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ARMED FORCES MEDICAL LIBRARY




        Washington, D. C.
i
 
 
# 
OBSERVATIONS
ON THE
  EPIDEMICAL DISEASES


                     OF


             MINORCA.


       FROM THE YEAR 1744 TO 1749.


             TO WHICH IS PREFIXED

A short Account of the Climate,  Productions, Inhabitants, and
          Endemial Distempers of Minorca.


       BY GEORGE CLEGHORN, M. D.
      Professor of Anatomy in the University of Dublin. .
with notes :;££)■&
*■
      BY BENJAMIN RUSH, M: D.,  (
Professor of the Institutes and Practice of Medicine in th*
          University of Pennsylvania.
   PHILADELPHIA:
PRINTED FOR F. NICHOLS
  Fry and Kammerer, Printers.
         1809. 
 
TO THE
     STUDENTS OF MEDICINE

                    IN THE

        UNIVERSITY OF PENNSYLVANIA.

    GENTLEMEN,

 1 HE following  work contains a greater mass of
practical  knowledge  in a small compass, than any
book perhaps of the same kind in medicine.  It has
passed through  many editions, and it now occupies
a place in the libraries of most of the physicians in
the British empire. Its merit consists  chiefly in the
number and  importance of  its  facts, which afford
the surest passport of a medical book to present and
future generations. The notes which I have added
to this first American edition of this valuable work,
are intended  to point out a few of its  errors, but
chiefly to impress those remarks, upon your minds,
which accord with the diseases  and mode of prac-
tice that  are  common in the United States. .The
notes  to which I allude, are distinguished from those
of the author, by the references being made by means
of the letters  of the alphabet.
   Permit me to  recommend to your imitation the
same  practice in improving the  science of medicine,
which has been pursued by the  author of this work.
It consists, as you will perceive, in delivering dis- 
iv
DEDICATION.
 eases from the insulated place they held in systems
 of nosology, and connecting them with climate, sea-
 son, aliments, drinks,  dress, and national  manners.
 To enable you to imitate our author with success, it
 will be  necessary  to  record facts  as  they occur.
 " Studium  sine calamo, somnium," said the  Latin
 poe +. The same thing may be said of the  most ex-
 tensive practice, where notes are not made of dis-
 eases.  A  correct knowledge  of them,  however
 strongly impressed upon the mind at the time they
 are seen, will pass out of the memory like a dream
 in the course of a few years;  By recording the facts
 which relate to them, the extremes of youth and age
 may be made to meet in a middle  point, or in other
 words, the benefits of long experience may be anti-
 cipated in early life.  The book  now  in your hands
 is a proof of the truth of this remark. It was com-
 posed and published before the author had attained
 the thirty-fourth year of his age.
   In  composing the notes which I have added to this
 work I have taken it for granted  that you are  ac-
 quainted  with the principles of medicine  which I
 have taught in the  university of Pennsylvania, and
 of course I have omitted an explanation of them in
 the occasional references I have made to them.
   I shall conclude this dedication by subjoining the
 following account of the life of our author extracted
from Dr.  Benjamin Hutchinson's Biographia Medi-
ca, from which you will discover some other of the
means, beside those that have been mentioned,  by
which he  acquired his  knowledge and reputation in
his profession.
  " Dr. George Cleghorn was born of reputable pa- 
DEDICATION.
V
 rents at Granton, in the parish of Crammond, near
 Edinburgh, on the 18th of December, 1716. His fa-
 ther died in 1719, and left a widow and five chil-
 dren.  George, who was the youngest son, received
 the  rudiments  of his  education in the  grammar
 school of Crammond, and in the year 1728, was sent
 to Edinburgh, to be further instructed in the Latin,
 Greek, and French; where, to a singular proficiency
 in these languages, he added a considerable stock of
 mathematical knowledge.
   " In the beginning of the year 1731 he resolved to
 study physic and surgery, and had the  happiness of
 being placed under the tuition of the late  Dr. Alex-
 ander  Monro, a name  that will  be revered in that
 university, as long as science shall be cherished and
 cultivated. This great professor  was  esteemed  by
 all, bvit especially by  those who  were more imme-
 diately under his direction. It was  the lot of young
 Cleghorn to live under his roof;  and, in one of his
 letters,  his  pupil appeared to dwell with  peculiar
 pleasure upon this circumstance,  observing that' his
 amiable  manners, and unremitting  activity in pro-
 moting the public welfare, endeared him to all his
 acquaintance,  but more particularly to those who
 lived under his roof, and had daily  opportunities  of
 admiring the sweetness of his conversation, and the
 invariable  benignity of  his  disposition.'  For five
 years he continued to profit by the  instruction and
example  of his excellent master, visiting patients  in
 company with him, and  assisting at the dissections
 in the anatomical theatre;  at the same  time he at-
tended in their turn the lectures in  botany, materia
medica, chemistry, and the theory and practice of me-
                       a 2 
VI
DEDICATION.
dicine* and by extraordinary diligence he attracted
the notice of all his preceptors.
  " On Dr.  Fothergill's arrival from England at
this university, in the year 1733, Dr. Cleghorn was
introduced to his acquaintance, and soon became his
inseparable companion.  These pupils then studied
together the different branches of science under the
same masters, with equal ardour and success; they
frequently met to compare the notes they had col-
lected from the professors, and to communicate their
respective observations.  Their moments  of relaxa-
tion, if that time can be  called relaxation, which is
devoted to social studies, were spent in a select so-
ciety of fellow students, of which Fothergill,  Rus-
sel, and  Cuming, were  associates; a  society  since
incorporated under the name of the Royal Medical
Society of Edinburgh.
  " Early in the year 1736, when young Cleghorn
had scarcely entered into his twentieth year, so great
had been his progress, and so high a character had
he acquired, that, upon the recommendation of Dr.
St.  Clair, he was appointed surgeon in the 22d re-
giment of foot, then stationed in Minorca, under the
command of general St. Clair.  During a residence
of thirteen years in that island, whatever time could
be spared from attending the  duties of his station,
he employed,  either in investigating the nature of
epidemic diseases, or in  gratifying the early passion
he had imbibed for anatomy, frequently dissecting
human bodies, and those of apes, which he had pro-
cured from Barbary,  and comparing their structure
with the descriptions of Galen  and  Vesalius. In
these pursuits he was much assisted  by his  corre- 
DEDICATION
vu
spondent Dr. Fothergill, who, he acknowledges, was
indefatigable in searching the London shops for such
books as he wanted.
  " In 1749 he left Minorca, and went to Ireland with
the 22d  regiment,  and in  the  autumn  of 1750 he
went  to London, and, during  the  publication of
' The Diseases  of Minorca,' attended Mr. Hunter's
anatomical lectures. In the publication  of his book
he was materially assisted by Dr. Fothergill. Of this
work the following eulogium has been  pronounced
by a competent judge: ' It forms a just model for
the imitation of future medical writers; it not only
exhibits an accurate state of the  air, but a minute
detail of the vegetable productions of the island, and
concludes with medical observations important in
every point of view,  and in  some instances, either
new,  or applied in  a manner  which  preceding
practitioners  had not admitted.'  It is a practice
for which we stand  indebted to Dr. Cleghorn, to
recommend acescent vegetables  in low,  remittent,
and putrid fevers, and the early and copious exhibi-
tion of bark,  which had  been  interdicted,  from
mistaken facts,  deduced from false theories.
  " In 1751  the doctor settled in Dublin;  and, in
imitation of Monro and Hunter,  began to give an-
nual courses  of anatomy. A few years after his re-
sidence in Dublin he was admitted into the univer-
sity as lecturer in anatomy.  In  the year 1784 the
college  of physicians of that  city elected  him an
honorary member; after  which, from  lecturer in
anatomy, he  was made professor, and had likewise
the honour of being one of the original members of
the Irish academy for promoting arts and sciences,
which  is  now  established by  royal authority. In 
Vlll
DEDICATION.
 1777, when the royal medical society was established
 at Paris, he was nominated a fellow of it.
   " About 1774, on the death of his only brother in
 Scotland, he sent for his surviving family, consisting
 of the widow and nine children, and settled them in
 Dublin  under his own eye, that he might have it
 more in his power to afford them that protection and
 assistance of which they might stand in need.  His
 eldest nephew, William, he educated in the medical
 profession; but after  giving him the best education
 which Europe could afford, and getting him joined
 with himself in the lectureship, the doctor's pleasing
 hopes were unfortunately frustrated by the young
 gentleman's death, which happened about the year
 1784.
  " Dr. Cleghorn, with an acquired independence,
 devoted his moments of leisure to farming and hor-
 ticulture. But his attention to these  employments
 did not diminish his care  of his relations, who, from
 a grateful and affectionate regard, looked up to him
 as a parent: the duties of which station he so ten-
 derly  supplied, as to  induce  Dr.  Lettsom, from
 whose memoirs this  account is taken, to  apply  to
 him the  words of Horace, ' Notus in  fratres animi
 paterni.' Dr. Cleghorn died in December 1789."
  With  cordial salutations, I am, gentlemen, very
respectfully your sincere friend,
                         BENJAMIN RUSH.
   September 1809. 
TO THE
       SOCIETY OF SURGEONS

                       OF

           HIS MAJESTY'S ROYAL NAVY.

     GENTLEMEN,

 AS many of you must be  sensible, how little the
 best information we can acquire in this temperate
 climate, qualifies us for treating the diseases which
 are frequent in  warmer latitudes, with the desired
 -UCCSS2, I t^he  the liberty to address the following
 sheets to your society.
  They contain, it is true, an account of the diseases
 only of a small, remote part of the British dominions j
 but of a part in  which numbers of his majesty's sub-
jects, beside the natives and those employed in the
 protection of the place, are often brought together,
 both in time of peace and war:  and as the qualities
 of the air, and the course of the seasons in Minorca
 correspond nearly with those in several other parts
 of the world, to  which our fleets frequently repair,
 it is probable that the diseases  may likewise be
similar.
  Would all who practise physic in our factories and
 colonies abroad embrace the opportunity which their
situation affords, to make proper observations on the
sick, and communicate them to the public, we should 
X
DEDICATION.
soon have a more exact and ample history of dis-
eases, than we are yet possessed of; and future prac-
titioners would be enabled to shun the dangers into
which many have fallen, and to conduct those com-
mitted to their care through the disorders to which
they are exposed, with satisfaction and honour to
themselves, and no small benefit to their country. It
is  therefore with great pleasure  that I see this is
particularly recommended, in the plan for publishing
medical  observations, which you have lately esta-
blished, and will,  it  is  hoped, prosecute  with  the
vigour which so useful an institution deserves.
   For my own part, I must confess, I had not been
long in  Minorca ere I had great reason to wish that
some of the practitioners who had been there before
me, and who must have seen how widely the predo-
minant distempers j»4his- islaxuLxliffer from those in
England, had been at the pains to furnish their suc-
cessors with some hints, some observations, by which
the fatal consequences  frequently attending  these
diseases, might have been timely foreseen, or hap-
pily prevented.
   Being therefore  fully convinced, that   some  re-
marks of this nature  might be usefvil to those who
should afterwards practise in this island, I determin-
ed to observe and record, with the utmost care  and
impartiality, whatever should appear conducive  to a
thorough knowledge of its diseases and their cure;
imagining that, next to the immediate care of the
sick, this would be the most essential service, which
one in my station could render to the public.
   With this view, in the year 1743, I began to keep
a diary of the weather, to remark the course of the 
DEDICATION.
xi
seasons,  to  describe  the diseases which they pro-
duced, and that commonly in the chambers of the
sick: which diary I continued, with no small labour
and assiduity, in the midst of an extensive practice,
both among the English and Natives, till the year
1749, when the removal of the regiment, in which I
have the honour to serve,  obliged  me  to leave the
island, and furnished  me  with  leisure for  revising
my observations, and collecting, from a vast multi-
tude of  cases,  such general remarks as appeared
worthy to be communicated to the public.
  You will observe that amongst the epidemics of
Minorca, tertian fevers make the most considerable
part. The diversity of their types,  the violence of
their symptoms, their fallacious  intermissions, their
sudden, and too frequently pernicious events, ren-
dered it necessary to give an explicit account of them;
and the more so, as they seldom appear in this man-
ner in the  northern  parts of  Europe; though in
Greece,  in Italy,  and the adjacent countries, it is
evident from  the remains  of antiquity,*  and the
writings  of the most judicious moderns,'!' that they
ever have been, and  still  are,  very frequent,  and
that  with a  surprising constancy and  uniformity of
symptoms; though to one who never had an oppor-
tunity of observing them in all shapes, nor seen them
amply  described, they have the  appearance of great
irregularity and confusion.

  * Hippocrat. Aphor. § iii. No. 21, and De Morb. Vulg. Lib.
vil. Asclepiad. apud Cxi. Aurel. de Morb. Acut. Lib. ii. Cap. x.
Galen de Morb. Temp, sub finem.
  f River. Lib. xvii. § iii Cap. i. Lancis. Epid. Torti Thera-
peut Special. Bianch. Hist. Hepat. p. 3, &c. 
xii             DEDICATION.
  And it is more  than probable, from the accounts
of several physicians* and travellers, that epidemi-
cal tertians are not wholly confined to the coasts and
islands  of the Mediterranean;  but that they are
equally frequent and destructive  in many other parts
of the globe, and perhaps may be deemed the anni-
versary autumnal  distempers of  most hot countries
in the world.
   A tertian, it is true, when once discovered, may
for the most part  be readily  cured, as we have so
safe and efficacious a remedy as  the  bark in our
hands.  But in warm climates,  such is the rapid pro-
gress of this distemper, that it  is  requisite we should
know  it in the beginning, that no opportunity may
be lost of giving the remedy in a sufficient quantity
to avert those dangers into which the sick are other-
wise very soon precipitated: yet the variableness of
its aspect, and its  frequently personating other acute
diseases, render this often difficult to the most ex-
perienced;  and much more so  to those who have
seldom or never seen  such tertians, as they are only
now and then to be met with in  England.
   These considerations induce  me  to believe, that
the  account of them contained in  the following pages,
will neither be unacceptable nor useless to many of
your society; and particularly to those, who, by their
station in his majesty's service, are often obliged to
take care of numbers of their  fellow  subjects, in
climates exposed to  such  disorders; whilst at the
same time  their  quick transition from one place to

   *  Spinel, de Semitertian.  Lib. iii. Cap.  i. Tennent on the
Diseases of Virginia, p. 12. Warren on  the Fever of Barbadoes,
p. 70. 
                DEDICATION.             xJii
another, prevents their acquiring a competent know-
ledge of the various epidemics from their own ob-
servation.
  To you  therefore, gentlemen, I address these re-
marks with the utmost deference and esteem, being
in hopes, that the motives which prevailed with me
to offer them to you and the public, will sufficiently
plead my  apology  to both, for any imperfections
which may appear in this performance, with regard
to method or expression. I am,

               Your most humble servant,
                           G. CLEGHORN.
b 
 
CONTENTS.
                   INTRODUCTION.
The Air in Minorca............Page 1
The Seasons of the Year............    2
Heat and Cold...............    2
Winds......i...........    3
Rain, and other Meteors............    4
The Soil, and its Productions..........    6
Corn...................    7
Wine....................    7
Pulse...................    8
Roots, Sallads, and Pot-herbs..........    9
Fruits and Trees cultivated.........../ 11
                indigenous..........\  21
Minerals.................   26
Fish...................27
Cattle..................
Domestic Fowl...............31
Wild Fowl.................32
Water Fowl................32
Birds of Passage..............32
Eatable Snails     .   .  .   .  :.........34
The natural Temper of the Minorquines......34
Their Diet................35
Their Festivals and Public Diversions.......37
Their ancient Usages.............   39
Endemial Diseases.............42
      Obstructions of the Abdominal Viscera  ....   42
      Hemorrhoids.............44
      Ulcers of the Legs...........44
      Ruptures...............45
      Sore Eyes   ..............45
      Nephritic Pains............45
      Convulsion of the Jaw in Children......46
      Accidents from endemial Causes......47
Their Notions of Witchcraft and evil Spirits.....48 
 xvi                 CONTENTS

                      CHAPTER I.
 The Weather described from the Year 1744 to 1749   Page 49
 A Thermometries Table...........73

                      CHAPTER It
 A short Account of the epidemical Diseases from 1744 to
    1749..................75

                      CHAPTER lit
 Tertian Fevers, why so called..........85
 The Diversity of Tertians occasioned by the different Types
    of their Periods, viz.
       Simple Tertians, true and spurious .......   88
       Double Tertians............88
       True, Spurious,  and Subintrant Double Tertians  .   89
       Triple Tertians.............89
       Semitertians..............gn
       Intermittent, Remittent, and Continual Tertians  .   90
       Anticipating and Postponing Tertians.....91
 The  Diversity  of Tertians occasioned by the different
    Symptoms of their Paroxysms    .....»  .   .   91
 Lipyria, Febris Syncopalis,  Assodes, Elodes, &c.  .   .   .   92
 The Constancy of Nature in the Course of Tertians   .   .   93
 Their most frequent Form in their Beginning   ....   94
       In their Progress............95
       In their State and Declension .........   96
 Signs of Security in Tertians..........98
      of Danger..............      99
      of Death, and when to be expected......IQj
 Appearances on opening the Bodies of the Dead  .   .   .  104
 What Species of Tertians are most common in Minorca  .  106
 Management of the  Non-naturals in the Cure of Tertians  107
 Of Bleeding................j14
 Of Vomiting and Purging...........U7
When Tertians may be left to Nature.......U9
When they require the  Bark..........J20
When Purgatives should be joined with the Bark  ...  123
When Cordials............:  .   ,  123
Prejudices against the Bark considered.....      125
Its Use recommended in several Cases, where  forbid by
   Authors   .  ,-  ....,.,.,   ,  .           190 
CONTENTS.
XVil
The Cure of the Symptoms in Tertians.....Page 132
Acute Pains in the Back and Limbs........132
Vomiting and Purging...........•   ■  132
Restlessnes and Head-achs...........133
Hemorrhages from the Nose..........133
Pain and Inflammation in the lower Belly......133
Coma ...................133
Hiccough.................134
Abscesses near the Hip............134
Parotids..................134
Of Relapses of Tertians, their Prevention and Cure  .   .  135
Of sporadic Tertians.............136
The Frequency of epidemical Tertians in many Parts of
   the Globe................137
The Bark recommended by the best Practitioners of dif-
   ferent Nations..............138

                     CHAPTER IV.
Of the Sudamina or Rash    ...........139
Of the Essere, called Favas in Minorca    ......140
Of the Cholera Morbus............I41

                     CHAPTER V.
In what Manner Dysenteries begin........143
How they terminate, and the Appearances in such as die
   of them.................1**
Ipecacuanha and Vitrum Antimonii recommended in some
    Dysenteries...............14°
The antiphlogistic Method in others........147
Hardened Excrements commonly collected in the Guts,
    when the Ilium, Colon, or Rectum is inflamed ...  148
Calomel with Opium, the best Remedy to dislodge them .  148
Of old inveterate Dysenteries..........1*9
Opium of great Service in them.........14"
In what Sort of Dysenteries the Bark is successful  .  .  150

                     CHAPTER VI.
General Remarks on the Summer and Winter Fevers   .  152
Of the Pleurisy in the Year 1746.........154
Its treacherous Remissions...........157
On what Days the Patients died.........I58 
xviii
CONTENTS.
Appearances in the dead Bodies.......PaSe 1^9
A Case of an Abscess in the Liver........1°"
The natural Evacuations which terminate Pleurisies  .   •  161
The capital Remedies in the Cure of Pleurisies   .  •   •  I65
Other collateral Helps............i69
Of the inflammatory Diseases, epidemical  at the same
   Time with the Pleurisy...........1'"
Extracts from Letters concerning the Pleurisy  .   .  -   •  171

                     CHAPTER VII:
Of the Smallpox in the Year 1742   ........l^4
Of the Smallpox in 1746............176
Their pestilential Disposition..........177
Two Cases cured by the early Use of the antiphlogistic
   Method................181
Three, wherein this Method failed........181
The Danger of the natural Smallpox, and  the Safety of
   Inoculation........     ......184 
 
 
THE
            INTRODUCTION,


WHEN  I  determined to write  upon the fevers,
which have,  of late years, been epidemical in Mi-
norca I thought it would not be improper, in the
first place,  to give a short account of the nature  of
the climate; the qualities of the soil, and its produc-
tions; the manners of the inhabitants, their diet and
way of life; and to mention some other diseases  to
which they are peculiarly subject.
  The following  introduction is intended for  this
purpose;  and the reader will easily discover by the
style, that it  was  composed during my residence in
that island.
  The air  is much  more  clear  and pure than  in
Britain; being seldom darkened with thick fogs: yet
the low valleys are not free from mists and unwhole-
some  vapours;  and in windy weather the spray of
the sea is driven over the whole island; as is evident
from the briny dew found on the leaves of vegetables
growing in the most inland parts of it. Hence it  is,
that utensils of brass or iron are extremely suscepti-
ble of rust, in spite of  all  endeavours to preserve
them; and  household furniture, if not frequently ex-
posed to fire or the sun,  contracts  a mouldiness, and
is destroyed by the moisture.
                        A 
2               INTRODUCTION.
   The summers are dry, clear, calm, and  hot; the
 autumns moist, warm, and unequal;  at one  time
 perfectly serene, at another cloudy and tempestuous.
 Nor are the summer and autumnal seasons of one
 year much different from those of another. During
 the winter, storms of any kind, are neither frequent,
 nor of long continuance (though sometimes  very
 violent); and whenever they cease, the weather re-
 turns to its usual serenity. The spring is always va-
 riable, but bears a stronger resemblance of the winter
 than of the  summer season.
   The changes of heat and cold are neither so sud-
 den nor so  great in this climate as  in  many others.
 In the compass of  a year,  the mercury in  Fahren-
 heit's thermometer seldom rises much above the 80th,
 nor falls below the 48th degree; and though it  has
 been observed, in extraordinary seasons, to reach the
 87th, and descend to the 41st degree; yet it attains
 not usually  to either of these extremities, nor con-
 tinues  at them long. In summer there is scarcely ever
 a difference of four or five degrees between  the heat
 of the  air at noon, and at night; and in winter the
 variation is  still less considerable.
   What I  have said with regard to the  thermome-
 ter, is  to be understood of one  kept within doors,
 and so situated, as neither to be affected by the solar
 rays, nor the influence of a fire. For if it be exposed
 to the summer's sun, it will rise 12, 14, or 16 degrees
higher than in the house;  and in other seasons,  the
 difference  between  the air in the shade, and that
heated by the direct rays of the sun, is  frequently
found much greater.  Yet even in the dog days,  the
heat of the atmosphere,  at  least in  open places. 
INTRODUCTION.              3
where  there is a free circulation of air, seldom sur-
passes  that of the blood of a man in health.
  The winds  about the vernal and autumnal equi-
noxes,  and sometimes  during the  winter,  are  ex-
tremely boisterous. In  the other seasons they  are
usually moderate; and according to  the seamen's
observations, they rarely blow in the same direction
near the islands adjacent to the gulf of Lyons, as in
the open sea.
  During the summer, in the mornings and evenings,
there is commonly a perfect calm: but the middle of
the day is cooled by refreshing breezes, which  rise
in the  east, and  following the  course of  the sun,
increase gradually till two or three  o'clock in the
afternoon;  and die  away insensibly  as  night  ap-
proaches.  This renders the intense heat of the sun
less dangerous and inconvenient; but if these breezes
intermit for a day, the natives themselves grow  lan-
guid and inactive from  the sultriness of the season.
  The northerly winds in general are cold,  dry, and
healthy; they dispel the mists, and make a clear blue
sky; whilst  those  which  blow from the  opposite
points  render the air warm, moist, and unhealthy.
That the influence of the  north wind  is superior to
the rest, is evident from hence, that the tops of all
the trees incline  to the south, and the branches on
the north side are bare and blasted. The next to it
in force is the northwest.   Both these winds are fre-
quent  towards the close  of  winter, and  in spring;
and as they are  dry and  cold, they shrivel up the
leaves  of the vegetables, destroy their  tender shoots,
and are often excessively detrimental to the vine-
vards  and rising corn. The  piercing blasts, which 
4
INTRODUCTION.
blow  at the same season from the  northeast, as
they are moister, and more frequently attended with
rain, are not so prejudicial. The south and southeast
winds are  by much the most unhealthy. In whatever
seasons they blow* the air is foggy,  and affects the
breathing;  but  in the summer  they  are  sultry and
suffocating. An excessive dejection of spirits is then
a universal complaint; and, on exposing the thermo-
meter to the rays of  the  sun, the mercury has fre-
quently risen above  the  100th degree.  The "west
wind is usually drier than the south:  the east is  cold
and blustering in the spring, and sidtry in the sum-
mer.
   The weather in this climate  is generally fair and
dry; but when it rains, the showers are heavy, though
of short continuance; and they fall most commonly
in the  night.
   The  sky in summer is clear, and  of a beautiful
azure, without clouds or rain;  but moderate dews
descend regularly after sunset.
   As  the  autumn draws  near, the weather becomes
less  serene; whirlwinds  and thunder are frequent.
In the nights, lightning, and  those  meteors called
falling stars, are  very common.
   At that season water spouts  are often seen in the
neighbourhood of the  island;  and  sometimes  they
break  upon the  shore.  Lucretius*  has  described

    * Nam fit ut interdum tanquam demissa columns,
      In mare de coelo descendat; quam freta circuni
      Ferviscunt, graviter spirantibus incita flabris,
      Et quaecunque in eo, turn sunt deprensa tumultu,
      Xavigia, in summum veniunt vcxata periclum.
                                  De Rer. Nat. 1. \i. 
INTRODUCTION.
5
diem  elegantly;  and  the various shapes  in which
they appear, are  well  represented by Dr.  Stuart in
the Philosophical Transactions.*
  About the autumnal equinox a sudden  alteration
in the weather ensues; the skies are darkened with
clouds, and the rain falls in such quantities, that the
torrents thereby occasioned,  pouring from the hills,
tear up trees by the root,  carry away cattle, break
down fences, and  do considerable  mischief to the
gardens and vineyards. But then these  anniversary
rains are much more violent than lasting, always fall-
ing in sudden heavy showers, with intervals of fair
weather. As they come after a long scorching sum-
mer, they are very acceptable and beneficial; for they
mitigate the excessive heat of the air, give a check
to the epidemical diseases, and by softening the sun-
burnt earth, render it capable  of being cultivated.
They are   commonly accompanied  with thunder,
lightning, and squalls of wind for the most part from
the north.  Such storms as these  are seldom seen in
cold countries; but they arc frequent enough in war-
mer climates; and the description given of them by
Virgil+ is equally just and  poetical.
  Hail  and  snow  arc often  intermixed  with the
rains  which fall in winter-and in  spring; but the
snow, for the most part, dissolves immediately; and
ice is here  an uncommon  appearance.
  It is not my design to give a geographical account
of the island, its situation, harbours, cities, and other
particulars  of this  nature:  these may be  met with
elsewhere.  I  shall only observe that the whole of it

  *  Plate 1. vol 4. Part II.     f virS- Gcoi-£. 1.. i. ver. 322
                       A  2 
6
INTRODUCTION.
is what the  sailors term low land;  excepting  a few
hills near the center, of which the most considerable,
named Toro  by the inhabitants, may be discovered
from sea, in clear weather, at twelve or fourteen
leagues' distance.
  The surface  of  the  island is rough  and unequal;
and in many  places divided by long narrow vales of
a considerable depth, which are called $arrancos by
the natives.   They begin towards the middle of the
island, and after several  windings,  terminate at the
sea.  The southwest side is more plain and regular
than towards the  northeast;  where  the- hills are
higher, with  low marshy valleys between them, the
soil less fruitful, and the whole tract unhealthy to
man and beast. Near the towns  and villages the fields
are well cultivated, and inclosed by stone walls: but
the rest, for the most part, is rocky, or covered with
woods and thickets. There are some pools of stand-
ing water, and but very few  rivulets; one  cannot
therefore easily account for cardinal De Retz's mis-
take, (see his Memoirs) when he describes a number
of" streams pouring into Mahon harbour,,  unless we
suppose him to have seen it in the rainy season.
  The soil is light, thin, and very stony, with a  good
deal of sea salt, and some calcareous nitre intermix-
ed.  In most places there is so little earth, that the
island  appears to be but one large irregular rock,
covered here and there with mould, and an infinite
variety of stones. Notwithstanding this, it is not only
extremely proper for vineyards, but produces more
wheat  and barley than could at first sight be imagi-
ned. And, if the peasants may  be credited, it would
always yield  a quantity of  corn and wine sufficient 
INTRODUCTION.
7
for the natives, did  not the violence of the winds,
and the excessive drought of the weather, in different
seasons, frequently injure their crops.
   The fields commonly lie fallow for two years, and
are sown the third.  About the latter end of winter,
or the beginning of spring, they are first broken up;
and  next autumn, as soon as the rains fall, they are
again ploughed, and prepared for receiving the pro-
per seeds.  The tillage is neither a laborious, nor an
expensive work; for a plough so light'as to be trans-
ported  from  place  to place,  on the  ploughman's
shoulder,  and to  be drawn by a heifer,  or an ass
sometimes> assisted by a hog, is sufficient for opening
so thin a  soil. The  later the  harvest happens, the
more plentiful it proves. The barley is usually cut
down about the 20th of. May new style, and the
wheat is reaped in June; s*o that the whole harvest
is commonly got in  by midsummer day. The grain
is not threshed with flails as in .England, but trodden
out on a smooth piece of rock  by oxen and asses, ac-
cording to the practice of the eastern nations.
   In the planting of vines it.  is customary to lay  a
large  stone  on every slip; this is  a protection,  as
Virgil observes, (Georgv-2.) against the excessive
heat of the sun, which would  otherwise, in so shal-
low a soil, deprive it of ail moisture; and at the same
time prevents the moulcfyfrom being washed away
by the immoderate rains. September is the season for
the  vintage. After the grapes are trampled, but be-
fore they are pressed, they are sprinkled over  with
powder of alabaster,* in order to  give  the wine a
  * Called by the natives Parell.
with the plaster of Paris.
It is got out of the same pits 
8
INTRODUCTION.
 brighter red colour.  Such wines  as  are  made with
 care,  from the fruit of old vineyards, still deserve
 the commendations formerly giveii them by Pliny.*
 And they have one property, seldom to be met with
 in wines of this complexion.  I mean  that of keeping
 the  body open, which renders them less heating, and
 therefore less prejudicial. But since the commence-
 ment of the war, as Mahon harbour has become the
 rendezvous for ships  of different  nations, the quan-
 tity of the wine has been more regarded by the pro-
 prietors, than its quality. Hence the  greater part of
 it grows sour in the beginning  of  the summer: and
 this is probably the principal reason why dysenteries
 have of late years been both more  freqiient and more
 fatal than usual.          . *  •„.  u
  The natives  hang up clusters of ripe grapes (1) to
 the  ceilings of their chambers,  in order  to dry for
 winter store. The sapa  vinl  (2), together  with  va-
 rious roots and  fruitjs preserved by being boiled  in
 it, amongst other uses, makes a considerable part of
 their bill of fare on fast days.  *
  In some places there ;are fields of hemp (3), flax (4),
 and  tobacco (5): they likewise sow bean's  (6), chich-
lings (7), chich pease (8), two species of the kidney

  * Lib. 24. C. 6. Vina Baleai-ica-cpnferuntur  Italic primis.
  (1) Uvx Pensilcs, Panjois.
  (2) Arrop.
  (3) Cannabis, Canein.
  (4) Linum, Lli.
  (5) Nicotiana, Tabach.
  (6) Faba, Favas.
  (7) Lathyrus, Guixes.            ~-f
  (8) Cicer, Cutrous, Garravar.sr.e.    v "J. 
INTRODUCTION.               9
bean (1), and lentils (2):  these being a considerable
part of their diet at such times as they are prohibited
from eating meat,  by their religion. There are a few
pease (3) in the vineyards and  gardens; but  these
are commonly reserved for the tables  of the wealthy.
   In the  moist fenny grounds they plant quantities
of canes (4), which they make use of instead of laths,
to support the tile,s, in the roofs of their buildings.
They have also in  some few places Indian wheat (5),
Job's-tears (6), and Indian reed (7): the hard, stony
seeds of the two  last  being perforated and strung,
serve them as beads for their rosaries.
   Their gardens  are more for use than  show> and
furnish most kinds of potherbs, roots, and sallading,
in great plenty: and the herb market of Mahon has
been as useful to  the British fleet in restoring the
health of the sailors, as the harbour  in refitting and
securing the ships. There are at all  seasons, cabba-
ges (8), coleworts  (9), lettice  (10),spinage (11), en-

  (1) Phaseolus. The common white large kidney bean is called
Mongeta; a smaller sort with a black spot in its middle Fesol o;
Guixon.
    (2) Lens, Llentias.
    (3) Pisum, Posols.
    (4) Arundo donax, Canya.
    (5) Mayz, Blad de las indias.
    (6) Lachryma Job, Lagrimas de viu.
    (7) Cannacorus, Mariettas.
    (8) Brassica capitata, Cols capdelladas,
    (9) Brassica aperta, Cols abertas.
    (10) Lactuca, Llatugas.
    (11) Spinachia, Espinachs. 
 10              INTRODUCTION.

 dive  (1), beets (2), parsley (3), cresses (4), leeks (5"),
 onions (6),  garlick  (7),  sellery  (8), radishes  (9),
 horse radish (10), sage (11), mint (12), sweet marjo-
 ram (13), wild marjoram (14), thyme (15), &c. You
 have  besides these  in winter,  carrots  (16), parsnips
 (17), turnips (18), artichokes (19*), asparagus (20), and
 colly-flower (21): in summer, love-apples (22), mad-
 apples (23), guinea-pepper (24), together  with va-
rious kinds of cucumbers (25), pompions (26), musk-
melons (27), and water-melons (28) in great plenty

    (1) Cichorium sive  Endivia, Escarolas.
    (2) Beta, Bledas
    (3) Apium sive Petro selium, Jullivert.
    (4) Nasturtium, Murrisa.
    (5) Porrum, Porras.
    (6) Cepa, Cebas.
    (7) Allium, Alls, Ai'as.
    (8) Apium dulce, Apits.
    (9) Raphanus, Ravas.
    (10) Raphan. rust. Cochlear. Spec. Raws de cavall.
    (11) Salvia, Sauvia.
    (12) Mentha, Herb a sana.
    (13) Majorana, Morredux.
    (14) Origanum,  Orenga.
    (15) Thymus, Them.
    (16) Daucus, Bastenagues.
    (17) Pastinaca, Xarovias.
    (18) Rapum, Naps.
    (19) Cynara, Carxofas.
    (20) Asparagus, Esparachs.
    (21) Brassica cauliflora, Colsflos.
    (22) Lycopersicon, mala Aurea,  Tomatils, Tomatigues.
    (23) Melohgena, mala insana, Anberginias-
    (24) Capsicum, Pebres.
    (25) Cucumis, Cubombros.
    (26) Pepo, Carabasas.
    (27) Melo, Melons.
    (28) Anguria, Sindrias. 
INTRODUCTION.
11
and perfection.  But as the climate is liable to severe
droughts, every garden is supplied with a deep well;
from whence, by means of the Persian wheel,* the
gardener  fills  his reservoir, and  from it  conveys
the water, by stone  canals,  to the different beds as
occasion requires.
   Beside the  fruits common  in England, such as
cherries (1), apples  (2), pears  (3), apricocks (4),
plumbs (5), peaches (6), medlars (7), mulberries (8),
quinces (9), and  walnuts (10); several others ripen
here, which in colder countries  seldom or never
come to perfection, even with  the help of a hotbed;
such as the large juicy pomegranates (11), of which
there is great  abundance in every  garden; lemons
(12), citrons (13), and oranges  (14), which are all
of late  years become  very common in  this island;
the almonds (15), which thrive perfectly well in this
•soil; and the Indian figs (16), which are the princi-

  * See a Figure of the Persian Wheel in Shavfs Travels.
    (1) Cerasus, Cireras.
    (2) Malus, Pomas.
    (3) Pyrus, Pyras.
    (4) Armeniaca, Aubercoes.
    (5) Prunus, Prunes.
    (6) Persica, Presechs.
    (7) Mespilus, Nesples.
    (8) Morus, Moros.
    (9) Cydonia, Codons.
    (10) Nux Juglans, Nous.
    (11) Punica, Magranas.
    (12) Limones, Llimons.
    (13) Citreum, Cidros.
    (14) Aurur.tium, Teronges.
    (15) Amygdalus, Merlas.
    (16) Opuntia  vulgo Herbariorum, Figas Meriscas. 
12             INTRODUCTION.
pal sustenance of whole families in September. The
prickly shrub that bears them grows wild among the
rocks, and  is often made use  of as a fence to their
gardens. To these may be added  some fruits of
smaller esteem,  as the jujubes (1), the true services
(2), Neapolitan  medlars (3), and  the berries  of the
nettle tree (4).
   In enumerating the trees which adorn their gar-
dens, I must  not  omit the cypress (o), laurel (6),
poplar (7),  Egyptian  thorn (8), bead-tree (9), and
a beautiful species of dog's-bane (10). Neither can I
forbear to mention the figtree  (11), which not only
produces large quantities of excellent  fruit,  (some
kinds of it, two crops  in a year) but affords a conve-
nient shade, under which the peasants usually regale
themselves. Nor must  the palm tree (12) be past over
in silence; for although the dates in this country never
come to perfection,  yet its inner branches,  when
blanched, serve as  ornaments  for  their processions
on Easter Sunday; and the others are used by the
children in passion  week,  for  striking  the  earth,
which is superstitiously termed by the inhabitants,
beating of Judas. The minds of  the people  are at

    (1) Zizyphus, Gingols.
    (2) Sorbus legitima, Serves.
    (3) Mespilus folio Apii lacin. C. B. Azarolas.
    (4) Celtis, Lotus, Lladons.
    (5) Cupressus, Cipre".
    (6) Laurus, Llori.
    (7) Populus, Poll.
    (8) Acacia, Aroma.
    (9) Azederach, Suclemoro.
    (10) Apocynum, Sede".
    (11) Ficus, Figuera.
    (12) Ptdma, Fasct. 
INTRODUCTION.
13
that time so inflamed by the sermons of their priests,
that it is dangerous for the Jews to be seen abroad.
  The vegetables hitherto  mentioned are produced
by culture.  I come next to speak of the indigenous,
which grow spontaneously in the island; and as there
is a vast variety of these, I shall not pretend to treat
them so fully as the subject deserves; nor am I equal
to the  task, botany, though sometimes  my amuse-
ment, never having been my study: all  I shall aim
at is briefly to point out the most remarkable  amongst
them.
  In the first place may be mentioned such  plants as
serve the natives for sallading and pot  herbs;  viz*
succory (l), prickly rock  asparagus (2),  alexanders
(3), buckshorn  plantain (4), goat's-beard (5),  fennel
(6), hawkweed (7), purslane (8),  sow-thistle  (9),
sorrel (10), water-cresses (11),  capers  (12), and
samphire (13).
  To the same  class belong borrage  (14), blites (15),

    (1)  Cichorium, Camarotjes.
    (2) Asparagus, Corruda, Esparachs.
    (3) Smyrnium, Cugulls.
    (4) Coronopus, Cornicellis.
    (5) Scorzonera, Tragopogon, Cuxa de dona
    (6) Foeniculum, Fenoi.
    (7) Hieracium, Cascunias.
    (8) Portulaca, Verdulagas.
    (9) Sonchus, Llecsons.
    (10) Acetosa, Vinagrellas.
    (11) Sysimbrium, Crexechs.
    (12) Capparis, Taparas.
    (13) Crithmus, Fenoi mart-
    (14) Borrago, Borratjes.
    (15) Blitum, Blets.
                         B 
14
INTRODUCTION.
beets (1),  orrache (2), dandelion (3) and  spatling
poppy (4).  The luxury of the present  age, seldom
or never, indeed, allows these a place at the table;
but in times of scarcity they have served as  common
food; particularly in the year 1685, when  a swarm
of locusts had destroyed the harvest.
  Of medicinal plants there is such variety, that
barely to recount them, will (I am afraid) be tedious.
Common wormwood (5), sea-wormwood (6), brank-
ursine (7), true maiden-hair (8), agrimony (9), win-
ter cherry (10), chickweed (l l), male pimpernel (12),
female pimpernel (13), common rest harrow (14), yel-
low rest harrow  (15),  snap-dragon (16), goose grass
(17), friar's cowl (18),  cuckow-pint (19), spleen-wort
 20), rough spleen-wort (21), brook-lime (22), black
    (1) Beta, Bledas.
    (2) Atriplex.
    (3) Dens Leonis, Caxal de veia.
    (4) Lychnis species, sive spumeum papavcr, Coulisse.
    (5) Absynthium vulgare, Donzell.
    (6) Absynth. maritimum, Donzell mari.
    (7) Acanthus, Camera.
    (8) Adiantum verum, Falzia.
    (9) Agrimonia.
    (10) Alkekengi, Orvalfi.
    (11) Alsine, Tina.
    (12) Anagallis  flore phoeniceo.
    (13)  \nagallis flore cseruleo.
    (14) Anonis vulgaris, Resta bovis.
    (15) Anonis lutea viscosa, spinis carens, C. B. Motxes.
    (16) Antirrhinum,  Cullons de gat.
    (17) Aparine, Amor de Hortola C' Rabosa.
    (18) Arisarum, Frare Cugot.
    (19) Arum, Rapa.
    (20) Asplenium, Dauradella.
    (21) Lonchitis.
    (22) Veronica species, becabunga. 
                INTRODUCTION.              15

briony (l), bugloss (2), ox-eye (3), shepherd's purse
(4), marigold (5), small red centaury (6), small yellow
centaury (7), germander (8), ground-pine  (9), great
celandine (10),hemlock (11), male-cistus (12), female
cistus (13), golden flowered samphire (14), sow-bread
(15), hound's-tongue (16), long-rooted sweet cyperus
(17), wild carrots (18), great dragons (19), viper's bu-
glos (20), dwarf-elder (21), golden cassidony (22),
horsetail (23), wild rocket (24), base wild rocket (25),
sea-holly (26), bank-cresses (27), giant fennel (28),

    (1) Tamnus, bryonia nigra.
    (2) Buglossum, Llengua bovina.
    (3) Buphthalmum, Bulichs.
    (4) Bursa pastoris, Bosa de Pastor\
    (5) Calendula, Lleva mat.
    (6) Centaur, minus vulgar. CentaurS.
    (7) Centaur, min. flav.
    (8) Chamaedrys, Usinetta:
    (9) Chamxpitys, Iva.
    (10)  Chelidonium majus, Celedonia.
    (11)  Cicuta.
    (12)  Cistus  flore rubro,  Stepa.
    (13)  Cistus  flore albo.
    (14)  Asteris species, crithmum chrysanthemum, Salsons.
    (15) Cyclamen, Pa de Pore.
    (16)  Cynoglossum, Llepasera.
    (17)  Cyperus longus.
    (18)  Daucus Sylvester, Bastenagues salvages
    (19)  Dracunculus major, Rapa mascle.
    (20)  Echium.
    (21)  Ebulus, Ebul.
    (22) Elichrysum,  Mansinillas.
    (23)  Equisetum, Coua de Cavall.
    (24)  Eruca, Ruca.
    (25) Reseda.
    (26) Eryngium. Cardpanical,
    (27) Erysimum.
    (28) Ferula, Cany a feller a. 
 16              INTRODUCTION.

 fern (1), fumitory (2), dog's-grass (3), greater turnsol
 (4), mule's fern (5), St. John's-wort (6), hypocistus
 (7), glass-wort (8), wild cucumber (9), sharp-point-
 ed dock (10), hart's-tongue  (11),  wood sorrel (12),
 mallows (13), white hoar hound (14), stinking hoar
 hound (15), base hoar hound (16), dog's mercury (17),
 sciaticacresses (18), Roman fennel-flower (19), broom
rape (20), peony (21), corn poppy (22), yellow  flow-
ered horn poppy (23), pellitory of the wall (24), tho-
rough wax (25), periwinkle (26), ivy (27), honeysuc•■

    (1) Felix, Falguera.
    (2) Fumaria, Fumisterra.
    (3) Gramencaninum, Grain.
    (4) Htliotropium majus, Giratol.
    (5) Hemionatis.
    (6) Hypericum, Transfiorina, Herba de san yuan
    (7) Hipocistus, Margalidettas.
    (8) Kali, Sosa.
    (9) Cucumis asininus.
    (10) Lapathum acutum, Paredellas.
    (11) Lingua cervina, Llengua de Cero.
    (12) Oxys, rujula.
    (13) Malva, Mauves.
    (14) Marhubium album, Malrubins.
    (15) Ballote, Malrubins bords.
    (16) Stachys.
    (17) Mercurialis, Malcorages.
   (18) Nasturtium sylvest. Iberis, Murrissa bord,
   (19) Nigella, Niella.
   (20) Orobanchc.
   (21) Pxonia, Pampelonia.
   (22) Papaver rubr. Rosellas.
   (23) Papaver corniculatum.
   (24) Parietaria, Maias.
   (25) Perfoliata.
   (26) Pervinca, Proenga.
   (27) Hjedera, Eur a. 
                 INTRODUCTION.              17

kle (1), bind-weed (2), burnet (3), common plantain
(4), water plantain (5), knot-grass (6), polypody of the
oak (7),  flea-wort (8), cinquefoil (9), small madder
(10), butcher's broom (11), willow-wort (12), round-
leaved water pimpernel (13), scabious (14), shepherd's
needle (15), sea onion (16), figwort (17) greater house
leek (18),smaller house leek (19), water-parsnip (20),
night-shade (21), louse-wort (22), thorn apple (23),
white mullein (24), vervain (25), swallow-wort (26),
 (1) Caprifolium, Madreseha.
 (2) Convolvulus, Corregiola.
 (3) Pimpinella sanguis orb. Pantinella-
 (4) Plantago, Plantage.
 (5) Plantago aquatica.
 (6) Polygonum, Ceutnous.
 (7) Polypodium, Polipodi.
 (8) Psyllium, Herba pucera.
 (9) Quinquefolium, Pau de Christ.
 (10) Rubia minor.
 (11) Ruscus, Brusc.
 (12) Salicaria.
 (13) Samolus.
 (14) Scabiosa, Scabiosa.
 (15) Scandix, pecten Vener.
 (16) Scilla, ornithogalum, Ceba marina.
 (17) Scrophularia, Herba pudent.
 (18) Sedum majus, Consolva.
 (19) Sedum minus.
 (20) Sium, Apits de Sichia.
 (21) Solanum, Morella.
 (22) Delpliinium, staphisagria, Metapoi.
 (23) Stramonium, Orval.
 (24) Verbascum, Trapo.
(25) Verbena,  Herba Verbena.
 (26) Asclepias
                     B2 
18              INTRODUCTION.
 navel-wort  (1), common nettles  (2),  and  Roman
 nettles (3).
   To these we  may add  such others as  have been
 transplanted formerly from foreign  countries,  but
 are now so  far naturalized here as to grow wild in
 several places;  such  as  the American night-shade
 (4), the Mexican jasmine (5), the passion  flower (6),
 the great spurge (7),  and the aloes (8):  which last
 seems to have been industriously cultivated near the
 farm houses, as a remedy for the accidents to which
 country labourers are much exposed; it having for-
 merly been in great esteem (as we learn from Dios-
 corides*) for healing recent  wounds.
   Beside these there is a number of aromatic plants,
 which thrive luxuriantly in this  soil, and by imbalm-
 ing the air  with fragrant exhalations contribute  to
 preserve as  well as restore the health of the inhabi-
 tants: the principal of these are lavender cotton (9),
 starwort (10), mountain-mint (11), horse-mint (12),

    (1) Cotyledon, Umbilic. Vener. Cocas de Parets.
    (2) Urtica vulg. Ortigas.
    (3) Urtica Romana.
    (4) Phytolacca, Rems de moro.
    (5) Jallapa flore purpureo, Juan de Notxe & Pedro de Notxe,
    (6) Granadilla,  Passionera.
    (7) Ricinus, Cagamutxe.
    (8) Aloes, Azibare.
    * Lib. ii. cap. 23. Aloe nascitur in Arabia, Asia, et aliis
iocis maritimis, inutilis quidem succo  extrahendo, sed conve-
niens recentibus vulneribus, si contusaemplastri forma, adplice-
tur.
    (9) Santolina, Abrot. fcem. Camomela.
    (10) Asteriscus foliis ad florem mollibus. An asterisc. annuus
nquat. patul. Tourn?
   (11) Calamintha.
   (12) Mentha, Mentastrum, Mendastra: 
INTRODUCTION.
19
penny-royal (1),  flea-bane  of  various  kinds  (2),
clary (3), poley-mountain (4),  Syrian herb mastick
(5), rue (6), French lavender (7), water-germander
(8), St. Peter's wort (9), and strong smelling clover
(10).
   The  garlick makes so considerable a part, both of
their food  and physic, that it deserves to be more
particularly mentioned.  Several  kinds  of it grow
here in such plenty that the  milk of the cattle, and
even the meat  itself, frequently participate  of  its
taste.  The only sort  which the natives use is  a
scorodo-prasum (11),  milder than the garden gar-
lick, and sweeter than the leek. What is commonly
eaten by the soldiers  and  sailors  is  another more
acrid species, with a triangular stalk \1^)'
   Of the thistle  tribe, the following deserve our no-
tice: the milky (13) and golden thistle (14) are both
esculent; the flowers  of the  prickly wild artichoke
(15) serve, instead of rennet, to  curdle milk.  In May

     (1) Mentha, Pelugium, Puriol.
     (2) Asteris species, Conyzie, Olivarda.
     (3) Sclarea, horminum, Tarach.
     (4) Polium montanum, Polio.
     (5) Chamaedrys  maritima, incana fruetsc. fol. lanceol. Frigola.
     (6)  Ruta, Ruda.
     (7) Stxchas, Tumani.
     (8) Chamjedrys pallust. Scordium, Scordi.
     (9)  Ascyrum exiguo folio, flore magno,  Stepara groga.
     (10) Trifol. bituminosum.
     (11) Allium capite sphaerico, folio  latiore, Porradolls.
     (12) Allium caule triangulo.
     (13) An Carduus  lact. peregrin, maj. sem. fusco? Card,.
 Gallofe.
     (14) Scolymus chrysanthem, ann. Caderlinas.
     (15) Cynara sylvesttis. 
20             INTRODUCTION.

the bees feed  chiefly  on  the white flowered star
thistle (1), which affords the finest honey; and the
broad yellow flowered fish  thistle (2) yields a coarser
sort, about a month later.
   The bounds to which I  propose to confine  myself
will not permit me to enumerate the different spurges
(3), whereof the arborescent  are the most beautiful;
nor the orchis's, among which those that resemble
the bee (4), and butterfly  (5), have the preference;
much less will they allow me  to describe the various
species of linarias (6), sea-lavender (7), rattle grass
(8), and the vast profusion of ranunculus's (9), and
geraniums (10), which enamel the meadows:  yet, I
cannot  omit a few plants, with  bulbous  roots, and
liliaceous flowers, which are  a peculiar ornament to
the fields; viz.  a white star of Bethlem (11), a blue
muscari (12), a flesh-coloured corn flag (13), vernal
daffodill (14),  with a yellow cup, an autumnal daffo-
dill with a large white flower (15), snow-drop (16),

    (1) Carduus stellat. sive calcitrapa, flore albo,  Card. Blanc.
    (2) Carlina. Arcana flore luteo  patulo, Card. Segrelle.
    (3) Tithymalus, Lletrera, Baladre.
    (4) Orchis fucum referens.
    (5) Orchis papilionem referens.
    (6) Linaria, one kind is called  Gallfave.
    (7) Limonium.
    (8) Pedicularis.
    (9) Ranunculus,
    (10) Geranium.
    (11) Ornithogali species, an lilium  Alexandrinum?  Liri
Bord.
    (12) Muscari, Aiasas.
    (13) Gladiolus, Coltel'ls.
    (14) Narcissus medio luteus.
    (15) Narcissus maritin.us C. B. Azucena.
    (16) Narcisso-leucoium, Aiasas. 
INTRODUCTION.
21
saffron  (l),  meadow  saffron  (2),  Spanish nut  (3),
and two species  of asphodell  (4), both of which are
luxuriant in the richest soils,  and from their flowers
the bees extract a considerable share of the finest
honey.
   Besides, in all the uncultivated parts of the island
thick evergreen  bushes of mastick (5), mock-privet
(6), and dwarf olive (7), sprout up  in  such abun-
dance,  that the broken surface of the ground is  at
all seasons covered with an agreeable verdure.
   Intermixed  with these is an immense quantity of
myrtle  (8), sweet gum cistus (9), and rosemary (10);
which jointly perfume the air with an exquisite fra-
grance; and from the  flowers of the last a delicious
kind of honey is collected early  in the spring.
   There is also a great deal of the strawberry shrub
(11,) heath of various kinds (12), and a long coarse
grass (13) on which the goats and black cattle feed,
when they are deprived of better  sustenance  by the
severity of the winter.

    (1)  Crocus, Safra.
    (2)  Colchicum.
    (3)  Sisyrinchium.
    (4)  1. Asphodelus albus  non  ramos C. B. 2. Asphodelus
minor foliis fistulosis, 1. Porraces, Albums, 2. Cebollas.
    (5)  Lentiscus,  Mata.
    (6)  Phillyrea, Ledern.
    (7)  Oleastellus, Ullastre.
    (8)  Myrtus, Murta.
    (9)  Cistus labdanifera, Stepara stepa.
    (10) Rosmarinus, Romani.
    (11) Arbutus comarus theoph. Arbose.
    (12) Erica, Bruc mascle, brucfemelle & sipel.
    (13) Graminis  species, Carex. 
22
INTRODUCTION.
   Shrub-trefoil (1), stinking  bean-trefoil  (2),  sea-
grape  (3), shrub-mullien (4), sloe-tree (5), dwarf-
palm  (6),  widow-wail  (7), and another  kind  of
spurge-olive (8), beside that which  affords the gra-
na cnidia (9), likewise grow in several places:  But
brambles  (10), wild  roses  (11), and some other
thorny bushes (12), are every where so common, that
it is requisite for those who would pass through the
thickets,  to dress like the peasants,  in short jackets
and leathern spatterdashes.
   Hitherto I have treated  of the lower vegetables:
I proceed next to the trees.  And here I must again
mention  the myrtle, mock privet, lentiscus, and ar-
butus, as they often rise to  the height of trees;  and
mixing with pines (13), wild olives  (14), and great
holm-oakes  (15), which never  lose their verdure,
supply the  cattle with shelter during the excessive
hot or cold  weather; and with  leaves to feed on,
when the summer's sun, or the blasts of the winter,
have destroyed the grass of their pastures.
    (1) Dorycenium monspeliens.
    (2) Anagyris foetida, Garrove bord.
    (3) Ephedra anabasis bellon. Trompera.
    (4) Phlomis fruticosa.
    (5) Prunus Sylvester, Prunoni, Arrinone".
    (6) Palma humilis folio flabelliformi, Garbaions.
    (7) Chamelrea tricoccos.
    (8) Thymelxa lanuginosa foliis sedi minor. C. B. P.  Palu
marina-
    (9) Thymel<ea fol. lini, Matapoll.
    (10) Rubus, Romagttera.
    (11) Rosa sylvestris, Gaverera.
    (12) 1. Genista: spinosx species. 2. Vel. Hierac. vc 1. Dent.
Leon, species, 1. Argelaguera, 2. Saccorell.
    (13) Pinus, Pi.
    (14) Oleaster, Ullastre.
    (15) Ilex, Usinas. 
                INTRODUCTION.             23
   But it is not the cattle alone which have been fur-
 nished with food from these woods and thickets; for
 in times of famine the inhabitants of this island have
 been obliged to have recourse to acorns, wild dates
 (1), the  berries of the myrtles,  the bramble, the ar-
 butus, and the like; which, if we may believe  the
 poets,* was the nourishment of the primitive race of
 mankind.
   From the qualities of the soil, and the abundance
 of uncultivated fruit which it produces,  one might
justly expect,  according to Virgil's remark,! that
 the olive would  thrive  well  in  this  island;  yet  the
 natives take so little  care  to propagate it, that they
 are  obliged to  import almost  all  their  oil  from
 France,  Spain, and Majorca; and as they purchase
 it with ready money, it is  a considerable  detriment
 to the country. I know it is commonly alleged that
they cannot have olives of their own growth  in plen-
ty and perfection, because  there are but  few hills
high enough to protect them from the cold northerly
winds: but I have been well assured by several very
good judges in such matters, that there  are  many
places, particularly in the Termino of Fer arias, where
this tender fruit  might be sufficiently sheltered; and
that the  want of  this  most useful commodity is  ra-
ther to be  ascribed to the  inattention  and neglect of

    (1) This is the fruit of the Palma humilis folio flabelli
formi.
    * Lucret. lib. v. Virgil's Georg. lib. ii. Ovid's .Aktam-
lib. i.
    t Difficiles primum terrae, collesque maligni
      Tenuis ubi Argilla, et dumosis calculus Arvis,
      Palladia gaudent sylva vivacis Olivx,
      Indicio est, tractu surgens Oleaster eodem
      Plurimus, et strati baccis sylvestribus Agri.
                                 Virg. Georg. lib. ii 
24
INTRODUCTION.
 the people, than to any other cause.  I have likewise
 been assured, that a Spanish governor of this island
 made use of his authority in obliging the inhabitants
 to cultivate the olive; and that his endeavours would
 have had  the  desired effect, if they had been duly
 seconded in succeeding times. Wherefore it were to
 be wished that some of his British successors would
 follow so laudable an example; for without their as-
 sistance it  is to be feared, that a people so  tenacious
 of the customs of their ancestors will scarcely come
 into a new project, however  advantageous  it might
 prove to posterity.
   From the berries of the  mastick  they extract an
 oil (as Diodorus Siculus tells us they did  in  his
 time) which is commonly used for lamps, and some-
 times by poor people for frying fish; in which case
 they previously correct its astringency by dipping in
 it a piece of soft  bread.  The leaves of the myrtle
 are very serviceable in tanning their leather, and in
 dyeing their cloths black, which is a favourite  colour
 among the Spaniards; and its tough flexible boughs,
 being properly twisted, make the best and  most du-
 rable rope  for the Persian wheel abovementioned.
  The berry-bearing savine (1) grows to a conside-
 rable height in several places near the sea coast;  and
the marshy valleys afford plenty  of oziers (2),  and
tamarisk (3), of which the islanders make hoops for
their  casks. The  carob-tree (4), the hawthorn  (5),

    (1) Sabina folio cupressi, C. B. Savina.
    (2) Salix viminea, Vime.
    (3) Tamariscus,  Tamarell.
    (4) Ceratia, Garrwoe.
    (5) Mespilus apii fol. sylv. spin. Spinal. 
INTRODUCTION.             25
and evergreen privet (l)  are likewise to be met with
in the woods; as also a few specimens of the agnus
castus (2).*
   And now  having taken a  view of the vegetable
kingdom, it would be no difficult task forme to show,
that the indigenous plants are  well adapted to the
nature of the climate, and wisely calculated for pre-
serving or restoring the  health of the inhabitants:
but as it would be tedious to descend  too far into
particulars, I shall only observe, that even the shape
and figure of the trees  seem to be somewhat more
than  merely the  effect  of chance. None of them
grow tall  or  lofty;  they never lose their leaves; and
the greater part of them  have their trunks so bent
by the north wind, that their tops, which  are broad
and bushy, stretch out almost  horizontally towards
the south, and  furnish a commodious  shelter to man
and  beast, against all inclemency of the weather.
What still makes them fitter for this purpose  is the
numerous climbers that  are  commonly joined with
them; particularly the traveller's joy  (3), and prick-
ly bind-weed (4), which.are often so interwoven with
the wide  spreading branches of the lentisc and wild
olive, as to render the retreat  which they afford al-
most impenetrable by rain or sun.  Had not nature
provided such a necessary cover, few or no animals

    (1) Alatemus, Llampugal-
    (2) Vitex, Alloch.
    * The reader may be pleased to take notice, that the Latin
names are those by which they are described by Tournefoil; the
others, in Italics, are those by which the natives distinguish
them.
    (3) Clematis, Vid. Auba.
    (4) Smilax aspera, Arritges
                        C 
26             INTRODUCTION.
could live  on these  rocks  in the tedious scorching
summers;  nor could they  well  endure the  heavy
rains and chilling blasts to which the climate is liable.
   From what has been said it sufficiently appears,
that these evergreen woods and thickets, which na-
ture has surprisingly raised upon a rock, are not
only a great ornament to this island, but of infinite
advantage to the inhabitants; as they furnish them
with fuel, and their cattle with food and shelter; and
as the  finer soil is washed away by the anniversary
rains, their fields would soon become barren, if they
were not constantly supplied with fresh manure from
the leaves of the vegetables,  intermixed  with the
dung of the animals which feed in the  woods.  The
natives, therefore, are much to be  blamed in  felling
so many of their trees,  and stubbing up the roots so
rashly, as they have done of late years, for immediate
profit,  since the damage will soon be  sensibly felt,
and not easily retrieved, by their posterity.
   The  mineral kingdom affords  less  variety here
than any other part of nature's works. The  soil is of
two kinds, whereof one is  light,  blackish, and very
fruitful;  the other, called terra agra by the natives,
is  a heavy, barren,  redcoloured  earth.  There  is a
potter's clay, of which  they make  tiles, bricks, and
a coarse kind of  earthenware.  Limestone and plas-
ter of Paris are found here in great abundance, and
supply the inhabitants \vTith different sorts of cement
for their buildings.  The stone commonly  used in
building is a white soft grit,  which  is easily cut
into any form, and quickly cemented by means of
the plaster of  Paris; so that they  raise walls, and
turn arches  with  great expedition. But  in  many 
INTRODUCTION.
27
places of the  island, especially towards the north-
east side, the only stone to be  met with is found  in
shivers, like slate. In caves not far from Ciudadella
is an infinite number of beautiful stalactites, some of
which are hard enough to admit of a polish.  There
are some fossil shells; but no  kind of metal, as far
as  I  know, occurs  in  Minorca; though there is a
good deal of metallic ore in the small island of Co-
lumba adjoining to it.
   With respect to the animals, I shall only mention
such as are used for  food by the inhabitants; be-
ginning with the  fish, of which there is  both plenty
and variety. Some of them are to be caught at  all
times either in the bays or harbours, or in the deep-
er water  at  sea; whilst others come regularly  in
shoals at certain  seasons of the year: but as  many
of them are unknown in Britain, or at least have no
name in our language,  I must refer the reader to the
bottom of the page,* where he will find inserted the

           * Pisces litoralcs,     Peix litoral,
    (1) Polypi prima species Rondeletii, Pop Juen.
    (2) Polypi secunda species Rond. Pop ver.
    (3) Loligo magna Rond. Eluja.
    (4) Loligo parva Rond. Calemar.
    (5) Sepia Rond. Sipia.
    (6) Urtica, Ortiga.
    (7) Anguilla Salv. Anguila.
    (8) Conger Rond. Congre.
    (9) Mursena omnium Autorum,  Morcna mascle, yfemele.
    (10) Salpa Rond. Saupa.
    (11) Sargus Rond. Sarch,
    (12)          Morruda.
    (13) Scaras Onias Rond. Variada-
    (14) Sparus Rond. Esperai.
    (15)' Aurata Rond. Orada. 
28               INTRODUCTION.

names given them  in Minorca, and those  bestowed
on them by the  best  authors  who have treated on
fishes.

             Pisces litorales,     Peix litoral.
    (16) Mclanurus Rond. Oblada.
    (17) Mormyrus Rond. Mabre.
    (18) Erythrinus Rond. Rubellio Aldr. Pagell.
    (19) Pagrus Rond. Pagre.
    (20) Dentex sive Synodon Aldr. Dental.
    (21) Coracinus Rond. Curbai.,
    (22) Buglossus, seu solea Rond. Llenguada.
    (23) Passer Bellonii, Pedas.
    (24) Cantharus, Cantara.
    (25) Lupus Rond,  Llop.
    (26) An  Acarnan Rond? Besuc.
    (27) Scorpius major Rond. Gesn. Cap rotx Rotje.
    (28) Scorpius minor sive Scorpaena Rond. Gesn. RastU Scor-
pera.
    (29) An  Anthis secunda  species Rond.? an Phycis Rond?
Mollera, Molle.
    (30) Mullus Barbatus Rond. Moll.
    (31) Channa Rond. Serra.
    (32) Merula Salv. & Rond. Mero, Enfos.
    (33) Turdus varia specie,  Tort musot, Jlavasado, Bovos, pin-
tado, Grivia.
    (34) An  Cestreus Rond.? Llisa-
    (35) An mugil Cephal. Rond.? Cap pla.
    (36) Julis Rond. Donzella.

          Pisces testacei is? crustacei, Peix de Closca.
    (1) Astacus Rond. Grumant.
    (2) Locusta Rond. sive Carabus, Llangosta.
    (3) Squilla lata Rond. Sigala.
    (4) Pagurus, Cabre.
    (5) Cancri varii, Cranchs peluts, reals, jfueus-
    (6) Squilla parva, Gambe.
    (7) Echinus varia specie, Voga mari.
    (8) Pinna magna, Nacre.
    (9) Pholas, Datil.
    (10) Testudo marina, Tortuga. 
INTRODUCTION.
29
      Ilie island abounds with cattle, sheep, and goats,
   which fumish the inhabitants with cheese and  wool,
   both for their own use, and for exportation. As lard
   or oil  is  commonly  used in dressing their  victuals,

               Pisces litorales,     Peix litoral.
       (11) Museums, Muscle.
       (12) Tellinae, Cluisas.
       (13) Osti-eum, Ostia.
       (14) Lepas, Patella, Pagellida.
       (15) Pecten, Cupina gravada.
       (16) Cancellus, Hermitan.
       (17) Cochlea varia specie, Comes & Caragols.
       (18) Mukx, Corns defell.
       (19)         Pau de Cabrit.

           Pisces Pelagii.     Peix de  alt al mur.
       *(1) Phociena Rond. Delfi.  *
       *(2) Centrine Rond. Peix pore.
       (3) Squatina Rond. Escat, Escat vexigal.
       *(4) Zygaena Rond. Llunada.
       (5) Catulus maximus, forte Canicula saxatalis Rond. Gats.
       (6) Catulus major vulg. Canicula Arist. Rond. Aldr. Gatons,
   Pintarotge.
       (7) Mustelus lacvis primus salv. Musolc\.
       (8) Galeus Acanthias,  Spinax Aldr. Caso.
       (9) Xiphias Piscis, Peix de Espasa.
       (10) Pastinaca Aspera Bellon. Romaguera
       (11) Pastinaca mar. lacv. Bellon. Ferrasa.
       (12) Aquila Bell. & S..lv.  Mila.
       (13) Rana Piscatrix, Buldroy.
       *(14) Torpedo, Tremulo.
      (15) Raia varia specie, Ratjada, Caputxi, Clavell, Clavcli
'  borrell, Cardayre.
      (16) Faber sive Gallus mar. Rond. Gall, Peix de san Pedro
      (17) Milvus Si.lv. Hirundo Rond. Xurign6.
      (18) Mugil alat. Rond. Hirundo Plin. Uranola.
      (19) Cuculus Aldr. Gallina, Gallinetta.
      (20) Lyra prior Rond. Grenau, Peix de san Rafael.
      (21) MuJlus imberbis Rond. pothis Cuculi species, Cabot dr
  '■■> mar.
                             r 2 
30
INTRODUCTION.
they make but little butter, and this by a very sin-
gular process. They boil the whey, which is pressed
from the curd in making  cheese,  and  skim off the
part which rises to the top;  when they have collect-
ed a proper quantity of this, they work it a considera-
ble time with their bare feet or arms, the only method

          Pisces Pelagii.     Peix de alt al mur.
     (22) Gurnardas griseus, Uliora, Baluerna.
     (23) Draco sive Araneus Plinii, Arana.
     (24) An Ophidion Rond.? an Acus lumbriciformis Willough.?
Drago, Saltan cono.
     (25) Uranoscopus, Callyonimus, Rata.
     (26) An Perca marina Rond.? Serran imperial-
     (27) An Stromateus Rond? Llampuga.
     (28) Pompilus, Pampul.

                 Pisces gregales autumnales.
     (1) Acus vulgaris oppian. Aguia-
     (2) Sardinia Rond. Sardina.
     (3) Thrissa Rond. Alatx.

                  Pisces gregales hyemales.
     11) Pelamys Bellon. Amia Rond. Bonitol.

                  Pisces gregales vernales.
     (1) An Thynni species?  Sirvia, Sirviola.-
     (2) Sphyrxna, sive Sudis Aldr. Espet.

                   Pisces gregales JEstivi.
     (1) Scomber, Veirat, Cavallar.
     (2) Trachurus Aid. Saurell.
     (3) Maenx duplex species, Mora & Xucla.
     (4) Smaris, Gerretts.
     (5) Boops Rond. primus, Voga-
     (6) Encrasicholus Aldr.  Anxove, Aledroc.

     Note. In the above catalogue offish it is to be observed that
Willoughby's names are commonly made use of; and such as are
marked with an asterisk are seldom or never brought to table. 
                INTRODUCTION.             31
 of churning with which they are acquainted; then by
 the addition of cold water the butter which floats upon
 the  surface is separated; and after being washed is
 boiled till the watery particles are evaporated. By this
 process it acquires, when cold, the taste and consis-
 tency of a thick, sweet, oil.
   Beef and mutton, though commonly lean, are eata-
 ble throughout the year: but in the spring, while the
 grass is tender, the latter is in its greatest perfection;
 and the former  in summer, when the cattle feed on
 the stubble and  leaves of the evergreens.
   The goats are fattest in autumn,  and are slaugh-
 tered from September to  January, chiefly  for  the
 use of the common people.
   But of all the kinds of meat none  is here in so
 great plenty and perfection as  pork; nor is  any
 other  so  much  esteemed by the natives.   It is in
 season from September to Lent. Bacon is to be had
 at all times; and, being fried or boiled, is  commonly
 eat with bread for breakfast.  They enrich  their broth
 with hog's lard; and from  the same animal they
 make a great variety of puddings, particularly sau-
 sages (sobreassados), scarce  inferior to  those from
 Bologna.
  They  have likewise  plenty  of rabbits;  as  also
hedgehogs, and land turtles, which are sometimes
eat by the poor.
  Their  domestic fowls are turkeys (1), geese (2),
ducks (3), cocks and hens (4), in  great numbers.

    (1) Gallo pavo sive meleagris, Galls de India.
    (2) Anser domesticus, Ojas.
    (3) Anas domestica, Anades-
    (4) Gallus gallinac. k Gallina, Galls & Gallinds. 
32
INTRODUCTION.
   In the woods and fields (besides various kinds  of
owls and  birds of prey, which I pass over, as they
never make a part of diet)  we have ring doves (l),
red legged partridges (2), stone curlews (3),  quails
(4), blackbirds  (5), solitary sparrows  (6), nightin-
gales (7), gold-finches (8), and an  infinite  number
of other small birds.
   Wild ducks of different kinds (9), wigeons (10),
teal (11), coots  (12), and several sorts of water hens
(13), are  common  about  the ponds and marshes;
kings-fishers (14) are frequent about the shore; and
flocks of rock-pigeons  (15) breed  in the caves and
hollows, formed by the dashing of the waves  round
the coasts.
   Beside all these, swifts (16), swallows (17), sand
martins  (18),  turtles   (19),  bee eaters (20), hoo-

    (1) Palumbus torquatus Aldr. Tudons.
    (2) Perdix ruffa, Perdius.
    (3) Oedicnemus Bellon. Charadrius Gesner. Sabellins.
    (4) Coturnix, Gualleras.
    (5) Mciula vulgaris, Torts.
    (6) Passer solitarius, Melleres.
    (7) Luscinia seu Philomela, Rossinols.
    (8) Carduelis, Cardemeras.
    (9) Anas fera, varia specie,  Anades rosas de coll blau, sayar-
t^s, soteras.
    (10) Penelope.
    (11) Querquedula, Anadons.
    (12) Fulica, Fotges.
    (13) Gallinula varia specie, Polio's de Riu Gallets de  Riu Tr
trtas.
    (14) Ispida, an Veterum Alcyon?
    (15) Columba rupicola, Coloms.
    (16) Hirundo Apus, Vinjolas.
    (17) Hirundo domestica, Uranellas.
    (18) Hirundo riparia, Culs blanchs.
    (19) Turtur, Tortora.
    •r20) Merops sive Apiaster, Abeyrol? 
                INTRODUCTION.             33
po's (l), and skylarks (2), arrive here in the spring,
and, after bringing forth their young, leave the island
in autumn.
   Woodcocks  (3), snipes  (4), a  small sort  of pi-
geon (5), green and gray plovers (6), redwings (7),
fieldfares (8),  oxeyes  (9), chaffinches  (10),  star-
lings (11), foreign quails (12), and daker-hens (13),
make their appearance  about the end of October, and
remain during the winter.  Cranes (14), wild  geese
(15), and curlews (16), sometimes  stop here, as if it
were to recruit themselves for a further flight; and
now and then we meet  with a  flamenco (17).
   It is  observed that the flesh of such  fowls as feed
on land frequently tastes of mastick or garlick; and
the water fowl are best in bad weather,  when the
storms  prevent their  going to  sea,  and living  upon
fish.
   But  as several of the   animals   abovementioned
are only to be met with at the tables of the opulent,

    (1) Upupa Aldrov. Puputs.
    (2) Alauda, Turrolas.
    (3) Scolopax, Segues.
    (4) Gallinago minor Aldr. Begasines.
    (5) An Columbalivia Gesner.? Xexels.
    (6) Pluvialis viridis & cinericea.  Kilots &juyes.
    (7) Turdus iliacus, Torts borrell.
    (8) Turdus pilaris.
    (9) Fringillago, Ulls de  bou.
    (10) Fringilla, Pinsans.
    (11) Sturnus, Estornells.
    (12) Coturnix, Gualleras babarescas.
    (13) Ortygometra, an Rallus terrestrisi
    (14) Grus, Gruas.
    (15) Anser ferus, Ojas  salvages.
    (16) Numenius sive Aquata.
     (17) Phsenicopterus, Flamences 
34            INTRODUCTION,
the plentiful provision of snails (1), with which na-
ture has furnished this island, are of infinite service
for the maintenance of the poorer families, who eat
them boiled, after  having been kept within doors
long enough to lose their earthy taste.  In dry wea-
ther, when they are in their prime, they lurk in the
chinks of the  earth and crannies of the  rocks, and
commonly stick together in large clusters like grapes;
which probably induced the Romans to give them
the name  of cochlea; cavaticce: but  in  wet moist
weather, they  leave  these places of retirement  in
quest of food, and  are frequently to be met with on
the stalks of the asphodells, the shoots of the vines,
and other vegetables; for what Pliny says of their
never coming out of their caves, or feeding on greens,
is intirely fabulous. Lib. viii. cap. xxxix.
   Having given these short hints relating to the na-
tural history of Minorca, I  shall now describe the
temper and manners of the people, so far as may be
necessary to introduce an account of their diseases.
   The natives of this island are commonly thin, lean,
and well built, strong and active, of a middle stature,
and an olive complexion. Their hair, for the  most
part, is black  and curled; in many chesnut coloured;
in some red. In a word, the young people are either
of a sanguine  or choleric constitution;  while those
of more advanced years  become dry, meagre, and,
what the ancients called atrabilious.  Such is the na-
tural impetuosity of their temper, that  the slightest
cause provokes them to  anger;  and they are equally
incapable  of  forgiving   and forgetting  an  injury.
(1) Caragols, Boves, Mongetas, Caragolins. 
               INTRODUCTION.             35
Hence it is, that quarrels about the merest trifles
daily  break out even among neighbours  and rela-
tions; and family disputes are hereditarily transmit-
ted from father to son. Thus,  though lawyers and
pettifoggers are very numerous in this country, yet
there  are still too few for  the clients.
  They do not commonly live to so great an age as
the inhabitants of more northerly countries; though,
perhaps, they  are equal in this respect to their near-
est neighbours on the continent. Girls soon arrive at
maturity, and soon grow  old. The menses, for the
most  part, appear before fourteen, and frequently at
eleven years  of  age; in  some they  return twice  a
month;  in  others, every three  weeks,  and continue
from three to seven days.  Both sexes are, by consti-
tution, extremely amorous. They are often betroth-
ed to each other while  children, and marry at four-
teen.  The women have easy labours, and commonly
return in a few days to their usual  domestic busi-
ness.  Lest the family should become too numerous
for their income, it is a practice among  the poorer
sort to keep their children at the breast for two or
three years.
   Bread of the finest wheat flour, well fermented
and well baked, is more than half the diet of people
of all ranks.  Rice, pulse, cuscassowe, vermicelli,
herbs and roots from the fields and gardens, sum-
mer fruits,  pickled olives, and pods of the Guinea
pepper, make  up  almost the other half; so that scarce
a fifth of their  whole  food  is furnished from the
animal kingdom; and of  this  fish makes by  much
the most considerable  portion.  On Fridays,  and
other fast days, they abstain entirely from flesh;  and 
36
INTRODUCTION.
during lent they live altogether on  vegetables  and
fish, excepting Sundays, when they are permitted the
use of eggs, cheese,  and  milk.  Most of their dishes
are high seasoned with pepper,  cloves,  cinnamon,
and  other  spices; many  of them are tinged  with
saffron;  many sweetened with  honey or sugar;  and
garlic, onions, or  leeks, are almost constant ingre-
dients. They eat a great deal of oil, and that  none
of the sweetest or  best flavoured; using it not only
with  sallads, but  also with  boiled  and  fried  fish,J
greens, pulse, &c. instead of butter. A slice of bread
soaked in boiled water, with a  little oil and salt, is
the common breakfast of the peasants, well  known
by the name of oleagua.  Their ordinary meals are
very frugal, and consist of little variety: but on fes-
tivals, and other solemn occasions,  their entertain-
ments are to the last degree profuse and extravagant.
The bill  of fare of a country farmer's wedding din-
ner would scarce  be  credited. This  custom,  with
many others, they seem to have  borrowed from the
eastern nations.
   People of all conditions use  wine at their meals;
and though drinking to  excess is not common, yet
the vulgar are not exempted from private  debauches,
drams of anniseed water being too  much in vogue.
In summer the excessive heat  obliges them to have
frequent  recourse to large  draughts of cold water,
the greater part of which is but very indifferent; for
the cisterns are seldom clean, and the water which
the springs and rivulets afford is often brackish, and
always hard; so that it is. neither proper for washing,
nor for  boiling pulse, and leaves a stony crust on 
                 INTRODUCTION.             37

 the sides of the teakettles, and other vessels in which
 it has been frequently boiled.
   Though the natives make three or four plentiful
 meals  a day, yet they  are generally costive; and
 many,  in  perfect health, have no occasion to ease
 themselves oftener than twice a week.
   They are  so much addicted to the  use of tobacco,
 as never to be without a pipe, either in their mouths
 or their pockets. In  summer almost every one sleeps
 an hour or two  after dinner, and some follow this
 practice throughout  the year.
   A fourth  of their  time is made up  of holidays, on
 which, though  work is prohibited, sports and pas-
 times are allowed. A considerable part of those days
 is spent in the churches, or in processions:  at  night
 the more  sedate divert themselves in their houses
 with music  and  cards; whilst the young  men  sere-
 nade their mistresses, in the streets, with the jarring
 musick of their guitars, and extemporary  love songs
 of their own composing.
   In the interval between the harvest and the vin-
 tage  there is a number of public diversions in dif-
 ferent places of the island.  Whether because the
 people have  then most leisure, or are in reality more
 cheerful from the serenity of the weather, as one of
 their proverbs* seems to hint, I shall  not determine.
 To their horse and foot races,f notwithstanding the

  * En lo estiu tout hombre viu. In summer every body is alive.
  f On St. John's day, June the 24th, and the Sunday following.
 On St. Peter's day, June 29. On St. James's day,  July 25. On
 St. Laurence's day, August 10. On St. Bartholomew's day,.
 August 24, and the 29th of the same month. On St, Gracia's
day, September 8.
                        D 
38       *     INTRODUCTION.
 immoderate  heat of the season, men,  women, and
 children flock from all quarters, and expose them-
 selves to the  sun in the middle of the day, dancing in
 the open air on the scorching rocks,  and rattling their
 castanets in  concert  with the  music of the guitar.
 Nor does their mirth finish with the day; as soon as
 it grows dark some pieces of pine tree are lighted as
 a torch in the middle of the street,  where the crowd
 assembles, and continues dancing till morning.
   Every year, on St. Peter's day, June 29, they have
 likewise a diversion in Mahon harbour, which may
 properly be called a boat race; and one cannot ob-
 serve the eagerness of the boatmen, and the  solici-
 tude  of their friends on shore, without calling  to
 mind Virgil's description of  a similar contest on
 the anniversary of Anchises's funeral. Mn. v. ver. 129.
   In the carnival too,  this people, however grave
 and serious at other times, freely indulge themselves
 in all manner of ludicrous sports and amusements;
 especially  during the last week of it, when  their
 revelling and extravagant mirth resembles more the
 ancient bacchanalia, than the diversions of  any mo-
 dern civilized nation: for night and day the streets
 are filled with people^in masks, and dressed in the
 most ridiculous habits; while  the  jarring  sound of
 castanets, pipes and tabors, violins,  guitars,  and their
 more  discordant   vocal  music, heightened  with
 screaming, shouting, and every wild  demonstration
 of intemperate joy, make almost one continued uproar.
   After this  excess of  mirth the fasts enjoined by
their religion succeed, and continue till the expira-
tion of lent; at  which  time  a sheep  or a lamb  is
slaughtered by each family; and on the joyful night 
INTRODUCTION.
39
which puts an end to  this mortifying season, they
endeavour, as it  were, by one  voracious meal  to
make  up for the  abstinence  which they have been
compelled to observe. This proves fatal to some, and
would undoubtedly be  so to many more, if nature
did not prevent the effects of their intemperance, by
a cholera morbus,  or some such relief.
   The last thing to be  taken notice of with regard
to the manners of these islanders, is, that their great
veneration for antiquity,  and the little intercourse
which they formerly had with other nations, have
occasioned a number of old customs to be still kept
here at this day.   Thus,  poetical disputes are much
in vogue amongst the peasants.* One of them sings
some  extemporary verses on whatever  subject he
pleases,  and  accompanies them with the music  of
his guitar: he is immediately answered, in the same
number  of unpremeditated lines, by another, who
endeavours to excel or  ridicule him; and  this  alter-
nate contest lasts, to the no small amusement of their
attentive companions, until the wit of the rival poets
be exhausted. These are the cartnina amoeboea  of
the ancient Greeks, in  imitation of which some  of
the  pastorals  of  Theocritus and Virgil  were
written.  In imitation of the ancients too, it is custo-
mary for lovers to pelt their mistresses with oranges,
as a  mark  of their regard;f though this  is a diver-
sion  reserved for the   carnival.  The  practice  of
throwing nuts and almonds at  weddings, which Vir-
gil  mentions  (Eclog.  viii,)  is  likewise retained.

   * These verses are called glossos, and those who excel in
making them, glossodors.
   \ Malo me Galatea petit lasciva puella, &c.
                                Virg. Eclog. iii. 
40
INTRODUCTION.
Soon after a person is deceased his friends and re-
lations assemble in the house to bewail their  loss,
and commemorate his virtues, weeping and howling
with  all the seeming agonies of distress; and that
this was an ancient custom, appears by the elegant
and  pathetic funeral dirge, which we find  in Lu-
cretius  (lib.  vi.)  And in  this island, as  in the
southern provinces  of France, and in Italy, the dead
bodies are not nailed up in coffins, but carried in an
open litter to the grave, which, we learn from authors,
was  also  practised, on  some occasions, among the
old Romans.*  Another instance of their inviolable
attachment to ancient usages, is the manner in which
the women wear their hair; for, contrary to the cus-
tom of all  the neighbouring countries, excepting
Majorca, they force it with  fillets to the back part of
the head, and bind it in a  queue of a considerable
length.  When the natural locks are not long enough
for this purpose, false ones are added to supply the
deficiency; for nothing is reckoned more unbecoming
than to be destitute  of a tail, or to appear with one
too short.  But not  to be tedious with too many in-
stances, I shall only add, that in the use  of the sling
the present inhabitants  of Minorca are no less dex-
trous than their forefathers, who are said to have
driven the Romans off their coasts by vollies of
stones (Flor. Epitom.  lib.  iii.)  The shepherds, or
those that tend  the cattle, seldom miss such of them
as fall under their  displeasure; and  by this  means
they have their flocks and herds so much at command,
that even the cracking of the empty sling is sufficient
   * See Cornelius Nepos on the burial of T. Pomponius
Atttcls, and Lispius's Notes on this passage. 
INTRODUCTION.
41
 to intimidate them, and bring them together in such
 parts of the pasture  as their keeper pleases: and as
 the cattle are often maimed and hurt by the severe
 chastisement inflicted by means of this instrument,
 the farmers find it expedient to forbid the use of it
 to such of their servants as are  of a cruel and mis-
 chievous disposition.
   The mentioning of their cattle puts me in mind of
 two other  singular practices which  prevail here, viz.
 that of castrating  animals by bruising their testicles,
 which,,  we learn  from Albucasis (Chirurg.  p. 2.
 cap. lxix.) was customary among the Arabians; and
 the way of slaughtering oxen, by thrusting a knife
 into the medulla spinalis, immediately behind the
 occiput, which is so much preferable to the method
 of knocking them  on  the  head, that it is surprising
 other nations do not fall into it.
   Having  gone through v/hat I intended to remark
 in relation  to the  natives, I should next, according
 to the plan of this  introduction, give a circumstantial
 account of the diet, and common way  of life, of the
 British soldiers in this island; but  as this would be
 a disagreeable  task, I  shall  only observe, that the
 excess of drinking is, among them, an universal vice,
 confirmed into a constant habit.  Pudet hxc opprobria
 nobis, &fc.
  But however different the Spaniards be from the
 English, in their meat, drink,  exercise, affections of
the mind, and habit of body; yet the health of those
of both nations is equally  influenced by the seasons.
 An epidemical distemper seldom  or  never attacks
one class of inhabitants, while the other remains un-
hurt; and  surprising  as it may  appear, it is never-
                      D 2 
42
INTRODUCTION.
 theless true, that the peasants, who are remarkable
 for temperance and regularity, and the soldiers, who,
 without meat and  clothes,  frequently lie  abroad
 drunk, exposed to all weathers, have diseases almost
 similar, both  as to  their violence and duration.
 Hence it is evident how far  the power of the air is
 superior to that  of the other nonnaturals in  produc-
 ing disorders of the animal economy.
   The diseases which, from their frequency in this
 island, I reckon  endemial, may be divided into two
 classes; the epidemic, or such as affect numbers to-
 gether at particular seasons; and the sporadic, which
 are equally common at all times of the year. To the
 first belong the rash, essere, cholera morbus,  tertian
fevers, fluxes, pleurisies, peripneumonies, erysipela-
 tous fevers, and those that are accompanied with ca-
 tarrhs: to the  second, obstructions of the abdominal
 viscera, the hemorrhoids, ulcers of the legs, ruptures,
 inflammations of the eyes, and nephritic pains.
   With respect to the epidemics, it may not be im-
 proper to observe in general, that acute fevers  are
 more frequent here than in England; that they are
 much  more violent,  but of shorter  duration;  that
 they  oftener  terminate  completely  by a manifest
 crisis; and in  all  respects agree much more exactly
 with what the  ancients have  said concerning such
 evacuations, and the  periods in which they usually
 happen.
   The most common diseases of the sporadic kind
 are obstructions,  indurations, and swellings of the
 glandular viscera in the lower belly; together with
 wind in the first  passages, and bad digestion.  The
 causes of these obstructions seem to be, in the first 
INTRODUCTION.
43
place, a scarcity of good water; for, as Hippocrates
has well observed,* Where  there are no rivers, and
the inhabitants are  obliged to drink stagnating, ill-
scented well water, such must  needs  hurt both the
belly and the spleen. And it is remarkable, that large
spleens, like those described by Trallianus (lib. viii,
cap. xii,) and hard tumefied livers, are not only com-
mon to the  human species here, but also to brutes;
particularly the sheep  that  feed  on the northeast
side of the  island, where the  waters are very brack-
ish; though the butchers, to whom this fact is well
known, generally ascribe it to their eating the horse-
mint and pennyroyal, which abound in the pastures.
   Secondly. The intense and long continued sum-
mer heats, by dissipating the finest particles of the
animal juices, necessarily leave the rest of a grosser
and more  earthy nature. And thus is a large pro-
portion  of that  kind of matter  generated  in the
blood, which the ancients called atrabilious; and this
being deposited in the viscera, occasions the above-
mentioned obstructions. See Boerhaave's Aphorisms
de Melancholia.
   Thirdly.  Another cause of these obstructions is
the frequency of acute diseases, and more especially
of tertian fevers, which, as  they frequendy relapse,
and go off with imperfect crises, weaken the tone of
the chvlopoetic viscera,  and at last terminate in hard
scirrhous tumors of the  liver and spleen.
    It is likewise  probable that their living so much
 upon pulse and crude vegetables,  the abuse of spi-
 rituous liquors, their high  seasoned diet, their pas-
 sionate temper,  and immoderate use of venery, co-
         * De Aere, Aquis, et Locis, sub finem. 
44
INTRODUCTION.
 operate with the causes just now mentioned, in pro-
 ducing the same effects.
   But such is the goodness of Providence, that eve-
 ry climate seems to yield domestic antidotes for the
 endemial diseases.* Accordingly we  find that this
 island  abounds  with whey,  honey, summer fruits,
 gentle cathartics, hieracea, cichoracea, and  all that
 class of plants and roots with aperient saponaceous
 juices, which antiquity has recommended as specifics
 or approved remedies in obstructed bowels.
   But in these distempers it is universally allowed,
 that nothing is of so much advantage as. the hemor-
 rhoidal  flux; and therefore,  however frequent and
 troublesome the piles may be in  this  climate, they
 ought to be considered rather as a benefit of nature,
 and a remedy, than as  a misfortune,  or a disease;
 more especially as they  prevent pleurisies  and  peri-
 pneumonies,  according  to the doctrine of Hippo-
 crates. De Humor. &  Epid. lib. vi.
   Baglivi f tells us, that at Rome ulcers of the legs
 are almost incurable, and wounds in  them difficult
 to heal; while the like  accidents  on the head are
 quickly cured without any trouble. The same thing
 happens here, insomuch  that  it is a proverb  among
 the natives, " Minorca is good for the head, but bad
 ufor the shins."]. This,  perhaps, is owing  partly to
 the redundancy of atrabilious particles in the blood,
 which naturally flowing into the inferior branches of
the aorta, constantly  keep open any outlet through

  * See the quotations from Ray and Bexorovinus, in Der-
ham. Physico I'hu olog. Book x.
  f Prax. Med. lib. i. p. 102.
  * Minorca es bo de Cap y mal de Camas. 
INTRODUCTION.             45
which they have once found the way;  partly to the
large obstructed viscera, compressing the vena cava,
and hindering the free return of the fluids from the
inferior extremities. Hence we find, that ulcers of
the legs, with black cicatrices  (such as may daily be
seen among the soldiers and  Spaniards), are men-
tioned both by Hippocrates (De Morb. Intern.)
and Celsus (lib. ii, cap. vii,)  as the effect of over-
grown spleens.
   And now it plainly appears why  ruptures are so
common  in this place;  for the  other  bowels being
swelled beyond their natural size, the  intestines are
too much confined; and from the nature of the aliment,
being frequently distended with wind, it is not to be
wondered at, that they often push through the rings
of the abdominal muscles.
   In so hot and dry a country as this all the parts of
the body are very subject to topical inflammations:
 But the eyes are most  particularly affected in this
 way; which seems to be occasioned  chiefly by the
 strong dazzling light reflected, during the summer
 season, from the white  rocks  and sand; to which we
 may perhaps add, that the floating  particles of salt,
 dust,  and minute insects, wherewith the air often
 abounds, do likewise injure  the  tender texture of
 this organ, and give rise to ophthalmias, or increase
 them.
    Whatever dissipates the finer parts oi our fluids,
 and increases the proportion of earth  and fixed mat-
 ter (and several such causes  I have already had oc-
 casion to take  notice of), will be apt to produce
 sand and gravel in the urinary passages;  though it is
 probable, that the calculous concretions and nephri- 
 46             INTRODUCTION.
 tic pains are chiefly  owing to the waters,  which,
 as I formerly observed, are mostly hard  and brack-
 ish, and let fall a large  quantity of stony sediment
 after boiling.
   The convulsion of the lower jaw in children ought
 likewise to be  reckoned among the sporadic dis-
 tempers.  And as it is both  very frequent and fatal
 in this island, and some of the neighbouring coun-
 tries,  I shall give a description of it from Hyacin-
 thus  Andreas, a Spaniard, who, about the  end  of
 the last century, published an abridgment of Rive-
 rius,  under the name of Praxis Medica Gotholano-
 rum, with very little addition of his own, excepting
 an account of this disease, which most other authors
 have omitted. In hac urbe nostra Barchinonensi af-
fictantur plurimi infantes,  adeo feroci convulsione
 mandibular inferioris, ut ea apprehensi, nullo possint
 motu Warn movere, et abhinc  suctus  lactis impeditur
 omnino. Emergit hoc malum  ex causa humiditatis re-
 gionis, et potissimum si matres,pra;gnationis tempore,
 minus sobrie vixerint; et uses fuerint alimentis humi-
 dis, et potibus gelidarum eximiis: et  quanquam  istas
 duas inveniamus causas, adeo manifestos, existimo ta-
 ?nen potius hanc cladem insolescere, ex peculiari cteli
 vel astrorum infiuxu, quam ex illis duabus: Nam  in
plurimis aliis humidis regionibiis laute bibunt mulieres,
 et tamen non affiictantur infantes  (ita attestantur
 medicij morbo isto diro, quemadmodum in hac nostra
 civitate, in qua  tot interfcit mala ista convulsio,  ac
 variola: aut morbilli. Unde si in toto orbe  premantur
 infantes unico tyranno, nempe variolis, in hac qui-
 dem civitate,  duplici confiictantur, sciz.  variolis  et
 convulsione mandibularum, qua a  nostris  midier- 
INTRODUCTION.
47
cults et obstetricibus vocantur  barrettas, in quarum
periculum incurrunt recenter nati, usque ad nonum
sui nativitatis diem, eoque transacto, omne discrimen
cessare docuit semper experientia.  It is needless to
add the remedies prescribed by our author, who in-
genuously confesses, that the disease is so seldom
curable, that in twenty years' practice he had scarce
known six recover.
   To  these we may add the following  hurts arising
from  endemial causes.  The children  and peasants
are often  ulcerated with the caustic milky juice of
the figtrees and spurges, which  are common in the
fields: in drinking corrupted waters sometimes leech-
es are swallowed, which I have known to occasion
 extraordinary symptoms, such  as coughs,  nausea,
 spitting of blood,  &c. to the great surprise of both
 the physician and patient, who were entirely igno-
 rant of the cause  of these complaints. The pastinacae
 marine,  and aquila, wound  dangerously  with the
 stings in their tails; and the scorpius, scorpaena, and
 draco, with the prickles of their back; (for which
 reason the fishermen are obliged by law to cut off
 these  weapons before they bring the fish to market).
 In the hot weather the viper, the land  scorpion, and
 the small black field spider, are reckoned poisonous.
 In the  spring the hedgehogs, flagrantes a-stu  ve-
 nerea, are  said  to pollute the waters, to which
 they have access,  and thereby occasion a strangury
 and  priapism to  those  who drink of  them: and at
 this season the flesh of  these animals  has the same
 effect, though it is wholesome  and innocent enough
 at other times of the year. But as accidents of this 
48             INTRODUCTION.
class rarely occur, it is sufficient barely to mention
them.
   In the opinion of the natives no diseases are more
frequent here than witchcraft, charms, and evil spi-
rits. Those nevertheless, I shall entirely omit, hav-
ing neither leisure nor inclination  to enlarge upon
the craft of the clergy,  and  the credulity of their
flocks: but whoever desires to see  this subject co-
piously handled,  may consult  the learned  father
Feijoo, who, in his useful and elaborate volumes on
vulgar errors, has taken occasion to expose the tricks
of those pious jugglers, who pretend to exorcise evil
spirits, together with several other impostures of the
same nature.
   These particulars I thought it necessary to pre-
mise, before we enter on  the history of the epidemi-
cal diseases. In excuse for whatever errors I may
have committed in this mixed essay, I hope  I may
be allowed to plead, that  I wrote it  in a part of the
world, which afforded me very little  assistance either
from men or books.
       Qualemcunque igitur venia dignare libellum
       Sortis et excusa conditionem meae.       Ovid-
Minorca, An. Dom. 1747. 
AN ESSAY
                    ON THE


  EPIDEMICAL DISEASES

                      IN


              MINORCA.


                CHAPTER I.

    Of the Weather from the Tear 1744 to 1749.

1 AM sorry that it was not in my power, for want
of conveniency and proper instruments, to determine
exactly the weight of the air, the quantity of rain,
and the force  of  the winds: notwithstanding which
omissions, I  flatter myself, the following short ac-
count of the principal variations of the weather, ta-
ken from a diary regularly kept, with very few in-
terruptions, will  neither  be entirely useless  nor
unacceptable:  and, in order to make it better un-
derstood, I shall  premise  a few  explanatory obser-
vations.
  In the first  place, in speaking of days and months,
I use the old  style, as is customary among the  En-
glish in Minorca; though the natives reckon by the
new: and where it appeared necessary to distinguish.
                      E 
50           OF THE WEATHER.
 the forenoon from the  afternoon, I have annexed
 a. m. or p. m. to the particular days.
    Secondly, Wherever a rainy day occurs, without
 any dots after it, the reader will be pleased to take
 notice, that  only drizzling rain, or a slight  shower
 happened on that day: but if two dots be placed after
 it, in this manner • • it signifies one or more smart
 showers to have fallen: if three dots • • • great rains:
 if four • • • • extreme heavy rains, or rather floods of
 water.
   Thirdly, Wherever the thermometer is mentioned,
 it is to be understood of a large mercurial one, gra-
 duated according to Fahrenheit's scale, and kept
 in a proper place within doors; except when I describe
 the heat of the sun's rays; which was measured by a
 smaller instrument  of the same kind, hung out at an
 upper window, in the open street, at a considerable
 distance from the walls of houses. Both these ther-
 mometers, being dipt in snow, fell to the 32d degree.
 Both were raised to the 96th, 97th, or 98th degree,
 by the natural warmth of persons in health. Nor did
 I  observe any other difference between them, ex-
 cepting that the mercury  m the smaller was  sooner
 affected  by heat or cold, and consequently a little
 quicker in its motions; which  occasioned its being
 found sometimes a  degree higher in summer, and
 as much lower in winter, than the quicksilver in the
 large thermometer.
   Fourthly, The height  of the thermometer, at a
 medium, during each month,  is calculated from ob-
 servations made  about three o'clock in the afternoon,
when the mercury is commonly higher by one or two 
OF THE WEATHER.           51
degrees in winter, and two or three in summer, than
in the mornings and evenings.
  Fifthly, The difference between the heat of air
warmed by the direct rays of the sun, and that in the
shade, is at a medium in summer, about 13 degrees.
Whenever it was remarkably greater, notice will be
taken of it;  as likewise of the  most extraordinary
heights to which the mercury rose, when the ther-
mometer  was exposed to the sun, at other times of
the year.
  Sixthly, The  mercury seldom or never sinks be-
low the 48th degree in Minorca, except when sharp
winds  blow from the north, which cause the weather
to seem as intensely cold as it is in England, when
the thermometer has been ten degrees lower. And
upon the  descent of heavy rains, particularly in the
autumn, the cold affects us much more sensibly than
one would imagine, from the alteration of the ther-
mometer.
  These things  being premised, I  proceed to de-
scribe the most remarkable changes of the weather,
in each month, during the period of time that pro-
duced the epidemical diseases, which are the subject
of this treatise.

             A.D. MDCCXLIV.
  January was  mild and temperate in the begin-
ning: but after the rains,  about the middle of the
month, it continued, for  the most part, cold and
cloudy.
  Rainy  days,  1, 6, 9, • • 10, • •  11, 14, 15, • • • •
19, • • with hail, 20 with hail, 24, 27, 30.
  The first days  of February  were cloudy, cold, 
 52           OF THE WEATHER.         1744.
 rainy,  and stormy: from the  4th to the  19th the
 weather  was moderate  and seasonable,  without ex-
 cessive rains or immoderate cold: from which to the
 26th it was fair and warm: but  afterwards to the
 end of the month, rough and  stormy as in the be-
 ginning.
   March, during the first week, was sometimes warm
 and sometimes cold: but  in the three last weeks
 piercing winds blew constantly from the north, with
 frequent rains, and sometimes hail.
   The  weather  continued  colder, and  more disa-
 greeable than usual, till  much rain had fallen about
 the middle  of April; the remainder of which month
 was mtfstly fair and temperate.
   The  first fortnight of May was likewise fair and
 temperate;  the latter part of it dry and warm, with-
 out any rain.
   June was clear, calm, dry, and sultry, as this and
 the two following months are constantly observed
 to be; the weather varying  much less in these than
 in the other months. Rainy day, 9.
   In July the northerly winds were higher and more
 frequent than ordinary, insomuch, that on some days
 the cold was more troublesome than the heat; nor
 do I ever remember to have felt so little heat in this
 month in Minorca.
  Rainy days, 6, at night • • • •  with thunder and
 lightning, 17, p. m.
  Coldest day, 8.          Therm. 70. \ Height at  a
  Hottest days, 21, 22, 31.           80.3 med. 76^.

  During the first days  of  August the northerly
winds continued; but  the rest of the month was 
1744.         OF THE WEATHER.           53
either calm, or the breezes came from the south, the
air being very hot and sultry.
  Rainy days, 2, a. m. 14, a. m.
  Coldest days, 3, 4.         Therm. 73. ? Height at a
  Hottest days, 27, 28, 29, 30.       80. S med. 77-^.

  In September the weather is always very unequal;
fair intervals, and  short violent storms reciprocally
succeeding each other: but this year the anniversary
rains were not so constantly attended with northerly
winds as they commonly are.
   Rainy days, 7, a. m.----with thunder and light-
ning, and  at night----11, at night,----15,  at
night,----18, at night,----19, at  night,----
22, at night, • • • •  with lightning, 23, at night, • •  •
with lightning.
   Coldest days, 17,  26.      Therm. 71. ? Height at a
   Hottest days, 1, 2, 3,             76.5 med. 73^.

   In the first part  of October the winds were mostly
 from  the north or northwest, the weather  variable
 and unsettled: but from the 14th to  the end of the
 month it was calm, warm, and fair.
   Rainy days, 2, at night, 4, at night,  • • 5,  at night,
 • •  13, a. m. and p. m. * • * •
   Coldest day, 14.          Therm. 65. > Height at a
   Hottest days, 1,2.               71. S med. 68^.

    November was remarkable for bad  weather.  All
 the first day,  and  the second before  noon, it blew
 violently from the north, with heavy rain: from the
 7th to  the 22d the  weather  was constantly cold,
 cloudy, and stormy, with hail, rain, and high winds,
                        E2 
54           OF THE WEATHER.         1745
from the north.  After a few fair days this month
ended stormy, as it began.

  HotlS;,.   ^ ^Height at a med. 5,

  From the first of December  to the 13th the air
was cold, but for the most part clear; the wind north
or northwest. But at that time shifting suddenly to
northeast, a violent storm began, and continued with
great fury to the 17th, more especially in the nights,
with hail, rain, and flakes of snow. On the 18th the
weather again cleared up; but on the 21st it became
cold, stormy, and rainy; and, excepting one fair day
or two, it continued so to the end of the month.
  Coldest days, 14, 15.      Therm. 44. > Height at a
  Hottest days, 26, 31.              57.$ med. 54.

              A.D. MDCCXLV.
  This year began with  strong  piercing northerly
winds;  nor did the  coldness  of the air  decrease
much before the latter end of January, though the
weather was mostly calm and clear with sunshine.
  Rainy days, 6, at night, • • with hail, 13, at night,
•  • 15, at night, • • 26, at night,
  Coldest day, 6.         Therm. 43. > Height at  a
  Hottest days, 26 to 31.        57.5 med. 52.

  The first week of February was  pleasant and se-
rene; the remainder was  mostly  cold, cloudy, and
overcast.
  Rainy days, 8, p. m. • • • 11, at night, • • • 15, • ■
21, • * • 24, a. ra. •  • • 25, 28, •  • 
1745.         OF THE WEATHER.          55

  Coldest day, 26.        Therm. 46. ? Height at a
  Hottest days, 7, 8.             61-5 med. 55.

  Except the first day, which was windy, contrary
to custom, March was warm, calm, and dry, without
any storms, the winds being mostly from the south
or west.
  Rainy days, 22, a. m. 23, •  •

  Coldest day, 1.        Therm. 51.? Height at a
  Hottest day, 12.               63.5 med. 59-

  April was likewise warm and temperate, but some-
what more  windy  and rainy than the  preceding
month.
  Rainy days, 3, 8, 23, • •  • 27, 28

  Coldest day, 17.        Therm. 58 ? Height at a
  Hottest days, 25, 26.           65.$ med. 61f|.

  On the 19th the therm, in the shade 62, exposed
to the sun 80.
  The heat of the weather increased greatly in May,
notwithstanding some unseasonable rains, and nor-
therly winds, about the end of the  month.
   Rainy days, 1, 7, 8, • •  16, • • 23, at night,----
 24, p. m. * * * * 25.
  Coldest days, I, 2.        Therm. 62.? Height at a
  Hottest day, 17.                  74. $ med. 68JL.

   On the 4th the therm, in the shade  65, exposed
 to the sun 88.
   The beginning of June was likewise unseasonable,
 with rains and  northerly winds.   The  rest of the
 month was calm, dry, and hot, as usual. 
 56           OF THE WEATHER.          1745.
   Rainy days, 4, a. m. • • • • and at noon, * •  • • 7,
 at night,
   Coldest clays, 4  to 7.       Therm. 69. ? Height at a
   Hottest day, 28.                  82. $ med.  731.

   On the 28th the therm, in the shade 82, exposed
 to the sun 98.
   July was a little more temperate than usual, t\\e
 heat of the air being frequently  allayed by breezes
 or showers.
   Rainy days, 16, a. m. • • •  17, a. m. • • • • and p.
 m. • • • • and at night, • • • • with thunder, 27, p. m,
 • • 29, at night, •  • • • with lightning.
   Coldest days, 21, 22.      Therm. 75.? Height at a
   Hottest days, 6, 25, 26.            80. J med. 77^f.

   On the 7th the therm, in the shade 79, exposed to
 the sun 100. 25th therm, in the shade  80, exposed
 to the sun  96.
   August,  except the first three days, was excessive
 hot and sultry, till the latter end, when the air was
 refreshed by brisk northerly breezes.
   Rainy days,  none.
  Coldest days,  1,  23 to 27.  Therm. 74. > Height at a
  Hottest day, 9.                   82.} med. 77ff.

  On the 9th the therm,  in the shade 82, exposed to
the sun 95.
  The  beginning of September  was  very  sultry,
though not always serene. But from the 12th to the
end it was  constantly either cloudy, rainy, or stormy
with violent squalls from the north. 
1745.         OF THE WEATHER.           57
  Rainy days, 12,  at night, • • • • 13, at night, • • •
14, at night, with  thunder, 16, p. m. • • • • and  at
night, • • • • with thunder, 17,  p. m. •  • • • 18, a. m.
•  • • and at night, • • • • with thunder  and lightning,
19, a. m. •  • • • and at night,  • • • ■ 20, •  • 27, * * • •
at night, with  thunder and  lightning,  28, • * 30,  at
night, with lightning.
  Much lightning  in the nights  of the  20th, 21st,
and 22d.
  Coldest day, 19. Th. 69. ?  H .  .      med# 75is.
  Hottest day, 9.      80.5     &

  On the 24th the  therm, in the shade 73, exposed
to the sun  89.
  The weather during October was fair, pleasant, and
serene, except  the rainy days, and some  few others,
the winds being mostly moderate and northerly.
  Rainy days,  1, a. m.  3, a. m. • • * *  7, at night,
• • • • with thunder and lightning,  8, a. m. • • • • 17,
at night,  with lightning, 25, 26, at night, • • • 27,
a. m. • * *
  Coldest days, 29, 30.       Therm. 61.? Height at a
  Hottest days, 1, 2.                69. $ med. 65ff.

   Almost  all November was  either cloudy or wet.
From the beginning to the 24th the wind was mostly
from the south, or southwest. Afterwards it changed
to the north, and the air continued cold and damp to
the end of the month.
   Rainy days, 2, 5, 7, at night, • • • 10, a. m.
and p. m.  • • and at night,  • • • 11, at night,  • •  14,
15, at night, •  • • with hail, 21, a. m. • •  26, •  • • 27,
• • 30, • • 
58           OF THE WEATHER.         1746.
    Coldest day, 27. Th. 50.> „ .  ,.  .      ,  -0 6
    Hottest day, 8.      65. \ HeiSht at  a med' 58^'

    The first week of December was  wet and  cold,
 with high  easterly and  northerly  winds. The re-
 mainder  was somewhat more temperate  and calm,
 the winds  being, for the most  part, southwest or
 southerly.
    Rainy  days,  1,  • • •  2, • • • 5, at  night, •  • •  7, p.
 m. • • 12, • • 18, • • 20, p. m. • • and at night, • • 21, • •
   Coldest days, 5, 6, 9.      Therm. 48. ? Height at a
   Hottest day, 27.                 60. } med. 53|f


              A. D. MDCCXLVI.
   The  greatest  part of  January was fair  and clear,
 with cold easterly winds.
   Rainy days, 6, • • • 10, • • 11, a. m. •  • 23, 31, • • ■
 with hail.
   Coldest  days, 7, 12.      Therm. 48.? Height  at a
   Hottest  day, 28.                57. $ med.  52|3.

   During February the  weather resembled  that of
the preceding month, though somewhat  colder,  and
more windy.
   Rainy days, 3, • • 6, a. m. • • • 7, a. m. • • 23, a. m.
' • 28, • •
  Coldest days, 2, 3, 15.    Therm. 45. ? Height at a
  Hottest day, 20.                57.$ medL51i|.

  On the  first of March  there  was a  remarkable
storm from the north, with  flakes of snow  in  the
evening. Next morning the fields were  covered with 
1746.         OF THE WEATHER.          59
snow a foot deep, which melted away soon after sun-
rising.  But some more fell the following night, and
continued upon the ground for three days ere it melt-
ed ; which is so extraordinary a phenomenon in this
part of the world, that it had never before happened
above once  or twice in the memory of man. From
the 5th day the cold gradually decreased to the 15th,
and afterwards, to the end of the month, we had fine
moderate weather.
   Rainy days, 13, 14, • • 28, a. m. • • • 30, a. m. • •
31,- •
  Coldest days, 3, 4.    Therm.    42. ? Height at a
  Hottest days, 24, 27, 30, 31.       60.$ med. 54 -/T.

   In Afiril the weather was exceedingly changeable,
and often rainy or overcast.
   Rainy days, 3, at  night, • • • • 4, a. m. • • • • 20,
f. m. • • • • 11, • * * with hail, 13, • • * • with a storm
of wind, 14, 17, at night,----18, a. m. • • 23, • •
  Coldest day, 13.          Therm. 54. ? Height at a
  Hottest day, 30.                 68.$ med. 59|f.
  On the 3d th. in the shade 57, exposed to the sun 83.
         29th              65,                 88.

   May was calm, serene, and seasonable, seldom ob-
scured with clouds or rain, until it drew near the end.
   Rainy days, 9, 21, 24, a. m. • • 29, 30, p. m.----
with thunder and lightning, and at night, • • • • with
thunder and lightning.
  Coldest day, 11.        Therm. 64. ? Height at a
  Hottest days, 4, 5, 18, 2.0.       70.$ med. 68^. 
  60           OF THE WEATHER.         1746.
    June, as usual, was dry, sultry, and serene.
    Rainy day, 15th.
    Coldest day, 11.        Therm. 69. ? Height at a
    Hottest days, 26, 27.            79. $ med. 73 Jf.

    The heat gradually increased from the end of June
  to the 20th of July, being very troublesome and un-
  easy, even  to those who  never exposed themselves to
  the sun. But during the latter part of the month, it
  was mitigated by daily breezes.
    Rainy days, 28, a. m.  29, a. m. and at night,
  30, a. m. •  • • • with thunder and lightning.
   Coldest days, 8, 29, SO.    Therm. 77. ? Height at a
   Hottest day, 19.                  87.} med  80§|.

   August was more temperate  than the  preceding
 month, the  heat being somewhat allayed by the nor-
 therly winds.
   Rainy days, 1, a. m. 19, a.  m. 27, p.  m.
 with thunder and lightning, 31, at night, • • • • with
 thunder and lightning.
   Coldest day, 29.        Therm. 70. ? Height at a
   Hottest day, 15.                81.$ med. 76|f

   September began with  storms  of wind  and rain;
 from the 4th to the 14th it was clear and warm; from
 which to the end of the month the  sky was constantly
 either darkened with heavy  rains, or was tempes-
 tuous with strong northerly winds;  the weather be-
 ing much colder  than  usual  at that  season  of the
 year.
   Rainy days, 2, p. m. • • • • with thunder  and
lightning, 3, a. m.----with thunder and lightning, 
 1746.         OF THE WEATHER.           61

and hailstones of an inch diameter, 15, a. m. • • • •
16, a. m. • • and at night, • • • • 17, • * * • with thun-
der and lightning, 18, • ♦ 19, • • 20, at noon, • • 'and
at night, • • • • 22, p. m. •  • 23, at night, • * • • 24, • •
and at night,  • • • 26, and  at night, • •  • • 28, at
noon, •• •  •
   Coldest days, 22, 26.    Therm. 58. ? Height at a
   Hottest day, 13.                74.$ med. 67^„.

   The first and last week of October were mostly
pleasant and serene : the two  intermediate weeks
were rainy and overcast;  and the whole month was
Uncommonly cold, with northerly winds.
   Rainy days, 8, p. in. and at night, • • • • 9, at night,
• • • 10, • • • at night, •  • • • 14, p.  m. • • 18,  20,
p. m. • • • • 21, • • • • with thunder and lightning, 22,
p. m. • • • • and at night, • • • • 30, a. m.  • • •  • with
hail.
   Coldest days, 8, 9.     Therm. 54. ? Height at a
   Hottest day, 1.                68.$ med. 58|i.

   During November the weather  was calm and sea-
sonable, with much sunshine on the days free from
rain.
   Rainy days, 1, at night, • • 2, • • • and at night,
• • • • 3, at  night, • • • • 4, • • • 5, • • 12, at  night, • • •
14, • •  17, a. m.  • • 19, a. m. • • 26, p. m.  • • •  •
   Coldest day, 20.        Therm.  54. ? Height at  a
   Hottest days, 28, 29.             62. $ med. 57 \\.

   In December there was no extraordinary cold wea-
ther, and very seldom high winds;  nor was the se-
renity of the sky much interrupted by clouds or rain.
                       F 
62           OF THE WEATHER.          1747.
  Rainy days, 14, • • • 15, • • 29, at night, •  • • 30,
•  • 31, • • • and at night,
  Coldest days, 11 to 15.     Therm. 54. ? Height at a
  Hottest day,                     59.$ med.  56.

             A.D.  MDCCXLVII.
  The weather of January was like that of the pre-
ceding month, but somewhat more wet and cold in
the beginning.
  Rainy days, 1, a. m. • • • 2, p. m. • • and at night,
•  • • 4, at night, • • 12, • • 14, • •
  Coldest day, 5.        Therm. 50. ? Height at a
  Hottest days, 20, 28.          59.$ med.  55-^-.

  During the first fortnight of February we had
vyarm,  fair,  summerlike  weather:  the third  week
was  rainy and tempestuous, with  some  hail and
snow; the fourth very changeable, the sunshine be-
ing often interrupted by showers.
  Rainy days, 16, p. m. • •■ • and at night, • •  • • 17,
a. m. • • and p.  m. • • with hail and snow,  19, at
night, •  • • 21, • • 24, at night, • • 25, 27, 28.
  Coldest day, 18.          Therm.  50. ? Height at a
  Hottest days, 5, 10.                62.$ med. 55ff

  On the 4th the therm,  in the shade 61, exposed
to the sun 78.
  From the beginning  of March  to the 21st the
weather was cold, and often wet; the winds mostly
from the north, and sometimes very boisterous: the
remainder of the month was fair and moderate with
westerly or southwest winds.
  Rainy days, 1, 2, •  • • 3, • • • and at night, • • • 9, 
 1747.         OF THE WEATHER.           63
 p. m.  14, a. m.  • • 17, at night, • • • 19, a. m. • •  20,
 a. m.  • • • with  hail.
   Coldest days, 6, 13 to 17.  Therm. 50.? Height at a
   Hottest day, 30.                  63. $ med". 54-il..

   April was fair and dry, but sometimes  very win-
 dy; in the fore  part of the month especially;  and
 the  wind being then  at north  did  great damage to
 the  fields and vineyards. About the middle and to
 the  end the southeast prevailed.
   Rainy days, 9, at night, • • • 10, at night, • •
   Coldest days, 2, 3.       Therm. 56. ? Height at a
   Hottest days, 27 to 30.         68.$ med 6Iff.

   Betwixt the 1st and the 9th of May the weather was
 often disagreeable, with rain, clouds, or much wind.
 But almost all the rest of the month was clear, calm,
 and warm.
   Rainy days,  1, 6,  p.  m. • • • 7, p. m. •  • • • with
 thunder and lightning, 8, at noon, •  • • 28, p. m. with
 thunder and lightning, 29, a. m. • •
  Coldest days, 1, 7 to 10.   Therm. 67. ? Height at a
  Hottest day, 31.                75. $ med. 71.

  On the 4th the therm, in the shade 70, exposed to
 the sun 88.
  June was hot and dry as usual.  On the 27th  of
the month dark clouds suddenly rose from the north,
a little before sunset,  and a storm of wind succeed-
ed, which lasted all that night.
  Rainy day, 23, a. m.
  Coldest day, 23.   Therm. 71.? „ . ,
  Hottest days, 26, 27.       80. $ HeiSht at amed.76. 
64           OF THE WEATHER.         1747.
   On the 24th the therm, in the shade 71, exposed
 to the sun 94.
   During July hot suffocating winds with unwhole-
 some vapours, from  the  south and east, were pre-
 dominant.
   Rainy days, 6, a. m. •  • • 7, a. m. • •  • 18, at night,
 • • • • 26, p. m. • • •
   Coldest day, 8.  Therm. 73.? TT .  .
   Hottest day, 21.         84. $ HelSht at a med. 79£.

   On the 12th the  therm, in the shade 80, exposed
 to the sun 99.  On the 21st the  therm,  in the shade
 84, exposed to the sun 100.
   The beginning of August was intolerably hot; nor
 was the rest much more temperate, though  it rained
 plentifully about the middle and end of it, the  winds
 being most commonly from the east and southeast.
   Rainy days, 9, p. m. 12, at night, • • • • with thun-
 der  and lightning, 15, at night,  • • •  • with thun-
 der and lightning, 16, p. m. • • • • with  thunder and
 lightning, 28, at night,----29, a. m. with thunder
 and lightning, 30, a. m. • • • and much  lightning at
 night.
  Coldest day, 30.          Therm. 74. > Height at a
  Hottest days, 8,  10, 11.           84.$ med.  80^.

  On the 8th the therm, in the shade 84, exposed to
 the sun 100. On the Uth the  therm, in the  shade
 79, exposed to the sun 98.
  The slight  showers  which fell first in September,
rather increased than  allayed the warmth of the air:
but the storms of wind and rain about the middle of
the month put an end to  the hot weather  for that
season. 
1747.         OF THE WEATHER.           65
  Rainy days, 8, 11, a.  m. 13, p. m. and at night,
• • • • 14, • • • • and at night, • • • • 18, at night, • • •
with thunder and  lightning,  19, • • • and at night,
. . . . 20, • • • 21, at noon, • • • with hail, 23, p. m. and
at night, • • • 24, a. m. • • • and at night,----25, • • 28,
p. m. • • • and at night, • • • • with thunder and light-
ning, 29, • • • and at night, • •  • • 30, a. m. • • • •

  Coldest day, 21.  Therm. 63. ? R .  h atamed.r2§§.
  Hottest day, 10.          81.$     s            30

On the  1st, theth. in the shade 79, exposed to the sun98.
       2d,                  80,               100.
     10th,                 81,                 98.

  Except a shower or  two, and  a storm of wind
from the northeast on the 21st, October was entirely
calm and serene.
  Rainy days, 4, p. m.  • •  and at night, •  • 17, p. m.
• • 19,  p. m. • • 21.
Coldest days,  19, 25, 27, 28.  Therm. 62.? Height at a
Hottest days, 10, 11, 12, 14.           70.$ med. 65ff

On the 2d, the th. in the shade 67, exposed to the sun 90.
      9th,                69,                 86.
     23d,                 64,                 83.
     26th,                63,                  88.

  Nor  was November less serene, though sometimes
more windy, especially  at the close of the month,
when it blew violently from the north.
  Rainy day, a. m. • • • with hail.

Coldest day, 27.  Therm. 51. ?  R •  h(. Qt ft med  60 a
Hottest day, 2.           67.$     5             30

On the 16th, the th. in the shade59, exposed tothesun 84.
      22d,                 62,                 82.
      27th,                51,                 74.
       28th,                54,                 78.
                          F2 
66           OF THE WEATHER.          1748.
  From the  1st to the 6th of December the wind
blew strong from the  southwest; as it did from the
southeast from the 20th to the 24th: the other days
of this month were mostly fair, calm, and agreeable.
The whole of the month was uncommonly warm for
the  season, except the  last day, when the  wind
changed to the north.
  Rainy days, 8, a. m. •  • • and at night, • • 9,12,
14,  • • with thunder and lightning, and at night, • •
17,  m • 24, a. m. • • • • 25, p. m.  • • • 28, p. m. • •
Coldest day, 31.   Therm. 53.? „ ....      , „o1<1
Hottest days, 3, 5.       64.$ Hei^ht at a med" 5Hf
Qn the 5th the th. in the shade 64, exposed to the sun 88.
      6th,                 63,                 84.

             A.D. MDCCXLVIIL
  The sharp  northerly wind, which began on the last
of December, was attended with some hail and snow
on the 4th, and continued to the 6th of January. It
then shifted to the northwest, and  though the wea-
ther was mostly fair and dry, yet the  air continued
cold till the rains fell, near the  end of the month.
  Rainy days,  2, a. m. • •  and p. m. • • 5, a. m.
  • • 6, at night, • • 15, at noon, • • 18, at night, • •
22,  at night, • •  • 23, and at night,  • • • 25, p. m. • •
Coldest day, 4.   Therm. 43. ? TT . ,
Hottest day, 22.          57. $ HeiSht at a ™ed. 5 1 jf.
On the 8th the th. in the shade 44, exposed to the sun 64.
      18th,                50,                68.

  The weather continued mild  and temperate to the
17th of February, though the rains that fell in the
i-coud week  were accompanied with high southerly 
1748.         OF THE WEATHER.          67
and southeast winds:  afterwards, to the end of the
month, we had dry, cold, north and northwest winds,
which did much mischief to the corn.
  Rainy days, 6, at night, 8, 9, • • 10, a. m. •  • and
p. m. • • * 11, a. m.  • • • 13, a. m. 15, at night, 16, • •
and at night, • • 18, p. m. 25, at night, • •  • with hail,
26, p. m. • • and at night, • •
Coldest day, 21.    Therm. 48. ?    .       med> ^
Hottest days, 6,8.         60.$    &
Onthc 1st the th. in the shade 56, exposed to the sun 76.
      19th,                 52,                 78.
      24th,                 54,                80.

   In the beginning of March the weather was win-
dy, but  not very cold :  between the 10th and 23d
we had violent storms of wind, rain, and hail, with
fair intervals.  The end of the month was remarka-
bly pleasant and serene.
   Rainy days, 7, p. m. with a little hail, 10,  a. m.
11, at night, • • • 12, a. m. • • and  p. m. • • with hail
and snow, and  at  night, •  • 13, at night, 14,  p. m.
16, p. m. and at night, • • • with thunder and light-
ning, and snow, 17, • • * 18, • • • and at night,  • • 19,
p. m. •  • • and at night, • • • • 20, p. m. 21, 30, p. m.
   Coldest days, 19, 21.      Therm. 50. ? Height at a
   Hottest days, 27, 29, 30.          63. $ med.  55-^-.
On the 14th the th. in the shade 51, exposed the sun 76.
       27th,                 63,               82.

   April was cold and stormy from  the  14th to the
 20th; all the rest of the  month was  calm, clear, and
warm,  except  the 25th, when it rained, and blew
fresh from the northwest.
   Rainy days, 6, at night,  14, p. m. • • • with thun- 
  68            OF THE WEATHER.          1748.
  <ler, 15, at night, • • • • 16, p. m. • • • with thunder
  and  lightning, and  at  night, • • • with thunder and
  lightning, 19, 24, at night, • • • 25,  • • 30.
  Coldest day, 16.            Therm. 55.?  Height at a
  Hottest days, 24, 28, 29, 30.          65.$  med. 6111.

    May was clear, calm, and  warm, excepting the
  15th and 16th  days, when it blew violently from the
  north.
    Rainy days, 20, p. m. 21, p. m.
  Coldest day, 16.         Therm. 61. ? Height at a
  Hottest days, 25, 30, 31.          72. $ med. 68-7-.

    About the middle of June the northeast winds
  blowing fresh for some days, allayed the heat of the
  air, but did great damage to the fruit trees.
    Rainy day, 26, at noon, • • •  •
   Coldest day, 18.          Therm. 71.? Height at a
   Hottest days,  12,  13.              80.$ med. 7511.

   The first weeks of  July were extremely hot and
 sultry, especially from the 6th to the 16th; the mer-
 cury in the thermometer rising daily above the 80th
 degree. Nor was  the latter  part  of it much more
 temperate, though it blew  from  the north pretty
 briskly on the 17th and  18th, and moderately about
 the end of the month.
   Rainy days, 2, a. m.  16, at night, 17th, at night,
 18, at noon, • • • • 31, at night, •  • •  with thunder and
lightning.
  Coldest day, 18.        Therm. 74. ? Height at a
  Hottest days, 14, 15, 16.         84.$ med. 71-5-.
On the 5th, the th. in the shade 79, exposed to the sun 96.
       7th>                 81,                 100.
     23d,                  81,                  98 
1748.         OF THE WEATHER.           69
  The excessive heat of the season continued to the
19th of August; when it intermitted for some  days,
the clouds  threatening rain, with  boisterous winds
from the riorth, especially  in the night time. On the
24th it again became sultry, and continued  so to the
end of the  month.
  Rainy days,  3,  a. m. 7, at  night, 19, a. m.  with
thunder and lightning, and at night,
  Coldest days,            Therm. 74. ? Height at a
  Hottest day, 15.                85. $ med. 79^*,
On the 9th, the th. in the shade 77, exposed to the sun 95.
      10th,                79,                 96.
      14th,                84,                 101.
      15th,                85,                 100.

  In September, though the sky was often overcast,
with signs  of rain, yet the showers were neither so
heavy nor  so frequent as  they commonly are  about
this time of the year: but large dews falling in the
nights, and constant breezes from the north, render-
ed the air temperate, as.it  commonly is in this month.
  Rainy days, 8,  at night, 9, at night, with thunder
and lightning, 17, at night, 18, at night, 23, at noon,
- • • • and at night, • • •  • 24, a. m. • •
  Coldest day, 25.          Therm. 66. ? Height at a
  Hottest days, 7, 8.              80. $ med. 73|§.

  On the 22d the therm,  in the shade 73, exposed
to the sun  96.
  The  first ten days in  October  were mostly fair,
clear, and calm, and also the last week of the month:
all the intermediate days  were either wet,  or windy
and overcast.
   Rainy days,  1, at noon, • • 9, p. m. 10, p.  m. • ' 
 70           OF THE WEATHER.         1749.
 and at night, • • • • 11, • • • • 12, at night, • • • • 14,
 • •  • 15,  • • 19, 20, at night, • ■  • • 21, at night, • •
 22, 23, at noon, • • • • 27, at noon,
  Coldest days, 12, 13.      Therm. 58.? Height at a
  Hottest day, 7.                   72. $ med. 65}\.

   Towards the beginning and  end of November the
 weather  was temperate and serene. During the mid-
 dle part  of the month it was frequently cloudy and
 cold with dry north winds.
   Rainy days, 8, at noon, • • • • with  thunder and
 lightning, and at night, • • •  • 11, a. m. 20, • • • • 22,
 26,
  Coldest day, 23.        Therm. 53. ? Height at a
  Hottest days, 1, 2, 3.            66. $ med. 58 J^.

   In December  the wind  was either southerly or
 westerly: hence  the weather  was never  cold; and
 though some days were foggy, yet by  much the
 greater part of this  month  was dry, clear, and very
 pleasant.
  Rainy days, 14, • • • at night, 21.
  Coldest days, 9 to  17.    Therm. 56.? Height at a
  Hottest days, 27 to 31.           60. $ med. 57}|.

              A. D.  MDCCXLIX.
  So mild was the weather in January that it scarce
 seemed to be winter.  The preceding autumn having
 been uncommonly dry, and the showers which fell
 during the first three months of this year being nei-
ther frequent nor  plentiful, the grain in  many places
perished for want of rain.
  Rainy days, 4, a. m.  7, at noon, and at night, • • •
18,  p. m. 19, at night,  20, at noon. 
1749.         OF THE WEATHER.           71
  Coldest days, 6, 7.      Therm. 53.? Height at a
  Hottest days, 1,2, 16, 17,       58.$ med. 55^.

  February was likewise mild and  temperate, the
mercury in the thermometer fluctuating between the
54th and 57th degree: a little rain fell on the first
days, a heavy shower on the 12th, slighter showers on
the 22d and 23d;  during the rest of this month the
air was clear and dry.
   March was fair, warm, and without rain, both to-
wards  the beginning  and  end;  the  thermometer
standing above the  60th degree.  Between the 9th
and 22d  day, frequent storms of rain, with some
hail, intervened, which sunk the mercury to the fifty
second degree.
   The weather during almost  all  April was mild,
clear, and agreeable.
   Rainy days, 7, a. m. • • • and p. m. • • • • 10, p. m.
• • • and at night, • • •
   Coldest days, 8, 9.        Therm. 56. ? Height at a
   Hottest day, 30.                  69.$ med. 62||.

   In May sudden heavy rains sometimes interrupted
the serenity of the weather; and at the close of the
month a strong westerly wind did much damage to
the vineyards. The harvest this year was so poor and
 scanty  (especially in the northern parts of the island,
 where the droughts were most excessive), that they
 scarcely reaped as much grain  as they had sowed.
   Rainy days, 3, p. m.----11, at noon, • • - • 12, at
 noon, • •  • 16, 19, 25, at night, • •  • 31, at night, • • •
 with thunder and lightning.
   Coldest day, 4.          Therm. 64. ? Height at a
   Hottest days, 24, 25.            73. $ med. 68f 
 72           OF THE WEATHER.          1749.
   During the month of June the air was dry and ex-
 cessively .hot,  though somewhat more temperate be-
 tween the 14th and the 25th; frequent gales coming
 from the north.
   Rainy day,  15, p. m.
   Coldest day, 1.          Therm. 69. ?  Height at a
   Hottest day, 30.                79. $  med. 74^.

   On the 29th the therm, in the shade 76, exposed to
 the sun 96.
   The weather has seldom been felt so extremely hot
 and sultry as this year in July; the quicksilver rising
 daily above the 80th degree  of the thermometer, and
 never falling below the 79th, even  in the night time,
 till the rains which fell in the latter part  of the month
 had cooled the air.
   Rainy days, 25, at noon, • • • 26, p. m.  • • • •
   Coldest days, 26, 27.       Therm. 77. ? Height at a
   Hottest day,  20.                  86. $ med.  82£.
 On the 3d the th. in the shade 82, exposed to the sun 102.
      4th,                84,                 100.
      13th,                84,                 104.
      14th,                85,                 104.

   In the beginning of August a general relief of all
his majesty's troops in the island obliged me to em-
bark for Ireland, and put an end to these observations. 
OF THE WEATHER.              73
A TABLE showing the greatest, least, and mean height of the mer-
  cury at three o'clock in the afternoon, in each month, from the
  year 1744. to 1749.
		1744	1745	1746	1747	1748 57 43 51^ •"31	1749 58 53 55-?-57 54
• January	G L M		57 43 52	57 48 52f^	59 50 5 5— 3031		
February	G L M		61 46 55	57 45 51A£ Dl 28	62 45 e c20 DOTS	60 48 55	
March	G L M		63 51 59	60 42 54 J °*31	63 50 54-L1	63 50 55-?-D33 1	64 52
April	G L M		65 58 fil24 01 3?)	68 54 5922	68 56 U130	65 55 61i^ U130	69 56 fi223
May	G L M		74 62 683T	70 64 6Hl	75 67 71	72 61 683T	73 64 68i
June	G L M		82 69 731	79 69 7012	80 71 76	80 71 7521 ' 330	79 69 74-5-' *30
July	G L M	80 70 '°TT 80 73 77-2-' ' 3 1	80 75 7711 1 ' 31	87 77 80ft	84 73 79-L	84 74 ''31	86 77 82,\
August	G L M		82 74 7725 ' ' 31	81 70	84 74 8O-3T	85 74 79JL ' ^31	
September	G L M	76 71 71 65 68fr 67 50 56	80 69 74,11	74 58	81 63 7022	80 66 7021	
October	G L M		69 61 65^ UJ31	68 54 58^-3°31	70 62 65^1	72 58 D;>31	
November	G L M		65 50	62 54 57U •" 30	67 51 60H	66 53 5 8-?.	
December	G L M	57 44 51i	60 48 roll	59 54 56	64 53	60 56 57A3	
G 
 
75
                 CHAPTER II.

Of the Rise, Progress, Declension, and Succession of the
  Epidemical Diseases,from the year 1744 to 1749.

              A.D. MDCCXLIV.

In the beginning of the year few diseases appeared,
except some pleurisies and tertian fevers; both which
are common in  Minorca,  and are frequently met
with in  all seasons; the first being  generally  the
chief amongst vernal epidemics, as the other is con-
stantly amongst the autumnal.
   During the cold  weather in March  many adults
were affected with catarrhs, and almost all the chil-
dren were seized with a smart fever, attended by a
cough; which disorders did not cease till the begin-
ning of summer.
   As the summer and autumnal weather of one year
never varies much from that of another, so the same
tribes of distempers return regularly with the seasons,
and succeed each other in the following order.
   Toward the end of June the young children (who
constantly suffer first by excessive heat or cold) are
attacked  with a vomiting, purging,  and periodical
fever, often of the erratic  kind, without any fixed
type, (a) •
  («) This disease  among children appears to  be what has re-
ceived in the United States the name of the  cholera infantum.
The author mentions it again in two other places. It  is briefly
described in a late publication on the diseases of India, by Mr.
Custis, surgeon of the Medea frigate. Our author's account of 
76       OF THE RISE, PROGRESS, Set.
   In the following month tertian fevers of various
forms appear among people of all ages, and spread-
ing from one to another, by contagion, continue  to
increase daily till about the time of the autumnal
equinox, when they  rage with the  utmost fury
amongst persons of all ranks and constitutions, whe-
ther natives or foreigners. Afterwards  they gradual-
ly decline; and as soon  as  the winter begins, their
contagion being rendered inactive by  the cold, few
persons who have hitherto escaped are infected. Yet
some primary fevers continue to January, and  re-
lapses are exceedingly frequent in the  latter months
of the year, (b)
   About the time when the tertians  begin, the cho-
lera morbus, rash, and  essere, become  frequent and
epidemical in a less degree: but are seldom met with
after September,  whilst the  tertians  continue  till
winter.

it accords with the same disease in our country, in making its
appearance sooner than the bilious fevers (of which it is a form)
in adults.
  (b) Our author has followed the physicians of the continent of
Europe in supposing  tertian or bilious fevers to be contagious.
They spread only from the action of an impure atmosphere, and
never extend beyond its influence. If a whole family succumb
under it, after it has  affected one of them, it must be ascribed
to the same air, and to the fatigue  or distress of nursing the
person first attacked, affecting the rest of the  family. The  ex-
tinction of this fever by cold, which our author mentions, proves
it to  be an  atmospherical disease, for cold  cannot penetrate
houses to destroy the contagion.  On the contrary, the shutting
of doors and windows which follows the action of the cold, ought
r/itherto accumulate and increase it. The small pox, which is i
contagious disease, is not checked by cold weather. 
OF EPIDEMICAL DISEASES.       77
   Diarrhoeas, dysenteries,  and tenesmus,  likewise
make their appearance  as  epidemicks,  in  summer
and autumn: but some years they occur so seldom,
as scarce to deserve that name; whilst in others they
are almost as numerous as the tertians themselves.
   There seems likewise to be a near alliance amongst
all the diseases above mentioned.  Those who have
the rash, or essere, to a great degree, are very liable to
tertian fevers; on the other hand, in the paroxysms of
tertians these cutaneous eruptions are apt to break out.
The cholera morbus sometimes hath its regular pe-
riods, like a tertian, as  the paroxysms of tertians are
frequently  attended with  a cholera. Sometimes  a
tertian is changed into a dysentery; or a dysentery
becomes a  tertian; and when one of these diseases is
suppressed, the other often ensues; nor is it uncom-
mon  for dysenteric fevers  to put on  the  form of
tertians;  and for the fits of tertians to be regularly
accompanied by gripes and stools, (c)
   It is remarkable that both dysenteries and tertians,
without any manifest cause, are sometimes more uni-
versal and severe in one part of the island in one year
than another; and often seem, as it were, to attack
particular families with uncommon severity; whilst
others in the same place, the same circumstances and
way of life, escape. Those, however, who live in low
valleys, or  near  stagnating  corrupted  waters,  are
commonly the greatest sufferers.
  To me it appears probable that all the summer
and autumnal diseases are the consequence ©f nature's
  (c) We see in the whole of this paragraph a striking proof of
the unity of the autumnal disease, however diversified it may
fce in its seats or symptoms.               G 2 
78      OF THE RISE, PROGRESS, Sec.
attempting to free the body from noxious humours,
either by throwing them upon  the skin, or by con-
veying them through the liver and other organs of
secretion, which open into the intestines, (d) And if,
with  the ancients, we allow distempered bile to be
the cause of tertian fevers,  it will perhaps be  easier
to account for their more obvious appearances, than
by supposing them to  arise  from  a lentor in the
smaller  arteries, according to  the modern theory:
but this is transiently offered  as a conjecture;  to re-
cprd  facts without framing any hypothesis,  being
my principal design.
   In  July 1744 tertian  fevers were numerous; but
during the two ensuing months they were neither so
universal nor so malignant  as they commonly  are at
this time of the year:  yet  obstinate  relapses  were
frequently met with till January.
   A  little  before  the equinox dysenteries of a bad
kind began to appear;  and  being propagated by con-
tagion, (e) like the tertian fevers, they soon increased
to such a degree,  that it was  doubtful which of the
two distempers was  more  universal. This year, in
the space of three months,  I had more patients with
bloody fluxes, than in all the former part of ray life;
and as no  manifest quality in the air, nor variation
in the weather, seemed  capable of producing  them,
it is probable that their uncommon frequency and
singular  severity were chiefly owing to the sour da-
  (</) It would have been more appropriate  to modern patho-
logy, had our author said, the miasmata inhaled during the au-
tumnal season.
  (e) The same objections apply to the contagiousness of the
dysentery, which apply to tertian and bilious fevers formerly
mentioned- 
          OF EPIDEMICAL DISEASES.       79
 maged wine, which, for the sake of gain, was at that
 time sold in the island by those whose duty it was to
 have prevented such abuses. But be this as it will, it
 is certain  that incredible havoc was made by those
 distempers among the lower sort of the  natives,  as
 well as among the soldiers and sailors of his majesty's
 fleet, which was then in the harbour. The most part
 of those who were attacked died about the winter
 solstice or  sooner; the rest continued weak, lean,
 and pale, like so many shadows, during the winter
 and spring; nor did  any method ^vhich we could
 suggest, entirely protect them from the torments of
 those painful distempers, until  the heat of the sum-
 mer, by increasing perspiration, had diminished the
 tendency of the humours to  the intestines.
   In December some were  cut off by the pleurisy;
 and many, worn out with age, intemperance, or fre-
 quent sickness, died about the end of this month and
 the beginning of January.


              A. D.  MDCCXLV.
   About the end of January a manifest alteration to
 the better was perceptible among the  sick. Those
 who had been reduced to the last extremity, by re-
 peated relapses of tertians, were now restored to their
 former health; and such as  were ill of fluxes, and
 had been despaired of,  began to show signs  of re-
 covery:  nor did any new  distemper, except a few
pleurisies, appear during the spring.
  Towards the end of May, and beginning of June,
heavy rains  having occasioned a sudden change in
the air from heat to cold, some were attacked with a 
80       OF THE RISE, PROGRESS, 8cc.
looseness, gripes, and cholic pains; and others with
an angina.
  June was scarcely  ended, when the tertian fevers
and cholera morbus began; and increasing daily ac-
cording to custom, came to their  greatest degree of
frequency in September; from which time they gra-
dually declined, and  seldom appeared after the win-
ter solstice. Those  distempers,  it was  observed,
were this year often  attended with fixed pains of the
side, and sometimes with a spitting of blood. (/")
  In July and August a slight jaundice,  without a
fever, which soon yielded to purgatives,  and sapo-
naceous medicines, was a common distemper.
  In September dysenteries broke  out, and continued
to the winter:  but they were  neither so  numerous
nor so malignant as in the  preceding year.
  As the dysenteries and tertian fevers disappeared,
the pleurisy, which  had been fatal  to a few in  the
autumn, became more frequent; and towards  the
close of the year, it raged more violently than I had
ever known, at least  among the English inhabitants
of the islands.


               A. D.  MDCCXLVI.
  I come now to a  year  remarkable  for dreadful
distempers  and much  mortality.  For the pleurisy
above mentioned continued to make great destruc-
tion  till April,  at which time it began to abate; and

  (/) These secondary pectoral affections often attend the au-
tumnal fevers in the southern states. They yield  to purging,
from which circumstance  it has  been erroneously inferred that
a pleurisy may be cured exclusively by that remedy. 
OF EPIDEMICAL DISEASES.       81
vanished entirely about the summer solstice. Toge-
ther with the pleurisy, two other diseases equally
fatal, the phrenitis and paraphrenias, were also epi-
demical:  and so likewise was an erysipelatous fever.
A few had large tumours of the parotids; and others
had inflammations of the  throat.  But those diseases
were peculiar to adults. Amongst the children  ob-
stinate, and often fatal chincoughs, became frequent
in March, and continued till summer:  some were
suddenly suffocated  by an  angina, without any ap-
parent  swelling: and to  complete the measure of
evils, the island was this year visited with the small-
pox, and of the most pestilential kind.
   The chincough had no sooner disappeared than a
periodical fever, accompanied with vomiting  and
purging, took its place, which proved alike fatal to
many children during the summer.
   In July the tertian fevers broke out as usual,  and
their violence  being augmented  by the  excessive
heat of  the season, many  persons died  suddenly
about the seventh day of the distemper: but the cold
weather of September prevented  their becoming so
general and continuing so  long  as they commonly
do;  for about the  end of October they gave way to
catarrhs  and quartan agues.


             A.D.  MDCCXLVII.
   The first part of  this year, though not very un-
healthy, produced some  few intermittents, together
with inflammatory  and  catarrhal fevers. And the
extraordinary heat of May ushered in the summer
diseases somewhat sooner than usual.  For about the 
82      OF THE RISE, PROGRESS, &c.
end of that month the cholera morbus carried off
many children, and in June the tertians became uni-
versal. Besides,  towards the end of June, the di-
arrhoea,  dysentery,  and tenesmus broke  out and
raged violently  for  some weeks:  but  contrary  to
expectation, they continued only a short time, and
after the beginning of September could scarcely be
reckoned epidemical.
  In the meanwhile, as  the dysenteries decreased,
the number of tertians was multiplied, and being of
a malignant kind, great mortality ensued, especially
in the southern parts of the island. General Wyn-
yard's regiment, which was quartered in Mahon,
was so severely handled by these fevers, that between
June and November  forty one men died; and the
most part of those  who  survived  continued weak,
sickly, and illcoloured till the spring.
  In October a few complained of coughs, and sore
throats:  and  the latter  end of  the year produced
pleurisies, which (as it commonly  happens) did not
affect the English so much as the Spaniards.


             A.D. MDCCXLVIIL
  Pleurisies were exceedingly mortal in the begin-
ning of the year, and carried off divers in the spring.
  In  March  many erysipelatous  phlegmons were
observed to break out on the extremities, which ge-
nerally terminated in abscesses.
  Towards the beginning of April  some complained
of sore throats and rheumatic pains. And about the
10th day of the  month there appeared  suddenly  a
catarrhal fever, which for three weeks raged so uni- 
OF EPIDEMICAL DISEASES.       83
versally, that almost every body in the island was
seized with it.  This disease exactly resembled that
which was so epidemical in the year 1733. (Med.
Essays, vol. ii. art. 2.) For in most part of the sick
the feverish  symptoms went  off  with a plentiful
sweat in two or three days; while the cough and ex-
pectoration continued some time longer.  In a few
athletic persons, who were not blooded in time,  it
terminated in a fatal pleurisy or phrensy. (g)  In
one or two the vessels on the coats of the  intestines
burst, and the patients expired after voiding  an in-
credible quantity of blood by the anus.
   The  ensuing summer proved very unhealthy to
the children, many of  them dying of the cholera
morbus, and periodical fevers; whilst others were
much affected with cutaneous  eruptions of different
sorts.
   The tertians began in July,  and finished their an-
nual career about the end of November. Many per-
sons died suddenly during the dog days, and about
the equinox.
   In the  meantime dysenteries prevailed  in Ciuda-
della among the lower sort of the natives,  whose
bread was made of damaged wheat, without  affect-
ing the soldiers and  others in  the same town, who
lived on better provisions.
   From the  end of November to the middle of Ja-
nuary pleurisies were predominant in all parts of the
island; and large  critical abscesses,  together with
various kinds  of  cutaneous eruptions, were more
frequent both among the English and Spaniards than
had ever  been observed.
   (g) This disease appears to be the influenza, of late years so
well known in the United States. 
84      OF THE RISE, PROGRESS, &c.
              A. D. MDCCXLIX.
  That part of this year, during which I resided in
Minorca, was  remarkable for dry weather  and few
distempers.  However, in March pleurisies  and ca-
tarrhal fevers now and then appeared; in April some
had anginas with aphthae in the mouth, and sponta-
neous salivations; others complained of pains in the
ears, and eruptions  on the face.  In June and  July
there were some specimens of the summer's diseases,
but so  few that they scarcely deserve  to be called
epidemical. 
85
                CHAPTER III.

              OF TERTIAN FEVERS.

HAVING described the state  of the weather, and
the succession of the  epidemical diseases, I come
now to treat particularly of  each,  beginning with
tertian fevers, which are,  by much, the most fre-
quent of all.
  These fevers never proceed uniformly, with con-
stant uninterrupted violence  from their first begin-
ning to their final termination; but,  sooner or later,
have periodical intervals, more or less evident, so
that the patient is by turns one day better and another
worse. They are  called tertians, or  fevers  of the
tertian kind, because each particular period  or re-
volution of the disease (which the Romans express-
ed by the word  circuitus) is completed in the space
of about forty eight hours; and a new attack  is be-
gun on the alternate days, or every  third day, if we
include the day on which  the  genuine paroxysms
happen, together with the intermediate one, accord-
ing to  the common method  of  reckoning, used by
physicians.
   The fevers belonging to this  tribe assume so ma-
ny, and such various  shapes, that,  though they are
essentially the same,  yet their appearance is often
very different; insomuch that when I reflect on the
several species which I have seen, I almost despair
                        H 
86          OF TERTIAN FEVERS.
of being able to give the reader any tolerable idea.of
them.  Nevertheless, as it  is of such  importance to
be  acquainted with the specific properties of each,
that without an exact knowledge of them,  we  can
neither foretel the return of the fits or intervals, nor
consequently administer  food or medicines at the
most convenient  hours; I flatter myself that it will
not be thought unnecessary to dwell a little on this
subject, and endeavour to describe the  particular
types and forms, in which the various kinds of ter-
tians appear, especially as no author who  has fallen
into my hands, is  sufficiently clear and accurate on
this head.  For those distempers are slightly passed
over by most  of the  moderns; and  although  the
Greeks and Arabians  had treated of them at great
length, yet in their voluminous  writings  we do  not
find them  described as they really are,  but as they
would  be, if Galen's  theory  of the four humours
was well grounded; their distinctions being deduced
from different  mixtures of bile and pituita, which
they assign as the cause of tertians; and having once
laid it down as  an axiom,  that each  species arises
from a particular humour, which must produce such
and such effects, they  ascribe symptoms to the fever,
from a preconceived  hypothesis, which seldom or
never  accompany  it in reality. (Vid. Simon Simon.
apud Sennert. torn. ii.  lib.  ii. c.  xvii.)
   Wherefore, in order to avoid the like mistakes, I
shall leave the reader to form what idea of the causes
of those fevers he  thinks fit, and endeavour to show
as  distinctly as I  can,  first, the differences  which
arise amongst them from the different types or forms
of their periods; secondly,  the distinctions occasion- 
             OF TERTIAN FEVERS.           87
ed by the  most obvious symptoms of their parox-
ysms; and,  thirdly, I shall describe the various ap-
pearance of the more frequent epidemical tertians in
their rise, progress, and termination, with as much
exactness as their own  irregular anomalous disposi-
tion will permit.
   But  it may not be improper, in the first place, to
apprize the  reader, that I  have used the appellations
commonly given to the various fevers of this class, in
a  manner  somewhat different from several who have
written upon this subjeci, though not without explain-
ing as clearly as I could in what sense I would be un-
derstood : and indeed whoever  consults  those wri-
ters will find that some of them so limited their de-
finitions as to  make  it doubtful if ever any  disease
existed  to which the name was  applicable;  whilst
others apply their terms in so loose and vague a sig-
nification, as to include several species, which ought
to be distinguished, in  order to  understand  their
history  and  cure.*  It may likewise be necessary
to inform those who  are not much conversant with
the  Hippocratical writings, that  by the odd days
are meant the 1st, 3d, 5th, 7th, &c; by the even days
the 2d, 4th,  6th, 8th, &c; and  that however singular
such  a distinction may appear in a country where no

  * For instance, if we  look into several of the Galenical wri-
ters, we shall find that, in order to constitute tie lertiana pura
or  exquisita, and some kinds of the  semitertiana, a number of
different circumstances is required, which seldom  or  never
occur in the  same patient. On the other  hand, Spigelius, who
wrote a particular treatise De Semitertiana, lias  extended the
meaning of that denomination  so far, that it incl'.ides almost
every species of the tertian tribe. 
88          OF TERTIAN FEVERS.
 such uniform diversity is  observable, yet it will be
 found next to impossible to give a tolerable idea of
 the diseases  in that climate without the assistance of
 this distinction.
   In this treatise tertian fevers are called simple, when
 there is but one fit and one interval during each period
 of the distemper. When the paroxysms do not exceed
 twelve hours,they are called true tertians; when thev
 continue longer, they are called spurious. In the true
 simple tertian the fit, for the most part, comes on in
 the middle of the day, and  goes off the same evening.
 In  the  spurious  simple tertian it comes on  much
 earlier, and often lasts above eighteen hours.
   They are  called double  tertians,  when there are
 two fits and two  intervals  within  the time of each
 period. But commonly there is some difference be-
 tween the  two fits, either  in  respect to the hour at
 which they come, the time of their  duration, or the
 nature and violence of their concomitant symptoms;
 whilst at the same time the third paroxysm of the
 disease resembles the first, the fourth agrees with the
 second, the fifth with the third, and so on.
   Some double  tertians begin in this manner: on
 the  evening  of Monday,  for  example, a slight fit
 comes on,  and goes  off early next morning: but on
 Tuesday, towards the middle of the  day, a more se-
 vere paroxysm begins, and continues till night. Then
 there is an interval to Wednesday evening, when a
 slight fit commences a new  period of the fever, which
proceeds in the same  manner as the first; so that
 (according to the way  in which physicians calculate
the davs of diseases, by beginning to reckon  from 
OF TERTIAN FEVERS.         89
the first hour of their invasion) both paroxysms hap-
pen on the odd days, while the greater part of the
even clays is calm and undisturbed.
   But in  most double  tertians the patient has a fit
every day of the disease; the severe one commonly
appearing at noon on the odd  days, the slight one
towards  evening  on the even days; though some-
times the worse of the two fits happens on the even
days. (A)
   Double tertians, if their fits do not exceed twelve
hours, are  named true;  if they are somewhat more
protracted,  they are called spurious; and if the fits
are so far protracted, that one is scarce ended when
another begins, they are called subintrant.  -
   There is a tertian  fever sometimes to be met with,
during each period of which there are three differ-
ent fits, and as many intervals. For example, towards
Monday noon the patient is seized with a paroxysm,
which declines about five  or six  o'clock the  same
evening:  a few hours after another fit begins, and
continues until morning; from which time there is
an interval  to  Tuesday evening,  when a third fit
comes on, and  lasts most part of the  night.  On
Wednesday there are again  two paroxysms, as on
Monday, and one on Thursday like that of Tuesday;
and thus the fever goes  on, with a double fit on each
of the odd days, and a single  fit on the even  days.
  This uncommon kind of tertian is the true semi-
tertian of Hoffman* and some others: but I shall
call it a triple  tertian, to distinguish it from  another

  (A) It is always a bad sign when the worst fit of an  autumnal
fever occurs on an even day.
  * Med. Rat. torn. iv. § i. c. v.
                       H2 
90          OF TERTIAN FEVERS.
very common fever, which proceeds in the following
manner.
  A fit begins on Monday noon, for example, and
goes off  the same night.  On Tuesday afternoon a
second fit  comes  on, and  gradually increases  till
Wednesday night, when it terminates. On Thursday
morning there is such another interval as happened
on  Tuesday morning: but on Thursday afternoon
another long fit, like the preceding, commences, and
returning regularly every other  day, leaves only a
short interval of ten or twelve hours during the eight
and forty.  This fever I shall call, with Celsus* and
Agathinus,f a semitertian.
  But the various kinds of tertians hitherto mention-
ed differ among themselves, according as their pe-
riodical intervals are more or less tranquil and free
from disturbance. When there is a complete apyrexy,
or entire vacation of fever between the fits, they are
called  intermittents; when  the  apyrexies are  more
imperfect  and obscure, remittents;  and continual
tertians,  when the paroxysms and their intervals are
less perceptible, though the violence of the symptoms
is somewhat abated on the alternate days. In double
tertians that interval is the most considerable which
follows the severe fit; for the slight fit oftener ends
in a remission than intermission, and frequently lin-
gers till  the other approaches: hence it is that the
night preceding the vehement fit is much more rest-
less than that which comes after  it, as has been ob-
served by Hippocrates. (Morb. Vulg. 1. vi. §2.)
  * Cel. lib. ii. c. iii.
  f Apud Galen de Febr. Different, lib. ii. c- ii 
OF TERTIAN FEVERS.          91
  These are the differences of tertian fevers, which
proceed from the types of their periods. But in some,
each period is  completed in a  few hours less  than
eight and forty; in others, in a few hours more: the
former  are therefore called anticipating, the latter
postponing tertians. In double tertians the vehement
fit often  comes on a little earlier in each period,
while the slight fit returns  at the same hour, or per-
haps later and later every other day:  so  that the
motions of one have no influence on those of the
other; whence it  appears,  that  each of these fits
hath its own proper independent cause.
   With regard to the types of the periods, and the
time of their duration, this may be sufficient. I come
now to the differences of tertian  fevers formed  by
the  symptoms attending their paroxysms.
   Many authors (and Hoffman in particular*) have
carefully enumerated the phenomena of the fits in
regular distinct tertians, according to the order in
which they succeed:  but so far are the  paroxysms
of the epidemical fevers, which are the subject of
our discourse, from having constantly one and the
same appearance, that no two  distempers can  differ
more than they often seem to do from one another.
 In both simple and double tertians, as well  as  semi-
tertians,  they  often begin  with a slight shivering;
sometimes without any sense of cold; and frequently
while the patient complains of cold his skin is  ac-
 tually warmer than  in a  natural state.  In  some a
 most intense degree of heat is  brought on; in others
 it is moderate. In a few  they terminate by  stool or
* Med. Rat. torn. iv. § i. c. ii. 
92         OF TERTIAN FEVERS.
urine rather than by sweat: sometimes they are so
complicated with fixed pains  of the  head,  breast,
belly, back, or limbs, as to  personate with great ex-
actness, a  phrensy, pleurisy, hepatitis lumbago, or
rheumatism; especially if the apyrexies are obscure
or imperfect.  Sometimes one  or two  symptoms of
the fit predominate with such violence, that the rest
are obscured  or altogether eclipsed.  Hence we so
frequently meet with  hemicranias, choleras, dysen-
teries, and chincoughs, returning regularly at stated
periods. And several fevers of this class,  upon ac-
count of some predominant symptom,  have had par-
ticular names bestowed upon  them.  For  example,
when the cold,  which ushers  in the  fits, continues
longer than ordinary, and is so very intense that the
surface of the body is chilled, whilst a burning heat
is  felt in  the bowels,  the fever is  called lipyria.
When  the  anxiety and  dejection  of mind, which
commonly happens in the first stage of the paroxysm,
is so far augmented as  to  degenerate into an abso-
lute fainting, the disease is termed febris syncopalis.
When exquisite pain  and burning heat in the bow-
els  render the patient restless,  and incapable of
continuing many moments  in the same posture, as-
sodes is the name appropriated to the fever. And it
is called elodes, when the skin  is constantly covered
with sweat; either from the viscera being inflamed,
or from a general  dissolution of the blood.*  For
although in the course of these malignant fevers it

   * Atque hoc  in  totum de sudoribus animadvertere oportet,
quod nonnulli quidem  ex corporis dissolutione, quidem ex in-
flammsitionis vehementia contingant.
                              Hippocrat. Pnenot. lib- 
OF TERTIAN FEVERS.          93
often  happens  that  you  can  neither  distinguish
paroxysms nor intervals, yet  it is evident that they
belong to the tertian  tribe, since, for the most part,
in their  beginning the periods  are sufficiently dis-
tinct;  and as soon as that violence of the symptoms
which occasioned the  confusion  in the height of the
distemper abates, they again become more regular,
and assume either their former or analogous types.*
   Whoever  rightly comprehends what I have  al-
ready said on tertian fevers,  will easily see that it
would be endless to reckon up the different species
into which they might be  divided,  and to ascribe
particular names to each.  Yet there is  another cir-
cumstance which renders this  subject still more per-
plexing. For such is the variable disposition of these
diseases, that they often change from one appearance
to another, and  seldom retain the same form from
their  beginning to  their termination;  each period
sometimes assuming  a new type;  and every parox-
ysm being attended with different symptoms. This
led  me  at first  to  apprehend that they were con-
fused, anomalous, and altogether without order:  but
after  being for some time acquainted with them, I
began to discover their regularity; and  the longer I
was conversant among the sick, the more I was sur-
prised at the constancy of nature in the production
and progress of tertian  fevers; their periods  being
perfectly similar in the Spaniards and in the English;

   *  Febris syncopalis minuta subtilis, est febris acuta faciens
 cadere pulsum etvirtutem in paroxysmo uno aut duobus parox-
 vsmis, cum additione dissolutionis accidente in corpore cum ve-
 locity.  Mure, paroxysmi hujua febris sunt paroxysm tertian..
                                  Avicen-  de Feb. c. nu. 
94,          OF TERTIAN FEVERS.
and  sometimes  not very different in him who  lies
upon the  bare ground,  destitute of assistance,  and
those who are treated in the most judicious methods,
under  every  advantage of fortune: and frequently
neither the  patient's intemperance, nor unskilful
management, can alter their  stated  course,  and
prevent their terminating in recovery,  (i) So much
are those  mistaken,  who imagine that the  bent of
nature in acute diseases can be altered or controlled
by every trifling accident or insignificant prescription.
   Most of these fevers make their  first  appearance
in the shape of a  true simple, or double intermittent
tertian. The  cold fit seldom lasts above  an  hour or
two; and as  it  goes  off some bilious matter is com-
monly discharged by vomit  or stool.  Then follows
an intense heat over the whole body, which raises
the mercury  in the thermometer to the  103d or 104th
degree:  and  lastly, a profuse sweat puts an  end to
the  paroxysm.  The  apyrexy is tolerably complete,
though for the  most part the patient complains  of a
disagreeable  taste,  loss  of appetite, headach,  and
pain in the small  of his back, and pit of his  stomach
upon a full inspiration. The pulse /luring the inter-
mission is almost natural:  in the fits it varies  accor-
ding to their predominant symptoms. W hen they
are attended  by acute pains in  the prsecordia, it be-

  (j) After the complete formation of an autumnal  fever, the
ordinary course of which is  five, seven, and  nine days, it  is
seldom cured by the  ordinary remedies employed for that pur-
pose. All that medicine does in this case is to  keep the system
afloat, and thus  to  prevent deatli. The sameness of the  issue of
this fever under all the different circumstances that  have been
mentioned, shows the strength of the remote cause,  in predo-
minating over national habits, and variety of predisposition. 
OF TERTIAN FEVERS.          95
comes small and obscure,  so  as to indicate greater
weakness  than there  really is: on  the other  hand,
when drowsy  lethargic symptoms come on, it often
resembles that of a person  in full health, though the
sick is  in the utmost danger.  The urine, whether
made in the  time of the  paroxysm  or  interval, is
always clear, frothy, and of a deep red colour, with-
out  any separation.  Blood drawn from a vein is
most commonly florid like  scarlet, without any sizy
crust: the serum  is sometimes tinged with yellow,
but oftener red like the lotura carnium, and in great
quantity.  Sometimes the serum and  crassamentum
remain  united in a lax gelatinous mass.
   As the  fever  advances to its height, the coldness
and shivering which  usher in the paroxysms become
less, or intirely imperceptible; in which case a cho-
lera morbus, or acute pains in the back or limbs, of-
ten supply their place: frequently the shiverings are
intermixed with flushings of heat. In the mean time,
the paroxysms themselves  become longer, and bring
on more formidable  symptoms;  such as headachs,
raving, sopors, apoplectic fits, bleeding at the nose,
cough, difficulty of breathing, palpitation of the heart,
irregularity of the pulse, sickness and anxiety, pain
about the upper orifice of the stomach, vomiting and
purging, heat, tension, pain and pulsation in the ab-
dominal viscera, subsultus  tendinum, and an infinite
variety of other complaints, which do not entirely
cease with the sweat that carries off the paroxysm;
so that the apyrexy is not  only shortened, but ren-
dered more obscure.
   Besides,  it often  happens, during  the second,
third, fourth,  or  fifth period, that the  tertian be- 
 96          OF TERTIAN FEVERS.
 comes  double, though at first it was simple:  or if it
 was double from the beginning, the weaker fit con-
 tinues,  without any intermission, till  the stronger
 comes on, and both being blended together, the dis-
 ease puts on the appearance of a semitertian, having
 one very long  fit, with a short  interval every forty-
 eight hours. Sometimes a double tertian degenerates
 into a triple tertian, two fits instead  of one happen-
 ing on the odd days.
   It must likewise be observed, that, in the progress
 of the fever, the regular order of the periods  is fre-
 quently disturbed, by the paroxysms changing their
 hour of invasion, and attacking  unawares without
 any previous cold. Nor are anticipating fits always
 a  bad sign, or those which postpone a  good one,,
 as some authors insinuate; on the contrary, the first
 frequently show the strength of nature, as the others
 do her weakness.
   After this  manner these proteiform distempers
 continue to vary their shape in every period, and to
 produce longer, more severe, or more frequent pa-
 roxysms, till they arrive at their height; about which
 time the  fits and intervals are often so  confused,
 that they are scarcely to be distinguished:  neverthe-
 less, if death be not speedily the consequence of this
 confusion, they commonly again put on a more sim-
 ple or regular form,  and,  after one or more  slight
 paroxysms, go away of their own  accord.
   Those fevers which come to their height  in the
third period, terminate in the fourth or fifth period;
those which  come to their height in the fourth pe-
riod, terminate in the fifth or sixth; and those which
come to their height in the fifth  period, terminate in 
OF TERTIAN FEVERS.          97
the sixth or seventh. When the most vehement pa-
roxysms happen on the odd days, the crises will be
on the odd days: when they happen on the even days,
the great changes of the distemper will likewise be
on the even days, (j)
  If the fever increases to  the  seventh period,  it
probably will not cease before the ninth: but it rare-
ly happens  that intermitting or remitting tertians run
out to so great a length. Yet I have seen every year
a few of the continual kind, which began with great
mildness, and increasing by slow degrees, broke out
violently in the third or fourth week, and soon after
ended in intermittents; though some of  them have
continued without  any considerable  interval for six
or seven weeks.  Hippocrates*  has  accurately de-
scribed  such  continual tertians, and tells us  that
they are apt to terminate  in dysenteries,  lienteries,
and tenesmus, which we find in fact  to be  too often
the case.

  (j) This remark has been confirmed by universal experience,
  * The other fevers were altogether of the continual kind with-
out any intermissions;  and the paroxysms in all like the semi-
tertians, one day better, another worse.  And of all the fevers
that then  reigned, these were the most  vehement, tedious, and
painful; beginning very mildly, but increasing always, growing
worse and worse on the critical days. After a little abatement
they  soon grew bad again, had stronger fits on the critical days,
and for the most part worse: shiverings were universally irre-
gular and uncertain, seldom and very little  in these, but more
in other fevers: sweats were common, but here least of all; and
so far from easing the patient, that, on  the  contrary, they did
him harm. The belly in all was disturbed, and in a bad manner,
but worst of all by much in these, &c. &c.
                           Clifton's Hippocrat. p. 57, 58
                           I 
  98          OF TERTIAN FEVERS.
    But it is much  more  common to meet with ter-
  tians, which set out furiously, with severe subintrant
  double paroxysms; so that for some days they have
  little or no interval.  On  the third or fifth day  a pro-
  fuse  sweat commonly brings on an intermission; and
  afterwards the  disease assumes the type of a double
  intermitting tertian, or of a semitertian. Such fevers I
  have frequently observed to terminate spontaneously
  on the seventh, ninth, and eleventh days; and, for the
  most part, they are less to be feared than those which
  begin deceitfully in  the  shape of a slight double or
* simple tertian.  For however mild and insignificant
  these intermittents may  at first seem to be,  we are
  never to trust appearances, till they have performed
  three or four revolutions.  Then indeed, if  the pa-
  roxysms are  not attended with acute pains in the
  viscera, and do not last above twelve hours; if they
  decline  with  plentiful warm  sweats, and leave the
  intervals tolerably free; if the patient bears  the dis-
  temper well, and begins  to have an appetite for vic-
  tuals; if small pustules break out in the inside  of the
  mouth, or scabs about the lips;* if the urine has re-
  covered its natural  complexion,  or is  cloudy and
  turbid, or lets  fall a white or a pale red sediment;
  I say, if all  these signs  concur about the  third  or
  fourth period, we may safely prognosticate a speedy
  recovery.
    On the  other hand, it denounces danger, when,

    * - It is to be observed, that these are only to be looked upon
  as a good sign when they come in the declension of the disease,
  attended with other signs of concoction; for if they break out
  in the beginning,  they prognosticate a dangerous or a tedious
  illness. 
OF TERTIAN FEVERS.          99
about this time  of the disease,  the paroxysms  are
long  and protracted;  or are accompanied with an
obstinate delirium, an  intense coma, great anxiety,
and pain in the loins, or about the upper orifice of
the stomach; when the patient has an utter aversion
to food, and even in the intervals  is so feeble, and
attended with such a swimming in the head, that he
can scarcely walk about; when the hypochondria and
epigastric region are  swelled, hard, and  painful to
the touch; when numerous  blotches, like the sting-
ing of nettles,  frequently break out on  the  skin;
when the urine  continues thin, clear, high coloured,
or covered with  an ashcoloured membrane like a
cobweb; and  lastly, it denounces danger, when lar-
ger evacuations come on than the strength can well
bear,  such  as vomiting,  purging,  bleeding of the
nose, colliquative  sweats, or the like.  For  fevers
 with  these appearances sometimes  are  immediately
 changed into mortal dysenteries;  sometimes they
become  continual  tertians,  and run out to a  great
 length; but, for  the most part, they preserve the form
 of remitting or intermitting* fevers, and daily grow-

   * In this and some other parts of this treatise it is inculcat-
 ed, that the danger in tertian fevers is rather to be estimated
 from the symptoms of the paroxysms, than the length and se-
 renity of the intermissions: on which subject, as Franciscus
 Torti has expressed himself with great clearness, Ishall here
 add a few remarks, from his Therapeutice Specialis, a valuable
 work, which I never had the good fortune to meet with till very
 lately.  He tells us that periodical fevers, and principally double
 or simple tertians, become malignant, either when they degen-
 erate into continual acute fevers, or when they still retain their
 intermissions,  but are accompanied with one or other of the
 following symptoms; which commonly proves fatal in the second
 or third fit, after its appearing in the  formidable manner which 
100         OF TERTIAN FEVERS.

ing  stronger, prove very dangerous  about the sixth
or seventh period; and though the patient may es-
cape, after a great struggle, by means  of some criti-
cal discharge,  such as purging, sweating, parotids,
or abscesses near the  hip;  yet Jiis  constitution is
commonly so shattered, that he  long  continues ex-

he describes.  1. A vomiting or looseness, like a cholera morbus,
or dysentery.  2. A looseness which often resembles the fluxus
hepaticus, and sometimes a  purging of atrabilis. 3. A cardial-
gia. 4. Cold sweats. 5. A syncope. 6. A constant coldness, neither
succeeded by heat nor sweat.  7- A lethargic disposition, little
different from an apoplexy.  Hence he makes so many different
species of malignant intermittents, and names them from the
predominant symptoms of the fit. 1. Febris cholerica seu dy-
senterica. 2. Subcruenta seu atrabilaris. 3.  Cardiaca.  4. Dia-
phoretica.  5.  Syncopalis. 6.  Algida.  7- Lethargica. He de-
scribes, with great accuracy, the manner in which each species
occasions death;  and takes notice, that in the six species first
mentioned, the pulse is constantly small, feeble, and greatly de-
pressed;  whereas in the seventh  it is rather  full, strong, and
slow (as in an  apoplexy), than weak and quick. This, which he
calls the lethargica, is extremely common in Minorca; the car-
diaca and cholerica are likewise frequent; and all the rest are
now  and then to  be met with,  except perhaps the subcruenta,
which I never  took notice of. Our  author likewise remarks, that
it is  not unusual  for some of the above mentioned symptoms to
attend continual periodical fevers,  though seldom in so great a
degree  of violence  as in the  intermittents. And he observes,
that  intermittent quartans rarely kill in  the fit, as the  tertians
do, but often  prove fatal by becoming  continual fevers.  The
whole work deserves to  be carefully perused, but particularly
the first  chapter of the third book,  from which the above re-
marks are collected, with a view to raise, rather than to gratify
the reader's curiosity. (£)
  (/t) The yellow fever appeared in Philadelphia in all the forms
which have  been  so happily enumerated by Dr. Torti in the
above note extracted from his works by the author. 
               OF TERTIAN FEVERS.          101

 posed to irregular paroxysms, night sweats, fluxes,
 obstructions  of the  chylopoetic  viscera,  and  every
 kind  of chronic distemper.
   Those  fevers are most to be dreaded, whose  vio-
 lence is greatest on the even days; and if the parox-
 ysm  stops  on  the third, fifth, or seventh  day, but
 continues on the fourth, sixth, or eight day, we must
 be upon our  guard, lest a sudden storm should  suc-
 ceed  this  treacherous intermission.*
   But the utmost danger is to be apprehended, if a
 few drops of blood fall from the nose;  if black mat-
 ter, like the grounds of coffee, is discharged upwards
 or downwards;  if the  urine is of a dark hue and a
 strong offensive  smell; if the  whole  skin is tinged
 with a deep yellow, or  any where discoloured with
 livid  spots  or suffusions;!  if a cadaverous  smell is

   * I inserted this caution, having seen a few double tertians
 change into simple tertians,  by the fits  intermitting on the odd
 day, and nevertheless  prove  fatal  soon afterwards ; a  case
 which  I had not found  so much as hinted at in any  author ex-
 cept Hippocrates, who tells us in the Pncnot. Coac. §>uibus tertio
 die subsistit  accessio et quarto ingravescit malum- Yet from the
 following passage in Torti I imagine that experienced physician
 must have met with  accidents of the same kind. Suspecta itaque
 ab exordio erit, ne in  continuant degeneret, intermittens, qua cum
pauco aut nullo rigore solet invadere, sed potius  cum  sensu caloris.
 Ite?n qux primo  die leviusculam (~dum modo tamen vere febrilemj
infert accessionem;  altero vero die (~non altera periodoj fortiorem,
et sic progrediendo modum servat graviorem per dies pares, loquendo
per modum exempli, de tertiana duplici ab ortu- §htod si eadem sic
orta in  simplicem statitn mutetur, etsi hoc laudabile sit, tamen non
desinit esse suspectum, si primam accessionem validam, debilis, ut
supra,  immediate prxcessit: potest enim facile ille typus  tnutari
qui ordine inverso potuit incipere.      Therap. Special- I. iii. c. ,
  f The English in Minorca are more liable than the natives to
become yellow in these fevers.
                              I 2 
102         OF TERTIAN FEVERS.
perceptible about the patient's bed; if in the time of
the fit he continues cold and chilly, without being
able to recover heat;  or if he  becomes extremely
hot, speechless,  and stupid; has frequent  sighs,
groans, or hiccoughs; and lies constantly on his back,
with  a ghastly countenance, his eyes half shut, his
mouth open, his belly swelled to an enormous size,
with an obstinate costiveness, or an involuntary dis-
charge of the excrements:  which formidable symp-
toms,  as they seldom appear before the  third revo-
lution of the disease,  so they frequently come on,
both in double and simple intermittents, during the
fourth, fifth or sixth period, even where the smallest
danger was not foreseen.  But at whatever time the
greater part of them  concurs, they afford a melan-
choly prognostic; for notwithstanding they sometimes
go entirely off with the paroxysm, and  the patient
seems to be left in a fair way of recovery, yet most
commonly they return in the next period with double
violence, and terminate in  sudden death. Agreeably
to this Hippocrates tells us, " In the summer, inter-
mittent fevers and the cholera morbus prevail; -and
as they sometimes  degenerate into malignant  acute
diseases, we should be upon our  guard; the fifth,
seventh, and ninth days point out the danger; but
we  must be cautious to the fourteenth." (De Morb.
Popular. 1. vii.) For the fifth day, if the bad symp-
toms just now mentioned, appear on it, will indicate
death on the seventh. In the same manner the se-
venth  will indicate the  ninth,  and the  ninth the
eleventh to be  fatal, provided  the paroxysms are
aggravated on  the  odd days; for if they are most
vehement on the even days, one of these days will 
             OF TERTIAN FEVERS.         103
 prove indicatory as well as critical. Hence we find
 Galen* lays down as a general  rule, that those who
 grow remarkably worse on the fourth day, die on the
 sixth; and with equal justice he might have said the
 same thing of the sixth day, with regard to the eighth,
 and of the eighth, with respect to the tenth.
   Nor is there  only a possibility, in many cases, of
 foretelling the day, but likewise the hour on which
 the patient will expire; for that stage of the  parox-
 ysm, which he  usually got over with most difficulty,
 will most probably in the end prove fatal,  as Galen
 has also  remarked. (De Crisib. 1. iii. c. x.) I have
 seen  some expire in what  may be called  the  first
 stage of the paroxysm; the skin being chilled and wet
 with cold sweats, their pulse small and irregular, and
 their senses entire to the very last. But the greatest
 numbers are hurried off in the height of the hot fit,
 stupified, senseless, the breathing short and laborious,
 and the skin covered with a burning fiery sweat.
   In the meantime it is to  be remembered, that as
 in all acute diseases, so particularly in those fraudu-
 lent deceitful  fevers, the presages either of death or
 recovery  are not always certain and infallible; it
 frequently happening that those  who.have laid in the
 paroxysm  for hours together, with few or no signs
 of life, have at  length  recovered, as it were, from
the jaws  of death, and asked for some  uncommon
 sort  of food,  to the great  surprise  of every body
 about them; on the other hand, the  fit anticipating
sometimes brings on death  before  the time it was
 indicated.

  * Etenim qui in quarto ad pejorem statum recidunt, plerujm-
 }ue sexto moriuntur.         De Dieb. Decret. 1. i. cap. iv. 
 104          OF TERTIAN FEVERS.

   I have examined the bodies of near a hundred
persons, who perished in those fevers, and constantly
found one or other of the adipose parts in the lower
belly, (the cawl, mesentery, colon,  &c.)  of a dark
black  complexion,  or totally corrupted; the  vesica
fellea full and turgid, and the stomach and intestines
overflowing with bilious matter;  the spleen  large,
sometimes weighing four or five pounds, and so ex-
cessively soft and  rotten,  that it  had more the ap-
pearance of congealed blood wrapt up in a membrane,
than  of an organical part.  In the cavity of the head
and breast nothing extraordinary was met with, ex-
cepting yellow serum, when the skin was tinged with
the same colour.
   Some observations relating to malignant tertians
are handed  down  to us  by  Coelius   Aurelianus,
which, for the reader's information, I shall transcribe
at the bottom of the page;* and whoever is acquaint-

  * Hxc passio (nempe. apprehensio sive oppressio) lethargis
similis est. Hippocrates et Diodes apsmav appellavit, Praxago-
ras Ka/txTufm,  Antigenes «vau<T<av, Asclepiades Catalepsin—■
Diodes ait (1) defectivasfebres tutas et innoxias esse frequentius
quam  sunt continue, quamquam et in his periclitentur, qui in
accessionibus apprehensi conticescunt, vel raptu quodam alterno
per membra tentantur, cum supra  dictis: quod saepe, inquit, est
accidens pueris.  Item Praxagoras  ait esse quasdam febres ex
anno duodecimo usque ad annum  xvi aut xvn, quae, quadem
privata pernicie, mortis  habent effectum:  atque  id in servis
magis  quam liberis evenire, sed  (2) excesso dierum numero pas-
siones  fiunt catocha: vehementes, ut etiam voce capiantur xgro-
tantes: horum aliquos etiam lethargicos fieri. Denique, inquit,
quidem liberati, et deinde (3) sanitatis creduli, plurimum quic-
quam sumentes, repente  in mortem venerunt.—Item Archige-
nes ait difficiles esse periodicos  typos horum  difficiliores esse

(1) Intermittentes.  (2) Imparibus diebus.  (3)  Sani sibi visi. 
                OF TERTIAN FEVERS.          105

 ed with this author's style, will easily discover how
 nearly the  preceding remarks agree with those of the
 old Greek  and Roman physicians. In some circum-

 tertianas, in  quibus quotidians accessiones  fiant, sed alterna
 diei interpositione, (4) suce similitudini respondeant,  quando in
 accessione vehemens occurerit oppressio, et appellavit pitos.
 Difficilis, inquit etiamsi  quotidianis diebus accessiones sibi si-
 miles fiant, et in accessione xgrotantes  supra dicta patiantur.
 Dehinc progrediens paululum idem  dixit periodicos typos  non
 esse perniciosos, sed horum esse molestos,  quibus accessions
 tempore (5) pressure vehementes eveniunt, et quodam (6) nubilo
 corpus  demergitur, quod item Rhigos vocavit;  sed hoc, inquit,
 est accidens roagis tertianis, aliquando etiam quotidianis, quae
 similibus  respondeat accessionibus.—Apud Romam vero inquit
 Asclepiades  frequentare advertimus (7)  has febres, cum cor-
 poris atque mentis oppressione, in  similitudine lethargic, qua
 secundo vel tertio in statu  accessionis constitute, statim reca-
 lefacto  corpore, vel  cessante vehementia, in resumptionem et
 resurrectionem mediocrem revocant xgrotantes. At si (8)  levi
Jigmento cessaverint, semel apprehenso aegro nullam resurrec-
 tionem  dabunt,  sed in  sudores, et respirationem celerem, in
 pulsum  febricitantem desinunt  et occidunt.—Autumni tempore
 ha:c passio magis irruit corporibus atque puerilibus frequenter
 setatibus;  item mulieribus humorosis, et  vacuis corporibus, et
 edacibus  hominibus.—Praterea omni febriculae haec passio ir-
 ruere potest sive continuis sive demissionibus intercapedinatis,
 hjemitritaicis etiam febribus, vel quotidianis, vel tertianis, vel
 quartanis, frequentius tamen quotidianis  accessionibus, vel ter-
 tianis, zegrotantes ista passione  afficiuntur, et propterea, diutur-
 nis accessionibus admoniti, tertianis similitudinem servant, ad
 typum quotidianum: sed omnium earum febrium gravius, quo-
 ties cum articulorum frigido torpore fuerit (9) qualitas: levius,
 quoties  tremore xgrotantes  afficiuntur:  item  magis et magis
 levius, quoties sine his qux supra diximus, solo fervore febres
 inltium  accipiunt.  Afterwards, having  accurately enumerated the
(4) Sibi similes sint.    (7) Tertianas duplices.
(5) Profundus Somnus.  (8) Non revera sed in specie tantum.
(6) Somno turbulento.   (9) Mos febris. 
106         OF TERTIAN FEVERS.
stances however there seems to be a difference; for
according to them  children are most  liable  to ma-
lignant tertians; whereas  by what I have observed
they were more frequent among adults and those of
an advanced age.  They likewise talk as  if  the fits
were more  to  be dreaded when they come on with
a numbness of the joints and  tremblings; but the
most formidable  paroxysms  which  I  have seen,
broke out into a burning heat at the beginning, with-
out any previous cold. (/)
   From  what  has been said  I flatter  myself that
young practitioners will be enabled,  not only  to dis-
tinguish tertians from all  other fevers, but likewise
to foresee the  times  of their paroxysms, and inter-
vals, and to make a rational conjecture concerning
their event. Before  I proceed to the cure  I  shall
only  remark, that, although we find  them appearing
every year in  the  several  forms and  types described

signs of the distemper, our author proceeds to describe it in the last
stage.  Cum sudore ssepius plurimo atque ferventi et in demis-
sione  sinceritati propinquantes rursum admonentur.  At si ad
pejora passio fuerit devoluta, fervor plurimus corporis  in super-
ficie, magis sentitur respiratio, oculorum conversio, menti quo-
quefixa conductio, manuum contractus, et musculorum, qui
buccas colligunt, tanquam ridentium, sudor igneus, et quibus-
dam in vultu  et thorace emergentes discolores vel stantes in
rotunditate (10) macula, in similitudinem (11) scatebrarum corpo-
ris, quas Graeci IovOu? vocant, et e magnitudine repentinus virium
casus, gutturis stridor, quern ronchum vocant, torpor  frigidus,
albidus vultus, et in ultimo (12) effatio, atque vitae periculum.
                            Lib ii. cap. x. De Morb. Acut.
  (/) This remark accords with general experience.  The lon-
ger the chill, the less  the danger of the fever which succeeds it.

(10) Exanthemata. (11) Sudoris guttularum.   (12) Suffocatio. 
            OF TERTIAN FEVERS.        107
in the beginning of this chapter, yet the true simple
and double tertian, and the semitertian, are by much
the  most frequent.  In July, when they first break
out, their type is commonly simple and regular; their
paroxysms  are  of short  duration; and after  three,
four, or five periods, they vanish of their own ac-
cord.  So just is Hippocrates's  observation, that true
tertians generally end within five, seven, or at most,
nine revolutions, notwithstanding what some of the
moderns have  alleged to the contrary.  (Praenot.
Coac.)  As the season advances the tertians become
more  dangerous and difficult, often  terminating in
those  malignant  fevers, called syncopalis, lipyria,
assodes, &c. especially if much rain, without wind,'
fall during  the dogdays. About the time of the equi-
nox they assume a surprising  variety  of forms, and
very often counterfeit  continual fevers, having long
redoubled paroxysms.  But as the winter draws near,
their  type  becomes  more  simple, and though they
prove tedious and obstinate  in  cold  weather, yet
they are more regular, and less dangerous  than in
the summer.
  In  the cure of tertians the  symptoms of the pa-
roxysms are more to be  regarded than the types of
the periods; for,  ceteris paribus, simple, double,
triple, intermittent, and remittent tertians, together
with the semitertians,  all require the same sort of
treatment.
  As soon as the fit comes on the patient should be
put to bed, and covered with clothes in such a man-
ner, that he may neither be suffocated with immod-
erate heat,  nor the critical sweats be  suppressed by
the admission of too  much cold. If it can conve- 
 108         OF TERTIAN FEVERS.
 niently be done, his bed should be placed in a large
 room, where he may breathe freely, in pure tempe-
 rate air. In the summer it will be necessary to keep
 out  the sun, and to refresh  the air frequently by
 sprinkling the  floor with vinegar and  water,  and
 opening the windows to  the  north;  during winter,
 or the autumnal rains, the cold and moisture of the
 weather must be corrected by a fire.
   While the cold fit continues, the patient should
 abstain from drinking. For  at that time the vena
 cava and subclavian vein are so full and turgid, by
 the blood being driven from the surface  of the body
 to the internal parts,* that the discharge of the  tho-
 racic duct is prevented: hence the liquor swallowed
 down remains  in the alimentary tube, loads the bow-
 els,  and creates anxiety. And therefore if the patient
 is thirsty, he must endeavour to allay it in the best
 manner he  can, by washing  his  mouth often,  and
 eating slices of lemons sprinkled with sugar. In the
 meantime, if a nausea  or inclination to vomit su-
 pervene, those salutary attempts of nature should be
 promoted by large draughts of warm water or weak
 broth, which commonly bring up a quantity of bilious
 matter, to the immediate relief of the sick.
   When the first stage  of the  paroxysm is over, or
 (to use Hippocrates's phrase)  zvhen the heat descends
 to the feet,]  liquids may then be given; but with such

  * Sanguis presentem horrorem metuens, ad partes maxime
 calidas concurrit.                      Hip.  lib. de Flat
  f Per totum morbum istud praecipue observari debet, ut cum
frigidi pedes fuerint, tum a sorbitione exhibenda, tum maxime
a potu abstineamus. Cum vero calor ad pedes descenderit, tunc
dare convenit.            Hip. de Vict. Rat. in Morb. Acut 
OF TERTIAN FEVERS.         1Q9
moderation,  that the  patient be  neither allowed to
take as much as he pleases, nor  suffered to be tor-
mented with thirst. As soon as  the  sweat breaks
out, he may then be permitted to drink at pleasure.
  The  Spanish physicians deny them liquors alto-
gether  till the fit  be  at its height: they then give
them in small quantity, always encouraging the sick
with Celsus's remark, " That  the thirst will cease
with theft; which will continue longer if they drink.''''
(Lib.  ii.  cap. vi.)  On  the other Hand, our people
run into the opposite extreme, by permitting the free
use of liquids in every stage of the paroxysm.  The
first of these errors, especially in tertians which have
long paroxysms, besides torturing the patient, aug-
ments the feverish heat, occasions a putrefaction of
the animal juices,  destroys the  solids,  and throws
life itself into the utmost  danger. By the  contrary
error the stomach is loaded, nature is  diverted from
expelling the critical sweat,  and  consequently  the
paroxysm is prolonged, (tn)
   The proper drinks  on this occasion are  those
which  allay heat,  prevent putrefaction, dissolve the
acrimonious particles of the blood, and convey them
through the kidneys and pores of the skin; such as
boiled water sweetened  with  sugar,  and  rendered
agreeably acid with lemon juice, spirit of vitriol, or
sliced apples infused in it; barley water mixed with

  (m) Truth, as our author observesj lies in the middle.of the
two extremes of practice that have been mentioned. In the be-
ginning of fevers of great morbid action, profuse drinking  adds
to the strength of the disease.  It is less hurtful, and happily
more necessary towards the close of fevers, after the long ab-
straction of aliment has disposed the fluids to a morbid acrimony.
                         K 
110         OF TERTIAN FEVERS.
   simple oxymel;  almond milk, and other emulsions;
   to all which nitre must be occasionally added.
     It is a noted question among physicians, whether
   during the fit the drink should be warm or cold? The
   Spaniards generally give crude water, cold from the
   cistern; and we find by experience that this, if it be
   not  hastily swallowed  down in great quantities,  is
   not  only safe  and innocent in summer  fevers, but
   much  preferable to warmer liquors,  as it quenches
   thirst more effectually,  strengthens at the same time
   the tone of the vessels relaxed and enervated by heat,
   and prevents the tendency of the  blood to a putridi-
   nous thinness. Hence  after  each draught the body
   seems to acquire fresh vigour, whereby it is enabled
   to perform the concoction  of the febrile matter, and
   discharge it by the proper emunctories.* And there-
   fore they are greatly to be blamed, who refuse their
   patients so powerful  and agreeable  a  remedy, in
f*spite of the earnest call of nature,  contrary to the
   advice  of the best practitioners.f Nevertheless, as
   there is a manifest hazard of the blood being coagu-
   lated by the  sudden application of intense cold, we
   must beware of giving ice water,  as the Italians and
   Sicilians do,  unless the patient has been accustomed
  to it when in health. And if the bowels are inflamed,

    * In hac curatione observandum est, a spirit, sulph. gutt.xx.
  cum libra aquae frigidae exhibitis sudores copiosos fuisse provo-
  cates, quod multis  experimentis nobis innotescit, qui plures
  tertianas febres  curatas vidimus,  eodem remedio, in summo
  accessionis aestu, et urgente siti exhibito, unde copiosi sudores
  provocabantur,  a  quibus non solum paroxysmus, sed etiam
  totus morbus integre solvebatur.    River. Obs. xix. Cent. i.
    f Vid. Hoffm. t. iv. § i. c. i. 5c t. iii. § ii.  c. xi 
              OF TERTIAN FEVERS.          111
 the safest way is  to  give the drink lukewarm, or a
 very little colder, (n)
   During the time of the critical sweats the patient's
 shirt and  sheets should  frequently be changed;  for
 when once  they  are thoroughly wet, they  do  not
 readily absorb the sweat; and besides this, there is
 a chance lest the  morbid exhalations  should be  ab-
 sorbed from the  wet linen by the cutaneous veins,
 and again conveyed  into the mass of  blood, (o)
   When the fit is over, and the patient has got a
 little rest after  his fatigue, it is needless, or rather
 hurtful, to confine him  constantly to bed, as is  the
 Spanish custom; yet he ought to keep within doors,
 or at least avoid  being exposed to the sun, and all
 violent exercise; which  is apt to bring on  inflam-
 mations in the bowels, and turn  an intermittent into
 a continual fever.
   In the paroxysms no kind of food should be given,
 unless the fits are of an uncommon length,  and  the
 patient very weak.  But  every three  or four hours
 during the intervals, a few spoonfuls of thin light

  (») The controversy between the advocates for warm  and
 cold liquors in fevers  can only be decided by attending to  the
 state of the fever. When the excitement of the blood vessels runs
 high, or when it is reduced very low, cold liquors are certainly
 hurtful. They increase reaction in the former case, and they
prevent it in the latter. In the intermediate states of the system
they are useful. Liquors a little warmed, by standing in the  air,
 allay thirst much more than such as are very cold.  This  has
 been confirmed by the experience of persons  who work in the
open air in hot weather, as well as by patients  in fevers.
  (o) The former of the  two  reasons given for changing  the
linen of patients after they are wetted with sweat, is  a good
one. The matter thus discharged  from the pores is perhaps
never conveyed into the body by cutaneous absorption. 
 112         OF TERTIAN FEVERS.

 nourishment  will  be  necessary to  support nature.
 The French  and Spaniards use  weak mutton or
 chicken broth in all fevers;  which practice is justly
 condemned by Riverius, (Prax. Med. lib. xvii.  c. i.)
 as  panada and other vegetable dishes  are not only
 more  agreeable  to the generality of the  sick, but
 likewise better adapted to prevent the  spontaneous
 tendency of the humours to an  alcalescent state. (/>)
 Nor can I think the summer fruits  are improper
 upon this occasion, though they  are forbid by  most
 authors, who have in this respect blindly copied after
 Galen.  Alexander Trallian* prescribes  the free use

  (p) The practice  of the British physicians in abstracting
 animal broths from patients in fevers of great morbid excitement
 should be imitated by the  physicians  of the  United States. In
 loiv chronic fevers, not only those  broths, but animal food may
 be. taken with safety and advantage.
  * Pomaceos fructus, exquisitis  tertianis liberaliter exhibere
 convenit, nempe uvam dulcem,  Persica cocta, et non  cocta,
 peponumque medullam; prrcsertim autem si etiam aegri siti vex-
 entur. Ego sane novi me frequenter jegros,  ne  amplius acces-
 sione  febris infestarentur, impedivisse,  cum  pepones  probe
 refrigerates, hora ante incursum morbi, assumere  jussissem,«t
 rursus  aquam temperatam copiosam, et quantam potuerint
 peponi superbibendam praecepissem.  Secutus itaque est, non
 multo post aquam epotam, aliquibus  sane sudor,  aliis copiosa
 bilis per alvum.  Offendi autem ego plerosque Romae medicos,
 qui ne nomen quidem peponum tanquam bilem procreantium
proferre audebant. Quum  itaque ego cuidam aliquando, ef si-
tienti vehementer et aestu  flagranti defatigatoque injunxissem,
 ut peponem  assumeret,  quidam praesens medicus exclamavit,
homo, cur aegrum magis "vis occidere?  Annon didicisti quod pe-
pon bilem producat? Lege Galenum de alimentis, ubi dicatma-
nifeste peponem comestum cholericos efficere.  Laboravi igitur
 ego, non parum, ut iis persuaderem, qui intellectu assequi po-
 terant, Galenum non dicere hic ipsos pepones bilem creare, sed
choleiam efficere. Proinde tertiana febre detentis, cum fiducia
dare debent. Qiiomodo enim ea, quae refrigerant et humectant,
bilem creare possint, non video.              Lib. xii c. vi. 
             OF TERTIAN FEVERS.         113
of grapes and peaches in tertians, and boasts of the
many cures  which  he had  performed to the great
surprise of his contemporaries, by giving water me-
lons, and large draughts of cool water an hour before
the  fit.  Avicenna  recommends  pomegranates  and
ripe plumbs, but above all the water melons.*  And
Galen himself,  though he was unreasonably preju-
diced against the summer fruits (a surfeit of which
threw him into a fit of sickness when a boy), yet in
the present  case he allows  the use of such of  them
as are not difficult  to be  digested. (Ad  Glauc. 1. i.
c. ix.)  And indeed in several other places of his
works he is obliged to contradict his own opinion of
their being  unwholesome nourishment;  particularly
where  he tells us, " that  those who are set to watch
 the vineyards,  and live for two months on grapes,
 figs, and bread, become  fat and lusty."  (De Alim.
 Facult. 1. ii. c. ii. et ix.)  Which  observation is an-
 nually confirmed  in Minorca, it being remarkable
 that the  persons  appointed  for  the same  purpose
 there commonly continue in  good health, though in
 that season tertians  usually  rage with  the greatest
 violence, (q)

   * In Opere Venet de Febr. c. xxxviii. p.  31.
   (q) The efficacy of a vegetable  diet in preventing autumnal
 fevers will depend much upon their grade.  Where they are at-
 tended with highly inflammatory or malignant symptoms, it is
 an almost certain preventive of them. The Bramins in India,
 who live wholly upon vegetables, enjoy good health in the
 neighbourhood of garrisons  and factories of Europeans, who
 sicken and die from a predisposition to the fevers of the country,
 induced by a diet of animal food.  Vegetable  aliment induces a
 predisposition to  fevers of weak morbi J. action. They are ob-
 viated by a cordial diet, and drinks.
                          K2 
114        OF TERTIAN FEVERS.
   Before I have  done with the diet of the sick,  it
may be  noted that, although in  the  beginning of
those fevers they commonly loathe every thing, ex-
cept thin, cooling, acescent liquors, yet  after some
days wine becomes less  disagreeable, and towards
the decline of the disease, a prudent use of it, mixed
with water, or made into whey, is often  absolutely
necessary to keep up the failing strength, and prevent
weakness, the worst of all distempers.
   With  regard to bleeding, it has been warmly de-
bated  among  both ancient  and modern authors,
whether it ought or ought not to be used in tertian
fevers. Much has been written on both  sides; but the
question appears  to me too general to admit of a po-
sitive answer. Celsus has justly observed that "Me-
dicines differ according to the nature of the climate;
one kind being necessary in Rome, another in Egypt,
and  a third in France."  (De  Med.  Praefat.) And
since we daily meet with a remarkable diversity of
symptoms among fevers of the tertian  tribe, even in
the same climate, at the same season of the year, it
cannot surely be  surprising that any one remedy is
not equally beneficial in all cases,  and  at all times.
   For my own part, when I was called  early enough,
in the beginning of those fevers I  used to take away
some blood from people  of all ages,  unless  there
was  a strong contraindication;  namely, from robust
adults ten or twelve ounces; from others a smaller
quantity in proportion  to  their strength  and years.
And farther, if a violent headach, and  obstinate de-
lirium, and great heat  or pains of the bowels were
urgent, within a day or two I repeated  the bleeding.
By which seasonable evacuation  the vehemencv of 
OF TERTIAN FEVERS.         115
the paroxysms  is somewhat diminished; the. apy-
rexies become more complete; the operation of eme-
tics and cathartics is  rendered safer and more suc-
cessful; and the  terrible  symptoms,  which  often
make their  appearance about the height of the dis-
temper, such as  raving sopor, difficulty of breathing,
inflammations of the abdominal viscera,  &c.  are
either prevented or mitigated, (r)
   But if  before I was called the fever had already
continued some time, and the mass  of blood appear-
ed to be too much melted down, or inclinable to a
putrid dissolution, which  is often the case,  during
the extreme hot weather, about the  fourth period of
the distemper,  and is readily known  by the great
alteration of the patient's  looks and his sudden  loss
of strength; or  if the first paroxysms of the  disease
were attended with profuse evacuations, whether by
vomiting, purging, sweating, or  a hemorrhage from
the nose: in all these circumstances I either omitted
the  bleeding entirely, or took  away  a very small
 quantity, though some importunate symptoms might
 seem to require a much larger evacuation.
   But when bleeding is allowed to be necessary, it is
 asked at what particular time of the periodical revo-
 lution it  ought  to be performed? The ancients* be-
 lieved that " to open a vein in the height of the fever,
 was  to destroy the patient;" and therefore they order
 you to wait for the intermission, or  the hour in which

   (r) This practice is judicious, and is sanctioned by similar
 success attending it in the United States.
   * Si vehemens  febris urget, in ipso impetu ejus sanguinem
 raittere hominem jugulare est; expectanda ergo intermissio, &c.
 Cel. 1. ii. c. x- 
116         OF TERTIAN FEVERS.
the symptoms  are generally most  moderate.   But
the experience  of the present age has taught us that
this operation is safe enough, at any time of the peri-
od, unless while the cold fit lasts, or is soon  expect-
ed; or while the skin  is covered with critical sweats.
(s) Of late years, encouraged by the example of some
practitioners of reputation,* I commonly opened a
vein in the beginning of the hot fit; by which means the
sick were immediately relieved; the immoderate heat
of the body (which is often productive of fatal effects)
was diminished; and the critical sweats were brought
on sooner, and in greater abundance. But when that
time of the paroxysm  was passed before my being
called,  I bled in the evening, when it abated or went
off, that I might be at liberty next day to make use  of
the remission or intermission, which commonly hap-
pens in the morning, to evacuate the first passages.
    For, the disagreeable taste in the mouth, loathing
 of food, giddiness, pain in  the forehead and  loins,
 and other constant attendants of tertian fevers, make
 it evident, that the stomach and intestines are over-
loaded with noxious humours, and particularly with
 corrupted bile; from which if they be not early dis-
 charged, very threatening symptoms  will be  apt to
 ensue about this state of the disease; such as violent
vomiting, redoubling or continuation of the parox-
 ysms, ravings, restlessness, pain, inflammation, gan-

   U) Bleeding is certainly safe during that  coldness of  the
 body which takes place in violent fevers. It generally removes
 it, and Dr. Sydenham has taught us the safety and advantage
 of bleeding during the sweating stage of those fevers where the
 sweats do not afford relief.
   * Astruc on Fevers, p. 71. Gourraigne de Febribus. 
            OF TERTIAN FEVERS.         117
grene of the abdominal bowels, and  lastly, sudden
death. Wherefore it  is not only necessary to wash
the stomach with warm water or weak broth in the
beginning of the fits, when indicated by an inclina-
tion to vomit, and to  keep the belly constantly open
with clysters; but likewise to empty the first pas-
sages by more powerful  means at the first conve-
nient interval.
   It is a controverted point whether  it is best to
discharge those noxious humours by vomit or stool.
At first view  vomits seem to be most eligible, as
they quickly empty the superior part of the alimen-
tary tube, which appears to be the principal seat of
the morbific matter. But  it must be considered that
whatever irritates much, and  produces  violent com-
motions, ought to be avoided in  the present case.
Cave ne inducas efiervescentiam bilioso'rum, is a cau-
tion given by Avicenna; and the Spaniards no more
than the Italians,  if their physicians  may be credit-
ed, cannot well bear rough medicines  of any kind.
(Vid.  Bagliv. lib. i. c. xv. § v.) Besides, the inflam-
mations  of the bowels, too frequently accompanying
tertians, are exasperated  beyond expression by the
strong contraction of the diaphragm  and abdominal
muscles  in this operation: and if the spleen or liver
is disposed to become putrid  (which is no uncom-
mon case in those fevers), it  is needless to, point out
the dangerous  consequences  that  may result from
the repeated efforts of vomiting. For which reasons
mild purgatives, though less powerful remedies, are
the safest, and therefore to be preferred in the gene-
rality of cases.  Those which  I have  found most be-
neficial are senna, manna, cremor tartari; but above 
118        OF TERTIAN FEVERS.
.all the sal catharticum amarum, which neither gripes
 nor disturbs the body,  and seldom fails of having
 the desired effect in a few hours, a circumstance of
 great moment  where the intervals  are  short.  But
 if vomits are to be used, they should be  given in
 the beginning  of  the disease, before repeated  pa-
 roxysms have brought on inflammations, or too much
 dissolved the texture  of the blood; taking care that
 the operation does not interfere with the fit, lest some
 sudden mischief should arise from the united shock
 of the remedy and the disease. (*)
   When  I first became acquainted  with those dis-
 eases, the uncommon violence of their  symptoms
 induced me to lay the principal stress of the cure on
 evacuations; and to have recourse to frequent bleed-
 ing upon  account of the inflammations of the viscera:
 endeavouring at the same time by repeated cathar-
 tics to discharge  the  corrupted humours from the
 intestines: but when  experience  had convinced me
 that the bark was both a safe  and effectual remedy
 in those circumstances, I then plainly perceived that
 such profuse  evacuations were unnecessary, if not
 prejudicial; and of late years, as I seldom omitted
 to bleed and purge once or twice, I rarely repeated
 either operation oftener.
   In semitertians and remittents, which approach to
 the nature of  continual  fevers,  I give  a cathartic

  (i) The remarks of our author upon the comparative effects
 of vomits and purges in these fevers are correct; nor  do his  ob-
jections to  the former  militate against  the propriety of the
practice of Dr. Sydenham, who gave them in the  advanced
stage of fevers, for it was in fevers in which there was no dispo-
sition to inflammation or congestions in the abdominal viscera, 
OF TERTIAN FEVERS.         119
early in the morning of that day on which the symp-
toms are  most  moderate; hastening the operation
with clysters (if occasion require), so that it may be
finished before the middle of the  day, about which
time the patient commonly grows  worse, (u) In true
simple and double tertians there  is generally an in-
terval every  morning, in  which the purgative may
be administered, but that which succeeds the worst
fit is the most proper, as it is more calm, and conti-
nues longer than the  other.
   Another inducement to purge in the beginning of
tertians is, that  these  fevers are  sometimes accom-
panied with worms in the first passages.
   Proper evacuations  being premised, if possible,
within the first four or five days of the distemper, I
carefully examine the condition- of the patient dur-
ing the third revolution, and determine  accordingly
in what manner it will be necessary to proceed.  If
the paroxysms of that revolution be neither longer,
nor  attended with more threatening symptoms, than
those  of  the second; if the patient preserves  his
strength,  bears his illness easily, and signs of con-
coction appear  in the urine; I  frequently trust the
whole business to nature, which commonly termi-
nates the fever about the fourth or fifth  revolution,
and, for the  most part, with an increase  of some of
the  natural evacuations;  so  that  sweats, cloudy or
thick urine,  and bilious stools often supervene,  and

   («) This practice  of giving purges on the days of remission
in autumnal fevers is judicious, and should be adopted by all
physicians. They operate soonest and most freely on those days,
and render the succeeding fits more easy 
120        OF TERTIAN FEVERS.
  sometimes  a spontaneous efflux  of spittle, or a co-
  pious expectoration of pituitous matter, (zv)
    But if the paroxysm on the fifth day be evidently
  the longest and most severe that  has happened; if it
  be attended with any doubtful or dangerous  symp-
  tom; if the sick  become  giddy, feeble, and languid-
  in these cases, without delay, I have recourse to the
  bark; and the  same evening, as  soon  as the sweats
  have procured a remission, I order two scruples or
  a  drachm of it in powder to be given every two or
  three hours, or every hour and a half, so that five or
  six drachms may be taken before next day at noon
  with as little interruption to their sleep as  may be|
  and the  assistants  are  strictly enjoined to comply
  punctually with these directions,  lest if this interval
  escape, we should not afterwards  have a favourable
  opportunity of giving a sufficient quantity of the me-
 dicine, as the fits about  this period of the disease
 are wont to become double, subintrant, or continual.
   Yet it  is not  always in our power to put an im-
 mediate stop to the fever by this means: on the con-
 trary, do what  we can, it will often proceed in its
 career, and, in spite of all our attempts, run obsti-
 nately on to the seventh or ninth day. But  the great
 advantage which  accrues  from the early use of the
 bark is, that it invigorates the powers of the body,
 prevents  or removes the dangerous  symptoms,  and
 m tertians, which of their own accord would conti-

  («) The bilious, or, as it was commonly called, the « break
bone fever which prevailed in Philadelphia in  the year 1780,
was attended with that constant hawking  and spitting in many
people,  which is called « screatus" by Latin writers   All who
had it, recovered speedily. 
             OF TERTIAN FEVERS.        121
nue  to  the  end of the  second week or longer, it
brings on a crisis sooner, and with much less dis-
turbance. In short, to use  the expression of one of
the greatest promoters of medical knowledge in this
age># " it proves an excellent assistant to nature in
what the ancients called, the concoction and matura-
tion of the  morbid matter;"  and (I must add) in
the expulsion of it  likewise, sensibly or  insensibly,
by the most convenient outlets. For so far is it from
suppressing any beneficial discharge, as  some have
asserted, that we daily observe a laudable separation
in the urine, warm, profuse, universal  sweats, plen-
tiful bilious stools,  and sometimes the  haemorrhoids
and menses coming  on after  it has been used;
though it effectually restrains the colliquative night
sweats, to which persons weakened by tedious  in-
termittents are incident.
   Having given the bark, in the manner directed, on
the fifth day of the fever,  if  a paroxysm  comes on
on the sixth, and declines the same evening, I order
a few more doses to be taken,  with a view to pre-
vent, if possible, or at least to mitigate,  the fit  ex-
pected  on the seventh. Yet  it sometimes happens
that the fit of the sixth  day unites  with that of  the
seventh, no remission  intervening, so that the heat,
restlessness,  raving,  and  other  complaints being
greatly augmented, the case seems to be much more
desperate than ever.  But those commotions which
follow upon  the use of the  bark in this stage of  the
fever, are more dangerous  in appearance than reali-

  * Monro on the Use of the  Bark in Smallpox and GangreriVs,
Med. Essays, Vol. v. Art. x.
                         L 
 122         OF TERTIAN FEVERS.
 ty; and so far from being  alarmed  at the  sight of
 them, I commonly give expectation that a remission
 with profuse evacuations will happen the next even-
 ing; at  the same  time  giving positive  assurances
 that if the patient  takes as much bark in that inter-
 val, as he did in the  former, he will either  have no
 more fits, or moderate ones, which will quickly yield
 to the same sort of management.
   By this method, when assistance is timely called,
 the most formidable kinds  of intermitting  and re-
 mitting  tertians,  whether  appearing in their own
 proper colours, or personating other distempers, may
 be certainly and speedily brought to a happy con-
 clusion about the end of the first week or beginning
 of the second.
   But if the fever has been  neglected  in the begin-
 ning, and you are not called till about the  third or
 fourth period; when by the use of spirituous liquors,
 strong vomits, or  violent exercise,  the bowels  are
 inflamed; or for want of seasonable evacuations, the
 first passages are  overcharged with corrupted gall,
 and other putrid matter;  the fits tedious and subin-
 trant; or perhaps  attended  with a stupor, syncope,
 cholera morbus, cold sweats, and great weakness.
 These,  indeed,  are terrible  cases,  yet such as  too
frequently happen, artd involve the physician in the
greatest perplexity. So many indications and contra-
indications present themselves at the same time, that
by obviating one symptom you hazard the  increase
of another:* nor,  under  such circumstances, is it

  *■ Saepissime ad aegrotos vocatus, tantam tamque  confusam,
mirabar, symptomatum turbam, ut purgatio  ne, an venaesectio,
vel neutra, imprimis foret eligenda, decernere anceps  et summi 
             OF TERTIAN FEVERS,         123

easy to lay down rules for managing the  sick: all
that can be  with safety advised is,  to  palliate the
most pressing complaints  in  the  manner hereafter
proposed;  in the meantime carefully watching the
evening, the  night, and the early part  of  the mor-
ning, for a remission;  and the moment it offers, to
fly  to  the  bark  as  to  the  only remedy which can
avert the impending danger.
   If the patient  seems strong enough to bear purg-
ing, I divide an  ounce or six drachms of sal cathar-
ticum amarum, and half an ounce of bark, into four
equal parts,  and order one to be taken every two
hours: the effect of this is,  that the  next fit is  miti-
gated, and  an  intermission  commonly ensues, in
which the  bark without the purgative  must be re-
peated to finish the cure.*
   But  if the patient is so excessively feeble, that
there is a manifest  risk of his dying in  the next pe-
riod of the fever, instead of  the  sal catharticum,  I
give the bark with cordials (among which wine  is
by much the best), and endeavour  to  have  six or
seven drachms  of  it taken in  the  space  of ten or

ponderis negotium  esset.  Nee  doctorum,  ut  gravissimorum,
consilia poterant in illis casibus suffragari, quin  in alterutra
operatione tentanda adhuc extaret ambiguitas.
    Guidet. de Tertian. Autumn, apud Bianch. Hist. Hepat. par.
      iii. p. 287-
  * Si tamen vacuatione opus sit, et ab urgente febre tempus
ad exhibendum catharticum denegetur, post V. S. cortex Pe-
ruvians, cum purgante medicamento idoneo conjunctus, statim
exhibeatur.              Geoffr. Mat Med. vol. ii. p. 188.
   Tuto igitur in perniciosis his frebibus febrifugum quocunque
 tempore potissimum purgantibus immixtum propinetur.
                     Bianch. Hist. Hep. par. iii. p. 28/. 
 124         o;-' TERTIAN FEVERS.

 twelve hours;  having found by  experience that  the
 paroxysms, if  a smaller quantity is given,  too fre-
 quently come  on  earlier  than usual,  and make all
 attempts to preserve  life unsuccessful.*
   When the sick  are out of danger, and have  re-
 covered a sufficient degree of strength, bleeding and
 purging may safely be directed,  notwithstanding the
 use of the  bark, if these evacuations  are indicated;
 and so  far is  opening  the bellv occasionally from
 bringing on a  relapse, that those who have had  the
 best opportunities of making the trial,f have found
 it to be  the most probable means of preventing a re-
 turn of the fever, (x)
   This is the method of using the cortex, into which
 I at length fell, after  trying a great variety of others.

  * For which reason, in such deplorable cases, Torti orders
 half an ounce or six drachms of bark to be swallowed at once;
 which he affirms is much  more  powerful than the same quanti-
 ty divided into several doses.  . Vid. Therap. Spec 1. iii. c. iii.
  f Qui dictitant febrem  per corticem Peruvianum deletam, si
 postea catliartica  propinentur, revocari, hosce toto quidem calo
 hallucinari, assidua nos docuit experientia, qua aegros post ex-
hibitum corticem  a febre liberos, per subrogata purgantia tutius
 a. relapsu praecaveri recognovimus.
                       Blanch. Hist. Hep.  par. iii. p. 283.
  Mixtionem rhabarbari cum china ipse  ego apud Italos, xx
 circiter abhinc annis,  primus faustam  prosperamque hisce in
 casibus expertus fui, felicemque exitum, cum  aliis, per episto-
las communicavi.              Lands, lib. ii. epid. iv. c. vi.
  Cortex cum rhabarbaro, anno 1710, non ea felicitate stimula-
bat alvum, qua anno 1708 et 1709, et propterea opus erat illius
i-emedii usum grandioribus catharticis interrumpere.
                                   Lane. epid. iv. c. viii.
  (x) This is true with respect to the acute fevers described by
our author, but in autumnal  fevers of weak  morbid  action  a
purge often brings back the disease.
', 
              OF TERTIAN FEVERS.         125
 Sometimes, indeed, extreme weakness, or some for-
 midable symptom, obliged me to have recourse to
 it  in  the  second period  of the  fever; but I never
 chose to give it before the third, nor to delay it after
 the fourth, in all cases of any consequence, provided
 there  was a proper interval for its administration;
 and with its assistance, if the patients  were not al-
 together  exhausted,  I  had the pleasure of seeing
 them  happily rescued from tertians of the most ma-
 lignant  kind, such as  the lipyria,  assodes,  febris
 syncopalis,  &c. What the poet says  on a different
 occasion being literally true in the present case.
              Hi motus, et haec certamina tanta
      Pulveris exigui jactu compressa quiescunt.
                                      Virg. Georg. iv.
 And the more experience I had of the bark, the
 more  I was convinced of both  its  innocency and
 efficacy; so that I heartily wish  I had always given it
 with as much freedom as I did during the last seven
 years  of my  stay  in Minorca: but the  prejudices
 against this medicine, which I had early imbibed
 from some  of the most approved  authors, made me
 for a long time use it with too much diffidence.*

  * Major medentium  pars apud nostrates, ut vulgi calumniis,
 et assiduis aegrorum querimoniis se subducerent, in hac tem-
 pestate  ad Peruvianum corticem confugere: At parum prospere;
nam in  perniciosos scopulos aegrotantes suos persjepe deduxere.
Usu febrifugi, per aliquot dies, equidem latebat sub cinere do-
loso ignis, verum postliminio violenter recrudescebat
                              Ramaz. Cons. epid. 1690.
  Adverte quacso, mi nepos, et diligenter observa febres inter-
 mittentes post epotam chinam nimquam ad -.eram et perfectam
 apyrexiam pertingere, qualis contingit,  quando natura sponte
 per sudorem aut alias vias accessionem disctitit, &c. &c. he.
                        Ramaz. de Usu &. Abusu Chinac,
                         L2 
126        OF TERTIAN FEVERS.
  In the first place, I suspected that the relapses, so
frequent from July to January, were in some mea-
sure owing to ihe general use of the bark: and as I
observed, that the  greatest  number of tertians went
away of their own accord  in a fortnight's  time, I
thought it would be more  advantageous to  the pa-
tient to suffer a few paroxysms,  and,  when  no im-
mediate  danger  appeared, to wait the spontaneous
termination of the  fever, than to hazard a return by
having  it prematurely suppressed: but afterwards,
by comparing a  number of cases  which had termi-
nated of their own  accord,  with  others wherein the
bark had been given, I evidently  saw that those were
most liable to a relapse whose  strength had been
most impaired by  the primary fever,  whether they
had been cured by  art or nature;  so that a delay in
giving the bark seems frequently to have produced
the effects ascribed to its having been used too early.
  Besides, while I was waiting for the spontaneous
crises,  even in cases where  the mildness of  the fits,
and the length  of the  intermissions, afforded the
most flattering hopes of a favourable  issue, I now
and then had the  mortification  to find my  patient
unexpectedly  seized with  a violent malignant pa-
roxysm, attended  by a  stupor, speechlessness, and
apoplectic symptoms, which seldom indeed proved
fatal immediately,  but were often succeeded  by such
insuperable weakness, that the bark  could  not be
administered, or was  given unsuccessfully,  so that
he died in the next period of the fever. The first two
or three accidents  of this kind I was willing to im-
pute to some  concealed irregularity in the use of the
nonnaturals; but I have since been taught  by too 
OF TERTIAN FEVERS.         127
many  instances, that during  the months of July,
August, and September, it is very common for those
fallacious fevers about the end of their second week,
suddenly to change  from  the mildest to the most
formidable aspect; and consequently that it is dan-
gerous to permit their continuing so long, (if)  The
repetition of such accidents first induced me to think
of writing on this subject, considering it as  an in-
dispensable  duty to  point out the  danger of such
omissions, to practitioners of less experience, in  or-
der to prevent them from being misled by the plau-
sible  theory of some authors, and the positive asser-
tions of others, though delivered in so dogmatical a
manner, as if they were wholly the result of careful
observation.  So that I must inculcate it  as  a  rule
of the utmost importance in the  cure of those epi-
demical tertians, never to wait longer than  the  end
of the first week, or the beginning of the  second, for
their spontaneous terminations, but without  farther
 delay to apply to the bark.
    Secondly, Before  I learned,  by  observing the
 course of those fevers when left to themselves,  that
 it is customary for them, in their progress, to vary
 their type, and increase  in  violence to  the third,
 fourth, or fifth periods,  I suspected  that the hasty
 administration  of  the  bark not only produced the
 inflammation of the bowels, delirium, and other bad

    (j) The yellow fever in Philadelphia in 1803 came on in like
 manner in the form of a mild remittent in its first stage, and
 went off with all  the symptoms of the worst grade of that dis-
 ease. We are told in Sir George Staunton's Account of the Em-
 bassy to China, that the malignant and mortal fevers of Batavia
  came on in the form of a tertian. 
 128          OF TERTIAN FEVERS.

 symptoms, which supervene about the  height of the
 disease, but likewise  occasioned  the paroxysm to
 double,  or  perhaps continue  without  remission;*
 whereas the fact is, that many tertians  which inter-
 mit during the first week, are very apt of their own
 accord to become  continual fevers  in the   second,
 and extend  to the  17th or 21st day, or farther, be-
 fore an intermission is  again perceptible; but if any
 interval, however obscure, appears about the fifth or
 seventh  day, and  you can  give them five or six
 drachms of bark as above  directed,  you will proba-

   * Chinam chinae  dare impuro corpore, id est in principiis
 morborum, nullis precedentibus signis coctionis, et corpore non
 purgato, piaculum est in aere Romano; methodus damnabilis
 ac perniciosa.   Dicunt multi dandum esse, ut impetus sympto-
 matum tunc furentium coerceatur ac refraenetur; ut inde aeger,
 symptomatum  sopita vi, diutius possit morbo resistere. At si
 tu loco fraenandorum symptomatum, parvos humores per chinam
 chinae in aliquo viscere figas, ac concludas,  et ita internam pa-
 rias inflammationem, ut frequentissime observavi, nonne tu cul-
 pandus eris? Nonne  tu  reus necis lege aquilia puniendus? Fe-
 bricitantes meos euro per leges coctionis et crisium—et raro
 cum recidiva:  quam recidivam singulis momentis ab usu chinae
 chinae expectato.           Bagl. de Fib. Mot Spec. c. xiii.
   Pariter rubris existentibus  urinis,  et supra modum tinctis,
 cave cane pejus et angue, ne chinam chinae praescribas, sive sint
 acutae  sive sint intermittentes febres;  nam acutae, facta interna
 inflammatione, statim praecipitabunt in deterius; intermittentes
 vero statim fient continue, graves, periculosae; quare si in aliis
 morbis, certe quando isti conjunctam habent urinam nimis ru-
 bram,  patiens,  longa, prudensque humorum coctio, semper
 expectanda;  si secus feceris, vel mortem vel longos et incura-
 biles morbos expectato.  Romae scribimus  in  aere Romano (in
the noxious air of Rome)—sancte  fateor, fere  centies hujus-
modi veritatem expertus sum Romae in aegrotantibus,  et  saepe
cum magno animi maerore, quando medicos  in contrariam ire
sententiam observabam.           Bagl. Prax. Med. p. 71, &c. 
OF TERTIAN FEVERS.         129
bly obtain a more perfect remission in the next pe-
riod; during which the like quantity must be  given;
and thus by repeating the remedy as opportunity
offers, the disease may be brought to an end, about
the ninth, eleventh, or  thirteenth  day. Nor are we
to hesitate in giving the bark, upon account  of the
crudity and redness of the urine, which I have fre-
quently observed  to become paler, turn cloudy,  or
let fall a sediment, by the use of this medicine.
   Thirdly, I was a long time in doubt, whether the
bark might be  given without prejudice, while1 the
first passages were full of  vitious humours, and  the
bowels were inflamed, or affected with  inveterate
obstructions;*  but I  have now  good reason  for as-
serting,  that in these very cases this medicine is of
the greatest use;  as it averts  sudden death, and
gains us time to join with it other means towards

   * Vid. Boerhaav. Aphor. 767.
   Nonnulli in his casibus (nempe tritaeophyis, hemitritseis et
aliis malignis  tertianis) solent more solito  chinam chinae prae-
scribere; quo  autem cum successu pluribus in locis hujus ope-
ns animadverti. Nam hoc remediiim impuro corpori dare, saepe
in segroti perniciem vertitur; potissimum in maximo apparatu hu-
morum in mesenterio.             Bagl. Prax. Med. p. 5S.
   Rom* scribo et in  aere Romano: et ideo garriant  quicquid
velint chins chinae fautores:  aliis forsan in urbibus egregium
est remedium, hic noxium experior.            Bagl. ibid.
   Si chinam dederis (ut fataliter plurimi faciunt), ventre adhuc
humoribus onusto, tria expectato, aut inflammationem, aut len-
tarn ac diuturnam febrem, aut mortem. Observa bene,  et S1
falsa dixero, me redarguas.  Roms scribo et in aere Romano.
                              Bagl. de Fib. Motr.  c. xm.
   In semitertiana (inquit Hoffmannus) omittantur pulveres ad-
 stringentes nee non cortex chinae, he.
                               Med. Rat. torn. 4 § i. c.  v. 
130        OF TERTIAN FEVERS.
completing a cure. For the quantity of acrimonious
contents in the primse viae is the effect of the altera-
tion produced in the circulating fluids by the fever;
and the longer this  continues  the more impurities
will be accumulated, till at last they bring on a vio-
lent cholera morbus;  or  perhaps make their  way
through the lacteals into the habit, and there occasion
very fatal  effects; all which might have been prevent-
ed by the  use of the bark, which removes the cause
of those impurities by putting a stop to the fever;
and by  corroborating  the solids, enables  them to
throw off  the excrementitious  fluids by the proper
emunctories. (2)
   Inflammations of the abdominal viscera are like-
wise natural effects of tertian fevers; for we find that
they often come on by little and little, and increase
with every paroxysm,  till at  last they end in a gan-
grene;  whereas the cortex, by bringing the fever to
a  speedy conclusion, impedes  the farther progress
of the inflammation;  so that  it afterwards  goes off
gradually of its own  accord,  as I have had occasion
to observe in a multitude of instances where acute
fixed pains, tension, and other  symptoms, made the
nature of the disease too plain to be doubted of.
   When the bowels are obstructed, we are  told that
the fever should be permitted to continue, in order
to remove  the obstruction, (Vanswiet. in Aph. Boer-
haav.  767.);  and this in many cases may  be  ad-

  (2) There  are cases in which so great a prostration of strength
takes place in the fevers which our  author has described, that
even a single evacuation from the  bowels has induced death.
Here bark and other stimulants are the only remedies that are
calculated to do service. 
OF TERTIAN FEVERS.        131
visable: but at the same time it  is well known, that
if the obstructing matter be suddenly dissolved and
pushed into the blood, it  is capable of occasioning
the most terrible effects.  (Aph. Boerhaav.  1104.)
And therefore I have commonly found it expedient,
in persons  troubled with hard overgrown livers and
spleens, to  prevent  the  repetition  of long, severe,
burning paroxysms, lest worse consequences  should
ensue. After the sick recovered their strength,  I
endeavoured to reduce the swellings of the belly, by
the use of saponaceous gum pills, washed down with
an infusion of juniper berries.
   When there is an icteritious  colour  in the eyes^
we are likewise  told that the cortex should not be
administered;* though  in my opinion it is for the
most part dangerous to delay it, after  the first ap-
pearance of that symptom; which is often succeeded
by a yellowness of the whole body, arising in this as
well as  in  other malignant  fevers  from a total cor-
ruption, or gangrenous disposition  of the mass of
blood, and is too frequently the  harbinger of death.
(See Warren on the Malignant Fever of Barbadoes,
p. xii.)
   Upon the whole, I am convinced that the unhappy
metastases, which some have observed to follow the
use of the  bark, are  exceedingly  rare, and  ought
rather to be ascribed to other causes than to this
medicine. (Med. Essays, vol. iv. art. xxiv.)  And I
will venture to affirm, that  more bad consequences
ensue from giving it too  late than too soon; pros-
tration of  strength,  sudden death,  or the  most ob-

        * Vanswiet. ubi supra, & Huxham on Fevers. 
 132        OF TERTIAN FEVERS.
 stinate chronic diseases, if the sick recover, being
 the usual effects of delay: whereas  the worst that
 commonly happens from the too early use of it is,
 that it does not at once restrain the paroxysms, like
 a charm, without any sensible evacuation, as it fre-
 quently does, when given after the fever has arrived
 naturally to its height, and begins  to  decline of  its
 own accord.
   Having delivered the  general  method of treating
 tertians, it is needless to say much about their symp-
 toms,  as  they commonly  disappear with the fever
 itself,  and seldom require  a separate cure.   Never-
 theless, it will  not be amiss to take notice of a few,
 which I have found the most troublesome.
   In the first stage of the paroxysms acute  pains in
 the  back  and limbs, with and  without rigors  or
 chilness, frequently happen; and  I have sometimes
 known them so intolerable, and  accompanied with
 such inexpressible anxiety, that persons of the sound-
 est judgment and morality have  been in hazard  of
 destroying themselves to get rid of it.  Before I was
 aware  that these pains were the forerunners of ter-
 tian paroxysms, I commonly had recourse to bleed-
 ing, and without observing  that it was attended with
 any  ill effect: but of late years they never alarmed
 me,  being well assured that they  would go away  of
 themselves, as the hot fit advanced.
  The vomiting and nausea, after washing the sto-
 mach two or three times  with warm water, is com-
 monly  allayed  by draughts  of salt of wormwood,
 lemon-juice and mintwater.  And if a constant vo-
 miting or purging hinders  the bark from being re-
tained, small doses  of laudanum  should be joined 
            OF TERTIAN FEVERS.         133
with it:  but  a moderate  bilious discharge is com-
monly beneficial, and therefore should never be sup-
pressed.
  Restlessness and headachs are  the  inseparable
companions of the hot fit; so  that the sick must
either be encouraged to bear them with patience, or
must be amused with some innocent prescription till
the sweats  carry them  off. When the headachs arc
constant  and troublesome  in the  apyrexies, I order
the limbs  to  be frequently bathed in  warm water,
and cataplasms of horseradish and leaven to be ap-
plied to the soles of the feet.
  Hemorrhages of the nose are  often of signal ser-
vice, in removing the  obstinate  headachs  and pains
in the abdominal viscera,  whether they  are e directo
or not; though for the most part they happen from
the nostril  of that  side, in which the pains are fixed;
for which reason they  ought not to be hastily stopt,
unless  they continue too long, or come  at a time of
great weakness.
  When the belly is sore  and painful  to the touch,
clysters  and warm fomentations give  great  relief.
When  the* pains are extremely violent, bleeding must
be  repeated: but during the hot weather we must
not be  too  free with the lancet  after the fourth pe-
riod of the distemper;  as the weakness commonly is
then too  great to admit of any such evacuation with
safety.
  If the patient  continues comatous and  stupified
longer than ordinary, we must  endeavour to rouse
him from that lethargic state by scarifying, cupping,
and blistering the  neck and back.
                       M 
134        OF TERTIAN FEVERS.
  Troublesome hiccoughs often  cease, upon apply-
ing cupping glasses without scarification to the pit
of the stomach, and giving small  doses of laudanum
with tincture of castor.
  If acute pain and pulsation in the  hip point out
that a critical abscess is about to  be formed there (a
case that hath occurred to me five  or six times), it
must be brought forward by cupping glasses, and ca-
taplasms applied to the place; and as soon as a fluc-
tuation  can be perceived, it must be opened  by a
deep incision;  otherwise,  the matter being lodged
under the posterior double edge  of the  glutseus ex-
ternus, instead of pointing outwards, may insinuate
itself betwixt the  muscles of the thigh; or may per-
haps work its  way into the cavity of the pelvis, by
the hole  through which  the musculus  pyriformis,
and the sciatic nerve pass  out; which seemed  to be
the case in one man, who  had first an abscess  in his
right hip, and some  time  afterwards another in the
left, and  died consumptive from the  immoderate
discharge.
  Parotids  must also be  brought to suppurate as
soon as possible:  but these are not very common in
Minorca; nor are they much to be wished for,  being
oftener symptomatical than critical.
  To conclude, as tertians personate almost all dis-
tempers, (a) so there are but few disorders to which
the human body is incident, that  will not sometimes
appear in the course of these fevers; and these, when
importunate, must be mitigated, as   in other  acute
diseases.
  (a) The yellow fever of Philadelphia in like manner has ap-
peared to be an epitome of all diseases. 
            OF TERTIAN FEVERS.         135
  It has been already remarked, that whether the
fever is cured by art or nature, there  is a hazard of
its returning within a fortnight or three weeks;  nor
could I ever fall upon  any certain  method of pre-
venting one relapse after another, till the cold wea-
ther, which commonly sets in about christmas, had
braced the solids, and given them sufficient strength
to throw  off the excrementitious humours by the
proper outlets; for  which reason I always  advised
those who were attacked in the beginning of the
season, to leave the  island,  if their  circumstances
would permit, and not to return until the spring.
And  there are many  instances of  persons  being
greatly recovered by the  change of air, even in the
first two or three days  of their being at sea. But if
they were obliged to remain  in the island, the best
chance they had of escaping  a relapse was to take a
dose of the cortex  every  morning and evening, for
several weeks; and now and then a gentle purgative,
if a bitterness in the mouth,  loss of appetite, swim-
ming in the head, or sickness at the stomach, the
common forerunners of it, should be perceived.
  But if,  notwithstanding all precautions, the fever
returns, the patient must  be  treated  as in the first
attack;  with this difference,  that as relapses are at-
tended with less heat and inflammation, bleeding,
especially in the fit, must be used with more caution,
or altogether omitted, and vomits may be given with
greater freedom. And, as they happen mostly in a
cooler season, they  do not threaten  such immediate
destruction, and consequently may be longer trusted
without the bark, if you are  disposed to attempt a
?:ure by other methods; though that remedy must 
136        OF TERTIAN FEVERS.
 never be  delayed when the fits are violent  or pro-
 tracted. In this manner the patient must be  content
 to go on till the turn of the year alters the constitu-
 tion of his body, and restores him to his  former
 health.
   It has been  insinuated by some that a long con-
 tinued use of the bark was liable to bring  on ner-
 vous  complaints  and lowspiritedness; but  in the
 multitude  of cases,  wherein I have been obliged to
 make use of it, I have not been able to discover that
 it had these or any other ill effects, when given in the
 manner above mentioned. And as to its occasioning
 dropsy, I do not remember to  have met with above
 one instance these ten years, where there was a pos-
 sibility of alleging that it gave rise to that distemper.
   It is not uncommon for a looseness to come on in
 the room of a  relapse.  Sometimes  instead of a ter-
 tian a quartan supervenes;  which nevertheless may
 be speedily taken off by the bark; but if left to nature
 alone it will probably continue  to the spring;  or per-
 haps first turn to a double quartan, and afterward to
 a triple quartan; which, as Celsus observes, is a dan-
 gerous distemper. (Lib. iii. c.  xv.)
   With respect to the tertians, which now and then
 appear at other times of the year, they are more of
 a chronic disposition  than those of the summer and
 autumn;  the cold fits being  longer, the hot  fits less
 severe, and the intermissions, more regular and per-
fect. Add  to this, that they are not so commonly at-
tended with critical eruptions about the mouth; nor
 do the sick discharge such quantities  of  gall either
upwards or downwards; and the urine oftener de-
posits a lateritious sediment:  but so far is this sedi- 
OF TERTIAN FEVERS.         137
ment from being the  criterion of intermittents,  that
I have frequently seen it in pleurisies, and other in-
flammatory fevers;  while in both tertians and quar-
tans I  have, for the most part, found the urine clear
without any separation; and in tertians the sediment
was oftener more like chalk than brickdust.
  Thus have  I given  the  history of those fevers,
collected from an almost infinite  number of cases,
carefully minuted in the chambers of the sick, with-
out trusting to memory, or regarding what  others
had said on the subject before me, or advancing any
thing but from  reiterated  examination. The  obser-
vations relating to the cure, which are by much the
most material, have been confirmed again and again
by the  experience of all who have practised physic
with attention, among either the English or Spanish
inhabitants of Minorca; therefore I am in hopes that
these remarks will not be  altogether useless  to the
public.  It is well known that contagious intermittent
and remittent fevers  of the tertian  kind, are anni-
versary distempers  in several of the warmer climates
both in Europe, Africa, and  America; and even in
the northern parts  of Europe they are often  epide-
mical after extraordinary hot dry summers.*  By all
that I have been able to learn of them from authors,
there is a  great analogy among them every where;
and though in some places they may require more
or less copious evacuations than we find beneficial in
Minorca, yet  I am persuaded that it may safely be

  *  Hoffm. Med. Rat. torn.  iv. cap. iv. sect.  i.  Short's  History
of the Weather, &c. Anno Domini 1237, 1540,1553,1574,1652,
1657, 1669. Wintringham, anno 1719; and Vunswiet. Comment.
jn Aph. Boerhaav. 767.
                     M 2 
138         OF TERTIAN FEVERS-
laid down, as a general rule in all cases of danger,
to give  the  bark liberally and without  hesitation
about the third or fourth period of the disease, whe-
ther evacuations have been previously used  or not.
Which practice is agreeable to the observations of
the ablest and most experienced physicians of diffe-
rent nations;  such as Morton* and  Sydenhamf in
England, Bartholin^ in Denmark, Hoffman||  in Ger-
many, Geoffroy§ in France, Rodriguez** and many
others in Spain,  Guidettus  and Bianchi in Pied-
mont,ff Torti in Modena,^ Musitanus|||| in Naples,
and Traversarrus^J in  Pesaro;  nay even in aere Ro-
mano, where Baglivi  declaimed against the use of
the bark with so much passion, Lancisi* has of late
years, as well  as the cardinal  de Lugof and father
Fabrii^ formerly, had  incontestible proofs of its be-
ing not only an innocent,  but  a necessary, powerful
remedy in the  cure of tertian fevers.

    * Exercit. de Morb. Acut.
    j Epist. Respon. I.
    I Ephemerid. German.
    |J  Med. Rat. torn. iv. § i. c.  i. obs. 5.
    § Mater. Med. torn. ii.
    ** Palaestr. Med. torn- ii. disc. 12.
    ff Hist. Hep. part iii.
    \\. Therapeut. Special, sparsirri.
    |||| Pyrctolog. c. xxiii.
    fl Apud Lands. 1. ii. epid.  iv. c. viii.
    ' Epid. sparsim.
    f Antym. Conyg. Pulv. Peruv. Vinci.
    t Id. ibid. 
139
                CHAPTER IV.

 OF THE RASH, ESSERE, AND CHOLERA MORBUS.


HAVING  given an  account  of  tertian fevers,
which was the  chief design of this treatise, I shall
endeavour to bring my remarks on the other epi-
demical diseases into as narrow bounds as possible,
by passing over such circumstances as are taken no-
tice of by the generality of authors.
  The cutaneous eruption which  we call  the rash,
or prickly heat, is  the sudamina or papula: sudoris of
the Romans, and the l^»* of Hippocrates, (Aphor.
§ iii. No. 21.),  who justly places  it among the sum-
mer diseases; it being so frequent in warm countries,
that few people escape having more or  less  of it
during the hot  weather; though children  are much
more affected by it than others.  It  consists of nu-
merous  minute pimples, or rather small, round, red
spots, just perceivable  by the touch, as  a kind of
roughness on the skin, which break out on different
parts of the  body,  especially after exercise or drink-
ing cold water.
  This  eruption is commonly looked upon as a sign
of health; and indeed while it continues  fresh on the
skin, no inconveniency arises from it except a fre-
quent  itching:  but if accidentally the  pimples are
driven in, by catching  cold, bathing in the sea, or 
 140      OF THE RASH AND ESSERE.
 any other error in the nonnaturals, the case too often
 becomes dangerous. And I have constantly observ-
 ed, that those who had a great deal of this eruption
 in  the  summer,  were  subject either to fluxes, he-
 morrhages from the nose, or fevers, upon the alte-
 ration  of weather  about the  autumnal  equinox.
 Wherefore I commonly advised them, as soon as the
 slightest signs of a retrocession appeared, (such as
 sickness,  headach, and preternatural heat) to lose
 some blood immediately, and make use of mild ca-
 thartics, vegetable food, and cooling acescent liquors:
 by which means  the  bad consequences above men-
 tioned,  if I  am  not greatly deceived, have been
 frequently prevented,  notwithstanding the  vulgar
 prejudices against evacuations  in  this and other
 similar cases.
   The  essere, so called by the Arabians, who first
 described them, though not uncommon in Minorca,
 appear much more seldom than the rash. They are
 hard, flat tubercles, of a pale colour and different
 forms, and break out chiefly while one is warm in
 bed, sometimes on one  part, sometimes on another,
 occasioning such  an  intolerable itching,  that it is
 impossible to refrain from scratching;  and the more
 they are rubbed the larger they become.  They sel-
 dom continue out above  an hour  or two at a time,
 but suddenly vanish of themselves, the skin reco-
vering its natural  colour, and come  back again  as
 unexpectedly as they went off;  the patient having
more  or less  anxiety about the pit  of the stomach,
during the time of their disappearing. The Spaniards
call them ronchados, from roncho  a nettle in the
Castilian language, they having exactly the appear- 
©F THE CHOLERA MORBUS.      141
ance of swellings occasioned by the sting of nettles:
in Minorca they go by the name of favas, probably
from their frequently resembling beans in shape and
magnitude. (£)
   It is commonly allowed by authors, and not with-
out reason, that those who have this sort of eruption
should make use of bleeding, purging, and proper
alteratives; otherwise  a  fever  is  liable  to  ensue.
(Vid. Sennert. lib.  v. part i. cap. xxvi.)
   The essere,  as has  been already observed, often
accompany tertian fevers, and appear most commonly
in the  hot fit.  Sometimes I have seen them so nu-
merous that the whole body was disfigured by them,
and painted in many places with all the colours of
the rainbow.  In  a few  such instances, which con-
trary  to expectation proved  suddenly mortal,  the
patient's death seemed  to be occasioned by  those
fiery pustules  being accidentally thrown upon  the
brain instead of the skin. For which reason, wher-
ever I  met with  them  in great abundance, I took
care to  make as liberal  evacuations  as the strength
and age of the patient would permit, and proceeded
speedily to give the bark; which effectually cures
both them and the  fever.
   As to the cholera morbus, it must be managed
according to the  method first hinted by Hippocra-
tes,* and of late described more fully by Sydenham,
(De Morb. Acut. § iv. c. ii.) To which I must add,

  (b) These eruptions now and then occur during the prevalence
of autumnal fevers in the United States.
  * Cholerae morbo conferunt, si quidem dolor adsit, anodyna;
venter autem superior, turn inferior potionibus humectantibus
curandus.                            HiP- de Affect 
142      OF THE CHOLERA MORRUS.
that if feverish  complaints, or fixed  pains in the
belly or sides come on, after the evacuation is stopt,
(as is  frequently the  case)  it  will  be necessary to
bleed and keep the belly open, (c)
   The  Spanish  physicians have often assured  me,
that they found  nothing  more beneficial in violent
deplorable choleras than drinking  of  cold  water:
which  practice   is  recommended  by  many  of the
ancients.*
   When  the cholera morbus  returns periodically,
like a tertian, it  must be cured as those  fevers  are;
but it denounces much more danger when it attends
the fits about the third or fourth period, than it does
in the beginning of the disease.

   (c)  Bleeding has  been found necessary of late years to cure
the cholera morbus in Philadelphia in many instances. The effi-
cacy of cold water in this disease in Minorca (mentioned in the
next paragraph) proves the correctness of that practice made
use of by our author.
  * Sin autem omnia antiqua stercora dejecta fuerint, et biliosi
humores transierint, biliosusque vomitus et distentio adsit, faSr
tidium, anxietas, virium labefactatio, tunc frigidae aquae Cyathi
duo aut tres propinandi sunt ad ventris adstrictionem, ut retro-
gradus humorum cursus cohibeatur, atque stomachus ardens
refrigeretur. Assidue  vero id, quum potam  aquam vomuerit,
fadto.           Aret. Cappad. de Curat. M. A. 1. ii. c. iv
   See likewise Cael. Aurel. de Morb. Acut. 1. iii. c. xxi. 
143
                 CHAPTER V.


              OF THE DYSENTERY.


i3 Y perusing the accounts which I kept of the sick,
while dysenteries were epidemical in Minorca, I find
that they began three different ways.
  First, Sharp indigested humours flowing frbm the
stomach, or (what seems to be more  frequently the
case) an increased  secretion of the  bile and  other
liquids necessary for chylification, produce a simple
looseness; which gradually washes off the  mucus
from the intestines, erodes their membranes, and at
last brings on severe gripes with bloody stools.
  Secondly, Others are seized with horrors, rigors,
and all the train of feverish symptoms, which com-
monly attend the first  attack of acute diseases;  and
in a short  time  afterwards a painful frequent eva-
cuation of slime streaked with blood ensues.
  Thirdly, Others have no preceding fever, but are
seized at first with a twisting of the guts, which (as
they e*press it) draws up their bowels into  knots;
and many, instead of griping pains, which shift from
place to place, and come at intervals, have acute fix-
ed ones in some particular part of the  belly, which
occasion complaints as various as their seat; some
being tormented with  stitches about the bastard ribs,
interrupting their breathing freely, as in the pleurisy: 
144        OF THE DYSENTERY.
others with a pain reaching from one hypochondrium
to the other, cutting them, as it were, in two; while
others complain only of a pain about the pelvis, with
a constant, fruitless, straining to  stool; though  the
body is, for the most part, costive, or discharges no-
thing but bloody slime.
  But in whichsoever of these ways dysenteries  be-
gin, in process of time the case comes to be pretty
much the  same; the intestines are irritated, inflamed,
and ulcerated; a fever, for the most part of the  pe-
riodical kind,  comes on; the constant stimulus in the
bowels diminishes the cutaneous discharges; and, of
course, a greater proportion of fluids is  thrown upon
the guts; the  flux increases, and what is discharged
becomes more ichorous, and  offensive  to the smell;
the strength decays; and death, or a tedious reco-
very, is commonly the consequence.
  Upon opening the bodies of the dead, I have con-
stantly found  the great guts either entirely mortified,
or partly inflamed, partly mortified, the rectum being
generally  most affected: in many I have seen scir-
rhous tubercles (*/) straitening the cavity of the colon
in several places; in a few, there were small abscesses
in the cellular membrane of the peritoneum conti-
guous to the colon  and rectum: sometimes the small
guts were  perfectly sound in appearance; but more
frequently their lower part was  inflamed, the convo-
lutions being  often preternaturally connected to each

  (d) The reader is requested to attend to the suddenness with
which tubercles  are formed in the dysentery.  They render it
probable that they are formed in the same sudden manner in
the lungs, and that they are the consequence, and not the cause
of that disease in the lungs which ends in pulmonary consump-
tion. 
             OF THE DYSENTERY.         145
other by membranes, as the lungs sometimes are to
the pleura. In two people the omentum (e) was almost
entirely wasted (the small remains of it being quite
black), while purulent water was found in the cavity
of the abdomen; in several it was inflamed and ad-
hered both to the guts and peritoneum; for the most
part the gall-bladder was full of  dark bile, and the
spleen, more or less, in a putrid condition.
   Almost all the dysenteries, which fell under my
observation,  unless they  were speedily cured in the
beginning, at  best proved  obstinate, and too fre-
quently fatal, in spite of  the many boasted specifics
for this distemper;  for which reason, whenever they
are epidemical, the utmost diligence  should be used
in applying the proper remedies before the strength
of the patient be  exhausted, and the coats of the
intestines too much injured. And even let the utmost
care be taken of them never so  early, the  event is
often dubious  or  unsuccessful;  though among  the
common soldiers this seems frequently to be owing
to a  want of means for keeping them clean, and con-
veniences for easing themselves, without being oblig-
ed to get often out of bed, and expose their bodies
to the open air. Which conveniences it were to  be
wished, that those who  have the direction of our

  (e) The exhausted state of the omentum  of fat,  or its total
destruction, generally  attends chronic diseases which end in
death, except in those  cases in which the functions of the liver
are impaired. An inference has lately been made  from these
facts  in favour of  the design of the omentum being to secrete
fat, to be conveyed to the liver in diseases which impair the ap-
petite and digestion, in order to be converted by a secretory
process into chyle for the nourishment of the bodv
                         N 
146         OF THE DYSENTERY.
fleets and armies, would order to be provided both
in the ships and hospitals.  (^)
   I shall not enter  upon a minute description of all
the rules  necessary to be  observed in the cure of
dysenteries;  but only  point out such methods of
treating the sick, as experience taught me to be the
most beneficial.
   When they begin like a  simple diarrhoea, without
fever or fixed pains in the belly, the first thing to be
done, is to empty the intestines of their acrimonious
contents as soon as  possible:  and the most efficacious
remedies  for this purpose,  as far as  I know, are the
radix ipecacuanha and the vitrum antimonii ceratum.
The latter I used to  give  from  five to ten grains
early in   the  morning:  of the  former  I directed
ten or fifteen  grains in  powder,  to be divided into
three doses, and to be taken in  the  forenoon at the
interval of two hours, or an hour and a half between
each dose. The most common effect of both was to
procure a thorough evacuation upwards and down-
wards during  the day; and they often threw the pa-
tient into  a sweat the ensuing night.
   The same  remedies I have likewise found  to be
serviceable in obstinate relapses of  intermittent  fe-
vers: but  I prefer the ipecacuanha, as being certain
in its operation; whereas the other sometimes did
not produce the intended discharge, at other times
occasioned greater commotions than were expected.
Nevertheless, I must acknowledge that now and then,

  (f) In some of the Spanish hospitals leather is made use of
instead of a bed  pan or linen to  receive the stools. It is easily
removed, and when washed and dried, may be employed as often
as it is required. 
              OF THE DYSENTERY.         147
 in desperate bloody fluxes, I have known  the  anti-
 monial medicine to be successful, after every thing
 else had been tried to no purpose.  But I return to
 the method of curing  them in the beginning.
   At first I repeat the abovementioned evacuations
 every other day for three or four times, and after-
 wards at greater intervals, if the disease continues;
 endeavouring, in the  meanwhile, by proper drinks,
 to blunt the acrimony in the  first passages, and de-
 fend their sensible  membranes  from being eroded;
 and every night at bedtime, I give a small dose of
 opium, sufficient to mitigate pain, procure rest, and
 promote perspiration, without  keeping the sick in
 a  constant  state of stupidity, or preventing a due
 discharge by  stool; as I  have seen some  do very
 injudiciously by the too liberal use of anodynes. (g~)
   But when the dysentery began in the second or
 third way above described, which was commonly the
 case in  the year 1747, I confided principally in  the
 early use  of the antiphlogistic method, with a view
 to hinder the  guts  from being farther inflamed and
 ulcerated.  Wherefore, when I was called in time to
 young people, I took away ten or twelve ounces of
 blood immediately, and  afterwards  repeated  the
 operation once or twice at proper intervals, according
 as the violence of the pain and degree of fever indi-
 cated: at the same time I ordered emollient clysters
 and fomentations to be frequently made use of;  and
plenty of warm,' soft,  diluent liquors,  for  common

  (g) The practice of our author  in the use of purges  and
opiates, accords with that of the most successful practitioners
in the United States. 
148         OF THE DYSENTERY.
drink; shunning  opium as much as the intolerable
torture of the distemper would permit.
   As soon as  the fever was somewhat abated, and
the violence of the pains assuaged, I next endea-
voured to procure  a sufficient discharge by  stool.
For it is to be  observed,  that  wherever the ilium,
colon, or rectum are inflamed, hardened excrements
are, for the most part, either the cause or the conse-
quence of the  disease; nor can we hope for a com-
plete recovery while such offensive  matter remains
in the bowels;  wherefore  purgatives of the  mildest
kind may first be made use  of, such as whey,  weak
broth, sweet oil, solution of manna,  cremor tartari,
&c. proceeding by degrees to the more active, till
the end proposed be obtained;  after the same  man-
ner as we are directed to do in Sydenham's bilious
cholic; which indeed is a disease nearly allied to the
dysenteries I am now treating of, and is always fre-
quent at the time when they are epidemical.  In both
cases, when other means have  failed,  six or seven
grains of calomel with a  grain of opium at night,
after the  use of the semicupmm, and a purging apo-
zem made of senna, manna, and sal catharticum the
next clay, have  proved successful,  and brought off a
prodigious quantity of round, hard,  fetid lumps, to
the great relief of the  patient; nor is it easy to con-
ceive  how so much  had been collected, or where it
had lodged so long, as in some cases I have observ-
ed: the patient  having eaten nothing for two or three
weeks, that could furnish much excrement, and dur-
ing that' time had taken several clysters and common
cathartics, which brought away liquid stools. (A)
  (h) This fact has been mentioned among others as a proof 
               OF THE DYSENTERY.          149
    Having by such methods removed the inflamma-
 tion of the  intestines, and dislodged their irritating
 contents, the tenderness of the bowels must be miti-
 gated by anodynes, and the  use of such medicines,
 as supply the want of the intestinal mucus.
    By these  means  dysenteries,  if taken  in time,
 have been speedily carried off;  as well as the tenes-
 mus, which is a disease very nearly allied to the for-
 mer, and equally fatal,  whatever Celsus may allege
 to the  contrary.  (De Med.  lib. iv. c. xxi.)  But if
 they were neglected in the beginning,  or did  not
 soon yield to the remedies above mentioned, the case
 commonly became  inveterate and  perplexing;  the
 same medicine which gave relief to one, often doing
 warm to another, as Hoffman justly observes.  (Med.
 Rat. t. vi.  §  ii. c. vii.) In general, it answered best to
 avoid such diet as would afford a large quantity of
 putrid, irritating  excrement;  to  drink plentifully of
 mild gentle  detersive balsamics; to give liquids of
 the same kind in  -clysters;  in short, to pursue with
 diligence the directions given us  by the great Boer-
 haave in his  Aphorisms,  (No.  966, 976.) with this
 addition, that it  was absolutely necessary to give
 opium twice a day,  in order to obtain some respite
 from perpetual torment,  and gradually  to  increase
 the dose from half a grain to five  or six, as use made
 it familiar; and once or  twice a week or oftener, as
 the strength  would allow, and the symptoms indica-

 that the liver performs the office of a chylopoetic viscus,  and
 that the faeces which are discharged during the king intervals
of eating, are formed from the chyle that is secreted from  the
fat of the omentum, and other parts of the body, and which is
 absorbed during the continuance of the disease.
                       N 2 
150         OF THE DYSENTERY.
ted, to hinder the acrid matter from being accumu-
lated in the intestines by giving clysters, cathartics,
or small doses of ipecacuanha.
  If by  these  means the patient  can be kept alive
during the first severe winter weather,  he stands a
good chance of holding out to  the summer,  which
commonly restores him to his former health, when he
must be weaned by degrees from the use of opium;
from the  continuance of which medicine, in such
cases, I have never found any  ill  effects ensue; on
the contrary, I  could name many people who have
been obliged to take it in this manner from Septem-
ber to the following June; and as far as I am able
to judge, it is to the opium they are chiefly indebted
for their lives, and the perfect health which  they at
present enjoy,  (f)
  The  great similitude there  is in many respects
between tertian fevers and dysenteries, induced me
frequently to make use of the bark in the last named
disease.  When the fever and gripes were  regularly
exasperated, either every day or every  other  day at
stated periods,  it has often effectually put a stop to
both; (i£) especially if the  exacerbation began with
chillness, and terminated in sweats: At other times

  (»)  Hundreds of patients with chronic dysentery and diarrhoea
can testify to the truth of this account of the safety and efficacy
of opium as a chronic medicine. It prevents the patients having
recourse to ardent spirits, over which it has the following ad-
vantages, viz. it gives more prompt and certain relief, and the
habit of using it, when it ceases to be necessary, is more easily
broken.
  (i) In cases where the dysenteric symptoms  become perio-
dical, the editor has administered the bark with equal success
in the intermissions of those symptoms. 
OF THE DYSENTERY.         151
it removed the fever, the flux continuing without
much alteration.  In some cases I  have given  it
merely with a view to prevent the mortification of
the intestines in the last stage of the distemper: but
I am  sorry to say that it was  seldom so successful
as I could have wished. 
152
                 CHAPTER VI.


Of the Pleurisy, and other Inflammatory Fevers,fre-
          quent in the Winter and Spring.


 x HE anniversary  epidemical fevers in Minorca
may be divided into two classes,  which at present,
for distinction's sake, we shall call the summer and
the winter fevers. The former break out in June or
July, and cease about  January, or somewhat sooner.
The latter seldom appear before November, and are
rarely seen after the summer solstice; so that one
seems to be the offspring of excessive heat; the other
of the sudden cold which the north winds frequendy
occasion.  And as the  same  sort of weather  recurs
regularly every summer  and autumn, so likewise do
the diseases: whereas those of the  winter and spring,
agreeable  to the variable disposition of those seasons,
are neither so uniform nor so certain; being some
years more frequent in one month, others in another.
The summer fevers are by much the most universal,
making up two thirds, or sometimes three fourths of
the whole annual diseases, and attacking the inhabi-
tants of every rank,  whether natives or foreigners,
without distinction: (/) whereas the others are  less

  (/) The autumnal fevers constitute about the same proportion
of all the acute fevers of several of the  middle and southern 
             OF THE PLEURISY, &c.         153
injurious to the English than to the  Spaniards; and
especially to the  peasants, whose houses  are  com-
monly built upon rising grounds, and not so  well
adapted  for keeping out the piercing cold of the
winter, as sheltering them from the  summer's heat;
so that I have known particular corners of the coun-
try almost depopulated, while the towns and villages
escaped any remarkable mortality.
   Both these classes of fevers, and indeed  almost all
others which happen in that climate, whether prima-
ry or symptomatical diseases, may be termed peri-
odical, having remissions at intervals,  more or less
considerable: but those of the summer, as has been
already observed, generally assume some  one or
other of the tertian types, being worse one day and
better the next alternately: whereas the winter fevers,
though they often counterfeit tertians, especially in
their beginning, yet  for the  most part have exacer-
bations equally strong every day, coming  on about
noon with or without cold shiverings, and  terminat-
ing towards morning, sometimes with gentle sweats,
sometimes without any sensible evacuation.
   It may likewise be remarked, that as the summer
fevers are generally  complicated with fluxes  and
painful obstructions in the  chylopoetic viscera; so
are those  of the  winter, with coughs, catarrhs, and
topical inflammations of the vital organs,  the brain,
the lungs, the heart itself; and hence it is that the
latter  are more  destructive  in proportion to  their

states. The same  disposition in winter fevers to appear with
daily exacerbations and remissions which our author has men-
tioned in the preceding paragraph, takes place in the United
States, not only in the winter, but during the succeeding spring. 
154        OF THE PLEURISY, &x.
numbers.  Notwithstanding which, as the former are
much more constant and universal, if we calculate
one year with another, we shall  find that " the au-
tumn produces  the  most acute and most fatal dis-
eases of all seasons;  and the paroxysms in the even-
ings bear some resemblance to it. For as the day of
any  particular disease is to the  year  that contains
the period or  circle of diseases, so is the  paroxysm
in the evening  to the autumn." (Hip. de  Morb.
Vulg.  1.  ii.)  And indeed the  conformity between
such of those  diseases as are described in the  Hip-
pocratical writings and the appearance of them at
this day in climates near the latitude of Greece, will
be abundantly evident to every one who considers
the preceding account with any degree of attention.
   Having premised those general reflections, in or-
der to  give the clearest idea I can of the  winter fe-
vers, I shall describe them as they appeared during
the last month of the year 1745 and the first part of
1746, when the uncommon destruction which  they
made among the English rendered them  more im-
mediately the object  of my attention; and as the
generality of them is called mal de costat by the vul-
gar, and the pleurisy by physicians, from theff being
accompanied with pains in the side, I have, in com-
pliance to prevailing custom, retained  that name in
the title of this chapter, though it will  appear in the
sequel, that they  ought rather  to  be  termed  peri-
pneumonies,  agreeably to the observations of Ze-
chius,* Hoffman,f and others.
  Those pleurisies began commonly like an ague fit,
with shivering and  shaking, flying pains all  over
  * Apud Bonet. Sepulchr. Anat. lib. ii. § iv.
  f Med. Rat. torn. iv. § 2. cap. iv. 
            OF THE PLEURISY, Sec.         155
the body,  bilious  vomitings and purgings,  which
were soon succeeded by quick  breathing, immode-
rate thirst, inward heat, headach, and other feverish
symptoms. In a few  hours  the  respiration became
more difficult and  laborious; the most part  of the
sick being seized with stitches in their sides, striking
upwards to the clavicle, and shoulder blade; oblique-
ly downwards  along the cartilages  of the bastard
ribs; or else darting across from the breastbone to
the vertebrae of the back; so that they could neither
cough, nor  make a full  inspiration without  great
pain.  Many complained chiefly  of  a load and  op-
pression in their breast, as if a millstone  had been
laid upon  it;  some of  a heaviness and  fluttering
about the heart, which at one time seemed to glow
with extraordinary  heat, at another to be chilled with
cold, as if it had been  dipt in icewater.  In a few of
the sick those  complaints  preceded the fever, in
others they did not come on till the day after,  (m)
  In the progress of the disease  it was  not uncom-
mon for the pains to move about in the thorax from
one place to another. Sometimes they would shift
from the breast to the limbs, and  of a sudden re-
turn to the bowels; and I have seen cases wherein,
after leaving one side, they have attacked  the  other
unexpectedly, and proved fatal in a  very short time.
The left side of the thorax was not near so liable to
be  affected  as the other;  forty-two out of sixty pa-
tients who were seized about the same time, having
had the  disease  in the right, (n) But whichsoever

  (m)  The whole of this  description of the pleurisies of Mi-
norca,  accords with the symptoms of what are called bilious
pleurisies in the United States.
  («) The greater disposition of the right side to be affected in 
 156         OF THE PLEURISY, &c.
 side was affected, the sick lay easiest on the oppo-
 site; though the generality were obliged to lie upon
 their backs, or to sit up in bed with their heads erect.
 Many were drowsy and inclinable to sleep; but they
 raved at intervals, or were much disturbed with ex-
 travagant  dreams.   Some laughed  in  their  sleep;
 others would awake in a fright and start out of bed,
 imagining that the house was in flames;  that those
 about them were endeavouring to push  them over a
 precipice;  to pieree  their  sides  with  daggers; to
 bind them down with cords, or  iron  hoops, and
 things of the like nature.
   In the  meantime the external heat of the body
 was in several  very moderate;  in  some less than
 natural; but  for the most part it was so intense as
 to raise the mercury in Fahrenheit's thermometer to
 the  102d degree, and often in the afternoon to  the
 104th.  The  pulse was likewise  very variable,  not
 only in different persons, but in  the same person at
 different times;  and, in respect  to  its  strength,  in
 different arms, that of the pained  side  being most
 obscure; and I have frequently found it like that of
 a man in health, or  even slower than natural,* while

the pleurisies mentioned by the author was probably the effect
of  a  combination of bilious fever with them, which disposes
to  hepatic pains and obstructions. The fixed position of the
patient  mentioned in the next sentence, shows the pleurisies
to have partaken in a degree, of the character of the pneumonia
notha.
  * Pulsum  in pleuritide minus celerem, aut fortem (febre ta-
men acuta in summo vigore nihilo minus subsistente) saepius
notavi: pulsfis  igitur celeritas  et magnitudo non semper cum
febre inflammatoria sociantur. Qui in pleurae aut pulmonum in-
flammationibus pulsui nimium fidunt, decipiuntur, &c. &c.
                       O'Connel de Morb. Acut. p. 235. 
             OF THE PLEURISY, &c        157
 the patient  was in the greatest danger; so that it
 could neither be depended upon as a prognostic sign,
 nor as an indication of cure. Nor was the colour or
 consistence of the blood more to be trusted; in many
 it had a white or pale1 yellow crust, the serum being
 of the same complexion; but for the most part it was
 red and florid.  It frequently changed its appearance,
 in  the space of a few hours,  in the  same person;
 what was drawn in the morning having a crust; that
 in  the afternoon none, et vice versa, (p) And I could
 never positively determine  which sort afforded the
 best or the  worst prognostic. The signs from which
 one could pronounce the  patient's recovery, with the
 most certainty, were his being able to sleep sound
 in the natural posture, and to make a full inspiration
 without  difficulty, while his  thirst and inward heat
 were moderate.
   Beside some abatement of the fever,  which com-
 monly happened every morning, it was remarkable,
 that upon the third day, or beginning of the fourth,
 there was frequently a great  remission, sometimes a
 total  cessation of every violent symptom; so  that
 the sick were thought to be out of danger: but on
 the fourth or fifth a delirium suddenly came  on,  or
 the breathing became more difficult than ever, and
 one or both of those  symptoms  increasing hourly,
 the patient expired in  a day or two, either suffocated
 or  raving mad; unless nature or art  assisting, he

  (o) It is evident from the state of the skin, the pulse, and the
blood, that this pleurisy partook a good deal  of a malignant
hature. The changes in the appearances of the blood drawn at
different times of the day, show how much they are influenced
by the varying force of the blood vessels.
                        o
                        u 
  158            OF THE PLEURISY, 8<c.

  had the good fortune to escape by means of some
  of  the  evacuations  to be  hereafter mentioned. It
  sometimes happened that the remarkable remission
  fell out on one of the days between the fourth  and
  the seventh; in which case the exacerbation succeed-
  ed on the following day. (/»)
    Out of twenty-one patients, whom I  lost by  this
  distemper, four died upon the fourth day; three the
  fifth day; three the sixth; three the seventh; three the
  eighth;  two the eleventh; one the fourteenth; and the
  remaining two, though the day cannot positively be de-
  termined, yet from some circumstances, it is evident,
  that it must have been the fourth or fifth.  And indeed
  such was the rapid progress of those mortal pleurisies,
  that if  any of them  survived the  seventh day, it
  seemed to be  entirely owing to bleeding.

   (p) The whole of this paragraph is a further  illustration of
 the bilious and malignant character of the pleurisies described
 by our author. The same supposed " remissions, and total ces-
 sation of every violent symptom," frequently took place in  the
 yellow fever in Philadelphia. The editor differs from the author
 in supposing them to be remissions.  On the contrary he believes
 them to be the effect  of the system  being reduced by a severe
 paroxysm of fever, below the points of sensation and reaction.
 That this was the case in the  pleurisies, he  infers from the fa-
 vourable issue of the practice of our author, mentioned in a sub-
 sequent part of his work, where he informs  us that the loss of
 thirty or forty ounces  of blood within the first three days, and
 bathing and blistering the  legs, prevented what he has called
 " the insidious intervals," or " treacherous remissions" of the
 disease, and induced such " commotions" in the system,  or so
 severe a paroxysm, as to  require bleeding  and  blistering  to
 subdue it.  The same  copious  bleedings prevented similar ap.
 parent remissions  in the yellow fever of Philadelphia, or if they
 had not been used to a sufficient extent, the repetition of them
relieved the system from its insensible and oppressed state, and
thereby created a  fever, and thus saved life. 
             OF THE PLEURISY, &c.         159
   I examined fourteeen of the bodies,  in all which
the lungs were principally affected; whilst in several
the pleura was perfectly sound, or only slightly at-
tached to  the  lungs,  which is a common  case  in
adults, as  every one knows who  is accustomed  to
dissections.  In many the lungs were converted into
a hard liverlike substance,  and sunk in water;  in
some the diaphragm was  inflamed;  in  others large
firm polypi were  taken out of the ventricles of the
heart  and large vessels  adjoining, (f)  Abscesses,
or rather half formed abscesses, with a sanious ichor,
and a rotten gelatinous substance, instead of  con-
cocted matter, were frequently found, even in those
who died so early as the fourth day,  either in the
lungs, or between the  lungs and pleura, where  they
adhered, or between the membranes of the medias-
tinum, near the diaphragm. And these abscesses had
sometimes emptied  themselves into the cavity  of
the thorax, so that the lungs floated  in  purulent
serum;  their  external  membrane,  and likewise the
pleura, being greatly thickened and converted, as it
were, into  a white crust,* like melted tallow grown

  (q) It  appears from our author's  dissections that polypi  as
well as tubercles are formed  by acute as well  as chronic
diseases.
  * I am now doubtful if this crust was the pleura and external
coat of the lungs, changed from a natural state by soaking in a
purulent fluid, or if it was not altogether a preternatural sub-
stance, formed by fluids deposited on those membranes, and
compacted together  by the motion  of the  lungs;  for I  have
lately been informed by Mr. Hunter, that, in those who die of
internal inflammations, he generally finds the surface of the ca-
vities and the bowels furred over, as it were, with a thick slough
of an ash colour, somewhat inclining to yellow, which he had
an opportunity of observing in all the different degrees of con- 
160        OF THE PLEURISY, &e.
 cold, part of them being eroded and detached from the
 rest. In some bodies the pericardium was full of puru-
 lent serum, its internal membrane and the outer sur-
 face of the heart, being affected in the same manner as
 I have just now described those of the lungs and pleu-
 ra. In two people whose heads were examined, the si-
 nuses of the dura  mater were stuffed  and distended
 with blood, the membrane itself being sound, and the
 pia mater, together with the plexus choroides, was in-
 flamed and much thicker than in a natural state.
   In one person,  whom I imagined to have died of
 a  pleurisy, the lungs  and pleura were sound; but
 there were polypi  in the heart, the  diaphragm  was
 inflamed, and a large abscess was found in the right
 lobe of the liver,  which had discharged  itself  into
 the abdomen, where much purulent stinking matter
 was collected; part of the colon and teguments near
 the liver being  sphacelated, the rest of the guts in-
 flamed,  adhering  to  each  other,  and beginning to
 mortify. This man, for  the  first  four days  of his
 distemper, had  no  great pain; on the fifth and sixth
 day it became violent;  after this he expectorated
 freely,  which  gave  hopes of his recovery to  the

 sistence, between a soft mucus slightly adhering to the parts,
 and a solid fibrous  lamella, so closely attached to them, that at
 first view they appeared to be  inseparably united: yet after
 maceration in water he could peel off the whole of this slough
 from the smooth, sound, natural membrane which it covered.
 This observation confirms  Haller's  opinion, that the membra-
nous adhesions, so frequently met with between the lungs and
pleura, are generally formed by the coagulation of the  watery
fluid which oozes from  the exhalent vessels of these parts.  See
Lin. Prim. Physiolog. No. 262. 
              OF THE PLEURISY, &c.         161
 twelfth, when he died, contrary to expectation, put-
 ting me in mind of  a  prognostic in Hippocrates,*
 which seemed to be applicable to his case, (r)
   Among the natural evacuations which terminated
 these pleurisies,  the  most frequent  was a plentiful
 expectoration without  hard  coughing. When  this
 discharge began early, and continued freely, it kept
 off or mitigated the dangerous symptoms so liable
 to come  on about the fourth or  fifth  day, and the
 fever disappeared about the seventh: but if the spit-
 ting did not begin before  the  exacerbation  of the
 fourth or fifth  day, it  often  proved insufficient to
 save the patient.  If he did recover, the fever seldom
 left  him before the fourteenth  day,  and frequently
 continued much longer.
   Hippocrates describes the colour and consistence
 of the expectorated matter, which  generally prog-
 nosticates death or recovery.  (Prasnot. Coac.)  But
 at the same time he  takes  care to inform us,  that
 every sort of spitting which  does not remove  the
 pain is bad; and every sort that  does  remove it is
 good: the latter part of which remark I have seen
 verified in some who  owed their lives to that evacu-
 ation, though the matter was  always  thin,  crude,
 and  ill-coloured.
   The next critical discharge  to be mentioned  is a
 copious efflux of urine, which soon after being made
 turns thick, and is either of a  pale red, letting fall a

  * Quibus autem pleuriticis dolores initio mites sunt, ingra-
 vescunt autem quinto aut sexto, facile ad duodecimum usque
perveniunt; ac rarp ilii  servantur.          Praenot Coac.
  (r) The result of this dissection shows the  uncertainty of no-
sology, and the necessity of our remedies being  governed by the
state of the svstem rather than by the name and seat of a disease
                        02 
162        OF THE PLEURISY, fcc.
lateritious sediment, or milky, as if mixed with lau*
dable pus, and  deposited an equal smooth white
one. Such urine alone terminated the  disease  in
some;  and in many  it proved an assistant  to  the
expectoration. (*)
  Sweats were common in these pleurisies:  in  the
beginning indeed they  were oftener symptomatical
than critical: but after the obstructions of the head
and breast were removed by the evacuations above
mentioned, they  seldom failed of coming  on to abate
the fever, and complete the cure.  And though they
did not always fall  out  on the critical days, yet it is
remarkable,  that those which were  most  profuse,
and brought about the greatest changes, which really
happened on the  4th, 7th, 9th, 11th, 14th, 17th, and
21st day,  much  more frequently than  on  others.
This is a circumstance  to  which  I had not always
attended, though I  find from my notes that  it  is a
true one.
  It was common for those  diseases to begin with
a vomiting and purging of green or yellow bilious
matter:  but there  were few instances where either
of those evacuations  could be reckoned critical,  ex-
cept in one man  who laboured under a dry pleurisy
with crude urine, and  had got to the eleventh day,
with the utmost difficulty, when a purging of porra-
ceous bile came on, and gave a turn to the distem-

  (s) Nature often employs this mode to relieve  herself of re-
dundant fluids, but not  always with success. Physicians should
follow her in availing themselves of the kidneys as well as the
bowels, blood vessels and pores, to discharge violent diseases
from the body. 
             OF THE PLEURISY, &o.         163
per, which afterwards went off gradually by sweat
and expectoration.
  One person who had a violent pleurisy in the right
breast, and had been four times bled, was  seized
with a hemorrhage from the right nostril on the se-
venth day;  and after losing four or five  ounces,  a
most profuse universal sweat came on, and put him
out of danger. (£)
  Another way which nature took to relieve herself,
was, by  translating  the morbific matter from  the
bowels to the  surface of the body.  In three  people
the disease  was,  immediately after  its  invasion,
changed  into the erysipelatous fever, described by
Sydenham, and was cured as he directs. In seven or
eight people  the  fever and all  other  complaints va-
nished the second or third day, an erysipelas  ap-
pearing on the inferior  extremities, which in some
fell lower and lower  every hour, and soon  made its
exit by the toes; in others, being more of the nature
of a phlegmon, it settled in one of the legs, and form-
ed an abscess, which  degenerated into fistulous ul-
cers, and proved very difficult  to be cured, (u)
  By reflecting upon these cases, and considering
that an erysipelas of the bowels would spread from

  (t) This fact is important, inasmuch as it shows, 1st, that the
loss  of a very small quantity of blood in the close of a disease is
often attended with the same beneficial effects as the loss of a
large quantity in its first stage; and 2dly, that a very small ex-
cess in the quantity of blood will keep  the system above the
salutary sweating point.
  («) The whole of this paragraph is calculated to establish a
belief in the unity of disease. The erysipelas has  in several in-
stances preceded the plague and yellow fever. It was in these
cases probably  brought on by a similar cause. 
164        OF THE PLEURISY, 8cc.
 place to place inwardly, as it does on  the  skin, I
 could account for several appearances in the predo-
 minant distempers, which at first seemed somewhat
 extraordinary; such as the inconstancy and mutabi-
 lity of the pains, and the frequent alteration of the
 pulse and breathing, according as the morbific mat-
 ter shifted its situation, and fixed upon different or-
 gans, the heart, the lungs, the midriff, or containing
 membranes of the thorax. And I imagined that the
 treacherous remission, so frequent on the third or
 fourth day, happened whilst the morbific matter was
 shifting from the  breast; which after being  reas-
 sumed into the  mass of blood, and falling upon the
 head, or returning again to the lungs, often occasion-
 ed tragical effects.
   When those  pleurisies first became  epidemical,
 their quick progress and uncommon  mortality sur-
 prised me  greatly.  I  attempted to  cure them by
 bleeding once or twice a day, if the complaints were
 violent, as  I had always used to do in inflammatory
 fevers: but the  remissions  in the mornings some-
 times induced me to  omit  the  operation; and the
 cessation of the  symptoms, which generally happen-
 ed about the third day, made me imagine that the
 danger was over; so that before the  patients were
 blooded above two or  three times, the exacerbation
 came on upon the fourth or fifth  day, and defeated
 all attempts by bleeding, blistering, or otherwise to
 relieve them.
   Those unforeseen events startled me greatly,  and
led me again to  review  the  whole progress  of the
disease, its symptoms,  and issue. I  had observed
that  some escaped by means of expectoration  and 
              OF THE PLEURISY, &c.        165
 purulent urine, without much assistance from phle-
 botomy: and considering the periodical revolutions
 of the fever, the quick transition of the stitches from
 one  part  to another, together with the prevailing
 colour of the blood, as well as that of the spitting,
 and other excretions, I was apprehensive that those
 were what authors call bilious pleurisies, which they
 allege are exasperated by large evacuations:*  parti-
 cularly  Duretus,f who  exclaims with great  vehe-
 mence against those physicians who trust principally
 to bleeding in the cure of those diseases, without
 waiting for the natural evacuations.  These motives
 induced me to use  the  lancet with  more  caution;
 and to rely chiefly on the speedy application of blis-
 ters for restraining the symptoms. But this manage-
 ment proved less successful than the former; and I
 was convinced  in a short time that,  instead of too
 much, too little blood had been  taken away in the
 beginning;  having been sometimes misled  by the
 insidious intervals of the disease; at others having
 trusted too much to the  faint attempts which nature
 made to relieve herself by expectoration and urine;
 the latter often becoming crude  on the fourth day,
 as the delirium advanced, though  it had  promised
 fair on the seconder third; the former frequently being
 checked about that period of the  disease, by the im-
 moderate  heat  of the lungs  rendering the matter

  * Ballon. Epid. Sparsim. Bianch.  Hist. Hep. p. iii. $ viii. &c.
 Bagl. Prax. Med. 1. i. c. ix. Lands. Epid. Rom. c. vi.
  f O homines reipublicae calamitosos atque funestos!  ipsam
 pleuritidem, qux sua sponte nuUius operis indigens cum tali
 sputo quiesceret, ex eventu reddunt mortiferam.
r                              Duret. in Praenot. Coac> 
 166         OF THE PLEURISY, &c.
 viscid, globular, and not to be  discharged, but with
 the utmost difficulty.
   I then began  to bleed more plentifully, and  re-
 peated it so as  to take  away thirty or lorty ounces
 within the three first days of the distemper; and en-
 deavoured, by bathing  the legs and blistering them
 on the third day, to  prevent the fatal  symptoms
 from  coming on about the fourth or fifth;  giving
 nitre   at the  same time liberally,  and camphire in
 small  doses, to promote the thinner secretions. This
 method succeeded well in several cases; expectora-
 tion and urine being thereby increased: but if they
 were  not increased, the commotions which arose on
 the fourth, fifth, or sixth day, made it always neces-
 sary to have recourse to bleeding again, and more
 blisters, in order to relieve the oppression of the
 head  and breast; and though for the  most part the
 patients  did escape,  yet they recovered with diffi-
 culty,  and continued coughing, spitting, and sweating
 in the nights, for several weeks, (w)
   At  last, about the middle  of March, when the
 disease raged with the utmost fury,  having  found
 that there was  an  absolute  necessity for bleeding
 largely without  delay,  in order to preserve life, I
 began to put in practice the following method of
 cure,  which seldom or never failed, not only in young
 robust people, but even in those of a more advanced
 age, (x)  provided I saw the  sick before the end of
 the third  day.
  (ty)  The reader is requested to compare this account'of the
 effects of copious bleeding in preventing the " insidious inter-
 vals, and treacherous remissions" of the disease mentioned in
page 158, and referred to by the editor.
  (x) Our author was not misled by the supposed weakness of 
             OF THE PLEURISY, he.         167
   If I was called, for example, in the morning, the
 patient was  immediately laid in a horizontal  posi-
 tion, and bled at the arm  until his pains abated, or
 he began to  faint;  neither of which  commonly hap-
 pened before 16, 20, or 24 ounces were taken away.
 If the  symptoms  continued, I ordered about the
 same quantity to be taken from the other arm in the
 afternoon, without regarding the  urine, expectora-
 tion, or  appearance of the  blood.  Next  morning,
 though there might be a great alteration for the bet-
 ter, yet, if there was  the least  room to suspect that
 any obstruction remained  in the head or breast, the
 bleeding  was  repeated: and  by carefully  weighing
 the  blood*  I  found  that between forty-eight and
 fifty-four ounces were frequently taken away during
 the first 24  hours  of my attendance.  This sudden
 copious evacuation commonly procured a cessation of
 all violent symptoms,  and afforded  an opportunity
 to give an antiphlogistic purge the next day. But if
 the symptoms  did not cease, or if the pains and dif-
 ficulty of breathing returned the day after the purge
 had been given, or if there was reason to suspect
 from the headach, giddiness, tingling of  the  ears,
 and disturbed  rest, that the brain  was in  danger of
 being affected, I had  again immediate  recourse to
 bleeding, taking away at different  times to the
 amount of 12,  18, or 24 ounces, in the  space of a
 day, either by the lancet or cupping glasses, or both,

 old age in the  use of the lancet. Experience proves it to be
 more necessary under equal circumstances in that stage of life,
than in any other.
  * In weighing the blood, I used the island weights, fourteen
otinces of which answer nearly to sixteen ounces avoirdupois. 
 168         OF THE PLEURISY,  &c.

 as occasion required; by which means the impending
 storm was happily averted; and as soon as the com-
 motions  were quelled, the purgative was repeated
 every other day  for three  times, unless some of the
 critical evacuations appeared  with such visible good
 effects as rendered it unnecessary.
   In  this manner I  found  with  Sydenham,  that
 pleurisies of the  most  fatal tendency might be hap-
 pily cured in the space of a few days;  and with as
 much certainty as  any distemper whatever.  And it
 was no less remarkable to observe, how quickly the
 sick recovered their usual health and strength, not-
 withstanding the great loss of blood which they had
 sustained; while many, who  had  been bled more
 sparingly,  continued in a languid,  infirm  state  for
 months,  without being able to get rid of the cough
 and pains in the breast, (if)

   (y) The copious bleeding used with so much success by our
 author in the treatment of bilious pleurisies is founded upon the
 system labouring under two distinct and violent morbid actions,
 the one in the lungs, and the other in the stomach and liver. The
 same disease yielded only to copious bleeding in the winter of
 1794-5 in  Philadelphia.  Nearly all  died who  were not bled
 twice as much as in a single pleurisy, or inflammatory bilious fe-
 ver. This  copious depletion by the lancet not only saved life,
 but prevented, according to Dr. Sydenham, a distressing and
 dangerous  cough. Our author discovers his usual good sense in
 continuing to bleed, while the symptoms of the disease retained
 their early violence, without any regard to the state of the
 urine, expectoration^ or the blood. Even the pulse in such cases
 should not  regulate the use of the lancet  Let  it not be sup-
 posed from what has been said, that the bilious pleurisy ap-
 pears in no other form than that which has been mentioned. It
 sometimes  assumes  in the United  States,  the  symptoms of
 the typhoid and typhus states of fever, in the former of which
bleeding is forbidden, and in the latter, bark and opium are the
most effectual remedies. 
             OF THE PLEURISY, 8cc.        169
   Hitherto I have  only mentioned the capital re-
medies made use of in the cure of those distempers.
But it may not be improper to take notice of some
other collateral helps, which were generally used in
the several ways of treating them above described.
   In the first place, the sick had warm barley water
with oxymel for common drink; and nitrous  anti-
phlogistic medicines in the  first days of the distem-
per; their bellies being kept open with clysters.
   Oily linctuses were exceedingly useful in allaying
the cough; and small doses of anodynes were often
.necessary, both for  that purpose,  and to  procure
slefcp when the height  of the distemper was over.
   If the pleurisy began with  a  bilious vomiting, it
was expedient to promote that  evacuation by large
draughts of warm water, in order to carry it off the
sooner.
   To ease the pains  in the breast the large leaves of
the opuntia, toasted in an oven, and split through the
middle, were frequently applied: these being thick
and succulent, retain the heat a long time, and pro-
duce all the good  effects that  attend anodyne emol-
lient cataplasms and fomentations;  as I  have fre-
quently experienced in  tertian  fevers, dysenteries,
and other diseases with  inflamed bowels,  as well as
in this  disease,  since I first learned  the virtues  of
the leaves from the natives  of Minorca.
   After bleeding twice or thrice, blisters  laid upon
the part affected were  often successful in  removing
obstinate stitches:  but  nothing affords such certain
and immediate relief as the  scarificator and cupping
glass; insomuch that among the many trials which I
have had of them, I do  not remember an instance
                        P 
170        OF THE PLEURISY, &c.
where they did not either carry off the complaint en-
tirely, or mitigate  it considerably:  but my glasses
were both wider and deeper than those  commonly
used in England.
  The phrensies and anginas, which now and then ap-
peared during this  constitution of the air,  required
the same method of cure: and as to the chincough,
which was so fatal  to children, the  chief difference
between it and the  pleurisy seems to have been, that
in one the morbific matter was thrown into the ve-
sicles of the trachasa, in the other it  stagnated in the
extremities of the pulmonary arteries.
  During the same period of time  catarrhal fevers
appeared among the adults, attended with coughs,
pains in the head and  bones, and frequently a deli-
rium; some  of which suddenly terminated on the
seventh  day. by profuse sweats; but most  of them
had partial crises sooner,  and  went  off by  degrees.
When large bleeding was neglected in the beginning,
they were liable to degenerate  into pleurisies. This
was likewise the case with the tertian fevers;  and
indeed it was remarkable that not only all acute  dis-
eases of this season, but even  accidental hurts  and
bruises required more plentiful evacuations  than or-
dinary; so inclinable was this constitution of the air
to promote inflammations, (z)
  I shall conclude this chapter  with  a paragraph or
two  from some letters, occasioned by the pleurisies
of which we have been speaking, in order to confirm
what has been said on them by the testimony of my

  (2) Our author discovers his education in  the schools of Hip-
pocrates and Sydenham by admitting an inflammatory constitu-
tion of the atmosphere, and its influence upon all diseases. 
             OF THE PLEURISY, &c.        171
friend Dr. Font, an eminent physician of Ciudadella
in Minorca, who has deservedly enjoyed a most ex-
tensive practice for upwards of thirty years.


          Didaco Font, M. D.  G. C. S.
   —Novus annus funera densa  produxit, grassante
febre inflammatory, quae caput et organa respiratio-
nis potissimum afficit, modo  pleuritis; modo peri-
pneumonia, interdum  phrenitis, interdum paraphre-
nias adpellanda. Hic  morbus, ut  vehemens,  largis
et repetitis venaesectionibus, cum interposita catharsi,
in  herba felicissime jugulatur.  Complures liberale
sputum, sine multa  sanguinis  jactura,  periculo eri-
puit. Nee desunt, quibus urinae purulentse fluxus diu
perseverans, saluti fuit.  At, nisi  istius  modi auxilia
mature accedant, vae aegris! nam postquam  morbus
per triduum impune  sasviit,  altasque  egit radices,
fero plerumque medicina paratur; et  neque venae-
sectiones, neque epispastica, neque cucurbitulae, ne-
que pectoralia tantopere decantata, impedire valent,
quo minus, juxta Hippocratis effatum, " .Septimo die
vel celerius sucewnbant, aut mente Icesi, aut orthopnea
suffocati."
   A te itaque peto,  vir experientissime, ut dato otio,
his quaesitis responsum praebeas.
  Annon pleuritis morbus  anniversarius in hac in-
sula, et quibus  mensibus?
   An semper febrem continuam,  cum  celeri pulsu,
acri calore,  &c. comitem sibi  adsciscat?  An potius
febri periodica remittcnte conjungatur?
   Nonne tutius est, morbi resolutionem per venaet 
172        OF THE PLEURISY, &c.
sectiones, quam  primum tentare, quam coctionem
ct crisin naturae praestolari?
  Ubi resolutio tentanda est, qua mensura et quibus
intervallis cruorem detrahere conveniat?
            Datum Magone tertio die Maii, S. V.
                anno M,DCC,XLVI.


              G.  C. Diadacus Font, S.
  —Anniversarius hac in parte insulse morbus est
pleuritis, hiemeque viget, quantum ex usu observavi;
et ubi rigida hyems plus justo prolongatur ad me-
dium aut finem  veris excurrere solet;  immo anno
1730, quamvis solito modo procederent tempestates,
memini hunc morbum, cum aliis inflammationibus
internis, magnam stragem fecisse;  aegris vel  mente
laesis, vel orthopnaea suffocatis.
  Pleuritis  non  semper febrem acutam continuam
habet adjunctam cum siti, calore, et celeri pulsu: imo
potius in ipsius principio febris est fere semper mi-
tis; pulsus quoad celeritatem, parum distat a natu-
rali, calorque  non est nimius, nee  mordax;  et  in
multis propensionem ad somnum observavi. Nequa-
quam  vero, licet ita ingrediatur, Ieniter  tractanda
est;  sed  eodem  modo ac si cum vehementi  febre
invasisset.
  Praeterea, pleuritis saepe sociatur febre quae perio-
dice remittit,  et intenditur, modo quotidie, modo de
tertio in tertium.*  Et aliquando sola febris tertiana
intermittens adest; sicuti observavi in quatuor aegris,
quorum  unus in initio septimi paroxysmi  e vita
decessit.
  * Vide GaW. Avicen. & Mercurial apud Bianch. p. iii. Schol.
2-5. & SpigetSle Semi tertian, cap. iii. 
             OF THE PLEURISY, &c.         173
  Quoad curationem; ubi tempestive vocatus sum,
primo scil. die, vel secundi initio, deposita mora, san-
guinis circiter quatuor libras, partitis vicibus, nuch-
themeri spatio, si aeger robustus sit, detrahere jubeo;
qua  subita et copiosa evacuatione morbus quando-
que  in  herba resolvitur.  Sin  vero persistat,  ante
diem quartum, totidem fere  sanguinis libras, partitis
vicibus, noviter extraho: et similiter prosequor, licet
ante diem  quartum magna et  notabilis  omnium
symptomatum  remissio contingat. Quae quidem re-
missio talis et tanta esse solet, ut aeger et  reliqui
rem jam in tuto putent; et ipse olim ita existimavi,
donee  infausti eventus aliter  docuissent.  Quippe
veniente die quarto, aut quinto,  supra modum ex-
acerbantur  symptomata, et furente nova procella,
aeger qui mox convaliturus sperabatur, orco traditur:
quod nulla alia methodo quam supra praescripta prae-
cavere  potui; diluentibus interim,  expectorantibus,
clysteribus, cucurbitulis et epispasticis, pro  ratione
symptomatum, diligenter adhibitis; ut et purgantibus,
post septimum diem. En methodus medendi, quae
meis et aegrorum votis respondet!  Ex centum qui
corripiuntur, nonaginta, aut  in initio resolutione, aut
postea manifesta crisi servantur.  Quae crisis, aut per
sudorem, aut  per expectorationem, aut per urinae
profluvium, modo sanguinolentae, modo puriformis,
aut  per diarrhceam perficitur;  adjutis vitae viribus,
sanguinis evacuatione,  et supra memoratis remediis
legitime exhibitis. Quibus inter  initia spretis, mors
ut plurimum succedit.
                    Datum Civitellae Maii 26, &.  N.
                     anno M,DCC,XLVI.
                       P2           # 
174
                 CHAPTER VII:

               OF THE SMALLPOX.


 I  HE smallpox  were twice epidemical in Minorca,
 while I resided  there, viz.  in  the year 1742, and
 1746. Without entering into a minute description of
 the disease, I shall only endeavour to give a general
 view of its nature and effects, in each of those years;
 from which it will appear how widely the infection
 of  one differed from that of the other.
   About the middle of March 1742, the smallpox
 broke out in Mahon, to the  great consternation  of
 the natives, who  had not seen them since the year
 1725, but well remembered  the  destruction which
 they then occasioned. The contagion quickly spread
 about, and was soon conveyed to the other towns and
 villages; insomuch that before the  end of April it
 prevailed in every part of the island. As it attacked
 almost all who were under seventeen, and many  of
 a more advanced age, the sick  were  so numerous
 during May and  June,  that every house might be
 called an hospital. About the end of July the  dis-
 ease suddenly disappeared, most of those who were
 susceptible of it having by that time undergone it.
  During the first six or eight weeks the distemper
was favourable, and seldom  proved fatal:  but its
virulence inijfeased with the heat of the weather; so 
OF THE SMALLPOX.         175
that in June and July it was not uncommon, both at
Mahon and Ciudadella, to bury ten or twelve of a
day. Nevertheless,  in  proportion to the numbers,
not many died; and what mortality there was, hap-
pened chiefly among children at the breast and the
common  soldiers.
  Among such multitudes of sick, all the different
species of smallpox, described  by authors, were
sometimes met with: but both the distinct and con-
fluent had a nearer  resemblance  to what Sydenham
calls the  anomalous, than to the regular smallpox.
For though the fluxed kind  commonly appeared on
the second or third  day, it was often the fourteenth
or seventeenth before the  roughness to  the touch
showed that those on the face began to turn;  and on
the legs  and arms  they frequently continued fresh
till near  the thirtieth. In these  kinds of smallpox
the secondary  fever raged  violently  between  the
fourteenth and twenty-fourth day; and almost all
who perished by the disease died on one or other of
the intermediate days.
  The constancy of nature in promoting one or other
of the common evacuations,  whereby part of the
morbid matter was  discharged, contributed to  save
great numbers; for  a plentiful salivation commonly
appeared with the eruption, and continued  till the
suppuration was completed, not only in adults, but
in those  of all ages;  even in children at the breast,
whose want of sense to spit freely, was probably
the chief cause of their suffering more than  others.
About the seventh  day or sooner the swelling of the
face came on;  and  it was regularly succeeded by a
tumefaction of the hands, and sometimes of {he 
176         OF THE SMALLPOX.
feet. But it was most remarkable in this epidemical
smallpox, that a moderate  looseness commonly ap-
peared, as the pustules began to dry, and continued
till  the skin  was in some  measure  cleared of the
thick  black crust that covered it;  by which means
the defect of perspiration was supplied, the symp-
toms  of the  secondary  fever were restrained,  and
many people  were happily rescued from the jaws of
death: whence we may learn, how reasonable it is
to give purgatives in this stage  of the disease, ac-
cording to the rules laid down for that purpose by
Drs. Friend  and  Mead.
   In  December,  1745, the smallpox were brought
from  Constantinople by one of his majesty's  ships,
and the following year  made a slow but  fatal pro-
gress over the whole island.  During the spring of
1746, they confined themselves to  St. Philip's Cas-
tle, without reaching Mahon, though they are but
two small miles asunder. In the summer and autumn
they were frequent in Mahon and  the neighbouring
parts.  Then they travelled northward to Ciudadella,
and disappeared in the spring; having carried off
almost all the children who survived the chincough
and summer fevers of the year 1746. It was how-
ever very remarkable,  that the longer the infection
continued in the island, the milder it  became; so
that there was much less mortality in the northern
parts than in the  southern, where it first broke out.
   Whilst the distemper raged at St.  Philip's Castle,
as I lived at Mahon, I saw but  few of the sick; but
I was informed  by the physicians  who attended
them, that the pustules  were commonly of the con-
fluent kind, and often intermixed with purples;  that 
             OF THE SMALLPOX.           177
they seldom rose or filled well, but continued either
hard like tubercles, or quite empty, or had a small
quantity of ichor, with a black spot in their middle,
and frequently seemed to wither before  they were
ripe; that the fever, instead  of  going off with the
eruption, increased as the disease  advanced, being
generally accompanied with a coma, delirium, diffi-
culty of breathing, incessant vomiting and loathing
of food; that the face seldom  or  never swelled, but
about the time that this  ought to have happened, a
soreness of the mouth or throat  gave  great uneasi-
ness, the skin separated from  the inside of the lips,
and the breath became very fetid; that three fourths
of the infected, in spite of all that could be contrived
for their preservation, perished  between the sixth
and the fourteenth days of the fever.  And the most
of those who survived remained blind, consumptive,
or lame with caries of the bones, sordid ulcers, &c.
so that this disease  approached nearest to  the plague
of all which had been known in the island.
  From those accounts (which  were  too well  con-
firmed by my own experience afterwards) I conjec-
tured,  that the  extraordinary mortality of the dis-
ease was  owing,  partly to  the  variolous  matter
abounding so much in the blood, that  the skin was
not capable of receiving the whole quantity; partly
to the peculiar  disposition of the air  at  that time,
which, as we have seen in the former  chapter,  ren-
dered the  head and  breast extremely liable to in-
flammations. Hence  I imagined that  many of the
sick died of a phrenitis  or peripneumonia,  on the
sixth, seventh, or eighth day, before the pustules had
time to ripen; while in pthers, the pustules  having 
17ff         OF THE SMALLPOX.
terminated in a gangrene, the corrosive  ichor re-
ceived into the blood proved fatal about the end of
the second week. It appeared to  me that  the  most
probable way of averting  those disasters would be,
to make large evacuations  in  the  first days of the
distemper, and to replenish the  vessels with mild
antiputrescent liquors;  by which  means, either  the
eruption would be prevented, or the pustules would
be fewer in number;  or at least disposed to suppu-
rate rather than mortify.  This method of treating
the smallpox is countenanced by Ballonius, (Ephem.
& Epid. 1. i.) and  strongly recommended by Boer-
haave,  (Aph. 1393.)  who probably took  the  first
hint from Rhazis;*  and if ever so bold a practice
could be justified, it was in such a pestilential kind
as this, which destroyed almost all who were left to
nature, or managed in the common way. These con-
siderations, and the visible good effects of bleeding
and purging  largely in the predominant pleurisies,
gave just cause to expect some benefit  from a simi-
lar method in the cure of the  smallpox; which  ap-
prehension was confirmed by the following accident.
   A young man, about twenty-six years of age, was
seized on Wednesday, May 21, between seven and
eight o'clock  in the morning, with a coldness  and
shivering,  which was soon succeeded  by common
feverish complaints, and a pain under his left breast,
straitening respiration. On Thursday morning, when

  * Si antequam apparere incipiant  variolae, aegrum medicus
inveniat, minuatur sanguinis multitudo—Venter autem si strictus
merit, infusiones quotidie in potu sumantur, ex hoc enim  aut
omnino prohibebitur pustularum egressio, aut si quid egressum
tuerit, parvum erit.  Vid. Op. Venet. de Febr. cap. xviii. p. 105'. 
              OF THE SMALLPOX.          I79
 I first visited him, imagining the case to be a pleu-
 risy, I ordered him to be treated accordingly.  In
 consequence of  which seventeen ounces of blood
 were taken away immediately; twenty ounces more
 in the afternoon, and fifteen on Friday morning; his
 belly was kept open by clysters; his drink was bar-
 ley water, to which oxymel and nitre  were  added;
 and sometimes a decoction of tamarinds; and leaves
 of the opuntia were frequently applied to his side.
 On Friday forenoon his pains  were easier:  but he
 complained greatly of an inclination to vomit, and
 after drinking warm water threw up a considerable
 quantity of bilious  matter.  In  the  afternoon an
 eruption was discovered all over his body, which,
 from the appearance of it on his face, and its being
 attended  with a ptyalism,  I  suspected to  be the
 confluent smallpox;  and  Dr. Segui, an  eminent
 physician of  Mahon, who was  consulted on  this
 emergency, confirmed  my opinion.   Our  patient
 was  blooded thirteen  ounces  on Friday  evening;
 and  afterwards  drank  plenty  of warm water, in
 order to carry off his vomiting; a clyster was like-
 wise injected, his head shaved, his whole skin clean-
 ed  and washed.  On Saturday morning the fever
 being moderate,  and the eruption thick all over him,
 he took a mild purge, which procured six or seven
 stools, and a grain of opium was given at bed time.
 On Sunday morning, after a restless disturbed night,
 his  spitting  having ceased, he complained of his
 throat being so sore that  he could scarce swallow,
 and that the stitch had moved from his left breast,
 and  fixed about  the  lower ribs  in the right  side.
These symptoms induced us to bleed him a fifth
time, to the quantity of eleven ounces, which were 
180         OF THE SMALLPOX.
 of a crimson colour, as all the rest of his blood had
 been,  without any sizy crust.  In the afternoon  he
 spit considerably, slept  sound, was free from pain;
 and after a good night's rest, on Monday morning his
 purge was repeated, which gave six or seven motions,
 without checking the  salivation.  After this all far-
 ther evacuations were laid aside (except clysters to
 keep the belly open); the pustules, which were small
 and numerous all over him, began to fill with good
 matter, and every  thing went on according to our
 wish.  On Tuesday morning his  face swelled; but
 abated on Thursday afternoon, the  pustules begin-
 ning to dry; while his right foot swelled, and be-
 came  painful, the ptyalism still continuing. Monday
 morning, June 2, his skin being dry every where, he
 took physic, which was  repeated on the Friday fol-
 lowing. He soon gained strength, and still enjoys a
 good  state of health.
    The next patient  whom I attended in this dis-
 temper was a Jew's daughter,  about five years  of
 age, to whom I was called on Saturday  morning,
 May  24, when the pustules were  just beginning to
 appear, she having been feverish  since Wednesday
 morning.  She was thrice  blooded by my  order,  in
 the space of twenty-four hours;  four ounces being
 taken away each time,  she was strictly kept to the
-cooling regimen;  clysters were frequently inject-
 ed; and she commonly took a paregoric  at night.
 The pustules  were low, small, confluent, and attend-
 ed with a  considerable salivation.  Her face swelled
 on Tuesday, her hands  the day following, and her
 feet on  Friday. On Sunday, June  1, the  pustules
 began to  dry  on her face.  On  Monday  she was 
               OF THE SMALLPOX.          181
 purged, and gradually  grew strong. This  and the
 former patient were the first two in Mahon, who at
 that time recovered of the smallpox.
    About the end of May, and  the beginning of
 June, three or four adults were attacked with violent
 feverish symptoms;   and  as  they  never  had the
 smallpox, it was suspected that they had catched the
 infection. They were all treated in the same manner
 with the man, whose case has  been already related,
 and in six or seven days got perfectly well  without
 signs of eruption. Nor did any of them take the
 smallpox afterwards, (a)
    Elevated with this success I began to  flatter my-
 self that I had now hit upon a method of cure which
 would generally answer:  but it was not long before
 experience convinced me of my mistake.
    A young man, about  twenty-one, was seized at
 noon, Monday, June  16, with feverish  symptoms,
 and a  violent pain in his  stomach, loins, and  left
 breast.  He lost  fifteen ounces of blood on Tuesday
 morning, seventeen ounces the same afternoon,  and
 fifteen on Wednesday morning.  All this day he was
 sick and squeamish, though he drank much warm
 water,  and vomited up bile along with it. He passed
 an uneasy night, with great pain at his stomach and
   (a) The same remedies have lessened the eruption where
 they have not annihilated the smallpox.  It was from observing
 these effects  of those remedies that  Dr. Boerhaave and Dr.
 Hillary supposed a specific existed  which would destroy the
 virus of that disease in the same manner that mercury is sup-
 posed to destroy the virus of the venereal disease. For awhile
 the same medicine was supposed to act in that way in preparing
 the body for the smallpox by inoculation, but  from similar ad-
 vantages having attended the use of purges and other evacua-
tions, it appears that the mercury acts upon the body in a man-
 ner equally mechanical. 
182         OF THE SMALLPOX.
in the small of his back,  and on Thursday morning
took a mild purgative, which operated several times
upwards, and procured six or seven stools. On Fri-
day morning the smallpox began to appear in his
face; his stomach was somewhat relieved, but the
pain in his back continued as bad as ever; his mouth
and throat were very sore; and I was informed that
he had been delirious all night.  Twelve ounces of
blood were drawn, which was red and florid, like all
the rest which had been  taken. In the afternoon the
pain of his back being severe, the part was cupped
and  scarified,  and a clyster was injected,  which
brought away mucji hard stinking excrement. Not-
withstanding this he  got no relief;  the  raving, vo-
miting, and restlessness increased, the pustules never
filled, his mouth was ulcerated, and his breath be-
came offensive to the smell. On Sunday  morning he
lay quite stupified and senseless; black spots ap-
peared in  the  middle of the pustules;  and  he ex-
pired that day about  noon. Upon opening the body
nothing extraordinary was found, except a monstrous
large gall bladder full of thick, green bile, and slight
signs of inflammation in the villous coat of the sto-
mach, the small guts, and pia mater, (b)
   A young lad of fifteen or sixteen years felt some
difficulty  of breathing,  and a pain  in his back  on
Tuesday noon, June  24. He concealed his illness to
Thursday, when he complained much of heat, thirst,
and headach, sickness at his stomach,  and a painful
oppression on both  sides of  the thorax.  Eleven
ounces of blood were taken on Thursday morning,
  (b) It would seem from the morbid state of the gall bladder
and stomach, which occurred in the above case,  that even  the
smallpox in Minorca partook of the bilious endemic  of  the
island. 
               OF THE SMALLPOX.          183
 eight ounces that afternoon, and ten next morning;
 clysters and diluent drinks  were used, &c. None of
 his  blood appeared sizy; and  before the last ten
 ounces were taken, something like the smallpox were
 seen on his face.  But the eruption never  advanced;
 and on Saturday morning purples came out all over
 him. He then began to use the bark every two hours,
 and took in all about six or seven drachms.  In the
 mean time he was very delirious, vomited often, and
 breathed with great difficulty. On Monday morning
 he was  seized with a hemorrhage from  the  nose,
 which continued till seven  at night, when he  died
 with black spots all over him.
   Soon after this a  robust middle-aged man fell sick,
 and was treated in the same way; on the second and
 third days of the disease he lost forty-nine ounces of
 blood;  on the third day the eruption  began to ap-
 pear; on the fourth he bled some spoonfuls from the
 nose; and purple spots broke out all over him.  The
 smallpox never rose; he  raved incessantly, though
 he was afterwards  twice  blooded, and had blisters
 applied. He died on the eleventh day. (c)
   These  unfortunate cases made me  lay aside large
 evacuations for the  future, and  content  myself with
 endeavouring to alleviate  the symptoms in the com-
  (c) The editor suspects the author was restrained from bleed-
ing as mudi as these two cases required, by the presence of
petechiae, and  by the blood not putting on a sizy appearance.
 Hundreds have perished from the petechiae being supposed to
mark a putrid,  instead of a highly inflammatory disease, and
thousands have perished from an ignorance that there are seve-
ral states of fever which indicate a higher and more dangerous
grade of disease than sizy blood, and in which the lancet has
been laid aside. That more bleeding was indicated in the tw«
last instances is evident from the hemorrhages from the  nose,
which took place in each of them. 
184          OF THE SMALLPOX.
mon way, by moderate bleeding, blistering, anodynes,
bark, and cordials, according as they were indicated.
But in spite of all my attempts to cure them, more
perished than  recovered. Nor could I find that any
other practitioner had better success, until time had
corrected the malignity of the disease.  In short, this
epidemical smallpox sufficiently verified the  English
proverb, "  That there is one sort in which the nurse
cannot  kill, and another which the  physician can
never  cure."  And since it is a matter  of  mere
chance, whether the best or the worst  kind is got in
the natural way, it is evident what great honour is
due to the  memory of those gentlemen who first in-
troduced the practice of inoculation into this king-
dom, where the safety and security of it has  been
confirmed by the experience of thirty years.
   This is all that  I have to offer to the  public with
regard  to some of the  most destructive distempers
incident to mankind, whose nature and effects my
situation afforded many opportunities of observing. I
have related the failure  as well  as  the success of my
endeavours to cure them, with  that fidelity required
in affairs which  so nearly concern the lives  of our
fellow creatures; and if these pages should be found
serviceable to  others,  by pointing out what will prove
hurtful or beneficial in similar cases, I  shall not only
think the pains which they cost me well bestowed,
but esteem it  a singular happiness that fortune put
it in my power to contribute so far to the welfare of
society.
    Hoc opus, hoc studium, parvi properemus et ampli,
    Si patriae volumus, si nobis vivere can.        Hon
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