped in the decoction, afterwards wrung out and applied to the part affected, with as much warmth as the patient can eafily bear.' As the clothes grow cool, trey muft be changed, and great care taken that the patient do not catch cold. A bladder may be filled with warm milk and water, and applied to the fide, if the above method of fomenting be found inconvenient. Fomentations not only eafe the pain, but relax the veffels, and prevent the ftagnation of the blood and other humours. The fide may likewife be frequently rubbed with a little of the volatile liniment.* ' Topical bleeding has often a very good effect in this difeafe.— It may either be performed by applying a number of leeches to the part affected, or by cupping, which is both a more certain and expe- ditious method than the oher. Leaves of various kinds might likewife be applied to the pati- ent's fide with advantage. I have often feen great benefit from you- g cabbage leaves applied warm to the fide in a pleu'ify. Thefe not only relax the parts, bu likewife draw offa lit le moiftur*, and may prevent the neceflity of bliftering-plafters; which however, when other things fail, muft be applied. If the ftitch continues after repeated bleedings, fomentations, &c. a bliftering-plafter, muft be applied over the part aff- cted, and fuffered to remain for two days. This not only procures a difcharge from the fide, but takes off the fpafm, and by that means aflifts in removing foe caufe < f the difeafe. To prevent a ftranguary when the blfteri g-pl ifter is on, the patient may drink freely of the Ara- bic emulfion.f If the patient iV coftive, a clyfter of tv in water-gruel, or of barley-wnt°r, in w dch a hm !ful of imllovvs, or any other emolli- ent vegetable has been b^kd, may be daily adminiftered. This will not only emp'y the bowels, but have the effect of a warm fomen- tation applied t -i the inferior vifcera, wnich will help to make a de- rivation from the breaft. The expectoration may be prompted by fharp, oily, and muci- laginous medicines. For this purpofe an ounce of the oxymel, or tfie vinegar of fquills, may be added to fix ounces of the pectoral decoction, and two table-fpoonsful of it taken every two hours. Should the fquill difagree with the ftomach, the oily emulfion may be adminiftered \% or, in place of it, two ounces or the oil of * See Appendix, Volat'tU Liniment. f See Appendix, Arabic emulfion. j Se? Appendix, Oily emulfion. OF THE PLEURISr. i33 fweet almonds, or oil of olives, and two ounces of fyrup of violets raav be mixed with as much fugar-candy powdered, as will make an eleftuary of the confiftence of honey. The patient may take a tea- fpoonful of this frequently, when the cough is troublefome. Should oily medicines prove naufeous, which is fometimes the cafe, two table-fpoonsful of the folution of gum ammoniac in barley water may be given three or four times a-day.* * If the p tient does not perfpire, but has a burning heat upon his fkin, and pafles very little water, fome fmall dofes 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 dofes, one of which may be taken every five or fix hours, in a little of the patient's ordinary drink. We fhall only mention one medicine more, which fome reckon almoft a fp=cific in the pleurify, viz. the decoction of the fenaka rattle-fnake root.t After bleeding and other evacuations have been preiriifed, 'he patient may take two, three, or four table-fpoonsfui of this decoction, according as his ftomach will bear it, t- ree or four times a-day. If it fhould occafion vomiting,, two or three ounces of fimple cinnamon-water may be nr'xed with the quantity of de- coction here directed, or it may be taken in fouller dotes. As this medicine promotes perfpiration and uri e, and likewife keeps the body eafy.. it may be of fome fervice in a pleurify, or any other in- flammation of the breaft. No one will imagine that foele 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 chufe; and likewife, that when one cannot be obtained, they may make ufe of another. Dif- ferent medicines are no doubt n^c ffary in the different perrds of a diforder; and where one fails of fuccefs, or difagrces with the pati- ent, it will be proper to try another. What is called the criiis or height of the fever, is fometimes at- tended with very alarming fympt ms, as difficulty of breathing, an irregular pulfe, convulfive motions, &c. Thefe are apt to frighten the attendants, and induce them to do improper things, as bleeding the patient, giving him ftrong stimulating medicines, or the like.—- But they are only the struggles of Nature to overcome the difeafe, in which fhe ought to be affifted by plenty of diluting drink, which is then peculiarly neceflary. If the patient's ftrength however bo much exrr.uPed by the difeafe, it will be neceffary at this time to fupport him with frequent fmall draughts of wine-whey, negus, or the like. When the pain and fever are gone, it will be proper, after the patient has recovered fufficient ftrength, to give him fome gentle purges, as thofe directed towards the enf of the acute continual fe- ver. He ought likewife to ufe a l;ght diet, of eafy digeftion, and his drink fhould be butter-milk, whey, and other things of a clean f ing nature. •See Appendix, Solution of rum airvioniac. f See Appendix, Dccoclhn f Hentka r-t. 134 OF A FERlrNEUMQNr. Of the Bajlard Pleurify. 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 obfcrving a cooling regimen. It is known by a dry cough, a quick pulfe and a difficulty of lying on th ? affected fide, which laft does n >t alwavs hnppen in the rue pleurify. Sometimes iadeed this difeafe proves obftinate, and requires bleeding, with cupping, and fcarificatioos of thepm affect- ed. Thefe, together with tne ufe of nitrous and ether cooling me- dicines, feldom fail to effect a cure. Of the Paraphrenitis. The paraphrenias,cr inflammation of the diaphragm, is fo nearly connected with the pleurify, and refembles it fo much in the man- ner of treatment, that it is fcarce neceffary to confider it as a feparate, difeafe. It is attended with a very acute fever, and an extreme pain in the part affected, which is generally augmented by cougtvng, fneez< ing, drawing in the breath, taking food, going to fto 1, maki' g wa- fer, &c. Hence the patient breathes quxk, and draws in his bow. els to prevent the motion of the diaphragm; is reftlefs, anxious, has a dry cough, a hickup, and often a delirium. A convulfiff*' laugh, or rather a kind of involuntary grin, is no uncommon fynip- tom of th's difeafe. Every method muft be taken to prevent a fuppuration, as it is impoflible to fave the patient's life when this happens. 1 he regi- men and medicine are in all refpects 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 make a deriva- tion from the part affected. CHAP. XVII. « OF A PERIPNEUMONT, OR INFLAMMATION OF THE LUNGS. x\S this difeafe affects an organ which is abfclutdy necef- fary to life, it muft always be attended with danger. Perfons who abound with thick blood, whofe fibres are tenfe and rigid, who feed upon grofs aliment, and clrinkitrong vifcid liquors, are moft liable to a peripneumony. It is generally fatal to thofe who have a flat breaft, or narrow cheft, and to fuch as are afflicted with an afthma, efpecially in the decline of life. Sometimes the inflammation reaches to" one lobe of the lungs cniy, at other times the whole of the organ is affected; in which cafe the difeafe can hardly fail to prove fatal. When the difeafe proceeds from a vifcid pituitous matter ob- ftructiog the veffels of the lungs, it is called ajburims or bajlard ft- Hpneumony. When it arifes from a thin acrid deduction on the lungs, it is denominated a catarrhal peripneumony, &c. CAUSES.—An inflammation of the lungs, is fometimes a pri- mary difeafe, and fometimes it is the confequence of other difeafes, as a quinfey, a pleurify, &c. It proceeds from the fame caufes as the OF A PERIPNEUMONY. 135 pleurify, viz. an obftru&ed perfpiration from cold, wet clothes, &c, or from an increafed circulati n of the blood by violent exercife, t.^e ufe of fpiceries, ardent fpirits, and fuch like. The pleurify and peripneumony are often complicated j in which cafe the difeafe is called a pleuro-penpneumony. SYMPTOMS.—Moft of the fymptoms of a pleurify 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. REGIMEN.—As the regimen and medicine are in all refpects the fame in the true peripneumooy as in the pleurify, we fhail not here repeat them, but refer tae reader to the treatment of that dif- eafe.* it may not however be improper to add, that the aliment ought to be more flender and thin in this than in any other inflam- matory difeafe. The learned Dr. Arbuthnot afferts, that even common whey is fufficient to fupport the pitieot, and that decoctions of bar- ley, and infofions of fennel roots in warm water with milk, are the moft proper both for drink and nourifhment. He likewife recom- mends :he ft earn of warm water taken in by the breath, which ferved as a kind of internal fomentation, and helps to attenuate the im- pacted humours. If the patient has loofe ftools, but is not weak. ened by them, they are not to be ft.pped, but rather promoted by the ufe of emollient clyfters. It has already been obferved, that the fpurious cri>afiard perip- neumony is occafioned by a vifcid pituitous matter obstructing the veffels of the lungs. It commonly attacks the old, infirm, ahd phleg- matic, in winter and wet feafons. The patient at the beginning is cold and hot by turns, has u fmall quick pulfe, feels a fenfe of weight upon his breaft, breathes; with difficulty, and fometimes complains of a pain and gi idinefs of his head. His urine is ufually pale, and his eclour very lit tie changed The diet, in this as well as in the true peripneumony, muft b very flender, as weak broths, fharpened with the juice of orange or lemon, or fuch like. His drink may be thin water-gru 1 fweetened with honey, or a decoction of the roots of fennel, liquorice, an;! quick grafs. An ounce of each of thefe may be boiled in three Eng- lifh pints of water to a quart, and fharpened with a little current- jelly, or the dike. Bleeding and purging are generally proper at the beginning 0- this difeafe; but if the patient's fpittle is pretty thick, or well con- cocted, neither of them are neceffary. It will be fufficient to rifiii: the expectoration by fome of the fliarp medicines recommended for that purpofe in the pleurify, as the folution of gum-ammoniac with oxymel of fquiils, &c. Bliftering-plafters have generally a gocd ef- fect, and ought to be applied pretty early. If the patient does not fpir, he mu:t be bled according as hir, ftrengta will permit, and have a geutle purge adminiftered. After- wards his body may be k< pr. open by clyfters, and the expectora; ioa promoted, by taking every four hours two table fpoonsful of the folution mentioned above. When an imflammatioa of the breaft does not yield to b!e*i- X36 OF CONSUMPTIONS. ing, blifterfng, and other evacuations, it commonly ends in a fuppu- ration, which is more or lefs dangerous, according to the part where it is fituated. When this happens in the pleura, it forhetimes breaksj outwardly, and the matter is difcharged by the wound. , When the fuppuration happens within the fubftance or body of the lungs, the matter may be difcharged by expectoration; but 1 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 be- tween the ribs. 1 If the patient's ftrength does not return after the inflammation is to all appearance removed; if his pulfe continues quick though foft, his breathing difficult and oppreffed; if he has c Id fhiverings at times, his cheeks flufh.d, his lips dry; and if he complains of thirft, and want of appetite, there is reafon to fear a fuppuration, and that a phthisis or confumption of the lungs, will enfue. We fh ill therefore next proceed to confider the proper treatment of that dif- eafe. CHAP. XVIII. OF CONSUMPTIONS. J\, CONSUMPTION is a wafting or decay of the whole body from an ulcer, tubercles, or concretions of the lungs, an em- pyema, a n?rvous atrophy, or cachexy. Dr. Arbuthnot obferves, that in his time confumptions made *ip above one-tenth part of the bills of mortality in and about Lon- don. There is reafon to believe they have rather increafed fince; and we know from experience, that they are not lefs fatal in fonte Other towns of England than in London. Youno perfons, between the age of fifteen and thirty, of a flender make, long neck, high fhoulders, and flat breafts, are moft liable to this difeafe. Confumptions prevail more in England than in any other part of the world, owing perhaps to the great ufe of animal food and malt liquors, the general application to fedentary employments, and the great quantity of pit-coal which is there burnt; to which we may add the perpetual changes in the atmofphere, or variabienefs of the weather. CAUSES—It has already been obferved that an inflamma- tion of the breaft often ends in an impofthume: confequ >ntly what- ever difpofes people to this difeafe, muft likewife be confidered as a caufs of confumption. Other difeafes, by vitiating the habit, mav likewife cccafion confumptions; as the fcurvy, the fcruphula, or king's evil, the vene- real difeafe, the afthma, fmall-pox, meaflss, &c. • As this difeafe is feldom cured, we fhall endeavor the more par- ticularly to point out its caufes, in order that people may be enabled to avoid it. Thefe are ----Confined or unwholefome air. When this fluid is impreg- nated with the fumes of metals or minerals, it proves extremelv OF CONSUMPTIONS. W hurtful to the lungs, and often corrodes the tender veffels of that neceffary org?.n. ----Violent paflhns, exertions, or affections of the mind ; as grief, difappointment, anxiety, cr clofe application to the ftudy of abflrufe arts or fciences. -----Great evacuations; as fweating, diarrhoeas, diabetes, ex- ceffive venery, the flu )r albus, an over-difchar^e of the menstrual flux, giving fuck too long, &c. ----The fudden stoppage of cuftomary evacuations ; as the bleeding pites, fweating of the feet, bleeding at the nofe, the men- fes, iffu^s, ulcers, or eruptions of any kind. ----Injuries done to the lungs, calculi, &c. I lately faw the fymp"oms of a phthffis occafioned bv a fnall bone flicking in the bronchia. It was afterwards vomited along with a confiderable quan- tity of purulent matter, and the patient, by a proper regimen, and the ufe of the Peruvian bark, recovered. ----Making a fudden tradition from a hot to a very cold cli- mate, change of apparel, or whatever greatly lsffens the perfpiration. ----Frequent and exceffive debaucheries Late watohing, ant drinking ftrong liquors, which generally go rcgethor, can hardly f tl to deftroy the lungs. Hence the ban companion generally fills a fa- crifice to this difeafe. ----Infection. Confumptions are likewife caught by fleeping with the difeafed; for which reafon this fhoul' be carefully av-idei. It cannot be of great benefit to the fick, and muft hurt thofe in health. ----Occupations in life. Thofe artificers who fit much, and are conftantly leaning forward, or prefling upon the ftomach and breaft, as cutlers, taylors, fhoe-makers, feamitreffesj &e. often die of c jnfumption ?. They likewife prove fatal to fingers, and all who have occafion to make frequent and violent exertions of the lungs. —-Cold. More confirrrptive patients date the beginning of their diforders from wet f :er, damp beds, night air, wet clothes, or catching cold after the body had been heated, than from all other cauf-s. Sharp, faline, and aromatic aliments, which heat and inflame the blood, are lik w'.fe frequently the caufe of confumptions.. We fhill only add, that this difeafe is often owing to an hered- itary taint, or a lcrophulous habit; in which cafe it is generally incurable. SYMPTOMS.—This difeafe gen-rally begins tvith a dry cough, which often continues for fome months. If a difpefition to vomit after eating be excited, by ir, there is till greater reafon to fear an approaching confumption. The patient complains of a more than ufual degree of h *at, a pain and cppreffibn of the breaft, efpe- cially 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 quick, foft fmall pulfe; though fometimes the pulfe is prttty full, and rather hard* Thefe are the common fymptoms of a beginning confumpiioc. A Iter war Is the patient begins to fpit a greenifh, wh:te or bloo- dy rnatur. His body is extenuated by the hectic fever, and col- (IO) 138 OF uuivoc/mri io/ivo. liquative fweats, which mutually fu ceed one another, viz. the onjj towards night, and the other in the morning. A loofenefs, andaa exceffive difcharge of urine, are often troublefome fymptoms at tbfl time, and greatly weaken the patient. There is a burning heatirr the palms of the hands, and the face generally fluflies after eating- the fingers become remarkably fmall, the nails are bent inwards? and the hair falls off". At laft th? fwelling of the fret and legs, the total lofs of ftrength, ihe finking of the eyes, the difficulty of fwallowing, and the cold. nefs of the extremities, fhew the immediate approach of death, whkh however the patient feldom believes to be lb near. Such is the ufual progrefs of this fatal difeafe, which, if not early checked, commonk lets all medicines at defiance. REGIMEN.—On the firft appearance of a confumption, if the patient hv:-s in a l.irge town, or any place where th? air is confined, he ought immediately to quit it, and make choice of a fituation in the country, where the air is pure and free. Here he muft not re- main inactive, but take every day as much exercife as he can bear. The beft method of taking exercife is to ride en horfe'*ack, as this gives'the body a great deal cf motion without much fatigue, Such as cannot bear this kind of exercife, muft make ufe of a car- riage. A long journey, as it amufes the mind by a continual change of objects, is gre-ttly preferable to riding the fame ground over and' over. Care h>Wiver muft be taken to avoidcatching cold from wet ciothes7 damp beds, or the like. The patient ought always fo 1 finifh his ride in the morning, or at leaft before dinner jotherwifej it will oftener do more harm than good. It is pity, thofe who attend the fick feldom recommend riding' in this difeafe' till the patient is either unable to bear it„or the ma- lady has become i lcurable. Patients are likewife apt to trifle witli every thing that is in their power. They cannot fee how one of the common actions of life fliould psove a remedy in an obftinate dif- eafe, and therefore they reject ir, while they greedily hunt after re- lief from medicine, merely becaufe they do not understand it. Thofe who have ftrength and courage to undertake a pretty long voyage, may expect great advantage from it. This, to my knowledge, Ins frequently cured a confumption after the patient was, to all app arance, far advanced in that difeafe, and where me- dicine had proved inelfectual. Hence it is reafonable to conclude,. that if a voyage were undertaken iu due time, it would feldom fail to perform a cure.* Such as try this method of cure ought to carry as much freft provifions along with them as will ferve for the whole tine they are at fea. As miik 12 nor eafily obtained in this fituation, they ought 10 live upon fruits, and the broth of chickens, or other young ani- mals which can be kept alive on board. It is fcarcely neceffary to add, that fuch voyages fhould be undertaken, if poffible in the " Two tlvngs chiefly operate to prevent the benefits which would arife from Sailing. The . r;r is, that- phylic'ans Seldom order it till th: difeafe is too tar advanced ; and the other ii. rha: they teldgm order a voyage of a fufficient length. A patient rruy receive no benefit by ci-oiling the channel, whoj fhould he crofs the Atlantic, might be completely cured. Indeed we have reafon m believe, that a Yovagc cf this kind, if taken in due time, would Seldom t»ii to cure aconfu.npt'on. OF CONSUMPTIONS. 139 mildeft feafon, and that they ought to be towards a warmer climate.t Thofe who have g. t courage for a long voyage may travel in- to a more fouthern climate, as the fouth of France, Spain or Por- tugal ; and if they find the air of thefe countries agree with them, they fhould continue there at leaft till their heahh be confirmed. Next to proper air and exercife, we would recommend a due attention to diet. The patientfhould eat nothing that is either heat- ing or hard of digeftion, and his drink muft be of a fof r. and cool- ing nature. All the diet ought to be calculated to leflen the acrimo- ny of the humours, and to nourifh and fupport the patient. For this purpofe he muft keep chiefly to the uf" of vegetables and milk.— Milk alone is of more value in this difeafe than the whole materia medic a. AfTes' milk is commonly reckoned preferable to any other; but it cannot always be obtained ; befides it is generally taken in a very fmall quantity ; whereas to p~ duce any effect, it ought to make a confiderable part of the patient's diet. It is hardly to be expected, that a jill or two of afles' milk, drank in the fpace of twenty-four hours, fhould be aide to produce any confiderable change in the hu- mours of an adult; and when people do not p.rceive its effects foon, th jy lofe hope, and fo leave it off. Hence it happens that this medicine, however valuable, very feldom performs a cure. The rea- fon is obvious: it is commonly ufed too late, is taken in too fmall quantities, ancf is not duly perfifted in. I have known very extraordinary effects from afles milk in ob- ftinate 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 expected to fucceed ? Aflb' milk ought to be drank, if poffible, in its natural warmth, and by a grown perfon, 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, fb as to make it a kind of meal. if the milk fliould happen to purge, it may be mixed with cold conferve of rofes. When that cannot be obtained, the powder of crahs' claws may be ufed in its ftead. Afles' milk is ufually ordered to be drack warm in bed; but as it generally throws the patient into a fweat when taken in this way, it would perhaps be better to giv^it after it rifes. Some extraordinary cures in confumptive cafes have been per- formed by women's milk. Could this be obtained in a fufficient quantity, we would recommend it in preference to any other. It js better if the patient can fuck it from the breaft, than to drink it afterwards. I knew a man who was reduced to fuch a degree of w?aknefs i:i a confumption, as not to be able to turn him- feJf in bed. His wife was at that tine giving fuck, and the child happening to die, he fucked her breafts, not with a view to reap any f Though I do not remember to have feen ore inftance of a genuine confumption of,the lungs cured F» m-dici/jr. <■•: I ^ra»-. J:nvvr. a NYffi-India Tovaje workworjdtr* in that OF CONSUMPTIONS. advantage from the milk, but to make her eafy. Finding himfelf however greatly benefited by it, he continujd to fuck her till he be- Came perfectly well, and is at prefent a ftrong and healthy man. ■ Some prefer butter-milk to any other, and it is indeed a very valuable medicine, if the ftomach be able to bear it. it does not agree With every perfon at firft; and is therefore often laid afide without a fufficient trial. It fhould at firft be taken fparingly, and the quan- tity gradually increafed, until it comes to be almoft the fole food.— I never knew it to fucceed unlefs where the patient almoft lived up- on it. Cows milk is moft readily obtained of any, and though it be not fo eafily digefted as chat of afles or mares, it may be rendered lighter by adding to it an equal quantity of barley-water, or allowing it to ftand for fome hours, and afterwards taking off the cream. If it fhould notwithstanding prove heavy on the ftomach, a fmall quae tity of brandy or rum, with a little f fugar, may be added, which will render it both more light and nourifhihg. his not to be wondered, that milk fhould for fome time difa- gree wifh a ftomach that hashot been accuftomed to digeft any thine but flefh and ftrong liquors, which is the cafe with many of thaw 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. This might be dangerous. It will be necefTaiu for fuch to eat a little, once a-day of the flefh of fome your.g animaQ or rather to ufe the broth made of chickens, veal, lamb, or fuel like. They ought likewife to drink a little wine, made into negu$ or diluted with twice or thrice its quantity of water, and to mak^ it gradually weaker till they can leave it oft altogether. t Thefe mult be ufed only as preparatives to a diet confifting chiefly of milk and vegetables, which the fooner the patient can be brought to bear, the better. Rice and milk, or barley, and milk, boiled with a little fugar, is very proper food. Ripe fruits roafted, baked cr boiled, are likewife proper, as goofeberry or currant tarts, apples roasted, or boiled in milk, &c. The juices, cqnferves, and preferves, &c. of ripe fubacid fruits, ought to be eaten plentifully, as the jelly of currants, conferves of rofes, preferved plumbs, cher- ries, &c. Wholefome air, proper exercife, and a diet confifting chiefly of thefe and other vegetables, with milk, is the only courfe that can be depended on in a bepdnnirg confumption. If the patient hits ftrength and fufficient refolution to perfift in this courfe, he will fci- dom be difapp anted of a cure. In a populous town in England, * where confumptions are very • common, l have frequently feen confumptive p .tients, who had beea fisnt to the country with orders to ride, and live upon milk and ve- getables, return in a few months quite plump, and free from any complaint. This indeed was not always the cafe, efpecially when the difeafe was hereditary, or far advanced; but it was the only method in which fuccefs was to be expected: where it failed,I ne- ver knew medicine fucceed. * Sheffield,' OF CONSUMPTIONS. 141 If the patient's ftrength and fpirits flag, he muft be fupported ay ftrong broths, jellies, and fuch like. Some recommend ftiell fifh in this diforder, and with fome reafon, as they are nourifhing and reftorative.t All the food and drink ought however to be taken in fmall quantities, left an over charge of frefh chyle fhould opprefsthe lungs, and too ir.uch accelerate the circulation of the bloed« The patient's mindought to be keptas eafy and cheerful as pof- fible. Confumptions are often occafioned, and always aggravated, by a melancholy caft of mind; for which reafon mufic, cheerful company, and every thing that infpires mirth, are highly beneficial. The patient ought feldom to be left alone, as brooding over his ca- lamities is fure.to render him worfe. MEDICINE.— Though the cure of this difeafe depends chiefly upon regimen and the patient's own ende-.v rs, yet we fhall men- tion a few things which may be of fervice in relieving fome of the more violent fyir.ptoms. In the firit ftage cf a confumption, the cough may fometimes be appeafed by bleeding ; and the expectoration may be promoted by the following medicines. Take frefh fquills, gum-ammoniac, 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 or any kind of fyrup may be added to it. Tivs may be form- ed 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. t> _ The lac ammoniacum, or milk of gum-ammoniac, as it is called, is likewife a proper medicine in this ftage of the difeafe* It may be ufed as directed in the pleurify. A mixture made of equ :1 parts of lemon-juice, fine honey, and fyrup of poppies, may likewife be ufed. Four ounces ©f each of thefe may be fimmered together in a fauce-pan, over a gentle fhe, and a table-fpoonful of it taken at any time when the cough is trou- blefome. It is common in this ftage of the difeafe'to load the patient's •ftomach with oily and balfamic medicines. Thefe, inftead of removing the caufe of the difeafe, tend rather to increafe it by heat- ing the blood, while they pall the appetite, relax the folids, and prove- every way hurtful to the patient. Whatever is ufed for removing thscough, befides riding and other proper regimen,ought to be medi- cines of a fharp and cleanfing nature; as oxymel, fyrup of lemon, &c. Acids feem to have peculiarly good effects in this difeafe; they both tend to quench the patient's thirlt and to cool the blood. The vegetable acids,as apples,oranges,lemons, &c.appear to be the moft proper. I have known patients fuck the juice of feveral lemons eve- ry day with manifeft advantage, and would for this reafon recom- mend acid vegetables to be taken in as great quantity as the ftom- ach will bear. For the patient's drink, we would recommend infufions of the bitter plants, as ground-ivy, the lefler centaury, camomile-flowers, f I have often known perfons of a confumptive habitf where the fymptoms were not vi- olent, reap great benefit from the ufe of oyfteri. They genfiruliv est them raw. and driak the juice along with them. 142 OF CONSUMPTIONS. or water-trefoil. Thefe infufions may be drank at pleafure. They strengthen the ftomach, promote digeftion, and at the fame time anfwer all < he purpofes of dilution, and quench thirft much better than things that are lufdous or fweet. But if the patient fpits blood, he ought to ufe, for his ordin u-y drink, infufions or decoctions of the vulnerary roots, phnts, Sec* % • There are many other mucilaginous plants and feeds, of a heal- ing and agglutinating nature, from which decoctions or infufions m y be prepared with the fame indention; as the others, the quince. I feed, coltsfoot,-linfeed, farfaparilla, &c. It is not neceflary to men- tion the different ways in which thefe may be prepared. Simple infufisn or boiling is all that is neceflary, "and the dofe may be at difcretion The conferve of rofes is here peculiarly proper. It may either be put into the decoction above prefcribed, or eaten by itfelf. No benefit is to be expected from trifling dofes of this medicine. I ne- ver knew it of any fervice, unl *Ss where three or four ounces at leaft were uied daily for a confiderable time. In this way I have feenifo produce very hippy effects, and would recommend it wherever there is a difcharge of >io< d fr:>m the lungs. When the fpitting up of grofs matter, oppreffion of the breaft, and the hectic fymptoms, fhew that an impofthume is formed in the ; lungs, we would recommend the Peruvian bark, that being the only < drug which has any chance to counteract the general tendency which 1 the humors th-n have to putrsfadtion. An ouoce of the bark in powder may be divided into eighteen'; or twenty dof-s, of which one may be taken every three hour? through the day, in a little fyrup, or a cup of horehound tea. If t^e bark fh >uld happen to purge, it may be made into an electuary, with the conferve of rofes, thus: Take old conferve of rpfes a quarter of a pound, Peruvian bark a quarter of an ounce, fyrup of orange or lemon, as much as will make it of the confiftence of honey. This quantity will ferve the patient four or five days,.. and may be repeated as there is occafrn. ' Such as cannot take the bark in fubftance, may infufe it in cold water. This feems to be the beft menftrum for extracting thevir-, tues of that drug. Half an ounce of bark in powder may be infufed for twenty-four hoorsin half an Englifh pint of water. Afterwards let it be pafled through a fine strainer, and an ordinary tea-rOipful of it taken three or four times a-day. We would not recommend the bark while there are any fyrap- toms of an inflammation of the breaft; but when it is certainly, known that matter is collected there, it is one of the beft medicines" which can be ufed. Few patients indeed have refolution enough to give the bark a fair trial at this period of the difeafe, otherwife we have reafon to believe that feme 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 ajbforption, the patient muft endeavor'to make it break inwardly, by drawing in the fleams of warm water, or vinegar, with his breath, coughing, * See Appendix, Vulr.tr ar a Deciclkr.. OF CONSUMPTIONS. M3 laughing, or bawling aloud, &c. When it happens to birft within the hings, the matter may be difcharged by the mou*h. Sometimes indeed the bursting of the v >mica occafions immediate de th by fui- focating the patient. When the quantity of matt-ir is great, and the patient's ftrength exhaufted, this is commonly the cafe. At any rate the patient is ready to fall into a fwoon, and fhould have volatib 'iilts or fpirits held to his note. If the matter difcharged be thick, and the cough and breathing become eafi?r, there may be fome hopes of a cure. The diet at this time ought to be light, but restorative, as chk ken-broths, fago- gruel, rice-milk, &c. the drink, butter-milk or whey, fweetened with • honey. This is likewife a proper time for ufing the Peruvian bark, which may be taken as directed above. If'he vomica or impofthume fhould difcharge itfelf into the ca- vity of the breaft, between the pleura and the lungs, there is no way of getting the matter out but by an incifion, ashas already been ob- il-rved. As this operation muft always be performed by a furgeon, it is not neceffiry here to defcribe it. We fhall only add, that it is cot fo dreadful as people are apt to imagine, and that it is the only chance the patient in this cafe has for his life. • A NERVOUS CONSUMPTION is a wafting or decay of ,■ the whole body, without any confiderable degree of fever, cough, or difficulty or breathing. It is attended with indigef ion, weak- nets, and want of appetite, &c Thefe who are ot a fretful temper, who indulge in fpirituous liquors, or who breathe an unwholefome air, are moft hable to this difeafe. We would chiefly recommend, for 'he cure of a nervous con- fumption, a light and nourifhir.g diet, plenty of ex?rcil; in free open air, and the ufe of fuch bitters as brace and ftrengthen the ftomach; ;-.s the Peruvian bark, gentian root, camomile, horehound, &c.— Thefe may be infufed in water or wine, and a glafs of it drank fre- quently. It will greatly aflift the digeftion, and promote the rure - f this dileale, to take twice a-day twent y or thirty drops of the elixir of vitriol in a glafs of wine or water. The chalybeate wine is 1 kewife an excellent medicine in this cafe. It strengthens the folids, and pow- erfully aflifts Nature in the preparation of good i food * Agreeable amufements, cheerful company,"and riding about, are however preferable to all medicines in this dtfeafe. For which reafon, when the patient can afford it, we would recommend a 1 ^ng journey of pleafure, as the moft likely means to restore his health. What is called afwptomatic confumption, cannot be cured with- out firft removing the difeafe by which it is occafioned. Thus, when a confumption proceeds from the fcrophula, or king's evil, from the fcurvy, the asthma, the venereal difeafe, Sec. a due attention muft be paid to the malady from whence it ariles, and therregimen and medicine directed accordingly. j When exceffive evacuations of any kind occafion a confumption, r •See Appendix, Cbatyt-.-gtc w:«. -f1 344 OF THE NERVOUS FEVER. they muft not only be restrained, bur the patient's ftrength muft be creftored by gentle exercife, nourifhing diet, and generous cordials, Young and delicate mothers often fall into confumptioiis, bygivr.g fuck too long. As foon as they perceive their ftrength and appe- tite begin to fail, they ought immediately to wean the child, or pro- vide another nurfe, otherwife they cannot expect a cure. Before we quit this fubject, we would earneftly recommend it to all, as they wifh to avoid confumptions, to take cs much exer- cife, without doors, as they can, to avoid unwholefome air, and to ftudy fobriety. Confumptions owe their prefent increafe not a lit- tle to the fashion of fitting up late, eating hot fuppers, and fpending every evening over a bowl of hot punch or other ftrorg liquors.—» Thefe liquors, when to freely ufed, not only hurt the digeftion, and fpoil the appetite, but heat and inflame the blood, and fet the whole conftitutiou on fire. CHAP. XIX. OF THE SLOW OR NERVOUS FEVER. ±\ ERVOUS fevers have increafed greatly of late years in this ifland, owing doubtlefs to our different manner of living, and the increafe of fedentary employments ; as they commonly attack \ perfons of a weak relaxed habit, who neglect exercife, eat little fo- ' lid food, ftndv hard, or indulge in fpirituous liquors. C \USES.—Nervous fevers may be occafioned by whatever deprefles the fpirits, or impoverifhes the blood; as grief, fear, anx- iety, waat cf fleep, intenfe thought, living on poor watery diet, un« ripe fruits, cucua-bers, melons, mufhrooms, &c. They may like- wife be occasioned by damp confined, or unwholefome air. Hence they are very c mmon in rainy feafons, and prove moft fatal to thofe who liv<* in dirty low houfes, crowded ftreets, hofpitals, jails, cr JUv~h like places. Perf ns whofe constitutions havebeen broken by exceffive venery, frequent £'ligations, too free a~i ufe of purgative medicines, orany other exceffive evacuations, are nn ft liable to this difeafe. Keeping on wet clothes, lying on the damp ground, exceffive fatigue, and whatever obstructs the perfpiration, or caufes a fpas- modic stricture of the folids, may likewife occafion nervous fevers. We fhall only add, frequent and great irregularities in diet. Too great abftinence, as well as excefs, is hurtful. Nothing tends lo snuch to preferve the body in a found ftate as a regular diet; nor can any thing contribute more to occafion fevers of the worft kind , than its oppofite. SYMPTOMS.—Low fpirits, want of appetite, weaknefs, ' wearinefs after motion, watchfulnefs, deepfighing, and dejection ot * mind, are gen erallv the forerunners of this difeafe. 1 hefe are fucceeded by a quick low pulfe, a dry tongue without any confid- erable rhirft, chillinefs and flufhing in turns, &c. After fome time the patient complains of agiddinefs and pain of the head, h bu*> generally, by their folicitud* and ill-dirc&sd cstye, hurt the fick. OF THE MILIARY FEVER. i53 linen fliould be frequently changed, and thofe in health ought to avoid all unneceflary communication with him. Any one who is apprehenfive of having caught the infection, 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 theapprehenfions ftill continue, or any unfavourable fymptoms appear. The perfon ought likewife to take an infufion of the bark and camomile flowers for his ordinary drink; and before he g©es to bed he may drink a pint of pretty ftrong negus, or a few glaffes of gen- erous wine. I have been frequently obliged to follow this courfe when malignant fevers preva;led, and have likewife recommended it to others with conftant fuccefs. v People eenerally fly to bleeding and purging as antidotes againft infection; Dut thefe are fo far from fecuring them, that they often, by debilitating; the body, increafe the danger. Thofe who wait upon the fick in putrid fevers, ought always to have a piece of fpunge or a handkerchief dipt in vit.egar, or juice of lemon, to fmell to while near the p itient. They oupht hkewife to wafh their hands, and, if poffible, to change their clothes, before they go into company. CHAP. XXI. OF THE MILIARY FEVER. JL HIS fever takes its name from the fmall puftules or blad- ders which appear on the fkin, refembling, h fhape and fize, the feeds of millet. The puftules are either re^l or white, and fometimes. both are mixed together. The whole body is fometimes covered with puftules; but they are generally mere numerous where the fweat is molt abundant, as on the breaft, the back, &c. A gentle fweat, or moifture on the (kin, greatly promotes the eruption; but when the ikin is dry, the eruption is both more painful and dangerous. Sometimes this is a primary difeafe; but it is much oftener on- ly a fymptom of fome other malady, as the fmall-pox, mealies, ar- dent,putrid, or nervous fever, &c. In all thefe cafes it is generally the effect of too hot a regimen or medicines. The miliary fever chieflv attacks the idle and phlegmatic, or perfons of a relaxed habit. The young and the aged are more li- able to it than thofe in foe vigour and prime of life. It is alfo more . incident to women than men, efpecioily the delicate and the indolent, who, neglecting exercife, keep continually within doors, and live up- on weak and watery diet. Such females are extreu .uy liable to be feized with this difeafe in childbed, and often lofe their lives by it. CAUSES.—The miliary fever is fometimes occafioned by vi- olent palfions or affections of the mind; as exceffive grief, anxiety* thoughtfulnefs, 8ec. It may likewife be occafioned by exceffive Watching, great evacuations, a weak watery diet, rainy feafons, eat- ing too frequently of cold, crude, unripe, fruits, as plunrbi, chet- (») »54 V* ii"l MiLisinJi jy£.rJiJ\. ries, cucumbers* melons, &c. Impure waters, or provifions which have been fpoiled by rainy feafons, long keeping, Sec. may likewife. caufe miliary fevers. They may alfo be occafioned by the ftoppagt,; of any cuftomary evacuation, as iffues, fetons, ulcers, the bleeding, \ piles in men, or the menftruel flux in women, Sec. This difeafe in childbed-women is fometimes the effect of great coftivenefs during pregnancy; it may likewife be occafioned by their exceffive ufe of green trafh, and other unwholefome thhigs, in which pregnant women are too apt to indulge. But iis moft general caufe is indolence. Such women as lead a fedentarj* life, efpecially dur- ing pregnancy, and at the fame time live grofsly,can hardly efcape this difeafe in childbed. Hence it proves extremely fatal to women of fafhion, and likewife to t'aofe won.en in manufacturing towns, who, in order to aflift their huibands, fit clofe within doors for al- moft the whole of their time. But among women who are active and laborious, who live in the country, and take fufficient exercife without doors, this difeafe is very little known. SYMPTOMS.-—When this is a primary difeafe, it makes itj attack, like moft other erup'ive fevers, w.th a flight fhivering, which is fucceeded by heat, lefs of strength, faiRtifhnefs, fighing, a low , quick pulfe, difficulty of breathing, with great anxiety and opprefe fion 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-womep the milk generally goes away, and the other difcharges flop. ' The patient feels an itching or pricking pain under the ikin, af- ter which innumerable fmall puftules of a red or white colour begin" to appear. Upon this the fymptoms generally abate, the pulfe be* comes 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 begin to dry, and fall off, which occafions a very difagreeable it/hing in the fkin. It is impoflible to afcertain the exact time when the puftules will either appear.or go off. Thty generally corqe out on the third or fourth day, when the eruption is critical; but, when fympto- matical, they may appear at any time of the difeafe. Sometimes the puftules appear and vanifh by turns. When that is the cafe, there is always danger ; but when they go in all of u fudden, and do not appear agsin, the danger is very great. In childbed, women the puftules are commonly at firft filled with clear water, afterwards they grow yellowifh. Sometimes they are interfperfed with puftules of a red colour. When thefe only appear, the difeafe grr„i by the name of a rajh. REGIMEN.—In all eruptive fevers of whatever kind, the chief point is to prevent the fudden difappearing of the puftules, and to promote their maturation. For this purpofe the patient muft be kept in fuch temperature, as r either to pufh out the eruption too fait, nor to caufe it to retreat pr 'maturely. The diet and drink ought ^therefore to be in a moderate degree nourifhing and cordial; but OF THE MILIARY FEVER. 1« neither ftrohg 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 clothes. Above all, the mind is to be kept eafy and cheerful. Nothing fo certainly makes an eruption go in as fear. The food muft be weak chicken broth with bread, panado, fa- go, or groat-gruel, &c. 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 fugar. Good apples roafted or boiled, with other ripe fruits of an opening cooling nature may be eaten. The drink may be fuited to the ftate of the patent's ftrength and fpirits. If thefe be pretty high, the drink ought to be weak ; as water-gruel, balm-tea, or the decoction mentioned below.* Wh?c the patient's fpirits are low, and the eruption does not rife fufficiently, his drink muft be a little more generous; as wine- . whey, or fmall negus; fharpened with the juice of orange or lemon* and made ftroriger or weaker as circumstances may require. Sometimes the miliary fever approaches toward a putrid na- \ cure, in which cafe the patient's ftrength muft be ifupported with i generous cordials, joined with acids; and, if the degree of putref* ' cence be great, the Peruvian bark, muft be adminiftered. If the J head be much affected, the body muft be kept open by emolient r clyIters.t MEDICINE.—If the food and drink be properly regulated, :" there will be little occafion for medicine in this difeafe. Should the ; eruption however not rile, .or the fpirits flag, it will not only be ne- t ceflary to fupport the patient with cordials, but likewife to apply , bliftering-plafters. The moft proper cordial, in this cafe, is goodi ;' wine, which may either be taken in the patient's food or drink; and! " if there be figns of putrefcence, the bark and acids may be mixed with wine, as directed in the putrid fever. Some recommend bliftering through the wholecourfe of this dif- ; eafe; and where Nature flags, and the erupiion comes and goes, it • may be neceffary to keep up a ftimulu.% by a c ntinual fucceflion of fmall bliftering-plafters; but we would not recommend above one at a time. If however the pulfe fhould fink remarkably, the puf- • tules fall in, and the head be affected, it will be neceffary to apply • feveral bliftering-plafters to the moft fenfible parts, as the infide of the legs and thighs, Sec. * Take two ounces of the ft-wings of hartOirn, and the farne quantity of farfaparilla,' noil them in two Englifh quarts of water. To the ftraineddecoclion add a little wlvte fugar, and let the patient take itforhis ordinary drip.k. f In the Covmsrcivm Literahium for the year 1735, we have the hiftory of an ! epidemical Miliary Fever, which ra^eri at Strafburg in the months of November* December, , snd January } from which we learn the neceffity of a temperate regimen in this malady, and likewife that phyfic:ans ate not always the firft who difcover the proper treatment of difeafer* 3 " This lever made terrible havoc even among men of robuft conftitutions, and all medicine proved in vain. They vv^re feized in an inftant with a (hiverinp, yawningj ftretching, and pains in ibz back, fucceeded by a moft intenfe heat; at the fame time there was a great lofs . of ftrength and appetite. On the Seventh or 9th day the miliary eruptions appeared, orfpot9 like flea-bites, with great anxiety, a delirium, reftk'lTnefs and totting in bed. Bleeding was fatal. While matters were in this unhappy fituation, a midwife of her own accord, gave tr» '. a patient, in'he height of the difeUe, a clyfter of rain water and hotter without fair, and for" his ordinary drink a quart of fpring water, half a pint of generous winej the juice of alerrton, *nd fix ounces of the white ft fugar, gently bdiled till a fcum arofe. and this with great fuc- ttfs; for the belly was foon loofened, the grievous fymotoms vanilhedj and the patient wa9 'eftored fohis fenfes, and matched from the jaws of death." This pfaftice Was imitated by >*ri;r$ with the like happy eflcft. j56 W THE REMITTING FEVER. Bleeding is feldom neceffary in this difeafe. and fometimes h does much hurt, as it weakens the patient, and deprefles his fpirits. Jt is therefore never to be attempted unless by the advice of a phy- fician. We mention this, becaufe it has been cuftomary to treat thisdifeafe in child-bed women, by plentiful bleeding, and other evac- uations, as if it were highly inflammatory. But this practice is gen- erally veryunfafe. Patients in this fituation bear evacuations very HI. And indeed the difeafe feems often to be more of a putrid than of an inflammatory nature. Though this fever is often occafioned in child-bed women by too hot a regimen, yet it would be dangerous to leave that off all of a fudden, and have recou-rfe to a very cool regimen, and large evac- cuations. We have reafon to believe, that fupporting tbe patient's fpirits, and promoting the natural evacuations, is here much fafer th in to have recourfe to artificial ones, as thefe, by finking the fpi- i its, feldom fail to increafe the danger. If the difeafe proves tedious, or the recovery flow, we would- recommend the Peruvian bark, which may either be taken in fub» ftance or infufed in wine or water, as the patient inclines. The miliary fever, like other eruptive difeafes, requires gent|J purging, which fhould net be neglected, as foon as the fever is goii|| off, and the patient's ftrength will permit. . 5 To prevent this difeafe, a pure dry air, fufficient exercife, and wholefome food, are neceflary. Pregnant women fliould guard 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 ftrictly to obferve a cool regimen. CHAP. XXII. OF THE REMITTING FEVER. X. KIS fever takes its name from a remiflion of the fyrap- toms, which happens fometimes fooner, and fometimes later, but generally before the eighth day. The remiflion is commonly pre- ceded by a gentle fweat, after which the patient feems greatly re- lieved, but in a few hours the fever returns. Thefe remiflions re- turn at very irregular periods, and are fometimes of longer, fome* times of shorter duration : the nearer however that the fever ap- proaches to a regular intermittent, the danger is the lefs. CAUSES.—Remitting fevers prevail in low marfhy countries abounding with wood and ftagnaticg waters ; but they prove molt fatal in places where great heat and moisture are combined, as in fome parts of Africa, the province of Bengal in the Eaft-Indies, &c wsere remitting fevers are generally of a putrid kind, and prove ve- ry fatal. They are meft frequert in clofe calm weather, efpecially after rainy feafons, great inundations, or the like. No age, fex, o: conftitution is exempted fr^m the a! tack of this fever; but it chiefly feizes perfons of a relaxed habit, who live in low dirty habitations* bre ithe an impure Itagnating air, take little exercife, and ufe uc» wholefome diet* OF THE REMITTING FEVER. 1S1 , SYMPTOMS.*-The firft fymptoms of this fever, are general- ly yawning, ftretching, pain, and giddinefs in the heal, with alter- nate fits of heat and cold. Sometimes the patient is affected with a delirium at the firft attack. There is a piin, and fometimes a fwel-r ling, about tbe region of the ftomach, the tongue is white, the eyes and lkin frequently appear yellow, and the puient is often afflicted with bilious vomitings. The pulfe is fometimes a lr tie hard, but feldom full, and the blood, when let, rarely fhews any figns of in- flammation. Some patients are exceedingly coftive, and others are afflicted with a very trouble tome loofenefs. , It is impolfible to defcribe all the fymptoms rf this difeafe, as they vary according to the fituation, the feafon of the year, and the conftitution of the patient. They may likewife be greatly changed by'the method of treatment, and by many other cirenmftances too tedious to mention. Sometimes the bilious fymptoms predominate, fometimes the nervous, and at other times the putrid. Nor is it at ail uncommon to find a fucceflion of each of thefe, or even a com- plication of them at the fame time, in the fame perfon. REGIMEN.—The regimen muft be adaoted to the prevailing fymptoms. When there are any figns of inflammation, the die!: mult be flender, and the drink weak and diluting. But when any nervous or putrid fymptoms prevail, it will be neceflary to fupport the patient with food and liquors of a more generous nature, lucli as are recommended in the immediately preceding fevers. We muft however be very cautious in the ufe ot things of a heating quality, as this fever is frequently changed into a continual by an hot regi- men, and improper medicines. Whatever the fymptoms are, the patient ought to be kept cool, quiet, and clean. His apartment, if poffible, fhould be large and frequently ventilated by letting in frefh air at the doors and win- dows. It ought likewife to be fprinkled with vinegar, juice of lem- on, or the hke. His linen, bed-clothes, &c. fhould be frequently changed, and all his excrements immediately removed. Though thefe tilings have been recommended before, we think it neceflary to repeat them here, as they are of more importance to the fick than practitioners are apt to imagine.* MEDICINE.—In order to cure this fever, we muft endeavor to bring it to a regular intermiflion. This intention may be pro- moted by bleeding, if there be any figns of iniiainmation; but when that is not the cafe, bleeding ought by no means to be at- tempted, as it will weaken the patient and prolong the difeafe. A * Theingenioos Dr. Lind,of Windfor, in his inaugural dlfT-rtation concerning thepu- trid Remitting Fever of Bengal, has the following obfervation : Indufia, lodices, ac rfra- gula, txpius iunt mutanda, ac ,-Eri exponenda ; faeces fordefque quam primum removendffe oportet eti3iu ut loca quibus aegri decumbent fint falubria et aceto confperfa j denique uC aegris cut* quanta maxima profpiciatur. Conpertum ego habeo, medicum hscc fedulo ob- fervantem, quique ea cxequi poteft multomagis aegris profuturum,quam medicum peritioiern hiile commodi«, deftitutum." * *' The patient's fhirt, bed-clothes, and bedding, ought frequently to be changed and es- pofed to the air, and all hii excrements immediately beterrioved; the bed-chamber fliould bcwell ventilated, aad frequently fprinkled with vinegar; in ftiort, every attention fhould be paid to the patient. 1 can Affirm, that a phyfician who put3 thefe in ptacYce will much of* tener fucceed than one who is even rcjore uilful, bu; has not aa opportunity of ufing theft mseoj." ic& OF 7HE YELLOW FEVER. vomit however will feldom be improper, and is generally of great fervice. Twenty or thirty grains of ipecacuanha will anfwer this purpofe very well; but where it can be obtained, we would rath- er recommend a grain or two of tartar emetic, with five or fix grains of ipecacuanha, to be made into a draught, a:-i given for a vomit. This may be repeated once or twice at proper intervals, if the ficknefs or naufea continues. The body ought to be kept open either by clyfters or gentle laxatives, as weak infufions of fenna and manna, fmall dofes of the lenitive electuary, cream of tartar, tamarinds, ftewed prunes, or the like, but all ftrong or draftic purgatives are to be carefully avoided. By this courfe the fever in a few days inay generally be brought to a pretty regular or diftinct intermiffion, in which cafe the Peruvian bark may be adminiftered, and it will feldom fail to perfect the cure. It is needlefs here to repeat the methods of giv- ing the bark, as we have already had occafion frequently to men- tion them. The molt likely way to avoid this fever is to ufe a whfclefome and nourifhing diet, to pay the moft forupulous attention to cleani' linefs, to keep the body warm, to take fufficient. exercife, and in hot countries to avoid damp fituations, night air, evening dews, and the like. In countries where it is endemical, the beft preven- tative medicine which we can recommend is the beft Peruvian bark, which may either be chewed, or infufed in brandy or wine, &c. Some recommend fmoaking tobacco as very beneficial in marfhy countries both for the prevention of this and intermitting fevers. CHAP. XXIIM OF THE YELLOW FEVER. JL O enter into a minute inveftigation of the difputed Ori- gin of this difeafe, (and whether it be imported and contagious, or Do- fAeJlic and Epidemic) under existing circumstances, would be to af. fume a province, unwarrantable as it regards the prefent work. So early as the year 1699, we learn the extftence of Yellow Fever in this city. At that, and for fome time fubfequent it was confidered an infetliausdiftemper, and in 1748, Dr. Lining pronoun- ced it an imported difeafe and contagious.'—The moft learned of the Faculty agree, "That as almoft all fevers are generally Epidemic, it is probable that fome matter floating in the atmofphere, and appli- ed ro the bqdies of men, ought.to be confidered as the remote caufe of fevers: and thefe matters prefent in the atmofphere and thus acting upon men, may be confidered either as contagions, (that is, effluvia arifing directly or originally from th* body of a ipan under a particular difeafe, and exciting the fame kind of difeafe in the body to whom "they are applied) or miasmata, that is efflu- via arifing from other fubftances than the bodies of men, producing a difeafe in the perfon to whom they are applied"—Hence we may infer, that this latter term embraces what is meant by Epidemic OF THE YELLOW FEVER. i& when applied to divers places, or Endemic when we fpeak of any one place. It is however evident, that the terms Epidemic and Contagious are fo connected, as not to be capable of an entire disjunction : The effluvia arifing from ether fubftances than the body of man, con- taminating the air, and producing difeafe in perfons predifpofed— what is the confequence ? By the accumulation of difeafe, a com- bination of Caufes proceeding from miafmata, combined with the effluvia arifing from the bodies of the difeafed—or in other words, Animal-dad Vegetable effluvia uniting—muftof neceflity produced fpeci .s of contagion or at leaft a variety. Dr. Cullen admits the probability of a variety in contagions. Yet obferves that though th-y have now b*en,or,icrved and diftin- guifhed for maay ages, and in many different pans of the world, they have been-always bund to retain the fame general character, and to differ only in circuinftances, that may be imputed to feafon, climate, and other external caufes, or to the peculiar c nftitutions of the f-veral perfons affected. • He rather inclines to admit the probability, that in each of thefe fpecies the contagion is of one Specific nature, which we apprehend coniifts in the union of the two effluvias already mentioned. Hence, whenever it can be proved, that any difeafe has been communicated from a combination of thefe, we may pronounce it contagious, and vice verfa. Then with refpect to the Contagious or Non-Cmtagiws nature of the Yellow Fever, as it occurred in Charleston, we need only de- mand, has it in any known inftance been communicated from one perfon to another ? The learned and experienced Dr. Ramfay of Chariefton, in a letter to Dr. Miller of New-York, fays " There is but one opinion among the Phyficians and Inhabitants, arvd that is* that the difeafe was neither Imported, nor Contagious. This was the unanimous fentiment of the Medical Society, who in purfuance of it, gave their opinion to the government laft fummer" (i. e. the fummer of 1800) that the rigid enforcement of the quarantine laws was by no means neceflary on account of the Yellow Fever." The doctor concludes by obferving " my private opin'on is, that our Yellow Fever is a local difeafe originating in the air of Chariefton." Cor- :v?fpondent to this is the opinion of Dr. Tucker Harris, communi- cated to Dr. Currie: " with refpect to the contagious nature of Yel- low Fever, fo far as it has occurred in this city, tnere is no instance, which can be cited to induce the fmaltft fufpicicn thereof. It ap- pears, that not only Europeans and strangers from differentiates, who vifit our city, take the difeafe ami die, without communicating it to the phyficians, nurfes or attendants, but that people from the country, ftrangers to our atmofphere, on coming to town, often ficken in their way home? and die in houfes on the road ; yet in no one inftance, ha^h the diforder been transferred to any of the indi- viduals of the family who received them in. ihi ?. in my opinion, is an undeniable ana convincing proof of the r.on-critagious nature or the Yellow Fever, Indeed I ftrongly doubt whether &y difeafe, originating from vegetable or marlh mialina, can be contagious, for as yet it never has been demonstrated : while on the other hand I 160 OF THE YELLOW FEVER. am inclined to believe, that animal, perhaps it would be more co& reft to fay Human effluvia, under certain modifications, prc.ve the fource of all (uch difeales as are of a contagious kind ; and the operation of this contagion is n. t,as happens in the cafe of Yelloiif Fever confined to trie autumnal months, but will exift at any feafon, This may perhaps, ferve in fome meafure, to difcriminate betweea Epidemic and contagious diforders, &c." Thefe facts corroborated by fuch high and undoubt°d testimonies, will eftablifh what I have already advanced with regard to the locali'y of this difeafe and pro* ceed to give the Definition.-— We Ytllcw Fever derives its appellation fromthf yellow iurrufi n which commonly appears in the eyes and on the Ikin, however, as this appearance is n^t univerfal, and frequently happening in many other cafes, the term may not be ftrictly proper. It was during- the Revolution, termed Camp-Fever. It appears to be a fever of the Typ ius kind, and by Dr. Cullen is very proper- ly cr, lied Typhus itlerodes. The term Yellow Fever is moft general!? applied to it, and as fuel we prefume it will continue to be handed down to the lateft posterity. CAUSES.—Authors appear to be divided as to the caufe of Yellow Fever, whicr. may be collected from what has been already faid. It is however believed that a particular idiofyncrafy, i. e. con. ftiution or derangement of the atmofphere, probably effected by the ftrong light and intenfe heat of the fun, depriving that portion ne .ren the earth of its proper quantity of vital air, leaving the Mephitk or heavier, part near to the furrace of the earth, forms one snot among the leift of caufes. The lofs cf a fmall portion of vital air renders this lower ftratum very unfit for refpiration, confequent- ly very unwholefome; when this circumstance takes place, and the atmofphere feems vitiated flowly and by degrees, the effect of Yel. low Fever or indeed any other is not fo confiderable; in proportion to the fuddennefs and degree of this idiofyncrafy and vitiated ftate of the atmofphere, fo is the violence of its appearance. Marfh miaf- ma,as has been already obferved is productive of Epidemics, and none deny vat contagious difor'ers are produced by the cadiala- tions from putrifying animal and vegetable fubftances. It may alfo be remarked, that moft climates experience an unhealthy andpef- tilenrial atmofphere, foon or immediately after the exhalations from . the putrifying collections of vegetable and animal matter begin to rife, which diffufmg hemfelves in the air, bring on difeafes of dif- ferent forces of malignity according to the contaminated 'ftate of the atmofphere, in conjunction with other predifpofing. circumftan- ces, and that thefe exhalations are principally produced by heat combined with fome peculiar ftate of the atmofphere, is an opinion backed by good authority. Dr. Harris, whofe opinion I have be- fore token the liberty to introduce, oblerves, after.having objected to the generally afligned caufes, " I am however decidedly of opu>' ion, that heat combining with fome u .known modification of the atmofphere cf our citv, h?s, in ten out of the laft thirteen years, given existence to this dreadful difeafe." SYMPTQMS.-~There is httle or. no difference imcxig author QF THE rEUQW FEVER. 16c of the prefent day with regard to thefe, \ have eonfWted eight ot ten of the greateft celebrity, and obferve an almoft wiqut of opin- ion—Before the fever fr us itfelf, the moft ufual fign of its ap- proach is a fud-Jen and univerfal pain of the head generally above one or both eyes, which in fome remit with fhort intervals,-caufing a giddinefsor vertigo, rather than fliarp pain, attended with an un- ufual feeMenefs and languor of the body. Dr. Rufh ftates among other premonitory fymptoms, a fudden drying up, or breaking out of m old fore, frefh eruptions in different parts of the body ; a ceflation of a chr >nic difeafe or a converfion of a periodical into a continual difeafe—a peculiar fallown k cf the complexion-r-a head- achy decoy cr increafe *f appetite, coftivenefs; a diminifhed cr increafed fecretion of urine, a hot and offenfive breath, conft nt fweats, and fometimes of a foetid nature, or a dry fkin; wakeful efs, or a difpofi ion to early or protracted fleep, a pre- ternaturally frequent pulfe; ?unuiual vivacity, or depreflion of fpirits, fatigue or fweats from li ht exertions; the hands when rub- bed, emitting a fmell like hepar (liv- r) of fulphur, and lastly a fenfe of burning in the •mouth. The fever is commonly ufliered in with alternative flight chills and heats, naufea, pains of the head, back, loins, and at the pit of the ftomach. Thefe fymptoms are often followed! in lefs than 24 hours with violeat rechings and vomiting of a green or yellow bile, the lmell cf which is very offenfive. The learned Dr. Mitchell very ingenioufly .rranges the patbog. tomic, (peculiar or alw ys attendant) fyraptoms of this difeafe into the fix following particulars. 1. A very great and fudden debility without any manifest caufe. 2. A feverish anxiety, generally very grievous. 3. A fhort quick anl difficult orthopnaic refpiration, (i. e. the patient cauuot draw his hreath with eafe unlefs in an upright pofture) after the fever is formed. 4. A contracted deep pirife; the artery feels tenfe, but the pulfe is c^mpr^ ffihle, to whicti fucceeds a deprefled, or foft and low pulfe, after the ftate of the difeafe, or after the yellow eftufion appears. 5. A pain of the fcorbkulus cor- dis, (pit of the ftomach)either much complained of or to be felt on fqueezi. g that part; and more or lefs fevere according to the fe- verity of the difeafe. 6. A yellowncfs in the eyes, or all over the body at the height of the difeafe; unlefs prevented by colliquative , or critical difcharges, to which may be added, a violent and unufual kind r f pain of the head, urlti's it h drowned as it were in the more grievous complaint about the pracordia, (the vitals or particularly the heart.) The three latter are fyrcptoms moft peculiar to this fever. At other times the patient is attacked with very great anxiety, fick- nefs a.d pain of the ftomach, attended wiih an exceiuve convulsive vomiting, which no medicine feems likely to relieve—After the firft day the lurface of the body is generally either col J, or dry and parched, the head-ach and ftupor cften ending in a delirium which proves fuddenly fatal in many cafes. It is to be obferved that the vomiting fometimes occurs as e°rly as the firft or fecond d?.y, but more commonly on the third, when it brings on h;ckup, inflamma- tion of the ftomach and vifcera, with a large difcharge by vomit of a black aircAfmi matter, (anciently denominated black choler)like id OF THE YELLOW FEVER. ccffee grounds, mixed with a bloody lymph, or coagulated blood. The atrabilious humor is often highly acrid; fometimes vifcid, in which latter cafe it is with difficulty ejected, and hence by its great acrimony it renders this fymptom violent and often fatal. We have been thus prolix in defcribing the fymptoms, becaufe we think much depends thereon, and indeed much more might be laid did we not prefume, a due attention to thefe, would difcover to any careful obferver the premonitory as well as concomitant ad« vances thereof—-with regard to Prognoftics, we decline advancing any obfervations, and proceed to the REGIMEN.—It may not be amifs to^Iefcribe under this par. ticular, what are confiJered as preventatives of fever—thefe are feverally pointed out by that eminent phyfician, Dr. Rufh. He advifes firft, where it is practicable, the flight of perfons expofed to its attack,but where this is impracticable, fafety fhould be fought for in fuch means as reduce the preternatural tone and f ulnefs induced in the blood veff-is by the'stimulus of the miafmata and the fupprek fion of cuftomary fecretions. Thefe are, i. A diet accommodated to the greater or lefs expofure of the body to the action of the mi-. afmata, and to the greater or lefs degree of labor or exercife, whicl£ are taken. In cafes of great expofure to an infected atmofphere*,' with but little exercife, the diet fhould be fimple in its quality and fmall in its quantity. Frefh meats and wines fliould be avoided; A little falted meat and Cayenne pepper with vegetables, prevent an undue languor of the ftomach, from the want of its ufual cordial aliments. But where a great deal of exercife is taken, broths, a lit- tle wine or malt liquors may be ufed with the fruits and garden vegetables of the feafon with fafety and advantage. The change from a full to a low diet fhould be made gradually. When made fuddenly it predifpofes to an attack of the difeafe. 2. Laxative medicines—-3. A plentiful perfpiration kept up by means of warm clothing ancf bed-clothes. The excretion whica takes place by the pores is of the firft neceflity ; as is a particular attention to clean linen or flannel; and 4. Blood letting. All thefe depleting remedies, wheiher ufed feparately or together, induce x fuch an artificial debility in the fyftem, as difpofes it to vibrate more readily under theampreflion of the miafmata. A fecond clafs of preventives, are fuch as obviate the internal action of miafmata, by exciting a general or partial determina- tion to the external furface of the body. Thefe are—1. The warm bath; it ferves the treble purpofes of keeping the fkin clean, the pores open, and of defending what are called the vital organs from difeafe, by inviting its remote caufe to the external iurface of the body. This cannot be too highly recommended. 2. The cold bath. 3. Wafhing the body morning and evening with fait water." 4- An- ointing the body with oil or frefh butter, c. lflues,fetons and blifters. " A third clafs of preventives are fuch as excite a general action, more powerful than that which the miafmata are difpofed to create in the fyftem, or an action of a contrary nature. Thefe are—1. Onions and garlick. The liberal ufe of thefe condiments in food hath exempted all thofe who ufed them in 1793, from yellow fever. OF THE YELLOW FEVER. t$$ 2. Calomel taken in fuch fmall dofes as gently to affeft .the gums. Several other controverted or at leaft doubtful particulars are en- umerated, which we pafs over in order to point out the neceflity of avoiding all its exciting caufes. Thefe are—i. Heat ano! cold: While the former has excited the yellow fever in thoufands, the latter has excited it in ten thoufands. It is not in middle latitudes on- ly, that cold awakens tnis difeafe in the body. 2. The early morn- ing and evening air, even in warm weather. 3. Fatigue from amufements ; fuch as filhing, gunning, dancing, and from unufual labor or exercife. 4. Intemperance in eating and drinking. 5. Partaking of new aliments ant drinks. , 6. Violent emotions or paflions of the m'.nd. 7. i'hc entire ceflation of moderate labour. 8. The continuance of nard labor. Thefe are the principal means of prevention which hive been enumerated as neceflary. The Regimen to be obferved after an attack, conftfts in the following: The patient fhould abtain from animal food ; the diet fhould con- fift of gruel, pauado, f.igo, chicken-broth, andnother fpoon-meats; he fhould ufe cool diluting drinks, fuch as barley*water, toaft and water, lemonade, apple-tea, tamarind-water, hop-tea, and alfo fmall 1 quantities of ripe fruits, which tend to keep the bowels foluble. The chamber of the fick fhould be fpacious and airy, and frequent- ly ventilated through the day : vinegar, fprinkled on hot bricks, fliould be introduced into the apartment frequently, and impregna- ted with aromatic herbs repeatedly fprinkled over the floor,' bed- clothes, &c. The paflions of the mind ought alio to be regularly attended to, and the excrements fhould not be fuffered to remain a moment in the apartment. Thefe circumftances are of infinite im- portance, as well to the fick, as to thofe who frequent them. MEDICINE.—Here a particular neceffity compels us to be minute in our obfervations.—This publication was originally, and is now intended, as an affiftant and guide to Families, and to fuch as are out of the reach of Phyficians. Happily for mankind, where this difeafe prevails, there are generally a fufncient number of emi- nent phyficians. Need we obferve the importance of an early ap- plication to an honeft and fkilful practitioner ?—Where however this highly prudent plan is neglected, or impracticable, we would recommend the following mode of treatment: In this fever the firft indication is to fubdue it by the moft fpeedy means in our pow- er. The fecond is to pravent the putrefcent ftate that follows fo rapidly after the febrile ftaj;e, or to oppofeits progrefs when begun, and at the fame time to fupp >rt the ftrength of the patient. The firft intention is beft accomplifhed by bleeding and purgatives; bleeding is beft performed within the firft twenty-four hours from an attack, or at moft within thirty-fix. Some practitioners have pointed out the exact quantity of blood to be drawn, but as an im- plicit attention to that rule may fubjeft us to error, we decline the infertion. In genera!, when the ufe of the lancet is indi- cated, one or more bleedings may be admitted, with a view to alle- viate the violent pains of the head, eyes, &c. provided it be per- formed within the time prefcribed. Io order to moderate the vio- lent determination to the head, the feet fhould be bathed in warn: it* of the yellow fever. water, and an opening clyfter adminiftered immediately. As ohftt. nate coftivenefs generally prevails, and the ftomach is feldom long capable to retain the common purgatives, we ought to improve the time to advantage. It may be here obferved that if perfpiration can be promoted foon after the attack, it may be a means to fub« due the fever: with this view, if there be no inclination to vomit, and the fkin is dry and parched, the following may be adminiftered to advantage, during the firft twenty-four >ours. Take antimon- ial powderf and Calomel, of each one fcruple, fyrup enough to make a mafs, of which eight pills may be made. Four of thefe may be taken immediately, and two more repeated every fecond or third hour after, till they either procure a due difcharge, or free perfpira- tion. Should however the firft dofe occafion a retchi.g or vomiting;, we fhould immediately defift and refort to the other means hereaf- ter laid down. If the prefcription operates plentifully by fweat and by ftool, the patient will in all p:obability recover, as by this means the fever is often prevented from forming itfelf. Should the ftomach not retain the foregoing, forty grains of jalap and twenty of calomel, or twenty of calomel with the like quantity of Crab's-eyes or magnefia, may be rubbed together, and divkied in- ( to ten powders; one of thefe may be given every two hours, in ti little cold tea, or they may be formed into ten pills, one of whicfyi to be taken at the fame periods, and continued during the whole of the febrile ftage, or until the gums are affected. When this .- fortunate circumuance takes place, the medicine muft be fufpended, and nourifhment with a little wine given. 2. As bark in fubftance Will rarely remain on the ftomach, decoctions are to be preferred, and as iu this ftage it is neceffary to exert every effort to refiff a tendency to putrefaction, four table-fpoonsful of the decoction of bark may be given every two hours. If the ftcmach fhould reject it, or whether it does or not, we ought not to neglect repeated clyf- ters of it, acidulated with vinegar or lime juice, at leaft every two hours, nor would it be amifs to rub the body with vinegar or lime- juice, as often as practicable. Some have recommended olive or fweet oil for this purpofe alfo. Sometimes the strained juice of wcod-forrel given internally and by way of clyfter, has been at- tended with good effects in reftraining the putrid tendency, and in one inftance has been known to check the black vomit. Hops, being ppffeffed of great antifeptic properties, an infufion of them may be taken in moderate draughts, at proper intervals. In cafe of vomitting, a blifter applied to the epigaftric region, particularly the pit of the ftomach, is almoft alone to be relied on. In this fe- ver, an inflammation of the ftomach and vifcera are almoft always prefent, and the tendency to putrefcence is fo great as to exclude the remedies ufually applied in other cafes attended with vomiting. Here it is effentially and absolutely neceflary to avoid all heating medicine. Wherefore, if the gums are not already affected, fric- tions of ftrong mercurial ointment, particularly over the hypochon- driac and epigaftric regions, may be ufed ; and if by this means the gums can be affected, a cure may be looked for. • Trom what has been faid we may collect, that the general plan OF THE SMALL-POX. 16; of treatment for this Hydra-difeafe, confifts of fuch Remedies, as tend to fubdue the inflammatory diathefis already pointed out- Bleeding, warm bathing, and purgatives, appear to be the moft ap- proved, to which may be added bliftering and the mercurial fric- tion. Am ug the purgatives, calomel appears to claim the prefer- ence, and when timely and prudently adminiftered, feldom fails to prove fuccefsful. Hence we are again induced, earneftly to advife timely application to a Profeflional Character. We fhall now conclude with fome remarks on the treatment of convalefcents. They fhould avoid every thing which may tend to bricg on a relapfe; among thefe may be reckoned a too early expofure to improper exercife, food, and drink. They fhould eat but little at a time, and that little fhould be eafy of digefiion. Their exercife fliould be gentle, and introduction to the air gradual: morning and night air fhould be avoided at all events- If wine had been uf ?d in the fever, it muft now be ufed more fparingly. Ba*k in fubftance or decoction, mould be continued in moderate dofes, until the debilitated fyftem is invigorated, the digeftive fac- ulty repaired and flxengthened,and the patient returns to his ufual mode of living. CHAP. XXIV. OF THE SMALL-POX. JL HIS difeafe, which originally came from Arabia, is now become lo general, that very few efcape it at one time of life or another. It is a moft contagious malady; and has for many years proved the fcourge of Europe. The fmall-pox generally appears towards the fpring. They are very frequent in fummer, lefs fo in autumn, and leaft of all in win- ter. Children are moft liable to this difeafe; and thofe whofe food is unwholefome, who want proper exercife, and abound with grofs humors, run the greateft hazard from it. The difeafe is diftinguifhed into the diftiuct and confluent kind, the latter of which is always attended with danger. There are likewife other distinctions of the fmall-pox: as the cryftaline, the bloody, &c. CAUSES.—The fmall-pox is commonly caught by infection> Since the difeafe was firft brought into Europe, the infection has never been wholly extinguifhed, nor have any proper methods, as far as I know, been taken for that purpofe; fo that now it has be- come in a manner constitutional. Children who have over-heated themfelves by running, wreftling, &c. or adults after a debauch, are moft apt to be feized with the fmall-pox. SYMPTOMS.—This difeafe is fo generally 'known, that a minute defcription of it is unneceffary. Children commonly look a little dull, feem liftlefs and drowfy for a few days be fore the more violent fymptoms of the fmall-pox appear. They are likewife more inclined to drink than ufual, have little appetite for folid food, complain of wearinefs, and, upon taking exercife* are apt to fweat, 166 OF THE SMALL-POX. Thefe are fucceeded by flight fits of cold and heat in turns, which as the time of the eruption approaches, become more violent, and are accompanied with pains of the head and loins, vomiting, &c. The pulfe is quick, with a great heat of the fkin, and reftleffnefs. When the patient drops afleep, he wakes in a kind of horror, with a fudden ftart, which is a very common fymptorrt of the approach- ing eruption; as are alfo convulfion-fits in very young children. About the third or fourth day from th£ time of fickening, the fmall-pox generally begin to appear; fometimes indeed they appear fooner, but that is no favourable fymptom. At firft they very nearly refemble flea bites, and are fooneft difcovered on the face, arms, and breaft. The moft favorable fymptoms are a flow eruption, and an abatement of the fever as foon as the puftules appear. In a mild diftinct kind of fmall-pox, puftules feldom appear before the fourth day from the time of fickening, and they generally keep coming' out gradually for feveral days after. Puftules which are diftinct, with a florid red bafis, and which fill with thick purulent matter, firft of a whitifh, and afterwards a yellowifh color, are the beft. A livid brown color of the puftules is an unfavorable fymptom $ as alfo when they are fmall and flat, with black fpecks in the raid-j die. Puftules which contain a thin watery ichor are very bad. A peat number of pox on the face is always attended with danger. It is likewife a very bad fign when they run into one another. It is a moft unfavorable fymptom when petechia?, Or purple, brown, or black fpots are interfperfed among the puftules. Thefe' are figns of a putrid diffolution of the blood, and fhew the daneef to be very great. Bloody ftools or urine, with a fwelled belly, are bad fymptoms ; as is alfo a continual ftracguary. Pale uriDe and a violent throbbing of the arteries of the neck are figns of an approaching delirium, or of convulfion-fits. When the face does not fwell, or falls before the pox come to maturity, it is very un- favorable. If the face begins to fall abcut the 1 ith or 12th day, and at the fame time the hands and feet begin to fwell, the patient generally does well; but when thefe do not fucceed to each other, there is reafon to apprehend danger. When the tongue is covered with a brown cruft, it is an unfavorable fymptom. Cold fhiverirg fits coming on at the height of the difeafe are Pkewife unfavorable. Griming of the teeth, when it proceeds from an affection of the nervous fyftem, is a bad fign; but fometimes it is occaficned by worms, cr a disordered ftomach. REGIMEN.—When the firft fymptoms of the fmall-rex ap- pear, people are ready to be alarmed, and often fly to the ufe of medicine, to the great danger of the patient's life. I have known children, to appeafe the anxiety of their parents, bled, bliftered, and purged, during the fever which preceded the eruption of the fmall-pox, to fuch a degree that Nature was not only difturbed in her operation, but rendered unable to fupport the puftules after they were out; fo that the patient, exhaufted by mere evacuations, funic under the difeafe. When convulfigns appear, they give a dreadful alarm. Trr.me- OF THE SMALL.POX: 167 diately fome noftrum is applied, as if this were a primary difeafe; whereas it is only a fymptom, and far from being an unfavorable one, of the approaching eruption. As the fits generally go off be- fore the actual 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, neceffary during the eruptive fever, is to keep the patient cool and eafy, allowing him to drink freely of fome weak diluting liquors; as balm-tea, barley-water, clear whey, gruels, Sec He fliould not be 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. His food ought to be very light; and he fhould be as little difturbed with 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. Every thing that heats and inflames the blood increafes the fever, and pufhes out the puftules prematurely. This has num- berlefs ill-effects. 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 a violence, they generally fall: in before they come to maturity. The good women, as foon as they fee the fmall-pox begin to ap*.- pear, commonly ply their tender charge with cordials, faffron, and marigold teas, wine punch, and even brandy itfelf. A11 thefe are given with a view, as they term it, to throw out the eruption from the heart. This, like moft other popular miftakes, is the abufe of a very juft obfervation, that -when there is a moijlure on thejkin, the pox rife better, and the patient is eafier, than when it continues dry and parched. * But thaus no reafon for forcing the patient into a fweat. Sweat- ing never relieves unlefs where it it comes fpontaneoufly, or is the effect of drinking weak diluting liquors. Children are often fo peevifh, that they will not lie a-bed with- out a nurfe conftantly by them. Indulging them in this, we have reafon to believe, has many bad effects both upon the nurfe and child.—Even the natural heat of the nurfe cannot fail to augment the fever of the child ; but if fhe alfo proves feverifh, which is of- ten the cafe, the danger muft be encreafed.f Laying feveral children who have the fmall-pox in the fame bed has many ill confequences. They ought if poffible never to be in the fame chamber, as the perfpiration, the heat, the fmell, Sec. all teud to augment the fever, and to heighten the aifeafe. It is com- mon among the poor to fee two or three children lying in the fame • Coovulfion-fit? are no doubt very alarming, but their effects arc often falutary. They feera to be one of the means made ufe of by Nature for breaking the force of a fever. I have always obferved the fever abated, and fometimes quite removed, after one or more convulfion-fits. This readily accounts for convulfions being a favourable fymptom in th* fever which precedes the erupt'ypn of ths fmall-pox, as evy thing that mitigates this fever lelTeas the eruption, / f I have known a nurfe, who had the fmal'-pot before, fo infected by lyib.-i confrantlv a-bed with a child in a bad kind of fmall-?ox, that Ihe had not only a great numoer of '.uf- tulei which broke out all over her body, b>:r at"rcrward9 a malignant fever which tr.rrninateii in a numberof impofthumes or boils, and from which ilie narrowly efcaped wi'h her life. W : mention th:i to pn other? r?c. 'heir guaid jgainft the dinger of 'b"s virulent 'nfeWo" x6t OF THE SMALLPOX. bed, with fuch a load of puftules trrt even their fkins flick togeuV er. One can hardly view a fcene oft is km.l without being fick- ened by the fight. But how muft the effluvia affect the poor pa- tients, many of whom perifh by this ufage.* A very dirty cuftom prevails among the lower dafs of peoptyi of allowing children in the fmall pox to keep on the fame linen dur* ing the whofe perind of that loathfome difeafe. This is done left they fliould catch coli; but it has many ill confequences. The lin- en becomes hard by the moifture which it abfc rbs, and frets the tender fkin. It likewife occafions a bad fmell, which is very per- - nicious both to the patient and thofe about him ; befides, fhe filth andtores which adhere to the linen, being abforbed, or taken up again into the body, greatly augment the difeafe. A patient fhould not be fullered to be dirty in an internal dif- eafe, far lefs in the fmall-pox. Cutaneous diforders are often occa- fioned by naftinefs alone, and are always increafed by it. "JVere the patient's linen to be changed every day, it would greatly re- frefh him. Care indeed is to be taken that the linen be thorough. ly dry. It ought likewife to be put on when the patient is moft cool. So ftrong is the vulgar prejudice in this country, notwithftand. ing all that has been faid agahdt the hot regimen in the fmall-po%. that numbers ftill fall a facrifice to that error. I have feer poof women travelling in the depth of winter, and carrying their chil. [ dren along with them in the fmall pox, and have frequently obfeni \ ed others begging by the fide-way with infants in their arms cover- ed with the puftules; yet 1 could never learn that one of thefe children died by this fort of treatment. This is certaiuly a fuffi. cient proof of the fafety, at leaft of expofing patients in the fmali* pox to the open air. There can be no reafon however for expofrar them to public view. It is now very common in the environs of great towns to meet patients in the fmall p x on the public walks. This practice, howeve/ well it may fuit the purpcfes of boafting in- oculators, is dangerous to the citizens, and contrary to the laws cf humanity and found policy. The food in this difeafe ought to be very light, and of a cool- ing nature, as panado, or bread boiled with equal quantities of milk and water, good apples roafted or boiled with milk, and fweetened with a little fugar and fuch like. The drink may be equal parts of milk and water, clear fweet whey, barley-water, or thin gruel, &c. After the pox are full, butter-milk, being of an opening and cleanfing nature, is a very proper drink. MEDICINE.—This difeafe is generally divided into four dif- ferent periods, viz. the fever which precedes the eruption, theerup- • This obfervation is likewife applicable to hofpitals, work-houfes, &c. where number* of children happen tohavethe fmill-poi at the fame time. I have feen above forty cbildrflk cooped uo in one apartment all'the while they had this difeafe. without any of them beine admitted to breathe the frefli air. No one can be at a lofs to fee the impropriety of fuch conduct. Itought to be a rule not only in hofpitals for the fmall-pox, but likewife for oth« difeafes, that no patient fliould be within fight or hearing of another. This is a matter to which too little regard is paid. In moft hofpitals and infirmaries, the fick. the dying, *al the dead, ate often to be feen in thefarne apartment* OF THE SMALL-POX. i6q rion itfelf, the fuppuration or maturation of the puftules, and the leeondary fever. % It has already been obferved, that little more is neceflary dur- ing the primary fever than to keep the patient cool and quiet, al- lowing him to him to drink diluting liqurrs, and bathing his feet frequently in warm water. Though this be generally the fafeit courfe that can be taken with infants, yet 2dults, of a ftrong con- ftitution and plethoric habit, fometimes require bleeding. "When a full pulfe, a dry fkin, and other fymptoms of inflammation ren- der this operation neceflary, it ought to be performed ; but unlefs thefe fymptoms are urgent, it is1 fafer to let it alone ; if the body ts bound, emolient clyfters may be thrown in. If there is a great naufea or inclination to vomit, weak came- mile tea or lukewarm water may be drank, in order to cleanfe the ftomach. At the beginning of a fever, Nature geneielly attempts a difcharge, either upwards or downwards, which if promoted by gentle means, would tend greatly to abate the violence of the difeafe. Though every method is to be taken during the primary fe- ver, by a cool regimen, &c. to prevent too great an eruption ; yet ; after the puftules have made their appearance, our bufinefs is to ' promote the fuppuration by diluting drink, light food, and if Na- ' ture fernis to flag, by generous cordate. When a low creeping ' pulfe, faintifhnefs, and great lofs of ftrength, render cordials ne- ceffary, we would recommend good wine, which may be made in- to negus, with an equal quantity of water, and fharpened with the juice of orange, the jelly of currants, or the like. Wine-whey fliarpened as above, is likewife a proper drink in this cafe ; great care however muft be taken not to over-heat the patient by any of thefe things. This, inftead of promoting, would retard the eruption. The rifing of the fmall-pox is often presented by the violence of the fever; in this cafe the cool regimen is ftrictly to be obferv- ed. The patient's chamber muft not only be kept cool, but he ought likewife frequently to be taken out of £ke bed, and to be lightly covered with clothes while in it. Exceffive reftleflhefs often prevents the rifmg and filling of the fmall-pox. When this happens, gentle opiates are neceflary. Thefe however ought always to be adminiftered with a fparing hand.^ro an infant, a tea-fpoon-ful of the fyrup of poppies may be given ev- ery five or fix hours till it has the defired effect. An adult will re- quire a table-fpoonful in order to anfwer the fame purpofe. If the patient be troubled with the ftranguarv, or fuppreflicn of urine which often happen? in the fmall-pox, he ihould be frequent- ly taken'out of bed, and if he be able, fhould walk ;-.crc fs the room with his feet bare. When h? cannot do this, he may frequently let on his knees in bed, and fhould endeavor to pafs hi? urine as often as he can. When thefe do not fucceed, a tea-fpoonful >cf the fweet fpirits of nitre may be occafionally mixed_ with his drink.— Nothing more certainly relieves the patient, or is more beneficial hi the fmall-pcx, than a plentiful difcharge cf urine. If the mouth be foul, and the tongue dry and clapped, it ought frequently to be wafhed, and the throat gargled with water and (12) x-70 OF THE SMALL-POX. honey, fharpened with a little vinegar or currant jelly. During the rifing of the fmall-pox,it frequently happens that flit* patient is eight or ten days without a ftool. This not only tends to heat and inflame the blood, but the feces, by lodging lb lorg in the body, become acrid, and even putrid ; from whence bad con- fequences muft enfre. It will therefore be proper, when the hoty is bqnnd, to throw 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 amo!?g the fmall-pox, the Peruvian bark muft immediately be sdminifterea in as large dofes as the patient's ftomach can bear. For a child, two draenms 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 fliarpened with the fpirits of vitriol, and a table-fpoonful of it given every hour. If it be given to an adult in the fams form, he may take at leaft three or four fpoonsfnl every hour. This medicine ought not to be trifled with, but muft be adminifered as frequently as the itomich can bear it; in which cafe it will (ften produce very happy effects. I have frequently feen the petechia? difappear, and the fmall-pox, which had a very threatening afpect, rife and fill with laudable matter, by the ufe of the bark and acids. The patient's drink ought likewife in this cafe to be generousjas wine or ftrong negus acidulated with fpirits of vitriol, vinegar, the juice of lemon, jelly of Currants, or fuch like. His food muft con- fift of apples, roafted or boiled, preferved cherries, plums, and other fruits of an acid nature. The bark and acids are not only neceflary when the petechia or putrid fvmptoms '"appear, but likewife in the lymphatic or chryftalline fmall-pox, where the matter is thin, and duly prepaid The Peruvian bark feems to poflefs a Angular power of ?ffrfjing Nature in preparing laudable pus ; or what is called good matter; confequently it muft be beneficial both in th:s and other difeafes, where the ciifis depends on a fuppuration. I have often obferved where the fmall-pox were flat, and the matter contained in them c»#ite clear and transparent, and where at firft they had the appear- ance of running into one another, that the Peruvian bark, acidula- ted as above, changed the colour and cOnfiftence of the matter, and produced the meft happy effects. When the eruption fubfides fuddenly, or, as the good women term it, when the fmall-poxJlrike in, before they have arrived at muturity, the danger is very great. In this cafe bliftering-plaflers muft be immediately applied to the wrifts and ancles, and the pa* tieut's fpirits fupported witfi cordials. Sometimes bleeding has a iurprifing effect in raifing the puftules after they have fubfided ; but it requires fkill to kno* 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 mean? '.o draw 'the humours tov^ards the extremities. OF THE SMALL-POX. 171 The moft dangerous period of this difeafe is what we call the fecondary fever. This generally comes on when the fmall-p-x begin to blacken, or turn on the face; ar.d moft of thofe who die of the fmall-pox are carried off by this fever. Nature generally atLempts,at the turn of the fmall-prx, to relieve the patient by loofe (tools. Her end..av rs this way are by no means to be counteracted, but promoted, and the patient at the fame rime Supported by food and drink of** ncur-fhinjs and cofrhal nature. If at the approach o the fecondary fever, the pufe be very quick, hard, and ftrong, the he :t interife, and the brear.-.irg labori- ous, with other fymptoms of an inflammation of tne breaft, the patient muft immediately be bled* The quantity of blood to be let emit be regulated by ihe patient's ftrength, age, and the urgen* cy of the fymptoms. But in the fecondary fever, if the patient be fairttifh, the pufc tules become fuddenly pate, and if there be great c Idnefs of the extremities, biifterir.g-plafters muft be applied, and tbe patient muft be fupported with generous cordials. Wine and even fpirits have fometimes been given in fuch cafes with amazing fuccefs. As-the fecondary feV-ris in great meafure, jf not wholly, owing to theabforpion of the matter, it would feem highly confo- nant to reafon, that the puftules, as foon as they come to maturi- ty, fhould be opened. This is every day practifed in other phleg- mons which tend to fuppuration ; and there feems to be no caufe why it fhould be lefs proper here. On the contrary, we have reafon to believe that by this the fecondary fever might always be leffened, and often wholly 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 lancet or a needle, and the mat> ter abforbed by a little dry lint. As the puftules are generally firft ripe on the face, it will be proper to begin with opening thefe, and th« others in courfe as they become ripe. The puftules gene- rally fill again, a lecond or even a third time ; for which caufe the operation muft be repeated, or rather continued as long as there is any confiderable appearance of matter in the pustule0. We have reafon to believe that this operation, rational as it is, has been neglected from a piece of miftaken tendernefs in parents. They believe that it muft give gre°r pain to the poor child; and therefore would rather fee it die than have it thus tortured. This notion however is entirely without foundation. I have frequently opened the puftules when the patient did not fie me, wuhout his 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 arifefromit. ^ Opening the puftules not only prevents the reforption of the matter into the blood, but likewife takes off the tenfi-n of the ikin, and by that means reatlv relieves the patient. It likewife tends ro prevent the pitting, which is a matter cf no fmall importance.-— Acrid matter by lodging 1 -*ng in the puftules, cannot fail to corrode the feid"i fkin : by which many a handsome face becomes fo ce-- 172 OF THE SMALL-POX formed as hardly to bear a refemblence to the human figure*. It is generally neceffary, after the fmall-pox are gone^ off, to purge the patient. If however the body has been open through the while courfe of the difeafe, or if butter-milk and ether things of an opening nature have been drank freely after the height of toe fmall-pox, purging becomes lefs neceffary; but it ought never wholly to be neglected. For very young children, an infufion of fenna and prunes, with a little rhubarb, may be fweetened with coarfe fugar, and given in fmall quantities till it operates. Thofe who are farther advanced muft take medicines of a fharper nature. For example, a child of five or fix years of age may take eight or ten grains of fine rhubarb in powder over-night, and the fame quantity of jalap in powder next morning. This may be wrougnt off with frefh broth or water-gruel, and may be repeated three or four times, five * or fix days intervening between each dofe. For children further ad. vanced, and adults, the dofe muft be increafed in proportion to the age and conftitution.f When impofthumes happen after the fmall-pox, which is not feldom the cafe, they muft be brought to fuppuration as foon as poffible, by means of ripening poultices ; and when they have been opened, or have broke of their own accord, the patient muft be purged. The Peruvian bark and a milk diet will likewife be ufeful , in this cafe. j When a cougJa, and a difficulty of breathing, or other fymp- toms of a confumption, fucceed to the fmall-pox, the patient rauit be fent to a place where the air is good, and put upon a courfe of affes' milk, with fuch exercife as he can bear. For further direc- tions in this cafe, fee the article Confumptions. Of Inoculation. Though no difeafe, after it is formed, baffles the power of medicine more effectually than the fmall-pox, yet more may be done before-hand to render this difeafe favourable than any one we know, as almoft all the danger from it may be prevented by inoculation. This falutary invention has been known in Europe above half a century : but like moft other ufeful difcoveries, it has till of late raa-'e but flow progrefs. It muft however be acknow- ledged, to the honour of this country, that inoculation has met with a more favourable reception here, than among any of our neigh- } bours. It is ftiil however, far from being general, which we have reafon to fear will be the cafe, as long as the practice continues in the hands of the faculty. No difcovery can be of general utility, while the practice of it is kept ki the hands-of a few. Had the inoculation of the fmall- * Thoughthis operation can nrvefdo harm,yet it is only neceffary when the patient ban great load of fmalUpox, or when the matter which they contain is of lo thin and acrid t nature, that there is reafon to apprehend bad confequences from its being too quickly refbrbed, or taken up again into the mafs "of circulating humiurs. fl have of late been-accuftqmed> after the fma'l-pox, to give one, two, three, four, «r five grains of calomel, accorrfns to the age of the patient, over night, to work it off neit morning W'th actable dofe of jalap. Or the jalap and calomel may be mix"d togctber»» doubt be ufed with auvanti-ein'thofe cafes where tin paccatis very mu,:Jj alarmed at thsSght of a-iv c itr;ng \i f,:Jt:.'fit, OF THE SMALL-POX. W tmall-poxhave been fully pointed out by the ^^'F^l in his Hiftorv of Health.? To thofe mentioned by the Dottor we hal!SoWd, that fuch as have not had the MfJ^^J period of life are not only rendered unhappy, but ^l«™ a creat meafure unfit for fuftaining many of the moft ufeful and im- nortanToffices. Few people would chufe even to hire a fervant wlTh d nof had the fmafl-pox, far lefs to purchafe a flave who had the chance of dying of this difeafe. How could a phyfician or furgeon, who had never had the fmall-pox hunfelf, attend others under that malady ? How deplorable is the fituationof female^ who arrive at mature agt without having had the fmall-pox A woman with child feldom furvives this difeafe; and if an inrant Kens to be feized with the fmall-pox upon the mother s breaft. Xhas not had the difeafe herfelf, .the fcene ™*J*J*S*$ If fhe continue to fuckle the child, it is at the peril of her own lite., » nd if fhe wean it, in all probability u will perifh. How often is tt alxedionate mother forced to leave her houfe, and ^ndon^g children at the very time when her care is molt neceiiary . i et SfflSaft&onBetthe batter of her fears, tteconfr Luences would often prove fatal. Ihave knownthe tender mother and her tucking infant laid in the fame grave, both unume y vicW to this dreadful malady. Bat thefe are ^^°^^% to mention. Let parents who run away with tne*r children to. ^dtthTfrn^iol or who refule to inoculate them » igfe-gj confider to what deplorable fituations they may be reduced by tni* miftaken tendernefs ! \, . . ..(•!• ;n mnn As the fmall-pox is now become an epidemical difeale in molt parts of the known world, no other choice remains out to render tne malady as mild as poffible. Tnis is the only manner of extirpa- on now ia in our power ; and tnough it may feem paradoxical the artificial method of communicating the difeafe, could it w- atural nvade .< »* ,ni ar-at '• fats this humane author, " arc the dangers attending the n t » Many an*jr«t, lay* I«i» «£n■ » Th na , inUa,on „„, , 5nf cY.on, Irom all which the inoculation »• £•« (* . klndly ^^^n. lt may attack weak or diapered bodies, by no meansdUpofed VntenLly cold, it may be communicated then at a featon of the year e.ther violently hotoi"^n,?*g°& ,t ^ay lay hold upon from ^ fort ot fmall-poa '»P!«BnawdXth fmKen i Krtei into a maritime place. pe,pie unexpectedly, when a dangeroufort*^^f^ ;^m erahce, or lewdnefs. It ft may fu-.rile u. loon.ifter exceffes «0?™^n^*^h " •, hard labour, or neceffary may likewife feize on the innocent a.ter »"d*fPe"^'^^^happv circv^ftances c3n be pre- joJn-e,. And i, U V'5^'*^*, ^k 'rs a-e WEorcdeformity as well as from vented by inoculation Byinsulation'»»"*»£;efi^ftfeatureS, and the moft beautiful death. Inthenatura ^»^^*^^* •^^^n0<*e«iS „«ly leaVes any ugly marks or complexions m.ferably augured I Whereas rnocu-1 y confiderab'e, and the fcarsPeven where the numbe.■£«*-£«» *eft« XVcotnpLints tVat«e frequent- .'ent thofe inexpreflible terrors that P«l«™;»CT™t& vi age are deoopulated, market* infomuch that when the\^f}^»^f^^^^ From ths tenor it arlfes, ruined, and the *«"**'*"* fP"*i/S*?,jS?tSon"or affiees where the fmaUoo* that juffce is frequently poftponed, or,*™™V**£™(Qn of the neceOary abfence of »ome ,ages. WitnefTe, andjur.es dare not.appear , »»^bT ^Sed with that rcte.enc- an! fpl.n- rentlemen, our honourable »"d uletul jud.e, are <»«*««» mj ofevent 0Uf bravc Purdue to their office and mem. Does no= '"""'f1^ '"herc they muft quickly fpread failorsfr,^ being ««d «,thf *" d,ttmS neverh'ad it before, and where they h.ve fcarce the infection among fuch of the crew who "^^f their cabins, and butve.y indifter- any ch,nce to escape, being half ft^^u^^.d^rv the mifeiie. attending thefe voor creature,, ently nurfed ? I.aftly.w.* regard to the fold£>; »e ™.,vabJe w5tbcui nunw, without when attacked by the fmall-pox °V « "fJ'thit ont «f tbiee tommonly petii. i" ivdglnts, without aoy accommodation i fo that one or i«™ J v I7<* OF THE SMALL-POX. rendered univerfal, would amount to nearly the fame thing as root- ing it out. It is a matter of fmall confequence, whether a difeafe be entirely extirpated, or rendered fo mild as neither to deftroy life nor hurt the conftitution ; but that this may b" done by inccula. tion, 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 dies j 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 eftablilhed for rendering this falutary practice univerfal; but am afitiid I fhall uever be lb happy. The difficulties indeed are many j yet the thing is by no means impracticable. The aim is great; no lefs than faving the lives of one fourth part of mankind. What ought not to be at- tempted in order to accomplifh fo defirable an end ? The firft ftep towards rendering the practice 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 1'ecommend it as a duty to others, but likewife practice it on their own children. Example will ever have more influence than pre* cept. The next thing requifiteis 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 tnat fo ufeful a part of man- kind fhould, by their poverty, be excluded from fuch a becefit. Should this fail, it is furely in the power of any ftate to render the practice general, at leaft as far as their dominion extends. We do not mean that it ought to be enforced by a law. The beft way to promote it would be to employ a fufEcient number of operators at the public expenfe to inoculate the children of the poor. Ttit would only be neceffary till the practice became general; after. wards cuftom, the ftrongeft of all laws, would oblige every indi- vidual to inoculate his children to prevent reflections. It may be objected to this fcheme, that the poor would refu'fe to employ the inoculators j this difficulty is eafily removed. A fmall premium to enable mother? to attend their children while under the difeafe, would be a fufticient inducement; befides the fuccefs attending the operation would foon banifh all objections to it. Even considerations of profit would induce the poor to em? fcrace this plan. They often bring up their children to the age of ten or twelve, and when they come to be ufeful, they are matched away by this malady, to the great lofs of their parents, and detri- ment of the public. The Britifh legislature has of late years fliewn great attention to the preferyation of infant-lives, by fupporting the foundling- hofpital, &c. But we will venture to fay, if one tenth-part of the fums laid out in fupporting that institution, had been beftowed to< wards promoting the practice of inoculation of the fmall-pox among ihe poor, that not only more ufeful lives bad been faved,, but the practice, ere now, rendered quite univerfal in this ifland. It is not to be imagined what effect example and a little money wiU have OF THE SMALL-POX. 177 upon the poor; yet, if left to themfelves, they would go'fcn forever in the old way, without thinking of any improvement. We only mean this as a hint to the humane and public-fpirited. Should inch a fcheme be approved, a proper plan might eafily be laid down for the execution of it. But as public plans are very difficult to bring about, and often, by the feififh views and mifconduct of thofe entrufted with the execution of them, fail of anfwering the noble purpofe for which they were defigned ; we fhall therefore point out fome other method by which the benefits of inoculation may be extended to the poor. There is no doubt but inoculators will daily become 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. This might be done at a very trifling expenfe, and it would enable every one to enjoy the benefit of this falutary invention. Two things chiefly operate to prevent the progrefs of inocula- tion. 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, it is no wonder mankind are fo averfe to it. But this objection is fufficiently anfwered by the fuccefs. Who in his fenfes would not prefer a lefTer evil to-day to a greater to-morrow, provided they were equally certain ? The other obftacle is the fear of reflections. This has a very great weight with the bulk of mankind. Should the child die, they think the world would blame them. This they cannot bear. Here lies the difficulty ; and, till that be removed, inoculation will make but fmall progrefs. Nothing however can remove it but cuftom. Make the practice fafliionable, and all objections will foon vanifh. It is faihion alone that has led the multitude fince the beginning of the world, and v, ill 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, will at length prevail. I am aware of an objection to this practice from the expend with which it may be attended : this is eafily obviated. We do not mean that every parifh ought to employ a Sutton or a Dimfdale as inoculators. Thefe have by their fuccefs already recommend- ed themfelves to crowned heads, and are beyond the vulgar reach ; but have not others an equal chance to fucceed ? They certainly have. Let them make the fame trial, and the difficulties will foon vanifh. There is not a parifh, and hardly a village in Britain, deftitute of fome one who can bleed. But this is a far mere difficu! t operation, and requires both more fkill and dexterity than inocula- tion. The perfons to whom we would chiefly recommend- the per- formance of this operation are the clergy. Mcft of them know fomething of medicine. Almoft all of them bleed, and can order a purge, which are all the qualifications necefTary for the practice of inoculationi The priefts among the lefs enlightened Indians per- 178 OF THE SMALL-POJ. form this office, and why fliould a Chriftian teacher think himfelt above it ? Surely the bodies of men, as well as their fouls, merit a pajt of the pallor's care ; at leaft the greateft Teacher who eve? 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 fuojecb Ije healthy, and of a proper age, they will feldom fail to fucceed to their wifh. I have known many inftances even of mothers performing the operation, and never fo much as heard of one bad confequence. A planter in one of the Weft-India iilinds h !-ii 1 to hive inoculatei, with his own hand, in one year, three hundred of his Haves, who, notwithitandi. g the warmth of the climate, and other unfavourable circumftances, all did well.— Gunmon mechanics hive often, to my knowjedge, performed the operation with as good fuccefs as phyficians. We do not however mean to difcourage thole who have it in their power, from employ.' ing people of ikill to inocuhte their children, and attend them while under the difeafe; but only to fhew, that where' fuch cannot be had, the operation ought not upon t at account to be neglected. inftead of multiplying arguments to recommend this practice, I fhall juft beg leave to mention the method wiiich I took with ray own fon, then an only child. After giving him two gentle purges, I ordered the nurfe to take a bit of thread which had been preT vioully wet with frefh matter from a pock, and to lay it upon his arm, covering it with a piece of fticking-plafter. This remained on fix or (even days, till it was rubbed off by accident. Ar the ufual time the fmall-pox made their appearance, and were exceed* ingly favorable. Surely this, which is all that is generally necefla* ry, may be done without any fkill in medicine. We have bean the more full on this fubject becaufe the bene. fits of inoculation cannot be extended to fociety by any other- means than making the practice general. While it is confined to u few, it muft prove hurtful to the whole. By means of it the contagion is fpread, and is communicated to many who might oth.trwiienever have .vil the difeafe. Accordingly it is found that nearly the fame numberdiepf thefmall-poxnowasDeforeinoculatiofli v/as introduced; and this important difcovery, by wnich alone more lives might be faved than by all the endeavours of the Faculty '; in a great meafure loft by its benefits not being exiendect to the vv-hcie community.*1 Tne fpring and autumn have been ufually reckoned the moft proper feafons ?br inoculation, on account of the weather being t.ien moft temperate; but it ou^ht to be confidered that thefe are £ aueraily the mOft unhealthy feafons of the W ole year. Undoubt- c.iiy the belt preparation for the difeafe is a previous good ftate of .health*. I have always obferved that children in particular are more fickly towerds the end of fpring and autumn, tnan at any ether time of the year. On this account; as well as for the ad- * Ev a well-laid plan for eitendirg 'noculation, more livrs mi/pt be faved at a fmall «»• ^eni-, thin arc at preftnc preferved by all tbe holp'iats in EcgUnd, which coll the public £u:t an amazing-fiim. 0/ THE COW-POX. i79 vantage of cooj air, I would propofe winter as the moft proper fea- fon for inoculation; though on every other confideratton, the fpring would feem to be preferable. The moft proper age for inoculation is between three and five. Many approve of inoculating on the breaft, and where no circum- flancfes forbid this practice, I have no objection to it. Children, however, are more liable to convulfions at t: is time than after- wards ; befides the anxiety of th j mother or nurfe. fhould the child be in danger, would not fail to heighten it by fpoilihg the miik. Children who have constitutional difeafes, muft neverthelefs be inoculated. It will often mend the habit, of body j but ought to be performed at a time when they are moit healthy. Accidental dif- eafes fhould always be removed befcjre inoculation. It is generally thought neceffary to regulate the diet for fome time before the difeafe be communicate-1. In children, however, great alteration in diet is feldom neceflary, their food being com- monly of the moft fimple and wholefome kini, as milk, water-pap, weak broths, bread, light pudding, mild roots, and white meats. ftut c?»lclren who have been accuftomed to a richer diet, who are of a grots habit, or abound with bad humours, ought to be put upon a inare diet before they are inoculated. Their food mould be of a light cooling nature, and their drink whey, butter- milk, and fuch like. We would recommend no other medicinal preparation but tv/o or three mild purges, which ought to be fuited to the age and ftrength of the patient. The fuccels of inoculators does not de- pend on the preparation of their patients, but on their management of them while.under the difeafe. Their conftant care is to keep them cool, ana their bodies gently open, by which means the fever is kept low, and the eruption greatly leiTened. The danger is fel- dom great when the putule3 -re few; and their number is general- ly in proportion to the fever which precedes and attends the erup- tion. I fence the chief fecret of inoculation confifts in regulating the eruoruefev r, whith generally may be kept fufficiently low by the methods mentioned above. The regimen during rhe difeafe is in all refpects the fame a- under the natural fmall-pox. The patient muft be kepi cool, his diet fhould be light, and his drink weak and diluting, Sec. Should any bad fynpttfms appear, which is feldom the cafe, they muft be treated in th- fame way as directed in the narural fmall-pDx. Pur- ging is nit lefs neceflary after the fmall-pox by inoculation than, in the natural way, an J ought by no means to be neglected, CHAP. XXV.$ OF THE COW.POX, dND ITS INOCULATION. Jf.N the preced;ng Chapter, the method ^f inoculating for-the fmall-pox has been ret-Mved, as having hitherto been fuoceestully- practifed during a number of year* ; nut uy a fonv.sate dilcvw„ry, 18a OF THE COW-POX." k is now found, that the infection may be introduced in a manner equally fuccelsful, and the difeafe rendered ftill lefs confiderable than by the former kind of inoculation. This is done by inocula- ting with matter either taken from a cow affected with the difeafe, or from fome perfon who had received the infection originally de- rived from that animal. It may be proper here to give a general account of the manner in which fo furprifing a difcovery has been made. In feveral parts of England, where cows are kept for the pur- pofes of the dairy, a peculiar eruptive difeafe has been occafionally obferved among the herd, and which affects in particular the udders and teats of thofe animals. It has, therefore pretty generally ob- tained the name of the Cow-peq, (vaccinia, or vacciola.J Till wfthio thefe laft two years, tne knowledge of this dif- temper has been chiefly confined to the people employed in the dairies, and to farriers and cow-doctors in the neighbourhood; but, by the latter, it appears to have been obferved with particular accuracy, and they have even employed means for its removal. it farther appears, that wherever the existence of this difeaf; was known, the fact was likewife afcertained, that the diforder % communicated by the touch t:> the milkers who handle the teats of the difeafed cows, and from them again is often fpread through 1* numerous herd ; that, when affecting the human fpecies, it is not merely confined to the local difeafe of the hands and arms, but alfo occafions a general indifpofition, often fevere, but never fatal, which runs a regular courfe ; and that the perfon who has once undergone the difeafe io communicated, is ever after fecure againft the infection of the fmall-pox, either in the natural way by conta- gion, or by inoculation. All thefe circumftances, however, though known, as we are tcld, from time immemorial in certain parts of the kingdom, ftill remained in obfcuriry till within thefe three years, when Dr. Jen- ner, of Berkley, in Gloocefterlfhre, conceived the important idea of employing the cow-pox to annihilate the fmall-pox, and publifh- ed feveral interefting particulars concerning this difeafe, which works have now made it known to the public in general. It appears, from obfervations made by thofe who are moft converiant with cows, that feveral caufes may produce fores upon the udder and teats of this animal, efpecially fuch as excite any irri- tation in thofe parts, during the feafon when the cows abound nioft in milk. The stinging of flies, or rough handling while milking, and other fuch external irritations, will often occafion fmall white bliftsrs on the parts; which, never extended more than skin-deep, and are generally eafy of cure. Another, and more ferious diforder in thofe parts, is faid to be fometimes produced by fuffering a cow, while in full milking, to re- main for a day or two unmilked; in order to diftend the udder when naturally fmall. This, it appears, is a common artifice practifedat fairs and cattle markets, with the view of increafing the price of the cow,a large udder being reckoned aa important circumstance in the value of that animal. By this cruel and unwarrantable artifice, OF THE COW-POX. i8f the veffels that fupply the udder are kept for an unufual length of time in a ftate of great diltention, which terminates frequently in a violent inflammation of thofeparts,fucceeded by large eruptions upon the teats and udder that fometimes leave deep and troublefome fores. The matter difcharged from thefe ulcers will communicate a diforder, like the other, into the hands of the milkers, when the ikin is broken in any part; and often produces foul and extenfive ulcers, which fometimes occafion puftules on the arms and fhonl- ders, and prove tedious and difficult of cure. The genuine cow-pox, however, is a diftinct difeafe from thofe which have been juft mentioned. It generally makes its appearance in the fpring, and fhows itfelf in irregular puftules on the teats or nipples of the udder. They are at firft of a palifh blue,'or rather a livid colour, and contain a thin, watery, and fharp fluid. The fur- rounding parts are inflamed and hardened. Thefe puftules, it feems are very apt to degenerate into deep corroding ulcers, which, as the cow-doctors term it, eat into the flefh, and conftantly difcharge a matter, which commonly increafe in thicknefs, and hardens at laft into a fcab. Now and then the cow becomes evidently indifpofed, rofes her appetite, and gives lefs milk than ufual; but it often hap- pens, that the diforder, though fevere, is entirely local. It appears that, the cow-pox never proves fatal to cows, nor is it infectious in the ufual manner of contagious diftempers, but can only be communicated to them or to the human fpecies by actually touching the matter which proceeds from the fores. Hence, the cows which are not in milk efcape the difeafe entirely, though con- ftantly in the fame field with thofe that are highly infected; and it feems to be only from thecircumftance of the milker handling the teats of the found cows, after touching the difeafed, that the cow- pox ever fpreads among the herd. We are informed that the cow-pox is familiar to the inhab- itants of the hundred of Berkley in Gloucefterfhire. It has like- wife been difcovered in various parts of the counties of Wilts, Someffets, Buckingham, Devon, and Hants; in a few places of Suffolk and Norfolk, where it is fometimes called the pap-pox: and in Leicefterfhire and Staffordfhire. Nor is it unfrequent in the very large milk-farms contiguous to the metropolis on the Middle- fex fide. It is here obferved generally to attack firft fome cow new-. ly introduced to the herd, and is fuppofed to originate in a fudden change from a poor to a very rich and partly unnatural diet whjch it is the practice to ufe, in order to bring the yield of milk to its higheft point. According to Dr. Jenner, the origin of the cow-pox is afcribed to a derivation from the norfe. The horfe is well known to be fiib- j°ct to an inflammation and fwdling in the heel, callei the greafc, from which is difcharged a very fharp matter, capable of producing irri- tation and ulcers in any other apimal to the furface of which it is applied. It is fuppofed that this matter is conveyed to the cow by the menvfervants of the farm, who, in feveral of the djury coun- ties, aflift in milking. One of thefe, having dreffed the horfe,-goes immediately to his occupation of milking ; and having upon h:s i82 OF THE COW-POX. hand fome panicles of the difcharge from the greafe, he, of courfe, applies it to the udder of the cow, where, if the animal be in a ftate for receiving the infection, it produces that fpcrcific change in thofe parts which gives rife to the difeafe of the cow-pox. The origin here afcribed to this diforder is principally founded % \. on the circumftance, that wherever the cow-pox appears, the greafi is generally found to have preceded it; and the opinion of the pro- pagation of the difeafe from the horfe to the cow is likewife current in fome of the dairy counties where the difeafe is known. But this opinion requires to be afcertained by further obfervations. This conjecture, refpecting the origin of the cow-pox, was no. fooner ftartedby Dr. Jenner, than attempts where made repeat- ediy, but without fuccifs, to introduce the difeafe in the nipple of the cow by direct inoculation of the recent matter of the greafe from the horfe's heel. The confequence of this experiment, when it took any effect, was a flight inflammation, and the production of a fmall puftule or pimple, but which difappeared in a few days, with- out exciting the fpecific difeafe of the pox. But the failure of thefe experiments by no mean' overthrows the opinion for the afcertain- ment of which they were made ; fince it is admitted that a certain predifpofition in the conftitution of the cow to receive the difeafe is alfo requifite for its production. It is remarked, that the matter dif charged from the fores in thehorfe's heel is likewife found to occafix:* at times, very tnuble- fome ulcers on the hands of the men that drefs them, attended with a very confiderable degree of inaifpofition ; both of which appear to be full as fevere as in the g^nume cow-pos, and in many points to refemble this latter diforder. But the perfon who has been infect d by the horfe is not rendered thereby entirely fecurfr . from afterwards receiving the fmall-pox. The puitular fores on the udder and teats of the cow, that ■ conflitute the genuine cow-pox, whatever be the way in which they are produced, are found by experience to poffefs the power of infecting the human ("pedes, when any part of the bo-y, where the ikin i-' brokenT cr naturally thin, comes into actual contact with the ::ia< ter which they difcharge. Hence it is, that with the milkers, the hauls are the par^s that acquire this diforder accidentally, and ;t there exhibits the following appearances: Inflamed fpots begin to appear on the hands, wrists, and efpecially the joints and tips ofc the iingers ; and thefe fpots al firft refemble the fmall blifters of a burn, but quickly proceed to fuppuration. The puftule is quite "'rcuiar, deprefied in the middle, and of a blueifh colour, andiS furrounded with a confiderable rednefs. The blue colour which the puftule almoft invariably aftumes, when the diibrder is com- munica;eJ directly from the cow, is one of the moft characteristic ' marks by which the cow-pox may be diftinguifhed from other dif" • ea'es which the milkers are likewife liable to receive from the cow. The matter of the puftule is at firft thin and colourlefs; but, as the diforder advances, it becomes yellower and more purulent. In a few days from the firft eruption, a tendernefs and fwelling of the glanus in the arm-pit come on, and fopa after the whole eoStituuQ& OF THE COW-POX. • 1&3 becomes difordered, the piilfe is increafed in quicknefs, fhivering, fucc=ed, with a fenfe of wearinefs, and pains aboat the loins, vomiting, head-ach, rind fometimes a flight degree of delirium. Thefe fymptoms continue with more or lefs violence from one dav to three or four, and, when they abate, they leave fores about the hands, which heal very flowly ; refembiing, in this refpect, the ulcers on the nipple of the cow, from which they derive their origin. It is to be obferved, that the cow-pox eruption, tnotigh very fevere on the hands, and occafioning much general illnefs, never produces a crop of puftules over diftant parts cf the body, arifing fpomaneoufly, as in the fmall-pox. It often happens, however, that puftules are formed in various parts which accidently come in contact with the difeafed hands, as on the ncftrils, lips, and other parts of the face where the fkin is thin; or fometimes on the fore- head, when the milker leans with that part upon the udder of an infected cow. From this account it appears, that the cow-pox as it affects the milkers, or what may be termed the cafual cow-pox in the human fpecies, is often a fevere diforder, fometimes cor.fiiiir.r; the patient to his bed during the period of fever, and genendh leaving troublefome fores, but it has never been known to prove fatal; nor are thefe fores, if properly attended to, followed with ■( any lasting injury of the affected parts, though they fometimes leave fears for life. • la confequence of the clofe investigation which this diforder has .'ately undergone, the following facts may be confidered as fully afcertained by the faireft experiments and moft accurate obftrvi- rions : Firft.—The cow-pox, in its na-' :ral ftate, cr when propagated immediately from an infected cow, to the hands of the milkers, is capable of affecting the human fpecies from one to another repeat- edly to an indefinite number of times; but after the firft attack, it is generally much milder in hs fymptoms, and in particular it is much lefs liable to>produce the fever and general indifpofition which always attend the firft infection. 1 here are inftances, however, where the fecond and even third attack have been as fevere in ever, refpect as the firft; but thefe are very rare. Secondly.—The fmall-pox in a confiderable degree fecirres a y perfon from the infection of the cow-pox ; and in this refpect ap- pears to act in a manner very iimilar to a previous attack of th? latter di'eafe ; that is, to confine its operation to the forming of local puftules, but unattended with general fever. Hence it is., that where all the fervants of the dairy take the infection fr<.,m the Cows, thofe of them who have previoufly undergone the fmall-p ;x are often the only perfons among them able to go through the ufual work. Thirdly—The-cow-pox, in its genuine ftate, when it: has been accompanied with general fever, and has run its regular courfe, ever a*ter preferves the perfon who has been infected with it from receiving the infection of the fmall-pox. This after?ion is, how- ever* to be taken with exactly the fame limitations as that of re-in- t84 of the cowpox. fection with the fmall-pox preventing a fecond attack oF the fame difeafe. No previous infection will entirely counteract the local effect on the arm, produced by the infertion of variolous matter in common inoculation : this may in a few cafes go fo far as to in- duce a degree of general fiever, flight indeed, but perhaps equal to that of the mildeft indifpofition caufed by a firft infection with this diforder. By the inoculation of either difeafe, however, the fmall- pox is equally add completely difarmed of Is virulence againft any fubfequent attack, which is the circumftance that fo much diftio, guifhes and fo strongly recommends this operation. Fourthly.—A comparifon of the two difeafes in refpect of the mildnefs of their fymptoms, and the hazard to life which they may occafion, will fhow a very great advantage in favour of the cow*- pox. Compared with the natural fmall-ppx, the natural or cafual cow-pox is both milder and infinitely more fafe ; no inftance having ever been known of a fatal event in the cow-pox, fo far as it affects the people employed in the dairies- When both difeafes are in- troduced by artificial inoculation, they are each rendered much lefs fevere ; and here too the" fuperiority of the cow-pox as a fafer and milder difeafe is extremely evident. Fifthly.—The cow-pox, even in its moft virulent ftate, is not communicable by the air, nor by any other of the ordinary meanlS of contagion, but can only be propagated, by the actual conta£fcjof matter of a puftule from the cow-pox with fome part of the body of the perfon who receives it. It is not yet afcertained, whether in all cafes an infection of fpecific infectious matter under the fkin be neceffary ; but in its moft active ftate, as it is when formed in the cow's udder, the fkin which covers the lips and noftrils readily re- ceives the infection without bring broken. In this refpect the contagion of the cow-pox feems to equal that of the fmall-pox io activity ; but the striking difference between the two difeafes in the cow-pox not being communicated by the air, Sec. is a circum- ftance fully and fatisfactorily afcertained. _ In the dairy-farm?, in- fected fervants fleep with the uninfected : infants at the breaft have remained with their mothers whilft only one of the two have had the diforder upon them ; and in no inftance has the difeafe of one been communicated by contagion to the other. It is this circum- ftance which gives the cow-pox its decided fuperiority; fince, by adopting this difeafe inftead of the fmall-pox, all the dread and all the mifchief occafioned by the contagion of the latter are entirehu removed. The inoculated cow-pox appears to have almoft as great a (u- . periority in point of mildnefs and fecurity over the ordinary inoco* * iation of the fmali-pox, as this has over the natural fmall-pox ; fo that the fame precautions which would be highly requifite in com- municating the latter becomes lefs fo where the diforder is to be introduced by inoculation v and ftill lefs where the cow-pox-is fub- ftituted in the room of the other. With regard to the method of performing Inoculation in the Cow-fox, Dr. Woodville, whofe indu'ky, judgment, and accuracy, appear to s>feat advantage in his obfervations on this fubject, advifes " that OF THE COW-POX, 6c. %B$ the lancet fhould be held nearly at a right angle with the /kin, ia order that the infectious fluid may gravitate to the point of the in- ftrument, which, in this direction, mould be made to fcratch the cuticle repeatedly, until it reach the true ikin and become tinged with blood." The act of inoculation having been performed, the firft proof of its fuccefs is a fmall inflamed fpot at the part where the puncture has been made, which is very diftinguifhable about the third day. This continues to increafe in lize, becomes hard, and a fmall circu- lar tumour is formed, rifing a little above the ikin. About the frx'h day the centre of the tumour fhows a difcoloured fpeck, owing to the formation of a fmall quantity of fluid ; and this continues to increafe, and the puftule or pimple to fill, till about the tenth day. After the eighth day, when the puftule is fully formed, the effects on the conftitution begin to Ihow themfelves; the general indifpofition being commonly preceded by pain at the puftule and in thearm-pit, followed by nead-ach, fome fhivering, lofs of appe- tite, pain in the limbs, ana a feverifh increafe of the pulfe. Thefe continue, with more or lefs violence, for one or two days, and always abate of their own accord, without leaving any unpleafant confequence behind them. During, or a little after, the general indifpofition, the puftule I in the arm, which had been advancing in a regular manner, becomes furrounded with a broad circular inflamed margin, and this is a fign that the body in general is afFe&ed. After this period, the fluid in the puftule gradually dries up, the furrounding rednefs be- comes fainter, and in a day or two vanifhes imperceptibly; whilft the puftule no longer increafes in extent, but on its furface a hard thick fcab of a brown colour is formed, which, if not pulled off, re- mains for nearly a fortnight} till at length it falls off, leaviDg the fkin beneath perfectly found and uninjured. It is a circumftance of great importance in favour of this method of inoculatioo, that though fome attention in choofing the matter for inoculation, and performing this flight operation in fuch a manner as to infure fuccefs, be requifite, very little medical treat- ment is neceffary in order to conduct the patient through it with perfect fafety. In moft cafes it is attended with fo little fever as fcarcely to be detected by an attentive obferver. To conclude this account of the cow-pox with a repetition of the circumstances which gives it a decided fuperiority over the fmall-pox, Dr. Woodville affirms (and his authority is unquestiona- ble) that of all the patients whom he inoculated with the variolous matter, after they had palled through the compos, amounting to upwards of four hundred, not one was,affectead wi'h the fmalkpox, though purpofely and repeatedly expofed to the infection ot fhe difeafe ; and what is not lefs extraordinary, nearly a fourth gart of' this number were fo flightly affected with the cow-pox-, that it neither produced any perceptible indifpofition, nor puftules. From the beginning ofthe world, the cow, has, in all coun- tries, been eiteemed a valuable animal. Befides cuhivating the ground which her fpecies performs, fhe fuppjjes us with an aliment (*3) i86 OF THE MEASLES. of her own preparing, the moft wholefome as well as nourifhing in nature; but never before was it known, except, as appears in |bme particular diftricts in England, that, even from a difeafe to which fhe is liable, fhe can likewife be further ufeful in preferring us from one ef the moft fatal calamities that ever iofefted human kind. 4. CHAP. XXVI. OF THE MEASLES. _J. HE meafles appeared in Europe about the fame time with ' the fmall-pox, and have a great affinity to that difeafe. They both came from the fame quarter of the world, are both infectious, and feldom attack the fame perfon more than once. The meafles are moft common in the fpring feafon, and generally difappear in fum- , mer. The difeafe itfelf, when properly managed, feldom proves fatal; but its confequences are often very troublefome. CAUSE.—Tiiis difeafe, like the fmall-pox, proceeds from in- fection, and is more or lefs dan erous according to the conftitution 4 of the patient, the feafon of the year, climate, &c J SYMPTOMS.—The meafles, like other fevers, are preceded ' cent dancer. In cafe the meafles fhould fuddenly difappear, it will be ne- ceffary to purfue the fame method which we have recommended when the fmall-pox recede. The patient muft be tupported with wine and cordials. Blistering plafters muft ?v applect to the legs and arms, and the body rubbed all over with warm t.anrMs.— Warm poultices may likewife be applied to the • eet and palms of thehands. . :,.,«,, When purple cr black fpots appear, the patient's drink fhould be fharpened with fpirits of vitriol; and if the putrid fymptoms in- create, the Peruvian bark muft be adminiftered in the fame manner as directed in the fmall-pox. Opiates are fometimes neceffary, but fhould never re given except in cafes of extreme reftleffnels, a violent loofenefs, or when the cough is very troublefome. For children, 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, the patient ought to be purged.* This may be conducted in the fame manner as directed in the fmaU- 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 h« ve that effect. , Patients recovering after the meafles fhould be careful whatv they eat or chirk. Their food for fome time ought to 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 beware of expofing themfelves too foon to the cold air, leaft a luflbcating cartarrb, an afthma* or a confumption of the lungs, fhould enfue. Should a cough, with difficulty of breathing, and other fyrop- toms of a confumption, remain after the meafles, fmall quantities of blood may be frequently let at proper intervals, as the patient's ftrength and conftitution will permit. He ought likewife to drink affes'-milk, to remove to a free air, if in a large town, and to ride, daily on horfeback. He muft keep clofe to a diet confifting of milk . and'vegetables; and laftiy, if thefe do not fucceed, let him remove to a warmer climate.* * Attempts have been made to communicate tbe meafles, as well as the fmall-pox, by inocis'ation, a:-d we make no doubt but in time the practice may lacceed. Dr. Home of Edinburgh, favs, he communicated the difeafe by the blood. Others have trirdthis method, and have not found it fuccred. Some think the difeafe would be more certainly communi- cated by rubbing the fkin ofthe patient who has the meafles with cotton, and afterwards ap- plying the cotton to a wound as in the fmall-pox ; while others recommend a bit of flann«! which had been applied to the patient's fkin, ail the time of the difeafe, to be ; ftetwards \M upon the arm or leg of the perfon to whom the infection i* to be communicated. There i« no doubt bur this difeafe, as well as the fmall-pox, may be communicated various ways ; the moft probable, howe-.er, is either from cotton rubbed upon the fkin, as mentioned abo»t» M by introducing a littl f the fharp humour which diflills from the eye* of the patient into the blood. It is agreed on all hands, that fuch patients as have been inoculated, had th? difeafe very mildly ; we therefore wUh the practice were more general, as the meafles b»« of late become very fatal. i8o OF THE SCARLET FEVER. THE fcarlet fever is fo tailed from the colour of the patient's {kin, which appears as if it were tinged with red wine. It happens at auy feafon of the year, but is moft common towards the end of fummer; at which time it often feizes whole families ; children and young perfpns are moft fubject to it. It begins like other fevers, with coldnefs and fhivering, with- out any violent ficknefs. Afterwards the fkin is covered with red fpots, which are broader, more florid, and lefs uniform than the meafles. They continue two or three days, and then difappear 5 after which the cuticle, or fcarf-fkin, falls oft". There is feldom any occafion for medxine in this difeafe. The patient ought however to keep within doors, to abftain from flrfh, ftrong liquors, and cordials, and to drink freely of cool and diluting liquors, if the fever runs high, the body muft be kept gently open by emollient clyfters, or fmall dofes of nitre and rhubarb. A fcru- ple of the former, with five grains ofthe latter, may be takeu thrice a day, or oftener, if neceflary. Children and young perfons are fome'imes feized at the begin- ning of this difeafe with a kind of ftupor and epileptic fits. In this cafe the feet and legs fliould be bathed in warm water, a large blif- tering-plafter applied to the neck, and a dofe of the fyrup of poppies given every night till the patient recovers.* The fcariet fever however is not always of fo mild a nature.--- It is fometimes attended with putrid or malignant fymptoms, in. which cafe it is always dangerous. In the malignant fcarlet tever the patient is not only affected with coldnefs and fhivering, but with languor, ficknefs, aad great oppreffion ; to thefe fucceed ex- ceffive heat, naufea, and vomitting, with a forenefs of the throat; the pulfe is extremely quick, but fmall and deprefied ; the breath- ing frequent and laborious; the fkin. hot, but not quite, dry ; the tongue moift, andcovered with a whitifh mucus ; the tonfils infla- med and ulcerated. When the eruption appears, it brings no re- lief: on the contrary, the fymptoms generally grow worie, and frefh ones comes on, as purging, delirium, Sec. ' When this difeife is miftaken for a fimple inflammation, and 1 treated with repeated bleedings, purging and cooling mediciues, it generally proves fatal. The only medicines that cau be depended on in this rale, are cordials and autifeptics, as the Peruvian bark, wine, (hake-i >ot, and the like. The treatment muft be in general fimilar to that of the putrid fever, or of the malignant ulcerous fore throat.r OF THE BILIOUS FEVER. WHEN a continual, remitting, or intermitting fever is ac- • companled with a frequent or copious evacuation of bile, either by vomit or ftool, the fever is denominated bilious. In Britain the, * Sydenham. „ , f la the year 1774, during winter, a very bad fpecies of this fever prevailed in^ r: jini^g^ It raged chierty amonj young people. The eruption was generally a«or tpln\0^ yftj, ^ quinley, and the inflammatory fymptoms were foblencV.d w'.t.i ot.iers cu a •^^j ^3';,.^- as to render the treatment of the difeafe very difficult. Many of the patir^f ^ jowa*^s t"j,e d * • cline of the fever, were afflict d with large f/-:!!:r iy kept open by clyfters or mild purgatives. But if the fever fhould remi; or intermit, bleeding will feldom be necef- lary. in t iis cafe a vomit may lie adminiftered, and if the body be b^und, a gentle purge; after which the Peruvian bark will gen- erally complete me cure. ■inc?feof a violent loofenefs, the patient muft be fupported with chicken broths, jellies of hartfhorn, and the like; and he may uf- the white decoilion for his ordinary drink.* If a bloody flux fhould accomp oy this f ver, it muft be treated in the manner re- commended under the article of Dyfentery. When there is a burning heat, and the patient does not fweat, ^ that evacuation may be promoted by giving him, three or four times a-day, a tablefpoonful of Mindererus' fpirit,t mixed in a cup of his ordinary drink; If the bilious fever be attended with the nervous, malignant, j or putrid fymptoms, which i? fometjmes the cafe, the pauent muft be treated in the fame manner as directed under thefe difeafes.* , After this fever, proper care is neceffary to prevent a relapfe. Forlhis purpofe the patient, efpecially towards the end of autumn, ought to continue the ufe of the Peruvian bark for fome time after he is well.. He fhould likewife abftain from all trafhy fiuits, new liquors, and every kind of flatulent aliment. CHAP. XXVII. OF THE ERYSIPELAS, OR Sr. ANTHONrs FIRE* *;j JL HIS difeafe which in fome parts of Britain is called the * rofe, attacks perfon? at any period of life, but is moft common be- tween the age of thirty and forty. Perfons of a fanguine or ple- thoric habit are moft liable to it. It often attacks young perple,' i and pregnant women ; and iuch as have once been afflicted with i' it are very liable to have it again. Sometimes it is a primary cil- eafe, and at ether times only a fymptom cf fome other malady. Lvery part ofthe b.dv is liable to be attacked by an er^fipelas, - but it moft frequently feiz-o the '.errs or face, efpecially the lslfr. * It is moft cowmen in autumn, cr when hct weather is fucceedeO by cnia an. • we!. ", ^ CAUSIl:).—The erysipelas may ce occafioned by violent 'pat- * See Aprrr.nix, Wb.te ./,.<-,-?/. n. ' * + Ss; Ay-tiiit. $*i-:: :j?,?• -'.-cm:, OR St. ANTHONYS FIRE. 191 ilotts or affections of the mind; as fear, anger, Sec. When the body has been heated to a great degree, and is immediately expo- led to the cold air, fo that the perfpiration is fuddenly checked, an eryfipelas will often enfue.* It may alfo be occafioned by drinking to excefs, by continuing too long in a warm bath, or by any thing that overheats the blood. If any of the natural evacuations be ob- itructedj er in too fmall quantity, it may caufe an eryfipebs. The fame eflect will follow from the ftoppage of artificial evacuations; as iflues, fetons, or the like. SYMPTOMS.—The eryfipelas attacks with fhivering, thirft, lofs of ftrength, pain in the head and back, heat, reftleflhet's, and a quick pulfe ; to which may be added vomittingj and' fometimes a delirium. On the fecond, third or fourth day, the part fwell?, be- comes red, and fmall puftules appear; at which time the fever gen- erally abates. When the erysipelas feizes the foot, the parts contiguous fwell-, the ikin fhines j and, if the 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 finall 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 and noftrils be very dry, and the pa- tient drowfy, there is reafon to fufpect an inflammation ofthe brain. If the eryfipelas affects the breaft, it fwells and becomes exceed- 1 ingly hard, with great pain, and is apt to fuppurate. There is a ...violent pain in the arm-pit, on the fide affected, where an abfcefs is often formed. If in a day or two the fwelling fubfides, the heat and pain abate,, the colour of the part turns yellow, and the cuticle breaks and falls off in fcales, the danger is over. When the eryfipelas is large, deep, and affects a very fenfible part of the body, the danger is great. If the red color changes in- to a livid or black, it will end in a mortification. Sometimes the in- flammation cannot be difcuffed, but comes to a fuppuration ; in which cafe fiftulas, a gangrene, or mortification, often enfue. Such as die of this difeafe are commor iy carried off by the fe- A ver, which is attended with difficulty of breathing, and fometimes with a delirium and great drowfinefs. They generally die about the feventh or eighth day. REGIMEN.—In the eryfipelas the patient muft neither be kept too hot nor cold, as either of thefe extremes will tend to make' it retreat, which is alvvavs to be guarded againft. When the dif- eafe is mild, it will be fufficient to keep the patent within doors, without confining him to his bed, and to promote the perfpiration by diluting liquors, &c. The diet ought to be flender, and of a moderately cooling and * The country people iacnany parts cf Britain call this difrafe a B'.afl, and imagine it proceeds from foul air, ox ill wind, as they lerm it. The truth is they often lie dew i to re.'c when warm and fatigued,*, vpon the damp-ground, where ihey fall - alieep, and lie fo Jong as to catch cold, whirh occafions the eryfipelas. This difrafe may indeed proceed from other caufes, but we may venture to fay, that nine t:mf ? cut tf \in :; :« cccai"i°ned by.col '■ caught tfter tbe acdy ha; \nn ^rearly r<-attdor rV;;ued. r9t OF THE ERYSIPELAS, ^—■- ■ ' ft- CHAP. XXVIII. OF THE PHRENITIS, OR INBLAMMATION OF THE BRAIN X HIS is fometimes a primary difeafe, but oftener only a fymptom of fome other malady; as the inflammatory, eruptive, or f potted fever, &c. It is very common, however, as a primary difeafe in warm climates, and is moft incident to perfons about the prime or vigour of life. The paffionate, the ftudious, and thofe whofe nervous fyftem is irritable in a high degree, are moft liable to it. CAUSES.—This difeafe is often occafioned by night watch- ing, efpecially when joined with hard jftudy, it may likewife pro- ceed from harddrinking,anger,grief,oranxiety. It is often occafioned by the ftoppage of ufual evacuations ; as the bleeding piles in men, the cuftomary difcharges of women, &c. Such as imprudent!y • Sec Append;:, DtfttTw o/}fro$ds. ;94 OF THE PHRENITIS, OR expofe themfelves to the heat ofthe fun, efpecially by fleeping with. out doors, in a hot feafon, with their heads uncovered, are often fuddenly feized with an inflammation of the brain, fo as to awake quite delirious. When repellents are imprudently ufed in an eryli- pdas, an inflammation ofthe brain is fometimes the confequence.— It may likewife be occafioned by external injuries, as blows or bruifes upon the head, &c. SYMPTOMS*—-The fymptoms which ufually precede a true \ inflammation ofthe brain, are pain of the head, rednefs of the eyes, a violent flufhing ofthe face, difturbed 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 ex. treme fenlibility of the nervous fyftem. When the inflammation is formed, the fymptoms in general;( are fimilar to thofe of the inflammatory fever. The pulfe indeed is often weak, irregular, and trembling; but fom times it is hard and. ., contracted. When the brain itfelf is inflamed, tha pulfe is always foft and low; but when the inflammation only affects the' integn. | ments of the brain, viz. the dura and pia matter, it is hard. A re. " markable quicknefs of hearing is a common fymptom of this difeafe, but that feldom continues long. Another ufual fymptom is a greafc- throbbing or pulfation in the arteries of the neck and temples.-^ % Though the tongue is often black and dry, yet the patient feldoni J| complains of thirft, and even refufes drink. The mind chiefly runs t upon fuch objects as have before made a deep impreffion on it; and j fometimes from a fuilen fiience,the patient becomes all of a fudden quite outrageous. A conftant trembling and ftarting of the tendons is an unfa. vourable fymptom, as are alfo a fuppreflion of urine ; a total want of fleep ; a conftant fpitting ; a grinding of the teeth ; which laft maybe confidered as a kind of convulfion. When a phrenitis fuc- ceeds an inflammation of the lungs, of the inteftines, or of the throat, &c. it is owing to a tranflation of the difeafe from thefe •; parts to the brain, and generally proves fatal. This fhews the ne- ceflity of proper evacuations, and the danger of repellents in all in- flammatory difeafes. The favourable fymptoms are, a free perfpiration, a crpious difcharge of blood from the nofe, the bleeding piles, a plentiful dif- .f charge of urine, which lets fall a copious fediment, -Sometimes - the difeafe is carried off by a loofenefs, and in women by an ex- ceffive flow of the menfes. As this difeafe often proves fatal in a few days, it requires.1? the moft fpeedy applications. When it is prolonged, or improper- * Iy treated, it fometimes ends in madnefs, or a kind of ftupidity • which continues for life. - In the cure, tv/o thiugs are chiefly to be attended to, viz. toV leflen the quantity of blood in the brain, and to retard the circulation towards the head. REGIMEN.—The patient ought to be kept very quiet.— Company, noife, and every thing that affects the ienfes,or diftnrbs the imagination, increafes the difeafe. Kven too much lights hurt- INFLAMMATION OF THE BRAIN. , 195 ful; for which reafon the patient's chamber ought to be a little darkened, aud he fhould neither be kept too hot nor cold. It is not however neceffary to exclude the company of an agreeeable friend, as this has a tendency to footh and quiet the mind. Neith- er ought the patient to be kept too much in the dark, left it fhculd occafion a gloomy melancholy, which is too often the confequence of this difeafe. The patient muft, as far as poffible, be foothed and humoured in every thing. Contradiction will ruffle his mind, and increafe his malady. Even when he calls for things which are not to be obtain- ed or which might prove hurtful, he is not to be pofitiveiy denied them, but rather put off with the promife of haying them as fooa as they.can be obtained, or by fome other excufe. A little of any thing that the mind is fet upon, though not quite proper, will hurt the patient lefs than a pofitiverefufal. In a word, whatever he was food of, or ufed to be defighted with, when in health, may here be nied ; as pleafing ftcries, foft muftc, or whatever has a ten- dency to footh tie paflions and compofe the mind. Boerhaave propofi'S feveral mechanical experiments for this purpofe ; as the loft no;fe of water distilling by drops into •* bafon, and the patient trying to reckon them,-&c. Any uniform found, if low and con- tinued, has a tendency to procure fleep, and confequently may be of fervice. The aliment ought to be light, confifting chiefly of farinaceous fubftances; as panado, and water.gruel, .fharpened with jelly of curr.nts, pr juice ot" lemons, ripe fruits roafted or boiled, jellies, preff rves.'&c. The drink fmall, diluting, and cooling; as whey, b.irley-w.'.ter, or decoctions of barley and tamarinds, which latter not only render the liquor more palatable, but likewife more bene- ficial as they are of an openi :g na'ure. MEDICiNJL—In an intUmmation of the brain, nothing more certainly relieves the patient than a free difcharge 6f bldod from the nofe. Wnen this comes of its own accord, it is by no means to be /stepped but rather promoted, by applying cloths dipped in warm \watertoihep?.rt. When bleeding at the nofe does not happen fpontaneoufly, it may be provoked, by putting a ftraw or any other fharp body up the nostril. ' Bleeding in the temporal arteries greatly relieves the head: but as this operation cannot always be performed, we would recom- mend in its ftead, bleeding in the jugular veins. When the patient's " pulfe and fpirits are fole w that he cannot be:r bbeding 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 affected, generally give more immediate relief. _ * A difcharge cf Mood from the hncmorhcidal veins is likewife w of great fervice, and ought by ail means to be promoted. If the " patient has been fubject to the bleeding piles, and that difcharge *shns been ftepped, every method rr.uft be tried to reftcre it; as the application of leeches to the parts, fitting over the {teams of warm water, fharp clyfter?, cr fuppofitories made cf heney. aloef, and r:ck-Jalt. tgfi OF THE OPHTHALMIA, OR If the inflammation of the brain be occafioned by the ftoppage of evacuations either natural or artificial, as the menfes, iflues; fetons, or fuch like, all means muft be ufed to restore them as foon as poffible, or to fubftifute others in their ftead. The patient's body muft be kept open by ftimulating clyfters or fmart purges j and fmall quantities of nitre ought frequently to be mixed with his drink. Two or three drachms, or more, if the cafe be dangerous, may bs ufed in the fpace of twenty-four hours. The head fhould be fhaved and frequently rubbed with vine- gar and rofe-water. Cloths dipped in this mixture may likewife be applied to the temples. The feet = ught frequently to be bathed in lukewarm water, and foft poultices or bread and milk may be kept conftantly applied to them. If the difeafe proves obftinate, and does rot yield to thefe medicines, it will be neceffary to apply a bliftering-piafter to the whole head. CHAP. XXiX. OF THE OPHTHALMIA, OR INFLAMMATION OF THE EYES. JL HIS difeafe may be occafioned by external injuries j as blows,purns,bruifes, and thelike. It may likewife proceed from doit, quick-lime, or other fubftances, getting into the eyes. It is often caufed by the ftoppage of cuftomary evacuations ; as the healing of old fores, drying up of iflues, the fupprefling of gentle morning iweats, or of die fweating of the feet, &c. Long expofure to the night air, efpecially in cold northerly winds, or whatever fuddenly checks the perfpiration, efpecially after the body has been much heated, is very apt to caufe an inflammation of the eyes. Viewing fnow or ether white bodies for a long time, or looking ftedfaftly at' the fun, a clear fire, or any bright object, wiil likewife occafion this malady. A fudden transition from darknefs to very bright light will often have the fame effect. Nothing more certainly occafions an ''rflammation ofthe eyes than night-watching, efpecially reading or writing by candle-light- Drinking fpirituous liquors, and excefs of venery are likewile very hurtful lb the eyes. The acrid fumes of metals, and of feveral kinds ot fuel, are alfo pernicious. 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 eyelids turning inward and hurting the eyes. Sometimes the difeafe is epl- \ demic, efpecially after wet feafons; and I have frequently known it prove in.ectious, particularly to tnofe who lived in the fame houfe t with the patient. It may be occafioned by moift air, or living in low damp houfes, efpecially in perfons who are not accuftomed to fuch fituations. In children it often proceeds from imprudent- iy drying up of tcabbed heads, a running behind the ears, or any other difcharge of that kind. Inflammations of the eyes often fuc- ^d the fmall-pox or meafles, efpecially ia children of a fcropha- »0us habit.' INFLAMMATION OF THE EYES. 197 SYMPTOMS.—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 it his eyes were pierced with a thorn. Sometimes he imagines hiseyes are full of motes, or thinks he fees flies dancing before him. The eyes are filled with a fcalding rheum, which nifties forth in great quantities, whenever the patient attemps to look up. The pulfe is generally quick and hard, with fome degree of fever. When the difeafe is violent, the neighboring parts fwell, and there is a throb- bing or pulfation in the temporal arteries, &c A flight inflammation ofthe eyes, efpecially from an external caufe, is eafily cured; but when the difeafe is violent, and contin- ues long, it often leaves fpecks upon the eyes, or dimnefs of fight, and fometimes total blindnefs. If the patient be feized with a loofenefs, it has a gofcd effect - and when the inflammation pafles from one eye to another as it were by infection, it is no unfavorable fymptom. But when the difeafe is accompanied with a violent pain of the head, and contin- ues long, the patient is in danger of lofing his fight. REGIMEN.—The diet, unlefs in fcrophulous cafes, can hard- ly be too fpare, efpecially at the beginning. The patient muft al> ftaia from every thing or a heating nature. His food fhould con- fift chiefly of mild vegetables, weak broths, and gruels. His drink. may be barley-water, balm-tea, common whey, and fuch like. The patient's chamber muft be darkened, or his eyes fhaded by a 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 object 5 and ought to avoid all finoke, as thefumes of tobacco, or any thing that may caufe coughing, fneezing, or vomiting. He fhould be kept quiet, avoiding all violent efforts, either of body or mind, and encouraging fleep as much as poffible. MEDICINE.--This is one of thofe difeafes wherein great hurt is often done by external applications. Almoft every perfon pretends to bepoflefled of a.remedy for the cure of lore eyes. Thefe remedies generally confift of eye-waters and ointments, with other external applications, which do mifchief twenty times for once they do good. People ought therefore to be very cautious how they ufe fuch things, as even the preflure upon the eyes often increafes the malady. Bleeding in a violent inflammation of the eyes, is always ne- ceflary. This fhould be performed as near the part affected as pof- fible. An adult may loofe ten or twelve ounces of blood from the ^ • jugular vein, and the operation may be repeated according to the urgency of the fymptoms. If it fhould not be convenient to bleed in the neck, the tame quantity may be let from the arm, or any oth- er part of the body. Leeches are often applied to the temples, cr under the eyes, with good effect. The wounds muft be fuffered to bleed for fome hours, and if the bleeding flop foon, it may be promoted by the ap- plication of cloths dipt in warm water. In obftinate cuCes, it will be aeceffary to repeat this operation feveral times. rp8 , OF THE OPHTHALMIA, 6c. Opening and diluting medicines ar^by no means *o be neglec- ted: The patient may take a fmall dofe of Glauber's fairs, and cream of tartar, every fecond or thirl day, or a deccct'on of tama. rinds with fenna. If thefe Se not agreeable, gently 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, whey, or any other weak diluting liquor. He ought likewife to take at bed-lime, a large draught of very weak wine-whey, in order to promote peripiration. His feet and legs muft frequently be bar ed ir luke- warm water, and his head fhaved twice or thrice a-week, and aftf r. ' wards wafhed in cold water. This has Often a remarkable good effect. If the inflammation does not yield to thefe evacuations, bh'^r- ing piasters muft be applied to the temples, behind the ears, or up.« on the neck, and kept open for fome time by the mild blifterirg-oint- ^ ment. I have feldom known thefe, if long enough kept open, fail Co remove the moft obstinate inflammation of the eyes; but for this i puppofe it is often neceflary to continue the difcharge for feveral weeks. When the difeafe has been of long Handing', I have feen very extraordinary effects from a feton in the neck, cr between the fhoukjl ders, efpecially the latter. It fhould be put upwards and down- \ wards, or in the direction of the fpine, and in the middle between H the fhoulder-blades. It may be drefled twice a day with yellow bafilicon. I have known patients, who had been blind for a con- jj fiderable time, recover fight by means of a feton placed as above. ■ When the feton is put acrofs tne neck, it foon wears out, and is both, J more painful and troublefome than between the fhoulders; befides, J it leaves a difagreeable mark; and does not difcharge fo freely. JQ When the heat and pain ofthe eyes are very great, a poultice 4 of bread and milk, foftened with fweet oil or frefh butter, may be !! applied to them, at leaft all night; and they lAiy be bathed with luke warm milk and water in the morning. If the patient cannot fleep, which is four-times the cafe, he may \ take twenty or thirty drops of laudanum, or two fpoonsful of the 1 fyrup of poppies, over night, mere or lefs according to his age, or the violence of the fymp orrs. * After the inflammation is gone off, if the eyes ftill remain weak ' and tender, they may be bathed every night and morning with coldt water and a little brandy, fix parts of the former to one of the latter. A method fh.uld be contrived Vy which the eye can be quite immerfed in the brandy and water, where it fhould be kept for fome time. I have generally found this, or cold water and vinegar, as good a ftrengthener of the eyes as any of the moft celebrated col* J lyriums. j , When an mflammation ofthe eyes proceeds from a fcrophuVj ous habit, it generally proves very obftinate. In this cafe the pa- tient's diet muft not be too low, and he may be allowed to drink Irnall negus, or now and then a glafs ot wine. The moft proper rneiicioe is the Peruvian bark, which may either be given in fub- ftance, or prepared in the following manner. OF THE QUINSEY. fo? Take an ounce of the bark in powder, with two drachms of Winter's bark, and boil them in an Knglifh quart of water to a pint; when it has boiled nearly long enough, add half an ounce of liquor- ice-root fliced. Let the liquor be ftrained. Two, three, or four table-fpoonsful, according to the age of the patient, may be taken three or four times a-day. It is impoflible to fay how long this med- icine fhould be continued, as the cure is fooner performed in fome than in others; but in general it requires a confiderable time to pro- duce any lasting effects. . Dr. Cheyne fays, " That JEthiop's mineral never fails in obfti- nate inflammations of the eyes, even fcrophulous ones, if given in a fufficient dofe, and duly perfifted in." There is no doubt but this and other preparations of mercury may be of fingular fervice in ophthalmias of long continuance, but they ought always to be adminiftered with the greateft caution,orby perfons of fkill in phyfic- It will be proper frequently to look into the eyes, to fee if any hairs be turned inwards, or preffing upon them.* Thefe ought to be removed by plucking them out with a pair of final' pincers. Thofe who are liable to frequent returns of this difeafe, ought conftantly to have an iffue in one or both arms. Bleeding or purg- ing in the fpring and autumn, will be very beneficial to fuch per- fons. They ought likewife to live with the greateft regularity, avoiding ftrong liquors, and every thing of a heating quality. Above all, let them avoid the night-air, and late ftudies.f CHAP. XXX. OF THE milNSEY, OR INFLAMMATION OF THE THROAT. X HIS difeafe is very common in Britain, and is frequently attended with great danger. It prevails in the winter and fpring, and is moft fatal to young people of a fanguine temperament. CAUSES.—In general it proceeds from the fame caules as ^ther inflammatory diforders, viz.au obftructed perfpiration, or whatever heats or inflames the blood. An mfiammation ot the throat is often occafioned by omitting fome part of the covering ufually worn about the neck, bv drinking cold « quor 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 likewife proceed from the negled of bleeding, purging, or a'-.y cuftomary evacuation. . Singing, f peaking loud and long, or whatever strains the tiroat, may likewife caufe an inflammation of that organ. I have often known the quinfey prove fatal to jovial companions, who atter fit- ting long in a warm room, drinking warm liquors, and unging with • Any foreign body lodged in the eye may be erpedu.oufly removed oy paffing > fmall hair prnetfbetween the eye-lid, and the ball of the ey^. In lome place, the pwfaats do thii very eiFe&oally, by ufinz their tongue in the fame manner. , ii{..c. Tt A. moft people are fond of ufing eve-w.ters and ontmenh ,n thj» and other dife.fa of the eye"™ have inferted fome of the moft approved terms of theft Aedrt.no m ere Ac.. p-ndtt. S^eAppcndij, Eye-wats* and Evx-fAfcrx. aoo OF THE QUINSEY, OR vehemence, were fo imprudent as to go abroad in the cold night air. Sittine; with wet feet, or keeping on wet clothes, are very apt to occafion this malady. It is likewife frequently occafioned by continuing long in a moift place, fitting near an open window, fleeping in a damp bed, fitting in a room that has been newly plaf- tered, &c. I know people who never fail to have a fore throat, if they fit even but a fhort time in a room that has been lately wafhed. Acrid or irritating food may likewife inflame the throat, and Occafion a quinfey. It may alfo proceed from bones, p'ms, or oth- er fharp fubftances sticking in the throat, or from thecnuftic fumes of metals or minerals, as arfenic, antimony, Sec. taken in by the breath. This difeafe is fometimes epidemic and infectious. SYMPTOMS.—The inflammation of the throat is evident from infpection, the parts appearing red and fwelled; befides, the patient complains of pain in fwallowing. His pulfe is quick and hard, with other fymptoms of a fever. If blood be let, it is gen- erally covered with a tough coat of a whitilh color, and the patient Ijpits a tough phlegm. As the fwelling and inflammation increafe, the breathing and fwallowing become more difficult: the pain af. fects the ears; the eyes generally appear red; and the face fwelli, \ The patient is often obliged to keep himfelf in an erect pofture, being in danger of iuffocation; there is a conftant n-'ufea, or in- clination to vomit, and the drink, inftead of paffing r to the fto- mach, is often returned by the nofe. The patient is fometimesl ftarved at laft, merely from an inability to fwallow any kind of food, i When the breathing is laborious, with ftraitnefs of the breaft, { and anxiety, the danger is great. Though the pain in fwallowing be very-great, yet while the patient breathes eafy, there is not fo much danger. An external fwelling is no unfavorable fymptom; but if it fuddenly falls, and the difeafe affects the breaft, the dan- ger is very great. When a quinfey is the confequence of forpe 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 fa- tal fymptoms. REGIMEN.—The regimen in this difeafe is m all refpects the fame as in the pleurify, or peripneumony. The food muft be light, and in fmall quantityy and the drink plentiful, weak, and diluting, mixed with acids. It is highly neceffary that the patient be kept eafy and quiet. Violent affections 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 patient is in bed, his head ought to be ( raifed a little higher than ufual. It is peculiarly neceffary that the neck be kept warm; for which purpok feveral folds of foft flannel may be wrapt round it. That alone will often remove a flight complaint of the throat, ef- peeially if applied in due time. We cannot here omit obferving the propriety of a cuftom which preva;ls among the peafants of Scoiland : When they feel any uneafinefs of the throat, they wrap INFLAMMATION OF THE THROAT. tot a ftocking about it all nig>.t. So effectual is this remedv, chat Jn many places it pafles for a charm, and the ftocking is applied whh particular ceremo ies; the cuftom however, is undoubtedly a gcod one, and fhonld never be neglected. When'he throat has been thus wrapped up all night, it reuft not be expofed to the cold air through the d y, but a handkerchief cr apiece of flannel kept about it till the inflammation be removed. The jelly of black currants is a medicine very much in efteem for complaints of the throat; and indeed it is of fome ufe. It fhould be almoft conftanly kepr in thc m^uth, and fwallowed down leifurely. It may likewife be mixed in the patient's drink, or tak^n any other way. When it cannot be obtained, the jelly of red currants, or of mulberries, may be ufed in its ftend. Gargles for the throat are v ry benefrial. They may be made of iage-tea, with a little vinegar and honey, or by adding to half a pint of the pectoral decoction, two or three fpoonsful 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 rendered more fharp and clcan- fing, by adding to it a tea-fpoonful of the fpirit of fal ammoniac.— Some recommend gargles made of a decoction of the leaves or bark of the black currant-bufh ; but where the jelly can be had thefe are unneceffary. There is no difeafe wherein the benefit of bathing the feet and legs in lukewarm water is more apparent; that p-actlce ought therefore never to be neglected. If people were careful to keep warm, to wrap up their t roars with flannel, to bathe their feet and legs in warm water, and OF COLDS AND COUGHS. 207 ftructed nerfoiration, might be prevented. But, after the difeafe h.is gathered ft^g'h by delay, all attempts to remove it, often prove vain. ,A p'eur fv, a peripni umony, or a fatal confumption of he lu-gs, are the common efftcts of colds which have either been t rally nrgl ctel or treated improperly. Mmy at;ernpt to cure a cold, by getting drunk. But this, to fay no worfe of it, is a very hazardous experiment. No doubt it nvy fomeiiin-s fu.c-ed, by fuddenly reftoring the perfpiration ; but when thee is any degree of inflammation, which is frequently. the - cafe, ftrong liquors, inftead of removing the malady, will increafe it. By f is means a conanoii cold may oe converted into an in- flammatory fever. vVhei thofe who labour for the'r daily bread have the mif- fortune to catch cold, they cannot afford to loofe a day or two, in order to ke:p themfelves warm, and take a little medicine; by which means the diforder is often fo aggravated as to confine them for a long urne, or even to render them ever after unable to fuftain hard labour. But even fuch of the labouring poor as can afford to take care of themfelves, are oft: n too hardy to do it; they affect to defpife colds, and as long as they can crawl about, fcorn to be confined by what they call a common cold. Hence it is, that colds deftroy fuch numbers of mankind. Like any enemy defpifed, they gather ftrength from dehy, till at length they become invin- cible.' We often fee this verified in travellers-, who, rather than loofe a day in the profecution of their bufinefs, throw away their lives by purfuing their journey, even in the fevqreft weather, with this difeafe up n them. It is certain however, that col rs may be too much indulged— When a perfon, for every flight cold, (huts himfelf up in a warm room, and drinks great quantities of warm liquor, it may occafion fuch a general relaxation of the folids as will not be eafily removed. It will thrrefore 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 carriage, &c.— An obftinate cold wlrch no medicine can remove, will yield to gentle exercife and a proper regimen of the diet. B '.thing the feet and legs in warm water has a great tendency to reftore the perfpiration. But care muft be taken that the water be not too warm, other wife it will do hurt. It fhould never be much warmer than the blood, and the patient fhould go immediate- ly to bed after ufing it. Bathing the feet in warm water, lying in bed, and drinking w:-irm water-gruel, or other weak liquors, will fooner take ffa fpafm, and reftore the perfpiration, than ail the hot fodorific medicines in the world. This is all that is neceffary for removing a common cold ; and if this courfe be taken at the beginning, it will feldom fail But when the fymptoms do not yield to abstinence, warmth, and diluting liquors, there is reafon to fear the approach of fome other difeafe, as an i flammation of the breaft, an ardent fever* or the like. If the pulfe therefore be hard and frequent, the fkin hot and dry. and the pitient complains of his head or breaft, it will be 2*8 OF A COMMON COUGH. neceflary to bleed, and to give the cooling powders recommended in the leader le/er every three or four hours, till they give a ftool. It w 11 likewife be proper to put a bliitering-plafter on the back, and give two table-fpoonsful of the faline mixture every two hours, and in fhort to treat the patient in all refpects, as for a flight fever. 1 have often feen this courfe, when obferved at the begin- ning, remove the complaints in two or three days, when the pa'ient had all the fymptoms of an approaching ardent fever, or an inflammation of the breaft The chief fecret of preventing colds lies in avoiding, as far as poffible, all extremes either of heat or c Id, and in taking cares when the body is heated, to let it cool gradually. Thefe and other circumstances rehting to this impor ant fueject, arefo fully treated of under the article Objlrutled Perfpiration, that it is needlefs here to relume the confideration of t em. OF A COMMON COUGH. A COUGH is generally the effect of a cold, wh;ch has either been improperly treated, or entuvly negl cted. When it proves ob. ftinate,toere isaiways reafon to fear ti e ~o .fequences, as this fhews•■ a weak ftate of the lungs, and is often the forerunner of a con« fumption. If the cough be vi tat, and the patient young and ftrong. with a hard quick pulfe, bleeding will be pr per ; but in weak and relaxed habits, bleeding rather prolongs the difeafe. When the patient fpits freely, bleeding is unneceffary, and fometimes hurtful, as it tends t.. leffen that difenarge. When the cough is rot attended with any degree of fever, and the fpittlu is vifcid and toug^, fharp pectoral medicines are to be adminiftered, ?s gum ammoniac, fquills, &c. Two table-fpoon- fuls of the folution of gum ammoniac may be 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 fimple cinnamon water, to which may be added an ounce of common water and an ounce of balfamic fyrup. Two table-ipQonsful of this mixture may be taken three or four times a-day. ' A fyrup made of equal p?rts 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 pleafure. But when the defluxion is fharp and thin, thefe medicines rather do hurt, in this cafe gentle opiates, oils, and mucilages v are more proper, A cup of an infufion of wild poppy leaves, and ' marfh-mallow roots or the flowers of colts-foot, may be taken fre- quently ; or a tea-fpoonful of the prregoric elixir may be put into the patient's drink twice a-day. Fuller's Spanifh infufion is alfo a very proper medicine in this cafe, and may be taken in the quan« thy of a tea-cupful three or four times arday.* When a cough is occafioned by acrid humours tickling the • S«c Appendix, Sfanijb l"fufion. OF A COMMON COUGH. 209 throat 2&c\ fauces, the patient fhould keep fome foft pectoral lozen- ges, almoft conftantly in his mouth ; as the Pontrefact liquorice cakes, barley-fugar, the common balfamic lozenges, Spanifh juice, &c. Thefe blunt the acrimony of the humours, and by taking off their ftimulating quality, help toappeafe the cough.f In obftinate coughs, proceeding from a flux of humours upon the lungs, it will often be neceffary, befides expectorating medi- cines, to have recourfe to iflues, fetons, or fome ot er drain. In this cafe I have often obferved the moft happy effects from a Bur- gundy-pitch plafter applied between the fhoulders. I have order- ed this fimple remedy in the moft obftinate coughs, in a great num- ber of cafes, and in many different conftitutions, without ever knowing it fail to give relief, 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 fhoulder-blades. It maybe taken off and wiped every three or four days, and ought to be renewed once a fortnight or three weeks. This is indeed a cheap and fimple medicine, and. confequently apt to be defpfed ; but we will venture to affirm, that the whole materia medka does not afford an application more efficacious in almoft every kind of cough. It 1m not indeed always an immediate effect; but, if kept on for fome time, it will Succeed where moft other medicines fail. The only inconveniency attending this plafter is the itching which it occafions ; but furely this may be difpenfed with confid- ering the advantage which the patient may expect to reap from the application; befides, when the i ching becomes very uneafy, the plafter may be taken off, and the part rubbedvwith a dry cloth, or wafhed with a littie warm milk and water. Some caution indeed is neceffary in difcontinuing theufe of fuch a plafter ; this however may be fafely done by making i' fmaller by degrees, and at length quitting it ^together in a warm feafon.t But coughs proceed from many other caufes befides defluxions upon ti.e lungs. In thefe cafes the cure is not to be attempted by pectoral medicines. Thus, in a c%h proceeding from a foulnefs and debility of the ftomach, fyrups, oils, mucilages and all kinds of balfamic medicines do hurt. The Jlomach cough may be known from one that is owing to a fault in the lungs by this, that in the latter the patient coughs whenever he infpires, or draws in his breath fully ; but in Ve former that does not happen. 'fhe cure of this cough depends chiefly upon cleanfing and ftrengthening the ftomach ; for which purpofe gentle vomits and f In a former eJltion of this book I recommended, for an obiY.nat- tickling cough, an oily e:nulfion, msdc with the paregoric elixir ofthe Edinburgh Ditpenfatory, inftead of the common ilka!tic ipirit. 1 have Since been told by fe eral practitioners, that ihey round it to be an excellent medicine in this di(ord.*r. and every way defer ving of the charafter which I had given it. Whee this rl'xir 's noi k/pe, ts p'ace may be fupplied by ad.ung to the com- mon oily e nulfion, an a.. Q'jate proportion ofthe Thebaic tinffure, or liquid laudanum. | Somecomolain chat the piuh-plafrer adheres too raft, while others find difficulty in keeping icon, rhis o.oceeds fiom the different kmd3 of pitch made ufe of, and likewife from the manner ufmakine't. . prn'rallv find it anfwers beft when mixed with a little btes-wax, and Spread as tool as police, The clear, hard, transparent pitch anfwers the- Fttrpolt beft. 210 OF THE HOOPING COUGH, bitter purgatives are moft proper. Thus, afi -r a vomit or two, the iacred tincture, as it is cilied, may be taken for a confiderable time in the ctafe of one or two' aole-fpocnsfui twice a-day, or as often as it is found neceffary, to krep the body gently open. People may make this tincture the-niMves, by infufing an ounce of Imra. picra* in an Englifh pint of white wine, letiing it ftand a few days,„ and then straining it. In coughs which proceed from a debility of the ftomach, the Peruvian bark is likewife of confiderable fervice. It may either be chewed, taken in powder, or made into a tincture along with other itomachic bitters. A nervous cough can only be removed by change of air and proper exercife ; to which may be added the ufe of gentle opiates. Inftead of the fap-naceous pll, the paregoric elixir, Sec. which are only opium difguifed, ten, fifteen, twenty, or twenty-five drops of* liquid laudanum, more or lefs, as circumstances require, may be taken at bed-time, or when the cough is moft troublefome. Im- merfing the feet and hands in warm water will often appeafe the violence of a nervous cough. When a cough is only the fymptom of fome other 'malady* it is in vain to attempt to remove it without firft curing the difeafe from which it proceeds. Thus when a cough is occafioned by teething, keeping the body open, fcarifying the gums, cr whatever facilitates the cu ting of the teeth, likewife appeafes the cough. Jn like manner, when worms occafion a cough, fuch medicines as re-* ^ move thefe vermin will generally cure the cough ; as bitter purga- tives, oiiy clyfters, and fuch like. Women, during the laft months of pregnancy, are often great- • ly afflicted with a cough, which is generally relieved by bleeding', and keeping the body gently open. They ought to avoid all flatu- lent food, and to wear a loofe eafy drefs, A cough is not only a fymptom, but is often likewife the fore- runner of difeafes. Thus, the gout is frequently ufhered in by a very tmublefome cough, which affects the patient for tome days before the coming on of the fit. This cough is generally removed by a pafoxyfmof the gout, which fhould therefore be promoted, by keeping the extremities warm, drinking warm liquors, and bath- ing the feet and legs frequently in luke-warm water. OF THE HOOPING-COUGH, OR CHIN COUGH. THIS cough feldom affects adults, but proves often fatal to children. Such children as live upon thin watery diet, who breathe unwholefome air, and have too little exercife, are moft liable to this difeafe, and generally fuffer moft from it. The chin-cough is fo well known, evsn to nurfes, that a de- fcriptionof it is unneceffary. Whatever hurts the digeftion, ob- structs the perfpiration, or relaxes the folids, difpofes to this difeafe; confequently its cure muft depend upon cleanfing and ftrengthening vhe ftomach, bracing the folids, and at the fame time promoting perfpiration, and the different fecretions. * See Appendix, Ultra Pkra. OR CHIN-COUGH. an The diet muft beligot and of eafy digeftion; for children, good bread made into pap or pudding, chicken-broth, with other light fpoon-meats, are prt?per ; but thofe who are farther advanced, may "be allowed fago-gruel, and if the fever be not high, a linle boiled chicken, or other white meats. The drink may be hyffop, it penny- royal tea, fweetened with honey or fugar-candy, fmall wine-w.ey : or if the patient be weak, he may fometimes be allowed a little negus. One of the moft effectual remedies in the chin-cough is change of air. This often removes the malady, even wh -n ihe change feems to be from a purer to a lefs wholefome air. This may in fome meafure depend on the patient's being -tmoyed from the place where the infection prevails. Moft ofthe difeafes of children are infectious; nor is it at all uncommon to fmd ihe chin-cough prevailing in one town or village, when another, at a very tmali diftance, is quite free from it. But whatever be the caufe, we are fure of the fact. No time ought therefore to be loft in remov- ing the patient at fome diftance from t ;e place where he caught the difeafe, and, if poflible, into a more pure and warm air.* When the difeafe proves violent, and the patient is in danger of being fuffocated by the cough, he ought to be bled, efpecially if there be a fever with a hard full pulfe. But as the chief inten- tion of bleeding is to prevent an ioflammation of the lungs, and to render it more fafe to give vomits, it will feldom be neceffary to repeat the operation ; yet if there are fymptoms of an inflammation of the lungs, a fecond or even a third bleeding may be requifite. It is generally reckoned a favourable fymptom when a fit of coughing makes the patient vomit. This cleaifes the ftomach, and greatly relieves the cough. It will herefore be proper to promote this difcharge, either by fmall d fes of ipecacuanha, or the vomit- ing julep recommended in the Appendix.! It is very difficult to make children drink after a vomit. I have often feen them happily deceived, by iufufing a fcruple or half a drachm of the powder of ipecacuanha in a tea-pot, with half a pint of boiling water. If this be difguifed with a few drops of milk and a little fugar, they will imagine it tea, and drink it very greedily. A fmall tea-cupful of this may be given every quarter of an hour, or rather every ten minutes, till it operates. When the child begins to ouke, there will be no occfion for drinking any more, as the water already on the ftomach will be fufficient. Vomits not only cleanfe the ftomach, which in this difeafe is generally loaded with vifcid phlegm, but they likewife promote the perfpiration and other fecretions, and ought therefore to be repeat- ed according to the obstinacy of the difeafe. They fhould not how- * Some think the air ought not t» be changed till the difeafe is on the decline ; but there feems to be no Sufficient reafon for this opinion, as patients have been known to reap benefit from * change of air at all perioda ofthe difeafe. It is not fufficient to take the patient out daily in a carriage. This reldom anfweri sny good purpofe ; but often does hurt by giving him cold. * See Appendix, Vcm\t\r.g Julep, 212 OF THE HOOPJNG COUGH, 6c. ever be ftrong ; gentle vomits frequently repeated, are both left dangerous, and more beneficial than ftrong ones. The body ought to be kept gently open. The beft medicinet for this purpofe are rhubarb ant its preparations, as the fyrup, tincture, &c. Of thefe a tea-fpoonful or two may be given to an infant twice or thrice a-day, as there is occafion. To inch as are farther advanced, the djfe muft oe proportional'y increafed, and repeated till it has the defired eff ct. Thofe who cannot be brought to take the birter tincture, may have aa infufion f fenna and prunes, fweetened with monn?, coarfe fu ;ar, or houey ; or a few grains of rhubarb mixed with a tea-fpoonful 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 difagreeable medi. cine when mixed with them. Many people believe that oily, pectoral, and balfamic medi- cines poffefs wonderful virtues for the cure of the chin-cough, and •ccordingly exhibit them plentifully to patients of every age ad conftitution, without cnfi-'ering that every thing of this nature muft load the ftomach, hurt the digeftion, and of courfe aggravate. the diforder.* •J The millepedes, or wood-lice, are greatly recommended for the cure of a cm-cough. Thofe who chufe to make ufe of thefe in- fects, may infufe two ounces of them bruifed in a pint of fmall whi e-wme for one night. Afterwards the liquor may be ftrai >ed through a cloth, and a table-fpoonful of it given to the patient three or four times a-day. Opiates are fometimes neceffary to alhy the violence of the cough. For this purpofe a little of the fyrup of poppies, or five, fix. cr feven drops of laudanum,according to the age of the patient may be taken in a cup of hyffop or penny-royal tea, and repeated occafionally.t The garlic ointment is a well-known remedy in Ncrth-Britain for the chin-cough. It is made, by beating in a mortar, garlic, with an equal quantity of hog's lard. With this the foles • f the feet may be rubbed twice or thrice a-day ; but the beft method is to fpread it upon a rig, and apply it in t e form of a rl "iter. It fhould be renewed every night and m ruing at leaft, as the garlic foon lofes its virtue. This is an exceeding good medicine both in the chin-cough,! and in moft other euighs of an obftinate nature. It ought not however to be ufed when the patient is very hot or feverifh, left it fhould increafe thefe fymptoms. The feet fhould be bathed once every two or three days iQ lukewarm water ; and a Burgundy-pitch plaster kept constantly * Dr. Dupt anjl fays, he has feen many good effects from the kermet mineral in tbil complaint, the cough being frequently alleviated even by the fi.ft dofe. The dofe for a child of one year old, is a quarter or a grain diflfolvfd in a cup of any liquid, repeated two or three times a-day. For a child of two years, the dofe is half a grain } and the quantity muft be thus increafed in proportion to the age ofthe patient. t Some recommend the extract of hemlock as an extraordinary remedy in the hooping* cough; but fofar as I have been able to obferve, it is in no way fuperior to opium, wnicBj when'proptrly adminiftered, will often relieve fome ofthe moft troublefome fymptoms of thii diforder. ' r # i As this difeafe is evidently fpafmodic, I am inclined to think that tonic medicines will m tune be round the moft proper for its cure. INFLAMMATION OF THE STOMACH, 6c. 2*3 between the fhoulders. But when the difeafe proves very violent, it will be neceflary, inftead of it, to apply a bliftering-plafter,-and to keep the part open for fome time with iffue-ointmenr. When the difeafe is prolonged, and the patient is free from a fever, the Peruvian bark, and other bitters, are the m ft proper medicines. The bark may eith-r be taken in fubftance, or in a decoction or infufion, as is moft agreeable. For a child, ten, fif- teen, or twenty grains, according to the age of the patient, may be given three or four times a-day. For an adult, half a drachm or two fcruples will be proper. Some give the exrract of the bark with cantharides ; but to manage this requires confiderable atten- tion. It is more fafe to give a few grains of caftor along with the Dork. A child of fix or feven years of age may take feven or eight grains of caft r, wito fifteen grams of powdered bark, for a dofe. This may bjmade into a mixture with two or three ounces of any fimple distilled water, and a little fyrup, and taken three or f_ur times a-day. CHAP. XXXII. INFLAMMATION OF THE STOMACH, AND OTHER VISCERA. jf\.LL inflammations ofthe bowels are dangerous, and require the moft fpeedy afliftance; as they frequently end in a fuppuration, and fometimes in a modification, which is certain death. CAUSES.—An inflammation of th- ftomach may proceedfrom any of the caufes which produce an inflammatory fever; as cold liquor drink while the body is warm, obftructed perfpiration, or the fudden striking in of any eruption. It may likewife proceed from the acrimony of the bile, or from acrid and ftimulating fub- ftances taken into the ftomach; as ftrong vomits or purges, corro- five poifons, and fuch like. When the gout has been reoelled from the extremities, either by cold or improper applications, it often oc- cafions an inflammation of the ftomach. Hard or indigefttMe fub- Itances taken into the ftomach, as bones, the ftones of fruit, &c. may likewife have that effect. SYMPTOMS.—It is attended whh a fixed pain and burning heat in the ftomach; great reftleffnefs and anxiety; a fmall, quick, and hard pulfe; vomiting, or, at leaft, a naufea and ficknefs; ex- ceffive thirft; coldnefs of the extremities; difficulty of breathing; c Id 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 it be eith r too hot or too cold. When the patient vomits every thing he eats or drinks, is ex- tremely reftlefs, has a hickup, with an intermitting pulfe, and fre- quent fainting fits, the danger is V'jry great. • REGIMEN.—All acrimonious, heating and irritating food and drink, are carefully to be avoided. The weaknefs of rhe r-a- 214 INFLAMMATION OF THE STOMACH, isi. tient may deceive the byftanders, and in luce them to give wines, fpirits, or other cordials; but thefe never fail lo increafe the dif- eafe, and often occafion fudden death. The inclination to vomit may lik -wife impofe on the attendants, and make them think a vomit nereffr.ry; but that too is almoft certain death. The food muft be light, thin, cool, and eafy of digeftion. It j muft be given in fmall quantities, and fhould neither be quite cold,' nor too hot. This gruel made of barley or oatmeal, light toa^ed' bread diffclv^ in boiling water, orverv weak chicken broth, is the moft proper. The drink fh. uld be clear whey, barley-water, water in which toafted bread has been b ilel, or decoctions of emollient vegetables^ as liquorice and mrrfh-aiallow roots, far- f aparilla, or the like. MEDICINE.—Bleeding in t'*is difeafe is abfolutely neceffary, and is almoft the only thing that can be depended on. When this , difeafe proves obftinate, it will often be proper to repeat this ope- j ration feveral times, nor muft the low ftate of the pulfe deter m from doing fo. ^ The pulfe indeed generally rifes upon bleeding, and •as long as that is the cafe, the operation is fafe. Frequent fomentations wWi lukewarm water, or a decocthnof emollient vegetables, are likewife beneficial. Flannel cloths dipped, in thefe muft be applied to the region of tve ftoron.ch, and reraov- \ ed as they ^;row cool. T^ey muft ne thev be applied too warm, nor be fuffered to continue til) they becmie quite cold, as either of thefe extremes would aggravate' the difeafe. The feet and legs ought likew'fe to he frequently bathed in luk-ewarm water, and w^rm brirks or pnul tires may be applied to the foles of the feet. The warm bath, if it can be conveniently ufed, will be of great fervice. In this, and all other inflamnp'n^s ofthe bowels, an *pifpaftic, or bliftering-plafter, applied over the part affected, is one of.the beft remedies I know. I have often ufed it, and do not recollect one inftance wherein it did not give relief to the patient. The only internal medicines which we fhall venture to recom- mend in this difeafe, are mild clyfters. Thefe may be made of warm water, or thin water-£ruel; and if the pa'ient is coftive, a little fweet oil, honey, or manna, may be added. Clyfters anfwer the pjurpofe of an internal fomentation, while they keep the bodv open, and at ' the fame time nourifh the patient, who is often in this difenfenna- ble to retain any food upon his ftomach. For thefe reasons they k muft not be neglected, as the patient's life may depend on them. . \ INFLAMMATION OF THE INTESTINES. THIS is one of the moft painful and dangerous difeafes that mankind is liable to. It generally proceeds from the fame caufes as the inflammation ofthe ftomach ; to whic'" nrv be rdded cftive- nefs, worms, eating unripe fruits; or great quantities of nuts, drink- * ing hard, windy malt liquors, as ftale bo'tled beer or ale, four wine cyder, &c. It may likewife be occafioned by a rupture, by fchirr- oiis tumours of the inteftines, cr by their oppofite fides growing •o-gether. INFLAMMATION OF THE INTESTINES-. 215- The inflammation of the inteftines is denominated Iliac pafion, Enteritis, be. according to the name of the parts affected. The treatment however is nearly the fame whatever part of the inteft- inal canal be the feat of the difeafe; we fhall therefore omit thefe diftinctions, left they fhould perplex the reader. The fymptoms here are nearly ihe fame as in the foregoing dif* eafe; only the pain, if poffible, is more acute, and is fituated low- er. The vomiting is lik wife more violent, and fometimes even the * excrements, together with the rlyfters, are difcharged by the mouth. The patient is continually belching up wind, and has often an ob- struction of his urine. While the pain lhifts, and the vomiting only returns at certain intervals, and while the clyfters pafs downwards, there h ground for hope; but when the clyfters and faces are v mired, and the pa- tient is exceeding weak, with a low fluttering pulfe, a p'ale coun- tenance, and a difagreeable or ftinki g breat \ there is great reifon to fear that the conlequences will prove fatal. Cl mmy lweat, bla ck, foetid fto t<, with a fmall i .ten nit ing pulfe, and a toal collation of pain, are figns of a mortification already begun, and of an approach- ing death. REGIMEN.—The regimen in this difeafe is in general the fame as in an inflammotion of the ftomach. The patient muft be 4 kept quiet, avoiding cold, and all violent paflions of the mind. His ' food ought to be very lignt, and given in fmall quantity; his drink weak and dihring; as clear whey ,rbarley-water, and fuch like. MED t CINE.—Bleeding in this, as well as in the inflamma- tion of the ftomach, is of the greateft importance. It fhould be performed as foon as the fymptoms appr-ar, and muft be repeated accordingto the ftrength ofthe patient, and theviolerice of the difeafe* A blistering plafter is here likewife to be applied immediately over the part where the moft violent pain is. This not only relieves the pain of the bowels; but even clyfters and purgative medicines,. which before had no effect, will operate when the blifter begins to rife. "* Fomentations and laxative clyfters are by no means to be omit- ted. The patient's feet and legs should frequently be bathed in warm water; and clothes dipped into it applied to his belly. Blad- ders filled with warm water may likewifeTbe applied to the region of the naval, and warm bricks, or bottles filled with warm water, to the foles of the feet. The clyfters may be made of barley-water or thin gruel with fait, and foftened with fweet oil or frefh brrter. Thefe may be adminiftered every two or three hours, or cftener, if the patient continues ccftive. If the difeafe does not yield to clyfters and fomentations, re courfe muft be had to pretty ftrong purgat ves: but as tYtfe, by irri- tating the bowels, often increafe the>r contr?ction, and by tha\ means frustrate their own intenticn, it will be neceffary to join t^eu. with opiates, which by allaying the pain, and relaxing the fpa,;- modic contractions ofthe guts, greatly aflift the operation cf pur- gatives in this cafe. What anfwers the purpofe cf opening the body very -vciV^ 216 INFLAMMATION OF THE INTESTINES. 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 a tea-fpoonful of it taken every half hour till it operates. At the fame time fifteen, twenty, or twenty-five drops of lauda um may be giv- en in a glafs of peppermint or fimple cinnamon-water, to appeafe the irritation, and prevent the vomiting, &c. Acidshave often a very happy effect in staying the vomiting, and appeafing the other violent fymptoms of this difeafe. It will there- fore be of ufe to fharpen the patient's drink with cream of tartar, juice of lemon; or, when thefe cannot be obtained, with vinegar. But it often happens that no liquid whatever will ftay on the ftomach. In this cafe the patient muft take purging pills. I have generally found the fallowing anfwer very well: Take jallap in pow- der, and vitriolated tartar, of each half a drachm, opium one grain, Caftile foap as much as will make the mafs fit for pills. Thefe muft be taken at one d^fe, and if they do not operate in a few hours, the dofe may be repeated. If a fto 1 canno- 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 had been tried in vain. The patient muft continue in the water as long as he can eafily bear it without fainting, and if one immerfion has not the defired effeft, it may be repeated as foon as the patient's ftrength and fpirits are recruited. It is more fafe for him to go frequently into the bath, than to contmue too long at a time, and it is often neceffary to repeat it feveral times before it has the defired effect. It has fometimes happened, aft r all other means of procuring a ftool had been tried to no purpofe, that this was brought about by immerfing the patient's lower extremities in cold water, or making him walk on a wet pavement, and dafhing his legs and thighs with the cold water. This method, when others fail, at leaft merits a »trial. It is indeed attended with fome danger; but a doubtful rem- edy is better than none. In delperate cafes it is common to give quickfilver. This may be g;ven to the quantity of feviral ounces, or even a pound, but fliould not exceed that.* When there is reafon to fufpect a morn- fication of the guts, this medicine ought not to be tried. In that cafe it cannot cure th^ patient, and will only hasten his death. But when the obstruction is occafioned by any caufe that can be remov- ed by force, quickfilver is not only a proper medicine, but the beft that can be adminiftered, as it is the fr teft body we know for mak- ing its way through the infeftind canal. If the difeafe proceeds fr m a rupture, the patient muft be hid with his hf ad very low, and the inteftines returned by gentle prefs- ure with the hand. If th;s, with fomentations and clyfters, fhould not fucceed, recourfe muft be had to a furgical operation, which may give the patient relief. • When quickfilver is given in two Urge quantities, it defeats Its own intention, u >« Irigs down the bottom of the ftomach, which prevents its getting over the Pylorus. 1» hi& cafe the patient mould be hung up by the beds, in order that the quickfilver may k* difcharged by his mouth. 9F THE COLIC. *r) 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 faces taken out of their guts. They fhould l-kewife beware of eating too frt ely of* four or unripe fruits, or drinking ftale windy liquors, &c. I have known it brought on by livi g too much on baked fruits, which are feldom good. It likewile proceeds frequently from cold caught by wet cloths, &c- but efpecially from wet feet. OF THE COLIC. THE colic has a great refemblance to the two preceding dik eafes, both in its fymptoms and method of cure. It is generally attended with cofuvenefs and acute pain of the bowels; and re- quires diluting diet, evacuations, fomentations, &c Colics are vanoufly denominated according to their caufes, as the flatulent, the bilious, the hyfteric, tfye nervous, &C. As each cf thefe require a particular method of treatment, we fhall point out their moft general fymptoms, and the means to be ufed for 'their relief. The flatulent, or wind-colic, is generally occafioned by an in* difcreet ufe of unripe fruits, meats of hard digeftion, windy veget- ables, fermenting liquors, and fuch like. It may likewife proceed from an obftructed perfpiration, or catching"cold.« Delicate people, whofe digeftive powers are weak, are moft liable to this kind or colic. The flatulent colic may either affect the ftomach or inteftines» It is attended with a painful stretching of the affected parr. The pitient feels a rumbling in his guts, and is generally relieved by a, difcharge of wind, either upwards or downwards. The pain is lei-. dom confined to any particular part, as the vapour wanders from; one divifion of the bowels to another till it finds a vent. When the difeafe proceeds from windy liquor, green fruity four herbs, or the like, the beft medicine on the firft appearance ot the fymptom is a dram of brandy, gin, or any good fpirits. The patient fhould likewife fit with his feet upon a warm hearth-ftone- or apply warm bricks to them; and warm cloths maybe applied 'to his ftomach and bowels. This is the only colic wherein ardent fpirits, fpiceries, or any thing of a hot nature, may be ventured upon. Nor indeed are they to be ufed here unlefj at the very beginning, before any fymp- toms of inflammation appear. We have reafon to believe, that a c^lic occafioned by wind or flatulent fo-ad might always be cured ■by fpirits and w:>rm liquors, if they were taken immediately upon perceiving the firft uneafinefs; but when the pain has continued for a confiderable time, and there is reafon to fear aa inflammation ot* the bowels is already begun, all hot things are to be avoided as poi- fon, and the patient is to be treated m the fame manner as for the- inflammatiDn of the inteftine j. Several kinds of food, r.3 honey, eggi. Sec. occafion colics in fome particular conftitutions. I h ive generally found the beft metfa- ■■-oi of cure for thefj, ws: to drink plentifully of iirall d:.h:.tirvr liquors, "C'5/ •r. -,«3 QF-JHE COLIC. as water-gruel, fmall pofiet-,- water with toafted bread foaked in k, &c. , y Colics which proceed from excefs and indigeftion generally cure .themfelves by occafioning vomiting or purging. Thefe difcharges are by no means to be.ftoppedj bit promoted by drinking plenti- fully of warm water, or weak poffet. W hen their violence k over, the patient may take a dofe of rhubarb, or any other gentle purge, £o carry offthe dregs, of his debauch. Colics which are .occafioned by: wet feet, or.catching cold, may generally be removed at the beginning, by bathing the feet and legs in warm water, and drinking fuch diluting liquors as will promote the perfpiration, as weak whey j or water-grue., with a fmall quan- tity ,of fpirits'. in it. . o ' ^ • Thofe flatulent colics, which prevail To much among country people* might generally be prevented were they careful to change, their clothes when they get wet,. :' They ought likewife to take a dram, or to drink,fome warm liqmcr after eating any kind of green train. We do not mean to recommend the practice of dram drink- ! „ ing, but in this cafe ardent fpirits prove a real medicine, and indeed the beft that can be adminiftered. A glafs of good peppermint<$jjB ter will have nearly the fame eff.ct as a glafs of "brandy, and in f<8j cafes is rather trj be preferred. • '^* f.. ■. The bilious colic is attended with very^ acute pains about there- gion of the naval. The patient complains of great thirft, and is generally coftive. He vomits a hot, bitter, yellow7 coloured hile, which being difcharged, feems to afford fome relief, but is quickly i followed J>y the fame violent pain as before. As the distemper ad-, yances, the propenfity to vomit fometimes increafes fo as to become almoft continual, ana the proper motion of the inteftines is fo far perverted, that there are all the fymptoms of impending iliac palfi»n. If the patient be young and ftrong, and the pulfe full and fre- quent, it will be proper to bleed, after which clyfters may be ad- miniftered. Clear, whey or gruel, fharpened with the juice of lemon, or cream of tartar, muft be drank freely. Small chicken broth, with a little manna diffolved. in it, or a flight decoction of tamarinds^ are likewife very proper, or any other thin, acid, openiug liquors Beiides bleeding and plentiful dilution, it will be neceffary to foment the belly with cloths dipped in Worm water, and if this vhouid not fucceed, the patient muft. be immerfed up to the breaft in warm water. . ^ In the bilious colic the vomiting is often very difficult to re- ftraki. When this happens, the patient may drink a decoction of • toafted bread, or an infufion of garden mint in boiling water. Should thefe not have the defired effect, the feline draught, with a few , drops of laudanum in it, may be given, and repeated according to the urgency of the fymptoms. A fmall quantity of Venice treacle may be fpread in form of a cataplalhi, and applied to the pit of the ftomach.^ Clyfters, with a proper quantity of Venice treacle or hV quid laudanum in them, may likewife be frequently administered*' The hyfteric coiic bears a great refemblance to the bilious. It :^ attended with acute pains about the region of the ftomach.. vomit- ing, Sec. What the patient vomits in this cafe is commonly of a CF THE COLIC. 2 to greetufh colour. There is a great finking of the fpirits, with de- jection of mind and diffimlty of breathing, which are .the eharact- eriltic fymptoms of this diforder. Sometimes it is accompanied with the jaundice, but this generally goes off of its own accord in a few days. In this colic all evacutions, as bleeding, purging., vomiting, &c. do hurt. Every thin^ that weakens the patient, or links the fpirits, is to be avoided. If however the vomiting fhould prove violent, lake warm water, or fmall poffet, may be drank to cleanfe the ftom- ach. Afterwards 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 cr twelve hours till the fvmptoms abate. The patient may likewife take four or five of the foetid pills every fix hours, and drink a cup of penny-royal tea after them. If afafcetida fhould prove difagreeable, which is fometimes the cafe, a tea-fpoonful of the tincture of caftorin a cupof penny-royal tea, or thirty or forty drops of the Joalfam of Peru dropped upon a bit of loaf fugar, may be taken in its ftead. The anti-iiyfteric plafter may; alfo be ufed, which has often a good effect.* The nervous colic prevails among miners, fmelters of leacf, plumbers, the manufacturers of white lead, Sec. It is very common in the cyder counties of England, and is fuppofed to be occafioned by the leaden veffels ufed in preparing that liquor. It is likewife ' a frequent difeafe in the Weft-Indies, where it is termed the dry ' belly»ache. No difeafe of the bowels is attended with more excruciating pain than this. Nor is it foon at an end. I have known it con- tinue eight or ten days with very little intermiffion, the body all the while continuing bound in fpite of medicine, yet at length yield, and the patient reover.f It generally however, leaves the patient weak, and often ends in a palfy. The general treatment ofHhis difeafe is fo nearly the fame with that of the iliac paflion, or inflammation of the guts, that we fhall not infiit upon it. The body i3 to be opened by mild purgatives given in fmall dofes, and frequently repeated, and their operation muft be affifted by fofc oily clyfters, fomentations, &c. The caftor- oil is reckoned peculiarly proper in thfc difeafe. Ijt may both be mixed with the clyfters and given by the mouth4 $ The Barbadoes tar is faid to be an efficaci-vus medicine in this complaint It may be taken to the quantity of two drachms three r times a-day, or oftener if the ftomach will bear it. This tar, mix- ed with an equal quantity of ftrong rum, is likewife proper for rub- » bing riie fpine, in cafe any tingling or other fymptoms of thepalfy, are felt. When the tar cannot be obtained, the back mayj)e rub- - bed with ftrong fpirits, or a Utile oil of nutmegs, or "of roferaary. If the patient remains weak and languid after this difeafe, he * See Appendix, Antl-Hyfteric Pfofier, f As the fmolce of tobacco thrown into the bowels*will often procure a ftool when all ath.-r means have filled, an apparatus for this purpofe ought Co be kept by every fur^eon. It may be purchafed at a fmall rtp^erjce, and*v':ll be of fervice in feveral other cafes, as the re- covery ot Jnvvned perfons, uz. r : Th; dale ii fiom en- tablc-ffooni'ul to two or thre;, if ncctSary to oyeg-ihi Sciy, 220 INFLAMMATION OF, THE KIDNEYS. muft take exercife on horfeback, and ufe an infufion of the Feru- vian-bark in wine. When the difeafe ends in a palfy, the Bath-wa- ters are found to be extremely proper. To avoid this kind of colic, people mi'ft fl.un all four fruits, acid?, and auftere liquors, Sec. Thofe who work in lead ou^ht never to go to their bufinefs fasting, and their food fhould be cily or fat. They may take a glafs of falad oil, with a little brandy or rum, every morning, but fliould never take fpiri s alone., Liquid ' aliment is beft for them; as fat broths, &c. but low liv;ng is had. d They fhould frequently go a little out of the tainted air; and fhould never fuffer themfelves to be ccftive. In the Weft-indies ard on the coaft of Guinea, it has been found of .great uf frr preventing this ch lie, to wear a piece of flannel round the waift, and to drink an infufion of ginger oy way of tea. Sundry o'her kinds of this difeafe might be mentioned, h>ut too mar y diftinctions would tend only to perplex the reader. Thofe al- I ready mentioned are the moft material, and fhould indeed beat- ; tended to, as their treatment is very different. But even perrrri8 ' who are not in a condition to diftbguifh very accurately in th-fe matters, may neverthelefs be of great fervice to patients in o licsof every kind, by only obferving the following rencra* nil s, viz. To bathe the feet and legs in warm water; to apply bladders filled with _ warm water, or cloths wrung out of it, to t!e ftomach and bowels;* to iT»akp the patient drink freely of diluting mucilaginous liquors; " and to give him an emollient clyAer every two cr three hoLrs. Should thefe not fucceed, the patient ought to be immerfed in warm watvr. INFLAMMATION OF THE KIDNEYS. CAUSES.—This difeafe may proceed from any of thofe caufes which produce an infl^ramatcry fever. It mayjikewife be occafion- ed by wounds or bruilcs of the kidneys; fmall (tones or gr v 1 lodg- ing within them; by ftrong diuretic medicines, as fpirits of turpen- tine, tincture of cantharides, &c. Violent motion, as hard riding or walking, efpecially in hot wearhei, or whatever drives the blood too forcibly into the k'.dneys, may occafion the malady. It may likewife proceed from tying too foftj too' much en the back, invol- untary contractions, or fpafms in fhe urinarv veffels, Sec. SYMPTOMS.—There is a fharp pain about the region of the kidneys, with fome degree of fever, and aftupor or dull pain in the thigh of the affected fide. The urine is at firft clear, and afterward^ f, of a reddifh colour; but in the worft kind of the difeafe it generajly- Jj continues pale, is paffed with difficulty, and commonly in fmall quan- tities at a time. The patient feels great uneafihefs when " e ende^v- i ours to walk or fit upright. He lies with moft eafe on the affect- 1 ed fide, and has generally a naufea or vomiting, refembling that which happens in .the c He. This difeafe how°ver may be diftinguifhed from the colic by , the pain being feated far'fpr backhand by the difficulty of paffing urine with whic it is c^nftantly attended. REGIMEN.~£very thing of a healing or ftimulating nature' INFLAMMATION OF THE KIDNEYS. 221 is to be avoided. The food muft be thin and light; as panado, fmall broths, with mild vegetaHes, and the like. Emollient and thin liquors muft be plentifully drank; as clear whey, or balm-tea fweet- ened whh honey, decoction of marfh-mallow roots: withbarl.*/and liquorice, Sec. The patient, notwithstanding the vomiiirp, muft conftantlv keep lipping fmall quant'ties of thefe or other c luting li- quors. Nct-hi:" g fo faf ely and cert;; inly abates the inflammai ion, and exp I3 the of iLn.nl! ing caufe, as copious dilution. The patient mnft .be kept eafy, quiet, and free from cold, as long ss any fymptoms of inflammation remain. MEDICINE.—Bleeding is generally neceffary, efpecially at the begining. Ten or twelve ounces may be let from the., arm or foot with a lancet, and if the pain and inflammation continue, the operation may be repeated in twenty-four hours, fc/ne-rially if the patient be of a full habit. Leeche. may Kkewife be applied to the hemorrhoidal veins, as a difchv.i-g,* from thefe will greatly relieve the patient. Cl ths dipped in warm water, or bladders filled with it, muft be applied as near as poffible to the part affected, and renewed as they grow cool. If the bladders be filled with a decoction of mal- lows and camomile flowers, to which a little faffron is added, and mixed with about a third pan of new milk, it will be ftill more bene- Ticial. Emollient clyfters ought frequently to be adminiftered; and if thefe do not open the body, a little fait and honey cr manna may be added to them. • The fame courfe is to befollowed whore gravel or ftone is lodg- ed in the kidney, but when the grave I or ftone is fparat'd from the kidney, and lodges in the Ureter,* it will be proper, befides the fomentations, to rub the fmall of toe back with fweet oil, and to give gentle diuretics; as juniper-wcter, fweetened with the fyrup ot marfh-mallows: a tea-fpoonful of the fweet fpirits of nitre, with a few drops of laudanum, may now and then be put in a cup of the patient's drink. He ought likewife to take exercife on horfe-back, or in a carriage, if he be able to bear it. When the difeafe is protracted beyond the feventh or eighth day, and the patient complains of aftupor and heavicefs ofthe part, has frequent returns of chillnefs, fhivering, &c. there is reafon to fufpect that matter is forming in the kidney, and that an abfeefs will enfue. When matter in the urine shews that an ulcer is already form- » ed in the kidney, the patient muft be careful to abftain from all ac- • rid, four and faked provifions, and to live chiefly upon mild mucil- aginous herbs and fruits, together with the broth of young animals, made with barley, and common pot-herbs. &c. His drink may be A whey, and butter milk that is not four. The latter is by fome reck- oned a fpecific remedy in ulcers of the kidneys. To anfwer this character however, it rauft be drank for a confiderable time. Cha- * The ureters are too long and fmall canals, one on each fide which carry the urine from the bafon ot the kidneys to the bladder. They are fometimes obfttu&ed by fmill pie- ces of gravel falling down frcruthe kidney, and. lodging in :vcm. 222 INFLAMMATION OF THE BLADDER. lybeate waters have likewife been found beneficial in this difeafe This medicine is eafily obtained, as it is found in every part of Great^ Britain. It muft likewife be ufed for a confiderable time, in order to prc.uce any falutary effects. 1 nofe who are liable to frequent returns of inflammation, or , obstructions of the kidneys, muft abstain from wines, efpecially luchfcs abound with tartar; and their foocU>ughtto be light, and of eafy digeftion. They fhould ufe moderate exercife, and fhould not lie too hot, nor too much on their back. INFLAMMATION OF THE BLADDER. THE inflammation of the bladder proceeds, in a great meaf- ure, from the fame caufes as that of the kidneys. It is known by an acute pain towards the bottom of the belly, and difficulty of palling urine, with fome degree of fever, a conftant inclination to go to ftool, and a perp tual defire to ma^e water. This difeafe muft b1: treated on the fame principles as the oneim.. mediately preceding. The diet muft be light and thin, and the drink of a cooling nature. . Bleeding is very proper at the beginnings and in robuft constitutions it will often be neceffary to repeat Ifr The lower part of the belly fhould be fomented with warm water4,-'p or a decoction of mild vegetables; and emollient clyfters ought fre- quently to be adminiftered, Sec. ' The patient fhould abftain from every thing that is of a hcr,: j acrid and ftimulating quality, and fhould live entirely upon; fmall » ibroths, gruels, cr mild vegetables. A stoppage of urkie may proceed from other caufes befides an' , inflammation of the bladder; as a fwelling of the haemorrhoids i veins, hard faces lodged in the rectum, a ftone in the bladder, ex- crefcences in the urinary paffages, a palfy of the bladder, hyfteric affections, &c. Each of thefe require a particular treatment, which ' does not fall under our prefent confideraticn. We fhall only ;or> . ferve, that in all of them mild and gentle applications are the iafeH$l us ftrong diuretic medicines, or things of an irritating nature, gen- erally increafe the danger. I have known fome perfons kill them- : felves by introducing probes into the urinary paffages, to remove, as they thought, fomewhat that obftructed the difcharge of urine,' . and others bring on a violent inflammation of the bladder, by ufe- ing ftrong diuretics, as oil of turpentine, Sec- for that purpofe. INFLAMMATION OF THE LIVER. - i THE liver is lefs fubject to inflammation than moft of theoth- r er vifcera, as in it the circulation is flower; but when an influmma- \ tion does happen, it is with difficulty removed, and often ends ina fuppuration or fcirrhus. CAUSES.—Befides the common caufes of inflammation, we may here reckon the following, viz. exceffive fatnels, a fcirrhus of the liver itfelf, violent fhocks from ftrong vomits when the liver was before unfound,- nn aduf: or ntraMliarian ftate of the blood, any thing that fuddenly cools the liver after it has been greatly heateci, feces pbftructing the courfe of the bile, drinking ftrong wines m INELAMMATION OFTHE LIVEk. 223 • fpirituous liquors, ufing hot fpicy? aliment, obftinate hypochondria- cal affections, &c. SYMPTOMS.—This difeafe is known by a painful tehfion of the right fide under the falfe ribs, attended with fome degree of fe- ver, a fenfe of weight or fulnefs of the part, difficulty of breathing, loathing dT food, great thirft, with a pale or yelbwifti colour of the ikin and eyes. The fymptoms here are various, according to the degree of in- flammation, and likewife according to the particular part of the liv- - er where the inflammation happens. Sometimes the pain is fo incon- fiderable, that an inflammation is not fo much rs fufpected; but when it happens in the upper or convex part of the liver, the pain is more acute, the pulfe quicker, and the patient is often troubled with a dry cough, a hickup, and a pre expending to the fhoulder, with difficulty of lying on the left fide, Sec. This difeafe may be diftinguifhed from the pleurify, by the pain being lefs violent, feated under tie falfe ribs, the pulfe not fo hard, and by the difficulty of lying on the left fide. It may be dift- inguifhed from the hyfteric and hypochondriac diforders by the de- gree of fever with which it is always attended. This difeafe if properly treated, is feldom mortal. A coaftant ••' hickuping, violent fever, and exceffive thirft,' are bad fymptomsi If it ends in a fuppuration, and the matter cannot be difcharged out- wardly, the danger is great. When the fcirrhus of the liver en- fues, the patient, if he obferves a proper regimen, may neverthelefs live a number of years tolerably eafy; ^ tout if he indulges in animal food and ftrong liquors, or take medicines of an acrid or irritating nature, the fcirrhus will be converted into a cancer, which muft in-.. fallibly prove tatal. , REGIMEN.—The fame regimen is to be obferved in this as in other inflammatory diforders. All hot things are to be careful-' ly avoided, and cool diluting liquors, as.whey, barley water, Sec. drank freely. The foodrnuft be light and thin, and the body, as well as ihe mind, kept eafy and quiet. MEDICINE.—Bleeding is proper at the beginning of th's dif- eafe, and it will often be neceffary, even though the pulfe fhould not feel hard, to repeat it. All violent purgatives are to be avoid- ed; thebodyhowevermuftbekeptgentlyopen. xV decoction of tama- rinds, with a little honey or manna, will anfwer this purpofe very-' well. The fide affected muft be fomented in the manner directed in the foregoing difeafe. Mild laxative clyfters fhould be frequent- ly adminiftered; and, if the pain fhould notwithstanding continue violent, a bliftering plafter may be apnlied over the part affected (. or rather a plafter made of gum ammoniac and vinegar of fquiHs, Medicines which promote the fecretion of urine have a very good effect here. For this purpofe half a drachm of purified nitre, or a tea-fpoonful of the fweet fpirits of nitre, may be taken in a cup of the patient's drink three or four times a-day. When there is an inclination to fweat, it ought to be promo- ted, but not by warm fudorincs. The only thing to be ufed for that purpofe, is plenty of diluting liquors.drank about the warmth 32* OF THE CHOLERA MORBUS, 6c, of the human blood. Indeed the patient in this cafe, as well as te all other topical inflammations, ought to drink nothing that is cold- er than the blood. If the ftools fhould be loofe, and even ftreaked with blood, no means muft be ufed to flop them, unlefs they be fo frequent as to weaken the patient, Loofe ftools often prove critical, and carry off the difeafe. If an abfcefs or impofthume is formed in the liver, all methods fhould be tried to make it break and difcharge itfelf outwardly, as fomentations, the application of poultices, ripening cataplafms, &c, Sometimes indeed the matter of an abfcefs comes away in the urine, and fometimes it is difcharged by ftool, but thefe are efforts of na- ture which no means can promote. When the abfcefs burfts into the cavity of the abdomen, at large, death muft enfue, nor will the event be more favourable wnen the abfcefs is opened by an incis- ion, unlefs in cafes where the liver adheres to the peritonawn, fo as to form a bag for the matter, and prevent it from falling into the cavity ofthe abdomen; in which cafe open ng the abfcefs by a fuffici- ently lar^e incifion will probably fave the patient's life.* If the diforder, inlpite of all endeavours to the contrary, fholild end in a fcirrhus, the patieut muft be careful to regulate his diet, &c. In fuch a manner as not to aggravate the difeafe. He muft not in, dulge in flefh, fifh, ftrong liquors, or any highly feafoned or falted provifions; but fhould, for the meft part, live on mild vegetables; as fruits and roots; taking gentle exercife, and drinking whey, bar- ley-water, or butter-milk, \f he takes any thir.g ftronger, it fhould be fine mild ale, which is lefs heating than wines or fpirits. We fhall take no notice of inflammations of the other vifcera. They muft in general be treated upon the fame principles as thofe already mentioned. The chief rule with refpect to all of them, i§ to let blood, to avoid every thing that is ftrong, or of a heating na- ture, to apply warm fomentations to the parts affected, and to caufe the patient to drink a fufficient quantity of warm diluting liquors. CHAP. XXXIII. OF THE CHOLERA MORBUS, AND OTHER EXCESSIVE DISCHARGES FROM THE STOMACH AND BOWELS. ' JL. HE cholera morbus is a violent purging and vomiting, at- ttfcded with gripes, ficknefs, and a conftant o'efire to go to ftool. It comes on fuddenly, and is moft common in autumn. There is hardly any difeafe that kills more quickly than thio, when proper means are not ufed in due time for removing it. CAUSES.—It is occafioned by a redundancy and putrid ac- rimony ofthe bile; cold, food that eafily turns rancid or four pn the ftomach; as butter, bacon, fweet-meats, cuevmbers, melons, • I know a fjcntleman who has had feveral abfceiTes of the liver opened, and is now » ilrc^S nzi befct.'-y o^a-., thc.'gh abevs eighty years of age. * OF THE CHOLERA MORBUS, "6c. 225 cherries, and other cold fruits.* Jt is fom ti nes the effect of ftrong acrid purges or vomits, or ;f poifonous fuMtances token into the ftomach. It mav likewiie proc:>-d from violent paflions or affec- tions of the mind ; as fear, anger, &c. SYMPTOM.—It is oenerally preceded by a cardialgia, or heart our 1, four btktag.-', and flatulencies, with pain ofthe fto- mach and inteftines. To thefe fucceed exceffive vomiting and purging of green, yellow, or blackifft cdc/ed bile, with a distention of the it: uach, ?n;i violent gr pine; pains. T ere is likewife a great thirft, with a very quick uneqoal pulfe, and often a fixsd acute pain about the regioi\of the navel. As the difeafe advances, the pulfe often finki io low as to become quite iniperceptioie, the ex- tremities grow cold or camped, and are often covered with a clam- my fweat, the urine is obftructed, and there is a palpitation of the heart. Violent hickuping^ fainting, ahd convulfions, are the figns of approaching death. MEDICINE. — At the beginning of this difeafe, the efforts of Nature to expei the offending caufe fhould be affifted, by promo- ting the purghg and vomiting. Fcr this ^urpofe the patient muft drink freely of diluting liquors; as wnev, out ter-milk, warm water, thin water gruel, fmall poffct, or, what is perhaps ^referable to any of them, very weak chicken broth. T us fhould not only be drank plentifully to promote the vomiting, but a clyfter of it given every hour in order to promote the purging. After thefe evacuations have been continued for fome time, a decoction of toafted oat-bread may be drank to flop the vomiting. J The bread fhould be toafted till it is of a brown colour, and after- wards boiled in fpring water. If oat-bread cannot be had, wheat- bread, or oat meal well toafted, may be ufed in its ftead. If this ' does not put a ftop to the vomiting, two table-fpoonsful of the faline julep, with ten drops of laudanum, may be taken every hour till it ceafes. The vomiting and purging however ought never to be ftopped too foon. As long as thefe difcharges do not weaken the patient, they are falutary, and may be allowed to go on, or rather ought to be promoted. But when the patient is weakened by the evacua- tions, which may be known from the finking of his pulfe, &c. re- eourfe muft immediately be had to opiates, as recommended above; to which may be added ftrong wines, with fp;rituous cinnamon wa- ters, and other generous cordials. Warm nrgus, cr ftrong wine- whey, wiii likewife be neceffary to funpor- the patient's fpirits, and promote the perfpiration. His legs fhould be bathed in warm water, and afterwards rubbed with flcnnel cloths, or wrapped in warm blankets, and warm bricks applied to the foles of his feet. Flan- nels wrung out of warm fpirituous fomentations fhould likewife be applied to the region of the ftomach. When the violence of the difeafe is over, to prevent a relapfe, it will be neceffany for fome time to continue the ufe of fmall dofes of laudanum. Ten or twelve drops may be taken in a glafs of wine, * I hive been twice brought to the gates cf death by this di ft /.?■, and both times it was occafioned by eating naai ba: :.-;/• 216 OF A DIARRHOEA, OR LOOSENESS. at leaft twice a-day, for eight or ten days. The patient's food ought to be nourifhing, but taken in fmall quantities, and he fhould ufe moderate exercife. As the ftomach and inteftines are generally much weakened, an infufion ofthe bark, or other bitters, m mall wine, fharpened with the elixir of vitriol, may be drank for iome Though phyficians are feldom called in due time in this difeafe, they ought not to defpair of relieving the patient even in the moft defperate circumftances. Of this I lately law a very striking proof. iu an old man and his fon, who had been both feized with it about. the, middle of the night. I did not fee them tm next morning, when they had much more the appearance of dead than of living men. No pulfe could be felt; the extremities were cold and rigid, the counte- nance was ghaftlv, and the ftrength almoft quite exhausted.:'* Yet from this deplorable condition they were both recovered by the ufe- of opiates and cordial medicines. OF A DIARRHOEA, OR LCOSENESS. A LOOSENESS, in many cafes, is not to be confidered as* difeafe, but rather as a falutary evacuation. It ought thereto^ never to be flopped, unlefs when it continues too long, or evident- Iv weakens the patient. As this however fometimes happens, we fhall point out the moft common caufes of a loofenefs, with a prop-. ex method qf treatment. ■ When a loofenefs is occafioned by catching c-ld, or an ob- ftructed perfpiration, the patient ought to keep warm, to dunk, freelv of weak diluting liquors, to bathe his feet and legs, frequent- ly in'luke-warm water, to wear flannel next his flan, and to take every other method to reftore the perfpiration. In a loofenefs which proceeds from excefs or repletion, a vom- • it is the proper medicine. Vomits not only cleanfe the ftomach, but promote,all the fecretions, which renders them of great impor- tance in carrying off a debauch. Half a drachm of ipecacuanha in powder will answer this purpofe very well. A day or two after the vomit, the fame quantity of rhubarb may be taken, and repeat* ed two or three times, if the loofenefs continues. The patient ought to five upon light vegetable food of eafy digeftion, and to drink whey, thin gruel, or barley-water. A loofenefs occafioned by the obstruction of any cuftomary evacuation, generally requires bleeding. If that does not fucceed, other evacuations may be fubftituted in the room of thofe which are obftructed. At the fame time, every method is to be taken to reftore the ufual difcharges, as not only the cure of the difeafe, but the patient's life, may depend on this. A periodical loofenelj ought never to be flopped. It is always an effort of Nature to carry off fome offending matter, which, if retained in the body, might have fatal effects. Children are very liable to this kind of loofenefs, efpecially while teething. If is how- ever fo far from being -hurtful to them, that fuch children gener- ally get their teeth with leaft trouble. If thefe loofe ftools fhould at any time prove fair or griping, a tea-fpoonful of magnefia alba, OF A DIARRHOEA, OR LOOSENESS. 227 with four or five grains of rhubarb, may be given to the child in a little panado, or any other food. This, if repeated three or four times, will generally correct'the acidity, and carry oft the gnpmg rv 1 • A diarrhoea, or loofenefs, which proceeds from violent paflions or affeaions of the mind, muft be treated with the greateft caution. Vomits in this cafe are highly improper. Nor are purges fafe, un- iefs they be very mild, and given in fmall quantities. Opiates, and other antifpafmodic medicines, are moft proper. Ten or twelve drops of liquid laudanum may be taken in a cup of valerian or pen- ny-royal tea every eight or ten hours, till the fymptoms abate. Eafe, cheerfulnefs, and tranquility of mind are here of the greateft im- portance. When a loofenefs proceeds from acrid or poifonous fubftances taken into the ftomach, the patient muft drink large quantities of diluting liquors, with oil or fat broths, to promote vomiting and purging. Afterwards, if there be reafon to fufpect that the bowels are inflamed, bleeding will be neceffary. Small dofes of laudanum may likewife be taken to remove their irritation. When the,gout, repelled from the extremities, occafions a loofe- nefs, it ought to be promoted by gentle dofes of rhubarb, or other mild purgatives. The gouty matter is likewife to be foliated to- wards the extremities by warm fomentations, cataplafms, &c. The perfpiration ought at the fame time to be promoted by warm dilut- ing liquors; as wine-whey with fpirits of hartfhorn, or a few drops of liquid laudanum, in it. When a loofenefs proceeds from worms, which may be known from the fliminefs of the ftools, mixed with pieces of decayed worms, &c. medicines muft be given to kill and carry off thefe vermin, as the powder of tin with purges of rhubarb and calomel. After- wards lime-wafer, eit er alone, or with a fmall quantity of rhubarb infufed, will be proper to ftrengthen the bowels, and prevent the new generation of worms, A loofenefs is often occafioned by drinking bad water. When this is the cafe, the difeafe generally proves epidemical. When there is reafon to believe that this or any other difeafe proceeds from the ufe of unwholefome water, it ought immediately to be changed, or. if that cannot be done, it may be corrected by mixing with it quick lime, chalk, cr the like. In people wijofe ftomachs^are weak, violent exercife immediate- ly after eating will occafion a loofenefs. Though the cure of this is obvious, yet it will be proper, befides avoiding violent exercife, to ufe fuch medicines as tend to brace and ftrengthen the ftomach, as infufions ?f the bark, with other bitter and aftringent ingredients, in white wine. Such perfons ought likewife to take frequently a gbfs or two of old red port, or good claret. From whatever caufe a loofenefs proceeds, when it is found Beceffary to check it, the diet ought to confift of rice boiled with milk, and flavoured with cinnamon; rice-jelly, fago with red port; and the lighter forts of flefh-meat roafted. The drink may be thin water-gruel, rice-water, or .weak broth made from Ifpn veal, ^ v/itfa 228- OF VOMITING. a {beep's head, as being more gelatinous than mutton, beef, or chick- en-broth. Perfons who, from a peculiar weaknefs, or too great an irrita- bility of the bowels, are liable to frequent returns of this difeafe, ihould live temperately, avoiding crude fummer fruits, all unwhole- fome foods, and meats of hard digeftion. They ought likewife to beware of cold moifture, or whatever may obftrucl the perfpiration^ i and fhOuld wear flannel next the fkin. All violent paflions, as fear* j anger, &c are likewife carefully to be guarded againft. , Jj OF VOMITING. VOMITING may proceed from various caufes; as excefs ic eating and drinking; foulnefs of the ftomach; the acrimony of the aliment; a tranflation of the morbific matter of ulcers, of the gout, , the eryfipelas, or other difeafes, to the ftomach. It may like-wile proceed from a loofenefs having been too fuddently flopped; from the ftoppage of any cuftomary evacuation, as the bleeding piles, the menfes, Sec. from a weaknefs of the ftomach, the colic, the iliac paf- fion, a rupture, a fit of the gravel, worms; or from any kind of poi- fon taken into the ftomach. It is an ufual fymptom of injures done to the brain; as contufions,compreffions, &c. It is likewife a fymptom of wounds or inflammations of the diaphragm, inteft- ines, fpleen, liver, kidneys, Sec. % Vomiting may be occafioned by unufual motions, as failing, being drawn backwards in a carriage, &c. It may likewife be ex- cited by violent paflions, or by the idea, of naufeous or difagreea- ble objects, efpecially of fuch ti ings as have formerly produced vom- iting. Sometimes it proceeds from a regurgitation of the bile into the ftomach: in this cafe, what the patient vomits is generally of a yellow or greenifh colour, and has a bitter tafte. Perfons who are fubject to nervous affections are often fuddenly feized with violent fits of vomiting. Laftly, vomiiing is a common fymptom of preg-, nancy. In this cafe it generally comes on about two weeks after t: the ftoppage of the menfes, and continues during the firft three or four months. When vcmiting proceeds from a foul ftomach or indigeftion, it is not to be confidered as a difeafe, but as the cure of a difeafe. It ought therefore to be promoted by drinking lukewarm water, or thin gruel. If this does not put a fto'p to the vomiting, a dofe of ipecacuanha may be taken, and worked off with weak camomile-tea. When the retroceffion of the gout, or the obstruction of cuft- omary evacuations, occafion vomiting, all means muft be ufed to reftore thefe difcharges; or, if that cannot be effected, their place muft be fupplied by others, as bleeding, purging, bathing the ex- tremities in warm water, opening iflues, fetons,perpetualblifters, &c i ^ When vomiting is the efff ft of pregnancy, it may generally be mitigated by bleeding, and keeping the body gently open. The bleeding however ought to be in fmall quantities at a time, and the purgatives fhould be of the mildeft kind, as figs, ftewed prunes, man- pa, or fenna. Pregnant women are moft apt to vomit in the morn- ing immediately after getting out of bed, which is owing partly to CF VOMITING. 229 the change of pofture, but more to the emptinefs of the ftomach. It may generally be prevented by taking a difh of coffee, tea or fome light breakfaft in bed. Pregnant women who are afflicted with vomiting, ought to b<- kept eafy both in body and mind. They fhould neither allow their ftomachs to be quite empty, nor fhould they eat much at once. Cold water is a very proper drink in this cafe; if the ftomach be weak, a little brandy may be added to it. If the fpirits are low, and the perfon apt to faint, a fpoonful of cin- namon-water, with a little marmalade of qupces or oranges, may be taken. If vomiting proceeds from weaknefs of the ftomach, bitters*will be of fervice. Peruvian bark infufed in wine or brandy, with as much rhubarb as will keep the body gently open, is an excellent medicine in this cafe. The elixir of vitriol is alfo a good medicine. It may be taken in the dofe of fifteen or twenty drops, twice or thrice a-day, in a glafs of wine or water. Habitual vomitings are fometimes alleviated by making oyfters a principal part of diet. A vomiting which proceeds from acidities in the ftomach, is relieved by alkaline purges* The beft medicine of this kind is the magnefi 1 alba, a tea-fpoonful of which may be taken in a difh of tea or a little milk, three or four times a-day, or oftener if neceffa- ry, to keep the body open. When vomiting proceeds from violent paflions, or affections of the mind, all evacuants muft be carefully avoided, efpecially vom - its. Thefe are exceedingly dangerous. The patient in this cafe ought to be kept perfectly eafy and quiet, to have the mind footh- ed, and to take fome gentle cordial, as negus, or a.little brandy and water, to which a few drops of laudanum may occafionally be added. When vomiting proceeds from fpafmodic affections ofthe fto- mach, mufk caftor, and other antifpafinodic medicines are of ufe, Warm and aromatic platters have likewife a good effect. The fto- mach-plafter of the London cr Edinburgh difpenfatory may be ap- plied to the pit of the ftomach, or a plafter of theriaca\ which will anfwer rather better. Aromatic medicines may likewife be taken inwardly, as cinnamon or mint tea, wi 'e with fpiceries boiled in iry &c. The region of the ftomach may be rubbed with rether, or if that cannot be had, with ftrong brandy, or other fpirits. The belly fhould be fomented with warm water, or the patient immerfed up to the breaft in a warm bath. I have always found the faline draughts taken in the act cf effer- vefcence, of Angular ufe in ftopping of vomiting, from wh-k ver cmfe it proceeded. Thefe may be prepared by diffolving a c' rochm of: he fait of tartar in an ounce and a half of frefh lemon juice, and adding to it an ounce of pepper-mint water, the fame quantity of fimple cinnamon water, and a little white fugar. This draught muft be fwallowed before the efferv^fcence is quite over, and may be repeat- ed every two hours, or oftener, if the vomiting be violent. A vio- ent vomiting has fometimes been flopped by cupping on the region of the ftomach after all other means had failed. As the leaft motion will often briog on the vomiting again, ever. after it has been flopped, the patient muft avoid all manner of act- •p.30 • OF THE DIABE1ES, tfc. ion. The dietmuft be fo regulated as to fit eafy upon the ftomach., and nothing fhould be taken that is hard of digeftion. We do not however mean that the patient fhould live entirely upon flops. Sol- id food, in this cafe, often fits eafier on the ftomach than liquids.. CHAP. XXXIV. . OF THE DIABETES, AND OTHER DISORDERS OF THE KIDNETS AND BLADDER. X HE diabetes is a frequent and exceffive difcharge of urine. It is felJom to be met with 'among youtig people; but often attacks persons in the decline of life, efpecially-thofe who follow the more violent employments, or have been hard drinkers in their youth. C AUSES.—A diabetes is often the confequence of acute dif. eafes, as fevers, fluxes, Sec. where the patient has fullered by e\. ceffive evacuations; it may alfo be occafioned by great fatigue, as riding long journies upon a hard trotting horfe, carrying heavy bur- dens, &c. It may be brought on by hard drinking, or the ufe of ftrong ftimulating diuretic medicines, as tincture of cantharides, fpir- its of turpentine, and fuch like. It is often the effect of drinking ■ too great quantities of mineral waters. Many imagine that thefe < will do them no fervice unlefs they be drank in great quantities, by j which miftake it often happens that they occafion worfe difeafes than n thofe they were intended to cure.^ In a word, this difeafe may eith- er proceed from too great a laxity of the organ, which fecrete the urine, from fomething that ftimulates the kidneys too much, or from 4 a thin diffolved ftate of the blood, which makes too great a quan- "1 tity of it run oft* by the urinary paffages. - :■ I SYMPTOMS.—In a diabetes, the urine generally exceeds in quantity all the liquid food which rhe patient takes* It is thin and pale, of a fweetifh tafte, and an agreeable fmell. The patient has a continued thirft, with fome degree of fever; his mouth is dry, and he fpits frequently a frothy fpittle. The ftrength fails, the appetite decays, and the flefh waftes away till the patient is reduced to fkin and bone. There is a heat of the bowels, and frequently the loins and feet are fwelled. - ^ This difeafe may generally be cured at the beginning; but after it hascontinued long, thecure becomes very difficult. In drunk- ards, and very old people, a perfect Cure is not to be expected** •.* REGIMEN.—Every thing that ftimulates the urinary pa&tjg; ges, or tends to r-tex the habit, muft be avoided. For this reafon"' the patientfhouldlivechieflyon folid food. His thirft may be quench-1 ed with acids; as forrel,juice of lemon, or vinegar. The mucilagin- ous vegetables, as rice, fago, and falop, with milk, are the moft pro-, per food. Of animal fnbftances, fhell fifh are to be preferred; as' oyflers, crabs, &c. . :> , ' fhe drink may be Briftol-water. When that cannot be obtain- ed, ^Toa-wate--, in which a due proportion of oak-bark has been OF THE DIABETES, &V. 231. macerated, may be ufed. The white decoction,* with ifinglafs dif- folved in it, is hkewife a very proper drink. • The patient ought daily to take exercife, but it fhould be fo gentle as not to fatigue him. He fhould lie upon a hard bed or mat- rats. Nothing hurts the kidneys more than lying too foft. A warm, dry air, the ufe of the flefh-brufh, and every thing that promotes perfpiration, is of fervice. ~For this reafon the patient ought to wear ' flannel next to his fkin. A large strengthening plafter may be ap- plied to the back; or, what will anfwer better, a great part of the body may be wrapped in plafter. MEDICINE.—Gentle purges, if the patient be not too much weakened by the difeafe, have a good effect. They may confift of rhubarb, with cardamum feeds, or any other fpiceries, infufed in wine, and may be taken in fuch quantities as to keep the body gent- ly open. The patient muft next have recourfe to aftringents and cor- roborants. t Half a drachm of powder made of equal parts of alum and the infpiffated juice commonly called Terra Japonka, may be ta- ken four times a-day, or oftener, if the ftomach will bear it. The alum muft firft be melted in a crucible, afterwards they may both be pounded together. . Along with every dofe of this powder the patient may take a tea-cupful of the tincture of rofes.t If the patient's ftomach cannot bear the alum in fubftance, whey may be made of it, and taken in the dofe of a tea-cupful three or four times a-day. The alum whey is prepared by boiling two Eng- kfh quarts of milk over a flow fire, with three drachms of alumj till the curd feparates. Opiates rre of fervice in this difeafe, even though the patient refts well. They take offfpafm and irritation, and at the fame time leflen the force of the circulation. Ten or twelve dr. ps of liquid laudanum may be taken in a cup of the patient's drink three or four times a day., The belt corroborants which we know,are the Peruvian bark, and wine. A drachm of bark may be taken in a glafs of red p> rt or claret three times a-day.. The medicine will be both more effi- cacious and lefs difagreeable, if fifteen or twenty drops of the acid elixir of vitriol be added to each dote. Such as-cannot take the bark in fubftance may ufe the decoction, mixed with an equal quan- tity of red wine, and fharpened as above. There is a difeafe incident to labouring people in the decline of life, called incontinency of urine. But this is verv different from a diabetes, as the water paffe's off involuntary by drops, and does not exceed the ufual quantity. This difeafe is rather trouble-;- fome than dangerous. It is owing to a relaxation of the fphincter of the bladder, and is often the effect of a palfy. Sometimes itj>rc- ceeds from hurts or injuries occafioned by blows, bruifts, preternat- ural labours, Sec. Sometimes it is the effect of a^fever. It may likewife be occafioned by a long ufe of ftrong diuretics, or of ftimu- lating medicines injected into the bladder. This difeafe may be niitigoted by the ure of aftringent and cor- •S.-e Afftni'ir, TVh\:t dtctfl'.tn. \ S.-« Appendix, Ti--!xrc>>fR:je:, 232 OF A SUPPRESSION OF URINE: roborating medicines, fuch as have ben mentioned above; but we do not remember ever to have feen it cured. In an incontinency of urine, from w. ateyer caufe, a piece of fponge ought to be worn, or a bladder applied in fuch a manner as to prevent the urine from galling and excoriating the parts.* OF A SUPPRESSION OF URINE. IT has already been obferved, that a fuppreffion of urine, may proceed from various caufes; as an inflammation ofthe kidneys, or bladder; fmall ftones or gravel lodging in the urinary paffages, hard faces lying in the rectum, pregnancy, a fpafm or contraction of the neck of the bladder, clotted blood in the bladder itfelf, a fwelling ' of the hemorrhoidal veins, &c. Some of thefe cifes require the catheter, both to remove the obstructing matter, and to draw off tre urine; but as thi. inftrument can only be managed with fafety by perfons fkilled in furgery, we fhall fay nothing further of its ufe. A bougie may be ufed by any cautious hand, and will often fucceed better'than the catheter. We would chiefly recomrrend, in all obstructions of urine, fo mentations and evocuatir ns. Bleeding,as far as the patient's ftrength will permit, is neceflary, efpecially w; ere there are fymptoms of top- ical inflammation. Bleeding in this cafe not only abates the fever, by leffening the force of the circular!' n, but, by reluxmg the folids, it takes off the fpafm or ftructure upon the veflels which occafi.n* ed the obftruction. ;J After bleedings, fomentations muft be ufed. Thefe may eith-1 er confift of warm water alone, or of decoctions of mild vegetables; as mallows, camomile-flowers, Sec. Cloths dipped in thefe mav eith- i er be applied to the part affected, or a large bladder filled with the decoction may be kept continually upon it. Some put the herbs th*mfelves into a flannel-bag, and apply them to the part, which is far from being a bad method. Thefe continue longer warm than cloths dipped in the decoction, and at the fame time keep the part equally moift. In all obstructions of urine, the body ought to be kept open. This is not however to be attempted by ftrong purgatives, but by emollient clyfters, or gentle infufions of fenna and manna. Clyft- ers in this cafe not only open the body, but anfwer the purpofe of an internal fomentation, and greatly aflift in removing the fpafras of the bladder and parrs adjacent. The food muft be light, and taken in fmall quantities. The drink may be weak broth, or decoctions and infufions of mucilag- inous vegetables, as marfh-maliow roots, lime-tree bud?, &c. A tea-fpconful of the fweet fpirits of nitre, or a drachm of caftile foap,.> may be frequently put into the patient's drink; and if there be no' inflammation, he may drink fmall gin-punch. Perfons fubject to a fuppreffion of urine ought to live very tem- perate. Their diet fhould be light, and their liquor diluting* They ihmld avoid all acids and auftere wines, fhould take fufficient exer* rife, lie hard, and avoid ftudy and fedentxry occupations. * A b-tle made of th: Indian rvbber, and properly appl-ti, 5nfwers this purpofe beft." 233 OF THE GRAVEL AND STONE. WHEN fmall ftones are lodged in the kidneys, of difcharged along with the urine, the patient is faid to be afflicted with 'h< grav- el. If one of thefe ftones happens to make a lodgment in toe blad- der for fome time, it accumulates frefh matter, and at length be- comes too large to pafs off with the urine. In this cafe the patient is faid to have the ftone. CAUSES.—The ftone and gravel may be occafioned by high living; the ufe of ftrong astringent wines; a fedentary life; Mng too hot, foft, or too much on the back; the conftant ufe of water impregnated with earthy or flony particles; aliments of an aftriu- g nt or windy nature, &c. It may likewife proceed from an hered- i tary difpofition. Perf ns in the decline of life, and thofe v/ho have been much afflicted with the gout or rheumatifm, are moft liable to it. S YMPTOMS.r-Small ftones or gravel in the kidneys occafion pain in the loin; 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 towards the bla der; the thigh and leg of the affected fide nre be- numbed; the tefticles are drawn upwards; and the urine is obstructed. A ftone 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 it was running in a full ftream -, by a violent pain in the neck of the bladder upon motion, efpecially on horfeback, or in a carriage on a rough road; from a white, thick, copious, ftinking, mucous fediment in the urine; from an itching on the top of the penis; from bloody urine; from an in- clination to go to ftool during the difcharge of urine; from the pa- tient's paffing his urine more eafily when lying than in an erect poft- ure ; from a kind of convulfive motion occafioned by the fharp pain in difcharging the laft drops of the urine; and laftiy, from found- ingor fearching with the catheter. REGIMEN.—Perfons afflcted with the gravel or ftone fhould avoid aliments of a windy or heating nature, as fait meats, four fruits, etc. Their diet ought chiefly to confift of fuch things as tend to promo(e the fecreti n of urine, and to keepthe body open. Ar- tichokes, afporagus, fpinnage, lettuce, parfley, fuccory, purflane, turnips, potatoes, carrots, and radifhes, may be fafely eaten. On- ion*, leeks;, and cellery are, in this cafe, reckoned medicinal. Th'2 moft prooer drinks, are whey, butter-m Ik, milk and waiter, barley- water ; decoctions or infufions of the roots ofm^rfh-mallows, parf- ley, liquorice, or of other mild mucilaginous vegetables, as lhleed, lime tree buds or leaves, Sec. If the patient has been acenftomed to generous liquors, he may drink gin and water not too strong. Gentle exercife is proper; but violent motion is ?.p"t to occafion bloo'Iy urine. We would therefore advife that it fhould be token in moderation. Perfons afflicted with gravel often pafs a great num- ber of ftones after riding on hcrfehack, or in a carriage; but thofe wjio have a ftone in Ihe bladder are feldom able to bear thefe kiad» (i6) a34 OF THE GRAVEL AND STONE. ' of exercife. W'here there is an hereditary tendency to this di feafe,a fedentary life ought never to be indulged. Were people careful, upon the firft fymptoms of gravel, to obferve a proper regimen of diet, and to take fufficient exercife, it might often be carried off, or at leaft prevented from increafing; but if the fairife courfe which oc- cafioned the difeafe is perfifted in, it muft be aggravated. MEDICINE.—In what is called a fit ofthe gravel, which is commonly occasioned by a ftone flicking in the ureter or fome port ofthe urinary paffages, the patient muft be bled, warm fomentations fhould fkewife be applied to the part aff [ted, emollient clyfters ad- rabiftereo1, and diluting mucilaginous liquors drank, &c. The treat- ment of this cafe has been fully pointed out under the articles, in. flammation of the kidneys and bladder, to which we refer. Dr. Whyte advifes patients who are fubject to frequent fits of gravel in the kidneys, but have no ftone in the bladder, to drink every morning, two or three h urs before breakfaft, an Englifh pint of oyfter or cpckle-fliell lime-water. The Doctor very juftly ob- ferves, that though this quantity might be too fmall to have any fenfible effect in diffolving a ftone in the bladder, yet it may very probably prevent its growth. * When a ftone is formed in the bladder, the Doctor recom- mends Alicant foap, and cyfter or cockle-fhell lime-water,* to be taken in the following manner: The patient muft fwallow everyday, '" in any form that is leaft difagreeable, an ounce of the internal part ' of Aiicant foap, and drink three or four Englifh pints of oyfter or cockle-fhell lime-water. The foap is to be divided into three dofes; the largest to be taken faffing in the morning early; the fecond at noon; and the third at feven in the evening; drinking above each dofe a large draught of the lime-water ;s the remainder of whrh he may take any time betwixt dinner and fupper, inftead of other li- quors. The pntient fhould begin with a fmaller quantity of the lime- water and foap than that mentioned above; at firft an Englifh pint of the former, and three drachms of the latter, may be taken daily. This quantity, however, he may increafe by degrees, and ought to p-^rfevere in the ufe of thele medicines, efpecially if he finds any a". >atement of his complaints, for feveral months; nay, if toe ftone be very large, for years. It may likewife be proper for the patient, if he be feverely pained, not only to begin with the foap and lime- wafer in fmall quantities, but to take the fecond or L' ir ! lime-water inftead of re firft. However, after he has been for fome time ac- cuftomed to thefe medicines, he may not ouly t?ke 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 fhells. The cauftic alkali, or foap lees is the medicine chiefly in vogue at prefent for the ftone. It is of a very acrid nature, and '^ught therefore to be given in fome gelatinous or mucilaginous liquor; as veal broth, new-milk, linfeed-tea, a folution of gum-arabic, or t decoction of marlh-mallow roots. The patient muft begin with * See Aj>p:ndix, Lims-wattr. •tfrfc INVOLUNTARY DISCHARGES, 6c. 23$ fmall dofes ofthe lees, as thirty or forty drops, and increafe by de- grees, as far as the ftomach can bear it.t Though the foap-lees and lime-water are the moft powerful medicines which have hitherto been difcovered for the ftone; yet there are fome things of a more fimple nature, which in certain cafes are fouud to be beneficial, and therefore deferve a trial. An infu- fion ofthe feeds of daucus fyheflris, or wild carrot, fweetened with honey, has been found to give conlideraole eafe in cafes where the ftomach could not bear any thing of an acrid nature* A decoction of raw coffee-berries, taken morning and evening, to the quantity of eight or ten ounces, wi'.h ten drops of fweet fpirits of nitre, has likewife been found very efficacious in bringing away large quanti- ties of earthy matter in flakes. Honey is likewife found to be of confiderable fervice, and may be taken in gruel, or in any other form that is'more agreeable. The only other medicine which we fhall mention is the" uva urfi. It has been greatly extolled of late both for the gravel and ftone. It feems however to be in all refpects inferior to the foap and lime-wa- ter; but it is lefs difagreeable, and has frequently to my knowledge, relieved gravelly complaints. It is generally taken in powder from half a drachm to a whole drachm, two or three times a day. It may however be taken to the quantity Of feven or eight drachms a-day, with great fafety arid good effect. * "chap. XXXV. OF INVOLUNTARY DISCHARGES OF BLOOD, SPONTANEOUS or involuntary difcharges of blood often happen from various parts of the body. Thefe, however, are fo far from being always dangerous, that they often prove falutary* Whea fuch difcharges are critical, which is frequently the cafe ifi fevers, they ought not to be flopped. Nor indeed is it proper at any time to flop them, unlefs they be fo great as to endanger the patient's life. Moft people, afraid of the fmalleft difcharge of blood from any part of the body, fly immediately to the ufe of ftyptic and astringent medicines, by which means an inflammation of the brain, or fome other fatal difeafe, is occafioned, which, had the difcharge been allowed to go on, might have been prevented. Periodical difcharges of blood, from whatever part of the body they proceed, mult not be flopped. They are always the efforts of Nature to relieve herfelf ; and fatal difeafes have often been the confequence of obstructing them. It may iadeed be fometimes neceffary to check the violence of fuch difcharges ; but eveli this requires the greateft caution. Instances might be g;iveri where the ftopping of a fmall periodical flux of blood, from one of the fingers, has proved fatal to the health. In the early period of life, bleeding at the nofe is very ccn> f The cauftic alkali may be prepared by mixing two p*rts of quick-lime with one of pot- ides, and fuffering thim to Hand till the lixivium be formed, which muft be carefully filtra- ted before it be ufed. It th« fetation don j;oc happen readily, a ftruU quantity <°m «n t0 ^enJ:y d,op? of thS oil «f turpentine in a little water given frequently, W* com laili to flop a bleeding at the nofe, or from any other pait. • OF THE BLEEDING AND BLIND PILES. 230 It is often owing to an hereditary difpofition. Where this is the cafe, it attacks perfons more early in life than when it is accidental. Men are more liable to it than women, efpecially thofe of a fan- guine plethoric, or fcorbutic habit, crofa melancholy difpofition. Ihe piles may be occafioned by an excefs of blood, by ftrong aloetic purges, hi^i-feaf'oned food, drinking great quantities of fweet wines, the neglect of bleeding, or other cuft©mary evacuations, much rising, great coftivenefs, or any thing that occafions hard or difficult ftools. Anger, grief, or other vi lent paflions, will like- wife occafion the piles. I have often known them brought on by fitting on the damp ground. A pair of thin breeches will excite the diforder in a perfon who is fubject to it, and fometimes even in thofe who never had it before, Pregnant women are often afflict- ed with the piles. A flux of blood from the anus, is not always to be treated as a difeafe. It is even more falutary than bleeding at the nofe, and often prevents or carries off difeafes. It is peculiarly benefic.al in the gout, rheumatifm, afthma, and hyp chondrical complai ts, and often proves critical in colics, and inflammatory fevers. In the management of the patient, regard muft be had to his habit of body, his age, ftrength, and manner of living. A dif- charge which might be exceffive and prove hurtful to one, may be very moderate, and even falutary to another. That only is to be efteemed dangerous, which continues t o lon^ and is in fuch a quantity as to wafte the patient's ftrength, hurt the digeftion, nu- trition, and other functions neceffary to life. When this is the cafe, the difcharge muft be checked by a proper regimen, and aftringent medicines. The DIET muft be cool but nourifhing, confifting chiefly of bread, mHk, co ling vege- tables, and broths. The drink may be ch .lybeate watr, orange- whey, decoctions or infufions of the aftringent and mucilag nous phnts, as tn" tormentil root, biftort, the marfhrnalLw-roots, Sec. Old conferve of rofes is a very good medicine in this cafe. It may be mixed in new milk, and may be taken in the quantity of an ounce three or four times a*day. 1 his medicine is in no great repute, owing to its being feldom taken in fuch quantity as to pro- duce any effects ; but when taken as here directed, and duly per- fifted in, I have known it perform very extraordinary cures in vio- lent hemorrhages, efpecially when affifted by the tincture of rofes ; a tea-fpoonful of which may be taken about an hour after every dofe of the co'ferve. * The Peruvian bark is likewife proper in this cafe, both as a ftreng hener and aftringent. Half a drachm of it may be taken in a glafs of red wine, fharpened with a few drops of the elixir of vitriol, three or four times a-day. The bleeding piles are fometimes periodical, and return regu- larly once a month, or once w three weeks. In this cafe they are alwavs to.be confidered as a falutary difcharge, a^d bv n -> avians to be ftopped. Some have entirely ruined their health by ftopping a periodical difcharge of blood from the ha^morrhoidal veins. In the blind piles bleeding is generally of ufe. The diet muft 243 SPITTING OF BLOOD. be light and thin, and the drink cool and iluting.^ It is likewile neceffary that the body be kept gently open. This may be done by final! dofes of the flour of brimltone and cream of tartar.— Tnefe may be mixed in equal quanti ies, and a tea:lpoonful taken two or three times a-c!ay, or oftener if neceffary. Or an ounce of thefl ;ur of brimftono, a. d half an ounce of purified nitre may be mixed with three or four ounces of tha. lenitive electuary, and a tea-fpoonful of it taken three or four times a-day. Emollient ciyfters are here likewife beneficial 4 but there is fometimes fuch an attraction of the anus, that they cannot be thrown up.% m this cafe I have known a vomit have a very good effect. When tne pile? are exceeding painful and fweiled, but dif- charge nothing, the patient muft lit over the steams of worm water. He may likewile apply a linen cloth dipped in warm fpirits of wine to the part, or poultices made of bread and milk, or of leeks fried w\h 1-utter. If tnefe do not produce a difcharge,and the piles ap- pear large, leeches muft be applied as near them as poffible, or, if they will fix upon the piles themfelves, fo much the better. When leeches will not fix, the ptes may be opened with a lancet. The operation is very eafy, and is attended with no linger. Various ointments, and other external applications, are recommended in the piles; but I do not remember to have feen any effects from thefe, worth mentioning. Their principal ufe is to keep the part moift, w 'ich may be done as we'd by a fort poultice, or an emollient cata- pialm. When the pain however is very great, a liniment made of two ounces of emollient ointment, and half an ounce of liquid laudanum, beat up with the yolk qf an egg, may be applied. SPITTING OF BLOOD, WE mean here to treat of that difcharge of blood from the ''r.::s oiriy which is called an hanioptoe cr fpitting of blood. Perfons ,.t ilen r make, and a lax fibre,'who have long ne ks and strait treats are mcft liable to this difeafe. It is moft common in the fpr'n?, and generallv attacks people before they are at the prime or puddle period of life. It is a common observation, that thofewho have been fubject to bleeding at the nofe when ycung, are after- wards^ moil fiable to an hemoptoe. C AUoES.—An naenu. ptoe may proceed from excefs of blood, from a peculiar weaknefs of'th*' lungs, or a oad confirmation of •the breaft. It is often occafioned by exceffive drinking, running, v/reftling, finging, or fpeoking aloud. Such as have weak lungs pught to avoid oil violent exertions of t! at oigap,as they value 1 fe.* They fhould likew;fe guard ap,ainft vi lent r.affions, exceffive drink|] ir.g, and ev=rv tiling that ocafions a rapid circulation of the blood,! This difeafe may likew:fe proceed from wounds ofthe lungs.' Thefe may either be received from without, or they may be oc- cafioned by hard bodies getting into the wind-pipe, and io falling jlown upon the lungs, and hurting that tender organ. The ob- itruction of any cuftomary evacuation may occafion a fpitting of Wood ; as neglect of bleeding or purging at the ufual feafons, the ftoppage of the bleeding piles in men, or tye menfesin women, $ft SPITTING OF BLOOD, 341 Jt may likewife proceed from a polypus, fcirrhous concretions, or any thing that obftructs the circulation of the blood in the lungs. k is often the effect of a long and violent cough; in which cafe it is generally the forerunner cf a confumption. A violent degree of cold fuddenly applied to the external parts of the body will occafion an hemoptoe. It may likewife be occafioned by breathing air which is too much rarefied to be able properly to expand the lungs. This is often the cafe with thofe who work in hot places, as furna- ces, glafs-houfes, or the like. It is likewife faid to happen to fuch as alcend to the top of very high mountains, as the Peak of Ten- eriff'e, &c. Spitting of blood is not always to be confidered as a primary •difeafe. It is often only a fymptom, and in fome difeafes not an .unfavourable one. This is the cafe in pleurifies, peripneumonies, and fundry other fevers. In a dropfy, fcurvy, or confumption, it is a bad fymptom, and fhews that the lungs are ulcerated. S YMP TOMS.—Spitting ot blood is generally preceded by a fenfe of weight, and opprtiffion of the breast, a dry tickling cough, hoarfenefs, and a difficulty of breathing. Sometimes it is inhered in with fhivering, coldnefs of the extremities, coftivenefs, great laffitude, flatulence, pain of the back and loins, &c. As thefe fhew a general ftricture upon the veffels, and a tendency of the blood to inflammation, they are commonly the forerunners of a very copious difcharge. The above fymptoms do not attend a difcharge of blood from the gums or fauces, by which means thefe may always be diftinguifhed from an hemoptoe. Sometimes the blood that is fpit up is thin, and of a florid red colour; and a; other times it is thick, and of a dark or olackifh colour ; nothing how- ever can be inferred fro.n this circumftance, but that the blood has lain a longer or fhorter time in the breaft before it was ditcharged. Spitting of blood, in a ftrong healthy perfon, of a found con- ftitution, is not very dangerous ; but when it attacks the tender and delicate, or perfons of a weak lax fiore, it is with difficulty remov- ed. When it proceeds from a fcirrhous or polypus of the lungs, it is bad. The danger is greater when the difcharge proceeds from the rupture cf a large veffel than a fmall one. When the extrava- fated blood is not fpit up, but lodges in the breaft, it corrupts, and gre.it! y increafes t«e danger. When the blood proceeds from an ulcer 01 the h.r>-s it is generally fatal. REGIMEN.— foe patient ought to be kept cool and eafy.—• Everv thong that •■- '? the oodv or quickens the circulation, in- creafes the langer. The rind ought likewife to be footo.ed, and every occafion of exciting the paflions avoided. The diet fhould be foft, cooling;, a . 1 1L1 der ; as rice boiled with milk, fmall broth% barley -gruels, pau'd\ &e. The diet, in this cafe, can fcarce be too low. Even water-gruel is fufficient to fupport the patient for fome days. All nr^ng liquors muft be avoide!. ThepatL'.tmay drink milk and wafer, oarley-water, whey, butter-milk, and fucn like. Every tring however fhould be drank, cold, and in fmall quantities at a rim**. Fie fh.-niH obferve the ftricWt filence, or ^ leaft fpeak with a very low voice. aa* VOMITING OF BLOOD. MEDICINE.—This, like other involuntary difcharges of the Wood, ought not to be fuddenly ftopped by aftringent medicines, More mifchief is often done by thefe than if it were fufferedto go en. It may however proceed fo far as to weaken the patient, and even endanger his life; in which cafe proper means muft be ufed for reftraining it. The body fhould be kept gently open by laxative diet; as roafted apples, ftewed prunes, and fuch like. If thefe fhculd not have the defired effect, a tea-fpoonful of the lenitive electuary may be taken twice or thrice a-day, as is found neceffary. If the feed- ing proves violent, ligatures may be applied to the extremities, as directed for a bleeding at the nofe. If the patient be hot or fever- ifh, bleeding, and fmall dofes of nitre will be of ufe ; a fcruple or ■ half a drachm of nitre may be taken in a cup of his ordinary drink twice or thrice a-day. His drink may likewife be fharpened ' with acids, as juice of lemon, or a few drops f the fpirits of vitri- ol ; or he may take frequently a cup of the theture of rofes. Bathing the feet and legs in lukewarm water has likewife a very good effect in this difeafe. Opiates too are fometimes bene- fical; but thefe muft be administered with caution. Ten or twelve drops of laudanum may be given in a cup of barley-wateMwice a? day, and continued for fome tirae,provided they be found beneficial, j The conferve of rofes is likewife a very good medicine in this cafe, provided it be taken in fufficient quantity, and long enough ' perfifted in. It may be taken to the quantity of three or four ounces a-day ; and, if tho patient be trvbled with a cnugh, it.;3 ihoL»l be made into an electuary with balfamic fyrup, and a little ofthe fyrup of poppies. If ftronger aftringents be neceffary, fifteen or twenty drops of the elixir of vitriol may be given in a glafs of water three or four times a-day. Thofe who are fubject to frequent returns of this difeafe fhould avoid all excefs. Their diet fhould be light a^d co 1, confifting chiefly of milk and vegetables. Above all, let them beware of vig- orous efforts ofthe body, and violent agitations ofthe mind. VOMITING OF BLOOD. .. ■ THIS is not fo common as the other difcharges of blood which hive already been mentioned ; but it is very dangerous, and requires particular attenurn. Vomiting of blcod is generally preceded by pain of the ftomach, ficknefs, and naufea ; and is accompanied with great anxiety, and frequent fainting-fits. '1 his difeofe is fometimes periodical; in which. care it is H$ dangerous. It ofver proceeds from an obstruction ofthe menfes in women ; and fometimes from the ftoppage of the hemorrhoidal flux in men. It may be occafioned by any thi^g that greatly flirn- ulates or wounds the ftorrfach, as ftrong vrmlts or purges, anrid p-ifon, fnarp or h?rd fubftances taken into the ftomach, &c. ft is often the effect of obftruction in the liver, the fpleen, or fome of the other vifcera. OF BLOODY URINE. 243 It may likewife proceed from external violetS^'as blows, brui- fes, or from any of the caufes which produce inflammation. In hyfteric women, vomitting of blood is a very common, but by no means a dangerous fymptom. \ great part of the danger in this difeafe arifes from the extra- vafated blood lodging in the bowels, and becoming putrid, by which means a dyfentery cr putrid fever may be occafioned. The beft way of preventing this, is to keep the body gently open, by fre- quently exhibiting emollient clyfters. Purges muft not be given till the difcharge is flopt, otherwife they will irritate the ftomach, and increafe the diforder. Alt the food and drink muft be of a mild coolhag nature, and taken in fmall quantities. Even drinking cold water has fometimes proved a remedy, but it will fucceed the better when fharpened with the weak fpirits of vitriol. When there are figns of an inflammation, bleeding may be neceffary ; but th e patient's weaknefs will feldom permit it. Opiates may be of ufe ; but they muft be given in very fmall dofes, as four or five drops of liquid laudanum twice or thrice a-day.* After the difcharge is over, as the patient is generally troubled with gripes occafioned by the acrimony of the blood lodged in the inteftines, gentle purges will be neceffary. OF BLOODY URINE. THIS is a difcharge of blood from the veffels ofthe kidneys or bladder, occafioned by their being either enlarged, broken or erod- ed. It is more or lefs dangerous according to the different circum- stances which attend it. When pure blood is voided fuddenly without interrup- tion and without pain, it proceeds from the kidneys ; but f the blocfcl be in fmall quantity, of a dark colour, and emitted with heat and pain about the bottom of the belly, it proceeds from the - bladder. When bloody urine is occafioned by a rough ftone de- fcending from the kidneys to the bladder, which wounds the ureters, it is attended with a fharp pain in the back, and difricuhy or mak'ng water. If the coats of the bladder are hurt by a ftone and the bloody urine follows, it is attended with the moft acute pain, and a previous ftoppage of urine. Bloody urine may likewife be occafioned by falls, blows, the lifting or carrying of heavy burdens, hard riding, or any violent motion. It may alfo proceed from ulcers of the bladder, from a ftone lodged in the kidneys, or from violent purges or fharp diuret- ic medicines, efpecially cantharides. Bloody urine is always attended with fome degree of danger; but it is peculiarly fo when mixed with purulent matter, as this fhews an ulc.-r fomewoere in the urinary paffages. Sometimes this difcharge proceeds from excefs of blood, in which cafe it is rather to be confidered as a falutary evacuation than a difeafe. If the difcharge however be very great, it may wafte the patient's ftrength, and occafion an ill habit of b^ody, a dropfy or a confumption. The treatment of this diforder muft be varied according to the different caufes from which it proceeds. *44 OF THE DYSENTERY, OR BLOODY FLUX. When it is owing to a ftone in the bladder, the cure depends upon an operation, a defcription of which would be foreign to our purpofe. If it be attended with a plethora, and fymptoms of inflamma- tion, bleeding will be neceffary. The body muft likewife be kept open by emollient clyfters, or cooling purgative medicines; as cream of tartar, rhubarb, manna ; or fmall dofes of lenitive elec- tuary. When bloody urine proceeds from a diffolved ftate of the blood, it is commonly the fymptom of fome malignant difeafe ; as the fmall-pox, a putrid fever or the like. In this cafe the patient's life depends on the liberal ufe of the Peruvian bark and acids, as has already been fhewn. When there is reafon to fufpect an ulcer in the kidneys or bladder, the patient's diet muft be cool, and his drink of a foft healing balfamic quality, as decoctions of marfh-mallow roots with liquorice, foiutions of gum-arabic, Sec. Three ounces of rnarfh- mallow roots, and half an ounce of liquorice, may be boiled in two Englifh quarts of water to one; two ounces of gum-arabic, and half an ounce of purified nitre may be diffolved in the ftrained liquor, and a tea-cupful of it taken four or fives times a-day. The early ufe of astringents in this difeafe has often bad confe- quences. When the flux is ftopped too foon, the grumous blood, by being confined in the veffels, may produce inflammations, ab- fcefs, and ulcers. If however the cafe be urgent, or the patient feems to fuffer from the lofs of blood, gentle aftringents may be neceflary. In this cafe the patient may take three or four ounces of lime-water, with half an ounce of the tincture of Peruvian bark, three times a-day. OF THE DYSENTERY, OR BLOODY FLUX, f THIS difeafe prevails in the fpring and autumn. It is moll common in marfhy countries, where after hot and dry fummers, it is apt to become epidemic. Perfons are moft liable to it who are much expofed to the night air, or who live in places where the air is confined and unwholefome. Hence it often proves fatal in camps, on fhipboarcL in jails, hofpitals, and fuch like places. CAUSES.—The dyfentery may be occafioned by any thing that obstructs the perfpiration, or renders the humours putrid ; as damp beds, wet cloths, unwholefome diet, bad air, &c. But it is moft frequently communicated by infection. This ought to make people extremely cautious in going near fuch perfons as labour under the difeafe. Even the fmell of the patient's excrements has been known to communicate the infection. SYMPTOMS—It is known by a flux of the belly, attended by violent pains of the bowels, a conftant inclination to go to ftool, and generally more or lefs blood in the ftools. It begins like other fevers, with chillnefs, lofs of ftrength, a quick pulfe, great thirft, and an inclination to vomit. The fto .Is are at firft greafy and frothy, afterwards they are ftreaked with blood, and at laft have frequently the appearance of pure blood, mixed with fmall filaments OF THE DYSENTERY, OR BLOODY FLUX.' 245 refembling bits of fkin. Worms are fometimes paffed both up- wards and downwards through the whole courfe of the difeafe.— When the patient goes to ftool, he feels a bearing down, as if the whole bowels were falling out, and fometimes a part of the inteftine is actually protruded, which proves exceeding troublefome, efpecial- ly in children. Flatulency is likewife a troublefome fymptom, efpe- cially towards the end of the difeafe. This difeafe may be diftinguifhed from a diarrhoea or loofnefs, by the acute pain ofthe bowels, and the blood which generally ap- pears in the stools. It may be diftinguifhed from the cholera morbus by its not being attended with fuch violent and frequent fits of vomiting, &c. When the^ dyfentary attacks the old, the delicate, or fuch as have been waffled by the gout, the fcurvy, or other lingering dif- eafes, it generally proves fatal. ^ Vomiting and hickuping are bad figns, as they fhew an inflammation of the ftomach. When the ftools are green, black, or have an exceeding difagreeable cadave- rous fmell, the danger is very great, as it fhews the difeafe to be of the putrid kind. It is an unfavourable fymptom when the clyfters are immediately returned -, but ftill more fo when the paffage is fo obstinately fhut, that they cannot be injected, a feeble pulfe, cold- nefs of the extremities, with difficulty of fwallowing, and convul- fions, are figns of approaching death. REGIMEN.—Nothing is of more importance in this difeafe, than cleanlinefs. It contributes greatly to the recovery of the pa- tient, and no lefs to the fafety of fuch as attend him. In all conta- gious difeafes the danger is increafed, and the infection fpread by the neglect of cleanlinefs; but in no one more than this. Every thing about the patient fhould be frequently changed. The ex- crements fhould never be fuffered to continue in his chamber, but removed immediately and buried under ground. A conftant ftream of frefh air fhould be admitted into the chamber ; and it ought frequently to be fprinkled with vinegar, juice cf lemon, or fome other ftrong acid. The patient muft not be difcouraged, but his fpirits k°pt up in hopes of a cure. Nothing tends more to render any putrid dif- eafe mortal, than the fears and apprehenfions of ihe fick. All dif- eafes of this nature have a tendency to fink and deprefs the fpirits, and when that is increafed by fears and alarms from thpfe whom the patient believej to be perfons of fkill, it cannot fail f» have the worft effects. A flannel waiftcoat worn next the ikin has often a ve^y good effect in the dyfentery. This promotes the perfpiration without over heatirg the body. Great caution however is neceflary in leaving it off. I have often known a dyfentery brought on by im- prudently throwing off a flannel waiftcoat before the feafon was fufficiently warm. For whatever purpofe this piece of dr.efs is worn, it fhould never be left off but in a warm feafon. In this difr'fe the greateft attrrtion muft be paid to the pa- tient's diet. Flefh, fift, and every thing that has a tendency to tun putrid or rancid on the ftomach, muft be ablbb.ed frcin. A pples 246 OF THE DYSENTERY OR BLOODY FLUX. boiled in milk, water pap ; and plain light pudding, with broth made of the gelatinous parts of animals, may constitute the princi- pal part of the patient's food. Gelatinous broth not only an- fwers the purpofe of food, but likewife of medicine. I have often known dyfenteries, which were not of a putrid nature, cured by it, after pompous medicines had proved ineffectual.* Another kind of food very proper in the dyfentery, which may be ufed by fuch as cannot take the broth mentioned above, is made by boiling a few handsful of fine flour, tied in a cloth, for fix or feven hours, till it becomes as hard as starch. Two or three table- fpoonsful of this may be grated down, and boiled in fuch a quanti- ty of new milk and water, as to be of the thicknefs of pap. This may be fweetened to the patient's tafte, and taken for his ordinary food.f In a putrid dyfentery, the patient may be allowed to eat freely of ' moft kinds of good ripe fruit; as apples, grapes, goofeberries, cur- rant-berries, straw-berries. Thefe may either be eaten raw or boiled, with or without milk, as the patient choofes. The preju- dice againft fruit in this dtfeaf^is fo great that many believe it to be the common caufe of dyfenteries. This however is an egregious miftake. Both reafon and experience fhew, that good fruit is one of the beft medicines, both for the prevention and cure of the dyf- entery. Good fruit is in every refpect calculated to counteract that tendency to putrefaction," from whence the moft dangerous, ] kind of dyfentery proceeds. The patient in fuch a cafe ought therefore to be allowed to eat as much fruit as he pleafes, provided it be ripe.J The moft proper drink in this diforder is whey. The dyfen- * The manner of making this brath is, to take a fheep's he-d and feet with the fkis upon them, and to burn the wool oft'with a hot iron ; afterwards to boil them till the broth is quite a jelly. A little cinnamon or mace may be added, to g'vt the broth an agreeable fla- to'rr, a:id the patient may tike a little of it warm with toafted bread three or four times a-day; A clyfter of it maylikewi fe be given twice a-day, Such as cannot ufe the broth made in this w.iy, may have the heid and feet fkinned ; but we have reafon to believe that this injures, the medicine. It is not our bufinefs here to reafon upon the nature and qualities of medicine, otherwife this mi^ht be ihewn to poflefs virtues every way fuited to the cure of ■j dyfenr.iry which does not proceed from a putrid (late or" the humours. One thin? ws know which is preferable to a I reafoie free circulation ofthe blood through the veffels of the head, may rccafion a head-ach. In perfons of a full habit, who abound with blood, or other humours, the head-ach often proceeds from the fuppreffion of cuftomary evacuations ; as bleeding at the nofe, fweating of the feet, Sec. It may likewife pro- ceed from any caufe that determines a great flux of blood towards thehead; as coldnefs ofthe extremities, or hang:ng down ofthe head for a long time. Whatever prevents the return of the blood from the head will likewife occafion a head-ach ; as looking long oblique* Iy at any object, wearing any thing tight about the neck, a new hat or the like. When a head-ach proceeds from a ftoppage of a running at 'he nofe, there is a heavy, obtufe, preffing pain in the fore part of the head:, in which there feems to be fuch a weight, that the patient can fcarce hold it wp- When it is occafioned by the cauftic matter of the venereal difeafe, it generally affects the fkull, and often pro- duces a caries of the bones. Sometimes the head-ach proceeds from the repulfson or retro- ceflion ofthe gout, the eryfipelas, the fmall-pox, meafles, itch, or other eruptive difeafes. What is called a hemkrania generally pro- ceeds from crudities or indigeftion. Inanition, or eraptinefs, will often alfo occafion head-achs. I have often feen inftances of this in nurfes who gave fuck too long, or who did not take a fufficient quantity of folid ftVd. There is 1 kewife a moft violent, fixed, conftant and almoft intolerable head-ach, which occafions great debility both of body and mind, prevents fleep, destroys the appetite, caufes a vertigo, dimnefs of fight, a noife in the ears, convulfions, epileptic fits, and fometimes vomitting, coftivenefs, coldnefs ofthe extremities, Sec. The head-ach is often fymptomatic in continual and intermit- ting fevers, efpecially quartaus. It is likewife a very common fymptom in hyfteric and hypochondriac complaints. When a head-ach attends an acute fever, with pale urine, it is an unfavourable fymptom. In exceffive head-achs, coldnefs of the extremities is a bad fign. When the difeafe continues long, and is very violent, it often terminates in blindnefs, an apoplexy, deafhefs, a vertigo, the paify, or the epilepfy. In this d:feare the cool regimen in general is to be obferved. The diet ought to confift of fuch emollient fubftances as will cor- rect the acrimony of the humours, and keep the body open ; as apples boiled in milk, fpinnage, turnips, and fuch like. Tne drink ought to be diluting ; as barley-water, infufions of mild mucilagin- ous vegetables, decoctions of the fodorific woods, &c. Tne feet and legs ought to be kept warm, and frequently" bathed in luke- (17) ijg OF THE HEAD-ACH. warm water ; the head fhould be fhaved, and bathed with water and vkiegar- The patient ought as much as poffible to keep in ad erect pofture, and not to lie with his head too low. When the head-ach is owing to excefs of blood, or an hot bilious constitution, bleeding is neceffary. The patient may be bled in the jugular vein, and the operation repeated if there be oc- cafion. Cupping alfb, or the application of leeches to the temples, and behind the ear?, will be of fervice. .Afterwards a bliflering- plafter may be applied to the neck behind the ears, or to any part of the head that is moft affected. In fome cafes it will be proper to blifter the whole head. In perfons of a grofs haMt, iflues or perpetual blifti rs will be of fervice. The bjdy ought likewife to be kept open by gentle lax t:ves. But when the head-ach pr~cerds from a copirus vitiated ^rwn ftagnating in the membranes, either within of without the ikuil, with a dull, heavy, continual pain, which will ntit: er yield to bleed- ing, nor gentle laxatives, then more p werful purgatives are necef. fary, as pills made of alces, ref ng of j ftp, or the like. It will alfo be neceflary in this cafe to blifter the wh h head, and to keep the back part of the neck open for a confiderable lime by a perpetual bhfter. When the hcad-ach is cccifir,ned by the ftoppage cf a running at the nofe, the patient fhould frequently fmell to a bottle of v h. tile falts ; he may likewdie take nuff, or any thing that will irritate the nofe, fo as to promote a difenarge from it ; as the herb mafjich, ground ivy, &c. A hemkrania, efpecially a periodical one, is generally cwing to a foubefs ofthe ftomach, for which gentle vomits muft be admin- iftered, as alfo purges of rhubarb. After the bowels have been fufficiently cleared, chalybeate waters, and fuch bitcers as strength- en the ftomach, will be neceffary. A p riodicd head-ach has teen cured by wearing a piece of flannel over the forei.ead during the night. When the head-ach arifes from a vitiated ftate of the hu- mours, as in the fcurvy, and venereal difeafe, the patient after pr p- er evacuations, mnft drink freely ofthe decocti n of woods, or ne decoction of farfapariUa, with raifins and liquorice.* Trefe if duly perfifted in, will produce very happy effects. When a collectio; of matter is felt under the ikin, it muft be difcharged by an incifiodj o:herw;feit will render the bone carious. . When the head-ach. is fo intolerable as to endanger the pa- tients life, or is attended with Continual watching an delirium, re- courfe mu". be had to opiates. Thefe, after pr per evacuations by clyPers or mild purgatives, may be applied both externally and in- ternally. The affected part may be rubbed with Bate's anodvne balf m, or a cloth dipped in it may be applied to the p rt. The patient may, at the f?.metime, take twenty drops of laudanum, in a cup of valerian or pennv-r yal tea, twice or thrice a-day. This is only to be done in cafe of extreme pain. Proper evacuations ought * See Appendix, Dstolihn of SarftpariHe, OF THE TOOTH-ACH, 25* always to accompany and follow the ufe of opiates.i • Whea the p tier.t carnot bear the lofs of blood, his feet ought frequently to be bathed in lukewarm water, and well rubbed with a coarfe cloth. Cataplafms with mustard or hprfe-ridifn, ought likewife to be applied to rhem. This courfe is peculiarly neceffarv when the pain proceeds from a gouty humour affecting the head. When the head-ach is occasioned by great heat, hard labour or violent exercife of any kind, it may be allayed by cooling medi- cines ; as the faline draughts with nitre, and the like. A little rcthef* dropt into the palm of the hand, and applied to the forehead, will fometimes remove a violent head-ach. OF THE TOOTH-ACH. ■ , ., . THIS difeafe is fo well known, that it needs no defcription.—- It has great affinity with the rheumatism, and often fucceeds pains of the fhoulders and other parts of the body. , , . .■ It may proceed fr^m obftructed perfpiration, or any of the other catufes of inflammation, 1 have often known the tcof h-ach. occafioned by neglecting fome part of the ufual coverings of the head, by fitting with the head bare near an open window, <:r ex™ pofing it to a draught of cold air. Food r drink taken either too- hot or too cold is very hurtful to the ceeth. Great quantities cf fugar, or oth; r fweatmeats, are l:kewife hurtful. Nothing is more deftructive to the tee-n a patient in extreme pain, take three hundred drops in twenty-four hours; but fueh 4o<« outht only to be adminiftered by a perfon of &i!l, A 252 OF THE TOOTH-ACH. wife receive the fteams of warm wa'er hto his mouth, through aa inverted funnel, or by hrd 'ij>g h.shead over the mouth of a porrin- ger filled with warm water, &r. Such things as promote the diichirjre of fdiva, or caufe the patient to fpit, are generally cf lervice. For this purpofe, bitter, hot, or pungent vege'abs nav be ch -vci; as geiviao, cahmus aromaticus, or peliitory o; Sjrvn- Allen ree-rauends the mot of yellow -waterflower-de-luce in this cafe. Tris root may either be rub- bed upon the tooth, r a lit le of it chewed. Br vokes fays he hardlv ever k~ew \* ftii to eafe the tooth-ach. It ought however to be ufed w'th caution. Many other heros, roots, and feeds, are recommended for curing the tootn-ach ;' as "he leaves or roots of millefoil or yarrow chewed, tooacco fmoaked or chewed, Oaves acre, or the feeds of mustard chewed, &c Thefe bitter, h^t, and pungent things, by occafio ing a greater flow of faliva, frequently give eafe in the tootr.-ach. Opiates often relieve the tooth-ach. For this purp fe a little ce.fton wet with laudanum.may be held between the teeth ; or a piece of sticking-plaster, about the biguefs of a shilling, with a bit of opium in the middle of it, of a fize n t to prevent the flicking ofthe other, maybe laid on the temporal artery, where the pulfa- tion is moft fenfiSle. Dela Motte affirms, that th-re are few cafes wherein this will not give rehef. If there be a hollow tor th, a fmall pill made of equal parts of camphire and opium, put into the ihollow, is often beneficial. Waenthis cannot be ha., fhe hollow tooth may be filled with gum maftich, wax, lead, or any fubftance that will (tick in it, and keep out tne external air. Few applications give more r lief in the tooth-ach than blfbr- jng-ptafters. Thefe may be apolied betW' en the fh ul■'ers ; but t!'ey have the beft effect when put behiid the ears, and made fo large as to c ver a great p -rt cf the l w-r jaw. After all, wh'.nthe tooth is cariou?, it is often impoflible to remove the pain without extracting ii ; aad, as a fpoilt tooth never becomes found again, it is prudent to draw it foon, left it fhould affect the reft. Tooth-drawing, like ble-di'ig,.i$ very much practi- fed by mechanics, as well as perf as of the me 'ical profefhon,:8- The operation howev- r is not without danger, rnd ought always'to be performed with care. A perfon una'quaint -d with the ftructure of the parts w 11 be in dai g :r of i uning the jaw-bone, or of draw* ing a f und tooth inftead of a rotteo one* Woen the tooth-ach returns perKdicaly, and the pain chiefly aff cts the gu is, i may be cured by the bark. Some pretend to have found j-reat benefit in the tooth-ach, from the application of an artficial magnet to rhe affected* tooth.— We fhallnotartempt to acepunt for its mode of operation ; but, if it be fcundto anf /f r, thoug ' only in particular cafes, it ertainly deferves a trial, as it is attended with no expenfe, and cannot do any harm. Elect icity ha? likewife been recommeaded, and par- * This may always be prevented by the operator ftrikmg upon the teeth with any piece of metal, as this never fails to excite the (tain in the carious tooth. fc OF 'IHE EAR-ACH. %$% ticolar inftruments have been invented for fending a Ihock through the affected tooth. Perfons who have returns of the to »h-ach at certain feafm?. as fpring and autumn, might often prevent it by taking a purge at thefe times. Keeping the teeth clean has no doubt a tendency to prevent the tooth-acn. The beft method of doing this is t wafh them daily with fait and wa-er, a dec ction of th bark, or ce ds from infects, or any hard body flicking 'n the e^r, every m-t -td muft be takn. to remove th m as foon a-} pofli le. The membranes may be relaxed, by dropping into the ear, oil of fweet almonds, cr olive oil. Afterwards the pa- tient ihould be made to fneeze, by takicg fnuff, cr fome ftrong fternuatory. If this fhould not f-rce .^ut the body, it muft be extracted by-rt. I have feen infect:;, which had got into the ear, come out of their own accord up. np mriog in o 1. When the paia of toe ear proceeds from inflamrhaticn, it muft be treated like other topical inflammations, by a cooling regimen, and openivg medicines. Bleeding at ihe beginning, either in the arm orjugul.tr vein, or cuppi :g in the neck, w"Il be proper. The ear may likewife be fomented with fleams of warm water; or flan- nel bags filled with boiled mallows and camomik-flowers may be applied, to it warm; or bladders filled with warm milk and wafer. An exceeding good method cf fomenting the ear, is to apoly it clofe to the m u*v. of a jug filled with warm water, or a ftrong decoction of camomib-flowrs. The patient's feet fhould be frequently bathed in lukewarm water, and he ought to take fmall dofes of nitre and rhubarb, viz. a fcruple ofthe former, and ten grains cf the litter, three times a-day.—His drink may be whey, or a decoction of barley and li- quorice, with figs or raifins. The parts behind the ear ought fre- quently to be rubbed with camphorated oil, or a little of the vola- tile liniment. ?54 ?A1N OF THE STOMACH, &c. When the inflammation cannot be difcuffed, a poultice of bread and milk, or roafted onions, may be applied to the ear, and frequently renewed, till the abfcefs breaks, or can be opened.-— Afterwards the humours may be diverted from the part by gentle laxatives, bhfters, or inues; but the difcharge muft not be fuddenly dried up by any external application. PAIN OF THE STOMACH, 6c. THIS may proceed from various caufes, as indigeftion; wind; the acrimonv of the bile: fliarp, acrid, or poifonous fubftances taken into the ftomach, Sec. It may likewife be occafioned by worms; the ftoppage of cuftomary evacuations*.; a tranflaticn of gouty matter to the ft mach, the bowel's, Sec. " Women in thi decline of life are very liable to pains of the ftomach and bowels, efpecially fuch as are afflicted with hyfteric complaints. It is lik wife very common to hypochondriac men of a fedentary and luxurious life. In fuch perfon^ it often proves fo extremely obfira'e as to baffle all the powers of medicine. 1 When the pain "of the ftomach is moft violent after eating, there is reafon to fufpect that it proceeds from fome fault, either in the dig ftion or the fcod. In this cafe the patient ought to change his diet, till he finds what kind of fcod agrees beft with his ftomach, and fhould continue chiefly to ufe it. If a change of diet dees not re^r've t^e complaint, the patient may take a gertle vomit, and afterwards a dole or two of rhubarb. Ke ought likewife to take an infufion of camomile flowers, or fome other stomachic bitter, ieither in wine or water. I have often known exercife remove this complaint, efpecially failing, or a long journey on horfeback, or in a carriage. : ' ' " " : - When a p3in ofthe ftomach proceeds from flatulency, the pa- » tient is constantly belching up wind, and feels an uneafy distention , of the ftomach after meals. Th:s is a moft deplorable difeafe, and is feldom thoroughly cured; In general, the patient ought to avoid all windy dieL and every thjng that fours on the ftomach, as greens, roots, Sec. ' This rule however admits of fome exceptions. There are many inftances of perfons very much troubled with wind, who have received great benefit from eating parched peafe, though that grain is generally fuppofed to be of a windy nature.* T is complaint may frkevvife be greatly relieved by labour, ef- pecially digging," reaping, mowing,'or any kind of active employ- ment by whkfi the bowels are' alternately comprefled. ana1 dilated. The moft obftinate cafe of this kind I ever met with, was in a per- £... fon of a fedentary occupation, whom I advifed, after he had 'ried ** every kind of medicine in yain,to turn gardener which he did, and has' ever fince enjoyed good health.1 ■ „ ; When a pain ofthe ftomach is occasioned by the fwallowing of acrl, or poifbheus ftibftances, they mull be difcharged by v< mit; this may be excited by butter,oils, or other foft things, which fheath and defend the ftomach from the acrimony ©fits contents. * Tl.efe are prepared by fireping or foaking peafe in water, and afterwards drjing thvJH mach bittars, with now and then a full glafs of good wine. The beft purge for an adult is jalap and cabmel. Fveand twenty or tnirty grains ofthe fori ner vvl a fix or few n of t:;e latter, mixed in fyrup, .may be taken early in the morning, for a dofe.— It will be proper that the patient keep the houie all day, and driok notiiing c id. The dojfe may be repeated -nee or 'vice a week for a fortnight or three weeks. Ou the intermediate days t.ie patient may take a drachm of the powder of tin, twice or thrice a-day, mixed with fyrup, honey, cr treacle. Thofe who do n A chufe to take calomeh may make ufe of the bitter purgatives; as aloes* hiera picra, tincture of fenna, and rhubarb, Sec. Oily medicines are fometimes found beneficial for expeWng worms. An ounce ot falad oil and a table-fpoonful of common fait may be taken in a glafs of red port wine thrice a-dav, or ftener, if t.ieftomach will bear it. But the more common form of ufing .oil is in clyfters. Oily clyfters fweetened with fugar o-- honey, are yery efficacious in bringing away the fhort round worms called afcaridesy and likewife the teres. The Harrowgate wa'ter is an excellent medicine for expelling worms, efpeially the afcarides. As this water is impregnated with fulphur, we may hence infer, that fulphur aiore mull be a g od medicine in this cafe; which is found to be a fact. Many practi- tioners give flour of fulphur in very large dofes, and with great fuc- cefs. It fliould be made into an electuary with honey or treacle, and taken in fuch quantity as to purge the patient. Where Harrowgafe water cannot be obtained, fea-water may- be ufed, which is far from being a contemptible medic oe in this cafe. If fea-water cannot be had, common fait diflblvtd in water may be drank. I have often feen this ufed by country nurfes with very good effect. Some flour of fulphur may be taken over night, and the fait-water in the, morning. But worms though'expelled, will foon breed again, if the fto- mach remains weak and relaxed ; to prevent whic-, //e would re- commend the Peruvian bark. Haifa drachm of bark in powder may be taken in a glafs of red port wine taree or four times _ a-day, after the above medicines have been ufed. Lim water is likewife good for this purpofe, or a table-fpoonful of the chalybeate wine taken twice or thrice a-day. Infufions or de ;octions of bit*erherbs may 1 kewifeoe drank ; as the infufion f *-anry, water trz-foil, cam- omile flowers, tops of wormwood, the leff*r centaury, Sec. For a child of four or five years old, fix grains of rhubarb^ five of jalap, and two of calomel, may be mixed in a fpoonful of fyrup or honev, and given in the morning. The child fhould keep the houfe all day, and take nothing cold. This dofe may be re* * A medical writer of the prefent age has enumerated upwards of fifty Britifh plants, all celebuted for killing and expelling worips. 25« OF WORMS. peated twice 2-weak for three or four weeks. On the intermediate days the child may take a fcruple of powdered tin and ten grains of oethiops mineral in a fpoonful of treacle twice a-day. This doiV muft be increafed or ciminifhed according to the age of the patient. Biffet f.iys, the great baftard black hellebore, or bears foot, iq a moil powerful vermifuge tor the long round worm. He orders the decoction of about a drachm of the green leaves, or abaut fif- teen grains of the'dried leaves in powder for a dofe to a child be- tween four and feven years of age. This dofe is to be repeated two Or three times. He adds, that the green leaves made into a fyrup with coarfe fugar, is almoft the only medicine he has ufed for round worms for three years paft. Before prefling out the juice he moiftens the bruifed leaves with vinegar, which corrects the medicine. The dofe is a tea-fpoonful at bed-time, and one or two next morning. I have frequently known thofe big bellies, which in children' are commonly reckoned a fign of worms, quhe removed by giving tnem white foap in their potrage, or other food. Tanfy, garlic^ and rue, are all good againft worms, and may be ufed varl us ways. We might here mention many other plants, both for -x- ternal and internal ufe, as the cabbage-bark, &c. but think the powder of tin with aethiops mineral, and the purges of rhubarb, and calomel, are more to be depended on. Ball's purging vermifuge powder is a v°ry powerful medicine. It is made of equal parts of rhubarb, fcammony,and calomel, with as much double refined fugar as is equal to the weight of all the other ingredients. Thefe muft be well mixed together, and reduc- ed to a fine powder. The dofe for a child is from ten grains to twenty, once or twice a week, An adult may take a drachm for a dofe.* Parents who would preferve their children from worms ought to allow them plenty of exercife in the open air ; to take Care that their food be wholefome and fu anciently folid ; and as far as poffi- ble, to prevent their eating raw herbs,, roots, or green trafhy fruits. It will not be amifs to allow a child who is fuojeel to worms, a glafs of red wine after meals ; as every thing that braces and ftrengthens the ftomach is good both for preventing and expelling theie vermin.'!" * A powder for the tape-worm refembling this, was long kept a fecret on the Contineatj it was htelv purchafed by the French king, and will'be found under the article Powder, in the A| penci*. f We think it nrreflary here to warn people of their danger who buy cakrs, powders an! other worm medicine*, atrandom, from quacks, and give them to their children without nrr.per car*. The principal ingredients in moft of thele medicines is mercury, which is nev-r to be trifled wth. I lately faw a ihocking inftance ofthe danger of this conduct. A g'rl jvho had taken a dofsof worm powdrr, bought of a travelling quack, went cut, an?* perhaps, v>as fo imprudent as to drink cold water during its operation. She immediately fwelled, ami died oa the fo.lowing day with all the fymptoms of having been poifoned. 2-9 CHAP. XXXVIII. OF THE JAUNDICE. J_ HIS difeafe is firft obfervable in the white of the eye, which appears yellow. Afterwards the whole fkin puts on a yel- low appearance. The urine too is of a faffron hue, and dies a wnite cloth of the fame colour. There is likewife a fpecies of ihis difeafe called the Black Jaundice. CAUSES.—The intermediate caufe of the jaundice is an ob- ftruction of the bile. The remote or occafional caufes are, ih- bites of poifonous animals, as the viper, mad dog, &c. the bilious or hyfteric colic ; violent paflions, as grief, anger, Sec. Strong pur- ges or vomits will likewife occafion the jaundice. Sometimes it proceeds from obftinate agues, or from that difeafe bein^ prema- turely ftopped by aftringent medicines. In infants it is often oc- cafioned by the meconium not being fufficiently purged ofti Preg- nant women are very fubject to it. It is likewife a fymptom in feveral kinds of fever. Catching cold, or the ftoppage of cuftoma- ry evacuations, as thewtv^j, the bleeding piles, iflues, &c. will oc- cafion the jaundice. SYMPTOMS.—-The patient at firft complains of exceffive, wearinefs, and has great averfion to every kind of motion. His fkin is dry, and he generally feels a kind of itchi g or pricking pain over the whole body. The ftools are of a whitifh or clay colour, and the urine, as was pbferved above, is yellow. The breathing is difficult, and the patient complains cf an unulual load or oppreflicn on his breaft. There is a heat in his noftr Is, a bitter tafte in the, mouth, loathing of food, ficknefs of the ftomach, vomiting, flatulen- cy, and other fymproms of indigeftion. If the patient be young, and the difeafe complicated with no oth^r malady, it is feldom daogereus; but in eld people, where it continues long, returns frequently, or is complicated with the drop- fy or hypochondriac fymptoms, it generally proves fatal. The black jaundice is more dangercus than the yellow. REGIMEN.—The diet fhould'be cool, light, and diluting, confifting chiefly of ripe fruits and mild vegetables ; as apples boil- ed or roafted, ftewed prunes, preferved plums, boiled fpinn^ge, &c. Veal or chicken broth, with light bread, are likewife very proper. Many have been cured by livirg p.lmcft wholly for fome days en raw eggs. The drink fhould be butter-milk, whey fweet ned with hopey, or decoctions of cool opening vegetables ; or marfh-mallow roots, with liquorice, Sec. The patient fhould take as much exercife ns he ran bear, either on horfeback, or in a carriage; walking, running, and even jump- ing, are likewife proper, provided he can bear &er^L without pain, and there be no fymptoms of inflammation. Patients have b^en often cured of th;s difeafe by a long journey, af.er medicines had proved ineffectual. Amufements are likewife of great ufe in the jaundice- The difeafe is often occafioned by a feden.ary life, joined to a dull mcl- ato OF THE JAUNDICE. ancholy difpofition. Whatever therefore tends to promote the cir* culation, and to cheer the fpirits, muft have a good effect; as dan* cing, laughing, finging, &c. MEDICINE.—If the patient be young, of a full fanguine habit, and complains of pain in the right fide about the region of the liver, bleeding will be neceflary. After :his a vomit muft be adminiftered, and if the difeafe proves obftinate, it may be repeated once or twice. No medicines are more beneficial in the jaundice than vomits, efpecisrfly where it is not attended with inflammation. Haifa drachm of ipecacuanha in powder will be a fuffident dofe for an adult. It may be wrought off with weak camomile-tea, pr luke- warm water* The body muft likewife be kept open by taking a fufficient quantity of caftile foap, or the pills for the jaundice recom- mended in the Appendix. • Fomenting theparts abou' the region ofthe ftomach and liver, and rubbing them with a warm hand or flefh-brufh, are likewife beneficial; but it is ftill more fo for the j*■ tient to fit in a bath of warm water up to the breaft. He ought to do this frequently, and fhould c ntinue in it as long as his ftrength will permit. Many dirty things are recommended for the cure of the jjton. dice; as lice, millepedes, Sec. But thefe do more harm than good, as people truft to them, and neglect more valuable medicines; be- fides they are feldom taken in fufficient quantity to produce any effects. People always expect that Iuch things fti' uid aft as charms, and confequently feldom perfift in the ufe of them. V mirs^ pur. §es, fomentations, and exe*nfe, will feldom fail to cure the jaun- icewhen it is a fimple difesfe ; and when con plicated witt* the dropfy, a fcirrhous liver, or other chronic complaints, it is hardly to fee cured by any mems. Numberlefs Britifh herbs areextoPed for the cure of this dif. eafe. Theauthor of the Medkina Bntannka mentions near a hun- dred, all famous for curing toe jaundice. The fact is, the difeafe often goes off of its own accord; in which cafe the laft medi one is always faid to have performed the cure. I have fci&etimes, how- ever, feen confiderable benefit in a very obftinate jaundice, from a decoction of hempfeed. Four ounces of the feed may he boiled in two Englifh quarts of ale, and fweet ned with coarfe fugar. The dofe is half an Englifh pint every morning. It may.be continued for eight or nine days. I have likewife known Harrowgate fulphur water cure a jaun- dice of very long Handing. It fhould be ufed for fome weeks, and the patient muff both drink and bathe. "The foluble tar-ar is a very proper medicine in the jaundice.— A drachm of it may be taken every night and morning in a cup of tea or water-gruel. If it does not open the body, the dofe may be increafed. Perfons fubject to the jaundice ought to take as much exercife as poffible, and to avoid all heating and aftringent aliments. CHAP. XXXIX. $§t CF THE DROPSY. X HE dropfy is a preternatural fwelling ofthe whole body, or fome part of it, ccafioned by a coll- ction of watery humour, fa is diftinguifhed by d:ff--rent names, according to the part affected, as the anafarca, or collection of water under the ikin; the afcites, or collection of water in the belly ; the hydrops pecloris, or dropfy of the breaft ; the hydrocephalus, or dropfy of the brain, &c. CAUSES.—The dropfy is often owing to an hereditary dif- pofition. It may likewife proceed from drinking ardent fpirits, or Other ftrong liquors. It is true almoft to a proverb, that great drinkers die of the dropfy. The want of exercife is alfo a very corhmon caufe ofthe dropfy. Hence it is jultly reckoned among the difeafes of the fedentary. It often proceeds from exceffive evacuations, as frequent and copious bleeding, ftrong purges often repeated, fr-quent falivations, &c. The fudden ftoppage of cuf- tomary or neceffary evacuations, as the menfes, the haemorrhoids, fluxes ofthe bellv, &c may likewife caufe a dropfy. I have known the dropfy occafioned by drinking large quanti- ties of c^ld, weak, watery f quor, when the body was heated by violent exercife. A low, damp, or marfhy fituation is likewife a frequent caufe of it. Hence it is a common difeafe in moift, flat," fe.iny countries. It may alfo be brought on by a long ufe of poor watery diet, or of vifcous aliment that is hard of digeftion. It is often the effect of other difeafes, as the jaundice, a f irrhus of the liver, a violent ague of long continuance, a diarrhoea, dyfentery, an empye-na, or a confu uption of the lungs. In fhort, whatever ob- it ructs the perfpiration, or prevents the blood from being duly pre- pared, may ocofion a dropfy. SYMPTOMS.—The anafarca generally begins with a fwelling of the feet and ancles towards night, which for fome time difappears in the morning. In the evening the parts, if preffed with the fin- ger, will pit. The fwelling gradually afcends, and occup;es the trunk of the body> the arms, and the head. Afterwards the breath- ing becomes difficult, t'r.e urine is in fmall quantity, and the thirft great: the bodv is bound, and the perfpiration is greatly obstruct- ed. To thefe fuc:eed torp r, heavinefs, a fl .w wafting fever, and a troublefome cough. This laft is generally a fatal fymptom, as it fhews that the lungs are affected. In an afcites, befides the above fymptoms, there i^ a fwelling of the belly, and often a fluctuation, which maybe perceived by ftrik- ing the belly on one fide,and laying the palm ofthe hand on "the op- olite. This may be diftinguifhed from ^.tympany by the weight of the fwelling, as well as by the fluctuation. When the anafarca and afcites are combined, the cafe is very dangerous. Even a limph afcites feldom admits of a radical cure. Almoft all that can be done is, to let off the water by tapping, v/hich feldom affords more thaa a temporary relief. When the difeafe comes fuddenly on, and the patient h voting 26z OF THE DROPSY. and ftrong, there is reafon, however, to hope for a cure, efpecially if medicine be given early. But if the patient be old, has led an ir- regular or a fedentary life, or if there be reafon to fufpect that the liver, lungs, or any of the vifcera are unfound, there is great reafon ro fear that the confequences will prove fatal. REGIMEN.—The patient muft abftain as much as poffible from all drir.k, efpecially weak and watery liquors, and muft quench his thirft with muftard-whey, or acids, as juice of lemons, oranges forrel, or fuch like. His aliment ought to te dry, of a ftimulating and diuretic quality, as toafted bread, the fhfh of birds or other wild animals roafted : pungent and aromatic vegetables, as garlic muftard, onions, creffes, h.;rfe-radiih, rocambole, fhalot, &c. He may o.lfo eat f.a-bilcuit dipt in wine or a little brandy. This is not only nourifhirg, bur tends to quench thirft. Some have been actu- ally cured of a dropfy by a total abstinence from all liquids, and living entirely upon fuch things as are mentioned above. If the pa- tient muft have drink, the Spa-water, or Rhenifh wine, with diu- retic medicines infufed in it, are the beft. Ex:rcife is of the greateft importance in a dropfy. If the pa* r.ent be able to walk, dig, or the like, he ought to c ntinue thefe exercifes as long as he can. If he is not able to walk or laboor,'" he muft ride on horfeback, or in a carriage, and the more violenf £ the motion fo much the better, provided he cm bear it. His bed k ought to be hard, and the air of his apartments warm and dry. If he lives in a damp country, he ought to be removed into a dry one, and, if poffible, into a warmer climate. In a word, every method fliould be taken to promote the perfpiration, and to brace the folids For this purpofe it will likewife be proper to rub the patient's bocrf^ two or three times a-day. with a hard cloth, or the flefh-brufh; and o, he ought cor,flantly to wear flannel next his fkin. v MEDICoNE.—If the patient be ycung, his conftitution good, nod the ciife :fe lias come on fuddenly, it may generally be remov. ed by ftrong vomits, briik purges, and fuch medicines as promotea diicharge by fweat ad ur'ne. For an adult, half a drachm of ipe- cacuanha in powder, and h If an ounce of oxymel of fquills will be a •irop^r vomit. This may be repeated as often as is neceffary, three Or four days intervening between the dofes. The patient muft not drink much after takhig the vomit, otherwife he deftroys its effect. ,i cup or two cf camomile-tea will be fufficient to work it off. Bstvyeen each vo oi% on one of the intermediate days, the pa- tient may take the following purge : Jalap in powder half a drachm; cream of tartar two drachms, calomel fix grains. Thefe may be made into a bolus with a little fyrup of pale rofes, and taken early in the morning. The lrfs the patient drinks after it, the better. If he be much griped, he may now and then take a cup of chicken broth. The patient may likewife take every night at bed-time the fol- lowing bolus : To four or five grains or camphor add one grain of opium, and as much fyrup of orange-peal as is fufficient to make them into a bolus. This will generally promote a gentle fweat, which frould be encouraged by drinking now and then a fmall cflp OF THE DROPSY. 2<5j Etf wine-whey, with a tea-fpoonful of the fpirits of hartfhorn in it— A tea-cupful of the following diuretic infufion may likewife be taken every four or five hours through the day. Take juniper lorries, muftard-feed, and horfe-radifh, of each half an ounce,afhes of broom half a pound ; infufe them in a quart of Rhenifh wine or ftrong ale for a few days, and afterwards ltr.iin off the liquor. Such as cannot take this infuilm, may ufe the de- coction of feneka-root, which is both diuretic and fudcrific. I ave known an obftinate anafarca cured by an infufion of the allies of broom in wine. The above courfe will often cure an inc'dental dropfy, if the constitution be good ; but when the difeafe proceeds from a bad habit, or an unfound ftate of the vifcera, ftrong purges and vomits are not to be ventured upon. In this cafe, the safer c urfe is to pal- liate the fymptoms by the ufe of fuch medicines as promote the fe- cretions, and to fupp:rt the patient's ftrength by warm and nourifh- ing cordials. The fecretion of urine may be greatly promoted by nitre.— Brookes fays, he knew a young woman who was cored of a dropfy by taking a drachm of nitre every morning in a draught of ale, after fhe had been given over as incurable. The powder of f quills s like- wife a good diuretic. Six or eight grains of it, with a ftruple of nitre, may oe given twice a-day in a glafs of ftrong eiimamon- water. ^ Bali fays, a large fp onful of unbruifed muftard-feed tak-ri every night and morning,and dri. king half an Englifh pot of the decoction ofthe tops of gr.en broom after it, has performed a cure after other powerful medicines had proved ineffectual. . I have fometimes feen good effects from cream of tartar in this dfeafe. ^ It promotes the difch rges by ftool and urine, and will at 1 'aft palliate, if it does not perf ,rm a cure. Ths patient may begin by taking an ounce every fecond or third day, aad may increafe the quantity to two or even to three ounces, if the ftomach w 11 bear it. • This quantity is not however to be taken at otce, but di- vided into three or four dpf s. To promote perfpiration, the patient may ufe the decoct'on of feneka-root, as directed above ; or he may take two table-fpoons- ful of Mindererus' fpirit in a cup of wine-whey three cr four times a-day. To promote a difcharge of urine, the following infufion of the London hofpitals will likewife be beneficial: Take of zedoary-root two drachms; dried fquills, rhubarb, and juniper-berries bruifed,of each a drachm ; cinnamon in powder three drachms; fait of worm-wood, a drachm and a half; infule in an Englifh pint and a half of old hock wine, aid when fit for ufe, filter the liquor. A wine-glafs of it may be taken three or four times a-day. In the anafarca it is ufual to fcarify the feet and legs. By this means the water is often difcharged; but the operator muft be cau- tious not to make the incifions too deep ; they ought barely to pierce-through the fkin, and efpecial care muft be taken, by fpiritu- ous fomentations and proper digestives, to prevent a gangrene. In an afcites, when the difeafe does not evidently and lpeedily 254 OF THE GOUT. give way to purgative and diuretic medicines, the water ought to be let off by tapping. This is a very fimple and fafe operation, and would often iucceed, if it were performed in due time; but if it be delayed till the humours are vitiated, or the bowels fpoiled, by long loaking in water, it can hardly be expected that any permanent relief will be procured.* After the evacuation of the water, the patient is to be put on a courfe of strengthening medicines ; as the Peruvian bark ; the elixir of vhriol; warm aromatics, with a due proportion of rhu» barb, infufed in wine, and fuch like. His diet ought to be drv and nourifrfng, fuch as is recommended in" the beginning ofthe chap- ter, and he fhould take as much exercife as he can bear without fatigue. He fhould wear flannel next his fkin, and make daily ufe of the flefh-brufh. CHAP. XL. OF THE GOUT. JL HERE is no difeafe which fhews more the imperfection of medirine, or fets the advantages of temperance and exercife in a stronger light, t:an the gout. Excefs and idlenefs are the true four. ces from whence it originaly fprung, and all who would avoid it muft be active ao.d temperate. Though idlenefs and intemperance are the principal caufes of the gout, yet many other things may contribute to bring on the dif order, and to induce a parcxvfm in thofe who are fubject to it; as inteofe ftudv ; too free an ufe of acidulated Pernors; night-watcK. ing; grief lood be let in this difeafe, it has generally the fame appearance as in the pleurify. In this kind of rheumatifm the treatment of the patient is near- ly the fame as in an acute or inflammatory fever. If he be young and ftrong, bleeding is neceffarv, which may be repeated according to the exigencies of the cafe. The body ought likewife to be kept open by emollient clyfters, or cool opening liquors; as deccction/; of tamarinds, cream of tartar, whey, f.nna-tea, and the like. rl he diet fhould be light, and in fmail quantity, confifting chiefly of roaft- ed apples, groat-gruel, or weak chicken broth. After the feverifh fymptoms have abated, if the pain ftill continues, the patient muft keep his bed, and take fuch things as promote perfpiration, as wine- whey, with fpiritus Mindercri. Sec. He may likewife take, for a feW nights, at bed-time, in a cup of wine-whey, a drachm of the cream of tartar, and half a drachm of gum guaiacum in powder. Warm bathing, after proper evacuations, has often an exceed- ing good effect. The patient may either be put into a batn of warm water, or have cloths wrung out of it applied to the parts affected. Great care muft be taken that he do not catch cold after bathing. The chrome rheumatifm is feldom attended with any confider- able degree of fever, and \s generally confined to fome particular part of the body, as the fhoul 4ers, the back, or the loins. There is feldom any inflammation or fwelling in this cafe. Perfons in the ' decline of life are moft fubject ta*the chronic rheumatifm. In fuch patie.itsit often proves extremely obftinate aad-fomerimes incurable. In this kind of rheumatifm the regimen fhould be nearly the^ fame as in the acute. Cool and diluting diet, confifting chiefly of vege*able fnbftances, as ftewed .prunes, coddled apples, currants or goofc-berries boiled in milk, is moft proper. Arbuthnot fays, " If there b? a fpecific in aliment for the rheumatifm, it is certainly whey;" and adds, that he " knew a perfon fubje^ to this difeafe, who could never be cured by any other method but a diet °f whey and bread." He likewife fays, that "cream of tartar in water- gruel, taken for feveral days, will eafe rheumatic pains confidera- blv." ^ This I have often experienced, but found it always more .efficacious when joined with gum guaiacum, as already directed.— In this cafe the patient may take the dofe formerlv mentioned, twice a-day, and likewife a tea-fpoon full of the volatile tincture of guni, guaiacum, at bed-time, in wine-whey. This courfe may be continued for n week,-or longer, if tlv> 27° OF TlIE RHEUMATISM. cafe proves obftinate, and the patient's ftrength will permit, h ought then to be omitted for a few days, and repeated again. At the fame time leeches, or a blistering plafter may be applied to the part affected. What I have generally found anfwer better than eith- er of thefe, in obftinate fixed rheumatic pains, is the* warm plafter* I have likewile known a plafter of Burgundy pitch worn for lome time on the part affected, give great relief in rheumatic pains. My ingenious friend Dr. Alex nder, of Edinburgh, fays, he has fre- quently cured very obftinate rheumatic pains, by ruobing ttie part affected, with tincture of cantharides. When the common tincture did not fucceed, he ufed it of a double or treble ftrength. Cupping upon the part aff.&ed, is likewife often very beneficial, and fo is the application of leeches. Thongh t h' s difeafe may- not feem to yield to medicines for fome time, yet they ought still to be perfifted in. Perfons who are fub- ject to frequent returns of the rheumatifm, will often find their ac- count in ufing medicin-s, whether they be immediately affected with the difeafe or not. The chronic rheumatifm is fimilar to the gout in this refpect, that the moft proper time for ufing medicines to ex- tirpate it, is when the patient is moft free from the diforder. To thofe who can afford the expenfe, I would reccommend the warm' baths of Buxton or Matlock in Derbyfhire. Thefe have,of- .''+ tea, to my knowledge, cured very obftinate rheumatiihis, and are always fafe either in or out of ihe fit. When the rheumatifm U complicated with fcorbutic complaints, which is not feldom the cafe, the Harrowgate wa'.ers, and thofe of Moffat, are proper. They < fhould both be drank and ufed as a warm bath. There are feveral of our own domeftic plants which may be ufed with advantage in the rheumatilm. One of the beft is the white muftard. A table-fpoonful of the feed of this plant may be taken twice or thrice a-day, in a glafs of water or fmall wine. The wa- ter-trefoil is likewife of great ufe in this complaint. It may be in- fufed in wine or ale, or drank in form of tea. The ground-ivy, camomile, and feveral other bitters, are alfo beneficial, and maybe ufed in the fame manner. No benefit however is to be expected from thefe unlefs they be taken for a confiderable time. Excellent medicines are often defpifed in this difeafe, becaufe they do not per- form an immediate cure; whereas nothing would be more certain than their effect, were they duly perfifted in. Want of perfever- ance in the ufe of medicines, is one reafon why chronic difeafes are fo feldom cured. Cold athing, efpecially In falt-water, often cures the rheuma- tifm. We would alfo recommend riding on horfeback, and wear- ing flannel next the ikin. Iflues are likevvife very proper, efpecial- ly in chronic cafes. If the pain affects the fnoulders, an iflue may be made in the arm; but if it affects the loins, it fhould be put into the leg or thigh. Perfons afflicted with the fcurvy are very ihbjett to rheumatic complaints. The beft medicines in this cafe are bitters and mild purgatives. Thefe may either fyp taken feparateiy or together, a: • See Appendix, ff'arm Ylaf.-r. OF THE SCURVY. 271 the patient inclines. An ounce of Peruvian bark, and half an ounce of rhubarb in powder, may be infufed in a bottle of wine; and one, two, or three wine-glaffes of it taken daily, as fhall be found neceflary for keeping the body gently open- In cafes where the bark itfelf proves fufficiently purgative, the rhubarb may be om.tted. Such as are fubject to frequent attacks of the rheumatifm, ought to ihakv choice of a dry, warm fituation, to avoid the night- air, wet cl-thes, and wet feet, as much as poffible. Their clothing fliould be warm, and they fhould wear flannel next their fkin, and make frequent ufe of the flefh brufh. CHAP. XLI. OF THE SCURVY, J. HIS difeafe prevails chiefly in cold northern countries, es- pecially in 1 w. damp fituations, near large marines, or great quan- tities of ft ignating water. Sedentary people, of a dull melancholy difpofition, are moft fubject to it. It proves often fatal to failors on long voyages, particularly in fhips that are not properly ventilated, have many p°;.ple on board, or where cleanlinefs is neglected. It is not neceffary to mention the different fpecies into whicjj this difeafe has been divided, as they differ from one anther chiefly in degree. What is called the land fcurvy, however, is feldom at- tended with thofe highly putrid fymptomsWuch appear in patients who have been long at fea, and which, we preiume, are rather ow- ing to confined air, want of exercife, and the unwholefome food eat- en by failors on long voyages, than to any fpecific difference in the difeafe. CAUSES.—The fcurvy is occafioned by cold moift air; by the long ufe of falted or fmoke dried provifions, or any kind of food that is hard of digeftion, and affords little nourifhment. It may alfo proceed from the fuppreffion of cuftomary evacuations; as the men- fes, hemorrhoidal flux, &c. It is fometimes owing to an heredit- ary taint, in which cafe a very fmall caufe will excite the latent dif- order. Grief, fear, and other deprefling paflions, have a great ten- dency both to excite and aggravate this difeafe. The fame obfer- vation holds with regard to neglect of cleanlinefs; bad clothing; the want of proper exercife; confined air; unwholefome food; or any difeafe which greatly weakens the body, or vitiates the humours. SYMPTOMS.—This difeafe maybe known by unufual weari- nefs, heavicefs, and difficulty of breathing, efpeci.lly after motion; rottennefs of the gums, which are apt to bleed on the flighteft tofl^h; a ftinking breath; frequent bleeding at the nofe; crackling of the joints; difficulty of walking; fometimes a fwelling and fometimes a falling away of the legs, on which there are livid, yellow^ or violet coloured fpots; the facets generally cf a pale or leaden colour. As the difeafe advances, other fymptoms come on; as rottennefs cf ihe teeth, hmmarrnnges or difcharges of blood from different parts ofthe body, fgul oblthrite ulcers/pains in various parts, efpecially 27* OF THE SCURVY. about the breaft, dry fcaly eruptions all over the body, Sec. At laft a wafting or hectic fever comes on, and the miferable patient is often carried off by a dyfentery, a diarrhoea, a dropfy, the pally, fainting fits,^ or a mortification of fome of the bowels. CURE.—We know no way of curing this difeafe but by pur. fuing a plan directly oppofite to that which brings it en. It proceeds from a vitiated ftate of the humours, occafioned by errors in diet, air, or exercife; and ihis cannot beiemoved but by a proper atten- tion to thefe important articles. If the patient has been obliged to breathe a cold, damp, or con- fined air, he fliould be removed, as foon as poffible to a dry, open, and moderately warm one. If there is reafon to believe that the difeafe proceeds from a fedentary life, or depreffing paflions, as grief, fear, Sec. the patient muft take daily as much exercife in the open air as he can bear, and his mind fhould be diverted by cheerful company and other amufements. Nothing has a greater tendency either to prevent or remove this difeafe, than conftant cheerfulnels and good humour. But this, alas 1 is feldom the lot of perfons af- flicted with the fcurvy; they are generally furly, peevilh and morofe. When the fcurvy has been brought on by a long ufe of falted provifions, the proper medicine is a diet confifting chiefly of frefh vegetables; as oranges, apples, lemons, limes, tamarinds, water- crefles, fcurvy-grafs, brook-lime, &c? The ufe of thefe, with milk, pot-herbs, new bread, and frefh beer or cyder, willfeldom failto re- move a fcurvy of this kind, if taken before it be too far advanced, but to have this effect they muft be perfifted in a confiderable time. When frefh vegetables cannot be obtained, pickled or preferved ones may be ufed; and where thefe are wanting, recourfe muft be had to the chymical acids. All the patient's food and drink fhould in this cafe be fharpened with cream of tartar, elixir of vitriol, vin- egar, or the fpirit of fea-felt. Thefe things however will more certainly prevent than cure the fcurvy, for which realon fea-faring people, efpecially on long voya* ges, ought to lay in plenty of them. Cabbages, onions, goofeber- ries, and many ether vegetables, may be kept along time, by pickling, frefcrving, Sec. and when thefe fail, the chymical acids, recommen- ded above, which will keep for any length of time, may be ufed. We have reafon to believe, if fhips were well ventilated, had got. ftore of fruits, greens, cyder, kc. laid in, and if proper regard were paid to cleanlinefs and warmth, that failors would be the molt healthy people in the world, and would feldom fuller either from the fcurvy or putrid fevers, which are fo fatal to that ufeful fet of men; but it is too much the temper of fuch people to defpife all pre- caution ; they will not think of any calamity till it overtakes them, when it is too late to ward off the blow. It muft indeed be owned, that many of them have it not in their power to make the provifion we are fpeaking of; but in this cafe it is the duty of their employer to make it for them; and no man ought to engage in a long voyage without having thefe articles fecured. I have often feen very extraordinary effects in the land fcurvy OF THE SCURVY. 273 from a milk diet. This preparation of nature is a mixture of ani- mal and vegetable properties, which of all others is the moft fit for reltoring a decayed conftitution, and removing that particular acri- mony ofthe humours, which feems to constitute the veryeffence of the fcurvy, and many other difeafes. But people defpife this whole- fome and nourifhing food, becaufe it is cheap, and devour with greedinefs, flefh and fermented liquors, while milk is only deemed fit for their hogs. The moft proper drink in the fcurvy, is whey or butter-milk. When thefe cannot be had, found cyder, perry, or lpruce-beer, may be ufed. Wort has likewife been found to be a proper drink in the fcurvy, and may be ufed at fea, as malt will keep during the longeft voyage. A decoction of the tops of the fpruce fir is likewife prop- er. It may be drank in the quantity of an Englifh pint twice a-day. Tar-water may be ufed for the fame purpofe, or decoctions of any of the mild mucilaginous vegetables: as farfapariUa, marfh-mallow roots, &c, Infufions of the bitter plants, as ground ivy, the leffer centaury, marfh-trefoil, Sec. are likewife beneficial. I have feen peafants in fome parts of Britain exprefs the juice ofthe laft men- tioned plant, and drink it with good effect in thofe foul fcorbutic eruptions, with which they are often troubled in the fpring feafon, Harrowgate wateris certainly an excellent medicine in the land- fcurvy. I have often feen patients who had been reduced to the moft deplorable condition by this difeafe, greatly relieved by drink- ing the fulphur-water, and bathing in it. The chalybeate-w- ter may alfo be ufed with advantage, efpecially with a view to brace the ftomach after dnnkmg the fulphur-water, which though it fharpenc the appetite, never fails to weaken the powers of digeftion. A flight degree of fcurvy may be carried offby frequently fuck- ing a little of the juice cf a bitter orange or lemon. When the dif- eafe affects the gums only, this practice, if continued for fome time, will generally carry it off. We would however recommend the better orange as greatly preferable td lemon, it feems to be as good a mediciue, and is not near fo hurtful to the ftomach. Perhaps oui own forrel may be little inferior to either of them. '. All kinds of falad are good in the fcurvy, and~ ought to be eat- en very plentifully, as fpinnage, lettuce, parfley, celery, endive, rad■■ ifh, dandelion, Sec. It is amazing to fee how foon frefh vegetables in the fpring, cure the brute animals of any fcab or foulnefs which is upon their fkins. It is reafonable to fuppofe that their effects would be as great upon the human fpecies, were they ufed ia prop- er quantities for a fufficient Length of time. I have feen good effects in fcorbutic complaints of very long Handing, from the ufe of a decoction of the roots of water dock. It is ufually made by boiling a pound of the frefh root in fix Englifh pints of water, till about one third of it be confumed. The dofe is from half a pint to a whole pint ofthe decoction every day. But iu all the cafes where I have feen it prove beneficial, it was made much ftronger, and drank in larger quantities. The fifeft way, however, is for the patient to begin with fmall dofes, and increafe them both in ftrength and quantity as he finds his ftomach will bear 274 OF THE SCROPHULA, OR it. It muft be ufed for a confiderable time. I have known iome take it for many months, and have been told of others who had ufed it for feveral years, before they were fenfible of any benefit, but v/ho neverthelefs were cured by it at length. The I profy, which was fo common in the country long ago, feems to have been near a-kin to the fcurvy. Perhaps its appear. ing fo feldom now, may be owing to the inhabitants of Britain eat- ing more vegetable food than formerly, living more upon tea and other diluting diet, ufing l.fs falted meat, being more cleanly, bet- ter lodged andcloathed, &c. For the cure of this difeafe we would recommend the fame courfe of diet and medicine as in the fcurvy. OF THE SCROPHULA, OR KING'S EVIL. THIS difeafe chiefly affects the glands, efpecially thofe ofthe neck. Children and young perfons of a fedentary life are very fub- ject to it. It is one of thofe difeafes which may be removed by proper regimen, but feldom yields to medicine. The inhabitants * of cold, damp, marfhy countries, are moft liable to the fcrophula. CAUSES.—'I his difeafe may proceed from an hereditary taint, from a fcorphulous nurfe, &c. Children who have the misfortu&i to be born of fickly parents, whofe conftitutions have been greatly* ( injured by the pox, or other chronic difeafes, are apt to be affe£leq :\ with the fcrophula. It may likewife proceed from fuch aifeafesai .i weaken the habit or viriate the humours, as the fmall pox, meafles; Sec. External injuries, as blows, bruifes, and the like, fometimes, / produce fcrophulous ulcers; but we have reafon to believe, when • this happens, that there has been a prediipofition in the habit to this difeafe. In fhort, whatever tends to vitiate the humours or relax the folids, paves the way to the fcr phula; as the want of proper, exercife, too much heat or cold, confined air, unwholefome food, bad water, the long ufe of poor, weak, watery aliments, the neglect of cleanlinefs, Sec. Nothing tends more to produce this difeafe in children, than allowing them to continue long wet.* SYMPTOMS.—At firft fmall knots appear under the chin, or, behind the ear?, which gradually increafe in number and fize, till they form one large hard tumour. This often continues for a long time without breaking, and when it does break, it only difchar- ges a thin fames, cr watery humour. Other parts of the body are likewife fable to its attack, as the arm-pits, groins, feet, hands, eyes, breafts, Sec. Nor are the internal parts exempt from it. It often affects the lungs, liver, or fpleen; and I have frequently feen the glands of the myientery greatly enlarged by it. Thofe obftinate ulcers which break out upon the feet and hands with fwelling, and little or no rednefs, are of the fcrophulous kind. They feldom difcharge good matter, and are exceedingly difficult to cure. The white fuellings cf the joints feem likewife to be of this k'nd. They are with difficulty brought to a fuppuration, and when opened, they only difcharge a thb. ichor. There is not a more gen- eral fymptom of thefcrcphulathana fwell ing of the upperlip and nofe- * The fcrophula, "as well as .erous and nourifhiag, bin- at the fame time light and 1 aiyof dig^fti* n: as wdl fermented bread, made of fouud grab, the flefh and broth of young animals, with now and then a glafs cf generjus wine, cj- good ale. The air ought to be open, dry a«d not too cold., and the pa ient fhould take as much exercife as he can bear.. [his is of the utnaoft importance. Child- ren who have fufficient exercife, are feidom troubled with the fcro- phula. MEDXINE.-^The vulgar are remarkably credulous with re- gard to the cure of the fcrophula; many of them believing in the virtue of the royal touch, that of the feventh fon, 8ec. The truta is, we know but little either of the nature and cure of this difeafe, and where reafon or medicines fail, fup rrftition always comes in their place. Hence it is, that in difeafes which are moft difficult to un- derftand, we generally hear of the greatest number of miraculous cures being performed. Here, however, the deception is eafily ac- counted for. The fcrophula, at a certain period of life, often cures of itfelf; and if the patient happens to be touched about this time, the cure is imputed to the touch, and not to nature, who is really the phyfician. In the fame way the infignificant noftrums of quacks , and old women, often gain applaule when they deferve none. There is nothing more pernicious than the cuftom of plying children in the fcrophula with ftrong purgative medicines. People imagine it proceeds from humours which muft be purged off, with- out confidering that thefe purgatives increafe the debility, and ag gravate the difeafe. It has indeed been found, that keeping the body gently open for fome time, elpecially with fea-water, has 3. good effect; but this fhould only be given in grofs habits, and io fuch quantity as to procure one, or at moft two ftools every d:n\ Bathing in the fair-water has likewife a very good effect, efpe rially in the warm feafon. I haveoften known a courfe of bathing in fait-water, and drinking it in fuch quantities as to keep the body gently open, cure a fcrophula, after many other medicines had been tried in vain. When fait water cannot be obtained, the patienc may- be bathed in frefh water, and his body kept open by fmall quanti- ties of fait and water, or fome other mild purgative. Next to cold bathing, and drinking the fait water, we would recommend the Peruvian bark. The cold bath may be ufed in fum- mer aud the bark in winter. To an adult half a drachm ofthe bai ac in powder may be given in a glafs of red wine, four or five times a-day. Children, and fuch as cannot take it in fubftance, may ufe the decoctum, made in the following manner: Boil an ounce of the Peruvian bark, and a drachm of Winter's bark, both grofsly powdered, in an Englifh quart of water to a pint: towards the end, half an ounce cf fliced liquorice-root, and a hand- ful of raifins may be added, which will both render the decoction lefs difagreeable, and make it take up more ofthe bark. The ,,;quor muft be ftrained, and two, three, or four table fpoonsful, :t>:<:crd- irg to the age of the patient, given three times a-day. The Moffat and Harrowgate watery efpeci?,!!;/ >■?:■ Ki^-, n^ *7« 0,?? THE ITCH. likewife very proper Medicines in the fcrophula. They ought not, however, to be drank in large-quantities, but fhould be taken fo as to keep the body gently open, and muft be ufed for a confidera- ble time. The hemlock may fometrmes be ufed with advantage m the fcrOphnla. Some lay it down as a general rule, that the lea-water is moft proper before there are any fuppuration or fymptoms of tabes f the Peruvian bark, when there are running fores, and a degree of hectic fever; and the hemlock in old inveterate cafes, approaching to the fcirrhous or cancerous ftate. Either the extract, or the frefn juice of this plant may be ufed The dofe muft be fmall at firft, and increafed gradually as far as the ftomach is able to bear it. External applications are of little ofe. Before the tumour break* nothing ought to be applied to it, unlefs a piece of flannel, or fome- thing to keep it warm. After it breaks, the fore may be dreffed with fome digeftive oin tment. What I have always found to anfwer beft, was the yellow bafilicon mixed with about a fixrh nr eighth part of its weight of red precipitate of mercury. The fore may be dreffed with this twice a»day; and if it be very fungous, and doe? not digeft weH, a large proportion of the precipitate may be added. Medicines which mitigate this difeafe, though they do not cure it, are not to be defpifed. If the patient can be kept alive by any means till he arrives at the age of puberty, he has a great chance to get well; Tbut if he does not recover at this time, in all probability he never will. There is no malady which parents are fo apt to communicate to their offspring as the'fcrophula, for which reafon people ought to beware of marrying into families affected with this difeafe. For the m?ans of preventing the fcrophula we muft refer the reader to the obfervations on nurfing at the beginning of the book* OF THE TTCH. THOUGH this difeafe is commonly communicated by infec- tion, yet it feldom prevails where due regard is raid to cleanlinefs, i refh air and wholefome diet. It generally appears in form of fmall watery puftules, firft about the wrifts or between the fingers; after- wards it affects the arms, legs, thighs, Sec. Thefe puftules are at- tended with an intolerable itching, efpecially when the patient is warm in bed, or fits by the fire. Sometimes indeed the flcin is cqv- esed with large blotches or fcabs, and at other times with a white fcurf, or fcaly eruption. This laft is called the dry itch, and is the moil difficult to-cure. The itch is f-idom a dangerous difeafe, unlefs when it is ren- dered fo by negle& or improper treatment. If it be fuffered to con- tinue too long, it may vitiate the whole mafs of humours; and if it be fuddenly drove in, without proper evacuations, it may occafion fevers, inflammations of the vifcera, or ether internal diforders. The beft medicine yet known for the itch is fulphur, which oueht to be ufed both externally and internally. The parts moft affected may be rubbed with an ointment made ofthe flour of ful- phur, two ounces^ crude fal anaivjoniac finely powdered, two drachms; OF THE ITCH. %%i hog'slard» or butter, four ounces. If a fcruple or half a drachrn ot the effence of lemon be added, it will entirely take away the dif- agreeable fmell. About the bulk of a nutmeg of this may be rub- bed upon the extremities at bed-time twice or thrice a week. It is feldom neceflary to rub the whole body; but when it is, it ought not to be done all at once, but by turns, as it is dangerous to ftop too many pores at the fame time. Before the patient begins to ufe the ointment, he ought, if he be of a full habit, to bleed or take a purge or two. It will likewife be proper, during the ufe of it, to take every night and morning, as much of the flour of brimstone and cream of tartar, in a little trea- cle or new milk, as will keep the body gently open. He fhould be- ware of catching cold, fhould wear more clothes than ufual, and take every thing warm. The fame clothes, the linen excepted, ought to be worn all the time of ufing theointment; and fuch clothes as have been worn while the patient was under the difeafe, are not to be ufed again, unlefs they have been fumigated with brimstone, and thoroughly eleanfed, otherwife they will communicate the in- fection anew.* I never knew brimftone, when ufed as directed above, fail to the itch; and 1 have reafon to believe, that if duly perfifted in, it never will fail, but if it be only ufed once or twice, and cleanlinefs neglected, it is no wonder if the diforder returns. The quantity of ointment mentioned above will generally be fufficient for the cure of one perfon; but if any fymptoms of the difeafe fhould appear again, the medicine muft be repeated. It is both more fafe and efficacious when perfifted in for a confiderable time than when a large quantity is applied at once. As moft people diflike the fmell of ful- phur, they may ufe in its place the powder of white hellebore root made up into an ointment, in the fame manner, which will feldom fail to cure the itch. Peopleought to be extremely cautions left they take other erup- tions for the itch; as the ftoppage of thefe may be attended with fatal confequences. Many of the eruptive diforders to which chil- dren are liable, have a near refemblance to this difeafe; and I have often known infants killed by being rubbed with greafy ointments that make thefe eruptions strike fuddenly in, which nature had thrown out to preferve the patient's life, or prevent fome other malady. Much mifchief is likewife done by the ufe of mercury in this 4ifeafef Some perfons are fo fool-hardy as to wafh the parts af- fected with a ftrong folution of the corrofive fublimate. Qthers ufe the mereuriat ointment, without taking the leaft care either to avoid cold, keep the hody open, or obferve a proper regimen. The confe- quences of fuch conduct maybe ea ry guested. I have known even the mercurial girdles produce bad effects, and would advife every perfon, as he values his health, to beware how he ufes them. Mer- cury ought never to be ufed as a medicine without the greateft care, * Sir John Pringle o'jferves, that though this dtfrife may feem trifling, thers is no oie in the army that it nRoretrouUlefome to cure, as the infection often lyrics in clothes, &c. irrd br*alct out a fecoid, or even a third time. The fame inconveniency occurs in private fjmii;ei, unlrTj particular r?:;ard is \.i\& To T^e ch»C5;r.g or Oswing erf :sr..~ clothes, which ♦it ii v- -to m-*ru aa ttf] pwft'.iori, i78 OF THE ASTHMA. Ignorant people look upon thefe girdles as a kind of charm, with- out confidering that the mercury enters the body. It is not to be told what mifchief is done by ufing mercurial ointment for curing the itch and killing vermin; yet it is unnecef- fary for either: the former may be always more certainly cured by fulphur, and the latter will never be found where due regard is paid to cleanlinefs. Thofe who would avoid thisdeteftabl*3 difeafe ought to beware of infected perfons, to ufe wholefome food, and to ftudy univerfal cleanlinefs.* CHAP. XLII. % GF THE ASTHMA. HP J. HE afthma is a 'difeafe of the lungs, which feldom ad- mits of a cure. Perfons in the decline of life are moft liable to it. ?tis diftinguifhed into the moift and dry, or humoral and nervous. The former is attended with expectoration or fpitting ; but in the htter the patient feldom fprs, unlefs fometimes a little tohgh phlega • by the mere force of coughing; CAUSES.—The afthma is fometimes hereditary. It may like- ■•.vife proceed from a bad formation of the breaft ; the fumes of metals or minerals taken into the lungs ; violent exercife, efpecial- ly running ; the obstruction of cuftomary evacuations, as the men- fes, haemorrhoids, &c. the fuddeh reiroceflion of the gout, cr striking iu of eruptions, as the fmall-pox, mealies, &c. violent paf- lions of the mind, as fudden fear or furprife. In a word, the dif- eafe may proceed from any caufe that either impedes the circula- tion of the blood through the lungs, or prevents their being duly expanded by the air. SYMPTOMS.—An anfthma is known by a quick laborious breathing, which is generally performed with a kind of wheezing ncife. Sometimes the difficulty of breathing is fo great, that the patient is obliged to ke^p in an erect pofture, otherwife he is in danger cf being fuffocated. A fit or paroxyifm of the afthma gen- erally happens after a perfon has been expofed to cold eafterly winds, cr has been abroad in thick foggy weather, or has got wet, «:r continued long in a damp place under ground, or has taken fome food which the ftcmach could not digeft, as pafteries, toafted cheeff, or the likr. The paroxyfm is commonly ufhered in with liftlelTneis, want of fleep, hoarfenefs, a cough, belching of wind, a fenfe of heavinefs about the breaft, and difficulty tof 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 foraetiraes inter- * l^heitch is nowby cleanlinefs banilhed from everygenteel family in Britain. Itftill however prevails among the poorer fort of peafants in Scotland, and among the manufact- urers in England. Thefe are not only fufficient to keep the feeds of the difeafe alive, but to fpread the Infeclion among othert. It were to bewilhed that fomeefteftual method could b* deviled for extirpating it altogether. Several country clergymen have told me, that bygettiBg fuch as were infec"ieil cured, and ftrongly recommending an attention to eieanlinefi, thev have ba i-iihed ijhe itch entirely out of thejr parishes. Why might not othtrs do the, farto f* OF THE ASTHMA. *79 milting pulfe, an involuntary flow of tears, bilious vomitings, &c. All the fymptoms grow worfe towards night; the patient is eafier when up than in bed* and is very deiirous of cod air. REGIMEN.—The food ought to be light,' and of eafy digef- tion. Bailed meats are to be prefered to roafted, and the flefli of young animals to that of old. All windy food, and whatever is apt to fwell in the ftomach, is to be avoided. Light puddings, white broths, and ripe fruits baked, boiled, or roafted are proper. Strong liquprs of all kinds, efpecially malt-liquor, are hurtful* The patient fhould eat a very light fupper, or rather none at all, and fhould nev- er fuffer bimfelf to be long coftive. His clothing fnculd be warm, efpecially in the winter feafon. As all diforders of the brer: ft are much relieved by keeping the feet warm, and promoting the per- fpiration, a flannel fhirt or waiftcoat, and thick fhoes, will be of fagular fervice. But nothing is of fo great importance in the afthma, as pure and moderately warm air. Afthmatic people can ft Horn bear eith- either the clofe heavy air of a large town, or the fharp, keen atmof- phere of a bleak hilly country; a medium therefore, between rhefe is to be chofen. The air near a large town is often better than at at a diftance, provided the* patient- be removed fo far as net to be affected by t^efmoke. Some afthmatic patients indeed, breathe ea- fier in town than in the country ; but this is feldom the cafe, efpe- cially in towns where much coal is burnt. Afthmatic perfons who are obliged to be in a town all day, ought at leaft to fle.v p out of it. Even this will often prove of great fervice. Thofe 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 fouthof France, Portugal, Spain, or Italy. Exercife is likewife of very great importance in the afthma, as it promotes the digeftion, preparation of the blood, &c. The blood of afthmatic perfons is feldom duly prepared, owing to the propr-r action of the lungs being impeded. For this reafon I'uch people ought daily to take as much exercife, either on foot, horfeback, or in a carriage, as they can bear. MEDICINE.—Almoft all that can be done by medicine in this difeafe, is to relieve the patient when feized wi'li a violent fit. This indeed requires the greateft expedition, as the difeafe often proves fuddenly fatal. In the paroxyfm or fit, the body is gener- ally bound; a purging clyfter, with a folution of afafcetida, ought therefore to be*adminiftered, and if there be occafion, it may be re- peated two or thres, times. The patient's feet and legs ought to be immerfed in warm water, and afterwards rubbed with a warm hand or dry cloth. Bleeding, unlefs extreme weaknefs or old age fhould forbid it, is highly proper. If there be a violent fpafm about the breaft or ftomach, warm fomentations, cr bladders filled with warm milk and water, may be applied to the part affected; and warm cataplafms to the foles of the feet. The patient muft drink freely of diluting liquors, and may take a tea-fpoonful. ofthe tincture of caftor and of faffron mixed together, in a cup of raJerian tea, twice or thrice a-day. Sometimes a vomit has a very v *8o OF THE APOPLEXY. ood effect, and fnatches the patient, as it were, from the jawfttff eath. This however will be more fafe after other evacuations have been premifed. A very ftrong infufion of roafted coffee is faid to give eafe in afthmatic paroxyfms. In the moift afthma, fuch things as promote expectoration or fpitting, ought to be ufed; as the fyrrup of fquills, gum ammoniac, and fuch like. A common fpoonful of the fyrup or oxymel ef fquills, mixed with an equal quantity of cinnamon water, may be taken three or four times through the day, and four or five pills made of equal parts of afafoetida and gum ammoniac, at bed-time.* For the convulfive or nervous afthma, antifpafmodics and bra- cers are the moft proper medicines. ^ The patient may take a tea-fpoonful of the paregoric elixir twice a-day. The Peruvian bark is fometimes found to be of ufe in this cafe. It may be taken in fubftance, or infufed in wine. In fhort, every thing that braces the nerves, or takes off fpafm, may be of ufe in a nervous afthma. It is often relieved by the ufe of affes milk; I have likewife known cow's milk drank warm in the morning, have a very good effect in this cafe. In every fpecies of afthma, fetons and iflues have a good effefl; they may either be fet in the back or ft ^e, and should never be allowed to dry up. We fhall here, once for all, obferve, that not only in the afthma, but in moft chronic difeafes, iffues are ex'renae- ly proper. They are both a fafe and efficacious remedy; and though they do not always cure the difeafe, yet they will often pro- long the patient's life. CHAP. XLIII. OF THE APOPLEXY. JL HE apoplexy is a fudden lofs of fenfe and motion, dur- ing, which the patient is to all appearance dead; the heart and lungs however ftill continue to move. Though this difeafe proves often fatal, yet it may be fometimes removed by proper care. It chiefly attacks fedentary perfons of a grofs habit, who ufe a rich and plen- tiful diet, and indulge in ftrong liquors. People in the decline of life are moft fubject to the apoplexy. It prevails moft in winter, efpecially in rainy feafons, and very low states of the barometer. CAUSES.—The immediate caufe of an apoplexy is a com- preffion of the brain, occafioned by an excefs of blood, or a collec- tion of watery humors. The former is called a fanguine, and the latter 2.ferous apoplexy. It may be occafioned by any thing that increafes the circulation towards the brain, or prevents the return * After copious evacuations, large dofes of aether have heen found very efficacious 'n removing a fit of the afthma. I have likewife known the following; mixture produce very happy e.Tecls : To four or five ounces ofthe folution of gum-ammoniac, add two ouncri^f fimple cinnainon-vrater, the fame quantity of balfamic fyrup, and half an ounceof paregoi'- elixir. Of tfcO, two. table fpocnsful may \% taken evcy three houri. OF THE APOPLEXY. 281 of the Wbod from the head; as intenfe ftudy; violent paffions,f viewing objects for a long time obliquely, wearing any thing too, tight abouf- the neck; a rich and luxurious diet; fuppreffion of urine; fuffering the body to cool fuddenly after having been great- ly heated ; continuing long in a warm or cold bath ; the excefBve ufe of fpiceries, or high feafoned food ; excefs of yenery; the fud- den striking in of any eruption ; fuffering iflues, fetons, &c. fud- denly to dry up, or the ftoppage of any cuftomary evacuation; a mercurial faliva tion pushed too far, or fuddenly checked by cold ; wounds or bruifes on the head; long expofure to exceffive cold ; poifcnou'? exhalations, &c. SYMPTOMS, and method of cure.-—The ufual forerunners of an apoplexy are giddinefs, pain and fwimming of the head ; lofs of memory; drowfinefs, noife in the ears, the night mare, a fpon- taneous flux of tears, and laborious refpiration. When perfons of an apoplectic make obferve thefe fymptoms, they have reafon to fear the approach of a fit, and fhould endeavor to prevent it by bleeding, a flender diet, and opening medicines. In the fanguine apoplexy, if the patient does not die fuddenly, the countenance appears florid, the face is fwelled cr puffed up, and the blood veffels, efpecially about the neck and temples, are tufgid; the breathing is difficult, and ptrfrrrned with a fnorting noife. The excrements and urine are oftm voided fpontaneoufly, and the patient is fometimes feized with vomiting. In this fpecies of apoplexy every method muft be taken to lefc fen the force of tie circulation towards the head. The patient fhould be kept perfectly eafv and cool. His head fhould be raifed pretty high, and his feet fullered to hang down. His clothes ought to be loofened, efpecially abou*- the r.eck,and frefh air admitted in- to his chamber. His garters fnould be tied pretty tight, by which means the motion of the blood from the lower extremities wiil be * retarded. As foon as the patient is placed in a proper pcfture, he fhould be bled freely in the neck or arm, and, if there be occafion, the operation may be repeated in two or three hours. A laxative clyfter, with plenty of fweet oil, or frefh butter, and a fpoonful or two of common fait in it, may be adrntr.ifterrd every two hours ; and bliftering-plafters applied between the. fhculders, and to the calves of the l.-gs. i As foon as the fymptoms are a little abated;, mid the patient is able to fwallow, he ought to drink freely of fome diluting open- ing liquor, as a decoction of tamarinds and liquorice, cream-tartar whey, or comncn whey with cream cf tartar diffolved in it. Or he may take any cooling purge, as Glauber's falts, manna diffolved in an infufion of fenna, or the like. All fpirits and other ftrong li- quors are to be avoided. Even volatile falts held to the nofe do mifchief. Vomits, for the fame reafon, ought not to be giver, cr f I knew a woman, who in a violent fit of anger was feized with* a fanguine apoplexy. She at firft complained of extreme pain, «' as if daggers had been thfuft through her head," as (he exprefled it. Afterwards ftie became comatofe, her pulfe funk very low, and was et* ceeding flow. By bleeding, bliftering and other evacuations, Ihe was kept alive for about a fortnight. When her head was opened, a large quantity of ftxtrarafated blooif ffH twutt-'itiir. the left ventricle cf the brajn, (*9) 2«a OF COSTIVENESS, 6c. any t%ing t at may oicrea'e the motion of the blood towards the head. In the ferous apophxv, th* fymptoms nre nearly the fame, on- ly the pulfe is not fo itroni:. roe countenance is lefs florid, and the breathing lefs difficult. IV-edlng is not fo neceffaiy here as in the former cafe. It may, however, ?roner.'liy be performed once with fafety and advantage, but fhould not be reputed. The patient fhould be placed in the fame pofture is directed above, and fhould have bli.p;- ring-pbfters opplied. and receive oprnin •; clyfters in the fame manner. Purees hi.jre are ii lev wife leoeffary, and the patient may drink ftrong holm-tea. If he be inefned to fweat, it ought to be promoted by drinking rmall win-'-w!">ey, or an infufion of car- duus bene lictus. A plentiful fweat kept up for fome confiderable time, has often carried off a ferous apoplexy. When apoplectic fymptoms proceed from opium, or other Jiarcodc fubftances taken into the ftomach, vomits are neceffary. The patieot is generally relieved as foon as he has difcharged the pjifon in this way. » Perfons of an apoplectic make, or thofe who have been attach- ed by it, ought to ufe a very fpare and flender diet, avoiding aU ftrong liquors, fpiceries, and high-feaibned food. They ought lik«» wife to guard againft all violent paflions, 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 fuf- fered to continue long wet. The body muft be kept open cither by food or medicine, and a little blood may be let every fpring and fall. Exercife fhould by no means be neglected : but it ought to be taken in moderation. Noftiing has a more happy effect in pre- venting an apoplexy than perpetual iflues or fetons; great care however, muft be taken, not to fuffer them to dry up, without opening others in their stead. Apoplectic perfons ought never to go to reft with a full ftomach, or to lie with their heads low, or to wear-any thing too tight about their necks. CHAP. XLIV. OF COSTIVENESS, AND OTHER AFFECTIONS OF THE STOMACH AND BOWELS. \\ E do not here mean to treat of thofe aftrictions ofthe bowels, which are the fymptoms of difeafe, as of (he colic, the iliac paflion, Sec. but only to take notice of that infrequency of ftools which fometimes happens, and which in fome particular conftitu- tions miy occafion difeafes. Coftivenefs may proceed from drinking rough red wmes, or other aftringent liquors ; too much exercife, efpecially on horfeback. It may I'.kewife proceed from a iong ufeof coldinfipid fcod, wfrch does not fufficiently stimulate the inteftines. Sometimes it is ow- ing to the bile not defcending to the inreitines, as in th jaundice; and at other times it proceeds from difeafes of the inteftines thenv OF COSTIVENESS, 6.c. 28$ fetves, as a palfy, fpafms, torpor, tumours, a cold dry ftate of the intestine?, &c. Exceffive coftivenefs is apt to occafion pains of the head, voir> iting, colics, and other complaints of the bowels. It is peculiarly hurtful to hypochondriac and hyfteric perfons, as it generates wind and other grievous fymptoms. Some people however, can bear coftivenefs to a great degree* I know perfons who enjoy pretty good health, yet do not go to ftool above once a week, and others not above once a fortnight. Indeed I have heard of fome who do not go above once a month. ,Perions who are generally coftive, fhould live upon a moiften- ing and laxative diet, as roafted or boiled apples, pears, Hewed prunes, raifins, gruels with currants, butter, honev, fugar, and fuch like. Broths with fpinnage, leeks, and other foft pot herbs, are likewife proper. Rye-bread, or that which is made of a mix- ture of wheat and rye to:-'etherw ought ro be eatem No psrfon troubled with coftivenefs, fhoulcl eat white bread alone, efpecially that which is made of fine flo-ir. The beft bread for keeping the body folnble, is what in fome parts of England they call mejlin. It is made of a mixture of wheat and rye, and is very agreeable to thofe who are accuftomed to it. Coftivenefs is increafed by keeping the body too warm, and by every thing that promotes the perfpiration; as wearing flannel, ly- ing too long a-bed, Sec. Intenfe thought, and a fedentary life, are likewife hurtful. All the fecretion and excretions are promoted by moderate exercife without doors, and by a gay, cheerful, fprightiy temper of mind. The drink fhould be of an opening quality. All ardent fpirits, auftere and aftringent wines, as port, claret, &c. ourht to be avoid- ed. Malt liquor that is fine, and of a moderate ftrength, is very proper. Butter-milk, whey, and other watery liquors, are f b ewife prop£r,arid maybe drank in turns,as the patient's inclination directs. Thofe Who are troubled with coftivenefs, ought if poffible to remedy it by diet, as the conftant ufe of medicines for that purpofe is attended with many inconveniences, and often with bad confe- quences.* I sever knew any one get iot^ a habit cf taking raedv cine f;r keeping the bjdy open, who could leave it off. In time the cuftom becomes necelfrry, and generally ends in a total relax- ation of the bowels, indigeftion, lefs of appetite, wa.'ling of the ftrength, and death. * The learned Dr. Arbuthnot advifes fh'ofe who are" troub'ed With cofiivenrfs to ufe, animal oils, as frefh butter, cream, marrow, fat broths efeciaiiy thofe made «i the'ntetn^t parts of animals, as the liver, heart, midriff, &>•. -He likewile recommends the exorefied oils of mild vegetables, as olives, almonds, paftaches, a^d the fruits themfelves; all o'i'y and mild fruits, as fi.s; deci&ions of mealy vegetables; thefe lubricate t*ie inteftines; fome Jaoonaceous lubftances whrch ftimoiati gently, as honey, hviirorhel, or boiled honey and water, unrrfined lug r, &c. The Dictor obferves, that fuch lenitive fohftances are proper for perfons of dry atra- bi'arian conftitutions, who are fnbj cl to aftriftlon of the be v, and the u'.Ies, and wilfoper- ite when ftronger medicinal fubftances are fometim?s ineffectual; but that fuch len;tivedlet hurts thofe whofe bowels are weak and lar. He likewife cibf'.rvr-, hat all watery fubftances ,re lenitive, and that even common water, whey, four milk, an« Hjuer-nsilk have that ef- fect: that new milk, efpecially affes milk, Stimulates ftill more when it fours on the fto- mach ; and that whey turned four, will purge ftrongly :—That moft garden fruits are like- Mfe laxative; and that fome of them, as grapes^ will throw .gch as take them iriraiodmtslyy V-' a ;h"!s;i morbus, or incurable diarrhcea. 284 WANT OF APPETITE.—OF THE HEART-BURN When the body canrot be k-pt open without medicine, we Would recommend gentle dofes of rhubarb to be taken twice or thrice a-week. This is not near fo injurious to the ftomach as aloes, j?ilap,-or the other draftic purgatives fo much in ule. Infu- fions of fenna and manna may likewife be taken, or half an ounce cf foluble tartar diffolved in water-gruel. About the fize of a nut- meg of lenitive e^ctuary,taken twice or thrice a-day, generally an- fwers the purpofe very well. WdNT OF APPETITE. THIS may proceed from a foul ftomach; indigeftion; the want of free air and exercife ; grief; fear ; anxiety ; or any of the de- prefling paflions; exceffive heat; the ufe of ftrong broths, fat meats, or any thing that palls the ap-etite, or is hard of digeilion; the immoderate ufe of ftrong liquors* tea. tobacco, opium, Sec. The patient ought, if poffible, to make choice of an cpen dry air; to take exercife daily on horfeback or in a carriage ; to rife betimes; and to avoid all intenfe thought. He fhould ufe a diet of eafy digeftion; and fhould avoid exceffive heat and great fa- tigue. If want cf appetite proceeds from errors in diet, cr any other part of the patient's regimen, it ought to be changed. If naufea and retchings fhew that the ftomach is loaded with crudities, a vomit will beof fervice. After this a gentle purge or two of rhubarb, or any ofthe bitter purgi lions. REGIMEN.—Perfons afflicted with nervous difeafes ought never lo fait long. Their fcod fhould be folid and nourifhing, but of eafy digeftion. Fat meats and heavy fauces are hurtful. All excefs fhould be carefully avoided. They ought never to eat more at a time than they can eafily digeft ; but if they feel themfelves weak and faint between meals, they ought to eat a bit of bread, and drink a glafs of wine. Heavy fuppers are to be avoided- Though wine in excefs enfeebles the body, and impairs the facul- ties of the mind, yet taken in moderation it ftrengthens the ftomach, aud promotes digeftion. Wine and water is a very proper driok at meals; but if wine fours on the ftomach, or. the patient is much troubled with wind, brandy and water will anfwer better. Eve- ry thing that is windy or hard of digeftion muft be avoided. All weak and warm liquors are hurtful, as tea, coffee, punch, Sec. People may find a temporary relief in the ufe of thefe, but they always increafe the malady as they weaken the ftomach, and hurt digeftion. Above all things, drams are to be avoided. Whatev-? er immediate eafe the patient may feel from the ufe of ardent fpir- its, they are fure to aggravate the maiady, and prove certain poi- fons at laft. Thefe cautions ars the more neceffary; as moft nerv- 28a OF NERVOUS DISEASES. cus people are peculiarly fond of tea and ardent fpirits, to ttic ufe of which many of them fall victims. Exercife in nervous diforders is fuperior to all medicines. Rid- ing on horfeback is generally eiteemed the beft, as it gives n.otion to the whole body without fatiguing it. I have known fome pa- tients, however, with whom walking agreed better, and others who were moft benefitted by riding in a carriage. Every one ought to ufe that which he finds moft beneficial. Long fea-voyages have au excellent effect; and to thofe who have fufficient refoiuciou, we would by all means recommend this courfe. Even change of place, and the fight of new objects, by diverting the mind, have a great tendency to remove thefe complaints. For this reafon a long jour- ney, cr a voyage, is of much more advantage than riding fhort journes near home. A cool and dry air is proper, as it braces and invigorates the whole body. Few things tend more to relax and enervate than hot air, efpecially that which is rendered lb by great fires, or stoves in imall apartments. But when the ftomach or bowels are weak, the body ought to be well guarded againft cold, efpecially in winter,by wearing a thin flannel waiftcoat next the fkin. This will keep up an equal perfpiration, and defend the alimentary canal from mapy impreffions to which it would otherwife be fubject, upon every fud- den change from warm to cold weather. Rubbing the body fre- quently witn a fiefh-brufh, or a coarfe linen cloth, is likewife ben- eficial, as it promotes the circulation, perfpiration, &c. Perfons who have weak nerves ought to rife early, and take exercife before breakfaft, as lying too long a-bed cannot fail to relax the folids. They ought likewife to be diverted, and to be kept as eafy and cheerful as poffible. There is not any thing which hurts the nerv- ous fyftem, or weakens the digeftive powers more than fear, grief pr anxiety. MEDICINES.—-Though nervous difeafes are feldom radically cured, yet the fymptoms may fometimes be alleviated, ahd the pa- tient's life rendered at leaft more comfortable by proper medicines. When the patient is coftive, he ought to take a little rhubarb, pr fome :ther mild purgative, and fhould never fuller his body to be long bound. Ali ftrong and violent purgatives are however to be avoided, as aloes, jalap, Sec. 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 neceflary. When digeftion is bad, or the ftomach relaxed and weak, the follow!ng^tifion of Peruvian bark and other bitters may be ufed with adrsixage. Take of Peruvian bark aft ounce, gentian-root, orange-peel, and coriander feed, of each half an ounce ; let thefe ingredients be all bruifed in a n#ortar, and infufed in a bottle of brandy or rum» for the fpace of five or fix days. A table fpoonful of the ftrained liquor may be trken in ha^lf a glals of water, an hour before break- faft, dinner and {'upper. Few thi?.gs tend more to ftrengthen the nervous fyftem than co)d bathing. This practice, if duly perfifted in, will produce very OF MELANCHOLY. a8§ extraordinary effects; but when the liver or other vifcera are ob- ftructed, or otherwife unfound, the cold bath is improper. It is therefore to be ufed with very great, caution. The moft proper feafons for it are fummer and autumn. It will be fufficient, efpe- cially 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 chil- ly for a long time after coming out, it is improper. In patients afflicted with wind, I have always obferved the greateft benefit from the elixir of vitriol. It may be taken in the quantity of fifteen, twenty cr thirty drops, twice cr thrice a-day, in a glafs of water. This both expels the wind, ftrengthens the ftomach, and promotes digeftion. Opiates are generally extolled in thefe maladies; but as they caty palliate the fymptcms and generally afterwards increafe the difeafe, we would advife people to be extremely fparing in the ufe of them, left habit render them at laft abfolutely neceffary. It would be an eafy matter to enumerate many medicines which have been extolled for relieving nervous diforders; but who- ever wifhes for a thorough cure, muft expect it from regimen alone; we fhall therefore omit mentioning more medicines, and again recommend the ftricteft attention to diet, air, exercise, and AMUSEMENT. OF MELANCHOLY. ; MELANCHOLY is that ftate of alienation or weaknefs of mind, whichj-enders people incapable of enjoying the pleafures, or performing the duties of life. It is a degree of infanity, and often terminates in abfolute madnefs. CAUSES.—It may proceed from an hereditary difpofition; intenfe thinking, efpecially where the mind, is long occupied by one object; violent paflions or affections of the mind, as kve, fear, joy, grief, pride, and fuch like. It may alfo be occafioned by exceffive venery, narcotic or ftupefactive pcifons ; a fedentary life ; fbli- tude; the fuppreffion of cuftomary evacutions; acute fevers or other difeafes. Violent anger will change melancholy into mad- nefs; am* exceffive cold, efpecially of the lower extremities, wil! force the blood into the brain, and produce all the fymptoms of madnefs. It may likewife proceed from the ufe of aliment that is hard of digeftion, or wiiich cannot be eafily affimilated, from a cal- lous ftate of the integuments of the brain, or ads) nefs ofthe brain itfelf. To all which we may add gloomy and miilaken notions of religion. SYMPTOMS.—-When perfons begin to be melancholy, they are timorous; watchful; fond of folitude; fretful; fickle ; cap- tious and inquifitive; folicitcus about trifles; fometimes niggard- ly, and at other times prodigal. The body is generally bound, the urine thin, and in fmall quantity; the ftomach and bowels infla- ted with wind ; the complexion pale; the pulfe flow and weak. The functions of the mind are alfo greatly perverted, infomuch that the patient often imagines,kimfelf dead, or changed into fome other animal. Some have imagined their bodies were made of 29o OF MELANCHOLY. glafs or other brittle fubftances, and were afraid to move left ttay fhould be broken to pieces. The unhappy patient, in this cafe, unlefs carefully watched, is apt to put an end to his own miferable .lite. When the difeafe is owing to an obstruction of cuftomary evacuations* or any bodily diforder, it is eafier cured than when it proceeds from affections of the mind, or an hereditary taint. A difcharge of blood from the nofe, loofenefs, fcabby eruptions, the bleeding piles, or the menfis, fometimes carry off this dileafe. REGIMEN.—The diet fhould confift chiefly of vegetables of a cooling and opening quality. Animal food, efpecially fdted or fmoke dried fifri or flefh, ought to be avoided. All kinds of fhell- fifh are bad. Aliments prepared with onions, garlic, or any thing that generates thick blood, are likewife improper. All kinds of fruits that are wholefome may be eaten with advantage. Boerharve gives an inftance of a patient who, by a long ufe of whey, water, and garden-fruit, recovered, after having evacuated a great quanti- ty of black coloured matter. Strong liquors of every kind ought to be avoided asprifop. The moft proper drink is water, whey, or very fmall betr Tea and coffee are improper. If honey agrees with the patient, it may be eaten freely, or his drink may be fweetened with it. Infufions of balm-leaves, penny-royal, the roots of wild valerian, or the flowers ©f the lime-tree, may be drank freely, either by themfelves, or fweetened with honey, as the patient fh ill chufe. The patient ought to take as much exercife as he can bear. This helps to diffolve the vifcid humors, it removes obstructions, promotes the perfpiration, and ail the other fecretions. Every kind of madnefs is attended with a diminished perfpiration ; all means ought therefore to be ufed to promote that neceffary and falutary difcharge* Nothing can have a more direct tendency to increafe the difeafe than confining the patient to a clofe apartment. Were he forced to ride or walk a certain number of miles every day, it would tend greatly to alleviate his diforder ; but it would have ftill a better effect, if he were obliged to labour on a piece of ground. By digging, hoeing, planting, lowing, &c. both the body and mind would be exercifed. A long journey, or a voyage, efpe- cially towards a warmer climate, wth agreeable companions,have often very happy effects. A plan of this kind, with a ftrict atten- tion to diet, is a much more rational method of cure, than confining the patient within doors and plying; him with medicines. MEDICINE.—In the cure of this difeafe particular attention muft be paid to the mind. When the patient is in a low ftate, his mind ought to be foothed and diverted with a variety of amufe- ments, as entertaining ftories, pastimes, mufic, &c. This feems to have been the method of curing melancholy among the Jews, as we learn from the ftory of King Saul; and it is a very rational one. Nothing can remove difeafes of the mind fo effectually as applica-r tions to the mind itfelf, the moft efficacious of which ismufic. The patient's company ought likewife to confift of fuch perfons as are agreeable to him. People in this ftate are apt to conceive unac* OF THE PALSY. 20* countable averfions againft particular perfoas; and the very fight of fuch perfon? is fufficient to diffract their minds, and throw them into the utmoft perturbation. When the patient's ftrength is high, or the pulfe admits of it, evacuations are neceffory. In this cafe he muft be bled, and have h:s body k-pt open by purging medicines, as m:mna, rhubarb, cream of tartar, or the foluble tartar. I have feen the laft have very happy effects. It may be taken in the dofe of half an ounce, diflolv'-d in wattr-gruel, every day, for feveral weeks, or even for months, if neceflary. More or lels may- be given according as it operates. Vomits have likewife a good effect; but they muft be pretty f rong, otherwife they will not operate. Wnatever increafes the evacuation of urine or promotes per- fpiration, has a tendency to remove this difeafe. Both thefe fecre- tions may be promoted by the ufe of nitre and vinegar. Half a drachm of purified nitre may be given three or four times a-day,in any manner that is moft agreeable to the patient; and an ounce and an half of diflilled vinegar may be daily mixed with his drink. Dr. Locker feems to think vinegar the belt medicine that can be given in this difeafe. Camphire and muflc have likewife been ufed in this cafe with- advantage. Ten or twelve grains of camphire may be rubbed in a mortar, with half a drachm of nitre, and taken twice a-day, or oftener, if the ftomach will bear it. If it will not fit upon the ftomach in this form, it may be made into pills with guni-af; foetida and Ruffian caftor, and taken in the quantity above directed.- If mufk is to be adminiftered, a fcruple or twenty-five grains of it may be made into a bolus with a little honey or common fyrup, and taken twice or thrice a-day. We do not mean that all thefe medicines fhould be adminiftered at once; but which ever of them is given, muft be duly perfifted in, and where one fails mother may be tried. As it is very difficult to induce patients in this difeafe to take medicines, we fhall mention a few outward applications which fometimes do good; the principal of thefe are iflues, fetons, and warm bathing, Iflues may be made in any part,of the body, but they generally have the belt effect near the fpine. The difcharge from thefe may be greatly promoted by drefling them with the mild blistering ointment, and keeping what are commonly called the orrice peafe in them. The moft proper place for a feton is be- tween the fhoulder-blades: and it ought to be placed upwards and downwards, or in the direction of the fpine. OF THE PALSY. THE palfy is a lofs cr diminution of fenfe or motion, or of both, in one or mere parts of the bedy. Of all the affections cal- led nervous, this is the moft fuddenly fatal. It is more or lefs dan- gerous, according to the importance of the part affected. A palfy of the heart, lungs, or any part neceflary to life, is mortal. When it affech the ftomach, the inteftines, or the bladder, it is highly dangerous. If the face be affected, the caie is bad, as it fhews that the difeafe proceeds from the brain. When the part affected feel i9* OF THE PAL*Y. cold, is infenfcbie, or waftes away, or when the judgment and mem- ory begin to fail, there is fmall hope of a cure. CAUSES.—The immediate caufe of palfy is any thing that prevents the regular exertion ofthe nervous power upon any par- ticuiar mufcle cr part of the body. The occafional and predilpo- fing caufes are various, as drunkennefs ; wounds of the brain, or fpinal marrow; preflure upon the brain, or nerves; very cold or damp air; the fuppreffion of cuftomary evacuations, fudden feai; want of exercife; or whatever greatly relaxes the fyftem, as drink. ing much tea,* or coffee. The palfy may likewife proceed from wounds of the nerves themfelves, from the poilbnous fumes of metals or minerals, as mercury, lead, arfenic. In young perfons of a full habit, the palfy muft be treated in the Tame manner as the fanguine apoplexy. The patient muft be bled, blistered, and have his body opened by fharp clyfters or pur- gative medicines. But in old age, or when the difeafe proceeds from relaxation or debility, which is generally the cafe, a quite contrary courfe muft be purfued. Tne diet muft be warm and in- vigorating, feafoned with fpicy and aromatic vegetables, as muf- tard, horfe-radifh, &c. The drink may be generous wine, mafi ttrd, whey, or brandy and water. Friction with the flefh-brufh or a warm hand, is extremely proper, efpecially on the parts affected. Bliftering-plafters may likewife be applied to the affected parts with advantage. When this cannot be done, they may be rubbed with the volatile liniment, or the nerve ointment of the Edinburgh Dif- penfatory. One of the beft external applications is electricity, The fhocks, or rather vibrations, fhould be received on the part affected, and they ought daily to be repeated for feveral weeks. Vomits are very beneficial in this kind of palfy, and ought frequently to be adminiftered. Cephalic fnuff, or any thing that makes the patient-fneeze, is likewife of ufe. Some pretend to have found great benefit from rubbing the parts affected with nettles-, but this does not feem to be any way preferable to bliftering. If the tongue is affected, the patient may gargle his mouth frequent- ly with brandy and muftard ; or he may hold a bit of lugar >n his mouth wet with the palfy drops or compound fpirits of lavender. The wild valerian-root is a very proper medicine in this cafe. It may either be taken in an infufion with fage leaves, cr half a drachm of it in powder may be given in a glafs of wine three cr four times a-day. If the patient cannot ufe the Valerian, he may take of fad volatile oleofum, compound fpirits of lavendar, and' tinc- ture 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-fpoonful of muftard-feed taken frequently is a very good medicine. The patient ought likewife to chew cinnamon, bark, ginger, or other warm fpiceries. *M"any people imagine,that tea has np tendency to hurt the nerves, and thatdrnkingiJie fame quantity of warm water would be equally pernicious. This however feems to be a mif- take. Many perfons drink three or four cups of warm milk and water daily, witbtut feel- ing any bad confequences; yet the fame quantity of tea will make their hands fhake for twenty-four hours. That tea affefts the nerves, is likewife evident from its pmriting l'ltey. oiCdfioninggiddinefs, dimnefs of the fight, ficknefs, &c. OF THE EPILEPSY, &c. «y, Exercife is of the utraoft importance in the pahy ; but the pa- 1:.ent muft beware of cold, damp, and mcilt air. He ought to wear flannel next the /kin; and if poffible, fhoidd remove into a warmer climate. OF THE EPILEPSY, OR FALLING SICKNESS. THE epilepfy is a fudden deprivation of all the fenfes. wherein the patient falls fuddenly down, and is affected with violent con- vulfive motions. Children, efpecially thefe who are -c^i. eatery brought up, are moft fubject to it. It mere frequently -Attacks men than women, and is very difficult to cure. When the ^ p;;epiy at- tacks children, there is reafon to hope it may go off in the time of puberty. When it attacks any perfon after twefcty years of age, the oure is difficult; but when after forty, a cure is hardly to be exr pected. If the fit continues only for a fhort fpace, and returns fel- dom, there is reafon to hope; but if it continues iong, and returns frequently, the profpect is bad. It is a very unfavorable fymptom when the patient is feized with the fits in his fleep. CAUSES.—The epilepfy is fometimes hereditary. It may I'.kewife proceed from blows, bruifes, or wounds on the head ; a collection of water, blood, or lerous humors in the brain; a polv- ous; tumors or concretions within the fkull; exceffive drinking; intenfe ftudy; excefs of venery; worms; teething; fuppreffion of cuftomary evacuations; too great emptinefs or repletion; violent paflions or affections or the mind, as fear, joy, &c. hyfteric affec- tions ; contagion received into the body, as the infection of the fmall-pox, meafles, &c. SYMPTOMS.—An epileptic fit is generally preceded by irn- ufuai wearinefs ; pain of the head ; dullnefs ; giddinefs; noife in the ears ; dimnefs of fight; palpitation of the heart; difturbed fleep; difficult breathing; the bowels are inflated with wind;- the urine is in great quantity, but thin ; the complexion is pale; the extremities are cold ; and the potient often feels, as it were, a ftream of cold air attending towards the h?ad. In the fit the patient generally makes an unufual noife; his thumbs ?re drawn in towards the palms ofthe hand; his eyes are diftorted ; he Harts and fbims at the mouth ; his extremities are bent or twifted various ways ; he often difcharges his feed, urine, and fxces involuntarily; and is quite deftitr.te of all fenfe and reafon. After the fit is over, his fenfes gradually return, and he complains of a k;nd of ftupor, wearinefs. and pain of the head ; but has no remembrance of what happened to him during the fit. The fits are fometimes excited by violent affections of the mind, a debauch of liquor, exceffive heat, cold, or the like. This difeafe from the difficulty of investigating its caufes, and its ftrange fymptoms, was formerly attributed to the wrath ofthe gbds, or the agency of evil fpirits. In modern times it has often, by the vulgar, been imputed to witchcraft or fafcination. It de- pends however, as much upon natural caufes as any other mala- dy; and its cure may often be affected by pernftiog in the vre Ct proper iman*. 194 OF THE EPILEPSY, 6c. REGIMEN.—Epilep'ic patients, ought, if poffible, to breathe a pure and free air. Their diet fhould be light but nourifhing. They ought to drink nothing ftrong, to avoid fwine's flefh, water- fowl, and likewife all windy and oily vegetables, as cabbage, nuts, Zee. They ought to keep" themfelves cheerful, carefully guarding againft all violent paflions, as anger, fear, exceffive joy, and the like. Exercife is likewife of great ufe ; but the patient muft be careful to avoid all extremes either of heat or cold, all dangerous fituations, as Handing upon precipices, riding, deep waters, and fuch like. MEDICINE.—The intentions of cure muft vary according to the caufe of the difeafe. If the patient be of a fanguine tem- perament, and there be reafon to fear an obstruction in the brain, bleeding and other evacuations will be neceffary. When the dif- eafe is occafioned by the ftoppage of cuftomary evacuations', thefe, if poffible, muft be restored; if this cannot be done, others may be fubftituted in their place. Iflues or fetons in this cafe have often a very good effect. When there is reafon to believe that the difeafe proceeds frc m worms, proper medicines muft be ufed to kill, ot carry off thefe vermin. When the difeafe proceeds from teething^ the body fhould be kept open by emollient clyfters, the feet fre-J quently bathed in warm water, and if the fits prove obftinste, a blistering-platter may be put between the fhoulders. The fame method is to be followed, when epileptic fits precede the eruption ofthe fmall pox, or meafles, Sec. When the difeafe is hereditary, or proceeds from a wrong forma ion of the brain, a cure is not to be expected. When it is owing to a debility, cr too great an irritability of the nervous fyf- tem, fuch medicines as tend to brace and ftrengthen the nerves may be ufed, as the Peruvian b°rk, and fteel; or the anti-epileptic elec- tuaries, recommended by Fuller and Mead.* The flowers of zinc have of late been highly extolled for the cure of the epilepfy. Though this medicine will not be found to anfwer the expectations which have been raife.H concerning it, yet in obftinate epileptic cafes it deferves a trial. The dole is front one to three or four grain?, which may be taken either in pills or a bo- lus, as the patient inclines. The beft method i? t~> begin with a fin- gle grain four or five rimes a-day, and gradually to increafe the dofe as far as the patient can bear it. 1 hav.-; kn ,wn this medicine, when duly perfifted in, prove beneficial. Mufk has fometimes been found to fucceed in the epilepfy. Ten or twelve grains of if, with the fame qiunrity of factitious cin- nabar, may be ma 'e up into a bolus, and taken every night and morning. Sometimes the epilepfy has been cured by tlectricity. Convulfion-fits proceed from the fame caufe, and muft be treated in the fame manner as the epil.-pfy. There is one particular fpecies of convulfion-fits which com* monly goes by the name of St. Vi;us'e dance, wherein the pa- tient is agitated with ftrange motions and gef.iculations, which by * S:e Appeayix. 'EldHn^yf.r the Epilepfy, CF THE HICXVP. a.95 the common people are generally believed to be the effects of witchcraft. This difeafe may be cured by repeated-bleedings and purges ; and afterwards ufing the medicines prelcribed above for the epilepfy, viz. the Peruvian bark and fnake-root, &c. Chaly- beate waters are found to he beneficial in this cafe. The cold bath is likewife of finguiar fervice, and ought never to be neglected when the patient can bear it. OF THE HICKUP. THE hickup is a fpafmodic or convulfive affection of the fto- mach and midriff, arifing from any caufe that irritates their nerv- ous fibre-. It may proceed from excefs in eating or drink:og; from a h ^ of tie ftomach; poifons ; inflammations or fchirrous tumors of the ftomach, inteftines, bladder, midriff, or the reft of the viscera. In gangrenes, acute and malignant fevers, a liickup is often the fore- runner of death. When the hickup proceeds from the ufe of aliment that is flatulent, or hard of digeftion, a draught of generous wine, or a dram of any fpirituous liquor, will generally remove it. If poifen 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, &c. it is very dangerous. In this cafe the cooling regimen ought to be ftrictly obferved. The patient muft be bled, and take frequently a few drops of the fpirits of nitre in a cup of wine. His ftomach fhould likewife be fomented with cloths dipped in warm w-ter, or have bladders filled with warm milk and water applied to it. When the hickup proceeds from a gangrene or mortification, the Peruvian bark, with other antifeptics, are the only medicines which have a chance to fucceed. When it is a primary difeafe, and proceeds from a foul ftomach, loaded either with a pituitous or a bilious humor, a gentle vomit and purge, if the patient be able to bear them, will be of fervice. If it arifes from flatulencies, the carminitive medicines directed for the heart-burn muft be ufed.. When the hickup proves very obftinate, recourfe muft be had to the moft powerful aromatic and antifpafmodic medicines. The principal of theft is mufk ; fifteen or twenty grains of which may*- be made into a bolus, and repeated occafionally. Opiates are like- wife of fervice; but thev muft be ufed with caution. A bit of fugar dipped in compound fpirits of lavender, or the volatile aro- matic tincture, may be taken frequently. External applications are fometimes alfo beneficial; as the ftomach plafter, or a cataplafin of the Venice treacle of the Edinburgh or London dif penlatory, ap- plied to the region ofthe ftomach. 1 lately attended a patient who tad almoft a conftant h;ckup for above nine weeks. It was frequently ftopped by the ufe of mufk, opium, wine, and other cordial and antifpafmodic med-cines, but always returned. Nothing however gave the patient f).much. eafe as bri/k fmall beer. By drinking freely of this, the hickup w: s «?'.'*en kept off for feveral days, which was more rhan ccuid be dona 296 CRAMP OF THE STOMACH, 6c. by the moft powerful medicines. The patient was at length feized with a vomiting of blood, which foon put an end to his life. Up- on opening the body, a large fcirrhous tumor was found near the pylorus or right orifice of the ftomach. The hickup may be removed by taking vinegar; or by a few drops of the oil of vitriol taken in water. CRAMP OF THE STOMACH. THIS difeafe often feizes people fuddenly, is very dangerous, and requires immediate afliftance. It is moft incident to perfons in the decline of life, efpecially the nervous, gouty, hyfteric, and hy- pochondriac. If the patient has any inclination to vomit, he ought to take fome draughts of warm water, or weak camomile tea, to cleanfe his ftomach. After this, if he has been coftive, a laxative clyfter may be given. He ought then to take laudanum. The beft way of administering 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 given by the mouth, which is oftef vomited, and in fome cafes increafes the pain and fpafms in the fto- mach. If the pains and cramps return with great violence, after the effects of the anodyne clyfters are over, another, with an equalor larger quantity of opium, may be given; and every four or five hours a bolus, with ten or twelve grains of mufk, and half a drachm ofthe 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 water fhould be applied to it. 1 have often feen thefe produce the moft happy effects. The anodyne balfam may alfo be rubbed on the part affected; and an anti-hylteric plafter worn upon it for fome time after the cramps are removed, to prevent their return. In very violent and lasting pains of the ftomach, feme Wood ought to be let, unlefs the weaknefs of the patient forbids it. When the pains or cramps proceed from a fuppreffion ofthe menfes, bleeding is of ufe. If they be owingto the gout, recourfe muft be had to fpirits, or fome of the warm cordial waters. Bliftering- plafters ought likewife in this cafe to be applied to the ancles. I have often feen violent cramps and pains of the ftomach removed by covering it with a large plafter of venice treacle. OF THE NIGHT-MARE. IN this difeafe the patient, in rime of fleep, imagines he feels an uncommon oppreffion or weight about his breaft or ftomach, wh'ch he can by no means fhake off. He groans and fometimes cries out, though oftener he attempts to fpeak in vain. Sometimes he imagines hiinfelf engaged wit an enemy, and in danger of be- ing killed, attempts to run awav, 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 precipice, and the dread of being dafhed to pieces fuddenly awakes him. *r OF SWOONlNGS. 19) This diforder has been fuppofed to proceed froih too much blood ; from a ftagnation of blood in the brain, lungs, &c. But it is rather a nervous affection, and arifes chiefly from indigeftion. Hence we find that perfons of weak nerves, who lead a fedentary life, and live full, are moft commonly afflicted with the night-mare. Nothing tends more to produce it than heavy flippers, efpecially when eaten late, or the patient goes to bed foon after. Wind is likewife a very frequent caufe of this difeafe; for which reafon thofe who are afflicted with it ought to avoid ftil flatulent food. Deep thought, anxiety, or any thing that oppreffes the mind, ought alfo to be avoided. As perfons afflicted with the night-mare generally moan, or make fome noife in the fit, they fhould be waked, or fpoken to by fuch 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 i3 a bad cuftom, and in time lcofcs its effect. We would rather have the patient depend upon the ufe cf fcod of eafy digeftion, cheerfulnefs, exercife through the day, and a light fupper taken early, than to accuftom himfelf to drams. A glafs of peppermint water will often promote digeftion as much as a glafs of brandy, and is much fafer. After a perfon of weak digeftion, however, has eaten flatulent food, a dram may be neceffary. Perfons who are young and full of blocd, if troubled with the night-mare, ought to take a purge frequently, and ufe a fpare diet. OF SWOONlNGS. PEOPLE of weak nerves or delicate conftitutions are liable to fwoonings or fainting-fits. Thefe indeed are feldom dangerous when duly attended to : but when wholly neglected, or improper- ly treated, they often prove hurtful, and fometimes fatal. The general caufes of fwoonings are, fudden tranfitions from cold to heat; breathing air that is deprived of its proper fpring or elasticity; great fatigue ; exceffive weaknefs; lofs of blood ; long fatting ; fear, grief, and other violent paf *ons or affections of the mind. It is well known, that perfons who have been long expofed to cold often faint cr fail into a fweon, upon coming into the h ufe, efpecially if they drink hot liquor, cr fit near a large fire. This might eafily be prevented by people taking care not to go into a warm room immediately after they have been expofed to the cold air, to approach the fire gradually, and not to eat or drink any thirg hot, till the body has been gradually brought into a warm temperature. When anyone, in confequence of neglecting thefe precautions, falls into a fwoon, he ought immediately to be removed to a cooler apartment, to have ligatures applied above his knees and elbows, and to have his hands and face fprinkled with vinegar or cold water. He fhould likewife be made to fmell to vinegar, and fhould have a fpoonful or two of water, if he can fwallow, with about a third pai t Of vinegar mixed with it, poured into his mouth. If thefe fhould (20) 298 OF SWOONlNGS. ., not remove the complaint, it will be neceflary to bleed the patient, and afterwards to give him a clyfter. As air that is breathed frequently lofes i s elafticity -t fpring, it is no wonder if perfons who r^fpire in it often fall int.') a fwoon or fainting fit. They are, in this cafe deprived of the very principle of life, hence it is that fainfn^ fit's are fo frequent in all crowdedaffembiies, efpecially in hot feafon.". Su:h fits, however, muft be confidered as a kind of temp rary d=ath ; and to the we^k ■and delicate, they fometi nes prove faod. They ought theref ire with the utmost care to be guarded againft. The method of do- ing this is obvious. Let affembly ro.rair, and all other places of public refort, ba large and well venrlated ; and let the weak and delicate avoid fuch pi ic^s, particularly in warm feafons. A perfon who faints, in fuch a fituation, ought immediately to be carried into the open air ; his t.-mples fhould be rubbed with ftrong vinegar or brandy, and volatile fpiri s of falts held to his nofe. lie fhould be laid upon his back with his head low, and have a little wina, or fome ot er cordial, as foon as he is able to fwallow it, poured into his rmuth. If the perfon has been fubject. to hyfteric fi s, caller or afafcetida fhould be applied to the nofe, or burnt feathers, horn, or leather, Sec. When fainting fits pr -cead from mere weaknefs or exhaustion, which is often the cafe after great fatigue, bng_ failing, lofs of blood or the like, the pa.'lent muft be fupported with generous cor- dials, as jellies, wines, fpirit u >us liqu- rs, &c. Thefe however muft be given at first in very fmall quantities, and increafed gradually as the patient is able to bear them. He ought to be allowed to lie quite ftill and eafy upon his back, with his head low, and fliould have frefh air admitted into his chamber. His food fhould confift of nourifhing broths, fago-gruel, with win?, new milk, and other things of a 1 ght and cor .iial nature. Thefe things are to be given out of the fit. All that can be done in the fit, is, to let him fmell to a botrle of Hungary-water, eau de luce, or fp:rits of hartfhera, and to rub his temples with warm brandy, or to lay a comprefs dipped in it to the pit cf * le ftomach. in fainting fits that proceed from fear, grief, or other violent paflions or affections of the mi.id, the patient muft be very cau- tioufly managed. He fliould be fullered to remain at reft, and on- ly made to fmell fcrne vinegar. After he is come to himfelf he may drink freely of warm lemonade, or balm-tea, with fome orange or lemon-peel in it. It will likewife be proper, if the fainting fits' have been long and fevere, to clean ths bowels by throwing in an emollient clyfter. It is common in fainting-fits,from whatever caufe they proceed,' to bleed the patient. # This practice may be very proper1 in ftrong perfons, of a full habit; but in thofe who are weak and delicate, ©r fubject to nervous diforders, it is dangerous. The proper method with fuch people ir, to expofe them to the free air, and to ufe cor- dial and ftimulating medicines, as volatile falts, Hungarv-water. fpirits cf lavender, tincture of caftor, and the like. ioc) CF FLATULENCIES, OR WIND. ALL nervous patients, without exception, are afflicted with wind or flatulencies In the ftomach and bowels, which arife chiefly from the want of tone or vigour in thefe organs. Crude flatulent aliment, as green peas, beans, coleworts, cabbages, and fuch like, may increafe this complaint; but ftrong and healthy people are feldom troubled with wind, unlefs they either overload their fto- machs, or drink liquors that are in a fermenting ftate, and conse- quently full of elaitic air. While therefore the matter of flatulence proceeds from our aliments, the caufe which makes air feparab from them in fuch quantity as to occafion complaints, is almoft al- ways a fault ofthe bowels themfelves, which are too weak either to prevent the production of elastic air, or to expel it after it is pro- duced. To relieve this complaint, fuch medicines ought to be ufed ?s have a tendency to expel wind, and by ftrengthening the alimentary canal, to prevent its being produced there.* The lift of medicines for expelling wind is very numerous ; they often however difappoint the expectations of both the phyfi- cian and his patient. The moft celebrated among the clafs of car- minatives are juniper berries ; the roots of ginger and zedoary ; the feeds of anife, caraway, and coriander ; gum afafcetida and opium; the warm waters, tinctures, and fpirits, as the aromatic water, the tinctures of woodfoot, the volatile aromatic fpirit, aather, &c. Dr. Whytt fays, he found no medicines more efficacious ia expelling wind than cether and laudanum. He generally gave the laudanum in a mixture with peppermint-water and tincture of caf- tor, or fweets fpirits of nitre. Sometimes in phce of this, he gave opium in pills with afafcetida. He obferves that the good effects of opiates are equally confpicuous, whether the flatuf nee be contained in the ftomach or inteftines ; whereas thofe warm medicines, com- monly called carminatives, do not often give immediate relief, ex- cept when the wind is in the ftomach. With regard to aather, the Doctor fays, he has often feen very good effects from it in flatulent complaints, where other medicines failed. The dofe is a tea-fpoonful, mixed with two table-fpoonsful of water f. In gouiy cafes he obferves, that aather, a glafs cf French brandy, or of the aromatic water, or ginger, either t ken in fubftance or infufed in boiling water, are among the beft medi- cines for exp?liing wind. When the cafe of flatulent patients is fuch as makes it improp- er to give them warm medicines inwardly, the Doctor recommends external applications, which are fometimes of advantage. Equal parts of the anti-hyfteric and ftomach plafter may be fpread upon a piece of foft leather, of fuch fize as to coyer the greater part of the belly. This fliould be kept on for a confiderable time, provided * Many nervous people find great benefit from eating a dry bifeuit, efpecially when the ftomach is empty. I look upon this ai one of the beft carmina:ive medicines : and \vou;d recommend it In all complaints of the ftomach, arifing from flatulence, indigeftion, &c. t Though the patientmay begin with this quantitv, it will be neceflary toj increafe the dofe gradually asthe ftomach caw bear it, /Ether is -,"\v given in cor.fiderably greater dots* pua it wa« n Dr, WMl'i time. r„w OF LOW SPLUTS. the patient be able to bear it; if it fhould give great uneafinef; s; may be taken off, and the following liniment ufed ia its ftead : Take of Bate's anodyne balfam, an ounce; cf the expreffed oil of mace, half an ounce; oil of mint, two drachms. Ler thefe ingredients be mixed together, and about a table-fpoonful well rub- bed on the parts at bed-time. For strengthening the ftomach and bowels, and confeqnently for leffening the product on of flatulence, the Doctor recommends the Peruvian bark, bitters', chalybeates, and exercife. In flatulent cafes, he think? fome nutmeg or ginger fhould be added to the tincture ofthe bark and bitters, and that the aromatic powder ihould be joined with the fifngs of iron. When windy complaints are attended with coftivenefs, which is often the cafe, few things v/ill be found to anfwer better than four or five of the following pills taken every ni^ht at bed-time : Take of afafcetida two drachms ; fuccotrine aloes, fait of iron, o and powdered ginger, of each, one drachm ; as much of the elixir prsprktatis as will be fufficient to form them into piils. On the other hand, when the body is too open, twelve or fif- teen grains of rhubarb, with half a drachm or two fcruples of the Japonic confection, given every other evening, will have very good * effects. In thofe flatulent complaints which come on about the time the menfes ceafe, repeated fmall bleedings often give more relief than any other remedy. With regard to diet the Doctor obferves, that tea, and Iike« i wife all flatulent aliments, are to be avoided ;'and that for drink, water with a little brandy cr rum5> is not only preferable to malt liquor, but in moft cafes alfo to wine. As Dr. Whytt has paid great attention to this fuVJect, and as his fentiments upon it in a great meafure agree with mice, ! have taken the liberty to adopt them ; and fhall only add to his obferva- tiors, that exercife is in my opinion fupericr to ail medicine, both for preventing the production, and likewife for expelling of flatu- lencies. Thefe effects however are not to be expected from faun- tering about, or lolling in a carriage ; but from labour or fuch ac- tive amufefeBts as give exercife to every part of the body. OF LCV/ SPIRIJS. ALL who have weak nerves are fubject to low fpirits in a greater or lefs degree. Generous diet, the cold bath, exercife, aud' amufements, are the moft likely means to remove th:s complaint.— It is greatly increafed by folitude and indulging gloomy ideas, but may of en be relieved by cheetful company and fprightiy amule- ment.9. When low fpirits are owing to a weak relaxed ftate of t,he ftomach and bowels, an infufion uf the Peruvian bark with cinna- mon cr nutmeg will be proper. Steel joined with aromatics may likewife in this cafe be ufed with advantage; but riding and a prop- er diet are moft to be depended on. When they arile from foulnefs of the ftomach and inteftines, OF HYSTERIC AFFECTIONS. - 301 ur obftructions in the hypochondriac vifcera, aloetic purges will be proper. I have fometimes knov/n the Harrowgate fulphur-water of fervice in this cafe. • When low fpirits proceed from a fupprcfiion of the menstrual or of the ha?m n hoidai Hnx, thefe evacuations may either be re- stored, or fome other fubftituted in their place, as iffues, fetons or the like. Dr. Why it obferves, that nothing has fuch fudden gpod effects hi this cafe as bleeding. When low fpiriis have been brought on by long continued grief, anxiety, or other diftrefs of mind, agreeable company, variety of amufemetits, and change of place, efpecially travelling into for- eign countries, will afford the moft certain relief. Perfons afflicted with low fpirits fhould avoid ail kinds *cf excefs, efpecially of venery and ftrong liquors. ^The moderate ufe of wine and other ftrong liquors is by no means hurtful ; but when tak.n to excefs ri;ev weaken the ftomach, vitiate the humours, and deprefs the fpirits. ' This caution is the more neceffary, as the un- fortunate and melancholy often fly to ftrong Honors 'cr rTef, by which means they never fail to precipitate their own destruction. OF HYSTERIC AFFECTIONS. THESE iiirewife belong to the numerous tribe of ccryciis dif- eafe*, which maybe juftly reckoned the reproach of medicine.— Women of a delicate habit, whofe ftomach and inteftines are relax- ed, and whole nervous fyftem is extremely fenfible, are moft fubr ject to hyfteric complaints. In fuch perfons an hyfteric fit, as it h< called, may be brought on by an irritation of the nerves of the ilomach or inteftines, by wind, acrid humour, or the like. A hid- den fuppreffion of the menfes often give rife to hyfteric fits. They may hkewife be excited by violent paflions or affections of the mind, as tear, grief, anger, or great difappointments. Sometimes the hyfteric fit refembles a fwoon or fainting fit, during which the patient lies as in a fleep, only the breathing is fo low as fcarce to be perceived. At other times the patient is affect- ed with catchings and ftrong convulfions. The fymptoms which precede hyfteric fits are likewife various in different perfons.— Sometimes the fits come on with coldnefs cf the extremities, yawn ing and stretching, lownefs of fpirits, cporeiiion and anxiety. ^ At other times the approach of the fit is foretold by a feeling, a^ if there were a ball at the lower part of the belly, which gradually rifes towards the ftomach, where it occafions inflation, ficknefs, and fometimes vomiting ; afterwards it rifes into the gullet, and_ occa- fions a degree of fuflocation, to which quick breathing, palpitation of the heart, giddinefs ofthe h -ad, dnnnefs of the fight, Lfs of hear- ing, with convulfive motions cf the extremities and other parts of the body, fucceed. The hyfteric paroxyfm is often introduced by an immoderate fit of laughter, and fomet mes it goes off by crying. Indeed there is not much difference between the laughing and cry- ing of an highly hyfteric lady. Our aim in tihe treatment of this difeafe, muft the fit or paro>:r'la wheo. prefent, and to prevent its ■"V: >e to fliorten reiirn, The 3oa OF HYSTERIC AFFECTIONS. longer the fits continue, and the more frequently they return, the difeafe becomes the more obftinate. Their ftrength is increafed by habit, and they induce fo great a relaxation of the fyftem, that it is with difficulty removed. It is cuftomary during the hyfteric fit or paroxyfm, to bleed the patient. In ftrong perfons of a plethoric habit, and where the pulfe is full, this may be proper; but in weak and delicate conftitu- rions, or where the difeafe has been of long Handing, or arifesfrom inanition, it is not fafe. The belt courfe in fuch cafe is to route the patient by ftrong fmells, as burnt feathers, afiifcetida, or fpirits of hartfhorn, held to the nofe. Hot bricks may alfo be applied to the foles ofthe feet, and the legs, arms and belly may be strongly rub- bed with a warm cloth. But the beft application is to put the feet and le^s into warm water. This is peculiarly proper when the fits prec de the flow of the menfts. In cafe of coftivenefs, a laxative clyfter with afifoetida will be proper; and as foon as the patient can. fwallow, two table fpoonsful of a folution of afafcetida, or of fonqe • cordial julep, may be given.* Ihe radical cure of this diforder will be beft attempted at a time w en «. e patient is moft free from the fits. It will be gready promoted by a proper attention to diet. A milk and vegetable diet, when duly perfifted in, will often perform a cure. If however the patiant has been accuftomed to a more generous diet, it will not be fafe to leave it off all at once, but by degrees. The moft proper drink is water with a fmall quantity of fpirits. A cool dry air is the beft. ' C 1 1 bathing, and every thing that braces the nerves and invigorates the fyftem, is beneficial ; but lying too long in bed, or whatever relaxes the body, is hurtful. It is of the greateft import- ance to have the mird kept conftantly eafy and cheerful, and, if pof- fif.ie, fo have it always engaged in fome agreeable and interesting purfuit. I he prop:-r medicines are thofe which ftrengthen the alimentary canal an ; the 'whole nervous fyftem, as the preparations of iron, the Peruvian bark and ether bitters. Twenty drops of the elixir of vitriol in a cup cf the infufion of t^ie bark, may be taken twice or thrice a- ay 'rhe bark and iron may likewife be taken in fub- ftance, provided the ftomach can bear them ; but they are generally given i too fmall dofes to have any effect. The chalybeate waters generally pro*'- beneficial in this diforder. if rhe ftomach is loaded with phlegm, vomits will be cf ufe ; but they fhould hat be too ftrong, nor frequently repeated, as they tend to relax and weaken the ftomach. If there be a tendency to coftivenefs, it muft be remove^, either by diet, or by taking an open- ing pill as often as it fhall be found neceflary. T? feffen the irritability of the fyftem, antifpafmodic medicines will be of ufe. The beft antifpafmodic medicines are mufjc, opium, * When hyfteric fit* are occafioned by Sympathy,they may be cured by exciting an oppo- site paflion. This is faid to have been fhe cafe of a whole fchool of vbung ladies in Hol- land, who wire ail cuied by beine told, that the fitft who was feized fhould be burnt to «eatb. Hut this meibod of cure, to my knowledge, willnotalways fucceed. I would therefore advifri that young laiies who are Subject to hyfteric fits fliould not be fent toboarding-fchool«|i» the difeafe may b^caugb.t by ixnitatien. 1 have known jnadnefa itfelf brought on by fympa^Jf* OF HYPOCHONDRIAC AFFECTIONS- 303 t and caftor. When opium difegrees with the ftomach, it may either be apphed externally, or given in clyfters. It is cften fuccefsful in rem ving thofe periodical -ead-achs to which hyfteric and hypo- chondriac patients are fubject. > Caftor has in f me cafes been f uod to pr cure fleep wh-re -pium failed ; for which reafon, Dr. Whytt a wiles, that thev fhould be joined together. 1 >e likewife recommends theanti hyfteric plafter to be applied to the abdomen.* Hvfteric women are often afflicted with cramps, in various parts of the body, w ich are moft apt fofeize chiefly recommend in deafnefs, is, to keep the head warm. From whatever caufe the diforder proceeds, this is always proper ; and I have known more benefit from it alone, in the moft obftinate cafes ef deafnefs, than from all the medicines i ever ufed.f OF THE TASTE AND SMELL. THOUGH thefe fenfes are not of fo great importance to man iu a ftate of fociety, as the fight and hearing ; yet, as the lofs of them is attended with fome inconveniency, they def rve our notice. They are feldom to be refb red when h ft ; which ought ro make ns very attentive to their prefervation, by carefully avoiding what- ever may in the leaft prove injurious to them. As there is a very great affinity between the organs of tatting and fmelling, whatever hurts the one, generally affects the ot er. Luxury is highly injurs us to thefe organs. When the nofe and palate are frequently stimulated by fragrant and poignant difhes, they foon lofe the power of diftinguifhing taftes and odours with any degree of nicety. Man, in a ftate of nature, may perhaps have thefe faculties as acute as any other animal. * A gentleman on whofe veracity lean depend, told me, that after ufing many thing' to ho purpofe for an obftinate ('e^fnefs, he was at laft advifed to put a few droos of his own nrine warm into hit ears every nightand morning, from which he received great benefit, Jt is probable that a folution of /"at ammoniac in water, would produce the fame effe&. | An i*''!::) v itzfnrU tin ben <■•■•» d bv O'ftricrfv. 3i2 OF THE TASTE AND SMELL. The fenfe of fmelling may be diminifhed or deftroy ed by dif- eafes ; as, the moifture, drynefs, inflammation or fuppuration of that membrane which tines the infide of the nofe, commonly called the olfactory membrane ; the compreflion of the nerves which nip- ply this membrane, or fome fault in the brain itfelf at their origin. A defect or too great a degree of folidity, of the fmall fpungy bones of the upper jaw, the caverns ofthe forehead, &c may like- wife impair the fenfe of fmelling. It may alfo be injured by a col- lection of foetid matter in thofe caverns, which keeps constantly ex- haling from them. Few things are more hurtful to the fenfe of fmelling, than taking great quantities of fnuff. When the nofe abounds with moifture, after gentle evacua- tions, fuch things as tend to take off irritation, and coagulate the thin fharp ferum, may be applied ; as the oil of anife mixed with fine flour ; camphire diffolved in oil of almonds, &c. The vapours of amber ; frankincenfe, gum maftic, and benjamin, may likewife be received into the nofe and mouth. For moistening the mucus when it is too dry, fome recommend fnuff made ofthe leaves of marjoram, mixed with the oil of amber, marjoram and anifeed ; or a fternutatory of calcined white vitriol; tvwrive grains of which may be mixed with two ounces of marjo- ram-water, and filtrated. The fteam or vapour of vinegar upon hot iron received up the nostrils is likewife of ufe for fattening the mucus^ opening obftructions, Sec. If there is an ulcer in the nofe? it ought to be dreffed with fame emollient ointment, to which if the pain be very great, a little laudanum may be added. If it be a venereal ulcer, it is not to be cured without mercury. In that cafe, the folution of the corrofive fublimate in brandy may be taken, as directed in the gutta ferena. The ulcer ought likewile to be washed with it; and the fumes of cinnabar may be received up the nostrils. If there be reafon to fufpect that the nerves which fupply the organs of fmelling are inert, or want ftimulating, volatile falts, ftrong fnuffs, and other things which occafion fneezing, may be applied to the nofe. The forehead may likewife be annointed with balfam of Peru, to which may be added a little of the oil of amber. The tafte may be diminished by crufts, filth, mucus, aphthae, pellicles, warts, &c. covering the tongue ; it may be depraved by a fault of the faliva, which being difcharged into the mouth, gives the fame fenfations as if the food which the perfon takes had really a bad tafte; or it may be entirely destroyed by injuries done to the nerves of the tongue and palate. Few things prove more hurt- ful either to the fenfe of tailing or fmelling than obftinate colds, efpecially thofe which affect the head. When the tafte is diminished by filth, mucus, &c. the tongue ought to be fcraped and frequently wafhed with a mixture of water, vinegar, and honey or lome other detergent. When the faliva is vitiated, which feld&m happens unlefs in fevers or other difeafes, the curing of the diforder is the cure of this fymptom. To relieve it however in the mean time, the following things may be of ufe: HL there be a bitter tafte, it may be taken away by vonr ts, purges, OF THE TOUCH, 6c. 315 and other things which evacuate bile. Wh?t is called a nidoroua tafte, arifing from putrid humours, is corrected by the juice of cit- rons, oranges, and other acids. A fait tafte is cured bv plentiful dilution with watery liquors. An acid tafte is destroyed by abfor- bents, and alkaline falts, as powder of oyfter-fhells, fait of worm- wood, Sec. When the fenfibility of the nerves which fupply the organs or tafte Is diminifhed, the chewing of horfe-radifh,cr other ftimulating fubftance, will help to recover it. OF THE TOUCH. THE fenfe of touching may be hurt bjr any thing that obftrucl? the nervous influence, or prevents its being regularly conveyed to the organs of touching ; as preflure, extreme cold, Bee. It may likewife be hurt by loo great a degree of fenfibility, when the nerve is not fufficiently covered by the cuticle or fcarf-fkin, or where there is too great a tenfion of it, or it is too delicate. What- ever diforders the functions of the brain and nerves, hurts the fenfe of touching. Hence it appears to proceed from the fame general caufes aspalfyr and apoplexy, and requires nearly the fame method of treatment. In zftupor, or deleft of touching, which arifes from an obstruc- tion of the cutaneous nerves, the patient muft firft be purged ; af- terwards fuch medicines as excite the action ofthe nerves, or stimu- late the fyftem, may be ufed. For this purpofe, the fpirit of harts- horn, fat volatile oleofum, horfe-radifh, &c. may be taken inwardly ; the disordered parts, at the fame time, be frequently rubbed with frefh nettles or fpirit of'fd ammoniac. Bliftering-plafters and fina- pifins applied to the parts will likewife be of ufe, as alfo warm bath- ing, efpecially in the natural hot baths. CHAP. XLVII. i OP A SCIRRHUS AND CANCER. x\. SCIRRHUS is a hard indolent tumour ufuaPy fisatcd in fome of the glands; as the breafts, the arm-pits, Sec. If the tu- mour becomes large, unequal, of a livid, blackifh, or leaden colouri and is attended with violent pain, it gets the name of an occult can- cer. When the fkin is broken, and n fames or ichorous matter of an abominable foetid fmell is difcharged from the fore, it is caiied an open or ulcerated cancer. Perfons after the age of forty-five, particularly women, and thofe who lead an indolent fedentary life, are moft fubject to this difeafe. CAUSES,-—This difeafe is often owing to fuppreffedevacua- tions ; hence it proves fo frequently fatal to women of a grofs habit, particularly old maids and widows, about the time when the me.iftrual flux ceafes. It may likewife be occafioned by exceflive fear, grief, anger, religious melancholy, or any of the deprefling paflions. Hence the unfortunate, the choleric, and thofe perfons who devote themfelves to a religious life m convents or monafte* (21) 3i4 OF A. SCIRRHUS AND CANCER. ries, are often afflicted with it. It may alfo be occafioned by the long continued ufe of food that is too hard of digeftion, or ofaa acrid nature ; by barrennefs; indolence ; cefbacy ; cold ; blows ; friction ; preflure ; or* the like. Women often fuffer from the laft of thefe by means of their ftays, which fqueeze and comprefs their breaft fo as to occafion great mifchief. Sometimes the difeafe is owing to an hereditary difpofition. SYMPTOMS.—This diforder feems often very trifling at the beginning. A hard tumour about the fize of a hazle-nut, or per- haps fmaller, is generally the firft fymptom. This will often con- tinue for a long time wilhout feeming to increafe or giving the patient great uneafinefs; but if the conftitution be hurt, or the tu- mour irritated by preflure or improper treatment of any kind, it begins to extend itfelf towards the neighbouring parts by pufhing out a kind of roots or limbs. It t :en gets the name of cancer, from a fancied refemblance between thefe limbs and the claws of a crab. The colour ofthe fkin begins to change, which is firft red, after- ! wards purple, then bluifh, livid, and at laft black. The patient compbins of heat, with a burning, gnawing, fhooting pain. The ' „ tumour is very hard, rough, and unequal, with a protuberance or rifing in the middle ; its fizc increafes daily, and the neighbourjffij veins become thick, knotty, and of a blackish colour. "^* The fkin at length gives way, and a thin fharp ichor beginsi to flow which corrodes the neighbouring parts till it forms a large un- fightly ulcer. More occult cancers arife, and communicate with the neighbouring glands. The pain and flench become intolerable; ■ the appetite fails; the ftrength is exhaufted by a continuaf hectic fever; at laft a violent haemorrhage, or difcharge of blood, from' fome part of the body, with faintings, or convulfion fits, generally put an end to the miferable patient's life. REGIMEN.—The diet ought to be ligh!, but nourifhing.— All ftrong liquors, and high feaf ned or falted provifi ms, are to be avoided. The patient may take as much exercife as he can eafily bear; and fhould ufe every meth d to divert thought, and amufe his fancy. All kinds of external injury are car fullv to be guarded . againft, parr'cul?rly of te affected part, which ou^ht to be defend- . ed from all preflure, and even from the external air, by covering it • with fur or foft flannel. MEDICINE.—This is one of th^fe difeafes for wtich no certain remedy is yet known. Its progrefs however may fometimes be retarded, and feme of its moft difeg*-eeable fymptoms mitigated, by proper applications. One misfor'une attending the difeafe is, that the unhappy patient often conceals it too long. Were proper means ufed in due time, a cancer might often be cured ; but after . the diforder hos arrived at a certain hdght, it gentr lly fets all medicine at defiance. When a fcirr us tumour is firft dife vered, the patient ought to obferve a pr per regimen, and to take tw ce or thrice a-week a dofe of the common purging mercurial pill. Some blood may alfo be let, and the part aff;cted may be gently ruboed twice a-day with a iittl'e of the mercurial ointment, and kept warm with fur or OF A SCIRRHUS AND CANCER. 3i<* flannel. The food muft be light, and a pint of the: decoction of woof's or farfapariUa may be drank daily. I have fometimes du- cuffedhard tumours, when had the appearance ofbegimng can- cers, by a courfe of this kind. Should the tumour however not yield to this treatment, but, on thecontran, become larger and harder, it will be proper to ex- tirpate it, either by the knife or cauftic. Indeedy whenever this can be done with fafety, the fooner it is dorie the better. It can anfwer no purpofe to extirpate a cancer after the conftitution is ruined, or the whole mafs of humours are corrupted by if. This, however, is the common way, whichmakes the operations feldom fucceed. Few people will fubmit to the extirpation till death flares them in the face ; whereas, if it were done early, the patient's life would not be endangered by the operation, and it would generally prove a radical cure. 0 When the cancer is fo fituated that it cannot -he cut off, or if the patient will not fubmit to the operation, fuch medicines as, will mitigate or relieve the moft urgentifiy?mptoms,)may be. ufed.- Dr« Home fays, that half a grain ofthejCQrfofive fubliraate of mercury,-! diilblvedin a proper quantity of ffcaoidy, and taken night and mor- ning,' will often be of fervice in cancers ofthe face and nofe, He\ likewife recommends an infufion of thefolanum or nightrfhade, in cancers of the breafts. ''n. But the medicine moft in repute at prefent for this difeafe is hemlock. Dr. Stork, phyfician at Vienna, has of late recommend- ed the extract of this plant as very efficacious in cancers of every kind. The Doctor fays, he has given fome; hundred weights of it without ever hurting any body, and often with manifest advantage. He advifes the patient however to begin with very final! dofes, as two or three grains, and to increafe the dofe gradually till fome good effect be perceived, and thereto reft without further increafe.— From two or three grains at firft, the Doctor fays he has incjreafed the dofe to two, three, or four drachms a-day, and finds that fuch dofes may be continued for feveral weeks without any bad con- fequences. The regimen which the doctor recommends during the ufe of the medicine, is to avoid farinaceous fubftances not fermented, and too acrid aromatics. He fays, good wine will not be hurtful to thofe who are accuftomtfd to it, nor a moderate ufe of tyiidi ; and adds, that the patient fhould live in a pure free air, and keep his mind as quiet and cheerful as poffible. The Doctor does not pretend to fix the time in which a cancer may be ref lived by the ufe of hemlock, but fays he has given it for above-two years in large dofes without any apparent benefit; never- tholofs the patient has been cured by p^rfifting in the ufe of it for half a year longer. This is at leaft encouragement to give it a fair trial. Though we are far from thinking the hemlock merits thofe ex(ravagant encomiums which the Doctor has beftowed upon it, yet, in a difeafe which has fo long baffled the boasted powers of medicine, we think it ought always to be tried. The powder of hemlock is by fome prefered to the extract.-^ 316 OF A SCIRRHtTS AND. CANCER. They are both niade of the frefh leaves, and may be ufed nearly in the lame manner. Dr. Nicholfon of B-rwick, fays, he gradually increafed the dofe of the powder from a ftw grains to half a drachm, and gave near four drachms of it in the day with remark- ably good effects. The hemlock may alfo be ufed externally either as a poultice or foihentation. The fore may likewife be kept clean by injecting daily a ftroug decoction of the tops and leaves into it. ' Few things contribute more to the healing of foul fordid ul- cers cf any kind than keeping them thoroughly clean. This ought never to be neglected. .The beft application for this purpofe feems to be the carrot p •. ltice. The root ofthe common carrot may be grated, and moistened with as much water as wifl bring it to the confidence of a poultice or cataplafm. 1 his muft be applied to the fore, and renewed twice a-day- It generally cleans the fore, erf „js th» pain, and takes away the difagreeabl; fmell, which are objects of no fmall importance in fuch a dreadful diforder.* Wert, or an infufion of malt, has been recommended not only as aTproir r drink, but as a powerful1 medicine in this difeafe. It muft be frequently mad.J frefh,* and the patient may take it at plea- ' fure. Two, three, or even four Englifh pints of it may be drank every day fcr a confiderable time. No benefit can be expected from any medicine in this difeafe, unlefs it be perfifted in for a long time. It is of too obstinate a nature to be foon removed; and, when it admits of a cure at ail, it muft be brought about by inducing an almoft total change ofthe habits which muft always be a work of time. Setons or iflues in the neighbourhood of the cancer have fcroctimes good effects.-}; When all other medicines fail, recourfe muft be had to Opium, as a kind of folace. This will not indeed cure the difeafe, but it will eafe the patient's agony, and render life more tolerable while it continues. TJBiavoid this dreadful diforder, people ought to ufe7 whole. fome food ; to take fufficient exercife in the open air; to be as eafy arid cheerful as poffible ; and carefully to guard againft all blows, bruifes, and every kind of preflure upon the breafts, or other glan- dular part$4 * London Medical EfTays. t In a cancer which had fet all medicines, arid even turgery, at defiance, 1 lately faw re- matKable effects from an obftiru'.e perfeverance in a courl&of antifeptics. I ordered the deep u cers to Bt wafhed to the bottom by means of afyringe, twice or thrice a-day, either witli an infufion cf the bark, pr a decoction of carrot, and that the patient flu uld tiJ with proper directions for ufing them. CHA?. XLVIII. OF POISONS. JQjVER Y perfon ought, in fome meafure, to be acquainted "with the nature and cure of poifons. They are generally taken unawares, and their effects are often fo fudden and violent, as hot to admit of delay, or allow time to procure the afliftance of phyfi- cians. Happily indeed no great degree of medical knowledge is here neceflary ; the remedies for moft poifons being generally at hand, or eafily obtained, and nothing but common prudence need- ful in the application of them. The vulgar notion tnat every poifon is cured by fome counter poifon, as a Ipecific, has done much hurt. People believe they can do nothing for the patient, unlefs they know the particular an- tidote to that kind of poifon which he has taken. Whereas the cure of all poifons.taken into ihe ftomach, without exception, de- pends chiefly on difcharging them as foon as poffible. Ther - is ho cafe wherein the indications of cure are more ob- vious. Poifon is feldom long in the ftomach before it, occafions ficknefs, with an inclination to vomit. This fhews plainly what cughtto be done. Indeed common fenfe dictates to every one, that, if any thing has been taken into the ftomach wh ch endangers life, it ought immediately to be difcharged. Were this duly re- .garded, the danger arifing from poifons might generally be avoided. The method of prevention is obvious, and the means are in the -bands of every one. e 'We fhall no* take up the reader's time with a detail of the .ridiculous notions which have prevailed among ignorant people in different ages with regard to poifons ; neither, fhall we mention the boafted antidotes which have been recommended either for prevent- ing or obviating their effects ; but fhall content ourfelves wifh pointing out the poifons moft c:mmon in this country, and the means of avoiding their dangerous confequences. y Poifons either belong to the mineral, the vegetable,'or the ani- mal kingdom. Mineral poifons are commonly of anacridor corroflve quality; as arfenic, cobalt, the corrofive fublimate of mercury, Sec. Thofe of the vegetable kind are generally cf a narcotic or ftupefactive quality; as poppy, hembek, henbane, berries cf the deadly night-fhade, &c- Poifonous animals communicate their infection either by the bite or fling. This poifon is very different from the former, and only produces its effects when received into the body by a wound. MINERAL POISONS.—Arfenic is the moft common of this clafs ; and, as the whole of them are pretty fimilar both in then- effects aid method of curel what is faid with refpect to it will be applicable to every other fpecies of corrofive poifon. When a perfon , has taken arfenic, he foon perceives a burning heat, and a violent pricking pain in his ftomach and bow-. els, with an intolerable thirft.. and an inclination to vomit. The tongue and throat feel rough and dry ; and, if proper means be not 3t8 OF POISONS. foon adminiftered, the patient is feized with great anxiety, hickup- ing,' fain tings, and coldnefs of the extremities. To thefe fucceed black vomits, foetid ftools, with a mortification of the ftoma'ch and inteftines, which are thetmmediate forerunners of death. On the firft appearance of thefe fymptoms the patient fhould drink large quantities of new milk and falad oil tiil he vomits; or he may drink warm water mixed witfc oil. Fat brc-ths are likewife proper, provided they can be got ready in time. Where no oil is to be had, frefh bu ter may be melted and mixed' with the milk or water. Thefe things are to be drank as long as the inclination to vomit continues. 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 ofthe poifon remains in the ftomach. Thefe oily or fat fubftances not only provoke vomiting, but likewife blunt the acrimony ofthe poifon, and prevents its wound- ing the bowels; but if they fhould not make the perfon vomit, half a drachm or two fcruples of the powder of ipecacuanha muft be giv- en, or a few fpoonsful of the oxymel, or vinegar of fquills may be mixed with the water which he drinks. Vomiting may likewife be excited by tickling the infide ofthe throat with a feather. Sh juld thefe methods however fail, half a drachm ot white vitriol, or five or Jix grains of emetic tartar, mult tie adminiftered. If tormenting pains are felt in the lower belly, and there is reafon to fear that the poifon has got down to the inteftines, clyfters pf milk and oil mail be very frequently thrown up ; and the patient muft drink emollient decoctions of barley, oat-meal, marfh-mal- lows, and fuch like. He muft likewife take, an infufion of fenna and manna, a folution of Glauber's falts, or fome other purgative. After the poifon has. been evacuated, the patient ought for fome time, to live upon fuch things as are of a healing'and cooling- quality j. to abftain1 from flefh and all ftrong liquors, and to live upon milk, broth, gruel* light puddings, and other fpoon-meats ..of eafy digestion. His drink should be barley-water, linfeedrtea, or infufiofiy-of any of the wild mucilaginous vegetables* VEGETABLE POISONS, befides heat and pain of the ftomach, commonly.occafion fome degree of giddinefs, and often a kind of stupidity cr folly. Perfons who have . taken thefe poifons mull 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 generally over as foon as they are difcharged. Not being of fuch a cauftic or corro- five nature, they are lefs apt to wound or inflame the bowels than t he mineral, fubftances; no time, however, ought tcbeloftin hav- ing th-m difcharged. Opium, being frequently taken byjniftake, merits; particular attention. It is ufed as a.medicine both*in a folid and liquid fortn, which latter commonly goes by the name of laudanum. It is ^in- deed a valuable medicine when taken in proper quantity ; but as anover-dofe proves a ftrong poifon, we fhail point out its common effect^, togeth t with the method of cure. •• •■■•■' An over-dofeof opium generally occafions great drowfflftfe, BITES OF POISONOUS ANIMALS. 3*9 with ftupor and other apopletc fymptoms. Sometimes the perfon r has fo great an inclination to fleep, that it is almoft impoflible to keep him,awake. Every method rauft however be tried for this pur- pofe. He fh uld be toffee, ihaked and moved about. Sharp blif- tering-plafters fhould be applied to his legs or arms, and ftimula- ting medi- ines, as falts of hartfhorn, &c. held under his nofe. It will alfo be proper to let bbod. At the fame time every method muft be taken to make him difcharge the poifon. This may be done in the manner directed above, viz. by the ufe of ftrong vom- its, drinking plenty of warm water with oil, Sec. Mead, befides vomits, in this cafe, recommends acid medicines with lixivial falts. He fays, that he has often given fait of worm- wood mixed with juice of lemon in repeated dofes with great fuc- cefs. If the body fhould remain, weak and languid after the poifon." has been extracted, nourifhing diet and cordials will be proper; but when therais reafon to fear that the ftomach or bowels are inflam-* ed, the greateft circumfpection is neceffary both with regard to food and medicine. OF THE BITES OF POISONOUS ANIMALS. 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 table to contract this difeafe are, aa far as we yet know, all of the dog kind, viz. foxes, wolves, and dogs. Hence it is called the rabies canina, or dog-maSnefs. It fo fel- dom happens that any perfon is bit by the two firft, that they fcarce deferve to be taken notice of. If fuch a thing fhould happen, the method ®f 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 eye feeming heavy and watery. He now, if not con- fined, takes off, runs panting along with a kind of dejected air, anc- enteavours to bite every one he meets. Other dogs are faid to fly from him. Some think this a certain fign of madnefs, fuppofing 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. When any perfon has been bit by a dog, the ftricteft inquiry ought to be made whether the animal was really mad. Many dif- agreeable confequences arife from neglecting to afcertain this point. Some people have lived in continual anxiety for many years, be- caufe they had been bit by a dog which they believed to he mad ; but3 as he had beeakillsd on the fpot, it was impoHibie to aicertaia 3*0 BYTES OF POISONOUS ANIMAhS. the fact. This fhould induce us, inftead of killing a dog the mo*. ment he has bit any perfon, to do all in our power to keep him alive, at leaft till we afcertain whether he be mad or not. Many fiircumftances may contribute to make people imagine a dog mad. He lofes his mailer, runs about in quell of him, is let upon by other dogs, and perhaps by men. The 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, find- ing himfelf clofely purfued, and taking every one he meets for an enemy, naturally attempts to bite in lelf-defence. He foon gets knocked on the head, and it pafles currently that he was mad, as it is th jn impoflible to prove the contrary. This being the true hiftory of, by far, the greater part of thofe dogs wMch pafs for mad, is it any wonder that numberlefs whimsi- cal mediciaes have been extolled fcr preventing the effects of their |»te ? This readily accounis for the great variety of infallible rem- edies 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 ivoudier that imaginary difeafes fhould be cured by imaginary reme* dies. In this way, credulous people firft impofe upon themfelves, and then deceive others. The fame medicines which were fuppofed to prevent the effects 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, trulls to it, and is undone. To thefe miftakes we muft impute the frequent ill fuccefs of the medicines ufed for preventing the effects of the bite of a mad dog. It is not owing fb much to a defect in medicine, as to wrong applications. I am perfuaded, if proper medicines were adminifter. ed immediately after the bite is received, and continued for a fufE- cient length of time, we fhould not lofe one ip a thoufand of! thofe who have the misfortune to be bit by a mad dog. The poifon is generally communicated by a wound, which rieverthelefs heals as foon as a common wound ; but afterwards it be^no to feel painful, and as the pain fpreads towards the neigh- bouring 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 fie firft. tymp.. toms of that dreadful difeafe occafioned' by the bite of a mad dog. But as we do not propole to treat fully ofthe difeafe itfelf, but to point out the method of preventing it, we fhall not «ake up time in ihewing its progrefs from the firft invafion to its commonly fatal end. The common notion, that this poifon mav lie in the body for many years, and afterwards prove fatal, is both hurtful and ridicu- lous. It muft render fuch perions as have had tr;e misfortune to be bit very unhappy, and can have no good effects. If the perfon takes proper medicines for forty davs after the time of his being bit, and feels no fymptom of the difeafe, there is reafon to beheve him out of danger. The medicines recomraeoded for preventing the effects of the / BITES OF POISONOUS ANIMALS. 325 bite of a mad dog. are chiefly fuch as promote the different fecre- tions, and antifpaunodics. Dr. Mead recommends a preventative medicine, which he fays he never knew fail, though in the fpace of thirty years he had ufed it a thoufand times. The Doctor's prefcription 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 j one of which muft be taktn every morning failing, for four mornings fucceflively, in half a pint of cow's milk warm. " After thefe four dofes are taken, the patient muft go into the cold bath, or a cold fpring or river, every morning fasting, for a month ; he muft be dipped all over, but not flay in (with his head above water) longer than half a minute, if the 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 medi- cine."* We fhall next mention the famous Eaft-India fpecific as it is called. This medicine is compofed of cinnabar and mult. It is efteemed a great antifpafmodic; ancL by many, extolled as an in- fallible remedy for preventing the effects of the bite of a mad dog* *' Take native and factitious 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 tofecure 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 reckoned a good antifpafmodic med- icine : " Take of Virginian fnake-root in powder, half adrachm, gum afafcetida twelve grains, gum camphire feven grains; make thefe into a bjlus 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 drachma camphire one drachm ; rub them together in a mortar, and divide the whole into ten dofes." Mercury is likewife recommended as 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 drachm 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. Thefe are the principal medicines recommended for preventing the effects of the bite of a mad dog. We would not however ad- vife people to truft to any one of them ; but from a proper combina- tion of their different powers, there is the greateft realon to hope for fuccefs. " Though we give thii prefcription on the credit of Dr. Mead, yet we would not advife any perfon who has reafon to believe that he has been bit by a dog which was really mad, to trufl to it alone. Mead was an ab'e phyfician, but he leemi to have been no great philofo- pker, and wa» fometimes the dupe of his own credulity. 322 BYTES OF POISONOUS ANIMALS. 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 tie medicines, we muft impute their frequent want of fuccefs. Dr. Mead fays, that the virtue of this medicine confifts in pro- moting urine. But how a poifon fhould be expelled by urine, with ! only three or four dofes of any medicine, however powerful, it is not eafy to conceive. More time is certainly n ceflary, even though the medicine were more powerful than that whxh the Doc- tor prefcribes. The Ealt-India specific is ftill more exceptionable on this ac- count. As thefe and moft other medicines, taken fingly, have fre- quently been found to fail, We fhall recommend the following courfe : If a perfon is bit in a flefhy part, where there is no hazard of hurting any large blood-veffel, the parts adjacent to the wound may J be cut away. But if this be not done foon after the bile has been received, it will be better to omit it. The wound may be dreffed with fait and water, or a pickle made of vinegar and fait, and afterwards dreffed twice a-day with yellow bafilicon mixed with red precipitate of meicury. ^ The patient fhould begin to ufe either Dr. Mead's medicine, or fome of the others mentioned above, if he takes Mead's medi- cine, he may ufe it as the Doctor directs for f urdays fuccefliveiy. ' Let him theu 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 woundf daily, one drachm ofthe mercurial ointment. This may be dene for ten or twelve days at leaft. When this courfe is over, he may take a purge or two, and wait a few days till the effect of the mercury be gone off. He muft then'begin to ufe the cold bath, into which he may go every mora* mg for five or fix' weeks. If he fhould feel cold and chilly for a long time after comiag out of the cold bath, it will be better to ufe a tepid one, or to have the water a little warmed. In the meantime we would advife him not to leave off all in- ternal medicines, but to take either one of the bolufes of fnake- root, afafcetida, and camphire ; or one of the powders of nitre, camphire, and fnake-root, twice a-day. 1 hefe may be ufed during the whole time he is bathing. During the ufe of the mercurial ointment, the patient muft keep within doors, and take nothing cold. A proper regimen muft be obferved throughout the whole courfe. The patient fhould abftain from flefh, and all falted[and high-feafoned provifions. He muft avoid ftrong liquors, and live nioftly upon a l'gnt and rather fpare diet. His mind fhould be kept as eafy and cheerful as poffible, and ail exceffive heat and vio- lent paflions avoided with the utmost care. 1 have never feen this courfe of medicine, with proper regimen* BITES OF POISONOUS ANIMALS. 323 fail to prevent the hydrophobia, and cannot help again obferving, that the want of fuccefs moft generally be owing either to the ap- plication of improper medicines, or not ufing proper ones for a fufti- cient length of time. Mankind are extremely fond of every thing that promifes 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 remarkably in the prefent cafe.— Numbers of people, for example, believe if they or their cattle were once dipped in the fea, it is fufficient; as if the fait water were a charm againft the effects of the bi:e. This, and fuch like whims, have proved fatal to many. , It is, a common notion, if a perfon be bit by a dog which is not mad, that, if he fhould go mad afterwards, the perfon would be affected with the diforder at the fame time; but this notion is too ridiculous to deferve a ierious confideration. It is a good rule, however to avoid dogs as much as poffible, as the difeafe is often upon them for fome time before its violent fymptoms appear. The hydrophobia has been occafioned by the bite of a dog which fhewed no other fymptoms of the difeafe but liitleflhefs and a fullen diipo- iition. Though we do not mean to treat fully of the cure of the hy- drophobia, yet we are far from reckoning it 'incurable. The notion that this difeafe could not be cured, has been productive of the moft horrid confequences. It was ufual either to abandon the un- happy perfons, as foon as they were feized with the difeafe, to their fate, to bleed them to death, or to fuffocate them between mattref- fes or feather-beds &c. This, conduct certainly deferved the feve- reft punifhment: We hope, for the honour of human nature, it will never again be heard of. I have never had an opportunity of treating this difeafe, and therefore can fay nothing of it from my own experience ; but the learned Dr. Tiflbt fays, it may be cured in the following manner : 1. The patient muft be bled to a confiderable quantity, and this may be repeated twice, or thrice, or even a fourth time, if cir- cumflances require it. 2. The patient fhould be put, if poffible, into a warm bath; and this fhould be ufed twice a-day. 3. He fhould every day, receive two, or even three emolli- ent clyfters, 4, The wound, and the parts adjoining to it, fhould be rubbed with the mercurial ointment twice a-day. 5. The whole limb which contains the wound fhould be rub- bed with oil, and,be wrapped up in an oily flannel, 6. Every three hours a dofe of Cob's powder fhould be taken in a cup ofthe infufion of lime-tree and elder-flowers. This pow- der is made, by rubbing together in a mortar, to a very fine pow- 324 BITES OF POISONOUS JNIMALS. dcr of native and factitious cinnabar, each twenty-four grains; of mufk, fixteen grains.* 7. The following bolus Is to be given every night, ant to be repeated in the morning, if the patient is not eafy, wafhing it down with the infufion mentioned above: Take one drachm of Virginian fnake-root in powder ; of camphire and afafcetida, ten grains each ; of opium, one grain ; and, with a fufficient quantity of ccn- ferve, or rob of elder, make a bolus. 8- If there be a great naufea at the ftomach, with a bitterneft in the mouth, thirty-five or forty grains of ipecacuanha, in powder, may be taken for a vomit. . 9. The patient's food, if he takes any, muft be H|ht ;.as pana. do. foups made of farinaceous or mealy vegetables, &c. 1 o. If the patient fhould long continue weak, and hibject to terrors, he may take half a drachm of the Peruvian bark thrice a-day. The next poifonous animal which we fhall mention is the VIPER. The greafe of this animal rubbed into the wound, is faid to cure the bite. Though that is all the viper-catchers gene* | rally do when bit, we fhould not think it fufficient for the bite of an enraged viper. It would furely be more fafe to^have the wound well fucked,t and afterwards rubbed with warm falad-oil.t A poultice of bread and milk, foftened with falad-oil, fhould likewife be appli. i ed to the wound; and the patient ought to drink freely of vinegar- whey, or water-gruel with vinegar in it, to make him fweat. Vin- egar is one of the beft medicines which can be ufed in any kind of poifon, and ought to be taken very liberally. If the patient be fick he may take a vomit. This courfe will be fufficient to cure the bite of any of the poifonous animals of this country. With regard to poifonous infects, as the bee, the wafp, the hornet, Sec. their flings are feldom attended with danger, unlefs when a perfon happens to be ftung by a great number of them at the fame time ; in which cafe fomething fhould be done to abate ihe inflammation and fwelling. Some, for this" purpofe, apply honey, others lay pounded parfley to the part. A mixture of vn. egar and Venice treacle is likewife recommended ; but I have always found rubbing the part with warm falad oil fucceed very well. Indeed, when the flings are 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 fhould likewife be bled, and * The Ornvtkiik medicine, as it is called, feems to me to confift chiefly of cinnabar.— Though it is faid to be infallible, as a preventative ; yet 1 would not advife any one to truft to it alone, indeed it is ordered to be taken in a manner which .gives it more the appearance- of a charm than of s medicine. Surely if a medicine is to produce any change in the body, ic,muft be taken for fome confiderable time, and in fufficient quantity. f The practice of fucking out poifons ib very ancient; and indeed nothing can be more rational. When the b te cannft be cut out, this is the moft likely^ way for extra&ing the poifon. There can be no dangerin performing this office, as the poifon does no harm unleft >t he tikeninto the body by a wound. The perfon who fucks the woum., ought however to rvafh his mouth frequently with falad-oil, which will (ecu^him from even the leaft inconve- nience. ThePsYLLi in Africa, and the Marsi in Italy, were famed for curing the bite*. or poiionous animals bv fucking the wound) and we are told, that .the Indians in North. America praclife the fame at this day. \ Salad or fweet oil, not only applied outwardly, but tak»n inwardly, is not only effica- "'o\it in curing the bite of the Viper, but alfo of the rattc-faaite. Ait. sues of poisonous animal* 325 t?k*» fome cooling medicines, as nitre, or cream of tartar, and fhould drink'plentifully of diluting Hquors. It is the happioefs of this ifland to have very few poifonous anirrial?, and thote which we have are by no means ot the moft virufent kind. Nine-tenths of the effects attributed to poifon or venom in this country are really other difeafes, and proceed from •quite diff rent crufes. We cannot however make the fame obfervation with regard to poifonous vegetables. Thefe abound every where, and prove ofen fatal to the igncrant and unwary. This indeed is chiefly owing 'o cnrleffnefs." Children ought early to be cautioned againft eating any kind of fruit, roots, or berries, which they do hot know ; and all poifonous plants to which they can have accefs, ovght, as far as poffible to be destroyed. This would not be fa difficult a tafk as fome people imagine. Poifonous plants have 110 doubt their ufe j and they ought to be propagated in proper places i but* as they often prove destructive , to cattle, they fhould be rooted out of all pafture-grounds. They ought likewife, for the fafety of the human fpecies* to be destroyed in the neighbourhood of all towns and villages ; which, by the bye, are the places Where they mbft commonly abound. I have feen the poifonous hemlock, henbane* wolfsbane, and deadly night- fhade, all growing within the environs of a fmall town, where* though feveral perfetoSi within the memory of tnofe living in it, had loft their lives by ohe-of other of thefe plants, yet no method, that I could hear of, had ever been taken to fbot them out; though this might be done at a very trifling expfenfe. Seldom a year paffes but we have accounts of feveral perfons poifoned by eating hemlock-roots instead bfparfnips, or fbime kinds of fungus which they had gathered for mufhrboms. Thefe ex- amples ought to put people upon their guard with refpect to the former, and to put the latter entirely ont of ufe. Mufhrboms may be «t delicate difh, but they arba d^^erous one, as they are gene* rally gathered by perfons who cfe not know one kind of ftifcgus from another, and take every thing for a mnfnroom which has that appearance. We might here mention many other plants and animals of a poifonous nature which are found in foreign countries; But as our obfervations are chiefly intended for this ifland, wefhall pafs thefe over. It may not however beamifs to .obferve, for the benefit of fuch of Our countrymen as go to Aniejica-, that an effectual reme- dy is now laid to be found fdr the]bife of the rattle-fnake.—The prefcription is as follows t Take of frit roots of plantain and hore- hound,in fummer, roots and branches together, a fufficient quanti- ty ; bruife them in a mortar, and fqueeze oirt'the ;juice, of which give, as foon as poffible, one laroje fpoonful; if the patient be fwell- ed, you muft force it down his throat. This generally will cure; but if he finds ho relief in an hour after, you may 'g've another fpoonful, which never fails.—If the roots are dried, they 'muft be moiftened with a little water. To the wound may be applied, a leaf of good tobacco fcoiSetfed with rum. '-r 326 ^BITES OF POISONOUS ANIMALS. Wergiye this upon the faith of Dr. Brooks, who fays it was the invention of a negro, for the difcovery of which he had his freedom purchateaY and a hundred pounds per annum fettled upon him during life, by the general Affembly of Carolina'. It is pofftole there may be in nature fpecific remedies for every kind of poifon ; but as we have very little faith in any of thofe which have yet been pretended to be difcovered, we fhall beg leave again to recommend the rnoft strict attention to the following rules, viz.. That when any poifgnous fubftance has been taken into the' ftomach,; it ought asToon aspoflible to be difcharged by vomits,, clyfters, and purges ; and, when poifon has been received into the body by a wound-, that it be expelledby medicines which promote the different fecretions, efpecially thofe of fweat, urine, and infenhV ble perfpiration ; tor which .may 'be joined antifpafmodics^ or^if uch medicines as take offtenfion and irritation ; the chief of whiac are. opium, mufk, camphire, and afafipetida. ..- j Kettering's specific for the hydrophobia, 'i ExtfaElfrcm the Journals oft the, Legiftature of Pennfftvania, cfJITarclj • '. 6, 1802. "The committee appointed to hear, the communication of Valentine Kettering, relative to his aire of the bite of a mad ani- mal, -,'■.. :.!■■ : Report—". That they conferred with the faid Kettering.on that fubject, who informed them, that.he ufes the herb called Red Chickweed, which, when ripe* or in full bloom, he gathers, and dries in the fhade, reduces it to a powder, and gives a fmall table- fpeonful at one time,, to a grown:.perfon in beer cr water, in we;ght one dtaqhrn arid one ferunle : for a child, an equal dofe, but givenj at three differenttimes, or itmay be eaten.on bread with butter, honey, or mola'Aes; as the p%rfpn chufes. For a beaft, a large fpoonful; if by 'weight, twa drachms and one fcruple. Whenufed green for a beaft> cut the herhiitje, andmix, with bran, &e. Wiien given to fw'me, mix.the powderedct; I fhall there- fore confine my obfervations chiefly to circunv":ances of importance, omitting fuch as are either trifling, or which occur but feldom. I ihail likewife pafs over the hiftory ofthe difeafe, with the different methods of treatment which it has undergone fince it was lb it intro- 328 OF*THE VIRULENT GONORRHOEA. duced into Europe, and many other circumftances of a fimilar na- ture ; all of which though thev might tend to araufe the reader, yet could afford him little or no ufeful knowle 4ge. OF THE VIRULENT GONORRHOEA. THE virulent Gonorrhoea is an involuntary difcharge of infec- tious matter from the parts of generation in efher fex. It gene- rally makes its appearance witu'n eight ir ten days after the infec- tion has been received ; fometimes indeed it appears in two or three days, and at other times not before : he end of four or five weeks. Previous to the difcharge the patient feels an itching, with a final! degree of pain in the genitals. Aferwards a thin glary matter be- gins to diftil from the urinary paffage, which ftains the linen, anJ occafions a fmall degree of titiUatinn, particularly at the time of making water; this gra lually incr afing, arifes at length to a degree of heat and pain, which are chiefly perceived about the extremity of the urinary paffage, where a flight degree of rednefs and inflam- mation likewife begin to appear. As the diforder advances, the pain, heat of urine, and runnirg? increafe, while frefh fymptoms daily enfue. In men, the erections become painful and involuntary, and are more frequent and lasting than when natural. This fymptom is moft troublefome when the patient is warm in bed. The pain which was at firft only perceived towards the extremity, now begins to reach all up the urinary paf. fage, and is moft intenfe juft after the patient has done makirg water. The running gradually recedes from the colour of feed, grows yellow, and at length puts on the appearance of mucus. When the diforder has arrived at its height, all the fymptoms are more intenfe ; the heat ofthe urine is fo great, that the patient dreads the making water; and though he feels a conftant inclination this way yet it is rendered with the greateft difficulty, and often oily by drops; the involuntary erections now become extremely painful and frequent; there is alfo a pain, heat, and fenfe of ful- nefs about the feat, and the running is plentiful and fharp, of a brown, greenifh, and fometimes of a bloody colour. By a proper treatment the violence of the fymptoms gradmllyF abates; the heat of urine goes off; the involuntary and pa-nful erections, and the'heat and pain about the fear, become eafier; the running alfo gradually decreafes, grows whiter and thicker, till at laft it entirely difappears. By attending to thefe fymptoms the gonorrhoea may be gene* rally diftinguifhed from any other difeafe. There are however fome few diforders for which it may be miftaken, as an ulcer in the kidnies or bjadder, the fluor albus, or whites in women, Sec. But in the former of thefe, the matter comes away only with the urine, or when the fphincter of the bladder is open ; whereas in the goo- orrhcea the difcharge is conftant. The latter is more difficult to diftinguifh, and muft be known chiefly from its effects, as puia, communicating the infection, &c. REGIMEN.—When a perfon has reafon to fufpect that he has caught the venereal infection, he outfit moft ftrictly to obferve a OF THE VIRULENT GONORRHOEA. 329 cooiing regimen, to avoid every thing of a h~a ing .'nature, as win :s, fpirtuou* liquor?, rich fauces, fpices, falted, high-feafoned and fmoke-Vel provifions, &c. alfo all aromatic and ftimulating vegetables as onions, garlic, {ballot, nutmeg, muftard, cinnamon, miT, ginger and fuc'1 like. His food ought chiefly to confift of nvld vegetables, milk, broths, light puddings, panada, gruels, cec% His 'rink may be barley-water, milk and water, decoctions of marfh-mallo-.-™ and liquorice, linfeed-tea, or clear whey. Of thefe he ought to drink pleir ifully. Violent exercife of "all kinds, efpeci- ally riding on horfeback, and venereal pleafures, are to be av ided. The patient muft beware of cold, and when the inflammation is violent, he ough* to keep his bed. MED:CINE.—A virulent gonorrhoea cannot always be cured fo^edily and effectually at tko fame time. The patient ought there- fore not to expect, nor the phyfician to promife i*-. It will. ften con- tinue for two or three week*;, and forne.imes for five or fix,, even where the treatment has been very prrper. Sometimes in teed a flight infection may be carried off in a few days, by bathing the parts in warm milk and water, and inject- ing frequently up the urethra a little fweet oil or linfeed tea, about* the warmth of new milk. Should thefe not fucceed in carrying off the infection, they will at leaft have a tendency to leffen its viru- lence. To effect a cure, however, aftringent injections w'di be found neceffary. Thefe may be various ways prepared, but I think thofe made wi h the wrhite vitriol are both moft lafe and efficacious.-— They can be made ftronger or weaker as circumftances may re- quire ; but it is beft to begin with the more gentle, and increafe their power if neceffary. I generally order a drachm of white vit- riol to be diffolved in eight or nine ounces of common or rofe water, and an ordinary fyringe full of it to be thrown up three or four times a-day. If this quantity does not perform a cure, it may be repeated, and the dofe increafed.* Whether injections be ufed or not, cooling purges are always proper in a gonorrhoea. They ought not, however, to be of the ftrong or draflhc kind. Whatever raifes a violent commotion in the body increafes the danger, and tends to drive the difeafe deeper in- to the habit. Procuring two or three ftools every fecond or third day for the firft fortnight, and the fame number every fourth or firth day for the fecond, will generally be fufficient to remove the inflammatory fymptoms, to diminifh the running, and to change * Although it is now very common to cure the eonorrhcea bv aftringent injeclions, ther- ere ftill many practitioners who do not approve th:s mode of praeTce. I can, however, from much experience, afl'ert that it is both the mod eafy, elegant, and efficacious method of cure ; and that any bad confequences arifing from it muft be owing to the ignorance or mifconducl ofthe practitioner himfelf, and not to the remedy. Many, for example, ufe ftron,? prepara- tion! of lead, all of which are dangerous when applied to the internal furfaces ofthe body ; others ufeelcharotics, which inflame and injure the parts. I have known a gonorrhea aclu- aJly cured by an injedion nude of grten-tea> and would always recotamead gentle mr.hods where they will fucceed. (22) 33© OF THE VIRULENT GONORRHOEA. i its colour.and confiftence. It gradually becomes more white and ropy as the virulence abates."1 When the inflammatory fymptoms run high, bleeding is always neceffary at the beginning. This operation, as in other topical inflammations, muft be repeated according to the ftrength and constitution of the patient, and the vehemence and urgency of the fymptoms. Medicines which promote the fecretion of urine are likewife proper in this ftage of the diforder. For this purpofe an ounce of nitre and two ounces of gum arabic, pounded together, may be di- vided into twenty-four dofes, one of which may be taken frequent- ly in a cup of the patient's drink. If thefe fhould make him pafs his urine fo often as to become troublefome to him, he may either take them lefs frequently, or leave out the nitre altogether, and take equal parts of gum arabic and cream of tartar. Thefe may be pounded together, and a tea-fpoonful taken in a cup of the pa- tient's drink four or five times a-day. I have generally found this anfwer extremely well, both as a diuretic and f -jr keeping the body> j i gently open. :* * When the pain and inflammation are feated high, towards the neck of the bladder, it will be proper frequency to throw up an emollient clyfter, which, befides the benefit of procuring ftools will ferve as a fomentation to the inflamed parts. Soft poultices, when they can conveniently be applied to the parts, are gf great fervice. They may be made of the ft ur of l:n- feed, or of wheat-bread and milk, foftened with frefh butter, or j fweet oil. When poultices cannot be conveniently ufed, cloths wrung out of warm water, or bladders filled with warm milk and . water, may be applied. I have known the moft excruciating pains, during the inflammatory ftate ofthe gonorrhoea, relieved by one or other of thefe applications. Few things tend more to keep off inflammation in the fpermat- ic veffels than a proper trufs for the fcrotum. It ought to be fo contrived as to fupport the tefticles, and fhonld be worn from the firft apo-arance of the difeafe till it has ceafed fome weeks. The above treatment will fometimes remove the gonorrhoea fo quickly, that the perfon will be in doubt whether he really laboured under that difeafe. This however is too favourable a turn to •*« often expected. It more frequently happens, that we are only able * if the patientcan fwallow a folution of falts and manna, he may take fix drachms, or» if his conftitution requires it, an ounce of the former, with half an ounce of the litter.— There may be difiolved in an Englifh pint of boiling water, whey, or thin water gruel, and taken early in the morning. If an infufion of fenna and tamarinds be more agreeable, two drachms of the former, and an ounce ofthe latter, miy be infulcd all ni^hcin an Enal'di pint of boiling water. The iufufion may be ftrt'.ve elecluary four ounces, cream of tart ir fvo ounces, ja'ap in powder, two drachms, rhubarb, one dridivn, and in much of ihe fyrup cf paie rofrs as will ferve to make upthewho'e into a foft electuary. Two or three tea-ft/consful of this may be takrn overnight, and abjut the fame quantity oexc oioming, ivery cay that the patient ckufes to tike a purge. '■*■ The .lofes of the above medicines may he increafed or dlmir.iihed according as the pa- tient rinds itneceff.ry. We hue ordered the fajts t "S- dilfolycdi.ia large quantity of water, - becaufe it renders their operation more mild. OF THE VIRULENT GONORRHOEA. 33 t 1 to procure an abatement or remiflion of the inflammatory fymp- toms, fo far as to make it fafe to have recourfe to thereat anti- ' dote mrrcury. Many people, on the firft appearance of a gonorrhoea, fly to the ufe of msrcury. This is a bad plan. Mercury is often not at all neceflary in a gonorrhoea; and when taken too early it dots mifchief. It maybe neceffary to complete the cure, but can never be proper at the commencement of it. When bleeding, purging, fomentations, and the other things recommended as above, have eafed the pain, foftened the pulfe, re-* lieved the heat of urine, and rendered the .involuntary erections lefs frequent, the patient may begin to ufe mercury in any form that is least difagreeable to him. . If he takes the common mercurial pill, two at night and one iii the morning w'.ll be a fufficient dofe at firft. Sould they affect the mouth too much, the dofe muft be leiTened ; if not at all it may be gradually increafed to five or fix pills in the day. If calomel be thought preferable, two or three grains of it, formed into a bolus with a little of the conferVe of hips, may be taken at bed time, and . the dofe gradually increafed to eight or ten grains. One of the I. ihoft common preparations of mercury now in ufe is the corrofive |''; fublimate. This may be taken in the manner afterwards recom- \ mended under the confirmed lues or p?>t. I have always found it one of the moft fafe and efficacious medicines when properly ufed. ■ The above medicines may either be taken every day or every [ other day, as the patient is able to bear them. They ought never: to be taken in fuch quantity as to raife a falivation, unlefs ia a very flight degree. The difeafe may be more fafely, and as certainly^ cured without a falivation as with it. When the mercuyr runs oil by the mouth, it is not fo fuccefsful in carrying off the difeafe, a3 when it continues longer in the body, and is difcharged gradually. Should the patientbe purged or griped in the night by the mer- cury, he muft take an infufion of fenna, cr fome other purgative.and drink freely of water-gruel, to prevent bloody ftools, which are very apt to happsn fhould the patient catch cold, or if the mercury has not been duly prepared. When the bowels are weak and the rnsr- cury is apt to gripe or purge, thefe difagreeable confequences may be prevented by taking, with the above pills or bolus, half a drachm ! cr two fcruples of diafcordium, cr of the Japonic confetti; n. To prevent the difagreeable circumstance of the mercury'.-s affecting the mouth too much, or bringing on a falivation, it may b° combined with purgatives. With this view the laxative m?rcu - rial pill has been contrived, the ufual dofe ofw'r.ichis half a drachm, or three pill?, night and morning, to be repeated every other day ; but the fafc-r way is for the patient t.-> fcegin with two, or even with one pill, gradually increafing ; he dofe. To fuch perfons as can neither fwalbw a bolus ner a pill, mer- cury may be given in a liquid form, as it can be fufpendeJ even iii a watery vehicle, b- me?.n:- cf win crabic; which not or.'- ferv^ 331 OF THE VIRULENT GONORRHOEA this purpofe, but likewife prevents the mercury from afl'ecting the" mouth', anc|feiders it in many reipects abetter medicine.* It happens very fortunately for thofe who cannot be brought to take mercury inwardly, and likewife for perfons whole bowels rre too tender.to bear it, that an external application of it will an- fwer equally wr 11, and in fome refpects better. It muff be ac- knowledged, that mercury t.ken iuwardly f r any length of time, greatly weakens and d fordersthe bowels ; for which reafon, when a ple'utiful ufe -^f it becomes neceffary, we would prefer rub inu 'o the mercurial pills. The common mercurial or blue ointment wiil aiifw r very wrll. Of that which is made by rubbing togeth-r equal quantities, of hog's lard and quick-fuVr, about a drachm miy be ufed at a time. The beft time for rubbing it en is at night, and the moft proper place the inner fide of the thighs. The-, patient fh ukl Hand bef re the fire when herr.hs, and fhould wear flannel drawersf ext his fkin at the time he is uiing the ointment.. If oint- ment cf a weaker r f*r -nger kind be ufed, t.e quantity mult be increofed or diminifhe J in proportion. 1 If cur g *he ufe of he ointment, thebilioma'icn of the geai- tH purts, t get her with the heat and feveriftinefs, fhould Return, or if the month fhould grew fore, the gums tend *r, and the breath become offenfive, a dofe or two cf Glauber's falts, or fome other ' cooling purge, may be taken, and the rubbing intermitted for a •few days. As foon h-~vv\ver as the figns of fpitting are gone off^ itMie virule">cy be oot qni'e corrected, the ointment muft be repeat- .** ed, but in fmall r quantities, and at longer intervals than before. Whatf-v r w»y mercury is adminiftered, its ufe may be perfifted in as long as any virulency is fufpected to r> main. During 'his, wfveh may be called the fecond ftage of the dif- orzfer, thrash fo ftrct a regimen is not neceffary as in the firft or inflammatory ftate, y-t intemperance of every kind mufc be avoid- ed. The fo. d muft be light, plain, and of eafy digeftion ; and the greaieft indulgence that nvy be. allowed with refpect to drnk is, a little wine diluted v/itb a fufficient quantity f water. Spirituous liquors are to h>e avoided in every fhaoe. I have often known the inflamma'ory fympt ms renewed and heightened, the running ia- cre-.ifed, a^d ;he ■ urerendered extremely difficult and tedious, by one fitcfexc flive dri king. Whe the above trea ment has removed the hea* of urine, and the forenefs of the ge ifal parts ; when the quantity of running is considerably leflened, with ,ut any pidn or fwelling in the groin or testicle fupervrnhr ; when the patient is free from invrtantary erections ; and laftlv, when the running becomes pale, whitifh, thick, void cf ill fm<-11, and tenaceous or ropy ; when all or moft cf thefe fymptoms appear, the gonorrhoea is arr'ved at its laft ftage, i nd we m?y gradually proceed to treat it as a gleet with aftringent and agglutinating medicines. *_Tak» qu:ckfilve> onr drachm, gum-arabic reduced to a mucilage two draebmiV*' the quickfilver be rubbed v/th the mucilaee in a marble mortar, unlit the globules of mer- cu'v entiidv difappf-ai ; afterwards add gradually, ftiil continuing the trituration, half an ounce of ba'lamic fyrup, and eight ounces of fimple cjr.namon-water. Two r*ble-fpoon*ful of this folution mi) be taken night and moruiig. Some teikon th';4 the bett form U) whUh "oukkfilver can be exhibited for the cute cf a goj.onhcea. 333 OF GLEETS. A Gonorrhoea frequently repeated, or improperly treated, often ends in a gleet, which inav either proceed from a relaxation, or from fome: remains ot the difeafe. It is however of the create J: importance in the cure oft,-gleet, to know from which of theie caufes it proceeis. When the difcharge proves very obftinate, and receives little or no cneck from aftringent remedies, there is ground to fufpect that it is owing to the latter ; but it the drain is incon- stant, and is chiefly obfervable whm the patient is stimulated by lafcivions ideas, or upon ftr.miicg to go to ftool,we may r,aiona„ly conclude that it is chiefly owing to the former% . . In the cure of a gleet proceeding from relaxation, t.Ae princi- pal defign is to brace, and reftore a proper degree of tealien to the debilitated and relaxed veffels. For this purpofe, befides re medi- cines recommended in the gonorrhoea, the patient may aove re- courfe to ftronger and more powerful aftringenis, as tne Peruvian bark * alum, vitriol, galls, tormentil, biftort, bakluftmes, tincture of gum kino, &c. The injections may be rendered moi^ altnng- ent by the addition of a few grabs of alum, or increafing the quan- tity of vitriol as far i< the parts are able to bear it. The laft remedy which we fhall mention in this cafe is the cold bath, than which there is not perhaps a more powerful bracer :n the whole compafs of medicine. It ought never to be omitted in this fpecies of gleet, unlefs there be fomething in tne constitution ot the patient which renders the ufe of it unfafe. Hie chief obje&ons to the ufe of the cold bath are a full haoit and an unfound state ot the vifcera. The danger from the former may always be lellened, it : cot removed, by purging and bleeding; but tne latter is an lnlur- mountable obstacle, as the preflure of the wat;-r. aad the iuaden contraction ofthe external veffels, by throwing the blood wi:ii too much force upon the internal parts are apt to occafion ruptures 01 the veffels, or a flux of humours upon the difeafed orgx:s. hut where no objection of this kind prevails, the patient oiigh* toplu^e over head in water every morning faffing, for three or four weeks together.. He fhould not howevr flay long in the water, and fhould take care to have his ikin dried as foon as he comas out. The regimen prop r in this1 cafe is the fame as was mentioned in the laft ftage of the gonorrhoea ; the diet muft be drying and aftringent, and the drink, Spa, Pyrmont, or Bnftol waters, with which a little claret cr red wine may fometimes be mixed. Any perfon ;nav now afford t® drink thefe waters, as they canoe every where prepared at almoft no expeaie, by a mixture cs cornmou ehalk and oil of vitriol. , r When the gleet does not in the fsr.alleit degree vieid to tn;te medicines, there is reafon to fufpect that it proceeds from ul-ers.-- In this cafe recourfe muft be had to mercury, and fuch medicine * The Peruvian baik may b.s comoined with other aflringcnw, and prepared in the bl- owing manner: _ . ,, . .,. . ,. , . ,.„ . i -i T-kc of Peruvian bark bruifrd fix drachni-:. ol f■■:?.■> gibs bruiied t*o dra'.....s , oot) them ina pound and an ha f ofwa.er to a pound •, n the A-amed i.-por add tnrte .n^ce* o. the Cmple tinfiu'e of the back. A fmall t:a-cuofui «f this may oc .\i ;c:i tare; ...n,, a- uy, willing to each cujj fifteen ot twenty drops oi'thc acii c;ixu ot vicnoL 334 OF THE SWELLED TESTICLE. as tend to correct any predominant acrimony with which the juices may be affected, as the decoction of China, farfapariUa, failafras, or the like. Mr. Fordyce fays, he has feen many obftinate gleets, of two, three or four years (lauding, effectually cured by a mefcuri?d in- unction, when almoft every other medicine has been tried in vain. Dr. Chapman feems to be of the fame opinion ; but fays, he has always found the mercury fucceed beft in this cafe wheu joined with terebinthinate and other agglutinating medicines. For which reafon the Doctor recommends pills made of calomel and Venice turpentine ; * and defires that their ufe may be accompanied with a decoction of guaiacum or farfapariUa. Tne laft kind of remedy which we fhall mention for the cure of ulcers in the urinary paffage, are the fuppurating candles or bou- gies ; as thefe are prepared various ways, and are generally to be bought ready made, it is needlels to fpend time in enumerating the different ingredients of which they are compofed, or teaching the manner of preparing them. Before a bougie be introduced into \ the urethra, however, it fhould be fmeared all over wiih fweet oil, I to prevent it from ftimulating too fuddenly; it may be fullered tq ' continue in from one to feven or eight hours, according as the pa- . tient can bear it. Obftinate ulcers are not only of en . ealed, but * tumours and excrefcences in the urinary paflages taken away, and | an obitruction of urine removed by means of bougies. Obftinate gleets may be removed by the ufe of bougies. OF THE SWELLED TESTICLE. THE fwelled tefticle may either proceed from infection lately contracted, or from t e venereal poifon lurking in the body ; the latter indeed is not very common, but the former frequently hap- pens both in the firft and fecond ftages of a gonorrhoea ; particu- larly when the running is unfeafonably check'.d by cold, hard drinking, ftrong drastic purges, violent exerckv, the too early ufe of aftringent medicines, or the like. In the inflammatory ftage, Bleeding is neceffary, which muft be repeated according to the urgency of the fyrnptoms.t The fcod muft be light, and the drink diluting. High-feafoned food, flefh, wines, and every thing of a he ting nature, are to be avoided. Fo- mentations are of lingular fervice. Poultices of bread an' milk, foftened with frefh butter or oil, are likewife very proper, and ought constantly to be applied when the patient is in bed, when he is up the testicles fliould be kept warm, and fupported by a bag or frufs, which may eafily be contrived in fuch a nxanper as to prevent the weight ofthe teftiele from having any effect. If it fhould be found impracticable to clear the tefticle by the cooling regimen now pointed out, and extended according to cir ' * Take Venice turpsht'ne, boilel to a [(ufitc'itnt degree of hardnefs, half an ounce, i ralomel half a drachm. Letthefe be mixed and formed into fixty pills, of which five or (ir may be taken night and morning. *f, during the ufe of thefe pills," tne mouth fhould c ■'■'■" t->.:-, or the breath become offeniive, they muft be difcontinued until thefe fymptoms dii*p- pear. f I have been accuftomed for fome time part to apply leeches to infljmrd tcfticlcs, which ^aftire Ju: always be?:} folio »ved b« th.c raoft happy effsfts, U OF BUBOES. 335 cumftances, it will be neceffary to lead the patient through fuch a complete anti-venereal courfe as fhall enfure him againft any future uneaGnefs. For tbjs purpofe, befides rubbing the mercurial oint- ment on the part, if free from pain, or on fhe thighs, as directed in the gonorrhoea, the potient muft be confined to bed, if neceffary, for five or fix weeks,fufpending the tefticle all the while with a bag or trufs, and Dlying him inwardly with ftrong decoctions of farfapariUa. When thefe means do not fucceed, and there is reafon to fuf- pecta fcrophulous or cancerous habit, either of which may fupport a fcirrhous induration, after the venereal poifon is corrected, the parts fhould beTomented daily with a decoction of hemlock, ,the bruifed leaves of which may likewife be added to the poultice, and the extract at the fame time taken inwardly.* This practice is ftrongly recommended by Dr. Stork in fcirrhous and cancels cafes ; and Mr. Fordyce affures us, that by this method he has cured difeafed testicles of two or three years {landing, even when ulcerated, and when the fcirrhous had begun to be affected with pricking and lancing pains, OF ifUBOES. VENEREAL Buboes are hard tumours feated in the groin, occafioned by the venereal poifon lodged in this par;. ^Ihey are of two kinds, viz. fuch as proceed from a recent infection, and fuch as accompany a confirm d iocs. The cure of recent buboes, that is, f uch'as appear foon after impure coition, may be firft attempted by dfperfton, and, if that fhould not fucceed, by fuppuration. To promote the difperfiqn of a buboe, the fame regimen mult be obferved as was directed in the firft ftage of a gonorrhoea. The patient muft likevt ife be blc ', and take fome cooling purges, as the decoction of tamarinds and fenna, Glauber's falts, and the like. If, by this courfe, the fwelling and other inflammatory fymptoms abate, we may fafely proc ed to the ufe of mercury, which muft be continued till the venereal virus is fubdued.t But if the buboe fhould, from the beginning, be attended with great heat, pain, and pulfation, it will be proper to promote its fup- puration. For this purpofe the patient may be allowed to ufe his ordinary diet, and to take now and then a glafs of wine. Emolli- ent rataplafms, confifting of bread and milk foftened with oil or frefh butter, may be applied to the part; and in cold conftitutions, where the tumour advances flowly, wi ite lily-roots, boiled, or fl:- ced onions raw, and a fufficient quantity of yellow bafilicon, may be added to the poultice. When the tumour is ripe, which may be known by its conical figure, thefoftnefsof the Ikin, and a fluctuation of matter plainly to be felt under the finger, it may be opened either by a cauftic or a lancet, and afterwards dreffed with digeftive ointm.nt- It fometimes however happens, that buboes cau neither be dif- * Theextracl of hemlock may be made into pii.s, and taken in the manner dreGcd under the article Cancer. f For the difperlion ofa bubo, ? number of leeches applied to the part afftc?.ed v.ill';. reund eoually effjc«iioas as.1 .v.he inflamed te!tkle. 33<* OF CHANCRES. perfed nor brought to a fuppuration, but remain hard, indolent tu- mours. In this cafe the indurated glands muft be confumed by caustic; if tney fhould become fcirrhous, they muft be diffclvedby ihe application of hemiock, both externally, and internaliy as di- rected ia the feirrhous teiticies. OF CHANCRES. CHANCRES are fuperficial, c Uous, eating ulcers; which may happen either with or without a gonorr cea. They .;re com- monly leated about the glans, and make their appearance in the fol- lowing manner : Firft a little red pimple arifes, which foon be- comes pointed at top, an.i is filled with a whidfh matter inclining to yellow. This pimple is hot, and itches generally before it br?uks ; afterwards it degenerates into an obftinate ulcer, the bot- tom of which is ufually covered with a vifcid mucus, and whofe edges gradually become hard and callous. S mietimes the firft ap. pavrance refembles a fimple excoriation of the cuticle ; which, how- ever, if the caufe be venereal, loon becomes a true chancre. A chancre is fometimes a primary affection ; but it is much oftener fymptomatic, and is the mark of a confirmed lues, fri- mary chancres difcover themfelves loon after impure coition, and are general!yfeated in parts covered with a thin cuticle, as the lips, the nipples of women, the glans penis of men, &c* . When a chancre appears loon after impure coir on, its treat- ment is nearly fimilar to tnat of the virulent gonorrhoea. The pa- tient muft cblerve the celling regimen, lofe a httle blood and take fome gentle dofes of lalts and manna- ire p-jrts affected ought frequency to be bathed, or rather foake-:* in warm milk and water, and, if the inflammation be great, an i mc'hrnt poultice cr cata- plafm may be applied to tnem. This courfe will, in moft cafes be fufficient to abate the inflammation, and prepare the patient for the ufe of the mercury. Symptomatic chancres are commonly accompanied with ulcers in the throat, nocturnal pains, fcurvy erupti ns aoout the roots of the hair, and other fymptoms of a confiimed lues. Though they may be feated in any of the parts mentioned above, they common- ly appear upon the private parts, or the infide of the thigh. They are alio lets painful, but freque. tly much larger and harder than primary chancres. As their cure muft depend upon that of the pox, of which they are only a fymptom, we fhall take no further notice of them, till we come to treat of a confirmed lues.f Thus we i.ave related moft of the fymptoms which accompany or fucceed a violent gonorrhoea,' and have alfo g*vtn a Inert view of their proper treatment there are, however, feveral others which * When venereal ulcers are feated in the lips, the infection may be communicated by kiffing. I have leen very obftinate venereal ulcers in the lips, which I have all the realon 111 the world to believe were crmmunicaud !>. ih;s manor-. Nurfc-soujjht to beware of Suckling infec"ted children, or having their breaft* drawn by per fons tainlea with the venerea) difeale. This cautiqn is very ncceilary ftr nurfes who re- lido in the neighbourhood of great towns. f 1 have found it answer extremely well to fpr'-nkle chancres twice a-day with calomel. This \v;!l of:ifi perform a cure without any other application whatever. If the chancre'. are upon the cuki, they may be walked with niijit ind water, a little v.arm> and jfiei- •waras th? ca!cn:cl mr* be ip; bed z$ above. OF CHANCRES. ftf- lometimes attend this difeafe, as a flrangury, or obstruction of urine, a phymofts, paraphymofts, 6c. A flrangury may either be occafioned by a fpafmodic qpnftric- tion, or an inflammation of the urethra and parts about the neck of the oladder. In the former cafe, the patient begins to void his urine with tolerable eafe ; but, as foon as it touches the galled or inflamed urethra, a fudden conftriction takes place, and the Urine is voided by ipurts, fometimes by drops only. When the strangury is owing to an inflammation about the neck ofthe bladder, there is a conftant heat and uneaiincfs of the part, a perpetual defire to make water, while tne patLnt can only render a few drops, and a troublefome tenefmus, or conftant inclination to go to ftool. When the flrangury is wir.g to fpft'ms, fuch medicines as tend to dilute and blunt the falts of the urine will be proper. For this purpofe, befides the common diluting liquors, foft and cooling emulfions, fweetened wiih the fyrup of p pp:es, may be ufed.— Should thefe n t have the defired effect, bleeding and emollient fomentaiions, will be neceffary. When the complaint is evidently owing to an inflammation about the neck of tne bladder, bleeding muft be more liberally per- formed, and repeated according to the urgency of the fyiup'cms.-— After oleeding, if the strangury ftill continues, foft clyfters, w ith a proper quantity of laudanum in them, may be adminiftered, and emollient fomentations applied to the region of the bladder. At the fame time, the patient may take every four hours a tea-cupful of barley water, to an Englifh pint of which fix ounces of the fyrup of marfn-mallows,four ounces ofthe oil of fweet almonds, and half an ounce of nitre, may be added. If thefe remedies fhould not re- lieve the complaint, and a total fuppreffion of urine fhould come en, bleeding muft be repeated, and the patient fet in a warm bath up to the middle. It will be proper in this cafe to difcontinue the diuret- ics, and to draw eft" the water with a catheter; l:ut as *he patient is feid^m able to be^r its being introduced, we would rather re- commend the. ufe of mild bougies. Thefe often lubricate the paf- fage, and greatly facilitate the difcharge of urine. Whenever they beg'ui to ftimulat-.* or give any uneafmefs, they may be withdrawn. t The phymofis is fuch a conftriction of the prepuce over the glans, as hinders i: from being irrwn backwards ; tne paraphymofts, on the c ;irrary, is fuch a conftriction cf the prepuce behiad the glans, as hinders it from bei g brought forward. The treatment cf thefe fymptoms is fo nearly the fame with tint of the virulent gonorrhoea, that we have no occafion to en- large upon it. In general, bleeding, purging, poultices, and emolli- ent fomentations are fufficient. bnould thefe howevsr fail of re- moving the ftricture, and the parts be threatened, with a mortifica- tion, twenty or thirty grains of ipecacuanha, and one grain of emetic tartar, may be given for a vomit, and may be worked oil with warm water or Uiin gr-A. It lometimes happens, that, i.i fpite of all endeavours to the contrary, the inflammation goes on, and the fymptoms of a begin- ning mortification appear. "Wiien thii; is the cafe, the prepuce muft 338 OF A CONFIRMED LUES. be fcarified with a lancet, and, if neceffary, divided, in order to prevent a strangulation, and fet the imprifoned glans at liberty.—. We fhall not defcribe the mannerof performing this operation, as it ought always to be done by a furgeon. When a mortification has actually taken place, it will be neceflary befides performing the above operations, to foment the parts frequently with cloths wrung out of a ftrong decoction of camomile flowers and bark, and to give the patient a drachm of the bark in powder every two or three hours. With regard to the priapifm, chordee^ and other distortions of the penis, their treatment is no way different from that of the gon- orrhcc. When they prove very troublefome, the patient may take a few drops of laudanum at night, efpecially after the operation of a purgative through the day. OF A CONFIRMED LUES. WE have hitherto treated of thofe affections in which the venereal poifon is fuppofed to be confined chiefly to the particular parts by which it was received, and fnall next take a view of the lues in its confirmed ftate ; that is, when the poifon is actually re- ceived into the blood, and circulating with it through every part of the body, mixes with the feveral fecretions, and renders the whole habit tainted. The fymptoms of a confirmed lues are, buboes in the groin, pain of the head and joints, which are peculiarly troublefome in the night, or when the patient is warm in bed ; (cabs and fcurfc in various parts of the body, efpecially on the head, of a yellowifh colour, refembling a honev-comb ; corroding ulcers in various parts of the body, which generally begin about the throat, from whence they creep gradually, by the palate, towards the cartilage of the nofe, which they deftroy; excrefcences or exoftofes arife in the mid- dle of the bones, and their fpongy ends become brittle, and break upon the leaft accident; at other times they are foft and bend like wax ; the conglobate glan.ls become hard and callous, and form, in the neck, armpits, groin, and mefentary, hard moveable tumours, like the king's evil; tumours of different kinds are likewife form- ed in the lymphatic veflels, tendons, ligaments, and nerves, as the gummala, ganglia, nodes, tophs, Sec. ; the eyes are affect d with itch- ing, pain, r-dnefs, and fomenmes with total blindn fs, and the ears with a finging noife, pain, and deafnefs, whilft tieir internal fub- ftance is ulcerated and rehdered cari.us ; at length all the animal, vital, and natural functions are depraved ; the face becomes pale and livid; the body amaciated and unfit for motion, and the mife- rable patient falls into an atrophy or wafting confumption. Women have fymptoms peculiar to the fex ; as cancers of the breaft ; a i'upprefiion or overflowing of the menfes ; the whites; hyfteric affections ; an inflammation, abfcefs. fchirrhous, gangrene, cancer, or ulcer of the womb ; they are generally either barren or fubject to abortion ; or, if they bring children into the world, they have an vniverlal ervfmela?, are half rotten, and covered with ulcer-. OF A CONFIRMED LUES. 339 Such is the catalogue of fymptoms attending this dreadful dif- eafe in its confirmed ftate. Indeed they are feldom all to be met with in the fame perfon, or at the fame time ; fo many of them, however, are generally prefent as are fufficient to alarm the pa- tient ; and if he has reafon to fufpect the infection is lurking in his body, he ought/immediately to fet about the expulfion of it, other- wife the moft tragical confequences will enfue The only certain remedy hitherto known in Europe, for the cure of this difeafe, is mercury, which may be ufed in a great vari- efy of forms, with nearly the fame fuccefs.* Some time ago it wss reckoned impoffible to cure a confirmed lues with ut a falvation. This method is now however pretty generally laid afide, and mer- cury is found to be as efficacious, or rather more fo, in expelling t: e venereal poifon, when adminiftered in fuch a manner as not to run off by the falivary glands. Though many are of opinion, that the mercurial ointment is as efficacious as any other preparation of that mineral; yet expe- rience has taught me to tcink otherwife. I have often feen the moft obftinate venereal cafes, where great quantities of mercurial ointment had been ufed in vaiB, yield to the faline preparations of mercury. Nor am t Angular in this opinion: My ingenious friend, Mr. Clare, an eminent furgeon of this city, allures me, that for fome time paft he has employed, in venereal cafes, a faline prepar-, ation of mercury with moft happy fuccefs. This preparation rub« bed with a fufficient quantity of any mild powder, he applies, in fmall portions to the tongue, where, with a gentle degree of fric- tion, it is immediately abforbed, and produces its full effect upon the fyftem, without doing the leaft injury to the ftomach or bowels ; a matter of the greateft importance in the application of this moft active and powerful remedy. It is impoffible to aftertain either the exact quantity of medi- cines that muft be taken, or the time they ought to be continued, in order to perform a cure. Thefe will ever vary according to the constitution of the patient, the feafon of the year, the degree of in- fection, the time it has lodged in the body, Sec. But though it is difficult, as Aftruc oblerves, to determine a prirori, what quantity of mercury will, in the whole be neceffary to cure this difteniper completely ; yet it may be judged of a pofteriori, from the abatement and ceafing of the fymptoms. The feme author adds, that com- monly not lefs than two ounces of the ftrong mercurial ointment, is fufficient, and not more than three or four ounces neceflary. The only chemical preparation of mercury which we fhall take notice of, is the corrofive fublimate. This was fome time ago brought into ufe for the venereal difeafe, in Germany, by the il- lustrious R.ron VanSwie'en ; and was foon after introduced into Britain by the learned Sir John Pringle, at that time phyfician to the army.' The method of giving it is as follows : One grain of rorrolive fublimate is diffolved'in cwo ounces of French brandy or malt fpirits; and of this felution, an ordinary table-fpccnful, or the- " The preparations which ! now chiefly uf?, in the confirmed lues, axe cj'ox:! and ca.'ci- c-d r.i-rcury. 34o OF A CONFIRMED LUES. quantity of half an ounce,is to be taken twice a-day, and to be or.. tinued as long as any fymptoms of the diforcfer remain. To thofe whofe ftomach cannot bear the folution, the fublimate may be given in form of a pill.* Several roots, woods, and barks, have been recommended for curing the venereal difeafe ; but none of them have been found, upon experience, to anfwer the high encomiums which had been. beftowed upon them. Though no one of thefe is to be depended upon alone, yet, when joined witn mercury, lome of them have been found to be very beneficial in promoting a cure. One of the beft. we know yet is farfapariUa, which may be prepared and taken according to the directions in the Appendix, f The mezerv.n-root is likewife found to be a powerful affiflant to the fublimate or any other mercurial. It may either be ufed along with farfapariUa, as directed in the Appendix, or by itfelf.— Thofe who choofe to ufe the mezeron by itielf, may boil an ounce of the frefh bark, taken from the root, in twelve Engl ir. pints of water to eight, adding towards the end an ounce of liquorice. The dofe of this is the fame as of the decoction of farfaparilia. We have been told that the -natives of America cure the vene- real difeafe, in every ftage, by a decoction of the root of a plant called Lobelia. It is ufed either frefh or dried ; but we have no certain accounts with regard to tl e proportion. Sometimes they mixother roots with it, as thofe of the ranunculus, the ceanothus, Sec. but whether thefe are defined to difguife cr aflift it, is doubtful. The patient takes a large draught of the decoct on early in the morning, and continues to ufe it for his ordinary drink through the day 4 Many ether roots and woods might be mentioned, which have been extoiltd for curing the venereal cifeafe, as the china- root, the roots of foap-worf, burdock, &c. as alfo the wood of guaiacum and fafafras ; but as none of thefe have oeen f unci to pof- fefs virtues fuperior to thofe already mentioned, we fhall, for ihe fake of brevity,pafs them over, and fhall conclude oor obfervations on this difeafe, with a few general rem/irks concerning the proper management of the patient, and the nature of the infection. * The fu'rl'mate may be givrn in diftilled water, or any other liquid that the patent ch(*ofss. 1 commonly order ten grains to be d-ffolved in an ounce of the fpirit of wine, /or the convenience of carriage, and let the patient tike twenty or thircy drops of it night and morning in half a glals of brandy or other fpirits. Mr. I>.bra, an ngenious chymift of this place, informs me, that he prepares a fait of mercury much more mild and gende in in operation than the fublimate. though equally efficacious. f See Appencix, DecoEllon of Sarfapari/fa. t Though we are ftill very muc in the dark with rcgird to the m thod of curing thii difeafe among the natives of America, yet it is generally affirmed that ttiey do cure it w.th speed, fafety andfuccels, and that without the leaft knowledge of mercury. Hence it becomes an object of confiderable importance todiic.-.ver their method of cure. Thii might fuuiy be done by making trials of the various plants which ar- tound in thofe parts, and pa< trcu.ac y of fuch a? the native* are known to make ule of. 'All people in a rude ftate take the r med- icines < hiel'y from the vegetable kingdom, and ire often poffeffed of valuaVc fecrets with re- gard to the virtues of plants, of which more enlightened nations are igii' rar.f. Indeed we incite nodoub: but fome p'aivs of our own growth, svp-e proper pains ,. km to difcover them, would be found as efficacious in curir.g the venerea) difeile as thole n ' merica. it muft however be rcmcmbired, that what vvillcure the vjneretf dilcafe in one country, will not al- ».■■<( b» found to hav; equal fucceft in an as the afthma, the gravel, and fuch like, mercury, if neceffary, mav be fafely ad- minifter." d, If fhe patient's ftrength has been greatly exhausted by ficktipfs, la' our, abflinenc1, or any other caufe, the ufeof mercury muft be po^poned, till by time, reft, and a nourifhing diet, it can be fufficiently rfft red. Mercury ought not to be administered to women during the menstrual flux, or whr-n the period is near at hand. Neither fhould it be given in 'Ir laft ftage of pregnancy. If, however, the woman be ~ot near the time of her delivery, and circumstances render it ne- ceffary, mercury may be given, but in fmaller dofes, and at greater inr-rvals than ufual; with thefe precautions, both the mother and child may be cured at the fame time; if not, the diforder will at least be kept from growing w .rfe, till the woman be brought to bed, and fufficiently recovered, when a more effectual method may be pur- fued, which, if fhe fuckles her child, will in all probability be fuffi- cient for the cure of both. Mer: my ought always to be adminiftered to infants with the greateft caution. Their tender condition unfits them for fupport- ing a falivation, and makes it neceffary to administer even the mild- eft preparations of mercury to them with a Tparing hand. A fimi- lar conduct is recommenced in the treatment of old perfons, who have the misfortune to labour under a confirmed lues- No doubt the infirmities of age muft render people lefs able to undergo the fatigues of a falivati n; but 'his, as was formerly obferved, is never neceflary ; befides, we have generally found, that mercury had much lets effect upon very old perfons, than on thofe who were younger. Hyfteric and hypochondriac perfons, and fuch ns are fubject to an habitud diarrhoea or dyfentery, or to frequent and violent attacks of the epilepfy, or who are afflicted with the fcrophula, or the fcurvy, ought ro be cautious iu the ufe of mercury. Where anv one of thefe diforders prevails, it ought either, if poffible, to be cured, or at leaf: palliated, befr- e the patient enters upon a courfe of mercury. When this cannot be done, the mercury muft be adminiftered in fmaller dofes, and at longer intervals than ufual. The molt proper feafons for entering upon a courfe of mercu- ry, are the fpring and autumn, when the air is of a moderate warmth. If the circumftaires of the cafe, however, will not admit of delay, we muft not defer the cure on account of the feafon, but rriuit adminifter the mercury; taking care at the fame time to keep 342 OF A CONFIRMED LUES. the patient's chamber warmer or cooler, according as the feafon of the year requires. The next thing to be confidered is the preparation necefTary to be obferved before we proceed to administer a courfe of mercury. Some lav great ftrefs upon this circumftance, obferving, that by pre- vimfly relaxing the veffels, and correcting any diforder which mav happen to prevail in the blood, not only the mercury will be dif- pofed to act more kindly, but many other inconveniences will be prevented. We have already recommended bleeding and gentle purges, previous to the adminiftration of mercury, and fhall only now add, that thefe are always to be repeated according to the age, strength, conftitution, and other circumftances of the patient. Af terwards, if it can be conveniently done, the patient ought to bathe once or twice a-day, for a few days, in lukewarm water. His diet in the mean time muft be light, moift, and cooling. Wine, and all heat- ing liquors,alfo violent bodily exercife, and all great exertions of the mind, are carefully to be avoided. A proper regimen is likewife to be obferved by fuch as are under a courfe of mercury. Inattention to this not only endangers the patient's life, but often alfo difappoints him of a cure. A much fmaller quantity of mercury will be fufficient for the cure of a per- fon wh •■ lives low, keeps warm, and avoids all manner of excefs, than of one who cannot endure to put the fmalleft restraint upon his appetites; indeed it but rarely happens that fuch are thoroughly cured. There is hardly any thing of more importance, either for pre- venting or rem. ving venereal infection, than cleanlinefs. By an early artention to this, the infection might often be prevented from entprhg the body; an»% where it has already taken place, its effects may be greatly mitigated. The moment any perfon has reafon to fufpect that he has received the infection, he ought to wafh the parts with water and fpirits, fweet oil, or milk and water ; a fmall quantity of the laft may likewife be injected up the urethra, if it can be conveniently done. Whether this difeafe at firft took its rife from dirtinefs, is hard to fay ; but wherever that prevails, the in- fection is found in its greateft degree of virulence, which gives ground to believe that a strict attention to cleanlinefs would go far towards extirpating it altogether.* * 1 have not only often feen a recent infection carried off in a fewdaysby means of cleanli- nefs, viz. bathing, fomentations, injections, ice. but have likewife found it of the greateft ad- vantage in the more advanced ft age i of the difeafe. Of this I had lately a very remarkable inftance, in a man whofe penis was almoft wholly confumed by venereal ulcer3 ; the matter had been allowed to continue on the fores, without ,iny care having been taken to clean thrm, liU, n twithftanding the ufe of mercury and other medic nes, it had produced che efTrclj abov- meutioned I ordered warm milk and water to oe injr&ed three or four times a-dav. into all thefinuous ulcers, in order to wafh out all the matter ; after which thev were fturX- ed with dry lint to abforb the fr»fh matter as it was generated. The patient at the fame tin'e took every day half a grain of the corrofive fublimate of mercury, diflolved rn an ounce of brandy, and drank an Englifh quart of the decoc"r.;on of farfapariUa. By this treatment in about fix weeks, he was perfectly cured ; and, what was very remarkable, a part of the penis wa> actually regenerated. Doctor Gilchrift has given an account of a fpecies of the lues venerea which prevails in the Weft of Scotland, to which the natives give the name of Sibb'ins or Hiwltn. The Doc- tor oblerves, that the fpreading of this difeafe is chiefly owing to the neglect of cleanlinei's, •and feem* to think, that by due attention to that virtue, it might be extirpated". The treat- OF A CONFIRMED LUES. 343 When the venereal d'feafe has been neglected, or improperly N treated, it often becomesya diforder of the habit. In this cafe the cure muft be attempted by restoratives, as a milk diet, the decoc- . fion of f rfipanlla, and fuch like, to which mercury may be occa- fioialiy ad-fed. It is a common practice in North-Britain to fend fuch patients to drink goat whey. This is a very proper plan, pro- vided the infection has been totally eradicated before hand ; but when that is not the cafe, and the patient trusts to the whey for finifhing his cure, he will often be difappointed. I have frequent- ly known the difeafe return with all its virulence after a courfe of goat whey, even when that courfe had been thought quite fufficient for completing the cure. One of the moft unfortunate circumstances attending patients in this difeafe, is the neceffity they are often laid under of hurry- ing t\e cure. This induces them to take medicine too fall, and to leave it off too foon. A few grains more of medicine, or a few days longer confinement, would often be fufficient to perfeft the cure ; whereas, by neglect of thefe, a fmall degree of virulence is ftill left in the humours, which gradually vitiates, and at length contaminates the whole mafs. To avoid this, we would advife, that the patient fhould never leave off taking medicine immediate- ly upon the difappearing of the fymptoms, but continue it for fome ; time after, gradually leffening the quantity, till there is fufficient \ ground to believe that the difeafe is entirely eradicated. It is not only difficult, but abfolutely impoffible to afcertain the exact degreeof virulence that may attend the difeafe ; for whirh reafon it will always be a much fafer rule to contirue the ufe of medicine too long, than to leave it off too foon. This feems to be the leading maxim of a modern practitioner of fome note for the venereal difeafe, who always orders his patient to perform a quarantine of at leaft forty days, during which time he takes forty bottles of, I fuppofe, a ftrong decoction of farfapariUa, or fome onVr anti-venereal fimple. Whoever takes this method, and adds a fufficient quantity of corrofive fublimate, or fome other active preparation of mercury to the decoction, will feldom fail to cure a confirmed lue<\ It is peculiarly unfortunate for the cure of this difeafe, that not one in ten of thofe who contract it, are either able or willing to fubmit to a proper plan of regimen. The patient is willing to take medicine ; but he muft follow his bufinefs, and, to prevent fufpi- cions, muft eat and drink like the reft of the family. - This is the true fource of nine tenths of all the mifchief arifing from the vene- real difeafe. I never knew the cure attended with any great diffi- culty or danger where the patient ftrictly followed the phySc-ian's advice ; but a volume would net be fufficient to point out the dreadful confequences which proceed from an oppofite conduct.— Scirrhous tefticles, ulcerous fore throats, madnefs, confumptions, >• carious bones, and a rotten progeny, are a few of the bfeiTiiigs de- rived from .this fource. rpent of this difeafe is fimilar to that of a confirmed luer or pox. T 'h- ya•::•:, a 6'U■ Je now T-iy common both in America and the Weil-India ittarJs,. mSy alio be cursd in the. A»mt nraiir.:.'. 3.44 DISEASES OF WOMEN. • There is a fpecies of falfe reafoning, with regard to this difeafe, which proves fatal to many. A perfon of a fourd conftitution con- tracts a flight degree of the diforder. He gets well without taking any great care, or ufing much medicine, and hence concludes rhat this will always be the cafe. The next time the difeafe occurs, though ten time more virulent, he purfues f. e fame courfe, and his conftitution is ruined. Indeed, the different degrees of virulence in the fmall pox are not greater than in this difeafe, though, as the learned Sydenham obferves, in fome cafes the moft fldlful phyficians cannot cure, and in others the moft ignorant old woman cannot kill the'patient in that diforder. Though a good conftitution is always in favour of the patient, yet too great a ftrefs may be laid upon it.— It does not appear from obfervation, that the moft robuft conft'tu- tion is able to overcome the virulence of the venereal contagion, after it has got into the habit. In this cafe a proper courfe of medicine is :;lways hdifbenfably neceffary. Although it is impoffible on account cf the different degrees of virulence, &c. to lay down fixed and certain rules for the cure of this difeafe, yet the following general plan will always be found fafe, and often fuccefsful, viz. to bleed and adminifter gentle pur- ges with diuretics during the inflammatory ftate, and as foon as the fymptoms of inflammation are abated, to adminifter mercury, in any form that may be moft agreeable to the patient. The fame medicine, affifted by the decoction of farfapariUa, and a proper regimen, will not only fecure the constitution againft any further progrefs of a confirmed pox, but will generally perform a complete eure. CHAP. L. DISEASES OF WOMEN. W OMEN in all civilized nations, have the management of domeftic affairs, and it is very proper they fhould, as Nature has made them lefs fit for the more active and laborious employments. This indulgence, however, is generally carried too far; and females," instead of being benefitted by it, are greatly injured from the want of exercife and free air. To be fatisfied of this, one need only com- pare the frefh and ruddy looks of a milk-maid, with the pale com- plexion of thofe females whofe whole time is fpent within doors. Though Nature has made an evident diftinction between the male and female with regard to bodily ftrength and vigour, yet fhe cer- tainly n ver meant, either that the one fhould be always without, or the other always within doors. The confinement of females, befides hurting their figure and complexion, relaxes their folids, weakens their minds, and difor 4ers all the functions of the body. Hence proceed obstructions, indigeft- ion, flatulence, abortions, and the whole train of nervous diforders. Thefe not only unfit women for being mothers and nurfes, but often render them whimfical and ridiculous. A found mind de- pends fo much upon a.healthy body, that where the latter is want- ing, the former is rarely to be found. OF THE MENSTRUAL DISCHARGE. 345' I have always obferved that women who were chiefly employ- ed without doors, in the different branches of hufbandry, garden- ing, and the like, were almost as hardy as their hufbands, and that their children were likewife healthy. But as the bad effects of confinement and inactivity upon both fexes have been already (hewn, v/e fhall proceed to point out thofe circumstances in the itructure and defign of females, which fubject them to peculiar dif- eafes ; the chief of Which are their monthly evacuations, pregnancy, and child-bearing. Thefe indeed cannot properly be called difeafes, butj from the delicacy of the fex, and this being often improperly man-' aged in fuch fituations, they become the fource cf numerous calam- ines. OF THE MENSTRUAL DISCHARGE. FEMALES generally begin to menflruate about the age of fifteen, and leave it off about fifty, which renders thefe two periods the moft critical of their lives. About the firft appearance of this difcharge, the conftitution undergoes a very confiderable change, generally indeed for the better, though fometimes for the v/orfe. The greateft care is now neceflary, as the future health and happi- nefs ofthe female depends in a great meafure upon her conduct 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 employ- ed in any active 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; her health, fpirits, and vigour decline, and fhe finks into a valetudinarian for life. Such is the fate of numbers of thofe unhappy females, who, either from too much indulgence, or their own narrow circumstances* are, at this critical period, denied < he benefit of exercife and free air. s A l'.zy indolent difp-fition proves likewife very hurtful to girls at this period. One feldom meets with complaints from obffruc- tions among the more active and iuduftrious part of the fex ; whereas the indolent and lazy are feldom free from them. Thefe are in a manner eaten up by the chhrofis. or green ficknefs, and other difeafes of this nature. We would therefore recommend it to all who wifh to efcape thefe calamities, to avoid indoler.'ce and inactivity, as their greateft enemies, and to be as much abroaJ in the open air as poffible. Ano'her thing which proves very hurtful to girls about this period of life, is unwholefome food. Fond of all manner of trafh, ' they often indulge in it, till their white humours are quite vitiated. Hence «nfue indteeftions, wait of.appttite, and a numerous strain of evils. If the fluids be not duly prepared, it is utterly impoffible * It »3 tlfe duty of mothers, and thofe who are intruded v/th the et'ircat^on of girls, to 3nftru£t them early in the conduct and management ot themfelves at this critical r^tiod of tiieirlivei. Falfe modefty, inattention, and ignorance of what is beneficial or hurtfit at thii *" time, are the fources of m.ny difeafes and misfortunes in life, which a few lenfibir IcfTons from an experienced matron might have prevented. Nor is care Ie<< re"cefFary in «^e fub- ftequent returns of this difcharge. Tuking improper food, violent afte&ions of the mind, or catching cold at this oeriod, is often full c':e»t to ruin the health, or to render the female ever after incapable of procreation. (23) 346 OF THE MENSTRUAL DISCHARGE. that the fecretions fhoul^ go properly on. Accordiflgly we find that fuch girls as lead an indolent life, and eat great quantities of train, are not only fubject to obstructions ofthe menfes, but likewife to glandular obit ructions ; as the fcrophula, or king's evil, &c. A dull difpofition is alfo very hurtful to girls at this period. It is a rare thing to fee a fprightiy girl who does not enjoy good health, while the grave, moping, melancholy creature, proves the very prey of vapours and hyiterics. Youth is the feafon for mirth and chcerfuinef s. Let it therefore be indulged. It is an abfolute duty. To lay in a ftock 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 happy youth to join in fprightiy amufements, let not the fevere dictates or hoary age for- bid the ufeful impulfe, nor d^mp, with ferious gloom, the feafon deffined to mirth and innocent festivity. Another thing very hurtful to females about this period of life, is f.rait clothes. They are fond of a fine fhape, And foofifhly imagine that this can be acquired by lacing themfelves tight.— Hence, by fqueezbg the ftomach and bowels, they hurt the digef- tion. and occafion many incurable maladies. This error is not in- deed fo common as it has been; but, as fafhions change, it may come about again : we therefore think it not improper to mention it., I know many females, who, to this day, feel the direful effects of that wretched cuftom which prevailed fome years ago, of fqueez- ing every girl into as fmall a fize in the middle as poffible. Human invention could not poffibly have devifed a practice more destructive to hqalth. After a female has arrived at that period of life when the menfes ufually begin to flow, and they do not appear, but, on the contrary, her health and fpirits begin to decline, we would advife, inftead of fhutting the poor girl up in the houfe, and doling her with iteel, aiafoct.jd-i, and other naufeous drugs, to place her in a fitua- ; bn where fhe can enjoy the benefit of frefh air and agreeable com- pany. There let her eat wholefome food," take fufficient exercife, r'T.d amufe hcfelf in the mcft agreeable manner; and we have little reafon to fear, but Nature, thus affifted, will do her proper work.— Indeed fhe feldom fails, 'Unlefs where the fault is on our fide. « This d;{change in the beginning is feldom fo inflantaneous - as to furprife females unawares. . It is generally preceded by fymp- toms which foretel its approach ; as a fenfe of heat, weight, and dull piiin in the loins; diftenfion and hardne's ofthe breafts ; head ach ; lofe of appet'te ; laffitu^e; p^lenefs ofthe c^imrenance; ami fometimes a flight degree of fever. When thefe fymptcms appear about the age at which the me•tfjrutil flux ufually begins* every thing fhoult be carefully avoided wii"hmaycbf:ruct that neceffarv and falutary evacuation ; and a''l means ufed to promote it; asf'r- tius frequently over the fieanis of warm water, drinking warm di- luting liquors, kc. All er the meifes hive c.nr? b^gun to flow, the greateft ca^ fhould be taken to avo:d cv-ry rhir.r that rr.ay rend to o'bflruct them. Females cu&^ftcbe Exceedir.g cautious of whac they eat OF THE MENSTRUAL DISCHARGE. 347 fcr 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-nilk, and fuch like. Fifh, and all kinds of food that are hard of digeftion, are alfo to be avoided. As it is impoffible to menti n every thing that may difagree with individuals at this time, we would recommend ;t to every female to be very attentive to what disagrees with herfelf, and carefully to avoid it. Cold is extremely hurtful at this particular period. More o£ the fex date their difeafes from colds, caught while they are out of order, than from all other caufes. This ought furely to put them upon their guard, and to make thera very circumfpect in the:r conduct at fuch times, A degree of cold that will not in the leaft hurt them at another time, will at this period be fufficient entirely to ruin their health and constitution. The greatest attention ought likewife to be paid to the mind, which fhould be kept as eafy and cheerful as poffible. Every part of the animal agronomy is influenced by the paflions, but none more fo than this. Anger, fear, grief, and other affections of the mind, often occafion obstructions of the menftrual flux, which prove abfo- lutely incurable. From whatever caufe this flux is obstructed, except in the state of pregnancy, proper means fhould be ufed to reftore it. For this purpofe we would recommend fufficient exercife in a dry, open. and rather cool air ; wholefome diet, and, if the body be weak and languid, generous liquors ; alfo cheerful company and all manner of amufements. If thefe fail, recourfe rnnfl be had to medicine* When obstructions proceed from a weals, relaxed state of the folids, fuch medicines ascend to promote digestion, to brace the folids, and affifl the body in preparing good blood, ought to be ufed. The principal of thefe are iron and the Peruvian bark, with other bitter and aftringent medicines.. Filings of iron may be infufed in wine or ale, two or three ounces to an Englifh qaart, and. after it has flood for two or three weeks it may be filtered, and about half a wine glafs of it taken twice a-day; or prepared flee! may be taken in the dofe of half a drachm, mixed with a little honey or treacle, three or four times a-day. The bark and ottier bitters may either be taken in fubftance or infufion, as is moft agreeable to the patient. When obstructions proceed from a vifcid ftate of the blood ; ©r from women of a grofs or full habit, evacuations, and fuch med- icines as attenuate the humours, are neceffary. The patient in this cafe ought to be bled, to bathe her feet frequently in war.u water, to take now and then a cooling purge, and to live upon a fpare thin diet. Her drink-fnould be whey, water, or fmali beer; pnd fhe ought to take fufficient exercife. A tea-fpoonful of the tincture of black hellebore may alfo be taken twice a-day in a cup of warm water. When obstructions proceed from affecticr.c of the mind, as grief, fe?r, anger, Sec. every method fhould be taken to araufe and divert the patient. And that fhe may the more readily fcrgrt the •aufe of her affliction, fhe ought, if poffible, to be rsmcve ! feoiu 348 OF THE MENSTRUAL DISCHARGE. the place where it happened. A change of place, by prefenling the mind with a variety of new objects, has often a very happf influence in relieving it from the deepest diftrefs. A frothing kind, and affable behaviour to females in this fituatiott, is alfo or jhe firft importance. An obstruction of the menfes is often the effect of other mala- dies. When this is the cafe, inftead of giving medicines to force that difcharge, 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 menjtrual fliix may be too great as well as too fmall. When this happens, the patient becomes weak, the colour pale, the appetite end digeftion -are bad, and ocdematous fw-tlings of the feet, dropsies and confumptions often enfue. This frequently happens , to women.about the age of forty-five or fifty, and is very difficult fo cure. It may proceed from a fedentary life ; a full d'et, con- fifting chiefly of faked, high-feafoned, or acrid food ; the ufe of fpir- ituous liqucrs ; exceffive fatigue ; relaxation ; a diffolved ftate of the blood; violent palfions of the mind, &c. The treatment of this difeafe muft be varied according to. its caufe. When it is occafioned by any error in the patient's regi- , men, an oppofite courfe to that which induced the diforder muft be purfued, and fuch medicines taken as have a tendency to reftrain the flux, and counteract the morbid affections of the fyftem from whence it proceeds. To restrain the flux, the patient fhould be kept quiet and eafy both in body and mind. If it be very viojent, fhe ought to lie in bed, with her head low; to live upon a cool and flender diet, as veal or chicken broths with bread; and to drink decoctions of nettle- ' roots, or the greater comfrey. If thefe be not fufficient to flop the flux, ftronger nflringents may be ufed., as Japan earth, alum, elixir of vitriol, the Peruvian bark, &c.* The uterine flux may offend in quality as well as in quantity. What is ufually called thefiuor albus, or whites, is a very common difeafe, ancVp-oves extremely hurtful to delicate women. This difcharge, however, is not always white, but fometimes pale, yel- low, green, or of a blackifh colour ; fometimes it is fharp and cor- rofive, fometimes foul and foetid, Sec. It is attended with a pale complex!on,"pain in the back, lofs of appetite, fwelling of the feet, and other figns of debility. It generally proceeds fr< m a relaxed state ofthe body, arifing from indolence, the exceffive ufe of tea, coffee, or other weak and watery diet. To remove this difeafe, the patient muft take as much exerdfe as fhe can bear without fatigue. Her food fhould be folid and nourifhing, but of eafy digeftioif ; and her drink rather generous, as red port or claret mixed with Pyrmont, Briftol, or lime-water. * Two drachms of alum and one of Japan earth may be pounded together, and divide! into eiehtornine dofes, one of which may be taken three times a-iJay. . - Perfon* whofe ftomachs cannot bear the alum ma* uke two table-fpoonsful of the tinc- ture of roles three or four times a-dayf to each dofe of which ten drops of laudanum may be eit't!ief« fliould fail, hilf a drachm ofthe Peruvian barfc, in powder, with ten drops of the elixir of titrlo! may be t/ktnfa a glafs of red wine, four times a-day. • OF PREGNANCY. 349 Tea and coifee zre to be avoided, I have often known. ftrOng broths have an exceeding good effect, and fometimes a milk del alone will perform a cure. The patient ought not to he too ong a-bed When medicine is neceffary, we knpw none preleraoie to the Peruvian bark, which in this cie ought always to be takenim fubftance. In warm weather the cold bath will be of coidideraiDle V1i u.»a- * Every mother who procures an abortion does it at t! e hisar.! of her r«fe; }(': there are not a ftw who iub this rilk merely to indent the trouble of bearing and twinging up ichildten. Jt.is fuieJy a moil unnatural crime, ajia c-an&ot, -veu in t!.e moft; abanc'or.eJ, w viewed Without horror; but in the decent ii'.,tro», it is ftill r.u.it ur.paidonauie.— 'I *;-'•«, "wrcrchss who d?.ily adv«iife their: alii ft a nee. to wprccp }j> 'V-jj hvOiitf'j ClJSiV:, in. pry oyia-' OF CHILD.BIRTH. 351 dered nitre, in a cup of water-gruel, every five or fix ftotirs. ^ If the woman be feized with a violent loofenefs, ihe ought to drink the decoction of calcined hartshorn prepared. If fhe be affected with vomitting, let her take frequently two table-fpoonsful of the faline mixture. In general, opiates are of fervice; but they fhould always be given with caution. Sanguine robuft women, who ire liable to mifcarry at a cer- tian time of pregnancy, ought always to be bled a few days before that period arrives. By this means, and obferving the regimen above prefcribed, they might often efcape that misfortune. ' Though we recommend due care for preventing abortion, we would not be understood as restraining pregnant women from their ufual eaercifes. This would generally operate a 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 princip?.l caufes of abortion. There are, however, force women of fb delicate a texture, that it is neceffary for them to avoid almoft every kind of exercife during the whole period of pregnancy. OF CHILD-BIRTH. MANY difeafes proceed from the want of due care inrfcUV- bed ; and the more hardy part of the fex are moft apt to defpife the neceffary precautions in this ftate. This is peculiarly the cafe with young wives. They th-nk, when the labour-pains are ended, th« 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 fetus,■ b»t proper care and management" are certainly necefkry for the re- covery of the mother. No doubt mifchief may be done by too much as well as by too little car*. Hence females who have tie freateft number of attendants in child-bed generally recover worft."'' >ut 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 actual labour, nothing of a heating nature ought to be given. The woman may now and then take a little panada, and her drink ought to be toaftand water, or thin groat gruel. Spirits, wines, cordial-waters, and other things which are given with a view to ftrengthen the mother, and promote the birth, for the moil: part, tend only to increafe- the fever, inflame the womb, and retard the labour. Befides, they endanger the woman afterwards,as they often occafion violent and mortal haemorrhages, or difpofe her to eruptive and other fevers. • Though the management of women rn child-bed has ieen praftifed as an employment fince the earlier! accounts of time ; yet it is ftill inrBoft countries on a very bad footing__". Few women think of following this employment till they are reduced to the neceflity of dointf it tor bread. Hence not one in an hundred of them h-v* any education, or proper kno.-.'- edye of their bufinefs. It is true, that Nature, if" ieft. to herfetf, w'>!i .genera I* exrel rh cann.ot help tailing notice of that 'idiculous cullom which fli'l prevails in forns parti f the country, ofcollcfting a number of women together upon fuch 0C'.»fiJv o-, do much mischief. •f In a violent fiood;ng zfcer delivery, I hive feen verv po^d effect, s from the following miitu e: Ta-re «f pcnnv-royal'water, fimp'e cinnamon-water, atrt 'yruo of popries, each, i«*j ounces, tlixir of vitriol a drichrn. Mix, and take two table f can^'ul every two hours, ■: r r it n r, if necefTary. A i Take of crabs' claws prepared half a ounce, purified nitre tu-> drachm?, faffron pow- derel half a drachm : rub them together in a mortar, and divide the whole into eight or nine toft ■■Vh»n the. pst'ent is low fpir':ed, or trouj'c 1 with fiyfterica' complaints. Are ought to :jkif,r-n.irn'.iv • '■■[\t or [i^ecndrjps ?.f th> f;.-^larr of r'afcriea in.a cup of venny-rojalM*. OF CHILD-BIRTH. .353 nation to go frequently to ftool -x a heat, and fometimes total fup- PlC 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 drachm of nitre may be dif- folved and taken three or four times a-day. Clyfters of warm milk and water muft be frequently administered ;'and the belly fhould be fomented by cloths wrung out of warm water, or by ap- plying bladders filled with warm milk and wrer to it. A fuppreffion cf the lochia, or ufual difcharges after delivery, and the milk-fever, muft be treated nearly in the fame manner as an infl unmation of the womb. In ali thefe cafes, the fafeft courfe is plentiful dilution, gentle evacuations, and fomentations of the parts affected. In the milk-fever, the breafts may be embrocated with a little warm linleed-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 more to prevent the milk-fever than put- ting the child early to the breaft. The cuftom of not allowing children to fuck for the firft two cr three days, is contrary to Na- ture, and common fenfe, and is very hurtful both to the mother 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. Tnis would prevent many of the difeafes which prove fatal .to women in child-bed. When an inflammation happens in the breaft, attended -with rednefs, hardnefs, and other fymptoms of fuppuration, the fafeft application is a poultice of bread and milk, fof tened with oil or frefh butter. This may be renewed twice a-day, till the tumour be either difeuffed or broug" t to fuppuration. 'The ufe of repellents, in this cafe, is very dangerous ; they often occafion fevers, and fometimes cancers *, \vx ereas a fuppuration is feldom attended with "' any danger, and has often the molt falutary effects. When the nipples are fretteJ or chapt, they may be anointed • with a mixture of oil and bees-wax, or a little powdered gum arable 1 may be fprinkled on them. 1 have feen Hungary water applied to the nipples have a very good effect. Should the complaint prove obftinate, a cooling purge may be given, which gererallv removes if, Th.2 miliary fever, is a difeafe incident to women in child-bed; but as it has been treated of already, we fhall take no further notice of it. The celebrated Hoffman obferve?, that this fever of child-bed women might generally be prevented, if they, during their pregnancy, 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 to avoid all fharp air. When the labour is coming on, it is net to be hast- ened with forcing medicines, which icflame the blood and humours, cr put them into unnatural commotions- Care fhould he taken, after the birth,.that the natural excretions proceed regu^rly • and if the pulfe be quick, a lit'le nitrous powder, cr feme ether coding me£ 4 ies, fhould ts adminiftered,- 3S 4 OP CHILD-BIRTH. The moft fatal diforder confequent upon delivery is the puerper ral, or child-bed fever. It generally makes its attack upon the fecond or third day after delivery. Sometimes indeed it comes on iooner, and at other times, though rarelv, it dees not appear before the fifth or fixth day. m It begins like moft other fevers, with a cold or fhivering fit which is fucceeded by reftleffnefs, pain of the head, great ficknefs at the ftomach, and bilious vomiting. The pulfe is generally quick, the tongue dry, and there is a remarkable depreftion of fpirits and lofs of strength, A great pain is ufually felt in the back, hips, and region of the womb ; a fudden change in the quan- tity or quality of the lochia alfo takes place ; and the patient is fre- quently troubled with a tenefmus, or conftant inclination to go to itobl. The urine, which is very high coloured, is difcharged in fmall quantity, and generally with pain. The belly fometimes' fwells to a confiderable bulk, and becomes feifceptible of pain from the flighfeft touch. When the fevtr has continued for a few days, the fymptoms of inflammation ufually fubfide, and the difeafe ac- quires a more putrid form. At this period., if not fooner, a bilious or putrid loofenefs, of an obftinate and dangerous nature, comes on, and accompanies the difeafe through all its future progrefs. • There is not any difeafe that requires to be treated with more fkill and attention than this : consequently the beft affiftance ought to be obtained as foon as poflible. In women of plethoric constitu- tions, bleeding will generally be proper at tne beginning; it ought however to be ufed with caution, and not to re repeated unlefs where the figns of inflammation rife high; in which cafe it will alfo be neceflary to apply a blistering plafter to the region of tie womb. During the rigour, or cold fit, proper m^ans fhould be ufed to abate its violence and fhorten its duration. For this purpofe the patient may drink freely of warm diluting liquors, and, if low, may take now and then a cup of wine whey; warm applications to the extremities, as heated bricks, bottles or bladders filled with warm water, and fuch like, may alfo be ufed with advantage. Emollient clyfters of milk and water, or of chicken water, ought to be frequently adminiftered through the courfe of the dif- eafe. Thefe prove beneficial by promoting a difcharge from the inteftines, and alfo by acting as a kindlv foment tion to the womb and parts adjacent. Great care however is requifite in giving them, on account ofthe tendej-nefs of the parts in thepelv is at this time. To evacuate the offending bile from the ftpmach, a vomit is generally given. But as this is apt to increafe the irritability of the ftomach, already too great, it v/ill be fafer to omit it, and to give in its ftead a gentle laxative, which will both tend to cool the body, and to procure a free difcharge of the bile.* The medicine which I have always f und to fucceed belt in this difeafe, is the faline draught. This, if frequently repeated, will often put a flop to the vomiting, and at the fame time leffen the < • Midwives ought to be yerycautious ia adminlftering vomits or purges to women in child-bed. J have known a Woman who was recovering extremely well, thrown, into the wofthammerit: danger by a ftrong j^rr wbjjjh waj gireji her by a* oflrfiyus tju'dwiff, OF CHILD-BIRTHi 3*5 violence of the fever. If it runs off by ftool, or if the patient be reftfef^ few drops of laudanum, or fome fyrup of poppies, may cx:cafionally^a ^e^ ^^ fo frequent tQ keQ andexhauft the patient, a ftarch clyfter, with thirty or forty drops of laudanum in itVmay be adminiftered as occafion fhall require; and the drink mav be rice-water, in every Englifh pint of which half an ounce (of eum-arabic has been diffolved. ShoUd thefe fail, recourfe muft be Bad to Culumbo-root, or fome other ftrong aftringent. Though i" general the food ought to be light, and the drink diluting, yet when the difeafe has been long protracted, and the pa- tient is greatly Ipent by evacuations, it will be neceffary to fupport her with nourifhing diet and generous cordials. . It was obferved that this fever, after continuing for fome time, often acquires a putrid form. In this cafe the Peruvian bark mult be eiven tither by itfelf, or joined with cordials, as circumftances mav require. As the bark in fubftance will be apt to purge, it wavbegivenindecoaion or infufion mixed with the tmaure of rofes or other gentle astringents; or a fcruple of the extraft of bark'with half an ounce of fpirituous cinnamon-water, two ounces cf common water, and ten drops of laudanum, may be made into a draught, and given every fecond, third, or fourth hour, as mall be founo" neceflary. . When the ftomach will not bear any kind ot nourifhment, the patient may be fupported for fome time by clyfters of beef-tea, or chicken-water. . ,..,,, ,t , To avoid this fever, every woman in childbed ought to be kept perfectly eafy ; her food fliould be light and fimple, and her bed-chamber cool, and properly ventilated. 1 here is not any thing more hurtful to a woman in this fituation than being kept too warm. She ought not to have her body bound too tight, nor to rife too foon from bed after delivery ; catchi. * cold is alfo to be avoided ; and a proper attention fhould be paid to cleanlinefs. To prevent the milk-fever, the breafts ought frequently co be drawn ; and if they are filled previous to the onfet of a fever, they fhould, upon its firft appearance, be drawn, to prevent the milk from becoming acrid, and its being abforbed in this ftate Coll ive- nefs is Ikewife to -be avoided. This wil Ibe beft effected by the ufe of milt clyfters and a laxative diet. . We fhall conclude cur obfervations on child-bed women by recommending it to them, above all things, to beware of cold.-- Poor wcmen, whofe circumftances oblige them to quit their boo to> foon, often contraft difeafes from cold, of whicn they never recover. It is a pity the poor are not better taken care ot m tms llLa Bu^he better fort cf women run the greateft haz rd from too rrmch hen. Thev are ^enerailv kept in a fert of bagnio tor the mft e: <"ht or ten days/ and then dreffed cut to fee company. The dan- cer of this conduct muft be obvious to everyone. The ftWcitions cu.lom of obliging women to keep tne home till they £o w church, is likewife a very carman caufe cf catcmBg 35<* OF BARRENNESS. cold. All church es are damp, and moft of them cold ; confequenth they are fr every worft places to which a woman can go to make her frit vifit, alter having been confined in a warm room for a month. OF BARRENNESS. BARRENNESS may te very properly reckoned among the* cifeaftsof females, a* few married women who have cot children enjoy a good ftate cf health, it may proceed from various caufes, as high living, grief, relaxation, Sec. but it is chiefly owing to an ob« ilruction cr. irregularity of the menftruai flux. . h is very certain that high livirg vitiates the humours, and prevents fecundity. We feldom find a barren woman among the labouring poor, while nothing is more common among the rich and affluent. The inhabitants of every country are prolific in prcpor- tion to their poverty; and it would be an eafy matter to adduce many instances of women, who, by being reduced to live entirely up'n a milk aad vegetable diet, have conceived and brought forth chil- dren, though they never had any before. Would the rich ufe the fame fcrt of food and exercife as the better fort of peafants, they would feldcm lave caufe to envy thiir poor vaffals and dependants, the bleflicg of a nun.erous and healthy offspring, while they pine m fcrrov/ for the want cf even a fingle heir to their extenfive dor mains. Affluence begets indolence, which r.ot only vitiates the hue mours, but induces a general relaxation ofthe folids ; a ftate highly Unfavourable to procreation. To remove, this, we would recom- mend the following courfe : Firft, fufficient exercife in the open i'ir; fecondly, a diet contiftirg chiefly ot milk and vegetables,; * thirdly, ihe ufe cf aftringent medicines, as ft eel, alum, dragon'? Ik of, elixir of vitriol, and the bpaw or Tunbridge waters, Peruvi- an bark, Sec. ;.anu lastly, ?.\.c\ v'ill, the cold bath. Bar rennets is often the confequence of grief, fudden fear, an\"ety, cr any of the p. flions which teud to obstruct the menftru- i'l flux. When barrennefs is fufpected to proceed from affections of'he '.r.i 11 the perfon ought to be kept as eafy and cheerful as poiTibi.: ; all diagreeable objects are to be avoided, and every MeihoJ. L.k.ii^o nmufer.nd entertain the fancy. CHAP. LI, DISEASES OF CHILDREN. c _ISEP. ABLE indeed is the lot of man in the itot? of in- fancy**"! "fie comes into the world more helplefs than any other ani- r>?al,"and stands much longer in need of ihe protection and care of ;ii:; parents; but, alas ! this care is not always beftowed upon him; " Dr. Cheyr.e av;rs, rhacwant of children h oftener the fault ofthe male than of the fern le and llrongly r:r;t< for a lon/rfetable i,aii,\-iA mi'V:; H ' •.•r- -Ve dr, he often fuffers as much from improper management' as he would have done from neglect'. Hence the officious care of parents, nurfes. and midwives, becomes one of the moft fruitful fources of the diforders of infants/f . It muft be obvious to every attentive perfon, tliat the tint dil- eafes of children arife chiefly fromi tneir bowels. Nor is this in the leaft to be wondered at, as they are in a manner poifoned wvh in- digestible drugs and improper diet as foon as t*ey come into the world. Every thing that the ftomach cmnot digeft may be c in- fidercd as a poifon ; and unlefs it can be thrown up, or voided by ftool, it muft occafion fickuefs, gripes, fpafmodic affections of the bowels, or what the good women call inward fi's, and at laft con- vulfions and death. As thefe fymptoms evidently arife from lomewnat that irri- tates the inteftines, doubtlefs the proper method of cure muft be to expel it as foon as p fable,. The moft fafe and effectual method of doing this is by gtntle vomits. Five or fix grains of the powder of ipecacuanha may be mixed in two table-fpoonsful of water, and" fweetened with a little fugar. A tea-fpoonful of this may be given to the infant every quarter of an hour till it operates; or, what will more certainly anfwer the purpofe, a grain of er.* dc tartar may be diffolved in three ounces of wafer, fv/eetened with a futle fyrup, and given as above. ~Thofe who are willing to ufe the emetic tar- tar, may give fix or feven drops of the antimonial wine, io a tea- ' fpoonful of water or thin gruel. Small dofes of the ipecacuanha wine will be found more gentle than any of the above, and ought to be preferred. Thefe medicines will not only cleanfe the ftomach, but will generally likewife open the body. Should this however not hap- ' pen, and if the child be coftive, fome gentle purge will be neceffary; lor this purpofe, fome manna and pulp of caifia may be diffolved in boiling water, and given in fmall quantities till it operates ; Or, what will anfwer rather better, a few grains of magnefia alba may be mixed in any kind of food tnatis given to the 'child, and con- tinued till it has the defired effect. If thefe medicines be properly adminiftered, and the child's btlly and limbs frequently rubbed with a warm hand before the fire, they will feldom fail to relieve thofe affections ofthe ftomach and bowels from which infants fuf- fer fo much. Thefe general directions include moft of what can be do^e for relieving the internal diforders of infants. They will likewife go a confiderable way io alleviating thofe which appear externally, ac? ' the ram, gum orfellon, Sec. Thefe, as was formerly obferved, are principally owing to too hot a regimen, and confequently will i« moft effectually relieved by gentle evacuations. Indeed, evacua- f Of the officious and ill-Judged care of midwives, we fhall addueeonty one inftance, viz. the common practice oftorturing infants, by Squeezing their breafts, to draw oft" the milk, as they call it. Though a fmall quantity of moiftuie is generally found in the breads of infants,- yet, as th?y are certainly not intended to give fuck, this ought never to bs drawn off. 1 hare feen this cruel operation bring on hardnefs, inflammation, an4 fuppuration of the breads ; but never knew any ill confequences from its being omitted. _ When the breafts are fcard, tie only application that we would recommend, it a foft poultice, or a little of the diachylon >after, fpread thin upon a bit of foft leather, about*the rue of half a crown, and a^piiccl over eicb nipple. Thefe may be fuffered to continue till tbe hardnefs cUfappeart. '35* OE THE MECONIUM. te>s^ one kind or other conftitute a principal part of the medi- cine of infants and will feldom, if adminiftered with prudence, ii any of their difeafes,, fail to give relief. OF THE MECONIUM. THE ftomach and boweU of a new-born infant are filled witlt a btackifh colotired matter ofthe confidence of fyrup, commonly •ailed the meconhtm. This is generally paffed foon after the birth by the mere effort of nature ; in which cafe it is not neceflary to' give the infant any kind of medicine. But if it fhould b» retained, or not fufficiently carried off, a little manna or magnefia alba may be given as mentioned above ; or, if thefe fhoul I not be at hand, a common fpoonful of whey, fweetened with a little honey, or raw fugar, will anfwer the purpofe; The moft proper medicine for expelling the meconium is the jaother's milk, which is always at firft of a purgative quality.— Were children allowed to fuck as foon as thev fhew an inclination for the breaft, they would feldom have occafion for medicines to difeharge the meconium •, but even where this is not allowed, thev ought never to have daubs of fyrup, oil, and other indigeftible ftufrV crammed down their throats. THE APHTHAS, OR THRUSH. THE aphthse are little whitiih ulcers affecting the whole infide of the,mouth, tongue, throat, and ftomach of infants. SomehTies thev reach through the whole inteftinal canal: in which cafe they are verv 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 nqt dangerous ; but if opake, yellow, brown, black, thick, or running together, they ought to be dreaded. It is generally thought that the aphthae owe their origin to acid humours; we have reafon however to believe, that they are more frequently owing to too hot a regimen both ofthe 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 thefe will occafion in- flammatory diforders even in adults ; is it any wonder then that they fhould heat and inflame the.tender bodies of infants, and fet as it were the whole conftitution in a blaze ? The moft proper medicines for the aptha? are vomits, fuch as have been already recommended, and gentle laxatives. Five grains of rhubarb and half a drachm of magnefia alba may be rubbed together, and divided into fix dofes, one or which may be given to the infant every four or five hours till they operate. Thefe pow- ders may either 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 neceffary to xeep the body open- It is common in this cafe to adminifter calo- mel ; but as that medicine fometimes occofions gripes, it ought al- ways to be given to infants with caution. Msnv things have been tecommended for garglinc the mouth OF ACIDTTIES. 359 tad throat in thi< difeafe ; but it is not eafy to apply thefe in very ■ voun.' children ; we would therefore recommend it to the nnrU to run the child's month frequently with a little borax.and honey ; or w'n 'he following mixture i Take (fine honey an ounce, borax a dracha, burnt alum half a drachm, rofe water two drachms; mix them together. A very proper application in this cafe, is a folution often or twelve grains of white vitriol in eight ounces of barley- water. Thefe maybe 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 acefcest ■ature, it readily turns four upon the ftomach, efpecially if the body be any way disordered. H?nce moft difeafes of children are ac- eomor.nied wr'th en tent figns of acidity, as green ftools, gripes, &c. The'e anpeannces nave induced many to believe, that all the dif- eafes of children were owing to an acid abounding in the ftomach and bowels; bur whoever confiders the matter attentively, will find that thefe rvmptoms of acidity are oftener the effect than the caufe of their difeafes. Nr.ture evidently intend* 1 that the food of children fhould be acefcent; and unlefs the body be difordered, or the digeftion hurt, from fome other caufe, we will venture to fay, that the acefcent ( quality of their food is feldom injurious to them. Acidity, how- ever, is often a fymptom of diforders in children, and, as it is fome- times a troublefome one, we fhall point out the method of relieve- ing it. When green ftools, gripes, purgings, four fmells, &c. fhew that the bowels abound with an acid, let the child have a little fmall broth, with light white bread in it; and it fhould have fufficient exercife in order to promote the digeftion. It has beeo cuftomary in this cafe to give the pearl-julep, chalk, crabs' eyes, and other testaceous powders. Thefe, indeed, by their abforbent quality, may correct the acidity ; but they are attended with this inconve- *; nience, that they are apt to lodge in the bowels, and occafion cof- l tivenefs, which may prove very hurtful to the infant. For this rea- fon they fhould never be given unlefs mixed with purgative medi- cines as rhubarb, manna, ardfuch like. The beft medicine which we kcow in all cafes of acidity, is that fine infipid powder called magnefia alba-. It purges, and at the fame time corrects the acidly ; bv which means it not only removes the difeafe, but carries ofPts caufe. It mav be given in any kind of 1 food, or in a nrxfu"3, ai recommended in the Appendix.* When an infant is troubled with gripes, it ought not at firft to be dofed with brandv, fpiceries, and other hot things; but fhould have its body opened with an emollient clyfter, or the medicine mentioned above ; and at the fame time a httle brandv maybe rub- bed on its hellv with a warm hand before the fire. 1 have feldon-; ft en this fail to eafe the gripes of infants. If it fhould happen, how- *v. er, not to fucceed, a little brandy or other fpirits may be mi> e.' • See Appeadia, Laxative absorbent Mosture, 360 CABLING AND EXCORIATION. v this difcovery, to bear fuch enmity to the minute infect which is the occult caufe of this border, that it immediately perforates the cuticle, and totally exterminates the infection. The experiment is eafy, and' a Trial is r« corr. mtaded t» thofe arHlfted with r'.r.r-vxrmtfMU--« ■'•■ •lUi.iuxs r- any feind.' A' *• OF THE CROUP, OR HIVES. 3^3 The moft obftinate of all the eruptions incident to children, are the tinea capitis, or fcabbed head, and chilblains. The fcabbed 1 head is often exceeding difficult to cure, and fometimes indeed the curep' *l fometime ago faw a very ftriking inftance of the danper of fubftituting rirynj: uieci- «mei in thepbee of cleanlinefs and wholefome food, inths Vounilint'Hofpital ac Aclcwo.-ru, where the children were grievoufly afflicted with fcabbed heads and other cutaneous d fui - >lers. Upon inquiry it was found, that very little attention was paid either to the propi ! v or foundnefs of their provifions, and that cleanlinefs was tota ly ntglicted ; accordingly v w»sadvifed, that they fhould have more wholefome ford, and be kept thoroughly cleai. -- This advice, however, was not followed. It was too troublefoirir lo the fervants, fupeiin- ttndants, Sec. The bufinefs wa» to be done by medicine ; which was accordiiiE'y attempted, but had nearly proved fatal to the whoie houfe. Fevers, And other internal liilordrrs imme diitely appeared, and at lermth a putrid dyfentery, which proved fo infectious, that it carrriei oft i great msnv of the chilorwi, and fnead over a toufilerabte put cf the neighlw«.nr.£ country, 364 OF THE CROUP, UK HIVES. Scotland it is called the croup. On the weft they call it the chock or fluffing. In fome parts of England, where I have obferved it, the good wcmen call it the rifing of the lights, and in America, the hives. lit feems to be a fpecies of afthma attended with very acute and vio- lent catarrhal fymptoms. This difeafe generally prevails in cold and wet feafons. It is moft common upon the fea-coaft, and in low marfhy countries.— Children of a grofs and lax habit are moft liable to it. I have fome- times known it hereditary. It generally attacks children in the eight, after having been much expofed to damp cold eafterly winds througe the day. Damp houles, wet feet, thin fhoes, wet clothes, or any. thing that obftrufts the perfpiration, may occafioo the croup. It is attended.with a frequent pulfe, quick and laborious breathing, which is performed with a peculiar kind of croaking noife, that may be heard at a confiderable diftance. The voice is fharp and fhrill, and the face is generally much flufhedj though fome'imes it is of a fvid colour. When a child is feized with the above fymptoms, his feet fhould be immediately put into warm water. He ought likewife to be bled,* and to have a laxative clyfter adminiftered as foon as poffibl*. He ftiould be made to breathe over the fleams of warm water and vinegar ; or an emollient decoction, and emollient cata- plafms or fomentations may be applied round his neck. If the fymptcms do not abate, a bliftering-plafter muft be applied round tne neck, or between the shoulders, and the child may take fre- quently a table-fpoonful of the following julep: Take penny-royal water three ounces, fyrup of althea and of poppies, each one ounce, • mix them together. Afafcetida is found to have a good effect in this cafe. It may be both given in form of clyfter, and taken by the mouth. Two drachms of afafcetida may be diffolved in one ounce of Mincere- rus'fpirit, and three ounces of penny-royal water. A table-fpoon- ful of this mixture may be given every hour, or oftener, if the pa- tient's ftomach be able to bear it. If the child cannot be brought to take this medicine, two drachms ofthe afafcetida may be diffol- ved in a common clyfter, and adminiftered every fix or eight hours, till the violence of the difeafe abates.f To prevent a return of the diforder, all thofe things which oc- cafion it muft carefully be avoided ; as wet feet, cold, damp, eaft- erly winds, &c. Children who have-had frequent returns of this "■ difeafe, or whofe conftitutions feem to difpofe them to it, ought to * In this difeafe bleeding isnot always proper; but in very full habits it certainly muft j*3 of ufe. f I was lately favoured with a letter from Dr. William Turnbull in London, a phyfician i of gre it experience, and who, from his former fituation on the nortbeafl coaft of England/ had many opportunities of obferving the fymptoms and progrefs of this dangerous difeafe.— 1 arrj forry tne letter came too late to be inferted at length ; but as the Doctor's fentimeats differ Very little from my own, this misfortune is the lefs to be regretted. The Doctor in- d :d obferves, that he never found bliilering of any fervice ; but recommends cataplafms ot sarlic, camphor and Venice treacle, to be applied both to the throat and foles of the feet — iIe likewife rccornmend»boluiles of camphor, caftor, valerian root, fait of hartshorn, ana mufk, adapted %o the age, ftrength, fee. of the patient; after which he advifes two fpoonsful ofthe following decoction : Take of garlic and diflilled vinegar each an ounce, hyfop-watcr "ight ounces ; beat up the ingredients together, gradually mixing :he water^and adding tbrrc o->fi',fs-of honev. l.erthe whotebclVnmerW over agenthjfire, aad aftsrwarit? Ru'zri .'oru'c / OF TEETHING. 36*$ have their diet properly regulated ; all food that is vifcid or hard of digeftion, and all crude, raw, trashy fruits are to be avoided.— 1 hey ought likewife to have a drain constantly kept open in fome part "f their body, by means of a feton or iffue. 1 have feme- times known a Burgundy-pitch phfter, worn continually between the fnoulders for feveral years, have a very happy effect in prevent- ing the return of this dreadful difcrder. OF TEETHING. Dr. Arbuthnot obfefves, that above a tenth part of infants: die in teething, by fymptoms proceeding from the irritation of the tender nervous parts of the jaws, cccafionicg inflammations, fevers, convuifnns, gangrenes, &c. Thefe fymptoms are in a t great mea- fure owing to the great deiicacy andexquifite fenfibility ofthe ner- vous fyftem at this time of life, which is too often increafed by an effeminate education. Hence it comes to pafs, that children who are delicately brought up, always fuffer moft in teething, 2nd often fall by convulfive diforders. About the fixth or feventh month the teeth generally begin to make their appearance ; firft, the incifores, or fore-teeth ; next, the canini, or deg-teeth ; and laflly, the molares, or grinders. About the feventh year, there comes a.new fet; ant about the twentieth, the two inner grinders, called dentes fapienta, the teeth of wifdom. Children about the time of cutting their teeth, IT.ver much, and have generally a loofenefs. When the teething is difficult, efpecially when toe dog-teeth begin to make their way through the gums, the child has ftartings in his fleep, tumours of the gums, watchings, gripes, green ftools, the thrufh, fever, difficult breath- ing, an \ convulfions. Difficult teething requires nearly the fame treatment as an in- . flammatory difeafe. If the body be bound, it muft be opened either > by emollient clyfters or gentle purgatives ; as manna, magnefia alba, rhubarb, fenna, or the like. The food fhould be light, and in fmall quantity; the drink plentiful, but weak and diluting, as infufions of balm, or ofthe lime-tree flowers ; to which about a third or .'• fourth part of milk may be added. If the fev?r be high, blading will be neceffary ; but this ia yery youig children ought always to be fparingly performed. Ic is an evacuation which they bear the worft of any. Purging, vom- iting, or fweating, agree much better with them, and are generally 'r more beneficial. Harris, however, obferves, that when an inflam-. ( mation appears, the phyfician will labour in vain, if the cure be not ' beguu with applying a been under each ear. If the child be feized with convulfion-fits, a bliftering-plafter may be applied between the fh mlders, or one behind each ear. Sydenham fays, that in fevers occafioned by teething, he never found any remedy fo effectual as two, three, or four drops of fpir- its of hartshorn in a fpoonful of fimple water, or other convenient vehicle, given every four hours. The number of dofes may be four, five or fix. 1 have often prefcribed this medicine with fuccefs, but always found a larger dofe neceflary. It may be given' from 166 OF THE RICKETS. five drops to fifteen or twenty, according to the age of the child, and when coftivenefs does not forbid it, three or«four drops of laud- anum may be added to each dofe. In Scotland, it is very common, when children are cutting ther teeth, to put a fmall Burgundy-pitch plafter between their i fhpulders. This generally eafes the tickling cough which attends teething, and is by no means an ufelefs application. When the ■' teeth are cut with difficulty, it ought to be kept on during the whole time of teething. It may be enlarged as occafion requires, and ought to b? renewed at leaft once a*for might. Several thi igs have been recommended for rubbing the gums, as oils, mucilages. Sec. but from thefe, much is not to be expected. If any thing of this kind is to be ufed, we would recommend a little fine honey, which may be rubbed on with the finger three or four times a-day. Children are generally at this time difpofed to chevt whatever they get into their hands. For this reafon they ought never to be without fomewhat that will yield a little to the preflure of their gums as a cruft of bread, a wax candle, a bit of liquorice- root, or Iuch like, ( With regard to cutting the gums, we have feldom known it of1 any great benefit. In obftinate cafes, however, it ought to be tried. It may be performed by the finger nail, the edge of a fix penny piece that is worn thin, or any fharp body which can be with fafety introduced into the mouth ; but a lancet, in a fkilful hand, is cer- tainly the moft proper. In order to render the teething lefs difficult, parents ought to take care that their children's food be light and wholefome, and that their nerves be braced by fufficient exercife without doors, the ufe ofthe cold bath, &c. Were thefe things duly regarded, they would have a much better effect than teething necklaces, or other nonfenfical amulets worn for that purpofe. OF THE RICKETS. THIS difeafe generally attacks children between the age of nine months and two yea? s. It appeared firft in England, about the time when manufactures began to flourifh, and ftill prevails moft in towns where the inhabitants follow fedentary employments, by which means they neghct cither to take prpper exercife them- felves, or to give it to their children. CAUoES.—One caufe of the rickets is difeafed parents.— Mothers of a weak relaxed habit, who neglect exercife, and live upon weak watery diet, can neither be expected to bring forth ftrong and healthy children, or to be able to nurfe them after they are brought forth. ^ Accordingly we find, that the children of fuch women generally die ofthe rickets, the fcrophula, confumptions, or fuch like difeafes. Children begotten by men in the decline of life, who are fubject to the g^m, the gravel cr other chronic difeafe, or who have been often afflicted with the venereal difeafe in their youth, are likewife very liable to the rickets. , Any diforder that weakens the conftitution, or relaxesthe habit of children, as the fmall-pox, meafles, teething, the hooping OF THE RICKETS, ?$1 oough, &c. difpofes tliem to this difeafe, It may likewife be c: r«T Honed by improper diet, as food that is either too weak and watery* or fo vifcid that the ftomach cannot digeft it. Bad nurimg is the chief caufe of this difeafe. When the nurfe is either difeafed, or has not enough of milk to nourifh the cmtcf, it cannot thrive. But children fuffer oftener by want of care in nur- ff s than warn of food. Allowing an infant to lie crfit too much, or n t keeping it thoroughly clean in its clothes, has the ntoft per- Bicious effects. rFhe want of free air is likewife very hurtful to children 111 this refpect. When a nurfe lives in a clofe fmall hcufe, where the air is. -amp and e niined, and is too indolent to carry tier chiM abroad into the open air, it will hardly efcape this difeafe* > A healthy child fhould always be in motion, unlefs when afteep■■; if it be fullered to lie or fit, inftead of being toffed and dandled about it will net thrive. SYMPTbMS.—At the beginning of t#s difeafe the child's I fh grows foft and flabby ; its ftrength is diminifhed ; it fofes its wonted, cheerfulnefs, looks more grave and compofed than ts natu- ral for ii.s age, and does; not chufe to be moved. The head and belly become too large in proportion to the other parts; the face appears full, and the' complexion florid. Afterwards the benes be- gin to be affected, efpecially in the more foft and fpungy parts.— riencethe wriftsand ancles become thicker than ufual j the fpme or back-bone puts on an unnatural fhape; the breaft is likewife often deformed ; and the bones of the arms and legs grow crook- ed All rhefe fymptoms varyliccording to the violence of the dif- eafe. The pulfe is generally, quick, but feeble;l the appetite anx$ digplf ion for the raoft part bad ; the teeth come flowiy arrd^ with d'fricul y, and they often rot and fall out afterwards. JRickety children generally have great acutsnefs of mind, and an understand- ing above t^eir years. Whether this is owing to tre'r being more in the company of adults tnan other children, or to the preternatiti- ral enlargement of the brain, is riot material. REGIMEN.—As this difeafe is always attended with emdeMi figns of weaknefs and relaxation, our chief aim in the cure m«ft be to brace and ftrengthen the folids, and to promote- digrfticn and the due preparation ofthe fluids." Thefe important ends wiU be beft anfwered by wholefome nfuntihiog die*, fuited ta the age and ftrength of the patient, op. n diy air, and fufficient exercife. IF the child has a bad nurfe, who either neglects her duty, or does net urderftand it, fhe fhould be changed. If the feafon be coId,.the chikl ought to be kept warm; and when the weather is hot, it ought to be kept cool; as fweating is apt to weaken it, and^too great a degree of cold has the ftme effect. Th \ limbs fhould be rubbed frequently with a warm hand, and the child kept as cheer- ful as poffible. The diet ought to be dry and nouruhins, as good bread, roaft- ed flefh, Sec. Ifcfcuit is generally reckoned the beft bread ; and pigeons, pullets, veal, rabbits, or mutton roafted or minced, are the moft proper flefh. If the child be When convulfion-fits arife from the cutting of teeth, befides gende evacuations, we would recommend blistering* and the ufe of antifpafmodic medicines, as the tincture of foot, afafcetida, or caftor. A few drops of any of thefe may be mixed in a cup of white-wine whey, and given occafionally. When cmvulfions proceed from any external caufe, as the preflure occafioned by ftrait clothes or bandages, &c. thefe ought immediately to be removed; though in this cafe taking away the caufe will not always remove the effect, yet it ought to be done. It is not likely that the patient will recover, as long as the caufe which firft gave rife to the diforder continues to act. When a child is feized with convulfions without having anf eomplaint In the bowels, cr fymptoms of teething; or any rafh or other difcharge which has been fuddenly dried up', we have reafon to conclude that it is a primary djfeafe, and proceeds immediately from the brain. Cafes of this kind, however, happen but feldom, which is very fortunate, as hVle can be done to relieve the unhap- py pitient. W en a difeafe proceeds from an original fault in the formation or ftructure of the brain itfelf, we cannot expect that» it fhould yield to medicine. But as this is not always the caufe, even of convulfions which proceed immediately from the brain, fome at- tempts fhould be made to remove them. The chief intention to be purfued for this purpofe, is to make fome derivation from the head, by blistering, purging, and the like. Should thefe fail, iflues or fetons may be put in the neck, or between the fhoulders. OF WATER IN THE HEAD. THOUGH water in the head, Or a dropfy cf the brain, may affect adults as well as children, yet, as the latter are more pecu- liarly liable to it, we thought that it would be moft proper to place it among the difeafes of infants. CAUSES.—A dropfy of the brain may proceed from injuries done to the brain itfelf by falls, blows, or the like; it may alfo pro- ceed from an original laxity or weaknefs cf the brain ; from fcirr- hous tumours or excrefcences within the fkull; a thin watery ftate ofthe blood ; adiminifhed fecretion of urine ; a fudden check of the perfpiration ; and lastly, from tedious and lingering difeafes, which wafte and confume the patient. SYMPTOMS.—This difeafe has at firft the appearance of a flow fev.r ; the patient complains of a pain in the crown of his head or oyer his eyes ; he fhuns the light ; is fick, and fometimes vomits; his pulfe is irregular and generally low ; though he feems heavy and dull, yet he does not fleep; be is fometimes delirious, and frequent-y fees objects double; towards the eud of this com- monly fatal difeafe, the pulfe becomes more frequent, the pupils are generally dilated, the cheeks fluflied, the patient becomes com- atofe, and convulfions enfue.* MEDICINE.—No medicine has hitherto been found fufiicicn? to carry off a dropfy of the brain. It is laudable, however, to * I very lately loft a patient in this difeafe, where 1 curios metaftafis feemed to takr place. The water at firft appeared to be in the abdomen, afterwards in the breaft, and ,aft of i.i it mounted up to the brain, where it foon pioved fatal. yrp OF SUREGRY. make ibme attempts, as time or chance may bring many things to light, of which at prefent we have no idea. The medicines gener. ally ufed are, purges of rhubarb or jalap, with calomel or bh'fter- ii}g-plafters applied to the neck or back part of the head. To which we would beg leave to add diuretics, or medicines which promote the fecretion of urine, fuch as are recommended in the common <&ogfy. A difcharge from the nofe ought likewife to be promoted $y caufing the patient to fnuff the powder of afarum, white helle- 'd>er.e or the like. Some practitioners have of late pretended to cure this difeafe 3>y the ufe of mercury. I have not been fo !>appy as to fee any amtances of a cure being performed in a confirmed drcpfy of the Iteiin; -T but in fo del berate a malady every thing deferves a trial. £ CHAP. LIE OF SURGERY* § O defcribe all the operations of ftrrgery, and to point out &ie different difeafes in which thefe operations are neceflary, would I asstend this article far beyond the limits allotted to it: we muft >' flerefore confine our obfervations to fuch cafes as moft generally jxrcur, and in which proper affiftance is either not afked, or not :lways to be obtained. Though an acquaintance with the ftructure of the human body k indifpentably neceflary to qualify a man. for being an expert fergeon; yet many things may be-done to fave the lives of their 8elk>w-men,. in emergencies, by thofe who are no adepts in anato- my- It is amazing with what facility the peafants dailv perform ssgerations upon brute animals, which are not of a lefs difficult na- ttarethau many of thofe performed on the human fpecies; yet they fEEdom fail of fuccefs. Indeed every man is in fome meafure a furgeon whether he ■anfrbeor not. He feels an inclination to aflift his fellc w-men in dif- faefs, and accidents happen every hour which give occafion to extr- *dfe this feeling. The feelings of the heart, however, when rut directed by the judgment are apt to miflead. Thus one, by a rafh attempt to fave his friend, may fometimes deftroy him ; while * .another, for fear of doing amifs, Hands ftill and fees his bofcra ffHend expire without fo much as attempting to relieve him, even when the means are in his power. As every good man would wifh ;?©. fteer a courfe different from either of thefe, it will no doubt be agreeable to him to know what ought to be done upon fuch emer- gencies. ?■ One reafon why this difeafe is feldom or never cured, may be, that it it feldom known Olltoo far advanced to admit of a remedy. Did parents watch the rirft fyraptoms, and call u phyfician in due time, i am inclined to think that fomething might be done. But thcO &,*sptoms are not yet fufficiently known, and are often miftaken even by phyficians them- "riw*. Of this 1 lately faw a (hiking inftance in a pat'enr, attended by an eminent prafti ituier of this city, who had all along miftaken the aifeafe for teething. * Late Practice has fully proved, that all Surgical Instruments, except *he laneet for Yatcin*tion» dipped in oil at the inftaot of ufing, leflen* the paiiwlt it falutary alfo to have att '.aJhuaienta at blood beat. A. 1 37* OF BLEEDING. NO operation offurgery is fo frequently neceflary as bleed- ing : it ought therefore to be very generally underflood. But though praaifed by midwives, gardeners, blackfmiths, &c. we have reafon to believe that very few know when it is proper. Ev- en phyficians themfelves have been fomuc ■, the dupes of theo- ry in this article, as to render it the fubject of ridicule. It is, how- ever, an operation of great importance, and muft, when feafo; ably and properly performed, be of fingular fervice to thofe in diftrefs. Bleeding is proper at the beginning of all inflammatory fevers, as pleurifies, peripneumonies, Sec. It is likewife proper in all topic- al inflammations, as thofe of the inteftines, womb, bladder, fto- mach, kidnies, throat, eyes, &c. as alfo in the afthma, fciatic pains, coughs, head-nchs, rheumatifms, the apoplexy, epilepfy, and bloody-flux. After falls, blows, bruifes, or any violent hurt re- ceived either externally or internally, bleeding is neceffary. It is likewife neceffary for perfons who have had the misfortune to be ftrangled, drowned, fuftbeated with foul air, the fumes of metals cr the like. In a word, whenever the vital motions have been fud- denly ftopt from any caufe whatever, except in fwoonings occafion- ed by mere weaknefs or hyfteric affections, it is proper to open a vein. But in all diforders proceeding from a relaxation of the fol- ids, and an impoverifhed ftate of the blood, as dropfies, cacochy- mies, &c. bleeding is improper. Bleeding for topical inflammations ought always to be per- formed as near the part affected as poffible. When this can be done with a lancet, it is to be preferred to any other method; but where a vein cannot be found, recourfe muft be had to leeches cr cupping. Tne quantity of blood to be let muft always be regulated by the ftrength, age, conftitution, manner of life and other circumftan- ces, relating to the patient. It would be ridiculous to fuppofe that a child could bear to loofe as much blood as a grown perfon, or that a delicate lady fhould be bled to the fame extent as a robuft man. From whatever part of the body blood is to be let, a bandage muft be applied between that part and the heart. As it is often ne- ceffary, in order to raife the vein, to make the bandage pretty tight, it will be proper in fuch cafes, as foon as the blood begins to flow, to flacken it a little. The bandage ought to be applied at leaft an inch, or an inch and an half, from the place where the wound is iatended to be made. Perfons not fkilled in anatomy ought never to bleed in a vein that lies over-an artery or a tendon, if they can avoid it. The former may eafily be known from its pulfation or beating, and the latter from its feeling hard or tight like a whip cord under the fin- ger. It was formerly a rule, even among thofe who had the charac- ter of being regular practitioners, to bleed their patients in certain difeafes till they fainted. Surely a more ridiculous rule could not be propofed:-- One perfon will faint at the very fight of a lancer, 37* OF INFLAMMATIONS AND ABSCESSES. while another will lofe almoft the whole blood of his body befow he faints. Swooning depends more upon the ftate of the mind than of the body : befides, it may often be occafioned or prevented by the manner in which the operation is performed. Crildren are generally bled with leeches. This, though fome- times neceffary, is a very troublefome and uncertain practice. It is impoflible to know what quantity of blood is taken away by leech- es ; befides, the bleeding is often very difficult to flop, and the wounds are not eafily healed. Would thofe who practice bleed- ing take a little more pains, and accuftom themfelves to bleed chil- dren, they would not find it fuch a difficult operation as they imag- ine. Certain hurtful prejudices with regard to bleeding ftill prevail among the country people. They talk, for inftance, of head-veins, heart-veins, breaft-veins, &c. and believe that bleediug in thefe will certainly cure all difeafes ofthe parts from whence they are fuppo- fed to come, without conildericg trat all the blood veffels arife from the heart and return to it again; for which reafon, uifeis in topical in* ilammations, it figuifies very little from what part of the body the blood is taken. But this, though a foolifh prejudice, is not near fo hurtful as the vulgar notion that the firft bleeding will perform wonders. This belief makes them often postpone the operation when neceffary, in order to referve it for fome more important oc- cafion, and when they think themfelves in extreme danger, shey fly to it for relief whether it be proper cr not. Bleedii g at certain Itated periods or feafons has likewife bad effects. It is a common notion that bleeding in the feet draws the hu- mours downwards, and confequently cures difeafes of the head and other Juperior parts; but we have already obferved that, in all topical affections, the blood onght to be drawn as near the part as poffible. When it is neceflary, however, to bleed in the foot or hand, as the veins are fmall, and the bleeding is apt to flop too foon, the part ought to be immerfed in warm water, and kept there till a fufficient quantity of blood be let. We fhall not fpend time in defcribing the manner of perform- ing this operation: that will be better learned by example than precept. Twenty pages of defcription would not convey fb juft an idea of the operation as feeing it once performed by an expert hand. Neither is it neceflary to point out the different parts of the body from whence blood may be taken, as the arm, foot, forehead, temples, neck, Sec. Thefe will readily occur to every' intelligent perfon, and the foregoing obfervations will be fufficient for deter- mining which of tKem is moft proper upon any particular occafion. In all cafes where the intention is merely to leffen the general mafs of blood, the arm is the moft commodious part of the body in which the operation can be performed. OF INFLAMMATIONS AND ABSCESSES. FROM whatever caufe an inflammation proceeds, it muft ter. minate either by difperfion, fuppuration, or gangrene. Though**!? ft impoflible to foretell with certainty in which of thefe ways any OF INFLAMMATIONS AND ABSCESSES. 375 particular inflammation will terminate, yet a probable conjecture may be formed with regard to the event, from a knowledge of the patient's age and conftitution. Inflammations happening in a flight d-gree upon colds, and without any previous indifpofition, willmcft probably be difperfed ; thofe which follow clofe upon a fever, or happen to perfons of a grofs habit of body, will generally fup- purate; and thefe which attack very old people, or perfons of a dropfical habit, will have a ftrong tendency to gangrene. If the inflammation be flight, and the conftitution found, the difperfion ought always to be attempted. This will be beft pro- moted by a flender diluting diet, plentiful bleeding, and repeated purges. The part itfelf muft be fomented, and, if the ikin be very tenfe it may be embrocated with a mixture of three-fourths of fweet oil, and one fourth of vinegar, and afterwards covered with a piece of wax-plafter. . If notwithstanding thefe applications, the fymptomatic fever increafes, and the tumour becomes larger, with a violent pain and pulfation, it will be proper to promote the fuppuration. The beft application f r this purpofe is a foft poultice, which may be renew- ed twice a-day. If the fuppuration proceeds but flowly, a raw on- ion cut fmall or bruifed may be fpread upon the poultice. When the abfcels is ripe or fit for opening, which may eafily be known from the thinnefe of the fkin in the moft prominent part of it, a fluctuation of matter which may be felt under the finger, and, gen- erally fpeaking, an abatement of the pain, it may be opened either with a lancet or by means of cauftic. The laft way in which an inflammation terminates, is in a gan- grene or mortification, the approach of which may be known by the following fymptoms : the inflammation lofes its rednefs, and becomes dulkifn or livid; the tenfion of the fkin goes off, and it feels flabby; little bladders filled with ichor of different colours fpread all over it; the tumour fubfides, ard from a dufkifh com- plexion becomes black; a quick low pulfe, with cold clammy fweats, are the immediate forerunners of death. When the fymptoms firft appear, the part ought to be dreffed with LOndon treacle, or a cataplafm made of lixivium and bran. Should the fymptoms become worfe, fhe part muft be fcarified and afterwards dreffed with bafilicum foftened with oil of turpentine. All the dreflings muft be applied warm. With regard to internal medicines, the patient muft be fupported with generous cordials, and the Peruvian bark exhibited in as lar?e dofes as the ftomach will bear it. If the mortified parts fhould feparate, the wound will become a common ulcer, and must be treated accordingly. This article includes the treatment of all thofe difeafes, which, in different parts of the country, go by the names of biles, impofi- '.umes, whitloss, &c. They are all abfeefles in confequ?nceof a pre- vious inflammation, which, if poffible, ought t*-be dif cuffed ; but when this cannot be done, the fuppuration fhould be promoted, and the matter difcharged by an incifion, if neceffary ; afterwards the Jbre may be dreflfed with yellow bafilicum, or fome other digeftiv^ eintajent. ■* OF WOUNDS. NO part of medicine has been more miftaken than the treat* ment or cure of wounds. Mankind in general believe that cer- tain herbs, ointments, and platters are poffeffed of wonderful heal- ing powers, and imagine that no wound can be cured without the application of them. It is however a fact, that no external appli- cation whatever contributes towards the cure of a wound, any other way than by keeping the parts foft, clean, and defending them from the external air, which may be as effectually done by dry lint, as by the moft pompous applications, while it is exempt from many of the bad confequences attending them. The fame obfervation holds with refpect to internal applica- tions. Thefe only promote the cure of wounds as far as thev tend to prevent a fever, or to remove any caufe that might obftruct er impede the operations of Nature. It is Nature alone that cures wounds: All that art can do is to remove obftacles, and to put the parts in fuch a condition as is the moft favourable to Nature's efforts. With this fimple view we fhall confider the treatment of wounds, and endeavour to point out fuch Heps as ought to be taken to facilitate their cure. The firft , thing to be done when a perfon has received a wound, is to examine whether any foreign body be lodged in it, as wood, ftone, iron, lead, glafs* dirt, bits of cloth, or the like.— Thefe, if poffible, ought to be extracted, and the wound cleaned, before any fdreflings be applied. When that cannot be effected with fafety, on account of the patient's weaknefs, or lofs pf blood, thev muft be fuffered to remain in the wound, and afterwards ex- tracted when he is more able to bear it. When a wound penetrates into any of the cavities of the body, as the breaft, the bowels, Sec or where any confiderable blood-veffel is cut, a flcilful furgeon ought immediately to be called, otherwife the patient may lofe his life. ' But fometimes the dif- charge of blood is fo great,, that if it be not ftopt, the patient may die even before a furgeon, though at no great diftance, can arrive.— In this cafe, fomething muft be done by thofe who are prefent. If the wound lie in any of thelimbs,the bleeding may generally be ftopt by applying a tight ligature or bandage round the member a little above the wound. The beft method of doing this is to put a ftrong broad garter round the part, but fo flack as eafily to admit a fmall piece of flick to be put under it, which mult be twilled, in the fame manner as a countryman does a cart rope to fecure his loading, till the bleeding flops. Whenever this is the cafe, he muft take care to twift,it no longer, as ftraining it too much might occafion. an in- flammation of the parts, and endanger a gangrene. In parts where this bandage cannot be applied, various other methods may be tried to ftop the bleeding, as the application of ilyptics, aftringents, &c. Cloths dipped in a folution of blue vit- riol in water, or thefijptic water of the Difpenfatories, may be ap- o'*ed to the wound. Whenihefe cannot be obtainlfl. ftroDgfpirits OF WOUNDS. 335 of wine may be ufed. Some recommend the agaric * of fche oak as preferable to any of the other ftyptics ; and indeed it deferves con- fiderable encomiums. It is eafiy obtained, and ought to be kept in every family, is cafe of accidents. A piece of it muft be laid upon the wound, anii I covered with a good deal of lint, above which a bandage may -bt applied fo tight as to keep it firrr4y on. Though fpirits, tinctures, and hot balfams may be ufed, .ie order to ft p the bleeding when it is exceffive, they are improper at other times. They do not promote, but retard the cure, and often change a fimple wound into an ulcer. People imagine, becaufe ha: balfams congeal the Wood, and feem, as it were, to fodder up the wound, that they therefore heal it; but this is only a deception.-— They may indeed ftop the flowing blood, by fearicg the mouths c*: the veffels ; but, by rendering the parts callous they obftruct the cure. In ffght wounds, which do not penetrate much deeper thaw the Ikin, the beft application is a bit of the common black flicking- plafter. This keeps the fides ofthe wound together, and prevents, the air from hurting it, which is all that is ^ neceffary. When a wouad penetrates deep, it is not fafe to keep its lips quite clcie: thii keeps in the matter, and is apt to make the wound f efter. In this c.ife the beft way is to fill the wound with foft lint, commonly call- ed caddis. It however muft not be fluffed in too hard, otherwife it will do hurt. The lintinay be covered with a cloth dipped ia oil, ce fpread v/ith the common wax-platter ; f and the whole muft be kept on by a proper bandage. We fhall not fpend time in defcribing the different bandage- that may be proper for wounds in different parts of the body;; common fenfe will generally fuggeft the moft commodious method! of applying a bandage ; befide, defcriptions of this kind are nc*t eafily understood or remembered. The firft dreffmg ought to continue on for at leaft two days 5 after which it maybe removed, and frefh lint applied as before.— If any part of the firft drefling flicks fo clofe as not to be removei. - with eafe cr fafety to the patient, it may be allowed to continue and frefh lint dipped in fweet oil laid over it. This will fatten i<-' lb as to make itTomeoff eafily at the next drefling. Afterward' the wound may be dreffed twice a-day in the fame manner till it bv quite he.ded. Thofe who are fond of falves or ointments, niav... after the wound is become very fuperficial, drefs it with the yellow * Dr. Tiflbt, in his " Advice to the people," give* the following directions for gather- ing, preparing, and applying the agaric. •'Gather in autumn," fays he, "while the ftut weather lads, the agaric of the oak, which is a kind of fungus or excrefcence itTufog fro^ the wood of that tree. It confifts at firft of four part*, which prefent themfelves fuccciiitrelv I. The outward rind, or fkin, which may be thrown away. a. Theaart immediately under this rind which is the beft ©f all. This Is to btbeat well with a hammer t II it becomes fofc and ve y pliable. This is the only preparation it requires, and a flice of it of a proper fize is to be applied direftly over the burfting-open blood veflels. It conftringas and brings them eloSt together, flops the bleeding, and generally falls off at the end of two day*. 3. The third part adhering to the fecond may ferve to ftop the bleeding from the fmaller veffels $ and the fourthand laft part may be reduced to powder as conducing to the fame purpofe." Wr«re th* agaric cannot be had, fponge mav be ufed in its Head. It muft be applied ia the hate snata- ner, and has nearly the fame effects. t See Appendix, Wax-Plafier. 376 OF BURNS AND SCALDS. bafilicum ; * and if fungus, or what is called prouMefh\ fhould rife in* the wound, it may be checked, by mixing with the ointment a little burnt alum or red precipitate of mercury. When a wound is greatly inflamed, the mcft proper application is a poultice of bread and milk, foftened with a little fweet oil or frefh butter. This muft be applied inftead cf a plafter, and fliould be changed twice a-day. If the wound be large, and there is reafon to fear an inflam- mation, the patient fhould be kept on a very low cliet. He muft abftain from flefh, ftrong liquors, and everything that is of a heat- ing nature, if he be of a full habit, andhas loft but little blood from the wound, he muft be bled ; and, if the fymptoms be urgent the operation may be repeated. But when the patient has been greatly weakened by lofs cf blood from the wound, it will be dan- gerous to bleed him, even though a fever fhould ecfue. Nature fhould never he too far exhaufted. It is always more fafe to allow her to ftruggle with the difeafe, in her own way, than to fink the patient's strength by exceffive evacuations. WouVed perfons ought to be kept perfectly quiet and eafy. Every thing that ruffles the mind or moves the paffions, as love anger, fear, exceffive joy, &c. are very hurtful. They ought above i all things to abftain from venery. The bedy fhould be kept gently open, either by laxitive clyfters, or by a cool vegetable diet, as roafted apples, ftewed prunes, boiled fpinnage,.and fuch like. OF BURNS AND SCALDS. § VARIOUS remedies are recommended for the treatment of thefe accidents; and it happens fortunately for the preflure of fuch an emergency, that fome of the moft common things are alfo the moft ufeful on the occafion. The pain of burns and fcalds may be instantly abated by immerfing the part affected in ccld water, or in- deed in any cold fluid, or in fpirits of wine. An excellent applica- tion likewife is vinegar, with or without powdered chalk in it. If the injury be on the fingers or hands, the application may be made by immerfion ; but if in any part where this wculd be inconveni- ent, the vinegar may be applied by means of linen rags dipped iii it. In flight injuries, the vinegar, if early and affiduoufly applied will of itfelf feon eff eta cure; but fhoufd any degree of pain, re- turn, the immerfion or fomentation muft be repeated. In recent burns or fcalds, attended with large blifters, excoria- tions, or 1 ts of fubftance, the vinegar ought to be applied till the pain nearly ceafes, which generally happens within eight hours.— Many practitioners recommend fpirits of turpentine inftead of vine- gar ; or lime-water ahd linfeed-oil. The vinegar need not be em- ployed longer than t elve hours, except on the outfide of the fores, which, while they continue to be fwelled or inflamed, fhould be fomented for a minute or two before .they are dreffed. For drefling the fores which arife from burns or lcalds, one of the belt applications is a poultice of bread, water, and fweet oil.— This mould be removed in fix hours, when the fores are to be * ?re ./^ren!**, Y«j.r.ow BaskicumJ OF BURti$ AND SCALDS. 377 covered with chalk finely powdered, till it has abforbed the matter* and appears quite dry. A frefh poultice muft be laid over the whole, which, with the fprinkling of the chalk, is to be repeated mornirg and cveningtill the fores are healed. After the fecond or third day, if the fores be on a part of the body where it is difficult to keep the p ultieefromfhiftirg,a piaffe* of cerate thickly fpread, may be ufed as a fubft tute in the davtime* When there are large blifters upon the par", they fir uld be opened with a. lancet before the application of theyinepr ; and the water they contain be preffed out with a linen cloth, that the vine- gar may act more cfe/vdy upon the burnt flefh, which in this cafe it does efticacioufly. x fevers cafes, and in cold weather, the vine- gar fh mid be nearly Moo ?-w->rrn. If the patient will not fuffer the vinegar to be'applied immedi- ately to thefurface, on account ofthe pain it excites,* a linen rag foaked in fweet oil may be previoufly laid or the part, covering, the whole with cloths dipped in vinegar ; and thefe applications are to be occafionally repeated till the pain and inflammation be entirely remo ed ; after which the parts fhould be dreffed, or, iF the burn- ing be very deep, with a mixture of that and yellow bafilicum. When the burn or fcJd is violent, or has p-oduced a high de- gree of inflammation, fo that there is reafon to be apprehensive of a gangrene, the fame method of cure become neceffary as in other . violent inflammations. The patient, in this cafe, muft be put upon a low diet, and drink plentifully of weak diluting liquors.— ' He muft likewife be bled, aa ! his body be kept open. But if the burnt parts fhould become livid or black, with other fymptoms of mortification, it will be neceffary to apply to them camphorated fpirits of wine, tincture of myrrh, and other antifeptics or correctors of putrefaction, mixed with a decoction of the Peruvian bark. In this cafe, the bark muft Ikewife be taken internally ; the patient at the feme time ufing a more generous^diet, with wine^ fpiceries,. &c. When barns are occafioned by the explofion of gun powder, . fome of the grains of the powder are aptto be forced into the fkin. At firft they produce much irritation; and, if they be not remov- ed, they commonly leave marks which remain during life. They Ihouid therefore be picked out as foon as poffible after the acci- , dent; and to prevent inflammation, as well as to diflolve anv pow- der which may remain, the parts affected, fhouid be covered for a day or two with emollient poultices. A ftrong folution offoap in water has long been in ufe wirh artificers employed in any bufinefs expofmg workmen to verv bad ;tfcilds. This is allovv-ed to be an ex:-*lfent remedy. Bu", as the foap would take fome time in diffolving, and the folution fome time in cooling, Dr. Underwood recommends a mixture of fix ounces of oil to ten of water, with two drachms of the ley of kali, or pot-afh. ^ This quantity maybe fufficient for a bum on the. hand or foot, which is to be immerfed, and kept about half an hour in the liquor, which will remove the injury, if recourfe to it immedi- ately be had ; but muft be repeated, as the paia BKiy require, ir' the fc.ildor burn be of fome Handing. (25) 378 OF BRUISES, As example teaches better than precept, I fhall relate the treat. ment of the moft dreadful cafe of this kind that has occured in my practice. A middle-aged man, of a good conftitution, fell into a large veffel full of boiling water, and miferably fcalded about one half of his body. Ashiscloth.es were on, the burning in fome parts'was very deep before they could be got off. For the hrft two ;' days the fcalued par's had been frequently anointed wth a mixture of lime-water and oil, which is a very proper applica1 ion for recent ' burnrgs. On the third day, when I firft faw him, his fever was hteh, and his body coftive.fer which he was bk d,and had an emolli- ent clyfter adminiftered. Pcultices cf bread and milk, foftened with frefh butter, were likewife applied to the affected parts, to abate the heat and inflammation. Kis fever ftill continuing high, he was bled a fecond time, was kept ftrictly on tfe coclii g regi- men, took the faline mix'ure with fmall dofes of nitre, and had an emollient clyfter adminiftered cnce a-day. When the i flamma- tion began to abate, the parts were dreffed with a digeftive com- pofed of brown cerate and yellow bafilicum. Where any black j opots appeared, they were flightly fcarified, and touched with the tincture of myrrh, and to prevent their fpreading, the Peruvian. £ bark was administered. By this courfe, the man was fo well in § three weeks as to be able to attend to his bufinefs. The moft ufeful application, we are told, with which families f can be provided againft any emergency of this kind, is a ftrong brine, made by placing fliced potatoes and common f It in alternate layers in a pan, allowing them to remain until the whole of the fait I is liqu'tied; which muft be then drained off, and kept in bottles, properly labeled, ready for immediate ufe. OF BRUISES. BRUISES are generally productive of worfe confequences than wounds. The danger from them does not appear immedi- ately, by which means it often happens that they are neglected. It is needl'efs to give any definition of a difeafe fo 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 warm vinegar, to which a little brandy or rum may occafionally be added, acd to keep cloths wet with this mixture conttantly applied to it. This is more proper than rubbing, it with brandy, fpirits of wine, or other ardent fpirits, which are commonly ufed in fuch ' cafes. In fome parts of the country the peafants apply to a recent bruife a cataplafm of frefh cow dung. I have often feen this cata- plafm applied to violent contufions occafioned by blows, falls, bruifes, and fuch like, and never knew it fail to have a gocd effect. When a bruife is very violent, the patient ought immediately to be bled, and put upon a proper regimen. His food fliould be light and cool, and his drink weak and of an opening nature; as whey fweetened with honey, decoctions of tamarinds, barley, cream-tartar whey, and fuch like. The bruifed part muft be bathed with vinegar and water, as directed above ; and a poultice. •' 0 OF ULCERS, 379 made by boiling crumbs of bread, elder-flowers, and cimomile flowers, in equal quantities of vinegar and water, applied to it.-- This poultice is peculiarly proper when a wound is joined to the brufe. It may be renewed two or three times a-day. As the ftructure ofthe veffels is totally destroyed by a violent bruife, there often enfues a great lofs of fubftance, which produces an ul :erous fore very difficult to cure. If the bone be affected, the fore will not heal before an exfoliation takes place ; that is, before the difeafed part of the bone feparates, and comes out through the wound. This is often a very flow operation, and may even re- quire feveral years to be completed. Hence i: happens, that thefe fores are frequently miftiken for the king's evil, and treated as fuch, though in feci they proceed folely from the injury which the folid parts received from the blow. Patients in this fituation are pestered with different advices.— Every one who fees them propofes a new remedy, till the feres are - fo much irritated with various and oppofite applications, that it is . often at length rendered abfolutely incurable. . The beft method of ♦ managing fuch fores is, to take care that the patient's constitution does not fuffer by confinement cr improper medicine, and to apply nothing to them befi .!es 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 ■warm. Nature, thus affifted, will generally in time operate a cure, , by tn rowing off the difeafed parts of the bone, after which the fore foon heals. * OF ULCERS. ULCERS may be the confequence of wounds, bruifes, or impofthumes improperly treated ; they may likewife proceed from an ill ftate of the humours, or what may be called a bad habit of body. In the latter cafe they ought not to be hastily dried up, other- wife it may prove fatal to the patient. Ulcers nappen moft com- monly in the decline of life; and, perfons who neglect exercife, and live grcfsly, are moft liable to them. They might often be pre- vented by retrenching fome part ofthe folid food, or by opening artificial drains, as iflues. fetons, or the like. An ulcer may be diftinguifhed from a wound by its difcharging a thin waterv humour, which is often fo acrid as to inflame and corrode the fldn ; by the hardnefs and perpendicular fituation of its fides or edges; by the time of its duration, &c. It requires confiderable ikill to be able to judge whether or not an ulcer ought to be dried up. In general, all ulcers which proceed from a bad habit cf body, fhould be fuffered to continue open, at leaft till the conftitution has been fo far changed by proper regi- men, or the ufe of medicine, that they feem difpofed to heal of their own accord. Ulcers which are the effect of malignant fevers or other acute difeafes, may generally be healed with fafety after the health has been restored for fome time. The cure ought not however to be 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 ulc r?, if the conftitution be good, they may generally be healed with fafety.-r- When ukers either accompany chronic difeafes, or come in th.ir , ftead, they muft be cautioufly healed. If an ulcer conduces to the patient's health, from whatever caufe it proceeds, it ought not to be healed ; but if, on the contrary, it wastes the ftrength and con- fumes the patient by a flow fever, it fhould be healed as foon as poffible. We would earnestly recommend a strict attention to thefe particulars to all who have the misfortune to labour under this dif- order, particularly thofe in the decline of life; as we have frequent- ly known people throw away their lives by the want of it, while they were extolling and generoufly rewarding thofe whom they ougr.t to have looked upon as their executioners. The moft proper regimen for promoting the cure of ulcers, is to avoid all fpices, falted and high feafoned food, all ftrcng liquors, and toleffen the ufual quantity of flefh meat. The body ought to be kept gently open by a diet confifting chiefly of cooling laxative- vegetables, and by drinking butter-railk? whey fweetened with i honey, or the like. The patient ought to be kept cheerful, and fhould 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 bafilieum ointment. Sometimes it will be neceffary to have i,he edges of the ulcer fcarifi- ed with the lancet. Lime-water has frequently been known to have happy effects in the cure of obftinate ulcers. It may be ufed in the fame man- , ner as directed for the ftone and gravel. My late learned and ingenious friend Dr. Whytt ftrongly re- commends the ufe of the f iution of corrofive fublimate of mercury in brandy, for the cure of obftinate ill-conditioned ulcers, I have ' frequently found this medicine, when given according to the Doc- tor's directions, prove very fuccefsful. This dofe is a table fpor n- ful night and morning; at the fame time wafhing the fore twice or thrice a-day with it. In a letter which I had from the Defter a little before lvs death, he informed me, " That he obferved wafh- ing the fore thrice a-day with the folution of a triple ftrength was very beneficial."* A fifrulous ulcer can feldom be cured without an operation.— It muft either be laid open fo as to have its callous parts destroyed by fome corrofive application, or they muft be entirely cut away by the knife ; but as this operation requires the hand of an expert - furgeon, there is no occafion to defcribe ir. Ulcers about the anus are moft apt to become fiftul us, and are very difficult to cure. Some indeed pretend to have found W. rd's fiftula pafte very fuc- cefsful ia this complaint. It is. not a dangerous medicine, and be- ing eafily procured, it may deferve a trial; but as thefe ulcers * In ulcrs ofthe lower limbs great benefit is often received from tight rolleu, or wear- ing a laced ftocking, as this prevents the iiux of humours to the fores, and difpofes thera to- heal. • OF DISLOCATIONS. 3*J generally proceed from an ill habit of body, they will feldom yield to any thing except a long courfe of regimen, affifted by meaicines which are calculated to correct that particular habit, and to induce an almoft total change in the conftitution. CHAP. LIU. OF DISLOCATIONS. VV HEN a bone is moved out of its place pr articulation,; fo as to impede its proper functions, it is laid to be luxated or diflxated. As this often happens to perfcns in fituations where no medical afliftance can be obtained, by which means limbs, and even lives, are frequently I ft, we fhall endeavour to point out the method of reducing the moft common luxations, and thofe which re- quir.' immediate afisftance. Any perfon of common fenfe and re- folution, who is prefent when a dislocation happen?, may often be of more fervice to the patient, than the moil expert furgeon can after the fwelling and inflammation have come on. t When thefe are prefent, it is difficult to know the ftate ofthe joint, and dan- gerous to attempt a reduction, and by waiting fill they are gone off, the mufcles become fo relaxed, and the cavity filled up, that the .-■ bone can never afterwards be retained in its place. A recent diflocation may gv nerally be reduced by extecfion . alone, which muft always be greater or lefs according to the ftrength of the mufefes which move the joint, the age, robuftnefs, and other circumftances of the patient. When the bone has been out of its place for a confiderable time, and a fwelling or inflamma- tion has come on, it will be neceflary to bleed the patient, and, after fomenting the part, to apply foft poultices with vinegar to it for fome time before the reduction is attempted, All that is neceffary arter the reduction, is to apply cloths dipt 4 in vinegar or camphorated fpirits of wine to the part, and to keep Jr> perfectly eafy. Many bad confequences proceed from the neglect of this rule. • A diflocation feldom happens without # the tendons and ligaments of the joint being llretched and fometimes torn. When thefe are kept eafy till they recover their ftrength and tone, all goes on very well; but if the injury be increafed by too frequent an exertion ofthe parts, no wonder if they be founa weak and difeafed ever after. DISLOCATION OF THE JAW. THE lower jaw may be luxated by yawning, blows, falls, chewing hard fubftances, or the like. It is eafily known from the patient's being unable to fhut his mouthy or to eat any thing, as the teeth of the under jaw do not correfpond with thofe'cfjhe up- per ; befides, the chin either hangs down, or is thrown toward one fide, and the patient is neither able to fpeak distinctly, nor to fwal- low withou t confide r able diffic ulty. The ufual method of reducing a diflocated jaw is to fet the patient upon a low ftool, fo as an afliftant may hold the head firm 382 DISLOCATION OF THE NECK AND RIBS. by preffing it againft his breaft. The operator is then to thruftt his two thumbs, being firft wrapped up with linen cloths that they may not flip, as far back into the patient's mouth as he caD, while his fingers are applied to thejaw externally. After he has g >t firm hold of the jaw, he is to prets it flro- gly downwards and back- wards by which means the elapfed heads of the jaw may be eafily puftied into their former cavities. The peafants iii fome parts of the country have a pfculiar way of performing this operation. One of them puts a handker- chief under the patient's chin, then turning his back to that cf the patient, pulls him up by the chin fo as to fufpend iimfrom the ground. This method often fucceeds, but we think it adangerou* , one, and therefore recommend the former. DISLOCATION OF THE NECK. \ THE neck may be diflocated Dy falls, violent blows, or the ^ like. In this cafe, if the patient receives no afliftance, he foon dies, . which makes people imagine tke neck was broken; it is however, for the moft part only partially diflocated, and may be reduced by J almoft any perfon who has refclution enough to attempt it. A J complete diflocation of the neck is inftantaneous death. ' When the neck is diflocated, the patient is immediately de- i prived of all fenfe and motion ; his neck fwells, his countenance appears bloated; his chin lies upon his breaft, and his face is gene- rally turned towards one fide. To reduce this diflocation, the unhappy perfon fhould imme- diately be laid upon his back on the ground, and, the operator muft place himfelf behind him fo as to be able to lay hold of his head with both hands, while he makes a refiftance by placing his knees againft the patient's fnoulders. In this pr-fture he muft pull the head with confiderable force, gently twiftkg it at the fame time, if the face be^ turned to cne fide, till he perceves that the joint is replaced, which may be known from the noife which the bones generally make when g ing in, the patient's beginning to breathe, and the head c:ntinuing in its natural pofture. This is one of thofe operations which is more eafy to perform than defcribe. I have known inftances of its being happiiy per- formed even by^ women, and often by men of no medical education. After the neck is reduced, the patient ought to be bled, and fhould be fuffered to reft for fome days, till the parts recover their prcper tone. DISLOCATION OF THE RIBS, AS the ar'iculation of the ribs with the back-':ore is very ftrong, they are not often diflccated. It does however fometimes happen, which is a fufrkiem reafon for our taking notice of it.— When a rib is diflocated either upwards or downwards, in order to replace it, the patient fhould be laid upon his belly on a table, and the operator muft endeavour topufh the head cf the bone into its proper pbce. Should this method not fucceed, the arm of the dif- ordered fide may be fufpended over a gate or ladder, and, while the ribs are thus ftretched afunder, the heads of fuch as are out of place may be tbruft into their former fituation. DISLOCATION OF THE SHOULDER, fcrV. 383 Thofe diflocations wherein the heads ofthe ribs are forced in- wards, are both more dangerous and the molt difficult to reduce, as neither the hand nor any inftrument can be applied internally to direct the luxated heads- of the ribs. Almclt the only thing that cin be done is, to lay the patient upon his belly over a cafk, or fome gibi ous body, and to move the fore part of the rib inward towards ihe back, fometimes fhaking it; by this means the heads ofthe luxated ribs may flip into their former place. DISLOCATION OF THE SHOULDER. THE humerus or upper bone ofthe arm may be diflocated in varbus directions ; it happens however moft frequently idown- wards, but very feldom directly upwards. From the nature of its articulation, as well as from its expofure to external injuries,/'this bone is the moft fubject to diflocatioh.of any in the body. A dif- 1 c.itijn of the humerus may be known by a depreffion or cavity on the top of the fhoulder, and an inability to move the arm. Vv hen the dill cation is downward or forward,the arm is elongated, and a ball or knp is perceived under the arm pit; but when it is back- ward, there appears a protuberance behind the fhoulder, and the arm is thrown-forwards towards the breaft. 1 he ufual method of reducing^iflocations of th° fhoulder is to feat toe patient upon a low ftool, and to caufe an afliftanr to hold his body fo that it may not give way to the extenfion, while another lays hold of the arm a little above the elbow, and gradually extends it. 1 he operator then puts a napkin under the patient's arm, and caufes it t be tied behind his own neck ; by this, while a fufficient extenfion is made, he lifts up the head ofthe bone, and with his hands dir cts it into its proper place. There are various machines invented for facilitating this cp ration, but :he hand of an expert iurgeon is always more fafe. in young and delicate patients, I have generally found it a v.ry eafy matter to reduce the fhoulder, by extending the arm with one hand, and thruftipg in the head of the bone with the other. In making the extenfion, the arm ought always to be a httle bent. DISLOCATION OF IHE ELBOW. '1 HE bones of the fore-arm may be diffecared in any d;rec- don. When this is the cafe, a protuberance may be obferved on that fide of it.e arm towards which the bone is pufned, from whic:>, and the pi tent's inability to bend his arm, a diflocation of this joint may eafily be known. Two afliftants are generally neceflary for reducing a diflocation ofthe elbow ; one of them muft hy hold ofthe arm, above, and theo±er below the joint, and make a pretty f.rong extenfion, wiie the operator returns re bones into their, proper place. After- wards the arm muft be bent, and fufpended for fome time with a fling about the neck. Luxations pfthe wrift and fingers are to be reduced in the fame manner as thofe of the elbow ; viz. by making an extenfion in different directions, and thrufting the head, of the bene into its place. 384 OF BROKEN BONES,^&e. DISLOCATION OF THE THIGH. When the thigh-bone is diflocated forward and downward, the knee and foot are turned out, and the Ug is longer than the other, but when it is difplaced backward, it is ufu&lly pufhed up. ward at the fame time, by which means the limb is lhortened, and the foot is turned inwards. When the thigh bone is difplaced forward and downward, the patient, in order to have it reduced, muft be laid upon his back and made fait by bandages, or held by afliftants, while by others an extenfion is made by means cf flings fixed about the bot- tom of the thigh a little above the knee. vv hile the extenfion is made, the operator muft pufh the head of the bone outward, till it gets irfto the focket. If the diflocation be outward, the patient muft be laid upon his f?.ce, and, during the extenfion, the head of the bone muft be pufhed inward. Diflocations ofthe knees, ancles, and toes, are reduced much in the fame manner as tnofe of the upper extremities, viz. by making an extenfion in oppofite directions, while the operator rejflaces the fcones. In many cafes, however, t e extenfion alone ^■pfficient, and tne bone will 11 p into its place merely by pulling theiimb with fufficient force. It is not hereOy meant; that force alone is fuffi- cient for the reduction of diflocations. Skill and addrefs will often fucceed better than force. I have known a dllocation of tie thigh reduced by one man, after all the force thateould be ufed by fix had proved ineffectual. CHAP. LIV. QF BROKEN BONES, 6c. X HERE is, in moft villages, fome perfon who pretends to the art of reducing fractures. Though in general fuch perfons are very ignorant, yet fome of them are very fuccefsful ; which evi- dently proves, that a fmall degree of learning, with a fufficient fhare of common fenfe and a mechanical head, will enable a man to be ufeful in this way. We would, however, advife people never to employ fuch operators, when an expert and fkilful furgeon can be had ; but when this is impracticable, they muft be employed ; we shall therefore recommend the following hints to their confidera- tion: When a large bone is broken, the patient's diet ought in all refpects to be the fame as in an inflammatory fever, He fhould likewife be kept quiet and cool, and his body open by emollient clyfters ; or, if thefe cannot be conveniently adminiftered, b food that is of an opening qualify ; as slewed prunes, apples boiled in milk, boiled fpinnage, and the Uke, It ought however to be here remarked, that perfons who have been accuftomed to live high, are net all of a fudden to be reduced to a very low diet. This might have fatfel effects. There is often a necejlity for indulging even bad habits, in fome meafure, where the nature ofthe difeafe might ,-equire a different treatment. OF BROKEN BONES. 38* It will generally be neceffary to bleed tjie patient jflitiiediately after a fracture, efpecially if he be young, of a full habit, of has at the fame time received any bruife or contufipc. This operation fhould not only be performed foon after the accident Happens, but if the patient be very feverifh, it may be repeated next day.— When feveral of the ribs are broken, bleeding is peculiarly necef- fary. If any ofthe large bones when fupport the body are broken, the patient muft keep his be ' for feveral weeks. It is by no means neceffary, however that lie fh uld lie all that time, as is cuftomary upon his-back. Tnis fituation finks the fpirits, galls "and frets the patient's fkin, and rendeis nim very uneafy. After the fecond week he may be gently railed up, and may fit feveral h( urs, fup- ported by a bed-chair, or the like, which will greatly relieve him.— Great care, however, muft be taken in raffing him up and laying him down, that he make no exertions himfelf, other ..ife the action of the mulcted may pull the b-ne out of its place.* Itisof great importance to keep the patient dry and clean while in this fituation. By neglecting this, he is often fo galled and excoriated, that he is forced to keep fhifting places for eafe.— 1 have known a fractured tnigh-oone, after it had been kept ftraight for above a fortnignt, difplaced by this means, and contLue bent for life, in fpite a auuiat could . e done. It has been cuftomary when a bone was broken, to keep the limb for five or fix weeks continually upon the stretch. But this is a bad pofture. It is both uneafy to the patient, and unfavourable to the cure. The beft fituation is to keep the limb a Utile bent.— This is the pofture into which every animal puts its limbs when it gees .to reft, and in wiiich fewest mufcles are upon the stretch. It is^eafily affected, by eitner laying the .patient upon his iide, or making the bed fo as to favour this pofition of the limb. Bone-fetters ought carefully to examine whether the bone be not fhattered or broken into feveral pieces. In this cafe it will fometimes be neceffary to have the limb immediately token, orr, otherwife a gangrene or mortification- may enfue. The horror # which attends the very idea of an amputation, often occafions its * being delayed in fuch cafes till too late. I have known this princi- ple operate fo ftrongly, that a limb where the bones were fhairered into more than twenty pieces, was not amputated before the third day after the accident, when the gangrene had proceeded fo far as to render the operation ufelefs. When a fracture is accompanied with a wound, it mult be dreffed in all refpects as a common wound. t All that art can do towards the cure of a broken bone, is to lay it perfectly ftraight, and to keep it quite eafy. All tight ban- " Various pieces of machinery have been contrived for cc-unrtrafting the force of the mufcles, and retaining the fragments of broken bones; but as^efcriptions or tnels without drawings would be of little ufe, Khali refer the reider to a cheap and uff;ul performance «« 00 the natu.e and cure of fraftures," lately publiflied by my ingenious rr.end Mr. AitRen, fu^eon in Edinburgh ; wherein that gentleman ha, not only given an account or the ma- chines recommended in fraclures by former authors, but Ins likewife edaedfevertl improve- ment of his own, which are peculiarly ufeful in compound iraclures, and in cales Where catieots with broken bones are obliged to be trwifportsd from o:ie nftce to another. 386 OF STRAINS. dages do hurt. They had much better be wanting altogether. A great many of the bad confequences which fucceed to fractured bones are owing to tight bandages. This is one of the ways in which excefs of art, or iaio r ne abufe of it, d es more milchief than would be occafioned by the want of it. Some of the molt fudden cures of broken bones which were ever known, happened where no bandages were applied at all. Some metnod however muft be taken to keep the member fteady ; but this may be done many ways without bracing it with a tight bandage. The beft method of retention is by two or more fplints made . of leather or p-fteboard. Thefe if moiftened before tney be ap- plied, foon affume the fhape of the included member, ana are fuffi- cient, by the afliftance of a very flight bandage, for all the pur- pofes of retention. The bandage which we would recommend, is that made with twelve or eighteen tails- It is much eafier applied and taken off than rollers, and anfwers all the purpofes of reten- tion equally well. The fplints fhould always be as long as the limb, with holes cut fer the ancles when the fracture is in ths leg. In fractures of the ribs, where a bandage cannot be properly ufed, an adhefiveplafter may be applied over the part. Th-patient( in this cafe ought to keep himfelf quite eafy, avoiding every thing that may occafion faeezing, laughing, cougning, or the like. He ought to keep his body in a ftraight pofture, and fhould tak- c^re . that his ftomach be comtantly diftended, by taking frequently fome ' light food, and drinking freely of weak watery liquors. The moft proper external application for a fracture is oxycrate or a mixture of vinegar and water. The bandages fhould be wet with this at every drefling. OF STRAINS. STRAINS are often attended with worfe confequpnees than l broken bones. The reafon is obvious ; they are generally negleft- ed. When a bone is broken, the patient is obliged to keep th^ member eafy, becaufe he cannot make ufeof it; but w^en a joint is oaly ftrained, the perfon finding he can ftill make a fhift to move it, is forry to 1 fe his time for fo trifling an aliment. 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 wa- ter. This is very prop r provided it be done immediately, and not kept in too long. , But the custom of keeping the part immerfed in cold water for a long time is certainly dangerous. It relaxes in- ftead 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 action ofthe parts from increaf- ing the difeafe. It fhould not however be applied too tight. I have frrquently known bleeding near the affected part have a very good effect -, but what we would recommend above all is eafe. It OF RUPTURES. 38? is more to be depended on than any medicine, and feldom fails to remove ihe complaint.* OF RUPTURES. CHILDREN and old people are moft liable to this difeafe.— In the former it is generally occfioned by exceflive crying, cough- ing, vomiting, or the like. In the latter, it is commonly the effect of blows or violent exertions of the ftrength, as leaping, carrying great weights, &c. In both a relaxed habit, indolence, and an oily or very moift diet, difpofe the body to this difeafe. A rupture fometimes proves .fatal before it is difcovered.— Whenever fuknefs, voniiting, and obftinate crftivenefs give reafon to fufpect an obftruction of tne bowels, all thofe places where rup- tures ufuaily happen ought carefully to be examined. The protu- fion of a very fmall part of the gut will occafion all thefe fymptoms, and if not re urned in due time, willprv, fatal. On the firft appearance of a rupture in an infant, it ou^l.t to be laid upon its back, with its head very low. While in this pofture, if the gut does not return of itfelf, it may eafily be put up by gentle preflure. After it is returned, a piece of flicking plafter may be ..applied over the part, and a proper trufs or bandage muft be con- • ftantly worn for a confiderable time. The method of making and \ applying thefe rupture bandages f r children is pretty well known. '» The child muft, as far as pofla le, be kept from crying, and from . all violent exertions, till the rupture is quite healed. In adults, when the gut has been forced down with great vio- lence, or happens from any caufe to be inflamed, there is often ' great difficulty in returning it, and fometimes the thing is quite im- practicable without an operation ; a defcription of which is foreign to our purpofe. As I have been fortunate enough, however, al- ways to fucceed in my attempts to retsrn the gur, without having recourfe to any other means than what are in the power of every man, I fhall briefly mention the method wl.ich I generally purfue. After the patient has been bled, he muft be hid upon his back, ■ with his head very low, and his breech railed high with pillows.— In this fituation flannel cloths wrung out of a decoction of mallows and camonfle ft wers, cr, if thefe are not at hand, of warm water, muft be applied for a confiderable time. A clyiter made of this decocVon, with a hrge fpoonful of butter and an cunce or two of fait, may be afterwards thrown up. If tke'fe fhould not prove fuc- cefsful, rtc urfe muft be had to preflure. if the tumour be very hard, confioerable 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 p lms of his hands, muft with his fingers artfully conduct the gut in by the fame aperture through which it came out. The manner of doing this can be much eafier convey- ed than defcribed. Should, thefe endeavours prove ineffectual, clyf- • A great many external appicat*ons are tecommended for drains, fome of which do good, and others hurt. The following ae Ajc > as may be ufed with the greateft fafety, %lg. poultices made of dale beer or vinegar and c.:-me3l, cam: horatej I:- rits of wine. Mindcr- nothing of the matter, he is given over for dead, and no further • notice taken of him. This conduct feems to be the refult of igno- rance, fupported by an ancient fuperftitious notion which forbids the body of any perfon killed by accident to be laid in an houfe that is inhabited. What the ground of this fuperftition may be, we fhall not pretend to inquire ; but furely the conduct founded upon. it is contrary to all the principles of reafon, humanity, and common fenfe. When a perfon feems to be fuddenly deprived of life, our firft - bufinefs is to inquire into the caufe. We ought carefully to ob- ferve whether any fubftance be lodged in the windpipe or gullet; and if that is the cafe, attempts muft be made to remove it.— When unwholefome air is toe caufe, the patient ought immediate- ly to b3 removed out of it. If the circulation be fuddenly ftopped from any caufe whatever, except mere weaknefs, the patient fhould be bled. If the blood does not flow, he may beimmerfed in warm water, or rubbed with warm cloths, &c. to prince the circula- tion.* When the caufe cannot be fuddenly removed, our great aim muft be to keep up tAe vital warmth, by rubbing the patient with ' hot cloths, or fait, and covereing his body with warm fand, allies" or the like. ( I fhould nowpioceed to treat more fully of thofe accidents, which without immediate afliftance, would often prove fatal, and to point out the moft likely means for relieving the unhappy fuffer- ers; but as I haveboen happily anticipated in this part of my fnb- . I ject bV the learned and hum me Dr. Tiflbt, I fhall content rnyfelf • with fele&ing fuch of his obfervations as feem*to be the moft im- portant, aad adding fuch of my own as have occured in the courfe ofipractice. OF SUBSTANCES STOPT BETWEEN THE MOUTH AND STOMACH. THOUGH accidents of this kind are very common, and ex- twmily dangerous, yet they are generally the effect, of carleffhefs. Chili! Fea fhould be taught to chew their food well,and to put nothong into their mouths which it would be dangerous for them^ to fwal- • low. But children are not the only perfons guilty cf this pirce of imprudence. I know many adults who put pins, nails, and other ' fharp-pointed fubftances into their mouths upon every occafion,and fome wko even fleep with the former there all night. This con- duct is exceedingly injudicious, as a fit of coughing, or twenty lother accidents, may force over the fubftance before the perfon is awarj.* When any fubftance is retained in the gullet, there are twp ways of removing it, viz. either by extracting it, or pufh.ng it down. The fafeft and moft certain way is to extract it ; but this is not always the eafieft; it may therefore be more eligible fome- • A woman in one ofthe hofpitals of thi* city lately difchswged a great number of pus* •■»'.'::h Ihe had (wallowed in i':r. c^wfs of her bufintf*, through, an ul«r iu her £ae» 39& SUBSTANCES BE'i whhN MOUTH tjf STQMACH. times to thruft it down, efpecially when the obftrufting body is of fuch a nature, that there is no danger from its reception into the ftomach. The fubftances which may be pufhed down without danger, are all common nourifhmg ones, as bread, fl^h, fruits, and the like. All indigeftible bodies, as cork, wood, bones, pieces of metal, and fuch like* ought if poffible to be extracted, efpecially if thefe bodies be fharp pointed, as pins, needles, fifh-bones, bits of glafs, &c. When fuch fubftances have not paffed in too deep, we fhould endeavour to extract them with our fingers, which method often fucceeds. When they are lower, we muft make ufe of nippers, or a fmall pair of forceps, fuch as furgeons ufe. But this attempt to extract rarely fucceeds, if the fubftance be of a flexible nature, and has defcended far into the gullet. If the fingers. and nippers fail, or cannot be duly applied, crotchets, a kind of hooks, muft be employed. Thefe may be made at once, by bending a piece of pretty ftrong iron wire at one end, it muft be introduced in the flat way ; and for the better con- ducting it, there fL«ould likewife be a curve or bending at the end it is held by, to ferve as a kind of handle to it; which has this fur-. ther ufe, that it may be fecured by a firing tied to it, a circumftance not to be omitted in any inftrument employed on fuch occafions, to avoid fuch ill accidents as have fometimes enfued from thefe instru- ments flipping out of the operator's hand. After the crotchet has paffed oelow the fubftance that obstructs the paffage, it is drawn up again,and hooks up be body along with it. Thecrotchet is alfo very conve ient, when a fubftance fomewhat flexible, as a pin, or fifh-, bone sticks acrofs the gullet, the hook, in fuch cafes, feizing them' about their nvddle part, crooks and thus difengages them; or, if they are very brittle fubftances, ferves to break them. When the obstructing bodies are fmall, and only ftop up apart ofthe paffage, and which may either eafily elude the hook, or ftraigfit en it by their refiftance, a kind of rings, made either of wire, wool, or filk, may be ufed. A piece of fine wire of a proper length may be bent into a circle, about the middle, of about an inch diam- eter, and the long unbent fides brought parallel, and near each other : thefe are to be held in the hand, and e circular part or ring introduced into the gullet, in order to be conducted about the ob- structing body, and fo to extract it. More- flexible rings may be made or wool, thread, filk, Or fmall pack-thread, which may be waxed for their greater strength and confiftence. One of thefe is to be tied fail to a handle of iron wire, whalebone, or any kind of flexible wood, and by this means introduced, in order to furround the obftrudting fubftance, and to draw it out. Several of thefe rings paffed through one another may be ufed, the more certainly to lay hold nf the obftructingbcxryj which may be involved by one, if another fhould mifs it. Thefe rings have one advantage, which is, that when the fubftance to be extracted is once laid hold of, it may then, by turning the handle, be retained fo ftrcngly in the ring thus twifted, as to be moved every way, which muft in many cafes be a confiderable advantage. SUBSTANCES BETWEEN MOUTH & STOMACH. 3^1 Another material employed on thefe unhappy occafions, is the A fponge. Its property of fwelling confiderably on being wet ^ is the [y princip I f »undatJon of its ufef ulnefs here. If any fubftance is firpt ' in the gullet, but wi hout fillirg up the whole pillage, a bit of fponge may be introduced into that part which is unftopt, and be- yond the fubftance. The fponge foon dilates, and grows larger in this moift fituation ; and indeed the, enlargement of it may be for- warded by making the patient fwallow a few drops of water. Af- terwards it is to be drawn back by the handle to which it is fatten- ed ; aid as it is now too large to return through the fmall cavity by which it was conveyed in, it draws out the obftructing body along with it. The comprcflibility of fponge is another foundation of its ufe- • fblnefs in fuch cafes. A pre> ty large piece of fponge may be com- preffed Or fqueezed into a fmall fize, by winding a firing of tape clofely about it, which may be eafily unwound, and withdrawn, after the fponge has been introduced. A bit of fponge may like- wife be compreffed by a pfxe of whale-bone fplit at one end; but this can hardly be introduced in fuch a manner as not to hurt the patient. I have often known pins and other fharp bodies, which had k fluck in the throat, brought up by caufiag the perfon to fwallow a bit of tou^h meat tied to a thread, and drawing it quickly up again. | This is fafer than fwallowing a fponge, and wUi often anfwer the 1 purpofe equally well. When all thefe methods prove unfuccefsful, there remains one more, which is, to make the patient vomit; but this can fcarcely be of any fervice, unlefs when fuch obftructing bodies are fimply engaged in, and not hooked or fluck into the fides of the gullet, as in this cafe vomiting might fometimes occafion further mifchief.— If the patient can fwallow, vomiting may be excited by taking half a drachm or two fcruphs of ipecacuanha in powder made into a draught. If he is not able to fwallow, an attempt may be made to excite vomiting, by tickling his throat with a feather ; and, if that fhould not fucceed, a clyfter of tobacco may be adminiftered. It is made by boiling an ource of tobacco in a fufficient quantity c£ water; this has often been found to fuceed, when other attempts to excite vomiting had failed. , When the obftructing body is of fuch a nature that it may with fafety be pufhed downwards, this may be attempted by means of a wax-candle oiled, and a little heated, fo as to make it flexible ; or a piece of whale-bone, wire, or flexible wood, with a fponge fast- ened ro one end. Should it be impoflible to extract even thofe bodies which it is dangerous to admit into the ftomach, we muft then prefer the leaft of two evils, and rather run the hazard of pufhing them down thaa fuffer the patient to perifli in a few minutes ; aud we ought to fcruple this refolution the lefs, as a great many inftances have hap- pened, where the fwallowing of fuch hurtful and indigeftible fub- ftances have been followed by no diforder. Whenever it is manifeft that all endeavours, either to extra?- $>2 OF DROWNED PERSONS. or pufh down the fubftance, muft prove ineffectual, they fhould be ., difconrinued ; becaufe the inflammation occafioned by perfifting in 4 them might be as dangerous as the obstruction itfelf. Some have died in confequ?nce ofthe inflammation, even after the body which * caufed the obftrudtion had been entirely removed. While fhe means recommended above are making ufe of, the patient fhould often fwallow, or, if he cannot, he fhould frequent- ly receive by injection through a crooked tube or pipe that may* reach down to the guilet, f >me emollient liquor, as warm milk and ( water, barley- ^ater, or a deco&ion of mallows. ' Injections of this kind not only (often and footh the irritated parts, but, when thrown in with force, are often more fuecefsful in loofening the obstruction than all attempts with instruments. When, after all our endeavours, we are obliged to leave the obOructing^bodyinte part, the patient muft be treated as if he had an inflammatory difeafe. He fhould be bled, kept upon a low diet, ar.d ' ave his whole oeck furrounded with emollient poultices. The like treatment muft alfo be ufed, if there be a»y reafon to fuf- pect an inflammation of the paffages, though "the obftructing body be removed. A proper degr.e of agitation has fometimes loofened the in- hering body more effectually than inftruments., Thus a blow on the b:;ck his often forced up a fubftance which fluck in the gullet; but this is It'll more proper and efficaci ius when the fubftance gets into the wind-pipe, in this cafe vomiting and fneezing are likewife to be excited. Pins which ftuck in the gullet have been frequent- ly difcharged by riding on horfeback, or in, a carriage. When any indigeftible fubftance has been forced down into the ftomach, the patient fhould ufe a very mild and fmooth diet, confining chiefly of fruits and farinaceous fubftances, as puddings, pottage, and foups. He fhould avoid all heating and irr'tating thin r*. as wii)e, pinch, pepper, and fuch like ; and his drink fhould be milk an- warer, barley-water, or whey. When the culletis io ftronglyand fully clofed, that the patient can receive no food by the mouth, he muft be nourifhed by clyfters of fcup, jelly, and the l;ke. When the patient is in danger of being immediately fuffocared, and all hope of freeing the poffage is vanifhed, fo that death feems at hand, if refpiration be not restored ; the operation of bronchotomy, or openrg the wind-pipe, muft be directly performed. As this operation is neither dinrult to an expert furgeo", nor very painful to the patient, and is often the only method which can be taken to preferv? life in thefe emergencies, we thought proper to mention it, though it fhould onlv be attempted by perfons (killed in furgery. OF DROWNED PERSONS. WHEN a perfon has remained above a quarter of an hour under water, there can be no confiderable hopes of his recovery.«^- But as feveral circumftances may happen to have continued life, in fuch an unfortunate situation, beyond the ordinary term, we ftiould never too foon refign the unhappy object to his fate, but try every OF DROWNED PERSONS. v 395 » method for his relief, as there are many well attested proofs of the I recovery of perfons to life and health who had been taken cut or the water apparently d^ad, and who remained a confiderable time r; without txhibiting any figns.cf life. • The firft thiag to be done, after the body is taken out of the water, is to convey it as foon as poffible to feme convenient place where the neceflary operations for its recovery may be performed. In doing this, care muft be tak^n not to bruife or bjure the body by carrying it in any unnatural pofture with the head downwards, or the like. If an adult bedv, it ought to be laid on a bed, cr on ftriw with the head a little railed, and carried en a cart cr men's. Ihpuliers, and kept in ns natural and eafy a pofition as pcffible.— A fmall body may be carried in the arms. Inattenip-in;?; to recov r perfons apparently drowned, the prin- cipal isoicntion to be purfued is, to reftore the natural warmth, upon whic'.i all the vital functions depend ; and to excite tbefe functions by the application of stimulants, not only to the fkin, but likewife to ti.e lungs, intestines, Sec. # Though cold was by no means the caufe ofthe perfon's death^ yet it wiii prove an effectual obftacie to his recovery. For this rea- fon, ftrippihg him of his wet clothes, his body muft be strongly rub- bed for a confiderable time with coarfe linen cloths, as warm as i they can be made; and, as loon as a well-heated bed can be got [ ready, he may be laid in it, and the rubbing should be continued. Warm cloths ou ht likewife to be frequently applied to the ftomach and bowels, and hot bricks, or bottles of warm-water, to the foles of his feet, and t > the palms of his hands. Strong volatile fpirits fhould be frequently applied to the nofe ; an/l th i lpiue ofthe back and pit of the ftomach may be rubbed with warm oraudy cr fpirit of wi e. The temples ought alfo to be chafed with v datile fpirits; and ftimulating powders, as that of to* bacco or marjoram, may be blown up the noftrils. To renew the Dreaihing a ftrong perfon may blow his own breath into the patient's mouth with ail the force he can, holding his noftrils at the fame time. When it can be perceived by the rifing . of i no chelt or belly that the lungs are filled with air, the perfon ou0ht to d-.-fi''r fr'/in obwing, and fhould prefs the breast ar.d belly fo as to: xpol tne air again ; and this operation may be repeated for fome time, alternately inflating and depreiTmg the lungs fo as to imitate natural refpiration. If the lu- a> cannot be inflated in this manner, it may be at- tempted by bio vving through one ofthe noftrils,and at the fame time keeping the other dofe. Dr. Monro for this purpofe recommends a wooden pipe fitted at one end f r filling the nostril, and at toe other for being lown Into'by a periods moi>th,or f t receiving t epipe of a pair of o-flows, to be employed for the fame purpofe,if neceflary. Wii n air caonot be forced int.- the cheft by the mouia or nofe, it may be neceflary to make an opening into the wind-pipe for this purpofe. It is needlefs, however, to fpend time in defcri- buig this operation, as it fhould not be attempted i^fefs bv perfons i;oiled in lurgery. 394 * OF DROWNED PERSONS. To stimulate the inteftines, the fume of tobacco may t e thrown up in form cf clyfter* There are various pieces cf appara- tus contrived for this purpofe which may be ufed wh-n it hand; but whsre thefe caun ;t be obtained, the bufinefs may be done by a common tobacco pipe. The bowl'of the p'pe muft be filled with tobacco well kindled, and, after--'..e fmall tube has been introdu- ced into the fundament, the fnmak may be forced up by blowing t rough a piece of paper full of holes wrapp?d round the mouth cf the pipe, or by blowing through an empty pipe, the mouih of which is applied clofe to that of the other. 'T his may alfo be done i: the following manner: A common clyffer-pipe with a tag nru t -d upon it may be introduced into the fuodament, and the mcu*h of the bag may be applied round the fmall end of a tobacco- pipe, i.i t;ebrwl of which tobacco is to be kiodled, and the fmcke blown up as directed above. Soould it be f und impracticable to throw up the fmoke of tobacco, clyfters cf warm water, with the addition ^ a little fait and fome wine or fpirits, may be fr. qu ntly adminiftePd. This may be done by a common clyfter-bag and .pip?; but, as it ought to be thrown well up, a pretty largeTyringe will anfwer the purp fe better. WTiile thefe things are doing, fome ofthe attendants ought to be preparing a warn bah, into which the perfon fhould be put, if fhe above endeavours prove ineffectual. Where there are no con- veniences for ulng the warm bath, the body may be covered with warm fait, fand, allies, grains, or fuch like. Tiflbt mentions an in- ftance of a girl who was reftored to life, af er fhe had been taken out of the water, fwelled, bloated, and. to all appearance dead, by laying her naked body upon hot afhes, covering her with others equally hot, putting a bonnet round her head, and a ftocking remd her reck, fluffed with the fame, and heaving coverings over all. After file had remained half an hour in tins fituation, herpulfe re- turned, fiie recovered fpeech, and cried cut, I freeze : I freeze: a litth cherry-brandy was given her, and fhe remained bu ied as it were under the afhes for eight hours ; afterwards fhe was taken cut, without any other complaint except that of laflif ude or weari- v nefs, which went off in a few days. 1 he Doctor mentions Ikewife an inftance of a man who was reftored to life, after he had remain- ed fix hours under water, by the heat of a dunghill. Till the patient fhews fome figns of life, ahd is able to fwallow, it wculd beufelefsand even dangerous to pour liquors into h'\s noutli. His lips however, and tongue, may be frequently wet" with a feather dipt in warm brandy or ether nrong fpirits; and, as fben as, he has recovered the power cf fwallowing, a little warm wine, or fome other cordial, ought every now and then to be ad- miniftered. Some recommend a vomit after the patient is a little re-anima* ted ; but if he can be made to puke without the fickening draught, it will be more fafe j this may generally be done by tickling ihe throat and fauces with an oiled feather, or feme other foft fub- ftance, which will not injure the parts. Tiflbt in ihis cafe recom- preods the cxvmel of fquills, a table-fpoonful of which, diluted with OF NOXIOUS VAPOURS. 39$ water may be given every qurter of an hour, till the patient has taken'five or fix d'fes.' wn- re that medicine is not at hand, a ftrong infufion of fage, carlomile fleers, or cardas benediclus, fweet- ened w th oin-?y. or fome warm wrter, with the addition of a lit- tle fait, may, he fays, fupply its place. The Doctor d jes not intend that a-;y of '.hefe things fh uld be given in fuch quantify as to oc- Galion vomiting. He thinks emetics in this fituation are not expe- We are by no means to difcontinue our • fliftance as foon aj. the. patients difcover feme token* of life, fince they fometimes ex- pire after thfe firft appearances of recovering. The wa-m and ftimulating applications are ftiil to be continued, and fmall quanti- ties of fome cardial liquor ought frequently to be admioiftered.—- Laftly, though the perfon fh uld be mmifeftly re-animated, tli^re fometimes remans an oppreffion, a c. ugh, and fever:flmefs, which effectually conftitute a difeafe. in this cafe it will be neceflary to bleed the patient in the arm, and to caufe im to drink plentifully of barley-wacer, elder-fl wer-tea, or any ot er foft pectoral infu- fions. Such perfons as have the misfortune f> be depriv d ofthe ap- pearances of life, by a fall, a bl w, fuff cati n, or the like, muft be treated nearly in the fame manner as thofe who have been for feme time under water, i once attended a pati -nt who was fo fru :ned by a fall from a h ^rfe, that for above fix hours he fcarcely exhibi- ted any figus of life; yet this man, by being bled, and pr per methods taken to k- p up the vit«l warmth, recovered, and in a few days was perfectly well. Dr. Alexander gives an inftance to the famepurp fe in the E inburgh Plnfioal and Literary Eflays, of a man who was to all appearance killed by a blow on the breaft, but reco.ered upon being immerfed for fometime in warm water. Tnefe, and other inftances of a fimilar nature, which might be ad- duced, amouit to a full proof of t' is fact, that many of thofe un- happy perfons who lofe their lives by fails, bfews, and other acci« debits, might DC faved by the ufe of prober means duly perfified L'i. OF NOXIOUS VAPCURS. AIR may be many ways rendered noxious, cr even deftructiy i to animd . This may either h ppon from its vivifying principle being deffroyed, or fr m fubile ex .alati^ns with which it is impreg- nated-. Thus air thu hasp-fled!hrougn burning fuel is i.either capable of fupp irting fire ..or tne life of ani oah. Hence the dan- ger of fleeping in cl fe chambers with coal fires. Some indeed fuppofe the a ger ere proceeds from the fulphurecus oil contain- ed in the coal, which is fet at liberty and diffufed all over tie cham- ber ; while ouiers imagine i> is owing to the air of the'room being charged witn phlogiston. Be this as it may, it is a fituation care- fully to be avoided. In feed ii is dangerous to fleep in a final! apartment with afire of aoy kind. 11 tely faw four perf ns wno had been fuftbeated by fleeping in an apartment where a imall fir• o: coal had been left burning. - The vapour which exhale fram wins, cyder, beer, or cttv:: 39$ OF NOXIOUS VAPOURS. liquors in the ftate of fermentation, contains fmething poifonous, which kills in thejaoiemonn-r a? the . a pour of coal. Hence th-re is always danger in going into cellars where a la-ge quantity cf thefe hqu-rs is in a ftate of fomentation, efpecially if they have been clofe fhut up for fome fime. There have been mar.y instances ofn. rf'-o$ itnrk dead on entering fuch places, and of ethers who have wifh difiic'ilfy efc pe'. When fubterrar.eous caves, that have been very lo~g fhut, are cpene1, or when deep" wells ave cleaned, wllch hwe not Ireu ctnpried Pr feveral years, the vapours ?r:ling from them produce the fame effects as thofe mentioned 3bove. ¥■ t this r.»af.-n no per- ibii oiv-l-t to ve.-rureint? a well, pit, a far, or my rb e 'hat is ca-no, and has been long (out up, ti'l the air has been fufficiently purified^bv burning gunpowder in ir. It is eafy to know, as has or en o' ferve.. in a former p?rt of this w.--rl», when th-* air of fuch places is unwholefome, }>y letting down ahghted candle, tl rwing in burning furl, cr the Ike. If thefe continue to burn, people may fafely verruve in ; but w ere they are fuddenlv extinguifhed, no one cor hr ro erter f 11 toe a;r h s been firft purified by fire. Toe offenfive fVell of lamps and. of candles, efpecially when their flames are extingoifh d, operate like ether vap urs, 'hough with lefs vi lence, a. d lefs fuddenly. There have however been inftance? of people 'k'lfed by ihe fumes of lamps which hrd b^en extin.^uifh^d in a clofe chamber, and pe'-fr^? of weak delicate breafts generally find t'emfelves quickly oppreffed in apartments illuminated with many candles. Such "s ore fenfible of their danger in thefe fituations, and re- treat feafenaMy from it, r'r» generally reli-ved as foon as they get into the pf Yeroce turpentine diffolved in the yolk of an egg.-— Should thefe thine;* nor b'j at hand, two or three large fpoonsful cf convnen felt may be put into the clyfter. The fame means, if ne- ceffary, v/hich were recommended in the former p-'rt of this chap- ter, mav he ufed to reftore the circulation, waiWh, Sec. Mr. Toffich, furgeon at Alloa, relates the Mte of a man fuf- focatec! by the fteam of burring coal, whom he recovered by blow- ing his breath into the patient's mouth, bleeding him in the arm and cttuifiug him to be well rubbed and tolled about. And Pr, .Fre* EFFECTS OF EXTREME COLD. 397 wen, of Suffex, mentions the cafe cf a young man who was fti-pt- fied by the fmokeof fe;.-coni, Vit was recovered by being plunged into cold water, and afterwards laid in a warm bed. Th; practkeofpluVi g perfor.s luff cooed.by noxious va- pours in cold water, would leem to ■ e fupport-.1 by the common exrtriono.ntof fuffccatiog dogs ;n ih?grcfh del am, and> afterwarus lecovcring them, by thr.wi -g them into the neighbouring lake:. EFFECTS OF EXiREME COLD. WHEN col \ is ;-xrrem-.dy fevere, and a perl n\s expofed to it for a beg time, it prov€S mor al, in c-r feqner.ee of its ftopping the circulation in the ex< remit ies, and. forcing too great a proporvon cf blooi towards the brain ; lo that the p-ifent oics or a Kir-d cr a?o?l xv, preceded bv great fieepir.efs. 1 he traveller,in this fix- ation, whi fiods himfelf begin io grow drowfy, :hoo.;o redouble h's efforts to extricate himfelf from the imminent danger he :.s ex- pofed f>. T"is fleep, w.-io he mig-.t confider as fome alleviation of his fuff rings, w -in d, if indulged, prove his laft. Such violent e-lefts of cold are happily not very common have oh'-owed, when his hands were ev-n butfligh ly affected wih coll, that the beft way to warn them was'by wafhing them in cold water, and continuing ■ to rub them- well for feme tin e. When a oe-fnn his been fo long exp .fed to the cold, tn?^. all appearances of life are . g ne, it- wnl.be nereis1 -o^ to rub him ad over with fnew cr col I water ; cr, whit will anfwer tetter, if it can be ob onned, to immerfe him in a bath ofthe very coldeft y. ate:;. There is the greateft encouragement to perlift in the ufe of tncle m^ns, as we are affur?-* that perfons who had remained in the fnow, or riad been exoofe \ to t-e freezing air during five or fix fuc- ' ceffive days, and-wno had difcover ed no maiks of life for feveral hours, have nevertheless been revived. lJ ; I have always thought that the whitloes, kibes, chjlblams, ana 30* EFFECTS, OF EXTREME HEAT, 6c. ether infhmma ions ofthe extremities which arefo common amon^ the peafants in the cold feafon, were chiefly cccafioned by their fudden tranfitions from cold to heat. After they have been expo- fed to an extreme d-gree of cob', they immediatdy apply t'eir , hands and feet to the fire, or, if they h.iv- occafion, plunge them ' into warm wattr, by wheh means, if a mortification do-s not hap- pen, an inflammation feldom fails to enfue. M^ft if 'he ;11 confe- quences from this quarter might be eafily avoided, by only obier- ving the precautions men iont d above. EFFECTS OF EXTREME HEAT. THE effects of extreme heat, though not fo common in this eountrv, a'renokfs fat .1 at a\ much more fudden tlnr thofe f cold. In hct c untries people frequently drop down dead in th ftrtets, exhaufted wih heat and fatigue. In t;,!s cafe, if any warm cordial can be poured into the mouth, it ought f*"> be done. If this cannot be effected,, thev may be thrown up in form cf a clyfter. Volatile fpirits and other things of a fli ulating nature, may Ke applied to the fldn, which fhould be well rubbed with.coarfe cbths, whipped with nettles, cr other stimulating things. Some of toe ancient phy- , ficians are faid to have reftored to life perrons apparently dead by beating them wih rods. CHAP. LVII. OF FAtNTING FITS, AND OTHER CASES WHICH REQUIRE IMMEDIATE ASSISTANCE. OTOONG ani • eahhy perfons, who abound with Hood, are often feized with fudden fainting fits, after vie lent exercife, drinking freely of warm or ftrong liqucrr, expofure to great: eat, intenfe application to ftudy, or the like. In fuch cafes the prtti Tit fliould be made to fir ell fo fomevinegar* His temples, forehead and wrifts, cught at the fame time to be bathed with vinegar mixed with an equal quant ly cf warm _ water; and tv/o cr three fpxmsful of vinegar, with fcurr five times as much water, may, if he can fwaibw, be poured ioto h:s mouth. If the fainting proves obftinate, cr degenerates ir.to zjyncope, that is, an aboliti n of feeling and underftandirg, the patient rruft be bled.. After the bleeding* a clyfter will be proper, and then te fliould be k*pt eafy and quiet, onlv giving him every half hour a cup cr twd of an infufion cf any mild vegetable, with the addition of a l'-ttle fugar and vinegar. When fwoonings whi'h arife from this caufe, cccur frequent- ly in the fame perfon, le fhould, in order to efcape 'hnn, cpfifinc himfelf to a light diet, confifting chiefly of bread, fruits, and other vegetables. His drink ought to be w *er cr fmall beef, acd he fhould fleep but moderately, and take much exercife. But fainting fits proceed much crener from a defect than an excels cf blood. Fence they are very ready to happen after great evacuations of any kind, obftinate watching, want of appetite, c: ' Inch like. In thefe, an almoft dh-eifly oppofite courfe to that men* tioned above, muft bs purfued. OF FAINTING FTTS, 6c. 399 The patient fhould be hid in bed, with his head low, and be- ing covered, fhould have h»s legs, thighs, arms,andlvs whole body rubbed flrongly with flannels. ^ Hungary-water, volatile falts, or ftrong fmelling herus, as rue, mint, or rofemary, may be held to i his nofe. His mout.* may be wet with a little rum cr brandy ; and if he can fw How, fome hot wine, mixed with fugar and cinna- mon, which is an excellent cordial, may be poured into lis mouth. A comprefs of fl. nnel dipt in hot wine Or brandy muft o-e applied to rhe pit of his ftomach, and warm bricks, cr bottles filled with hot wat'r 1 id to his feet. As foon as the patient is recovered a little, he fhould take fome , ftrong toup or broth, or a little bread or bifcuit foaked in hot fpiced wine. To prevent the return of the fits, he ought to take often, but in fmall quantities, feme light yet ftrengthening ncurifhment, as panada, made with foup inftead of water, new laid e: gs lightly po-died, chocolate, light roaft meats, jellies, and fuch like. Thofe fainting fits, whic. are the effect of bleeding, or of the violent operation of purges, belong to t'nis clafs. Such as happen. after artificial bleediog? are feldom dangerous, generally terminating as foon as the patient is laid upon the bed; indeed periods fubj cc to this kind fhould always be bled lying, in order to prevent it. Should the fainting howev r continue 1 nger than ufual, volatile fpirits may be held to the nofe, and rubbed on the temples, &c. When fain ing is the effect of too ftrong or acrid purges or vomits, the patient muft be treated in all refpects as if he had tak- ea poton. He fhould ^e made to drink plentifully ot milk, warm water, and cil, b.rley water, or fuch like emollient clyfters will likewife be proper, and the patient's ftrength fhould afterwards be recruited, by giving him generous cordials, and anodyne medicines. Fain tings are often occafioned by indiafftion. This may either proceed from the quantity or quality ofthe food. When the former cf • hefe is the caufe, the cure will be beft performed by vomiting, which may be prom 'ed by caufing the patient to drink a weak infufion of camomile-flowers, carduus beneditlus, cr the like. Wh n the: diforder proceeds from the nature of the food, the patient as in the cafe cf weaknefs, muft be revived by fir r»g fmells. Sec. after which he fhould be made to fwallow a large quanti- ty of light warm fluid, which may ferva to drown, as it were, Me offending matter, to foften its acrimony, and either to effect p. dif- ci.arge of it by vornitirg, cr force it down into the inteftines. Even difagreeable write will fometimes occafion fwoonings, efpecially in people of weak nerves. When this happens, the pa- tLnt fhould te carried in the opeu air, have ftimulating things held to his nofe, and ti^ofe fubftances which are difagreeable to him ought immediately to be removed. But we have already taken notice of fwoonings which arife from nervous diforders, and ifoall therefore fay no more upon that head. Fainting-fits often happen in the progrefs of difeafes. fa the beginning of putrid difeafes they generally denote an oppreffion, at the ftDmach, cr a mafs of corrupted humours, and they ceafe after evacuations either by vomit or ftool. When they occur it the be- 400 0FJ FAINTING FITS, 6c. ginning of malignant Yevers, they indicate great danger. In each of thefe cafes, vinegar ufed both externally and internally is the beft remedy during the paroxyfm, and plenty of lemon juice and water after it. Swoonings which happ-jn in.chTeafes accompanied with great evacuations, muft be treated like thofe wricti are owing to weaknefs, and the evacuations ought to be reftrained. Whon they happen to !/ards the end cf a violent fit of an intermitting fever, or at that of each exacerbation of a continual fever, the patient muft be fupported by fmall draughts cf wine and water. Delicate and hyfteric women are very liable to fwoonirg or fainting fits after delivery. Thefe migo.t be often p.evemcd by gen- erous cordials, and the admiflion of frefh air. When they are oc- cafion od oy exceffive flooding, it cughtby all means to be restrain;d. They are generally the effect of mere weaknefs or exhauflion. i>r. Engleman, relates the cafe of a w-man "'in child-bed, who, after having been happly delivered, fuddenly fainted and lay upwards pf a quarter of an hour apparently dead. A phyfi. ian was lent for; her own maid in the mean while,being out of patience at his delay, attempted to aflift her herfelf, and extending herfelf upon her rr.if- trefs, applied her mouth to her's, blew in as much breath as fhe pcf- fibly could, and in a very fhort time the exhausted woman awaked as out of a profound fleep ; when pr per things.being given her, ihe foon recovered. " The maid being afked how fhe came to think of this expe- . dient, faid fhe had feen it practifed at Altenburgh, by midwives, upen children, with the happieft effett." We mention this chiefly that other midwives may be induced to follow fo laudable an example. Many children are bom with- out any figns of life, and others expire focn after, their b;rth, woo might wirhout all ttoubt, by proper care, be reftored to life. From whatever caufe fainting-fits proceed, frefh air is always of the greatest importance to the patbnt. By not attending to this icircumftance,. people often kill their friends when they are indeav- ouring to fave them. Alarmed at the patient's fituation, they call in a crowd of people to his afliftance, or perhaps to witnefs his exit, whofe breathing exhaufts the air, and increafes the danger. There is net the leaft doubt but this practice, which is very common among thejower fort of people, often proves fatal, efpecially to the delicate and fuch perfons as fill into feinting fits from mere ex- hauttion or the violence of fome difeafe. No more perfons ought ever to be admitted into the room where the patient lies in a fwoon than are abfolutely neceflary for his afliftance, and the windows of the apartment should always be opened, at leaft as far as to admit a ftream of frefh air. Perfons fubject to frequent fwoonings, or fainting-fits, fhould neglect no means to remove the caufe of them, as their confequen- ,ce;s are always injurious to the conftitution. Every fainting-fit leaves the perfon in dejection and weaknefs; the fecretions are tfiereby fufpended, the humours difpofed to stagnation, coagula- tions and obftructions are formed, and if the motidh of the Wood ft s -lotalty intercepted, or very cjoafiderably ebscked, pchpufes are OF INTOXICATION. 4d Jfometimes formed in the heirtor larger veffels. The only kind of fwoonings not to be dreaded are thofe which fome time mark the crifk in fevers; yet even thefe ought, as foon as poffible, to be removed, OF INTOXICATION. • THE effects of intoxication are often fatal. No kind of poif- on kills v.icfi certainly than any over dofe of ardent fpirits. Sometimes, by deftroy ing the nervous energy, they put an end to life at once; but in general their effe&s are i.ore flow, and in ma- ny refpects fimilar to tnofe of opium. Other kinds of intoxicating li- quors may prove fatal when taken to excels, as well as ardent fpirits; but they may generally be difcharged by vomiting, which ought al- ways to be excited when the ftomach is over-charged with liquor. More of thofe unhappy perfons, who die intoxicated,, lofe their lives from an inability to conduct themfelves, than from the destructive quality of the liquor. Unable to walk, they tumble down, and lie in fome awkird pofture, which obstructs the circula- tion or breathing, and often continue in this fituation till they die. No drunken perfon fhould be left by himfelf, till his clotnes have been loofened, and his body laid in fuch a pofture as is moft favor- able for continuing the vital motions, difcharging the contents of the ftomach, &c. The beft pofture for difcharging the contents of the ftomach is to lay the perfon on his b-tly ; when afleep he may be laid on his tide, with his head a iittie railed, and particular care mult be taken that his neck be no way bent, twifted, or have any ti'Jng too tight about it. The exceffive degree cf thirft occafioned by, drinking ftrong liquors, often induces people to que ich it bv taking'what is hurr- Bful. I have known fatal confequences even from drinking freely "of milk after a debauch of wine or four punch; thefe acidliquors, together with the heat of the ftomach, having coagulated the milk in fuch a manner that it ccu'd never be digefted. 1'he fafeft drink after adebau h is water with a toaft, tea, infufions of bain, (age, barley-water, and fuch like. If the perfon wants to vomit, he may drink a weak infufion of camomile flowers, or lukewarm water and oil; but in thi- condition vomiting may generally be excited by on- ly tickling the throat with the finger or a feather. inftead of giving a^detail of all the different fymptoms of intox- ication wo.ich indicate danger, and propofing a general plan of treat- ment for perfons in this fituation, I fhall briefly rela'e toe hiltory of a cafe which lately fell under mv ownoiofervation, wherein moft of thofe fymptoms usually reckoned dangerous concurred, and where the treatment was fuccefsful. A young m n, about fifteen years of age, had, for a hire drank ten glaffes of ftrong brandy. He foon after fell faft afleep, and con- tinued in that fruition for feveral hours, till at length his uneafy manner of breathi g, the coldnefs of the extremities, and other threatening fymptoms. alarmed his friends, and made them fend for me. I found him ftill fleeping, his countenance ghaftiv, and his fkin covered with a cold clammy fweat. Almoft the only figns of life remainiag were, a deep laborious breathing, and a convulfive motion or agitation of his bowels, 4ez OF SUFFOCATION AND STRANGLING. I tried to roufe him, but in vain, by pinching, fhaking, applying volatile fpirits, and other ftimulating things to his nofe; &c. A few ounces f blood were likewife takon from his arm, and a mixture of vim-gar and water was pmred into his mouth ; but, as he could not fwallow, very lit1 le of this got into the ftomach. None of thefa things having the leaft effect, and the dang :r fetming to increafe, I ordered hjs legs to bs put into warm water, and a fharp clyfter to be immediately adminiftered. This gave him a ftool, and was the firft thing that relieved him. It was afterwards repeated with he iarae happy effe to cure him of an ague, expired under very fimilar circumftances. OF SUFFOCATION AND STRANGLING. THESE may fometimes proceed from an infraction of the lungs, produced by vifcid clammy humours, or fpafmodic affection of the nervs of that organ. Perfons who feed grofsly, and abcund in rich blood, are very liable to fuffecating fits from the former of thefe co.ufes. Such ought as foon as they are attacked, to be bled, to receive an emollient clyfter, and to take frequently a cup of diluting liquor with a little nitre in it. They fhonld like- wife receive the (teams cf hot vinegar into their lungs by breath. ing. Nervous 8e afthmatic perfons are melt fubject to fpafmodic af« fections of the hugs. In this cafe the patient's legs .fhould be im- merfed in warm water, and the fleams cf vinegar applied as above. Wrm diluting liquors fhe uld Ikewife be drank; to a cup of which a tea-fpoonful cf the parygcric elixir may occasionally bead- ded Burnt paper, feathers, cr leather, may be held to the pa- tient's nofe, and frefh a;r fhould be freely admitted to him. -Infants are often fuffocated by the carefeffnefs or inattention of their nurfes.* An infant when in bed fhould always be laid fo that it camct tumble down with its head under the bed-clothes; aniv.hen ii a cradle, its face ought never to be covered. A fm 11 degree cf attention to thefe two fimple rules w uld fave the lives cfmanv infant*, and prevent others from being rendered weak and fickly all their days by the injuries done to their lungs. Inftead of laying down a plan for the recovery of infants, who are fuffocated, or overlaid, as it is ternjed^ by their curies, I fhall give 'he hiftorv of a cafe rehired by IMonfieur Janm, ofthe Royal College cf Su gery at Pari?, as it was attended wain fuccefs, and •Thefe accident* are not a ways the eitirfts of careleflnefc. I hive known an Infan * r.vf rl.iir. by its mutrei being feized in the night with an hyfteric lit. This ought to (trvt as i i mtion a«»inft employing hyfteric women ai nurfej, and fliould likewise teach fufh »<..jk» nevei to lay an icfant in the fame be,d with themfelvej, but io a fmaj. adjacent out.' OF SUFFOCATION AND STRANGLING. 403 pontains almoft every thing that can be done on fuch occafions. A nurfe having had the misfortune to ^v r-lay a hild, he was called in and fouod the infant wituout nv figm of life; no pulf- ation in the artjrfes, n ■> refpiration, the fee livid, the eyes open, dull, and tarmfhed, 'he nofe full of fniv >1, the mouth gaping, in fhorr, it was almoft cold. Wnilfl fome li len clothes and a par- cel of afhes were wanning, he had the boy unfwathed, and laidhim in a warm bid, and on fe right fide. He then was rubbed all over with fine linen, for fear of fretting his tender and delicate fkin. As foon as the afhes had received thtir due degree of heat, Mr. Janin buried him in i-oem,except the face,placed him on the fide oppofite to that on which he had been at firft laid, and covered him with a blanket. He had a bottle cf eau de luce in his pocket, which he prefer.ted to his nofe from time to time ; and between whiles fome puffs -f tobacco were blown up his noiftrils: to thefe fuc- ceeded the bl ^>wing into his mouth, and fqueezing tight his nofe. Animal heat began thus to be excited gradually ; the puliations of the temporal artery were foon felt, the breathiog became more fre- quent and free,and the eyes clofed and opened alternately. At length the chll fetched ^ im cries expreflive of his want ofthe breaft, w ich being applied to his mouth, he catched at it with avidity, and fucked as if nothing had happened to him. Though the pulfa- tions ofthe arteri-s wer- by t is time very well re-eft ac.lifhed, and it was hot weather, yet Mr. Janin thought it advifable to leave his little patient three quarters of an hour 1 nger under the afhes. He was afterwords takin out, denned and dreffed as ufual; to which a gentle fleep fucceed d, and he continued perfectly well. Mr. Jo. in mentions likewife an example of a yourg man who had hanged himfelf through defpair, to whom he adminiftered help as effectually as in the preceding caie. Mr. Glover, Surgeon in Doctors Commons, London, relates the cafe of a perfon who was reftored to life after twenty-nine min- utes hanging, and continued in good heahh for many years after. The principal means ufed to reftore this man to life were, ' opening t e temprol arery and t.e extern: 1 jugular ; rubbing the £>ack. mouth, and nerk,with a quantity of volatile fpirits and oil; ad- ^ miniitering the tobaccc-clyfter by means of lighted pipes.and ftrong frictions cfth.j legs and arms. This couife had been continued! ' for about four hours, when an incifion was made into the windpipe, and air bl wn strongly thrcugh a canuli into the lung?. Aoouc twenty minutes aftc- this, the blood at the artery began to run do. n the facr, and a flow pulfe was juft perceptible at the wrift. The frictions were continued for fome time longer; lis puife be came mere frequent, and Ms mouth and ncfe loeing irritated with fpiri $ offal amoriac, he opened his eyes. Warm cordials were then adminiftered to him, and in two days he was fo well as to be able to walk eigh' miles. Thefe cafes are fuftscient to fhew what may be done for the recovery of thofe unhappy perfons who strangle themfelves in a fit ofclefpair. AH OF PERSONS WHO EXPI&E IN CONVULSION FITS. ^ CONVULSION Its often continue the lit feene of acute orch»- nlc diforders. ' When t'vs is the cafe th-re can remain but fmall hopes ofthe patient's recovery aft-or expiring ia a fit. But when a perfon win appear* to W hi p-rfect hf ahb,is fuddrn.ly fe'zed with a coovulfion fit, and feems to exph\°, fome attempts ought al- ways to be made to reftore hi n to life. Infans are molt liable to -convulfions, and are often carried off very fuddenly by one or more fits, about the time of teething. There are many we'ii authentica- ted accounts of irfr.ms having been reftored to life, after they had to all appearance ex;vno i m convulfions; out we fhall oi lv relate the tbllowhginifrnce, mentioned bv Dr. }-hn,r v., in his pamphlet en the pratlicabihty of recovering perfons vifibly dead. In the peri fh, of St. Clements in "Colcheter, a chll! of fix months old, lying upon its mother's lap, having had the breaft, was feized with a ftrong convulsion fit, which lasted fo long, and end- ed with fb total a privation of motion in the body, lungs, and pnlfe, that it was deemed abfolutely dead. It wts accordingly stripped, laid out, the paffing bell ordered to be tolled, and a coffin to be made; but a neighbouring gentiewoo-un -vv/ho u'ed tn admire the child, hearing of us fudden death, haftened to the houfe, and upon examining the child, found it not cold, its joints limber, and fan- cied that a glafs the held to its mou'h and nc f was a little damped with the breath ; upon which fhe took the child in her lap, fat down before the fire, rubbed it, and kept it in gentle ogitalion. In a quarter of an hour fhe felt the heart begin to beat fa'ntiv ; Ihe then put a little ofthe mother's m'i'k im« :ts noutv, co-tinued to rub its p?lms and foles, found the child begin to move, an 1 the milk was fwallowed ; nnd in another quorter of an hour fhe r?.d the fatisfaction of reftoring to its difconfolate mother the bone, quite recovered, eager to lay hold of the breaft, and able to fuck again, The child throve, had no more fits, is grown up, and at prefent alive. \ Thefe means, which are certainly in the power of every prr- fon,were fufficient to reftore to life an infant torJlapprarar.ee dead, and who in aU probability, but for the ufe of thefe fimple endeav- ours, would have remained fo. Ther are however many other things which might be done in cafe the above fhould not fucceed ; as rubbing the body with ftrontr rpirit% crvrriog it with warm afh- es or fait, blowing air :nto the lungs, throwing up warm ftimula-. ting clyfters or the fmoke of tobacco into the inteftines, and fuch 11 Ir p ' When children are dead born, or expire foon after (he birth, the fame means ought to be ufed for their recoverv, as if they had exDired in circumftances fimilar to thofe mentioned above. * Thefe directions may likewife be extended to' dults,'attention being always paid to the age and other circumftances of ttlepa- The foregoing cafes add obfervations afford fufficient proof of the fuccefs which may attend the endeavours of perfons totally.ig- norant of medicine, in aflifting tfeofe who are fuddenly deprived of OF PERSONS WHO EXPIRE, 6c. 40$ life by any accident or difeafe. Many fads of fimilar nature might be adduced, were it neceffnry ; bir 'hefe, it U noped, will beiuifirienr to call no the attention of tne public and to excite the hum-ne and ben-vol jn to ex rt their uuiioft endeavours for the prefervation ofto.e;r fcfow-inui. Tk'jociety for the recovery of drowned perfons, instituted at Am- sterdam ill tht \ - ar 1767,T1 ad the iatisfr.ccion to find that no few- er than 150 perfons, in th^ fpace of four years, had been laved by the means pointed out by theim, many of whom owed their prefer- vation to peafants and people of no medical knowledge. But the means ufed with lb much efficacy in recovering drowned perfons are, with equ?.l bio ck, applicable to a number of cafes where the power of life feeing in realty to be fufpended, and to remain doa- ble of renew ng ail their functions on being put into motion agJ.n. It islhocking to reflect, that for want of this confi-eration many I perfons rave been committed to the grave in whom the principles of life might have been revived. The cafes wherein fuch endeavours are moft likely to be at- tended witn fuccefs, are all thofe called fudden deaths from an inev- itable caufe, as apoplexies, hyfterics, buntings, and many other dif- orders wherein perfons in a moment fink dowa and expire. The various cafuaii ies in which they may be tried are, fuffoca tions \ from the fulphureous lamps of mines, coal-pits, &c. the unwhcle- s fome air of long unopened wells or caverns ; the noxious vapours, arifing from fermenting liquors ; the fleams of burning charcoal -r fulphureous mineral adds ; arfenical effluvia, &c. » The various ace dents of drowning,, ftrangling, and'apparent -' deaths, by blow*, falls, hunger, cold, Bee. likewife furnifh oppor- tunities ot trying lucn endeavours. Thofe perhaps who to ap- pearance are killed by lightning, or by any violent agitation ofthe paflions, as fear, j oy, furprife, and fuch like, might alfo be fre- quently recovered oy the ufe of prop jr means, as plowing ftrongly into tneir lungs, &c. The means to be ufed for the recovery of perfons fuddenly •deprived of life, are nearly the fame in all cafes ; they are practi- cable by every one .vho happens to be prefent at the accident, and require no great expenfe, and lefs ikill. Tha great dm is to reftore the warmth and vir.l m tions. This may in general be attempted by means of Oeat, friction, bleeding, blowing air into the lung?, administering clyfters and generous cordials. Thefe must be vari- ed according to circiruitances. Common fenfe, and the fituation ofthe patient, will fuggeft the proper manner ofcond'.ictiug them." Above all we would recommeud perfeverance. People ought never to defpair on account of difcouraging circumft uices, ~r to leave oft" their endeavours as long as there is the leaft hope of fuccefs. Where much good and no hurt can be done, no one ought to grudge his labour. It were greatly to be wifhei, that an i-ftitmion fimilar to that of Amsterdam, was eftablifhed, upon a more extenfive plan, in Great-Britain ; and that a reward was allowed to every one who* would .be instrumental In reftorii3g to life a ptribn feemingly hpt OF GOLD BATHING, AND dead.* Men will do much for fame, but ftill more for mdney. Should no profit, however, be annexed to thofe benevolent offices, the heart-felt pleafure which a good man muft t-iijoy on reflecting that he has been theh'ppyinftrumenf of fwin;' one of his fellow. creatures from an untimely grave, is itfelf a fufiicicnt reward. »T—>»MW—»»»—. CHAP. LVII. Cautions concerning cold bathing and drink* ing the mineral waters. JLjLS it is now fafliionable for perfons of all ranks to plunge into the fea, and drink the mineral waters, I was defirous of rend- ering this work ftill more extenfively ufeful, by {he addition of fome practical remarks on thefe active and ufeful medicines. Find- ing it is impoflible to bring thefe obfervations within fo narrow a compafs as not to fwell the book, already too large, into an enorm* ens fize, I r-jfolved to confine myfelf to a few hints or cautions; which may be of fervice to perfons who bathe, or drink the miner- al waters, witoout being able to put themfelves under the care of a phyfician. No part ofthe practice of medicine is of greater importance, or merits more the attention of the phyfician, as many lives are foft, and cumbers ruin their health, by cold bathing, and aa im- prudent ufe of mineral waters. On fome future occafion I may probably refume this fubject, as I know not znf work that contains a fufficfent number of practical obfervations to regulate the patient's conduct in the ufe of thefe active and important medicines. We have indeed many books on the mineral waters, and feme of them are written with much ingenuity; but they are chief- ly employed in afcertaining be contents ofthe waters by chymical anolyfi:. This no doubt has its ufe, but it is by no means of fuch importance as f me may imagine. A man may know the chymic- .1 analyfis of all the articles in the materia medicat without being able properly to apply any one cf them in the cure of difeafes. On? page of practical obfervations is worth a whole volume of chymical analyfis. But where are fuch obfervations to be met with ? Few phyfirians are in a fituation to make them, and fewer ftill are quali- fied for fuch a talk. It can ooly.be accomplished by practitioners who ref de at the fountains, and who poffifing minds fuperier to focal prejudices, are capable of diftfoguifhing difeafes with accura- , bracing qualities of cold water, is the nervous. This includes a great number of the male, and almoft all the female inhabitants of great dties. Yet even thofe perfons cught to be cautious in ufing the cold-' ath. Nervous people have often weak bowels, and may, as well as others, be fubjtct to congestions and obstructions of the vifcera ,■ and in this cafe they will not be able to bear the effects of cold water.. For them, and indeed for all delicate people, the beft plan would, be to accuftom themfelves to it by the moft pleafing and gentle degrees. They ought to begin'with the tempente batti, and gradually ufe it cooler, till at length th? cold proves quit-i agree- able. Nature revolts agninft all great trasfitions; and thofe who do violence to her dictates, have often caufe to repent of their temerity. Wherever cold bathing is practifed, there ought likewife to be tepid baths fr the purpofe mentioned above. Indeed it is the practice of fern.3 countries to throw cold water over the patient as ioon as he comes cut ofthe warm bath ; but though this nr:y not injure a Ruffian'peafart, we dare not recommend it to the inhabit- ants of this country. 1 he ancient Greeks and Romans, we are told, when covered with fweat and dull, ufed to plunge into the ri- vers, without receiving the fmdie!t injury. Though th^y might often efcape danger from this imprudent conduct, y^'t it was cer- tainly contrary to found reafon. I have known many robuft men throw away their lives by fuch an attempt. We would not how- ever advife patients to go into the cold water when the body is chilly ; as much oxorcife, at leaft, ought to be taken*as may excite a gentle glow all over the body, but by no means fo as to over- teat it. * The late celebrated Dr. Sraoljct has indeed faid, that if be were perfuaded he lwd an u'cerin the lungs, he would jump into the cold bath 5 but here the Doc"t.age than discretion ; and that he w%$ more a man of wit than a phyfician, evejy one will allow. A nervous afthma, or an atrophy maybe miftaken for a pulmonary con- sumption ; yU in the two former, the cold bath provei often beneficial, though I never knew it fo in the latter. Icdfedall the phthisical patient? 1 evej fsw, who have. trie* >.Le cojdbaih, wer,««videntlj hurt by it, DRINKING MINERAL WATERS, 429 To young people, and particularly to children, cold bathing is of the firft importance. Their lax fibres render its tonic powers peculiarly proper. It promotes their growth, increafes their ftrength, and prevents a variety of difeafes incident to child- hood. Where infants early accuftomed to the cold bath, it would feldom difagree with them ; and we fhould fee fewer inr ances or the lcrophula, rickets, and other difeafes which prove fatal to ma- ny, and make others miferable for life. Sometimes indeed, theie diforders render infants incapable of bearing ihe fhock of c Jd wa- ter; but this is owing to their not having been early and reguiarly accuftomed to it. it is however neceflary here to caution young men againft too frequent bathing; as i have known many fatal confequences refult from the daily practice cf plunging into rivers, and continuing there too hong. . The moft proper time cf the day for ufing the cold bath is no doubt the morning, or at lenft before dinner ; and tne beft mode, that of quick immerfion. As cold buthirg has a conftant tendency to propel the bl©od and other humours towards the head, it ought to be a rule always to wet that part as'fcon as poffible. By due . attention to this circumftance, there is reafon to believe, that vio- lent head-achs, and other complaints, which frequently proceed from cold baihing, might be often prevented. The cold bath, when too Lng continued in, not only occafions an exceffive flux of humours towards the head, but chills the blood, cramps the mufcles, relaxes the nerves, and wholly detents the inten- tion of bathing. Hence, by not adverting to this circumftance, expert fwimmers are often injured, and fometimes even lofe their lives. All the beneficial purpofes of cold bathing are anfwered by one immerfion, at a time ; and the patient ought to be rubbed dry the moment he comes out of the water, and fhould continue to take exercife for feme time after. Wheu cold bathing occafions chillnefs, lofs of appetite, lift leff- nefs, pain of the breaft or bowels, a pr nitration of ftrength, cr vio- lent head achs, it or gut to be difcontinued. Though thefe hints are by no means intended to point cut all ' the cafes whoro cold bathing may be hurtful, nor to illustrate its extenfive utility as a medicine ; yet it is hoped ihcy may ferve to guard people againft fome of thofe errors into uhich, from ^ mere inattention, they are apt to fall, and thereby not only endanger ffieir own l:v.-s, but bring an excellent medicine into difrtpuie. OF DRINKING THE MINERAL WATERS. THE internal ufe of water, as a medicine, is no fefs an object of the phyfician's attention than the external. Tore elementary water is indeed the moft inoffenfive of all liquors, and cordtitutes a principal part of tho food of every animal. But this elemem is often impregnated with fubftances of a very active and penetrating nature; and of fuch aninfidious quality, that, while they promote • The celebrated Gari fays, tl,?.'. imrae-fnn in cold water is fi' only for the y;uu5ij of \'.ors and bears; and recr-nimei^s ws:;:; bathing, as conducive t•> '.h* arowOi and itren.-th. «l nfarts. l-N^v egretioully d:> the preatei'r itu- cr whenever t^iv lols ;:,!.'. ul lJi't.'> 3:-.i lu.' *.u:e re.iij.nMi, *'i phytic in place ot obferv .0-. and cxpsi.i-nc;. (-7) 410 OF DRINKING MINERAL WATERS. certain fecretions, and even alleviate fome difagreeable fymptom*, they weaken the powers of life, undermine the conftitution, aud lay the foundation of worfe difeafes than thofe which they were employed to remove. Of tois every practitioner muft have feen inftances; and phyficians of eminence have more than once declar- ed that they have known more difeafes occafioned than removed by the ufe of mineral waters. This doubtlefs has proceeded frcm the abufe of thefe p:werful medicines, which evinces the neceflity of uOng them with cnution. By examining the contents of the mineral waters which are melt ufed in this country, we fhall be enabfed to form an idea of the danger which may arife from an improper application of them either externally or internally, though it is to the latter of thefe that the prefent obfervations are chiefly confined. The waters moft in ufe for medical purpofes in Britain, are thofe impregnated with falts, fulpher, iron, and mephitic air, either feparately, or varioufly combined. Of thefe the moft powerful» the faline fulphurous water of Harrowgate, of which I hav« had more occafion to obfervethe pernicious confequences, when impro- perly ufed, than of any other. To this, therefore, the following re. marks will more immediately relate, though they will be found ap- I plicable to all the purging waters in the kingdom which are strong enough to merit attention.* The errors which fo often defeat the intention of drinking the purgative mineral waters, and whica fo frequently prove injurious to the patient, proceed from the manner of ufing them, the quantity taken, the regimen purlued, or ufing them in cafes where they are not pr-per. A very hurtful prfjudice ftill prevails in this country, that all difeafes muft b^ cured by medicines taken into the ftomach, and that the more violently thefe medicines operate, they are the more likely to have the defired effect. This opinion has proved fatal to thoufands, ard will, in all probability, deftroy many more before it can be wholly eradicated. Purging is often ufeful in acute dif- eafes, and in enrcnical cafes mavpave tve way for the operation of other medicines; but it vill feldom perform a cure ; and by ex- haufting the ftrength of ihe patient, wiil often leave him in a worfe condition t;an it found him. That this is frequently the cafe with regard to the mere active m'sr.eral waters, every perfon converfant in thefe natters will readily allow. Strong ftimulanis applied to the ftomach and bowels for a length of time, muft tend to weaken and deftroy their energy; and what ftimulan's are more a£rive than fait and fulphur, efpecial- ly when tnefe fubftances are intimately combined, and carried tnrough tie fyftem by the penetrating medium of water ? '1 hofe bowels muft be ftrong indeed, which can withstand the daily • Thr ereateft clafs of mineral water« in this country Is the chalybeate. In many parts of Britain thefe are robe found in almoil eve.y fi Iii j bur thole chiefly in uf', tor roedicjl p'irpofe*, are th-pureinp chalybeate*, at the wateisof Scarborough, Cheltenham, Thorp .Arch. Nevil Holt. See. Of thole *h'e« do not purae, the water* of Tunbrtdge lUnd in ihe Ivgheft-eputc Thr Salir.e purging water*, ai thofe of A&on, Epfon, Rilburn, &c. are alfo in very general eireem ; btit the fountain* moft frequented by the fick in this country* are thofe to which the miners'* impart a certain degree of heat, at JJath, Briliol, Buxwo» ** OF'DRINKING MINERAL WATERS. 411 operation of fuch active principles for months together, and no be injured. This however is the plan purfued by moft of thofe who drink the purging mineral waters, and whofe cirrumftances* will permit them to continue long enough at thofe fafliionable places of reforr. Many people imagine that every thing depends on the quan- tity of water taken, and that the mere th^-y drfek they -*ill the fooner get well. Tr.is is an egregious error ; ft .r while the un- happy patient thinks he is by tis means eradicating his diforder, he is often in fact undermining the powtrs of life, and ruining h 5 cocftiiution. Indeed nothing can do this fo eff.ctuo.lly as weak- ening the powers of digeftion by the improper application of ftrccg ftimulants. The \ery tffence cf health depends on the di- geftive organs performing their due functions, and the meft tedi- ous mala ties are all connected with indigeftin. Drinking the water in too great quantity, not only injures i the bowels and occafions indigeftion, but generally d.feats the intention for which it is taken* The difeafes for toe cure of which miueral wa-ers are chiefly celebrated, are mostly of the chronic kind ; and it is well known that fuch difeafes can I only be cured by the flow operation of alteratives, or fuch I rffledicines as act by inducing a gradual change in the habit. \ This requires length of time, and never can be effected by medi- * tines which run eff by ftool, and operate chiefly on the firft paffages, . Th Te who wifh for the cure of any cbftinate malady from the mineral waters, ought to take them in fuch a manner as hard- ly to produce any effect whatever on the bowels. Wiih this view a half-pint glafs may be drank at bedtime, * and the fame quantity an hour before breakfaft, dinner, and fupper. The dofe, however, muft vary according to circumftarces. Even the quan- tity mentioned above will purge fome perfons, while others will drink twice as much withoutbeng in the leaft moved by it. Its cpmition on the bowels is the o; ly ftandard for ufing' the toater as an alterative. ^ No more cught io be taken than barely to move the body ; nor is it always neceffory to carry it this length, provided the water goes off by the other en.unctories, and does net occafion a ci illn.efs, or flatulency in the ftomach cr bowels. When the wa- ter is intended to pu:ge, the quantity mentioned above may be all taken before break'aft. I would net only caution patients who drink the purging min- eral waters ever night, to avoid heavy fupp rs, but alfo from eating heavy meals at any time. The ftimulus of water, impregnated with falts, feems to create a falfe appetite. I have feeoi a d< licate perfon, after drinking the Harrowgate waters of a morning, eat a br. aktaft fufficient to have ferved two ploughmen, devour a plentiful dinner of flefh and fifh, and, to crowu all, eat fuch a fup- per as might have lhtisfied an hungry porter. * When 1 fpealc of drinking a glafs ofthe water o»er-night, I muft beg leave to caution thofe who fol'uw this plan adrift caring heavy lumpers. Tl er grain We have reafon, however, to believe, that grits,. or coarfe oatmeal, Will anfwer that purpofe ftill better. Oatmeal is frequently made into bread ; but it is a much more wholefome, as well asagreea'ie f od, when made into hafty pud- ding, an! eaten with milk. The peafants in many parts of Bri- tain moke two meals a day ofir, wHle their children almost whol- ly fubfift on it ; and it is well kn wn that both old and young who are thus fed, ar,- health-, aod robuft. The opinion 'nf oatmeal bting heating, and occafioning fkin eifeafes, iswhnly with-ut foundation. Bread made of oatmeal, when not leavened, will fometimes occafion the heartburn ; but this is no proof of its heoting quti-.ty. U-leavened bread, of wheat or any other graii., prwkvts tre fame effed on a debil- - itated ftomach. Qatmeal thoroughly boiled feldom gives the heart- burn. OF BOILED GRAIN. 421 Perfons who are fed on oatmeal bread, or haity pudding, are not more fubject to difeafes of the fkin than thofe who live on wheatmeal. Cutanoous diforders proceed mere from the want of cle;nlinefs,than from any particular nliment. The French, fo far from thinking that oatmeal is heafng, ljxak of it as peffefiedofa cooling quali'y; .md even the Englifh give oatmeal, or grit gruel, to lying-in w< men, and fick people if every defcription,;- which fhews ihtt ttv.ry are inconfiftent with themfelves, in alledging that the blood is fired by the ufe of oatmeal. A lieut ■ anr ofthe army, refiding at a country villagewithh a few miles ofEdnburgh, win: a wife and tenchil. reo,hav:ngnocther income than his half pay, fed the wh.-ieof his children with hafty pudding and butter-milk only, from a convidion that it was the moft wholefome and full diet that fell within the reach of his nar- row circumstances. They grew apace, and it was the univerfaL remark of the neighbourhood, that they wtre as fprightiy, healthy, and robuft as ot .er children, and at the fame time perfectly free from all fkin difeafes. Children are feldom well, unlefs when their bodies are gently- open. But this is more likely to be the cafe when fed en oatmeal and milk, than when their bellies are crammed with a ftar.chy fubftince made of the finest flour ; yet this in England is the common food of children. I have feen an infant fluffed four or five times a-day with this kind of food. There needs no conjuror to tell the confequences. A late Author, a man of learning, but the dupe of prejudice, has by a rinicnloos definition, endeavoured to reprefent oats as pr. per food for horfes only. I wifh the horfes in England for five fart'tings. What makes good puddings will make good dumplings, and f:efe will, at any time, fupply the place of bread. The C u; t alfo remarks, that the negroes in America prefer Indian corn to rice j and oat the Bavarian peafents prefer it to wheat; that it nrght be imported from North America at about four or five fhilf ogs per bufbel ; that when made into flour, it would eoft only one penny farthing per pound ; and that it io highly nutritious, and the cheopeft food known. During the late ■ fcarci.y a hrg- quantity of t: b grain was imported ; but fuch ie the averfion cf the common people of this country to every fort of food to which they are n >t accuftomed, that they re ruled to purchale ir, and the merchants were very .great Infers by the importation. On the fime principle the Germans, till within a few years, could not be induced vo ear potatoes, ib.c vn;;h now they ore became eo:- tremelvfond of them/ 422 , OF BUTTER. The American, the Italian, and the German, all cook Indian" corn the fame way as the North Briton does his oatmeal, by making it into hafty pudding. It may be eaten in a variety of ways. Some eat it with a fauce compofed of butter and brown fugar, or butter and moL*ffes. Others eat it with milk only. In either way it makes a good, cheap and wholefome diet, by no means difagreeable to thofe win are accuftomed to it. Ihe only other grain we thall mention as beft when boiled, is buck-wheat: It is of a very mucilaginous nature, and of courfe highly nutritious. In feveral parts of Europe, ir constitutes a prin- cipal part ofthe food of the lower po pie. In former times it was eaten in Ruflia, not by the lower claffes only, even the nobility made ufe of it. Boiled and then buttered,it was fo great a favorite of the great Czar Peter, that he is faid to have feldom flipped on any thing elfe. OF.BUITER. IT has been faid that the Englifh have a thoufand religions, and but one fauce. It muft be allowed that they ufe butter with al- most every kind of food. Butter, though a good article cf diet may be ufed too freely, and in this country, I am convinced that is the cafe. To weak ftomachs it is hurtful, even in fmall quantities, and when ufed freely, it proves prejudicial to the ftrongeft. Butter, like other things of an cily nature, has a conftant tendency to turn rancid. This procefs, by the heat of the ftom- ach, is greatly accelerated, infomuch hat many people, foon after eating butter, complain of its rifing ia their ftomachs, in a ftate highly difagreeable. Oils of eveiy kind are with difficulty mixed with watery fluids. This is the reafon why butter floats on the ftomach, and rifes in fuch an unpleafant manner. Perfons afflided with bile fhould ufe butter very fpnringly. Some fceptical authors doubt whe.her or not aliment of any kind has an effed on t>;e bile. One thinjf, however, is certain, that many patients afflided with complaints which were fuppcfed to be cccafioned by bile, have been completely cured by a total ab- stinence from butter. The mcft violent bilious complaints that I ever met with, were evidently occafioned by food that became rancid on the ftomach, as the cholera morbus and the like. Nor can fuch com- plaints be cured, till the rancid matter is totally evacuated by vomiting and purging. But luppofing butter did not poffefs the quality cf becoming rancid on the ftomach, it^ may neverthelefs, prove hurtful to digeftion. Oils of all kinds are cf a relaxing qnalitv, and tend to impede the adion cf digeftion. Hence the cuftom of giving rich broths and fat meats to perfons who have a voracious appetite. , The free ufe of butter, and cth:r oily fubftarc^, rot only tends to r<4ax the ftomach, and impede its adion, bi t to induce a debility of the folids, which pavos the v/ay to many maladies. In a country where two thirds of the inhabitants lead fedentary lives, OF BUTTER. 4*3 a debility of fibre muft predominate. Whatever encreafes that debility ought to be av tided. C ildren, without exception, are difpofed to difeafes arifing from relaxation. Butter of courfe, ought to be given to them wi h a fparing hand. But is this the cafe ? By no means. Bread and butter constitute a great part of the food of children, and lam convinced that the grofs humours with which they are frequently troublex., are partly owing to this food. As children abound with moiffure, bread alone is, generally fpeaking, better for them than bread and butter. I nave been aftonifhed to fee the quantities of butter eaten by grcfs women who lead fedentary lives. Their tea bread is general- ly contrived fo as to fuck up butter like a fponge. What quantities of crumpets and muffins they will devour in a morning, foaked with this oil; and afterwards complain of indigeftion, when they have eaten what would overload the ftomach of a ploughman. Dr. Fothergill is of opinion, that butter produces the nervous or frk head-ach, fo common among the women of this country. As a proof of this, it is of en cured by an emetic. Oils, m certain quantities, excite naufea, and even vomiting. They muft of courfe prove unfriendly to digeftion. A Dutch failor, we are told, can digeft train oil. So may an Englifh faiior ; but it would be very improper food for a London lady. To fome of the leaner farinaceous fubftances, as the potatoe and the like, butter makes a very proper addition; but eating it to flefh and filti of almoft every defcription, is certainly wrong. The flefh eaten in tlis country is generally fat enough without the ad- dition of butter, and the more oily kinds of fifh. as falmon or her- rings, are lig iter on the ftomach, and more eafily digefted when eaten without it. Butter is rather a grofs food, and fitter for 'he athletic and la- borious, than the fedentary and delicate. It iskfs hurtful w en eaten frefh than falted. Salt buter cereal ly tends to induce fkin d feafes, and I am inclined to think, the free ufe of it at fea may have fome fhare in bringing o that dreadful malady fo deftrudive to our brave (ailors, the fea fcurvy. There is a method of rendering felt butter lefs hurtful, but it feems not to be kn ^>wn in England. What i mean is to mix it with an equal qur.ntity of honev, a;id keep it for ufe. In this way it may be given to children with greater freedom. In North Britain this method of mixing butter with honey is well known, and from a common prover , I take the cuftom to be very ancient. But er, in itfelf, is not fo hurtful, as when combined wish certain o: her things. For example: bread made win butter is almoft iodL-eftible, andpiflries of every kind are little better : yet many people almoft live upon paftry, and it is univ.rfally given to children. It is little better, however, than poif n, and never feds to diforder their ftomachs. The fond mother cannot pafs a paftry fh p, without treating fur darling boy with fome ofthe dainties, and then wonders how he got the cough, or cholic. I have known a manf.emingly in perfed hs;.lth, wh? by eat. 424 OF FRUTTS, AND ROOTS. ing a penny-worth of paftry, as he paffed along street, was feized with fuch an afthmatic fit, that he was obliged to becarried home, and had nearly loft his life. This occurred whenever he inadvert- ently ate any thing baked with bufer. Every thing that proves very injurious to health ought, as far as poflible, to be prohibited, by laying a high duty upon it. A duty on paftry would be ferving the public in more refpeds than one. It would fave many lives, and leffenfi me tax on neceffaries. Cheefe, as a diet, is likewife injurious, to healt"r. It fhould never be eaten but as a deffert. It occafions conftipation, fires the blood, and excites a conftant craving fer drink. It is very improp- er for the fedentary, and hardly to be digefted even by the athletic. If men will live on dry bread, poor cheefe, fait butter, broiled bacon, and fuch like parching food, they will find their way to the ale-houfe, the bane of the lower orders, and the fource of half the beggary in the nation. OF FRUITS, AND ROOTS. FRUITS and roots form a large clafs of fubftitutes for bread. The latter, being produced under ground, are lefs liable to fuffer from trie inclemency of the feafons than grain. Men who wifh to inflame the minds of the multitude may inveigh againft the fubftitutes for bread ; but reafon and found fenfe fey, the more fubftitutes for bread the better. When one fails, recourfe can be had to another. In warm climates the inhabitants have many fubftitutes for bread,-and as their feafons are more uniform than curs, they can generally depend cm the plant, or whatever it is, proving produft- ive. The, plantain-tree, commonly called the Indian-fig, which has from time immemorial been cultivated in South-America, bears fruit of a fweetifh tafte, which will diffolve in the mouth without chewing. It is eaten either raw, fried, or roafted. When intended to fupply the place of bread, it is gathered be- fore it is ripe, and eaten either boiled or roafted. The banana is nearly of the fame nature, but its fruit is greatly fuperior both in tafte and flavour. The inhabitants of the South Sea, or Ladrone iflands, are fupplied with bread from a tree which has been lately impDrted into our Weft India iflands, and will it is hoped, be found to an- fwer the fame purpofe there. It has a flight degree of fweetnefe, but not much flavour. It refembles new bread, and requires to be roafted before it is eaten. Thofe who have tailed it fay, that it is in no refped fuperior to the potatoe. In ibme of the Weft India iflands the inhabitants fupply the place of grain by making bread from the root of a fhrub called the caffada or caffava. Though, to my tafte, this bread is very inGpid, vet the natives are fond of it to fuch a degree that I have knov»n fome of them eat it, during their refidence in England, in preference to the finest London bread. But the moil general fubftitutes for bread in the Weft-Indies are the yam's. There are three different lpeofes of this plant the OF FRUITS AND ROOTS> 4*f' loots of which are ptomifeuoufly ufed for bread. They-are faid to be very nutritious, of eafy digestion, and, when properly dreffed, are by fome preferred to the beft of wneaten bread.. The tai^e is fomewhat like the potatoe, but more lufeious. The negroes gen- erally eat (hem btiled, and beaten into a mafh. The white people have them ground into^flour, and make bread and puddings of them. They can b.: preferved for feveral feafons,- without Lfing any of th^ir primitive goodnefs. Of all the fubftitutes for bread in Europe, the potatoe is the mod extenliv ly ufeful. This plant is a native of Peru, and. has boen in En.rope abi.ut two-hundred y rs. Liks moft other ira- pora t dif ovories, it mod-? but a flow progrefs, and is fill far fr m 'xrino fo geoertily cultivated as it deferves to be. It is in- deed known in moft parts of Europe, but its culture is'beft u< der-< flood in Ireland and tne northern parts of England. A* Itarwich, ., howtn.- >-, thepn ference is given to the Dutch potafo< s, br.ughr. over by the pocjVtis between that place and Helvoet Sluys. There is a fght fandy foil in Ifelland very favourable to the culture of that ineft; triable root. As this plant thrives in every f til, and feldom fuffors from the inclemency of the feafons, wo muft blame ourfelves if we fufttr a • famhie to exifl. Indoed no fuch thing can ever be, where due at- tention is paid to the culture of putatoes. A far greater quantity of farinaceous food can be rai'eoVon an acre of ground planted wito potato s, tl'.an fown with any kind of grain. It is not un- common t • hive a return of forty for one. They are not fo hearty a food as corn, but no man will ever perifh for hunger who. can have potato es. ... •;$>-. on , Pc tat.oes abound, with an imtipid juice, Which induces* foai^ to think that" they are not very nutritious. Facts, however/are agtin'.t {his .pinion. Some of the ftou'eft men we __ know, are brought up n milk and potatoes. Dr. Peai-feu, whVhas beftow- ed fome paiiis in analizing this root, fays, that potatoes and water alone, v.nth c ;nuaon fait, can ncuriflr-men completely. They differ in colour and confiftence, but liofWterially with regard to their nun live qualities. Some fink tne firm kind are* the moft nutritious ; but the Jrifh, w.o muft be good judges, give the, preference to the mealy. The difference, however, depends much on the mode of cooking them. ' * More than half the fubftance of potatoes confiits of water, and experience fhews, t at the mode of cooking, which raoft di- niiaiihes their moifter, is to be preferred. In Loadon th -y are drenched in watxr and wafhed before they are broug-it to market, which accounts, in a great meaiiire, for the bad qu..hty of the London potatoes." They are dreffedin a varie y of ways, but fimple boiling or roafting feems to be all the cooing they require,, to render them ra proper fubftltute for bread. Some are fond of making bread of them. This, in my opinion, is marring both. Why man- ufadure any thing into bread, which requires only tf& aid (28) 4*6 OF FRUITS AND ROOTS. of the1 fire to make it fuch ? Nobody thinks of making dough of the bread fruit; but the potatoe might with as great pro- priety be called the bread root, as it is made into bread by the fame procefs. Stewed mutton-and potatoes make not only a nourifhing but a very palatable difh. The excefs of fat of the mutton, which when otfeerwife, cooked iuftains great lofs is thus preferved, by being abforbed by the potatoes. It is, however, to be obferved, that when potatoes are ufed in broth or flews, they ought previoufly to be boiled, and the water thown away, as it contains fomething deleterious. Simple boiling'or roaftirg is fufficient to prepare po- tatoes to-fupply the place of bread, but when they are intended to ferve as a meal, they require fomething of a foftenmg nature, as milk, butter, or bofht What a treafure is a milch cow and a potatoe garden, to a pocr man whh a frrge family, who lives in the country ! Yet, with a little attention from landlords and farmers, almoft every man might be fo accommodated. What a fource of real wealth and population ! Men would multiply, and poverty, unlefs among the profligate, be unknown. Horles are fometimes fed with potatoes, and become very fond of them. With the ad- dition of a fmall quantity of hay, they are found to be fufficiently nourifhing. I would beg leave to recommend, both to landlords and farnv ers,- a careful perufal of Earl Winchelfea*S excellent letter to Sir John Sinclair, on the advantages of cottagers renting lands. This humane Nobleman takes up the matter in a truely patriotic light, and fliews that farmers, inftead of leflening the number cf poar, do every thing they can to multiply them; and I am lorry to fay, that, fo Far as my obfervation goes, it agrees entirely with his tordfhip's. Some think that the potatoe, unlefs it is made into bread, Will not keep. An aeddew taught me the contrary. Many years ago a friend of mine fent me a potatoe, after it had been roafted in an oven, on account oijits fingular figure. I laid it on a ihelf among fome other thinfcs%f the like kind, and was furprifed, on removing them many years after, to find the potatoe quite frefh though as dry as a bone. On grating it down it was perfectly fweet; and as fit for making foup as the day it was roafted. I ap- prehend that nothing made into bread would have kept fo long. Posterity will hardly believe that a fcarcity of bread could be felt in Britain, at a time when it was known that a fufficient quantity of farinaceous food c^uld he raifed in one county for the inhabitants ofthe w^ole ifland. Let proper encouragement be given to the culture of potatoes, and fet famine at defiance. M.'ny other domestic roots, fprcuts, &c. are very wholefome, and may occafionally fupply the place of bread. Of thefe Mr. Bryant of Norwich, reckons above forty; but we fhall only take notice, by way of fpecimen, of the moft ufeful and pro- dudrve. It is worthy of remark, that no nation can be very populous, which does not draw a great part of its food from un- der ground. OF FRUTTS AftD ROOTS. 427 The Jerufalem artifchoke is a native of Brazil; butj having been long cultivated in this country, it is too -*vell known to heed any defcription. From its tafte, which is like that of artichoke bottoms, it would feem to be nutritious, and is far from being unpleafant to the palate. Some reckon it windy, but this may be correded in the cooking, by warm fpices, and as the plant is very produdive, we would racommend it to be ufed in the fame manner as potatoes and the other farinaceous roots. Of the efculent roots in this country, the parfnip is reckoned the moft nourifhing. It is likewife of eafy digeftion, and is agreea- ble to moft palates. Some indeed diflike it on account of its fweet- nefs; but that is a proof of its nutritive quality, fugarbeing the moft nourifhing thing in nature. We are told that, in the north of Ire- land, the poor people make beer* from this root. f Tnere is not any plant that affords a more ftrikiDg proof of the benefits of culture than the turnip. In its wild ftate it is good for littleor nothing; but, when properly cultivated, it not only affords wholefome nourifhment for man, but furnifhes the principal winter food for cattle. There is a fpecies of this plant which grows in North Britain, called the yellow turnip, which is fweet and of a fuperior quality to thofe produced in the fouth, particularly about • London, which are bitter and ftringy. The yellow turnip is the moft nourifhing, and alfo the molt hardy in fuftaining the winter. It is eaten with milk to cure the confumption aud fcurvy* Mar«* graaf fays, he could extrad no fugar from the turnip, which affords ground to conclude, that it is not fo nutritive as certain other rocts. Not oiWy the root of the turnip, but the top/j when young, make very pleafant greens. The fprouts, if gathered when very tender, make excellent fallad. The carrot, like the turpip, is good for little in itsnatural ftate, being fmall, tough and ftringy. Manured, it grows large, fuccul-* ent, and of a pleafant flavour. It ought, however, to be eaten young, otherwife it lies on the ftomach, and is hard of digeftion^ It is an ingredient in feveral foups, and being folid, may in fome meafure fupplv the place of bread* Salfafy, fltirrets, and the feveral kinds of beets* are all pleaf- ant and nourifhing- They are likewife of eafy digeftion, and may be dreffed in a variety of ways* Margraaf has by experiments difcovered, that both fkirres and beets contain a confiderable quantity of fugaf. Though the extrading a faccharine fait from thefe plants may be no objed while we poffefs the Weft- India iflands, yet it ferves to fhew that they poffefs a quantity of nutritious matter, fufficient to give them a rank among the articles calculated to fupply the place of bread. The oni m, we are told, was a greit favourite in Egypt four thoufand years ago, and Dr* Haffelqueft fays, it is not to be wondered at, for whoever has taited the onions of Egypt raufl allow, thaf none <£n be better in any part of the globe. There, he fays* they are fweet, though in many countries they are ftrong and naufeous. There they are foft, v/hereas in northera 428-- OF FRUTTS AND ROOTS. countries they are hard : aud their coats fo compad, that theyi are difficult to digeft. This very quality may hdwever recom- mend them in countries where food is fcarce. The Dodor ob- ferves. rnou the Turks eat ihem roafted with the'r meat as we do bread, and are fo fond ot them that they wifh to be indulged with. this difh in paradifa. From the Doctor's- account one would be induced to believe, that the onion ufed in Egypt was of a different fpecies from ours; but I am rather inclined to think it may depend on the mode of culture, as well as on the warmth of climate and the difference of foil, as we find in the fouthtrn parts cf Europe they are milder than in 'the more northerly. In Spain they are very mild, and a root weighing two pounds will grew from a fingle feed. Onions are dreffed in a variety of ways, but, in regard to wholefomenefs, there'is no method better than fimple boiling.. By this method of cooking, they are rendered mild, of eafy digeftion, and go off witout leaving any difagreeable heat in the ftomach or bowels. Many fhun them on aco unt ofthe ftrong difagree- able fmell they communicate to the breath. Mr. Bryant fays, this may be remedied, by eating a few raw parfley leaves im- mediately after, which will effedually overcome the fcent of the onions, and likewife caufe them to fit more eafy on the ftomach. The leek is generally reckoned Jtmong pot-herbs; but as the root is the part chiefly ufed, the confideration of it comes under the prefent head of difculfion. Indeed, it is as properly a root as the onion, which grows chiefly above-ground. The leek, as well as the pnion, is faid to be a conftant diflr at the tables of the Egyptians, who chop them fmall and eat them with their meat. The leek is ufed as a pot-herb in moft parts of Britain, efpecial- Ty in Wales, where the natives are faid to be fond of it. In Scot- land a full grown fowl and a fmall piece of fait beef, ftewed with a large quantity of leeks, is a very favorite difh. In my opinion the leek is not fo generally ufed any where as it deferves to be. There is no ingredient goes into foup that is more wholefome, or that gives it a better flavour, than leeks. They are in many re- fpects medicinal, and to my tafte, as an ingredient in foups, they are greatiy fuperior to the onion, or any other pot-herb whatever. It is a fad worthy of obfervation, that the boiling of vege- table fubftances thoroughly,extricates a confiderable quantity of air, and makes them lefs liable to produce flatulency. I could mention a great many more efculent plants which might occafionally fupply the place of bread, but the above fpeci- men is fufficient to fhew how liberal nature is in fupplying man with food, provided he will take the trouble of cultivating and cook- ing it. Mr. Bryant, in his hiftory of efculent plants, enumerated above four hundred and fiftv, each of which affords a wholefome nourifhment, and may occafionally be ufed in place of bread. OF BROTHS AND SOUPS. 4*9 THESE may likewife be confidered as fubftitutes forbread. If properly made they will ferve both for bread and drink. Though broth is a difh cf the greateft antiquity, and may be confidered as extremely delicious, yet it is not a favourite in this country. Here the peopb are fond of what they call folids j yet thofe very folids 'they make into br.th by fwallowing as lhu'h drink .after them as they can get. The only difference is, the foreigner makes his broth in a pof, and the Englifhman mokos his in the ftomach.' A v^ry fenfible anonymous writer obferves, that in England a pound of meat makes Amply a pound of food ; -whereas m as.y oth?r country in Europe, that quantity cf animal food, when slew- ed down with vegeraoles aad Scotch barley, will produce an am* pie meal f r half a dozen people. Hence he jtiftly infers that * among th? variety of fchenies which may have been devifed by the •humane for relieving the diilrefles of tne poor, a better and more ■ extenfive charity cannot be devifed than that cf inflruding them in a new mode of cookery. The fame author ad..U- that the refult of his experiments on this fubjed had exceeded his molt fanguine expeditions, and that eacn day gave him frefh proofs of the excellency of his plan for teaching the poor and needy to find themfelves in a wholefome and palatable diet, at the c eapeft rate, in which ["Jitcle or no bread was refluired. He concludes by afferting that there is fcarce a place in this kingdom where twenty r- yerfons ,may not have a wholefome, hearty, and palatable meal for three fhiljings. The writer who has paid most attention to the improvement ofcockery for the benefit of the poor, is Count Rumford.* In his economical and philosophical eilays, he has given fuch a variety of forms for making wholefome, cheap and nourifhing foups, flews, and othor dtihes for common ufe, that little more feems neceffary to be faid on the fubjed. I fhall only obferve that the mode of ■ living on broths, foups, hafty-putiding, and fuch iike, fo warmly ' and juftly recommended bv tne C-unt,' has'been pradiced in the northern ports of this kingdom from time immemorial. There the ; food of the common people is lafty-pudding with milk for break- - fall and fupper, aud broth, with v-getabfes and meat for dinner. The poorer fort often make broth without meat; but they all ufe vegetables in great abundance, and fometimes they fupply t*~e place of meat with butter. As the haftv-pudding and milk I make a complete meal, no brevd is neceflary either at fupper I or breakfaft ; nor is much requ red at cinner, as th« the orcth ' is made thick with barfey, cabbage, and a variety -f cth.tr vegeta- bles or pot-herbs. Cabba>.e is a favourite bgredient in the > Scotchman's broth. It is fel iora made without this article, which is not eaten fo early as in England. It is there fuffered to grow to maturity, and when that is theeffe there is no plant more produc- tive. This the Germans know well, and make it into sour crmt.^ne of •the beft antidotes againft thefcurvv v/ith whi h we are acquainted. This kind of diet not only laves bread but crick. The la- bourer who lives on hafty-puddiug and foups, feldom has occafion -no OF BROTHS AND SOUPS. for drink ; while he who is burnt up with dry bread and cheefe, or fait mtat broiled, his ac-v tinual thir fc, and fpend.1 the greater port of his earnings in liquor. This, by ading as a powerful fim- ulous, may make nim do more work for fome time, but it generally cuts him off in the middle of his days. The Englifh labourer, who works harti and drinks hard, feldom lives long, and is an old man ivheu hefhouU be in his prime. The roasting of meat is a wafteful mode of cookeiy, which ought to be avoided by the poorer fort of people, as much of the fubftance, and the molt nutritive parts, are loft by fcorching, and fly offby evaporation. I know it will oe faid, that I recommend flops in place of folid food. They are fuch flops, however, as the greateft heroes of antiquity lived upon ; and thougn I have vifited moft parts ofthe iflaad, I know of no better men than thofe who live in the manner defcribed above, nor are the people any where more healthy, or longer lived. Broth is not only a difh of great antiquity, but one that can be jnade in a great variety of ways. It receives into its compofition, animal and vegetable fubftances of every kind that are ufed in diet, and it may be feafonedTo as to fuit every palate. Indeed, people early accuftomed to eat broths properly made, are generally Tone} of them fot their whole lives. It would be difficult to aflign a reafon why the inhabitants of South Britain fhould diflike a dilh fo much relifhed by other nations. Cuftom, no doubt, fettles all thefe things; but how cuftoms arife is not fo clear a matter. If any alteration in diet is to be introduced with effect, it muft begin with children. What? ever men are accuftomed to eat when young, they generally pre- fer for the reft of their lives. Were the children in South Britain taught to eat hafty-pudding, with milk, for breakfaft and fupper ; and broth with vegetables and meat coifed in it, for dinner, they would relifh thefe difhes as long as they jived, would find little oc- cafion for bread, and ftill lefs for drink ; and would thrive better than on their prefent food. What parents love themfelves, they generally give to their children, without any regard to its being proper for them or not, I have feen a father who was fond of ftrong beer, make his fon, an infant, guzzle it at every meal; and the mother who delights in tea, does not fail to give it to her daughter whenever fhe takes it to herfelf. By this condud, the fon becomes a tippler, and the daugh- ter fips tea in the place of folid food, until fhe js eaten up with va- pours and other nervous diforders. Count Rumford fays, browa foup is the common breakfift of the Bavarian peafants, to which they occafionally add bread. This he avers is infinitely preferable in all refpeds to that per- nicious wafh, tea, with which the lower claffes of inhabitants of th«3 ifland drench their ftomachs, and ruin their constitutions. He adds, that a fimple infufion of this drag, drank boiling hot, as the poor generally drink it, is certainly poifon, which, thougn it be forsetiraes flow in its operation, never fails to produce fatal effeds, CONCLUSION. 4& even in the strongest conftitution, where the free ufe of it is continu ed for a confiderable length of time. The German on his polenta, the ^American on his mujh, and the North Briton on his hafiy puddingve wonderful remedy is accordingly vamped up, and preparations are made for commencing a lucrative trade with the public. Should the channel of commumcat.n be the public papers, it is a fettled point, that if d- ily or frequent advertife- ments can be fupported for the fpace of fome months, the.fame cf the medicine, whatever be its real character, is eftabliftVd. fhe beter to promote this purpofe, innumerable authorities iu favour of the nostrum are aflerted in general terms ; venality is again ex- erted to furnifh fpecific testimonials in its fupport; and if, among the number of unfortunate purchafers, or patients, there exists any perfon who has not 6nly taken it with impunity, but even with ibme advantage (and what extremely powerful medicine may not fometimes by Chance have good effects ?) the fortuitous incident is immediately blazoned with all the ostentation of inter: fled zeal and r ^ccted popularity ; and a reference to u corrupted tcftiraony re- founds through every channel pf information. By a ftrange affeci- ation, truth now is confidently adduced in fupport of falfehood.; and the recovery of one or tv/o perfons is .rendered the unhaapy means * of draining the purfe, undermining the' health, and deftroying the lives of thoufands. Such, in fact, is the general progrefs of empiricifm. Were the talk not invidious, and the objects too d-fpicable for any other than juridical cognizance, which they merit in a fuperlative degree, the reprefentation here given might be fupported by unqueftionahfe authority. It is hoped, however, that enough has been faid to iuflue ice the»minds ot the judicious with refpect to this iniquitous practice, which becomes every day mere alarming, and threatens the more redulous part of the community with the moft fatal effects. This country, through the blefling of Providence, has been exempteoVfrom the horrors of famine, and for years the fword ; but the infatuation of a numerous body of the people has liib- jected it to the ravages of another public calamity, which, though generally more flow in its operation than any of the former, is equally deftrn&ive ig the end, puraanity fhudders at thehorri- CONCLUSION. 433 ble depredations committed on thehuman comtitution by this p pnirical tribe who fuofift by public delufion, and not, where th4 an in the Separable ruin of thofe whom they mbce into theh mtres. Wha confumptive vifages, what enfeebled frames, what mutilated- dies, and what palfied limbs, are the miferable monuments of that ignorance and criminal temerity by which they ^"i^cerVain difeafes, it is doubtlefs an object of importance to the uofort.aiate patients, that their cureftiould be conducted with f-crecy,and lik.wife to many, at the lmalleft poffible expenfe ; but they do not confider that, whife they are economical in this ar- ticle they' are fatally prodigal of health. They grain with eager- ne &-box or the phial, which they are aflur.d cont^m, tne elxir o* ip.~eJy ano1effectual convalefcence ; but, das ! the flattrr- hg hope proves of fhrt duration. Theymay tc:l perhaps, f,i-a little, afuppreffion of the fymptoms ofjtheir difeafe; but ne de- ftructive embers are fmothered, not extinguished ; and while prey- ing upon ihe vitals, are acquiring a malignity which will again break forth with redoubled violence. , . , , , r It is nnt/tiowever, in one difeafe only, nor m the lower clafs of the people, that this infatuated credulity operates; we hood it prevail even amongft thofe from whofe fuperior fituations in Up more difcernment might be expected ; but who have neverthelefs become voluntary dupes to the meaneft artifices of^empri ilp. Witnefs the fuccelsful impolture practiced with regard to tne m- fp,aion cf urine ; the v'fionary notion ot charms, i*c. But it is time that fuch chymencal doctrines fhould be con- fumed to the regions of baroarifm, and fiourifh no longer ma fell where-r.lmoft tvery other physical prejudice has been rooted up and xolor-d by the progrefs of fcience. lo effect this iaiutory purpoi*', nothing can have a more powerful tendency than the view which irs been given, in the preceding pages, of tne amies arm cure of c'ife-'fe*:. By removing the mvfterious veil which tor a i..i:g time ccnWei this ufeful branch of knowledge from the eves of the puH'c, it ought, en one hand, to preclude forever all rdources to empirical i-vpoltors, and on the other, to mow in what cafes it will be or "ner to coil h the afliftance of a phyfician. Avothm the bounds prefcribed bv this limitation any perfon of an orcmarv ra- pacitv may aa in conformity to the rules which have beea'dd-ver- ed 'By this means a prudent economy will be cculubed, uuhap- pvpa'icnts will no longer be fhipwrecked on the dangerous recks of empiricifm, with all their deceitful allurements, but will be con- ducted through the fafeft and moft direft road to ibe recovery of healtn, when that deferable object is practicable. «* Ah ! in what per">ls is vain life engag'd ! What flight negledls, what trivia^laults deftroy The ha(dieft frame ! Of indo'ence, ol toil, We die ; of want, of fuperfluity : i _ The all-furrounding heaven, the vital air. Is big with death. And thou;h the putrid fouth Ke fhut; though no convulfive agony Mialce, from the deep foundations ot the world, Th' imprifon'd plagues ; a fecret venom ctt f prr"r-< "Jr." ■**■ :b>. 'vatrr, and the lapd. APPENDIX: CONTAINING A Lift -of Simples and of fuch Medicinal Preparations as ought fo be kept in Readinefsfor Private Praclice. The Method of preparing and compounding fuch Medicines as are recom- mended in the former Part of the Book, with the Addition of feveral Others of a fimilar Nature. Remarks on the Dofes, Ufei, and Manner ef applying the different Pre- parations* JMsdicamemorum varietal ignorinti*-filia eft. Bacon. INTRODUCTION. IGNORANCE and fuperftition have attributed extraordinary niedical virtues to almoft every production of nature. That fuch vir- tues were often imaginary, time and experience have fufficiently (hewn. Phyficians, however, from a veneration for antiquity, ftill retain in their lifts of medicine many things which owe their reputation entirely ta the fuperftition and credulity of our anceftors. The inftruments of medicine will always be multiplied, in pro- portion to men's ignorance of the nature and cure of difeafes •, when ihefe arc fufficiently understood, the method of cure will be fimple and obvious. Ignorance of the real nature and permanent properties of thofe febftances employed in the cure of difeaf js, is another reafon why $hey have been .fo greatly multiplied. Phyficians thought they could «fiect by a number of ingredients, what could not be done by any one «£ them. Hence arofe thofe amazing farragos which have fo long dif- graced the medical art, and which were efteemed powerful in propor- tion to the number of Gmples that entered their composition. The great variety of forms into which almoft every article of medicine has been manufactured, affords another proof of the imper- fection of the medical art. A drag v/!iioh is perhaps moft efficacious in the. fimpleft form in which it can be admit.illerad., has been never- thelefs ferved up info many different (ha pes, that one would be induc- ed to think the whole art of phyfic lay in exhibiting medicine under as many different modes as poffible. Different forms of medicine, no doubt, have their ufe; but they ought never to be wantonly increafed. They are by no means fo ne- ceflary as is generally imagined. A few grains of powdered rhubarb, jalap, or ipecacuanha, wfl aft ..illy perform all that -can be done by the difl^rent preparations of thefe roots, and may alfo be exhibited in APPENDIX. • 435 as fafe and agreeable a manner. The fame obfervation holds with re- gard to the Peruvian bark, and many other fimples, of which the pre* parations are very numerous. Multiplying the ingredients of a medicine, not only Tenders it more expenfive, but alfo lefs certain, both in its dofe and operation. Nor is this all. The compound, when kept, is apt to fpoil, or acquire qualities of a different nature. When a medicine is rendered more fafe, efficacious, or agreeable, by the addition of another, they oughti no doubt, lo be joined ; in all other cafes, they are better kept afunder. The combination of medicines embaraffes the phyfician, and retards the progrefs of medical knowledge. It is impoffible to ascertain the precife effect of any one medicine, as long as it is combined with others, either of a fimilar or diffimilar nature. In the exhibition of medicine, regard fhould not only be had to flmplicity, but likewife to elegance. Patients feldom reap much bene- fit trjom things that are highly difagreeable to their fenfes. To tafte or fmell like a drug, is become a proverb ; and to fay truth, there is too much ground for it. Indeed no art can take away the difagreeable tafte and flavour of fome drugs, without entirely deftroying their effi- cacy i it is poflible, however, to render many medicines lefs difguft- ful, and others even agreeable ; an object highly deferving the atten- tion of all who adminifter medicine. The defign of the following pages is, to exhibit fuch a lift of drugs and medicines as may be neceffary for private practice. They are con- siderably more numerous indeed tnan thofe recomraended in the form- er part of the Book, but arc ftill greatly within the number contained in the moft reformed difpenfatories. The fame medicine is feldom ex- hibited under different forms; and where different medicines an- fwer nearly the fame intention, there is commonly no more than one of them retained. Multiplying forms of medicine for the fame intention tends rather to bewilder than aflift the young practitioner, and the ex- perienced phyfician can never be at a lofs to vary his prefcriptions as occafion requires. The chemical and other difficult preparations are for the moft part omitted. All of them that are ufed by any private practitioner are not worth preparing. He will buy them much cheaper than he can make them. Great care however is neceffary to obtain them genuine. They are often adulterated, and ought never to be purchafed unlefs from per*. fons of known veracity. Such of them as are in common ufe, are in- serted in the lift of drugs and medicines, Their proper doles, and manner of application, are mentioned in the practical part of the Book, wherever they are prefcribed. Such articles of medicine as are to be found in the ho ufe or gar- den of almoft every peafant, as barley, eggs, onions, &c. are likewife, for the moft part, omitted. It is needlefs to fwell a lift of medicinfs with fuch things as can be obtained whenever they are wanted, and which fpoil by being kept. The preparations made and fold by diftillers and confectioners are alfo generally left out. Thefe people by operating upon a larger plan, generally make things better, while it is in their power to afford them much cheaper than they can be prepared by any private hand. The quantity ordered of every medicine is as fmall as well could .be prepared, both to prevent unneceffary expenfe, and that the medi- fcinc might not fpoil by keeping. Almoft every medicine fuffcrs by being 41$ APPENDIX. kept, *nd fhould be ufed as foon after it has been prepared as poffible. Even fimple drugs are apt to fpoil, and fliould therefore be laid in fmall quantities, they either rot, are confumed by infects, or evaporate fo a9 to lofe their peculiar tafte or flavour, and often become quite infigni- ficaut. In the preparations of medicines, I have generally followed the mot approved difpenfatories ; but have taken thi liberty to differ from them whenever my own obfervations, or thofe of other practical wri- ters, on whofe judgment I could depend, fuggefted an improvement. In feverai compofitions, the ingredient on which the efficacy of the medicine chiefly depends i6 increafed, while the auxiliaries, which are .generally ordered in fuch trifling quantities as to be of no impor-. tance, are left out, or only fuch of them retained as are necefftry to give the medicine a proper confidence or the like. The colouring ingredients are likewife for the moft part omitted. They increafe the price and bulk ofthe medicine, without adding any thing to its vakc. It would be well if they were never ufed at all. Medicines are often adulterated for the fake of a colour. Acrid and pen.poifonous fubftances are, for this purpofe, fometimes introduced into thofe medicines which ought to be moft bland and emollient. Verdigreafe, for example, is often mix^-d with ointment of elder to give it a fine green colour, which entirely fruftrates the inlentiQn of that mild ointment. Thofe who wifh to obtain genuine medicines fhould pay no regard to their colour. Some regard is likewife paid to expenfe. Such ingredients as greatly increafe the price of any composition, without adding confid- erably to its virtue, are generally either omitted, or fomewhat lefs ex- tenfive fubftituted in their place. Medicines are by no means pow-' erful in proportion to their price. The cheapeft are often the beft, be- sides, they are the lead apt to be adulterated, and are always moft ready to be obtained. With regard to the method of compounding medicines, I have .generally followed that which feemed to be the moft fimple and natur- al, mentioning the different fteps of the procefs in the fame order in which they ought to be taken, without paying an implicit regard te the method of other difpenfatories. For many of the remarks concerning the preparation &c. of med- icines, I have been obliged to the author of the New Difpenfatory. The other obfervations are either fuch as have occurred to myfelf in prattice", or have been fuggefted in the courfe of reading, by authors whole names I am not able diftinctly to recollect. I have followed the alphabetical order, both with regard to the fimpfts ana preparations. A more fcientific method would have been agreeable' to fome perfons, but lefs ufeful to the generality of readers. The different claffes of medicine have no great dependence upon one another, and, where they have, it is hard to fay which fhould ftand firft or laft; no doubt the fimple preparations ought to precede the more compound. But all the advantages arifing from this method of arrangement, do not appear to be equal to that fingle one, of being o.hle, on the firft opening of the book, to find out any article, which, by the alphabetical order, is rendered quite eafy. % The dofe of everymedicine is mentioned whenever it appeared neceffarv. 'When this is omitted it is to be underftood that the medir cine may be ufed at difcretion. The dofe mentioned is always fojr aa APPENDIX, r 427. adult, unlefs when the contrary is expreffed. It is not- an eafy m.-u-ier to proportion the dofes of medicine exactly to the different ages, con- ftitution s &c of patients; but* happily for mankhuly mathematical exactnefs is by.no means neceffary. , ■ % Several attempts have been mae'e to afcertain the proportional dofes for the different age3 and conftit«ilions of patients ; but after all that can be faid on this fubject, a great deal muft be left to theVjucig- ment and (kill of the perfon who adrniniflers the medicine. The'fal- lowing general proportions may be obferved ; but they are by no means intended for exact rules. A patient between twenty and fourteen may take two thirds of the dofe ordered for an adult; from fourteen to nine, one half; fro.n nine, to fix, one fixth ; from two to one, a tenth ; and - below one, a twelfth.* Difpenfatories are ufually written in the Latin language. Even :' authors who write in Englifh, generally give their prefcriptions in lat- in ; and fome of them fhew fo great an attachment to that Jang ur^o, as firft to write their recipes in it, and afterwards tranflate them ; while others to compromife the matter, write the one half in Latin and the other in Engliih. What peculiar charm a medical prefcription, when written in Latin, may have, I fhall not pretend to fay ; but have ven- tured to make ufe of the plaineft Englifh I could, and hope my pre* , fcciptions will fucceed no worfe for it. N. B. The Apothecary's weights, and the Englifh wine meafures, are ufed throughout the whole book, the different denominations oi which will appear from the following Table :— A pound contains twelve ounces. An ounce - - eight drachms. A drachm - - three fcruples. A fcruple - - twenty grains. A gallon contains eight pints. A pint - - -. fixteen ounces. An ounce - - eight drachms. A table fpoonful is the meafure of half an ounce, A tea-fpoonful is one fourth of a table fpoonful. Sixty drops make one tea-fpoonful. * The following Table of Doses for different Ages, is giv- en by Dr. Thomfon. [The Common Doje being taken at one DrUchm.'} Parts df the Proportions Ages. Common Dofe. of a Drachm. 7 - - - f - - - - 4 " 7 - - - A- - - - Weeks Months -j Years < 14 28 5 7 14 21 63 77 log 12 20 {►■grams. common dofe. - - 3° i - '-40-.J. one drachm* 2 T •n^ - 50 - JS j- grains- 43» rA LIS'T Of SlMPtt*,,AitD SUCH MEDICINAL PREPARATIONS, At OVGSt TQ BE KEPT IN READINESS FOX PRIVATE PRACTICE. A GARIC Alum , Antimony, crude ■ i ■ ■ cinnabar of r ■ fulphur of Balfam of Capivi ----- of Peru ~...... ofTolu Bark, cafcarilla -.....■- cinnamon ■ ■ ■■■ Mezerion —— Peruvian ——• Winter's, or canella alba Borax Calamine ftone, levigated Caftor, Ruffian Cauftic, common —. . '■ lunar Earth, Fuller's *-----Japan -----Armenian bole ——-- French, ditto Extracts of gentian ——— of guaiacum ■ of Hellebore, black - of hemlock ■ ■ of jalap ,. of liquorice m of Peruvian bark ------- of poppies »■ ■ of wormwood Flowers of camomile m, of colt's foot .. of elder ______of rofemary ____— of damalk and red rofes Fruits, almonds ---- bitter apple ■ caflia fiftularis ____ Curaffao oranges .---- figs, dried ---- French prunes ---- Jamaica pepper -•— juniper, berries ---- nutmegs — ■■■ tamarinds Gum, aloes —— ammoniac, in tears ——- arabic Gum camphor — galbanum —- gamboge -—- guaiacum ;■—— kino ---- myrrhs ---- opium Hartfhorn, calcined ■ ■ ■ ■■ (havings of Herbs, leffer centaury —- peppermint ---- lpearmint ---- penny-royal —— lavin ---- trefoil —— uva urn* —— wormwood Lead, Litharge —- white —— fugar of Lemon-peet Mace Magnefia alba Manna Mercury, crude — — .. - calcined .--------<$)thiop's mineral '■■ calomel ■ ■■■■■ corrofive fublimato » red precipitate ------->— white ditto Mufk Oil, effential, of amber ..... ■■ of annife -----------of cinnamon .....— of juniper —■■----—— of lemon-peel ■<----■ ■ ■■ ©f peppermint Oil, expreffed, of almonds -■ i of linfeed Oil of Olives, or Florence oil . ■ of palms r .ii ■- ■■■ of turpentine Orange-peel .Oyfter-fhells prepared Poppy-heads Refins benzoin ■» ■ - - ■ flower of .*. i ■■ Burgundy pitch ■■in i dragon's blood Refins, frankincenfe ■ liouid ftorax - white, or rofin fcammony Roots, birthwort ■ calamus aromaticus ■ contrayerva —— garlic ----gentian .---- Ringer ----. hellebore, black, white —— jalap —— ipecacuanha —-—- lily, white —— liquorice . marfhmallow - mezerion —— rhubarb ——. farfapariUa ---- feneka .---- fquills —— tormentil —-7- tumeric • ——- Virginian fnake .---- wild valerian —— zedoary Saffron Sal ammoniac crude ' m volatile Salt, Epforn —— of Glauber —— of hartfhorn ----nitre purified, or prunel — Polychreft ----Rochel —— of tartar Seeds, anife ---- caraway ——• cardamom —— coriander —— cummin ——> muftard LIST OF SIMPLES, 6c. 439 Seeds, fweet fennel *— wild carsot Senna Spanifh flies Spermaceti Spirits, aetherial, or aether ■> of hartfhorn —----of lavender compound -------of nitre ------- ditto dulcified -------of fal ammoniac -------of fea fait ----— of vinegar —----of vrtriol -------of wine rectified •— . — volatile aromatic Steel, filings of ----raft of, prepared ----foluble, fait of Sulphur vivum ■ balfam of —----- flower of Tar — Bar badoes Tartar, cream of -------emetic ...... »■■■ foluble ■'■■ ■ vitriolated Tin prepared Tutty, levigated Turpentine, Venice Verdigreafc Vitriol, green ——— blue -------white Wax, wrote ---- yellow Woods guaiacum — logwood ——- faflafras ——— faunders, red- Zinc, flowers of w MEDICINAL PREPARATIONS. BALSAMS. 1 HE fubject of this fection is not the natural baliams, but certain compofuions, which, from their being fuppofed to poffefs bal* famic qualities, generally go by that name. This clafsi of medicines was formerly very numerous, and held in great efteem ; modern practice, however, has juftly reduced it to a very narrow compafs* Anodyne Balfam. '" Take of white Spanifh foap, one ounce ; opium, unprepared, two drachms ; rectified fpirit of wine, nine"ounces. Digeft them togeth- er in a gentle heat for three days, then ftrain off the liquor, and add to it three drachms of camphor. This balfam, as its title expreffes, is intended to eafe pain. It is of fervice in violent strains and rheumatic complaints, when not atten- ded with inflammation. It muft be rubbed with a warm hand on the part affected ; or a linen rag moiftened with it may be applied to the part, and renewed every third or fourth hour, till the pain abates. If the opium is left out, this will be the Sapenacedft Balfam. LocateRis Balfam. « Take of olive oil, one pint; Strafburg turpentine and yellow wax, of each half a pound j red launders, fix drachms. Melt the wax with fome part of the oil over a gentle fire ; then adding the renaming part of the oil and the turpentine ; afterwards mix in the launders pre- vioufly reduced to a powder, and keep them ftirring together till the balfam is cold. This balfam is recommended in erofions of the inteftines, the dyfentery, hsemorjfhages, internal bruifes, and in foms complaints of the breaft. Outwardly it is ufed for healing and cleanfing wounds and ulcers. The dofe, when taken internally, is from two fcruples to two drachms. - The Vulnerary Balfam. Take of benzoin, powdered, three ounces ; balfam of Peru, two ounces; hepatic aloes, in powder, half an ounce ; rectified fpirit of wine, two pints. Digeft them in a • gentle heat for three days, and then ftrain the Balfam. This Balfam, or rather tincture, is applied externally to heal recent wounds and bruifes. It is likewife employed internally to remove coughs, afthmas, and other complaints of the breaft. It is faid to eafe the cholic, cleanfe the kidnies, and to heal internal ulcers, &c. The dofe is from twenty to fixty drops. This, though a medicine of fome value, does not deferve the ex- travagant encomiums which have been beftowed on it. It has been celebrated under the different names of The Commander** Balfam, Perjian Balfam, Balfam of Berne, Wade's Balfam, Friar's Balfam, fefuit's Dropt, Turlington's Drops, &c. . BOLUSES. AS bolufes are intended for immediate ufe, volatile falts and other ingredients improper for being kept, are admitted into their compofn tion. They are generally compofed of powders, with a proper quan-; APPENDIX. 44* tity of fyrup, conferve, or mucilage. The lighter powder? are commonly made up with (yrup, and the more ponderous, as n ercury, &<*. with con- ferve; but thofe of the lighter kind w» uld be more conveniently r.^de up with mucilage, as it increafes the'r bulk lefs thin the other additions, and likewife occafions the medicine to p fs down more eafily. Aftringent Bolus. Take of alum, i^powder, fifteen grains ; gum kino, five grains I fyrup a fufficient quantity to make a bolws. In an exceffive flow of the menfes, and other violent difcharges of blood, proceeding from relaxation, this bolus njay be given every four Or £ve hours, till the difcharge abates. Diaphoretic Bolus. Take of gum guaicum, in powder, ten grains ; flowers of fulp'ur and cream of tartar, of each one fcruple ; fimple fyrup, a fufficient quan- tity. ^ . In rheumatic complaints, and diforders of fhe fkin, this bolus may be taken twice a-day. It will alfo be of fervice in the inflammatory quinfey. Mercurial Bolus. Take of calomel, fix grains; conferve of rofes, half a drachm. Make a b&lus. Where mercury is neceffary, this bolus may be taken twice or thrice a-week. It may be taken over night ; and if it does not operate, a few grains of jalap will be proper next day to carry it eff. t Bolus of Rhubarb and Mercury. Take of the beft rhubarb, in powder, from a fcruple to half a drachm ; offcalomel, from four to fix grains ; fimple fyrup, a fufficient quantity to make a bolus. This is a proper purge in hypochondriac conftitutions ; but its prin- cipal intention is to.expel worms. Where aftronger purge is neceffary* jalap may be ufed inftead of the rhubarb. Peroral Bolus. Take of fpermaceti, a fcruple ; gum ammoniac, ten grains; fait of hartfhorn, fix grains; fimple fyrup* as much as will make them into a bolus. This bolus is given in colds and coughs of long (landing, afthmas, and beginning confumptions ofthe lungs. It is generally proper to bleed the patient before he begins to ufe it. Pupgwg Bolus. Take of jalap, in powder, a fcruple; cream of tartar, two fcpiples. Let them be rubbed together, and formed into a bolus, with fimple fyrup. Where a mild purge is wanted, this will anfwer the purpofe very well. If a ftronger dofe is neceffary, the jalap may be increafed to half a drachm or upwards. CATAPLASMS AND SINAPISMS. CATAPLASMS pc:ff fs few or no virtufs fuperior to a poultice which rnny be fo made, as in moft cafes, to fupply their place. They are chieily intended either to aft as difcutients, or to promote fuppura- tion ; and as tl.cy may be of fervice in fome cafes, we fhall give a fpeci- men of each kind. Difcutieni Cata/Jafm. Take of barley-meal, fix ounces; frefh hemlock leaves, bruifed, two ounces ; vinegar, afuflicient quantity. Boil the meal and hemlock in the vinepar for a little, and then add two drachms of the fugar of lead. (29) 442 'APPENDIX. Ripening Cataplafm. Take of white lily root, feur ounces ; fat figs and raw onion?, bruifed, of each one ounce ; yellow bafilicum ointment, two ounces, gum gatbanum, half an ounce ; linfeed meal, as much as neceffary. Boil the roots along with the figs in a fufficient quantity of water ; then bruife and add to them the other ingredients, fo as to form the whole into a foft cataplafm. The galbanum rntift be previously diffolved with the yolk cf a;: egg. Where it is neceflary to promote fuppuration, this cataplafm may be ufed by thofe who chufi to be at the trouble and expence of making it. For my part, I have never found any application more proper for this purpofe than a poultice of bread 3nd milk, with a fufficient quantity cf either boiled or raw onion in it, and foftened with oil or frefh butter. Sinapifms. Sinapifms are employed to recal the blood and fpirits to a weak part, as in the palfy. and atrophy. They are alfo of fervice in deep feated pains, as the fciatica, &c. When the gout feizes the hen' of the ftomach, they are applied to the feet to bring the diforder to thefe parts. They are likewife applied to the patient's foles in the low ftate of fevers.— Theyfhould not be fuffered to lie on, however, till they have raifed buf- fers, but till the parts become red, and will continue fo when preffed wifh the finger. Thefinapifm is only a poultice made with vinegar inftead of milk, and rendered warm and ftimulating by the addition of muftard, horfe- radifh.- or garlic. The common finapifm is made by taking crumb of bread and muf- tard-feed in powder, of each equal quantities ; ftrong vinegar, as much as is fufficient, and mixing them fo as to make a poultice. When finapifms., of a more ftimulating nature are wanted, a little bruifed garlic may be added to the above. CLYSTERS. THIS clafs of medicines is of more importance than is generally im- agined. Clyfters ferve not only to evacuate the contents of the belly, but alfo to Convey very aftive medicines into the fyftem. Opium, for ex- ample, may be adminiftered in this way when it will not fit upon the ftomach, and alfo in larger dofes than at any time it can be taken by the mouth. The Peruvian bark may likewife be, with good effeft, adminif- tered in form of clyfter to perfons who cannot take it by the mouth. A fimple clyfter can feldom do hurt, and there are many cafts where it may do much good. A clyfter even of warm water, by ferving as a fomentation to the parts, may be of confiderable fervice in inflammations of the bladder, and the lower inteftines, Sec. Some fubftances, as the fmoke of tobacco, may be thrown into the bowels in this wsy, which cannot by any other n»eans whatever. This may eafily be effefled by means of a pair of hand*bellows, with an appa- ratus fitted to them for that purpofe. Nor is the ufe of clyfters confined to medicines. Aliment may alfo be conveyed in this way. Perfons unable to fwallow, have been, for a confiderable time, fupported by clyfters. Emsllient Clyfter. Take of linfeed tea and new milk, each fix ounces. Mix them. If fifty or fixty drops of laudanum be added to this, it will fupply the place of the Attodyne Clyfter. Laxative Clyfter. Take of milk and water each fix ounces; fweet oil or frefh butttf, and brown iugar, of each iwo ounces. Mix them. APPENDIX. 443 If an ounce of Glauber's fait, dr two tiu!e fpoonsful of common fait, be added to this> it will be the Purging Clfter. Carminative Clrfter. Take of camomile flowers, an ounce; anife-feeds, half an ourtce.—- Ki'il in a pint and a halfof water to one pint. In hyfteric and hypochondriac complaints this may be adminiftered inftead of the Fat id Clyfter, the fmell of which is fo difagreeable to mofl patients. Oily Chfter. To four.ounces of the infufion of camomile flowers, add an equal quantity of Florence oil. This clyfter is beneficial in bringing off the fmall worms lodged in the lower parts of the alimentary canal. When given to children the quantity mult be proportionably Ieffened. Starch Clyfter. Take jelly of ftarch, four ounces; linfeed oil, half an ounce. Liqui- fy the jelly over a gentle fire, and then mix in the oil. In the dyfentsry or bloody flux, this clyfter may be adminiftered after every loofe ftool, to heal the ulcerated inteftines and blunt the fharpnefs of corroding humours. Forty or fifty drops of laudanum may be added ; in which cafe, it will generally fupply the place of the Aftrin- gent Clyfter. Turpentine Clyfter. Take of common decoction, ten ounces; Venice turpentine, diffol- ved with the yolk of an egg, half an ounce ; florence oil, one ounce.— Mix them. This diuretic clyfter is proper in obftru&tons of the urinary paffages and in colicky complaints proceeding from gravel. Vinegar Clyfter. This clyfter is made by mixing three ounces of vinegar with five of water gruel. It anfwers all the purpo&sof a common clyfter, with the peculiar advantage of b«ing prober either in inflammatory or putrid diforders, efpecially in the latter. We think it unnec<:ffary to give more examples of this clafs of medi- cines, as ingredients adapted to any particular intention may be occa- fioaally added to one or other of the above forms. , COLLTR1A, or ETE-WATERS. EYE-WATERS have been multiplied without number, almoft every perfon pretending to be pofleffed of fome fecret preparation for the cure of fore eyes. I have examined many of them, and find that they are pretty much alike, the bails of moft of them being either alum, vitriol or leid. Their effetfts evidently are, to brace and reftore the tone of the parts; hence they are principally of fervice in flight inflammations ; and in that relaxed ftate of the parts which is induced by obftinate ones. Camphor is commonly added to thefe compofitions : but as it feldom incorpsr.ucs properly with the water, it can be of little ufe. Boles and other earthy fubftances, as they do notdiffolve in water, arelikewife unfit for this purpofe. Coilyrium of Alum. Take cf alum, half a drachm ; agitate it well together with the white of one eerg. This is the Cwllyrium of Riverius. It is ufed in inflammation ofthe eves, to allay heat, and reftrain the flux of humours. It muft be fpread upon linen, and applied to the eye?, but fhould not be kept on above three or four hours at:. time. 444 APPENDIX. Vitriolic Collyrium. Take of white vitriol, half a drachm ; rofe water, fix ounces. Dif- folve the vitriol in the water, and filter the liquor. ' This, though fimple, is perhaps equal in virtue to moft of the cele- brated collyria. It is an ufeful application in weak, Watery, and infla- med eyes. Though.the (lighter inflammations will generally yield to it, yet m thofe of a more obftinate nature the afliftance of bleeding and blif- tering will often be neceffary. When a ftrong aftringent is judged proper, a double or triple quan- tity of th<* vitriol may be ufed. 1 have feen a folution of four times the ftrength of the above ufed with manifeft advantage. Collyrium of Lead. Take fugar of lead, and crude fal ammoniac, of each four grains. 2);ffolve them in eight ounces of common water. Forty or fifty drops of laudanum may be occafionally added to this collyrium. Thofe who chufe may fubftitute inftead of this the collyrium of lead recommended by Goulard ; which is made by putting twenty-five drops of his Extratl of Lead to eight ounces of water, and adding a tea-fpoonful ©f brandy. Indeed, common water and brandy, without any other addition, will in many cafes anfwer very well as a collyrium. An ounce of the latter | may be added to five or fix ounces of the former, and the eyes, if weak, bathed with it night and morning. CONFECTIONS. CONFECTIONS containing above fixty ingredients are ftill to be found in fome of the mnft reformed difpenfatories. As moft of their in- tentions, hewever, may be more certainly, and as effectually anfwered*by a few glaffrs of wine ot grains of opium, we fhall pafs over this clafs of medicines very flightly. Japonic Cpnfeclion. Take Japan earth, three ounces: toropentil root, nutmeg, olibanum, bf each two ounces ; opium diffolved in a fufficient quantity of LifboM wine, a drachm and a half; fimple fyrup and conferve of rofes, of each fourteen ounces. Mix and make them into an elecfuary. This fupplies the place of the Diafcordium. The dofe of this eleftuary is fro:ti a fcrUple to a drachm. CONSERVES and PRESERVES. EVERY Apothecary's fhop was formerly fo full of thefe prepara- tions, that it might have paffed for a confectioner's ware-haufe. They poffefs very few medicinal properties, and may rather be claffed among fweet meats than medicine1:. They are fometimes, however, of ufe, for feduci--'g into bolufes or pills fome of the more ponderous powders, a< the preparations of iron, mercury, and tin. Conf.Tves are compositions of frefh vegetables and fugar, beaten to- gether into an uniform mafs. In making thefe preparations, the leaves of vegetables muft be freed from their ftocks, the flowers from their cups, and theyellow part of orange-peel taken off with a rafp. They are then to be pounded in a marble mortar, with a wooden peftle, into a fmooth mafs ; after which thrice their weight of fine fugar is commonly added by decrees, and the beating continued till they are uniformly mixed ; but the conferve will be better if only t ""d mav he ufed at difcretion. Prcftrves are made by fteeping or boiling frefb vegetables firft in Water, and afterwards in fyrup, or a folution of frgar. The fubjed is either preferved moift in the fyrup, or taken out and dried, that the fu- f gar may candy upon it. The laft is the moft ufeful method. <■ Candied Orange-Peel. Soak Seville orange-peel in feveral waters, till it lofes its bitternefs ; then boil it in a folution of double-refined fugar in water, till it becomes tender and tranfparenf. Candied lemon-peel is preoared in the fame manner. It is rjcedlefs to add more of thefe preparations, as they belong rather Jo the art of the confedtioner than that ofthe apothecary. DECOCTIONS. WATER readily extracts the gummy and filine parts of vegetables; and though its adtion is chiefly confined t« thefe, ytt the refinous and oi'y being intimately blended with the gummy and faline, are in great p rt taken up along with them. Hence watery decodtions and infufions . of vegetables, conftitute a large, and not unufcful daft of medicines.— Although, moft vegetables yield ttieir vimus to water, as well by infufion as decodion, yet the hitter is often nec:fl'.uy, as it fives time, r>nd does in a few ;iiinutes what the other would require hours, and fometimes days, r to eff- &. The medicines of this clafs are all intended for immediate ufe. DcccQion of jilibeca. T«ke of the roots of marfh-mallows, moderately dried, three ounces; raifins of the fun, ore ounce, water three pints. B ;il the ingredients in the water till one third of it is confumed ; afterwards ftrain the decodtion and let it ftand for fo.ne time to fettle. If the roots be thoroughly dried»,they muft be boiled till one half the water be confu:ued. In coughs, and fharp defludt ions upon the lungs, this decoction may be ufed for ordinary drink. The Common De coil ion. Take of camomile flowers* one ounce ; elder flowers, and fweet fen- nel feeds, of each half an ounce, water, two quarts. Boil them for a lit- tle, and then ftrain the decodtion. A medicine equally good may be prepared by infufing the ingredi- ents for fome hours in boiling water. This decoction is chiefly intended as the bafis of clyfters, to whisii 44<5 APPENDIX. other ingredients may be occafionally added. It will likewife ferve as a common fomentation, fpirit of wine or other things being added in fuch quantity as the cafe may require. Decoclion of Logwood. Boil three ounces ofthe fliavings, or chips, of logwood, in four pints of water, till one half the liquor is wafted. Two or three ounces of Am- ple cinnamon water may be added to this decodtion. In fluxes of the belly, where theftronger aftringents are improper, a '• tea-cupful of this decodtion may be taken with advantage three or four times a-day. Decision of ihe Bark. Boil an ounce of the Peruvian bark, grofsly powdered, in a pint and a half of war-r to one pf it, then ftrain the decoction. If a tea-fpoon- ful of the weak fpirit of vitrioi be added to thij medicine, it renders it both more agreeable and • ffir ici-^us. Compound Dtcoclion of the Bark. Takeof Peruvian !vnk ami Virginian frn-k:-root, grofsly powdered, each three drachms. 3 .s them in a pin of water to one halt. To the ftr&L'.ed liquor add an o'niceanda half of aromatic water. Sir John Prir.gie lecommends this as a proper medicine towards the decline of malignant fevers, when the pulfe is low, the voice weak, and the head ^.ffedted with a ftupor but with little delirium. This dofe is four fpoonsful every fourth or fixth hour. Decoclion of Sarfaparilla. Take of frefh farfapariUa root, fliced and bruifed, two ounces j fliavings of guaiacum wood, one ounce. Boil pver a flow fire, in three quarts of water, to one ; adding towards the end, halt an ounce of fafla- ) fras wood, and three drach ns of liquorice. Strain the decoction. ■ This '.-.ay either be employed as an afliftant to a courfe of mercurial } alteratives, < rr.k?r> after the mercury has been ufed for {o\r>e time. It ftrengtheiis the fto r■ .ch, and reftores flefh and vigour to habits emacia- ted by the venereal ^ife fe. Ir may alfo be taken in the rheumatifm, and cutaneous diforders pr ceedjng from foulnefs of the blood and juices. For ali thefe intentions it is greatly preferable to the Decoclion of Woods. This decodtion m*y be taken, from a pint and a half to two quarts jn the d^y. * The followi'.g decodtion is faid to be fimilar to that ufed by Kennedy, in the cure of the venereal difeafe, and may fupply the place of Lifhon ' diet drink : Takeoffarfip3ri!!3, three ounces jliquorice and mezerion root, of each half an ounce ; fhavings of guaicum an^ faffafras wood, of each one ounce ; crude antimony, powdered, an ounce and a half. Infufe thefe ingredients in eight pints of boiling water for twenty-four hours, then boil them till one half of the water is confumed ; afterwards ftrain the decodtion. This decoclion may be ufed in the fame manner as the preceding. ' Decoclion of Seneka. Take of Seneka rattle-fnake root one ounce ; water, a pint and a half. Boil to one pint, and ftrain. This decodtion is recommended in the pleurify, dropfy, rheumatifm, and fomeobftinate diforders ofthe fkin. The dofe is two ounces, three or four times a-day, or oftener, if the ftomach will bear it. White Decoclion. Takeof the pureft chalk, in powder, two ounces ; gum arabic, half an ounce j water, three pints. Boil to one quart, and ftrain the dfepe-, #011, APPENDIX. 447 This is a proper drink in acute difeafes, attended with, or inclining to, a loofenefs, and where acidities abound in the ftomach or bowels. It is peculiarly proper for children when afflidted with fournefs of the ftomach, aud for perfons who are fubjedt to the heart-burn. It may be ' fweetened with fugar, as it is ufed, and two or three ounces of fimple cinnamon-water added to it. An ounce of powdered chalk, mixed with two pints of water, will occafionally fupply the place of this decodtion, and alfo of the chalk juttp. DRAUGHTS. THIS is a proper form for exhibiting fuch medicines as are intend.- ed to operate immediately, and which do not need to be frequentlv re- peated, ts purges, vomits, and a few others, which are to be taken at Dne dofe. Wherea medicine requires to be ufed for any length of time, it is better to make up a larger quantity of it at once, which faves both troub.e and expence. Anodyne Draught. Take of liquid laudanum, twenty-five drops ; fimple cinnamon- water, an ounce ; common fyrup, two drachms. Mix them. In exceffive pa'n, where bleeding is not neceffary, and in great reft- leffnefs, this compofing draught may be taken and repeated occafionally. Diuretic Draught. Take of the diuretic fait, two fcruples ; fyrup of poppies, two drachms ; fimple cinnamon-water, and common water, of each an ounce. This draught is of fervice in an obftrudiion or deficiency of urine. Purging Draughts. Take of manna, an ounce; foluble tartar, or Rochel fait, from three to four drachms. Diffolve in three ounces of boiling water to which add Jamaica pepper-water, half an ounce. As manna fometimes will not fit-upon the ftomach, an ounce or ten drachms of the bitter purging falts, aiflolvcd in four ounces of water, may be taken inftead of the above. Thofe who cannot take falts, may ufe the following draught: Take of jalap in powder, a fcruple ; common water, an ounce ; aromatic tindture, fix drachms. Rub the jalap with twice its weight of fugar, and add to it the other ingredients. Sweating Draughts. Take fpirit of Mindereru:, two ounces ;. f.tlt of hartshorn, five grains; fimple cinnamon-water, and fyrup of poppbs, of each half an ounce. Make them into a draught. In recent colds and rheumatic complaints, this draught is of fer- vice. To promote its effedls, however, the patient ought to drink freely of warm water-gruel, or of fome other weak diluting liquor. Vomiting Draughts. Take of ipecacuanha in powder, a fcruple; water an ounce ; fimpls fyrup a drachm. Mix them. Perfons who require a ftronger vomit, may add to the above half a grain, ©r a grain, of emetic tartar. Thofe who do not chufe the powder, may take ten drachms of the ipecacuanha wine ; or half an ounce of the wine, and an equal quantity of the fyrup of fquills. ELECTUARIES. ELECTUARIES are generally compofed of the lighter powders, mixed with fyrug^ honey, conferve, or mucilage, into fuch a confiftence, that the powder* nay neither feparate by keeping, nor the ma's prova too ftiff for fwallowing. They receive chiefly the milder alterative med- icines, aad fuch as are not ungrateful to the palate. 448 APPENDIX. Aftringent eledtuaries, and fuch as have pulps of fru'.t in them, fhould be prepared only in fmall qmntities ; as aftringent medicines lofe their virtues by being kept in this torm, and the pulps of fruits are apt to f rment. For the extraction of pulps it will be neceffary to boil unripe fruits and ripe ones ir they are dried, in a fmall quantity of water till they be. come foft. The pulp is then to be preffed out through a ftrong hair jQ fieve, or tnin cloth, and afterwards boiled to a due confidence, in an eartnen veffel, over a gdtle fire, taking rare to prevent the matter from burning by continually flirting it. The pulps of fruit that are both ripe and frefh, may be prefled out without any previous boiling. -n Lenitive Eledluary. Takeof fenn^,in fine powder, eight ounces ; coriander feed, alfo in powder, four ounces ; pulp of tamarinds and French prunes, each a pound. Mix the pulps and powders together, and with a fufficient quantity of fimple fyrup, reduce the whole into an eledluary. A tea-lpoouful of this ekdtuary, taken two or three times a-day, . generally proves an agreeable laxative. It likewife ferves as a cenvenient vehicle for exhibiting more adtive medicines, as jalaps, fcammony, and fiich like. Tnis may fupply the place of the electuary of Caff.a. Eleduary for the D fentery. Take ofthe Japonic confedlion, two ounces; Locatelli's balfam, one ounce; rhuharb in powder, half an ounce; fyrup of marfh-mallows, en-.ugh to make an dedtu .ry. Jt is often dangerous in dyfenteries to give opiates and aftringents, without interp. Ci<\o purgatives. The purgative is here joined with thefe ingredients, which ra.dtis tais a very faf and ufeful medicine for the purpofes xpreffed ..n tne title. About toe ,-u.kof a nutmeg fh uld be tak*n twice or thrice a*dav, as the lympron s and confivutio!' m.>y require. Elt;luy for the Epilepfy. Take cf Peruvian bark in powder, an ounce ; of powdered tin, and wild valerian root* eiich half an ounce ; fimple fyrup, enough to make an ek-uu«-ry. Dr. Mead diredls a drachm of an eledluary fimilar to this to be taken .eiw g and mornii g, in the epilepfy, for the fpace of three months, it will be proper, however, to difcontinue the ufe of it for a few .'ays e»e y :.ow and then. 1 have added the powdered tin, becaufe the epilepfy often proceeds from worms. Eledluary for the Gonorrhoea. Take of lenitive eltdtuary, three ounces ; jalap and rhubarb, in powd-r, of each two Oracbms; nitre, half an ounce ; fimple fyrup,enough ti m kr an e' ctuary. During thf inflammation and tenfion of the urinary paffages, which acco- >mv a virulent gom rrhcea, this cooling laxative may be ufeaV with adv.n. t-.i't. To! dofe is a drachm, or about the bulk of a nutmeg, two or three tmvs u.(uj; more or lefs, is may be neceffary to keep the body gently open. A" iiedlu ry m.de of cream of tartar and fimple fyrup will occafion- ally fuptdv the place oi this. A Mer the inflammation is gone off, the following .-elcdtyary may be jifed : 1 • !< e of lenitive eledtuaryrtwo ounces; balfam of capivi, one ounce; gut;; guaiacum and rhubarb, in powder, of each two drachms; fijnpU APPENDIX. 449 fyrup, enough to make an eledluary. The dofe is the fame as of the preceding. Eledluary of the Bark. Take of Peruvian bark, in powder, thrte ounces ; cafacarilla, half in ounce ; fyrup of ginger, enough to make an eledluary. in the cure oft.bitiiate inter-nitting fevers, the bark is affifted by the cafacarilla. Ir. bedtic habits, however, it will be better to leave out the cafc»rilla,and put thr e dr-.ch -.s of cru e fal ammoniac in its ftead. E/edlu.iry for the Pjles. Take flowers of fulphur, oneource; cream of tartar, half an ounce; treacle, afufricie;>f qu intity to form an e^dtuary. v A tea-fpuontul of this ipirit. A table fpoonful of it may be taken every two or three hours. EXTRACTS. EXTRACTS are prepartd by boiling the fubjedl in water, and eva. porating the flramed decodtion to a due confiftence. By this procefs fome ofthe more active parts of plants are freed from the ufelefs, inriiflbluble earthy matter, which makes the larger fhare of their bulk. Water, how- ever, is not the only menftruum ufed in the preparation of extracts ; fome- times it is joined with fpirits, and at other times redtified fpirit alone is employed for that purpofe. Extradts are prepared from a variety of different drugs, as the bark, gentian, jalap, Ac. but as they require a tronblefome ahd tedious operation, it will be more convenient for a private praftitioner to purchafe what he needs of them from a profeffed druggilt, than to prepare them himfelf.—- Such of them as are generally ufed are inferted in our lift of fuch drugs and medicines as are to be kept for private pradtice. FOMENTATIONS. FOMENTATIONS are generally intended either to eafe pain by taking off tenfion and fpafm ; or to brace and reftore the tone and vigour of thofe parts to which they are applied. The firft of thefe intentions may generally be anfwered by warm water, and the fecond by cold. Certain -«iubftances, however, are ufually added to water with a view to heighten its effedls, as anodynes, aromatics, aftringents, Sec. , We fhall therefore fubjoin a few ofthe moft ufeful medicated fomentations, that people may have it in their power to make ufe of them if they chufe. Anodyne Fomentation. Take of white poppy-heads, two ounces; elder flowers, half an ounce, water, three pints. Boil till one pint is evaporated, and ftrain out the li- quor. :•- This fomentation, as its title expreffes, h ufed for relieving acute pain. Aromatic Fomentation. Take of Jamaica pepper, half an ounce ; red wine, a pint. Boil them for a little, and then ftrain the liquor. This is intended, not only as a topical application for external com- plaints, but alfo for relieving the internal parts. Pains of the bowel;, which accompany dyfenteries and diarrhaeas, flatulent colics, uneafmefs of the ftomach, and retchings to vomit, are frequently abated by fomenting the abdomen and region of the ftomach with the warm liquor. Common Fomentation. Take tops of wormwood and camomile flowers, dried, of each twq ounces; water two quarts. After a flight boiling, pour off the liquor. Brandy or fpirit of wine may ba added to this fomentation, in fuch quantity as the particular circumftances of the cafe fhall require ; but thefe are not always neceffary. Emollient Fomentation? This is the fame as the common decodtion. Strengthening Fomentation. Take of oak bark, one ounce ; granate peel, half an ounce ; alum, fcsyo drachm^ j fmith's forge water, three pints. Boil the water with the APPENDIX. 45t bark and peel to the confumption of one-third : then ftrain the remaining decqdtion and diffolvealum in it. This aftringent liquor is employed as an external fomentation to weak parts ; it may alio be ufed internally; GARGLES. HOWEVER trifling this clais ot medicines may appear, they are by do meaas wimout their ufe. They feldom indeed cure difeafes, but they often alieviate very difagreeable fympioms; as parchednefs of the mouth, foulnefi of the tongue and fauces, &c. they are peculiarly ufeful in fevers and foar throats. In the latter, a gargle will lometimes remove the difor- der ; and in thf former few things are more refrefhing or agreeable to the patient, than to have his month frequently wafhed with fome foft detergent gargle. One advantage of tbefe medicires is, that tkey are eafily prepared.— A little barley water and honey may be had any where, and if to thefe be adc'cG as iruch vinegar as will give them an agreeab.e fhaipnefs, they will make .. vtry ui'eful gargle for fofteniog and cleanfing the m~uth, Gargles have the belt effect when injected with alyringe. Attenuating Gargle. Take of water, fix ounces, honey, one ounce, nitre, a drachm and a half. Mix them. This cooling gargle may be ufed either in the inflammatory quinfey, or ip fevers, iit cleaning the tongue and fauces. Common Gargle. Take of rofe-water, fix ounces, fyrup of clove, July-flowerf, half an ounce, fpirit of vitriol, a fufficient quantity to give it an agreeable fharp- nefs. Mix tbera. ' This gargle, befides cleanfing the tongue and fauces, acts as a gentle repellent, and will fometimes remove a flight quinfey. Detergent Gargle. Takeof the emollient gargle, a pint, tincture of myrrh, an ounce, honey, two ounces. Mix them. When exulcerations require to be cleanfed, or the excretion of tou"»h vifcid laliva promoted, this gargle will be of fervice. Emollient Gargle. Take an ounce of marftimallow roots, and two or three figs, boil them in a quart of water till near one half of it be confumed, then ftrain out the liquor. If an ounce of honey, and half an ounce of fpirit of fal-ammoniac, be added to tke above, it will then bean exceeding good attenuating gargle. This gargle is beneficial in fevers, where the tongue and faucei are rough and parched, to foften chefe parts, and promote the difcharge of faliva. The learned and accurate Sir John Pringle obferves, that in the in- flammatory quinfey, or ftrangulacion of the fauces, little benefit arifes from the common garbles, that fuch as are of an acid naturr do more hatm than good, by contradting the emunctorits of the faliva and mucus, and thicken- ing thofe humours, that a decodtion of figs in milk and water has a contrary effect, efpecially if fome fal-ammoniac be added ; by which the faliva is made thinner, and the glands brought to fecrete more freely ; a circumftance alvvpys conducive to the cure. INFUSIONS. VEGETABLES yield nearly the fame properties to water by in- fufion as by decoction ; and though they may require a longer time to give out their virtues in this way, yet it has feveral advantages oyer t.hp 45* APPENDIX. other ; fince boiling is found to diffipate the finer parts of many bitter and aromatic fubftances, without more fully extracting their medicinal principles. The author of the NewDifpenfatory obferves, that even from thofe vegetables which are weak in virtue, rich infufions may be obtained, by returning the liquor upon frefh quantities of the fubject, the water loading itfelf more and more with the active parts ; and that thefe load- ed infufions are applicable to valuable purpofes in medicine, ns they contain in a fmall compafs the finer, more fubtle, and active principles of vegetables, in a form readily mifcible with the fluids of the human body. ^ Bitter InfufioH. Take tops of the leffer centaury and camomile flowers, of each half an ounce ; yellow rind of lemon and orange peel, carefully freed from the inner white part, of each two drachms. Cut them in fmall pieces, and infufe them in a quart of boiling water. For indigeftion, weaknefs ofthe ftomach, or want of appetite, a tea-cupful of this infufion may be taken twice or thrice a-day. Infufion of the Bark. To an ounce of the bark, in powder, add four or five table-fpoons- ful of brandy, and £ pint of boiling water. Let them infufe for two or three days. This is one of the beft preparations of the bark for weak ftomachs, In diforders where the corroborating virtues of that medicine are re- quired, a tea-cupful of it may be taken two or three times a-day.. Infufion of Car duns. Infufe an ounce of the dried leaves of the carduus benedictus, or bleffed thiftle in a pint of common water, for fix hours, without heat ; then filter the liquor through paper. This light infufion may be given with great benefit, in weaknefs of the ftomach, where the common bitters- do not agree. It may be flavoured atpleafure with cinnamon, or other aromatic materials. Infufion of Linfeed. Take of linfeed, two fpoonsful ; liquorice root, fliced, half an ounce ; boiling water, three p nts. Let them ftand to infufe by the fire for fome hours, and then ftrain off the liquor. If an ounce of the leaves of colt's foot be added to thefe ingredi- ents, it will then be the Pedloral Infufion. Both thefe are emollient mucilaginous liquors, and may be taken with advantage as ordinary drink in difficulty of making water ; and in coughs and other com- plaints of the breaft. Infufion of Rofes. Take of red-rofes, dried, half an ounce ; boiling water, a quart; vitriolic acid, commonly called oil of vitriol; half a drachm ; loaf fugar, an ounce. Infufe the rofes in the water for four hours,in an unglazed earthen veffel ', afterwards pour in the acid, and having ftrained the liquor, add to it the fugar. In an exceffive flow of the menfes, vomiting of blood, and other haemorrhages, a tea-cupful of this gently aftringent infufion may be taken every three or four hours. ^It likewife makes an exceeding good, gargle. APPENDIX. . 453 As the quantity of rofes ufed here can ha^e Httle or no effect, an equally valuable medicine may be prepared by mixing the acid and water without infufion. Infufion of Tamarinds and Senna. Take of tamarinds, one ounce, fenna, and crystals of tartar, each two drachms. Let thefe ingredients be infufed four or five hours in a (|» pint of boiling wateT, afterwards let the liquor be ftrained, and an ounce or two of the a omatic tincture added to it. Perfons who are eafily purged may leave out either the tamarinds or the cryftals of tartar. This is an agreeable cooling purge. A tea-cupful may be given i evety half hour till it operates. This fupplies the place of the Decoclion of tamarinds and Senna. Spaniffj Infufion. i Take of Spanifh Juice, cut into fmall pieces, an ounce, fait of tar- I tar three drachms. Infufe in a quart of boiling water for a night. To I the ftrained liquor add an ounce and an half of the fyrup of popies. r In recent colds, coughs, and obftructions of the breaft, a tea-cup- ful of this infufion may be taken with advantage, three or four times y a-day. r ■ Infufion for the Palfy. I Take of horfe-radifh roof fhaved, muftard-feed bruifed, each four | ounces, outer rind of orange peel, one ounce. Infufe them in two , quarts of boiling \«ater, in a clofe veffel for twenty-four hours. «. In paralytic complaints, a tea-cupful of this warm ftimulating ;| medicine may be taken th ee or four times a-day. It excites the action ofthe folids, proves diuretic, and if the patient De kept warm, promotes perfpiration. If two or three ounces of the dried leaves of marfh-trefoil be ufed inftead of muftard, it will make the Antifcorbutic Infufion. JULEPS. THE bafis of juleps is generally common water, or fome fimple diftilled water, with one-third or one-fourth its quantity of diflilled f fpirituous water, and as much fugar or fyrup as is fufficient to render B the mixture agreeable. This is fharpened with vegetable or mineral f acids, or impregnated with other medicines fuitable to the intention. ' , Camphorated Julep. | Take of camphor, one drachm ; rectified fpirit of wine, ten drops *, I double refined fugar, half an ounce ; boiling diftilled water, one pint. I Rub the camphor firft with the fpirit of wine, then with the fugar; laftly, add the water by degrees, and ftrain the liquor. In hysterical and other complaints where camphor is proper, this julep may be taken in the dofe of a fpoonful or two as often as the fto- mach will bear it. Cordial Julep. Take of fimple cinnamon-water, four ounces*, Jamaica pepper- water, two ounces ; volatile aromatic fpirit, and compound fpirit of - lavender, of each two drachms ; fyrup of orange-pee!, an ou,nce. Mix them. This is given in the dofe of two fpoonsful three or four times p-day, in difoiders accompanied with great weaknefs and deprefiion of fpuits. Expeclcratitig Julep. Take of the emulfion of gum ammoniac, fix ounces; fvrup c- fquills, two ounces, Mix them. 454 APPENDIX. In coughs, afthmas, and obftructions of the breaft, two tabic fpoonsful of this julep may be taken every three or four hours. Mufk jfutep. Rub half a drachm of mufk well together with half an ounce of* fugar, and add to it gradually, of fimple cinnamon and peppermint water, each two ounces ; of the volatile aromatic fpirit, two drachms. in the low ftate of nervous fevers, hickupping, convulfions, and other fpafmodic affections, two table-fpoonsful of this julep may be taken every two or three hours. Saline Julep. Diffolve two drachms of fait of tartar in three ounces of frefh lem- on juice, ftrained ; when the effervefcence is over, add, of mint-water, and common water, each two ounces ; of fimple fyrup, one ounce. This removes ficknefs at the ftomach, relieves vomiting, promotes perfpiration, and may be of fome fervice in fevers, efpecially of the in* flammatory kind. Vomiting Julep. Diffolve four grains of emetic tartar iri eight ounces of water, and add to it half an ounce ofthe fyrup of clove July flowers. In the beginning of fevers, where there is no topical inflammationt this julep may be given in the dofe mi one table-fpoonful every quarter of an hour till it operates. Antimonial vomits ferve not only to evac* uate the contents of the ftomach, but likewife to promote the different excretions* Hence they are found in fevers to have nearly the fame effect as Dr. James1 Powder. MIXTURES. A MIXTURE differs from a julep in this refpect, that it receives into its compofition not only falts, extracts and other fubftances diffo- luble in water, but alfo earths, powders, and fuch fubftances as cannot be diffolved. A mixture is feldom either an elegant or agreeable medi- cine. It is neverthelefs neceffary. Many perfons can take a mixture, who are not able to fwallow a bolus or an electuary; befides, there ars medicines which act better in this than n any other form. AJlringent Mixture. Take fimple cinnamon water and common water, of each three ounces; fpirituous cinnamon water, an ounce and a half, Japonic con- fection, half an ounce. Mix tnem. In dyfenteries which arc not of long (landing, after the neceffary evacuations, a fpoonful or two of this mixture may be taken every four hours, interpoling every fecond or third day a dofe of rhubarb. Diuretic Mixture. Take of mint-water, five ounces ; vinegar of fquills, fix drachms; fweet fpirit of nitre, half an ounce ; fyrup of ginger, an ounce and an half. Mix them. In obftructions of the urinary paffages, two fpoonsful of this mix- ture may be taken twice or thrice a-day. Laxative abforbent Mixture. Rub one drachm of magnefia alba in a mortar with ten or twelve grains ofthe beft Turkey rhubarb,and add to them three ounces of com- mon water j fimple cinnamon-water, and fyrup of fugar, of each one ounce. As moft difeafes of infants are accompanied with acidities, this mixture may either be given with a view to correct thefe, or to open Appendix. 4$$ the body. A table-fpoonful may be taken for a dofe, and repeated three times a-day. To a very young child half a fpoonful will be fufiicient. When the mixture is intended to purge, the dofe may either be increafed, or the quantity of rhubarb doubled. This is one of the moft generally ufeful medicines for children with which I am acquainted. Saline Mixture. Diffolve a drachm of the fait of tartar in four ounces of boiling water ; and when cold, drop into it fpirit of vitriol till the effervefcence ceafes; then add of peppermint-water, two ounces, fimple fyrup, one ounce. Where frefh lemons cannot be had, this mixture may occafionally fupply the place of the faline julep. Squill Mixture. Take of fimple cinrtamon-water, five ounces ; vinegar of fquills one ounce, fyrup of marfhmallows,an ounce and a half. Mix them. This mixture, by promoting expectoration, and the fecretion o£ urine, proves ferviceable in afthmatic and dropfical habits. A table- fpoonful of it may be taken frequently. OINTMENTS, LINIMENTS, AND CERATES. NOTWITHSTANDING the extravagant encomiums which have been beftowed on different preparations of this kind with regard to their efficacy in the cure of wounds, fores, &c. it is beyond a doubt, that the moft proper application to a green wound is dry lint. But though ointments do not heal wounds and fores, yet they ferve to de- fend them from the external air, and to retain fuch fubftances as may be neceffary for drying, deterging, deftroying proud flefh, and fuch like. For thefe purpofes, however, it will be fufiicient to infert only a few of the moft fimple forms, as ingredients of a more active nature can occa- fionally be added to them. Teli'ow Baftlicum Ointment. Take of yellow wax, white refin, and frankincenfe, each a quarter of a pound ; melt them together over a gentle fire ; then add of hogs' hrd prepared, one pound. Strain the ointment while warm. This ointment is employed for cleanfing and healing wounds ahd ulcers. Ointment of Calamine. Take of olive oil, a pint and a half; white wax, and calamine ftone levigated, of each half a pound. Let the calamine ftone, reduced into a fine powder, be rubbed with fome part ofthe oil, and afterwards added to the reft of the oil and wax, previoufly melted together, con- tinually ftirring them till quite cold. This ointment, which is commonly known by the name of Tur- ner's Cerate, is an exceeding good application in burns and excorations from whatever caufe. Emollient Ointment. Take of palm oil, two pounds ; olive oil, a pint and half; yellow wax, half a pound ; Venice turpentine, a quarter of a pound. Melt the wax in the oils over a gentle fire; then mix in the turpentine, and ftrain the ointment. This fupplies the place of Ahh** Ointment. It may be ufed for anointing inflamed parts, &c. 4 c6 APPENDIX. Eye Ointment. Take of hogs' lard prepared, four ounces ; white wax, two drachms ; tutty prepared, one ounce ; melt the wax with the lard over ( a gentle fire, and then fprinkle in the tutty, continually ftirring them till the ointment is cold. This ointment will be more efficacious, and of a better confiftencr, if two or three drachms of camphor be rubbed up with a little oil, and intimately mixed with it. Another. ■ Take of camphor, and calamine ftone levigated, each fix drachms ; verdigreafe well prepared, two drachms, nogs' lard and mutton fuet prepared, of each two ounces. Rub the camphor well with the powder ; afterwards mix in the lard and fuet, continuing the triture till they be perfectly united. This ointment has been long in efteem for difeafes of the eyes. It ' ought however, to be ufed with caution, when the eyes are much in- flamed or very tender. Iffue Ointment. Mix half an ounce of Spauifh fli.s, finely powdered, in fix ounces of yellow bafilicum ointment. ., This oint.snent is chiefly intended for drefling blifters, in order to t keep them open during pleafure. J Ointment of Lead. <, Takeofoliveoilhalfapi.it; white wax, two ounces ; fugar of lead, three drachms. Let thefugnr of lead reduced into a fine powder, be rubbed up with fome part of the oil, and afterwards added to the other ingredients, previoufly melted together, continally ftirring them till quite cold. This cooling and gently aftringent ointment may be ufed in all cafes where the intention is to dry and flcin over the part, as in fcald- ing, &c. Mercurial Ointment. Take of quickfilver, two ounces ; hogs' lard, three ounces; mutton fuet, one ounce. Rub the quickfilver with an ounce of the hog's lard in, a warm mortar, till the globules be perfectly extinguifhed; then rub it up with the reft of the lard and fuet, previoufly melted together. The principal intention of this ointment is to convey mercury into the body by being rubbed upon the fkin. Ointment of Sulphur. Take of hogs'lard prepared, four ounce ; flowers of fulphur, an ounce and an half ; crude fal ammoniac, two drachms; effence of lem- on, ten or twelve drops. Make them into an ointment. This ointment, rubbed upon the parts affected, will generally cure the itch. It is both the fafeft and beft application for that purpofe, and, when made in this way, has no difagreeable fmell. *• White Ointment. Take of olive oil, one pint; white wax and fpermaceti, of each. three ounces. Melt them with a gentle heat, and keep them csnftant- !y and brifkly ftirring together, till quite cold. If two drachms of camphor, previoufly rubbed with a fmall quan- tity of oil, be added to the above, it will make the White Camphorated Ointment. Liniment Ointment. Take equal parts of Florence oil, or frefh drawn linfeed oil, am' APPENDIX. ASfy lime water ; fhake them well together in a wide mouthed bottle, foas to* ' form a liniment. , This is found to bean excellent proper application for recent fcalds or burns. It may either be fpread upon a cloth, or the parts affected may be anointed with it twice or thrice a-day. White Liniment. This is made in the fame manner as the white ointment, two-thirds ofthe wax being left out. This liniment oaay be applied in cafes of excoriation, where on ac- count of the largenefs of the furface, the ointments with lead or cala- mine might be improper. Liniment for the Piles. Take of emollient ointment, two ounces, liquid laudanum, half an ounce. Mix thefe ingredients with the yolk of an egg, and work them well together. Volatile Liniment. Take of Florence oil, an ounce ; fpirit of hartshorn, half an ounee. 1 Shake them together. This liniment, made with equal parts of the fpirit and oil, will be more efficacious, where the patient's fkin is able to bear it. Sir John Pringle obferves, that in the inflammatory quinfey, a piece of flannel, moiftened with this liniment, and applied to the throat, to b« I renewed every four or five hours, is one ofthe moft efficacious remedies, and that it feldom fails, after bleeding, either to leffen or carry off the | complaint. The truth of this obfervation I have gften experienced. f . Camphorated Oil. Rub an ounce of camphor, with two ounces of Florence oil, in ai mortar, till the camphor be entirely diflb'ved. i Tais antifpafmodic liaiment may be ufed in obftinate rhtumatifms, and in fome othe/.cafes accompanied with extreme pain and tenfion of tye parts. PILLS. MEDICINES which operate in a fmall dofe, and whofe difagreeable tafte, or fmell, makes it neceffary that they fhould be concealed from the palate, are moft commodioully exhibited in this form. No medicine, i however, that is intended to operate quickly, ought to be made into pills, as they often lie for a confiderable time on the ftomach before they are diffolved, fo as to produce any effect. As the ingredients which enter the compofition of pills are generally fo contrived, that one pill of an ordinary fize may contain about five grains of the compound, in mentioning the dofe we fhall only fpecify th'a number of pills to be taken, as one, two, three1, &c. Compofing Pill. Take of purified opium, ten grains, Caftile foap, half a drachm.— Beat them together, and form the whole into twenty pills. When a quieting draught will not fit upon the ftemach, one, two, or three of thefe pills may be taken, as occafion requires. Foetid Pill. Take of afafcetida, half an ounce ; fimple fyrup, as much as is re- ceffary to form it into pills. In hyfteric complaints, four or five pills, of an ordinary fize, may be taken twice or thrice a-day. They may likewife be of fervice to perfons afflicted with the afthma. When i: \= neceffary to keep the body open, a proper quantity ef rhubarb. a'oTS, or jalap, may occafionally be add-:l to the above mafs. (3°) - 45$ APPENDIX. Hemlock Pill. Take any quantity ofthe extract of hemlock, and adding to it about a fifth part its weight ofthe powder of the dried leaves, form it Into pills of the ordinary fize. The extract of hemlock may be taken from one grain to feveral drachms io the day. The beft method, however, of ufing thefe pills, is to begin with one or two, and to increafe the dofe gradually, as far as the patient can bear them, without any remarkable degree of ftupor or giddinefs. H Mercurial PilL Takeof purified quickfilver and honey, each half an ounce. Rub them together in a mortcr, till the globules of mercury are perfectly extinguifhed ; then add ofCiftile foap, two drachms ; powdered liquor- ice, or crumb of bread, a fufficient quantity to give the mafs a proper con- fiftence for pills. . When ftronger mercurial pills are wanted, the quantity of quick- filver may be doubled. The dofe of tbefe pills is different, according to the intention with which they are given. As an alterant, two or three may be taken daily. To raife a falivation, four or five will be neceffafy. Equal parts of the above pill and oowdered rhubarb made into a mafs, with a fufficient quantity of fimple fyrup, will make a Mercurial^ purging Pill. Mercurial Sublimate Pill. Diffolve fifteen grains of the corrofive fublimate of mercury in two drachms ofthe fatura ted folution of crude fal-ammoniac, and make it *ntoapafte, in a glafs mortar, witO a fufficient quantity of the crumb of bread. This mafs muft be formed into one hundred and twenty pills. This pill, whi;h is the moft vgreeable form of exhibiting th$ fubli- wate, has been foUnd efficacious, not only in ruring the venereal difeafe, but alfoin killing and expelling worm:, after other powerful medicines ■: had failed.* ,,,..,. u , *_• For the venereal difeafe, four of thefe pills may be taken twice a-day, as an alterant three, and for worms two Plummer's Pill. Take of calomel, or fweet mercury, and precipitated fulphur and antimony, each three drachms; extradt of liquorice, two drachms Rub the fulphur and mercury well together ; afterwards add the extract, and with afuflicient quantity of the mucilage of gum-arabic make them rnto P1 SThis pill has been found a powerful, yet fafe, alterative in obftinate cutaneous diforders; and has completed a cure after falivation had fail- ed. In venereal cafes it has likewife produced excellent effedls. Two or : three pills of an ordinary fizrmay be taken night and morning, the pa- tient keeping moderately warm, and drinking after each dofe a draught of decoction of the woods, or of farfapariUa. Purging Pills. 1 Take of fuccotorine aloes, and Caftile foap, each two drachms ; ot fimple fyrup, a fufiicient quantity to make them into pills.# Four or five of thefe pills will generally prove a fufficient purge.— For keeping the body gently open, one may be taken night and morning They are reckoned both deohftruent and ftomachic, and will be found to anfwerMJ the purpofes of Dr. Anderfon's pills, the principal ingredi- ent of which is aloes. . . - .. Where aloetic purges are improper, the following pills may be ufed * See a paper on this futjedl in the Edinburgh Phficdi and liter on- E/ajs, lj the ingenious D{. J«hn Gardner, APPENDIX. 459 Take extraft of jalap, and vitriolated tartar, of each two drachms; fyrup of ginger, as much as will make tkem of a proper confidence for pills. Thefe pills may be taken in the fame quantity as the above. Pill for the Jaundice. Take of Caftile foap, fuccotorine aloes, and rhubarb, of each one drachm. Make them into pills with a fufficient quantity of fyrup or Thefe pills, as their title expreffes, are chiefly intended for the jaun- dice, which, with the affiftance of proper diet, they will often cure. Five or fix of them may be taken twice a-day, more or lefs, as is neceffary to keep the body open. It will be proper, however, during their ufe, to interpofe now and then, a vomit of ipecacuanha or tartar emetic. Stomachic Pill. Take extract of gentian, two drachms ; powdered rhubarb and vitri- olated tart«r, of each one drachm ; oil of mint, thirty drops ; fimple. fyrup, a fufficient quantity. . .... - Three or four of thefe pills may be taken twice a-day, for invigora- tine the ftomach, and keeping the body gently open. B Squill Pills. Take powder of dried fquills, a drachm and a half; gum ammoniac,' I and cardamom feeds, in powder of each three drachms; fimple fyrup, a. I fufficient quantity. f In dropfical and afthmatic complaints, two or three of thefe pills may \ be taken twice a-day, or oftener, if the ftomach will bear them. Strengthening Pills. Take foft extraft ofthe bark, and fait of fteel, each a drachm. Make In diforders arifing from exceffive debility, or relaxation ofthe folids, is the chlorofis, or green ficknefs, two of thefe pills may be taken three times a-day. ___ PLASTERS. PLASTERS ought to be of a different confiftence, according to tht purpofes for which they are intended. Such as are to be applied to th* breafts or ftomach ought to be foft and yielding; while thofe defigned for the limbs fhould be firm and adhefive. It has been fuppofed, that plafters might be impregnated with the virtues of different vegetables, by boiling the recent vegetable with the oil employed for the compofition of the plafter ; but this treatment does not communicate tothe oils any valuable qualities. * The calces of lead boiled with oils unite with them into a plafter of a proper confiftence, which make the bafis of feveral other plafters. In boiling thefe compofiftons, a quantity of hot water muft be added from time to time to prevent the plafter from burning or growing- black. This, however, fhould be done with care, left it caufe the matter to explode. Common Plafler. Takeof common olive oil, fix pints; litharge, reduced to a fine pow- der, two pounds and a half. Boil the litharge and oil together over a gentle fire, continually ftirring them, and keeping always about half a feredto cool, and the water well preffed out of it with the hands. This plafter is generally applied in flight wounds and ^conations ofthe fkin. It keeps the part foft and warm, and defends it from the air, which is all that is neceffary in fuch cafes. Its principal ufe, however, is to ftrve as a bafis for oth^r platters. 4 neceffary. ) POWDERS. THIS is one of the moft (i nple forms in which medicine can be ad- miniftered. Many medicinal fubftances,however, cannot be reduced into powder, and others are too difigreeable to be taken in this form. The lighter powders cnay be mixed in any agreeable thin liquor, as tea or water gruel. The more ponderous will require a more confiftenc vehicle, *s fyrup, conferve, jelly, or honey. Gums, and other fubftances which are difficult to powder, fhould be pounded along with the drier ones, but thofe which are too dry, efpecially aromaucs, ought to be fprinkled during their pulverization, with a few drops of any proper water. Aromatic powders are to be prepared only in fmall quantities at a time, and kept in glafs veffels clofeiy flopped. Indeed no powders ought to be expofed to the air or kept too long, otherwife their virtues will be in a great meafure defrayed. Aftringent Powder. Takeof alum and japan earth, each two drachms: Pound them to* gether, and divide the whole into ten or twelve dofes. In an immoderate flow ofthe menfes, and other haemorrhages, one of thefe powders may be taken every hour, or every half hour, if the dif- cb>rgc be violent. Powder of Bole. Take of bole armenic, or French bole, two ounces ; cinnamon, ona ounce ; tormentil root and gurn arabic, of each fix drachms ; long pepper, one drachm. Let all thefe ingredients be reduced into a powder. This warm, glutinous aftringent powder, is given in fluxes, and ot'ier diforders where medicines of that clafs are neceffary, in the dofe of •a fcruple, or half a drachm. If a drachm of opium be added, it will make the powder of bole with Wrum, which is a medicine of confiderable efficacy. It may be taken in the fime quantity as the former, but not above twice or thrice a-day. Canninali've Pcnvder. Takeof coriander-feed, half an ounce; gingeri one drachm; nut- megs, half a drachm, fine fugar, adra«hinand a half. Reduce them into powder for twelve dofes. This powder is employed for expelling flatulencies arifing from indf-' geftion, particularly thofe to which hyfteric and hypochondriac perfons are foliable. it may likewife be given in fmall quantities to children in their food, when troubled with gripes. Diuretic powder. Take of gum arabic, four ounces; purified nitre, one ounce. Pound them together, and divide the whole into twenty-four dofes. During the firft ftage of the venereal difeafe, one of thefe cooling powders may be taken three times a day, with confiderable advantage. Aromatic Opening Powder. Takeof the beft Turkey rhubarb, cinnamon, and fine fugar, each two drachms. Let the ingredients be pounded, and afterwards mixed; well together. > » 462 APPENDIX. When flatulency is accompanied with coftivenefs, a tca-fpoonfal of this powder may be taken once or twice a-day, according to circum- ftances. Saline Laxative Powder. Take of foluble tartar, and cream ©f tartar, each one drachm. Pu- rif.ednitre, half a drachm. Make them into a powder. In fevers, and other inflammatory diforders, where it is neceffary to keep the body gentlyopen, one of thefe: cooling laxative powders, may be taken in a little gruel, and repeated oceafionally. Steel Powder. Take filings of fteel, and loaf fugar, of each two ounces; ginger, two drachms. Pound them together. In obftrudlions o' the menfes., and other cafe* where fteel is proper, a tea-fpoonful of this powder may be taken twice a-day, and wafhed down with a little wine or water. Sudorific Powdtr. Take purified nitre and vitriolated tartar, of each half an ounce ; opium and ipecacuanha, of each one drachm. Mix the ingredients and reduce them to a fine powder. This is generally known by the name of Dover's Powder. It is a powerful fudorific. In obftinate rheumatifms, and other cafes where it is neceffary to excite a copious fweat, this powder may be adminiftered in the dofe of a fcruple or half a drachm. Some patients will require two fcruples. It ought to be accompanied with the plentiful ufe of fome warm diluting liquor. ' Worm Powders. Take of tin reduced into a fine powder, an ounce ; iEthiop'S mine- ral, two drachms. Mix them well together, and divide the whole into i fix dofes. , i One of thefe powders may be taken in a little fyrup, honey, or trea- : cle, twice a-day. After they have been all ufed, the following anthel- mintic purge may be proper ; Purging Worm Powder. Take of powdered rhubarb a fcruple; fcammony and calomel, of each five grains. Rub them together in a mortar for one dofe. For children, the above dofes muft be leffened, according to their age. If the powder of tin be given alone, its dofe may be considerably in- creafed. The Lue Dr. Alfton gave it to the amount of two ounces in three days, an fays, when thus adminiftered, that it proved an egregious anthelmintic. He purged his patients both before they took the pow- der, and afterwards. Powder for the Tape-Worm. Early in the morning the patient is te take in any liquid, two or three drachms, according to his age and conftitution, of the root of the male fern reduced into a fine powder. About two hours afterwards, he is to take of calomel and refin of fcammony, each ten grains; gum jam- bouge, fix grains. Thefe ingredients muft be finely powdered and given in a little fyrup, honey, treacle, or any thing that is moft agreeable to thepatient. Heisthen to walk gently about, now and then drinking a difh of weak green tes, till the worm is paffed. If the powder of the fern produces naufea, or ficknefs, it may be removed by lucking the juice of aa orange or lemon. I 'i* : fldicine, which had been long kept a fecret abroad for the cure of the tape-worm, was fometime ago purchafed by the French King, and made public for the benefit of mankind. Not having had an op- portunity of trying it, I can fay nothing from experience concerning i;y APPENDIX. 4*3 efficacy. It feems, however, from its ingredient1;, to be an active medi- "■ cine, and ought to be taken with care. The dofe here prefcribed js ftifi. ' ficient for the ftrongeft patient; it muft, therefore, be reduced according , to the age a/id conftitution. STRUPS. SYRUPS were fome time ago looked uporras medicinesof conside- rable val»*e. They are at prefent, however, regarded chiefly as vehicles for medicines of greater efficacy, and are ufed for fweetening draughts, juleps, or mixtures ; and reducing the lighter powders into boluTes, pills, and eledtuaries. As all thefe purpofes may be anfwered by the fimple fyrup alone, there is little occafion for any other ; efpecially as they are feldo;n found but in a ftate of fermentation ; and as the dofeof any medicine given in this form is very uncertain. Perfons who ferve the public muft keep whatever their cuftorr.ers call for ; but to the pri- vate practitioner nine-tenths ofthe fyrups ufually kept in the fhops are unneceffary. Simple Syrup. ^ Is made by diffolving in water, either with or without heat, about 1 double its weight of fine fugar. k If twenty-five drops of laudanum be added to an ounce ofthe fimple fyrup, it will fupply the place of diacodium, or the fyrup of poppies, and will be found a more fafe and certain medicine. The lubricating virtues of the fyrup of marfhmallows may likewife be applied, by adding to the common fyrup a fufficient quantity of mucilage of gum arabic. Thofe who chufe to preferve the juice of lemons in form of fyrup, may diffolve in it, by the heat of a warm bath, nearly double its weight of,. line fugar. The juice ought to be previoufly ftrained, and fuffered to Hand till it fettles. The fyrup of ginger is fometimes of ufeas a v/arm vehicle for giving medicines to perfons afflicted with flatulency. \t may be made by infu- fing two ounces of bruifed ginger in two pints of boiling water for twenty four hours- After tr.e liquor h?s been ftrained, and has flood to fettle for fome time, it may be poured off, and a little more than double its weight of fine powdered fugar. diffolved in.it, TINCTURES, ELIXIRS, ferV. . RECTIFIED fpirit is the direct menltruum of the reiins and effential oils ot vegetables, and totally extracts thefe active principles from fundry, fudft-inces, which yi Id them to water, either not at all or only in part. It dillbJves likewife thofe parts of animal fubftances in which their peculiar fmells and taftes refide. Hence, the tinctures prepared with rectified fpirits form an ufeful and elegant clafs of medicines, poffefling many of the moft efiential virtues of fimples, without being clogged with, their inert or ufelefs part^. Water, however, being the proper menftruum ofthe gummy, faline, and faccharine parts, of medicinal fubftancea, it will be ne:effary, in the preparation of feyer.l tindlurcs, to make ufe of a weak fpirit, or a com- pofition of rectified fpirit and water. Aromatic Tinclure, Infufe twoouncesof Jamaica pepper intwopintsof brandy, with- out heat, for a few days; then ftrain off the tincture. This fimple tincture will fufficiently anfwer all the intentions of the rrore coftly preparations of this kind. It is rather too hot to be taker* ty itfelf; but is very proper for mixing with fuch medicines as might ci;herwife prove too cold for the ftomach. 464 APPENDIX. Compound Tindlure of the Bark. T*ke of Peruvian bark, two ounces; Seville orange-pell and cinna- mon, of each half an ounce. Let the hark be powdered, and the other ingredients bruifed ; then infufe the whole in a pint and a half of bran- dy, for five or fix days, in a clofe veffel; afterwards ftrain off the tinc- ture. This tincture is not only beneficial in intermitting fevers, but alfo in the flow, nervous, and putrid kinds, efpecially towards their decline. The dofe is from one drachm to three or lour, every fifth or fixch hour. It may be given in any fuitable liquor, and occafionally fharpened with a few drops of the fpirit of vitriol. Volatile Foetid Tindlure. Infufe two ounces of afafastida in one pint of volatile aromatic fpirit, for eigit days, in a clofe bottle, frequently fhaking it. Then ftrain the tinc- ture. This medicine is beneficial in hyfteric diforden, efpecially when at- tended with iownefs of fpirits, and faintings. A tea-fpoonful of it may be taken in a glafs of wine, or a cup of penny-royal tea. Volatile Tindlure of Gum Guaiacum. Take of gum guaiacum, four ounces : volatile aromatic fpirit, a pint. Infufe without heat, in a veffel well ftopped for a few days; then ftrain off ' the tindlure.f ! In the rheumatic complaints, a tea-fpoonful of this tincture may be taken in a cupof the infufion of water trefoil, twice or thrice a-day. Tindlure of Black Helebore. Infufe two ounces ofthe roots of black helebore, bruifed, in a pint of proof fpirit, forfevenor eight days ; then filter the tindlure through paper. A fcruple of cochineal may be infufed along with the roots, to give the tinc- ture a colour. In obftructions ofthe menfes, a tea-fpoonful of this tincture may be taken in a cup of camomile or penny-royal tea twice a day. Aftringent Tindlure. Digeft two ounces of gum kino, in a pint and a half of brandy, for eight days ; afterwards ftrain it for uie. This tincture thorgh not generally known, is a good aftringent m«di cine. With this view, an ounce, op more, of it may be taken three or four times a-day. Tindlure of Myrrh and Aloes. Take of gum myrrh, an ounce and a half; hepatic aloes, an ounce.— Let them be reduced to a powder, and infufed in two pints of rectified fpirits, for fix days, in a gentle heat ; then ftrain the tincture. Thi. is principally ufed by furgeons for cleanfing foul ulcers, ahd re- ftraining the progrefs of gangrenes. It is alfo, by fome, rcconi mended as a proper application to green v\o;inds. Tindlure of Opium, or Liquid Laudanum. Take of crude opium, two ounces ; fpirituous aromatic water and mountain wine, each ten ounces. Diffolve the opium, fliced, in the wine, with a gentle heat, frequently ftirring it ; afterwards add the fpirit, and ftrain off the tindlure. As twenty-five drops of this tincture contain about a grain of opium, the common dofe may be from twenty to thirty drops. Sacred Tindlure, or Tindlure of Hiera Pier a. Take of fuccotoiire aloes in powder, one ounce ; Virginian fnake-root and ginger, of each two drachms. Infufe in a pint of mountain wine, and f A very good tindlure of guaiacum, for damefticufe, may be made, infufing two or three ouncet cf the gum in a bottle of rum cr brandy. APPENDIX. 4^5 half a pint of Brandy, for a week, frequently fhaking the bottle, then .ftrain oft the tincture. Thij is a fafe and ufeful purge for perfons of a languid and phlegmatic habit; but is thought to have better effects, taken in fmall dofes as a lax- ative. % The dofe, as a purge, is from one to two ounces. Compound Tindlure of Senna. Take of fenna, one ounce ; jalap, coriander feeds, and cream of tartar, of each half an ounce. Infufe them in a pint and a half of French brandy for a week ; then ftrain the tindlure, and add to it four ounces of fine fu^ar. This is an agreeable purge, and anfwers all the purpofes of the Elikir falutit, and of Daffy's Elixir. The dofe is trom one to two or three ounces. Tindlure of Spanifh Flies. Takeof Spanifh flies, rtduced 10 a fine powder, two ounces ; fpirit of wine, one pint, infufe for two or threeday&, then ftrain off the tincture. This is intended ae an acrid ftimulam for external ufe. Parts affected with the palfy or chronx rheumatifm mav.be frequently rubbed with it. Tindlure ofthe Balfam ofTolu. Take ofthe balfam o' Tolu, an ounce and a half ; rectified fpirit of wine, a pint. Infufe in a gentle heat until the balfam is diffolved ; then ftrain the tincture. Tms tincture poffeffes all the virtues ofthe balfam. In coughs, and other complaints ofthe breaft, a tea-fpoonful or two of it may be taken in a bit ot loaf fugar. But the beft way of ufing it is in fyrup. An ounce of the tincture, properly mixed with two pounds of fimple fyrup, will make what is commonly called the Balfamic Syrup. Tindlure of Rhubarb. Take of rhubarb, two ounces and a half; leffer cardamom feeds, half an ounce ; brandy, two pints. Digeft for a week, and ftrain the tindlure. Thofe whochufe to have a vinous tindlure of rhubarb, may infufe the above ingredients in a bottle of Lisbon wine, adding to it about two ounces of proof fpirits. If half an ounce of gentian root, and a drachm of Virginian fnake-root be added to the above ingredients.it will make the bitter tincture of Rhu- barb. All thefe tinctures are defigned as ftomachics and corroborants as well as purgatives. In weaknefs ofthe flopiach, indigeftion, laxity of the intef- tines, fluxes, colicky and fuch like complaints, they are frequently of great fervice. The dofe is from ha! fa fpoonful to three or four fpoonsful or more, according to the circumftances ofthe patient, and the purpofes it is intended to anfwer. Paregoric Elixir. Takeof flowers of benzoin, half an ounce, opium, two drachms. In- fufe in one pound of the volatile aromatic fpirit, for four on five days, fre- quently fhaking the bottle ; afterwards ftrain the elixir. This is an agreeable and fafe way of administering opium. It eafes pain, allays tickling coughs, relieves difficult breathing, and is ufeful in many diforders of children, particularly the hooping-cough. The dofe to an adult is from fifty to an hundred drops. Sacred Elixir. Take of rhubarb, cut fmall, ten drachms; fuccotorine aloes, in powder, 5x drachms ; leffer cardamom feeds, half an ounce ; French brandy, two pints. Infufe for two or three days, and then ftrain the elixir. This ufeful ftomachic purge may be taken frooi one ounce to aq ounce and a half. 466 sirr&jsViA. Stomachic Elixir. ^ Take of gentian root, two ounces ; Curaffoa oranges, one ounce ; Vir- nian fnake-root half an ounce. Let the ingredients oe bruifed, and in- fed for three or four days in two pints of French brandy, afterwards ftrain out the elixir. This is an excellent ftomachic bitter. In flatulencies, indigeftion, want of appetite, and fuch like complaints, a fmall glafs of it may be taken twice a-day. It likewife .elieves the gout in the ftomach, when taken in a large dofe. Acid Elixir »f Vitriol. Take of the aromatic tincture, one pint, oil of vitriol, three ounces.__ Mix them gradually, and after the fsces have fubfi-led, filter the elixir through paper, in a glafs funnel. This is one ofthe beft medicines which 1 know for hyfteric ?.nd hypo. chondriac patients, afflicted with flatulencies arifing from relaxation or de- bility ofthe ftomach and inteftines. It will fuqeeed where Me moft celebra- ted ftomachic bitters have no effect. The dofe is from ten to forty drops, in a glafs of wine or water, or a cup of any bitter infufion, twice or thrice a-day. It fhould be taken when the ftom?ch is moft empty. Camphorated Spirit of Wine. Diffolve an ounce of camphor in a pint ot rectified fpirits. This folution is chiefly employed as an embrocation in bruifes, pal- fies, the chronic rheumatifm, and for preventing gangrenes. The above quantity of camphor, diffolved in half a pound ofthe volatile aromatic fpirit, makes Ward's Effence. Spirit of Mindertr us. Take of volatile fal ammoniac, any quantity. Pour on it gradually, diftilled vinegar, till the effervefcertce ceafes. This medicine is ufeful in promoting a difcharge both by the fkin and urinary paffages. It is alfo a good external application in ftrains and bruifes. When intended to raifea fweat, half an ounce of it in 3 cup of warm gruel, may be given to the patient in bed, exery hour, till it has the de- fired effect. VINEGARS. VINEGAR is an acid produced from vinous liquors by a fecond fer- mentation. It is an ufeful medicine both in inflammatory and puuid dif- orders. Its effects are, to cool the blood, qurnch thirft, counteract a ten- dency to putrefaction, and allay inordinate motions of the fyftem. It like- wife promotes the natural fecretions, and in fome cafes excites a copious fweat, where the warm medicines called alexipharmic, tend rather to pre- vent that falutary evacuation. Weaknefs, faintings, vomitings, and other hyfteric affections, are often relieved by vinegar applied to the mouth and nofe, or received into the ftomach. It is of excellent ufe alfo in correcting many poifonous fubftances, when taken into the ftomach ; and in promoting their expulfion, by the different emunclories, when received into the blood. Vinegar is not only an ufeful medicine, butferves likewife to extract, in tolerable perfection, the virtues of feveral other medicinal fubftances.— Moft of the odoriferous flowers impart to it their fragrance, together with a beautiful purplifh or red colour. It alfoalfifts or coincides with the inten- tion of fquills, garlic, gum-ammoniac, and feveral other valuable medicines. Thefe effects, however, are not to be expected from every thing that is fold under the name of vinegar, but from fuch as is found and well prepared. The beft vinegars are thofe prepared from French wines. It is neceffary for fome purpofes that the vinegar be diftilled, but as I APPENDIX. 4, Antimonial Wine. Take a glafs of antimony, reduced to a fine powder, half an ounce.— Lifbon wine, eight ounces. Digeft, without heat, for three or four days, upw and then fhaking the bottle ; afterwards filter the wine through paper. The dofe of this wine varies according to the intention. As an altera- tive and diaphoretic, it may be taken from ten to fifty or fixty drops. In a large dofe it generally proves cathartic, or excites vomiting. Bitter Wine. Take of gentian root, yellow rind of lemon-peel, frefh, each one ounce ; long pepper two drachms ; mountain wine, two pints. Infufe with-. out heat for a week, and ftrain out the wine for ufe. In complaints arifing from weaknefs of the ftomach, or indigeftion, a glafs of this/wine may betaken an hour before dinner and fupper. Ipecacuanha Wine. Take of ipecacuanha, ir. powder, one ounce ; mountain wine, a pint. Infiife for three or four days ; fnen filter the tincture. This is a fafe vomit, and anfwers extremely well for fuch perfons as cannot fwallow the powder, or whofe ftomachs are too irritable to bear it. The dofe is from one ounce to an ounce and a half. Chalybeate or Steel W:r.-:. Take filing ox iron, two ounces; cinnamon and mace, of 'tch two APPENDIX. 47> drachms ; RhenMi wine, two pints. Infufe for three or four weeks, fre- quently fhaking the bottle ; then pafs the wine through a filter. In obftructions of the menfes, this preparation of iron may be taken, in the dofe of half a wine-glafs twice or thrice a-day. The medicine would probably be as good if made with Lifbon wine, fharpened with half an ounce of the cream of tartar, or a fmall quantity of the vitriolic acid. Stomach Wine. Take of Peruvian bark, grofsly powdered, an ounce; cardamom feeds, and orange-peel, bruifed, of each two drachms. Infufe in a bottle of white port or Lifbon wine, for five or fix days ; then ftrain off the wine. This wine is not only of fervice in debility of the ftomach a«d intef- tines, but may alfo be taken as a preventative, by perfons liable to the in- termittent fever, or whorefide in places where this difeafe prevails. It will be of ufe likewife to thofe who tecover flowly after fevers of any kind, as it affifts digeftion; and helps to reftore the tone and vigour of the fyftem. A glafs of it may be taken two or three times a-day; •\* A GLOSSARY. ALTHOUGH terms of art have been feduloufly avoided in the compo- fitionofthis treatife, it is impoflible- entirely to banith technical phrafes when writing on medicine, a fcience that has been lefs generally attended to by mankind, and continues therefore to be more infected with the jargon ofthe fchools, than perhaps any other. Several perfons having expreffed their spinion that a Gloffary would make this work more generally intelli- gible, the following cortcife explanation of the few terms of art that occnr, has be*n added in compliance with their fentira.:nts, and to fulfil the origi- nal intention- ofthis treatife, by rendering it intelligible and ufeful to all racks and claffes of mankind. ABDOMEN, The belly. Abforbents^ Veflels that convey the nourifhment from ihe inteftines, and the fecreted fluids from the various cavities into the mafs of blood Acrimony, Corrofive fharpnefs Acute, A difeafe, the fymptoms of which are violent, and tend to a .fpeedy termination, is called acute Adult, Of mature age Aduft, Dry, warm Antifpafmodic, Whatever tends to prevent or remove fpafm Aphtha, Small whitifK" ulcers ap- pearing in the mouth Aftridlion, A tightening or lefien- ing Atrahilarian, An epithet commonly applied to people of a certain tem- perament, marked by a dark com- plexion, black hair, fpare habit, &c. which tho ancients fuppofed to arife from the atra bilis, or the black bile BILE or GALL, A fluid which is ftcreted by the liver into the gall- bladder, and from thence paffes into the inteftines, inorJei to pro- mote diee.'ion CACQCHTMIE, An ur/ueakhy ftate of the body. Caries, A rottennefs of the bene Chyle, A milky fluid fepaf ated from the aliment in the inrtftines, and conveyed by the abforbents into the blood to fupply the wafte of the animal body Chronic, A difeafe whofe progrefs is flow, in oppofition to acute Circulation, The mo.ion cf the blood, which is driven by the heart through the arteries, and returns by the veins Comatofe, Sleepy Conglobate Gland, A fimple gland Conglomerate, A compound gland Contagion, Infectious matter Cutis, The fkin Cutaneous, Of or belonging to the fkin Crifis, A certain period in the pro- grefs of a difeafe, from whence a decided alteration either for the better or the worfe takes place Critical, Decifive or important Critical days, The fourth, fifth, feventh, ninth, eleventh, thir- teenth, fourteenth, feventeenth, and twenty-firft, are by fome au- thors denominated critical days, becaufe febrile complaints have been obferved to take a decifive change at thefe periods DEBILITY, Weaknefs Delirium, A temporary diforder of the mental faculties Diaphragm, A membrane fepara- ting the cavity of tne caeft from that of the belly. Diuretic, A medicine that promotes the fecretion of urine Drafiic, Is applied to fuch purga- tive medicines as are violent or harfti in their operation. EMPYEMA, Acolleaion ofpuru- lint matter in the cavity of the breaft Eids.r.ic, A difeafe peculiar to a certain diftrict of country. Epidemic, A difeafe gece/ally in- fectious. A GLOSSARt. 433 Exacerbation, The increafe of any difeafe. FOECES, Excrements Fmtid, Emitting an offenfive fmell Fatus, The child before birth, or when born before the proper peri- od, is thus termed Flatulent, Producing wind fungus. Proud flefh GANGRENE, Mortification Gummata, 1 Venereal excrefcences Ganglia, j Gymnaftic, Exercife taken with a view to preferve or reftore health. The ancient phyficians reckoned this an important branch of med- icine HECTIC FEVER, A flow confu- ming fever, generally attending a bad habit ot body, or fome incu- rable and deep-rooted difcf fe Hemorrhoids, The piles Hemorrhage, Difcharge of blood Hyfochondriatifin, Low fpirits Hypochondriac vijcera, The liver, fpleen, &c. So termed from their fituation in the hypochondriac or upper and lateral parts ofthe belly ICHOR, Thin bad matter impofthume, A collection of purulent matter Inftammation, A furcharge of blood, and an increafed action of the vef- fels, in any particular part of the body LIGATURE,' Bandage Lixivium, Ley MILIARY ERUPTION, Eruption of fmall puftules refembling the feeds of millet. Morbific, Causing difeafe, or difeafed Mucus, The matter difcharged from the nofe, lungs, &c Mjfinfety, A double membrane which connects the inteftines to the back bone NERVOUS, Irritable Nanfta, An inclination to vomit Nodes, Enlargement of the bones produced by the venereal difeafe PECTORAL, cvfedicines adapted to cure difeafes of the breaft Privet, The bones fituated at the lower part ofthe trunk ; thus na- med from their refembling in fome meafure a bafon Peritonaeum, A membrane lining the cavity of the belly and cover- ing the inteftines Pericardium, Membrane contain- ing the heart Perfpiration, The matter difcharged from the pores of the skin in form of vapour or fweat Phlogifton, Is here ufed to fignify fomewhat rendering the air unfit for the purpofes of refpiration Phlegmatic, Watery, relaxed Plethoric, Replete with blood Polypus, A difeafed excrefcence, or a fubftance formed of coagulable lymph, frequently found in the large Mood-veffels Pus, Matter contained in a bile REGIMEN, Regulation of diet Reffum, The ftr*ight gut, in which the fceces are contained Refpiration, The act of breathing SALIVA, The fluids fecreted by the glands of the mouth Sanies, A thin bad matter, difchar- ged from an ill-conditioned fore Scitrhous, A ftate of difeafed hard- nefs Slough, A part feparated and thrown off by fuppuration Spafm, A difeafed contraction Spine, The back bone Styptic, A medicine for ftopping the. difcharge of blood Syncope, A fainting-fit attended with a complete abolition of fenfa- tion and thought TABES, A fpecies of confumption Temperament, A peculiar habit of body, of which there are general- ly reckoned four, viz. the (an- guine, the bilious, the melancho!- . ic, and the phlegmatic VERTIGO, Giddinefs ULCER, An ill-conditioned fore Ureters, Two long and fmall canals which convey the urine from the kidnies to the bladder Urethra, The canal which conveys the urine from the bladder. f3*) INDEX. ABLUTIONS Jewifh and Mahometan, well calculated for the pre- fervation of Health, 97. Abortion, caufes and fymptoms of 350. Means of prevention, ibid. Proper treatment in the cafe of, ibid. Abfceffes, how to be treated, 224, 362. Accidents, See Cafualties. Acids, of peculiar fervice in confumptions, 141. In putrid fevers, 150. Not fuitable to the meafles, 188. Acidities in the bowels of infants, the origin of, 359. Method of cure, 3-60. Ackworth, foundling hofpital at, caufe of the children their being af- flicted with fcabbed heads, and fatal confequences of their ill treat- ment, 363, note. Addifon, his remark on the luxury of the table, 92. AEther, very ferviceable in removing fits of the afthma, 279. Is excel- lent for flatulencies, 300. ASthiops mineral, ftrongly recommended by Dr. Cheyne in inflamma- tion ofthe eyes, 199. Africans, their treatment of children, 37, note. Agaric ofthe oak, its merit as a ftyptic, 375. Method of gathering, preparing, and applying it, ibid, note. Agriculture, a healthful, conftant, and profitable employment, 59. Is too much neglected in favour of Manufactures, ibid. Gardening the moft wholefome amufement for fedentary perfons, 61. Ague a foecies of fever no perfon can miftake, and the proper medicine for, generally known, 121. Caufes of, Hid. Symptoms, 122.— Regimen for, ibid. Under a proper regimen will often go off with- out medicine, ibid. Medical treatment of, ibid. Often degenerates into obftinate chronical difeafes, if not radically cured, 125. Peru- vian bark the only medicine to be relied on, ibid. Children how to be treated in, 126. Preventative medicine for thofe who live in marfhy countries, ibid. Air, confined, poifonous to children, 48. A free open air will fome- times cure the moft obftinate diforders in children, 49. Occupa- tions which injure the health by unwholefome air, 52, 53. The qualities of, act more fenfibly on the body than is generally imagi- ned) 81. The feveral noxious qualities of, fpecified, ibid. In large pities, polluted by various circumftances, 82. The air in churches, fcow rendered unwholefome, ibid. Houfes ought to be ventilated daily, ibid. The danger attending fmall apartment, ibid. Perfons whole bufinefs confines them to town ought to fleep in the country, ibid. High walls obftruft the free current of air, ib d. Trees fliould not be planted too near to houfes, ibid. ^ frefli air peculiarly neceffa- ry for the fick, ibid. Theifick in hofpitals in more danger from the want of frefh air, than from their diforders, ibid. Wholefomenefs of &C morning air, 83. The changeablenefs of, one great caufe •? INDEX. 475 uatching cold, n2. Thofe who keep moft within doors, the moft fenfible of thefe changes, ibid. Of the night, to be carefully guard- ed againft, 113. Frefli air often of more efficacy in difeafes than medicine, ibid. Its importance in fevers, 12c, 128. States of, lia- ble to produce putrid fevers, 148. Muft be kept cool and frefh in fick chambers under this diforder, 156. Change of, one of the moft effectual remedies for the hooping cough, 211. The qualities of, a material confideration for, afthmatic patients, 279. The vari- ous ways by which it may be rendered noxious, 396. Confined, how to try, and purify, ibid. Method of recovering perfons poifon- ed by foul air, ibid. Frefh, of the greateft importance in fainting- fits, 400. Aiken, Mr. his treatife on the nature and cure of fractures, recommeu ded, 385, note. Alkali, cauftic, recommended in the ftone, 233. How to prepare it, ibid, note. Aliment, is capable of changing r,he whole conftitution of the body, 67, Will in many cafes anfwer every intention in the cure of difeafes, ibid. The calls of hunger and thirft, fufficient for regulating the due quan- tity of, ibid. The quality of, how injured, ibid. A due mixture of vegetables neceffary with our animal food, 68. To what the bad effects of tea are principally owing, ibid. Water, good and bad, diftinguifhed, 70. Inquiry into the qualities of fermented liquors, with inftru&ions for the due making of them, ibid. The qualities of good bread, and why adulterated by bakers, 72. General rules for the choice of food, ibid. Ought not to be too uniform, 73. Meals ought to be taken at regular times, ibid. Long fading injurious both to old and young, ibid. Breakfafts and fuppers. 74. Changes of diet ought. to be gradually made, ibid. General obfervations on, 413. Amaurofis, See Guttaferena. American Indians, their method of curing the venereal difeafe, ^40. Amufements, fedentary, improper for fedentary perfons, 60. Ought al- ways to be of an a&ive kind, 85. Anafarka. See Dropfy. Anger, violent fits of, injurious to the conftitution, 101. Tranquility of mind effential to health, 102. Animal food, cautions in giving it to children, 42. Injurious effects when ufed by nurfes, 50, note. Animals that die of themfelves, unfit for food, 68. Overdriven cattle rendered unwholefome, ibid. The artifices of butchers expofed, ibid. Too great a quantity of, gene- rates the fcurvy, ibid. Injurious to many habits, 41c. Animals and plants, the analogy in the nourifhment of, ftated, 92 Anthenf 7 fire, St. See Eryfipelas. Aphtha, , See Thrufh. Apoplexy, who moft liable to this diforder, 280. Caufes, ibid. Symp- toms and method of cure, 281. Cautions to perfons of an apoplectic make, 282 Apothecaries weights, a table of, 437. Apparel. See CUatbing. Appetite, want of, caufes and remedies for, 284. Arbuthnot, Dr. his advice in the inflammation of the lungs, 135. His advice for perfons troubled with coftivenefs, 283, note. Arfenic, the effects of on the ftomach, 317. Medical treatment when the fymptoms appear, ibid. *7* INDEX. Arts. See ManufadTkrtt. Afcim, See Dropfy. Affes milk, why it feldom does any good, 134. Inftru&ions for taking* it- 139* Afthma, the different kinds ofthis diforder diftinguifhed, with its caufes, 2-78. Symptoms, i'M. Medical treatment,.279* Remedies prop- er in the moift afthma, 280 Atmofphere. See Air. It ALUs purging vermifuge powder, preparation of, 258. Balfams, how to prepare, Anodyne balfam 440 Locatelli a balfam, ibid Vulnerary balfam, ibid. Bandages, tight produce moft of the bad confequences attending fractur- ed bones, 386. Hark, Peruvian, the beft antidote for failors againft diforders on a for- eign coaft, 58. How to be adminiftered in the ague, 123. Dis- tinction between the red bark and quill bark, ibid, note. A decoc- tion or infufion of, may be taken by thofe who cannot fwallow it in fubftance, 124. Is often adulterated, ibid, note. Is the only medi- cine to be depended on in agues, 125. How it may be rendered more palatable, 126. May be adminiftered by clyfters, ibid. Cold water the beft menftrum for extracting the virtues of thia drug, 142. How to be adminiftered in the putrid fever, 151, and in the eryfipe- las, ro2. In an inflammation of the eyes, 197. Its efficacy in a malignant quinfey, 201. In the hooping cough, 212. A good med* icine in vomiting, when it proceeds from weaknefs ©f the ftomach, 22c. Its efficacy in a diabetes, and how to take it, 231. Is good againft the piles, 239, and worms, 257. Its ufe dangerous for pre- venting a fit of the gout, 266. A good remedy in the King's evil, 275, and in thefiuor albus, 348. JBarley water, how made, 131. JSarrennefs in women, the general caufes of, 356. Courfe of relief, ibid. Dr. Cheyne's obfervations on, ibid, note. Bat** waters pood in the gout, l6f. Math, cold, the pood effects of, on children, 48. Recommended to the ftudious, 67. Is peculiarly excellent for ftrengthening the ner- vous fyftem, 289. Therefore fhould never be omitted in gleets, 333 Is good for rickety children, 368. Cautions concerning the improp- er ufe of, in adults, 406, 409* t Bath, warm, of great fervice in an inflammation of the ftomach, 215. Bathing, a religious duty under the Judaic and Mahometan laws, 97. Is conducive to health, ibid. Bears foot recommended as a powerful remedy againft worms, 257. Beds, inftead of being made up again as foon as perfons rife from them, ought to be turned down and expofed to the air, 84. Bad pffects of too great indulgence in bed, 86. Damp, the danger of, 111. Soft are injurious to the kidneys, 233. per, the ill confequences of making it too weak, 71. Pernicious arti- fices of the dealers in, ibid. Bells, parift: the tolling them for the dead, a dangerous CXfftotn, TOfr. Silt, 373- , - Bilious colic, fymptoms and treatment or, 317. Bilious fever. See Fever. #*{ of a mad deg. SeeZJojv . INDEX. 477 fiitttrs% warm and aftringent, antidotes to agues, 123. Are ferviceable in vomiting when it proceeds from weaknefs in the itomacn, 225. Bladder, inflammation of, its general caufes, 222. Medical treatment of, ibid. Bladder, ftone in. See Stone. Blaft. See Eryfipelas. Bleeding, cautions for the operation of, in fevers, 120. In the ague 122. Its importance in the acute continual fever, 129. in the pleurify, 131. When neceffary in an inflammation of the lungs,, 135. Caution againft, in a nervous fever, 146. In the putrid fever, 1 $•. In the miliary fever, 15c. When neceffary in the fmall pox, 108. When ufeful in the meafles, 187. When neceflary in the bilious fever, 189. Under what circumftances proper in the eryfipelas, 192. Mode of, proper in an inflammation of the brain, 195. Is al- ways neceffary in an inflammation ofthe eyes, 197. When proper and improper, in a cough, 208. When proper in the hooping cough, 211. Is almoft the only thing to be depended on in an in- flammation ofthe ftomach, 215. And in an inflammation ofthe inf. teftines, ibid. Is neceffary in an inflammation of the kidneys, 221. , Its ufe in a fuppreffion of urine, 233. Is proper in an afthma, 2 ,g. Is dam erous in fainting fits, without due caution, 298. Cautions proper m the puerperal fever, 354. Is an operation generally pes- formed by perfons who do not underftand when it is proper, 371. In what cafes it ought to be had recourfe to, ibid. The quantity taken away, how to be regulated, ibid. General rules for the opera- tion, ibid. Qlbjedions to bleeding by leeches, ibid. Prevailing pre- judices relating to bleeding, ibid. The arm the moft commodious part to take blood from, 372. . _ , ,. Bleeding* the nofe, fpontaneous, is of more fervice where bleeding is neceffary, than the operation with the lancet, 237. Ought not to be ftopped without due confideration, ibid. How to ftop it when neceflary, ibid. Cautions to prevent frequent returns ot, 238. Blind perfons, when born fo, might be educated to employments fuited to their capacity, 308, note. Blifters, peculiarly advantageous in the nervous fever, 145. When only to be applied in the putrid fever, 151. When proper in the miliary ft ver, ITc. • Seldom fail to remove the moft obftinate inflammation of the eyes, 197. A good remedy in the quinfey, 200. Proper tor a violent hooping cough, 211. Is one of the beft remedies for an inflammation of the ftomach, 215. Are efficacious in the tootn> 5W, involuntary difcharges of, often falutary, and ought not. tc> be raihly ftopped'235. The feveral kinds of thefe difcharges, with their ufual caufes, ibid. Methods of cure, 247. „ Bhod fpitting of, who moft fubjed to,, and at what feafons, 240..Its caufes,^. Symptoms, ibid. Proper regimen in, 241. Medical treatment, ibid. Cautions for perfons fubjed to it, 24 /. SW.vomiting of, its caufes and fymptoms, 242. Medical treatment, ibid. 2?W-ftiot eye, how to cure, 310. if/Wy-flux, See Dyfentery: , . . •• Boerhaave, his obfervations on drefs, 91., note. His mechanical expedi- ents to relieve an inflammation of the brain, 19c. fiolufis, general iules for the preparing of, 44«- ^he aftringent 4 7 8 INDEX. ibid. Diaphoretic bolus, ibid. Mercurial bolus, 3!8. Bolus of rhubarb and mercury, ibid, Pedoral bolus, ibid. Purging bolus, ibid. Bones, the exfoliation of, a very flow operation, 385. Bones, broken, often fuccefsfully undertaken by ignorant operators, ibid. Regimen to be adopted after the accident, ibid. Hints of condud if the pa. tient is confined to his bed, ibid. Cleanlinefs to be regarded during this confinement, ibid. The limb not to be kept continually on the ftretch, ibid. Cautions to be obferved in fetting a bone, ibid. Tight bandages condemned, ibid. How to keep the limb fteady by an eafy method, ibid. Fractures of the ribs, 386. Bowels, inflammation of. See Stomach. Boys, the military exercife proper for them, 46. Braidwood', Mr. his fkill in teaching the dumb to fpeak, 310, note. Brain, inflammation of, who moft liable to it, with its caufes and fymptoms 195. Regimen, ibid. Medical treatment, 195. Bros ', proper food for children, as foon as they can chew if, 41, cruft of, the beft gum-ftick, 42. The beft modes of preparing it in food for children,'*^. Good, the qualities of and for what purpofe adulterated by the bakers, 70, 77. Toafted, a deopdion of, good to check the vomiting in a cholera morbus, 225. A furfeit of, more dan- gerous than any other food, 417. Thefinelt notalways the beft adapted for nutrition,!^. Houfehold bread the moft wholefome, i u Violent, ought not fo WfrEX. 4$- be taken immediately after a full meal, 6c. Is as neCeftaf? as food for the prefervation of health, 85. Our love of activity, an evidence of its utility, ibid. Indolence relaxes the folids, ibid. The indulgence of carriages as abfurd as pernicious, ibid. Is almoft the only cure for glandular obftructions, 86. Will prevent and remove thofe diforders that medicine cannot cure, ibid. Is the beft cure for complaints in the ftomach, 87. How to be taken within doors, when not to be done in fhe open air, Hid. Active fports better than fedentary amufe- ments, ibid. The goff, a better exercife than cricket, ibid. note. Ex- ercife fhould not be extended to fatigue, ibid. Is as neceffary for the mind as for the body, 107. Is often of more efficacy than anv medi- cine whatever, 117. The beft mode of taking it in a confumption, 138. Is of the greateft importance in a dropfy, 262, Mufcular, for the gout, 266. Is neceflary for the afthmatic, 278. Is fuperior to all medicine in nervous diforders, 286. And in the palfy, 292. Is prop- er for pregnant women, unlefs they are of a very delicate texture, 35©. Want of, the occafion of rickets in children, 567. ExtradJt, general rules for making; but are more conveniently purchased ready made, 450. <- Eyes, inflammation of, its general caufes, 196. Symptoms, ?'*«/. Medi- cal treatment, 197. How to be treated when it proceeds from a fcro- phulous habit, 198. Advice to thofe who are fubject to this com*. plaint, 99. Are fubject to many difeafes which are difficult to cure, 308. The means by which they are frequently injured, ibid. General means of prevention, 309* The feveral diforders of,, with their media cal treatment, 310. Eyt-voaters, general remarkson, and their principal intentions, 443. CoK lyrium of alum, ibid. Vitriofic coUyrium, ibid. Collyrium of lead, ibid. FAINTING FITS, how to cure, 297/398. Cautions to perfons fabjeft to them, 400. Falling ficknefs. • See Epilepfy. Fafiing, long, injurious to thofe who labottr hard, 56. Fs hurtful both to old avid young, 73. Fathers, culpably inattentive to the management of their children, 35", Their irregular lives often injure the conftitution of their children, 36. Pear, the influence of, very great, in occafioning and aggravating difi- safes, 102. Its various operations, 103. Feet, injured by wearing tight fhoes, 90. The wafhing of, -.n agreeable article of cleanlinefs, 97. Wet, the danger of, 97. Bathing them in warm water, a good remedy in a cold, 207. And in the hooping cough, 211. Fermentation, the vapour of liquors in a ftate of, noxious, 39c. Fivers, of a bad kind, often occafioned among labourers by poor living, 55. Frequently attacks fedentary perfons after hard drinking, 61.— Nervous, often the confequence of intenfe ftudy, 63. Putrid and ma- lignant, often occafioned by want of cleanlinefs, 95. The moft genera! caufe of enumerated, 117. The diftinguifhing fymptoms of, ibid.— The feveral fpecies of, ibid. Is an effect of nature, which ought to be affifted, 118. How this is to be done, ibid. Cordials and fweatroeats improper in, 119. Frefh air of great importance in, ibid. The mind ofthe patient ought not to be alarmed with religious terrors, ibid.— Cautions as to bleeding and fweating in, ibid, 120. Longings in, and, the calls of nature, deferve attention, ibid. Cautions to prevent a re- lapfe, ibid. Fevtt*, acutecontinua% who moft liable t* iz-j. CaulW, ?&/. Syrr|p- 486 INDEX. torn*, ibia. Regimen, ibid. Medical treatment, 125. Symptoms fa vourabl- and unfavourable, ibid. Regimen to be obferved during re- covery, ibid. Fever, bilious, general time of its appearance, 189. Proper treatment of, ace ording to its fymptoms, ihid. Fever, intermitting. See Ague. Fever, niliary, from what the name derived, and its general appearances, 153. Who moft liable to it, ibid. Caufes, ibid. Symptoms, 154.— Regi'nen, ibid. Account of a miliary fever at Strafburg, 155, «/* — Proper medical treatment, ibid. Cautions for avoiding this diforder, 156. How to prevent, in child-bed-women, 353. Fever, milk. How to prevent, 353. Fever, nervous, why more common now than formerly, and who moft liable to it, 145. Its caufes, ibid. Symptoms and proper regimen, 146. Medical treatment, ibid. Fever, puerperal, or childbed, the time of its attack, and fymptoms, 354. Medical treatment of, 355. Cautions for the prevention of this fever, 356- ... Fever,,putrid, is of apeftilential nature, and who moft liable to it, 1491 Its general caufes, ibid. Symptoms, ibid. Other fevers may be con- verted to this, by improper treat-nent, 150. Favourable and un« favourable fympto ns of, .bid. Regimen, 151. Vledical treatment, 152. Cautions for the prevention ofthis diforder, 153. Fever, remitting, derivation of its name, 157. Its caufes and fymptoms; ibid. Proper regimen, 158. Medical treatment, ibid. Cautions for avoiding this fever, 159. Fever, fcarlet, why fo named, and its ufual feafon of attack, 189. Prop- er treatment of, ibid. Is fometimes atten ed with putrid and malig- nant fymptoms, ibid. Medicines adapted to this ftage of the malady, ibid. Hiftory of a fever of this kind at Edinburgh, ibid. note. Fever, fecondary, in the fmall-pox, proper treatment of, 170. Fever, yellow, definition, 160. Its caufes, 161. Symptoms, ibid. Regi- men, 162. Preventative, 163. Medicine, 164. Flatulencies in the fto-nach, remedies againft, 299. The feveral caufes of, ibid. Medical tre.itment of, 300, Flatulent colic, its caufes, and feat of the diforder, 217. Remedies for, ibid. Flower-de-luce, the yellow water, the root of, recommended for the tooth-ach; 252. Fluor albus defcribed, with its proper treatment, 346. Fomentations, how to m ke and apply, 450. General intentions of ibid. Anodyne fomentation, ibid. Aromatic fomentation, ibid. Common fomentation, ibid. Emolient fomentation, ibid. Strengthening fomentation, ibid. Food. See Aliment. Forgivenefs of injuries, ought to be practifed from a regard to our own health, 101. Fractures. See Bones, broken. Frozen limbs, how to recover, 397. Fruit, unripe, very hurtful to children, 42. Ripe, one of the beft medi- cines, both for the prevention and cure of a dyfentery, 244. Fruits occafional fubftitutes for bread, 424. The plantain tree ufed for that purpofe in warm climates, idid. Yams, a proper fubftitute for bread in the Weft-Indies, ibid. Psmerals, the great number of vifitors attending them, dangerous to their healtn, 97. % INDEX. 4*7 GALLING, in infants, the caufe and cure of, Gangrene, proper treatment of, 373. Gardening, a wholefome amufenoent for fedentary perfons, 6i Qargles for the throat, how to make, 201, 203. General intentions ef, 451 Method of making the attenuating gargle, ibid. Common gargle, Hid. Detergent gargle, iid. Emollient pargle, ioid. For the mouth of infants in the thrufh, 358. Garlic ointment, a North-Britifh remedy for the hooping-cough, how to apply it, zit. Generals of armie , how they ought to confult the health of the men they command, 56. Gilders. See Miners. Ginger, fyrup of, how to prepare, 463. Girls, The common mode of education prejudicial to their conftitution, 47. Means of rectifying it recommended, ilia. Gleet, how occafioned, and its fympt^rrs, 343. M-thod >f cure, ihid—- Regimen, 334. Obftinate gleets cured by mercurial inunctions, ibid. How to apply bougies, ibid. • Glover, Mr. his courfe of treatment for the recovery of a hanged man, 4°3- Genorrh&a, virulent, the nature of, and its fymptoms, 328. RegimeB, 329. Medical treatment, ibid. Is often cured by aftringent injec- tions, 330. Cooling purges always proper in, Hid. Mercury feldom neceffary in a gonorrhoea, 331. How to adminifter it when need- ful, ibid. Goulard, M. preparation of his celebrated extract of Saturn, 450. His various applications of it, / id. Gout, the gener i| caufes of, 264. Hcv to treat a loofenefs occafioned by repelling it from the extr mities, 265. The fources of this diforder, and its fymptoms, ibid. Regimen for, ibid. Wool the b^ft external application in, 266. Why there are fo many noftrums for, 266, 267. Proper medicine after the fit, ibid. Proper regimen in the in- tervals between fits to keep off their return, ibid. How to remove it from the nobler parts to the extremities, 268. Gener 1 cautions to prove t danger by miftaking it tor other diforders, Hid. M. Cadet de Vaux's prefcription, 268, note. . Grain, various kinds of, when boiled, a good fubftirute for bread, 417. Gravel, how formed in the bladder, 108. How diftinguifhed from the fto-ie, 233. Caufes and fymptoms, ibid. Regimen, i'.id. Medical treatment, 234. Green-ficknefs, originates in indolence, 346. Grief, its effects permanent, and often fatal, 104. Dinger of the mind dwelling long upon one fubject, efpecially of a difagreeable nature, i'-id. The mind requires exercife as well as the body, 105. Innocent amufements not to be neglected, ibid. Is productive of nervous r$wgate water, an excellent medicine for expelling worms, 257. Antl fo'the jaundice, 260. In the fcnrVy, 272. Head-ack, the fpecks of, dift'mguifned, 249'. Caufes of, ibid. Regimen, ibid. Medical treatment, 250. Health of the people in general, a proper object of attention for the magif. fr.ites, x. Ought to be attended to in matrimonial contracts, 35. Is often laboured for after it is deftroyed, 66. Rules given by Cdfus for th*" :)refervation of, 114. Mtatufoefk the nature ofthis difojder, with its caufes, and remedies fot, 283, 284. Meat, extreme, how to recover perfons overcome by, 398. Hemlock, a good remedy in tbe king's evil, 275. Is recommended by Dr. Storck for the cure of cancers, 315. -Hemp-feed, a decoction of, good in the jaundice, and how to prepare it, 260V Hickup, its caufes, nnd method of treatment, 295. Hoffman, his rules for guarding child-bed women againft the miliary ^fever, 353. JToney, a wholefome article of food for children, 43. Is recommended in the ftone, 233. Hooping-couvh. See Cough. Horje-tattfh, the chewing of, win reftore fenfibility to the organs of tafte when injured, 312. Hofpitals, the want of frefh air in, more dangerous to the patients than tfheip diforders, 82. Cleanlinefs peculiarly necelT-.ry in, 99. Often fpread infection by being fituated in the middle of popukus towns, 100; How they might be rendered proper receptacles for the fick, ibid. Particularly in infe&ious diforders, ivid. The fick in, ought not to be crowded together, »68, note. Houfes* inftead of contrivances to makf them clofe and warm, ought to be regularly ventilated, 81. In marfhv fituations unwholefome; 82.— Oueht to be built in a dry fituation, in. Danger of inhabiting new- built houfes before thoroughly dry, i id. Are often rendered damp by unfeafortable cleanlinefs, ibid. Are dangerous when kept too clofe and hot, 113. fhfbandme*, the peculiar diforders they are expofed to, from the vicifTi- tudes ofthe weather, 54. Huxham, Dr. recommends the ftudy of the dietetic part of medicine, x. Hyarocephalus. See Drcpfy. Hyarophobia, Dr. Tiffot's method of curing, 323. Kittering's Specific, 3*6. Syarops peiloris. See Dropfy. Hypochondriac affeSions, frequently produced by intenfe ftudy, 64. Their caufes, and who moft fubject to them, 303. The general intentions of cure, ibid. Regimen, 304. i/yftencs, a diforder produced by the habitual ufe of tea, 70. General caufesof, 301. Symptoms, ibid. Proper treatment of, ibid. Regi- men, ,302. Medicines adapted to, ibia. Hyfteric eolic, fymptoms and treatment of, 217. ' JAILS, why malignant fevers are often generated in them, 82. Often fpread an infection by being fituated in the middle of populous towns, 99. Ought to be removed, rid. ffanin,M. his relation of the recovery of an overlaid infant, 40a. And of a roan who had hanged himfelf, ibid. yin>njiri», thediffe/entftageJofits appearance, with the caufes ofthis INDEX. 4^9 diforder, 2Cf, 260. Symptoms, and regimen, ibid. Medical treat- ment, ibid. Jcfuits bark. See Bark. Jews, the vhole fyftem of their laws tending to promote cleanhnels, 96« 97• ... n. Iliac paliin, a particular kind of inflammation in the inteftines, 214. Impafrbu-ne in the hreafi, in confumptions, how to make it break inwardly, when not f> be difcharged by other means, 142. Impofthumes after the fnall-pox, proper treatment of, 172. Incontinence of urine, diftinguifhed from a diabetes, 232. Experiment for relief, 233. Indite/lion, is one confequence of intenfe ftudy, 64. General caures, ana remedies for, 283. Indolence, its bad effefts on the conftitution, 85. Occafions glandular obftructions, 86. Ill confequences of too much indulgence in hecL ibid. Is the parent of vice, 87. Caufe of moft nervous diforders, 303. Infancy, the foundation of a good or bad conftitution, generally laid in this feafon of life, 33. Infants, nearly one half of thofe born in Great-Britain die under twelve years of age, 32. Perifli moftly by art, ibid. Ought not to be fuckled by delicate women, ibid. Importance of their being nurfed by theit mothers, ibid. Often lofe their lives, or become deformed, by errors ia clothoT* them, 36. How the art of bandaging them became the prov- '■ ince 'f the midwife,r'3 ■----——— of the inteftine*. See Inteftinn. -.- of the kidneys. $ee Kidneys. .- of the liver. See Liver. .- of the lungs. See Peripneumt*t (32) 49» INDEX. ————— of the ftomach. See Stomach. -------— of the throat. See Quinfey. —--------of the womb. See Womb. hifafion, advantages of over decoctions, 451. How to obtain rich infu- fion from weak vegetables, i'id. Preparation ofthe bitter infufion, ibid, Infufion of the bark, Hid. Infufion of carduus, i id. Of in- feed, ibid. Of rofes, Hid. Of tamarinds, and fenna, ibid. Spanifh infufion, 453. For the palfy, Hid. Inns, the great danger of meeting with damp beds in them, 111. The fheets in, how treated to fave wafhing, i'id. Innoculation ofthe fmall pox more favourably received here than in neighbouring countries, 172. Cannot prove of a general utility while kept in the hands of a fpw, ibid. No myftery >n the procefs, 173___ May fafely be performed by parents or nurfes, i'id. V.rious methods of do;np it, ibid. The clergy exhorted to remove t^e prejudices againft rhe operation, 174. Arguments cited from Dr. Mackenzie in favour of inoculation, 175, note. Ought to be rendered univerfal, 176. Means of extending the practice of, 175. Two obftaeles to the progrefs of, ftated, 178, Might be performed by clergymen, or by parents themfelves, ibid. The proper feafons and age for performing it, 178: Will often mend the habit of body, ibid. Neceffary prepa- ration and regimen for, ibid, ---------- Of tbe Cow-pcx, 179, 185. InfeHs, when they creep into the ear, how to force them out, 253. Poifon- ous, tbe bite&of, how to be treated, 324. Intemperance, one great caufe of the difeafes of feamen, 57. The danger of, argued from the conftrudtion of the human body, 91. The analogy in the nourifhment of plants and animals, i'id. Is the abufe of nat- ural paflions, ibid. In diet, ibid. In liquor and carnal pleafures, 92, The bad confequences of, involve whole families, i'id'. Effedts of drunkennefs on the conftitution, ibid. Perfons who feldom get drunk, may neverthelefs injure their conftitutions by drink, i id. The habit of drinking frequently acquired under misfortunes, 93. Is pe- culiarly hurtful to young perfons, 94. Leads to all other vices, ibid. Intermitting Fever. See Ague. Inteftine<, Inflammation of, general caufes from whence it proceeds, 215. The fymptoms, regimen, and medical treatment, 216. Cautions to guard againft it, 217. Intoxication produces a fever, 91. Fatal confequences of a daily repetition ofthis vice, ibid. Perfon0 who feldom get drunk may neverthelefs in- jure their conftitution by drinking, 92. Getting drunk, a hazardous remedy for a cold, 207. Often produces fatal effects, 401. . Proper cautions for treating perfons in liquor, ibid. The fafeft drink after a debauch, ibid; Remarkable cafe, ibid. Jebnfon, Dr. extraordinary recovery of an infant feemingly killed by t ftrong convulfion fit, related by, 404. IfTues, how to make them take the beft effect, 291. Itch, tbe nature and fymptoms of this difeafe defcribed, 276. Sulphur, the r < ft remedy againft, 277. Great danger of the injudicious ufe of mercurial preparations for, ibid,. Cleanlinefs the beft prefervative againft, 2-8, note. Juleps,.t\\e for™ of, explained, 453. Preparation of the camphorated jnlrp./rW. Cordial julep, ibid. Expectorating julep, ibid. Muft iufep,/7/V. Saline julep, ibid. Vomiting julep, ibid. KERMES MINERAL, recommended by Dr. Duplanil, for the Hooping- cough, 212, note. „ INDEX. 491 Kidneys, inflammation of, its general caufes, 220. Its fymptoms and prop- er regimen, ibid. Medical treatment, ibid. Where it proceeds from tne ftone a'id gravel, 221. Cautions for thofe fubject to this diforder. ibid. See Gravel. King t e-vil. See Scrophula. LABORIOUS EMPLOYMENTS, the peculiar diforders incident to, 54. The folly of nen *mulati.tg e..ote. Are proper to apply to children where inflammations appear in teething, 365. Objections to bleeding with them, 372. Leeks, a proper ingredient in foups, 430. Lemons. See Oranges. Ltprofy, why lefs frequent in this country now than formerly, 274. R$« quires the fime treatment as tbe fcurvy, i id. Lientery, proper treatment for, 248. Life may frequently be reftored, when the appearances of it are fuC* pended by fudden cafualties, 388, 392, 403. Lightning, perfons apparently killed by, might poflibly be recovered by the ufe of proper means, 40;. Lime-iuater, recommended to prevent gravel in the kidneys from degene- rating to the ftone in the bladder, 233. Is a good rerredy for worms, 257. Happy effedts of, in the cure of obftinate ulcers, 380. Lind, Dr. his prefcription to abate fits of an ague, 122, note. His direc- tions for treatment of patients under putrid remitting fevers, 157, note Liniment, for burn?, preparation of, 456. White liniment, ibid. For the piles, ibid. Volatile liniment, ibid. Liquors ftrong, expofe children to inflammatory diforders, 43. Fer- mented, the qualities of, examined, 71. The bad confequences oic making them too weak, ibid. Why ail families ought to prepare their own liquors, ibid. Cold, the danger of drinking, when a perfon is hot, 112. > Liver, fcirrhous, produced by fedentary employments, 62. Liver, inflammation of, its caufes and fymptoms, 223. Regimen and medical treatment, 224. Abfcefs in, how to be treated, ibid. Cau- tions in the event of a fcirrhous being formed, ibid. Lobelia, an American plant ufed by the natives in th* vtnersal ^ifeafir?) Loch-.i, a fuppreffion of, how to bs treated, 353* Locked J*w. See Tetanus. 49 2 INDEX, Longings, in difenfes. are the calls of nature, and often point out what' may be of real ufe, 119. Loofenefs, habitual, general direction for perfons fubjedt to, 108. Its general caufes, 224. A periodical loofenefs ought never to be ftop- ped, 225 Medical treatment of, according to its various caufes, ibid. Means of checking it when neceffary, 226. In children, proper treat- ment of, 361. I.nve, why perhaps the ftrongeft of all the paflions, 105. Is not rapid in its progrefs, and may therefore be guarded againft at its com- mencement, ibid. To pretend to it for amufement, cruelty to the object, ibid. Children often real martyrs between inclination and duty, 106, note. Lues, confirmed, fymptoms of, 338. Mercury the only certain remedy known in Europe for this difeafe, 339. Saline preparations of mercu- ry more efficacious than the ointment, ibid. How to adminifter cor- rofive fublimite, 340. 'American method of curing this difeafe, ibid. Lungtf, injured by artifts working in bending poftures, 59. Studious per- fons liable to confumptions of, 63. Luxury t* Vhlv injurious to the organs of tafte and fmell, 311. MACKENZIE, Dr. his arguments in favour of inoculating in the fmall- pox, 175, note- Mad Dog. See Dog. Magnefia alba, a remedy for the heart-burn, 285. Is the beft medicine ia all cafes of acidity, 359. Magnets, artificial, their reputed virtue in the tooth-ach, 231. Malt liquors hurtful in the afthma, 278. See Beer. Man, wW inferior to brutes in the management of his young, 33. Was never intended to be idle, 35. ManufaSures, the growth of, produced the rickets in children, 47. More favourable to riches than to health, 47. Some, injurious to health by confining artifts in unwholefome air, 53. Cautions to the workmen, ibid. Compared with agriculture, 59. Are injurious to health from artifts being crowded together, 60. And from their working in con- fined poftures, ibid. Cautions offered to fedentary artifts, 61. Seden- tary arts better fuited to women than to men, 86, note. Matrimony ought not to be contracted without a due attention to healtb and form, 35. Mead, Dr. his famous recipe for the bite of a mad dog, 321. His charac* rTjsa pbyfician, ibid, note. Meals ought to be taken at regular times, 74. Reafons for this uni- formity, ibid. Meafles, have great affinity with the fmall-pox, 186. Caufe and fymp- toms, ibid. Proper regimen and medicine, 187. Inoculation of, might prove very falutary, 188; note. Mechanics oui»ht to employ their leifure hours in gardening, 62. Meconium, the beft mode of expelling it, 358. Medicine, the origin of the art of, 11. The operation of, doubtful at beft, v ibid. vIs made a myfttry of, by its profeffors, 15. The ftudy of, ne- gledted by gentlemen, 16. This ignorance lays men open to pretend- ers, ibid. Ought to be generally underftood, ibid. A diffufion of the know'edgc of, wouM deftroy quackery, 18. Objections to the cultiva- tion of medical knowledge anfwerfed, ibid. The theory of, can never fupply the want of experience and obfervation, 33. Medicines, have more virtue attributed to them than they deferve, 115 — Ought not to be adminiftered by the ignorant, nor without caution, 116. Want of perfererance in the ufe of, one reafon why chronic dif INDEX. 4J3 eafes are fo feldom cured, 270. Many retained, which owe their repu- tation to credulity, 437. Are multiplied and compounded in propou- tion to ignorance of the caufes and nature of difeafes, ibid. Difad- vantages of compounded medicines, ibid. Are often adulterated for the fake of colour, 436. The relative proportions of, for different ages, 437. A lift of medical preparations as ought to be kept for private practice, 438. Melancholy, religious, its effects, 106. Leads to filicide, ibid. Defined, with its caufes, 289, 290. Symptoms and regimen, ibid. Medical treatment, 291. Menftrual difcharge in women, the commencement and decline of, the moft critical period of their lives, 345. Confinement injurious to growing young women, ib:d. and tight lacing for a fine fhape, 346. Symptoms of the firft appearance of this difcharge, ibid. Objects of attention in regimen at this time, ibid. Ought to be reftored when- ever unnaturally obftructed, and how, 347. When an obflruction proceeds from another malady, the firft caufe is to be removed, ibid Treatment under a redundency of the difcharge, 348. Regimen and' medicine proper at the final decline of the menfes, 349. Mercury may be given in defperate cafes of an inflammation of the intef- tines, z 14. Cautions tor adminiftering it, ibid, note. Great caution neceffary in ufing mercurial preparations for the itch, 276. Is feldom neceffary in a gonorrhoea, 329. How to adminifter it when needful in that diforder, ibid. Solution of mercury, how to make, 330, note* Is the only certain remedy known in Europe for the cure of a confirm- ed lues, 338. Saline preparations of, more efficacious than the roercu- riaUfintment, ibid. How to adminifter corrofive fublimate in venereal cafes, 339. Neceffary cautions in the ufe of mercury, 340. Proper feafons for entering on a courfe of, 341. Preparations for, ibid. Regf- men under a courfe of, ibid. Mez.reon root, a powerful afliftant in venereal cafes, ibid. Midwifery, ought not to be allowed to be practifed by any woman not properly qualified, 351, note. Midwives, hiftorical view of the profeffion, 36. How they became in- trufted with the care of bandaging infants, with the ill effects of their attempts at dexterity in this office, 37. Inftances of their rafhnefs and officious ignorance, 357, note. Military Fever. See Fever. Milk, that ot the mother, the moft natural food for an infant, 42. Cow's milk, better unboiled than boiled, 42. Is a good antidotefgainft the fcurvy, 43. Of more value in confumptions than the whole Materia Medico, 138. Its great efficacy in the fcurvy, 272. A milk diet prop- er both for men and women, in cafes of barrennefs, 356. Milk Fever. See Fever. Millipedes, how to adminifter for the hooping-cough, 211. Mind, difeafes of, to be diftinguifhed from thofe of the body, 115; See Paffions. Miners, expofed to injuries from unwholefome air, and mineral particles, 53. Cautions to, ibid. Mineral waters, the danger of drinking them in too large quantities., 230. Are of confiderable fervice in weaknefs of the ftomach, 284.— Cautions concerning the drinking of, 406. Mixtures, general remarks on this form of medicine, 454. Compofition ofthe aftringent mixture, ibid. Diuretic mixture, ibid. Laxative ab- forbent mixture, ibid. Saline mixture, ibid. Squill mixture, ibid. Molaffes, an intoxicating fpiri* m*cn ufed by the «ommen people at Ftf- inbiirgh, 94, noti. 494 INDEX. Mothers, prepofterous, when they think it below them to nurfe their owu children, 33. Under what circumftances they may he really unfit to perform this tafk, ibid Importance of their fuc*kling their owr. chil- dren, 32, note. Delicate mothers produce unhealthy fhort-lived chil- dren, 35. Their milk, the beft food for children, 39. Ought to give their children proper exercife, 46, and air, 49. Mouth, cautions againft putting pins or other dangerous articles into, 38 1. Mufcular exercife a cure for the gout, 265. Mufhrooms, a dangerous article of food, as ether fungufes are often gath- ered inftead of them, 325. Mufic, the performance of, recommended as a proper amufement for ftu- dious perfo' s, 66. Mufk, extraordinary effects produced by, under particular circumftances, in the m rvous fever, 147. Is a good remedy in the epilepfy, 293.— A'dfor the hickup, 2^5. Deafnefs cured by, 310. Muftard, white, a good remedy in the rheumatifm, 269. NATURAL hiftory, the ftudy of, neceffary to the improvement of agri- culture, 13. Nervous difeafes, the moft complicated and difficult to cure of all others, 286 General caufes of, 287. Symptoms of, ibid. Regimes, 288.— Medical treatment, 289. A cure onl) to be expected from regimen, ibid. The feveral fy; ptomsof, though differently named, all modifi- cations of the fame difeafe, 290. Nervo s colic, its caufe and fymptoms, 217. Medical treatment of, ibid. Nervous fever. See Fever. Nightmare, its caufes and fymptoms defcribed, 2 v6. Proper treatment of, 2 7. Nitr., purified, its good effects in a quinfey, 199. Is an efficacious reme- dy for the dropfy, 262. Promotes urine and perfpiration, 291. Nofe, ulcer in, how to cure, 311. Stoppage of, in children, how to cure, 360 See Bleeding at. Nurfes, their fuperftiticus prejudices in bathing of children, 48. The only certai- evidence of a good one, 50. Their ufual faults pointed out, 51. Adminifter cordials to remedy their neglect of duty towards children, ibid. Their miftaken treatment of eruptions, ibid. And loofe ftools, 52, are apt to conceal the diforders of children that arife from their own negligence, ibid. Oughtto be punifhed for the mif- ■ fortunes they thus occafion, ibid. Senfible, often able to difcover dif- eafes fooner than perfons bred to phyfic, 114. Are liable to catch the fnall-pox again from thofe they nurfe in that diforder, 167, no.e. Nurferv ought to be the largcft and beft aired room in a houfe, 49. OATS and barley, more wholefome when boiled, 420. Oatmeal, frequently made into bread, and peafants fed on it, are healthy and robuft, 420, 421. Erroneoufly fuppofed to occafion fkin difeafes, ibid. Oitmeal and tr.ilk a proper food for children, ibid. Oilt an antidote to the injuries arifing from working in mines or metals, 53. Salad oil, the beft application to the bite of a wafp or bee, 324.— Can phor ted, how to prepare, 456. Oils, effential of vegetables, the proper rrenftruum for, 46;. Ointment for the itch, 277. Ufe of ointments when applied to wounds and fores 455. preparation of yellow bafilicuro, ibid. Ointment of Calamine, W Povoders, general inftructions for making and adminiftering, 461. Aftrin- gent powder, preparation and dofe of, ibid. Powder of bole, ibid.— Carminative powder, 462. Diuretic powder, ibid. Aromatic purging powder, ibid. Saline laxative powder, ibid. Steel powder, ibid.— Sudorific powder, ibid. Worm-powder, ibid. Purging worm powder. ibid. Powder for the tape-worm, ibid. Pox, fmall, who moft liable to, and at what feafons, 165. Its caufes and fymptoms. 166. Favourable and unfavourable fymptoms in, ibid.—- Regimen, 167. How the patient ought to be treated during the erup- tive fever, ibid. Children in this diforder ought not to lie together in the fame bed, 168. Should be allowed clean linen, ibid. Patients under this diforder ought not to appear in public view, ibid. Medical treatment, 169. The fecondary fever, 171. When and how to open the puftules, ibid. Of inoculation, 172. Of the Cow-pox, 179. Pregnancy, how to treat vomiting when the effect ot, 288. Rules of con- duct for women under the diforders incident to, 349. Caufes and fymptoms of abortion, 350. How to guard againft abortion, ibid.— Treatment in cafes of abortion, ibid. Child-birth, 351. Prefer pt ons, medical, patients expofed to danger by their being written in 1. atin, «7- Provifions, unfound, the fale of, a public injury, 6j. Puerperal fever. See Fever. Pu ges, the frequent taking of them renders the habitual ufe of them ne« ceffary, 107. Tneir efficacy in agues, 122. Proper form of, for an in- flammation ot the inteftines 215. Cooling purges always proper ina gonorrhoea, 329. Midwives too rafh in the giving of purges, 354, note. Form of a gentle purge, for infants difordered in their bowels, 357 For the thrufh, 358. Puftules, in the fmall-pox, favourable and unfavourable appearances of, 171. The fuppuration of, to be promcttd; ?-• When a."d hew to open, 171. Putr.d fever. See Fe-vfr. INDEX. &7 $VACKS put out more eyes than they cure, 310. See Emptrics. Quackery, how to deftroy, 17. Quakers, their mode of drefling recommended, 91. Quinfey, a common and dangerous diforder, and to whom moft fatal, 199. Its caufes, ibid. Symptoms, ibid. Regimen, 200. Medical applica- tions, ibid. How to promote fuppuration, ibid. How to nourifh the patient when he cannot fwallow, 202. Advice to perfons fubject to this aiforder, ibid. ——------malignant, who moft fubject to, and its caufes, 203. Its fymptoms, ibid. Regimen and medical treatment, 204. RATTLE SNAKE, Negro remedy for the cure of its bite, 325. Regimen ought to co-operate with medicine to accomplifh the cure of dif- eafes, 11. Will often cure difeafes without medicine, 116. See Ali» ment. Religion, true, calculated to fupport the mind under every afflidtion,jo6. The inftructors in, ought not to dwell too much on gloomy fubjects, ibid. Remitting fever. See Fever. Replet.on, impairs the digeftive powers, 72. Difeafes occafioned by, 73. 1 How to treat a loofenefs produced by, 227. [ Refentment, the indulgence of, injurious to the conftitution, toi. I Refins, and effential oils, the proper menftruum for, 461. * Refpirat on, how to reftore in a drowned perfon, 393. Rheumatifm, acute and chronic, diftinguifhed, 268. Caufes, ibid. Symp- toms, ibid Medical treatment, ibid. Cautions to perfons fubject to ";.■ this diforder, 270. jlfj Rice, contains a nutritious mucilage, 77. A general article of diet, 419. Simple boiling of, renders it a fubftitute for bread, ibid. v., Rickets, the appearance of, in Britain, dated from the growth of manufac- tures, and fedentary employments, 44. The caufes of, 366. Symp- toms, ibid. Regimen and medical treatment, 367. Rollers, pernicious tendency of applying them round the bodies of in- fants, 39. Romans, ancient, their great attention to the cleanlinefs of their towns, 96. Rojes, conferve of, its great virtue againft haemorrhages, 236, 239. Ruptures, are chiefly incident to children and very old perfons, 387. The caufes respectively, ibid. Method of treatment, ibid. Cutting fhould be avoided if poffible, ibid. Cautions for perfons afflicted with a rup- - ture, 388. Often prove fetal before difeovered, ibid. note. Rutherford, Dr. his preparation for the cure of a dyfentery, 246. * SAILORS, their health injured by change ot climate, hard weather, and ' bad provifions, 56, 57. Many of their difeafes fpring from intempe- t» ranee, ibid. Ought to guard againft wet clothes, ibid How the il! 1 effedts of fait provifions might be corrected, ibid. Peruvian bark, the beft antidote to failors on a foreign coaft, 58. Cleanlinefs greatly con- ducive to their health, 97. Sal-prunnela, its good effects in a quinfey, 202. Saline draughts, of good ufe for ftopping a vomiting, 228. Preparation of, for this purpofe, ibid. Peculiarly good in the puerperal fever, 354. foLvat.on, not neceffary in the cure ofthe venereal difeafe,.34i.j Sarfapanlla, a powerful afliftant in venereal cafes, 340. Scabbed head in children, difficult to cure, and treatment, 363. Scarlet fever. See Fever. < Scalds. See Burns. School, fending children there too young, its bad confequences, 46.— Ought to be feated in adrv air, and ought not to be too much «jow- ded, 50. ■Jp* INDEX. &Bt/Jaus in the fiver, proper regimen in the cafe of, 222. See earner. SimphuLr,. nature ofthis difeafe, and its caufes, 274. Symptom , ibid.—. Regimen and medical treatment, 275. 'L-wy, why prevalent among the Englifh, 67. Where moft prevalent, ™d the two diftif,aions of, 271 Caufes ©ft ibid Symptoms and sure, 273 Inftructious to fea-faring men, ibid. Extraordinary ef. feels of milk, 273 Proper liquors, ibid. lizttntary life includes the greater part of the human fpecies, 58. Few tper£>ns follow agriculture who are capable of other bufinefs, ibid. Se- <#entary and active employments ought to be intermixed, for the fake •tf health, ibid Artifts fuffer from unwholefome air, by being crow. ied together, 59 The poftures artifts are confined to, injurious to health, ibid. Diforders produced by, ibid. Cautions offesed to tht Sedentary, 60. Sedentary amufements improper for fedentary perfons, ibid. Hints relating to improper food, ibid. Exercife, a furer relief &rk>w fpirits-than drii king, ibid. Gardening a wholefome am ufe. orcnt for the fedentary, 6t. Diforders occafioned by intenfe ftudy, ibid- Dietetical advice to the fedentary, 66. Sedentary occupational better adapted to women than men, 86, note. j u&a.-wv'ter, a good remedy in the king's evil, 274. Sbnfos, diforders of, 307. &&»-,.h-, foluble, a good remedy for the jaundice, 263. Cream of, a goes remedy in a dropfy, 263. And rheumatifm, 268. Tafte, how to reftore the fenfe of, when injured, 311. * Tny.nrs, are expofed to injuries from breathing confined air, 60. Are fob* jedt to confumptions, ibid. note-. Often lole the ufe of their legs, ibid. Hints of inftruction offered to them in regard to their health, 61. T".z, the cuftomary ufe of, injurious to female conftitutions, 36. Dcftroys, their digeftive powers, and produces hyfterics, 69. The bad qualities of principally owing to imprudence in the uie of it, ibid. Green, chewing of, a remedy for the heartburn, 284. Has a powerful effect upon the r.erves, 292, note. Is bad for perfons troubled with flatulencies, 299.—, Occafions an unneceffary confumption of bread, 417. Bad effects of anj immoderate ufe of, ibid. ftething, the diforders attending,. 365. Regimen, and medical treatment in, 366 Applications to the gums, and how to cut them, ibid, 367. temperance, the parent of health, 91. Tefticles, fwelled, the caufe of, 334. Regimen and medicines in, ibid.—.. Treatment under a cancerous or fcrophulous habit, ibid. Tetters Sir Paul Joddrell's prefcription for, 362, note. Tetanus, or the locked-jaw, the caufes, 30&. Symptoms and medicine, Thirft, how it may he quenched when a perfon is hot, without danger, 113. Thought, intenfe, deftrudtive of health, 62. » Thrufto in infants, the diiorder and its canfes defcribed, 358. Medicar treatment of, ibid. Tmttures andelixirs, the proper medicines to exhibit in the form cf, 463.—. Preparations of the aromatic tincture, ibid. Compound tincture ot tbti bars, ibid. Volatile foetid tincture, 464. Volatile tincture of guar guaiacum, ibid. Tincture of black hellebore, ibid. Aftringent tincture, ibid. Tincture of myrrh and aloes, ibid. 1 inciure of opium, or liquid laudanum, ibid. Tincture of hiera picra, ibid. Compound tindlure of fenna, ibid. Tincture of Spanifh flies, ibid. Tincture ofthe ballam of Teh, 465. Tincture of rhubarb, ibid. *" '-\. Are the firft object to be purfued when poifon.has been received into 'he ' .ftomach, 317. Their ufe in the hooping cough, : you defeat the benignant purpofe* «f ADVICE 10 MOTHERS. 5n nature, and will feverely feel her refentment. The moroifl£ ii the beft time to eat fruit, when the ftomach is not loaded with other aliment. Even in the evening I had rather fee it introduced, thaa the enervating luxuries of the tea-table, or the ftill worfe prepara* ^ tions for a fupper of animal food.. A meal of this fort fhoald not be made twice in one day. After a hearty dinner, a long interval is neceffary before nature can require, or even bear without injury, aft5iherftibftnntial repaft. Supners are doubly prejudicial on ac- count ofthe latenefs of the hour, and the danger of going to bed with a full ftomach. Apoplexies are often occafioned by fuch in- confiderate and unfeafonabie indulgence, but its certain effects are reftlefs nights, frightful dreams, broken and unrefrefhing numbers, an incapacity of early rifing next morning, head-achs, palenefe of alpect, and general relaxation. Whoever fets any value on health or beauty, will always make very light repafts at night, and will go to bed early; that is to fay, never later than ten or eleven o'clock, r in order to enjoy fweet repofe, and to rife betimes, with renovated ftrength and alacrity, to the pleafures and duties ofthe enfuing day. Pure air and moderate ex?rcife are not of lefs importance than t -food and drink. Women arj much confined by their domeftic ^•employments and fedentary purfuits ; for this very reafon they i ought io go out frequently, and take exercife in the open air— ' not in a clofe carriage, but on foot or on horfeback. When pre- v vented by the weather from going abroad, dancing, provided it be not continued to fatigue, is the moft cheerful and healthy amufa* ment within doors. The only fedentary diverfions proper for women are playing on fome mufical inftrument, tinging, and read- \ ing aloud delightful pieces of poetry or eloquence. Young ladies : and mothers fhould wholly refign the card-table to old maids, who can only injure their own health, and who have no tafte fer any other mode of focial intercourfe. It may feem a little ftrange that I fhould think it in any fort neceffary to ^.commend cleanlinefs to the fairtfex ; 1 am far from intending to convey the moft diftant infinuation of their negligenc* in this refpect:; I only wifh to heighten their idea of its utility, and to point out farther methods of increafing its benefits. ^ They are rather too fparing of water, from an apprehenfion of it? injuring the fkin or giving it a difagreeable roughnefs. Ti.is is a great mil- take. Pure water may be truly confidered as a fountain of health, and its frequent ufe is the beft means of improving the fkin and ftruigthening the whole frame. The offices performed by the fkin are of greater importance than moft people imagine. It is not merely a covering or fhield to guard the fine organs of feeling from irritation or external injury, but one of the grand outlets admirably contrived by nature for expelling the noxious and fuperfluous humours of the body. 'Ihe perfpirable matter th»s thrown out will of itfelf clog the pores, and relax the fkin, ualefs care is taken co promote its eafy efcape bv keepingthe entire lurface of the body perfectly clean, well-braced and elaftic, which can only be done by frequent wafhing, and inftantly wiping the parts dry. Thofe who have not a bath to plunge into, fhould wafh the face, neck, hands. en ADTICB TO MOTHERS. and feet, every morning and night; and experience wili foon con- vince them, that, the more they accuftom themfelves even to the partial appt~?ti on of clean water, the mere comfcrtable and enlive- ning they will find it. If mifguided tendernefs has produced an extreme delicacy cf habit as well as cf fkin, it w;)i be proper to ufe luke-warm water for fome time: and then gradually to diminifh its emperature, till cold water can be employed, not only wi»h fafety, but with benefit. As a prelorvative of nealth, it is far more brocing and more invigorating than warm water, though t>e latter may be" often advifeable in cafes of particular infirmity, indifpofi- tion, t difeafe. All women of delicacy and good ferfe are fufficiently attentive to remove any ouiwar 1 foil or vifible dirt from thtir perfon \ but they do nr t all knew, that a vapour, too fine to be perceived by the eye, is c. nftantly ifluing from the pores, the little orifices or mcuhs of v/hich muft therefore be kept clean and unobflructed. For the lame reafon, the linen and interior articles of drefs fhould be often changed, as they become impregnated with the perfpirable matter, and, when fcul, would not only prevent the efcape of any more, but would even have a part cf what they had received re-abferbed by the fkin, and thrown back into the fyftem. The whole drefs alfo fhould be loofe, and as light as may be found confiftent with due warmth,fo as not to increafe perfpiration too much by its heavi- nefs, nor to check either that cr the free circulation ofthe blood by its preflure. Amo g many improvements in the modern fathions of female drefs, equally favourable to health, to graceful eafe and elegance, the dilcontinuance of flays is entitled to peculiar approbation. It is, indeed, fcvprffible to think of the old ftraight waiftco2t of whale- bone, an of tight lacing, without aftonifhment and fome degree of horror. We are furprifed and fhocked at the folly and perverfe- nels of employing, as an article of drefs, and even as a perfonal ornament, what muit have checked youthful growl!'- what muff. ho.vj' produced diftortions and. deformity—befides cccafionicg various irregulorities and difeafes. 1 need not point out the aggra- vated'miichief of fuch a preflure on the breafts and wr.mb in a ftate of pregnancy ; bu* I muft notice a defect very prevalent amcrg ycu g women of the prefent day in London, who, though they h >ve not worn ftays, may be fairly prefumed to inherit from their , mothers fome of the pernicious effects of fuch a cuftom. The injury to wfrch I allude, is the want cf nipples. This un- natural defect feems to have originated from the ufe of laced ftays; and as children fo often refem. le their parents in cut ward form, it is not improbable that the d?ught r may bear this mark of a mother's imprudence, and may even traofmit it to her own female children. Where ftays have never been ufed, the want of a nipple is as extra- ordinary as the want of a limb ; and no mother is found thus dif- quahned from difcharging one of her moft facred' dutits. But, in London, the inftances are too frequent to be afcribed to accident, and cannot, perhaps, be accounted for mere fatisfactcrily than in the manner here fuggefted. In ray fummary of the means of promoting health and beauty, ADVICE TO MOTHERS. 5*5 ahecrfulcefs or good humour is mentioned the left, though certain- ly it is not the leaft in point of efficacy. It has the happieit in- fluence on the body and mind ; it gives a falutary impulfe to ihe circulation of the blood, keeps all the vital organs in eafy and agree- able play, renders the outward deportment highly pleafing, whila the perpetual funfhine within fpreads a fafcinating leveiineis ever the countenance.—Its oppofite, peevifhnefs, cr ill-humour,embitters life, faps the csufti^tion, and is mere fatal to beauty, than the fmall-pox, becaufe its ravages are more certain, more diiguiting, and more permanent. Such are the chief points which I wifh to imprefs upon the minds of women before marriage. Obje&s of fo muc < importance ia every ftate or period of life, are deferving of peouliar regard whe^i an union of the fexes is propofed. ^ It is Mtrle fhort - of intenticrol murder on the part of a weak, languid, nervou?, or cefcrmed wo- man to approach the marriage-bed. Improper paflior 3 may urge. her to become a wife; but ihe is wholly unfit to bfcome a mother. She riiks her own life—fhe difappoints the natural wifhes of a huf- band—and fhould fhe have children, her puny, fickly offspring, as I before obferved, will have little caufe to thank her fi..r their wretched exiftence. The evil is not confined to her own family; fociety at large is materially injured ; its well being depends on tnj vigour of the members thnt compofe it; and univerfal experience has fully proved, that the frame of a hulbandman or a hero is not to be moulded or cherifhed in the womb of debility, and that the bold eagle wiil never be brought Lrth by the timid dove. I cannot conclude thefe hints without adding a few words on the choice of a hufband. Having endeavoured to prove that health is fo indifpenfible a requifire in females before marriage, they may well fuppofe that I deem it no lefs neceffary in the other fex. 1 am always fbrry to fee that precious blefling facrificed in an alliance with infirmity, or youth and beauty configned to the frozen arms of age. Mifery muft be the inevitable confequence of fuch unca' u- ral matches. But I fear that my remonftrances will have little effect in reftraining the undue exercife of parental authority, or in at- tempting to open the eyes of a woman to her certain deftruction. when fhe fuffers herfelf to be dazzled by the fplendour of riches, 0; charmed by the found of an empty title. CHAP. II. RULES OF CONDUCT DURING P.REGNANCT/ J_\YTER what I have already faid on the fubjed cf heahb. 1 hope I need net make ufeof any new arguments to convince women of its increafed importance the moment they conceive—n moment from which they may begin to date the real perfection of their being. Nature has now entered upon her grandeit wcrk, ;vid nothing is wanting but the mother's care to complete it. i h-* ex- ertions of this care are not left to whim, to caprice, or even to the ftrong irapulfes*of parental love. The fdf-pref orvotion of tie mother is made dependant on the proper aifcharge of her duty, her 514 ADVICE TO MOTHERS. own health, her ftrength, her very life are clofely entwined with the well being of the embryo in her womb ; nor can fhe be guilty ofthe leaft negleft, without equal danger and injury to both. I am forry to think that any awful warning fhould be neceflary to check the commiflion of fo wicked an outrage upon nature, as an attempt to procure abortion. This can never be effected with- out either the probable death ofthe mother, or the certain ruin of her conftitution : the ftimulants which are ufed to force the womb prematurely to difcharge its facred depofit, muft inflame the parts fo as to caufe a mortification; or will convulfe and enfeeble the whole fyilem in fuch a manner as to leave no chance of future health or enjoyment to the deftroyer of her own child. In the ancient hiftory of the Jews, we read of two harlots warmly contending for a living child. How different is the cafe with our women of that defcrip'ion !—Their with, if they conceive, is to prevent or deftroy the life of the embryo, even at the rifle of their own. Is a monfter ofthis fort lo be pitied, when, in the ex- tern ion of her fhocking purpofes, fhe brings on thofe deadly fyrnp- • tonw which muft foon clofe her guilty career ? ^ The unnatural mother, however, is not always the only mon- $ fter concerned in thofe fcenes of horror; her bafe feducer is too often the advifer of the defperate refolution, and crowns his guilty ?oys with double murder. Another ruffinn, fome male or female practitioner in midwifery, is alfo engaged ir. the hellifh plot, and Lndsahand.to perpetrate the foul deed, alike regardlefs of the mother's danger, and deaf to the cries of infant blood ! I never Bead, without fhuddering, any advertifement of temporary retreats or pretended accommodations for pregnant ladies. I always view it as a wicked allurement to unfortnate women, and as a daring hint from fome ready aflaflin of innocence. It is not long fince one of thofe wretches was convicted of killing both mother and child ; end 1 have myfelf feen a great number of embryos exhibited by a man, who, I firmly believe, obtained them in this way. The dread of public ihame or of private fcorn, though no ex- cufe for murder, may urge the victim of feductaon to commit a crinio at once lb abominable and fo dangerous. But is it poffible • hat a married woman fhould madly and wickedly attempt to pro- cure a"; rnn.ioi.1, merely from an apprehenfion of a large family, or to avoid too trouble of bearing and bringing up children ? Can fhe n po to tafte the joys, and yet deftroy the fruits of love ? What a frantic idea !—The fame poifon puts an end to both. "And in vain docs fhe flatter herfelf that her guilt is concealed, or that no law exlfts to punifh it. The laws of nature are never violated with impunity ; and in the cafes alluded to, the criminal is made at once to feel the horrors of late remorfe,and the keenelt pangs of a torn, diibrdcred, and incurable frame. But fuppofe that a mifearriage brought about by fuch detefta- blc means did not endanger the health and life ofthe mother, fnp- * pofe that an act held in juft abhorrence, both by earth and heaven, could poffibly efcape punifhmeut; fuppofe a woman, deaf to the cries dnatwre, incapable of tender emotions, and fearlefs of any ADVICE TO MOTHERS. £15 immediate fufferings in her own perfon—I have one argument more to make her ftop her murderous hand : perhaps the embryo, which fhe is now going to deftroy, would, if cherifhed in her womb, and afterwards reared with due attention, prove the fweeteft comfort of her future years, and repay all her maternal care with bcundlefs gratitude. It may be a daughter to nurfe her in her old age, or a fon to fwell her heart with joy at his honourable and fuc- celsful career in life. I only wifh her to paufe for a moment, and to confider, that by the wilful extinction of the babe in her womb, all her faireft hopes are extinguifhed alfo, and that the prefent danger is aggravated by tho certainty of future defpair. A wifh to prevent even one act; of fo much horror has induced rr.e to dwell on this unpleafant part of my fubject. But folly, ig- norance, and carelefinefs, are of-en productive of as fatal effects as a criminal defign j and though I may not be able to reftrain the Utter, yet I hope the former may be corrected by better informa- tion. With this view, I fhall make fome farther remarks on the greit preferv\itives of health mentioned in the preceding chapter,— The general rules their hid down hold good in every condition of life ; but a ftate of pregnancy requires a greater degree of care and judgment in their practical application. Cheerfulnefs, or good humour, which before was placed laft in the order of difcufiicn, muft now take the l^ad, being fuperiqr to all other confiderations during pregnancy. In this ftate, more than in any other, the changes cf bodily health feem to be almoft wholly under the influence of the mind ; and the mother appears well or ill, according as fhe gives way to pleafant or to fretful emotions. I admire that fragment of ancient hiftory, in which we are informed, that the eaftern fages, while their wives were preg- nant, took care to keep them cenftantly tranquil and cheerful, by fweet and innocent amufements, to the end, that from the mother's womb, the fruit might receive no impreffions but what were plea- fing, mild, and agreeable to order. So fine a leffon of wifdom, and cf parental, as well as conjugal love and duty, cannot be too clofe- ly ftudied, cr too diligently carried icto practice, by the hulband who fets any valge on his wife's health—who wiihes to fecure her affection and gratitude—and who pants for the exquifite happinefs of being the father of a lively, well-formed, and vigorous child. It is during Dregnancy alfo that every woman fhould be doubly attentive to preferve the litmoft fweetnels and fereuity of terrper, to difpel the glooms of fear or melancholy, to calm the rifing gufts of anger, and to keep every O'her unruly paflion or defire under the fteady conToul of nuldntis and reafon. The jcy of becoming a mother, and the anticipated pleafure of prefenting a fond hulband with the deareft pledge cf mutual love, cught naturally to mcreafe her cheerfulnefs, and would certainly produce that efket, were not thofe emotions too often checked by a fulfe alarm at the fancied danger of her fituation. It is therefore of the utmoit importance to convince her, that her terrors are groundlefs; that pregnancy is not a ftate of infirmity or danger, but affords the ftrongeft pre- famption of health and fecuritj 3 that the ftw miunces fhe may 516 ADVICE TO MOTHERS. know of mifcarriage or of death, were owing to the improper conduct of the women themfelves, befides beisg too i.oxoah\ era.le to be compared with the countlefs millions (f perfonsin the like con- dition, who enjoy both then and afterwords a greoter degree of health tuan they ever before experienced ; and, laftly, that the changes which fhe feels in herfelf, and her quick perception s of un- eafmefs, are n Nt fyraptoms of weaknofs, but the confequences of an increafed fenfibility of her womb, and ti.nely warnings cf the effects of indrfcreiion or intemperance. A late writer on this fubject: very juHy cbferves, that, when fuch an ircreafe of fenfibility takes phc? in a woman of a very irri- table frame and temper, it muft certainly aggravate her former complaints and weakneffes, and produce a variety of feverifh effects* She grows more impatient and fretful : her fears as well as her angry paflions are more readily excited ; the body ntceffarily fuffcrs whhth- mind, debility, emaciation, and many hectic fymptoms, fel- low. But the cr!y rational inference to be drawn from thefe facts is, that the feelings are more acu.e in a ftate of pregnancy ; and that any previous indifpofition, either of body • r mind, now requires a more than ordinary degree of care and tenderaefs. though the chilling influence of fear, and the depreffions of * melancholy, are very injurious to the mother's heaui ana to tta growth of the fartus in her womb; yet anger is a ftill more formi da- ble enemy. It convulfes the whole fyftem, and forces the blood in- to the face and head with a great impetucfity. The danger is in- creafed by the Ufual fulnefs of the habit in pregnancy. When the tlood runs high and rapid, a veffel may burft, and in fuch a part as to terminate, or bring into great peril, the exiOence of both the mother and the child. Cafes often occur of the burfting of a blood veffel in the brain, occafioned by a violent guft of pafiioQ. How much mere likely is it to rupture thofe tender veflels that connect the mother and the child! Yet to the latter this is certain death.— 1 knew a female who had the aorta, or great artery, fo diftended that it forced its way through rhe breaft-bone, and rofe externally to tl e fize of a quart bottle. This extraordinary diftention was chiefly ov, i g to the violence cf her temper. I have alfo met with a moft fli eking inftance of a fight irg woman, who, in to.e parox^fm of rage and revenge, brought forth a child, with all its bowels hang- ing out cfits lirle body. There is no doubt but that paflionate wcmen are racft fubject to abortions, which are oftener bwicg to outward violence or internal tumult, than to any ether caufe. An a-.cident ofthis fort is the more alarming, as the woman who once mifcarries, has the greateft reafon ever after to dread the repetition of the fame misfortune. Cards -or any kind of gaming, at all times, the worft cfamufe- ments, fhould be particularly avoided during pregnancy. The tern-. per is then more liable to be ruffled by the changes of luck, and the mind to be fatigued by conftant exertions of the judgment and rnemory. Old maids, as I before obferved, are the only clafs of females who may be allowed to fpend fome of their tedious hours in iuch Abfurd and jfuch unhealthy paftimes. t • ADVICE TO MOTHERS. 517 Without entering into farther details, it will be e?fy for 'he fenfible mother, to apply the principle here laid down, to every pai'- fion and propenfity which may tend ro excite painful emctit hs of the mind, and to impair in the fame degree the health ofthe body- She mufti am to keep even natural defires within due iomons,le!t pleafure itfelf, if immoderately indulged, may produce the fame effect as pain. Among many excellent hints io> pregnant ladies contained in a Latin poem tranflated by Dr. 7V/.r,we ratc-L with the following juft admonitions : ' Subdue defires ; nor let your troubled mind, lnimod'tate love, or fear, or fadnefs find : G'-ve rot y(.urieive» ev'n tQ the nupcia) joy, Or aught that m.ij your ftrength ct peace tkftroy. And again, » Curb each loofe defire, Left added fuel qurnch tfce former fi-e : Lift m /hoUldiole the fruits of pleafure gond And love itfelf undo what love had done. The enjoyments of the table muft alfo be kept under the nice Oonrroul of moderation, in a ftate of pregnancy. Any excefs, or any deficiency of proper fupplies, will now be moft feverely felt.— The well being of both the mother and child will depend on her purfuing a happy medium between painful reftraint or unneceffary felf-denial, on the one hand, and the indulgence of a depraved or intemperate appetite op the other. But, as the natural defire of aliment increafes with the growt. and increafing wants of the child, it will be prop r to cotifider ihofe variations as they appear in ths different ftages of pregnancy ; and to fhew how far it may be alfo advisable to gratify the involuntary, and often very wild and whimfical defires, which are known by the name of longings. Before I enter into particular details concerning the diet of pregnant ladies, I muft beg lsave to urge with increafed earn fl- nefs my former general prohibition agaiuft Mrong liquors, unripe fruits, paftry, and all forts of food that are high-feafoned, inflamma- tory, or hard of digeftion.^ If thefe are improper ferfore marriage, they muit be dou ly pernicious afterwards, when they may not only injure th? mother's health, but poifon, infeft, or impoverish the fountain of life and nutriment, whence her child is to derive fupport. Every femle, therefore, will fee the importance of guarding againft bad habits or the indulgence of a vitiated tafte at an early period; that fhe may not have any painful reftraints to fubject herfelf to when a mother, or be then under the neceflity of making any great change from her former mode of living. I have already laid it down as a fixed principle, that a ftate of pregriaBcy is not a ftate of infirmity or difeafe, but of increafed lenfibility; and that the changes which a woman then feels in her- felf, though fometimes accompanied with a little pain or uneafinefs, are but notices of her fituation or warnings againft indifcret.on cr intemperance. Let us mow apply this principle to the regulations of diet, aad we fhall find it to be the moft un.orring guide to pregnant women in all th*ir conduct, but more efpecially in the choice and quantity of their food and drink. * 5i8 ADVICE TO MOTHERS. The whcle term of pregnancy may be divided into two n-ar!v equal parts, the one comprehending the four months that immedi- ately follow conception, and the other, the remaining five months that precede delivery. During the fir 3: period, when there is in moft women a ftrong tendency to an extreme fulnefs of the habit, nature gives the plaineft cautions againft. improper indulgence, by a weaknefs of the ftomach, frequent returns of naufea and vomitings, head-achs, coftivenefs.; and the ether fymptoms and. effects of in. digeftion. It is a very abfurd and a very fatal miftake, to fuppofj that women are then in greater need of nourifhing things ; when, on the contrary, in confequence ofthe ceafing of the menfes, and the redundancy of blood in the fyftem,,'the ftricteft temperance is not only proper, but abfolutely neceffary toprevent illnefs. When this is neglected—when no regard is paid to the hints of the ftate ofthe ftomach and of the whole habit, .fo kindly given by nature, bleeding becomes the only expedient to fave the life of the thought- lefs or obftinate glutton ; but fhe fhould remember, that it is her own intemperance which renders that operation advifeable. The alledged or fancied wantsof the child may be urged as a plea for fome little excefs, or an incitement to more than ordinary gratification ; but the frivolity of fuch an excufe will appear, upon confidering, that the foetus, for the firft two months, dees not exceed a hen's egg in fize, and that its growth for the next two months, even till the afcent of the womb, or the ufual time of quickening, is ib fmall as to require very little nourifhment.. - This is amply fup- plied from the natural fulnefs cf the fyftem before noticed, with- out thedang.nr^us aid ofthe mother's intemperance. It inquires but a moment's reflection on the part of any woman of common fenfe to be convinced thafc. what diforders herfelf, muft injure the contents of her womb ; and that the injury is the greater, in pro- portion to the delicacy and flow expanfion of thofe contents. To r verftep the bounds of temperance in the early ftage of pregnancy, from an idea ofthe embryo's wanting fuch fupplies, would be al- moft as frantic as to drown an infant for the purpofe of quenching its fuppofed thirft, or to gorge it even to burfting, in order to fatisfy the cravings of imaginary hunger. But the abfurdnotion of the embryo's wants has been attend- ed with incalculable mifchief of another kind—it has given a fan- to the moft whimfical and the moft pernicious defires. Green-fick. girls dc not indulge in fuch filly and fuch hurtful fancies as many pregnant women j yet the propensities ofthe former are checked by the force of ridicule, of argument, or of authority, while the longings of the latter bid defiance to all control; and it is even deemed the height of cruelty not to gratify them in their wildeft extent. To the candid difcuffion of this very interefting part of my fubject, I hope I need not requeft the ferious attention of every female reader. One of the natural confequences of conception is the ceafing of the menfes, which is accompanied with a redundency of blood, greater or lefs in proportion to the previous fulnefs of the habit.— Such a fwell in the vital ftream gives rife to feverifh appearances ; fuch as heat in the palms of the hands, fluihings in the face, and a ADVICE TO MOTHERS. cxy fl:ght head-ach. But the ftomach is moft affected by the change- which then take place in the womb and the whole habit. It as often d'iturbed by the complaints already defcribed—naufca, vomfc. ting, heart-burn, and the like. Thefe, as I faid before, are noj. fymptoms of indifpofition or difeafe, the rnpft healthy woman beictr, as fubj ct to them in the early months of pregnancy as thofe who are delicate and iiifirm. It is thus that every mother receives timely notice of her fituation, with proper warnings not to overcharge the ftomach, when its powers of digeftion are lb weak, and a fulneL of the habit is fo manifeft. Unhappily all pregnant women are not alike difpofed to attend to thofe kind intimations of nature'-, and, perhaps, many of thena do not know, that the uneafmefs; ■ arifing from the above caufes would i)j removed by perf?verance ir a temperate cooling diet.— They think they ought to eat more, irv.°ea:l of lefs, in their new ftate, and torture their invention to find out fomething to conquer the fqueamifhnefs of their appetite. This is a very fruitful fource of whims and fancies, the indulgence of which is almoft always in- jurious. It cannot indeed be otherwife; as the weaknefs or dimi- nution of any worn ;n's ufual appetite, on fuch occafions, is not a owing to a mere diflike of common or ordinary food, but to a real unfitnefs of the ftomach to receive much of any food. What then are we to expect, when things equally improper, perhaps, both ia quantity and quality, are forced upon it, to fatisfy fome artificial •raving, or fome imaginary want ? As foon as a woman begins to confult her caprice, inftead of attending to nature, fhe is fure to be encouraged in abfurdity by old nurfes, or female goflips, who take a delight in amufing her creduli- ty by the relation of many wonderful and alarming injuries, laid to jtave been done to children, through the unfatisfiei defires of their mothers. Every fairv tale, however repugnant to common fenfe, gains implicit belief; for reafon dares not intrude into the regions of fancy; and were a man bold enough to laugh at fuch fictions, cr to reraonftrate with a pregnant woman on the danger of giving way to any of her extravagant wifhes, he would certainly be con- fidered as a conceited fool, or an unfeeling monfter. Argument is loft, and ridicule has no force, where people pretend to produce a hoft of facts in fuppprt of their opinion. Every woman, who brings into the world a marked child, can immediately aflign the «ufe ; yet no mother was ever able, before the birth, to fay with what her child would be marked and I believe it would be equally difficult afterwards, without the aid of fancy, to difcover in a flefh mark any refemblance to the object whence the impreffion had been fuppofed to originate. On examining various inftances of flefh-marks, and other dreadful events, faid to be caufed by difappointed longings, it hae appeared that moft of them were the effects of obftructions, of preflure, or fome external injury; and that none could be fairly traced to the influence of imagination. Similar accidents are ob- fervable in the brute fpecies: and even in plants unconfeious or" their propagation or exiftence. It is alfo well known, that farom! 52o ADVICE TO MOTHERS* chiHren are bora with marks on their fkin, though their mothers uevpr experienced any longings; aud that, in other cafes, where Women had been refufed the indulgence of their longings, no ettoct ;was perceptible in the child, though the mother's imagination had continued to dwell on the fubject: for a confi lerable time. The doctrine of imagination, like every thing founded in ab- lurdity, confu?es itfelf by being carried too far. The fame power of marking or disfiguring the child is afcribed tfjl the fudden terrors and the iwgr mfi>d cravings of pregnant women. The abettors of this ^octrin i are not even content with a few fpecks or blemifhes on the ikin, but maintain that the mother's imagination may rike off a leg or an arm, or even fracture every bone in the child's b~>dy. I have feen a child born without a head ; but it'was not allsdged that the mother had been prefent at the beheading of any porfon, or had ever been frightened bt the fpeeVicleof a human body deprived of its head. If fhocki^fights of this kind could have produced fuch effedls how many headlefs babes had been born in France du» ring Robespierre's reign Of terror 1 . L In order to fhew that the fancy, however agitated or ftrongl^ impreffed with the dread of any particular object, cannot ftirnp its refembiance, or even the fmalleft feature of it on the child in the womb, Dr. Mocre relates the following ftory of a remarkable oc- currence within the fphere of his own knowledge:— " A lady, who had great averfion to monkies, happened un- fortunately, during the courfe of h°r pregnancy, to vifit in a family where one of thofe animals war, the chief favorite. Oa being ihewed into a room, fhe featectherfelf on a chair, which flood before a table upon which the favourite was already placed ; he not natu- rally of a referved difpofition, and rendered more petulent and wan- ton by long indulgence, fuddenly jumped on the lady's fnoulders. She fcreamed, and was terrified ; buton perceiving whohad treated her with fuch indecent far -liarity, fhe actually fainted ; and through the renaming courfe of her pregnancy, fhe had the moft painful conviction that her child would be deformed by fome fhock- ing feature, or perhaps the whole countenance of this odious mon- key. ^ " The pangs of labour did not overcome this impreffion,forio.. the midft of her pains fhe often lamented the fate of her unf rtu- nate child, who was doomed through life to carry about a human foul in the body of an ape. When the child wis born, fhe called to the midwife with a lamentable vo ce for a fight of her unfortu- nate offspring, and was equally pleafed and furprifed when fhe re- ceived a fine boy into her arms. After having enjoyed for a few minutes all the rapture of this change to eafe and happinefs from pain and mifery, her pains returned, and the midwife informed her that there was ftill another child. 'Another!' exclaimed fhe, then it is as I have dreaded, and this muft be the monkey after all. She was however, once more happily undeceived, the fecond was as fine a boy as the firft. I knew them "both :-—they grew to be ftout comely youths, without a trace of the monkey in either their rices or difpofition*." ADVICE TO MOTHERS* 5^1 Having before enlarged on the dangerous effects of the paf- fions,andot fear in particular, during pregn mcy, it cannot be fup- pofed that I look upou tn? tful objects, fcenes of horror, or ay other caufes of a fudden fh ck, as mv tors of indifference. On the contrary, I would have them very carefully avoided, as they have often caufed abortion, or otncrwife injure (the healtn both of the mother and child,1* though they cannot difoolour the fkin, derange the limbs, or alter the fhape of the latter, it is from tois filly ap- prehenfion, in confequence of any fright, th .t 1 wifh to rd eve the min 's of credulous and timid poor women, who may do themfelves a real injury by the dread of an imaginary evil. It was precifely witjj the faoae view tha* I endeavoured to ex- pofe the abfurdity of believing that flefh-marks on a child were the confequences of his Mother's fancies or unfuisfied longings. This Ifttlly doctrine has been the caufe of great uneafinefs in many fami- lies, and has done much mifchief to feveral pregnant women, foaie- 7 times by giving afan&i m to the indulgence of their moft i-npropsr whims, and at other times by making them pine for extravagant ' -unattainable gratifications. * ' .: It is another great miftake to fuppofe that the nrevaknce of fuch a belief can anfwer any one good purpofe. Surely the fictions of ignorance, fuperftition, or impofture, are not neceffary to fecure to women in a ftate of pregnancy, th »fe kind compliances, and that tendernefs of treatment, which their fituation requires. I he fond hufband will embracej^itn eagemefs every opportunity of fupply- . ing the real wants of tne wife now doubly dear to him, and even of anticipating her filent-wifh for any rational enjoyment. But fhe fhould alfo know, that the tyranny of caprice will prove no lefs in- jurious to herfelf than difagreeable toothers. Let not pregnant la 'ies imagine that I am for confining the fphere of indulgence within very narrow limits. I fh- uld be more inclined to enlarge than to contract: its boundaries, as far as nature and reafnn would all )W. I would not even be particularly ftrict, except in cafes of evHent^anger. Whilt^ I di fcounged cor'cious defires, or improper whims an 1 fancies, I w-^uld diftin£,u#ih t'rem from real and involuntary longings, which are f metimes occafioned by that weaknefs and diforder of the ftomach f > ufual, as I b fore obferved, for three or four months after concep'i >n. '1 here can be no doubt as to the caure of fuch 1 nngings; fcr a fimibr effect is known to take place at other times, and not only in women, but in men, when their ftomachs are weakened or dif-rdered by intem- perance, iilnefs, or any accident. 1 have often m.-t with cafes of this kind in fevers, epiiepfies, and ether nenous rnfeafes; ami where the craving often recurred, cr fteadily c ntinued, I have al- ways directed that it fliould be indulged, though the ox j-c*t of de- fire might not appear confiftent with the regimen commonly prefcri- * I knew an inftance of a mother, who n-t only loft the fwus through i fright, but wa3 Otherwise fo much . 'k&^d ai r.fva toenjay an hour's health. I rar.nrttjieiffore too ftrong*. |y cenfure the ft;nOc impulte v/hich fo often urgis p.-et.iant women,,and nurfts with infants at the b.-eaft, to ru& among crowds at a dicadful nie} an execu:!on, cr ar.y (.u.u ih.\k ng fpecude. (34J 522, ADVICE TO MOTHERS- be \ in fhore complaints. When the longings are involuntary, and the feelings acute, a patient may fuffer much from difappointment or delay; and cafes frequently occur of perfons who recovered from the moft tnpelefs ftate, after having difobeyed the doctor's com- mands, and been freely indulged in what they had fo ardently de- fir-d. I do not fay that the cure was abfolutely effe&ed by the ure of the for oidden food or drink ; but I am convinced from re- peated obfervatioos, that the ftrong and fudden appetite for fuch f iod ordriok, jhowever ftrange it might feem, was a fymptom of a favoranle change in the complaint, and a fure indication of return- ing health. ' , On the fame principle, therefore, tha£ rigid prohibitions or | denials might be attended with muoh pain m a ftate ofpregnancyya. ftate of exquifite fenfibility, I ftrongly reootnmend a fpeedy com- pliance not only with what may be deemed the natural ahd reafon- 4'i a :le defires of the mother, but even with all her involuntary longing*, which d > not evi ently arife from caprice, and are not directed to . things of a noxious quality. I would pay little regard, for inftance, to the whim of fuch a lady as is represented by Smollet, longing for a hair from her hufband's beard, and, what was worfe, wanting to have the pieafure of plucking it out herfelf; or to the more dif* gulling wifh of another lady, defcribed by Addifon, who longed to partake with a flock of carrion-crows, which fhe law feafting on . the fl°fh of a dead horfe. . It would be alfo carrying my plan of compliance too far to let a pregnant woman live chitfly on unripe frums, raw onions or any j other acid and acrimonious fubftances ; which could not fail to in- jure her own health and that of her child. An opinion prevails that a woman in fuoh a ftate can digeft every thing fhe likes or longs for j but, fuppofing this to be true, it does not follow that living on trafh, or on improper art'cles of food or drink, will not be detrU . mental to the foetus in her womb. Slight or momentary deviations* from th^ rules f wholefome diet or ftrict temperance may be occa- fionally allowed, but perverfe habits are never to be indulged. I hope therefore it will not be deoined needlefish fevere to recom- mend, in the earlv period of pregnancy, a becoming check on abfurd or pernicious defires, and a moderate ufe of fuch things as hav^ been always found to'agree with the ftomach and conftitution. I do not infift upon a total change from fcr ner modes of living ; bur, unlefs the appetite be wry much vitiated, it will direct women at that time to what is moft Draper and P.ilutary. They have general-. ly a diflike to animal food ; and, if induced to eat it freely, from a miftaken notion of their b°ing then in greater need of fuch aliment, they are fore to fuffer fome inconvenience. On the contrary, their natural relifh for rioo fru'ts and boiled vegetables may be fafely gratified. Milk? j,f the time of parturition, the inquietude entirely ceafes. In the firft cafe, as this judicious writer obferves the 'abforbing powers of the child feem too ftrong for the parent: but in the latter, the retaining powers of the parent are ftronger than the abforbing ones of the ^ child ; fo that, on the whole, it appears natural that women ihoufd become thinner when they are pregnant. ' One direction more is neceflary with reg|rd to fuppers. They (hould never be later than nine o'clock ; after which an hourlnay be fpent in cheerful converfation, as the beft means of preparing for the * enjoyment of found repofe. I hope that the cuftom of going to bed early, and of rifing early, which is one of the beft prefervatives of health at all times, will be particularly adhered to during pregnancy. Women in this condition fliould not, upon any account, be tempted tc fit np after ten, and they will find no difficulty in rifing at fix, though towards the conclufion of their term they may fafely remain an hour longer in bed every morning. in my former hints to women before,marriage, I pointed out the peculiar importance of open air and frequent exercife tp females, ■who, in general, fpend too much of their time in domeftic and fedentary employments. I recommend a variety of active diver- fions both without doors and within, according to the ftate ofthe weather. I would have young ladies dance and jump about as much as they pleafe, and as nature wifely prompts. But, when they become wives and mothers, their deportment muft be different, or they will rifle the lofs of the embry'6* in their womb—a lofs al- ways attended with irreparable injury to their own health. Mif- carriages are often occafioned by great bodily exertions, though in the form of amufement as well as by the ftraining efforts of hard labour. It was not without the jufleil reafon that Hippocrates for- bade dancing and all violent exercife during pregnancy ; he himfelf had been witnefstoa fectus being dropt on the ftage by a performer in the d-incingline. Let not pregnant women then attempt to vie with other females in the lively dance; the former fhoud even ADVICE TO MOTHERS. 525 avoid all crowded affemblies, whether gay or ferious; for befidei the impurity ot the air in fuch places, of the bad effects of which they are very fufceptibie, they are expofed to great danger from any accidental preflure. 1 have known a lady to fuffer abortion in con- fequence of an elbow at entering a church door. How much mure likely is this to happen at balls, at play-houfes, and other places of amufemenr, which are commonly more frequented than places of worfhip ! When ! fay that violent exertions and hard labour are apt to oc- cafion mifcarriages, I do not mean to recommend indolence and in- activity to pregnant women. This would be running into the oppo- fite extreme, which is ftill more dangerous than the other Indolence in pregnancy is not only one of the great caufes of abortion but of I the puerperal or child-bed fever, fo fatal to de'icate mothers. A wo- man who lives fully, and neglects exercife, cannot fail to bring on a plethora, or a fuilnels of the habit and redundancy of humours, which muft be productive of very bad effects. The whole frame be- comes languid : all the vital organs feem to lofe their energy ; the powers of the womb in particular, are enfeebled or perverted ; and though a mifcarriage fliould not take place, the labours are fure to be ong, fevere and dangerous; aud the offspring puny and deformed. "*/Jn order, therefore, to fecure the bleffings of a happy delivery and a healthy child, a pregnant woman ought to take every day a moder- ate degree of exercife, fuch as fhe has been moft acccuftomed to, on- ly ufing lefs exertion, and guarding againft fatigue. Some writers on midwifery have aliened, that in the early months of pregnancy, the exercife fhould be very moderate, but might be .fafeiy increafed in the latter months. The abfurdity of fuch a no- tion has been very ably expofed by the faireft reafoning, and the in- controvertible evidence of facts. The example of the brute fpecies has firft been referred to. as, in every thing that refpects the prefervation of life, their inltinct is more unerring than the fanciful fpeculations of man. It is obferva- ble of the quadrupeds in our fields and parks, that the moft frifky of them, when pregnant, affume a grave and fteady deportment ; their natural fondnefs for going together in herds and flocks is fufpended ; and, if left to their own inclinations, they gradually leffen their ulual exercife as they advance in pregnancy. Ihe fame thing is well known to De equally true of wild ani- mals. In a ftate cf pregnancy they take no more exercife than is * neceffary to procure their food. If forced to greater exertions in felf defence, or when hard purfued, they often dvcp their young ; and though beafts of prey have no claim to pity, yet furely the haimlefs and timid hare ought net in that ftate to be worried, merely to gratify a cruel of inconfiderate fportsman's fondnefs for the chafe. It is ftill more inexcufable to over-load, cr to ftrain by ill-timed labour, a mare in foal, which has frequently caufed a premature o.pulfion cf her young. From thefe remaiks on the inftmotive conduct of brutes a very wife leflbn lias been drawn for the j;i:i..ance cf pre jnnt, \ica:ai.~ 526- ADVICE TO MOTHERS. They are not. for fometime after conception, more fenfible of fatigue than at any othtr period, nor have they any certain proofs of their own condition. What,then it has been reafonably afked. fhould di- rect them to make any change in their cuftomary exercifes ? f hefe may be continued, but never to a violent or immoderate df gtee, for at leaft four months, not only with fafety, but with the utmolt bene- fit. When the contents'of the. womb begin to increafe very percep- tibly, the fame degree of exercife, which pregnant women before en- joyed with pleafure, will now make them faint and weary ; a ftrong hint to diminifh it. Their own feelings will direct them better than the caprice of others ; and no fubtlety of argument fliould induce them to believe that nature in this cafe alone deviates from her uni-, form courfe of action, and requires them to exert themfelves more in proportion as they are lefs capable of it; or, in plainer words, to run the fafter the greater weight they carry. Slow, fhort walks in 'lj the country, or gentle motion in an open carriage, muft be fir bet-"^^ ter fuited to the advanced period of pregnancy, by uniting the ad-w^ vantages of frefh air with thofe of agreeable and falutary exercife. In order to leave no doubt on this fubject, an appeal has been Jttrde to facts, and particularly to the experience ot women, who fol- low very hard occupations in the country. They feel no inconvenfittf. ence from tne ufual employments in the early monthspf pregnancy, and require no indulgence, but a little abatement of their toil wheir they become unwieldy. They know nothing of artificial precepts which would teach them to invert the order of nature. Temperance end moderate exercife, proper periods of labour and of reft, the coun- try air, and the cheering influence of a contented mind, infure to them the continuance of health in every ftage, an exemption from the common difeafes pf pregnancy, an eafy lying in, and a fpeedy recov- ^ ery from child-bed. 1 he vigour alfo of their offspring is juftly pro- ' Verbial. ' It would be painful tocontraft with this picture the enervating effects of indolence and luxury in high life, or the truly pitiable con- dition of poor married women in manufacturing towns, and in great cities. The confined impure air which they breathe in thefe places, relaxes the frame and deftroys its activity. What they eat, what they drink, is often imrjroper, fometimes pernicious. Their meals and their hours of reft are equally irregular. The victims of po\> erty are feldom able to procure the means of fcanty fubfiftence, ■without the facrifice of neceffary fleep. Their condition is really more diftreffing than that of female flaves in the "Welt-Indies.—- Thefe experience a little mercy when pregnant, their owners being actuated by the double impulfes of felf-intereft, and of humanity towards breeding women ; but, in London, the wretched hireling experiences no lenity on account ot her pregnancy ; Ihe is even obliged to conceal her fituation as much as fhe can, in order to get employment ; and has often no alternative but to perifh with fam- ine, or to run the rifle of mifcarrying by continued exertions at the wafhing-tub, or at fome other toilfcme work, for fixteen cr eigh- teen hours, according to the caprice or the fordid views of her un- ADVICE TO MOTHERS. 527 feeling employer. To impofe fuch talks on the hnngry and diftref- fed—to caufe abortion by oppreflive labour—under what pr tence the inhuman miftrefs may ftrive tojullify her owncondiL&—-is cer- tainly murder / i hough my former remarks on drefs may be eafilv applied^) a ftate cf pregnancy, y<.t this is a matter of fo much concern to mothers and to their children, that i hepe my female readers will pardon me for troubling them with fome farther obfervations on the fin jeft. Before marriage, errors in drefs can only injure their own hialth, or disfigure their perfons; but, after ccncepti. n, the form, the health, and the very exriknee of the child, will greatly ■depend upon the mother's chefs. Indeed, were 1 to aflign apiufe not only for the diminutivenefs, debility, and dift rtion of infants, fL but for thole fiefb-marks which zre fuperhifioufly afcribed to diap- :■ pointed kmgings, I fhould be much more inclined to impute thefe l,. evils toprw-liure upon the wemb, than to the alledged influei.ee of »0he mother's fancy. The gradual alient cf the womb, after the PHourth month, is wifely defigned by nature, to acquire more fpace Wf}>r eafy growth and expansion. But her benignant purpofes are Barebfeated, if ihe body be girded by tight bondages, or fqueszed within the narrow circle of a whalebone prefs. ^^ I need not flop to explain a thing in itfelf fo obvious, as the ■deration of fuch fatal checks on the increafing fize of the fetus ; pat how they fhould be productive of flefh marks and deformity, p^may require fome little illuitration. It is well known that young g trees and plants, and, in a word, vegetables- of every kind, when "confined in their growth, get diftorted, or take on a bad ftrpe; and that the tender bark as well as 'toe fruit will be marked, if they fuffer the leaft compreflion cr reftraint. Why fhould not -Compreflion have fimilar eftefts on the fetus in the womb, where it is almoft in the ftate cf a jelly ? The great wonder is, t at "it fhould ever efcape bearing the marks of a tight laced mother's indifcretion. The doctrine here laid down des not reft folly even upon thefaireft reafoning by analogy, but is fupportod by facts. Na- tions that almoft go naked are ftrangers to fiefh-marks and deform- ities, except what may arife from accidental injury, or external vio- lence. But in proportion as men remove from a ftate of nature,*^ and falfe refinement introduces as perfonal ornaments, tight and oppreflive incumbrances of drefs, we fee a pigmy or deformed race crawl about, to pnblifh their mother's folly, and to reproach I them with having thwarted or cramped nature in her operations. In my " Domtftic Medicine," as well as in a former part of the prefent work, 1 felt great pleafure in paying a juft compliment to the tafte and good fenfe of the ladies, lo admirably difplayed in the prefent fafhions of drefs. The high-heeled fhoes, in which they ufed to totter about as upon ftilts, and the tight laced ft ays, vsfich gave them the appearance cf infects cut almcft afunder in tbe r id- die, are happily exploded ; the poet's fiction is realized— The phi- lofopher's wifh is gratified, in feeing Beautv arrayed by the Grrc s; and health, eafe and elegance, alike conf ulted in the drefles cf cur fair countrywomen. 528 ADVICE TO MOTHERS. But as fafhion is very changeable; as there is nothing, how- ever ridiculous or hurtful, to which it cannot give a lar.ction ; and as the return to old atfurdities and eld prejudices may be dreaded unlefs the propriety and importance ofthe preknt ref rm are ftrongly imprtfled upon the mind, I fhall endtavcr to heighten t efe by a view cf the dreadful eviis which arofe from the lorn.er fyftem of tight bandage?, aid offtiff and cumberous clothing. It is not many years fince the fugar-loaf fhape was univerfal. Iv admired, and the fmall waift, thcugh ccrirary to nature, was looked upon as the diftinguifbing mark of elegance. Hulbancis ufed often to make it ihtir Dr aft, that when they married their wives, t ey cruld fpan t em rrixd ti e middle. It was then thought that n thing could produce a fine fhape but tight lacing, though it never failed to have the comrary effect. Net only deformity without ; me fure, but death itfelf was often the confequence. Ladies were keewn to drop down lifekfs in the dance, when no ether caufe could be nfligned but the tighrnefs of the drefs. IVIifcarriages werwji fiequemly occafioned by the fame caufe ; and various other ir.jvjiW ries to the fastus muft have far exceeded till power of calculation. Yet, during the prevalence of fo ftrange an infatuation, while m deformity was deemed beauty, all remenftrances on the luljc&jP would have proved unavailing, it would then have been ufeleis^lrj employ fuch arguments as now carrycenv ction to the urprtjudiced mind. We may at prefent obf&rve, with the hope cf being lifteled to, that nature, when left to herfelf, gives every animal, except thefe that are formed for fwiftnefs, a prominency about the middle. If this is cot only cemprefled, but the belly fqueezed dole* to the ' back-bone, off. ructions of the vifcera muft enlue ; and no great knowledge ofthe human frame is neceflary to fatisfy any perfon, that fuch obftructions muft prove fatal to health. \\ hen the vef- fels that take up and convey the nourifhment to the body, have; their functions by any means impeded, the v»holt fyftem mi.ft fuf- fer. and at length perifh bv a gradual decay. But nothing can fo effectually impede the funcdons of thofe foft parts as preflure. The ftrmach becomes incapable cf performing the grand office of di- geftion ; the midriff is forced upwards ; the cavity of the chefl is thereby leflened, and fufficient room is not left for a proper play ofthe Inngs. A difficulty of breathing, coughs, and pulmonary cccfiimptiors are the natural confequences. All thofe dangers occafioned by tightnefs round the waift, are. obvicufly increafed during pregnancy, when the heart, the lungs, g tne fon ocr, and all the adjoining parts are in a ftate of tender fyra- p-'thy vvith (he womb ; and when the growth of the foetus r.eceffa- rily re-quires mere rocm. asioefcre obferved, for eafy expanfien. To confine it at that period muft inevitably produce weaknefs, dc- fcrnn'ty, cr abciticD. " Remember," fays the ingenious author Oi Padotrcpkia, ————" Remrmber, nor to gird too tight Yr>ur fv»el!'ina wzifl-, though p'erfirg to tbe fight j N>«», for a ft pr, within the ftraighten'd womb, Like Gallic motheis,the poor child entomb." ADVICE TO MOTHERS. &9 But ycung Englifh wives have often been jr uilty of the fame fatal imprudence, not, indeed, fo much for the fake of " fhape," as from impulfes of falfe modefty, and for fear cf appearing either in- j decent, or too proud of the happy proofs cf tr tir fecundity. I ht pe, however, that the days of foliy and cf abfurdity in ! thofe refpects are pan ; and that the evils, which were then L fre- * quent, will operate as a warnii g againf^ any p<.flible reft' raticn of that moft awkward and moft pernici us contrivance called fiajs.— Let me alf very earneftly f.rbid the ufe of tight necklaces, tght garters, or any ligatures which may reftrain ihe eafy mciLn ofthe limbs, (r obftruct the free circuhtun ot tl e blood and juices. I fhould farther > ofcrve, that it is not encugh to have dilccutinued the high-heelecl fhoe, unlefs t e fhape ot the foot and *oes is a Httle atnndedto. rl rifling as u is cirrumftance may appear, the Leg- ^•fcet of it has often been attended not only with pain, with cranps, fc^and with corns, but with many ftill mere diitrefling confequences. Of theft I fhall have occafion to fpeak more fully io my ebferva- jgltion^ on the ^ refs of ct iktren. ft To fum up in a few words the chief part cf my advice on this Efcbiect to pregnant women, ai d to the fair fex in general, i need 3i4c^ut a fingle i.flertion, that a flowing c'reh, fufamed by ihe IhNilders, and gently comprefled by a zone round the middle, with only as much tightnefs as is neceflary to keep rhe clcti es in c« n- ta& with the body, ever was, and ever will be, the meft healthy, (|Rfortable, and truly elegant habit that females can wear, cr fan- cy invent. & Tie hints concerning cleanlinefs, which are given in the laft - chapter, will be ftund no lefs ufeful after marriage than before, with this fingle exception, that, during pregnancy, lukewarm wa- ter is preferable to cold, not enly for a total immerfion of tne body, but alfo for partially lathing the upper and lower extremities, more efpecially the latter. 1 have, indeed, known many pregnant women, who always ufed cold water on thefe cccafcns, and who plunged into the fea two cr three times a week c'urirg the fum- mer months, without injury. Yet 1 think their example too bold, and too dangerous, to be recommended to general imitation* CHAP. 111. A FEW REMARKS UN CHILD-BIRTH. t T X HERE is not any part of medical fcience wl*ich has teen cultivated with greater iifiiduity, and finally with greater fuccefs, . thin Midwifery. T he errors cf ignorance, tl e rafhiiefs of prefinp- tion, the arrufng theories cf inj'tr.ic us farcy, have at length giveu way to the unerring dicla'cs cf reafon and expei ience. Joy tl eie it has been clearly proved, that in every htaltfy ?nd well termed fubjecT, the powers cf nature alcne are fully adeci-are to the <;c- . ccnplifhmer.t of her greateft wcik, tie prelcivalicn cf the hutran fpecies ; and that the bufy interlerei ce of a mar is rrcre hi ely to cifturb and in jtde lUn to i fl 11 her eficits. V. hr.uvtr u£trer;. 53O ADVICE 70 MOTHERS. ces of oriinion may prevail on otler points merely fpertilative, all well-informed practitioners are now agreed in this, that the regu- lar procefs of a labour muft never be hurried on by artificial means, nor interrupted by the meddling hand of intfifcretion or oflicioufnefs. It is painful to reflect on the numbers that muft have perifhed,/, while a contrary method was purfued. Pe- pie hot.i taken it into* their heads, that a woman in labour could not ule too much exer- tion on her own part, nor be,too much aided by others, to quicken delivery. In the poem before referred to, this notion is inculcated in the form of medical precept. The poor woman is there defired '• To grafp fome (Irene fuptwrtwith all her pow'r, ,c T' incteafe her efforts in that painful hour." A happy revolution has now, however, taken place in the fyf-' tem of midwifery; and the moft eminent profeflcrs have made^, it the firft object of their public duty to reprobate the abominable cuftom of giving affiftance, as it was called, by dilating the internal and external parts artificially; and cf exciting patients, not only^Oy the ftrongeft perluafions, but by the ftimulus of hot cordials, to kelfity themfelves, as they termed it, and to exert all their voluntary forcejl beyond the dictates cf nature ; " as if," fays Dr. Denman, " a l&n ' bour was a trick to be learned> and not a regularproccfs of \ the conftitution." * '•. * Though the wTriter now quoted, and many others of no^lefs celebrity, have omitted nothing of importance in their direction^ both to midwives and lying-in women, yet as their bocks, front being deemed works of profeflional fcience, are feldom read by the' latter, I fhall felect a few of their moft ufeful remarks, and exhibit them in the plaineft form I can, to guard w men in labour againft the fatal confequences of th&r own errors, cr the improper advice which may be given them by others. On the fiflt figns of approaching labour, pregnant women are too apt to take alarm, and inftantly prepare as for a work of the greateft toil and danger. Their fears are as groundlefs as then- preparation is unneceffary. If they have nothing to injure their health during the previous ftate of pregnancy, they may rely with perfect confidence on the admirable refources of nature. When left to herfelf, her efforrs are always adapted to the conit'.tution of the patient, and to the Hate of thofe delicate and acutely fenfible parts, which would fuffer the greateft injury from fudden or ilk timed violence. All that is required of women in labour, is a be* -^ coming f ubmiflion to her courfe of operations. The fteps, by which fhe advances to her great end, are fometimes flow, but al- ways fafe; and fhe is not to be hurried or difturbed, with impu-p nity. It is true in almoft every fituation, but particularly in child- birth, that thofe who are moft patient actually fuffer the leaft. If they are refigned to their pains, it is impoffible for them to do wrong; but if\ from too much eagernefs to fhorten thofe pains and *o haften the final effect, a woman fhould keep in her breath, and iLaiii with all her might to increafe, as fhe may imagine, the in- ADVICE TO MOTHERS. 51i r ftinctive acTjon of the womb, the confequences muft always be in- jurious, and often fatal. In the fir It place, fuch improper efforts of the patient may ex- i hault her ftrength, fo as to render her incapable cf undergoing the j neceffary fatigue which attends the complete expulfion of the child. On the other hand, if the parts are not duly prepared, violence is more likely to tear than to dilate taem ; and accidents'of this kind have often occafioned a fever, or have rendered a woman miferable for the remainder of her life. The imprudence of taking hot and cordial notvrifhment during labour, is no lefs reprehenfiblt. In plethoric habits, it muft have a feverifh effedt : in any conftitution, it is at that time a dangerous nimuiant. The nature of the principle which fliould actuate the yfcpmb, is immediately changed j.the pains are rendered diforderly and imtarfedt ; and the foundation of future mifchief and difficulties, in fbme form or other, is invariably laid. A labour may be fo flow, or ifuch long duration as to render a little refrefhment from timedjb e neceffaiy ; but this fliould always be of a mild and cooling Qual- ity, the very reverfe of inflammatory food or fpirituous liquors. Z < I have aiready intimated, that in all ordinary cafes, the chief du- tyo^a midwife is to let nature take her regular courfe without bufy infWprence ; to reflrain, rather,, than encourage the exertions ofthe patient's ftrength ; and when thefe may be involuntarily carried too fjfcMjJtom the impulfe of acute pain, to refill them by the application of#0me equivalent force. But I am forry to add that the contrary method is too often purfued, efpecially by practitioners in country places, where the patients are fo widely fcattered, that difpatch is the firlt object of confideration, and the dictates of humanity are disre- garded from ftronger views of intereft. The moment an order comes for the man-midwife, he packs up his bag of tools, which may be juflly called the inftruments of death : he mounts his horfe and gal- lops away, refolved tohaftenthe procefs by all practicable nitans, that he may be the fooner ready to attend to another call. At what- ever ftage of labour he arrives, he fpuis on nature with as much ea- gernefs as he before had fpurred on his horfe, though the clofely ei twined lives of the mothei and her offspring way be endangered by his precipitancy. Yet fuch, perhaps is the impatience of the poor woman herfelf, and fuch very often the ignorance of the by- flandcrs, that the quicker he is in getting through his work, if no obvious injury be done at the moment, the greater reputation he un- *3leferved!y acquires, and the more he enlarges the fphere of his mur- derous practice. Inftruments are fometimes neceffary, but they fhould be ufed as feldom as poffible. One method of preventing the evils which muft always arife from the hurry of profeffional men, would be to pay them more lib- erally for their patient attendance. They have nothing but the full employment of their time to truft to for the means of fupport; and it is juft that they fhould have an adequate compenfation for fo valuable ufacrifice. But ad this cr.unct be generally expected, I would reccrn- 531 ADVICE TO MOTHERS. rscird the cheaper encouragement of female midwives. none of whom fcc«reveT,ought to be permitted to practice, without a regu ar licei cc, obtained—not by money—but by proofs of real qualifications, lOuch perfons could fpare more time, and would be found much fitter af- fiants to lying-in women, than any furgeon, whatever may be his Hilt or talents. I do not infifl on the point of delicacy, but of abfo- IiBtc fafety, being perfuaded that hundreds of lives are deitroyed for ©ne that is preferved by the ufe of inftruments in labour. At fuch times alfo, it is highly improper to admit any perfon but r&e midwife and a difcreet nurfe into the apartment. To fay noth- ing of the noxioufnefs ofthe breath and perfpiration of feveral peoptif hkx clofe room, the officious folly, the filly tattle, the inconfiderate Jsiiguage, the fluctuating hopes and fears of fo many goftps, muft he productive of the very worft effects.. Let me. therefore, conjure pregnant women never to comply with the requeft, however well meant, of their female friends, to be fent for at the moment of la- ta or j they are fure to do fome harm j it is impoflible they can>u do any good. The patient will find quietnefs and compefure, of far greater fervice than the noify rallying round her of her friends, ^to awaken and cherifh the idea of danger. •* After delivery, when repofe is the chief reftorative of fatigued. nature, and when the purity of the air in the patient's chambers the beft prefervative from fever, the exclufion of vifitants muft be ftill iMore ftrongly infifted upon. The whifper of fond congratulation from the man rhe holds dear, and whom fhe has made happy, is all tfca? fhould be allowed even for a moment. With the fame view of quieting any flutter of the fpirits, and of preventing the uneafinefs ■which a mother naturally feels from the cries of her child, the opera- toon of waffling and drefling the infant fhould for a few days be per- formed in an adjoining room. As the pains of labour, however regular in its progrefs and hap- py in its iffue, muft produce fome irritation in the fyftem, and a ten- dency to fever external quietnefs, and perfect compofure of mind as ^arell as of body, are certainly the firft objects. But our care fhould fce extended to fome other points alfo. Too much attention cannot fee paid to cleanlinefs ; all impurities are to be inftantly removed. It is equally neceffary to change the linen often, on account of its retain- ing, the perfpirable matter, which would foon be thrown back into the fcabLt, and there produce the worft efTtdls. Whenever the weather permits, the upper fafhes of the windows are to be let down a little to admit the frefh air ; yet fo as not to expofe the patient to its direct current, for fear of checking the gentle and falutary perfpiration, which naturally follows the fatigue of a labour, and is defigned to a- tiatc a-ny inflammatory or febrile fymptoms. It would be no lefs dan- gerous to think of increafing or forcing this natural difcharge by large foes, a load of bed-clothes, clofely drawn curtains, or the ftill more pernicious heat of candle impregnated with fpices, wine or fpirits. A fever is almoft fure to be the confequence of fuch ill-judged expedi- ents, in whatever manner they may act. Sometimes they will put a ttt.d fton to pcrpiration, though they fet the body on fire, and thas ADVICE TO MOTHERS. 553 prorluce the very evil which they were foolifhly employed to pre- vent. At other times they caufe fo profufe and violeo.t a fweat. as muft not only exhauft the ftrength of the patient, and frequently iteC- , tro* the power of fuckling her child, but prepare the wav for tbe i ready attacks of a fever upon the leaft expofure to cold. A temperate degree of warmth, therefore, will beft promote t!*at difpofition both to fleep and to perfpire, which every woman fe-tla after abour The fires fliould be fuited to the feafon, or rather to the Itate ofthe weather, and made barely fufficient to counteract the efforts of cold and of dampnefs or moifture. The drinks fhould be mild and diluting ; and the bed clothes fhould be light and porous, to favour the efcape bf the perfpirable matter, while they afford a comfortable covering. A due regard to this regulation is the more neceffary, as the patient muft not be in a hurry to quit her bed, even Vhen fhe may fancy her ftrength and fpirits perfectly recovered. She (hd&ld be informed, that the womb does not refume its natural ftase t, for two or three weeks ; and that her lying in bed for that time is r*rno(l condufive to fo defirable a purpofe. A fofa is very convenient 1 to recline upon, while her bed is at any time adjufting, or to afford fome relief from a long continuance in the fame pofition. But I Would by no means advife fitting up in a chair, or removal into anotb- ^jPbom for the reception of company, till the end of the third week, and, then only in cafe of the moft perfect confeioufnefs of health and "Jligour. The oppofite extreme of too much indulgence is, indeed, more prevalent. It is a lamentable truth, that numbers of women aftet having been fafely brought to bed, are killed by imaginary kindnefs. They are fmothered inftead of being kept moderately warm. The "action of heat from without, is increafed within by inflammatory food and drink. Neither of thefe fhould be in any cafe allowed. Wo- men of ftrong and full habits have nothing to fear from emptinefs or fatigue i but may be faid to invite danger and difeafe by improper ^gratifications ofthe palate. They fhould confine themfelves for at leall three or four days, to barley-water, -ofuel, and beef-tea. Very weak and delicate women may be allowed fomething more nutritious,' fuch as calves-feet jellies, or veal and chicken broths, which are much better fuited to the weaknefs of their ftomachs, and will foon- er afford the wanted nourifhment than folid animal fubftances. If the rules of temperance before laid down have been followed during pregnancy, the patient will be eafily reconciled to abftemiou3 living for a few days. Indeed the relaxed ftate of the ftomach at this time commonly pr vents any natural craving for animal food. But, if a woman has been unhappily accuftomed to luxuries, or if foupfi fhould difagree with her, fhe maybe indulged with a little fifh, a Ut- ile boiled veal or chicken, and bread pudding. Every fucceeding day will render fuch indulgence fafer. Hot ipices, however, and ar- dent fpirits in any form or mixture, are to be abfolutely prohibited during the whole time of lying-in. Wine itfelf is liable to do much mifchief till every fymptom of fever or inflammation difappears j and, 534 ADVICE TO MOTHERS. even then, fhould be vary fparingly ufed, not more than a glafs ot two being allowable at the principal meal only. But though quietnefs, repofe, the admiffion of frefh air, ftrict cleanlinefs, and a temperate cooling regimen, muft contribute very much to prevent fever, and to promote a woman's fafe and fpeedy recovery from childbed ; yet all thefe prudent meafures will .often fail without her own faithful difcharge of one ofthe moft facred du- ties of a mother, that of fuck1 ing her infant. Unlefs the miik, which is ready to gufh from her nipples, finds the proper vent, it will not on;y diflend and enflame the breafts, but excite a great degree of fe« ver in the whole fyftem. Every at em pt to difperfe it by artificial means, being an a£t of flagrant rebellion againft nature, is as danger- ous to the mother herfelf, to fay notHng of her child, as an attempt to procure abortion. The evident determination of the blood to the breafts, for the wifeft and moft benignant purpofe, can never be gar, peled with fafety. It is either depofited upon fome other part, thdjpif to produce inflammation: or, it purgatives and fudorifics are ufed to > carry it of bv different outlets, the violence of their action muft be *■ attended with dari^erous (hocks, even to the firmelt habit. It may be faid, that there are inftances without number, qf mothers who enjoy perfect health, though they never fuckled thjfe1 children. 1 pofitiveiy deny the affertion ; and maintain, on,the contrary, that a mother, who is not prevented by any particular weaknefs or difeafe from difcharging that duty, cannot neglect it without material injury to her conftitution. The fame midwives who would aflift her in procuring a mifcarriage, if fhe wanted it, may now alfo undertake to difperfe her milk with the utmoft eafe and fafety. Let her not truft to the wicked delufion. The mifchief is not the lefs certain from its being perhaps unperceived at the time ; and cruelty to one child, often deftroy5 the power of procreating another. If we takeaviewofallanimatednature.it is fhocking to find, that woman fhould be the only monfter capable of withholding the nutritive fluid from her young. Such a monfter, however, does not exift among favage nations. They cannot feparate the idea of bring- ing forth a child, from the neceflity of giving it fuck. The wives of the American favages are faid to extend this mark of motherly tendernefs and folicitude even to inf nts that die upon the breaft. After having beftowed upon them the rites of burial, they come once a-day, for feveral weeks, and prefs from the nipple a few-drops of milk upon the grave of the departed fuckling. I have fee^n a drawing taken from nature by a gentleman at Botany Bay: itrepre-< fented a female of that country, after having opened one of her veins, and made an ineifion in the navel of her fickly child, endeavouring to transfufe her blood into its body, and hoping thereby to reftore its health and prolong its-exiftence. Obfervation and experience bad taught her, that the umbillical cord, or navel firing, was the medium through which the foetus, while in the womb, received nourifhment from its mother 5 fhe fancied,therefore, thatfhe could transfer her blood? ADVICE TO MOTHERS. i 3 5 through t>e fame ch mnel, snd renovate a life which-was dearer to her than her own ! Let the mother in civilized fociety, who, from motives of felfifh ea'e and imaginary pleafure, denies her infant the vtal fir■■■•am with which fhe is abundantly fupplied for its fuf- tenanoe, think of thi poor fcvage, and ftart with horror at her own nnnatuml depravity. It is alfo a great miftake on the part of fuch felfifh mothers, to fancy that they can take more pleafureby abandoning their infants to the c.->re of hirelings. Some of them may be callous to all re- proaches of confeience for the frequent difeafes of thofe children ; but leaving imnl fentiment and natural tendernefs out of the que:" ion, pleafure is inf parably connected with 'he enjoyment of health, and I have already fhewn how much this is endangered by a mother's unwillingnefs to become a nurfe. I need not repeat jWhat I faid of the inflammation and fuppuration of the breaft; but ■Hyhint on barrennefs, as one ofthe probable confequences of an attempt to difperfe the milk, may be farther enforced by obferving, ihat the womb is the part moft likely to be affe&ed in fuch cafes; the repelled humor has often been depofited on that delicate or- gan, and has there produce! deep-feated and frequently incurable Sogers. Many mftonces ofthis fort, as well as of other diforders ar^jng from the fame:qgufe, and equally fatal to fecundity, gave rifeto my former affcrtion, however harfh it may found in the ear of &{fronabte perverfenefs. T But I can with equol confidence affure the fond parent, faith- ful to her truft, and eager to cherifh her infant with the vital fluid which nature has kindly given her for that purpofe, that nothing, elfe can fo effectirally promote h?r recovery from child-bed, the fpeedy return of good health, and the long continuation of that in- viluable blelTmg. Befides, all nurfes concur in declaring, that the act Keif is attended with fweet, tnrilling, and delightful fenfation* of which thofe only who have felt them can form any idea. I have already admitted, that a mother may be prevented front giving fuck, by fome particular weaknefs or diforder; and in touching on the fame fu^jedt in another work, I obferved that wo- men of delicate conftitutions, fubject to hyfteric fits, or other ner- vous affections, made very bod nurfes. Left that remark might give too great a (cop* to excufes, on the ground of pretended weok- riefs or delicacy, T added, that ev-ry mother who could, ought cer- tainly to Toerform fo tender and agreeable an office. I now go far ■ ther, and mamtain that every woman, who is not able and willing to difchvrge tbe divies of a mother, has no right to become one. The fame perfonal defect, or conftitutional infirmity, which may rlifqualifv her f^r nurfinec, ofght *o be confidered as an equally ftronjr. difqu linco inn for 'manVrg. But if, after marriage, any rublequent difeafi1 or accident fhould ronder the difcharge of a mother's firft duty impracticable-or dangerous, ihe is, in fuch cafrs only blameH'e for calling in the aid of another to fuckle her chill In the next chanter, I fhall have occafion to fpeak of the fain- tary e~nnote tbe at- mofphere of great cities. Let her apartments be lofty and foacinus, dry rather than warm, and expofed to the fun's morning r?vs. \ have already explained the importance of cleanlinefs, and of occa- fionally letting down the uoper fafhesof the bed-room windows m fine weather, to admit frefh air, and to prevent fever. An atten- tion to thefe points is not lefs neceflbry on the new-born infant's ace unt, than on his mothers. Let not the firft air he breathes be f ml from confinement, too much rarefied by heat, or charged ^ith any n xious exhalations. The mild temperature to which be his been ufed in the womb, renders it very proper to preferve for fome 'ira-'i the fan e moderate degree of warmth in his new place of refidence. But he is not on that account to be roafted before a great ftY'% or kep: panting in fteam and pollution. If'fhp room be kfpt properly ventilated and free from impu- rity, the infant wili foon get hardy enough to be taken out into the oner, air, not on!v without the leaft danger, but with the greateft a 'vantage ; provided always that the feafon of the year, and the. ftate of the weather, encourage fuch early experiments. A month fpent w:thin, doors, is c'oriinemer.t long enough in almoft every cole ; and the nurferv is then to be frequently exenarged for green fHds and ftinnv eminences. There vouf child will drink, as it w -re, the v'fo.l ftr°am pure from its fource; he will draw in at ev&ry breath frefh fupplies of ftrength and alacrity; while the bra- cing'action ofthe ?or on the Surface of his bedy, will give a de- gree of firaicefs unattainable by any other ireans. ADVICE TO MOTHERS. 550 In the courfe of a few months, tr,e ftate of the weather need not be much regarded ; and its unfav rable changes, unlefs t;'e hpat or cold be intenfe, muft: not operate as a check on thofe daily excurfions from t e lmdery. Our climate is very fickle; we fhall fufer muc-i from its rapid variations, if we are not freely expoied to toem in early K>; do not therefore facrifice the future comfort and fafety ofthe gnwnman, to mift: ken tendernefs for the i fant. If your child be accuftomed from the cradle to go out in all weath- ers, he will h >ve nothing to fear from the bleak north, or the ful- trv fouth, but will bear every change of feafon, of climate, and of atm fph re, not only without danger, but without pain or incon* venien e. What is here faid of tbe importance of rrefhair, and of fre- quent exoofureto all forts of weather, in early life muft derive ad- - di ional weight from a confideration of the bad effects of confine- \f. meat md of u .wholelome air up in children. Thi? part ofthe "*•" fu ->ject is oret v fully difcuffed in my "D mefticMedicine." I th re exolTned the reafon whv fo few or thJ infants that are put into hofpitals or parifti work-houfes live. Such places are generally cro v led wth old, fickly, and infir a people, by which means the air is r°ndo-id fo extremely pernicious, that i becomes a poifon to young children. I alfo took notice of one of tne w rft afiti&io s of poverty in great t owns, where the p lorer fort of inhabitants live in low, dirty, con^ned lnufes,to which me frefh -ir as hardly any accefs. Th ^ugh grown people, who are nardv and remit, may live ia ftrh fiurtims, yet they generally prove fatal to their off- fpring, few of woom ar ive at maturity, and-t nofe who do are weak ad deformed. "• Virile i wis con tiering the hard lot of the poor, molt of whofe children parifh oeoaufe the wretched par-nts are not in a condtion to take them often out into the open air, I could not bir ^bf-rve th't the rich wre without any excufo for neglect ng fo effential a part of'hoir duty. It is their bufinefs to fee :hat their children be daily c irried abr ad and that they be kept m he open air for a fuffi dent t; me- Tnis will il vays fucceed better, if the mother goes along wth them. Serva its are often negligent in thefe matters, and allow a child to fit or lie on rhe damp grcund, inftead of leading or carrying it about. The m th r furely n e s ar as well as hor chil'ren, and how can fhe be better empl yed than in attending them ? . In the fame chapter, I had forther occafion to cenfure a very bid, though a very prevailing cuftom, of mak-ng chil ren ikep in findl apartments, or crowding two or three be s into one c: a-n. ber. Inlead of this, the nurfery and the fleeping rooms ought always to be the largelt and moft airy apartments in the houle.— When children are fhut up in fmall rooms, the air not.only^becomes unwholefome, but the heat relaxes their folids rend, rs them ddi- cote, and difpofes them to colds, and many ether diforders, partic- ularly of the convulfive kind. A!lmed:cil men, who have *ad mum onctice in the treatment of children, sgree in opmicm, that CQQvuliwn-ht s,of which fo many infants die, are to be chiefly alw- C4Q ADVICE TO MOTHERS* bed to a confined and impure air. I with to imprefs this truth on the minds of mothers and nurfes, to make them feniiolc of the.dan- ger of fmall or clofe rooms, and of the pernicious folly of covering an infant's face in bed or the front of its cradle, and thereby ma- king it breathe the fame air oyer and over all the time it deeps. It may be of no lefs confequence to repeat and enforce my cautions to parents againft fending their children, while very yc 1.1 g, or indeed at any age, to crowded fchools, the atmofphere of which is really a floating mafs of putrid effluvia. The breath and perfpi- ration of fo many perfons in a room, even fuppofing them ail to be in good health, muft wafte and corrupt the air, deftroy its vital properties, and of courie render it wholly unfit for the fupport of animal life. But fhould any one child happen to be difeafed, all the reft are very likely to catch the infection. When I fee a poor baby, before it can well walk, carried in a nurfe's arms to fchool, I really feel ftronger emotions of pity, and of alarm for its fafety,. than if I had feen it conveyed to a peft houfe. In the latter place, children would be kept feparate, and proper means would be ifrd to prevent the fpreading of contagion ; in the former, all are thrown together, and .there remain with relaxed lungs, open pores, and fteaming bodies, fo as to render it almoft impoflible for any to efcape. As thoufands of children die every year, the victims of djfeafes caught at fchools, and as the health and conftitutions of ftill greater n imbers are irretrievably ruined by the confinement and the bad air of fuch places, parents muft not be offended at thefeeming harftinefs of my language in reprobating fo abfurd, fo cruel, and fo unnat- ural a practice. I know that as foon as children begin to run about, they require the moft watchful care to prevent mifchief.—Will any mother urge this as a reafon for being tired of them, and for confining, as it were in ftocks, that reftlefs activity which is wifely defigned by nature to promote their growth and vigour ?—Will fhe, from a wifh to fave herfelf fome trouble, or to gain time for other bufinefs infinitely lefs important, fend her little babes to fchool, under the filly pretence of keeping them out of harm's way ? I hope what I have already faid is fufficient to convince perfons of com- mon underftanding, that they cannot be expofed to gre?ter harm, than by being fixed to a feat in the midft of noxious fteam for fix or feven hours a day, which fhould be fperit in the open air and cheer- ful exercife. Should it be alledged, that children are fent young to fchool, from a becoming zeal for their early improvement, I need only reply, that learning, however defirable, is too dearly bought at the expenfe of the conftitution. Befides, learni g can never be acquired by fuch prepofterous means. Confinement and bad air are not lefs injurious to t' e mind, than to the body ; and nothing fo effedually prevents the growth of the intellectual faculties, as premature ap. plication. Sending a child to fchocl n> bis nurfe 3 arms, is the fure way to make him an ideot, or to give him an unconquerable dif- guft to books : theon'y book he fliould then look at, is tbe great vol- ume of nature. This is legible at every age, and is as gratifying to ADVICE TO MOTHERS. 541 a child as to a man : It abounds with the moft delightful and moft ufeful information : It is equally conducive to pleaiure, health, and knowledge., A thoufand abfurdities in the fafliionable modes of education prefent themfelves now to my view ; but I muft only take notice of errors in the phyfical treament of children; and lureiy no error of this fort can be more reprehenfible, than that which I have been juft defcribing. Debility of body and mind is the certain confequence of fending very young children to fchool •, and of fending then*, at any age, to crowded or confined fchools. The terms of inftruction are in general fo low, that a matter or miftrefs of a fchool is obliged to take a great number of fcholars, in order to get a living *, and can feldom afford to rent a fpacious room in an open and elevated fitua- tion. Yet not only thio is as abfolutely neceffary for health, but a i lively fingng. it is of far greater importance than moft people may De aware of, to aflcciate in early life the idea cf pie- fure and c eerfulneis with fo falutary an operation. During the uf ot the lukewarm bath, the whole b< dy is to be irrmerfed in it every night as well as morning. But w hen recourfe is nad to a Id bathing, it muft be uied in the manner above prefcri- bed in the mc rniug only. At night it will be enough to wafh the lower parts; and even for this purpofe a little warm water may teadced to the a Id in lev ere weather. Every danger will thus be avoided ; evr ry benefit will be iecured ; and the habit of perional cleanlinefs being rent erec familiar in childhood, will be retained through life, and will contribute very much to its duration and en- joyment. SECTION III. Of Children s Drejf. THERE is not any part of my profeffional labours which I review with greater pieafure, than my exertions in early life to ref- cue infants from the cruel tortures ct iv. athing, of rollers, and of bandages. "V\ hen I firft ventured to take up the fubject, about halt a century ago, it certainly requirrc the ardour, the ccurage, the enrxuiialm of youth, to animate my oppofticn, nctccly to the prevalence of cuftom and the ftubbcrLefs of eld prejudices, but to tie doctrines of the Faculty themfelves. Abfurd as we may bow think the practice of twaddling and wrapping up a child, i?li it was as ftift" as a log of wood ; the arguments in favor of a lcofe and eaiy drefs, which I mace ufe of in my Inaugural Dififet tenon,*- were vehemently combated by the moft eminent n en, who at that time taught medicine in the Univerfity of Edinburgh. The reform W:.ich has fince taken place, though not carried to the extent that it ought to be, is an encouragement to ule lefs reierve in ccrdem- ning the remains of fo pernicious a fyftem. It cannot be deemed a matter of aftonifhmert, while medical men declared themfelves advocates for fuch a mode cf clctbrg, * De infantum *;u conlnvaada. 54* ADVICE TO MOTHERS. that it fhould be carried to the moft dangerous excefs, by ignorant, bufy, or ielf-conceited women. They fancied that the fhape, beau- ty, and health of the infant depended wholly on the expertnefs of the perfon employed' in drefling it. The midwife was to new-mould the head, and to fhape e^ry limb, according to her own fancy, and then to retain the parts, in the form (lie gave them, by clofe preflure. Her ftupid prefumption was farther encouraged by the vanity of pa- rents, who, too often defirous of making a {how ofthe infant as foon as it was born, were ambitious to fee it made up in perfect trim, and to have as much finery heaped upon it as poffible. Thus it came to be thought as neceffary for a midwife to excel in bracing and drcf- fing 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 ev- eiy bone had been fractured in the birth ; while thofe cruel liga- tuVes were often fo tight, as not only to gall and wound its tender frame, but even to oblfruct the motion of the heart, lungs and ether organs neceffary for life. In the progrefs of folly and vice, when the influence of depraved fociety had extinguifhed in the breafts of many mothers every fpark of natural affection, and had prompted them to abandon their chil- dren to the care of hirelings, the mercenary nurfe was glad, for the iake of her own eafe, to follow what phyficians taught, and mid- wives practifed. The infant was kept fwathed in the form of an Egyptian mummy, as incapable of motion as the latter, and almoft a6 deftitute of every fymptom or indication of life, except its unavailing cries. Though dwarfifhnefs, deformity, difeafes, or death, muft have frequently been the confequehce, yet the nurfe efcaped all blame as the*bandages prevented any limbs from being broken, and the poor victim bound hand and foot, might be thrown any where, and i' -re left with the utm(jfl"indifference, while fhe attended to her pri- v~ e concerns. The only thing relating to the drefs of infants which feemed to grife from any tendernefs, was a regard to its warmth : Unfortu- nately this was carried too far : and children fuffered from the quan- tity, at well as from the tightnefs of their clothes. Every child has feme degree of fever after the birth; and if it be loaded with too many clothes, the fever muft be increafed, often to fuch a degree, fr'irn the concurrence of other caufes of heat, as to endanger the life of the infant. Even though no fever fliould be excited, the greateft debility mult be the confequence of keeping a child in a ftate of per- petua! watte by exceffive perfpiration. Befides, in fuch a condition, 2 child is liable to otch- cold upon expofure to the leaft breath of air; audits lungs relaxed by heat, and never fufficiently expanded, are apt to remain weak and flaccid for life, fo that every cold will have the moft alarming tendency, and probably terminate in an afth- ma, or a confumption. , All the former evils, arifing from the fallacy of medical theo- ries from the prefumption of midwives, the folly of parents, the un- willingnefe of fome mothers to do their duty in beccroing nurfes, thefeifiih views of hirelings, and the quite oppofite, though no lefs ADVICE tQ MOTHERS. f47 fatal fuggeftions of mifguided tendernefs, were farther aggravated by the imperious dictates of falhton. Reafon, experience, and true tatte, would have long fince triumphed over filly ipeculations, igno- rance and caprice, had not every confideration been facrificed to pre- vailing forms ; fo that from the infant in its twaddling clothes, to its grand-mother in her fhroud, drefs muft be wholly regulated by the etiquette of faihion. Againft this lpecies of hitherto unfnaken tyranny, I fhall therefore point the chief force of my arguments ; after a few more ftrictures on the abfurdity and pernicioufnefs of the other caufe—of tight and oppreflive cloathing, which has re- ally inflicted deeper wounds on population, than famine, peftilence, and the lword. To begin with the error of phyficians : It is almoft inconceiva- ble, how any fet of men, who profeffed to be the admirers and fol- lowers of nature, fliould have been fo totally blind to her obvious moi'e of proceeding in the prefervation of infant life. She forms the body foft and flexible to facilitate its future growth ; fhe- fur- rounds thefetus in the womb with fluids, to prevent its receiving any injury from unequabpreffure, and to defend it againft every, thing that might in the ieaft cramp 01 confine its motions ; ihe adapts tne fame means to the fafe delivery of the child, all whofe bones are fo griftly and elaftic as to yield with furprifing pliancy to every ob- ftruction in the act of labour, and afterwards to refume their proper form unlefs reftrained or diftorted by the bufy interference of m;;n. Yet people of pretended fcience have been bold enough to aflert9 that a child when it comes into the world, is almoft a round ball j and that it is the nurfe'spart to <~Jftft nature in bringing it to a prcper lhape. We fhould rather fay,^et the meddling hand be amputated, which dares to offer violence to the works of nature. If, through the inexpertnefs or impatience ofthe midwife, any of the child's del- icate limbs have been fractured or put out ot joint, they win require immediate care and proper bandages *, but let not prefumptuous fol- ly attempt to mend what nature has made perfect, or peiverfely con- fine what was formed, for the utmoft freedom of motion and expan- f^on. I have of en had occafion to obferve. that the inftinct of brutes ii an unerring guide in whatever regards the prefervation of animal life. Do they employ any artificial means to mould the limbs of their young, or to bring them to a proper fkape ? Though many of thefe aTe extremely delicate when they come into the world, yet we never find them grow weak or crooked for want of twaddling-bands. Is nature lefs kind or lefs attentive to the human fpecies ? Surely not- but we take the bufinefs out of nature's hands, and are juftly punifhed for our arrogance and temerity. This argument may be rendered ftill more unanfwerable by an appeal to the conduft of thofe natior s that approach neareft to a flateof nature. They have no idea of the neceflity of rollers or bandages to ftrengthen the imaginary weaknefs, or to bring to a proper fhape the imaginary deformities of their infants, lhey allow them from their birth the full ufe of every organ ; carry them abroad in the open air i w alti their bodies daily in ceii vaer ; and gives 548 ADVICE TO MOTHERS. them no other food or phyfic but the truly medicinal and nutritive fluid, with which the mothers aTe benignantly fupplied by nature. Such management tends to render their children fo ftrong and hardy, ihact by the time our puny infants get out ofthe nurfe s arms, theirs are able to fliift for themfelves. I referv^ fome remarks on the perfect fhape of thofe favages for a diftindt chapter, in which I Brwrsra to conlraft it with the dwarfifhnefs and deformity of civiiized stations. Inftead of confideringa child at its birth as a round ball, which iacght to be brought to a proper fhape by a midwifes or a nurle's af- fiance, I would have both thefe descriptions of people look upon its kittle body as a bundle of foft pipes, repienifhed with fluids in caatmual motion, tbe leaft ftoppage of which is attended with im- nmsnent danger. Tight preflure a!ways weakens, and may fome- tiiai.es fufpend* with deadly effect, the action of the heart, the lungs, z; dlail the vital organs ; it impedes the circulation of the blood, and t&e equal diftribution of nourifhment to the different parts of the Ibcdy; it diftorts the pliant bones, cramps the mufcu ar powers, pre- vents growth, and renders the whole frame equally feeble and mif- fflwnen. Even were reafon filent on thofe points, and were we unwarn- ed! ofthe bad effects of fwathes and fillets by paft experience, human- ity ought to reftraiii us from putting a helplef* innocent to the moft craek torture, fqueezing its tender body into a prefs at the inftant of ks wlearfe from former confinement, and loading it with chains as a5&e £rii mark of our attention. 1 have often been aftonifhed at the iafenfibiiity of midwives and nurfes tg the cries of infants while i&tetFwg—cries that feldom ceafed till the powers of the poor crea- tors were exhaufted. Yet fo far from feeling any emotion of pifir, it is ufual for the midwife or nurfe to fmile at fuch cries, sxul to endeavour to perfuade the mother if within hearing, that fcfce violence of the fcream is a fubject of joy, not of forrow, as k proclaims the child's health and vigour. I have already explained iLc eaufe and important purpofe of a new born infant's firft cry, ac promote refpiration and circulation. The loudnefs of that cry i» indeed a proof of the ftrength of the child s lungs ; but every foBhiequent ery is the language of pain, the exprefiive tone of irrita* «k>« and fuffering. If you do not inftantly attend to it, you may he guilty of murder* Think of the immenfe number of children s&at die of convulfions foon after the birth ; and be affuted, that liffeare much oftener owing to galling preffure, or fome external iEjory,than to any inward caufe. 1 have known a child feized with convBlfion fits foori after the midwife had done twaddling it, and immediately relieved by taking off the Tollers and bandages. A Icofe drefs prevented the leturn ofthe difeafe ; and though this will aot always cure fits produced by tight clothing, as the effect of the injury may continue after the removal of the crufe, yet it is one of she neceffary means of relief, it being impoflible that a patient can recover, as long as the caufe which firft gave rife to the diforder Continues to act. It may be proper in this place to give as clear, fimple, and ADVICE TO MOTHERS* zs9 concife an account as I can of the nature of convulfions, -that mM~ wives and nurfes may learn to fliudder at the idea of oocafionifig, bf their mifconduCt, the moft fatal, as well as the moft frequent di!ca£- es incident to childhood. I he heads of infants being proportionality larger, and the nervous fyftem more extended, than in grown per- fons, their nerves are more fufceptible of irritation; and convulses* fits are the confequences of keen irritation ; however excited. Time great Boerhaave was of opinion, that moft of the diforders of chi dxca might be ranged under the clafs of convulfions. It is certain thaiatt the different caufes of uneafmefs to a child form but one generall or undiitinguifhed fenfation of pain, which he has alfo but one way of expretfing, namely, by his cries ; and if thefe are not attended mj^ and no relief is or can be given, acute and unmitigated pain commwrn- ly produces a fit. If aay ftronger reafon need be urged for inucoe- diately attending to an infant's cries, it is that they are almoft always owing to mifmanagement. . I admit, that the moft incurable convulfions are thofe which pro- ceed trom fome original fault in the ftructure of the brain, itfeiyF, whence the nerves iffue. But fuch cafes feldom occur, although the brain has unqueftionably been often injured, and convulfions occa- fioned, by a midwife s prefump uous attempts to model the fkuHSoC the new born infant. I have already hinted at this deteftable prac- tice, and fhall prefently make fome farther remarks on its banefoJ prevalence, and its horrid effects. Children are alfo fubject to convulfions from cutting the te£t& with difficulty, or from a feverifh irritation of the fyftem at the ap» proach of the fmall-pox, meafles, and other eruptive difeafes. i am far from being difpofed to blame nurfes for what they cannot pre- vent ; though I believe that the dangerous fymptoms, which ofteB attend teething in particular, are chiefly, if not wholly owing to the previous improper and enervating treatment ofthe child. The other convulfions here alluded to generally go off as the eruptive difeafe, of which they may be called the forerunners, makes its appear- ance. There is another caufe of convulfions, for which midwives aad nurfes flatter themfelves that they are not in any fort blameable, I mean acute pain in the ftomach or bowels. But whence does this pain arife ? either from the tight preffure of thofe parts ; from the relaxing effeft of a hot and impure atmofphere ; or from fome acrid fubftance in the fhape of food or phyfic conveyed into the ftomach, and irritating the alimentary canal. If you attend to the directions before given on the fubject of air, wafhing, and cleanlinefs ; if you pour nothing down the infant's throat but the wholefome, unvitiated juice, defigned for him by nature ; if you flacken, inftead of bracing your wrappers round his body •, you may depend upon it that his ftomach and bowels will never be difordered as to occafion con- vulfions. The only part of an infant's drefs or covering which may be appfied pretty clofe, is a broad piece of thin flannel round the navel to guard againft any protrufion there, from the accidental violence of the child's cries. But take care not to make the preflure too 5' e takes alarm at the imperfect in- dentation ofthe bones on the crown of the head, and not only ftrives to prefs them clofer and to brace them by means of fillets, but is careful to keep the he«d warmly covered, to prevent the poor baby, as fhe fays, from catching his death by the expofure of thofe open parts to the air. Deformity is the leaft of the evils that attend fuch actsof aftonilhing infatuation, fhe delicate texture of the brain is peculiarly liable to be affedted ; and though neither convulfions nor any other perceptible complaint may immediately follow yet a weak- nefs of underftanding, or a diminution ofthe mental powers, is often the confequence, and defeats all the efforts of the beft education af- terwards. The oflification, or growing hardnefs of the bones of a cbi'd, and particularly thofe of the fcull, is incomplete in the womb, to fa- vour the purpofes of eafy and fafe delivery. In confequence of their foftnefs and pliancy, they admit of being fqueezed together and even of lapping over without injury, fo as to make the head conform to the fhape and dimenfions of the parts through which it is to be expelled. They will foon refume their proper place, if left to the kind management of nature, and not tampered with by the profane finger of a conceited midwife or a filly n'utfe. As to the opening or imperfect identatioh ot the bones of the fcull, it is owing to the fame caufe, and defignedfor the fame impor- tant purpofe, to facilitate the birth of the infant. The free action of the external air is then neceffary to promote the firmnefs ind com- ADVICE TO MOTHERS. $ 5« paCtnefs of thofe bones, and to make them prefs info each other* and for n futures for the perfect defence of the brain» not only agoinit blows and bruifes, but colds and defluxions. Warm and tij?ht covering directly counteracts all tnefe benignant int-n'ions of na'ure, and renders the fkull a very we^k fhield for the tecum y c* its precious contents. The curious diftinction made by Herodotus, in the field of bat- tle, between the fculls of the Egyptians and the Perfians. l^as ften been quoted to illu trare and confirm this doctrine. That hiftotiai hiving vifited tte fcene of action, where the flain. of thofe two n - tions had been feparated, fays that on examining 'heir i-er^ins be found the foills ofthe Egyptians fo firm tnat the 1-nnft 'o-nes could hardly crack them, wffle thofe of t' ePerra were io *" ..i and weak as to be eafily fractured by a final! pebble. A t r ba- ting the fact he accounts for it by obf>rving, that the Ea vpri i-:s were accuftomed from their infancy to go barHieaded ; wo orcas the Perfians, on the contrary, ol way s wre thick trra*. Tnefe were fko the heavy turbans which they ftiil ufe, and w ich feme travell rs thhk the air of the country ren ers neceffary. i b.-!I eve with Roffeau, that the generality of mothers will pay more regard to the fuggeftion of fuch travellers than to the remork of the ju- dicious hiftorian, and will fancy the air of Per a t- be universal. In oppofision, howev r, to filly conceits and prejudices, 1 muft affure my female readers, that there is no part of the'human frame which fuff rs more from heat and preffure thon the head, and none of courfe which ought to be kept cooler and lefs encumber- ed. A thin, light cap, {lightly fattened-with a bit of tape, fhould conftitu«e the whole of an infant's head-drefs, from the moment of its b;rth till the mcreafed growth of the hair renders any other protection unneceflory. As foon as nature fupplies your child with this belt of all coverings, never think of any thing more, even whnn you tak? him out into the open air, unlefs rain or intenfe heat or cold fhould make the occafional ufe of a very hght and ea- fy hat ai'vifable. I muft alfo forbid the ufe of ftay-bands to keep the p w infant's ' ead as fixed and immovable as if it were placed in a pillory. One would fuppofe tnat our heads were fo bodly fe- cured by the Author of our being, that they would fall off if they w°re not hel * faft by thore pernicious contrivances. It is ftrange that women fh ull be lb blind to the importance of letting the head move freely in every direction, in order to facilitate the dif- charge ofthe fluid excretions voided at the mcuth ! It is not neceflary to enter into minute details refpectmg the other parts of an infant's drefs. Any nurle of common ienfe and docility will eafilv catch the fpirit of my former arguments e~ the fubject, and will pay; due regard to the following general direction, with the writer's verv plain and fenfible remarks : Rational ten- dernefs " fays this author, "fhews itfelf in making the drefs light, fimple, and loofe. By being as Hght as is coitfftent with due warmth, it will neither encumber the infant, nor caufe any wafte of his pow- ers ;-in confequence of its finnpiicity, it will be readily and en hy put on, fo as to prevent many cries and tears, an cbject ot infinite 552 ADVICE TO MOTHERS. importance:—and its loofenefs will leave hull room for moving and ftretching thofe little limbs wnica have oeen long heaped tog °t ner, ani for the growth and expanfion ofthe entire frame." I before defired the nurfe to have always a fjft warn blanket in readineis to wrap up the infant on bei ig taken out of the bath, in that wrapper the chili fhouU be k^pt for at leaft ten minutes, in gentle motion, and then dreffed. A oiece of fine flannel round the navel, a linen or cotton fhirt, a flannel petticoat, and a linen or cotton robe, are foon pat on ; and where faftenings are requifitej they Ihould confift of tape, without the dangerous ufe of pins. Their punctures and fcratches are very irritating; and I M;eve rhe fact mentioned in mv " Domeftic MMic'ne" is fqr from being fin- gularor extraordinary, where pins were found flicking above trlf an inch into the body of tne child, after it hod die' of convulfion fits, which in all probability proceeded from that caufe. No part of an infant's drefs fhould hang lown above two or three inches lower than the feet. L v.g robes aad long p * ticoats fe»ve only to conceal the nurfe's inottenti n to cleanlinefs, and are, even on that account, very inp'-^per as well as cumberfome. The night clothes fhould be much lighter than thofe worn by day, from a due regard to the fruition ofthe infant, w'n fhould at all rimes, either in bed or out, exp°rience nearly th? fame d jgree of warmm. Every moifture or impurity fhouH be io^anriy re noved, and as thofe parts ofthe drefs which are next the fkii are conn:antly in. bibing perfpirable marter, they mould be changed frequently. In- deed, the fame clothes ought never to be kept on far many <*?vs together. Away with finery; but take care that the child is al- ways clean and dry. I wifh I could here clofe my remarks on drefs, without having any juft caufe to apprehend a ftronger refinance tr> rdl my precepts from fafhion than from folly, ignorance and prejudre. Folly may be laughed out of its errors; ignorance mav be inftructed ; and even the ftubbornnefs of prejudice may be borne down by the irrefutable force of argument. But fafhion bids defiance to the combined efforts of ridicule and reafan. The only favorable cir- cumftance is, that, being fickle as well as imperious, it may, in its changeful whims, fometimes fall in with the dictates of true tafte, and give both eafe and elegance to the human form, t his has been happily the cafe in the difcontinuance of fome of the moft painful, awkward, and disfiguring articles of female drefs; I meon the high-heeled fhoe, and the whalebone ftays, which I hope, will never again make their frightful appean nee. But though fafhion has lately carried the loofe an •' 1'ght atf re of our fair country women almoft to the extreme of n dity, yet it cruelly and abfurdly retains too much ofthe bracing met1 d ia childhood and youth, when the tender and er^w'ng frome ^eqinr >s the utmoft eafe and freedom. It is true, w1 n ■-> 1 n t <°e t e once familiar fpectacle of a mother laving her d-ugV*»r ^wn uoo- a carpet, then putting her foot upon the girl's *?.-k, and br aknq half a dozen laces in tightening her ft*>yr, to give her a Herder waift. But the abfurdity of ihe contrivance is only changed fro* > ADVICE TO MOTHERS. 5i3 ftays, to diagonal bandiges, or ribbands, faftened acrofs the breaft and moulders with (training violence to caufe an unoamral promi- nence before, a frightful indentation behind,and a wiery lliftnels m the motions of the pinioned arms. Yet 'his is called grace and degance. The ooor fufferer in fuch chains feels no relief fj"^ "e dife ntinuance ofthe whalebone prefs, when fha finds that>' uiksa fetters bind as faft." The breaft and (boulders are not the onlv parts which are tnus corded. The necks of young females feldom efcape lone ligature that muft impede the free accefs of the blood to the head, and its return thence. Ribbands or other faftenings of glovos above the elbow, bracelets on the wrifts, and garters either above or below the knee, feem as if purpofely conrrived to obftruct circulation in the upper and lower extremities. The toes alfo, the motion ot which is as free and eafy in infancy as that of the fingers, are loon fqueezed together, for fear of the young ladies becoming iplay- footed. Even this is not enough, without occafionally putting tne feet into wooden ftocks, to make a child turn out her toes, atter ail power of motion has been previoufly deftroyed in them I Boys, indeed, efcape fome of thofe partial bandages, but they are fubie&ed to a general preffure no lefs injurious in the tight huffar dreffes before alluded to. Silly mothers are very i opatient to ftrip them of their loofe frocks, and to make them look like little men, which is often the caufe of a much nearer refemblance to monkeys. It is really aftoniming that health and growth mould be perverfely facrificed to fafliionable fmartnefs. Ail that nature requires in drefs, is eafe and comfortable w irrath. Tn the progrefs of fociety to refinement, decency and elegance are united with the former. At length, falfe tafte becomes diffatisfied with natural fimplicity and beauty, and introduces in their ftead fantaftic finery and cumbrous ornaments. The way to reform is plain and eaty, if we have courage enough to (hake off the tyranny of fafhion, and to confult our reafon and our feelings. fo mo- hers to dilpoied, the following details will not appear unimereitrng. The proper drefs of infants has been already defcribed with diffident minutenefs. Very little alteration need be made or live or fix years, except that of fhortening the frocks and P;;«!C0*ts> when children begin to learn to walk , and foon after ^^hera with eafy fhoes, adapted to the natural fhape of the foot, neither too largJ, which would caufe a muffling kind of pawnor too fmall lo as to cramp motion, give prefent pain, andprepare toe port5 tor greater fufferings. Where this caution refpedhng <^;^£ "*" of fhoes to be attended to during life it would not odly praent corns, and the painful confequences of nails f^Sf**™ ^> but many excruciating maladies which may be traced to t,.e tght preffure of the toes, and fufpended orcujatioyn thejfeet. A well made fhoe anfwers the two-fold purpfe ^ feannnel , and of de- fence againft external injuries, including cold ^d moifture But when fafhion is more regarded pan eafe, we feye nc' «*» wonder at the number of cripples we meet ™*tottWaJ"l£ £e victims of their own folk. Whatever changes mavbe thought 0* (36) 154 ADVICE TO MOTHERS- ceffaryin the lubttanc* or materials of fhoes, according to the age of rie woarer, toe difference of exercifo, or woo'her, or of fe grmndfor which they are intended, the' grand principle of hoving them made eafy, and fuited 'o the fhape of the foot, fh ^uld never be loft Tght of. The ^iff rent 'i^ct m alfo of the toes on each foot, renders it advif-able to ave a correfpo- dmg difference in t e form f each fhoe, whico fhould not be afterwirds chang°d from one ft to the other. It may be (aid, that fhoes wifl thus get a little cro k-d, a^d will the fooner wear mr on one fi 'e ; but furely eafe and health are infinitely fuperi r to iuc- trifling ronfider ^rio^s, It losing of t' e firft importance o ke^o the ieet alwavs clean, dry, and warm, children mould weir fL nol or wo^ft-d focks in cold and wet weather. Befides the other a: v tages attending tWh practice, it will be faund one of the bea prerervativos from chil- blins, efpecially if children, when col', are n t permitted to run tothe fire, "btit^re accufto ned to wrrm themfeives with pr per exer-ffe. The focks fh mid be fitted to the faot, ns well as the fhoes, and mould touch ev^ry part with gpntle preffure. If too fh >rt or too tig'H. thev will produce he tff ct dreody defcribed; and i too big, foas to mak? folds wthin th- fh e«, thev will gall rind irritate th- fkin. I» is farther defirable to have f cks" an I the /e°t ~f noekiogs made wit- 'iff rent divffnnsor fpa^es, l:k«" the ffng rS f gfoves, to abforb fe perfipiraole matter between th: toe% and riius prevmt the equally u plearam and unwhct< fome effect of hs f-rtli^g there. Wtl the tr ubh of having the toes as w°ll i? 'he fi 'g^-rs fitt d with prop--r covering, be deemed an ob- jetoo of any confequence by people who take infinite pains to adan» their drefs, in a thdb^and other inftances* to the m -ft incon- venient and unhealthy fafhinns ? I h lie ftockifgs, as foon as rivs ad iimal article of drcT-fholl be faund ne-effaty. Silk, co'.ton or threod ft >rk ngs, are for from being fo well calculated to pr -rn e inf n ii'de perfolr tion in the I ~>wer extremi'ies, or to favour tne mo:;on o: th fluids to Pe upper parts. ' ht-y are evert injuri- ous in cfa of fweat, either from exercife, or the nature of any bo- divi 'unl's conftitfti n. inftead of fuffering the offe_fiv mci?ure to efoaoe, as worked woul', they retain it in elfe contact with the *km, incr afe its pu'refceot tendency, and not only chek all farther perfpiration. but rauf^ a re-abforpti n of a p rr ft e mat- ter alrea yoerfpired. Worfted ftockr gs may bt w rn thxker or thhnr according fo theftrte of thQ weather ; ard if the: fhow of g'eiter finery be th mght indifpe ffable for y; img gentlemen or y: untrhd' sin their teens, a pdr offilk ftockirgs may l>e drawn ov°r the w 11 m n^, t^ gratify parental vanity. I ftead of gar ters, the bad eff^r -+' which I have already noticed, ft-vlrings r ay be early kept up by flips of tape 'ahened to the band that encircle* the want in the drefs of either fex. ADVICE TO MOTHERS. 55$ My former remorks on the tight huflar dreffes of little boys*, who cught t<. be kept much longer in petticoats, 3nd on the diago- nal braces of yon:g ladies, who are thus cramped and diftorted, preclude the neceflity of any farther obfervations concerning the due degree of eafe which mould always be confuhed in the body- clothes of both fexes. But it is proper to (ay fomething of the changes in point - f warmm, which may be requisite in different ftates of the weatner. I have met with feveral plauftble arguments in favour of an uniformity of drefs in all fiafons; and the exampb df the greoc Newton has been urged, to induce us, like him, to wear camlet in winter as well as in fummer. But though • that illuftri- cus phli -f :pher made himfelf immortal by his amazing difccveries, yet his narunl life did not greatly exceed the ordinary period of threescore years and ten. Me cannot therefore be mentioned as a rem..rkable inftance of long^evity; and even had be 1 ved many years longer, t'ne number ot his days might be more renfonablv a(- cribed fo his temp, ranee, his regularity, the habhual fweeiDefs of his difpofition, and the exquifite pleaftire arifing from his fuccelsful refearches, than to the unvarying famenefs of his drefs. It does not therefore imply the fmallelt diminurion of our rev- erence for the great Newton, if we look upon nature as a more un- erring guide than any philofop »er. Obferve how kindly fhe varies the covering of animals, according, tor the temperature of the cli- mate, and the difference of the feafons. Their hairy coat i3 bnger and thicker io cold countries than in hot; and its growth and warmth ate evidently increafed, at the approach of winter, in the chilly regions of the north. Her care of the feathered race is dis- played in a differem manner. She gives theinftinctive impulfe that makes them anticpate the rigours of whter,and wing their way to milder climates. Though men caniiot fhift their places of abode at every feafou wth the facility of birds of paffage, the)* can profit by th" example of nature's kind protoctooTi of other animals, and can accommodate their cloatmng to the fenfible changes of the fea-' fon and weather. Let it not be fuppofed that I am for recommending thofe peri- odicol fafhions of drefs which are reguhted by the dates cf an al- manac, in fuch a Country as ours, where tl.o weather is fo change-- abb, where the clofe of autumn is frequently fevere, and where^ tint only in the fpring, but even after the commencement ot rhe fummer months, wg may fay in the words of the poet, That winter oft at eve refurries the brrtze. Chills the pale morn, and bids his dYn'in,;'fl<£ts Deform the day ddightlefs. I fhould be ftill lefs inclined to encourages ridiculo'as attention to ev^ry little change of the air and weather, as indicated by bar- ometers and thermometers. • Our fenfes wili afford us all riecelTary information en this bead, without the aid ot mathematical lnitru- meats. It is only in calo of confiderable tranntions from h;at^o cold, or the contrary, that our feelings wil dire&. us to guard againft danger, by fuitable changes of apparel. Poor, nervous, dil- h"%.^mgs are affected by a pafe; cloud, or Ihiftmg b:e?th a< % H« ADVICE TO MOTHERS. wind. But my rules are intended for healthy children, habituated to the cold bath every morning, and thus prepared to bear w:th- out uneafmefs or injury, any flight variations of the weather which may take place in the courfe of the day. Yet even fuch children are not to be expofed in thin cottons to the keen action of the win- ter's cold, nor fmothered with woollens in the fultry heat of fum- mer. Both thofe manufactures, which a1 carried, to great perfec- tion in England, are well fuited to the different fealons. But I muft obferve, that fine linen is at all times the mot proper covering next the fkin on every part, except the feet and legs, for the reafons before mentioned ; it fufficien ly increafes internal warmth, with- out any unneceffary ftimulus, or difagreeable friction. Particular infirmities, or a defective perfpiration natural in old age, may ren- der flannel or fleecy hofery advifable; but linen next the ikin is beft fuited to early life, and requires little trouble to keep it always alean. The upper parts of the human frame do not ftand in need ot much covering. Nature takes care of the head ; fo that even the tjhin cap. recommended at an infant's birth, becomes wh lly un- neceffary, either by day or by nighr, in three or four months.— When children are taken out, according to my former intimation, a light, eafy hat, mode of ftraw or beaver-fur, is very proper; and #" the under fide of the brim be died green, it will afford a pleafmg relief to the eyes, and prevent the injurious effects of too glaring a fight: The pink or vivid colours, fometimes ufed by females in the linings of their hits or bonnets, may give for the moment a feem- fcg frethn^fs to the cheek, but mull very much impair the fight by their dazzling brilliancy. v We fhould not apply any covering whatever to the necks of young perfons of either fex. When they grow up, in order to avoid being pointed at for Angularity, they may preferve fome lit- tle fhow of conforming to fafhion, but without checking the circu. la'ion in fo dangerous a part. Females matt never be induced to wear tight necklaces ; nor muft males brace their collars, or uleany ftiffening in their ftocks or cravats, through weak compliance with ri^e whim of the day. Even keeping the neck very warm, though without any clofe preffure, increaf s its delicacy, or rather its fenfi- N bility, and renders it fufceptible of cold upon the leaft expofure. The fleevs of frocks, gowns, and coats, fhould be made loofe, to leave the motion of thearnts perfectly free and unconfined.— Though glr ves are unneceflarv except in very cold wc-a her, yet I have not any ftrong obj ction to their ufe, pt vided they flip on eafily, and are made of porous mat erin Is, to facilitate the evapora- tion of the perfpirable matter. Leather is of all fubftances the leaft adapted to this important purpofe. I fholl conclude thefe obfervations on drefs, with a p'cture of faftnonable abfurdiries given in the laft editi n of my " Domrftiq Medicine." It is not from an rver-weening fondnefs far my own errrarks,that I occafionally refer to, or make extracts from that work: bur as fome of the points there touched upon are here more fttflydifcuffed, it would be the effect of falfe delicacy on my part, ADVICE TO MOTHERS. 557 to luppreft now any thing ufeful or pertinent which then occured to me. After having applauded the judicious reforms of female drefs, for their attention to health, fimplicity, and real elegance, I exprefk ed fome concern at not being able to pay my own fex the lam- compliment : " An affectation,' I obferved, " of what is called military fmartnefs, feems to have converted their whole apparel in to a fyft m of bandages. The hat is as tight as if it was intended for a helmet, or to defy the fury of a hurricane. Its form alfo being oy no means fuited to the natural fhape of the head, it muft be worn for a confih erable time, wbh very painful and unequal preffur*0. before it can be made to fit its new block. The neck is bolftered up and fwathed with the moft unnatural ftiffnefs. Eafy motion without, and. free circulation within, are alike obftructed, v Blotches and eruptions in the face, head-ach, apoplexies, and fud- r den ligatures or tight buttoning ; and the legs, which require the ut- > moft freedom of motion, are fcrewed into leathern cafies, as if to \ convey an idea that the wearer is fometimes mounted on horfe- *[ back. To complete the wh le, and in order that the feet may be *r. kept in as tight a prefs as the heap1, when fhoes are to be worn, th« fhape of the foot and the eafy expanlion of the toes are never con- fulted, Out fafhion regulates the form ofthe fhoe, fometimes fquare toed, more frequently pointed, and always fure to produce cramps and corns, the keen, the fenfible announcers of every change of the weather, i have lb long employed ferious argument upon thefe fubjects in vain, that I am now accuftomed to view them with pit; laatrv ; and when I meet with fuch figures diiguiled, and ren- rtered truly auk ward botn in their motions and appearance, I car- no' nelp thinking with Shakespeare, " that fome of Nature's jour- neymen had made them, and not made them well, they imitate humanity ft abominably.*' SECTION IV. Of tbe Injury dene to Children by the too early and mneteffary ufe cf Med?- icines. Of all the abfurdiries that prevail in the treatment of infants, there is none fo grofslv repugrant to common fenfe, as the frenzy of giving them phyfic before we give them food. They fcarcel y be- gin to breathe, when fome purgative flop is forced down their throats, and the tender ltoraach and bowels are thrown into a ftate •f the moft unnatural irritation* It often appeared to me v^r $58 ADVICE TO MOTHERS. ftrange, how people came to think that the firft thing given to a child fhould be drugs; but after duly confiderirg the matter, I perceived it to be the effect of fuperficial knowledge. 'J he more 1 examined this point, the more I was ftruck with the truth of the philclcpher s remark, that mere ignorance hath never done any material injury ,- that error alone is dsflruclive ; and that we do not err in things we are profeffcdly ignorar.t of, but in thofe which we conceive we know. ' To begin with n edicines at the birth, is a ftrong illu;tration of tne mif- chief ol conceited fkill. ^ It would never enter into the minds of perfons wholly unac- quainted with medical fcience, that evacuations ought to precede the firft fupplies of nourifhment. But a little (mattering of phvfic gave rife to the idea of cleanfing tbe firft pafLges ns focn as poffible, m order to bring away the black, vffcid, fyrup like fir fiance con- tained in the in'eftines of a new-bore infant. The fallacy of fuch a fuggefiion can only appear upon a more accurate and cempre- heafive view of the fubject. In the firft place, the meconium, as it is called, generally paffes foon after the birth, without any excitemert but the mrre effort of nature. When rhis dees not take place, every defirable purpofe is fare to be effected by the thin, wattrrifh, and purgative quality of the mother's milk. Do you fuppofe that any chemical procefs can equal this ? Or do you imagine that the retention of the meconium for a few hour*, can do half as much mifchief, as your oils and your fyrups, your indigeftible or your acrimonious trafh, muft oc- cafion i But it was enough for midwives and nurfes to hear phy. ficia~s, who knew very little more of he matter than themfelves- prefcribing things cf an opening nature to purge off the remains of the meconium. This vicquifition of imaginary ieienee was too flat- tering to female vanity, not to be difplayed upon every occafion ; and many a fevere twinge have poor infants fuflbred, from a mid- wife's defire to fhew her profound fkill in phyfic. I was once fent for by an intimate friend, to look at a new- born infant who appeared to be in great agony. I foon difcovered t hat the complaint was the belly-ache, caufed by fome injudicious purgative. As the midwife was prefent, I remonftrated with her on tne raftmefs of thus tampering with an infant's delica"e ccr.fti- tution. She replied in a tone of feif-fufficiency and furprife, " Good God! Doctor, I only- gave the proper phyfic to bring away the tconomy." 1 fhould have fmiled at her affectation of medical cant, and het ridiculous attempt to catch at the found of the nord meconium, had not the ferin-us mifchief fhe had done fuppreffed every emotion ot laughter. I reprimanded her in very pointed terms, and made her feel the burning blufhes c f confufion, when I fhew- ed that poifon was as likely to be ufed for phyfic, as eamcr.vj for the word meconium, from the fame, impulfe of conceited folly. But the whole blame in fuch cafes is not, as I have already in- timated, to be laid to the charge of midwives and nurfes ; the fac- ulty themfekvs have paid too ittle attention to the medical treat- ment of children ; and, in conlequence of their fuperficial knowl- edge cf theefe important fubjec~ts9 have»fanctioQed errors of the moft ADVICE TO MOTHERS. 5$?. total tendency. I once heard a medical profeffor of great celebrity lay, that he had met with a cafe, where the meconium was not brought away for three months after th- child's birth, and then only oy means of °ro g draftic purge?. Though o-e nf the firft aip.tomifts in Europe, he was led into this miftake bv the ■ lackifh colour of the child's ftools, which, Mr wmt of practical obfenntion an-4 experience, he could not account for out by alcrib;ng i- to the fupp fed remains cf the meconium. There is no'hi-g fo abfurd, fays an ancient writ r, w irh has m-tbeen u tern.' by fome philcf pher. I am f rry to add, that a fimiior aifartion might bt made with ftill greater trut^ concerning fhe profeflbrs i f phyfi". Ir w uh! be well, h wever, if th? idea ~f the neceffity of giving medicines to children, was eo: fined to one opening dole to purge off the meconium. Unfortun telv, the error comnatt d at the oirth is repeat-d again a^d again ; and (eldoin ceafes but vith the poor creatur.'s life. Oor tes are deemed neceffary to make it fleep ; carmimtives o exp I win \ or to cure the gripes ; laxatives and empties 'ocleanletne ftomach ; and ten thoufand other una*, oiling 4 and pernicious contr va cps ro relieve c mplaints, which are entire- ly the eff cts of bad nurfing, and which admit of no remeoy but by a complete reform in tnat department. When a medical man is fent for to attend an infant, his firft duty is to inquire v to the conduct of the nurfe ; and if there are fault?, to have them rectified. H will feldom find occafi n to prefcribe any thing elfe. \ hcr~- cann t be a greater error than to lupp tfe that the faults of nurfes may be repaired by drugs. Medi- c.ne, however fiVUfuily adminiftered, cannot fupply the place of proper nurfing ; and when given without fkill, which I fear is too often the cafe, it muff be productive of much mifchief* The fol- lowing facts will place this matter in ♦he cleareft light. About forty years ago whe 11 undertook the charge of a laige branch of t:e Foundling hofpital at Ackworth in Yorkfhire, I found that the children at nurfe had till then been attended uy the country ap thecaries, wh<>, fure of being paid fir their diugs, al- ways look care to exhior them with a liberal hand. Every cup- board and every fhelf in the houfe was filled with phials a d galli- pots. Undtr fuch treatment, alf the children died annually. As it w's evident to me, 'hat this morality couid not he ; aural, I fuggeft d to theg vernors, rhat the c ildrm had little or no occa- fion for medi ines, and 'hat with proper care they would t rive a d do well. A n~-w arrangement took place. The nurfes were for--, l>idden, at their peril, to give any medicine but what fhoul be ordered by me ; and were advifed to rely more on the faithful dif- charge of their duty than on dofes of phyfic. The confequence was, that the expenfe far drugs did not amounr to a hundredth part of what it had been before, and that not ?bove one in fifty of the children died annually. An opportunity of making experiments on lo extenfive a fcale feld m occurs. I had at tnat time the fole luperintend.mee of an immenfe number ofci.il ren fpnai over fine healthy country, where the mirles found it their intereft to do in every refpect what I defired, as they loft, their, appointment rti $6o - ADVICE TO MOTHERS. cafe ofthe leaft neglect. The happy refult ofthe plan left no doubt of its pr priety. It was theory verified by practice. A little roflection would foon fatHy an attentive obfervcr of noture. that fhe never defign^d the young of any (pecies to be brought up by the aid of medicinr. Other animals, following the guidance cf iLfipct, rever fail in this important bufinefs ; but man becomes in all things the creature cl art, and is mifled by it. I have frequently met w th inftances of families who had loft every child whiie they trufted to phvfic and employed the faculty, but who* at length bee mirg wife through deipair, and confictering that their offspring couid only die, left off the ufe of medicine altogeth- er, and from ih?t time never lit a fingle child. If we wifh for a more generol illuftraticn ofthe effects of thofe two different modes o*% treatment, we fhall find it in that part ofthe ifland where 1 was born (North .firitain) and where the carmen pecple have a ftrong aw* very juft vverfion to giving theii children medicines. The fruits of thei*- good fenfe are displayed io a numerou and healthy progeny, but puninefs, ficknefs, and death, find their way, in company with the doctor, into the houfes of parents ot higher rank. As the children of the latter are often obferved not to thrive, the common remark is, No wonder ! they gave the poor things phyfic. It is irdeed poffible, that cales may txreur to jultify the ufe of medicines ; but this very feldom Happens when children are prop- erly nurfed, unlefs the poor creatures may have inherited debility from the enervated conftitutions ol their parents. 1 may go farther and ?fiert, tfot even when the frequtnt or continued ufe of medi- cines is deemed neceflary, a child kept in ex'ilenceby the help of drugs has little realon to thank its parents for preferving its life.— It lives only to be a burthen to fociety ; and never can be faid to enjoy life fo much as to render the pofl ffion of it a bleffing. In all ether cafes cf flight ancl accidental irdiibofiticn, I do not hefitate tc give a decided opinion, that medicines do injury at eaft twenty times far once that they do good. A late writer on the mai-agement of children (Nelson) thinks it a matter of regret that they can feloom be brought to take phyfic without force. When I confider the almoft infinite number of young mrrtyrs to medicine, infead of lamenting the circumftance here flated, I rejok e at it, from the fulled conviction, that if chil- dren had no reluctance to twajlow drugs, we fhould lofe a great many rxore of them. 1 knew it is acorrrncn pr ctice with many others, to lay a child on its back, to ftop its nofe, and force the rcedici ue down its throat. This is adding the danger of fuffocation, and the certainty of difguft, to the hazard of a dc (e too often in its own nature injurious. Bribing rnd coaxing children, as foon as thvy become fufceptible of fuch impreffions, are almoft equally bad. Telling a child, that if it will take its phyfic, it fhall have a leward, is informing it bef re-hand, that the potion is unpleafant; and, after that, the chHd is fure to refute it, be it rendered ever fo pala- table. Where medicine is abfolutely neceffary, which, as I faid before, is very feldom the cafe, it may be fo contrived as to make a part of the child's focd. Eefides, a child fhould he accuftomed very ADVICE TO MOTHERS. S** early to refufe nothing ; and it wijl not refufe to take medicine.— It will act from habitual fubmiffion to authority, not from the cruel impulfe of force, or the pernicious allurement of a bribe. I could here point out many eafy contrivances to make chil- dren take phyfic, were I not affured that they are already too often poifoned by it. If drugs do not directly produce infirmity, dif- eafes, or death, thefe are fure to be ultimately the confequence of fubftituting medicine in the place of proper nurfing, and fooliflity iuppofing that the former can fupply the defects of the latter. Art opens all her refcurces in vain; nor can the greateft efforts of hu- man ingenuity make amends for the want ot good air, cleanlinefs, healthy breaft milk, wholefome food, and proper exercife. The ne- glect of any of thefe effential points is attended with irreparable mif- chief ; and on the contrary, a due attention to thefe precludes the neceiiity of any medical aid. Yet fo ftrangely addi&ed are fome * women to drench infants with drugs, that, when 1 employed nurles in my own family, it was with difficulty I could prevent them front giving medicines privately to the children. I hope tnat fathers, owill profit oy this hint, to exert their utmoft vigilance and authori- ty in the like fituation. There is not any notion which I have found it more difficult to root out of the minds of mothers, than that children abound with ill humours, and that thefe can be carried off only by purging medicines. If a fpot appear on the fkin, the child muft have h'.s guts fcoured out, to make the offenfive pimple vanifh, and tofweetea his blood, as the mother calls it. They little know, and can hardly be made to conceive, that all purgatives, however mild m their : operation, throw the ftomach into immediate diforder,, weaken its digeftive powers, vitiate the juices defigned for the folution ot food, and thus prevent thedue preparation of the chyle whence the blood is formed. This is the fure way to generate noxious humours, in- ftead of expelling them : and to taint or impovenih the vital ftream, inftead of purifying it. The other medicines, which the fears and tellies ot movers have introduced into the nurfery, are almoft as pernicious. H ad I leifure to make out the long liftx>f them, with a defcription cf their effects at an early age, it would appear that they ought to be more properly denominated poifons than remedies. They always do iome injury ; they cannot do any good; they are adminin erect either frivoloufly, or for the relief of complaints which are cauied by bad nurfing, and which do not admit of a medical cure. To truth to phyfic for what phyfic cannot effect, is aggravating the evil of for- mer errors by a ftill greater one, and quickening a poor inia- rs career to the grave. Were a h. w to be made and ftrictly enforced, which fhould abfolutely prohibit the adminiftering of drugs to children, I am fure it would fave the lives of thoufands every year in this metropolis alone. - I have elfewhere made a few remarks on the uiual conduct ot London mothers, whofe faith in medicine does not feem in the leatt abated by the moft ftriking and the moft lamentable proofs, not merely of its ineifocv, but of its pratwrnfoefc. ^ henever any S&. ADVICE TO MOTHERS. of ther children appear indifpofed, or do net feem to thrive, which Biuft be frequently fre cafe where ti.cy are lo badly w rfed, away the mothers run t"» the apothecary. His end » is t<-o often cherk- ed, and even his judgment is liable to be biaffed by bis inraedone ioteref:. He derives his luflport (mm the fale of his drugs, and will leldontVfifl the temptation to fend large fupplies wh re he knows the parents are in a condition to pay. t hyfic, in a variety of farms, is fubrituted for the only rational means • t tftoring the child's health, fome neceffary change of ar, exi-rcile, cl vhing, cf diet; tne mifchief begun by the nurfe is completed by »he d ctor; ac i de^th comes fooner or later to put an end to the tufferings of the t rtured victim. It gives me pain to write any ftrictures on the interefted views and reprehenfi lepractice of ev:n ke his chnru.t roll, muft fwallow dru^s every day? Yet, fucn is theintauatim of mothers, that, if this be not done, they think t^eir chil rtn neglected, nnd difrnifs one apothecary to make way far ano'her, who adminifters medickrs with a m re liberal, or rather a more defirnctive hand. If the apothecary be'a danger-us man, the quack is ftill m re fo. Yet I hardly ever knew a m~tner or nurfe who Ird not by her the noftrum of f mae quack, wi h which ftie every now aocl t ea kept defing the infant. Were the b ofted fpecific, like the anodyne'necklace, a mere chip in porridge, it would do n harm to t e child, and w uld ferve only to amule the mother, a d to levy a contri1 u ion on ^er credu* lity. But it is very often madr up cf octive ingredients, which ought to be adminiftered w th the greateft circumfpecticn. Moft of the noftrums given to ch lo-ren are ftrong • pia»es or purgatives, of a nature very different from th? innocent efficacy of a good nurfe's lullabies. ' 1 hey may quiet or compofe the infant, and feem to give it eafe for a time, but they never fail to deftroy the pow rs of digeftion, and to induce uoiverfal debility, with all its baneful <;3nfequen< es. There is, however, another clafs or defcription of quack medi* ones,which, though they earmot kill with greater ultimate certain- ty than the former, are more fudden and violent in their fatal mode of operation, I mean t e cake? and powders, and various other compofrtions, which are advertifed for the pretended cure of worms. A child's pale locks frig ten the mother into a belief that worms are the caufe; and fhe goes immediately to the worm doclcr, who adminifters h*s draftic dof s, without the leaft regard to the delica- cy of tr.e patient's conftitution. His fole aim is to expel worms; and if any appear, e *riumphs in the fhow of fuccefs, though al* nays attended with great danger, and fometimes with death. I ADVICE TO MOTHERS. 56$ have known a noftruraof this kind to kill in twenty-four hours;— but that was nothi g to the quack ; he had fold his medians ; oni he gave himfelf little concern about the injury it might do in par- ticular cafes. 1 would not have faid fo much ofthis {hocking indifference to murdor, had I not feen proofs of it, and in fome too, whopretenc ed to eminence in that line. I once told a lady, that her daugnter was in a deep confumption, and that fhe ought to go into the country, to take exercife on horfeback, drink affes' milk, and uie a light reftorative diet. But inftead of following this advice, fhe took her daughter to a very celebrated w^rm doctor, who foon relieved her from ail her trouble. Here I cannot help lamenting that confidence in worm-powders or worm-cakes is not confined to the weakeft of the fair fex, but is difcovered even in men of rank and talents. I have feen, though : with heartfelt concern, names ofthe firft refpectability fubfcribvd i. to tne certificates ofthe efficacy of fame of thefe noftrums. \ am ■ far from queftionhog the integrity ofthe perfons who figned fuch ;;, papers; but toey certainly kn.-w not wtiat thev did. They fancied they were only atteftmg a plain matter of fact, though the ihmg was far beyond the poffible roach of their judgment or knowledge, They had feen a quack medicine given to a child, and had alio (hen worms afterwards voided by that child. What then ? As the fame ►, effect might be produced by very dangerous poifons, how c odd v people, wholly igncranr ofthe ingredients, tell whether the operation .; afcribed to them v/as not at the rifk of the child's conftitution, or of its life f Even fuppofing that fome apparent good and no percepti- ble mifchief attended the experiment in one or two cafe?, are they fufiicient grounds for the general recommendation of any jecrct medicine, to which the lives of thoulands of children yet unborn may be facrificed ? I hope thefe remarks will prevent men of char?c- 1 ter from rafhly giving a fanction to the poffible deceptions of quack- ery, and will alfo leflen the refpect which individuals or the public at large may feel for fuch inconfiderate teftimoiials. To refume now my detail of various inftances of maternal weaknefs; I have to obferve, that the ftrangeft, and not the leaft mifchievous infatuation of all, confifts in giving medicines to chil- dren in good health, with the filly view of preventing difeafes. The fpring and fall are the periods confecrated to phyfic in the calender of mothers and nurfes. At thofe feafons, if children are ever fo well, they muft have a dofe or two of what is falfely called an in- nocent purge, to keep them pure and hearty. Thus they are mace really fick, for fear they fhould become fo ;* and their confutations are enfeebled by the perverfe means employed to ftrengthen them. I have already faid fo much oa the bad confequences which muft refult from the ufe of laxatives, efpecially in childhood, that no far- ther difluafives againft fo abfurd 2 practice feem neceflary, excop', this one remark ; that purging, like bleeding, induces a habt which cannot be left off with fafety. Every purge paves the way for another, till the bowels are deftroyed. Such medicines, therefore fhould never be adminiftered but in cafes of actual illnefs, and to e%r>e! fome greater poifon than their;'>l'."£c. &4 ADVICE TO MOTHERS. As this is a point which cannot be too Arongly enforced, I fcall lay before the reader Mr. Locke's fentiments on the fame rub- ject. They derive dmble weight from his medical fk-11, and from the extraordinary precifion •'f his manner of reafoning upon any topic. As he was r gularly bred to phyfic, he is exempt ifam the fulpidrn i: cur; d by fime latt-r philof pher", of having wrirten under the iiraence of prejudice againft the f icuby. '* Perhaps," fhys he, "it will be expected that I (hould give fome directions of phyfic, to prevent difeafes : for which I have only this one, veryfacredly to be tbferaed, never to give children any phyfic for prevention. Ihe observa- tion of what I have already a*dvifed will, 1 fuppofe, do that better, than the ladies1 diet drinks, or apothecaries medicines. Have a j.rtit care of tampering toat ry, 1 ft, in'ead pt preventing, you draw on difeafes. Nor even up n every little indifpofrh n ;n phyfic to oe given, or the phyficim to be called to children, elpeu lly if he be a bufy man, that w:ll pretently fill th their ftomachs with dnigs. It is fafer to leave them wholly t$ nature, than to p\ t them into the hands of one forward to tamper, or that thinks children are to be cured, in ordinary diftempers, by any thing but diet, or a method very lit le • ifferingfrom it; it feemi g fuitable both to my reafon and experk t ce. that fhe tender conftituti ns of children fhould have as little done to them as is poffible, and as the abfolute neceflity ofthe cafe r quires." To add any thing by wav ot comment or dluo° ration to Ian- ' guage at once fo clear and fo forcible, woul! betray the greateft weaknefs. It is enough for me to quote fo unexceptionable an authority in fupport or my favourite d' ctrine. 1 he eief defign of the prefent treatife is to fupnr ede the ufe of medicines in early life, and to fhew how health may be effectually preferved by good cuding alone. An at'ention to tne ruks her- laid down is the only method of preventing difeafes, with whi.h I am acquainted.— A child ufed to the cold Dath, and to the full enjoyment of frefh air, cannot be liable to coughs, colds, f .re eyes, or denuxicns." A clean dry Ikin, never relaxed by fculnels r heat, will favour the efcape of noxious or reJunda t humours, whileex^rcife will not fuller the feeds of corruption to lurk in any part of the frame. Inftead- of baneful phyfic, let your in'ant have the alin ent prepared for him by na'ure ; and you may be fure that the milk of a real hy, temperate nurfe, will never give him the gripes or the colic; it will nourifh, but not inflame him ; it will keep the habit pure, the action of the blood regular, and the furface ofthe wheiebody free from blotches or eruption*. Indeed, I know of no difeafe againft which a child may not be fecured by tot rational conduct of his nurfe. The preSifpofing caufes of all the complaints ot infams, are the weak- nefs of all the digeftive powers, and the irritability of the nervous fyftem. Both are obviated by the method i propolis. The ftomach is fupplied, but not overcharged, with fuch food as is fuited to its ftrength ; and every thing that may irritate the nerves, or give rife to convulfions, is averted with all poffible care. Even in the midft of contagion, or of epidemical diftemp rs, the purity ot a well- Durfed child's habit will correct the malignity of the infection, and diiarm ii of its ufual tenors. ADVICE TO MOTHERS. 56$. The enmettnefs with which I have recommended mocuhtfoa m another work, mav feem a little in^onfiftem with the doctrine here lai' down ; but it is becaufe very few children are nmfad according to mv plan, that I think it advifeabln to guard them all ze;ainft the pofliSle danger of cat-hing the fmall-oox by accdent. Befides, it is of imports nee to ben ole to eommand time, place, and circum- ftances, particularly as I have fhewn in my " Dorreftic Medicine,'' with what eafe and fafety the operation may be performed by mothers and nurfes without the leaft occafion for any farther med> aal advice or affiftance. SECTION V. Ofthe Food proper for Children. • THE pernicious follv of making phvfic precede food at an ia- r" font's birth is, I h"pe, fufficiently expofed in the former lection ; and notice is there tak-.m of the admirable manner, in which the thin diluted, and gently opening properties of the mother's milk, are adapted to every medicinal as well as alimentary purpofe.— Na'ured es not afford, nor can art contrive, any effectual fubfti- tute for that delicious fluid. By degrees the milk acquires confift- ence, and affords greater nourifhment to the child, as he becomes ,. more capable of digefting it. At length, his bodily ftrength in- |*eafing, and his t-eh burftinr through the gums, he can take more folid and fubftantial food, which requires ftill greater powers of digeftion. ' Thefe changes an* fo obvious, that they cannot be :;■■ miftaken. Ignorance is pleaded in vain, and the leaft deviation from fo plain a road to health, is' punifhe 1 with lafting inhiry.— The infant, after having derived it<; w-nole fuftenance and growth, while in the womb, from the mother's juices, cannot without the greateft danger have its fupplies totally altered at its birth. It muft ft'll be fed from the fame congenial fource, or the fhock of a fud- den and unnatural change will prove very trying to its tender con- ftitution. -" In my advice to mothers at the time of lying-in, I endeavour- ed to convince faem ofthe imminent danger to their own health, which would arife from their neglect of the moft fa red of all-ha ies, that of fuckling their children. It is an obi gation fo Tr ngly en- forced by namre, that no woman can ?vade toe performance f it , with impunity. But cheerful obedience to this (bv reign law is at- tended with faefweeteft pleafure of which the human heart is fuf- •eptible. The thrilling fenfations, as before obferved, that ac- company the act of givi ?g fuck, can be c n^eived only by thofe who have felt them, wnilo th mental raptures of a f nd moth t at fuch moments are far beyond the powers of d-fcrvton t fancy. «^he thus alio enfures , the warm returns of afte&io and gratitude from the objects of her tender care, and after all, the fatisfaction to fee her daughters follow her example. and recommend it to others. J6V5 ADVICE TO MOTHERS. Though I expreffed myfelf pretty fully on this head in the place above referred to, yet when 1 confider it, new ideas arife in my mind, and I am more and more irnpreffed with a fenfe of its iii^rtance. People have been often amufed with illufi: ns of uni- ▼,-r'a) remedies. Long experience has almoft deftr yed my faith in fhe^ ni ncy of even the beft fpecifios. But were I called upon to p mt m.t any one remedy for the greateft part, not only of the dif. eaihs; but 0t the vices alio cf fociety; I would declare it to be the it: dt mention of mothers to the ourfmg and rearing of their chil. dron. " Would you have mankind return all to their natural ltu ties " fays the eloquent Rousseau, in one of his fine fallies of fen- ' t nental eathufiafm, " begin with mothers of families: you will be aft ^iftied at t e change this will produce. Almoft every k nd of depravation flows fucceffively from this fource ; the moral order of thi g? ?s broken, and nature qui e fuaverted in our nearts; home is • fs cheerful and engaging ; the affecting fight of a rifing family no snore attaches the hufband, nor attracts the eyes of tne ftranger'j the mother is lefs truly refpectable, whofe children are not about her : families are no longer places of refidence ; haKit no longer e:/brc?s the ties of blood ; there are no fathers, nor mo/hers, chil. dren, brethren, nor lifters; they hardly keow (how fliould they F, I've) earn other ? Each cares for no ore but himfelf; and when * home a fards only a melancholy folitude, it is' na ural to feek diver*' fion elfe where. ■'*Bot," continues he, " fhould mothers again condefcetidrto NUR3B "their children^ manners ^ would form themfelves; the fentb rr>f nts of rature would revive in our hearts ; the ftate would be re- pp pled ; this principal point, this alone, would re-unite every thing. A tafte for the charms of a domeftic life, is the beft anti- d^v- againft corruption of manners. The noife and battle of chil- -hnn, which is generally thought troublefome,- becomes hence g;ro ahie; they render parents more neceffary, mere dear to each other, and ftrengthen the ties of conjugal affectic n. When a family is ell lively and animated, domeftic concerns afford the moft de- bt htfal occupation to a woman, and the moft agreeable" amufement to a man. Hence, from thecorrection ofthis one abufe, will foon rr-fhlr ? general refi rmation ; nature will quickly re-affume ail her rioets ; let wives but once again become mothers; and the men will prefently again become fathers- and hufbands." To this fkeich, drawn by the pencil of fo great a matter, I fhall only add, that the happy confequences of fuch a reform would be no lets (biking in a mem with th mot tender f lici u le, till they - on pr vide for theralolve?.— Not o dy the inhabitants of the howling wildernefs, the de-wolf and the fell tygrefc, but °van the mooflers ofthe greet d-ep, draw cuf their br^art and g ye ftrk to^t eir y ung. Will woman then fuff r herfelf to hn ft'gmatzed as the only unfeeling monfter that can defert rhe iffue of her ov/n womb, and abandon it to the care of another? W 11 fhe alone entail the curfe other unnaturaJ con- •' duct on her ^ plefs poPe ity ? $ut let me vindicate the fcoais character from fo foul a re- proach. It is not fa much the fault of tie women, as cf w at is •■ impr periy call d civilized fociety. In its ruder fta^e, this never happened. It n ver.hnppens among favnge nations. I linvealready mentioned fome remarkable i ft ncesf their parental leade/euefs. The influence of fo nr ng a orinciple can be weakened only by tbe prevalence of vice, and of art ficiai refinement. Wherever an m.- n cen- fimplicity of manners prevail, th** children are not brought up by pe ^xv; t- e women ere net fatisfied to be mo! hers by feahres, as an old writer exprpffe^ it—to bring f rth, and then caft off their offspring. They think with him, that nothing can be more contrary to nature, tban fuch n imperf >& fort of mother, wh->, afar haviirg nouri(hed in h r womb, and with h-r hlood, fomething winch fhe di 1 not fa -, r: fades no^w her breaft-milk to amar fhe lees living, be- come a human creature, and imploring the affiftance of its parent! In the potifne', or rage^ by fhamelefs ex mple, are eager to get rid of their chil- dren as foon as b- -rn, in ord. r to. foend t; e time thus gained from the difcharge of'he:r duty in difliparion or ind. lence- set not hufbandsbe dereved ; kt 'hem n~r expect attachment from wives, who, in neglecting to fuckle heir, cildrc, rend afunder the ftrr njured her health by vice, nurfing will notleffen, but increafe her ftrength ; and if any conffitudonal de- fect renders her wholly unfi f r fuckling her child, fhe ought to /abftain from procreation* The woman x&Q cannot diicharge the 568 ADVICE TO MOTHERS. duties of a mother, ought again and again to be told, that (he int. no right to become a wife. In cafes of accidental injury or difeafe, where it may be impof- fible for the mother, or highly improper on her part, to give the child the breaft, fhe is to be pitied in being thus deprived of the greateft pleafureoflife,the pleafure of feeding and rearing her own offspring. But the number of thofe women who really cannot fuckle is very fmall, compared with thofe who will not. The latter excite eur indignation—not our pity ; they ftifle every emotion of ten- dernefs ; they are deaf to the voice of nature ; they facrifice the moft important duty to vicious purfuits; and madly barter joys that will pleafe on every refle&ion, for fuch as never can bear to be recalled. Little do thofe diflipated mothers think of what their poor in- fants are likely to fuffer, when committed to the care of hirelings.— Ought they not to confider, that the woman who parts with her own babe to fuckle one of theirs, unlefs (he is impelled by the keeneft diftrefs, gives a proof in the firft inftance of her not being a good mother ? rlow then is it to be expected that (he fhould become a gOod nurfe ? Even fhould fhe acquire, in time and from habit, a tender affection for her fofter-child, ought not a mother of any fen-. fibilitf to take alarm at the idea of having that child's love tranf- ferreq.fron herfelf to a ftranger ? Indeed, the claims of the nurfe who does her duty faithfully, are greatly fuperior to thofe of the parent who neglects her's. It was a faying of Scipio Africanus, that he took her to be more his mother who had nurfed him for two years, though fhe had not brought him forth, than her who, after fhe had brought him into the world, deferted and abandoned him. But I am ftill better pleafed with the anecdote related by Van Swieten, of a Queen of France, who gave her fon fuck, and would not defift from fo doing even when fhe was taken ill of an intermitting fever. It happened during one of the fits, that another matron gave her breaft to the thirty and crying child ; at which the queen was fo much difpleafed, that fhe thruft her finger into the child's mouth, in order to excite a vomiting, being unwilling that another fhould perform any part of a mother's office. I fhall not enl trge any farther on this fubject, I hope I have faid e 'ough to excite good mothers to the moft afliduous obier- vance of their duty, and to warn others of the evils inseparable from the neglect of it. Such as may refolve to obey the dictates of nature and reafon, will find the following directions of fome ufe in the profecution of fo laudable *a purpofe. The mother, after delivery, fhould be indulged with a few hours fleep, to recover her from the fatigue which fhe has lately undergone, and to allow due time for the fecretion of the milk, be- fore the infant is put to the breaft. The child can fuffer no incon- venience from this delay. Being replete with blood and juices, he has not the leaft ccafion for any frefh fupply of nutriment, til he mother is prepared by neceflary repofe to give him the grateful and fpontaneous beverage. 1 before pointed out the means to be employed when the nipples are not fufficiently prominent to afford ADVICE TO MOTHERS, . Sfo a proper hold. But whatever the form of the nipples may be, they fhould be wafhed with a Httle warm milk and water, in order to remove the bitter vifcid fubftance which is lurnilhed round them to defend the tender parts from excoriation. I would alfo advife the mother, during the whole time of her nurfrg, to wafth the nipples, immediately after giving fuck, In warm water. When- ever this can be conveniently procured ; and, in cafe the fupplies of the nutritive fluid are very copious, or feem to exceed the infant's wants, fhe may always prefs out a little of the milk before the child is put again to the breaft, as the firft drops iffuing from the foum tain at every treat are the moft liable to fournefs and putrefcency. I need not urge a fond mother freely to give her child wtiat nature freely produces. The only check in this refpect is not to fuffer the infant to fleep at the breaft, or to fuck till vomiting eufues. But any attempts to entice the baby to the ufe of fpoon-meat are ftill more improper. This is a common practice, not only with hired nurfes, but even with affectionate mothers, from a foolifh though prevalent ideaoflefleningthe demands on the breaft, cr of ftrengthening the child with additional nourilhment If the nurfe be not irregular in her own manner of living, the need not fes having a plentiful fupply for the infant; and fhe may reft affured that her milk is far better fuited to his young ftomach, and will ifford a greater quantity of nutritious chyle, than any preparation which art can devife. Another error no lefs prevalent, and more injurious than the former, is the idea that a woman, when nurfing, cannot eat and drink too heartily, as it is termed, to fupport her own ftrength and that of the infant. On the contrary, the tainted ftream of intem- perance muft enfeeble and diforder tne child, while the nurfe really feffens her own power of giving fuck, and invites the attacks of a fever by her thought lefs indulgence. The cooling regimen before recommended muft be ftrictly compl'ed with for the firft week after delivery; and tnough a more liberal diet may then be allowed, yet this allowance muft n >t extend to grofs meats or hearing liquids— A pint of porter or ale twice a-day for at leaft a fortnight more, will be quite fufficient, and nimal food fhould be very fpanngly nfed for a much longer period. Indeod it would be happy for'he children, as well as for their nurfes, if the latter would confine themfelves, without painful reftraint, to the falutary varieties r a milk and vegetablediet. It is a great miftake to fuppofe, that a nurte is better fitted for her office by iiving on animal iubltances ; the reverfe is the truth. The milk of women who live wholly on vegetables, is more abundant in quantity, will keep longer, and is far Tweeter and more wholefome than what is prepared from ani- mal food, which, befides its inflammatory tendency, mutt iubjtdt the children to gripesland wonns. Thefe remarks are merely defigned to correct fome vulgar errors refpecting tne quantity and quality ofthe alimentmoftprop- er for nurfes, but not toimpofe upon any woman the neceflity of a total change from her former and ufual man ner of lmng. I would have her continue 'he temperate ufe of what the has found hy ex* (37) tfo ADVICE TO MOTHERS. perience to be moft conducive to her health ; and that will alfo t agree beft with her child* Her natural appetite may be fafelv in- dulged ; but gluttony muft br repreffed, and a depoaved ti. re for fpirituous liquors, or high-feafoned fnod, muft never be gratified. it has been juft hinted that the breafc-miik of a woman uj good health is abundantly fufficient for an-infanr's fupport Nothing elfe fhould enter hislips for at leaft three or fcur months after the birth. A little thin pap or panada may then be occ fionally in- * traduced, with a view of familiarifirg it to the child's tafte, and thereby leifauing the difficulty and danger of a complete and fud- den alteration at tne time of weaning. But no (pices, no wine, no fugar, (li mid at any tone be mixed with his food or drink. Thefe and the like contrivances of (illy women f make an infant's fpoon meat what they call palatable and nourifh5ng, or fure to vitiate his natural taite, to inflame his blood, and to fill theftomarh withflime and acidities. Sugar, in parti ular, has another very bad effect: its frequent ufe not only gives children a difreiifh for a wholefome fimpiicify, but entices them to fwallow more than they otherwife would, or than they want, and ihus makes gluttons of them even before they can be ftrictly faid to eat. Infants are commonly deprived of the breaft too foon. What people call folid food is fuppoled to contribute more to their growth i and health. But, in the firft place, milk, though a fluid, is imme- diately converted into a folid fubftance in the ftomach, where it is foon after digefted, and then affords the beft nutriment poffible.— It alfo appears contrary to nature to put folid fubftances into the mouth of a child, before it is furnifhed with teeth to chew them.— I fhould therefore took upon the previous cutting ofthe teeth as, thefureft indication ofthe proper time for weaningchildren. I do not mean to lay this down as an invariable rule. The ftate of the nurfe's health, as well of the child's, fhould be duly confidered. It feems only that the cutting of the teeth gives a f?rt of hint of the ufe to which they may be applied. It is farther remarkable that, during the continuance of this ufually fharp and painful operation, children, as it were inftmctively, carry every thing that is put into their hands up to their mout s. Give them on fuch cccaflons crufts of bread, pieces of bifcuir, dried fruits, or frefh liquorice- root, wh'ch they my fuck and chew. Corals, glafs, and the like hard bodies, are very improper, as they will either bruile the gums and caufe an kifiammation, or make them hard and callous by continual rubbing, fo as to render the cutting ofthe teeth ftill more difficult, and the pain more acute and lafting. A few weeks before the intended time of weaning, that is to fay, in the interval between the firft fymptoms of cutting the teeth and the appearance of at leaft four of them, fpoon-meat fhould be given more frequently, and in greater quantity, reducing in thelike degree the proportion of breaft-milk, till the gradual increafe of the one and diminution of the other render the change almot imper- ceptible. The beft fpoon-meat that I know, confifts of bread and milk, prepared in the manner pointed out in my Domeftic Medi- owe i that is, firft boHlng the bread in water, afterwards pouring the ADVICE TO MOTHERS. 57* water off, and then mixing with the bread a proper quantity cf new milk unboiled. I there obferved, that nrlk ufed this way was more wholefome and nourifhing than when boiled, and was ltfs liable to occafion coftivenefs. It is not neceffary, however, to confine children, after they are weaned, to one particular fort of food. The bill of fare may be gradually enlarged with the child's growth, provided always that it confift of an innocent variety. He may have bread and miik at one time, bread pudding at another, and bread fliced in broth, or ia the gravy of roaft meat, diluted with water, now and then, till at length his teeth bei'>g properly grown, and fit to chew meat it- felf, he maybe allowed a little of it at dinner, w'th a due pr por- tion of bread and of wholefome vegetables. But I muft forbid in the mot pefitive manner anv ar ificial fweetening- of his food, all fpices cr fealbning, ex:ept fait, all farts of paftry, butter in every torm,unripe fruits, and fermented liquors. N As I h-ve great reliance on t e difcretion of good mothers, s when well informed of their duty, I fhould be forry to tire them by too many details, or to fetter them by unneceffary reftraints ; I mall theref re only add one caution more on th:s port ofthe fub- ject. and that is, not to adopt the pernici :us cuftom of giving food Co drink to children during the night. Even in the courfe o£ the day, they fhould not be crammed every hour, and trained up in tie habits of early gluttony. Temperance is that fure prefervative of health, which they cannot be taught to practice too foon. Let them eat freely at proper intervals; and the longer they are kept from the things already forbidden, the more rapidly will they thrive, and the gre iter number of difeafes will they efcape. As I have admitted that cafes may occur, in which it would be impoflible or improper for a mother to fu kle her own child, I fhgll fuggeft a few hints on the choice of a nurfe, and the remain- ing duties of thep^rent. From what I have faid of the admirable manner in which the milk of a woman newly delivered is adapted to the various wants of a child cewly born, it will be eafily infer- red, that, when the mother cannot difcharge that important duty, a nurfe who has juft lain-in cught to be preferred. Othenvife the milk will not hive the purgative qualities proper to bring away any remains of the meconium, nor will it be exactly fuited to the infant's weak powers of digeftion. Inconveniences always arife the mo- ment we oppofe the intentions of nature. This is what obliges us to have recourfe to the precarious aid cf art. When there is a difference of more than a week in the time cf delivery between the moiher and the nurfe, fome opening medicine may be necefbry to cleanfe the firft paffages : A table-fpoonful of whev cr water, with the addition of a little honey or raw fugar, will commonly anfwer the purpofe. But the infant's ftomoch cannot be-fo eafily re- conciled to foreign fuftenance, or made ftrong enough to digeft the thick milk prepared for an older child. On the other hand, many difficulties muft attend the very ex- pedient which I propofe. It will not be eafy, except in cities like London where there are feveral lying in hofpitals, to get nut?* C72 ADVICE TO MOTHERS- newly delivered for new-brrn infants, then as the nurfe cannot be removed to the child, the latter muft be taken to the nurfe, and muft remain with hr r till fhe can go to the parents, houfe. If an exact coincidence as to the time of delivery be made the leading confidera*ion, an improper perfon may be,fixed upon from that chv cumftance alone, though unqualified in all other refpetts. Thus, as I before hinted, whatever courfe we take, when we deviate from nature, we fhall find numberlefs perplexities and obftacles in our way. ^ Almoft every body is a judge of the other requifitles iri a nurfe, iuch as henlth, plenty of breaft-milk, the thriving ftate of her own child, cleanlinefs and good temper. The laft quality, though of very great importance, is feldom inquired into. Parent* are commonly fatisfied with the healthy appearance of the nurfe and her child, or with a midwife's favourable account of her milk; and feem to forget that a good difpofition is as effential as a good conftitution. I do not fay that an infant will fuck in the vices of his nurfe ; but he will certamly fuffer from them. They are doubly injurious in fpoilingher milk, and leffening her. tender care of the child that is at her mercy. The twin founders cf the Ro- man empire were faid to have been fuckled by a fhe-wolf; I fhould think it much more unlikely that an infant could be properly nur- fed by a paffionate or ill-tempered woman. The mother is not to fuppofe herfelf relieved from all trouble by the choice of even a good nurle. The latter may give the child the breaft ; but fhe fliould be directed and zealoufly affifted by the former in the difcharge of every other duy. This will render her labour eafy, and her fituation comfortable. She fhould alfo have every indulgence confiftent with good fenfe and with the rules before laid down. She fhould not be debarred from the occafional company of her hatband ; a rigorous chaftity, or a total abftinencefrom wedded fays, is often as hurtful to the nurfe and child as immoderate gratification. It is by humouring her that you will engage her to humour you in the ftrict obfervance of all your reasonable injunctions. The child's father alfo fhould pay very afliduous attention to the proper treatment of his offspring. His advice, his encourage- ment, his fuperintending care, will have the happieft effect. Is not our ad miration of Catos character increafed, when we rr-ad in Plu- tarch, that the man, who governed in Rome with fo much glory, would quit every bufinefs in 6rder to be prefent when the nurfe wafhed and rubbed his child ? Such inftances are feldom to be met with with in cur times ; we thi^k ourfelves far above all the trifling concerns of the nurfery. Yet, according to the remark I made on the fame fubject in another work, it is not fo with the kennel or the ftables; peopl: ofthe firft rank are not afhamed to vifit thefe places, and to fee their orders for the management of their dogs and their horfes pbeyed, though any of thofe fportsmefl would blufh were he furprifed in performing the fame office for that being who derived its exiftance from himfelf, who is the heih of his fortunes, and the future hope of his country. ADVICE TO MOTHER?. 573 If Cate's wifdom and parental affection could be heightened by contraft, I might eaoly point to a noble duke w-o is more at- tentive to the breed of dogs than to th t of the tuman fpecies, and who has laid out more money up n the magnificence cf a kennel, f* an he ever expended for the r-.lief of p-v-rtv. I am told that his grace is verv particular in the choice of fkilful nurfes to wait upon the females of his canine family, wh n they are fick, cr in the jhww. I do not blame his tendernets far brute animals ; but I am forry it fhould be confined to them, when a more natural fphere lies open for the exercife of his humanity. This hint will be taken by thofe for wuom it is intended: guifadt ille capit. SECTION VI. Of Exercife and Reft during Infancy. i I MADE ufe of the plaineft reafoning I could in the firft I Chapter of my " Domeftic Medicine," to (hew how much the • health, the growth, and the ftrength of children, depended on ex- ercife : and to warn parents of the melancholy effects of inaction, and of fedentary employments in early life. It doe's not appear to roe that any new arguuimts on that fubjett are neceflary -, but it may be of fervice to mothers and nurfes to be informed how the principles there laid down fhould be reduced to practice during in- fancy. They are otherwife apt to fall into great errors, not con- sidering that as much mifchief may often arife from uatimely and violent exercife, as from the neglect of it when moft effential. It has been juftly obferved, that children require oo exercife for the firft and fecond months after their birth, but a gentle mo- don fomewhat like that to which they had been accuftomed in the l mother's womb. A frequent change of pofture, however, is ad- vifeable, left by always laying them on the fame file, or carrying them on the fame arm, their foft limbs may be moulded into an improper fhape. But violent agitations of any fort may do them much greater injury, by deranging the fine ftru&ure ot the brain, and giving rife to the incurable evils of intellectual or nervous weaknefs. Other parts of the body, as well as the brain, are expofed to grert danger by tofling infants on high, or rapidly dancing them, as it is called before their little limbs have gained fome degree of firra- nefs. A great deal of the fpine is griftly, and the breaft entirely fo. Confider then what may be fe effect of the grafp or ftrong preffure of your hands againft thofe places in order to prevent the child from falling. As he advances in age, his bones acquire folidi- ty, and his whole body becomes able to endure a little fhock.— Briik, lively, and frequent exercife, will then be of the greateft fervice to him ; and you run no rilk ot laying the foundations of any difeafe, or of deftroying any part of that admirable fymmetry m thehuman frame on which health and beauty alike depend. In the courfe of a few months, a weil-nurfed child, unfettered by any check on the free motion of his limbs, will be aole to exer- otfe himfelf, and to gather ftrength from every ne a- effort. Wnen 5T74 ADVICE 10 MOTHERS. you take him into the fields, which you (hould do every day in fine '■". weather, let him roll upon the dry grabs ; and, when in the mir- iery, upon the carpet. He will foon learn the ufe oi his legs, with- out the leaft poffibility cf making them crcoked by the preffure of fo light a body. When he begins to walk, ycu muft help him a little in his firft experiments ; lead him about with tbe fupport of yc ur hands, and then by the finger only, till you perceive he can clo without your affiftacce. Go-carts and leadintr-ftrings not enly retard the increafe cf a child's activity, and produce an awkward-, nofs of gait very hard to he corn cted afterwards, but often affect the chert, lungs, and bowels, ia fuch a manner as to pave the way for habitual ind'geftken cr coftivenefs, and for afthmatic or confump. tive complaints. Nothing can be more ridiculous than the numberlefs contri- vances cf mothers to teach th -ir children to walk, as if it was a thing to be learned by their inftruction ; and to keep them propped up by wooden machines, or fufpended by back-firings, as if their lives and limbs wore to be endangered by the leaft tumble. They ,v are too near the ground, and toofight to hurt themfelves by falling. ," Befides, the oftener they fail, the fooner they will learn, when down to get up again; and the only wray to moke them Cure-footed, is to accuftom them hetimes to truft more to the proper manage- ment cfther own legs, than to any artificial fupport. As to the beft time for exercife during infancy, it admits of a very fimple regulation. That fart of pafhve exercife, which con- fifi,s cf"agreeable motion in a nurfe's arms, muft never be omitted after the ufe cf ibe bath in the morning, and cannot be too often repented in the courfe of the day. But when the child is able to take exercife himfelf, it will be eafy to manage matters io as to let him have as much as he likes before meals, and never to royze him into acti 9 upon a full ftomach. If left to himfelf, cr to nature^ he will then be more inclined to ftillnefs and repofe. The fubject of reft requires fome farther confideration. A heelthv, thriving child fleeps more than two-thirds cf his time for a few weeks after his birth. So ftrong a propenfity muft be indul- ged by day as well as by night; but, with judicious management, he will be gradually brought to want and to enjoy repofe by night only. This is evidently the order of nature; and fuqh a habit, begun in childhood, and continued through life, will contribute more to its enjoyment and duration, than 2ny one maxim cr rule cf health ever yet laid down by human wifdom. Nurfes, indeed, are too apt, for their own eafe, or to gain time for other concerns, to cnerfh the fleepy difpofitkn of infan.s, and to increafe it by various t. ings of a ftupefactive quality. All thefe are extremely pernicious. I would not fuffer opiates, under the name of cordials or carminatives, or in any fhape or form whatev- er, to be given to a child in health. The only compefing means* wlueh art mav at any time be allowed to employ, are gentle motion and foft lullabies. Ivery much approve cf the little cots now in fafhion, which being fufpended by cords, are eafily moved from fids to fide and promote the defired end, without the danger whic? ADVICE TO MOTHERS.' 575 f.^.ent rocking was often attended with. Thofe fwlnging cots are in exact conformity to the fuggeftions ofthe beft medical writer?, ancient aud modern. Galen mentions the propriety cf placing children to fleep fo leclulis pendcntibus, or hanging Utilebeds.- and the reafon far fuch a contrivance is thus explained with great clearnefs and fimplicity, by Van Swieten .• c< As !hefaetus" fays this accuro te obferver of nature,i: hang- ing from the navel-firing in the womb, is eafily fhoken this way and that, while the mother moves her body : hence it has been rea- sonably prefumed, that new-born infants delight in fuch a vibrating motion. They have therefore been laid in cradles, that they might enjoy this gentle exrrcife, am! be more and more ftrengtheaed.— Daily experience teaches us, that the worft-tempered children are foothed by this motion,- and at laft fink into a fweet fleep. But the fhakirg of the cradles fhould be gemle and uniform ; on which ac count, thofe cradles that hang by cords are the beft of all, as they may by a flight force be moved equably, and without any noife. At the i fame tim-% the motion communicated to thefe cradles is impsreepti- bly diminfhed, and at laft ceafes without any fhock." In Engl end, as well as in moft other parts of Europe1, cradles ; •" fixed upon wooden rockers, have been in ule from time immemorial. No evil could arife from their continuance, while in the hands of careful and affectionate mothers ; but, when left^ to the manage- ment of impatient nurfes, or of giddy boys and girls, the delicate texture of an infant's brain would often be expofed to great dan- ger. The agitation of a cradle by fuch perfons has been compared to the jolting of a ftage-coach bafket; and I believe that a poor child would fuffer as much from the one as from the other, were he not a little more confined in the former. It is poffible to con- ceive a more fhocking object than an ill-tempered nurfe, who, in- ftead of toothing the accidental uneafmefs or indifpofition to lleep of her baby, when laid down to reft, is often worked up to the hgheft pitch of rage ; and, in the excefs of her folly and brutality, endeavours, by loud,harfh threats, and the impetuous rattle ofthe cradle, to drown the infant's cries, and to force him into (lumber ! She may fometimes gain her point, but never till the poor victim's JKrength is exhaufted. '• To guard againit this evil, the tracfition from rocking-cradles to fixed bedfteads was not neceflary. The gentle motion before defcribed, at once fo natural and fo pleafing to infants, may be given them with eafe and fafety in little bafkets fufpended by cords, as ufed in the Highlands of Scotland under the name of creels, er in the more elegant contrivances of fwin^ing cots, whicn are now coming into fafhion. I am forry to fee any of the latter furrcund- ed with clofe curtains, which have almoft as bad an effect as confin- ing the infant in a room of the fame dimeniions. One green cur- tain maybe hung at fome diftance from his face, fo as to intercept the light in the day-time but not to obftruct the free communication of air, or to reverberate the exhalations from his lungs aud body. Green window-blinds in the fleeping-room will aufwer m the fame purpofe. Care fhould alfo be taken not to expofe infants either in -*7* ADVICE 10 MOTHERS. evil* Th^edi?wQ,0bUq?eli^ht»0r they will become fquint- rJ^^jWi^^L^ ^^henup, and exattly the on/& X ? hld d0WSt0,reft' ff thc Ijghl co^e uP°n them from Shi', fT *?"' Wlllrtak.e that direaion, and thufthey will get the hab;t of looking crofs-wife. 6 t~M;«2' °Kfti!!!Pedter moment to pay ftrift attention to their toedding. Nothing can have a more relaxing tendency, or be at i«L » flS* -^e unfavourable to cleanlinefs, than beds and pil- lows fluffed with feathers. Thefe abforb and retain the perfpiVa- Die matter, as well as every other impurity, fo that the child who ueeps upon them muft inhale the moft noxious vapour, while its action on the furface of his body muft deftroy the energy of the lkm, and render his whole frame both within and without, the ready receiver of difeafe. Horfe-hair cufhions and mattreffes are tarpreferable; but if foft brat- were ufed hdtead of hair for the liuitmgot children's beds and pillows, thefe would more readily let any moifture pafs through them, would never be too much heated, and rmght be frequently changed or renewed without any great troucle or expenfe. My former hints concerning a child's drefs are equally applicable to his bed-clothes, which fhould be loofe, eafy, anc as light a% may be confiftent with due warmth. I fay the lefs en the fubject of cold, as moft mothers are too apt to run into the oppofite extreme. CHAP. V. OF DWARF1SHNESS AND DEFORMITY. X HE chief caufes of defects in the fize and form of Chil- dren, have been occafionally touched upon in the preceding chap- ters ;but the prevalence of fuch evils, and the lamentable confe- quences with which they are followed, require to be more fully and diftinctlv confidered. I muft not weaken the influence of im- portant truths by fupprefling any part of them, or by leaving them two widely fcattered. I muft fhaki off the reftraints of falfe deli- cacy, and by candidly pointing out the grand fource of fo many private and public calamit es, endeavour to prevail on parents to adopt the moft effectual remedy. Let not the faireft part of the creatiou be offended with me far faying, that, in all cafes of dwarf- iflinefs and deformity, niney-nine out of a hundred are owing to the folly, mifconduct or neglect of mothers. The following re- marks are not written in the fpirit of reproach, but with a view to the moft durable reform. It would be difficult to mention any thing in which fociety is fo deeply interefted, as in the proper union of the fexes. This has often engaged the attention of legiflators, and marriages have been prohi: ited in various difeafes and perfonal difqualificarions. We have even an inftance upon record, where the community interpo- fed, when degeneracy in the royal line was likely to be the confe- quence of their king's injudicious choice of a wife. Hiftory tells re. that the Lacedaemonians condemned their king Archidamus for ADVICE TO MOTHERS. : r 7 having married a weak, puny woman ; " becaufe," faid they, "in- ftead of pr. pagatiog a race of heroes, vou will fill ti:e throne with a progeny of changelings." 1 am aware tnat any checks on the liberty o'f individuals in their matrimonial contracts, would be deemed inconfiftent with the freedom ofthe Britifh conftitution ; and indeed, it is ftrange that laws fhould be neceflary to convince men, that health and term are, or ought to be, powerful confiderations in the choice of a wife. Every part of animated nature proclaims at ud, that like begets like; and though a puny, dwarfilh, or diftorted woman, may become a mother, it will often be at tne rifk other own life, and always wiih a certrintv of tranfmitting fome of her infirmities to her innocent and ill fated offspring. But the inhentauce of parental weaknefs and deformity is one of thofe curfes which argument or expoftulation cannot avert.— The voice of reafon is difregarded, and objects of natural defire are overlooked, by avarice and pride. I (hall therefore confine my ob- fervations to fuch evils as may be prefumed to admit of a cure, becaufe they arife rather from error and folly ^ than from depravity or wilful perverfenefs. It feems to be the natural wifti of every pregnant woman to bring forth ftout, healthy, and beautiful infants. Yet, Mr. Locke did not hefitate to affert, that, if mothers had the formation of their own children in the womb, we fhould fee nothing any where but defarmity. The foetus is happily placed in better hands, and under the guardian care of nature. But though it cannot be new-mould- ed, altered in its fhape, or disfigured by the mere fancies and capri-. cious defires of the mother, it may fuffer no lefs i jury from her ignorance, her folly, or mifconduct. I hope I made it fufficiently evident in my cautions to women during pregnancy, that the foetus may not only be checked in its growth, but marked alfo and dif- torted by tight or heavy preffure on the woraho—by ftays, girdle?, or the like improper ligatures. In vain does nature provide for the eafy and gradual enlargement of the embryo, if her benignant pur- pofes are counteracted by the bracing reftraints of a fitly mother \s drefs. After the birth, as I before obferved, fill grea.'er danger awai's the infant from attempts to mend his fhap;—to keep his head and limbs in proper form—and to fecure him againft accident. The worft accident that can befal him is far lefs alarming than the certain confequences of fuch prefumptuous improvements and ili- directed care. He becomes puny, fluuted, deformed, difeafed j and, though perhaps caft " in nature's happieft mould," is fure to be fpoiled bv the disfiguring touch of man. I have already explained the fatal effects of meddling with the loft bones of an infant s fkull at the birth ; of confining them by any check ; or covering them too warmly. I fhe wed how wonder- fully the pliancy of thofe bones was contrived to yield to obftruc- tions, for the purpofe of promoting eafy and fafe delivei-y, and af- terwards to refume of themfelves their proper place and form, if they had been fqueezed together in the act of parturition. I alio 5 - ? ADVICE TO MOTHER S. infifed on the importance of a thin and light cap; that the air may act upon them freely, to render them hard and cempact^ and of courfe fitter to defend the brain, from ccld or any external injury. Bot while roi4wives aad nurfes are fuffered to purfue a contr ry plan, we need not wrnder atTmeefdog''with fo many inftances of early convulfions, of idictifm, and of heads misiha'pen, infirm, or fetceptii*le of cold upon expofure to the leaft breath of air. I was no Jefs earned in mv dautioc'sagainft*the ufe of banda- ges, crcf oppreflive covering for any other, part cf the tender fra ne. I did rot mego.ify the danger, but (imply feated the refult of frequent obfervation. I never knew a fingle inPance of a child's attainment to full fize and vigour, after having been cruelly con- fined during infancy in fwathes or fwadcUing'-clothes. How, in- deed, is it peflible, when the action ofthe heart, the lungs, the ar- teries, and of ail the vital crgans, is cramped and enfeebled ?— when the free circulation of the blood and fecretion of thehumcurs are prevented; and wnen the impatience of reftraint urges the in fant to wafte all his ftrength in continual but unavailing efforts to burft his fetters. As I knew that external objects were more likely to make fome imprtffion on the minds or fny female readers, than argu- ments drawn from the ftructure oj^the human frame, I endeavoured to fix their attention' firft On the young of brute animals, many of which, as kittens, puppies, &c. though very delicate when brought into the world, never want to be ftrengthetied, kept in due form, cr preferved from accidents, by means of fwaddling-bands. Chil- dren have as little occafion for any fuch defence againft danger. In reply to the idle objections of mothers and nurfes, founded*- on the diffi. recce in point cfalertnefs between kittens and infants, it has been admitted, that the latter are certainly heavier than the for- mer, but they are more feeble in the fame proportion : they are in- papal Ie of moving with fufficient force to hurt themfelves, and if their limhs get into a wrong fituation,-the uneafmefs they feel foon induces them to change it. Is it not abfurd to put them to real pain by galling ligatures for fear of imaginary bruifes ; and to dif- tort thir tender bodies effectually by fqueezing them into a prefsj left thev fhould grow diftorted from being left at liberty to ftir ? While I was writing on this part of the fubject laft autumn, I could not help being ftruck with another iltcftration of it, which pre- fent ed itfelf every day to my view. Above three hundred cattle were grazing in a field before my window all of them nearly ofthe fame fize, well-formed and vigorous, without the leaft mark of fe- blenefs or diftorticn. They had not been kept panting, when young, in tight and cumberfome wrappers, nor had they been ftunted in their growth by improper management. They might be tuly celled the offspring of nature, reared and brought up in con- tinuity to her laws. How painful and humiliating did I feel the con r. it, wren 1 compared them with the fiofter-children of art, with bipeds of various fhapes and fizes—with the hunch-backed, crooked-legged, lame, ricketty, diminutive, and deformed human beings, whom I often faw talking through the fame field 1 ADVICE TO MOT. TIERS. 57*> Should it be alledged, that inferences drawn from a fpecies fo differ nt from our own are not concl6five» let us next turn our eye* to what takes place in lavage nations, who are : 11 known to be tall, rebuff, and well proportioned. Indeed, any inftance to the contra- ry is fo very ;-'re a d extraordinary among riynr, that it was vul- garly believed they put all their puny and mhfhapen children to death. The fact is that they have not any fuch, becaufe they never thwart the purpofesof nature, or dilbbey lie£ dictates m the treat- menf"of their infant progeny. Theperfett form of the North American favages will be more clearly conceived from the following anecdote of the prefiViee.t of the Royal Academy, than from a whole volume cf travel*. Thlfc juftly admired painter, who is amative of America, having difplayed in his youth ftrong proofs of uncommon talents, was fent to Italy, at that time the grand fchool for the imitative arts. Upon ins firft feeing the Apollo Belvidere, he is faid to have exclaimed, " O ! what a fine Moh.iwk Indian!" Almoft every body has at leaft heard, that the Apolh Belvidereas one oftheraoft beautiful and exquilite pieces of ftatuary in the world. I muft not here omit Buffon's account of the metIVod of bringing up their yourg, purfued by ether unpolifhed nations, as we proudly call them. " The ancient Peruvians," fays he, '• in loofe ly fwathin.g their children, left their arms at full liberty. When they threw afide this drefs, they placed them at freedom in a hol- low, dug in the earth, and lined with clothes. Here their children, unable to get out and crawl into danger, had their arms quite loofe, and could move their heads and bend their bodies, without the riik of falling or hurting themfelves. As foon as they were able to ftand, the nipple was hhewn them at a diftance, and thus they were enticed to learn to walk." The fame writer obferves, " that the young negroes are often in a fituation in which it is with more difficulty they come at the breaft. They cling round the hip ofthe mother with their knees and feet, and by that means Mick fo clofe, that they ftand in no need of being fupported, while they reach the breift with their hands, and thus continue to fuck, without letting go their hold, or being in any danger of falling, no'.wi'hftanding the various morions of the mother, who all the while is employed in her u'ual labour. Thefe children begin to walk at the end of the fecond month, or rather to fhufrle aleng on their hands and knees ; an exercife that gives them ever afterwards a facility of running almoft as fwift ia that manner as on their feet." To this very interefting defcription, lean add, upon the tefli- mony of a friend of mine who had been feveral years on the coaft of Africa, that the natives ceitherput any clothes on their children, ner apply to their bodies bandages of any kind, but lay them on a. pallet, and fuffer them to tumble about at plenfure. ^ Yet the? are all ftraight, and feldom have any complaint. Good health, as y/ell as a good ihape, is the confequence of their free, uncocfi ed motion during infancy ; while, among us, on the contrary, reftraint, or what is the fame thing, tight preffure, checks growth, diftons the Sl» ADVICE TO MOTHERS. frame, aad renders it at cnce. diminutive, unfightly and infirm.— There is always a clofe and very natural connection between de. * locality, weaknefs and difeafe. The more we enlarge our furvey ofthe human fpecies in vari- ous parts of the world, the lefs doubt fhall we entertain of trie prin- fitjal caufe of dwarfifhnef s and deformity. We fhall find that men- kind are ftucted and diftorted in proportion to their degree of civifzation; that people who go almoft naked from their birth, and five in a ftate of nature, are well-fhaped, ftrong and healthy—and that among others who boaft of higher refinements, the greater at- tention that is paid to drefs,the nearer are the approaches to the ftat- »re and to the weaknefs of pigmies. Sterne, who knew fo well how to enliven the moft ferious fubjects, reprefents himfelf as ftruck with the number of dwarfr he faw at Paris. I am very forry to obferve, that we need not go fo far as Paris to be convinced of the lamentable effects of tight clothes, bad nur- f ng, and confined impure air. Many ot thefe matters are not much better ordered in the Englifh metropolis; every narrow lane in London fwarms with ricketty children; and thou: h we cannot jfay of the people whom we meet with in the ftreets, that every third man is a pigmy, yet we may with ftrict truth afl'ert, that many of the women are evidently ftunted in their growth, and, both in fize and robuftnefs, are below the ftandard of mediocrity. With re- gard to females, indeed, born and bred in this city, as more atten- tion is unfortunately paid to the tightnefsof their cfrefs, and to the artificial moulding or pretended improvement of their fhape when young, the far greater part of them muft be of a diminutive ftat- «re, and numbers are diftorted either in body or limbs. CHAP. VI. BANEFVl EFFEtTS *F FAREVtAL TENDERNESS, OR OF WHAT UJr BE CALLED AN ZXTREMELr DELICATE AND ENERVATING EDUCATION. jLiAVING repeatedly had occafion to point out the evils fa at mnft arife from the inattention of mothers to any part of their duty, and efpecially from abandoning their children to the manage- ment of hired nurfes. I (hall now proceed to explain the bad con- fequences of the oppofite extreme. Too much care operates in the fame manner as too little, and produces fimilar effects. A cafe or two, (elected from many which haveoccured to me in the courfe of practice, will fufficiently illuftrate the truth of this affertion. The grand rule of life, which reafon and experience concur to recommend, is always to purfue the golden mean; to fteer a middle courfe between dangerous extremes; and to take care, in avoiding anv one vice or folly, not to run into its oppofite. Mothers are too ap; to forget this admirable leffon, in nurfing and rearing their chil- d v.- •■■.. They do not feem to know the proper medium between cru- el n^;-lcct or indifference on the one hand, and the fatal exceffes of un^y and fondnefs on the other. In givipg Way to the ftrong im- ADVICE. TO MOTHERS. &* pulfes of natural affedion, they commonly go too far, and do a"? much mifchief to heir offspring by mifguided tendemefs, as by to- tal infenfibility. . It is not my intention to combat thofe fine feelings ot mothers, without which the human race would foon be extinct. I only wijfc to fee them kept a little more under the control of reafon. i wiifc to fee the moft amiable of all paflions, maternal love, difplayed in promoting the health and fortifying the conftitutions of children— not in relaxing them by every fpecies of foftnefs and effeminacy, When this paflion is carried beyond the proper bounds, it ceafes to be love • it becomes a fort ot blind infatuation, always injures, and often deftroys the object of its regard. Mothers fhould never zor- 2et the fable Of the monkey fnatching up one of its young m a mo mert of alarm, and, in order to fave it frjm danger, fqueezirg n with fo clofe an embrace as to occafion its death. What a juft p:& ure of darling children fo frequently killed bykindnefsf^ Nature provides for thehelplefs ftate of infancy in the ftrong attachment of parents. A child comes into the world chiefly de- pendent on the mother's care for the prefervation or its being. She is tremblingly alive to all its wants. Every tender office .fhe per- forms increafes her fond folicitnde, till at length it gams the full pot- feflion of her affections, and her fole with is to make m happy.- What a lamentable thing it is that fhe fhould fo frequently miftake the means! ,n , . . . , Indeed there cannot be a greater miftake than to imagine tha* extreme tendemefs or delicacy of treatment will promote the health, the growth, the prefent or the future happmefs ot a child. It mutt have quite a contrary effect. Inftead of fupplying the real calls of nature it creates a thoufand artificial wants: inftead cf guarding the infant from pain and difeafe, it renders him much more fufap- tibleof both, and left-capable of enduring either : inftead of happt, nefs, it enfures mifery in every ftage of his exifteuce, as the infirm- ities of body and mind, which are comraded in the cradle, will fol- low him with incurable obftinacy to the grave. The writer, whom I quoted on the fubject ot tucklmg, is no ■ lefs forcible in his cenfure of matermd fondnefs. He fays, the ob- vious paths of nature are alike forfaken by the woman who gives up the care of her infant to a hireliug, or, in other words, who neglects the duties of a mother ; and by her who carries thefe duties to excefs • who makes an idol of her child; increafes his weaknefs, by preventing his fenfe of it; and, as if fhe could emancipate him from the bws of nature, hinders every approach of pain or diftrels ; ^thou^thinkinrthat, for the fake of preferving him at prefent from a few-trifling inconveniences, fhe is accumulating on his head a Xnt foad of anxieties and misfortunes--with out thinking that Sisi a barbarous precaution to enervate and indulge the cmld 81 ^HeXn'begs'of movers to attend to nature, p*^** imck foe has delineated ;-" fhe continually exercifes her children £d forfifies their conftitution by expenmen s of every kind, m. Sing mem betimes to grief and pain. In cutting their teeth, they c>2 ADVICE TO MOTHERS. experience the fever ; griping colics throw them into convulfnns; the hooping-cough fuftbcat s, and worms torment them ; forfeits corrupt their bio d ; and the various term-nrations to which their. humours are fubject, cover them with troublefome eruptions ; al- moft the whole period of childhood is ficknefs and danger. But, in paffing hroiigh t lis courfe of experiments, the child gathers ftrength aod f rtitude; and, as foon as he is capabfe of living, the j principles of life become lefs precarious. " Tins," he adds, " is the law of nature. Why fhould yon net contrary to it ? Do you.not fee that, by endeavouring to cor rect her w )• k, you fpoil it, and prevent the execution offer defigns? Act you from without, as fhe does within. This, according jto you, would increffe the danger ; on the contrary, it will crente a diverfion, and leffari it. Experience fhews, that children delicately educated die in a greater proportion than others. Provided you do not make them exert themfelves beyond their powers, lefs rifk, is run in exercifing, than indulging them in eafe. Inure them there- fore by degrees to thofe inconveniences which they muft one day fuffer. Harden their bodies to the intemperature of the feafons, , climates, and elements ; to hunger, thirft, and fatigue." As the philofopher was aware that the latter part of his advice wrould ftir up all the fears and alarms effond mothers, he takes fome pains to convince them that it may be followed with perfect fafety. He very juftly obferves, that, "before the body h:s ac- quired a fettled habit, we may give it any we pleafe, without dan- ger ; though when it is once arrived at full growth and confiftence, every alteration is hazardous. A child will bear thofe viciffitudes, which to a man would be infupportable. The foft and pliant fi- bres ofthe former readily yield toimpreffion ; thofe of the latter are more rigid, and are reduced only by violence to recede from the. forms they have affumed. We may therefore," he concludes, 'bring up a child robuft and hearty, without endangering either its life or health ; and though even fome rifk were run in this re- fpect, it would not afforo1 fufficient caufe of hefitation. Since *hey are rifks infeparable from human life, can we do barter, than to run them during that period of it wherein we take them at the lead disadvantager"—Heave this queftiontobe duly confidered by every l.iothe r who is not blind to thecleareft evidence of truth, or wilfully deaf to the moft commanding tones of eloquence andargu- The familiarity of any obj?ct'lsflens our furprife at it, or there are few inftances of human folly which would aftoniih us more,than that of a fond mother, who, in order to protect her child from a little pain or uneafmefs while he is young, multiplies his fufferings when he comes to maturity. Strange infatuation ! to facrificethe man to the infant, oi:d, through over-folicitude for a year or two after his entrance into life ; to fhorten its natural extent, and to fill up that contracted fpan of exiftence with weaknefs, irritability, and difeafe 1 Did any body ever think of rearing an oak plant in a hot- houfe, thence to be removed to the bleak mountain ? And is the puny,'enervated nurflicg better prepared to endure the tt-awfiiion ADVICE TO MOTHERS. $83 from the lap of foftnefs to all the accidents of a rugged and a ftor- my world ? As ftrong examples often make fome impreflim where other modes of reafoning fail, I fhall here beg leave to introduce the hif- tory of a young gentleman, whom I attended at a very early period of my practice, and who fell a victim to the exceffive fond efs of an h"hilgeiu m. ther. With every wifh to promote her fhn's heahh and happinTs, (he was as far as reflected intention, th.3 umccLit bn: abfolute caufe of totally deftroying both. She brought en relaxa- tion and debility, by her mifguided endeavours to avert pain ; and while fhe hoped to prolong the life cf an only fori, the mearis v.hioh' fhe made ufe of for that purpofe, nOt only abridged its duration, but precluded his power of enjoying it. Though he was buried at the age of twenty-one, he might belaid to have died in his cradle, for life has been well defined, not to' confift in merely breathing, . but in m iking a proper ufe or our organs, orfenfes, our faculties and of all thofe parts of the human frame which contribute to the . confeioufnefs, of our exiftence. That he never attained to this ftate of being, will fully appear from the following narrative. Edward Watkinfon was the only fon of a country clergjmian, of amiable manners and found learning, but of a reclufe turn of mind. the mother was a daughter of a London tradefman, and had been educated with extreme delicacy. She naturally purfued the fame line of conduct towards her own child ; and her fond huiband was too much under the influence of the like fatal weaknefs. Many a child is fpoiled by the indulgence of one parent; in the cafe now before us, both concurred to produce that enervating effect. For fome time after his birth, matter Neddy was reckoned a promifing boy. When I firft faw him, he was about eighteen years of age: but, to judge by his fook, one w uli have tinp ted him to be at leaft eighty. His face was long, pal-*, and deeply fur- rowed with wrinkles—his eyes were funk in their fackets—his teeth quite dec yed—his nofe and chin almoft touched each other— his breaft narrow and prominent—his body twifted—his hgs like fpindles—rhis handsand fingers approaching nearly to the farm of birds claws—in fhort, his whole figure exhibited the truly pitiable appearance of a very old man, finking under the weight of years and intimities in to the grave. It wosatMidfummerlpaidmyfirftvifit. I then found himwTap- ped up in clothing fufficient for the rigours of a Lapland winter, and fo clofely muffled that one could hardly fee the tip of his nofe. He wore feve-al pair of ftcckin^s; his gloves were double, and reached his elbows ; and, to compleat the abfurdity of his drefs, he was tight laced in ftays. Though armed in this manner at all pete's, he feldom peeped out of doors except in the d<^g days, and then ventured no father than the church, which was orly forty pa- ces from his father's houfe. I believe this was the moft diftant exr curfion he ever made; and the extraordinary attempt was always accompanied with peculiar care, and many additional prefervatives, from eld. ... , r «j i. The eye of his parents might be truly kul tq watch over nun 5^4 ADVICE TO MOTHERS. not only by day, but by night alfo, as he flept in the fame bed with them, having never been permitted to lie alone, left he fhould throw the clothes off, or feel the want of any immediate afliftance. It did not once occur to his father or mother, that all the inconveniences which they fo much dreaded, could not be half fo injurious as the relaxing atmofphere of a warm bed, furrounded by clofe curtains, and impregnated with the noxious effluvia from their lungs and bodies. His food and his drink were of the weakeft quality, always adminiftered warm, and by weight and meafure. When I recom- mended a more nourifhing diet, and a little generous wine, I was told that the ftrongeft thing matter Neddy h?ud ever taken was chick* en vjtter, and that they durft not venture on wine or animal food for fear of a fever. Thus was the poor lad reduced almoft to a skeleton, through the filly apprehenfion of a difeafe, of which he was not fufceptibie. Nature was in him too weak to fpread a hec- tic flufh even for a moment over his countenance, which had ac- quired the colour of a par-boiled chicken. All his vital powers were languid ^bnd even his fpeech refembled the fqueaking of a bird, more than the voice of a man. When I fpoke of exercife, I was told he took a walk every fine day in the hall, and that was deemed fufficient for one of his deli- cate conftitution. I mentioned a horfe—the mother was frighten- ed at the very name of fo dangerous an animal. On telling her that I owed the firmnefs and vigour of my own conftitution to riding every day, fhe began to think there might be fomething fpe- oific in it; and fhe therefore contented to the purchafe of a little horfe. But tame as the creature was, it did not quiet the mother's alarms. Matter Neddy, though placed upon the poney's back.was not entrufted with the reins. Thefe were given in charge to a maid-fervant, who led the hcrfe round the orchard, while the cau- tious rider faftened both hands on the pommel of the faddle: and the father walking on one fide, and the mother on tl e othcr, held him faft by the legs, U ft he might be brought to the ground by any fudden ftart of his high metted racer. This exhibition was too ridiculous not to excite the laughter of the neighbours ; which foon put an end to matter Neddy's equeftrian exercife. The timidity of a youth thus brought up is mere eafily con- ceived than defcribed. Feuful of every thicg, he woutd run from the moft inoffenfive animal, as if he had been purfued by a lion or a tiger. His weaknefs in this refpect being known to the village boys, it was a common practice with them, whenever they faw him peeping through his father's gate, to frighten him into the houfe by calling to the pigs to bite him. This fportive alarm had the fame effect as the fudden rufh of a mad bullock. With fuch exceffive weaknefs both of mind and body, mafter Neddy had fome good points about him. His parents reprefented him as a perfect model of morality ; and I had no right to doubt the truth of their reprefentation, though I did not give him quite fo much credit on that fcore, becaufe he did n^t noffefs fufiicient force of eenftitutien tobercapable©f any kfadofviee. But I viewed. ADVICE TO MOTHERS. $2$ with mixed *motiens of admiration and pity, fome proofs of learn- ing and abilities which he left behind him. I was the more fur-, prifed, as the inceffant care beftowed on his perfon feemed to leave very little time for any mental acquirements. Improper food, tight or oppreflive clothing and want of freift air and exercife, have in their turn proved deftructive to thoufands. This young man fell a victim to them all; and ir would have been a miracle indeed, had he furvived their combined influence. He d;ed without a groan, or any mark of difeafe except premature old age, the machine being fairly worn out before he completed his twenty-firft year. His death proved fatal to both his parents, whofe lives were clofely bound vp in that ofthe lad. The father had perceived his ow error, but not before it was too late. On reading my inaugural differtation, which was then published in Latin, und^r the title already mentioned, he fent for me, and be^ed 1 would endeavour to fave his fon. The youth, alas! was far bevond the reach of my moft zealous efforts : I could only witnefs the certainty of his fate. Medicine was of as litrle ufe to him, as coniblarion to his afflicted parents. The bitter- .nefs of their grief was increafe! by felf-reproach ; and friendlhip exerted her foothmg voice in vain. The father on his death-bed •onjured me to tranflate my differtation into Englifh, as he thought it might be of infinite fervice to mankind. My compliance with his requeft gave rife to the " Domeftic Medicine," of wmch that euay on the means of preferving the lives of children, conftitutes the firft, and, in my opinion, the beft chapter. _ The above relation may to fome appear romantic; but did I fuppofe anv one capable of queftioning my veracity, I could name fevered perfons ofthe firft refoectabilitv, who kaow, that, lo far from b°ing heigh'ened, it falls fhort of the truth, indeed I mignt go farther, and affert, from my own too frequent obfervation, that a mater Neddy is not fo Angular a phenomenon in many other tarn. ilte, and that the evils of p .rental folly are much oftener entailed upon favourite heirs, than the power of fully eojoying the ettates which defcend to them. , ,. . „ . i But it is in the female world, more efpecially, that maternal fondnefs fpreads its fatal ravoges. Girls remain I nger than boys under the immediate and almoft exclufive care ot their mothers ; and when the latter are more guided by love than reaion, by the impulfes of a tender heart inftead of the dictates of an enl ghtened mind, the former are doomed to weaknefs and muery. 1 Inall not offend my fair readers by a repetition of the remarks already made on the acquired defects and infirmities of too many ot our young women ; nor fhall I attempt to defcribe the fan- trem and almoft endles variety of nervous difeafes from whichfo fewof them are exempt: J fhall now confine myfelf to a fingle inftance of the ef- fects of extreme delicacy in the education t a daughter, as the counterpart of my ftory of a fon cut off oy the like means. Ifabella JVilfon was in early life a very prnnifing child, and the Object of her mother's adolatry. This good wonm had no idea SSfheSlthand bea»ty weremorelikely to te decayed tta* m. (38) 586 ADVICE TO MOTHERS. proved or preferred by exceffive care. In the choice of die;, clo'h*--, exercife, &c. the delicacy of her faeet g:rl wa<; always the ruir.^; idea. It is effy, indeed, ro render tne human frame more d- lica'e; bin t"> make it more robuft, requires a v^ry different mode f pro- oeed>«\ A s the child did not feem' afflicted wnyh ay particular complaint, the doting mother exulted.at the h.-ppy efT-cts of her •own management, and never thong" t that the ta'v-r 'Tin, the fine limbs, and the languifhmg faftivts, which the'fo ma h \dmired, were 'h ■ fare fymptoms of debit" ty and of 1 'en.t difeafe. IfabeV.a's mmtal improvement, in \vh"ch (he furpaffed many other young girls of her af;e at the fame fch^ 1, w s no Ids flatter- \ ing to her miftaken parents. Boo fhe hod fere, ly attai ed ner fourteenth year before tre ^ni iilu,V r v ■ ;'h d, md the regular fu^ctl ns f both mind and body ^;ro ve its ufe. The chii .ires of the rich and ofthe poor are alike facrificed to the miftaken views Of their parents, the former by their confinement at home or at 59° ADVICE TO MOTHERS. fchool, f. r the feke off me truing attainments, and the latter, Ijy premature e devours to g t a livelihood. There is, however, a very material <. inference oetween both, as the error in oue caie, arifing from fafhion or caprice, is infinitely lefs pardonable than the other, which is too often occofioned oy want. It is ftrange that moth-, rs in the higher ranks of life, who muft Have felt or frequently obferved t e deqilitating effects of fafhiena- ble modes of educarie.n, fhould p riift in making their own dau^h. ters fit f r hours t^ge her at a taniLy iir-frame, or at the needle in learning fancy w-uks, which can never be cfthe leaft fervko, out muft do their health and their form irreparable injury. The very poftures, in which they ar* thus empl 'yed, not only tend to dih.it their pliant limes n d b dies, but to impede the action of the pri - cipal organs of life, wnich require above all things an expanded chert for the eafy performance of their refpective functions. I can- not too often repeat that perfonal defarmi'ies, pole compL&ions, head-aches, pains ofthe fhoinacb, lots of appetite, indigeftion, con- fer nptions, and numberlefs ether enemies of youth and beauty, are the fure confequences of long cert*nuance in a fitting or inclin- ng a;ti;u ie. vVha' fo many young ladies fuffer at a critical lime of life, aud the ftill greater clanger whica often awaits them when they become wives and mothers, are chiefly owing to the fame caufe—early confinement in fedentary purfuits ; and the want of frequent = xereife in the open air. To fetter the active moti.ns of children, as foon as they get the ufeof th?ir limbs, is a barbarous oppofition to nature ; and to do fo, under a pretence of improvement, is an infult upon com- mon fenfe. It may, indeed, be the way to train up enervated . puppets, but n^ver to form accomplished men cr women. I always behgl.', with muAh heart-felt concern, poor little creatures of ten or twelve years of age, and f onetimes younger, who areexhibhed by heir filly parents as prodigies of learnicg, or diftinguifhed for their extraordinary proficiency in languages, in elocution, in mufic, in drawing, cr ev-n in fane frivol, us acquirement. The ftrength of the mind as well as of the body is exhaufted,. and the n^turU growth f both is checked by Cue hi untimely *xtrtior.s. i am net for difcouraging ihe early introduction of youtn into the fweet fo- ciety of the Mufes and the Grace?; but 1 would have them pay their court alio to the Godhefs of Health, and fpend^a confiderable part 0*1 their time, during the above period at leaft, in her enlven- ing fports and gambols. It would be foreign to my ir mediate purpofe to fay any thing farther of the literary purfuits of boys* than that more frequent in- tervals between the lrurs of ftudy than are now ufual, fbrnidbe allowed for recreation and active exercifes. But a much greater reform is wanted in female education, 'he whole of whi :h appears to be upon a wrong bahs. 11 ave to others the morel part ofthis bufinefs, arid fh. II only take a medical view of the fnbj.ct. ft grieves me to fee health impaired by a 'clcfe application to objects of very little confequence while the moft important quafficatfocs are difregaded. Every girl fh ould bs Drought up with a vie* of be- ADVICE TO MOTHERS. eg? ing ~ wife ind a mother; or whatever her other accomplifhmenrs- may be, fhe will prove totally unfit for the difcharge of thefe c'utiet- on which tlii: affections of h-t.huiband, the well-being of her proge- ny, and ner own happ'nefs, mint denmd. Iffne herfelf is languid ?■.;:! noolcot, liowran fhe hope to bring forth active'and vigor; us_ children ? Aud if (he knows nothh g of the proper management of t*em, mu^r uV not hove recourfe fo hirelings, and tauft ennrdv to tiu*ir core, to their Ikill, and to their ridehoy, inthedeareft concerns Cliife? It is crmmcn to fee women who are fuppofed to have had a very gente 1 education, lb ignorant when they come to have chil- dren, of every r in.-', wnh whioh a mother ought to be acquainted, th -t the infant itfelf is as wife in thefe matters as ies parm:. Had tret me fpent by fuch females in the acquifition of what can never be of any fervice to thorn, been employee! under the e)e cf a i'a«j,a- rcus matron in learning domeiM? virtues and the art of rearing chil- dren, they would have fecured the attachment of their huii^auos, made their (br.s and daughters ufeful members of fociety, and been fhenifelves an example and an ornament to '.he fex. If a y ung mon be intended for the army or navy, he is fent to the academy to be infb uchea in thole branches of frier.ee wi ich are deemed necefkry for hes making a figure in the propofed de- partment. But ayoungwo'nan, who iVis got a more difficult part "to act, has no Iuch opportunity afforded her. She is fuppofed to • require no previous courfe of training,—to need no affiftance but thai of nature, to fit her f r the difcharge of ner duties when fhe comt-s to be a mother. Did fhe live in :; (hate of nature, that idea would rot be far wrong ; but, in fociety, every thing is artificial, and muft be learned as an ar'. The art in queftion, however, can neither be learned from b^oks, ner from ccnverlation. Thefe may have'their ufe, but, they will not make an accomplished nurfe. Indeed, 'nothing can farm this firft of characters, but practice; and if furh practice is cot ac- quired under fame experienced matron, it will celt many lives to learn it any where elfe. A mother may blunder en, as moft of them do, till fhe has killed a number of children, before fhe is ca- pable of rearing one. At laft, perhaps, fhe fueceeds. ir is in mis way we find many wealthy citizens, who have had feveral children, yet die without any, cr leave on'y one to enjoy their ample fortune. All practical things are the moft difficult to learn, becaufe they can only be learned from obfervation and experiment. Thus I. have known a girl, whole mother had eighteen children, take one of them and bring it up by the hand, merely from the force oh ex- ample and imitation. Had this girlitud £ I the art under tr.e ableft medical inftructcrs, or read the beft bocks that ever were written on the fubject, fhe could not have done whai fhe effected with the utmoit eafe, becaufe fhe had fo often (een it fucceed under her mother's management. ihe inferei.ee is very plain; that acquirementsof littlevatiue, cr merely ornamental, ou:Sht net to be ailiououily cultivated at tne expenfe of health, or to the neglect of things cf tS*e fir'i importance, & ADVICE TO MOTHERS. and that a great part of the time inconfiderately fpent by young lathes m iiiiic\ works, and in learning to draw, to paint, cr to play Upon fome mufical inftrument, cf which they will never feel the war.t, or which at belt will afford them.only a momentary gratifi- cation,-had much better be employed in pract;calltflbns on the du- ties of wives and mothers, which they will loon be called upon to difcharge, and their ignorance of which will colt them many an ach- ing heart. As to the other evil before hinted at, which is owing to pov- erty, and which confifts in putting young children to fedentary or" unwholefome employments, in order to get their bread, it is a mat- ter of he m. ft painful confideration, when viewed either by the eye of humanity cr cf policy. The fource of the fw eetcft pleidures is thus embittered to the parent; and fociety lofea the valuable fervices ofthe man, through the feeble, untimely, and exhaufting efforts of the child. In vain do we look for the full grown fruits of autumn, after a too early expacfion of the buds of ipricg ; and we never fee a coh, if put too foon to hard labour, turn out a ftrong and ctive) orfe. When I touched upon this fubject in the firft chapter of my ct DomePdc Medicine," I thought I could not urge a ftronger proof of my affertion, teat the conftitutions-of children were ruined by fuch premature endeavours Jo earn a livelihood, than the immenle number of rickety, fcrophulous, and diminutive creatures, that iwarm in all cur manufacturing towns. There the infants fuffer feverely in the very firft ftage cf life, for want of proper exercife and proper nurfing, while the diftreifed mothers are bufy at other work. The next ftep, aho.rft as foon as they feel the ufe cf their legs and arms, is to employ them in feme ofthe lubordinateor pre- paratory parts of the manufactures, which are the more injurious to growth and health for requirirg conftant confinement rather than active exertion. Very few of thofe poor objects attain to ma turity, and fewer fall to manly vigour. Moft of them die very young, and the reft are weak and fickly all their lives, fo that inca- pacity of labour at an advanced age is the fure ccnfequencecf the forry earnings of childhood. But there is ancther fit of devoted beings mere pitiable ftill than thofe which 1 have cow defcribed—1 mean ihe children that are bound apprentices to chimney-fweepers. If any creature can exift in a ftate of greater wmtchednefs, or is ajufter.cbjtct of com- inifcraricn than a toy who is forced to clean chimneys in this country, I am very much miftaken. Half naked in the i oft bitter ccId, he creeps tlor.g the ftreets by break of day—the ice cutting t] rough his fee'—his legs bent—and his body twiffed. In this ftate he i compelled to work ! h way up thefe dirty no:fome paflage?, many cf which are almoft too narrow for a cat to climb- In or- der tcfubdue 'he terror which he muf. fed in his firft attempts, Ins frvage maft rcften lights up fome wet ftraw in the fire-place, which leavt-s the pocr crea:«re no alternative but that cf certain fuffocaticn, o? cf inftantly getting to the top. I have w itneffed ftill greater cruelty : I have more than once feen a boy, when the ADVICE TO MOTHERS. S<& chimney was all in a blaze, forced down the vent, like a bundle, ot vet rags, to extinguifh the flame. On the very day (the twmty-fecond cf laft October) when I ws come to this part of my fubject, an indictment far cruelty to a yc-ung chimneysweeper happened to.be tried at the Weftneinf er (cflions. The wretched fuflerer had been decoyed into the houfe of a woman who carried on this horrid bufinefs, but who promifed to employ him only as an errand-boy. He had not been long there, however before he was put to learn the trade, as it is called. Some domeftic leffbns were deemed neceffary to prepare him f cr public exhibition. The child, not being able to climb with the readinefs expe&ed, ufed to be ftripped naked by the foreman, and whipped round the room with birch rods. His body, legs and arms, were feverely bruifed by the beatings he had received. This was not all. Though his knees and elbows had been rendered fear by repeated trials, yet when the poor creature could not mount quirk enough, his cruel inftructor ufed to goad him (while in the chimney) in the legs and thighs, by a needle put into the er.d cf a ftick. . , It alfo came out in the courfe of the evidence, that unfortunate children of this fort, are taught to climb by being taken to the porch of St. George's church, where, at the rifk of their lives, they are obliged to mount the perpendicular wall. I am always happy to fee juftice tempered with mercy, efpecially when the punifhnoent is at the difcretion of the judge cr magistrate; tout alter a culprit had been fullv convi&ed of thofe attrocious acts, I could not help thinking that lenity towai'Sls him was carried too far in fentenciug him only to fix months imprifonmect. 1 am ftill mere grieved ty think, that any buontfs which requires fuch dreadful modes of trainirg, fhould be ictera'cd. Perhaps I (hail be told, that beys fo traired are neceffary. I deny the affertion. Chimneys are kept clean, without Inch cruel and dangerous means, net enly in many countries en the ccnti* nent, but even in fome parts of our own ifland, where the houfes are much higher than in London. In North Britain, for inftance, a bunch of turze or of broom anfwers the purpofe,acd does the bu^- ficefs much cheaper and better. Onemanftands at the top and another at the bottom of the chimney, when a rope is let down by means of a ball; and the bunch of furze or broom, being properly faftened on, is pulled up and down tili the chimney as quite cleaned. The little trouble and expenfe attending the operation are the ftrongeft incitements to repeat itfocften as to preclude therxffibhi- ty of chimnies ever taking fire. Is this- the caie in London,tccugh hundreds vi lives are every year facrificed to the moft barbarous method of'preventing danger ? How vain fhall we find the boafts that are made of mighty improvements, in' the metropolis of the Britifh empire, if we fairly confider thai it is at leaft a century be- hind the meaneft village in the kingdom in almofi every thing that regards the prefervation of human life ! I have often heard the plea of neceffity urged to rmiify domg wrong- but never more ablbrdlv than, in th<° employment of boys $94 ADVICE TO MOTHER*. to clean chimmes. Experience c1*a»Improves »W it ran be much better cone \v thovit them ; and fhaiiove, in p^vi-r^' op;v htion to reafan and humanity,continue-apract:"e wr.irhis . qnally forbidden by both ? The abolition of the flave trade has of late rears become a very popular topic among us ; and rhe caufe t' the po-T Afri- cans ha j been pleaded with lips of fire in < ur fenate. B t while our pride is fkitered by the idea of relieving flaves abroad, we make a fet'ot our fellow-fubjects at home infinitely greater flaves, ancttar more miferable ! This is fomething like the fafhionable chimera of univerfal philanthropy, v och pretends to be alive to the fofferings of the diftant Hcttmtcts, but in reality fteels the heart againft fpectacles cf much keener wretchedne.fs in our own ftreets. My late worthy friend, Jonas Hanway, who literally went about, doing good, ufed all his influence to ameliorate the condition of (hole unhappy creatures ; which, in a certain degree, he effected. But there ate fome cuftoras, that can be thoroughly mended only by being completely abolifhed. While boys are forced up chimri s, they, muft be miferable, whatever laws are made for their relief. A law prohibiting the practice altogether, would be at once laying tha axe to the root of the tree ; and the evil admits of no other re- medy. Had Mr. Hammy taken up the matter upon this ground, he had fpirit and perfev^rance fufficient to have carried it thr ugh, and to have obtained aa act cf parliament for the effectual relief of ihe moft wretched beings on the face of the earth. He confined his benevolent exertions to a partial alleviation of » heir miferies, be- caufe it had never occurred to him, tharthe climbing boys, as he calls them, were wholly unneceffary. What a pity he did not car- ry his views a little farther, a% in hat cafe, he cetainly would nor have remained fatisfied with any thing fhort of their total • emancipation from fuch cruel and ufehfs bondage ! Th e fituation of thofe children cf mif .ry i now become more hepekfs, iu confequence of the death of Lady Montague, who ufed to make fuch of them as could go to her houfe, happy for at leaft en3 day in the long and lingering year. I often wifhed to fee her well-known t Jents exerted in their favour ; they could not have had aa abler or a better advocate. The amiablenefs of her charac- ter would have given additional force to the impreflive productions of her pen ; and the legiflature might have been induced to inter- pofe lis authority in fappreffmg an employment at oncefo deftrec- tw- and fo degrading to the human fpeeies. But furely then; is humanity enough in both houfes of parlia- ment to take up this fubject, without any other appeal to their fadings than a bare reprefentation of facts. Many touches more would be neceflary to finifh the melan- in ly picture of the wretchednefh of young chimney-fweepers. It is enough for me to fketch the principal outlines^ in hopes that i'bine perfon more at leifure may be induced to lay on the internal ;oknn iue;. In addition, however, to the miferies already defcribed, ikuft net omit the malignity of the dif-rders, vita which thofe w?r creatures-j if they live long enough, aire almoft fure to be aiHic- ADVICE TO MOTHERS, 52£ ted. They are not only deformed and {hinted in their growth, but, in confequence of having their pores clogged, and the furfkee of their bodies con inually covered wmi a coat of dirt competed of foot, (weat, &c. they are fuDJecl to various maladies unknown to the reft cf mankind. I need only give an inftance of one of thofe difeafes, which is ■\illcd by the (ufterers the f-t-wort, but which tne late Mr. Pott has very properly named the Chimney-fweepcr s cancer. He defcribes it as a ragged, ill-looki.g fare, with hard ai.d riling edges, rapid in its progrefs, painful ho all its attacks, and moit cer.aLJy defiructiye in its eve t. Extirpation by the knife, on its £ift appearance, acd the immediate removal ofthe part affected, ie looks upon as the cr.ly chance of putting aftcp o, rr preventing the fatal iifae of the dOt_fe. His rtfleftion on trie fuoject does equal honor to his heart and to his uu trflandiog. " Th.e fate of thefe people," (ays he, " feems fingularly hard. In their early i. fancy, they are mcit fre- quently tieateel wbh great brutality, and almoft ftarved with cold x. d hung.r. They are thruft up narr,.w, and fometimes hot chim- nies ; where they am bruited, burned, and almoft fuitocated ; and U when they get to puberty, they become peculiarly liable to a moft noifeme, painful, a'.id fatal difeafe." CHAP. VIII. OF ACCIDENTS, V^HILDREN are not only lamed and maimed,but they often lftfe their h'ves bv accidents, owing to the careleffaefs or inconfide- rate neglect cfnvrfes and mothers. A c: iid fhould never be left alcne in a pL ce of danger, or in any fituation where he may, throu. h his own want ofexperier.ee, be expofed to the deftructive elements of fir.- and water. We daily hear cf children that have been burned to de-ath, in confequence cf their clothes having. caught fire; and even grown people often lofe their lives by fimilar accident^. Afflicting events of this kind often t>ke place even under the mother's eye ; and, what is (urprifing, their frequency'does net prepare women for the moft effectual method cf exiinguiihi.-£ the lire. Diffracted bv the frightful fcene, aad the cri-.s ofthe fuflerer, they rufh to tear nil'' h ? bi rnmg clothes.'. But, before this can be effected, the mifchief i? done. The attempt, therefore mould never ba made, t he clot.ing, inftead cf beicg orn off, ought to bv preffed clofe to the body, and whatever is at hand wrapped o^r it, fo as to exclude the air, upon which the blaze will go out. It is the action of the air that keeps it alive, and morcafes is vohe- meuce. A carpet, a table-cloth, a blanket, any clofe wrapper, will inftantly extinguifh it. Ladie?, whofe drefs is to very liable to ca:ch fire, fhould in fuch a cafe have rcccurie to thefe means, a:,d be the r own prefervers, foil end of running out of the room, fa: ning the flame, and ufekhly (creaming for help, vhrch come: too Vv.t tc fave them frcm tortnres ami from ci^iih. 596 ADVICE TO MOTHERS. Our newfpapers frequently contain accounts of perfons, who, fey running about, not only accelerate their own deftruction, but frighten others into an abfolute incapacity of afford!jig them any afliftance. A cafe nearly of this fcrt very lately fell under my ob- servation. A beautiful woman, with her clothes in a blaze, had been fuffered to run out into tne ftreet? before any body ventured ro approach her. An hackney-coachman.feeing her in this'fituation, jumped off his box, and wrapping his coat round her, extinguiftied the flames. Though her life was faved, no remedy could be found (for the cruel ravages of the fire en her perfon. She loft the ufe of tome of her limbs, and v/as moft ihockingly disfigured. Few peo- ple, are ignorant of what ought to be done to extinguiih flame; but pretence cf mind or courage is'wanticg in the moment of fudden danger, ?.r.d the confequences are of ccurfe deplorable. I admire the practical philofophy of the good wcmen in North Britain, who are employed in fpimiing flax, or tow as they call it» Whenever the flax round the diftaff catches fire by accidect,they immediately wrap their apron about it, and it is cut in an inftant. But where ihe fire affects an animated being, efpecially a darling child, 1 am afraid few mothers would have the refolulion to act in the feme manner. Nor is this the cafe with mothers only- 1 have known a fhther ftand by, and fee his darling daughter burned to death, with- out any immediate and rational effort for her relief ; the powers both of his mind and body were fufpended by the fhock ; and he remained like a ftatue at the very crifis ofthe alarming cataltropfie. Nay, I have known children carried into the ftreet, that the air anight extirguifh the flame- It muft be evident enough, from what I have faid of exceffive in re in the treatment of children, that I would not have mothers Or hutfeii ovcr-folicitcus about trifles. But where expefure to dan- ger may be attended with irreparable mifchi-f, it cannot be too cauticufly guarded againft. 1 would therefore have the upper gar- mets of children, when they can run about, made cf woolen mate- rials, which do t ot io readily catch fire as manufactures of flax and ontton, I would alfo have children taught very early to dread the fire ; and I think that the beft way of impreffing their minds with the d'nger of coming too near it, is to fuffer them to burn their fingers (lightly, yet fo as to give them fome pain. This would have more effect than a thoufand admonitions. When children are cold, they are very apt to get clofe to the fire ; by which means they not only run the rifk of being bnraed, buLof inducing whitloes or other inflammatory diforders of the tx- ti emities. In thefe cafes, hewever, I would not have the preventi« care of the nurfes or parents carriedtoo far. The actual experience of the tingling effect will operate more powerfully than any which can be faid to young people to make them avoid it; when they have ©nrefelt the (mart, a tew words to remind them of the caufe will be quite fufficient; and they will eafily acquire the habit of rubbing their hands aad running about, rather than going to the fire to warm themfelves, after having been cut in the cold. 1 have always been glad to find thofe femi-circular irons* called ADVICE TO MOTHERS: 507 guards, fixed up round fire-places in nurferies, and in all the apart- ments to which children had acceis. It gives me ftill greater plea- fure to fee wire-fenders, two or three feet in height, now frequently made ufe of even in parlours and drawing rooms. They are excel- lent preferv .tives from the danger to which grown perfons, partico- larly lad;es, as well as giddy boys and girls, may be expofed, v/hea (binding or fitting by the fire. Children are very fond of roafting things, fuch as chefmits, potatoes, &c. in the fire. I knew a lady, Who had nearly loft her life by an accident arifing from a circumftance of this fort. A lit- tle boy was poking in the fire for a potatoe, which he had put in to roaft ; his clothes caught the flame, and, though his mother was {landing by. he was dreadfully burned. She, being a nurfe at the time, held an infant in her arms, which rendered her lefs capable of affvfting the other child. The effect of the fhock on herfelf was fe- rioufly alarming ; it dried up her breaft-milk, and produced a fe- ver, the violence of which left little hopes of her recovery for three weeks: fhe was then feized with a convulGon fit, which came on critically, like that which often precede;* the eruption of the ('mall pox in infants, and is far from being an unfavourable fymptom.— Her fit proved equally falutary; it abated the force of the fever, and (he grew better every day af ter. This lady was attended by my excellent friend the late Dr. John Gregory and myi'elf, who had both defpaired of her recovery. The accide ts from fcalding are ftill more numerous. Chil- dren are in continual danger where victuals are cooking; and^mong the lower and middle ranks, the kitchen is the nurfery. One of the fineft boys I evef faw, loft his life in this manner. He was dancing round the kitchen, when a pot full of food for fome do- meftic animals, which had been juft taken off the fire, ftood in his way ; he fell backwards, and was fofcalded, that, in fpite of all my ,beft endeavours, he died. Nothing hot fliould ever be left within a child s reach ; other- wife he will very probably pull it over him ; in which cafe, before the clothes can be got off, he may be fealded to death. Children are alfo apt to carry every thing to the mouth ; and a very final! quantity of any liquid, boiling hot, will occafion death, if taken in- to the ftomach'. A melancholy proof of this occurred not long fince. A child put the fpout or a tea-ketde to its mouth, and drank a little ofthe boiling water, which proved almoft inftantly fatal— Numberlefs inftances have come to my knowledge, of childresi having pulled off 'he table difhes full of hot victuals, with which they were fealded in a terrible manner. Indeed, victuals, or any thick fubftances, in a burning hot ftate, are much worfe than fluids, as they adhere m%-e clofely to the (kin. . Perhaps there is not a more painful death, than tbat which is the confequence of fcalding or burning. When inftantanecus, it is nomine ; but when fingering, it is dreadful beyond imagination* We can only form fome imperfea idea of it from the intenfe paia occafioned by fcalds or bums, though not of deadly efteS. I once had a patient, abou^one halt of whofe iten was fealded, by falliag 5-oS ADVICE TO'MOTHERS. into a boiler.' vThou.oh thisnnn rec veved, vet fo great was his agony, thar,every time he was drefied,he ufed to beg and prav to be put to death. Accide. ts by cchl water, though not fo frequent in eorlv life as f' ofeoccafrned by fire, ought neverthelefs to be gua^e ' aca'mft with anv; pre'aution. Chii .ren, who have no idea that th-Te ele- ments are hoftile to life, are often dead before they kn^w their danger. Wells and pieces of witer near houfes ore frequently feft open, or without anv fence round them, as if tn v wer deft med for traps to albore the unwary to deftrncti n. Is- v n-ot well known th.it yoiing'teople are fond of lookiog inT) the water,, eSeciallv when they can fee their ownimo.se or iiker:efs ? And, is it*an uvi common thing for them, when viewing themfelves in fhe watery mirror, to tumble in, and be drowned? Even to this day I fliudder at the recollection of a draw-well in my father's garden, without the leaft railing to keep children at a proper diftance. A thoufand times, in playful mood, have I fported on the margin of the abyfs, and cannot now conceive how I efcaped a fatal flip. It is a week fecnrity againft the danger cf open well , cr ponds, cr phs, or the like cavities to tell a child to take care. The effect of fuch a filly piece of advice is well expofed in Gay's fable of the old hen and the young cock of which the moral is— " Reftrain your child—you'll foon believe The text which fays we fprung from Eve," But it is not only in yards and gardens that the leaft flip may fometimes be fatal to children ; they are often expofed to almoft as much •!an*rer within doors, by falls in varicys fituations. I (hall firft mention the dark and winding flair-cafes, which remain in all old houfes, efpecially in that part of London which is called the City.- Children muft be endowed with a degree of precaution far beyond thn ir years, to avoid tumbling upon thofe flairs ; and, if they do make a falfe ftep, thev often roll from the top to the bot- tom. A?, from the ufual lighmefs of a child, ?. feg or an arm is f Horn broken by fuch an accident, little notice is token of it at the time ; but ai hough it may not feem to do much' hurt for fhe prefent, it often lays the foundation of future maladies. "The fine organi- ze ion cr ftructure cf t*e brain nay receive a dargercus fhock ; and there is reafon to believe that the hydrofcephalus intemus, is fome- fures the confequence of bruifes, or blows, cr ether injuries done to the head, i loft a moft promifiog boy, through an affectior of his br;rin, wh:ch i thought was owing to a faU from a kircher. dreffer. All children have an inebnation to climb, and to get upon flcls, chairs, tables, &c. A fall from ore of thefe is m< re danger- ous than mothers and nurfes are apt to imagine. A child's^ head is large, and, being fpecifically heavier than -the body, is the part moft liable to ftrike the ground, and thus to caufe a concuffion of the brain, which may be attended with fatal coufequences. Ail the furniture of a nurfery fhould be low, fo as to pr -elude at once the defire of climbing and the danger of falling. TVe t~bles fhould atfobe made without corners, as thefe fharp projections often d% u&chief. I have already declared royfetf a warm irdvocate for in- ADVICE TO MOTHERS. <** jfabeirg the -afdcfe a -t <-by of children, o3 •■.-•vch their growth, t d health Very much depend ; but, till t tey acquire reafon and expe- r once :o iv.iiole tnem, it is the bufinefs of (heir parr-ots to t^ke care, t'vt thev niov'. abcui, and .n ways remain in a fphcre of perfect fafety. F~r the fame reafon, Fiirfes fhould never leave any deadhv weapon within tee reach of children. Knives and fliaro inftnw me ts, with which they may cut or wound themfelves, are vn improper playthings. Yet i remember to have read in fome newi • pap:r a curious ftory, of feveral lives having been faved by a knife m the hand of an infant. It happened uear one of thofe extenfive woods on the continent, w ence hungry wolves often fally forth in queft of pT.-°v. The wife of a peafant, who lived in a cottage at ' no great dift-mc, was gone out upon fome bufinefs, leaving an in- fant in fae radle, under the care cf three or four more of her young family, one of whom gave a kn;fe to the baby to atnufe it. During the mother's abfence, a wolf, impelled by hunger, rufhed into the cottage, and made its firft fnap at the infant's arm, whics, being extended with the knife in a playful manner, it entered the throat ofthe ravenous animaj, and proved its death. As the wo- men in our happy ifland have no occafion to arm their cniklren > againft fuch enemies, I do not fuppofe that they w-ill be tempted by a; the defire of hearing their infants cried up as heroes, to intruft them with weapons, which are far more likely to hurt than to de- fend them. But to return to more fi rious and neceflary precautions : I muft next take notice of fome fatal acrid nts which frequently occur, ■ though they may be eafily guarded againft.. We daily hear of chil- dren falling from windows and being killed ; this mut be owing to the want of proper prefervatives ; a few bars fixed acrofs the win- dows of the nurfery, or of any high apartments where children are fuffered to play about, would prevest fuch difafters. Yet eafy as the remedy is, we finl it too often neglected. How frequently have I feen, with much alarm, children hanging out of windows in a ftate of imminent dang r, and no regard paid to them by any perfon within! this is peculiarly the cafe with the children of the poor in London, who commonly live in the upper ftories, and fel- dom or never have, their windows fecured by bars. To keep fuch windows conftantly (hut would exclude the frefh air, io neceffary to heahh, and even to exiftence; while, on the other hand, having them open, wthout the guard or defence here recommended, is ex- pofing the g:ddy and thoughtlefs to certain mifchief. On the leaft n^'fein the ftreet, a child is apt to run to the window, and, leaning forw '.rd in tajr r gaze, is often daltrd againft the pavement. lo my former remarks on hanging eots, my chief aim wois to fliew how muen fa far and more conducive to fleep their gentle mo- tion was th m the violent and dangerous rocking cf a n idle. I have now an obfervation of greater extent to make on beds no gen- eral, which is, that they often prove fatal to chihhon, iniiead of being places of eafy and fecure repofe. It is too auto: nary for mothers and nurfes to take infants into bed with them far the whels 4*o ADVICE, TO MOTHERS- night. This is always relaxing, an \ fometimes attended with the melancholy effect of fuffoca tion. Either in France or in Holland, I am not now pofitive which, there is a prohibitory law againft out- tin^ any child to fleep in the fame bed with its mother or nurfe. - Though we hive no fuch law in England, maternal care ought to fupplv the want of it, efpecially as it is lot an extraordinary, or a very uncommon thing to hear of a child's bein?: fmothered by the accidental rollmg or proffer*1 of a grown psrfon during fleer*. Taeuieoitum-ui> bedfteads is not lefs noxious or dangerous. They exclude the ar from the bed-clothes all day, and render them frouzy and unwholefome. Children may alfo be inadvertently killed in them. Thefervant, or perhaps the mother, turns up the bed in a hurry, without examining whether the child is in it or not; the infant incapable of making any noife in this fituation, is fmoth- ered before the miftake is found out ; and tears flow in vain to remedy what a little caution might have prevented, or what could never have happened in a proper bed. Children fuffocated in this manner, as well as thofe accident- ally overlaid, might be fometimes reftored to life. Yet I do not recollect any inftances, except the one mentioned in my " Domeftic Medicine," of its having been done ; though it muft be as practi- cable as in Cafes-of drowniog, of firs, and various other cafuailties, at- tended with a fufpenfion or feeming extinction of all the vital pow- ers. It is not my bufinefs, however, to fuggeft the ufe cf very precarious reftoratives, when the means of prevention are fo eafy and certain. I fhould never have done, were I to engage in a particular de- fcrip ion of all the dangers to which children are expofed in our ftreets, partly through the want of a good medical police, and port- ly through the negl gence of their parents. The impertance and the neceflity of the farmer, I may take fome other opportunity to enlarge upon ; my prefent wifh is, to excite the attention of moth- ers to the perils which await their children at almoft every corner, when they are fuffered to run about by themfelves, or intruded to young people who have neither fufiicient ftrength nor experience to protect dafhed out, or their bodies crufhed to atoms, in the midft of thofe dangers to which thev are foinconfid- erately expofed ? Though'the immediate authors of fuch difafters defcrve in moft cafes to be hanged, yet I do not know how any- jury could conicienticufly acquit tne negligent parent of fome parti- cipation in he crime. Let me therefore conjure mothers, in particular, never to per- mit their young ciiildren to go alone into the ftreets, and never to rely upon one child's protection of another. It is alio a mother's duty to make her children, as foon as they are capable of it, aware of danger, and to inftruct them how to avoid the numberleis ene- mies that bef t them on all (ides, and too often prove fatal to in- fant life. A good police would certainly go a great way towards the prevention of many of tnofe difafters which io frequently occur in our ftreets, but no laws can ever be made tnat will fupercede the mother's care and attention in watching over the health and fafety of her ch.ldren. .' -i--------------------------1 . ■ - i ..,',' CHAP. IX. OF FOUNDLING HOSPITAL*, AND OTHER CHARITABLE INzTU UTIONS FOii IHE REARING OF POOR OR ___ DESERTED CHILDREN. X KE proper qualifications and indifpenfible duties of mothers n iving fo far engaged our attention, 1 am not withou*; hopes that the remarks whicn have been made on thole important fubjects, will be of fame fervice in the middling and higher ranks of life. But it gives me pain to think, that there are great numbers of poor women, who do not want lo much to be taught, as to be enabled to difeharge their duty. They would willingly, devote all their time and care to the nurfing of their cnildren ; but the want of common necefiaries forces them to be otherwife employed.— Ihey fee their infants knguilh ; hut the dread of famine is an ob- ject of ftill keener concern. They are not dead to the impuifes of natural affection ; but its warm emotions in their hearts are foon chilled by diftrels. It is poverty, whofe icy hand congeals the ftreams of maternal comfort, and whofe withering breath blafte fome of the faireft buds of human life. Vanity is more gratified than reafcn, by the acknowledg- ment that there is not any country in the known world which is io much diftinguifhed as England tor its charitable inftitutions. How - mortifying is it to add, that there is not any country in which char- ity is fo much abufed and perverted ! Vv hen I lock at fuch a buil- ding as the Foundling Hoipital, much more like a palace than a nurfery for pocr children—when I confider the vaft (urns laid out in raifing that ftructure, and the ftiil greater (urns which have fmce been expended and continue to be expended upon the moft pomp- ous and ufelefs parts of the tftabiiftiment--l cannct help crying OUt with RoCHEFOUCAULT, that virtue or charity would never gofo ' far, if pride did not keep her comlm~,\. « ft is ir.uch to te lantnttd, that the flats fci the rtijefttihot' (39J 602 ADVICE TO MOTHERS. the old and theyoung, in every pitiable fiouation, which at differ- ent times have been enc uraged ty t e people of England, fh uli all becmn-.cted with fuperb buildings, profitable jobs, and a train of offices aa4. employments, w ich prey upon the funds, an^ render their uf • to the public very fmall, in comparif n to what it might ohherwife nave been. This grofs mif'application—this v afte of charitable contributions,! not the only thing to be fund fault witji in the management, of he Foundling Hofpital. Nev>r did any inftitution holdout fairer clai -s to tie fupport of the"benevolent and humane, and never was any m r. liber dly patronifed ; yet, from ignorance and inexperience, inftead of prefrving the lives of chil -ren, it has too frequently ac ekrated their death. The firft fuggeftion-of a Foundling Hofpitd was ortainly very plaufiDle; i s profeffe', object wos to refcue from mifi.ry and deftruction theinnocent victims tnat would < iherwife b doomed to both by the defertion of their parents. Thus m.ny valuable lives would be faved to fociety, and fuc a refouree would be open- ed to unfortunate motners, as would rem" ve, or confiderably wc ,.k- en, any temptation to the commiflion cf the moft unnatural acts. The prude, the bigot,and the canting hypocrite, might, indeed, - condemn fuch a fuppofed encouragement to the .illicit union of the fexes ; but humanity can never lock upon the prefervation of a hu. man being as a cr me. An undertaking therefore, of fo fpecious a tendency, could not fail to meet with ffa moft generous fupport. Independently of all private contributions, fixty thoufand pounds a year out of the public money were for feveral years appropriated by parliament to fo laudable a purpofe. A palace, as i before obferved, inhVad of a nurfery. foon re red, its he~d. The doors wer*- thr wn op-n for the admiffin of civferted children frnm all parte, not to be nurfed and educated ther", but to be fent down to 'he diftant counties, and in their conveyance numbers of the poor infants perifhed. I am Dot here making a v^gue cr an im : ary calculation ; I am ftating what fell under my own notice, wnen 1 was phyfician to a very confiderable branch of the Fo undlinp; Hofpital. I have elfewhere defcribed the mortality which was occad'oi ed by the improper ufe of medicines among thofe who had furvived the fatigues ci tbe jcurney. I have alfo explained the very eafy means I made ufe of to put a ftop to fuch afflicting ravages, while the children and their nurfe-wereundermyinfpecTon&ccntroul. Butallmyremonftrances againflhaviLgthemdraggedaway from thofenurfes too faon,crowded into hofpitals, confined in fchools, or put out to unhealthy employ- ments, were unavailing. I was told, that the eftablifhed rules and euftonwof the hofpital could not be deviated from, though their evident effect was to deftrov health, and to enfeeble the minds as well as the bodies of the unfortunate victims. I have often viewed with indignation the fallacious reports of the numbers of children faid to be brought up and provided for at fuch places. I am very confident, that were an accurate fit made cut of thofe who perifhed through unfeafonable removals, improper treatment; bad nurfing? difeafes cccaConed by too early confoie- ADVICE TO MOTHERS. 603 rr.ent iii fchools, as well as by infection in hofpitals, and, laftly, th'-.aipn wh >.t I call murderous occupations, it would appear that nor one in ten of the infants received there,ever lived to become an ufeful member of fociety. ' But, befides the evils here hinted at, there is a fundamental error ia the plan itfelf, not only of the Foundling Hofpital, but of all parocbral and ether charitable inftiturions for the maintenance and eduction of poor children. Every feneme which tends to fe- parate the parent from the child, whatever impofing appearance it may wear, is a bad oDe, and will eventually be found to do mif- chief. it is flying in the face of nature, a thing tha* never can be done with Impunity ; it is rending afunder the firft and the ftrongeft bonds of focie'y—parental and filial affection : it is perverfely at- tempting to bhn.t and deftroy the finelt feeling ofthe heart, moth- erly-love, without which the human fpecies could not long exift.—> All nature points cut the mother for the nurfe of every thing that is brought forth alive; nor can her place be fupplied by any inftitu- tion- Thofe who make the experiment will foon be convinced of their temerity an.; folly. A few years ago I met with a letter addreffed to lord FitzwilU iam, then viceroy of Ireland, on the fubj.-ctofthe proteftant charity Ichools in that country. As the author's fentiments agree with mioe in many points, and par.icularly with refpect to the pernicious eff cts of f. pirating children from tiieir parents far the fake of edu- cation, I fhall here give them in his own words. Some people may think the language too ftrong ; but the nature of the fubject requir- ed the mofl*p.ointed energy. 6: My Lord, I do requeft that you will take the trouble of reading tbe account of this invelerately illiberal inftitution in any common almanac ; and every line will, 1 think, carry its own rep- robation to an ingenuous mind. The children, as it is regulated in their unnatural fyftem, are all placed in fchools remote from their farmer abodes ; or, in other words, they are torn from all the fweet affociations that attend t.e interefting idea cf home. This is, indeed, a charity which thrives on the extinction of all the other charities of life ; and the feelings of nature muft be eradicated, before they can become nurflings of the ftate. They are bo.nifhed from their vicin^ age to a remote quarter of the kingdom, where all the traces and ties of kindred are loft and cut oft"; all habitudes ofuhe heart ('mothered in the cradle; and, when fent into the world, they know not the fpnt which gave them birth, the mother that bore them, nor the blood that flows in their veins. I think of the fpeech of Lo- uan, the Indian chief,when ail'his kindred were murdered, " There remains 'not a drop of my blood in the veins cfany living creature. The writer here takes occafion to direct his remarks to the heart, as well as to the head—to exert ail his powers of pathetic, as well as argumentative eloquence. " It is," fays he, " a cold, cheeriefs, and forlorn feeling of this nature, which muft freeze the young blood, and, placing the mind in a ftale of fallen infulation, makes its reaction upon fociety'rat her dangerous than beneficial »— i hz ties of kindred operate as a fcrt of external confeience upon 604 ADVICE TO MOTHERS. he conduct of men, deterring them from the comhv.flion of great crimes, for fear of the difgrace which would be r fleeted on their relations. There is a family pride, a domeftic honour, among he very pooreft and loweft of the community, that guards, and lanc- tions, and is a fort of God for the little houfehold. Fven the high- eft have fuch workings of nature. Lady Macbeth txclaim?, had he not refemblea my father when he flept, I had done it. The imagined countenance cf her father was the only confeience left, and came between her and murder. But charter-fchool policy makes a fort of maffaere of all thofe domeftic moralities which operate up n character and conduct, without being able to put a higher and no- bler prineple of action in their place ; and thus, 1 fear, the fame policy has bred up many victims for the laws, while they only thought of making profelytes to religion." Though the fufject is here confidered only in a moral light, yet I could not refill the ump:ation to make a fhort extract from fuch a mafterly letter ; and I do not think that any of ivy readers will be di'pleafed at the perufal of it. But 1 have ftill lets occafon to make any apology fi r Hating the author's opinion of the moft effectual means of remedying the evil, as the leading feature of his plan of reform exactly corresponds with what I recommended above thirty years ago. I was then lamem ing that poverty often obliged mothers to neglect their offspring, in order to procure the neceffa- ries of life. 1 obferved, that, in fuch cafes, it became the intereft as well as the duty of the public to aflift them ; but I contended that ten 'houfand times more benefit would accrue to the ftate, by enabling the poor to bring up their own children, th. n ft\ ; all the hofpitals that ever could he erected with that view. In a fubfequent edition of thofe remarks, I added, that, if it were made the intereft of the poor to keep their children alive, we (houtd lofe but v ry few cf them ; and that a fmall premium given annually to each poor family, for every child they nad alive at the year's end, would fave more infant bves than if the whole revenue of the crown were ex- pended on hofpitals for that purpofe. It gave me great pleafure to find, that tbe writer juft now quoted had reafened in the fame manner en the hundreds of rhou- fards w-hich had been expended, n ercly, he fays, to create foundings ;^ the tenth part cf which, if properly employed, would have ' een of infinitely more fervice tc fockty. The proper mode of employing charitable contributors, he thinks, fhould c nfft chiefly 'in giving premiums to fuch paren's as haw (hewn mcft zeal and capi"i»y in educatirg their children. thus, lictwithftanding th° different points of view in which we examinee the abufe of fo in potent a part of public charities, the very means which 1 advifed for favrng the lives, ard promoting the bcclily he. 1th of infants, appear to him the moft conducive alio t0 their intellectual and moral improvem-nit; The prejudices in fa ver of eld ini.ituticns nuft 1 e ftrong. in- deed, v her they can refill the cleared evidence ofafa&s, and the plain reductions cf fair argument. Yet, in the qiHrfhor before us, U wthe public, or the ftate, nay rr.oft c-flectuelly contribute to the tuifiEgacdreaiicfcot rxcniranis. cnev.c Id fuppofe lhat ncjac* ADVICE TO MOTHERS. 605 peal to paft experience, nor any great depth of reafoning, were ne* ceffary to demonftrate the i.npropriety of feparating children from their parents. Nature forms the chain that oiuds them ; and, if poflible, it (hould never be broken. I have (hewn how the lives of the mother and the child are entwined, not only during preg- nancy, but after delivery. To part them, is to endanger the health and exiftence of both. They are equally neceffary to each other's well-being ; and the long r they are kept together, the more fenfi- ble they become of the duties they owe to one another, which* when faithfully difcharged, tend greatly to increafe the fum of hu- man happinefs. But how are we to expect that any regard will be paid to this doctrine by narrow-minded unfeeling overfeers ofthe poor, who make a greater merit of faving a fhilling to their parifh, than of ha- ving fifty lives to the community ? We now and then hear of fuch perfons being dragged into our courts of juftice, to anfwer for their cruelty to pregnant women ; but no account is kept, and of courfe no cognizance can be taken of the immenfe number of infants that are torn in our parochial receptacles, from the arms of their dif- treffed mother?, and areconfigned to an untimely death, or to cer- tain debility ami protracted wretchednefs. Even the (how of hu- manity in fome of th tfe places, ferves only to excite our ftronger in- dignation. It is a cobweb, through w~ich the penetrating eye can eafily fee writtenup in letters of blood, Children murdered here under the fanblion of Charity. Are we not always (hocked at reading or hearing any accounts of the oarbarous policy that prevails in China, where avaricious as wall as diftreffed parents are encouraged oy the permiflion of the law, and by the force of example, to deftroy their female children, in order to avoid the expenfe of rearing them ? And is th; re a father or a mother in Great-Britain, who would not join in a gene- ral outerv againft an act of parliament for the immediate drowning of all infants taken to parifh work-houfes ? Y t, humanity itfelf muft acknowledge that inftant death is ieifini ely preferable to a lingering exiftence in a ftate of pain, of mifery, of continual fuffer- ing and difeafe. I do not, therefore, hefitate to affert, that fuch policy as that of the Chinefe, or fuch an act of parliament as I h.. 02 now mentioned, would, in reality be an act of mercy, contrafted with the prefent moft barbarous.moft inhuman, and moft deteftable method of taking care, as it is falfely calle', of poor infants thrown upon the parifh. Nothing was left undone by the late Jonas Hanway to probe this fare to the bottom- He fpared neither time, pains, nor ex- penfe, to procure the fulleft information on the fur jeft, before he publifhed his " Plea for mercy to the children of -he Poor. He *'there ftates, as the refult of his inquiries and c Iculations, that not more than one in feventy of the children configned to the parifh, ever arained to mature age; and that even that one feldom ne- came an ufeful member of the community. Among many inftances of the moft horrid nature, he takes notice of a memorandum he met with in the books of a certain parifh, where the names of particular 606 ADVICE TO MOTHERS. nurfes were inferted, with theremark of their being " except /■!//. ing nurfes." This teftimonial of their expertnefs in murder, was deemed by the overfeers, who had tried them, the ftrongeft recom. mendatiqn to conftant employment. Let it not be fuppofed, that I mean to involve all overfeers of the poor in one general charge of infmticide. I know feveral of them to be very amiable and tender-hearted men, who would do every thing in their power to promote the ends of true chariy and fhj rfal intere^s of humanity, were they not tied down by the eftab- jifhed rules of their office. - That part ofthe inftitution which re- lates to the nurfing and rearing of childrm, being radically wrong, the moft zealous exertions of any individual, during his fliort con- tinuance in office, will operate but as a temporary palliative of an evil m its own nature incurable. It is not a partial reform,' but a .> total change of fyftem, that can in fuch cafes be productive pf any good effect. • a--^1- fappor-f'i'S of Foundling Hofpitals may imagine, that a juftiticatiOn of their plan is implied even in my cenfures of parochial eftablifhments for poor children. They may fay, that the laudable end of their charity is not tofeparate infants from their moth.rs, but to provide-far thofe from whom cruel and unnatural mothers have feparated themfelves. I before paid the juft tribute of ap- plaufetothe fpirit of fuch an inftitution, and to its profeffed objects ; but I lamented the abufes which had arifen out cf it, or rather which were inseparably connected with the execution ofthe fcheme. Its obvious tendency and its actual effect have been to create foundlings, to encourage the defertion of young children, whom many of their pa rents would never have confignedto a reccep- tacle of that fort, but from cruel neceflity, and from a vain hope that due care would be taken of the poor,creatures. I have fhewn the extent of that care, the dreadful (weep of mortality, which ac- companied it, and its cenfequent infufficiency to promote the de- fired end. I would not however have Foundling Hofpitals entirely abol- iihed. I would endeavour, in the firft place, to render them lefs neceffary, by a method which I fhall fully explain in the next chap- ter, and of which the great object will be to take away from poor mothers all temptation to abandon their children. But as fome women may be prompted, by other motives than that of v/ant, to deftroy their young, let thei»e be a receptacle ever open for the refcue of fuch victims, and for the prevention of fuch unnatural crimes. If mv plan for the relief of poverty, above hinted at, be carried into full effect, the number of foundlings of the latter de- fcription will-dwnys be fmall, and will not require any very cx- penfive eftablifhment. There will be no occafion for fhowy buil- dings—no room for luTarive jobs, offices, or appointments. Two or three truftees, without falary or emolument, and actuated folely by humane and charitable motives, will be fufiicient to receive the • money, and to lav it out according to well-regulated and maturely confidered inflections. The prefent abufes are very great ~nd flagrant; but the reform is very eafy, if it be zealoufly undertaken ADVICE TO MOTHERS. Co) ^n?6^?^1^1 hy.mea of talents and virtue. I take it for granted that (uch perfons will alio poffels dignity of mind enough to uetpiiet:.e wretched fuggeftions of ignorance, of prejudice, of eti/y, ma.igmty, fordid intereft, and difappoioted vamty. the foregoing remarks nre purpofely confined to fine of our moit popular eftablifhments for te nurfing and rearmg of children- it would lead me too far to enter into a detail of all t e fchemes which nave affumed the like name of charitable inftitutions in the neighbourhood of London alone. The former have at leaft, the merit of having been well intende I ; but moft of the latter are founded :n fraud, and have no other aim but to enrich fome artful projector, at the expenfe of the public credulity. This is an inex- hauftable fund for any man who can invent a quack me'icine, a new mode of faith, or the ohm of fome fpecious c arity. We have feen footmen in the firft fepartmeiv, coal-heavers in the fecond, and fwindlers in the third, driving their clrrfots with rival folen- dor and fuccefs. But the victims of the laft deception are moft to be pitied, becaufe they are poor, innocent, and helplefs children; while the dupes of the 'wo firft being people of mature years and experience, cannot lay claim to any c mpaflion for fuffering not only their purfes, but their very fouls and bodies, to be fported with by ignorant and audacious impoftors. C H A P. X. SKETCH OF A PLAN FOR THE PRESERVATION ANp IM- PROVEMENT OF THE HUMAN SPCIES* VV ERE this fubjeft to be difcuffed with a degree of ex- tent fuited to its importance, it would require a large volume.— But I mean to touch only on a few of the principal points, merely with the hope of exciting more general attention to a matter, which, though of the higheft concern, h s hitherto bem very (lightly con- fidered. I (hall not dwell upon truths v/h'ch are obvious to almoft every p rfon of common underftanding, rjiat tie r.T mrces and lia- bility of a ftate depend upon the number, vigour, and induftry of its fubjects; and, on the contrary, that where little value is fet on the increafe of population, on tne growth, heahn, or life ofman, the political fabric, however fhnwy, ftands on a rotten foundaiion, and muft fooner or later fink into an abyfs dug out of its own in- humanity. It is enough to mention thefe truths, in order to fe- cure the ready affent of ail thinking people ; but the practical in- ferences to be drawn from them may admit of a great drv\ rfity of opinions. The plan which I am about to propnfe, whether ap- pr wed of or not, may be productive of' ne good effect at leaft, that of enerdfing the ing^nuby of others, and perhaps of conduct- ing public and private charity to mere ufeful purpnies than thofe to which they are now applied. I hone I need not go over the old ground again, or repeat my former arguments, to prwe that there is not aoy law of nature fo clear, fo forcible, or fo haloed, as that which ordavs every mothe; 008 ADVICE TO MOTHERS* to be the nurfe of her Own vonng. Th.- well-being of Hoth, as I before obferved, depends o^ the foithful difcharge of this duty.— Everv attempt to div^t the breat-milk fronvits proper channels, endangers the mother's life; and it is beyond the power of wealth to procure, or of art to devife, any nutriment fo congenial ro the conftitution of the infant, as fhe very juices of which it is compo- led, and which have folong foftainel it in the womb. Is it equally impoflible to fapplv the tender ca'-e and unwe ried attention of a parent; and the rich, who truft to hirelings, find by woeful expe- rience, that half their children oerifh in early life. Is it a wonder, then, that a far greater mortality fhould await the poor infants thrown upon the pariti, or configred to an hofpital, wh°re no in- dividual is interefted in their prefervation ? I have faithfully pared, as a matter which came within the Cohere of mv own knowledge, that nine out of ten of the defeated foundlings died before they at- tained to maturity; and it app°ars from Mr. Hanway's unqueftfan- able account, that fixtv-nine out offeventvof the poor parim chil- dren peri(h in the fame untimely manner. Can it therefore be called charity to perfevere in meafures which are fo destructive to the population of the country ? I before fuggeflei' what appeared to me the bet fubftitute for a Founllmg Hofpital, confined in its objects to the preservation of fuch children is mi$ht other vile periti bv neglect, and of fuch as may be deprive 1 of their mothers **t an early aae by the " hand of fate." . Poor orphans and deferted infants being in the fame pre- dicamsnt, though from different caufes, mul be reared by Gran- gers. The only expedient m thefe unavoidable deviations from nature, is to place the children unVr the care of nurfes of unex- ceptionable character, in a healthy part of the country, and not to take them awav till of age to he put ar^entices. This very cir. cumftanre will promp every nurfe to ufe her beft endeavours to rear a dvhd who 's to flay with her if he thrives and does well, till he is fourteen years of age. It is the only chance of making a ftraneer acquire in time a maternal ahfe-t:on for her nurfling.. It is alfo the only change of a poor child's acquiring a good conftitu- tion, and that kind of early education which is beft fuited, to rural employments. But for the relief of poor women, who in pregnancy may be exoofel to numberless a^Votirns, ^d who, aftefdelivery, may of- ten be forced to part whh their children, T wculdnot recommend either hofpitals or oariti work-houfes. Thefe receptacles are little better than half-wav bouf°% or rr-nductArs to the grave. In their room, I wonH heve a fund ^--blifhed ro afford indigent mothers every, neceffarv comfort an^ affr nn^e at their own habitations, du- ring pregnancy a? wil a= in child-bed, and afterwards to enable them to nurfe a-1! bring up their infants themfelves. Bv thefe means more liv°s arnuhl be prery all the charitable in- fhifutions now exiting m this -ennt^-v, w'thout cofting cne half of the monev, rv ^Ven?fmer the henrt? of children from their parents. It is impoffible, without h-arf-fe-f fon-ow, to think ofthe im- menfe number of fine children that areloft for want of a little timely ADVICE TO MOTHERS- 609 aid to mothers. How many of thefe poor women pine wifh g&eir offspring in obfcurity, and in unavailing ftruggfes for their faipnsort! The dread of ill treatment, of difeafes, of death, and {what as fH« more terrible to a delicate mind) the dread of fhame, keeps them from work-houfes and hofpital?. Their groans are unheard—meir wants unpitied—and they pafs like filent (hadows f> the grave 5 I low many others, no lefs tenderly attached to their young', are driven by extreme diftrefs to leave them to the veiy uncertain care ot others, and to hire out their breafts, and their own diftraiSedl at- tention, to a ftranger! When a mother abandons her chill, to fuckle that of another woman, one ofthe iofams is almoft fare to die ; and it frequently happens that bo-h (hire the fame fate. There is a third clafs of truly pitiable objects, though too often regarded with cruel indifference and contempt; I mean the poor women whom we daily fee begging with two, three, or more chil- dren, and entirely dependent on fo pie-arious a refource for a mor- fel of bread. While hefe can lie under hedges, and get fcraps of food thev may live; but fhould a fevere winter overtake them, when ' they muft cling to the rock for fhelter, they will all be loft, it is not unlikely that many of thofe poor infants may be the iffue of men who have fought for their country ; and that faey were turned oat of houfe anaharbour, left th~ v ftnnld become troublefome to theparifh. Can public or private ch.ari.tv be better employed than in pre- ferving to many lives to the ftate ? And how are thev to be preferv- ed ? Not by tearing the poor children from the arms of their mo- thers, and fen ling them to hofpitals and work-houfes, to be pot un- der the care of" excellent killing nurfes"—but by enabling the mo- thers to nurfe them agreeably' to the defigns of nature, and thus rendering fertility, not what it now is, a curfe to the poor, Sat the fource of the fweereft pleafures, and the greateft of all bleffings. A very fmall part ofthe vaft (urns collected in this kingdom by taxes, under the title of poor rates, and by voluntary contributions,would be fully fuflicient for the oropofed fund; and I am perfuaded that the wifdom and humanity of parliament and of government c^uli not be better exerted, than in preparing and carrvms into effect either this, ar fome other more advifable plan, for faviug the lives of fuch an incalculable number of devoted victims. Vanity, as I before obferved, has a very great fhare in the erec- tion and fupport of alms-houfes; or the rich and the trulv humane woul \ readily difcover, in the hints now given, a much more ufeful as well as a more charitable method of employing their fuperfluous " weahh. I Hope, however, that the confeious pleafure of do;ng real good, will induce many ladies, bleffed with affluence, toanit poor women to nurfe and rear their children in their own little huts or habitations, though not infcribed on the outfide with any vorm com- pliment ti the pride of a patronefs or a founder. Is not the fight of arifing famty, who -re indebted to vou for he-lth,. and even for exiftence, a thoufand times more gratifying to the human heart, than the fillv oftentation or parade or a public charity ? It would imply a verv unbeccnfa >g doubt ofahe good fenfe and 61 o ADVICE TO MOTHER a. natural feelings of my readers, to dwell any longer on tli'u head ; but many of them may think the other-part of my plan, expreffed in the title of the prefent chapter, and having for its avowed object the im- provement of the human fpecies, a little romantic. Yet, I flatter myfelf that I fhall be able to prove, that there is nothing of fanciful or im- practicable theory in .the fuggeftion ; and that the improveme.it as ■well as the prefervation of the human fpecies, may be effectually pro--. moted by the fame means—well-timed affiftance, and proper encour- agement to mothers. In the firft chapter of this work I threw out fome hints on the proper choice of wives and of hufbands, with a view to the procrea- tion of a heathly and vigorous iffue; and I lamented, that the impulfes of natural inclination were too often checked in civilized fociety by the meaner paflions of avarice and falfe pride. I alfo took notice of cafes in which marriage had been forbidden by thelegiflatures of dif- ferent countries. But though it would be difficult to frame, and to enforce any complete fyftem of laws for regu.ating the union of the fexes, and though fuch legal reftraints on marriages would be in- compatible with the liberty of individua s in a free government like ours, yet it is in the power of every ftate to encourage the rearing of fine children, by granting to every mother a premium annually, in proportion to the age and number of healthy children (he brought up,- The profpect of a liberal and honourable reward at the end of every year would encourage mothers to exert all their (kill, and ufe every endeavour to rear a numerous and healthy offspring. It would ex- cite a general emulation among mothers*, and the object of the vir- tuous ftruggle .would be, who ibould have the fined children. The name of Cornelia that famous Roman mother, would "ho longer ftand alone on the records of maternal affection : But Englifh women, when requefted to (hew their jewels or their brightefl ornaments, would throw open the nurfery, and exhibit alovely family to the fpectator's admiring gaze. , Let it not be frivoloufly objected, that a fond mother cannot want, or cannot feel a ftronger ftimulus, than natural affection, to make her take care of her child Poor women are forced by keen dif- trefi- to neglect their infants, in order to earn a bit of bread They requhe therefore preient fupplies, and the aifurance of a future re- ward ; not merely to induce them but in fact to" enable them to be- llow more time and attention upon this one important object. Again j hen, I mult affert, that a part ofthe public money, as well as of private charitable contributions, cannot be applied to. a better purpofe, than to the eftabliftiment of a fund for the fupport and encouragement of fuch mothers. The pood effects of this plan wou d far exceed any prefent conjecture or calculation. The population of tbe country would increafe with almoft inconceivable rapidity. Inftead of puni- nefs, deformity, difeafes, and early deaths, the rifing generation would be cTifHnguifotd for their health, beauty and vigour: and we fhould foon fee a ft cut and hardy race fpring up, to repay with ufury, in valuable fervices to the (tate,'the hums expended in nurfing an<' rear- ing them. I do not know any one inftitution upon earth, ir which hu- mairty and enlightsnedpolicv would be found mere happily united. ADVICE TO MOTHERS. 611 The effects of premiums have been proved in a variety of other inftanees, fuch as the culture of vegetables, the growth of flax, of hemp, of potatoes, the planting of trees, and the improvement ofthe breed of cattle. Is it not a matter of juft furprife that no attention of this fort fhould ever have been paid to the perfonal or bodily im- provement of the human fpecies ? We know that the moft tender plant is not more fufceptible of any fhape or form than infant man. We know that his ftrength and figure are certainly as improveable as thofe of any pther animal, were proper methods purfued for theac- compliihment of fuch defirable purpofes. Yet the breed of men is alone neglected, while every effort of ingenuity is called forth, and therefources of wealth areexhaulled, in experiments to improve the breed of fheep, of horfes, and of oxen ! I never met with more than one man who took up this fubject on a ferious ground. His plan was a good one had he poffeffcd iufficient means to carry it into execution. He propofed to purchafe a fmall ifland, pnd to plant it with aS many people of both fexes as it would very comfortably maintain. Of theie, he meant to fuperintend the diet, occupations, marriages, and the management of their children, •with a view to try how far the breed might be improved. It was a fpeculation worthy of an enlarged mind. Were every perfon of land- ed property in the kingdom, ofthis gentleman's way of thinking, and could our country fquires in particular be induced to pay half as much attention to the breed of men as to that of dogs, horfes, and cattle, the progrefs of the human fpecies to perfection would become more rapid, and more aftoniflting, than the degeneracy fo often com- plained of in every fucceflive age. Nor would this progreflive improvement of man be confined to the body only; it would extend itfelf alfo to the mind. Every thing great or good in furure life, muft be the effect of early impreffions ; and by whom are thofe impreffions to be made but by mothers, who are mod interefted in the confequences ? Their inftructionsand example will have a lading influence, and of courfe, will go farther to form the morals, than all the eloquence of the pulpit, the efforts of fchool-mafters, or the corre£live power pf the civil magiftrate, who may, indeed punifh crimes, but cannot implant the feeds of virtue — If thefe are not fown in childhood, they will* never take deep root j and where they are not found to grow, every vice will fpring up with baneful luxuriance. In this view of the fubject I could eafily find a thoufand argu- ments to enforce the political importance of the plan which 1 i.jvc fuggefted; but I undertook only to (hew that periect heath and growth, that perfonal beauty and vigour, were moft hi ^ to be the fruits ofthe well-dhected and well-encouragedcare of mothers in the nur5ng and rearing of their children. Other authors have enlarged on the culture ofthe heart and the underftanding, the rirft and chief part of which they all acknowledge to be the iuconteftible province of mothers, the eloquent writer whom I h:*.ve repeatediv quoted,and who has taken fome pains to illuftrate this poi:::, ai^ues whh pe-i iuftnefs that, if the early part of education, which concerns v-i mod, 612 ADVICE TO MOTHERS- had been defigned for fathers, the Author of nature would doubtlefs have furniihed them With milk for the noUrifliment of their children. It is in concurrence with his opinion, that I have addreffed this little book of inftruction to females ; and as he has very beautifully com- pared infant man to a (hrub expofed to numberlefs injuries in the highway of life, I fhall join him in calling on the tender and provi- dent mother, to preferve the rifing (hrub from the fhocks of human prejudice. I fhall fay to her, almoft in his words, Cultivate, water tie young phnt before it die ; fo fhall its fruit be hereafter delicious to your tajte Erebl an early fence round the difpofition of your child: others may delineate its txtent,- but it remains withy$u only to raife the barrier. APPENDIX. WHEN I firft turned my attention to the nurfing and manage- ment of children, the late Dr Cadogan's pamphlet on that mbje& fell into my hands. I perufed it with gre?t pieafure, but foon icU it; and though I have been in queft of it for above forty years, ; rcver could fet my eyes on it till within thefe few days ; which makes me conclude that it is out of print. That fo valuable a fragment may not be loft, 1 fhall iniert the principal part ct it in this Api-tr.ctx ; and I hope it will render the book more exteniiveiy uieiul, rnd, at the fame time, tend to coroborate my fentiments concerning mothers. '* In my opinion," fays the ingenious writer whom i am now quoting, *" the bufinefs 01 nurfing has been 100 long fatally ieftto the management of women who cannot be fuppofed to have proper knowledge to fit them for fuch a talk, notwithftandingthey iook upon it to be their own province. What 1 mean is,2 philofophic knowledge of nature, to be acquired oniy by learned obfervation of experi- ence, and which therefore the unlearned muft be incapable of. They may prefume upon the examples and tranfmitted cuftoms ot their great grandmothers, who were taught by the phyficians. of their un- enlightened days ; when jiijlicians, as appeals by late dilcoveries, were miftaken in many thiiigD, being led away by hypothetical rea- fonings to entertain very wild conceits, in which they were greatly bewildered themfelves, and milled others to believe know not what ftrange unaccountable powers in certain herbs,roots and drugs; and alfo in fome fuperftitious practices and ceremonies; for ah which notions there being no foundation in nature, they ought ro be look- ed upon as the effects of ignorance^ or the artifices of defigning quacks, who found their account by pretending to great knowledge in thefe occult qualities, and impoiing upon the credulous. The art t f phyfic has beet much improved within this laft century : by ob- ferving and following nature more clofely, many ufeful dilcoveries have been made, which help us to account for things in a natural way, that before feemed myiterious and magical, and which have confequently made tbe practice of it more conformable to reafon and good fenfe. This being the cafe, there is great room to fear that thofe nurfes, who yet retain many of thefe traditional prejudices, are capitally miftaken in tbeir management of children in general, and, fancying that nature Ins left a great deal to tbeir (kill and contrivance, often do much harm where they intend to do good. Of this I fhall endeavour lo convince them, bv (hewing bow I think children may be clothed, fed, and managed, with much lefs trouble to their nurfes, and infinitely greater eafe, comfort, and fufetv, fo the little ones. 6/4 ADVICE TO MOTHERS- "When a man takes upon him to contradict received opinions ^md prejudices fanctiried by time, it is expected he fhould bring valid proof of what he advances. The truth of what I lay, that the treat- ment of children in general is wrong, unreasonable and unnatural, will in a great meafure appear, if we but confider what a puny val- etudinary race moft of our people of condition are, chiefly owing to bad nurfing, and bad habits contracted early. But let any one who would be fully convinced of this matter, look over the Bills of Mortal- ity. There he may obfeive, that almoft half the number of thofe who fill up thatbiack lift, die under five years of age ; fo that half the people that come into the world, go out of it again before they become of the leaft ufe to it, or themfelves. To me this feems to deferve ferious confideration ; and yet'I cannot find that any one nun of fenfe and public fpirit has ever attended to it at all; notwith-' Handing the maxim in every one's mouth, that a multitude of inhab- itants is the greateft ftrength and beft fupport of a commonwealth. The mifconduct, to which I muft impute a great part of the calamity, is too common and obvious to engage the idle and fpeculative, who are to.be caught only by very refined refearches j and the bufy part of mankind, where their immediate intcren is not concerned, wili al- ways overlook what they fee daily ; it may be thought a natural evil, and fo is fubmitted to without examination. But this is by no means the cafe ; and where it is entirely owing to mifmanagement, and pof« fibly may admit of a remedy, it is ridiculous to charge it upon nature, and fuppofe that infants are more fubject to difeafe and death, than grown perfons ; on the contrary, they bear pain and difeafe much bet* ter, fevers efpecially (as is plain in the cafe of the fmall-pox, gene- rally moft favourable to children) and for the fame reafon that q twig is lefs hurt by a dorm than an oak. In all the other productions of nature, we fee the greateft vigour and luxuriance of health, the nearer they are to the egg or the bud ; they are indeed then moft fenfi- ble of injury, and itis injury only that deftroysthem. When was there a lamb, a bird, or a tree, that died becaufe it was young ? Thefe are under the immediate nurfing of unerring nature, and they thrive ac- cordingly. Ought it not therefore to be the care of every nurfe and every parent, not only to protect their nurflings from injury, but to be well affured that their own officious fervices be not the greateft the helplefs creatures can fuffer. " In the lower clafs of mankind, efpecially in the country, dif- eafe and mortality are not fo frequent, either among the adults or rheir children. Health and poderity are the portion pf the poor, I mean the laborious. The want of fuperfluity confines them more within the limits of nature ; hence they enjoy bleffings they feel not, and are ignorant of their caufe. The mother, who has only a few rags to caver her child loofely, and littie more than her own bread to feed it, fees it healthy and ftrong, and very foon able to fiiift for itfelf; while the puny infect, the heir and hope of a rich family, lies lan- guifhing under a load of finery that overpowers his limbs, ^bhoTring and rejecting the dainties he is crammed with, till he dies a victim to the miftaken care and tendemefs of lifo fond mother. In the ccur'V ADVICE TO MOTHERS* <£r 5 of my practice, I have had frequent occafion to be fuhy fatisfied of this j and have often heard a mother anxioufly fay, the child has not been well ever fince it has done puking and crying. Thefe complaints though not attended to, point very plainly to their caufe. Is it not yety evident when a child rids its (tomach'feveral timer, in a day that it has been overloaded ?—When it cries, from the incumoiance and confinement of its clothes, that it Is hurt by them ? Whi'c the^natu- ral ftrength lads, (as every child is born with more he-nth and ftrength than is generally imagined) it cries at or rejects the fuper- (luous load, and thrives apace; that is, grows very fat, bloated, and didtnded beyond meafure, like a houfe-lamb. But in time the fame oppreflive aufe continuing, the natural powers are overcome, beinjj no longer able to throw off the unequal weight; the child now not able to cry any more, languishes and is quiet. The misfortune is, thefe complaints are not underftood ; it is twaddled and crammed on, till, after gripes, purging &c. it finks under both burdens into a convuiflon-fit, and efcapes any further torture. This would be the cafe with the lamb, were it not killed when full fat. " 1'hat the prefent mode of nurfing is wrong, one would think needed no other proof than the frequent mifcarriages attending it, th: deaths of many, and ill health of thofe that furvive.**** What I am going to complain of is, that children in general are over-clothed and over-fed ; and fed and clothed improperly. To thefe caufes I jm* pute almoft all their difeaies. But to be a little more explicit: The firft great miftake is, that they think a new-born infant cannot be kept too w.irm; from this prejudice they load and bind it with flannels, wrappers, rwathes ftays, &c which altogether ;;re almoft equal to its own weight; by which means a heathy child in a month's time 11 made fo tender and chilly, it cannot bear the external air ; and if, by any accident of a door or a window left carelefsly open too long, a re- frefhing breeze be admitted into the fuffocating atmofphere of the ly- ing-in bed chamber, the child and mother fometimes catch irrecover- able colds ; but, what is worfe than this, at the end of tbe month, if things go on apparently well, this hot-bed plant "u? fent out into the country to be reared in a leaky houfe. that iets in wind and rain at every quarter. Is it any wonder tbe child never thrives afterwards ? The truth is, a new-born infant cannot weil be too cool and loofe in its drefs ; it wants lefs cloathing than a grown perfon in proportion, becaufe it naturally is warmer, as appears by the thermometer and would therefore bear the cold of a winter's night much better than any adult perfon whatever. There are many inftances, both ancient and modern, of infants expofed and deferted, that have lived feveral days; .:o it was the practice in ancient times, in many parts of the world to expofe all thofe who the parents did not care to be incumbered with ; that v.-ere'deformed,or born under evil ftars; not to mention the many foundlings picked up in London hreets. Thefe in'lnccs may ferve to ihew that nature has made children able to bear even great hard- fliips' before thev are madt weak and fickly by their miftaken nurfes. But, befides tbe mifchief arifing from the weight and h at of thefe fwaddlinsi-clothes, they ave put en fo tight, and the child is fo cramp. ed bv '.hem, thr,t its qv\kU inn.e net icom. mi the limbs any lite.:,-, 0 6*6 ADVICE TO MOTHERS. to aft zr\d exert themfelves in the free and eafy manner they ought. Tim a a very hurtful circumftance : for limbs that are not ufed will ncrei be ftrong, and fuch tender bodies cannot bear much preffure; the circulation reftrained by the compreifion of any one part, muftpro- ' duct unnatural fwellings in fome other, efpecially as the fibres of in- fants, are fo eafily diftended. To which, doubtlefs are owing the anany drftortions and deformities we meet with every where ; chiefly •aanca^ women, who futffer more in this particular than the men. *• Jf nurfes were capable of making juft obfervations, they might fee and take notice of that particular happinefs, which a child fhews &y aft its powers of expreffion, when it is newly undreffed. How pieced, how delighted it is with this new liberty, when indulged for a four minutes with the free ufe of its legs and arms ! But this is not to iiit long ; it is twaddled up as before, notwithftanding its cries and ■coE'jT'laints. **l would recommend the following drefs : a little flannel waift- ax&r without (Jeeves, made to fit the body, and tie loofly behind ; to • that it is en.tirely owing to this mifconduct. I am confident from expertence, that there would be no fever -at all, were things managed rightily were the child kept without food of any kind till it was hungry ; whichit is impoffible it fl ould be juft after the birth,and therj applied to the mother's breaft : it would fuck with ftrength enough, after a few repeated trials, to make the milk flow gradually, in due proportion to the child's unexercilcd faculty cffv^Uowirg, an&fbc ca1' ( 40 ) *i8 ADVICE TO MOTHERS. of its domach. Thus the child would not only provide for itfelf the bed of nourifliment, but, by opening a free paffage for it, would take off the mother's load, as it increafed, before it could opprefs or hurt her: and therefore effectually prevent the fever, which is caufed only by the painful didenfion of the lacteal veffels ofthe breafts, whenthc milk is injudicioufly fuffered to accumulate. Here let me defcribe a cafe of pure nature, in order to illuftrate this material point yet far- ther. When a healthy young woman lies in of her firft child, before the operations of nature have been perverted by any abfurd practices, her labour would be ftrong, and, as 1 have chofen to indance in the cafe of a fird child, perhaps difficult; but in a few minutes after her delivery, (he and her child, if it be not injured, would fall imo a fweet fleep of fix or feven hours ; the mother,, if no poifonous opiate ha6 been unneceffarily given her, would awake refrefhed, the child hungry. A little thin broth with bread or fome fuch light food, fhould be then given her ; and foon after the child be put to fuck. In one hour or two the milk would infallibly flow ; and, if nothing elfe be given it, the child would grow ftrong, and fhe recover perfectly in a few days. This is the condant courfe of nature, which is very little attended to, and never followed. The general, practice is, as foon a& the child is born, to cram a dab of butter and fugar down its throat, a little oil, panada, caudle, or ome fuch unwholefome mefs. So that they (et out wrong, and the child dands a fairchan of being made fick from the fird hour. It is the cudom of fome to rive a little road pig to an in- fant, which, it feems, is to cure it of all the mother s longings. Much nonfenfe has been propagated, and believed, about women's longings, without any foundation in truth and nature. I wifh thefe matters •were a little more inquired into for the honour of the fex, to which many imperfections of this kind are imputed, which I am (ure it does not lie under. " Hence I may be aflced, what is to be done with a child born fick, that indead of fleeping, cries ineeffantly from the birth, and is hardly to be quieted by any means ? Let good care be taken that it is not hurt by the drefling, or rather let it not be dreffed at all, but wrap- ped up in a loofe flannel. If, notwithdanding this precaution, it ftill continues crying ; indead of feeding it, for it is certainly a prepofte- rous thing to think of feeding a child becaufe it is fick, though potfW bly this may dop its mouth for a little while, let it be applied to th? mother's bread ; perhaps it may bring the milk immediately, whir ii would be the bed medicine for it in fuch a cafe ; or the nipple in its mouth may quiet it, though it does not bring it. And it is certainly better it fhould be quieted without food than with it, which muft ne- ceffarily make it worfe. Sometimes indeed the child may be fo very ill, that it will not even attempt to fuck. In fuch a cafe, which I think can happen but rarely, let the phyfic I fhall recommend a little farther on, where children are unavoidably to be dry-nurfed, be given, a little every hour, till it takes effect, dill attempting to bring it to fuck the mother's milk, which is the bed phyfic or food it can *>3ke. "When a child fucks its own mother, which, with a very few ex- ceptions, woold be bed for every child and every mother, nature ADVICE TO MOTHERS. 6ry has provided it w ith fuch wholefome and fuitable nourifhment, fuppo- fing her a temperate woman that makes fome ufe of her limbs, it can hardly do amifs. The mother would likewife, in mod hyderical ner- vous cafes, edablifli her own health by it, though fhe were weak and fickly before, .as well as that of her offspring. For thefe reafons I could wifh, that every woman that is able, whole fountains are not greatly diflurbed or tainted, would give fuck to h*r child. I am very fure that forcing back the milk, which mod young women mud have in great abundance, may be of fatal confequence ; fometimes it endangers life* and often lays the foundation of many incurable difeafes. The reafons that are given for this practice are very frivolous,and drawn fron falfe premife^, that fome women are too weak to bear fuch a drain, which would rob them of their own nouriftiment. This is a very midaken notion ; for the fird general caufe of mod people's difeafes is, not want of nouriftiment, as is here imagined, but too great f ullnefs and redun- dancy of humours ; good at firft, but being more than the body can employ or confume, they ftagnate, degenerate, and the whole mafs be- comes corrupt, and produces many difeafes. This is confirmed by the general practice of phyficians, who make holes in the fkin, perpetual bliders, iflues, &c, to let out the fuperfluity. I would therefore leave it to be confidered, whether the throwing back fuch a load of humour as a woman's fird milk, be mod likely to mend her conftitution,or make her complaints irremediable. The mother's firft milk is purgative, and cleanfes the child of its long-hoarded excrement; no child, therefore, can be deprived of it without manifeft injury. By degrees it changes its property, hecomes lefs purgative, and more nourifhing ; and is the bed and only food the child likes, or ought to have for fome time. If I eould prevail, no child fhould ever be crammed with any unnatural mixture, till the provifion of natuie was ready for it; nor afterwards fed with any ungenial alien diet whatever, at lead for the firfi three month; for it is not well able to diged and affimilate other aliments fooner I have feen very healthy fine children, that never ate or drank any thing whatever but the mother's milk for the fird ten or twelve months. Nature feems to direct this, by giving them no teeth till about that time. There is ufually milk enough with the firft child 5 fometimes more than it can take ; it is poured forth from an exuberant, overflowing urn, by a bountiful hand that never provides fparingly.— The call of nature fhould be waited for to feed it with any things more rubftantial, and the appetite ever precede the food •, not only with re- gard to the daily meals, but thofe changes of diet, which opening, in- creafing life requires. But this is never done in either cafe, which is one of the greated miftakes of all nurfes. Thus far nature, if fhe be not interrupted, will do the whole bufinefs perfectly well; and there feems to be nothing left for a nurfe to do, but to keep the child clean and fweet, and to tumble and tofs it about a good deal, play with h, and keep it in good humour. * When the child requires more folid fuftenance, we are to inquire what, and how much is mod proper to give it. We may be well allu- red there is a great midake either in the quantity or quality of children's food, or both, as it is ufually given them ; becaufe they are made fick by it ; for to this miftake I cannot help imputing nine in ten of all'.heir difeafes. As to quantity, there is a mod ridiculous error in the common praftice ; for it is generally fuppofed, that, whenever a child cries, it wants victuals ; and it ii accordingly fed ten, twelve^ or more €20 ADVICE TO MOTHERS. times 'n a day and nicrht. ^his is fo obvious a mifapprehenfion, that I am fiirprifed it (W»M ever prevail. *f a child's wants and motions be diligently and judicioufly atten^e"' to, it w'M be found fh^r it ver cries but from pain ; now the fird fenfations of hunger are not atr.-n.i-.i Vth pain ; accordingly a chiH (I mean this of a very young onev that is hungry, will make a hundred other figns of its want, before it will cry for food. Tf it be healthy and quite eafy in its drefs, it wi hardly ever cry at all. In eed thefe figns and motions I fpeak of ate but rarely to be obferved ; becaufe it feldom happens that children are ever fuffer- ed to be hungry. In a few, very few, whom I have had the plea- fure to fee reafonably nurfed, that were not fed above two or three times in four and twenty hours, and yet were perfectly healthy, ative, and happv, T have feen thefe fignals, which were as intelligible as if they bad fpoken «' There are many faults in tbe quality of their food ; it is not Ample enough. Their paps, panadas, gruels, &c. are generally enrich- ed with fugar, foice, and fometimes a drop of wine, neither of which they ought ever to tafte. Our bodies never want them ; they are what luxury only has introduced, to the deflection of the health of man. k'T*. Tt is not enouih that their food be fimple, it (bould be alfo liarht. Several peor^e T Gn^, vre miftaken in their notions of what is light 5 and fancy that moft kinds of pa^rv, puddings, cuftards, &c are light, lba*ts, light of digeftion But there is nothing heavier in this fenfe than unfermentH flour and eggs boiled hard, which are the chief in- gredients n* thofe preparations. What I mean by light, to give-the beft idea I can of it, is anv fubftance that is eafily fenarated, and foluble in wt^ water. Good bread is the lighted thing I know •, the power of due fermenr-arinn. in wh con^^sthe whole art of making it, breaks and attenuates tbe tenac*ouned in the habit; much more fo than when taught to expect food at ail times, and at every little fit of crying or uneafmefs. Let this method it obferved about a twelve-month when, and not before, they may be weaned; not ail at onqe, but by infenlibie degrees ; that they may nei- ther feel, nor fret at, the want of the bread, 'ibis might be very eafily managed, if they were fuffered to fuck oniy at certain tiii.es. Were this plan of nurfing literally purfued, the children kept clean and fweet, tumbled and totted a»out a good deal, and carried out every day in all weathers, I am confident, that, in fix or eight months time, molt chil- dren would become healthy and flrong. v/ould be able to fit upon tiie ground without fupport, to divert themfelves an hour at a time, to the great relief of their nurfes ; would readily find the ule ot their tegs, and very foon fhift lor themfelves. " If it be afked whether I mean this of children in general, and • The London bakers arc lul'aecled of putting alum into their Lre.ed wholiy upon ijciung till stf<*i that age. 622 ADVICE TO MOTHERS. r that weakly ones, born of unhealthy parents fhould be treated in the fame manner : I anfwer, that it is not fo common for children to in- herit the difeafes of their parents, as is generally imagined ; there is much vulgar error in this opinion ; for people that are very unhealthy feldom have children efpecially if the bad health be on the female fide ; and it is generally late in life when chronic difeafes take place in moft men, when the bufinefs of love is pretty well over ; certainly children have no title to thofe infirmities which their p rents have acquired by indolence and intemperance long after their birth. It is not common for people to complain of ails they tbink hereditary, till they are grown up ; that is, till they have contributed to them by their own irregulari- ties and exceffes, and then are glad to throw their own faults back upon their parents, and lament a bad conditution when they have fpoiled z very good one. It is very feldom that children are troubled with fami- ly diftempers. Indeed, when we find them affected with fcrophulous cr venereal complaints, we may reafonbly conclude the taint to have been tranfmitted to them ; but thefe cafes are very rare, in comparifon of the many others that are falfely, and without the leaft foundation, imputed to paients ; when the real caufe is either in the complainants themfelves, or bad nurfing, that has fixed them early in bad habits. In one fenfe, many difeafes may be faid to be hereditary, perhaps all thofe of malformation,-by which I mean not only deformity and diftortion, but all thofe cafes where the fibres and veflels of one part are weaker in proportion than the reft; fo that upon any drain of the body, whether of debauch or too violent exercife the weak part fails fird,and diforders the whole. Thus complaints may be produced fimilar to thofe of the parent, owing in fome meafure to the fimilitude of parts, which poflibly is inherited like the features of the face ; but yet thefe difeafes might never have appeared, but for the immediate acting caufe, the violence done the body. Mod didempers have two caufes : theone, a particular ftate of the folids and fluids of the body, which difpofe it to receive certain infections and impulfes ; the other, the infection or impulfe it- felf. Now what I contend for is, that though this predifponent date or habit of body be heritable, yet the difeafes incident to thefe wretch- ed heirs may be avoided : y preventing the active caufe ; which may be done inrmny cafes by a due attention to the non-na?u:als as they are called ; in plainer words, by a temparate, active life ; in children, by good nurfing. Therefore I conclude, that, inftead of indulging and enfeebling yet more by the common methods, children fo unhappily born, what I am recommending, togethdr with the wholefome milk of a healthy nurfe, is the bed, the only means to remedy the evil, and by which alone tHey may by degrees be made healthy and drong. And thus, in a generation or two of reafonable temperate perfons, every taint and infirmity whatever, the king's evil and madnefs not excepted, would be totally worn out. " The plain natural plan I have laid down is never followed, be- caufe mod mothers, of any condition, either cannot, or will not un- dertake the troublefome tafk of fuekling their own children ; which is troublefome only for want of proper method ; were itrightly managed, there would be too much pleafure in it, to every woman that can pre- vail upon herfelf to give up a little ofthe beauty of her bread to feed her offspring ; though this is a miftaken notion, for the breafts are not fpoiled by giving fuck, but by growing fat. There would be no fear of offending the hufband's ears with the npife cf the fqualhng brat, iha ADVICE TO MOTHERS. 623 child, was it nurfed in this way,would be always quiet,in good humour, «ver playing, laughing, or (keeping. In my opinion, a man of fenfe •annot have a prettier rattle (for rattles he mud have of one kind or other) than fuch a young child. I am quite at a lofs to account for the general practice of fending infants out of doors, to be fuckled or ery-nurfed by another woman, who has not fo much underftanding, nor can have fo much affe£lion for it, as the parents ; and how it comes to pafs, that people of good fenfe and eafy circumffances will not give themfelves the pains to watch over the ' health and welfare of their children, but are fo carelefs is to give them up to the common methods, without confidering how near it is to an equal chance that they are dedroyed by them, fhe ancient cudom of expofing them to wild beads, or drowning them, would certainly be a much quicker and more humane way of difpatching them. There aTe fome, how- ever, who with to have children, and to preferve them, but are mif- taken in their cares about them. To fuch only I would addrefs my- felf, and earnedly recommend it to every father to have his child nur- fed under his own eye ; to make ufe of his own reafon and fenfe, in fuperintending and directing the management of it; nor fuffer it to be made one of the myderies of the Bona Dea, from which the men arc to be excluded. I would advife every mother that can, for her own fake as well as her child's, to fuckle it; if fhe be a healthy woman, k will confirm her health ; if weakly, in mod cafes it will redore her. t need be no confinement to her, or abridgment of her time ; four times in four-and-twenty hours will be often enough to give it fuck •, letting it have as much as it will fuck out of both breads at each time. It may be fed and dreffed by fome handy reafonable fervant, that will fubmit to be directed ; whom, likewife it rhay fleep with. No other woman's milk can be fo good for her child ; and dry-»nurfing I look upon to be the mod unnatural and dangerous method of all ; and, ac- cording to my obfervation, not one in three furvives it. To breed a child in this artificial manner, requires more knowledge of nature and the animal ceconomy, than the bed nurfe was ever miftrefs of, as well as more care and attention than is generally bedowed on chil- dred; the (kill of a good phyfician would be neceflary to manage it rightly." ******** The Doctor is here led to date his opinion as to the precautions neceffary to be taken in the choice of hired nurfes, and m\ reafons why the children entfruded to their care fliould be, treated fomewha' differently from thofe who are nurfed in a more natural way, and fuck their own mothers. He does net deem it enough that hired nurfes fhould be clean and healthy ; he looks upon their age as a material con- fideration. «« Thofe," he fays, " between twenty and thirty are cer- tainly of the bed age ; becaufe they wbl have more milk than the very young, and more and better than the old. But what," he thinks, "of the utmod confequence is, that great regard fliould be had to the time of their lying-in, and thofe procured, if poffible, who have not been brought to bed above two or three months." He juitly ob- Jfcrves, that " nature intending a child mould fuck about a twelve- month, the milk feldom continues good much longer -" and be * H.: 624 ADVICE TO MOTHERS. with a ftill greater degree of evidence, « that if a new-born infant be deprived of its own mother's milk, it ought undoubtedly to have what is moft like it: the newer it is, the more fuitable in all refpects to its tender nature." ******* After cenfuring a very common practice with^poor women, who, if they can get nurfe-children, wiil fuckie two or three of them iuc- ceflively with the fame milk, he proceeds thus : " A nurfe ought to have great regard tp her diet: it is not enough that fhe be fober and temperate; her food fhould confift of a proper mixture of flefh and vegetables: (he fliould eat one heurty meal of unfalted flefh-meat every day, with a good deal of garden-duff, ai.d a little bread. Thin broth or milk would be bed for her breakfad and fupper. Her drink lhould be fmdl-beer, or milk and water ; but on no account fhould fhe ever tooch a drop of wine or flrong drink, much lefs any kind of fpirituous liquors; giving ale or brandy to a nurfe is, in effect, giving it tp the child ; and it is eafy to conclude what would be the confequence." **•* this equally candid and judicious writer does not enter upon his promifed defcription of the treatment proper for children put out to nurfe, without again reminding his readers, that the plan, which he would lay down, could he prevail, would be that of nature, excluding art and foreign aid entirely. « But," he adds, " when this is broke in upon, a little adventitious (kill becomes indifpenfibly neceflary ; that, if we are not perfectly right in following clofely the defign of nature, we may co-operate a little, and not be totally wrong in coun- teracting it, as is too often the cafe. tVhatl mean is, that every child, not allowed the mother's fird milk, whether it be dry-nuifed or fuck- led by another woman,lhould be purged in a day or two after the birth, and this purging continued for fome time; not by regular dofes of phyfic that may operate all at once, but fome lenient laxative fhould be contrived, and given two or three times a-day, fo as to keep the child's body open for the fird nine days, or fortnight ; ieffening the quantity infenfibly, till it be left off. It lhould be fo managed, that the operation of the artificial phyfic may refemble that of the natural. This is fo material, that, for want of it, moft children in the firft n>onth break out in pimples all over ; the nurfes call ;t red-gum, and look upon it to be a natural thing, and that the children will be un- healthy who have it not. So indeed they will be in all likelihood; and it is better that thefe foulnefies, which become acrid and hot by remain- ing too long in the body, fhould be difcharged through theflrin, than not at all ; or that they fhould be lodged in the blood, or fall upon the vitals, to lay the foundation of numberlefs future evils; but it i& chief- ly owing to the neglect of this method at fird. A child that fucks its own mother, unlefs it be greatly over-fed, pr kept too hot, will never be troubled with this tumour at all." ***** The following is the form of the gentle purgative which the Doctor recommends ro fuch infants as have been deprived of the fal- utary operation of thcTr mother's milk: " Take manna, pulp of caflia, ofpach half an ounce: diffolve fbem in about three ounces of thin broth. Let the child take two :.boensful three tijr.es a-day, varying the quantity according tp the' ADVICE TO MOTHERS. 6lf ofleft 4 which, at firft, dught to be three or four ftools in four-and- twenty hours." Among other rules for the conduct of hired nurfes, this experi* • enced phyfician particularly enjoins fuch women " to keep tne chil- dren awake by day, as long as they are difpofed to be to, and to amufe arrd keep them in gooa humour all they can ; not to lull and rock them to deep, or to continue their iieep too long ; which is. only aone to fave their own time and trouble, to the great detriment ot the chil- dren's health, fpirits and underdanding." * * * * *^ here he re- fers to his former obfervations on the changes to be gradually made in the diet of children, when they come to require more fond lulte- nance than bread-milk ; and he takes occafion to introduce the fol* lowing remarks : i( A child may be allowed any kind ot mellow fruit, either raw, Itewed, or baked, roots of all forts, and all the prodi.ee or the kitchen- garden, I am fu- e all thefe things are wholefome ana gooa for them, and every one elfe, notwithdanding the idle notion ci their bting windy, which they are only to very debauched ftomachs ; and 10 is milk : but no man's blood wants the cleaniing, refrtfi. ing power of milk, more than his, whofe domach, ufed to inflammatory things of higl relifh, will not bear the fird chili of it. To cbi.uren, all this kind of food, taken in moderation, is perfectly grateful and falutary. ^ Some may think that they carry into the domach the eggs ol future wcrms ; but of this I am not very apprehenlive ; for I believe there are few things we eat or drink that do not convey them. But then they can never be hatched in a healthy iulide, where all the juices are fweet and good, and every gland performs its office ; the gail, in par- ticular, would dedroy them ; bullock's gall has been iound to be a good and fafe vermifuge. It is my opinion, we fwallow the eggs of rr any little animals, that are never brought to life within us, except where they find a fit ned or lodgment in the acid phlegm or vitiated tumours of the ftomach and bowels. Were thefe totally dilchar..<-d everyday, and the food of yederday employed in nourifhment, and the fuperfluity thrown off to the laft grain, no worms could ever breed or harbour in our vitals. As foon as the children have any teeth, at fix or eight months, they may by degrees be ufed to a little fleth-meat: which they are always very fond of, much more io at firft, than of any confectionary or padry wares, with which they fhould never debauch their tafte." I have elfewhere enlarged on the fatal effects of thefe palatable poifons ; and I am not without hopes that Vender and rational mothers v til pay fome little attention to my warnings. A reform in this article rtone—the total difufe of padry in the diet of young children—will £© a great way towards preventing many of the word complaints to uhich they are fubject. From the above rematks on the proper food of infants, the Doc- tor makes a very natural tranfition to the confideration of their dif- eafes. He begins with expofmg the abfurdity of popular errors and popular prejudices with refpeft to teething. " Breeding teeth," he ays « has been thought to be, and is fatal to many children; but % r 626 ADVICE 70 MOTHERS- am confident this is not from nature, for it is no difeafe, or we couiti not be well in health till one or two and twenty, or later. Teeth are breeding-the greateft part of that time ; and it is my opinion, the laft teeth give more pain than the firft, as the bones and gums they are to pierce are grown more firm and hard. But, whatever fever, fits, or other dangerous fymptoms feem to attend this operation of nature, healthy children have fometimes bred their teeth without any fuch bad attendants ; which ought to incline us to fufpect the evil not to be natural, but rather the effect of too great a fulnefs, or the corrupt hu- mours of the body put in agitation by the dimulating pain the tooth caufes in breaking its way out. This I believe, never happens with- out fome pain, and poflibly a little fever ; but if the blood and juices be perfectly fweet and good, and there be not too great a redundancy of them, both will be but (light, and pafs off imperceptibly, without any bad confequence whatever. The chief intention of the method I am recommending is, to preferve the humours of the body in this date, and therefore, if it fucceeds, children fo managed will breed their teeth with lefs pain and danger than are commonly obferved to attend this work of nature." In fupport of this opinion, I can ftate from my own experience, tjiat I have never known cutting the teeth, as it is called, attended with any pain of an alarming nature, except in cafes of previous difeafe, mifmangement or bad nurfing. Fevers, convulfion-fits. and other dan- gerous fymptoms, are always, upon fuch occafions, the confequences of an extreme fulnefs of the habit, a vitiated date of the blood and juices, fome conditutional weaknefs, or a great irritability of the ner- vous fyftem. The ufe alfo of corals, and the like hard fubdances, by rendering the gums callous, muft oppofe additional refiftance to the burfting tooth, and greatly increafe the acutenefs of the pain. But the Do tor's text requires no comment. I (hall therefore, refume my quotation from his valuable pamphlet. " As I have faid," continues he, " that the firft and general caufe of moft of the difeafes infants are liable to, is the acid corruption of their food, it may not be amifs juft to mention an eafy and certain rem- edy, or rather preventative, if given timely, at the firft appearance of predominating acid ', which is very obvious, from the crude white or green ftools, gripes and purgings occafioned by it. The common method when thefe fymptoms appear, is to give the pearl-julep, crabs- eyes, and the teftaceous powders, which, though thev do abforb the acidities, have this inconvenience in their effect, that they are apt to lodge in the body, and bring on a coftivenefs very detrimental to in- fants, and therefore require a little manna, or fome gentle purge, to be •dven frequently to carry them off. Inftead of thefe, I would re- commend a certain fine infipid powder, called magnefia alba, which, at 'he fame time it c-rrects and fweetens all fournefs rather more effect- ually than the teftaceous powders, is likewife a lenient purgative, and keeps the body gently open. This is the only alkaline purge I know of, and which our difpenfatories have long wanted. I have taken it myfelf, and given it to others, for the heart-burn, and find it to be the beft and moft effeaual remedy for that complaint. It may be given to children from one to two drams a-day, a little at a time in all their iosd, till the aciditi€3 be quite overcome, and the concomitant fymp* ADVICE TO MOTHERS- C27 tpms difappear entirely. I have often given it with good and great effecT, even when the children have been far gone in difeafes firft brought on by prevailing acid. " It is always eafier to prevent difeafes than to cure them ; and as neither children, nor indeed grown perfons, are ever feized with chronic difeafes fuddenly, the progrefs of decaying health being per- ceptibly gradual, it is no difficult matter for a phyfician of common fkill to obferve the firft ftep towards illnefs, and to foretell the confe- quence, in all thofe whofe habit of life is well known to him. But to parents and nurfes in general, thefe obfervations may not occur, I will therefore point out a few certain figns and fymptoms, by which they may be affured, that a child's health is deciying, even be -.r. it appears to be fick. If thefe are neglected the evil increafes, t :ws from bad to worfe, and more violent and apparent complaints will fol- low, and perhaps end in incurable difeafes, which, a timely remedy, or I (light change in the diet and manner of life, had infallibly prevent- ed. The fird tendency to difeafe may be obferved in a child's breath.' It is not enough the breath be not offenfive ; it fhould be fweet and fragrant like a nofegay of frefh flowers, or a pail of new milk from a young cow that feeds upon the fweeteft grafs of the fpring; and this as well at fird waking in the morning,as all day long. It is always fo with children that are in perfect delicate health. As foon, therefore, as a child's breath is found to be either hot, or ftrong, or four, we may be affured that digedion and f urfeit have fouled and didurbed the blood, and now is the time to apply a proper remedy, and prevent a train of impending evils. Let the child be reftrained in its food ; eat lefs ; live upon milk or thin broth for a day or two ; be carried, or walk if it is able, a little more than ufual in the open air. Let a little of this pow- der, or any other proper phyfic, be given ; not that I would advife phyfic to be made familiar ; but one dofe adminiftered now, would prevent the neceflity of a great many that might afterwards be prefcri- bed with much lefs good effect. " If this firft fymptom of approaching illnefs be overlooked, -tl e child, who, if it was healthy, would lie quiet as a log all night, will have difturbed fleep, reftlefs, terrifying dreams ; will be talking, ftart- ing, kicking, and tumbling about; or fmiling and laughing, as is com- mon with very young children when they are griped ; and the nurfe6 fay they fee and converfe with angels. After this will follow lofs of appetite and compleaion, ch ck of growth, decay of ftrength, cough, confumption, or elfe colics, gripes, worms, fits, He. difeafes that re- quire all the fkill of a good nhyfician ; and happy for them, it the ut- mqd he can employ will reftore them to any degree of lading health- « There is one thing more which I forgot to mention in its prop- er place, and therefore I mud take notice of it here : that is, the de- cree of exercife proper for children. This is of more confequence than all the reft ; for, without it, all our care in feeding and clothing will not fucceed to our withes ; but when by due degrees a child is brought to bear a good deal of exercife without fatigue, it is incon- ceivable how much impropriety and abfurdity in both thefe articles :, ,.mi ^-dure unhurt. A child, therefore, fhould be pufhed forward*, $28 . ADVICE TO MOTHERS. and taught to walk as foon as poffible. An healthy child a year old will be able to walk alone. This we may call the sera of their deliver- ance; for this great difficulty furmounted, they generally do well, by getting out of the nurfe's hands to fhift for themfelves. ' And here I mud endeavour to correct a great miftake, .which is, that molt people think it wrong to put weakly children upon their legs, efpecially ii they are the lead bent or crooked : but whoever will venture the experi- ment will furely find, that crooked legs wiil grow in time itrong and ftraight by frequent walking, while difufe will make them worle and worfe every day. As they grow daily more and more able, fet their walks be gradually increafed, till they can walk two miles on a ftretch without wearinefs; which they will be very well able r/> do before they are three years old, if they are accuflomed to it every day. To lead them fuch a walk. lh< uld be impofed as an indifpenfible talk upon , their maids, for to them it will be the highed pleaf ure ; to far from a burthen to them, that if they perform the daily duty, they will, from the impulfe of their own active vigour, be found running, leaping, and playing, all day long. Thus, a dull, heavy child may be made play- ful and fprightiy, a weakly one healthy and flrong, and confirmed in good habits and perpetual health. " There are fome other little niceties that were they obferved in the nurfing of children, would be of fome ufe to them; fuch as making them lie draight in the bed. I do not mean extended like a corpfe, but that tbeir limbs may be free and eafy. I have fometimes feen children a year or two old lie doubled up in bed as in the womb, efpe- eially in cold weather ; and from the condraint of their podure, fall into profufe fweats. This will be prevented if they are laid ftraight; and fleep relaxing all the mufcles of the body, the knees will naturally be bent a little. They fhould be taught to ufe both hands alike ; for employing one more than the other will not only make the hand and arm fo ufed, but alfo that fide ofthe body bigger than the other. This is fometimes the caufe of crookednefs. It would likewife not be amifs to forward their fpeaking plain, by fpeaking plain difljnct words to them, ini'ead ofthe namby-pamby dyle, and giving them back their own broken inarticulate attempts ; by which means, I believe, fome thildren fcarcely fpeak intelligibly at (even years of age. I hink they oannot be made reafonable creatures too foon." * ***** As this effay was written in the form of a letter, the Doctor con- cludes it with an apology to the gentleman to whom it was addreffed, for the loofe manner in which the thoughts were laid before him. The writer very candidly confeffes that he had " neither time nor patience to think of form and order, or fupporting them by affected demonflra- tions taken from mechanical principles and powers. " All I have en- deavoured," fays be, " is to be intelligible and ufeful; and therefore I have avoided as much as poffible, all terms of art; together with lear- ned quotations, as often produced out of vanity, and to fhew deep reading, as for the fake of proof. ***** I fhall only add by way of perfuafive to thofe who may be inclined to make a trial of the meth- od I recommend, that I am a father, and have already practifed it with tfif pioft defirable fuecej?." ADVICE TO MOTHERS.' 62$ In a poftfcript to the tenth edition of this pamphlet, dated July !c 19-' the author exPreffes himfelf in the following manner : , " ls now above twenty years fince I wrote the foregoing effay; and though I have made a few alterations, it was only to explain thofe pallages that contained any apparent difficulty or obfcurity : I have never yet found caufe to alter effentially any one opinion delivered in it. I have through the whole induftrioufly laboured at the greateft plain- nefsand fimphcity ; and yet my meaning has been much miftaken.—• Some have verv ftrangely expeaed to find in it the general cure of chil- dren's difeafes, though it be profeffedly written only to prevent them, byedablifhing good health ; a very different thing (whatever people may think) from the cure of difeafes. Sick or weak children, wheth- er fuch by nature, or made fuch by bad nurfing, cannot perhaps be brought immediately into tbe habits here recommended, but muft firft be cured of their maladies by a (kilful phyfician ; who, if he be alfo an -honeft man, willintroduce thefe, or fimilar habits of management to continue them in health and ftrength. But in treating their difeafes, as well as in nurfing them, I am very fure many capital errors are com*. mitted. I objea greatly in particu ar to the frequent ufe of anttmoni- al and mercurial medicines ; which, though they give fometimes a little temporary relief, by difcharging crude and phlegmatic humours, killing worms, &c. I am very confident a repeated ufe of them breaks the blood, relaxes the fibres, and » every way deftruaive to the confli- irution of children. Prefent relief feems to be all that is defired, and therefore all that is intended by medication ; the flow, but permanent effeas of good habits few have patience to expea. Others have ne- gleaed effentials, to lay ftrefs upon trifles. A lady of great fway among her acquaintance told me long ago, with an air of reproach, that (he had nurfed her child according to my book, and it died. I afked.if (he had fuckled it herfelf ? No.—Had it fuckled any other woman ?—It was dry-nurfed.—Then, madam, you cannot impute your misfortune to*my advice, for you have taken a method quite contrary to it in the moft capital point. O ! but, according to my direaion, it had never worn (lockings. Madam, children may die whether they do or do not wear dockings." A dronger illudration could not be given of the folly of attending only to trifles, and aaing diametrically oppofite to the diaates of reafon and experience in mat- ters of the greated moment* FINIS. CONTENTS. INTRODUCTION. -.-.-. pdgt ^ CHAP. I. Hints to Women before Marriage. - - • - - 509 CHAP. II. Rules of Condua during Pregnancy. - » • - r 12 CHAP. III. A few Remarks on Child-birth. - - • - - eif) CHAP. IV. Of the Nurfing and Rearing of Children. - - - 537 Se c t. I. Ofthe Influence of Air on the Health and Lives of Children. ibid Sect. II. Of Warm and Cold Bathing. - - - 541 \;|5ect. Til. Of Children's Drefs.......545 Sect. IV. Of the Injury done to Children by the too early and unne- ^ eeffary Ufe of Medicine. - - - - - 557 'vSect.'V. Of the Foodproper for Children. » 565 5^7ct. VL Of Exercife and Reft during Infancy. - - - 573 CHAP. V. Of twartflinefs and Deformity. ----- 576 CHAP. VI. Baneful Effeas of Parental Tendemefs, or what may be call- ; ed an extremely delicate and enervating Education. - 58c CHAP. VII. Of Employments.unfavorable to the Growth and Health of Children. - - - - - -- - 589 * CHAP. VIIL Of Accidents. »--.-.-. jqc. CHAP. IX. Of Foundling Hofpitals, and other Charitable Inftitutions, for the Rearing of Poor or Deferted Children. - - - 6ei CHAP. X. Sketch of a Plan for the Prefervation and Improvement of the Human Species. ------- 607 APPENDIX, - - - - * - 613 BOOKS Minted particularly for JOSEPI BUMSTEAD, Printer an : . Bookfeller, No- 77, State-Street, Bofton, where Books are Bought, Sold, Exchanged—New given for Old. I PF DUTIES of Hiftory, by Dr. Dodd. . - 75 2 Enfield's Speaker. - - -87* 3 Pleating Inftruftor. - * 87s - 4 Valuable Secrets of Arts, Trades, &c. - - 87^ t Jenks' Devotions, &C. • * °7k 6 William and Jeanette. «■ «oo 7 Letter* of Werier and Charlotte. - - i°o f Wonderful Storv Teller. - - - i«o 9 P^rim's Progrefs. - 75 10 Peyrouoo 20 Buchar.'a Domeftic Medicine, with his^dvice to Mothers. 300 30 Do. Advice to Mothers, (feparate) - - 87I tr5> T B Being chiefly in the Line of Books by WholefaU. and having at arefent on hand a Large and General Affortraent, folicits the Orders of Gentlemen in the Book Bufinefs, and thofe who porchafe by Wfcolefale.