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UNITED STATES  OF AMERICA

FOUNDED  1836
WASHINGTON,  D. C.
SPO   16—67244-1
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                 THE


   AMERICAN

      MEDICAL  GUIDE

               FOR


 THE  USM OF FAMILIES,

        IN TWO PARTS,

Part ist. a  MATERIA  MEDICA. Being
   A  TREATIES ON ALL THE MOST USEFULL^ v
      ARTICLES used as  medicine,
      ••antmniNG THOSE which        .•L,rr?&
          ARE THE PRODUCE OF
           OUR* OWN COUN-   \ .
             "'.■*  TRY.     .  ••*•  '
                       ■)*vf  \> -v  •
  Part, ad THERAPEUTICS, od, the art
     or CURING THE VARIOUS DISEASES
        of the HUMAN BODY.

        TO WHICH IS ADDED

  A short description of the constituent parts of

      THE  HUMAN  BODY,
BY THOMAS W- RUBLE. M. P«
        RICHMOND, (KY.)

PRINTED BY E. HARRIS, FOR THE
            AUTHOR.
1810 
      United  States of Americk,  v

4         District of Kentucky,   Set,      >;
 %>              -            ',              , £     #
 _OE it ' remembered,  that on <the 24th* day ?~     £.
 December, in the-year  of our Lord 18.10. and in
.the 35th. year,of the independance of the United
 States of Amerka, ..Thomas W. "Ruble  of*the  said
 District,'hath  deputed in this office the  title of j.
 book,  the right wherofjie  claims  as  author in  the.
 words and figures follow%gjft6, wit)    .        , • '■   '
 '  THE  AMERICAN  MEDICAL   GUIDE,  '
 FOR THE USE OF  FAMILIES, in two parts,
   Part 1st. A MA TERIA MEDICA, being a trea-
 ties ojri all- the  most  usefull  articles used  as medi-
   ne^nneeding those .which are. tn*e*,p!j^duce of our
 own country.                        lv        * «,.
   Part .■$£THERAPEUTICS, or, the1 arll of  cur- ■']
 in.g the various diseases of the human ^od^^.|\rhich
.bemadded, a shdrt description of rHe ronstitueSt"parts
 of the Human Body.  By THOMAS W.  RUBLE* .,
 M.TD.-—-In. conformity  to  the act of congress tif i&j-\J
 United Stales, Entitled "an act for* the'enc.01i.rage- .".'
 ment of'Ifcirnifig  by* securing the copies  fff*iifatps$ .
 Charts, and Books, to the authors and proprietors of
 such copies during the term therein mentione^'^'and '
 also to. "an  act  intitled  an  act, suplememanl/ to
 an act entitled an  act, for the encouragement oflear- <
 ning by  securing  the' copies  of maps, charts,  and
 books, to the  authors  and proprietors of such copies
 during the  time  therein mentioned, and  extending
 the benefits therof to Ae arts of designing, engrav-
 ing, and etching, historical & other print|.
                                           *

                  John Hf IIa?inah,  clk:\

                   District  of Kentucky. 4
r *
   V 
          APOLOGY.


   V-/ PON  presenting the public with'a new trea-
ties on medicine it may be necessary to make some
ipology:—The great number of. mepical  books with
which every book store abound, might be  thought
sufficient ;  while the profession of originality  will
not be sufficient to ren'der it acceptable with a dis-
cerning public ;  it will be thpught  at least,  that the
•ubject must be pretty well exhausted, both of mat-
ter and variety of foint;  but, on the contrary, it will
be acknowledged, by every candid physician  at least,
that,  the multiplication of facts, by an attentive ob-
server, cannot but be acceptable to the faculty them-
selves :  bu£l would not be thought to intend an in-
sult upon the  gentlemen of the  profession  by an in-
sinuation^  that, the  present work, in the  humble,
'didactic  style in  which it is couched, will be  in
any wise an acce^tabje morsel  to thejr more refined
palates ; it was never intended for*tljem, but for an-
other description of readers,  among;  whom , by  a
practice of many  years, I know that a great deal of
ignorance, and even supersticious error still prevail,.
and with whom-. I know it will meet with a  more fa-
vourable reception, however correct,  or  competent
those extant may be considered b^" some.  v
  Every author, and editor, in  presenting the public
with a new work, or a new edition of an old  work, is
certainly governe/l in a measure by one pommon mo-
tive, viz. proffit; but* I trust that it was not the prim-
ary object wtth me : I first conceived the idea from
the following circumstance j In practice, I have dis-
covered, that, the  want of an acquaintance with the
different drugs of the ^shops, and even many which
arethe produce of our own country, with the pi opper
method of admidistration, antl  management,  was the
.greatest difficulty that private practioners meeWw'.th,
and in most families in which I h:.ve admincsu-red
medicine, I have found  more trouble in prescribing
the mode of exhibiting ard managing ihe  various ar-
ticles, and  reconciling them.to them, than ^ little,. 
Civ]
 but after a few times attendance, I have generally
 reconciled the Jamily to the use of some of the most
 powerfull drugs*of the shops, at the very name of
 wnxh they would at first shuder ;  for in the  course
 of my practice, I  have ever  endeavoured  to  justify
 my prescriptions,  rather than conceal them, and from
 this mode of condcut, many families now deal out o-
 pium, mercury, tartar, &c. with a liberal hand, that
 once would have turned pale  at the very name.  I have
 therefore in my treaties o*n the materia medica,  en-
 deavoured to render the mode of administering tne-
 dicine, and the management as familiar as possible.
 In this, I think I may chalenge the world for  to pro-
 duce a work now extant as full as it ought to be,  and
 I know  that I once should have considered,  such  a
 work of inestimable value, f *
    As to the curative part,  I trust, I shall be excused
 for offering to the public at the same time, with  the,'
 formec, the best mode of practice which my  experi-
 ence would enable me, in a form and language which
 I intended, at least, should come down to the  capaci-
 ty of every man, whose education and understanding
; should enable him to derive any benefit from the  use
 of letters—And as to my  mode of  practice,  I shall
 only observe, that.it is one which  I have culed from
 the writings of authors, both ancient and modern, and
 more particularly my own experience  and observa-i
  tion.
    It might be thought unpardonable in an author,  to
  detract from the merit of other authors altho  it might
  be with a view to obviate the charge  of arrogance,
... but I cannot avoid a rem ark or two, upon  that head,
  merely to shew why I do not consider the authorities
  extant, competent in point of merit.—It will be re-
  membered that all those authors are foreigners,  or
  received their education, and  whose  practice  have
   been in large maritime cities, where diseases materi-
   ally differ from those of the interior parts of a  large
   continent, atid where drugist shops, are as plenty as,
   prist mills are in many parts of this country ; most of
    he people, into whose hands this little work will fall, 
,*.
                       [v]

are the inhabitants, of a yet desart courftry in com-
parison to those ; many of whom must  ride  fifty or
an hundred miles, befoie they can find,  either a drug-
ist shop, or a regular physician—From what has been
said, 1 hope at least, to be pardoned for intruding so
far upon the public, as to solicit the perusal of  the
following.work, and then they ."will decide according
to its merit.
                             THE AUTHOR,
   December ad, 1810.
m
4 '. 
PREFACE-
 XT has been several years  since I first had  a wort
 upon the following plan in contemplation, the embar-
 rasments in which, the project was involved frequent-
 ly, induced me to abandon the idea.—The importance
 of becoming an author,  the  difficulty  with which a
 work Would be accomplished  by one,, who had  not
 been in the habit of writing<for the press,  the multi-
 plicity of other engagements, hut above all  an.incom-
 petency  to t form  a  system of rules of practice to
 please even myself;—but, another  reflection  would
 still arise, that I w'as, or at least thought I was able
 at present to furnish' a work,  that  would  be  highly .
 useful to my countrymen^ and  to  delay it  until  I
 should be able to furnish a. work free from  imperfec-
 tion, might in fact amount to a denial of the work, un-
 der any shape.—I at length* embarked in the  woik,
 and now  present it to  the, public,  in  a much more
 imperfect state,  than  I intended, the whole has gone
 immediately from under my handtothe compositor's-
 case, who ha* often stood by and wailed for a  sheet,
 while I was in the mean time engaged in other busi-
 ness, and seldom ever had time to write a  sheet at a
 time, but from reviewing the work I can assure  the
 public, that it contains  my sentiments  in geneial,
 much more .correct than could be expected  from  the
 hasty manner in which, it has been penned ;  and in
 the mean time, I have the consolation  to hope that I
 may at some future period be  able, to  present  the
 public with another edition, as the present' impres-
 sion is but small, provided it should meet with as fa-
 vourable  a reception  as my  vanity prompts  me to
 hope for.— In the former part, I mentioned in  part,
 my object in the form of that part, which  treats on
 the various articles of medicine.—I have now to  ob-
serve, that my list is much shorter than  that-of any
 other extant;  but it  contains  all  the  most  useful, '
 both of the shops, and the produce of our own  coun-
 try, and such, as I have in the course of my  practice,
 considered as essentially necessary ;—as to my  ar- 
     rangem^nt, both of drugs and diseases,  I must  ac-
     kntfwteJgc, that it is unsatisfactory, but  it being a
     r>oint of little importance in a treatise intended, only
     for private practice,  I hope  to  be  excused,  and. in
     truth,. I am unable to hold nosoWy, as so very essen-
     tial to practice.—I h-xvi added a short sketch, of ana-
     tomy or a short description of the  constituent' parts
     of the human body, as it appears  to me,  impossible
     to understand medical language, or the diseases upon
     wMch it treats, without seme knowledge of the parts
.  *  coicerned,b«t in this, Lhave not thought itnecessa-
"'*   fy, to treat of th? more minute parts, but merely to
'  V  'give some idea'of the principal parts, essential to the
     'iue organization of  an animal body.
       There is an  omission, which, it may not be impro-
     per to sunpl/Tn thta- place.-^-THe title co son^e of the
     .classes  of medicine are not familiar as I  could wish,
     a purgative, and jan "emetic will be easily  understood;
     by every one, but an astrigent, tonic,  or stimulant,
     are not so familiar ; astringents are such medicinal
     substances as taste rough in. the mouth as alum, some
     barks, &c.—such substances, when applied to animal
  j  matter, in a dead state, condenses, and  renders  the
     parts more solid and less  liable to putrifaetion, as in
     the tanning of leather, and we  suppose  their  effect
     upon living animal matter,  to  be  in a measure  the
     game, and by that means strengthens the solid,  and
     gives tone to the softer parts,  bkters  are  supposed
     to hive the same effect, and are called tonics, but  it
     appears to me  that it ivould have  been,  as well to
     have included all jrffdicrne of a  similar effect  under
      the same head.             ._' .           #
        I have placed stimulants as the common title of all
      the rest, for I could not see any advantage in  distin-
      guislnng them'according to the  difi^xrent  modes in
      which tVey excite acjjon, or the  different^parts upon
     which  theV act, as by producing sweat  urine, saliva,
I    [ &c. to conclude' upon.this head, in a work intended
     ' for private practice, itis  unnecessary, or at least of
      little consequence.
        I for some tjmc had it  in view to subjoin a glossa- 
 ry, but upon reviewing the work, I considered it tin-
 necessary, for altho many technical termd,  have un-
 avoidably occured, 1 havs generally subjoined an ex-
 planation, and altho this may not be found always to
 be the case, it will be found only in the small scraps of
 metaphysical reasoning, which is unimportant to the
 plain reader.
   In the course of the work, I have frequently  em-
 ployed the word  quack,  and akho a  very common
 one,* it is not so very well understood, and is  some
vtimes usedjt© the injury of thev public.   A quack is
 a person who makes a bablingprofession of any art or
 science  witheut duly qualifying himself for the'dis-
 charge of the duties of such profession,  and of all im-
 postors,  those in medicine are the most criminal;—
 A taylor may spoil his customers "cloth, a blacksmith
 may burn his employers iron, in both  cases the  darn* .
 ages are trival and easily assertained, and  they can-
 not do much damage  before  they will be detected —
 But, in a man making a profession of -physic or.sur-*
 gery, an imposition is a crime of the deepest dye, the
 life of those who may employ him depends upon his
 skill, if his mode of treatment should be inert,  altho,
 not directly injurious, yet he deceives his patient and
 prevents the calling in the aid.of a better, and it 13
 truely a pitcy, but that some criteria  could he devis-
 ed'by which the public might be able  to decide with.
 more safety and  propriety upon the  pretentions of
 persons  making a.profession of so important a calling.
 But on the other jiand, so farfrom being criminal, it
 ij truely laudable, in  those whose circumstances will
 •d Jmit of it,  to keep by them  anJ assortment'ef medi-
 cine, and in (he mean time,  it is their duty,  to  be-    $
 stow as many of *heir leisure hours as possible jupon    $
 the studdy of meJicrne ; by this course  a man jnay iri
 a short time come to derive infinite advantage to him
 £
  snu.l n.uc vumc uu uenve innaite advantage 10 mm*   .
  If anl fanily, and without injuring hiy&elf. be of\ »|
  cat service to his more ioligent neighbours, this is  i  \
  ore  especialy  applicable to the thinly  Inhabited  '
 parts of the United States where regulaM^ysiciaiu^-jfj
.wf me:it arc sorcdy to be found.             -  -"*„/** j 
OF PURGATIVES
                     JALAP.

  This is one of the stronger purgatives, and is en-
tirely  safe—the dose  for an  adult is about  half a
drachm—nothing more is necessary  than to wet it
with water or spirits to render icfit to swallow. It is
best not to eat any thing for an hour or two after tak
ing it,or until  it begins to work ; and after its ope-
ration is  over, warm soup, or the like, is best for the
first meal.   It has become a very common practice
to join Caloml with it; 25 grains of Jalap and 8 or
10  of Calomel, is  a common  dose  for  an adult.
From the adhesive property  of the Calomel, it is pro-
bable  that it is not carried off during the operation
of the Jalap ; and therefore it might be prudent not
to take any large quantity of any thing cold into the
Stomach  for 24 hours after taking it.
  This purgative, especially with  calomel, has be-
come  very  much into use in fevers of almost every
description, but  sometimes very improperly ; it,how
ever  answers tolerably well in pure  bilous or  inter-
mittent or  remittent  fevers ; in which it should all-
ways  given  on the  day  before  the barks.
   It  is  the best purgative  in  the cure of the vene-
real disease,  old ulcers &c. in these casts  a dose
ought to be given every ninth  day for three or four
times, and once a  fortnight  afterwards untill the
cure  is finished:  such a course  is also proper in the
cure  of  tetterous eruptions, tinea  cappitis  (scald-
head)  and other-obstinate cutaneous diseases, such
Aseases  are  very apt to make their appearance at
times  for some time after they have been cured.
                     A 
PURGATIVES.
or some other mnre  formidable disease some times
attack the  patient, as a fever, rheumatism or the
like;  in such  cases  a dose or two of Jalap will be
the best  remedy, this is especially the case in sore
legs of a long stanidng.
             GLAUBER'S  SALT.

  This is a mild and pretty  brisk  purge ; but as a
purge, it does little more than emptying the bowels
From one to two ounces is generally  necessary.——
There can  scarcely a case happen in which  there  is
any danger to be apprehended in the  use of the salts.
The cases in which they are especially proper,  are in
all fluxes of the belly.   In diseaes  of this, kind, it  is
best to give the salts in small  doses; I usually divide
a common dose, as an ounce or table spoonfull, into
six  or eight parts, and give'them at intervals^of from
half an hour to an hour apart,  until the stools become
watery, but that quantity is not always necessary.

  These diseases depend upon a tendency to putrefac-
tion  in  the mucus  lining of the  bowels;  by its
antiseptic powers, it checks that disposition ; and as a
purgative,  it caries off  whatever may be- offensive,
or from its taint may keep up the disease.  The first
process toward putrefaction in animal matter, is the
evolution or formation of infinite numbers of animal-
cnlae and such is found to be the state of the stools of
Dysenteric patients.—I generally give  the salts in
the morning and, opiates  at night___asttringents,
are improper in the  first stages of this disease, and
untill the salts have been  used for  some time.

  In  cholera infantum or a purging and vomiting of
children, the same course is proper. Salts is alwaya
improper when  used :o obviate costiveness as it ne-
ver- fails to increase the evil. 
PURGATIVES.
3
              jCASTQR OIL.

  This is a very mild and safe  yet, brisk purge ;  the
dose for an aduit is various, from i  to z ounces, half
an ounce,  or a common  table spoonfull  is a  small
dose—there is no danger in  an over dose, as in this
case the oil will pass through  the bowels unaltered.
Its principle use is in cholic  with  costiveness,  and
in other  inactive  states of the bowels.  It has  a
very peculiar property which renders it highly pro-
per in these cases, which is,by  frequent use the dose
tnay be leessned.

   The seeds (palmacrystaOwill answer  every pur-
pose of the  ail—from 4  to .10 seeds  is  generally
necessary.   Their operation is more rough than the
pure  oil.                   ~*
            CREAM OF   TARTAR.

  This  is  a mild laxative,  and is most commonly
used to prevent costiveness  where a person is confi-
ned to bed by disease, half an ounce or more  is  ne-
cessary as a purge—for keeping the  bowels regular,
a common  tea-spoonfull twice or three times a day,
or oftener, is necessary.
  It is one of  the best medicines  for  carrying  off
the water in dropsy, especially that  species  called
Anasarca,  which is when the  water is collected in
the cellular membrane, or in the flesh, as  it is ^said
among the vulgar, which begins by a swelling of the
legs.  For this purpose  it is  best to purge once every
4 or 5 days pretty briskly with it,  and give  two or
three tea-spoonfulls every d-.y  in the interval—For
Strengthening  the system,  iron, barks, &c.   In us-
ing all saline purgatives, it is the best to give plenty
of cool water.   The Cream  of Tartar is very hard to
 dissolve,  but may be takeiwnto the mouth and was-
hed down with water.
            / 
4
CALOMFX:
                  CALOMEL.

  This mercurial is a purgative, and one oFthe moss
valuable ; it is slow, but is thought to carry offbile
better than most other purgatives  ; but I am not cer-
tain that this opinion is well  loundtd.l have given
Jalap both with and  without it in  bilious  diseases,
but never was able to perceive the difference, except
given in such  a  maner  as to affect  the glandular
system.

  In some cholics, and  frequently in fevers, a vio«
lent vomiting attends, owing to an inverted motion
ofthe stonach and bowels,   it frequently  happen*
that no other purgative will stay on  the stomach-
in this case calomel is the only thing to be depended
upon ; for it can be thrown into the stomach by mix-
angit  wiih a little sugar, honey, or molasses.   It is
extremely hard to be reject by vomiting, and by ex-
citing  the stomach and  intestines  into their natural
aclion, removes the complaint. It is also proper as ft
laxative, or  rather purgative, in slow or nervous fe-
ers, attended with torper.  As  a vermifuge, or medi-
cine for destroying worms in children, it is excellent
but in cases not attended with fever, it is  better to
mix it with some preparation of iron  ; as the filings
or rust, &c.   If the dose be sufficiently large, it will
purge  pretty  well in 8 or 10 hours.   A dose should
be given about three or four nights, one after another
without intercession—it is best  to give it at night,
and give a gentle purge in  the mornii g after  every
other dose to prevent it from affedling the mouth and
gums—for this purpose castor oil is one of the  best,
but jalap will answer the  purpose very well.

   It will require from 8 to io, or 12, grains of cal-
omel as  a purge for an adult.  For a child two years
old, one third as much as an adult, and more or less
according'to the age and strength  of the child. 
PURGATIVES,
*
              MAT APPLE ROOT.

  This is in use  as a purgative  by many quacks and
empylies ; but it is only a safe and  useful purgative
in the hands of a skillful person.  There is but  on«
season of the year ptoper for digging it, which  is in
the fall after  the top is dead ; in the spring it is too
corrosive  and nauseating, and  proves an emetic in-
stead of a purgative.   It should be  dried in a shede
when well dried, ground fine and kept in a close ves-
sel.   The dose in powder  is 20 grains, or 15 grains
of the powder and8 grains  of calomel, or a tea spoon
fuh of cream of  tartar.  It  is said  to answer every
intention of jalap.
                  RIIEUB/fRB.

   Thisis a gentle purgative, and  requires a  large
dose to operate briskly as such ; from 30 to 40 grains
is generally neqessary.  1 have seldom  employed it
of late  years as a purgative, but some times as a
strengthening laxative, m cases of female weakness.
Its u»e in Dysenteiy I entirt.lv  discard, as  being
founded upon erroneous principles-
               WHITE WALNUT.

  An extract made of the inner bark or root is a tol-
erable purgative.   It ought to be made  by  boiling
in harass, or rather an earthen vessel, and  boiled
down in  a very gentle  heat—From  10 to 20 or 30
grains is generally necessary.   It answers in a mea-
sure the same intentions as jalap. 
$     .         PURGATIVES.
                     ALOES.

   There  is three  sorts of this drug; but those call-
ed Hepatic and Socotorine, only is used in medicine
for man, the other is given as a purge to horses.
   Aloes is a slow purge, and never  produce watery
stools ; but from  5 to  10 or  15 grains, empty  the
bowels ; but it acts  chiefly on the rectum or lower
end  of the intestinal  canal.

   It is  a  useful purgative  joined  with calomel, 3 ■
grains of the  former, and 5 or 6 of the latter, in
obstructed menstruation, in women of weak watery
habits—it ought  to be given about 24 hours before
the usual time of menstruation, or if that be unknown.,
two  or three days  before the full of the  moon ;  anon
smaller doses, as  two grains  of each twice a week?
during the  interval. It may be made  into pills of i
grain of calomel and two grains of aloes ; and used?
instead of Anderson's pills.                      \

   Aloes is highly improper in hot bilous habits, or
persons with black hair, black eyes, lean visage, and
all persons, inclined  to  piles, as the large use of
them will  induce a disposition to that disease in  al-
most every person  ; but in fat or corpulent persons,
especially  women  of costive  habits, and  freefrom
Haemorhoidal   complaints,  especially  where there
is a  swelling  of the  legs, &c.  it  is a very useful
laxative. 
EMETICS.
              TARTAR EMETIC.


  This 13 the only drug which I have employed for
some years as an  emetic, having fr>m  many years
experience found it so certain and safe, andto answ-
er every intention or purpose to be expected from
medicines of that class, that I have entirely neglected
almost all  others.   The  celebrated ipecacuanha I
have  entirelv neglected.   My  method  of practice
with it I believe differs considerably from that of a-
ny  other  physician of my acquaintance,  and from
that  circumstance, I shall  be more particular  in
treating upon it.
  As an emetic,  or puke, my method of managing
it is this : I put from 3 to 5  grains of tartar into 10,
12, or 15  spoonfulls of cold  water,  and give 3  or 4.
at first, and  after waiting half an hour, g^ve one  or
two more, and repeat it every fifteen or twenty »ain-
Utes for twice or three times, by which time  at least
a motion is  to be expected ; but if it  should not come
on, I give half a  pint, or a  modertate   draught,  of
water about blood warm, which, if the  patient be
kept pretty warm, will seldom fail to bring on a mo-
tion ; and in all cases I encrease its operation by giv-
ing warm  water,  and moderate it by cocl.  If its
operation comes on in an hour or an hour and a half,
it is soon enough, and it is not necessary to give wat-
er either cold or warm, but with an  intention of in-
creasing or diminishing its  action. 
a
EMETICS.
   Much is said about the danger of taking any thing
 cold into the stomach  for a long time after taking
 tartar,  but  from  either observation or theory  I am
 unable  to  say  wherein the  danger  consists.—It
 is however possible, or even probable, that  to take a
 larg- quantity  of  any thing cold into  the  stom.
 ach  suddenly when it is warm and charged with it,
 might  be dangerous by bringing  on a cramp, and
 many instances are reported to have been within the
 knowledge of evev reporter ; but I  well know from
 many years experience  that two or three spoon-fulls
 of cool water may be taken at any time with safety
 an!  often with advantage, and  in  all cases, cool
water taken in  mall quantities at two or th ee min-
utes  interval is one of  the best  methods of mode-
rating if operation, and is more agreeable than salt
soups and especialy in fevers.

  The only case  in which I have ever experienced
any difficulty in the management  of tartar, was  in
 nervous  women,  in  whom it is  very apt to in-
duce pains and spasms,  in  which  case, warm teas
 aromatics &c. will give  relief.

  Full vomiting is always to be prefered to purging
 in fevers of evey kind, and  in croup  or hives  in
 chileren.

  It would be very difficult if not impossible to point
 out aU the diseases and  the different stages of dis-
 ease  in  which vomiting in  a  greater, or less degree
 U proper---it is certainly proper in  the first stages
 of all fevers, and  it is frequentlyneces.«ary to repeat
 it at intervals for several  davs—Hea<l  achs is fre-
 quency caused by a feverish state  of the body and
 an inactive state  of the stomach;  nothing  removes
 this  more certain than a g~>od dose  of  tartar.
   After an intermittent or remittent  fever has been
 imnerf-ctlv cured, a hot  liver  and  hard spleen  fre.
 q entlv remains ;  a full vomit repeated once  or twice
 is the best remedy. 
EMETICS-,
    In croup,  it is an almost infalliable remedy when
  assisted  with bleeding  and warm bathing &c.
    Full vomiting (from the violent  exertion which
  it occasions) is  frequently improper in pleurisies &
  other inflamations  of the breast: but even  in these
  diseases  it  is  of  the  utmost service  given  in
  •mall doses, as from a quarter to half a grain  every
  15 or zo minutes, either dissolved  in  water,  or in
  pills.  As a febrifuge, or cooling medicine in fevers,
  there is perhaps  nothing equal to it ; it has (with me)
  almost superseded  the  use  of nitre and the other
  neutral salts as a cooling  medicine   given as above.
  It is  likewise  of service  in  Influenza, or  common
  colds and coughs.   In these cases, and  especially in
  fevers, where sweating is necessary, lo or 15  drops
  •f liquid  laudanum with  every dose is proper.  It is
 one of the most useful medicines in Obstinate chronic
 colics—^in cases  of this kind, after a full puke, give a
 third or half a grain in a pill,  twice or 3 times a  day,
 with two or three grains of some preparation of iron,
 aa the rust or filings, a^.d a little flour to give it a con-
 sistence ; after using it a few  days, the dose may be
 increased from time to time ;  and after the  disease
 has abated, it may be omitted a week at a  time, and
 then repeated again a few days.

   Before we  quit this subject it may not be impro*
 per to  observe  that  Antimony, upon  which  the
 medical powers of the tartar intirely depends, has ge-
 nerally been treated by  medical writers under that
 title,  and a vdst  number of preparations  have been
 prepared by  the  chemists and kept in the shops un-
 der different  names, arid were  more or less active
 according as the mVtaline part was in a condition to
 become active in the stomach.
   The crude antimony of the  shops, being combined
with sulphur,  is not \,\ a state to be  acted  upon and
therfore unfit to be employed  as a medicine.
   What I have now to observe is, that after giving
many of them  a fair trial during a considerable prac-
                        B 
" u
jo                EMETICS.

rice, I do not consider any  of them  equal  to  the
tartarized antimony,,or emetic tartar, and from the
success which I have had  with it in such a number
of diseases I have been  ready to conclude it to be
one of the most universal remedies with which we
are acquainted.
  Since I have been in Kentucky I have found it of
great service in seme scorbutic complaints which are
very common in this country  especially among chil-
dren, some times under the form  of an itch which is
most common in winter and spring ; I have also  met
with another kind in which red spots appear  over e-
very part of the body, at first  resembling measles but
soon blisters and become ulcerous ; these cases were
cured by giving it in srhall doses two or three times
a day sufficient to induce some  sickness and even
vomiting at times—I have also given it in the vene-
real disease during the mercurial  course with evident
advantage ; 1 first  began with the sulphur precipita-
turn but geneily employ the tartar-
               IPECACUANHA,

  This drug I have entirely neglected for some years,
as I could see no advantages which it possesses over
Tartar.             »
   I he common Indian physic, or Bowman's root, may
make a very good substitute—the method of  using
which, is this :  make a strong decoction  by boiling:
the root in  water—take half a gill at  a time, fifteen or
twenty minutes apart, until it  begins to work, aftet
which nothing more  is necessary.   Ifgiven in pow*-
der, 20 or 30 grains of the bark  of  the  foot,  dried!
and powdered, is necessary ; audit is also necessary
to drink warm water to hasten its operation.   It \t
proper to observe that after a  drastic purge or puke,;
it is proper to take some good soup,  seasoned to the
taste,, fdr the fi-i st meal. 
TONJCS.
               PERUVIAN BARK.

   There are three kinds of this bark imported  from
 South America—the red, the yellow,  and the pale*
 1 am of opinion, that there is a  greater difference in
 the color than in their powers as a  medicine.    The
 led is said to be the best, but the yellow  is most in
 Use.'  The first disease in which it is of use is fevers,
 of several kinds.  It is  a sovereign  remedy in inter-
 mittent fevers, (agues) if rightly managed ; two ounces
 IS generally sufficient to cure an  ague;  but  if  not
 rightly managed, a pound may be given without  any
  advantage  ; and it may be always observed as a rule
 that' if it fails curing or preventing the return of tne
 fever on the first or second trial, it is needless-to re-
 peat'it.
    The method of curing an ague, is as follows :  The
 harks must be given on the day that the ague is ex-
  pected; on  the day preceding, it is proper to give a
  dose of tartar or jalap : begin to give the barks about
  two hours before the time that the ague is expected,
  to a grown person, give half a drachm, or a »large tea
  spoon full every 15 or 20 minutes, until the  time the
  ague was expected is fully past an hour or two ;  wet
  the bark  with cold water, and add  10 or 15 drops of
  laudanum to every other  dose, observing  to  keep
  warm enough to keep  up a little moisture upon the
  forehead—exercise is of great advantage, where the
  patient is  able to bear it,  otherwise it is necessary
  to  keep waiafi  by the fire or  otherwise, and if the
  forehead   become obstinately dry  at any  time, the
'i  |>ark  may be discontinued  as  it wilt aaswtrno
 ■  -good purpose  at that  time, Lut if a moisture, cen I.e 
 ia                 TONICS.
 sue
 kept up until the time of the expected fit of the a-
 gue is past an hour or two tl.e intervals between the
 doses may be longer,  and if ti e return of the  fever
 be intirely  prevented, it wil> be netessary to take a-
 bout three doses on the succeed ng day,  morning ^
 noon and night,  and two on the sco ncl and one on
 the  th^d :  it.is  course  will be sufficient to secure
 a pericn ag-  nst a relapse for ihrc§,or four weeks e-
 ven in tho*c unactusu med tosituatwnfc exposed  to
 the  nrat-er  which produce  those ft vers.
   To what has been said u may not be improper tQ
 repeat, first,  that the patient be in a proper state to
 take the baik when he  begin, which is  known by
 his bring easily put into  a sweat, or-at least a mois-
 ture raised upon his forehead by exercise or warmth.
 2d. that the ba;k be'taktn in due time, that is, an*
 hour or  two before the expected ague or  fever, 3d
 that it be taken in sufficient quantity, and that it be
 assisted with laudanum which also prevents it frcm,
 griping 01 runing off.by stool.  4thly that it be taken
 in smaller quantities a few days longer to strengthen
 the system ar.d prevent a retoose.
 The next case in which the bark is considered a re-
 medy is a remittent fever, or what  is vulgarly called
 a dumb agiie.~It is ali\yays best to turn such fevers
 into  pure intermittent if possible by puking, purging,
 bleeding &c. btfee the baik is employed,  hut if af-
 ter the use of these a plentiful sweat" sbou'd not be
 obtained, if any moisture  can be brought on it will be
 proper to try the bark during the time, or as  long as
 any moisture can be kept up, but if the forehead be-
 come obstinately dry, the barks may be'discontinued
 as in that rase they will do more harm  than g< od; it
 is to be <bseived th t  wine or good cyder is all ways
proper when the baik is.
  Th? ba/k is generaly  given in nervous or flow
 fevers, but in  these its use is more difficult .* in these
 ftv-r* opium and blisters are the  proper remedies •
 hut the barl^  in  doses of half a drachm three or four
 times in the day with wine &c. will be of benefit., 
                     TONICS.                 i.j

    In putrid fevers, or in ft vers attended  with any
 symptom* pf j.u'.i rdity,  seen as purple spots ci b'is-
 ters  ab'.mt ihu kiue» ire. the bark  is of the utmost
 importante, ana  should be given  freely with  wii.e,
 g^'od cydei, vkc.
   i ho bi. k  is much  depended upon in some  cases
 of niort.fixation, b"t  n this it requires some caution,
 £or if g»e«t pain  ad fever  attet d, the  bark  will b?
 injurious: but if there is but little fever it is proper
 to g ye the ba k  freely  as  it  will  prevent the pu-
 trid matter from affecting the system, and especially
 the stomach.
   The ba k  is one of the principal  remedies in fitt-
 er albus (whitesj in women, 20 or 30 grains three or
 lour times a day with elixir vitriol and balsam copai-
 ya,  cerecloth, &c.
   The bark is a disagreeable  drug to most  people,
 and it being ntcessuiy to take it in large quantities,
 frequently prevent people from taking enough to ef-
 fect  a cure—-They are  always best g;ven in  sub-
 stance, aid are 'ess bitter wet  with cold water than
 spirits or wine, and when the stomach has been v^-
 ry weak I have found it necessary  to  conceal ihe
 tas»e  intirely, for this   purple  l  have frtqunt'iy
 made^ it  up  ir.-.o  pi•'^  by  ad.hng  seine imr  and
 making it into  paue cf a  pri oer consis e\\ce  fl" *°*-
 mi: g pills, roliirg rhem we'l in flour.  t?ke two, tl ree
 or more into the movtii and wa?.h them down  with -•
 large d. aughts  o? Wite',  or raiher buttermilk
   it is pioper  to mention that it is the  best to  give
 the burk,  in substance in most  cas^s, but in weak-
 ness  or, such diseases a3 rtqiure strengthening  me-
 dicine, the  bark  rru.y be given in  sprits and make
 a  tolerable  agreeable' b.tter ;  for this  purpose an
 ounce or  more  may be put to a  euart of spirits  and
 a few bits of orange peel added: of this a  table spoon
 full  may be taktn  two  or  three times  in  the  day
especialy  when the stomach Is most empty. 
14
TONICS.
            COLUMBO,  THE  ROQT.

  This drug has not been in use or  even known in
Europe cr  America but fifty or sixty years, a  d has
hitherto been imported from s >me of the tail- India
islands—The species  of plant  to which it belongs is
entirely  Unknown.
  We have a plaat^growing in  many parts of  Ken-
tucky the root of which possesses precisely the same
sensible properties—The root in its green state ve-
ry much resembles a parsnip but is more tender, the
stalk  is  smooth,  and of a purple  color, and grows
from six to  eight feet high,  the  leaves  are  long,
thick, and smooth, and come out of the stalk four iti
a place ; toward the  top it  puts out  a number  of
branches which are set with a pale purple flower.
  It appears that the  root may be  found in different
states of strength, the root of the young plant be-
fore it bears seed, dug in the fall after the leaves are
dead, or in the spring as soon  as the leaves begin  to
appear is in a good state, but after it puts up a stalk
and bears seed, the root is then spongy and unfit for
use until the next season when the large part decavs
and the  smaller roots remain sound but bear no topj
 these  roots are best.
   It. is a strong bitter, and when green it has a con-
 siderable degree of aromatic  with it—when  dug it
 should be cut  small  and  strung on thread and hung
 in  an  airy apartment, for if it is not  dried speedily
 it  will mould and spoil.

    As far as I Have had an opportunity of trying it
 I have found it to be in no wise different from the
 imported,  except in its strength, for  I believe it is
 seldom  as strong, which  I suppose to be  owing  to
 the difference in climate, the imported growing near
 the equinpctial.
    The  medical powers of this root is that of bittera
  in general and it is one of the most agreeable.
    Given  in a dose of half a drachm in the same
  manner as  the peruvian bark it will seldom fail to
r 
TONICS.
i$
Cure the fevers in which the bark is proper.
  It is also  esteemed useful in vomiting and othet
diseases of the stomach  proceeding from debility.
  When it was first brought into use in Holiand it
was  considered as a remedy in Dysentery, but like
Rheubarb and many other articles it has long since
ceased to  be employed in that disease, except by the
ignorant.
                ALDER BARIC.

   This shrub grows in abundance  about  branche*
and in wet grounds  in almost every part of the At-
lantic States, and in some parts of Kentucky.—Its
blossoms are a long, round body resembling some
kinds of worms, and possesses the same powers as the
bark but are weaker.
  The bark I have used as a substitute for the peru-
yian, and believe it to be  superior  to the  dogwood
or any other of our domestic barks in fevers.
  It is also of service in some cutaneous diseases, as
also, boils &c.—in old and obstinate ulcers, as those
in the legs, it will dispose them to heal kindly, which
it must do oy encreasing the strength of the system
in general—It may be given in substance, as half a
drachm or more  at a dose, or it may be taken in de-
coction, half a pint of a strong tea may he taken two'
or three times a day.
                    IRON.

 ' This is a- most valuable medicine in many diseases
Chere has formerly been a great many preparations of
this metal kept in the shops under  different titles
imnorring different medical powers, such as "crocus*
marth astringents"  and "crocus-martis apperiens'
i. e. binding, and  opening s;ifron of iron,  but such
distinctions  are no.v obsolete—I have for  seve*l 
  r<                  TONICS;
 ■»»-=«
 years kept but three or four  preparations  by rr.e—
 the Tincture  Martis, Rust, and an extract.
    The  tincture is  made  by  dissolving the  scales
 found about the smith's  anvii- block  in the spirit of
 sea-salt, and then adJing an equal weight of pure
 spirits.—This is a tolerable agreeable medicine, and
 at thr same time very effectual — The dose for an a-
 dult  is 15, or 26 drops in a gill of water three" times
 in the day.
   I have frequntly cured the ague in v?ry small chil-
 dren  with it by giving 6  or 8 drops of it in  cool wa-
 ter sweetened  wth white sugar, every fifteen or 20
 minutes  instead of the  barks, and observing the samt
 rules.
   The filings,  if fine, is  a very good preparation for
 worms in children w-ith big bellies ana  pale counte-
 nances,  for  this purpose, about f»ur or five grains
 may be given to a  child of that many years  old, giv-
 en  every morning for  several  days  ti<g ther—The
 Rust  (linbigo Ferri) ground very fine a >d given in
 doses a little larger will  answer this purpose  very
 well—how it Would answer in  agues, 1 cannot  tell,
 but suppose  th^t  its action 611 the  stomach would
 not be sufficiently  strong.
   An excellent dry preparation of iron is made thus:
 Take  any quantity 01 clean iron filings ; put to  it an
 equal  weight of cream of tartar, to wheh  add any
quantity  of cyder or even watery keep it pretty warm
 or even hot  until it becomes dry, repeat the process
two or three times, when dry it  may be  ground fine
and rhen  is not  a disagrte ible medicine t > take }  mix-
ed with sugar,  children of any 'age will take it—Or
by adding a  little  honey, or flour to it, it  may be
made  into pills; without  the adlition of some tough
substance it  wMl crumble  to pieces when dry. I have
freq"ently added the extract of rheuhub,  gentian*
or coliimb-* ro it which  not only gives rhem sue  gth
but is an addition to its medical powers : this is a ve!
rv act;ve preparation of iron, and by obse.ving  the
 rules  directed for  the harks will seldom fail to  cure
agues, and especially if of a  long standing. 
                  TONICS.         *         iy

   in doses of fifteen grains or a scruple it will gene-
rally purge pretty briskly, but in the cure of chronic
diseases, as weakness,  dropsies, cachexy,  chlorosis
orgreen sickness in girls owi i g to a retention of the
menses, or an obstruction «_f that  discharge, as also,
in Hysterical, Hypochondrical,  and a long train of
diseases depending upon debility,  it is to be given
in smaller doses  as from  five  to  ten grains twice a
day and continued f ira sufficient length of time, and
it may  be observed also, that it is  proper to begin
with, a dtlse large enough to iiuiuce  a little sickness,
and after two or three days  it will not have that ef-
fect.—To  conclude, the effect of this drug under e-
verji form is in a measure  the same,  it invigorates
the system,  increases the circulation of the blood,
and,improves the appetite.
   Copperas or Green vitriol, is a very good prepara-
tion of iron,  and  may be given in safety—the  dose
may be from 4 to 10  grains or  more, two or three
times a day.
               DOGWOOD BARK.

  The medical powers of this bark appears to me to
differ very little from the oak. but  from its  being
more bitter it would be  thought a greater  tonic  by
some.   I  have attempted the cure  of intermittent
fevers with-it and have been successful  in  some—
I have tried it twice in myself, and succeeded  in
preventing the fever, but in both cases it retufned in
five  or six days with equal violence.   From hence I
conclude  that it is in no wise- to be  depended upon
when the peruvian  bark is :c be had, notwithstand*
ing some are of a different opinion.
  It, however, is an  antiseptic,  and  I-have found it
of service in  putrid fevers,  and it may be possible
that my bad success with it  might  be owing to my
not  taking a  sufficient quantity, it being extceemly
nauseating. 
I«
TONICS.
                   OAK BARK.

    It is probable that there is but little diiTeretrce in'
  the medical  powers of the different  kinds of oak
 bark, but I  have generally made choice of two, the
 white oak, and the chesnut  oak; the latter is much
 the strongest, but the white oak is  more agreeable,
 I have cured agues with it, but think it best to join
 columbo, gentian or some other good bitter with it—
 but its most valuable properties is as a stomachic, in
 weakness of the  stomach and bowels, from which
 proceed indigestion, acidity, heart-burns, colics, dy-'
 sentery,  head-ach &c. as a preventative of these dis-
 eases, I do  not know of any  thing better : the  best
 and most agreeable maner of using it in these cases
 is to chew it and shallow  the  juice—Another  most
 valuable property it has is, that it will cure the scur-
 vy in the gums and preserve the teeth, those1 useful!
 instruments  of pleasure,  profit, and beauty,  sound to
 the greatest ag2 ; I have known c ises where  the'
 teeth had been very much damaged by  scurvy, be- '
 come sound  and clean, by washing them every  day
 with a weak  spirit of vitriol, and  then using the bark
 as  above, but to have that effect it must be continued
 for several months.—The young twigs will  answer
 ■-he same purpose and are more agreeable to chew
 by frequent  use, both chewing and  swallowing, the
 teeth will be preserved and the diseases of the stom-
 ach prevented  or cured.   It would be well for  pa-
 rents to  inculcate upon their children  the propriety
 of this practice at an early  period—by habit it  be-
 comes agreable and no inconveniency ; and they are
 much e'asier  acquired when young than old.

   Any person inclined to doubt the effect of the oak
 bark in preserving the teeth, will remember what a"
,power it  possesses in preserving animal matter from
 putrefaction, asm tannig—All  bitters and  astrin
 jmts possess the same powers in a greater or  les? 
■^
ASTRINGENTS  AS  TONICS,
                  LOG WOOD.

  This is an astringent of tolerable strength;  the
-•nly use made of it as a medicine is in fluxes and o-
ther lax  states of the  belly; but  from experience I
am not able to  place that confidence in  astringen«a
in those  diseases that most  people do ; I have  betn'
-disappointed too often to repeat after oihers, it how-
ever may be of service in some cases after the ir.fLm-
atory stage is over, especially in children—rfor chil-
dren it may be  made into a tea, wh ch they will take
very well, and there  is little danger of their taking
too much.
                     GALLS.

  This is an excrescence growing upon a kind of oak
•from the wound of an  insect  where it deposits its
egg which may  be found in it.
  They are a powerful astringent, but they are sel-
dom given  inward'y, their principal use is  in the
form of an ointment in piles and fallii g (own of tie
annus  and uterus,  but in the two last cases it is the
best in decoction.
  The/best method of making them into an ointment
is to break them small and boii them well, thm strain
the wattr through a cloth, and  add a quantity of hog?s
lard;  then  boil down  untill  the wattr is < nt,  tak-
ing care  toward the last not  to burn  it,;  minding
also to stir it well. 
 ao            ASTRINGENTS.

                    ALUM.

   This has  frequently been  used as a' medicine ia
 some diseases, pai ticuliarly Hemorhages,  or involun-
 tary discharges of biojd, especially in female com-
 plaints of that kind, but in most if not all the cases
 which I have met wuh  opium has proved the most
 effectual remedy—As to those hemorhagie said to be
 owing to an active cause, I judge cold to be the most
effectual remedy.

  It is one of the best gargles to cleanse the mouth >
 and throat in fevers, and  in inflamations of those
parts, but it is considered  better in a decoction of.
oak bark.
  It is also of great service to those who are subject
to a  bad bieath, also in sore mouth, it, in  these cases
should be  kept in the mouth an hour or two at a time
two or three tunes in the day.

  In sore eyes  it is equal, if not  preferable to white
 vitriol or  sugar of lead: for this purpose four or  five
 grains should be dissolved in an ounce  of water,  and
 the eyes wet with it twice a day.
               BLUE VITRIOL.

  This T have frequently employed in intermittent
fevers—it is to be dissolved  in  Whiskey or  other
spirits ; a grain to the  ounce,  or  10 grains to the
quart ; an adult may take from 30 to 60 drops,  or a
tea  spoon  full instead of the bark, ai.d is equally cer-
tain to cure.   1 generally employ  it when the bark
has fdil-d.   It is excellent in agues,hi children, who
will seld >m take the bark, while they will take the
blue vitriol fieelv, as it has but very little taste but
of spiiit ;  from 8  to  1 2 drops is a dose  for a child of
two } e-irs old, and in pn portion for older or younger.
In the exhibition  of medicine for the curs of an ague 
ASTRINGENTS.             af
it is difficult to assign the dose,  or the distance of
time between  the doses ;  .Ins  must depend,  in a
nreasure, upon the judgment of the physician, which
is to be understood fr< m the effects of the medicine,
and whether it be the bark, blue vitriol, tartar emet-
ic, columbo, &c. be  sed, it is always necessaiy to
give the medicine in  doses sufficient to induce  tome
sensible effect upon the  stomach,  and  to  keep  up a
moisture upon the forehead at least.

  The blue vitriol makes an excellent wash  for old
ulcers, especially for horses with  scratches, warts,
fistula, &c. for this purpose, put an ounce to a quart
of chamber lie, or an ointment may be made of it by
grinding it very  fine,  and mixing it with lard and oil
of turpentine, or turpentine itself, which  is better.
Verdigris in an ointment answers the  same purpose.
                     LEAD.

   This is seldom,  if ever, used  internally of late
years.  The sugar of lead is  the only  preparation
deserving notice, and this  is  principally used  as a
wash, or ointment, for sot e eyes, old ulcers and erup-
tions, to dry and heal them up.   It  is a  very good
application  in St. Anthony's fire,  or the rose, but
should not be applied until the patient be bled and
purged ; and then  a scruple diss  Ived in a  pint  of
water, and a linen wet with it from time to time and
applied over the part affected.  It is also used  as an
injection in  gonorhoeas,  or  gleets,  in the  ventrial

disease—about the  same  strength.
   White lead in powder  is 01 e of  the best  applica-
tions to ga'diug and excoriations in children, cr per-
sons  who from disease  are  subject to  guiding, by
lying, sitting, &c.
   To make  an ointment  of either, grind  them  fine
and mix them w^li with the common ointment. 
as             ASTRINGENTS.

                 LIME WATER.

   This is made use of inwardly-for the gravel ther*
is not a better med cine.
   Put half a pound of fresh burnt lime into a gallon
or a gallon and a half of water—keep it  well stopped.
up in a jug  or  bottle ; of this, half a pint may be ta-
Icen twice t>r three tines a day.'  There  is  so much
difference in the strength of lime, that  there is but
little certainty in any rule; the best method is to take
twice or three times a day half a pint or a pint that
tastes pretty rough or strong,  but not so  strong as'
to be  disagreeable.
   But the safest method is  to  make what may he
Called carbonated lime, thus :  Put 'any  quantity of
strong lime water into a pewter or earthen dish, and
set it in a tub  of beer in a distillery, when  the beer
is working, and after standing there a  day or two,
the lime will all fall to the  bottom in   a fine  white
flour;  pour off the water and  dry  the   powder, and
keep it for  use.   Care should be taken   that none of
the beer  work up into it, as  that would spoil the
whole. It must be set so low as to be below the mouth
of the tub, otherwise the carbon-that rises from the
beer would not get into the dish.  Of this  powder,  a
table spoon full may be taken  three or four times  a
day—it  has little or no taste,  aid  no quantity  of  it
■will be injurious, whileit is an excellent medicine in
that  disease.  " Heart burn, head-achs, colics, and
 any ether  disease that pioceeds fiom sourness  in the
stomach aid bowels,  is cured by it.  It may be giv-
 en to infants at any age, and will cure belly achs and
many other diseases to which they  are subject.
   Lime water, as directed to be made cbove, and
 used so strong as to taste piettv rough,  is  one of the
 best applications in white swellings  and old ulcers,
  and especially where tl'e  bone  is  naked 01  affected
 with rottenness—it sln.u  d be  thrown  in  wuh a svr-
  ir ge, so as to wash the bo; t< in «ut well tvi.e  a day
  artii the rottenness carts off aid the\ilcei heals.
    It is alr.iosi U.e only thing that is necessary  in the 
ASTRINGENTS,
*5[
tureofold ulcers in the legs—wash the ulcer twice
a day with the lime water,  and fill  it up wi.h  lint,
andapplv  a pLister over it, then take a strap oc' trong
linen  long enough tawrap up the greater part of the
leg; it should be about two i ,ches or not so much  in
Width ;  begin bwlow the ulcer and wrap it up, letting
the bandage lap over every time.   Sometimes it  is
necessary to wrap  the whole foot and up to the knee,
as tight as it can well be  drawn—this is  necessary
when the foot and leg is swelled ;  the bjndige will
feel aukward a few days, but by use it  will  be no
inconvenience ; it :>ug it to be continued a considera-
ble time after it is healed ; as it would be good to  con-
tinue it until all* the lived or liver color  is  pressed
back and gone, and the skm  of  its natural  color.—
To annoint the part wiih an ointment made of sugar
of lead will be proper.
              MAGNESIA ALBA.

  This is a fine drug, kept in the shops,  very much
the nature of the carbonated lime ; its  principal use
is to destroy acidity (sourness) in the  stomach and
bowels ;  it has but little taste,  and is never injurious,
given in  any quantity.   Many  diseases proceeds
from the ailiment,  or food, sourirg in the first passa-
ges, and especially in children  and little  infants.'—
When there is any suspicion that that  may  be the
case, the magnesia should be tried, as it will never
do any harm, and often much good—it may be given
in milk, or any other substance which the  child can
swallow in the form of pap. 
STIMULANTS.
                   MERCURT.

  There are a great many preparations of this drug
kept in shops, but I have never found use for  more
than six, which are the  following :  Calomel,  oint-
ment, corrosive sublimate, the  Hue  pills, red  pre-
cipitate, and yellow mercury, usually called  turpetk
mineral.
                   CALOMEL.

   This is a very mild mercurial ;   it  operates  as    J
a  gentle  purgative,  (see purgatives,)   and from
the small quantity  it  takes,  and its  being almost
tasteless, is a valuable medicine, especially in the
disease of children — for a  child  of  two  years old,
from 3 to 6  grains will generally answer-the inten-
tion of a purge for worms ; I generally  give  a  dose    <
in a bit of sugar, or arty other  substance with which
it may be mixed, which ought to be  of some consist-   J
ence, as it will not dissolve in water or  any thing of    i
the kind, and if put into any thin  substance,  it will
immediately sink to the bottom.   When  I  give  it
for worms, (for which it is one of the best remedies).
I generally give  enough to purge, every night for 3
or four nights, giving a purge  of  castor oil or jalap
every o^her morning after the first, to prevent its af-
fecting the system too much.   It will  be proper to
give the child or  patient no  large  quantity of any,
thing cold at a time, during the course, and for a few
days after; and also, a person that has  made use of
an\ quantity of any mei curial, ought to avoid getting
■wet or very cold  for some time afterwards :  and  if
at anv  time it should affect the mouth, much, it should
be carried off by a purge. 
STIMULANTS.             *$
     Vomiting, from whatever cause it may proceed,
   very frequently defends upon an inverted motion of
   the stomach and intestines, which  is  frequently si*
   violent that no other purgative will be retained  long
   enough to have any effect, but to increase the evil.—
*  Calomel, from its weight and extreme  finaness, if
   once taken into the stomach cannot be thrown back
   ag»iu, and will then induce the  natural action of the
   bowels  downward, accordingly,  1 have found it ah
   effectual rerrkdy, especially if attended with costive-
   ness, ip  which case it ought to be given in a pi etty
   large d ise, as ten or fifteen grains, and if it  should
   affect the gums it may be carried off by other  purga-
   tives: when given in cases of vomiting it should be«
   given ,with sugar or something which will part  with
   it easily when taken into the stomach lest it  should
   be  thrown up again.                  »
      Calomel, and the  mercurial  ointment, has  beeh
   much employed of late years in  fever, but I have nev-
   er  employed them  except the calomel as a pu'gative*
   but it is probable that mercurials  may be of service
   in  slow, or nervous fever.
      As a mercurial calomel is a very mild, and yet ef-
   fectual preparation and is proper in all  cases where
   a mercurial course is necessary, as in the cure of the
   Venereal diseass, which we shall cake for an example
   in  which the fallowing  rules are to be observed. In
   the first place that it be given in due quantity, se-
    condly  that it be continued a sufficient length  of time
    and fourthly,  that a proper regimen be observed du-
    ring the course:-—Upon the  first head it may be ob-
    served, that the quantity must  always be determined
    by its effect, whichwe  are to nnderstand from its ef-
    fect  on the mouth, I judge  it always to be necessary
    to keep up a slight soreness of  the gums, which will
    be attended with some  increase of spittle : in people
    who have not been accustomed to  it, from one to two
    grains in a pill every night will be sufficient ;  but in
    venereal cases, or other diseases of the surface, and
    frequently in other cases, Imake use of the mercurial
    ointment at the same time ; but never depend  upon 
a6              STIMULATS.

leTTthan a grain every night: and if it affect the
mouth too much, a gentle purge will check us pro-
gress : but in persons who have taken much mercury
the quantity must be encreased until  th?  desired ef-
fect is produced—I once had an old letcher who put
himself under me for cure, he had taken large quanti-
ties without being cured; I gave him 25  grains  ot
Calomel every night for several times  without any ef-
fect, afcer waiting a few days I gave him  eight grains
of turpeth mineral, or yellow mercury, it puked, pur-
ged, and  salivated him well, anothor  dose a week  af-   i
ter had the same effect-, it  s-allivated him  for  three
Weeks when he left me and got well without any fur-
ther trouble.— From the above case and  subsequent
observations, I am of the opinion that where the sys-
tem has become accustomed to mercurials that  it-will
not answer as well as some of the stronger prepara-
tions.
   As to the length of time that it may be necessary
to  continue a  merciirial course, it  will depend  so
much upon circumstances that it might be somewhat
difficult to determine a prior,  but I should suppose
25 days for the shortest, and 45 or 50 the longest—-  '
but there is so much defends upon the last article off
 our enquiries that we shall  refer to that head.
    Upon the regimen to be  observed so much depend
 that the course may not only be inefficacious but may
 be highly injurious, or even dangerous—It is neces-
 sary in the first place to keep very warm and dry  ; by
 getting wet and cold, or even wet in the warmest
 weather, many have lost their health  forever,  and
 in all cases, during a mercurial course  it is  allways
 necessary to keep as warm  as agreeable, or so warm
 as to keep a little moisture  upon the forehead, w< u'd
 oe stiM better :' it is also improper to take any large
 quantity 01 any thingcold into the stomach at a time.
 It was formerly the practice to keep a person during
 a mercurial course intiiely upon warm drinks and di-
  et, with sarsaparilla, china root &c. but  from a  con-
  siderable practice, I can venture to tkink it improper
  and t never debar my patients, in any ca?  "rom cohi 
STIMULANTS.             *?
svater, but permit them to take it in small quantities
as often  as they may  need it—but  without keeping
regularly warm, all oiher  prescriptions are in vain.
  During a mercurial course  it  is necessaiy  to pay
some little attention to diet—on.thb point trephysi-  *
cians  formerly went  to  too great an  extreme ; the
only rule to be observed  is this, eat temperately of
light diet, such as fresh beef,.fowl, soups &c. season-
ed with salt  to suit the taste, butte-r-.mil.k, and other
sour milk is a very proper diet ; bacon, butter, cheese
Sec. keep up the heat and strength of the system too
much.  Purging at intervals of from seven to  fifteen
djys is also proper.  1 have also thought that I have
derived benefit from the U3e of tartar emetic  during
a mercurial course, moderate exercise  in a w^rm A*?
is also proper.
         BLUE MERCURIAL PILL.

  Take quick-silver, one  ounce, honey  about twj?.
spoon-fulls, rub them in a mortar untill they are per-
fectly incorporated into a blue mass,  and untill  the
globules intirely disappear ;  add wheat flour enough
to make it of a proper consistence for  forming pills,
of th's make  iop pills—Of these from one to  three
may be taken in the day, to be regulated according to
the effect.
  This is a very mild, yet efficacious  mercurial;  I
have thought it less irritating to the system tl an some
others, and have for that reason generally employed
it as an alterative in some  nervous  affections, as
some kind of epileptic fits, cramps he. as in these dis-
eases the system is generally in such an i> ritable state
that mercurials  seldom  fail to increase the coir plaint
for some time after the commencement of a  mercu-
rial course. 
a*             STIMULANTS,

          MERCURIAL OINTMENT.

  Take of quick-silver one ounce, rub it with an e^
qual weight, or less of turpentine in a mortar until
well incorporated, add four ounces of sleeps suet or
a mixture of hogs lard and tallow.
  This is a most valuable mercurial,  a drachm rub-
ed into the thighs arms &c. every night will  soon  %
saivate—It is one of the best remedies in ringworms
and tetterous eruptions,; it is pf service in some in-
dolent tumours that do not supuiaie well.



          CORROSIVE  SUBLIMATE.

   This is a very sfong mercurial, and too rough tq
be given except  well  diluted, or  incorporated with
seme othei substance —It may be dissolved in spirit?
about  16 grains to the quart, of which a table spoon-
ful!  may be taken three times a day, and more or less
according to circumstances—'Another method of exr
hibition is in pills, but it is very difficult  to make it
into pills, as  it ipon fenders every thing friable that  r;
it is mixed with. In pills from a quarter, to one third
of a grain may be taken two or three times a day, but
there  are many who tan scarcely  bear that quantity.
   There are some medical writers who suppose it is
 not so effectual in the venereal disease as some other,
 but with n>e it has proved infallible, but it is much
 in use among quack pretenders who being ignorant of
 the rules necessary to be observed during  the course
 have failed.
   The corrosive sublimate makes a verv good wash
 for some old ulcers called phagedenic, from which a
 water formerly  kept in the shops was called: it was
 made by dissolving a*bout 15  grains of the corrosive
 sublimate in a quart of weak lime water—The nicer
 so  called, and in which  it was thought most proper
 was a corrosive ulcer which was of too  moist a na-
  ture, with loose flesh. 
               STIMULANTS.             30

             RED PRECIPITATE

  Jled precipi  ate 1^ seldom used internally, but may
beg  en i  s-fety in rather larger doses than the cor-
rot'vi. sublimate, but it muse be gou. d v^ry fine and
irud^  into pitis, a?  it is hard to dissolve.
  Put the principal use m^e pf ted precipitate is as
an escarouc £.>r desti  ymg  fungous or proud flesh in
ulcers, and for cltansii g ill conditioned seres——
A powder was formerly kept in the shops called pul-
vus angelicus, made by gruding equal parts of burnt
alum and red precipitate together.   It also makes an
excellent ointment  for the itch, ringworms and tet»
terous eruptions, and other similar diseases  of the
skin.
             YELLOW MERCURT.

  This is a very powerful  mercurial, and  seldom
employed but in  venereal cases where other mercu-
rials have been  employed without effecting  a cure,
and by that  means the system becomes so accustomed
to it as scarcely  to be affected by the milder prepara-
tions, this is then proper ; given from 5, to 8, or 10
grains, it vomits and puigeSi and then salivates : two
or three doses a  week a part is sufficient in any case.
  Those who  would wish to be suddenly cured
jnay try it, and especially if they have any discharge
from the uterus  or urinary passage, in these cases it
lias bee.n thought the most effectual of any, but from
the roughness of its  operation it is seldom used except
In strong robust persons. 
                STIMULANTS.

                    OPIUM.

  Opium is one of the most valuable medicines, an<|
deserves a volume, or at least much more  than  the
limits of this  work will permit me to say at present,
and therefore shall mciely give what my own experi-
ence will enable me.
  Up n the diret t effects of this drug there is a dif-
ference  in opinion: L/r.  Cutlen calls it a  sedative,
and supposes it immediately decreases the  sensibili-
ty of the system; while  Dr. Darwin, Brown  and o-
tJiers hold that it increases the sensibility of the sys-
tem, and the latter opinion is now generally adopted
and when  we come to examine into  tl e cause of this
diffvience, it is easily accounted for ; it is not our bu-
siness to inquire into the mode of its  operation  but
the proper mode of management."—Every day's  ex-
perience pr< ves it to be one  of the most  si ddenly
powerful  stimulants'with w hich we are acquainted,
and therefore its first effect is an increase of sensorial
power or strength  and vivacity, directly oposite to
£he old opinion among physicians, and still remaining
among the people  in common; who still suppose it
jtp have no oher effect than merely  to stupefy  and
benumb the senses, and thereby  induce sleep, but on
the contrary, the first effect observed after taking a
full dose of opium  is similar to that of spirits, it in-
duces a pleasant serenity of mind, ret ders  a person
theerf'ul and  lively,  easing all pain and soothing all
pare and trouble ; after a length of time a disposition
to sleep comes  on, which is  sound and pleasant, a
person wakes free  from care and pain, after the sleep
goes off, if the dose was sufficiently large, some nau-
sea is felt at the stomach, which is removed by a little
spirits—These are its effects in health, we are now
to exammine its effects in disease.
   In all languid states of the system with small pulse
 it is proper ; in  all inflarnatory  diseases with a full
pulse and dry  skin, and high  color, as  in the first
Stages of almost all fevers, it is improper, increasing
the heat and  preventing sleep : but after thcinfiama-
%o 
                STIMULANTS.             $i

tory s*age lS gone off, and the pulse has become small
and hard, opium is the i  a remedy : it will alwa\ s be
found of service when in small doses, it gives ease jf
in inHamatory diseases it will increase the Ik at of the
body and ^ive no ease,  nei-her will it indice sleep
but in  large  doses, and  then the sleep  wiil  not be
sound but interrupted ; but if t can be so managed as
to produce sweat, it will then be of service in  any
Case ; the best method is to give it with tartar emet-
ic in small doses j from one third to half a grain of
the tartar and nearly as  much opium in a pill  : or*
instead of the opium,  ten  or 15 drops of laudanum*
   When  the  strength  is exhausted  by fever,  with
 restlessness & watching, itis weakness prevents sleep,
 of is even the  cause of delirium; opium  will give im-
 mediate relief,  and often  effect  a cure : upon taking
 a dose of opium, the patient becomes easy,  his deliri-
 um  goes  off,  he at first  becomes more  wakeful, a
 sweat breaks out, and after a due time h,j  falls into a
 pleasant and refreshing sleep, wakes better, his  appe*
 fite returns  and he is soon well;  but when a patient
 is hot and dry, wants Cool air, cool water, acids &c.
 a large  draught of cold water will often answer the
 same purpose in a measure, that opium will in the case
 above stated.
   In slow or nervous fever (Typhus) it is  one of the
 best remedies,  the patient is drowsy and dull owing
 to an inactive  state of the system and especially if a
 twitching and trembling,  with a loss of the voluntary
 motions, as the use of the hands and difficulty of pro-
 nunciation:  opium by rousing  the  system  into ac-
 tion causes a flow of sonsorial  power, and enable*
 the system to overcome the disease.
    The solution of fever, often, if not always depends
 upon an incresed  energy of the brain,  and a change
 in the state of the fluids bv the due circulation  of the
 blood, at some period after the  fever has wasted the
 exitability of the system.   Opium possesses the pow«
 of increasing that energy in a high degree.
    Dr. Brown of E Jinborough says that opium cures
 ttintcen head-achs out  of twenty; this  is nearer tlvs 
  £*              STIMULANTS

  truth than many would suppose at first: s pain in the
  head is often occasioned by an in active  state of the
  Stomach ; a glass of spirits, or a dose of opium,  or a
  full meal of strong diet removes the complaint.
    In locked j<w,  opium  and wine is esteemed  the
  only rvrnedy— l'his disease in all the cases which I
  have had an opportunity of observing, appeared to«be
  brought on by  pain  aid  irritation ; opium  tak^s off
  botn pain and irritation, & thereby cures the disease.
    It ought in this disease to be given  in large quanti-
  ties and it is id be d served that patients in this dis-
  ease will bear much more than in health: when the
  patient  cannot take it by the  moutn, it will answer
  equally  well in glyster, but it requires double thi
  quantity that it does by the mouth.

   .. Infants can bear but i very small quantity of it—
  for a child under a fortnight old, from half a drop to
  a dr-p in a dose—It  may be given to them in safety
  as soon as they  are b>rn ; to a living child in a prema-
  ture birth it is of great  advantage for a day or  two J
  from one fourth to one third of a drop may be given
  two or  three times  a day, which may be easdv done
  by  droping any certain number of drops of bieast
  milk, as ten or fifteen,  and then drop a  drop  of lau-
  danum into it, and after stirring it well, drop out ay
„ portion or part that may be thought proper.
     It is often of service in vomiting, especially in chil-
  dren; it isalsd  of j*reat service when  attended with a
  lax.
     In  all kinds of nervous"  affections U is among  the
  best of  remedies ; there is one  very  pamful  one to
  ^vhich delicate women are very subject, call, d among
   the good women  the weed, which it  immediately re-
   moves ; it is also of great service id  hysterical and
   bypechondrical complaints. — It is of the utmost im-
   portance  in dysentery,  in which it ought to be g ven
   in pretty large doses every evening and  the  bowels
   emptied the next morning with G. salt(see salts)—
   it not only relieves the pain and  gripjig; bnt fre-
   quently removes the disease suddenly, but if not car- 
STIMULANTS^               $$
t*ied off by a gentle purge it ssldom fails to increase i
the heat and fever.
  In all painful  states from  wounds, or  whatever
fcause, except inflamation, opium is of advantage in
preventing fever from irritation, which is often trou-
blesome and sometimes dangerous;
  It is the most certain medicine to prevent  abor-
tion—a very dangerous case, which often happens
between  the fir^t  and third month of pregnancy',
attended with a violent flooding, which  frequently
carries off the unfortunate womp when  the case is
unknown; and it is a misfortune that not  one mid-
wife in ten knows  any thing about the cause.  In this
case opium is proper, and will generally  stop, or a-
bate, the discharge ; but if it should fail, the certain
cure, is by a manuel or instrumental operation.
  It is the most  powerful and proper remedy in hem-
orhages, or discharges of blood, from whatever cause,
especially in those to which women are so liable.
  It is said there are hemorhages owing to an active
cause in which opium might be improper ;  but theses
cases;  are  much   more  rare ;  for  in   nine  ca-
ses out of .ten,  such  discharges depend  upon  the
weakness of the arterial system, forif the quantity of
blood be too great  the arteries are unable  to  empty
themselves sufficiently, and are therefore upon a con-
stant strain, and of course  liable  to be ruptured-^-
opium, by increasing  the  strength,  removes both
the cause and effect;  and I have  not  yet  met with
the case in which it has failed, whether the discharge
be from the lungs,  stomach,  nose, annus, uterus  or
kidnies, but in some cases, cold may also  be of ser-»
vice.
   Another case at least deserves to be mentioned,
which is what is called, ifter  pains—manv women
suffer  much more  from them than  they do in labor.
Some physicians suppose these pains to be owing  to
blood coagulated in the uterus,  &c. and that those
pains are necessary for its  expulsion.  Surely such
wen never thought, or if they did, they were incapa* 
34
STIMULANTS.
bleof deriving any advantage from  thinking.   No-
thing is more common  than for large coagula to be
discharged without any pain,whatever ; and  it  may
also be observed, that such coagulum is seldomer dis-
charged in those cases than  when  there  is no pain.
The true cause is irritation, and is most commonly
met With in women of delicate and  nervous habits.
Opium is of the  utmost advantage, and  although  a
quantity sufficient to give intire  relief would in-
duce too much intoxication and injure  the stomach,
yet it may be given freely and enough to  render the
pains  weak and more  tolerable,  and repeated every
three  or four hours, as occasion may require.
  The exhibition of opium to the unaccustomed,  is
at  first difficult,1  and requires caution—the  dose
being  so various according to* circumstances and the
difference in patients, that it requires  riibre  experi-
ence and skill  than any other  article  in  the whole
•materia medica.   It is necessary sometimes to begin
with a large dose, and afterwards lessen it; in other
cases  it may bs proper to begin with a smaller, and
enlarge it as occasion may require.
  The smallest dose supposed to be dangerous to'an
adult  in a common state of health, is about 4 grains ;
but I have never found it necessary to give more than
from one to two  grains'ata dose, but in robust  per-
sons in great pain from wodnds or  the like,  I have
given more ; in locked jaw, mania, or the like,  more
riiay be necessary.-  I have met with a few cases in
which the smallest doses  would increase pain, and'
which would not give way to the largest: the mo3t
Temarkable, was in a  case  of sUpurative rheumatism,
in which there was a painful  and lax state of the
bowels with delirium.
  Like spirits, tobacco, and'other  substances called5
narcotics, by frequent use  the  system  becomes ac-
customed to its stimulus, and refuses to obey without
an  increase of the quantity.  I knew a. woman  who
had used an ounce in a week.  The best form of ex-
hibition is in pills, either by itself or with other  sub-
 stance* suited to produce the desired effect—as half 
                STIMULANTS,             3$

a grain of opium and as much tartar emetic, in a pill,
is a powerful medicine to produce sweat—this wiil
answer the purpose of  a  powder usually kept in the
shops, under the name  of Dover's powder.    This
has been  much esteemed in acute rheumatism, but
the pill above will answer the same purpose.   The
method of managing it in this disease is this :  After
bleeding, and a purge if costive, give  a dose  either
in a pill or powder, and keep the patient  warm be-
tween two blankets, give but little drink until the
sweat begins to come out, after which he may take a
little w»rm tea.  The dose must be  repeated once
an hour, or as often as the  patient can  bear  without
inducing sleep or vomiting, of which  there is  little
danger, if he sweat well—this ought to be continued
ten or twelve hours at leat, and the patient   should
be put into dry warm clothes and  permitted  to eat
and sleep.
   The most common form of using opium is in tinc-
ture,  called laudanum, which may be prepared thus «
Put one  ounce of opium  into a pint  of good proof
brandy or rum, keep it in a moderate heat for two or
three days, shaking It at times and then strain it. Of
this, if well made, a drachm contains about 3 grains of
opium, and from 30 to 60 drops is  a dose, but more
or less according to circumstances ;  always observe
that a second dose may be regulated by the   effects
of the first.
   To conclude this subject, with those who  become
acquainted with it, it becomes an universal remedy, it
cures the sick, comforts the afflicted, gives a  cheer-
ful serenity to the mind, and soothes all care whether
in disease or health.  People who are unacquainted
with  it can tell a thousand frightful tales  about the
mischief it has done, and the dangers cf using it, and
suppose if the wind should harden to change  to ano*
ther point of the compass  while a person is  sleeping,
fie can never wake again. 
3ry             STIMULANTS,

                  HEMLOCK.

   This is a poisonous plant, possessing considerable
powers, but is not  a native of the United States.
An extract of it is  imported from  Europe, and  in
different conditicns.  Sometimes it  looses its  pow-
ers, either in preparing or keeping ; but when  good^
it has been found a valuable remedy in certain diseases
of the skin and glands, both  given inwardly and ap-
plied outwaidly.  When given inwardly it is proper
to give it in a dose of one or two grains, and increase
tie dose a grain at  a  time,  until  it produces  some
sickness or sensible  effect, and even  after  that to
gradually increase the dose, for, like all other  medi-
cines of the kind, as the system becomes  accustom-,
ed to it, it will require a greater quantity to produce?
the same effect as it did at  first,  and always  upon
beginning to use a second parcel, or  the first of any
parcti, to begin with small dosos until the  strength
as discovered.
   The principal use is in cancerous or  schirous dis-
eases, [see cancer and  schirous.J    It is  proper  to
use it both inwardly and in poultice in all hardened
glands, [see anatomy.] The way  to use  it in poul-
tice, is to make a soft poultice of corn or other  meal, ;
and first moisten the extract and spread it, thin o-
ver it, and apply it hot  and continue to renew it
twice a day for weeks, or until a cure is obtained.-—
It is proper to anoint the tumor, before applying  th©
poultice, with mercurial ointment.
     JAMESTOWN WEED, {STRAMONIUM.)

    This is now a  native ^f our own country, and
  grows in-rich or manured land about  almost  every
,  plantation,  from   long  experience I have found it a
  most valuable  medicine, as applied externally.  I
  have never ventured upon it inwaid!y?but am siorn/r
  |n the opinion that it would be equally safe  and aa* 
                STIMULANTS,             tf.

swer every purpose of the Hemlock.   I have taken
the seeds in a small quantity,  and find their sensible
effects to differ very little from  the hemlock.    The
seed  in  poultice  answers - every  purpose  that the
leaves  do, and from their beirg easier preserved, are
to be preferred."  They ought to be ground or  beat
line, and kept stopt up in a bottle, and will then  keep
any length of time and always be ready for use. They
are to bo spread upon a  poultice in the  same- manner
as the  hemlock.  The green leaves  by  being  wrapt
in other leaves, as cabbage, and covered in  hot  em-
bers, become soft and. make  an excellent  poultice,
and possess all the  powers of any part  of the  plant.
   'I here are several diseases in  which  I have  em-
ployed the Jamestown.   The first I shall mention is
schirus and cancer.  While yet  in an  occult state,
that is, before the skin  is broken, for  after a cancer
becomes an open ulcer,  there is no remedy but ex-
tirpation : but many hardened glands may le brought
to supurate kindly by the use of Jamestown  and  mer-
curial  ointment.  In all  diseases  of  the  glands, it
is proper  to anoint the gland or part wiih  mercurial
ointment, and apply a poultice as above, renewing it
twice a day, and continue it for weeks,  or  until all
the hardness is gone.
   There is a kind of boil or bubo whxh comes under
the arm or jaw, or in the groins, which  continue  for a
long time, the Jamestown poultice will  either res.lve
or  supuri.re  these in a shcrr, time, ar.d n.alic them
heal kindly.
   There is another disease which is a species cfboil
that make much emplcyment for cancer quacks, but
which in reality have  nothing cancerous in  il.im.
They come about the joints,  ths reck and" spine, and
other parts where there is no fat—the)  beo-ih iile a
boil  and are very painful, they do nor r.upirate  well
and have  a touoh white matter in  them which  can
scarrcly.be get out ; they generally ri^e i:i' several
small heads, and continue to spread, a»e red or Iwid,
hard, very sore and painful.  The patient frequently
£c:ts alarmed, supposes it is a cai.ur and ap^.^ to 
38
STIMULANTS,
 some good woman or other person whom  they SUp>
 pose to bi a judge from  having had  such  a cancer^
 who pronoiuce it a  cancer—they immediately  hi*
 away to a caicer curer,  who applies his wet fire^
 ratsbane, bluestone, &c. to it, and kills a  large por«
 tion of the flesh and membranes, which at leng'h se-
parate, except some  fibres of nerves or  tendons—
these are supposed to be the roots, and are tore  out
 at great length with their nippers or tongs, &c. in*
 flic ting the most exquisite torrnent upon the patientt
 enough to extort shrieks  from the hardiest  Indiarj
 warrior.  After this operation is  over a  few  days^
 the young flesh begins to put out in every part of the
 Wound. This is frequently thought by the infernal ig-'
 Jioramus to be more cancerous flesh, and  the  cruel
 process has to be gone through again and again,  un-
 til the suffering wretch  suffers more torment  than a
 thousand deaths, until at length despairing, he quit$
 his doctor and applies to one  whose method of curor-
 is more mild, one who by  some charm,  or invisibl '
 immaterial or incomprehensible medical agent, pro-
 mises him a sudden and certain cure.   He touches
 it with the hand of the seventh son  of  the seventh
 son, or he applies his magical straws to it, or  whis-
 pers some pious ejaculation oyer it, and bids his won-
 dering patient return home and be well; all he has
 to do, is to apply a little lint or a mild ointment to it,
 and according to his faith, so it is  unto him, and so
 after perhaps the loss o#a  limb or  two he is cured by
 the divine conjurer.   This is the  usual termination.
 There are also two other little tumors, usually  called
 fcancer warts, blister cancers, &p. which in fact have
 nothing cancerous in  them, and will usually go off
 without the use  of any means whatever.  In all these
 cases and many  more of  the kind, the Jamestown
 poultice, duely persisted in, will infallibly  perform  a
 fwre. 
                STIMULANTS.             3^

               SPANISH FLIES.

  This drug is seldom  used except in plaisters  t*
prdduce blisters.   To  enumerate all  the diseased
states in which blistering is proper, would be a tedi-
ous task ;  but it  may be proper to make some  gener-
al remarks before we enter into particulars. ^
  There are many substances which will raise a blis-
ter when applied to the skin, but whether there is
s-ny known that would answer the purpose as well,
6r not, is uncertain.  I cannot attribute the  benefi-
cial effects of cantharadi**  altogether  to the dis-
charge by blister, for it appears«to me there is a por-
tion of the active matter taken up  and carried into
the circulation, and thereby  excites the system into
action, and hence they are of great advantage in the
last stages of the slow  Or nervous fever, attended
with tgrpor,  sleepiness and  insensibility, as  a dif-
ficulty in speaking and the other voluntary motions.
I have seldom  found  them of  much  service  art
the first stages  of  fevers ;   if after evaluation  by
bleeding, puking and purging, head ache, pain in the
back and  shoulders, otc.  should remain, blistering
will then be proper.  In case of head ach, apply the
blister on the lower part of  the neck,  or where it
joins the shoulders.   For a pain in the back, apply it
to the lower  part of the small.
   Blistering is one  of the  most useful  remedies ift
chronic rheumatism.   In this case they  ought to bis
applied to or as  near the part affected  as may be ",
they  ought to be large and kept open as long  as  can
well be done, oV repeated, for weeks, or longer if thd
disease should require it, and in the mean time bleed*
ing and purging, with cream of tartar frequently em-
ployed ;  and when  the  disease  is removed,  or  the
eyintoms  in a  measure  abated,   bark,   columbo»
or the bitters, iron, &c. should be  plentifully  given*
   In  most diseases  of the head, as sore eyes, blind.
ness, deafness, and pain  in  the  head of any  kind,
blistering gives  relief.
   In pleurisies  cr inflamation of  the breast,  blistef* 
 Id          ^   STIMULANTS

 ing over the part affected will always give relief, arid
 if the pain should shifc  to  another part,  a  hlister
 should again be applied over the part.   If the pain
 affect only a small space, the blister may be small, as
 two inches square, but if the whole breast  be  affect-
 ed,  it  should  be  large in  proportion ;   and if it
 be a bastard pleurisy, or an inflamation of the  lungs,
 the blister ought to be applied on the  middle of the
 breast, and pretty large, and kept open until the  dis-
 ease be removed. The same is to be observed in croup;
©r hives—if the disease  be violent^ or does not go off
 immediately upon bleeding, vomiting, warm bathing,
 otc.   Blistering is also ©f use in quinsies  and infla-
 mations of the tongue, jaws, Sec. and  should be  ap-
 plied high oh the breast  or on the back of the neck.
 In many cases of delirium, in madness, or  a state of
 distraction, blisters applied to the back of the neck*
 are proper.   In hydrocephalus, or a dropsy   of  the
 brain, and in phrensy, or an inflamation of the brain*
blistering in a like manner is  among the best of rem-
 edies.
   The  method  of making a blistering plaister, is
 simply7 to grind the flies fine, and sprinkle them upon
 a ph-ce of linen covered over with paste or common
 plaister, wet it with vinegar and apply it to the part.
 Wet a cloth, folded 3 or 4 double, with vinegar,  and
 apply over it to keep it moist. It is commonly proper
 to liy a quantity of tow  over  the plaister,  which will
 hold it to its  place the better.  And in ten or twelve
 hours it may betaken off"—take off the blister, which
 is sometimes filled  with a j--lly, which should also be
 taken off, and a colwart  or cabbage leaf, softened by
 laying it over hot embers, applied over the  part,   and
 renewed twice  a day.     When cabbage leaves can-
 not be had, a very small quantity of the  finest  flies
 may be dusted through! piece of muslin over  a plais-
 ter and aoplied—if some flies be mixed with  tallow
 and  applie!,  it  will keep  up a discharge, or even
 csniiTion plaister may answer the purpose. 
                 STIMULANTS*             4«.
                                             0f IK
        TURPENTINE, AND ITS OIL.

   This medicine has formerly been supposed to pos-
 sess various powers according 'o the tret that produ-
 ced it ; but this distinction is very much laid aside}
 and Dr. Cullen  is of the opinion,  that  the  balsams
 scarcely possess  any  power worth notice  different
 from the turpentines.
 v.. Their principal effects  are as strengthened in
 Weakness of the back or joints, and in the unnary and
 gen Trial  organs  there is scarcely  any  thing that e-
 quals it.  The thiner kinds are the best.   ft  is of
 great advantage in weak joints or back, to apply it in
 a cere cloth.  For this  purpose  tt is  necessary to
 boil it sometime in water,to take  off some of the ac-
 crimony and give it a  proper'consistence—spread it
 on thick linen or soft  leather,  apply it  warm and
 Wear it until  it falls off of itself.
   The oil of turpentine is a valuable remedy in somS
 Species of rheumatism, especially that  called  sciatic
 and  lumbago, but it  is  espei ially ustful when  the
 pain is fixed in the hip or other joint: ; it >s necessa-
 ry to take it in large  quantity and continue it  for a
 considerable length <»f time.  It is necessary  to be-
 gin with 10 or 15 drops  in a glass  of spirits, and  en-
 large the dose as far as it can  be wit: out heating the
 urine,  , By this method, about twenty years ago, I
 cured myself of a sciatic, of considerable standing;
 and  I have frequently known it  cure  after contrac-
 tions had come  on,  and the limb shrunk.   In fine, I
' have never known it ful when  duely  persisted  in ;
 and especially if a purge of jalap was taken once in
  15 or aodays.



                BALSAM ioPAIVt.

    The balsam copa^va differs ve-v little in its rriett'-
 h-l powers from turpentine.  It is often of service
                         ¥ 
41
STIMULANTS.
in gleets in men, and in the fluor albus In women ; but
if the discharge be colored, especially green Or yel-
low, it will be injurious.   In these diseases, twelve
or fifteen drops, once or tv/ice  a day, will  be pro-
per ;  but even that quantity may bring on a heat and
difficulty in making urine, but some will bear double
that quantity without any inconvenience.
  Dr. Cullen says it  is of service in  hemorhoidal
complaints, given from  twenty to forty drops mixed
with sugar, once or twice a day.
  There is a variety of balsams produced by  differ-
ent trees, but their medical virtues are considered by
Cullen and others as differing but very little.
  There is a small knob or hill  high up on the  Ken-
away or new  river, that has a species of fir  growing
upon it.   On the body  of the tree, and  larger  bran-
cries, there are a great  many  vessicles,  or  blisters^
whjch contain a very pure balsam, which is collected
and sold at a  dollar per gill.  From what experience
I have had, it appears to  answer  the same  purpose
that the copaiva balsam does.  It is  much  celebra-
ted among the country  people for   healing  fresh
wounds, ulcers, &c. an error that itis extremely hard
to beat them out of.
                JLSSAFOETIDA.

  The medical  powers, of this gum U  very well
known by almost every good housewife, in hysterical
and hypocoudrical cases ; from this circumstance  it
will be the less necessary to say much ;  it is not only
one of the best remedies in these diseases, but in  all
other nervous complaints.  It is also  of  service  in
some  affections  of the lungs attended with a dry
cough, colics and other diseases of the stomach and
bowels.  It is thought best given dissolved in spir-
its— u tea spoon full of strong tincture may  be given
•ncs or twice a day  in  a cup  of sage tea—in cub- 
               STIMULANTS.             4|

stance It maybe given from 3 to 6  or  more grains,
«nce or twice a day.
         CASTOR, OR BEAVER STONE,,

  Is one of the most valuable drugs of the class ;  it
is of great service  in female weakness,  especially
when attended with nervous affections.   It requires
but little skill in the use of it—from ten to twenty or
(thirty grains may be given, once or twice, a day ;  or
it may be given in tincture, made by putting an ounce
cut small into a pint of good brandy,  of which a tea
spoon full may be given twice a day in a citp of tea.
               CUM GUAIACUM.

  This gum wac once  much employed  in the cure.
cf the venereal, but it is now almost entirely neglect-
ed in that disease, and the only disease that it is much
esteemed in is chronic rheumatism, but even in this
I have never found it  of much  advantage ; but  i 4
some cases I have thought it beneficial, when assist-
ed by  purgatives, blistering.and barks.
 The  best method of using it, is to take it in substance
from 10 to 15 or 20 grains, twice  <»r three, times, a
day, or dissolvedin strong spirits, as the first shots of*
brandy, twenty or thirty drops or  more  in  a cup cf
tea or milk, twice or three times a day.
                SNAKE ROOT.

  There are tyo kinds of this root, thel'..:kandtlis
ienaka, but their medical powers  appear to  me to
be precisely the same.
  Much Jus of late been said about the power of this 
44              STIMULANTS*

dreg in the croup or h.ves, a  very fatal disease a-
tnong children.  L»r. xvrcher  anu Dr. Bartcm of Phi-
ladelphia rec ommend it very mui h,» but from the great
athnity of tai. disease to that of pleurisy and  pneu-
monic inhamation, I am much inclined to think it no
better calculated for ihc cure of hives than of pleu-
risy, and that its reputation will «oan fall in the  one
as it long ago has in  the otn. r.   However,  it may be
a remedy, but I rnu-t, until better informed by expe-
rience, consider it as a doubtful one.
   The moist hives and phmisy are highly inflamato- ■.
ry diseases, in which, stimulants are  always doubtful  ■
remedies, and I consider the  snake  root as a  stimu*.:
Jant medicine, and therefore, I know' that unless it
excite plentiful sweating, it will  prove injurious.--^
However, there is a  spciies  of hives  or  croup,  in*
which there is'no matter appearing loose on the lungs,  •
but'the patient-continues  hoarse, and  the  cough, if  >
any, dry ;  in^his case I should judge it to be a reme-
dy well suited to the  i tentibn of cure.   The me-
thod  of using it is to  put  an  ounce  into  a  quart  of
water, boil.it till half gone, and give a spoon full ev-
ery hour.   For  more on this disease,  see  tartar  e-
..tnetic, bleeding, Spanish fli^s, he.
   There is  one observation which I would wish  to
introduce here, and that is, physicians  ought  never
to recommend a new medicine  until  experience had
convinced them that  it was equal to  any to be  lttd.
  41 £

#1
                 CAMP HIRE.

  Upon the direct effects of  cam phire on  the sys«
teri', a'thnrs disagree as much as they  d> upon opi-
um—the one suppose it to he a stimu-anr,  the ether
a sedative ; but the sensible effects when applied to
the most sensible parts of the system, prove it to be
a stiirulant, and  that  like all  other dings <>f that
«las<5, it indirectly may  prove a sedative, but  its 
              STIMULANTS.                43

powers are not veryT  considerable, except in large,
ao«es,  as from twenty to thirty grains.
   It has been employed in many diseases, but those
oly in which  it promises to  be useful  are few.   In
putrid  fever there is little doubt but that it is of ser-
vice—-ii is well known to be a powerful antiseptic-
It is also of use joined with opium in nervous fever ;
in the^e cases it  should be given dry,  because when
dissolvtd in spirits it is too hot and stimulant.
   UrVl.dlen suppos' sjjitmay be  of use   in nervous
diseases, and says  that given in a pretty   large dos&
at night, it has bee-i known to prevent an epileptic
fit that was expected.  But  after all  that h?s been
said about it by other writers, 1 have never been abla
to esteem it a very  valuable  medicincci except exter-
nally,  and even then its effects were only to  be  at-
tributed to its volatility  in carrying off the heat of
the part,  and therefore  its effects  cannot be  ex-
pected to  b*  permanent.   Its  effects  in  fainting,
head ach  &c. I need not mention, as  that is withiff
the knowledge of every good wife.        '■
                  ■ CINNAMON.

  This is more used as an aromatic for its agreeable*
ttess than a a medicine ;  but as a  medicine, it is of-
ten of service as in water brash, and other  cold  wa«»
tery diseases of the stomach  and  system  generally,
as cachexy, chlorosis, and after the w^ter is carried
off in diopBies '»t warms and strengthens the stoinaCh
and system in general.
                  SASSAFRAS.

  After the cinnamon, I hav*» thought proper to give
this a place, m.twithsU  ding ir  has, with a Icr-g  ist
tf other ax ticks fcrmcily kept in the shops, Ucn in. 
4tf.              STIMULANTS.
-es=r
tirely neglected in modern practice ; I merely intro.i
duce it to remove some errors which  prevail—it i?
thought by the vulgar to render the blood too thin
and weak, while on  the  contrary, in  weak watery
habits, used as a tea,  it has a considerable effect in
promoting the circulation and  consequent  genera-
tion of the blood.   It  is to be observed that there are
two kinds, the male  and the female—the male is  on-
ly fit for use—the bark of the  root, and the  root it-
self is the best—they may easily be distinguished by
chewing, the female is weak and mucilaginous,  the
ether is warm,  pungent,  with some  astringency.-r*
This makes an excellent tea,  and was formerly  ex-
ported from America to Europe in large quantities
ibr that purpose.
                SAL AMONIAC.

  This is not much used as an  internal  medicine^
but I have thought it one of the be3t neutral salts in
cases of fever—it  may  be  given from  five to  ten
grains or more, every half hour—it requires to be
given in honey or molasses, as it  is  exceeding pun-
gent.   It is a very convenient and sufficiently  pow-
erful caustic, for touching venereal warts,  polipuses
in the nose, or any other soft and moist tumours—it
also makes an excellent  wash for old ulcers, whicls
are foul and smell bad.
                 HARTSHORN.

  Spirit and Salt of Hartshorn.—These stimulant
drugs are of use in a variety of diseases, but  princi-
pally externally and in smelling bottles.   They are
proper in fevers, of the slow or nervous kind, attend-
ed with torpor—ten or fifteen grains of the salts mry
ke given in a little molasses or hooey, two or thtve 
               STIMULANTS.             /fj
                                            t. ,a
times in the day ;  or, which is better, 25 or 30 drops
ef the spirit, may  be given in a £up of  warm  wine,
or other sweet whey, three or  four  times,  half an
hour or less apart, and keeping the patient warm, is
one of  the most powerful means known to  produce
sweat.  It is one of the most powerful solvents of
animal matter known, ■ and  hence in  contusions it
takes out the blackness and swelling. From a drachm
to a drachm and a half, combined with  an ounce of
any animal oil, by rubbing them well together,  make*
a  very useful application to part?  affected with
rheumatism, if not inflamed.
                  FOXGLOVE.

  This is a plant very common in Britain.   It is es-
teemed a! powerful dieurectic, but it is also an emetic*
It is chiefly used in dropsies, especially of the breast.
It has also been thought of use in consumptions.
  The best method of using it, as directed by Dr. E.
Darwin, is this :  Put four  ounces  into a pint ci
proof spirits and as much water;  after keeping it
warm 24 hours, press and strain the  tincture ;  but
this is wasting the drug, and it costs something with
us—I have therefore made nearly an equal  quantity
by adding fresh quantities of spirit  and  evaporating
it in a moderate heat to the consistence of honey, and
then adding it to other  spirits.   Dr. Darwin sup-
poses it necessary to keep the tincture  of an ecuafc
strength, and that with the strongest tincture, thus
made, it is proper to begin  with about 30  drops  •>
times a day, and increase the quantity  until  it hai
the disired effect, or produces some nausea  or sick-
ness at the stomach.   Used in  this manner it v/il«
generally carry off a watery swelling in  the  limbs in
a short time, but cannot evacuate the water i: lodged
in any of the cavities of the  bod/.   It h  almost the
only remedy dependsd upon  in < i;onsy of ihg br::.^?- 
$8              STIMULANTS,

          NITRE, OR SALT-PETRL*.

  This salt is used in  several  diseases, but I  caa
scarcely think it entitled to much  credit, except in
dropsies called anasarca, which  is a  swelling  of  the
feet, legs, &c. in this disease it will  generally  carry
off the water in a short time if ta! en in d<»ses of from
15 to 30 grains, or as much as the stoma, h will easi-
ly bear.  As the water is carried off by nitre,  it is
always pecessary to strengthen  the system against a
relapse with iron, bitters, &c.  as  the  swelling  will jp]|
seldom, fail to return again w tnout  the use of some
strengthening medicine, which is  not  so apt to be
the case,' when the. water is ca: ned off by the chrys-
tals or cream of tartar. ,.,,,,.
  Nitre is aUo  frequently used in fev-rrs pf an inftanv
story kind, but  it is a d sbgtecable medicine,  and in
no  wise answers'the purpose a- weli as tartar emetic,
except it be to procure sleep in burning fevers, whe>e
Opium is improper.  For this purpose, 1 have mixed
from a scruple to half a  drachm with  about  half the
yolk of an egg,  and given it to  he  swallowed undis-
solved—after entering the■ s>ofiiac!i  n immediately
begins to dissolve, cooling the  stomach, and there-
fey   induces  sleep,  if  the  dt>sc   be  sufficiently
large,, arid Very  frequently it induces sweat also.—  V^J
I have frequently  observed  the  s.*i.e  effect  from  a
draught of Cool water< especially  where the  patient :%
had been kept upon warm drink, as the  ignorant are
Very apt to do.                             - (
   It is thought to be an excellent remedy for foun*
deredhorses^ and such 3s cannot  make water easily''
when rode of worked hard.
<1i 
                Stimulant^

               white  vitriol.

  The principal use of this article is an emetic, or an
•pthalmic in sore  eyes.   As  ah  emetic  it is given
from 6 to 30  grains, to empty the  stomach when
poison or an over portion of spirits, &c. are taken—
it operates suddenly and  without violence,  and its
Operation is over immediately.
  As an opthalmic,  or in sof*e  eyes, it may he u-
sed iti solution, or ointment—in solutipn about four
grains to the ounce of water will  be  strong enough,
but it may be made stronger or weaker at pleasure-
in ointment about a drachm  to a ounces of the simple
ointment will answer the purpose—grind it very fine
and mix them well together—anoint  the edges of
the eye-lids at night.
  It is also used in gleet or fluor albus, as  an injec-
tion, and upon the first commencement of a gonorhoea
in venereal cases, or after the virulence is  subdued,
if a gleet remains, it is  proper—the  vitriol in  pro-
portion of a drach to eight  ounces or  half pint of
water, and thrown up  the urinary passage  in  men
or vagina in  women—a common syringe full  two or
three times a day.
                   JtRSENIC*

  This  substance,  although considered one of the
strongest poisons, is recommended as an useful  me-
dicine by some ;  but is only of real uSe as a caustic.
         CERUSE. OR WHITE LEAD.
  This possesses no medical powers internally, but
it is of great use in galdings in children and aged and
helpless people in some diseases—nothing is necessa-
ry bvit to dust it through a  piece of book-muslin upori
the part,
                    G
49 
fe'1'" !" "     '   I II jl il , >  ' I I  I    IMWPHW  '".Uplift
PREPARATIONS*
              COMMON CAUSTld.

  A caustic is a  burning application,  intended ti
destroy or eat  away flesh, for opening tumors or des-
troy iog cancers, wens, &c.
  The best method of preparing the  common stroog
caustic i  as follows :   Pout'a quantity of good lime
Watt r i< t> about twice as  much strong  lie,  boil it
down uKtil diy, increase t''e heat  u"t'l it rut s thin
like oil, pour it out upon a snovih stone or iron
plau-, and while hot cut it into smTi long pieces and
keep them in  a via! well stopped.
 * Wl en  it is'used to open an abscess or  Wen, or to
destroy a cancerous  tumour, cut  a  h>.le through a
piece > f thin leather as large as the place you mean to
destr.y:  bn one.side  spread sticking plaister;  ap-
ply it w.rni  to the part;  place a  suitable piece or
pieces of > our  caustic in the  the hole, cover it  with
anotherb;tof plaiste., let it  remain on 8,  to, or  ia
hours, according to the depth you would  wish it  to
penetrate.
  There is a liquid caustic used by some  under the
name of wetfire^ made thus : Take ashes ofdj&bark,
tnake a le, »>oil it down  till dry, put  it into a bottle
and put w;ld potatoes coit.   The potash imbibes the
moisture from the potatoes and forms a 1 quid  solu-
tion, which is  to be poured off  and kept  for use.—
Liquid- are  alwa\s unhandy c .ustics, they penetrate
but slowly to what the Caustic  in  a  dry  solid state
does.
   There is another caustic very proper in sotne ca<
ses, koovn to  the a .ci mts by the name  of  Pulvut
Angeli mj, made by rubbing burnt alum and red pre-
cipitate together ; v is very proper for dressing the
ulcer after the extirpation of a cancer with arsenic^ 
               PREPARATIONS^            51

and for taking out the skin which covers a  wer\
a! cr ns contents are taken out, and many other  pur-
poses of the kind.
              LUNAR  CAUSTIC

  Take silver in thin plites, or rather filings, one
ounce, acquafortis  two ounces ; keep them in a mo-
derate heat in ag1a«s vesseil untill the shver is dis-
solved; increase the heat uiuiil  the matter  become.
dry ;  put it into a large ciucible, increase the heat
untill the matter become thin like oil,  which it will
do before it b.-come red—pour it iufco an iion or clay
mould, or on a smooth iron pr stone and. cut it into
small neat pieces while hot;  keep them  well  sloped
in a glass---Copper or other u «-tta s w  II answer the
Panic purpose, but aie more subject to, l.quify.
         EMPLAISTERS, (SALVES }

   Plarsters are various  accoidingto the intention—-
we have seltcted a few forms, being as many as ws
Considered necessary.

   A c°mmon plaister, proper  for dressing  wounds,
ulcers, &c. fot ktepiig i-u'  the air ami cold, is ma<.'e
thus :   I akeof bees w.x and r.ui.ton suet, of  each
th»ee pounds, ot yellow iosin one pound,  melt theru
together and stiah. it w ile- hot.

   T he following is the  fvst preparation  necessary
towards making  a very .-ehl plaister, < ailed st'cki.ig
plaister, propei  for iiohihg on d e:-sine>,  &c.  it is
What was fnm Vy called Ut achy Ion, and is on'y of
Use as a base for <»ihei  plaisters, or to keep a part
warm and defend it f; urn the air :   Take  of lu-har-
a^e one iart, of olive or sweet  oil two  parts, bcil 
5»
PREPARATIONS.
them together-until the litharage is dissolved.   I«
this process it is necessary  to  add a little hot water
at times, to keep the oil from burning black—it must
be kept stirrirg until done—-it must not be made a*
hot as to fly alout upon putting in the water.
            STICKING PLAISTER.

  Take of the above plaister of litharage  five parts,
and of the best white rosin one, melt them together.
Thisplaister is used for keeping on other dressings,
and keeping the lips of wounds together  instead of
sewing them, and for drawing, or rather holding the
sides o.t ulcers in, during their cure.
  There is a mercurial plaister, directed  by dispen-
satory writers, but I think it  a superfluous  waste of  J
mercury, as every intention may  be answered by an-* f£
ointing the part  with mercurial  ointment,  and eft*
vering it with a common plaister or poultice.
                     ELM.

  The red or slippery elm may properly be mention*
ed in this place.   It  is the bark  that  is used as a
plaister or dressing in wounds, burns, &c. it ought
to be scraped or rasped very fine, and steeped in wa-
ter either warm or cold so as to form a viscid smooth
plaister, and is then applied to wounds,  burns, &c.
but is the most proper in burns.   I  have  employed
it ii.  wounds sometimes, but do  not esteem  it very
much, as it keeps the wound too moist and close and
will  prevent it from healing.  I have frequeutly em-
ployed it in form of tent in gun-shot wounds, and es-
teem it much better than the tent made with lint and
cerate, being easily  introduced and drawn.  It ought
to be beat somewhat soft and soaked in water  until
covered with gum. 
              PREPARATIONS.            '53

          BLISTERING PLAISTER.

  A plaister for raising blisters is frequently kept in
the shops, but this is an unnecessary waste of flies-
cover a cloth with any  common cerate or plaister,
#r even paste, and sprinkle the flies over it,-
        SUGAR OF LEAD OINTMENT.

  Take of sugar  of lead  two drachms, white bees
wax, two ounces, of olive  or other soft  oil  half a
pint;    rub  the  sugar  of  lead  previously  with
some of the oil, then add the rest of the wax  and oil
melted together and stir it until cold.   This is a«
excellent medicine  in chaps and excoriations.
              ISSUE OINTMENT.

   It is frequently of great benefit to keep  a blister
running for a length of time, and the usual method
of cabbage leaves  is insufficient and  inconvenient—
•the following ointment is intended for this  purpose:
Take of rosinous ointment seven parts, cantharides
one part, grind the flies very fine, dust them through
a search, and mix them well together.
              ROSIN OINTMENT.

  Take of hogs lard  eight parts, white  rosin five
parts, yellow wax two parts, melt and mix them well
together.   This is used for cleansing  and healing
wounds and ulcers.  Add spirits  of  turpentine suf-
ficient to make a soft ointment, and it makes, one of
«ht  best dressings for burns. 
 2*4            PREPARATIONS,

                  LINIMLN7S.

   Of these there are many d'rected by dispensatory
 Writers—-they   are   interd  d   to  give  ease,
 fcy app-yingex'iernjlly, and consist oi sp-rrs, cam-
 phire, opium ind soap.   I he f llowiiig; "'S an  excel-
lent one for revolving tumour* upon the  j >ints, soft
wens, bruises, &c.    fak-  of .a i-.de  or  otle»  g *d
soap one ounce, camphire  half an  ounce, spirits  uf
turpentine a table spoon full, whiskey or oilier spir-
its half a pint, vinegar hilfa pint, keep it wann a«d
shake it at tinc »or a day or two.  Anoint the par$
affected twice a day, or  wet a cloth with it and ap.
             CARBONATED LIME.

  I have treated: of lime, p3ge a a, where I also gavf
some directions for preparing the caibonated  lime,
but upon reviewing that article, I haye thought some
other ohscvaticns necessary.
  Carbin is one of the most  plentiful  substances in
nature; in combination with lime, itmak s  up near-
ly half the we-ght of good  limestone, maible, &c.
which it loofes in burning-   Chucoal is almost pu>e
carbon;  when drove  off from  these  substances  bj
burning, it unites wuh oxygen,  anl  becomes  an a-
cid, or sour air—large quantities of it are constantly
found floating in thje air, hence  if lime water  beset
in an open vessel, sp  that the air can come to it free-
ly, it unites with the  lime and "forms a  crust  over it,
whieh being broke falls  to the bottom, and  another
will soon be formed.  This crust is pure ca  bonated
lime, and may be ground fine and a swer  the .purpo-
ses mentioned, under the tit'e in  the  precede g pa-
ges. It may be prepared in a shortsr time,  as  men-.
tioned, page 2i, but if it be   not stirred  frequently,"
at will be formed in a crust aid  will f oi pr >c*ed ss
fast, but if agitated it will fall in a fine' powder. 
       WEIGHTS AND MEASURES.

               TROY  WEIGHT.

Pounds. '  ounces*   drachms.   scruples.   grains*
    x       i a       96        a83       5760
             I        8         24        480
                       x          3         60
                                 x         a©

             LIQUID  MEASURE.
Gallon.	pints.	ounces.	drachms.	cub. in»
X	8 l	118 id 1	1024 ia8 8 1	331 28.87$ 1.8047 0.3*56
   The exhibition of medicine to  the unaccustomed
by dra■ hm>, sctuples, g-ains,  &c. at first is  some-
Wnat di ;icult.   It is impossible for a physician at all
tinier to carry  his scales and weights about him,  and
it  would increase  the  demand very much if  tvery
person who should find it necessary to exhibit  medi-
cine sh uld purchase a set ;  but in fact there are  few
drugs which require so much nicity, and those  which
do. may be divided into  small parts  with sufficient
exactness by mixing a grain, or a certain number of
grain.,, w.th any oth r 9ub.ua.njce, ^nd d viding it a-
gai 1.  In oider to speedily  acquire the h;bit of  giv-
ing  >ut doses of medicine without weighing, put up a
dose   nicely weighed  in   a  paper----let it he Z
m- 1 He dose for an adu't.   By frequently-observing it
and making trials, a person will in a very short time be
able to g ve a dose of most drugs without  weighing,
e  g of tartar emetic put up 3 grains, orjalap put upi
30, oc calomel  put up c,  &c.  and such  drugs  as are
to h giv-„ in  p;Jh, and to be contin-ied  for some
lime, take aa much as you wish to make  up.  e.g. 
   56      WEIGHTS AND  MEASURE!

   ioo grains of calomel is to be made in pills contain*
   ing one grain each-rafter making it  up into a stiff
   paste with flour, fit for forming pills, roll it out intd
   a long roll, cut it into four  pieces, roll them again
   into smaller rolls like a pipe stem, divide in the mid-
   dle  and so on, make pills.
     When you are about to exhibit medicine to a strong
   robust person, it is easy to make the  dose a little lar-
-v.*ger, and to a weaker, smaller.   Such things  as are
   soluble, as tartar emetic, it  is easy to give a certain
   quantity at a dose—if it be a 4th or a 10th of a grain,
   by putting a certain number of spoonfulls of water
   to every grain, and  giving  as  many  as you would
   Wish  to give parts of a  grain at a dose.
     The same rule must be observed in  the exhibition
   of liquids—a drop from a two ounce vial of spiritpui
   tincture,  as tincture of  opium, weighs about half a
   grain—a  common tea spoon  holds about 66 drops', and
   it musL be a very small one  that does not hold 45.—
   To ascertain the proper dose for children  of differ-
   ent ages,  is also somewhat difficult ,to the unaccus-
   tomed.  For a child of three years old, one  third as
   much as for an adult, is generally a  proper dose.*»  t
       It  is an opinion  among the  ignorant that a
   child cannot bear  some medicine,  as tartar,  jalap,
r  &c. this  is an error, they bear them as easy, if  not
   more so, than adults.   1 have  given tartar  to chil-
   dren  of  every  age, v/ithout any  bad consequence
   whatever.  There  is  some nicety  required in  the
    administration of opium to infants—to a child un-
    der 10 or 12 days,old,  it is  not always safe  to give a
    drop, especially to new born infants, from one fourth
    to half a  drop is  enough, which may  be given then!
    by dropping one drop of laudanum into 8 or  10 drops
    of breast milk,  and then dropping out 2, 4 or 6 drops,
    as may be thought proper.
       The best form of exhibiting emetics is in solution
    in water, as their effects upwards are more  certain,
    but if it is intended that their operation  should  not
    be very sudden but more  permanent, they "may be
    given in a pill or powder, and in a larger dose. 
WEIGHTS AND MEASURES.     57
   The following is a standard for  doses, from  the
 American dispensatory.
                                     Grains.
 Aloes     -                 ,      from 5 to 15
 Bears foot            -              10    20
 Castor      -      -       -      •    10    20
 Peruvian bark       -       -      *    ao   120
 Columbo    -                         10    a%  *
 Jalap      -      -      •      .     20    36"^
    extract      -      -      -      10    20
 Verdigris      -      -          -   1-8    i-at
 Blue vitriol      .      -      -     I-2      I
 Stramonium      -      -              1     e
 Digitalis      -                     n
 Iron filings             -       .      3
 Steel dust      ...         l
 Gum guaiacum     "      .      -     10
 Red precipitate      -      -         j.a
 Corrosive sublimate      -      „      x.s
 Cinnamor*.     -        .
 Camphire       .       .        -    '  3
 Magnesia    -      -          -   -   in
 Mu k     -      .
 Opium       ....
Seneka, pulv.      .                   V    6t>

ll*\  k  "                     "      IO    30
Rheubarb      -      .        .       T«
Sugar of lead
       3
      10
       5
      20

     1-*
      20
      20
      20
5    ao
1-2     %
10    40
X-3    5
^orctirld'o^sp"lrito!sea sait>from ***>

Spirit of vitriol    .      .             10     40
Tincture of columbo     .    ".       H     ?®
Tincture  of digitalis
Tincture  of iron
Ticture  of gum guaiacum
Tine tuie  of opium        ,      .       *
Tincture  of cantharides      -      .   1Q     *°
H
IO    40
J5    3°
20    30
10    40
10    20
49-
ao    4o
*°    3o 
$8     WEIGHTS  AND r.ZEASUREl
 Ether,  (nitre)    -     -    -    .   _ xo     ao
 Ether, (sulphur)         -        -     20     60
 Oil of turpentine       •     •       -    10     30

                                     -  Ounces.
 Lime water       -       •       •      4    I2>
• Seneka, in decoction      -     -     -  1.     2
. Castor oil      ...        1-2     X
. Antimonial wine       -       -        1-3     *

   These are the doses for adults from 20 to 60 yeart
i ef age—-they may be  varied for children according
„to the following-table :
Age.	, Proportic
JVlonths, 2	1.15th
7	1-12
14	1-8
28	*-5
Years, 3	1-4
5	i-3
7	1-2
34	2-3
63	11-13
77	5-6
100	46
  Sixty drops of water, ons hundred of spirits,  of **■
one hundred  and twenty  of  pure spirits,  make  a
drachm by measure—480 drops of water make  an
ounce—so that if a person wish to give any  certain
portion of any soluble substance in solutionis tartar
emetic, he. it may easily be done by attention to the
above rule. 
BjWMjgMggiggw p*ES*2gS*S!SSiSji*
                   REGIMEN*

   Physicians in all  ages  have  pbced  considerable
 ptress upon diet, drink, &c.  in sickness,  and.it is
 true that it is frequently necessary to pay seme *at- *
 tendon to  the mode of living  mete  ihan what the
 appetite will suggest ;  but I am clear in the opinion
 that many  have  carried it to such  an" extent  that
 they have done more harm than good by it.   In pre- '■
 scribing regimen there are but two objects  in ques-
 tion, which is recording to the intention  to  be an-
 swered—the first is in  those  diseases which  Dr.
 Brown calls the sthenic  diathesis, cr  that state, cf
 the body in which there is too much strength,  l&at,
 or increased action of the body, as in all ir.flamaiory
 diseases, v/ounds or ulcer?, where there  is too great v
 a discharge cf matter :  the other he calls the  r.s<hun-
 ic diathesis, or  thr.t.state of the boJy h: \. l.ich there
 is a want of strength ir.a  action.    lor  the  former
 rtate, light diet or evcn.  starving v/iih coll  water,
*cool air, bleeding,  purging and vomiting, heirg all
 means of reducing the lutt and action of the system,
 are ['roper,  in the asthenic, or disease  with weak-
 ness,  in which  there ate  ulcers or wounds, they are
 dry, &c. the contiary regimen is 'proper, as strong
 nourishing diet, heat, Sec,
   Through the  following work we  shall  often  have
 occasion t,» prescribe the regimen in the cure of cl:sr
 eases, and in ordtr  to avoid-the necessity of  repeat-
 ing the various  articles 01 diet which belong  to the
 cold or hot regimen, I shall  point  out  some  of tba
 most proper article, and f.n.is of d-tt  which belono-
 to each;  and.it may be observed th-t wheie  the . ct
 gimen is not prescribed in the method  of cute,  that
 it is  unnecessary to P„y a..y attention to  the  diet, as
 ai.,. alteration from the usual  metis of living is un-^
 f.vcessary.
 ^  All kinds of fruit, ei.her  raw  or  dressed in any
 "'n1' bcion£ tc th- sochi,- --J ■•■<", and ar* also ts 
6o
REGIMEN.
 be considered even as medicine, as they are of great
 service in keeping the bowels lax.   Panada is  a  ve-
 ry good diet, and may be varied to suit the appetite.
 One of the best forms  is to boil good light wheat
 bread in water and add  a  little  sweetening,  and  if
 agreeable, a little  vinegar, cyder, or even  wine may
 be added;  but  if much  fever, or  any inflaraatory
 symtoms be present, the cyder and wine are not  so
 proper.  In fever it often happens  that the patient
 has no appetite for many days,  and  without  proper
 treatment sometimes  for weeks—the friends  are  a-
 larmed and suppose the patient must perish  or suf-
 fer, but in this  they err, it is seldom proper to force
 food upon the  sick  against their  will—in  these
-r-Mes. buttermilk is one of the most valuable  things
 t   . can be given—it serves as drink, and  will sup-
 port the patient, and often is as strong  a diet  as  is
 proper—being acid, it is a cooling  medicine  and  al-
 ways sits easy upon the stomach—if sweet milk be
 snide a little sour with vinegar,  it will answer very
 well, but it does not sit  s > easy on the stomach, and
 where the patient is taking med'eine it will be more
 apt to prevent it fiorn having effect, and it  is also
 harder of digestion.   When light  diet  is  directed,
 fresh met, as chicken, veal, or even beef, with fresh
 meat soups, will be proper, but in that case  the meals
 ought to be more modi-rate than usual—pork  or fat
 mutton mav in  this case  afford  too much  nourish,-
 ment.   This kind of diet is especially proper in the
 cure of the venereal disease, or  any other  where a
 mercurial course is necessary, or in the  cure of old
 and obstinate ulcers, as  in the legs, &c___in this re-
 gimen, it is proper to season with salt to suit the ap-
 petite, but avoid spices, spirits,  &c.   After a spell
 ©ffcver, or  other  sickness, when the^  appetite re-
 turns, it frequently returns suddenly and strong, and
 1 have often seen a patient crave broiled beef, steak,
 or ham, the first thine,  and  I have never known any-
 bad consequences follow the indulging them in what-
 ever, they may de ir**, but they ought not at first  to
 fully'gratify their appetite, but. eat a little at a time 
REGIMEN".
61
  Sndoftener.  Cool drink, as water, buttermilk,  &c.
  is always  proper—nothing is more  injurious  and
  weakening  than to keep a person upon hot drinks.-—-
  Butter is one of the strongest  diets,  and  is  always
  hard of digestion, and therefore imptoper in sickness.
    There is little that can be said upon the other,  or
  strengthening regimen—a person's   appetite is  as
  good a guide as any,  but it may  be  observed  that
  good soup is one of the best forms  of diet;  and it
  may always be made a rule, that where  bark, wine,
• or opium is  proper, the strengthening regimen is also
  proper, or that no diet which affords sufficient nour-
  ishment in moderate  quantity.wiil be injurious.
    A most egregious error still prevails  among the
  good women and much mischief is often done by it,
  viz. keeping child-bed women too hot and upon warm
  drink, as tea, water &c. A woman after  delivery ought
  to alter as little from her usual mode of living as possi-
  ble ;  those  aci ustomed to the air ought  still to have
  fresh air,  their  drink should be cool, but in smaller
  quantities, as a gill at a time, and that as often as they
  may want it,  her diet should be nourishing from the
 first, nothing tends to weaken more than warm drinks. 
BLEEDING.
  'Bleeding is an operation that requires more  car©
than skill in the pt rformance, but  icquires  as  much
Skill as any other nud Cdl prescription to kn >w when '
it is proper.   It is a remedy employed by trie ignor-...
ant upon ail occasions, being one that is within  their
power at any tim-, it -seldom  does much harm, and
is.often of service; but in some cases  it proves in- *
junous, by  inducing  debility  and  protracting the
cure.  'I he doctrine cf plethora, or a redundance cf
thick strong blood bein^ a cause of disease, is  very
much laid aside among physicians.   The pulse with a
skillful physician, may be a good criterion  to decide
as to the propriety of bleeding,but  for my part I have ■
seldom thought  proper to depend upon it altogether. .
   In inflamatory diseases, during the first stages, the
pulse is fu'l,  quick,  and hard—this among physi-jj
tians is almost universally considered as  an  inoica-
tion of the propriety of bleeding, but where the  dis*
ease be fever, and that known  to' be of ihe bilhous
kind, bleeding  is  not only often unnecessary  but
impioper, as it prolongs the disease—such is the case
in   n ost  of  fevers   in  this  country.     Where
plentiful bleeding  has  hi en   employed  in  fevers in
this country, ihe disease has never failed to be pro* •
tracted, if it has rot proved Ltal.   I seldom bleed
until I have first employed other remtd cc—if I fail
to remove the fever, and the pulse  remain quick and
had, however small it may  be, 1 then judge bleeding
proper ;  if bleeding at first fails to give relief, it will
be unnecessary, if not iir.prrpcr to repeat it often. It
is n. t the drawing off the Lad  blood -that  is of ser-
vice  in diseases, neither is it lessening  the quantity
because the system is too full, but it is  because the
stiengthof the  arterial fystcm is  not able to  pi o-
pell the blood with sufficient velocity, in cons-, cutnee
of the loss cf streigrh : or, as in highly h.flainatory
fevers, the increased action upon the mass  of  blood 
                  BLEEDING.               63

induces too much heat, which in its turn serves to in-
crease the irritability or the systeai, and h one Cduse
of the increased action.  To lessen the  quantity  of
blood, is a means oi lessening Lh=r  irritation  m a du-
plicate ratio—hence it i* found to be one of tie most
powerful means of removing  iuilaniation, whether
local or general.
   Before the circulation of the blood was discovered,
physicians supposed that the different ve;n:i termina-
ted in the different parts of the body, a> the cephalea
in the head, &c. hence blood .vas to be drawn  from
the different parts of the body according  to  the seat
of the disease, and they supposed bleeding to have a
tendency to draw the cusease toward tie part where
the operation was performed.   But  these opinions,
which were evidently founded in ignorance, aj-e near-
ly iuiilXiside—it is now known  that  every  drop  of
blood in the body passes through the heart,  at least
three hundred times every day, or six or seven hun-
dred times in every twenty-four hours—hence it  is
easily seen that it is entirely immaterial  whit  pjrt
of the body blood is  drawn from—the arm is the most
convenient, the skin is thiner and the  veins larger.
  There are arteries and tendons tlm lie close  ui.der
the veins  in  some parts of the body—an  artery  is
known bv its pulsation,  which  is  frequent in the
bend of the arm.  In bleeding where a pulse  is felt,
great care  is  required not to cut into the  artery,  as
it may be very clitficnlt to  stop  the  blood—where-a
tendon is near it, it is known by its hardness, and'the
injuring ifought to be avoided.
   Another evil frequently happens for  the want  of
care and sometimes for the want of judgment, even
in physicians, which is not cutting the orifice direct-
ly into the vein, but by drawing the  skin  downwards
with the left thumb the orifice m the skin will be a-
bove as soon as it is let at liherfy,  and if the orifice
should be small the  blood will lid up the cells in  the
cellular membrane, and is very  fret;i:ently  attended
With bad and sometimes fatal consequences.    When
thu happens to any extent and becomes black and 
CM
BLEEDING.
 painful, an incision made into the part is one of thi
 best remedies, and the "next beat is to apply a linen
 wet with spirits of hartshorn, two or three timts in
 the day.
   It would be difficult to give directions for holding
 the lancet, but it may be observed, that if  the lancet
 is held too low behind it  is  very  uncertain or diffi-
 cult to open a neat orifice—the incision  in the  skin
 will be long in proportion to that in the vein—if  it
 is held too steep, it may pass through the vein  too
 far, and be apt to injure the parts below ;  but if  nei-
 ther tendons nor arteries b?  in the way, it  will do no
 injury.  It is  always  best to make the  incision with
 a pretty quick stroke.
   I have sometimes met with cases in fevers, pleu-
 risies, &c. in which the vital principle was so far ex-
 hausted, that the circulation  had  nearly  {.topped in'
 the extremities—the  blood thick and heavy, so  that
 it was extremely difficult to draw offa sufficient quart*T
 tity ; while bleeding is one of the best remedies.  In
 this case blood may be drawn from the  jugular veins
 with ease and entire safety—the blood  returns from
 the head to the heart  with more  force than it does
.from the extremeties.   In children, when the veins
 are small and the child fat, it is  often very difficult ,£$£
 to draw blood—-in this case it may be drawn from the  ■*
 jugular also. 
PART SECOND.
On the  cause, distinguishing symptoms  and
      proper method  op  curing diseases.
                   FEVERS.

  Those diseases wherein there is an increased heafc
cf the system, the pulse is quicker than in health.—■
There is an interruption of some of the natural func-
tions? especially of the secretions of sweat,  and of
moisture upsn the internal- surfaces,  as  the mouth
and stomach.  Diseases attended with these symp-
toms, are various, but may be considered  of two dis-
tinct classes—the one a primary disease*  the other a
symptom of some other.   We  shall first consider
those of a primary  kind, with their causes, distin-
guishing symptoms and proper method of cure.
  Medical writers in treating of the cause  of  dis-
eases, have divided the cause  into  two classes,  the
remote, and proximate.  The remote cause is the fo-
reign matter or power that when applied to the body
produces the proximate cause of disease,  6r that  ac-
tion or state of the living solids which are called dis-
eased.  The remote cause of intermittent fevers,  is,
now known to be some effluvia that arises from stag*
nant water or wet grounds in a warm season,  and
now known under the indeffinite names of marsh ef-
fluvia & miasmatta—what the precise nature of  that
matter is, has not been ascertained, but it has  gener-
ally been supposed to be the production of vegetable
matter in a state of putrif.iction, but from a  number
of facts which I have observed since I have been  in
Kentucky, I am clear in the opinion that  it is  simple 
66                  FEVER.

hydrogene, or the base of water in  combination  witri
caloric or the matter of heat; and I have thought it
probable, that the solution of vegetable and perhaps
animal matter too, may be necessary to furnish cal-
oric to effect a decomposition of water, while the
caloric that made a part of the substance of the ve-
getable enters into combination with the hydrogene
and gives  it the gaseous form.  This gas or air has a
strong smell resembling putrid fish—this smell is very
common about stagnant water," marshes, &c.  especi-
ally in the evening or at night.  Lavoisier says  that
it is but one thirteenth part  as  heavy as  common
atmospheric air, and of course it soon rises  into the
upper regions—it is highly inflamable, and may there
take fire and form  those meteors so commonly  seen
shooting in every direction at night.  From a  num-
ber of observations which I made on the Ohio,  a few
miles abot^tbe rapids, during a very sickly season,
I collected a number of facts which go to prove that"
the  matter  which   produce  those fevers  is  much
lighter than common air, and has some, if not all, the
properties of hydrogene gas, and  we know  nothing.' \
about the  properties of any other gas or matter which
arises from  either stagnant  waters or  vegetable or
animal matters during the  putrifactive process, I
therefore  conclude  that hydrogene  when applied; jjj
to the human body produces  those diseases called  iri-
termittent fevers, and perhaps most other  forms  of
the same disease.  To explain all the phenomena  at-     i
tending, or consequent upon the proximate or imme-
diate cause of that state of the  body  called  fever,  id
may be difficult, but I think the most of them may be
explained to a degree of csrtainty.   The ingenious  U
investigation of Dr. E.  Darwin has  thrown* much  j
light upon the  subject, but in order to render his the-  1
ery entirely new and consistent he has  gone into  er-  1
ror,  by  attributing every  phenomenon to certain  !j
modes of animal actions, entirely distinct from chem-  I
ical and mechanical  process ;  while I  should sup-  1
pose that it would require a good deal of philosophy
 to enable a man to believe that such a mass of flud* 
rEVER.
6-,
 and solids as an human body, in such a high degree of
 temperature, that when deprived of life so soon runs
 into a state of putrefaction, should not in any degree
 be liable to that process while living;  or that  the
 paroxisms of an intermittent fever depend  intirely
 upon a mere libration between an extreme of debility
 or exhaustion & an accumulation of sensorial power.
 Without attempting a refutation of the absve theories,
would hope to be pardoned  for  my presumption  in
attempting another solution of those mysterious phe-
nomena that may differ from them in some points.
  Hydrogene arid caloric, or if you will  have  it  in
 plain English, the basis of water and heat,  are  the
 only twq agents in the putefactive process, and a vs-
 ry small quantity  of water with a  proper degree of
 heat, is sufficient to break down by that  process the
 structure of all bodies at all subject to it.  Hence  I
 conclude that hydrogene gas is the very essence, or
 rather the active power, in  the putrefactive  process,
 and if  this be  right,   when  taken  into  the  lungs it
 may be  absorbed  and carried  into the circulation,
 and so far change the state of the fluids as to  act as a
 stimulant to the sanguiferious system.   I hav  >-.»en
 long of the opinion, that  the first;  sensible effect ef
 this mstter upon the system, was that of a stimulant.
If a large quantity be taken in suddenly by a person
unaccustomed to it, it excite? the system into action
and causes a flow  of strength and spirits, or in  Dr.
 Darwin's language, of sensorial  power,  which may
 be so great as to be observed by  the patient  himself,
 or those about him—he supposes  himself in an un-
 common high state of health—this  lasts with him but
 a snort time, perhaps aot over twenty-four orthirtysix
 hours, before he begins to feel  his apirits sink/he
 feels a soreness and lassitude, sometimes a chill suc-
 ceeds, followed by a fever, with all its  concomitant
phenomena.
  In the first place,  the effluvia  when  mixed  with
 the blood, either directly proves a stimulant  or by
 changing the state of the fluids by  a commencement
 •t,  or a tendency  to, the putrifaxtive process, proves 
<sa
FEVER,
a stimulant to the heart and arteries.  The contin,
ual application of this stimulus, increases  the action
of the sanguiferious system, and is the cause of the
increased heat, which in its turn increases the sens*.
bility—the violence of this process  at length ex.-
hausts the irritability—a state of quiescence or  in-
activity comes on, or the  actions  at least besome
weaker,  lassitude  is  then  perceptible—during this
state of quiescence, the circulation is  slow but the  L
pulse is still quick and small—the  blood  now  exper  *}]
riences a considerable change, both in its appearance
and quality, for the want of due oxygenation  it  be-
comes thick and black, the arterial system  is unable
to acquire a sufficient stock of irritability, #or  senso-
rial power, to render it capable of being  roused into   ^
due action again, hence the pulse becomes small and *
hard, their motion  is like the steps  of a  weak man
under a heavy burden, he steps  short and quick, bu*
takeoff apart of his load and his steps will be longewfe',
 and slower—take off a part of the load of blood  bjp* i
 bleeding and  the  arteries are  then able to empty«ht.*
themselves more completely, of course the pulse is
 fuller and softer, but there being no change  effect-   ,
 ed as  yet  in the state  of  the blood,  the  fever
 or  heat and increased  action of the system still
 remains.  If the blood be  examined when cold, it
 will be found that the gluten separates from the  red
 globules, which for the  want of oxygene  are dark .;■
 and fall to the bottom ; or if the putrefactive process
 has gone a little farther, the blood appears mixed red
 and black, and will not form a coagulum—livid spots
 appear about the joints, a foeted cadaverious smell is   *
 perceived, with every symptom of putridity. But says
 Dr. Darwin, if the putrefactive process was to take
 place, air wonld be evolved, and sudden death would
 be the consequence.  But I have never seen  an  in-
  stance of blood throwing out air, or at least  enough
  to cause ebulition, though I have seen it in  a state
  of putrefaction ;  but it is in the complete death  and  „
  putrefaction of the solids that this air  is  seen.  I
  think it unnecessary to insist any  farther upon  ths 
FEVER.
6?
  possibility or even the probability of the putrefactive
 ' process affecting the whole system  during life,  as
  there has been  instances enough of its proceeding  so
  far before death, that the corps as soon as the breath
  was out has been found so putrid as  to barely hold
  together until  it could be  disposed  of;  while even
  before the breath was gone the foetor was  intolera-
  ble.  This appears to be the course  of the disease
  where the stroke was sufficiently violent; but when
  it is lighter, or owing to some state of the  system,
  after the first precursory symptoms are past, and the
  state of lassitude comes on and  has continued for
  some time, there is an increase of sensibility! there is
  a sense of soreness felt in the muscles of the abdo-
  men and in the the thighs,  shortly after, the blood re-
  cedes to the heart and large vessels.  The  cause  of
  this recession of the blood and  high sense  of- cold
  when the body is actually as warm as usual, and that
  in the warmest weather, is  not easily explained.   It
  appears to me  that the system  perceiving the  pres-
  ence of some injury in the distant part of the sensi-
  tive organs, the blood and nervous fluids, or spirits,
  recede to the central parts  as if by a law of the  ani-
  mal economy,  intended in certain  emergencies  to
  render the surface less sensible of injury,, as in  sur-
  prise.   It appears to me that the cold  stage  com-
  mences with  an increased state of irritation from the
  predisposition to fever,hence the recession of thespirit
  of animation. The inactive state of the vessels on the
,  surface, admitting of an accumulation of the senso-
  rial power of irritability in the  extremities of the
  nerves and sensible parts on  and near  the surface,
  with an  accumulation of the  spirit  of animation  in
  the prime sensorium, both combining to  throw the
  system into violent action, this violent action is the
  cause of the increased heat  of the body,  which to-
  gether constitute fever.
    We shall now endeavour to explain the remaining
  phenomena attending the paroxism  of an intermit-
  tent fe\er, which are the state  of the secretions  of
  ci:ne,sw«atj&c. 
^o                  FEVER.                        1

  The urine during  the interval differs very little    J
fiom a state of health, and during the cold stage it is
pale and in small quantity, and without  sediment—
during the hot stage it  becomes  high  coloured, but-    |
stilt deposits no sediment—after  the sweating stage
comes on, the urine continues high coloured, but be-
gins to deposit a sediment, and continues to do so for
eome time after, until  it regains its natural color.
During the cold stage there is scarcely  any percep-   M
tsble moisture thrown out' from  the surface, which *   H
may be discovered by holdiBg a glass or  any cold  •  . <
polished body near the surface—it is the same during
the hot stage, but previous to the commencement of
the sweating stage, the moisture begins to arise and
soon comes out in such profusion that the heat of the
 body is not generated fast enough to give it the gas-
 eous'form, and hence the surface and cloths are wet.
   Now it appears to me that there is something lodg-
 ed in some part of the system, which acting like an
 yest, produces, or communicates a taint to^he wholo
 taass, and is the cause of another paroxism.
   I suppose this poisonous or putrid leven, or what-
 ever it may be called, to be lodged in the glands,  and
 those which are soft are distend with it,  or by it,
 as the spleen, liver, he.
   It only remains upon this head for  me  to answer
 some objections which  have been urgtd against  this
 theory of fever, as far as it may be  considered a  mo-
 dification of the old, doctrine of a morbid lentor  and
 putridity with its expulsion, and in doing this I can-
 not afford to enter into a minute  discussion of the
 various objections which may'have been started, but
 there are one or two which deserve notice—I have
 already mentioned one, which is, that one concur-   *;,
 rent circumstance always attendant upon the putre-
 faction of animal matter, is the  evolution  of a  gas,
 or air.   It appears to me that there must be a com-
 ple solution of the parts before the  gaseous matters   *
 could be set at liberty so as to assume that form, and    '«
 as I observed above, I  never saw a visible gas thrown    1
 cut from bleed in a state of putrefaction ; but thers   ' 
FEVER.                  ji
 i$ no doubt but the foetor which always  attends  the
 putrid process in animal matter after it arrives  at  a
 certain point is a gaseous matter, but I hope that no
 person will venture to assert that this gas  is thrown
 but in sufficient quantity to induce anebuliti'on in the
 very first moments that the putrid process commen-
 ces, or that the air or gas so visible in the mortifica-
 tion of animal solids arises from the living parts in a
 state of putridity, while yet half alive.  The putrid
 process in a living body may differ materially from
 that of a dead one, but  although we are  not able to
 explain satisfactorily the cause of that difference, it
 is not a sufficient reason for doubting the existence
 of it, it maybe  owing  to  its slow  progr-so,  being %
 kept back or  modified by the action of the system,
   I observed above, that I though- it probable  that
 the miasmatta,  or rather hydrogene gas, was the re-
 mote cause of all fevers of a  primary nature, and  I
 might say from yellow fever, or plague,  to the slight-
 est cases of billions fever, and the difference is  ow-
 ing to  either  a difference in the state of  the  body or
 the state of the gas, and other circumstances. There
 is also a great difference in the type of those fevers,
 although they may be epidemical, owing  to the state
 ofthebedyandto the  difference  in situation.   In
 those who hve in high and dry  countries,  especially
 in free-stone, the inflamatory symptoms  run higher,
 are cured by  depletion only, and seldom  ever re-
 E t,he.barkfc» wine, Pr opium ;  but  in  lower situa-
 tions, as in the neighborhood of rivers, ponds, marsh-
 es, &c.  almost every case inclines to he remittent
 or intermittent  kind.  In higher situations  i?l"me

 ZTsTZTandgeneraffytowards  *«  "«&



ponds, &c/and«pS in   °^   ^^ °*- "^
come aft.r tZfT^.n  S°Uthe™  countries, be- 
***
FEVER.
situations, the fever is but light, an indisposition is
generally felt a few days, a chill comes on, and fever
follow of the pure intermittent or remittent type.
SYMPTOMS  AND METHOD OF CURE IN
                    FEVERS.

  The fevers so common in this  country,  and all o-
ver the continent, and which is the effect of effluvia
mentioned above, varies its form, and is either a con-
tinual fever, remittent, or intermittent.   A  contin-
ual fever is the most common form, in its first stages
atleat,and thi symptoms vary only in  degree.  A3
the usual precursory symptoms  are  seldom taken
much notice of, I shall not notice them in this place.
When  the fever is fully formed, there  is  a pain in
the head and back, and frequently in  every  part o£
the body—-a. sense  of something like a  flame,  fre-
quently flies up the spine to the head—the skin is dry
and hotter  than usual, the pulse  is in general  quicker
and harder—sometimes thepulse  is small from the
first, but more commonly not until the  fever has con-
tinued for some   time——-the  patient 13 generally
drouthy and desires cold water—if the fever be the
pure intermittent kind, in  its first stages, water has
a disagreeable taste, as if mixed with  soap ;   but  if
that be  the case, it soon changes into its  proper
form.  Sometimes the above symptoms are so slight
that the patient will keep  about for  days, or even
weeks—in others the attack is  sudden and  violent*
If the attack be slight or rather slow, the fever gen-
erallysoon shows symptoms of putridity, or is attend-
ed with nervous affections, and scarcely ever has any
intermission.
   These are the symptoms common in the western
countries,  and sometimes in  the  Atlantic states
where agues are common,  but in the higher parts ,o£
the Atlantic states, and especially in  the  free-stone
 countries,  the only symptom is of the pure inflatnato;-/ 
                     FEVF.R.

 kind, scarcely pver -ruinate in agues, except  upon
 1 irge rivers, or very large ponds or marshes.
   Tr>'.;tmcnt___I he treatment <vill be  various  ac-i
 cording to the symptoms.   If  the patient was full of
 blood before the attack and h:a pulse is hard, bleeding
 will be necessary, then a vomit with tartar emetic,
 and after the-operation is "over give plenty of cool
 drinks—begin wiih small quant * <es and  increase it.
 During the operation, keep  the  patient  warm, and
 for some time after, let him gradually cool and keep
 as* cool as he may desire, and let him  take as much
 cool water as he may wish, and cocl air also.  In  the
 i!'.vt place it will be necessary to keep  the bowels
 reg :lar—for shis  purpose,  cream  of  tartar is  the
 best, or tai tar emetic ; if the fever 'ccatinues high
 until next morning, it will be  proper  to  give  tartar
 emetic in small  doses in cool water for. several hotirs
 —for this purpose, dissolve fotlr or five  grains in
 three times as  many spoon-fulls of water,  and give
 one  at a  time, half an hour apart—this will  scarcely;
 fail to loosen the belly and abate the fever.,  Towards
 the  evening of the  sesond day, if  the pulse should
 continue quick and hard, complexion  high and sur*
 face dry, it will  be necessary to bleed again.   This
 course will seldom ever fail to bring on a remission,
 if not an entire intermission in 24 or 48 hours,  after
 which it  must be treated as  such.,
   It may be necessary to observe that it is  always
 proper to keep the patient as quiet as'possible—if he
 has any appetite the cooling regimen  should be  ob-
 served.    ...
   It has become a very  common  practice  to  purge
 with calomel and jalap, but I think  the practice im-
 proper;  it may answer in.pure miasmatic, or rather
 hydrogenic, fevers ; that is, where the fever is known
 to proceed from that cause, and that it will readily
 run into that form,.or upon the first attack in  other
levers ; but after the fever has continued a few daya
U is  improper, as it weakens  a person  much m< re
than a puke, and never has as good an effect in break-
ing the fever.
                     k 
 ?4                  FEVER,

   Whenever the fever terminates in in intermittent:
 or  remittent fever,   it is to be  cured with  the
 bark, wine and opium, (which see) but in doing which
 never neglect to observe the following  rules :  If a
 remittent fever, (dumb ague) begin to give the bark
 In the morning when the patient is  most free from
 fever, and even not then unless some moisture can be
 perceived upon the forehead.   Continue to  gfive it
 at intervals of half an  hour or more apart; if it  op-
 press the stomach, opium  may be given.    If  thd
 forehead becomes dry, and the fever begins  to rise,
 decline giving bark, &c. for that time ;  and endeavour
 on the next morning to break the fever  more com-
 pletely by another puke, and on the third  day  the
 bark, coluftito, or some preparation of iron,  may bs
 tried again, with opium and plenty of acids, blisters;
 &c. and in the mean time,  if any symptoms  of  pu-
 tridity should appear, give  15 or ao grains of cam-/
 phire, ground up with white sugar, three or four
 times in the day, and continue the bark and wine or
 good old cyder—tartar emetic in small doses three or
 four times through the day  will also  be of advan-
 tage.
  In a pure intermittent fever or ague, observe the
 following rules :
  Let the time of accession  be  known—give a dose
 of tartar, or rather puke with tartar, on the  day be-
 fore you intend to give the bark—begin to give the
 bark two hours before  the cold stage  is  expected—
give it in large doses, as from one to two drachms,
from hslf an hour to an hour apart, according to the
 size of the dose and other circumstances—after the;
second or third dose,  give  ten or fifteen drops of
laudanum with every dose, or every other, as the case
may require—the laudanum wiil assist the operation
 of the bark, and prevent it from  gryping  or  running
offby stool—continue to give it  until the time of ac-
cession of the cold stage is  past an  hour 6r two,
when the doses may be both less, and  less frequent.
 On the day following, give about three doses, mor:> 
                    FEVER.                  75

ing, noon, and night—the next two,  and the third

  It mav be further observed, that the forehead be
moist during the whole course, for if any fever be
present, or rise, it will be not only in vain to give the
bark, but injurious.  This course, if rightly managed,
will never fail to cure an ague, and so as to prevent
the return, except in those who from  a high  and
healthy situation have settled in  an unhealthy one—
in such it will be apt to return three  or  four times
during the first season, but is always easier cured af-
the first attack.
  There is one or two observations  which may be
proper before we quit intermittent fevers.  A  hard
tumid spleen frequently remains  after the ague, is
cured, and is frequently painful, and as long as it re-
mains, the patient cannot  be said to be well—his
complexion will generally be bad.  In this case, if it
should remain any time after cure, it  will be  proper
to puke with tartar once  or twice,  or a mercurial
purge, as jalap and calomel, may answer, and  anoint
the part well with strong mercurial o'ntment—rub it
in well every night, and if something hot  be applied
it will still be better.   It is the  same with hot liver,
which  frequently  remains if the   cure has not  beea
Well conducted.   After purging, iron, bark, &c.
  It is generally believed among the vulgar, that the
agus may be  cured  in almost  every instance by
charms, and a thousand other insignificant tricks.—.
The whole mystery in this, is, that  in some  slight
cases,  or where the system has nearly overcome the
disease and ithas become one of  Dr. Darwin's casts
of mere l'.bratlon  between two  extremes, or  rather
it has  become habitual, while the first cause has  gone
off, a strong impression made upon the mind, especial-
ly at or just before the time of an expected paroxism,
Will support the energies of the  brain  and prevent
the fit; but this will not answer in infants, because
their mind* cannot be impressed with a sense of hor-
ror; neither will it answer in a  person of  a  sound
iuc^ment, who is usable to believe in the agency  of- 
t$                  FEVE*.

angels, devils, ghosts, hobgoblins, witches, vWnpyrs,
and a long catalogue of invisible, immaterial, medica|
physical agents, that never had any  other existence
but in the imagination of the credulous ignorant.
                   TYPHUS.

  The next state of fever which I shall  take  notice
of, is, what among physicians is called Typhus—it is
sometim.! called the slow fever, nervous  fever, &c.
it is called  Typhus from a Greek  word  signifying
stupor—slow fever from its  slow  or  gradual  pro-
gress—nervous, when any nervous affections attends
it, as involuntary motions, such as a twitching of the
limbs, &c.   Sometimes the patient goes about, as
mentioned  above, for a considerable length of time,
and in some cases until within a day or two of death
symptoms of putridity always  attend in  this case,
while the febrile symptoms never run high, but  are
constantly  present.  In other  cases the attack is
more violent, but soon puts on the  nervous appear-
ance, with stupor, a loss of voluntary motion,  a dif-
ficulty of pronunciation, a  trembling of the hands
with an inability to use them, deafness and blindness
generally attend, when the pupils of the eyes will be
found larger than usual, being all symptoms of great
debility.
'-'- Blistering the extremities is one of the first reme-
dies to be employed—opium is the next, and  should
be so managed  as  to  produce  some  moisture, but
Without much heat.  Calomel is a proper laxative if
Costive, and maybe of service as a stimulant  to  the
system generally—the tincture of iron made with the
spirit of sea salt, is also of service.   The elixir  of
vitriol should be given with all the water the patient
drinks.   In this fever the patient seldom has any ap-
petite4or food,  and must be supportedby buttermilk,
good whey, vinegar, cyder, wine and even  spirits is
proper—In this state ef fever camphire is also  ex<* 
\
                   FEVER.                  7}

cellentr  The intention of cure should be  directed
to the following objects :   First, to excite the tor-
pid insensible system into stronger action—second,
to keep the bowels lax, and to present putridity both
in the bowels and  system generally—and third, to
support the patient by some drink that  may afford
nourishment; also, by  cordials, as wine, &c.   In
this state of fever I have rffever yet lost a patient,
except ohe, and that was  through  the  nigardly  pe-
nurious disposition of  her father,  although I have
often seen persons in it unable to  pronounce  a  sin-
gle word distinctly, or to  raise a hand to  their'head,
but it requires more care-and attention than  anyo-
ther state of fever.   The physician should  attend
}o the exhibition oi' every dose until there is an evi-
dent change for  the  bettsr, which generally  will
take place under proper treatment in a  day or two at
most.
   After a person recovers from a low state of fever,
he should be very careful to  live   regular for some
time—eat and drink moderately—be  careful  of  ex-
tremes of either heat or cold, and use moderate exer-
cise until they recover strength.         r.
               SCARLET  FEVER.

   From the small number of cases of this kind which
 I have met with, I am unable to say any thing from
 experience, I shall therefore merely extract what  I
 consider proper from Cullen, who' says it  is not  a
 common disease.  He says it makes its appearance
 about the beginning of winter, and continues through
 that season.  It commences with  the  usual  symp-
 toms of fever—it  most resembles the attack of  tha
 malignant sore throat, and measles, but in this  there
 is no cough or catarrhal symptoms;  but early in  tic
 disease- there  is some uneasiness felt in the' th. oat,
 st>me inflamation of  the tonsils,  with some  sloughs,
^hich are whiter than in the maligfuntsore  throat—
•is   '•*."' 
§8                 FEVER.

ppon the third  or fourth day  a scarlet  eruption
appears  upon  the  skin, which remains for  three
or four days after its first appearance, when it goea
off with a separation of the cutticle, with an  abate-
ment of the fever, some ulceration appears on one or
both tonsils, which soon heal, a swelling of the body
like a dropsy, frequently follow, but soon goes off.
  Dr. Cullen prescribes what is called the  antiphlo-
gistic treatment, viz. bleeding  and a  gentle  puke,
avoiding both cold and heat.  Mild astringent gar-Ji
j$es  will he proper, as those made with allum, honeyjf
bark, &c.
  To carry off the swelling, if any should come  on,
a few doses of salt-petre  is  better  than purges, as*
they do not weaken the patient.
   The only cases of this disease which have fell  un-
fkr my care were women in chilbed, and  I  judged
feeing kept too I ot was the cause.
'# 
i> I'lWI ff'M"""W?WW
    PHRENSY, OR  AN INFLAMATION OF
                  THE BRAIN.

    Phrensy, as a primary disease, is said to be a rare
 occurrence, but it  is supposed  to  be  frequently  a
 symptom of some other.
   'The symptoms are, a high fever with  violent head-
 achy a redness of the face and eyes, the  patient  can-
 not bear either light or  noise, a constant watching
 and delirium, even to fury.  The most suddenly vio-
 lent case I ever saw was in a girl of  about eight  or
 nine years old ; she had been subject  to attacks of it
 at times—the first symptoms of attack  was with  a
 violent head-ach* on Saturday morning—I saw her,
 on Sunday  evening, there  was great  pain in  the
 head with drowsiness,  the  circulation had nearly
 ceased  in the  extremities, so  that blood  could not be
 drawn—she died on Monday.  This is the only case
 of phrensy of a primary kind which I have met with
 for several years ; but what is cabled a symptomatic
 phrensy, is more common, but is scarcely to  be dis-
 tinguished from the other but by the other symptoms
 attending it.
   The treatment must be those of common inflama-
 tion, as plentifully bleeding,  small  doses of tartar
 emetic, a large blister applied to the back of the neck3
 or if the case be violent, shaving the head and apply-
 ing cool water or  vinegar, or  even  blistering the
 hjad is recommended; but  there is scarcely" any
 thing abates  inflamation more  than bleeding and
 alight vomiting ; gentle purging with calomel assisted
 by  glysterswill also be proper—The  patient should
 be kept as quiet as possible and his room darkened.
  Ir the disease prove obstinate, bleeding  should ba
repeated, with small doses of tartar, emetic, until the
symptoms abate—buttermilk or whey  will be pro-
per, and is the enly diet necessary. 
* ... \    ■ \ \  . • t;'"- * \      * ■
PNEUMONIC INFLAMATION,  USUALLY
            CALLED  PLEURISY.

  Physicians have distinguished inflamations of the
breast into two kinds—-the one they call  a bastard
pleurisy, and the other simply pleurisy.  It is called
pleurisy from its affecting the pleura,  a  membrane
lining the inside of the breast—in it the pain is acute
and is generally fixed in some part of the  breast.—*
In the perineumonic.notha, or bastard  pleurisy, the
pain is more deeply seated, and  affects the back and
shoulders as well as the breast.   A common pleuri-
sy is  a disease that cannot be mistaken—it is a highly
inflamatory disease, and is always attended with the
usual symptoms of an inflamitory fever, and in most
points it is to be treated  as such. ;;i The bastard pleu-
risy is an inflamation of the substance^  of  the lungs,
and is more dangerous,' though less painful—in it the
pulse is full, quick and hard at first,  but after  some
time they become softer  and  slow, as  in  health, or
even more so, but sre generally  irregular*  ..  -_     )
  -The cause of pleurisy  is generally cold  applied to,
the body,  but  I  suppose  more particularly to the
lungs.   The subc^ance of the lungs  I  believe  to be
insensible to either cold  or hear, and  perhaps  infla-
mation of the  substance of the lungs would scarcely*.
£*ive any pain if the membranes were not  affected.—■
Young people full of blood and  vigour  are the most
subject to  this disease,especially those who live  in
high and airy  situations, or countries, especially  jp
northern climates.                               «
   The treatment of this disease i3 the same as other
 inflamationa—plentifull bleeding, a blister applied
 over the part  rained; but if the inflamatipn be gen-
 eral, as  in a bastard pleurisy, it may  be applied  to
 each side  of the breast,  or  to the back below thd
 sShoulch-r blads.  Tartar emetic in small doses is one
 of the most powerful moans  of  abating inflamation,.
 whether local or general;  fullvorr.'uing is considered 
INFLAMATION
81
 improper, as the violent exertions increase the  pain
 and may be dangerous ; but if in exhibiting the tar-
 tar as above, a motion  or two should  be induced,  it
 will be no disadvantage.  After bleeding, &c. I have
 sometimes given opium combined with tartar, as  in
 dovers powder, or half a grain of each in a pill—this
 will generally be found profitable when there is  tor-
 por, or a  drowsy disposition  with  delirium, after
 the disease has continued for some time ;  but if the
 first or second dose  should not produce  a  general
 sweat, it will be improper to continue it any farther.
 Opium, snake-root, and all other stimulants, are in-
 jurious in inflamatory diseases, except  they  can be
 made to produce sweat without much heat.   Partic-
 ular attention should be paid to the state of the bow-
 els from the first, for if not kept lax, or emptied once
 in twenty-four or forty-eight hours at farthest, a pu-
 trid lax is apt to come on, which will  prove very in-
 jurious.  Hot applications  to  the  pained part will
 sometimes give ease, but are not as good as blisters.
 If the pain should change its  place after  blistering,
 a blister should'be applied again over the pain.  Large
 draughts of any thing cold it is said is improper, as
 it may increase the pain, but I  have been  in the
 habit of allowing small draughts of cool water,  and
 have never observed any bad consequences to result
 from it.
   As plentiful bleeding  is one of the  best  remedies
 in this disease, it may not be improper to introduce
 an observation here which  should have  been under
 the head of  bleeding:—Some in  prescribing copius
 bleeding direct it  untill  fainting come on, but it is
 well known that many persons w;U faint at the sight
 of blood, while others will scarcely  faint while they
 have any blood left.  Fainting in bleeding depends
 almost university upon the mind and if a person can
 be diverted to any other object during the operation,
 and for a few minutes after, not one in twenty would
ever faint.
  In applying blisters in case of pleurisy in women
they should be applied behind the breasu on the ribs, 
 l-i            INFLAMATION.

 as it would be not only disagreeable, but less effectu-
 al upon or between the breasts.


                O?  QUINSIES.  *

   Medical writers distinguish five kinds of quinsies
or inflamalions  of that kind, but there are but three
or four which deserve to be distinguished in practice
   The first  is  an inflamation  of the tonsils or al-
monds of the ears, but is seldom confined  to  the
glands alone.  The second kind is the malignant sore
throat, or french  measles—The third is  called  the
croup, and bold  hives—The fourth is the mumps.
   A common quinsy or  inflamation of the  throat is
seldom dangerous except in children,  but if attended
with  hoarseness  and  a foul  tongue,  there may be
some  danger, and espeoially in children—Bleedingin
the first place is  necessary, and then a puke,  and af-
terwards keep the bowels lax by glysters or gentle
purgatives, and if the  inflamation be great, and the
tongue should swell a blister will be proper, it should
be applied  either to the back of the  neck or breast
and the bleeding should be repeated—In slight cases
it  may be sufficient to keep the parts  warm by a flan-
el cloth, or a poultice  may be  applied to the neck at
night—To frequently wash  the  mouth  and  throat
with a strongdecoction of  oak bark and alum is of the
utmost importance and should by no means be  omited
especially if there should be any white spots or ulcers
upon  the tongue or tonsils.


       MALIGNANT SORE-THROAT
                                   M

   This is said to be a contagious  disease, tut with
 what propriety I am  net  prepared to say, hut I am
convinced that the number of contagions  are not so
large  as has generally been supposed; I   have  ne-
ver seen,  an   instance  that afforded   a: y  cir-
 cumstance  that   might    lead to  such a  conclu- 
          I                   *
                INFLAMATION.             83.
                 v                              -

 sion:  it is very common for one or two in a family to
 have the disease about the same time, while half off
 those  exposed to the contagion did not take it.
   The first symptoms of this disease are generally a
 fever, pain in the head, anxiety, a slight  swelling of
 the throat with  some stiffness in the neck, hoarsness
 with a soreness  of the throat, the fauces are of a dark
 red color, spots  soon appear which increasing soon
 cover the parts.about, the tongue become foul and
 the breath bad, if the bowels be not emptied by salts
 or some other purgative in the first two or three day»
 a dysentery or putrid lax generally comes on,  there
 is generally an efflorescence or eruption of smsll pim-
 ply over the body, a small irregular pulse with marks
 of putridity frequently attend, the patient is frequent-
 ly d.-lirious and  comatose but unable to sleep  s jund.
   In this disease there is a strong tendency to putri-
 dity, a fetid breath with a dark livid color upon tha
 fauces are fatal symptoms, which is said some times
 to happen by the third day, and generally  before the
 seventh.
   There  is a good deal of nicety  required  in the
 managemrnt of this disease, and my experience in it
 does not warrant my being very  positive  upon that-
 head—Bleeding  is generally forbid, but I am inclin-
 ed to  think bleeding  in a  measure proper;  I  think
 bleeding seldom immediately injurious by  ir.duceing
 debility in the first stages of diseases or before a per-
 son ha* been  reduced by disease, but where a disease
 is not suddenly dangerous as in most cscs of reVers m
 tlv.s countty a person recovers much  sccner  when
 bleeding has  not been freely employed .than where it
 has;  but.in all violent  influraatcrv diseases,  altho
 symptoms of debilit maybe apparent earlv in the Un-
 ease il the pulse be hard, however sn,„]i, moderate
 bleeding should be employee; the quantity, sa ,1 id  sl-
ways be  reg-.lated  according to f ;i-cuimf.;nre-. ; the
 quantity of blood in  the veins cannot  d'lminish sud-
denly,  and all that may be pre.-.ent in an nV:f oropo*-
 Hop tcythe strength ;,f the arteries will be nvurim,
 Uiugzti a p-rt wiil ny. intense debility b.a'ou L>> 
C*             INFLAMATION.
 contrary it will relieve the system and save some ex-
 penditure of sensorial power, it may however be pro-
 per to employ bleeding with caution by drawing off
 but a small quantity at a time.   The sovereign febri-
 fuge, emetic tartar should not be omited but should be
 given as soon as possible  so  as to move the  patient
 both up and down—To prevent the tendency to pu-
 trefaction give  camphire and alum in a bolus two or
 three  times a day  with a little honey to render it fit
 to swallow,  also cool water  and cream  of tartar. '
   The mouth and throat should frequently be wash-
 ed with the decoction of oak  bark and alum.
   Medical writers prescribe the bark in  large  quanti-
 ties, but in substance it is very  difficult  to  swal-
 low in this disease,  especialy  in children ; but the
 same signs should  indicate the use of the bark in this
 as in other cases viz. a moisture upon  the forbead
 or a disposition to sweat,  for  this  purpose  opium
 with tartar and camphire may be tried; if the  patient
 cannot swallow the bark or  any  other  drug which
 may be thought  proper, it will  answer in glyster,
 either iu substance or in decoction
  A blister may be applied to the back of the neck ;
 or if the  glands  be tumefied  about the neck,  they
 should be blistered, or a blister upon the breast may
 answer as well, and they should be  kept open until
 the symptoms abate.
  It is often difficult to get children to take medicine
 shat is as disagreeable as the bark, but in  that  case
 it is said the bark answers equally well in gly ster.__
 It may always be observed that a drug given in glys-
 ter, should be given in double  quantity.


                   MEASLES.

  This is one of the  contagious  diseases which a '
person is subject  ro take but once.   It is  said to  ap-
pear in January, rs an epidemic, and to go  off about
summer, but may happen at any  tine.   It always
commences with  more or les; fever, and in about four 
INFLAMATION.
85
 days the eruption begins to make its  appearance—it
 is always attended with hoarsness and a  dry cough  4
 —the eyes are inflamed and give out  tears—the  pa-
 tient is generally drowsy—ihs  eruption  resembles'
 the scarlet fever, but the pimples and desquamation
 is not so considerable.  The affection of tlve lungs I
 conceive to be the most dangerous part  of the dis-
 ease—if a person be careful to avoid  heat  and live
 upon weak diet, there is seldom any danger.  I know
 from sad experience the bad consequence  of taking
 cold.   I had the measles at about  23 years of age—-
 rode five or six miles out and home again on  the day
 the eruption made its appearance—my fever was but
 slight  before—there  was  a  snow on the  ground,
 which had a yellowish appearance to me—my  fever
 and cough became very high for  several  days—the
 measly spots  continued  to make their  appearance
 whenever I was  warm for several  weeks—a very
 troublesome dry cough continued  for tv\ oyears after.
 I made use of some few medicines and my cough went
 off; .but what  was equally bad, my hands which had
 been subject to be hot and dry in the palms, as  also
 the hollows of my feat, now was attacked with a most
 intolerable itching, and  upon rubbing became very
 painful—this would continue for  a few days, when
 it would go  off with a desquamation of the  cutticle,
 which  would become dry and hard, and in a week or
 two peel off with some  appearances of tetterous  e-
 ruptions, and at  intervals of from  two to three or
 six months ; it continues to do so yet, and I am now
 in my 45th ve.ir,  but the itching and pain  has ceased
 to attend it for many year?,  yet am still  subject to
 cough  upon very slight cold,"andain seldom free from
 it.  1 may  veiv.ure  to state as a melancholy truth that  -
 three-fourtbs of  the human  race shorten  their days
 and render themselves unhealthy through life by im-
 proper conduct.
  The  reader will pardon this  digression, upon "re-
flecting that if it docs not afford  him  instruction  it
may be a caution.
  From the  rare  occurrence of rajacles, I have  trot 
*6   '         INFLAxMATION.

had an opportunity ,of learning much from experience,.
but sholl state what I judge  the  most  proper treat-
ment, in which I find it necessary to deviate but lit-
tle from former writers.
   If the fever should run high bleed, and give cool-
ing laxatives, for which cream of tartar, or tartar e.
properly managed will be proper ; but I  suppose that
if a proper regimen was observed there would seldom
be much nesa of medicine, except for the cotigh—A
person should live upon light diet, use moderate exer-    %
cise, be carefull to avoid any extreme of either heat
or cold, but  especially cold, cool driuk or  diet will '*£>■
not be injurious but it might be proper  to avoid tak- y"'~
ing any large  quantity at a  time—*t  is not only ne-
cessary to observe these rules untill the disease has
disappeared  from the surface but for some time after
as a   person \s not free from the  disease for two ojc
three weeks  afterwards, which may be known by the
measly spots appearing upon geting very waarm.
   They-cough will be most certainly relieved by opi- •
um, and to avoid any increase of  fever, it  should be
combined with tartar e.  opium  alone for a time im-
pedes the secretion of moisture in the lungs, stomach
and mouth while nothing promotes it more  than tar-
tar.  I generally employ opium in this maner in pneu-
laonic inflamation where the cough was troublesome,
and always with advantage.

                 SMALL  FOX,

  This is a disease which I  have little knowledge of
*ro:■:  experience,  but it appears that  when the pock
is distinct it requires but little medicine or  attention
hut if it be confluent it will require both—In the dis-
tinct  the pustles are  fewer and distinct from each o-
ther  and surounded by a red circle.  In the conflu-
entthe pustles run into each other and the  areola or
circle is less distinct, especially on the face which is
some times covered :   this kind is ulway dangerous St
frequently fatal, I shall  therefore give  seme direc-
tions  for the treatment.
      * 
*
                  iNFLAMATIolt           fy

    Whenever a person from being exposed to the con-
  tagion or from the usual symptoms shall judge that
  lip has taken the small po?;, he should be- carefull  to
  keep quite cool, and to tike a purge, and tak* cream
  of tartar in all his drink; if the febrile symptoms r;n
  high a bleeding will afso be proper ; if convulsions
  should precede th; eruption, which is often the  case
  in children, laudanum  wiH be the  best  remedy, if
  when the eruption appears it should bs distinct, no-
  thing more will hi necessary but to avoid  heat and
  to live light—But if the  pimples upon the face  are
  numerous, when they are not distinct, but are in clus-
  ters or run into each other, and especially  if the fev-
  er does not  abate upon the fifth day, it wiil require
  «Teat care and attention.
    The bowels must be kept regular or rather  loose
 by flour of sulphur and cream of tartar—If any symp-
 toms of putridity  appear which may be known by the
 matter in the pustle not puting on "the appearance of
 pus, or becoming yellow, it continues thin,.ahd white
 or of a brown color,  there are dark .spots' over the
 body with  watery blisters, the  skin  under  them
 is   of   a  purple  or livi I  color, the urine is soma
 times bloody, the fever which had subsided in a mea-
 sure  at the time of the eruption  returns again, but
 with an  increase of debility.   In this case  "the bark
 and wine are to be given in large  quantity,  i f the. os-
 tient cannot swallow the bark in substance  it mr,v'c; '
 given in decoction, or in glyster,  an opiate  to be giv-
 en every day ; blister are aim  advised ; the mouth
• to be kept clean with gargles :  but a preventative is
 always  better than a cure, and we now know of on;
 both  certain and safe, and in the power of every o—-
 son,  and which it is the duty of every parent, guar-
 and master of a family to employ.  Altho  the smafl '
 pox may seldom visiit us we ought never to consider
 ourselves intiraly secure while liable to the conta-
 gion, for we know not how soon  we «>ay be visit- ?
 again so Ion • as it is in any part of the world, but by
 a.little care and attention  it may be  shut ourT <V-.,
 *mong mankind bv the kt.-.e pox. 
38
INFLAMATION'.
                  KINE POX.

  This is one of the most extraordinary discoveries"
that ever hapened in the science of medicine ; what
change a disease can effect in an animal which will
prevent the same disease is a  mysterious problem—
but how  one diseas should prevent another, is still
more incomprehensible ;  but it is enough that we
know the truth of the fact—The following is  an a-
bridgement of the history of the disease as given by
Dr. Jener and others.

  The kine pock proceeded,  in   the  first  instance
from a disease called the  grease in horses:  in  the
dairy counties in England the men and women  pro-
miscously milk the cows together ; it was  observed
that the men being careless in washing  their  hands
after dressing  the horses heels  affected the cows
teats with a disease, which in its turn  was  commu-
nicated to the women, and it was  also observed  that
those persons would not take  the small-pox.   From
these circumstances Dr.   Jenner was  induced to
make an  experiment by inoculating with some of uhe
matter from a cow, the experiment succeeded,  the
discovery was made, committees were  appointed by
medical societies to enquire into  the truth of the re-
port ; their experiments furnished a  complete  con-
firmation of the fact,  which continues to receive  ad-
ditional confirmation by thousands of  instances  in
both Europe and America.

  In inoculating with the kine-pox, nothing more is
necessary, than to make a slight incission in  the arm
on the outside about  half way between  the  shoulder
and elbow ; it ought  not to be so  deep as to cauje it
to bleed,  but if it should bleed freely, it will be pro-
per to let it stop before the matter is applied.   The
proper time for taking the matter from a pustule for
inoculation is at  any time after it rises until the mat-
ter begins to turn white which is  generally from the
fifth to the tenth or fifteenth day : the pustule gener- 
               INFLAMATION:             89

 ally begins to rise about the fifth day, and the  fever
 about the ninth, but it is said there has been instan-
 ces of the pustule not making its appearance before
 the tenth or twelfth day and  then succeeding  well.
 The success of the inoculation is known by the fol-
 lowing signs :—At some period, commonly about the
 ninty-sixth hour a clear  pustule begins to rise,  with
 some inflamation around, the middle is  sunk or  ra-
 ther it does not rise,  and is black,  it continues  to
 spread until the fifteenth  or   eighteenth day,  still
 spreadingby blisters  rising around the  edge.   Al-
 though the pustule for some time has the appearance
 of a blister it seldom  has much  water in it;  at the
 time, or even before  the fever  becomes  general  the
 glands under the arm become inflamed and sore ;  on
 the ninth day the fever becomes general some  times
 attended with considerable pain in the head &  back,
 but in others the fever is  scarcely  perceptible,  ex-
 cept a person should  use exercise,  when  a soreness
 in the joints and glands will be perceived : the  fever
 begins to  abate in two or three days, but may  easily
 be perceived to be present  in a degree  by exercise
 or drinking  spirits, for some time  longer.   It will
 always be prudent  to live  light,  if the  fever runs
 high, and  particularly to avoid extremes of both heat
 and cold.
   In small children,  we must often  judge from  the
 appearance and progress of the pustule,  as there  is
 seldom much appearance of indisposition in them.
   It is said  that there has been instances of persons
 having gone through  the disease twice, but  it is  not
 common ; the place  inoculated will  commonly  in-
 flame considerably for three or four  days  and then
 go olf.  In persons who have  never hnd either  the
 kine or small pox, there is a great difference,  some
 will  take  it  upon, the first trial, while  others  will
 scarcely takejt at all ; in such it is necessary to  re-
 peat it until it docs take'effect, and in all cases it is
 proper to  repeat it until the proper symtorps enu-
 merated above take place.— I he matter of kine-pox
w very difficult to preserve  any leBgth  of time, the


    ______-    ___3i_____ 
tp             INFLAMATION.

best method is to wet a number of threads with the
matter, and as soon as dry put them into a quill with
as little air as possible and seal it tight with wax.

   INFLAMATION OF THE  STOMACH.

  The inflamations of the stomach  is  of two  kinds,
the one is a more violent  and  acute disease, the o-
ther is of a more cronic form.   In the first the sub-
stance of the stomach is   inflamed, and there is  a
considerable fever attends  it.  In the second, the
inflamation is more confined to the internal surface,
and is seldom attended with much fever, and the pain
as less  acute.   The symtoms of both are nearly the
same, but differ in the degree of violence.—There
is a pain in  the stomach  with  vomiting ;  scarcely
any thing can be taken into the stomach without in-
creasing  the pain and vomiting,  a hickup  frequently
attends it, the pulse is generally small and hard with
a great loss of strength.
  In the latter, or what is called an erythematic in-
flamation, the symptoms are not always ssfficient to
give notice of the disease, but some times a  soreness
of the mouth and throat attend, if in this case there
is any pain felt in the stomach upon taking into it a-
liy thing  acrid, an inflamation  may be suspected.
  In the phlemonic  inflamation  of the stomach,
scarcely  any medicine will be retained, small quanti-
ties of cool water with a few  drops of spirit of vi-
triol may be  tried, but bleeding freely  is  the princi-
pal remedy to be depended upon, and ought to be re-
peated according to circumstances, a blister  four or
five inches square should be applied over  the  stom-
ach, and the patient  kept loose  in  the bowels by
glysters .  The diet, whenever the  patient is able to
to bear any, must be  light and soft, as thickened
milk panado &c.  If the disease be  of the  erythema-
tic kind, which may some times be known by a vom-
iting, with some soreness of the mouth, with a quick-
er pulse than in health, small and hard ; some times
the  inflamation is said to change its place and  pass 
INFLAMATION
*«
 through the whole length of the intestines like  the
 thrush.
   Some bleeding may also be proper, but I conceive
 the disease to be caused by an acrid or corrosive  hu-
 mour, which should  be destroyed  or corrected  by
 borax, a weak lime water, or sugar of  lead in small
 quantities, alum also may answer.

   INFLAMATION OF THE INTESTINES.

   The inflamation of the bowels is  called enteritis.
 The inflamation of the boweUjmay be known  by  the
 following symptoms, there is always  a considerable
 fever attends, there is a pain, and frequently a   tu-
 mefaction of the bowels, costiveness  usually attend
 and some times vomiting, the pain is some times  felt
 in one part of the belly, but most commonly over the
 whole abdomen.  Among the many  causes assigned
 by physicians, I consider two as certain, and danger-
 ous, one is worms, and  the other is the sudden stop-
 age of a^ lax, especially when the lax  attended a  fe-
 ver.—Of the first, I some years past saw a  girl of
 about eight  or nine years old ; the abdomen was  ve-
 ry  much swelled  hard and exceedirg painful  and
 could not bear any pressure,  calomel  and  cream of
 tartar was given  in  small  repeated  doses,  blisters
 and poultices were applied,  a supurafcion at  length
 took place between  the  peritonaeum and  muscles
 of the abdomen, which was discharged  1 y an  incis-
 sion upon the navel, and for several days considera-
 ble portions  of fat  came away—she  recovered—I
 have  known several  cases,  but  never saw  any  as
 bad.—Of the other kind I have known several  cases
 and one proved fatal—It wasin  a woman  of about
 forty  years of age, who had laboured under an inter-
 mittent fever for  eight  or rfine months, was,much e-
 maciated, hud  a  violent  cough  with  freciuent dis-
 charges of larg« quantities of blood from  the  luno-s
w..icn was always very  daft; a violent  lonsness  a*d
 tenessmus attended ;  she was also hysterical and  her
 paroxysm irregular, generally twict in 24 hours and 
9j            INFLAMATION.

at irregular periods.—She took the bark on "Wednes-
day, which sloped the fever and lax ,   she remained
well,but without a stool until the  Sunday  following
when a pain in  the bowels^came on with a swelling,
1 saw her on Tuesday, but  her  case  was hopeless,
she died about eight or nine days after.
   Persons recovering from  fever,  always  ought  to
take care to keep the bowels regular  for  some  time
afterwards with cream of tartar and flour of sulphur.
   The same after recovering from a  dysentery,  or
other laxes.—The disease is generally to be  treated
precisely as the inflamation of the  stomach,  but in
this there is an opportunity  of exhibiting medicine
as a.cooling laxative, there is  nothing  better  then
cream of tartar, which should be given in small quan-
tities, blistering the abdemen over the naval,  or 'the
part pained, will also  be proper—the blister should
be five or six inches square.

      INFLAMATION OF THE LIVER.

   An inflamation of the liver is called Hepatitis, it
jej a very common disease in Kentucky and  is often
the consequence of fever, being  imperfectly cured,
or impr°Perly managed.  It  is said there  is   two
kinds  thC one acute and the other chronic, but  I am
inclined to Relieve that the acute would  always ter-
minate in the c.hronic, if not  removed by medicine ;
that viscus is not very sensible, and  there  are but
few membranes about 't, and a slight inflamation will
scarcely be perceptible, and may  exist  a long  time
without being understood—I once had it for two or
three weeks myself,  and  scarT-cly   suspected it; it
was owing to my curing an ague Imperfectly, I  was
sensible of some degree of fever, my  urine was high
coloured, appetite bad, a better, disagreeable taste in
my mouth, some stiffness and uneasiness i;i the  right
hypochondrium and shoulder and   even that  side of
my head and face.—1 took, a  dose of tartar e. the
bile was thrown up  in large quantities of a salt taste
like a brine, and so hot as to almost scald the mouth** 
                INFLAMATION.            94

I have met with a number of cases of the kind,—the
usual symptoms area pain in the right  side—the  li-
ver is generally enlarged and may be  felt just be-
low the nbs ; if the  d.sease be violent, a pain is felt
under the clavicle, and  the shoulder,  a dry cough
generally attends it, but not always ; the patient can
lie easier upon that side than in  any other position,
a slight  discolouration of  the skin is mentioned  by
same writers ; heikup some times .ittend,  and a dis-
charge of blood from some part of the body  is  very
common in the the  advanced stages. -
  The treatment, in general, the same as other infia-
mations, one, two, or   perhaps three bleedings  may
be necessary if the case is violent,  If  it is the* cri-
sis or  remains of fever, and acute and  not of a  long
standing, an emetic will be proper, with blisters over
the part ; but if it has assumed a more  chronic  form
after bleeding and a mercurial purge, give  calou-cl
ever)' night, anoint  the' part well  every  night  with
strong mercurial ointment, if a  salivation should  a-
rise 00 fast give a  gentle purge at times and  abate
the quantity of mercury.   It is  necessary  to  keep
up this course for  three or  four weeks, by which
time it will generally go off ; if the  disease be  vio-
lent, a supuration some times takes place ; when any
danger of that is apprehended,  it will be  proper  for
the patient to lie as  much and quiet  upqn the  right
side as he can wA\ bear, in order that.-an adheseion
of the liver may tike place, as  inflamed membrance,
will soon adhere if they lie together,, and  then  if  an
abscess should be formed, it will generally  make  its
way through the external parts  and may be,  opened
and hjaled like another abscess.
   It is thought necessary by some to give hark, ironK
he. atter»the inflamation goes off to strengthen  the
system, against a rtlapse ;  but I am inclined to  think
it unnecessary, unless  con:iderable'dibi!ity should be
present. 
94             INFLAMATION.


     INFLAMATION OF THE KIDNIES.

  This inflamation called also nephritis,  is usually,
attended with a dull pain in the back,but I know  it
may exist in a high degree  when there is  no stone
without giving much  pain.
  In the year i8co, I went into the water in the
bottom of a mill-dam, after the water was drawn .off,
when I was very,warm,  and staid in it three  or  four
minuets above my waist,—on  the  next morning I
had a considerable fever, my urine resembled  butter
milk,.the inflamation run very high for a  week or ten
days with a discharge of blood and pus ;  in  a  few
weeks I had recovered, but some weakness remained
—about the first of January I was very  much expo-
sed to a cold sleet by ridirfg five  or six miles in a
bad night ; I was immediately after seized with  the
same disease, which brought on a virulent* gonorrho-
ea  with  a discharge of  bloody  urine and  puss.—I
recovered in about six months, but was very  stiff  in
the back for two years or more.
  It will always be proper to  distinguish between  an
idiopathic inflamation and that occasioned by a stone.
I think they may pretty certainly  be distinguished
by the following singns  :—if it be  occasioned by a
stone, the pain is violent, while there is but little fe-
ver in the system generally ;  a numbness and  pain
runs down the thigh affected,  which I believe <not to
be the case when there  is  no gravel or  stone—in
the inflamation proper there is no difficulty in mak-
ing water, and the quantity is as usual,  but attended
with pain and heat in the urethra.  In the other case
great sickness and vomiting frequently  attend, oc-
casioned by  the great iritation and pain.
  The treatment of the two, I conceive ought to be
different :—a large dose of opium ought to be  given
and then bleeding, and the patient put into  a warm
bath where a stone is judged-  to  be present.   The
opium will not only be improper, but injurious in ths
other cass—in the idiopathic—purging  pretty brisk- 
INFLAMATION.             95
ly with cream of tartar, will be proper, as also bleed-
ing, and if the  disease prove obstinate,  it should be
repeated from time  to time ; the diet should be light
in both cases, as vinegar, milk, & butter-milk or soups.
I found great benefit from lying  altogether upon the
floor.—1 think, that the inflamation, if  it  continues
long, extends down the ureters and affects  the uri-
niry and genitials—in that case,  a slight  mercurial
course wiil be found of advantage, with the spirit of
vitriol. 
                 OF FLUXES.

              DYSENTERY.

  Authors have distinpuished a variety of  diseases
under the title of fluxes, Sauvage enumerates  thirty-
six, and  subdivide them into many more ; but I  can     1
see no propriety in distinguishing more than two or
three ; dysentery, or bloody  flux, diarhoea, or  a con-
tinual  loosness.    lientery  or a  loosness  without
pain or griping, in which the aliment generally pass-  .
es off undigested.—The first is  the subject of our
present chapter.
   The symptoms of this disease  is  two well  known     ^
to need any description—it  was formerly,  and is yet
considered by some a highly^ contageous disease, but
I have been of a contrary opinion for many  years, as
nothing is more common than for one or two in a fam-
ily to have it and the rest remain well.   It is epidemic
and owing to some  invisible cause  and  as incompre-
hensible  as the cause of influenza, or the famous mi-
asmatta; but it is  entirely immaterial what is the
remote cause, unless it would lead to a more success-
ful method of cure.
   From observations,  I am  of the  opinion that  it is
owing to a tendency   to putrefaction in  the'mucus
membranes lining the bowels, which  in some cases
appears very evident from the fetid stools  and  ten-
der state of the lining, which is  often  discharged  in
considerable pieces.   If the stool be black,  it shews
 a higher state of the disease , and it is 'attended with   '
fever in the first stages, and if the disease beviolent
 the pulse wiil shew that the fever is general p lX- mav
 then be necessary to bleed.
   I h.ive for many years  confined my  prescriptions     *,
 in this disease to  very few medicines, and the  man-
 agement is  vcy  simple;   although  the  griping be
 great, the bowels  are not alvvavs found  in a  loose
 state ; but the excrements  is generally  discharged
 in hard globules.
   In the first place it is proper to  empty the  bevels 
FLUXES.                 gf
 by a purge; for this  purpose,  there  is  none  equal.
 to salts ; tl.is not only empties the bowels, but  it is
 a  cooling an.i'sc:puc„an I prevents  the putrefaction
 from progressing.  The »ait should be given in sm A.l
 ddoes,  half an h >ur or an hour  apart ; and if t'ne dis-
 ease be violent, it should be  given in sufficient quanti-  .
 ty to make  the; stools watery, which may take five.or
 lix hours.   The continual  application, of the s.alt<to
 the bowels  is much mote eflVtual ti^n to ejtve a full
 dose at a time.   '1 he sajt g'v^n  in this  manner  is
 often sufficient'to cute  a (lux when the lisease is not  .
 very violent, and sometimes without purging.   ChiS
 course should be "given every mooning, ;;nd after the
 second day, if the disease -continue,  give a grain of
 opium in, a pill at night, and salt enough to empty the
 bowels the i.ext  day.-  Astnngents  have almost al-
 most always been preset ibed by physicians alter eva-
 cuation, but I have never been able to derive much
 benefit from them, at least, their effects are  always
 doubtful, and I  seldom have recourse to  then, per-
 haps because I have  not met with  a case in ten years
 in which the other remedies above failed.


                 DIARRHOEA.

   The same medicine and the  same rules are  to  hi
 employed and observed in diarrhoea, br common lax,
 bat this is  frequently more  obstinate than dysentary,
 and in it I  have found astringents  of more service.—
 Pjjopleare apt to pav bii't little attention to a lax  if
 it is not attended with pain,  or  some  disagreeable
 symptoms, but this is wrong, as by becoming  habitu-
 al n will be more difficult to cure, and  especially itt
 a&cd people, its


                  LIENTERY.

   A liente-v is nothing more than a brisk  lax  with-
out, pain or ^"jp^g, and is probably owing  to  cIk* 
9%
FLUXES.
same cause, and I see bat little  propriety  in dlrLiti-
guishing them, as the method of cure is the same.
  Tenesmus, or a violent inclination and pressure at
stool without being able to void  any thing  except a ..
little mucus, very commonly attends both  diarrhoea
and lientery, and is the most troublesotrie symptom j    |
it is  the most effectually removed by opium, especi->
ally in glyster.  Astringents, as alum, logwocd, oak-
bark, &C. are often of service aLo ;  but  it  must be"*
acknowledged that the most powerful remedies  often
fail in curing it, and especiaify after it  has  been of a
longstanding.


             CHOLERA  MORBUS.

  This is a violent attack of vomiting and purging
the contents of the stomach are  generally  acid^jbur
after the stomach has been  emptied the discharges
irenerallv bile.  It occurs in the warm seasons in cold
countries ;  but in the warmer climates at any  sea-
son.   It sometimes proves  sunddenly  fatal;  but  if
less violent, it may last for some length of  time* but
it seldom terminates favorably without the  assistance
of medicine.   It is not, I belihve, ro common  a dis-
ease  in America as in Europe—perhaps owing to the
inhabitants living more uniformly upon strong diet,
animal food, &G.  The first medicine to  be employ-  ;
ed is alkalies, as magnesia  alba, chalk,  lime, &c.—if
it should not moderate the symptoms, or even  put* >
stop  to them, elixir of vitriol and opium—thejepitrm'' .
should be given in doses of from half a grain  to a
grain at a time, an hour or longer  apart;   if it will'1^
not stay upon the stomach,  double the quantity may
be given in glyter—from 60 to an  hu^red drops  of'"*
laudanum may be put into a gill of warm water, and
thrown up.   Medical writers generally direct  plen-
ty of diluents, or watery liquors, to be  taken with a
view of washing out the bile which proves  s  stimu-
lus to the stomach and bowels—a  thin gruel or the
like is recommended.   I: is necessary to make u&e of 
RHEUMATISM.
$*
  opium for some time after, but I should rather de-
 pend upon litne, magnesia, white oak bark and other
 strengtheners—a small quantity of  the tincture of
 iron will be pipper.
                   «

                RHEUMATISM.

   The rheumatism is one of the most common dis-
 eases to which mankind is subject, as there is scarce-
 ly one in five but is troubled with  it more or  less,
 while the pathology  of it is one of the  most obscure
 of any disease ; that it can so suddenly be transferred
 from place to place  appears inexplicable, but if we
 knew a certain method  of cure it would be immate-
 lial whether we  understood  either the remote or
 proximate  cause, or not ; but  this is  not the case,
 for it would be considered  as  an evidence of quack-
 ery in a physician who should say he could cure it
 at  all times.
   Physicians have considered  it of two  kinds,  and
 galled  the one acute, the other chronic, but I  think
 improperly—the one they  call an inflamatory  dis-
 ease, the other not ;  but I am not able to make  this
 distinction—the acute rheumatism is nothing but a
 violent attack  of the  same disease, bv.t it must be ac-
 knowledged that there  is such a difference in  the
 state and appearance of the disease, that I  know of
 no  symptom that is constantly attendant upon it, but
 J>ajn and soreness.^  I ha^e  seen violent  attacks cf
 rheumatism without any inflamation or  swelling  ap-
 pearing ;' in other cases of the  most chronic form I
 have seen considerable swelling and even inflamation,
 while there is  one circumstance which attends  rheu-
 matism of the most chronic form that always attend
 inflamation, heat  almost universally increases  the
pain while cold diminishes it.
  The first state of rheumatism  I shall mention, is
 the purely acute or inflamatory attack—it  is gener-
ally brought on by going into the water, a  cold  cu*
 l»r, or any other way becoming suddenly cold v^en 
     ico            RHEUMATISM.
     ■RXS
     very hot, or  in  some  cases without srch  previous
     heating.  It is  atterdtd  with  high  fever,  a quick
     strong pulse, great p,un in every joint  or over  the
     whole body, thelar^e joints generally swell  and ap-
     pear inflamed, but this swelling a> d inflamation does
 /   not always appear visible, and ihe patient cannot
 /    bear lobe moved without giving the greatest pain-—^
\ *'  if not properly treated it  puts on a pure  chronic
[     form.
•       If attended with fever, and especially with infla-
     mation, bleeding will be necessaiy at cording to cir-
     cumstances, then  sweat with  opium and  tartar emetic
     half a grain of each, given at  intervals  of from  half
     an hour to an hour and an half as directed under opi-
     um, (see opium) if it should not i/.tireiy remove the
     pain and soreness, it will be  proper  to  give a grain
     of cilotnel and as much opium in a  pill ewry night. "^
       There is something d fficull to account for in some"'
     cases.   I once  met with a case in  a lad of  about 13
     years of age  who could not b?ar the sm-illest^ parties
     of opium,  and  his pain was  increr.se d  in proportion
     to the qua^titv—a high fever  ar>d cUlirium attended,
     W'th inflamation and gangrene in the feet—a supu-
     ration took place in.one which let  the os calcis (heel
     bone) bare—le had a opnstant delirium—1  give him
     tartar emelc in cms;' 'tn-ble  dices, lut without any
     effect—his b. wels were e\ic!trtly  ;<rTe( ted w uh rheu-
     matism, ',vl.ile no part of the  bociy wts  fitc  from  it.
     A supuration is not a  comn  on thirg,  Lnt  there is
     son-tt-imc: a'a collection of a,t ran? paier-t or yellow-
     ish substance of the c-on.istcnce of the glare  of an egg
     tSkes place ner.r the j* i'-*6 •frldch  ma lie ulcers  very
     difficult to hevtl—such shruld be warred wuh tolera-
     ble strong  hire water at :! ^rirHcd wiih barje.
        If rhe at.t»'V of rhf'^mntism-br moderate  and  con-
     fined to a ;•'-* t with sdrencs  and p;dn, h*thii g-t with
     cald wi'cr two or th-"^- ti res a day." will remove  it
     in m'est cysts in a short t'tM e. ' I.ilstr rug  is ^!so a
     very'good rtmccy—tit h;i-ltr Miotild br? applied over
     the  p;.rt and  k< pt  "-pen :s" long  as it  can.   It
     frequently uf.'.c'.s the b-wi*. uf ths'ueck and head, aod 
                 RHEUMATISM.        *    101

  even the brain or the'membranes whhin the cranium
  This is alwa\s a dangerous c*se and ought to be re-
  moved as quick as  possible—«• 1 once had a patient
  yvl: >  had  b.en aflettcJ  in this maiier  upwarus of
  twelve 'mouths,   by blistering the back,  and ba/k of
  the neck, and keeping the blisters open  for four.or
  five wetks, opium, «alomel, guiaicum Sec. wete  em-
  ployed, as also  bleeding purging  he. he  remained
  well,  except some little stiffness in his neck, for about
  six months, when l.e died suddenly withoutpain, «s
  by a stroke of the ap-.^piexy.   He could  always hear
  something crack in i.is bend upon walking.
    After rcmovug a rheumatism,  whether  acute or
  chiontt, it is proper to  g've  bark,  iron, and other
  • trengtheners, for some tune  after, to strengthen  the
  system and prevent * relapse.
    When it'afiecls the small of the back, it  is  called
 lumbago—if it affects the hip join', it is cal'ed sciat-
 ica.   In the lumbago the same  t> c-.tn.ent is prober
 that is.in any other part of the body.   Wb.'n it'af-
 fects the hip or any other joint the oil  cf turpentine
 is a valuable remedy, but rest  is  of equal, service.
   It appears tome that the rheumatism  is  putiru-
 lsrly coidmed to  the  mcnbiaies  and' n.uscl-s,  but
 that it <;< metii.v affects ire Ijgamtnt ard lubii^i..-,*
 ghmd  of a jo-nt, and in this case it is that ire  spir.t
 cf turpentine is mdst especiallynisefU.
  I had  a sciatic about the year i 793, which becsrr-e
 vc,;, trouhle^n.e — i ;;,ade use cf about half  a pi^
 oi o.l ol  tut;emne in  abtmt two months,  which  en--
 tireljrtnrvcdit;  but\ before it  left me it wotdd
 com.tm.es be in my knee, and  vi  times wo.dd  U
 sow inc..nve„ie.-.ce for several v.ars, but oil of tur-

WMlcTbe irct- from pa,,.  a,,| soreners, it   ,v„i.ld usu-
»«;  <:-ackttpo„ wa!ki.g-it  has  left n.xknec  fc r
^'•tal ve.r^bu'  f,ei„*er Midof the fib. la, or  If.
t'co.nenfthelei. .,.., h,en a  little sore   for  year,
»nd*Mnei,rr.es  th, external part of the foot  ha, been-
t••"-■, »rr:xtnp:,..fuhbi,i  b.tbing with  cold  water
W"ew' tWiCC »jii  ^vays«.n.ove the pin,  at lca« 
     *cx    *           ©OUT.
     ST—a                     ,
     it is ahvays most painful when hot.    I  might fill a
     volume with the variety of cases  and forms  under
     which I have observed the  disease,  and the various
     means which I have employed—frequently with suc-
     cess, but  some baffled my skill entirely.  By a pro-
     per attention to what has been said, any person may
     be able to give relief in most cases, especially in the;
     first stages,.


                         GOUT.

       Of this disease I have but little  knowledge  from
     experience, and'had it not been a disease  handed
     down by a heriditary  taint, it is probable  we should
     ifiow but little of it in the  the United States,  but a,'
     mong the luxurious and idle.
       Writers assign a variety of causes of the gout, and
     some apparently  contrary;  they  also differ  in the
     method of cure.  Dr. Darwin, with most otherjjwri*
x    ters, prescribe light diet and exercise, and abstinence
     from spirits and wine ;  while Dr.  Brown prescribes
     high living and plenty of generous wine.
       Dr. Cullen says an indolent sedentary life,  a full
     diet of animal food, and the large us?  of wine, he.
     are some of the causes :   another set of causes  he
     supposes  are such as from  that state induce debility;
     among which he enumerates the following;  excess
     in venery, intemperance in the use  of spirits, intern-.
     perance in eating, intense  study, night watching, ex-
     cessive evacuations, the ceasing from the usual  la-
     bour, the sudden change from a very full to a very
     spare diet, the large use of acids and ascessants, and
     cold applied to the lower parts.
        It is divided by medical  writers into three or four
     kinds—the one they call regular—it  is  an inflama-
     tion that appears in the joints, and after continuing
     for a time, goes off, leaving  the person  in  a better
     state of health,  ad.  Atonic, which  appears to arise
     fror. a gouty taint in  the  system,  but doei not put
     on any regular form.  ■ 3d.  Retrocedant—when after 
                      GOUT                  103

  ftrr.e slight affection bf the joints, It recedes  and af-
  fects some of the vicera, and when it attacks  any of
  the vicera first, it is called misplaced.
    Whenever a person of  between thirty or forty
  years oi age has reason to believe tbat he is liable to
  bz attacked by thp gout from a heriditary  taint, or
  from atiy  other cause, he may expect the  following
  symptoms as a signal for the attack :
    Head-ach,  stupor  and  numbness,  a pricking or
  tingling in the thighs and legs, loss of appetite, which
 frequently returns more keen preceding the  attack,
 the attack generally commences in the morning  and  *
  commonly toward the spring time of the year, a pain
  is felt in the great toe or ball of the foot—the other
  symptoms much resemble an intermittent fever, as a
  cold, hot, and sweating stage ensues-.
   In peasons subject to gout,  there are frequently
 formed chalky substances upon the bones, and espe-
 cially about the smaller joints of the hand.
   !s-v.*»cians in all ages have found so much difficulty
 in the treatment of the gout, that it is much like
 chronic rheuaiatism, and some other, a reproof to the
 faculty.
   The indication of cure says. Cullen,  are  two, vis.
 "When the fit is off, to prevent the return—when the
 disease is on, to moderate the violence  of the disease
 and shorten the paroxism as far as can  be done with
safety.
  The first intention is to be answered by  the fol^
 lowing rules : constant ^exercise, Tow diet,  &e.  is
 thought often to secure a  person, notwithstanding
 a hereditary taint.   The exercise necessarv, is vtvt
 lar labor, moderate but continued, through life
   ew> Was it ever  intended by  the hand that
-ormod us that we should wallow in luxury and idle-
ness r                                J
  After the disease has become habitual, Walking
 Iiard will bring it on.                             a
  As to diet, the same author, I think,supposes that
>t irnccessaiy to observe  the lew regimen  in the
$>«;« e ct hfe, for if the unstituticn \h  Ucn  dispel 
 i3«                 GOUT*

 eel  to the disease by intomperance, in  the decline of
 life, too Iowa regimen :my bri, g on astute of debili-
 ty, and be the cause of g-JUt -- milk, he supposes one of
 the best  a'iments—when this diet is  proper, spirit-
 uous liquors, whether fermented or di-tilled, are im-
 proper.  It will  be  observed that, sudden changes
 from one extreme to another are  always improper;
 and in those accustomed  to  high living, an entire
 cha.ig, in the mode of living  from one  extreme to
 another,  is pernicious-;  and such changes must be
 estimated as proper or improper  according to  their
 effects.'
  Infinite hns been the medicine  and prescriptions,
 both by quacks and physicians, for the  cure of the
 gout, but none have ever supported  its  reputation
 long,  for, altho the disease  is some times cured by
 the f iree of medicine,  it generally must take a year
 ertwo, and after all for the want of a knowl-ge of the
 proper treatment  according to the  nature of the case
from tiie  infinite variety of concomit ant cirtui^fta'n.
ces, other diseases are frequently induced which fre-
 quently prove fatal.   But from  the rare'occurrence
of the disease in the Utited States, and the probabi~
lity that  th >se who may be so unfortunate as to  inhe-
rit the disease from their ancestors, also inherit the
patrimony with it that may enable them to have the
benefit of professinal aid, I shall therefore prescribe
no farther, but recommend it to such of my country-
men a~, may not think fit to submit to low diet and
and exercise aione'to consult other writers. 
           St. ANTHONY'S  FIRE.        105

       ERTSIPELAS, St. Anthony's fire.

   This is an inflamation upon the surface, most com-
 monly upon the face, but often  upon  the Jegs,  and
 may tfcppen upon any other part of the bod>.   It  is
 commonly preceded  by fever,  which  generally at-
 tends it as long as it continues to spread.   The  i»kin
 appears inflamed and shining,'of rather a  yellow co-
 lour, small blisters soon  appear  which continue  to
 spread for some time, and it  is  sometimes attended
 with delirium,
   bleed and give a purge of G. salt  or  cream  of
 tartar.   If the  inflamation and fever be great, an  e-
 metic in the first place would be best, and  then  keep
 the belly loose with flour of  sulphur  and cream of
 tartar, and the bleeding may be repeated if necessa-
 ry.  The cooling regimen should be observed.
   Meal applied externally, is  directed by  writers
 but with what view I cannot tell.  What I consider
 most rational, and which has always succeeded  well
 with me, is "told water—the part  may  be  bathed
 with it, or clothes wet and applied frequently, or re-
 newed as they  become warm;  and  after  sutficien
 evacuation as" ajbove,  a solution of  sugar  of  fcadt
 may be applied—a drachm to the pint.
                        *

                NETTLE-RASH.

  Prom the vague account which I find  in authors
 of this disease, I do not know that I  am r'c'quainted
 with it, but I have  frequently  met  with*'* disease
 which  I  suppose may he it.   From my own feel.n-s
 Under  it I do not take it to be so mild a disease as It
 is gener-dly descried to be ;  although -I have never
 known any person to die with it, I have known them
 frequently suffer very much
  It begins with ^ itching on different parts  of the
 oo.ly, frequ^fy over tvery part except  ttfc hands
and lace, wmch are ?eldo u affected with it.   It at
n-st appears like the sp'ns in thi nisa.Ics,  but soon 
ic6
NETTLE-RASH.
rise up in eminences, especially if scratched—after
continuing a few days it goes off.   The disease ^ is
not always so mild/it is sometimes attended with
pain in the back and hips, and a colic  with violent
paroxisms at intervals of a few minutes.  When the
disease goes off, it generally leaves a swelling of the
scrotum  in men ; and  I knew one man very much in>
jured by  it,
   The best and only remedy-that I ever could find in
it, is  an emetic—a full dose of tartar emetic  has  ne-
ver failed giving immediate relief in any  c-;*  that
has come within my knowledge.


    INFLUENZA, CATARRH, OR COLD.

   What  is usually  called a cold is too common a
complaint to need  any description*  It  is  generally
termed a catarrh when  a  cough and expectoration
of mucuntttend.   Sometimes the head*' is  more af-
fected than the lungs, with a discharge of thin acrid
matter from one or both nostrils,  it  is then  called
cornza.   When the complaint is very  general  it* is
called influenza, which I think  a' proper  title, and
that, that of cold ought to be rejected^as I believe it
to be seldom the real cause, but that it is owing to, or
caused by, something that floats in the atmosphere/'
 and that it is in no wise contagious.                ,
   I found my opinion chiefly upon the following cir-- !•
 cumstances :   They  are universally a general  com-
 plaint throughout the country at the same  time,  be-
ginning  upon the north and proceeding to  the south,
 and that at a  time when  there  is  no perceptible
 change in the state of the  atmosphere, either from
 cold to heat or heat to cold ; and on  the  contrary,
 when the most sudden and violent changes happen,
 no such disease takes pluce.   It  may  be  not only
 possible, but even probable,  that  a similar disease
- laay be induced by  cold under  some circumstances ;
 but rheumatic afftctions ai'ci some other complaint are
 the  consequence  of cold,  it appears to me lb,at iit 
INFLUENZA.
■ io7
 sound person without  any predisposition to disease,
 cold will induce no  such disease.   Whatever may-
 be the cause of the disease is immaterial, unless  our
 knowledge of the cause might enable us  to  avoid  it,
 or lead to some knowledge of the method of cure.—
 The disease appears to be an inflamation o£ the su-
 perfices of the vessels  of the head, or lungs, or both,
 and is communicated to the system  in  a greater or
less degree, according  to the violence of the symp-
toms.
  The treatment is to be the same as other inflama-
 tory diseases.  When  it  may be  deemed necessary,
 rest, light diet, antl plenty of drink, either cold or
 warm, at going to bed  If more should  be necessary,
 bleed, and if more, an  emetic.  If the  head  be af-
 fected with pain, or the breast, apply blisters.
  When the influenza prevailed in the fall  of 1807,
many persons by  exposing themselves  to  cold  and
hardships through the  winter after brought on pneu-
monic inflamations, which in a number of cases were
 attended with rheumatic  affections  of the  breast,
 head, &c. In which, after the inflamatory symptoms
were removed'by the usual means, I found baik of
great service.
                    CROUP.                 4

  This in a very  common disease among  children
 under six or eight years of age, and sometimes older,
 cr even adults, but that is seldom.  It is  seldom if
 ever that very young children,  or before  they are
 weaned have it.   It  appears to  me  that  there are
 two kinds, the one moist and acute,  and  the  other,
although an acute  disease,  come*'on more gradual
and lasts much longer.
 # In the first there is every symptom of an  inflama-
uon of the  lung,,  with, a freat  quantity  of  tough-
pnlcgm, which ca,Vcarcelrbe coughed up,..attended
 ^h pain and soreness ofthe breaft.  In the other a"
 ^racncs JS the  (:r$: ry;n:om- lhn   lv£           .
# 
xo8
CIjpUP.
the disease, which will often last for several days.—*
In both cases they appear evidently to strangle for
the want of breath.  In the last case the  child will
run about as usual and often  appear cheerful  while
it is able to go, but in the former  they  always  shew
symptoms of distress, sspecially  upon coughing  or
motion.
  In the moist kind, bleed and  give a gentle  puke
of tartar emetic in small quantities, and  be sure t&   j
keep the child warm.  Bathing, or putting the  child  i
into a  warm bath up to  the chin, is of great service, j
after it has been in  the  bath for  a  little time, the
heat of the water may be  increased by adding hot  .
water  until it  raises the whole  to the heat of thevi
blood, which is more than  they can bear at first.   If
the bleeding,  he. should  not  entirely  relieve the
child,  a blister should be applied to  the breast, arid
small  repeateddoses of tartar given, and the blister
kept open.  The same  treatment is proper  in the
other  case, or dry croup ;  but in this there is a mem-
brane  of a strong  mucus, lining the inside  of the
■wind pipe, which sometimes extend? down the  small-
er branches into the lungs—in  this, small  repealed
doses  of spirits  of hartshorn  should be  giyei. in a
little tea or water, and a bottle with a good  quantity  ■
frequently held  to the nose.  I  never was «b e  to
discover muchbenefit derived frcm blistering in this.
I believe there are but few cases that would require
any  thing more than a puke,andbleeding if employed
in time.  Great care should be taken to prevent  the
 child from taking cold for several days afterwards, as
 they seldom evtfr recover again if they relapse.
 
„ »„>WM. » . »n ■.......m ■■»■»! 11 mi mi"\,, :\fi±L*y -?r«m«ESygv»-P''»*
HEMORHAGES.
         BLEEDING  AT THE  NOSE.

   Thi~ discharge maybe owing to a variety of causes,
 as great lit at and strong pressure of the b'ooJ upon
 the vessels in the head.   This is a common cause  in
 yoang people, of a sanguine temperament.   It fre-
 quently  happens in inflamation of the liver, in fevers,
 and many other  diseased states of the body.
   When it happens in young people, if the discharge
 be not profuse, it requires but little attention'; but if
 the discharge be so great as to weaken or endanger a
 person, it will be proper to use means to put a stop to
 it.
   If the pulse  be small and  hard,  and astringents
 fail, and the person has no fever,.laudanum  may  be
 tried—give a moderate  dose, an.I ;;fter  waiting half
 an hour, and the pulse should become  no fuller and
 soft'-r, some more may  be  given — if  the  discharge
 continue, the lower extremities should be put into
 Water as warm as the patient can bear  it, and cold
 Water, or any otber cold substance, held it. the month
 against the roof.  There are few  cases  but what
 may be stopped by the use of cold and  astringents—
 blue vitriol, coperas, or  alum, dissolved in water a; .1
 thrown up the nose,  will seldom  fail  to stop  the
 bleeding.  It requires some caution  in the application
 of cold to the head, especially if the patient be very
 hot, as happens* in  harvest fields.  1  have knowu
 personsj-uined for life by it, by bringing on a  rher-
 Jiiut.c  affection of the neck  and spine,  which piovtd
 incurable.
   That such disch?v.^es are  crjtiCai anti ou„;,lt not l0
 be checked is g,■*,(■■. A'y  &n error—the pulse^nd other
 circumstances will always  srj«w thei propriety  or
 impropriety of such discharges.  I  have never 'tcea'
any of those hcmoihages called active, or cy/'p-  to 
HEMORHAGES.
an active cause, except fhere was a spasmodic state
of the arterial system ; and it appears to me that if   ^
such active hemorhages did ever take place,  that the
discharge must soon remove  the cause, and the dis-
charge cease of course.  If there should  be  any  ir-
regularity in the pulse, it may be judged to be  owing   ^
to that cause.  1 have heard of cases  where, when
the discharge was stopped at the nose, it would take
place by some other outlet, or the patient died from
a rupture of some of  the larger vessels—if such  a
case ever did take place, it must be  owing to  that
cause ;  and in that case, opium and the foetids would
have been the proper remedy ; and from my frequents
success with it, I place my chief dependence in  it,
as the last resort  at least.
         BLOOD FROM THE LUNGS,

              OR  HEMOPTHISIS.

   This is a disease in which I have had an  opportu-
 nity' to try but few medicines, but I have  met  with
 some.  Those which were symptomatic I do not con-
 sider as proper in this place, but the cases  which I
 mean are where the  disease was  primary and was
 supposed the presages of a phthisis pulmonalis, or a
 consumption of the lungs.   Two cases  were cured,
 or got well, under the use of a glass of new milk and
 whiskey once or twice a day,  after medicine  had
 been tried in vain—in both cases spirits had been for-
 bidden, but whether the  cure was  to be ascribed to
 the spirits in that form or not,* I cannot  say—it was
 the prescription of a  French physician.   Bleeding
 and astringents are prescribed with- gentle exercise,
 cs riding in a carriage, or a voyage at sea, he.  The
 internal remedies  directed by medical  writers, are,
 -astringents and gentle   laxatives—of astringents,
 alum may be considered as one of  the*  best,  which
. may be; taken in smalt doses, as 5 or 6 grains, and fie-
 qutnly repeated.                         ■*"* 
              HEMORHAGES,      •         ili

         PILES, OR  HEMORHOIDS,

   This disease is usually classed  with hemorhages,
 but it is not  always  attended  with a discharge of
 blood—they frequently remain  a long time, and are
 painful tumours without any discharge of blood—in
 others they become schirous and  hard—in  others,
 excrcrsnces grow from the verge of the  annus, like
 warts or the comb of a cock, and is hard and  painful
 —jn others the annus is hard and  breaks in chops,
 forming painful ulcers.  These  several diseasss are
 distinguished by medical and surgical writers  by va-
 rious names.
   When there is a  distention  of the blood  vessels
 about the annus without any discharge, it  is  called
 blind piles, and if it break  and  bleed,  open piles.—
 When any excrescence or new body is  formed, it is
 called acccording to their figure, as  ficus, a fig, con-
 dilomata, a knuckle, warts,  he.   The tumour  is  ei-
 ther internal or external.
   A very erroneous opinion prevails among the peo-
 ple, and was formerly propagated by some physicians,
 that thehemorhoidal discharge  was  an effort  of na-
 ture to relieve the system from  some other disease,
 or a  redundance of blood,  called pAhory ;  and as
 an evidence of the correctness ,of  the opinion, pa,
 tients frequently assert thev feel much relieved when
 such discharge takes place.'  The truth  of  the case
 'VlVi the disease  is owing either to an obstruction
 oi the blood by the  hemorhoidal veins,  by costive-
 ness  pregnancy, or debility ;  this obstruction brinp-
 on a diseased state, which is removed in  a measure
 whenever the blc*d is  discharged-;  and  from  some
 experience in  practical am clesr in the opinion,
 tut whenever a person  permit* the disease  to be-
come habitual, they are surrendering their  health
and tuture  happiness to  a most  troublesome and dis-
-'L-'eesble disease, uhicji often renders  the  ur.fortu-
'•-ie  victim of ervc.ra misery to himself and all a-
 ->u:bim;  while I btlhve there is  scarcely  a case
 L \ ft' p«in^ .>«• L . .__' *  »      • *          J
                                       ec  cr pre.
«.ycr rnrrCns fctt right be  easily u-v 
fta            HEMORHAGLS.
vented by a little care at first.   As costiveness is  a
frequent cause, a person should never permit  them-
selves to be subject to it;  but more especially  if
thev perceive any uneasiness about the annus.   Ma-
ny persons, especially  women, are in the  habit  of
i;sing Anderson's pills, and other aloetics, to keep
the bowels lax, but it is a highly improper medicine A
for that purpose in most persons, as it  is a very heat*
ingdrug—they should be continued no  longer than
absolutely necessary.
  As a  laxative, or medicine for keeping the, bowels
in order, there is nothing equal to flour of''sulphur
and cream of tartar—they niay be used together  or
separate—the flour of sulphur is the most  proper by
itself in the piles, as they keep the bowels lax   withjf-*,
out irritation ;  and if the patient has been subject  to
the discharge, it  will  be  necessary7 to bleed .about
three or four days before the full of the moon, until
he shall find himself free from the complaint,  and -in
the mean tithe live upon such diet as has a tendency
to keep  the bowels loose, such  as soups, sallads, ripe
fruit either dried or green, fat meats, &c.
  The external remedies in the common piles,  where
the tumours are sofc, are astringents, <■£  which an
oitment directed under oak bark is one cf the  best-
ir the tumour be within the  annus,  a  strong  decoc-
tion  of oak bark arid alum should be thrown up once
or twice a day.   The sugar of lead ointment will an-
swer very well  ; or  a weak solution of blue vitriol,
white yiirh I, alum,  coperas,  all  aie  good.   If the
tumcurs be hard,  or like Warts, they  should  be an-
ointed uith a strong mercurial ointment every night,
and if they do not give way  to it, the Jamestown poul-
tice applied and kept on A\  night, will  seldom  fail  to
resolve  the tumours—sometimes they  will  sive way
to no medicine, but must  be  extirpated,  either  by
rubbing with the caustic or  by  the knife,  or irfcfrome
cases by tieing  a strong thread around the basis?—
Hefore any means be  employed to remove  any  tu-
mour by extirpation, care should be tab'.n that i;  bs
fco part  cf the gut that protrudes. 
kEMORHAGES,
"3
 ,  It frequently happens that ulcers are formed about
the annus by diseases of this kind,  especially the in-
ternal piles—they frequently come on without giving
much notice—they make a small hole near the verge
of the annus, not much larger than a pin hole,  thro'
which a thin humour is discharged, which will  stain
linen, otherwise it might be thought only a sweating i
of the parts ; after continuing some time it causes
an itching and excoriation,  and little excrescences
and papulae  arise—they" frequently become calous
and so hard that a probe can scarcely be passed in—
they frequently  make  their way into the  rectum,
bladder, or among the muscles of the thigh, he.   In
this, as in other cases  of  the piles, we  are  advised
by some of the ancients, to permit  the discharge to
continue,  as salutary, except it become  painful or
troublesome  ; but this 1 think an error ;  every un-
natural discharge, if continued, is  injurious to  the
constitution, and ought to  be stopped'immediately.
These ulcers are generally very difficult to cure, but
if an opening can be made into them, they^ay gen-
erally be cured by throwing a strong lime water  into
them about twice a day with a good syringe.   The
ancients generally  passed  a strong thread  through
them and into.the gut, and by tying it tight, soon cut
it open into the gut, and  then by  proper dressing
healed them  up; but they  may generally, be healed as
above—the only difficulty is making  a sufficient o-
pening into it, and  washirjg^he ulcer to the  bottom.
It the person be otherwise  unhealthy, the pernvian
or alder bark *ay be given, and if  upon  the  healin*
up of the ulcer, any  complaint  should "come, on  a
purge of cream of tartar, or even salts,  may  answer
the purpose; and if after a purge any pain orirrita-
tion shou.d come on, a  glyster  with  laudanum,  will
he proper.                                 :.*..
                      P  *''- 
it*
DIABETES.
                  DIABETES.

  This disease is  an increased  discharge  of  urlne^
which is sweet and has been found to contain sugar—»
it commonly comes on gradually and appears in gen-
eral  to disorder the  system but very little—thirst
and  an  uncommon   appetite frequently attends—
weakness comesonT and at length  a fever puts an
end to the patient.
  The true cause of this disease is  unknown, and I
believe it to be a rare disease in the United  States,
so rare that I have not met with  a case  in  fifteen
years.
  Dr. Cullen had met with but few cases  and they
proved fatal, and he declines giving any opinion as
to the proper method of cure, but some  other medi-
cal writers recommend  m«di-cin«, and it is  said  that
the disease has been-frequently cured.
  Dr. Gilly, relates several cases of persons cured
by the use of the nitric acid,  or aquafortis, as fol-
lows:   Take-nitric acid a drachm and an  half,  bar^
ley water half a pint, simple syrup  two ounces, mix
them together, four large  table  spoon  fulls  may be
taken in the day with the same quantity  of water.—
Others recommend the bark, lime water, opium, Ike


       INCQNTINUANCE OF URINE.

  This disease .may be awing to several  causes, but
the most common, is caused by weakness in aged peo-
ple, and is often a symptom of other diseases,  and is
sometimes the fruits of excess in drinking spirits—
it sometimes attends the advanced  state of pregnan-
cy.  When debility or weakness is  the cause, it will  1
be much relieved, and if the patient be  not very old
sometimes  cured, by frequently bathing the  back
and urinary passage with cold water, especially be*
fore  going to bed  at night.  Also, strengthening me-
dicine, as bark, iron, he.   Some recommend blistor--
*x> the back, as also, tincture of cantharado*. 
dp.opsy.
«J
  The disease sometimes  defies the power  of me-
dicine and a p.diative is ail that can be  expected—
for this purpose a  sponge  may be fixed  and  worn
iconstai.tly, which will be found of service.
  When pregnancy is the cause, to lie in bed astauck
as possible will give relief,


                   DROPSY.

  Dropsy  is a collection of water in some part of the
body—if in the adipose membrane it  iscalud  ana-
sarca,  ifinthebeliv :t is  called  ascites,  if ir. the
b-e.'st  it is called hydra thorax, if in the head hvdro
.cephalus.
  AodSHrcous swellings most commonly b. gin in the
feet and legs,  whn h look pah and  shiring,  when
pressed with the  finger a p-n is left which soon fills
up again—the water leaves the feet in a.geai  n.i-a-
suiem the Light  «-nd the face and upper  ^.rts of the
body are found swelled in the morning, but falls  ta
the lower  parts again through the day.
  The causes of this disease are  various—whatever
weakens the circulation of the blood may be a cause,
but it is more commonly a s>mptom  of  some  other
than a primary disease—it often attends a consump-
tion, an inflamation of the liver,  pregnancy,  and a
variety of other  diseased states  of the system—it
frequently happens after a recovery from a low state
of fever—it is seldom  attended with much  dan^r
»nd will frequently go  off of itself when slight  ; W
it the swelling be great and of a long standing it will
always require medicine.
  Strong  purges have most commonly been employ-
ed to carry off the water, bat very improperly, for
they are very weakening, and although they evacuate
the water, it will soon return  again.
  Salt-petre given in doses of f.om  ten  to  twenty
grains  three or four times a day, will  ,„ general pa.
ry tl.c  water off very soon,  and then it is  necessary
to give some preparation ofiron and bitters  to pre! 
*
iio*                DROPSY.
vent a return—cream of tartar will also,  taken in
doses of from two scruples to a drachm  three  times
a day, evacuate the water in a week or two, and it ia
not so apt to return as when carried off by nitre—
strengtheners  are always necessary after the water
has been evacuated.
  A variety of other means have  been  recommend-
ed and employed by physicians for the cure of drop-
sy, as abstinence from water, drinking  plenty of wa-
ter, sweating, laced stockings and bandages, friction,
&c. but the means directed above have never  failed
with me, and 1 scarcely pay any  attention to regi-
men during the  cure.    I have often   known it
cured before it had been  of  long standing, or verv
considerable, with iron only, or iron and bitters.
  The disease called  Cachexy is  a kind of dropsy,
which is  not always attended with swellings—the
blood is very thin and watery—iron,  bitters,   he,
together,  never fail to cure thisv
  There is,a great difference in countries in this dis-!
ease.   In limestone countries, a  cachexy  is  seldom
seen—on the east side of the blue ridge it is  a  very
common disease,  so much so  that I have  known
neighborhoods that a third of the  people  looked  like
the dead, and that in as high and  apparently healthy
as any part of the world.   A person not well cured
of an ague scarcely  ever  recover  their complexion
again in the eastern states.  The disease is scarcely
known in Kentucky and most  of the western coun-
tries ;  however hard or long a spell of ague a person
may have, they generally  recover their  complexion
immediately.
  I have not met with a  case  of  chlcrisis,  or green
sickness, in girls  in Kentucky.


                   ASCITES.

  This is a dropsy of the belly, generally in the cav-
ity, but sometimes between  the   peritonaeum   and
muscles, sometimes it consists  of bladders  of water 
DROPSY.
n?
arising from some of the  internal parts, frequently
the ovari in women.   From the swelling and weight
of the belly, a dropsy may be distinguished from what
is called a tympanitis, being wind only—r(a disease I
never saw.)  In a general dropsy, or  anasarca,  the
lower part of the belly frequently  swells ' and gives
rise to a  collection  between  the  peritonaeum  and
muscles, he' it may always be distinguished from  a
collection of water in the cavity by pressing upon it
with the finger—if in the adipose membrane it wiil
form a pit, which will fill up again.*'  It is  said  tha;:
an acites may be distinguished by a  fluctuation,  but
this I think an error, for the  bowels only  will  be
heard and felt to fluxtuate as much, or  more so, than
in ascites.

  If the collection  of water be In the ovaii, which
sometimes happens, it  may  be cured by extracting'
the diseased part, which may be done by a handy sur-
geon with little danger.                       "*

   In a common ascites, or collection of water in  the
cavity of the abdomen,  there is scarcely  anv tine--
alb that can be done is to draw  off the  waiter  by tup-
ping, called paracentesis, which is  very simple  u  d
may be performed by any person after teeing it onto
performed.  I was well acquainted with  a man who
performed it upon his wife,  at first, at intervals of a
few months, and at last once a month, or oftcner.—
There is an account in Chesselden's  anatomy,  of  a
Woman that lived from fifty to eighty,  by  frequent
tapping.   '1 his being the only  remedy differing f.oji
the cure of.r.r.asarca, which always ought tobe° tih-d
first, I sh.dl sr.y no more uprn  it, as  a  person  pos-
sessing some knowledge of the position of the mus-
cles of the -bdoiiiv;;^ and other parts concerned, cucht
to be  called  upon to  perfoim the  operation! a fur
which  any handy person may do it nn  safety.    No-
thing more is necessary  than., to make  an  incision
through the skin and some of the ncnbrar.es  jb.v.;t
thu-t  inches in  a direct  line  btlow the- navt!,  a-J 
 siS                DROPSY.

 then force an instrument called a Trochar* into the
 hollow, and then drawing out i[,e s'etl. h ivn g the
 canule in.  As the water   s  drawn  ofl,  tlu  belly
 should be swathed tight, odurw ist th>e  patient will
 be apt to faint.  The banda •••_ sbe-uld  be kept  on  a
 few days, until the abci^i en contract.

   * A Trocbar is a silver  case*  about the size of a
^goose-quilL with a snei thing like a Lodkin in it, <wi(A
 # three square point.


         DROPSY  OF THE  BREAST.

   The collection of water may  be  in different situa-
 tions  about the breast, but it is very difficult to dis-
 tinguished them.  There are two  only  in which a
 cure is  to be  expected,  and not  always  in th^m.
 When the water is in the cellular texture of the lungs
 and parts about, there is a hope that it may be eva-
 cuated—when it is in the cavity of the breast, it may
 be discharged by tapping as in  the ascites.   It some-
 times accompanies anasarca, but frequently without
 (it.  This disease is sometimes attended with a weight
 and anxiety about the lower part of the breast  and a
 difficulty of breathing,  especially when the patient
 first lies down.  It is somewhat  difficult  to  distin-
 guish it from an asthma.   I  have  in some  instances
 seen anasarcous swellings about the  neck and ster-
 num, but from the small space between the ribs it can
 scarcely be perceptible there.
    Dr. Darwin  esteems the tincture  of digitalis  as
 one of the best remedies^— thirty or forty drops from
 a two ounce phial may be given twice a day,  and in
  the mean time  some  tonic, as tircture  cf iron  or
 bark and opium at night.   Another means of evacu-
  ating the water is by sweating ci her in a hot tub  or
  room, or by medicine—?5or 30 drops  of the spirits
  of hartshorn, given in  half a pint of wine whtywiirm,
  and repeated every half hour for two or three times,
  will generally bring out a profuse sweat. 
DROPSY".
1t$
  If all medicine fail, and  there  should be evident
aio-ns of a collection of water in the  hollow of the
breast, on either side an opening may  b? made  with
little danger, by any handy  person  —it  should  be
made rather forward than  behind  on  that  side the
water is judged to be in, and within an  inch of the
termination of the libs in the cartilage  that  con- ^
nects them.   The muscles and skin should be drawn
down when the incision is made, so that  when the
water is drawn off, it may  slip  up  and  shut up the
passage into the hollow—*it should  be  made two or
three inches long and as close as may be to the edge
of the rib below, as  an artery lies near  the lower
edge of the other.   These operations  ought never
to  be  attempted by  any  person but a  cautious
physician, when such may be had,  but for the  w.arvt
sf such, any handy person may perform ft.


           DRO?SY OF THE HEAD,

  This is a disease to which children are more sub-
ject than grown persons, but scarcely any age is  ex-
empt from it.  Dr.  Rush thinks that most  cases
supposed  to be a worm fever, is a  dropsy of the head.
Certain it is  that children- are more liable to col-
lections of water in the head, than  grown  person?,
but I suppose it is often a symptom only of fever or
some other disease—if it happen in children, a fever
 is the most common symptom—a dilation of  the  pu-
 pils of the eyes always attends it in adults,  frequent-
 ly  drowsiness and stupor—it sometimes rs the  eaus-3
 of madness or distraction, and there has been rnstan-
 ces of the disease being removed by the trepan,  but
 it is not every case that will admit of it, as the water
 is sometimes formed in the ventricles of the  brain,
 and there would be  too  much danger attending s.
 puncture into thepiamater, or membrane which im-
 mediately invest the brain, but if between the dura-
 mater and skull,  it would be entirely  safe  to  disr-
 sharge it with the trepan, or if under the dyiamatcs 
ii-b.               DROPS "i*.

it might be discharged by an expert and skillful sur*
geou.  I have scan several cases,  one in  a y-oung
man of about zz years of age—jr.he attack commenced
with fever, which abated upon the use of the ordina-
ry means in two or three days—the patient remained
drowsy and in a torpid state, so much so that he  ap-
peared to be almost deaf and blind,  and would scarce-  '
ly'take notice of any thing that was said to him—he
would walk about the house, but  would stumble over
any thing in the way—the pupils  of his eyes were ve-
ry much dilated—his father refused  to permit blis-
ters or any further application,  as he supposed  hirs
so far recovered as to be safe, but he  died in  a few
days.
   In children the disease is more easily  discovered,
as the sutures in the head  being less  perfect, they
admit of a  distention.
   In the treatment, mercury is  much recommended.
Calomel to be given  inwardly, and the  mercurial
ointment applied externally—blisters also applied to
the back of the head and neck are  proper,  as  also
purging frequently with   cream of tartar in large
closes; if all these fail, and the person be  an  adult,
eleven six or  eight  years  old,  a skillful surgeotv
should be called for, and when every symptom shew
a collection of water to be  present in some part  of
the head, the  trepan  should be  employed—there  is ..
little or no clanger attends  it in  the  hands of  a skii- ,
 ful operator.
   In all the cases in children where I have suspect^'''"-
 ed the disease, calomel and brisk  purging has suc-
 ceeded.

                   RICKETS.

   Rickets  in children has generuUy. been  classed bv
 authors with dropsy or intumecence, but  as it  is  a
 very raredisease in the United States, and the rem-
 edies are but few that are worth employing,  I shall
 say but little upon it.  It is supposed,to be heredita-
 ry, or at leait the predisposition  to it is more conirr. ji* 
DROPSY'.
12$
• ft some families than in others.   It seldom makes
its appearance in children under nine months old or
after two years.
 -  The first symptoms are a softness of the flesh and
the child becomes leaner, the heid appears two  large
in proportion for the rest of the body, and the sutures
are in general found too open, they  cut  teeth but
slow,, the ribs become fUt or like a  dog's, while the
breast bone is pushed up, the joints are enlarged and
the bones appear soft, the belly is too large, and the
appetite generally good, but the belly-too loose, the
child is usually more accute and sensible than  natu-
ral for its age, but sometimes the reverse.
   In what few cases I have  met with,  the  disease
was imperfect, or at least, the symptoms mild in their
degree,
   In the cure I have never attempted to employ any
thing but cold bathing and  electricity, which  have
always succeeded-—in the worst cases that I ever met
with these remedies  alone effected a  cure in  three
or four months.  A few gentle shocks should be pass-
ed from  the  extremetiestf-through  the  head  about
twice a week, and the child emnu-rsed in cool water
once every morning, until it recovers its health.


      SCHROPHULA, OR KINGS EVIL,

   This, like the rickets, is not so common in Amer-
 ica as it is in Europe, but it being communicated by
 a hereditary taint, makes its  appearance sometimes,
 and probably may be produced by  some accidental
 circumstance, b-.t \t has been  so far observed  to be
 an hereditary disease, tlrft it  is said that where  a
 child much, resembled the schrophulous  parent, it
was subject to the  disease, while  those whose fea-
tures and complexion  resembled the sound parent
remained free and healthy.
   It is  said that it seldom makes its appearance in  a
 child under two or three years old, and that it is e-
 qually rare for a person to have the first attack after
                     Q 
it*             KINGS  EVIL.
the age of puberty, but in those once subject to it, tt
frequently makes its appearance through life.
  The disease most commonly makes its appearance-.
in small tumours below the ear or about  the  neck
and under the j*vvs, but they may also happen in any
other part of the body, but most commonly affect the
glands  and sometimes  the  bones  themselves.    A
swelling of the upper lip is a very common symptont
of the di.uase, and there is a crack which  sometimes
extends up to the nose.   It  also affects  the  joints
much iike chronic rheumatism, but  without the pain
and soreness.   A tumour is often formed around the
joint, and notwithstanding the  pari may look  in-
flamed very much, but of a more purple  colour, there
is in no wise a correspondent degree of pain—A kind
of purulent matter is often  formed  which at ler.gth.
will make its way through  the integuments—as the
ulcer grows older the  matter becomes  less purulent).
and tne ulcer is exceedingly dirficult to heal, and ve*
ry much resembles those made by  rheumatic  affec-.
tions of the same parts.
  The disease most commqpily comes on iri the spring;
more violent, and will sometimes in a  measure dis-
appear during the latter part of the summer, and ap»
pear again the next.
  In the cure of this diseas?, superstition  and ignor-
ant credulity has formerly had a  greater shaie  or
been more frequently employed than  in  any  other*
Whatever ; and I have now a surgical treatise  in my
possession, which treats largely  of the cure of the
evil by the touch of the king,  and labours   very  hard
to prove the  fact, but like  the doctrine of witches,
hobgoblins and faries, it has in a great  measure, lost
its  repute, even in England
  There are several diseases which are considered ts>-
belcng to this class, as white swellings,  wens, &c,
but as  they require but little  medicine,  I shall not
treat of them in this place, and I might have deferred
the disease altogether u' til 1 had come to the sur-
gical part of the work,  for  it is  generally acknowl-
edged, that there is very little can be doue by meii- 
            VENEREAL DISEASE.        *ag

cine inwardly; hut in what few cases of  schropbula
I have met with I  have been more fortunate—1 have
generally employed purging at intervals, and  given
the extract of hemlock,  and applied  the  Jamestown
poultice, with mercurial ointment; but I  am  doubt-
ful whether the ointment  was really  of service  or
not.  Frequent cold  bathing  is  also considered of
,'greatservice.  If ulcers are formed, the lime  water
wash is one of the best, or burnt alum may be  sprin-
kled upon them.   Gentle shocks of electricity is al-
so a powerfud remedy in removing tumours before a
supuration takes place.   The  muriated soda has of
late been employed, it is said,  with  considerable  ef-
fect, but of this I  have  no knowledge—lime  water
may answer the same purpose, and may be given  as
directed under that article.    Whatever  medicine
may be employ ed, it must be  continued for  a great
length of time, or until the disease is entirely  remo-
ved, otherwise it may be expected to return again.


            VENEREAL DISEASE.

   This disease is always communicated by  infecT
tion, or the application of infectious matter to sjome
part of the body.  Some physicians suppose that  it
c*n scarcely be communicated without actual coition
or seme act equivalent, but this I know  lobe an err r,
as h.ve frequently known  children to contract  the
 disease by sucking persons ii.ficted.  I have known
an  instance of a child but  two or  three  years of
 age contracting the  disease by lying  with a  young
 woir.2n that was infected—it first appeared  in  his
 feet and crept up  until the whole system was  affect-
 ed, but in  a particular,degree  affected the mouth  and
 genitials. the glands, penice and prepuse was ulcera-
 ted; this  circumstance shews that it is  particularly
 a disease of those parts.   I also knew  another case
 if a male child about the ssme age, affected in a high
 degree with many latge venereal excresences about
 i'v.' genitials, lower belly, thighs, &c. 
X


    b*        VENEREAL  DISEASE,

      When the disease produces ulcers they are cailea
    chancres—when iiiflamation of the  glands, bubos—
    tvhen a discharge fiom the urethra in men or the va-
    gina in w men, it is calle gonorhoea—if it he a slight
    Weiping of a thin Or transparent matter, it is called a
    gleet—if it affects the system generally, it  is called
    siphylis, lues venerea, pox, &c.
      It is a doubt whether the disease vvas known to the
    ancients or not—the first certain  account we have
    of it was at Naples,in the year 1493.  Columbus re-
    turned to Europe from the discovery  of America  in
    March of the same year,  and it has been  reported
    and believed that his crew contracted the disease for
    the first time from the natives of some of the West-
    Indies.  Whatever might be the source of  the. dis-
    ease, it made dreadful ravages in  Europe for many
    years after its appearance—the wretched victim was
    shunned and abandoned by  every body—the physi-
    cian approached him with extreme caution, as it wac
    soon found that the malady  defied the powers of me-
    dicine, notwithstanding their shops contained three
    times  the number of a modern physician.    But thro'
    the experience of later ages, and  the  knowledge of
    the proper use of mercury, every species are curabta
    in a short time, or at least while the bones are sound,
    or even then, for  a carious bone from  a  venereal
    cause heals with ease  if the virulence  is  removed
    from the system by a proper medical course.
      The first syTmptoms of the disease  are somewhat
    various, and comes on  at different  lengths  of  time
    from the time the  infection  is received—frequently
    in men in a few hours,  but sometimes several weeks ;
    in women it generally begins with a heat in the va-
    gina and a discharge of a hot fluid, at first colorless,
    but soon stains linen a yellow color,  an itching  of the
    external parts soon comes on, and the hot and acrid
    matter erodes the parts it falls upon.
       In  men a  slight  inflamation  upon the gland's
    penis sometimes appear;   in others no  such inflama-
    tion takes place, but some heat and  pain is  felt iu
    making water—it is first fw-lt about the exit, but gra- 
           VENEREAL  DISEASE.        ji$

dually creeps up until the whole urinary passage  is
infected and great heat and pain  is felt  in  making
Water—a thin transparent discharge is  at  first per-
ceptible, which increases in quantity  and changes in
appearance—it becomes at fitst white, then  yellow,
and frequently at last gree% and even bloody ;  about
this time a painful erection of the  penis  takes  pLce
at night when the patient is warm in bed, frequently
with chordee whicn draWs it  down  ar.d crooked—
ihocturnal pains of the shoulders, head,  l<-gs, Sec. be-
gin to come on— ulcers in tcie  palate, n-outh,  nose,
&c.-^-gumata and nodes arise, which are aiv/ays worst*
at night—the bones at length corrupt and no  part
escape its ravages, the whole system of both  solid3
and fluids are corrupted, and as Wiseman says, d.-af-
r.ces, noise in the ears, polypus,' opthalmia,  fistula,
lacrimals, fierce catarrhs, cohes, diarhoea and  tabes
closes  the scene, r.r.d leaves the patient a  loathsome
heap of corruption.
  There is still another manner of it3 progress, and
I have met with a great many cases  of  it  in  a few
years past, in which men have no discharge or hua;
in urine, but violent itching  with chancres, excre-
scenccd, he.  remain  the only ' symptoms  for  sor.u
time—the mouth is in  the next pL^ attacked,ulcers
appear scattered over different paits, and may aiwavs
be distinguished from o:ke-r ulcer: by their cracking
in different directions.   This state of the  disease is
often attended with tttterous eruptions  upon  differ-
ent parts of the body, or like Ilea bites  all owr,  or
pustle3 arise in different pLee-s.
   Sometimes 1 'mve met with the  disease in  the im-
agination only, but this is more cotniiionly the  cace
af'er a person has been cured—he' snppj.es 'hat  I: a
Still feels the venereal pains, aid  will rjn from on*
physician to  another until he ruins both h'.s b,.dv a;, i
estate.
  I shall now give directions for the  cure,  which "»{'
the bones ha  sound require but littl-j skill, but a  peu:
deal of care and  attention  to certain  i-Jes.   Dr.
w-.m s.;;rji^ to rippo:? ih;:: by attc:uio:i to rc«S -<-n 
 **6i        VENEREAL  DISEASE.

 and cleanliness, that the slighter cases  will  sponta-
 neously cure of-themselves, but  notvuthatanding my
 respect for that veneiablc author, I am ui.able to be-
 lieve that such cases ever occur; and  i ot a ithstand*
 |ng it is said thjt the Indians and other  pretenders
 Say they can cure a confirmed lues without mercury,
 I do not believe them, as I have  known a number of
 cases where such a method of cure had been  tried in
 vain, and although it would abne the symptoms for a
 time, the disease would always return with equal vi-
 'olence.              '■■
   Upon the first attack while the disease is only  su-
 perficial, it may be frequently cured by purging  and
 astringent lotions and injections, sugar of lead, white
 vitriol, blue vitriol, he.  but when a person finds him-
 self smitten and the disease begins to  make  its  ap-
 pearance, observe the following rules :  If it begin
 with heat of urine, or appear to be in  the  urinary]|
 passage, or vagina in women, let the patient anoint
 the parts about with  mercurial ointment lest any of
 the infection should  be upon  the surface—take a
 purge of some cooling purgative, as G. salt or cream
■of tartar—dissolve a drachm of  sugar  of  lead  in a
 pint of water and throw  a syringe full up the  urinary
 passage two or three times  a day,  this  will seldom
 fail to cure a gonorrhoea in  a  week or  two,  if it be
 not very  violent, or has  not been of a long standing;
 but when  the disease has been  of  a long standing,
 or has made its appearance on any other part of the
 bodv, a mercurial course is  the  only remedy, and as
 X have given particular  directions  for the  manage-
 ment of such a course, under the title of mercury, in
 the preceding part of this work, 1 shall not repeat it
 here, but  only  observe  that  the patient  should be
 careful »o keep the system sensibly charged for a suf-
 ficient length of time, which should be continued for
 2 or 3 weeks after the  ordinary symptoms had en-
 tirely disappeared;  but it may  be proper to  observe
 that it frequently happens that a gleet or thin, or ra-
 thei transparent, discharge  frequently  remains  for
 a lo; g time after the cure of the venereal disease, and 
           Venereal  disease.        *$

 is only to be cured as a common gonorhoea  or  gleet
 without any venereal taint, (which see.)  The  next
 caution necessary, is to  keep  equidiy  warm at  all
 times, and that should be as warm as the patient can.
 well bear without beii g disagreeable.   A small por-
 tion of tartar emetic g;ven  at intervals through the
 day, especially towards the  last, is a valuable auxili-
 ary,  and much better than di^t drinks, guaiacumj,
 Sarsaparila, &c. which I never use.
   Chancres,  or other ulcers which  may be hard tft
 heal, may be washed  with  a solution  of corrosive
 sublimate in sal ammoniac—a  scruple  of the subli-
 mate and a drachm of  the ammoniac to a quart of wa-
 ter—if warts or other excrescences, they should be
 frequently rubbed wit"h caustic  or sal ammoniac,'and
 anointed well  with a strong.mercuriai ointment-, un>
 til removed.   \f  nodes or knots  upon the bones
 should remain after the other symptoms have  disap-
 peared, it may be Suspected that the bone is unsound^
 and if it  shv uld not supurate,   it may be  hastened
 with the jamestown poultice,  and  when open the
 bone should  be scraped clean and frequently washed
 with lime water aid dressed with dry  lint  as  other
 dheases of the bones.
   Sometimes upon the suppression of a gonorhoci
 or by taking cold, an inflamation of the testicles take?
 place—in this case bleed andg've a purge with Calc-
 mel and cream of tartar—support the  testicles uitf>.
 a bjg truss,  and  anoint them  well with mercurial
 ointment.  S  m ;  advise bathing with cold wat^r, but
 I  am doubtful  of the propriety  of  applying cold t*
 inflamed glands, while I have  never known the ci-
 ther course  fail  to check  the'inflamation immedi-
 ately.
   Another troublesome circumstance frequentdv hap-
 pe -s—-the glands a< d  penis sometimes  swell so that
 the- praepuce or skin binds so hard above  as to pre*
 vent the circulation of the blood and bring on a mo'ra-
 tification—this may also happen in ether accidental
 CaSv?, as  in children, from the sp.mgy ttx'.ure of «.h«
paits it may  easily be  reduced by gradual ■ es^iite i* 
%■*{       VENEKEAL piSEASL.

the hand, without giving much pain, and after repla-
ced, put properd)andages around it until the inflama-
tion goes off, and it will retain its natural position.
To relieve the pain of priapismus and chordee, cold
applications are the best.   .                    -  ..
   It was observed above, that a gleet frequently  re«
mained after the virulence of the disease was entire-
ly subdued, and that sometimes for a  great length of
time—in this case  the treatment  is' precisely  the
same as in a similar disease which  frequently hap-
pens without any venereal taint, and is  sometimes
brought on by hard straining ;   cold  may  also some-
times be considered a cause ;  sometimes  there  may
inflamation attend it- and  the patter have  the  re-
semblance of a  virulent gonorhoea-—if this be  the
case, bleeding end purging will be necessary, which
will seldom  fail to abate the violence of the -disease ;  <
andaff?rthe heat,' &C are gone off. it is to be cured  1
by the following'rules  wha;ever wa\ have been the
cause :  Give ten or fifteen drops of copaiva every
evening, or in its place as many  drops of the oil of
turpentine may answer—take  the ba k  or other  bit-
ters—-applv a cerecloth to thv ba^k,  a.>d .continue  it
as'long as it will stay on;  but the principal  depend-
ence is in the copaiba or turpentine.   If it  should   *
continue any time after usirg the .hove  doses,  the
doses should be larcer and increased as far as can be, i
bore without increasing the  heat  of the urine too v
much.   The  disease  proceeds in   general frorn  a
weakness  of the spermatic vessels, and must be cured
by strengtheners, and of course  astibgent injections
are of no service.  Cold bathing  is  of great service,
bathe the back and genitials every night before going
to bed for some time—if it proceed from the  vene-
real disease being imperfectly cured, it is apt to be
the cause of much mischief, brir.gingon caruosities,
cr fleshy excrscences, hard to remove. 
               # .dONSUMPTION.

                CONSUMPTION.

  Consumption of the lunge, called phthisis pulmon-
alis, is in no wise a common disease in the south-
ern parts of the United States,  but  as  we advance
farther north, cases of consumption are much more
common.       $.
  I do not know that any bills of mortality have been
kept in the different parts of the United States, but
from my acquaintance in the middle; states, I  do not
suppose that  one-fiftieth person  dies of consump-
tion, but as we proceed northward it is a more  com-
mon disease ;  but still less common than in Britain,
where it is said that sixty thousand people die annu-
ally witn consumption, ffnd  OTiieny young people.—
From the  great  prevalence  of the disease  in the
northern climate, it w#uld appear that the  intense
cold of the winters must he injurious  to the  lungs,
and at least a temote  cause of the disease.   1 he
lungs are insensible to either cold or heat, and  it  is
higiuy probable that if they were capable of pain
from cold that thejS*wnuld often suffer from the con-
tinual application of cold air.
  It i» (h rught that cat irth, or a common cold,  is
seldom if ever a cans.' of consumption,  but their be-
ing frequently^ repeated with violence may cause ob-
structions  in  the lun^s, and lay the foundation for a.
consumption.;  but the  naost  common  cause.appears
to  .e a hereditary tairrt. .  Medical  writers  distin-
guish four  or five kinds of consumption—organic,  tu-
bercular, membrane..v^,  catarrhal haemoptoic  con-
sumption ; but perliaps tlis remote  cause  is  always
the same.
   The first symptoms of an orginic consumption,  i*J
a difficulty of  breathi;-.;r, upon using exercise  there is
S tightness aero-sthe breast, a  dry cough and an ina-
b'litv' to tike  in a full breath,  it  is often attended
with ostivenes, head-nche, vomiting, eke.   As the
disease advances the cough  becomes  more moist, a
thin frothy mucu- is coughed up  of  a  saltish taste,
f.epiciit rigors.pains ;n different parts of the hreastj
                     11
>U 
s3o            CONSUMPTION*.

the abscesses which were forming in the lungs novr"
begin to break and a puru'e ;t matter is  coughed up,
the patient now feels better than  before  while the
cough was dry, and  the patient-often  supposes him-
self to be upon the uie-nd, but the continued increase
of purulent matter  from  the lungs soon convinces
him otherwise—the matter is often  streaked with'
blood and of an offensive smell—the pulse is exceed-
ing quick, nard and sm.ll—a constant  fever in the
day, but sweats at night.   Sometimes one lobe of the
lungs is affected only, and sometimes both.   I opened
a person who died of a consumption that had  no af-
fection of the right  lobe, it appeared souncLas usual,
but the left  lobe  was entire^ jK>ne  and the cavity
filled with puss,  nl.e  vmselFwifre entirely wasted,
the heart w-s uncommonly- large, the pericardium
■was half an inch thick and adhered in most places  to
the heart, and was of a membraneous  or fibrous texf* •*-
ture, as also the  heart which had not the smallest
appearance of a muscular texture.
   When  a  person who may suspect  an  herditary
 taint, or any other  cause that ma^ bring on  a con-
 sumption, has the symptoms above, he  ought  to take
 means  to prevent the progress.   Small  repeated
 bleedin™  is proper, with bhsters over  the  breast;
 gentle laxatives  should be  frequently  employed to'
 obviate costiveness.  The tincture of fox-glove should
 be given in doses of from 25 to 30 drops once or twice
 a day—a gentle puke orfce ortwice a week will also
 be-proper.  The diet should be light, but nourishing,
 as soups and'nilk—animal food  is generally impro-
 per-  Flannel should be worn next to the  skin, and
 all sudden  changes from heat to cold or cold to heat
 avoided.  Jbrong diet should not be  taken  until some
 time after  the sy mptoms have gone off.
    An  approaching consumption  may generally be
 cured, during  the first stages, but by a  little neg-
 lect it may soon be too late, which  is generally  ths
  case;  y:t nothing  is more common than  to hear
  quack pretenders boasting  of the large number  of
  consumptions which they have cured, when  in f4(— 
CONSUMPTION
»#
    $hey r.e«|er cured one in their lives.  In this country
     the trdr symptoms of consumption  are  very  little
     understood among the people in common ;  and it  is
     a misfortune that physicians are no.t always as hon-
     est and candid as they ought  to be, and frequently
     endeavor to raise their fame for curing consumptions
     Defeat hey ever  had an  opportunity of  treating a
     case in their lives.
       There is a nervous affection of the breast  that  in
     its'symptoms is very much like a consumption, from
     tubercles in its first stages, that is often a  very trou-
     blesome disease and is somethpes  cured  for a con-
     sumption, but is often very difficult to remove, espe-
     cially in the sedentary.    Exercise  is  of great im-
     portance in both diseases, and in  consumption is  of
     the utmost importance-.
        Dr.  Samuel  K. Jenings  of New-London, Va.
     whose parents^, grand parents,  and all  his brothers
   .  and sisters died of consumption, has  had  several at-
     tacks—fie cured himself about 4 or  5yeaisagoofa
     most violent attack by small repeated bledings and a
     free use of the axe  for a  corfsi ieiable time, which
♦   entirely removed the complaint.  It is a consolation
     that if the disease can be kept off  until a middle age
     of life, say* 30, ir*eld(»m comes on after  that time.
     It may be farther observed, that exercise to fatigue,   ,
     or to increase the heat of the body, is  improper—a
     journey or a sea voyage is always advised.
        What  is  called a tuberculous  consumption   is.
     scarcely to be distinguishedJr^i<t what is called  the
      organic, but it is of ajatrre'ehronic form—hard tuber-
      cles, like glands."are frequently found in the lungs of
      persons where there was no consumption  suspected,
----- ifnd may remain for  life—when  they supurate and
     form abscesses in the lungs  they are generally incu-
     rable—a paliative is all that can be expected—opium
     to relieve them from the cough and to  procure sleep
     and ease may be  employed—elixir vitriol is of the
     utmost service in checking the night  sweats and to
     preserve the appetite.
        A catarrhal consumption at first resetnbles a com-
                             -n 
,3*            CONSUMPTION.

mori catarrh in a measure, a tickjing it is srfid is felt
about the top of the  wind-pipe, and a cough  with
mucus, as in the organic, Which has a saitish.tasle at '
first, but turns sweet as the  disease advances,  and
when spit in water will sipk after the/froth has se-
parated from it.
  A pituous consumption will come on later lin life
than in others, and may, it is said,  be  distinguished
from the others by its being  atteneed  with a  more
copious discharge of matter  from the firsthand has
seldom either taste or smell.
  In this disease the balsams and gums may be cm-
ployed with advantage, as there is less fever than in .
tke others—opium is of  great  service in removing
the most troublesome symptoms.
  To conclude—from'the  r. re  occurrence of the
disease at all in this  country, I  have  had  but  little    *
opportunity of acquiring much knowledge by experi-
ence i-nd  observation, and find to many doubts  sug-
gested by every candid writer* of the success of every
prescription, aid ev^jra  difference  cf opinion,  seme
prescribing contrary remedies, ihat I believe that  if
I had ever bee>. attacked  i should have depended ve-   y
ry little upon medicine, but  upon, low  diet and exer-
crie, and  in the mean time have etnployed the  hern-    '^
kck, tartar emetic, digitalis, &.c. a::d this course has
succeeded in the mosr 'of the cases v. h.-ch  have fallen
ui.der mv c?re.  1 key 1  avebotn but few that  I was
sftisfied \vere.phlhvsi( at,..but what veie  too far ad- v
vanctd.   I am incibed to tld; k the disease t.c belong.  '--
to, cr much of the nature;  or schrcphtila, and w hen-
ulcers afe  formed, the air being ctrnst«jJ.U  applied
prevents them from healing.
   T'tert is a s; exits cf moss, called lichen  island**
cu?, or iceb.Aud L-.e-r  wort or mo>s, much recomn.end-
ed b\ acme writers, but with which  1  have  h..d no
act ua'ctaiice—thcie are n;any  n <des of exhibiting
it, prescribed  by  author.-,  some of which may b-
seen  in Dr. Keeses  medical guide.   One method,
which-is  peihapo as'good as any, is, to  put  a  fable
spoor, full into half a piu^t of wnter or milk and bcii
li foi. a  dose twice a day'. [Sec Reeses medical guide.] 
                     SCURVY.                 133

                     SCURVY.

   With a true scurvy I  am  entirely  unacquainted,
having never seen a  case of it.  It is a disease only
incident to sailors, soldiers, he. owing to a confined
situation and living too much upon salt meat.^
   Its principal symptoms  are  a  palj  countenance,
weakness, tender gums, *fotttd breath, livid spots,
&c. he.
   1'he cure is not to be expected  from the use of me- «
dicine, but a change of diet—a vegetable  and  urilk.
diet is the only remedy.   (.Jf vegetables, onions, gar-
lic, radishes, turnips and all tho^e herbs  which  are
of a hot pungvu'L nut-arc  are proper—u'Oi-t is also re-
commeuuei.
   There are a variety of  dise-.sed states  forri(rrly
supposed  t<#behmg to  this  ibis, and  cabled land
scurvy or «eoi i^jii.-., but  which are now denied ta/ue-
Iongyjsqrw at" all;  but  a^ some of them  are  very
enmnfon in • his country, ?-;.d IJwk/w of .io other name
for them,  I have put them  t^ndW^th-u  tule.
   They ar.j'al\.-:.ys a'.t.-nd;: 1 with diseases  of the sur-
face a'.d-com.i only with itching—it  is very common..
in winter  and4oi'.en  suppose! to he ths common itch,
but i:..y be V..m.-,v:i from  it b;  its  nor. b~iug conta-
gi<:Usrnoi- . cing ■cured by St. i  bur  or  me.curiais.—'.-.
Will geUcraiiy go oh' in "s.Uu\nicr  (.Li;.lc'A—-it is -ex-
cejjc^ngb.'  trouide'j^me   amoi'g  caiidreu   to.vardj
spring, ti.e baiid^ i..fl\s.>i.:g and biiiteri. j v/iih sweil-
 ii.g and extreme sofor.css  and paiu.
    The proper remedi:.:.. ar.- fm,.b.:o,.i-'is and spi.-it or
 elixir of viviivd, with it rui.k d;et.   Give  a dose of
 tart;i,  arte; v. hub give tartar in smuilndoses twice a
 da\. eno^h to induce a I.ttle  nausea, unci after ins.
 S'l'.kiies.-, nf the i..iu.- is  i.vir gtve spirit of  virriol.-1-
 All external appdi ati-.ns  -i'^ in v;-in, if ojut injui'lue-s,
-.before the utc of the «ibo\o ir.edh.i..-:s fyi'so'.:.e ti>:ie ;
 but afu-r they have-bev:; uted for a ;•--.-. JjvS, bu'.hir'g.
 in cold  w:.tcr "» s;.ic «ud; w-ter .a..v h~ d  service, cr
 sup.u of le-'.d r.'V then be safe, but the interna! icm-
 ^.lijs tritt gene; »'Iy -cure it ';-. a week  cr  ;y, j v. .:!;;.<.; 

 .134               JAUNDICE;

 any exrernal application.          ,
   i have met with many cases in children and some-
 times in grown persons in Kentucky^  of a  disease
 Which I suppose to he of the same class, but  varying
 in the symptoms.  Sometimes  an  eru.-tion  or  eflo*
 rescepce appears over the bi-iy somewhat resembling
 measles, generally attended with it. huig, bur not al-
 ways— sometime.-; blisters  arise after it Has  continu-
 ed for some time, which socn  form  sip;bc ulcers-—
 'frequently there are ulcers in the mouth and throat,
 ■which will  not be cured by the coin.uou g,;rg!es.
   These ca*e.;  art all to^be cured in the same  man-
 tier as terse first rneitnr - d.   Aatimonial wir.e  or
 tartar emetic may be made use of.   ) he tartar will
 be best  in pilu, as the dose may be better ascertain-
 ed, and  the stomach will bear  a largr  porii.n.
   I never knew but one or two ca^ts priove fatal,  in
 them there was great heat, pain and itchmg in the
 hands and feet, with swelling,  large  absce».ces were
 formed which laid the bone- bare.    In these'* cases
 the lungs were mucrr^iffecud with a  dry cough and
 difficulty of breathing.


                   JAUNDICE.

   This  disease needs no description, being known by
 every old woman, and always is  apparent  uporcthe
 surface, and is known by a yellow suffusion, especial-
 ly of the eyes and nuilr.
   It is generally, if net;always, caused by a concrete
 substance,  called a gall-stone,  stopping up the  pass-
 age of the bile in its  way from  the liver or gall  blad-
 der to the guts, which 'it  enters  a little below the
 stomach.
   m Vomiting  is generally sufficient  to remove the
 stores—a vomit of tartar m?.y be given, and  I  hav#
 thought it  more certainly effectual an hour  or -m6re
 after a dose of laudanum.  There <s nothing f.ivou.-;
 tit descent of a stone  from  the kidii^s more  t\; u
. opium,  and from analogy have generally em proved \i 
           STONE, OR GRAVEL*         135

3n jaundice.  Some physicians seem to doubt the pro-
priety of full or hart vomiting, especially  if  attend-
ed with.pain in the region of the liver, which might
induce a suspicion of inflaination—in this case a pien-
t'uul bl.-eding and the antipidugtstic effects of the tar-
tar  wi'l always prevent any danger.   If after a full
vomit, &.C as abovc^ the due-.ffe should net  b-igin  to
aba.e in 2.4. or 36 hours, tlw nest remedy to  be em-
ployed is puig ig;  f'U  this purpose, 10 or  rs grains
of calomel sh-uid oe given in the morning,  15 or  20
grains of jalap given four or five hours after, and it
necessary, warm fomentations to the stomach j *&*?
whxh, spirit of vittiol, or  as some tecum■n?-.nd, spirit
of nitre, (aquafortis) to be  plentifully given, which.
will scarcely  fail  to effect a cure.   The opiates nay
also be of service at the sain a time.


             STONE,  OR GRAVEL.

   It appears that a stone is sometimes, if not al way?,
fi;»t fortned in  tie kick.ies, and the first roiice obit
is bv it3 passage from thence  by the ureters to  the
bladder, which  if the stone be large  is_ generally  at*
tended with a violent pain in the  back  and  the  hip
 of  the side—a numbness and  pv.n  is fell  down  the
 thigh,  it  is  frequently  attended with a  vomiting,
 sometimes blocdy urine,  the pain gunera-iy reiaiU
 or abates at times and then comes on again
    Bleed and give a pretty large dose-^f laudanum,
 put the patient into the warm bath andyufathe bicb»
 if  c:>stiv*, give a cWj of  castor  oil—if*the the pa!''
 should not abate or entirely go off, it will  be proper
 to repeat the bleeding according, to circumstances*
  These mean* repeated  will seldom fail to  effect  t.hs
 pissa^re  of the  stone to t.ic bladder in  24 hears  and
  often m  half that time.
    To  prevent  the increase cr  injury arising from .7
  Rtone mi the bladder, is sometimes '>,t of the {wwcf
  of m»:du:ine, a* d even when  medicine  vem-ws  lb-;
  'U.inful syiupto.r.2, it is very  dilu^f t.o evpbb.n-:»[»•• :^ 
T"?  f
t36         STONE,  O^ GRAVEL.

what principle—it is  well known that there  is no
substance known that will dissolve the stone  in the
bladder  that can be  borne ;  it is  also well  known
that  a person may remain for years with a stone of a
considerable s'ze in  the bladder  without suffering
much pain or inconveniency.
  Whenever a person supposes a stone in the  blad-
derj  he should usu medicine to prevent the progress
of the disease.   Itfis sometimes attended whh a paiti
and airfield ty in making water—this is genet ally worse
when a person is costive or rides much.
  Acids, aH:alies and astringents,  are the 'principal
remedies employed—liine water  is  commonly em-
ployed, (which see)  but sometimes acids answer bet-
ter,  and then the spirit of nitre is best.   Of  the as-
tringents, uva ursa-^of bear's breech, has been  prin-
cipally employ ed, but it possesses no  properties that
sbould'give it advantage over other astringents, and
they have a'sb byen employed with advantage.
  Instead of th<? nitric aci i, some rec mrnend the
muriatic, or spirit of sea salt.  Alkalies or acids will
seldom f.iil to give  relief, aud  should be taken  at
times as long or  as often as any  symptoms are per-
ceived.
  Sometimos a person having a rough  r'one  and not
very lar-e will be subject to  violent  attacks  by the
stone f^limg into the neck of the bladder ; such per-
roh sought to keep a curved bar in form of a catheter,1
either of elastic gum or metal; bv them—by  introdu-
cing it the stone would be pushed back, and the pain
re over!; but when ?,11 other remedies fail, the stone
may  be extracted by an operation. 
«a    ■-"          i  i. i a.    a—   '"■ i  ■"iJ
            NERVOUS DISEASES.

  Of all the diseases to which mankind  are  liable,
there are none more troublesome than those belong-
ing to this class, and at the same time the treatment
is equally dificult and uncertain, and it certainly re-
quires considerable experience to enable  a physician
at ail times to distinguish whether a disease  belongs
to this class or not, and when he  has determined, it
is equally difficult to point oUt the proper method o£
cure.   Many diseases of this kind are  very difficult
to  distinguish  from other  accidental diseases, but
•hey are generally attended with  a disorder either of
the mental powers or  of the voluntary motions.—
When the mental  faculties  are  interrupted, the pa-
tient is generally supposing himself to be  laboring
under some other dangerous malady—it is then call-
ed hypochondriasis or  hypo, or. melancholy—if ia
women it is commonly called hysterics.   The fol-
lowing all belong to the class of  nervous diseases :—
Palsy or the loss of  motion,   apoplexy,  epilepsy,
ehorea or St. Vitus dance, mania or  madness, palpi-
tation of the heart, asthma,  tetanus  or  locked jaw,
colic, hydrophobia, iispepsia or indigestion,  chin or
hooping cough, and cramps.

 MELANCHOLY AND HYPOCHONDRIASIS,

    These diseases  are nearly the same,  and scarcely
 require any  difference  in the treatment;  they  are
 known by a diseased state of the  imagination,  tb
 patient payinj a particular attention to every litt
  diseased feeling and usually supposes  himself  lab
 ing under some dangerous  disease,  as  consumptiou
  •r decay of some  kind, and are frequently under some
  dreadful apprehensions of  death, and  parting from
  his friends* torments, &c.  When the disease is bad
  it is evident  in   the  countenance and complexion,
  which instead of sanguine is  rather livid or  purple,
  ^specially about the mouth,  These diseases, with 
S3§        NERVOUS DISEASE!

hysterics" in  women, are  unfortunately  thought of
man\ to exist only in the  imagination, and  the  un-
fortunate sufferers feel themselves insulted with mi-
just ridicule.   In men the disease is  seldom attend-
ed with much pain, but  wh.it is in a great  measure
imaginary, and therefore in  the  estimation  of  most
rt en not to  be  pitied ;   but if we reflect  or think
rightly, we shall find that half our evils are imagin-
ary' also.  In men those d seases frequently originate
in their folly, and yet men of great talents and learn-
ing are frequently subject to them.
  The causes are various. ■•  Intense  study upon ab-
struse subjects ;  hence divines  and the religious are
very subject to hypo; disappointment in  love or in
business", and perhaps some other causes not well un-
derstood ; but whatever may be the  cause the me-
thod of cure  is generally the same.  When the dis-
ease proceeds from  disappointment  in  love or mis-
fortune in business, it is then truly painful ; it is ex-
tremely hard to resist the  passions and act as if we
had none, and I know that it requires the utmost ex-
el tions and fortitude ; and if after all  our prudence
■we  should be assailed by this dire mabdy, which dis-
patches 'so many,.or makes them do it themselves, it
will be in vain to seek relief  in the shop of the apoth-
ecary.  Whenever a psrson finds himself under the
necessity of grappling with misfortune, he must de-
pend upon his own exertions—raore  may be done by
exercise, regimen, See. than by medicine,  and I  ne-
ver knew it cured without^
  As the disease begins  in the mind  only, the cure
must be 'L»gtin there also.   One of the most common*
causes,  as mentioned abore,  is intense study  upon
gloomy abstruse subjects, hence the honest divine is
frequently subject to it,  while the hypocrite will  es-
cape, that cau-,e at least.  The limits of  this work
wiil not admit my entering upon  a prescription ia
full for such patients, and  it  wculj be a vanity  to at-
tempt .in-abridgment, as  they, at  best, would be a ,x
to consider it as too problematical  at firA view, and
shall only observe to such, that  were  they i.h\Q ^ 
             NERVOUS DISEASES.        hj

  form the same opinion of the great fir t cause, or pi-
  rent of the universe a;. 1 iongsince havedone, it would
  in a  moment  dispell  all  their  gloomy melancholy
  thoughts upon that subject forever.
    The next class of persons 1 shall mention are those
  who are disappointed  or crossed in  that  | owerful
  passion, sexual love, which is perhaps the most pain-
  ful cause of this disease whatever—this passion in its
  gratification is  the sun it of  all human huppiness,
  and on the contrary, disappointment from that quar-
  ter brings with it the keenest torment of any of which
  mankind are capable.   To such I shall only cb-erve,
  that it is a pity that any  human  be'u g should  suffer
  for one of the  «ther sex, when  there  are  so  maty
  thousand who possess all the  charms  the   dear idol
  does, and all that  is  necessary  to  remeve the- rd
  object  from the mind, is to seaich for, and  make up
  an acquaintance wiih a new  one j for I knew ,tl at
  nothing more is necessary to enamour a mr. with an
  agreeable woman  than  a  familiar acquaintance.-—
  This prescription will  not. so  well  suit my  female
  patients, as custom, whether rigM or wroi g. has de-
  baredthem from the priviledge of deri  vg  th,e  b n-
  efit in full from the means above  ; but on  the  otl er
  hand I  trust I shall have fewer patients of  that sex,
  f >r it  has pleased the great parent^in his wisdom rot
  to implant in  the  female breast that  ungovt n able
  strength of passion  thathehjsin the male. 1 can scarce-
  ly believe that the custom of the man making the first
  advance originated in  accidental  custom only,  but in
  a difference in temperament.
     The abo\e observations apply  with  equal propri-
  ety to  those who may have lost a companion.   It ia
  not only unnecessary but improper to mourn the loss
  of .i companion—the best remedy is to look cut for
  another as quick .ii possible.
    Thr.* next ca ise  of  this d se:>se is  f'btappoii'tment
  in business.   A man  cvho u prcud «.f the reputation
*' of an honest man,  and thicuji nisfnrtune  f"ls_#nd
  ha^ a Tanyity to support,  whose  vce fare aid  Futum
  prospenty entirely depends  upou his conduct, a ue-. 
»4©         NERVOUS DISEASES.

•ire to comply with his contracts on  the  one hand,
and the duty of providing for the support of a family,
is truly a bitter dilema,  and especially if  despair  of
ever extricating himse.f from his  difficulties  should
take place.   In this situation the  best remedy is  to
think as little as possible upon  his misfortunes,  and
»et upon some course of business ard let that engage  «
all his thought*; but still it must  be acknowledged
that a desparate case is enough to kill  all  the plea-
sures possible to the human heart.   In this place I
cannot help but obssrve, that  it  is  a pity but that
■ome legal mode of relief could be devised which
might relieve in a measure the unfortunate without
giving a shelter to  villainy.
   In all these cases, agreeable company and enters
tait.ing conversation is a powerful remtry.  Let the
 thoughts of his misfortunes  be  banished from  his
 mind as quick as possible.  It is  too con mqn a prac-
 tice for men  to  endeavor to  drown their  sorrow*.
 with intoxication-.-this ought to he carefully avoid-
 ed, and even drinking enough to  raise the spirits at
 all, as they will he depressed  as much  in proportion
 whenever the spirit leaves them again, and by  these
 means they inevitably destroy themselves  and  bring
 utter ruin both upon themselves  and family, vrithout
 a possibility of relifef..  In this disease people seldom
 think of making use of the proper remedies, but  take,
 a pleasure  in  solitude and  ruminating  upon  their
 misfortune, and are often ready to adopt  some  des-
 parate plan to  relieve themselves  from their mise-
 ries.   But what has  been said more properly applies
 to melancholy than hypo, for  the latter  often comet
 on without any apparent cause—the patient supposes
 himself lab  ring under some  fatal  malady, as con-.
 sumption or some  kit d of decay—he has  frequently a
  alight cough, but without an  expectoration of much
  matter, generally what he does cough up is a  tough
  semi-transparent mucus, but  sometimes white ;  he
  has pains about the breast and shoulders.   Dr.  Cul-
  len thinks that this disease depends upon  a rigidity
  Mi fibre and a want oi due action, but I conceive  th* 
            KERVOUS DISEASES.        t4«

proximate condition of the system is but  very  little
understood—1 am convinced that the  action  of the
arterial system is too weak, and the blood is not suf-
ficiently  oxygenated, aid  hence the livid,  languid
complexion a .id countenance of most  of  these  pa-
tients ;  upd whjt can the rigidity of a fibre depend
upon but the continual exertion of the vital princi-
ple, which must ciu&e a continual waste of sensorial
power  and hence induce relaxation.
  The ancients supposed tbut the disease was seated
in what is called the hypochondriac region, whicb is
about the short ribs, and this opinion  was not  alto-
gether erroneous, as that it the seat of the  livei,
spleen and stomach, and these are generaly found in a
diseased state, hence the dispeptic symptoms,  as vo-
miting, he,  which ofterf accompany  that form of
dise-se called hypo.
   The propc treatment of this disease, as to  exer-
cise, he. has been  mentioned above, but as medicine
is always sought for bf such patient*,  and which is
•ften of service in giving relief, altho  it does not al-
ways effect a cure, it is best to give it a trial.  Small
bleedings just before the full of the moon  is proper,
and in the,mean time some  preparation of iron,  the
tincture I think one of the best—take  calomel 20
grains, opium 15,  r.ssafoetida 10, make 24 pills, take
one every day at three o'clock  in  the afternoon or
about three or four hours after  dinner, or'if  accus-
tomed to eat but twice a day, an hour  before dinner,
as it is the best to take  it  upon  a  tolerable  empty
stomach—gentle laxatives to keep the bowels regu-
lar, as  nothing  hurts  hypochondriacs  more than
costiveness—flour of  sulphur  is  among the best ;
light,  but nourishing diet—if wind or  acidity,  heart-
burn, &c. give chalk, lime water, or lime  which has
lost its causticity by lying in the air.
   The intention of cure is to favour the free  circu-
lation of the blood as much  as  possible—the system
will of course become strong  and all the irregular
motions of the nerves be removed.   As to the  true
melancholy  I have nothing to add, except what  may 
*<  r4x         NERVOUS  DISEASES.

     TeLte to the want of appetite which so frequently at-
     tends it, and it scarcely itquires  any  tie.itu.t it eif-
     feient,  bitters,  ehxir vitriol a- d other  fciunutlncs
     Will of course suggest themstlves.

                       HYSTERICS.

       There are a vartery of net vous affections, to wbic rt
     Women  are subject  ad are  generally c lle.i hy ste-
     rnal but  a pu e hysteric pan xy  in 01 fit is aiu.nded
     vith tlie followii g ^y mptcmt:—A sensatn n  is, ft It
     of aome fullness  ami pain  in  the lower  part  of  the
     belly  as if a round bail  was there, which  s< ems  to
     liae upwaids until it reaches  the  breast  and threat,
     and sterns to thteau n suffocation, a stupor con.es on.
     as it' fainting tr.e breatk Mops  but  the  conp!t\i<n
     (.( es  not  alur as in faintii g. tut tie face is latltr
     fiihhtd;srmctiu es laughing aid semturnes  i-r.\ ii g
     attend  ; frequei  tly coi vuljive >| i-Mi s,  as  ajtikng,
     throwing the limbs about, b aljngtl t bica^t, a is-m-
     b'mg < I tl t I mc.s fteqt t r.t  y at'» nd, but  it may  al-
     ways beebservtd ;s  a rule, 1 iq<n  fail  tiig tit co-
     lour cc minces in the face, it is an hysteric ft— wo-.
     men between the Ege of pi-lerty   aid thuty  I ve or
     foity are  n ost  liable to it.    Those of a  sanguii e,
     temperament  are  the n ost subjt ct to it, and espei ial-
     ly if full of blood ; but the melai.ch lie tempar. nit nt
     is subject^to hypo.   It is  said  that  men  are  son e-
     ti nes subject to hysteric affections,  and  th<st   wo-
     rt en may  be sul ject to the hypo.   The  truth of the
     case  is, they are nervous diseases and  some s\mp-
     trrns are  common to the disease  in both  sex.    Hut
   »  the disease in women is frequently owing to a d fTVr-
   -. ent cause, and in  general  the  disease  differs  very
   '■  much ; buf some medical writers say  that  the In po
      in women has been, mistaken for the bysterits, hut I
     ■can see no necessity for the distinction, as  they, in
   •   a great measure require the same treatment.
        li prescribing  the treatment of  this disease,  it
   ~  %vi 1 be unneces?ar\ for me t ■> give partii u!ar  direc-
   \ *ions for the uses of the- various  auicles  proper, ts 
               NERVOUS DISEASES; .    \  ... 14%
                    '"'*                          -■»  r
   temove or prevent an  approaching fit. , The { same
   measure's should be employed  as m fainting ;  parti-
   cularly spirits, or  suit  of hartshorn should be a.ppl.ed
   to the tvose and cold water sprinkled on the face and
♦  bre.ist.  In attempting the cure, if the pulse be gen-.
   trally sfhall  and hard, or hard  at «ll, a  bleeding will
   be proper, especially if the patient b^ full  of  blood,
   after which  the baik and oth^r tonics, as  iron, cop-
   peras, and blue vitriol, in small dus?s twice a day.—
   The nervous medicines should also be given, as, cas-
   tor, assafottida, opium, wiihcold bathing,  and anti-..
   nioni.ds are alsJ of service, but above all,  light diet
   easy of digestion, as young animals, soups-,  &c. with
   gentle exercise, cheerful company—going  a journey
   in a carri.tgi: Will  be of more service than all the drugs
   of the shops, and  1 have known them often effect a
   cure where  all  oth;r remedies  fail.   Particular  at-
   tention  shou'd always be  paid to the slate  of the
   menses, and the bowels should be kept  regular wi'h
   fl nir of sulphur or castor oil—assafoetida  will alse*
   have a tendency to keep the bowels regular.

                      PALSEY.

     The palsey is the loss of sense  and motion in some
   yart of the body,  but  most commonly  on  one side,
   when it is called hemiphlegia ; it is sometimes  caused
   by tne formation  of a  schirous tumour  which com-
   presses fhe  nerves on one side, or it may be caused
   by a collection of a watery fluid on one side.   A pal-
   sy may also be more local and confined to a particu-
   lar part, "and is known by the  above  svmptoms, loss
   of sense  and   motion—it sometimes  begins  by  an
   involun a'ry motion of the thumb or some  other part
   of the body, but  it frequently seizes  a person sud-
   denly.  r
     In  the cure  of palsy as in most other nervous  af-
   f ctions, thete is  a good deal of room to doubt  of suc-
   ce-s or a*t least a sudden cure is  not to be. expected.
   lfr'i- pitient  is token suddenly and  is of a sanguine
   cu.;..'iexi^.a  or appears full of bloody  bleeding .may A-~ 
 U4-        NERVOUS DISEASES:

proper—cold bathing with friction of the  parts, at
also flanuel worn next to the skin, blisters and issues
should be applied to the pare affected—stimulant ap-
plications, as mustard, is supposed to  be of service.
The bowels should be kept regular by proper  laxa-  ;
tives.  When the disease comes on gradually^  elec-
tricity is one of the most valuable remedies-—-a  gen-
tle shock should be passed from the foot to the  hand
four or five times at a time, twice  a  week, and if no
symptom of appoplexy it may be passed through the
head also.

                 APOPLEXY.

  The first symptom of the disease is often suddel
and unexpected death,  but not always—the symp-
toms are sometimes more moderate—a loss of  sense
and voluntary motion, with an appearance of a  pro-
found sleep with a snoring, the pulse  is slower  gen-
erally, much slower while the vessels of the head and
neck are much distended, the face bloated, the pupils
of the eyes dilated, owing to the loss  of sensation.—
 It is sometimes preceded by  symptoms which  might
 give the alarm, as head-ache,  bleeding at the nose,
redness of the eyes, noise in the ears lrke the ringing
of bells, a numbness in the limbs, drowsiness particu-
larly after dinner, the night mare and disturbed sleep.
 If an attack of the apoplexy should not  prove fatal,
 the patient seldom escapes a   paralisis,  or palsy  in
some degree.
  The cause of apoplexy, both remote and proximate,
is of exceeding  didicult solution ;  it appears howev-
er evident  that the blood is  forced  with too great a
 violence upon the brain, causing a sudden  compres-
 sion there, and sometimes a rupture  of some of the
 vessel* of the brain.
  3:eeding, if the patient appear full of  blood, will
 be proper—a light and regular course of diet should
 be  carefully attended to.  Physicians generally di-
 rect th.j blood to bi taken from the temporal artery
 #r jjgul'Af vein, but this I think an almost antiquated 
NERVOUS DISEASES.
145.
prejudice.  Purging is also directed, but it is thought
more etfectuil if brought on by acrid glysters, as well
as strong purgttives given in divided doses.
   Apoplexy is sjinetnnes brought o i by poisons,  as
lead, btc. when this is the case, vomiting  should  be
excited if possible.
   Upon the whole I hive to acknowledge that I have
very little knowledge  of the disease from experience,
and as it generally proves so suddenly fatal, if a per-
son should escape the first attack he  should  care-'
fully avoid the carise if possible, as anger or violent
exercise—avoid  all extremes,  keep the head cool
and take some of the nervous medicines,  as  castor,
assafoetida, &c.
   A pituous  or  watery apoplexy  is  also  mentioned
bv writers, but whether such effusions of serum had
taken place suddenly  or gradually  is  uncertain.   I
have known people to suddenly become drowsy and
be  subject to an  irresistable torpor  or  sleep for  a
great length of time.   Mercurial  purges in this case
would be  proper, and blisters to the back cf the neck,
and repeated at times for some weeks or months ; and
it is probable th.it salt-petre might favour the  reab-
sorption of the fluid.

                   EPILEPSY.

   This is a vdty common diseise  and is of a variety
of difference—sometimes  the  fit is  attended with
violent convulsions,  in  others  it  is  sometimes so
 slight that the patient will not fall, and can remem-
 ber what passes.
   The cause of this disease maybe various.   In per-
 sons who have died of epilepsy, there has frequently
 some diseased  appearances been  observed  in  the
 brain, but they  are in no wise uniform, and frequent-
 ly there  are no  such diseased  appearances  to be
 found.    Where any. obstructions, indurations or
 effusions, as dropsy of the brain, are the cause, there
 is some hope of cure, but we  can scarcely discover
 the cause u'nti'  i". is too late.
                      T 
146         NERVOUS DISEASES.

   I generally employ the same remedies as I do  for
hypochondrical and hysterical affections, but  where
1 suspect the disease to be ow;ng to obstructions or
acrimony, which is sometimes supposed to be a cause,
1 begin bv a gentle purge, and then give  the mercu-
rial, (see b ue pills) every night for four or five weeks,
and then the nervous medicines, as castor,  assafoeti-
da, &c. issues are also esteemed of set vice.   There
are some persons more liable to them  at   night—in
this case 1 g.-nerally give a pill of opium and camphor
at night.  tincture of iron  I have  thought of ser-
vice, as  also elixir of vitriol, and other stomachics.
   The disease is sometimes caused by worms,  espe-
cially in children, which are then  to be destroyed.
A large dose of camphire twice a  day with  half a
grain  of blue vitriol with every  other  dose, I have
known to succeed.  The miscleto of the white oak
has been esteemed a remedy among the vulgar, and
quacks,  but it appears not to answer the purpose with
some  candid physicians who have tried it.
   From the great difference in the cause, there is rea-
sonto hope that if one remedy fails that another may
succeed.

             ST. VITUS DANCE.

   This is a disease to which young people  in general
are subject.   The chief symptom  is an  involunta-
ry jerking and hobling alori*, while the foot and arm
of the same side is commonly aff.cted.   A  variety of
odd actions attends it, and will frequently bs thought
to hi designed.
   In the cure, a puke is recommended, and then the
bark, cold bathing, iron and other strengthening me
dicine, as also electricity.   Worms it is said is often-
the cause.
   1 was  once called to a girl of about  eleven  years
old, who was taken with a pain in the left hypochon-
drium, which lasted but a few minutes, some  invo-
luntary motions followed, as twitching and thrown.•»
'.he arms about, she soon lost her  speech,  and v* 
            NERVOUS  DISEASES.         i47r

was in no pain, but appeared cheerful as ever, or ra-
ther more so.   It was the opinion of the  neighbors
that the child must be bewitched,  and it  was  with
difficulty that I could prevent them from trying  their
charms and amulets.  I put her in a salivation tenor
fifteen days, and as it went off gave  her castor and
flour of sulprnr and tonic medicine.   She  entirely
recovered in two or three mouths.

     PALPITATION OF THE  HEART.

  This disease is  not very common  but frequently
fatal to those once  attacked  with it.   It  is  often
thought to be owing to an aneurism or  distention  of
the aorta or some of the larger vessels, but this  I am
inclined  to think to be a symptom only, and that the
disease is a truly nervous affection, and is brought on
by a loss in the veins of a power to return  the  blood
to the heart, causing an over distention of the 'arte-.
ries, heart and larger veins, so that the valves  can-
not prevent the return of the blood by the artery to
the heart again, nor prevent its being forced back by
the veins, and the blood drawn from  a  vein  his the
same appearance .in a great degree as blood  from  an
artery, especially when drawn from large veins, but
it has  not  that appearance  in  the  smaWer.   The
veins in  the  extremities are scarcely  as  full  as in
health, and the  extremities are generally  pale and
cold, the face rather bloated and has  something of
a dark or livid cast, with  a countenance expressive
of distress and anxiety, the pulse is irregular and the
action of the heart so strong as to b^ seen and  heard
beating against the sides.
   There may be a variety of remote causes, but the
prordmate cause or condition has appeared to me to
be the same in all the  cases vvhich I have s.-en  ; and
a person once attacked with it'will generally b; sub-
ject or rather liable to  it for along time, or  ws long-
as he lives.  Fear orsudden surprise will cause the
 blood to recede from the surface of the body  and be
 '.b.cr.vn  in larger quantities upon the heart and  large 
l43         NERVOUS DISEASES.

vessels, and is attended with a loss of sensation upon
the surface  anu  an  increase  of stimulus upon the
heart and arteries causing palpitation or even epilep-
sy if the cause was violent, \\ hich will be apt to re-
turn again upon every occurrence that may suddenly,
or in a high degree excite the passions, whether fear,
anger, love, sorrow, he.
  From some law of the animal economy upon all
sudden emergencies the sensorial power  of sensation
and irritation is either suddenly exhausted  or  thai
upon which its  existence depends recedes from the
surface, &  according to the degree of fright or anger,
the surface  is found more  or less insensible ;  it the
passion be very sudden and violent  the  surface be-
comes entirely insensible to any injury whatever ;  if/
the  passion be anger without  any mixture of sur-
prise or fear, the complexion  is  that  of a person
strangling, but it surprise or fear the  blood intirtly
recedes from the surface and the person is  quite pale,
but in both cases sensation is gone from the surface,
while tbere is an actual increase of the energy  of the
brain and system  in general, as  it  relates* to  action
or bodily exertion.   This state cannot last long, for
even without any exercise the passion subsides, and
a person finds himself weak & trembling.   There  is
some predisposition in the nervous system,  of some
persons   that ;uponsuch emergencies will bring on
fainting, epilepsy, or a palpitation  of the heart, that
will  frequently recur  upon  any circumstance that
may induce much excitement, or the disease becomes
habitual.
   From what has been said it-will be seen that such
patients should by all possible  means avoid all  sud-
den excitment as anger, love, fear, he. a sedentary
employment is generally advised, but very improper-
ly, as it debilitates and renders the  person liable .to
palpitation upon the slightest exercise or exertion—
that kind of occupation that  will require constant re-
gular exercise without any  increase or irregularity
of exertion, is the most prober. 
            NERVOUS DISEASES.         149

   When the disease occurs, the main intention is to
increase the venal absorption as much as possible, by
stimulant  applications  to the  suvlace, as bathing
with water or spirits as  hot as can be  borne, with
strong friction, especially of the extremities—strong
mercurial ointment is also a very poweiful and  per-
manent stimulus—bleeding will  also give relief,  but
if the blood can be brought to the surface the patiert
will soon recover—opium and \yaue in  small  quanti-
ties will be of service, but large doses of either will
be injurious if the-y should not remote the disease be-
fore the operation is over.

           MANIA,  OR MADNESS.

  It is not every maniac that is to be esteemed a mrd-
nian, or that is continually furicus, but every  pcrion
habitually deranged belongs  to  this  cLcs.   Mama.
and 11 cfai.choly is re co rc?:Iy  abie'd chat 1  am ii din-
ed to believe that  melancholy, or the cause of melan-
choly, generally  precedes mania, and may  be  gener-
ally considered as  the remote cause,  i  have  l.nown
but few cases of mania but what was brought  on by
intei.se study upon religious cnbjects ; but a  t-tvon g
engagement of the  mind upon any <.r.e t.ubjvcc who-
ever it niav br, may inc.uce it saimiy, cq'■t^i.diy  n  it
be an object of fear or aversion and  ib.cieloie v/ben
a person finds himself i-cb-ect t)  .study one  subject
too long, be should endeavour to bleak his  mind . *i
f;um it and eng; ge bimrelf in  some otb.tr  business
that will eug.ige his i.Lt.e 1.t.i..:n..  V-hen a mania  has
i'.ct been of long st aiding, bleffSing is  advised, shav-
ing the head a:;.-! b;«h.irg it v ith cold  watr r is  pro-
per ;  keeping the beb\ reralar bv c- olifc.?- mif-air •• s
is abo  proper, 'is  maniacs  ate  >cv  ^bbjectto  ccv-
tifcene:-.;.  Camphi; e las re«jn  g;vi i> in large drrrs
 and  it is eaid with good effect, Jar..est own. it is  e..ii
has been ti'cd and Yansweiun  ra\ s, has <umdii.
   it is a common practice to confine  m; ''■ intn  in a
dark or strange  appartnc r t,  and ll.eurEl best  to  Ur.
iirargcrs attcud upon .hen:. 
NERVOUS DISEASES,
  Fear.has been thought useful and has been accor--y  \
dingly employe.;, but how far it may have been use-
ful, I am not able to say.   Vomiting  and purging-
with low diet has generally been tmployed, hard  la-
bour, it is said  has been employed to advantage.
  In this disease I have not had  much opportunity
of experience,  and it is  one of those  diseases that
frequently set  the Skill  of the  faculty  at  defyance.
I have heard of one%ho was cured by  the  trepan—
Sh? had been deranged  thirty   years, and  hdd  fre-
quently gone through the hands of the faculty  but
without a cure.   Upon  trepaning  a  considerable
quantity of water was discharged  and  she immedi-
ately recovered.  It is well known  that  any pres-
sure upon the brain will cause a derangement..

                 ASTH MA.

  This disease is known by a difficulty of breathing;.*?
some times a  person will be seldom  free from it,.but
worse at night ; the patient cannot lie  down, wants
cool air, the fit in a measure goes off towards  morn-
ing.   It is often a hereditary complaint, and seldom
appears very early in life, or at least not before  pu«
berty or after  ; it affects both sex, and Cullen  saya
most frequently the male, but I think this is  not the
case in America, for as far as  my observations  will
enable me  to judge, 1 think there is three cases  of
females to one in  the male.
  The disease is generally considered as of two kinds,.
the one called moistand the other dry—some cough
frequently  attends the disease, b/it in some the eough
is dry and there is seldom  much  coughed  up ; in o-
thers there is  a considerable expectoration of mucus ;
it is then called  moist;  it is sometimes attended
w-th some symptoms of fever,  but generally there is
no such symptoms except the urine, which is similar
to that in an intermittent fever—at the commence. .
■ mentofthe fit the urine is pale but high coloured after-
wards there is almostconstantly some tightness across
the breast—frequently after these fits have continued 
            toEMVOUS DISEASES. '       i$t

lor some time they abate or entirely cease, h the  pa-
tient will remain free from them for months, but af-
ter a person has been once attacked th.jy generally
are subject to it through bfe, and may b-s brought on
by heat or a sudden clung? from cold to  heat at any
time.
  The cure of asthma is of a piece  with most other
nervous diseases, attended wit.n arjgreat deal of un-
certainty.  Some general rules as t > diet may be  ne-
cessary, such diet as  may be of a laxative nature is
the best, asco-,tivetiess is always injurious  to asth-
matic patients.  In the moist  asthma I hav^ fjund
opium  and assafoetida  of great service,  and have
sometimes known a full dose  of opium  given in  the
evening not only prevent the fit for that night, but t9
put an end t > the disease for  that timr;.  In  the  dry
asthma I have generally employed  tartar,  either  by
itself orVith opium, but I think it b.-st  to give it
Withdaudanufn  in as  1 ir^e a d)?e m tho sto nuch will
well bear, and-ev-s.i if it should indice a  motion  or
two it will be  no  disadvantage—this  ought to  be
given in the evening.
  Asthmatic patients,  much  trouble! with it, soon
become  weak  and  emaciated—sr rengtheiiers  will
then be  proper, as  iron, bsrk, he.  od  diet  and
drinks generally  agree  with  asthmacic, the best,
teas and coffee  is generally iniuri.njs—nod^rate  ex-
ercise is of advantage, but violent is always injurious.
  Every difficulty of breathing is nu to be oisider-
ed as an asthma.  Authors have distinguished sev-
eral kinds of difficult  breathing  under title of dys-
pnoea, but as a primary disease, I  kn hv  nothing a-
bcut them, and therefore shall let them alone.

        TETANUS, OR LOCKED JAW.

  This is not a very common  disease, but frequently
fatal when it does  happen, and I suppose would be
much more so, if not cured, for although it be class-
ed  among the  nervous diseases, I believe, if taken ia
time it might generally be cured* 
K3
NERVOUS  DISEASES.
  The cause of tb.is disease is said to be various, bitt
I have known nor heard of no case but what was the  -
effect or brought on by a wound, but it  is  said that
cold suddenly applied to thj body when very  hot, is
some times a cause.   It is  most  common in hot
countries and in warm seasons.   If it is brought on
by cold, it is said not to happen for seyeral  days af-
ter the cold has been.applied, and if from  a wound
or pome tare often not  until it hsd  healed up, or for
many days after and then often  when  there was no
pain or any symptom which might have  gave a sus-
picion of it.
  The first symptoms is  generally  a  stiffness in the
back of the neck, with some une.iainess at  the  root
of the toigue,  as the disease increases, a pajn is felt
at the pit of the stomach,  the   patient is generally
soon unable  to swallow any* thing and then tl^e' treat-
ment becomes more difficult, the jaw  becomes ,so
tight locked as  not to be opened  without great  forced
and as great pain.   In the mean time,  the muscles
oi the baek cf  the neck and back become  convulsed
and contracted, ami are counteracted by  those on
the breast, nee!:, and bi'ly, the  belly  is convulsed
am' bar 1, tiv; spasms or convulsions are  soon extend-
ed to every musele ii the body, and soon closes the
see  ie i;i the m v,t frnghtfal manner  to be conceived.
   VVhen the disease proceeds from  a wound, a tipdit-
ness about the pit of Ms stomach is s'ime  times the
first symptom, slight spisms is perceived in the limbs
if the wound w„s in a limb ; if the jaw be  moved,  it
is felt in the part as if the  wounded, part  and jaw
were connected—as these  symptoms  increase, the
convulsions &c.  become general, and close the scene  Mi
as in other cases.                                     ^
   From whit has been said th ; disease  may be  easi- .•
ly known as soon  ai it makes   its  appearance and
should be immediately attended to.
  Opium and wine has hitherto  been considered as
tbe principal remedies. —Wj are  advised  to  givc
laudanum in  moderate clones, but I cannot  seethe
ieason for any  caution ; it is a disease that  admits  ot" 
            Nervous  diseases'.         15*3

to delay.   I have met with two or three  cases, one
of which was violent—they all  recovered.  I gave
laudanum in as large doses as I  could well venture
upon.   In the last, which was  the  most violent,  I
gave sixty drops at a time, every  hour  for four  or
five hours, when the spasms began to abate—he con-
tinued to have some symptoms for several days,  but
at length recovered ; he was very weak  and  became
considerably emaciated  before he  entirely  recover-
ed.  I am clear in the opinion that opium should be
given in large doses from  the first, and it  will  be
easily seen from the above c?.<;e, that a person will
bear much more than.in health,  for although  in  the
above case upwards of two hundred drops was given
in three or four horirs it  induced  no  disposition to
sleep,   If the patient should be unable  to  swallow,
it should be given in glyster in double or threble the
quantity, as from one hundred to one hundred  and
fifty drops, and repeated according to the  effect, in
from one to two hours, and the  use of it continued
according to circumstances, until every  symptom
has disappeared.   It has been a common  practice to
join wine with it, and I suppose may  be proper, or
at  least not injurious, but I doubt wether it  is  neces-
 sary.   .It has also been a practice to  anoint  the  pa-
 tient all over with a strong mercuriJ ointment,  but
 this I must beg leave  to think  highly improper.-—
 The disease consists in an increased irritation, and
 nothing gives greater or more permanent excitement
 than mercury, and when used in nervous diseases, is
 very apt to increase  the complaint for some  time.—
 As to cold bathing, I think it also a doubtful remedy ;
 for although  cold will  diminish  excitement  for a
' while, it will not prevent the rapid increase  of irri-
 tability, which always  takes place during a quesent
 state from cold.
    How to explain the operation of opium in the cure
 •f tetanus, I am a little at a loss, but I  suppose that
 it must act as a stimulus to the sensorium, and there-
 by overcomes the irregular exertion  of the  system,
 which  is e'mploved  to  overcome  or relieve pain—
                      U 
*5*
NERVOUS DISEASE!
opium certainly has the property of diminishing tftft
irritability of the system, which it must do either by
acting as a stimulus or additional excitement,  as all
increase  of excitement exhansts the  excitability or
irritability, which is the same thing,  but it  effects1
this in a different manner from mercury, as it never
increases spasmodic affections.   But enough of this ;
it is enough that we know  its.power  in the disease.
  Wine was mentioned as a remedy—how far ser-
viceable it may be, I am not able to say ;  but certain
it is, that its good effect, if  any,  must depend upon
the alcohol or spirit which it contains, and if it be
serviceable at all, other spirits must answer the pur*
pose equally well or better ; and where  opium  can-
not be  had,  it would be  proper to give spirits in
quantity sufficient  to induce intoxication, but ought
not to be depended upon any longer than until opi-
um can be obtained.

                    COLIC.

  This disease is so called from its affecting the gut
called colon, and is thought often to  be  occasioned
by a spasmodic structure of the exit from the colon,
and hence Cullen has placed it among the nervour
diseases ; and certain it is, that the diseases  of the
bowels of this description are to bs considered in this
light.  If the irritability of the bowels be  wanting,
the belly becomes too slow, and hence  wind and cos-
tiveness—this brings on spasms  with violent pain
and griping, called colic—this is sometimes attended
with vomiting of bile, and is then called a bilious co-
lic—sometimes it is attended with an  inflamation of
the bowels, (which see)—it is sometimes occasioned
by poisonous substances, as  lead, copper, &c. to which
painters and those engaged in the manufacture  of
those metals are subject, it is  then called the dry
gripes, nervous colic, lead colic, &c. A stone or gra-
vel is sometimes attended with symptoms  of  colic,
and is then called nephritis or  stone colic—if at-
tended with none of these  symptoms, it  is  simply 
NERVOUS-DISEASES.         15S
tailed colic, or wind colic.   The  bilious colic  is
known by the vomiting of bile, which is  sometimes
attended with jaundice, especially in women, and  is
sometimes  called a  hysteric colic—it is attended
With great pain in the region of the colon  or navel—
gometimes attended with fever, thirst, &c.
   In this  colic, bleeding is always proper,  especially
if the pulse be disturbed, and the patient of a  gross
habit—the  bowels should then be emptied  with a
large dose of castor oil, and if it should not have the
desired effect, it should be assisted by glysters made
strong with table salt after the oil he. has had time
to have put the bowels into  motion—if there  is no
symptoms of an incarnation, 25 drops of laudanum
may be given with a little mint water, or  essence  ef
pepper-mint, or rather a few drops of the oil of anise ;
hot applications to the belly, or the   patient may be
put into the hot bath.  If acidity abound^ which is
often the case, and give out a great  quantity  of air,
alkalincs  as lime, magnesia, chalk, or  the  like, will
give a check to it.  If it should  be evident that in-
flamation is present, a blister applied over the navel,
six inches square, will be proper.
   In the  nervous colic, the belly is drawn in, a weight
er pain is felt at  the pit of the stomach, with  a loss
of appetite, it does not come on so suddenly  and vi-
olent, is often  attended with a cough, especially if
occasioned by the  fumes of lead or  copper.   If the
disease be violent, a vomit will be proper, and  then
 the castor oil, and opium, with laxative gly.;;ers, and
 after stools are procured, opium should be given free-
ly to allay the spasms which will still cause pain, and
in the mean time the diet should be  bacon or  other
 oilv meats, and  ripe fruits either   green or  dried,
 bark, iron and other strengtheners should be  g'ven.
   In the nephritic colic, the pain extends to the ge-
 nitials and other symptoms of gravel attend—stools
 afford relief in other colics, but none in this—eating
 gives relief in this, but not  in  others.   Turpentine
 in glysters are advised in this,  and  the  a Laliest *;
 lime, &c. with plenty of opium. 
*t
550        NERVOUS DISEASES.

  Where there is no other symptom but  a  redun-
dance of wind with a rumbling, which being expelled
gives ease.   Lime, chalk  or  magnesia,  and gentle
purges are also neeessary—strengtheners,  as white
oak bark, columbo, &c. may be made use of to pre-
vent the return. -

        CRAMP OF THE  STOMACH.

  This is often taken for a colic, and is frequently
fatal.   It is known by a violent pain in the region
of the stomach, drawing the patient down double—
it remits and returns at a few minutes  interval—it
is not attended with wind, and the pain does  not  ex-
tend downward.
   Give plenty of opium, oil  of anise, spirits and
warm applications to the stomach.  If it should  not
go off immediately, bleed, and  apply  a  blister over
the part.

        CHIN, OR HOOPING COUGH.

   This disease needs no description—children  are
m«st commonly.the subjects of it—the  younger  the
more danger. ' If'it  come on  with fever and  dry
cough  the disease is dangerous. ' A great discharge
of matter from the lungs is unfavorable, but not  so
much so as a dry cough.   A  ceasing of the  cough
through cold or any other cause, is a dangerous case.
   If ti.e cough and strangling be violent,  an emetic
will be proper, and one of the best remedies ;  after
which, put as  much tartar to paregoric elixir as it
Will dissolve,and give 12 or 15 drops at a  time, four
or five  times through the day,  or add  about four
measures of water to one of laudanum,  to an  ounce
vial full add eight g-ains of tartar  emetic  and  sugar
enough to make it sweet, of this  10 or  15 drops may
be given twice a day.  When  the cough  is dry at
first and attended with fever, opium may  be  impro-
per, even vvith tartar ; then the best  remedy  ij  fu^j
vomiting, which may be repeated if necessary. 
                       4




           NERVOUS DISEASES.        ?5>

  If the disease becomes habitual and continues long,
cither the bark or some preparation of iron should
be given, and laudanum at times.
  If from cold or any  unknown  cause  the  cough
should stop, a  puke should  be given, and then a purge
of calomel, and apply a blister to the breast—bleed-
ing will also be proper,  with  warm bathing—great
care should then be taken  to prevent the child from
taking cold a fresh, for if it relapse  a second time, it
can scarcely be saved.

                    CRAMP.

  When cramps in the limbs become troublesome or
violent, especially in  young people, they require the
*ame treatment as epileptic fits.
   Pregnant women ate very subject to cramps—the
best remedy u to lie as much as  convenient in  bed,
apply clothes wet with camphire in strong'spirits or
laudanum—laudanum may also betaken iuwardly.

        INCUBUS,  OR  NIGHT  P.IARE.

  This to some is so troublesome  as to he consider-
«da>  a disease—it always conies on at night or when
the sleep is imperfect.   It is supposed  by some  a
stagnation of the blood, and thought that  some-may
die with it, but I know that there is no interruption
of the  vital functions, as I once had an  opportunity
cf observing a man who went to sleep  upon his  back
in the sun at midday.   I  am  convinced it is nothing
more than a state of the mind during a partial sleep,
and what may  be the proximate condition of the
system that may induce such  a state of the mind I am
 not piepared  to say, but I conceive it to be attended
with no danger, but may  be somewhat troublesome.
   The best remedy that  I know cf is to eat  no sup-
 per, or a light one at least, and take 2J  cr 30 drops
 if Isiiimium before going  to bed. 
ANIMAL POISONS.
HYDROPHOBIA, OR BITE OF A MAD DOG,

  A great  number of  nostrums  have been recom-
mended in this dire malady, and said to have proved
effectual, but how many deserve even  a trial I  am
unable to say.  There is a great deal  of experience
required to establish the infalibility of any medicine
in any particular diseases, and in this there is a great
deal of room for deception, owing to the uncertainty
of the disease of the dog.   I am now nearly 45 years
old, and I  have never seen but one or two dogs
which 1 believed to be mad, but have seen  many
said to be  so.   But as such  a  disease is common
and so fatal, it is proper whenever a person is sup-
posed to be bit by a mad dog or other  animal, to  cut
out or destroy the part  as quick as possible, and then
the most certain remedy is to put the  person under
a mercurial course, and continue  it for four or  five
"weeks.  When the wound is in a part that cannot
well be extirpated, it may answer to  make one or
more incisions as deep at  least as  the wound, and
put  plenty of common salt into the place.
   I am very sceptical or I  should  believe  that  the
disease  has  been    frequently cured  after  the
symptoms had come on, by a small plant, the  name
of which 1  do not know.  Jacob  Miller, a Tunker
preacher, brought it into useon Blackwater,|V. he has
long since removed to Ohio, not  far from Dayton—
if any   specific  could be discovered it would be  a
valuable acquisition to the materia medica,   I  may
make the same observation as to my scepticism about
a miraculous ttone said to be sometimes found in the
possession of some fortunate Dutchman that has the
divine power of  extracting the poison at  any time
after the wound  has been  received before death, or
perhaps afterwards, and thereby secure the patient
from farther danger, and the stone has such a strong 
             ANIMAL POISONS.          15$

appetite for the poison that it will adhere  tightly to
the part until it has got out every atom  of it, but
will not touch the part if there should be  no poison
there ; and all this is as well established by testimo-
ny as that  granny  &$$££ was seen walking in
the air with her feet upwards.

    BITES OR STINGS OF POISONOUS
                  ANIMALS.

  If it be the bite of a snake, make an  incision into
the wounded part and apply salt.  It might''prevent
a great deal of the  danger, to  tie something  round
the limb above the part until the poison could be ex-
tracted—it should be bound so tight as to prevent!
the circulation of the blood,.
  The bite of a spider is often as bad  as  that of a
snake,(and requires  the  same  treatment, but  their
teeth aire not so long, and the poison is therfore easier
extracted. 
-  ...  •      >  '  .                 ■        ■  ■-?

           DISEASES OF WOMEN,'
  The first disease peculiar to women,  takes  place
about the time of puberty or the state of womanhood
— at this period a  considerable  change  takes  place,
If from cold or the want of due  exercise in the  air
the menstrual discharge  should be kept  back—the
complexion fades,  the strength  wastes, a yellow or
green cast  in  the face, a swelling of the feet h legs,
great debility, the breathing is short and difficult up?
on using exercise,  head ach, heart burn,   eating of
chalk, dirt, Sec.
  This  disease is seldom to be  met with in  Kentuc-
ky, but very common in the  atlantic states,  especi-
ally on the east side of the  Blue-ridge.
  In the cure, it is in the^rst place  necessary to
take care xo keep the bowels regular—aloes Tshrne of
the best for that purpsse — Anderson's  pills, is a very
good form.   If the legs  and feet  be much * swelled,
cream of tartar should be  taken—some  preparation
of iron is  then  to be  depended  upon  to strength-
en   the system and  give  the  blood  the  necessary
momentum—it  has been  thought, by  some  that
it is most  effectual  in  solution  and  conjoined'
with bitters ; and  every old wife;  has  her formulae,:
but most of them are too nauseous  to be taken to any
advantsge—if a tincture be prefered, that made with
spirit of salt  is  a very agreeable medicine, bur. 1 have
seldom known any preparation fail  to answer the pur-
given in sufficient quantity and persisted in a sufficient
length of time.                                  -*
  The time of the appearance of  the menses is vari-
ous, but seldom under  fourteen,  and often  not tilj
eighteen years of age.   If at any time  after  the  ap-
pearance of muturity, a  girl's  health  begins  to  de-
cline, or she  should complain of pain in  the back 01-
bowelsf she should take a brisk pur^e—8 or 10 grains
ofcalomel  will be  proper, and after three  or  four
Ivmirs some jalap may be ^iven,  but nothing  favour? 
           DISEASES  OF WOMEN.        161

the discharge more than gentle shocks of electricity
passed from one foot to the other by way of the pel-
vis, or parsed from the foot to the other arm so that
the shock may be sure to pass through the abdomen ;
nothing u of more  service than exercise—bleeding
may give a temporary relief, but is one of the surest
means to increase the evil, while the above  course
will never fail if rightly conducted.

       SUPPRESSION OF THEMENSES.

   After the menstrual  discharge  has  commtneedi
 care ought always to be taken to avoid cold during the
 time and a little before and after, a slight inattention
 may ruin the health forever, and cause sterility if not
 death, and menstruation  is often forever after at-
 tended with great pain.   It is  the duty of mothers
 to instruct their daughters at this critical  period and
 put them upon  their guard against any imprudent ex-
 posure to cold or wet.
   If the suppression or obstruction be  entire,  there
 is more hope of a cure than if it be partial  and at-
 tended with pain and didiculty.  Aloetics, calomel,
 iron & opium are the principal remedies to be depen-
 ded upon—electricity is also a very powerful remedy.
 If the time of menstruation be unknown, give  about
 ten grains of calomel about three days before the full
 of the moon, purge it oifin the afternoon, or  about
 eight or ten hours after with a little cream of tartar j
 at night give a good pill, -as three  or four  grains  of
 assafoetida, the next night g've a grain of opium  or
 fifty drops of laudanum wir.h 4  or  5 grains of aloes.
 If this fail bringing on the discharge, give a grain of
 calomel and two of aloes in a pill three nights togcth-
 er every week until  the nt< * fill moon.   If the pa-
 tient look pale and weakly, some preparation of iron
 should also be given—electricity  is also of-the - ut-
 most service abmit the-time that menstruation  U ex-
 pected or intended to be brought on—varm.bathing
 or putting the patient into the hot bath  up to the
 w* iit is also of service—bleeding  is almost univer-
                       V
__________________^"vy_____ 
i6z       DISEASES OT WOMEN.

sally employ-ed,  and generally gives relief for the
present, bu: tendi to confirm the disease ;  an unna-
tural discharge ought never to be  substituted for a
natural one, for at best it is only a paliative, and al-
ways retards the cure.

       DIFFICULT MENSTRUATION.

  This is  a  very  common  case, and when once
brought on or cot.lirried, ii one of  the most difficult
to remove,  and is often the cause of barreness ;  and
it frequently happens that the unfortunate  woman
suffers every month as much as most women do  irt
moderate labor.  The same treatment is proper in it  '
as presortbed in an obstruction, but  frequently to no
purpose ;  all that can be done is io give ease  during
the time;  and for this purpose, he~t and  opium are
the principal remedies—to  apply  clothes  wet with
spirits hot  to the back snd belly gives ease, also  sit-
t'ngover the steam of hot water— a tincture  of  gum
guaiacu n has been  much recommended  lately  by iti
inventor, but its powers under different forms have
been long known, without acquiring any  reputation in
diseases of that kind, and  the powers  of emmena-
gogues have alimst becom? obsolete  among modern
pracciti merg.  I am notable  to give credit to such
recommendations without a fair trial, or without its
active pr.ve>s  should- indicate the propriety of its
u e  in such corn daint3.  From the  infinite number
rf quack nostrums that are  continually7 hawked about,
Ian always suspicious.

                  FLOODING.

  This, ai  a diseaied state of menstruation,  I must.
acknowledge I am bat little acquainted  with, except
i  i women between  45 and 5*0, but that such cases d >
occur I have no dcubt, but 1  have  never met with
them in a dangerous d'-gree.   The mist of the ose*
vhieh thave hid an opportunity of becoming a.-..
p-iainted »vith, h+\'z been in an ab >rtton, bct".veearth.e 
           DISEASES OF WOMEN.        165

first and third month.   As to the distinction between
an active and a passive menorhagia (flooding)  I think
it necessary to say but little ; for if  I am  right, in
however active a state the uterine vessels ma\ be. at
the commencement of  hemorhage, its  continuance
must soon bring on relaxation, and then if the  dis-
charge continue, it must depend upon debility  or re-
laxation ; and it  would seem from the interim  that
is between the two states, the vessels  would  have
time to close.  If such active cause does ever exist,
it must be owing  to a spasmodic affection  ;  and in
what few cases which I have met with of  this kind,
has been in women subject to nervous paroxism.
   From whate-\er cause it may proceed, I have ever
found opium an effectual remedy.  If it depends up-
on activity or tention, it  must be of the  spasmodic
kind—opium is the most powerful antisgasmodic we
are  in possession of.   If upon  a torpor and weak-
ness of the vessels, epium will remove that by an in-
crease of sensorial power ; and I have  never found
It necessary  to employ any other remedy  to check
the complaint for the; present; but in persons sub-
ject  to this complaint, I have generally observed de-
bility and a disposition  to return at times,  frequent-
ly not over two weeks apart, but someiimes  three.
In this  case iron and bitters should'be employed du-
ring the intervals, with  exercise, but  such  should a-
void all violent exercise and haid strainirr,  as  also
*ioI:n.t  passion.

                  ABORTION.
                     -  '  .- ***
                     ■  '  ..V- -*■
  When an  abortion happens between the  first  and
third month, it ia often, or raifteTffgenerally, attended
with a dangerous hemorhage, bwdn,r ;to a partial de-
tachment of the placenta, or after-brr'tb, wh.ch.ri ve-
ry difficult to ex pell, owing to its STfailrte'ss, but ni i'y
be easily separated with the finger a-bl 5rxugh.C-awav,
when if cleared away cntittly the chac.^.arge fihmedj-
ately ceases a^d  the cia-gsi i-j over.   For  the  wane
cf th.s litae inlciiiut.eu, many a  wemcrjr  is  lcjt.—- 
J64       DISEASES OF WOMEN.
There is another circumstance that I  have thought
truly  strange—writers  upon  midwifery  generally
doubt of the propriety of a ro»nual operation, a  rea-
son for which I can by no means  discover.   When I
was young in practice, and depended more  upon the
opinion of others tiian my own, I followed  the  usual
method—opium I found in all cases check  and  oftsn
stop the discharge.  I at lergth met with a case in
which the discharge was in a measure checked,  if not
entirely stopped—between two and  three  weeks af-
ter I w'as called to see her, the discharge had  again
commenced, she  had some fever,  there had  as  I was
informed been  a discharge for  some time which was
foeted—I attempted to examine the uterus, which I
found too close—I made a small scoop well polished
with which I extracted the foetus and membranes in
a putrid state—she recovered and did  well.   This
circumsrance taught me the impropriety of delay^—I
have always since extracted the contents, and in ten
years practice have never met with a case  but  what
did well, but have known  bad consequences follow.
where it was not submitted to.  However if the dis-
charge be slight, it will be proper to put a stop to it
with opiates, cold and rest ;  as where the  breach  is*
small a woman may go her time,  but even  in that
case the child is apt to be small and emaciated.
  Abortion  at more advanced  periods  belong  moro
properly to midwifery, but as they are often attend-
ed with dangerous flooding it is proper to check it if
possible by opiates and astringents, cold, he.  but if
it should> continue so as to endanger the life of the
mother, the foetus should be extracted by  art, foot-
ling, in which there is  no  daager  if performed  by a
skilful midwife..
  It may be further proper to observe, that  both in
this case and a true delivery, a portion  of the pla-
centa is sometimes k-ftbenind  and is always danger-
ous, and frequently fatal—midwives  ought to be  ve-
ry careful of this, which may  be easily known by ex-
amining the  placenta and see  whether it  all he there,
and if any be missing the midwife ought carefully -J 
*
            DISEASES CF WOMEN.        165

 examine and extract whatever be found,  for if it be
 left a dangerous fioodb.g or something as bad mzy be
 the consequence, and it may then be out of the power
 of art to give relief.
   A few v/ords in this plrce also may not be  impro-
 per upon the treatment  of child-bed  women.    Al-
 though  the moderns treat both child-bed women  and
 children in a much more rational  manner than what
 the ancients used to do^  still there ate many old pre-
judices, ignorant ancl'often  superstitious  customs,
retained among midwives and nurses, but  still  ftwer
in America  than in Europe.
  The  supposed  power of  the  loadstone  and the
 aetites  or eagle stone in  promoting hbour is still
 held up by some midwives, but these are not  of the
 most dangerous errors—the greatest is in the mode
 of treatment after delivery—as soon as put  to bed,
 hot stews with ginger, spices, he. are  given  with a
liberal hand, the doors and windows are  closed  ard
all air excluded, weak diet and hot drinks is the only
support. This regimen is yet the death of thousands,
and it is the next thing  to impossible  to  beat these
knowing women out of the old track.
  The practice of exhibiting spirits, spice, Sc. either
during or after labour is very pernicious.   If the la-
bour be tedious and the be  fat'gued, and  there  be
no fever, a little spirits wiil not be improper, and the
same after delivery ; in  the mean time  she ought to
deviate  as little as possible from her ordinary mode of
living—she ought  to have as much cool water as she
may desire, and if any caution be  necessary, it is not
to take  it in  a large qantityat a time—the tame as
to her diet, whatever her appetite may crave  will be
proper and safe, if the me.-«l be not too full.  I  have
 known women from the  first hour cat as  usual,  and
never knew  it injurious.  Cool air  ought  not  te»  be
excluded, for nothing is more rtcessary ?fter fatigue-
than cool air and cool water—every ptudent  perron
 v. ill cenain'y ?void cold in  t'-e ex'icme nt  n.ci. a
 time.   it is well known that the poor who I avc fly
wtsiit accommodations succeed as wed if not  Dcv.e 
166        DISEASES  OF WOMEN.
than the ricK and we are tcld that in Africa the wo.
man immeciat tl y cots into a liver cr the l'ke to wash
herself a..d i hi'!.!.
  I have known ctvcral instances of convulsions to'
fellow dtkveiy,  and they also sometimes precede it.
In both casts b'eech'g freely is the first rreans to be
employed, ard then give 40 or 50 drops of laudanum.
  Another vtry distressing complaint ofttn  attend
women after  delivery, called  -after pairs  ;  they are
re Idem violent with  the f.rst child, but become worse
every other after.  Opium,  the sovereign anodine,
was formerly entirely forbid.
  It Is thought by some physicians  to be  owing  to   *
large coagula fotmirgin the uterus, but this I Jcnow
to be error, fcr I have scarcely ever known such c«<?
agula tc be excluded where there wss such pain, while
on the ether  har.d/large ccagula will be  discharged.
without pain  at -II.   It appears to me more probable
that a torpid states cf the uterus is the cause, and
that the pain commences in the parts  abcut—irrita^
Lie and delicate women ere most subject to them.
  Ever anxious to give  relief from pain when  called
vpon, I began the exhibition  of opium in small quan-s
titles in the  fi: sf cases 1 tver rr.et with, I  now  give
evough to re de,(*th:e patients's  situation easy  in a
great measure—the y will ger.trally  bear  note  than
in health—it will arswer the purpest better in  gH"S-
ter, from 40  to 60 cr 80 drops may be given in g'ys-.
ter ?r.i repeated cr.ee or twice a  day or  as  occasion
n ay repuire.   As soon  as the v,crr;n  is  free  from
pain, cr at least within  ^4 cr 36 heurs, scrre  cream
cf tartar shcuhl be  given an.1 repeated to prevent
costiveness frcm the use of the op'um, but may  be
discontinued as  scon as a  stool is obtained.
  The next  cisease to  be ncticed  as belonging  to
clvk'-bed is what is called  {he purperal fever.   It
comes en with the usual sympton s of fever, a quick
pulse and dry skm, ger.erally  scrre  wandering pains
arc felt in the abdomen ar.d  frequently evcy  symp-
tom of hflamaiion.   ""1 he cause of this fever  is not
generally unckr-tocd, but a» a suppression  ci"  the Io- 
           DISEASES OF  WOMIIf.       i6y

 eh'al discharge  so  frequently  at'cnis  it  aid o'd.n
 precedes it,  it may be cmuidertd ai c oinectel w.ch
 it, either as a sympt >m  or a  ciuse — i fesh cm-
 mencement of the lochial dschirge g- ,-,s rebel:.    A
 very distressing la* almoit always  co nes on  s )oner
 orlater, the stools are  extremely fetei  ad s >me-
 times appear hi a ferment  like yest, bit  sometimes
 there will be portions of hard exerenent, aod  it  miy
 be possible that a costive slate before d_L»'ery  may
 have  a shir./  in disposing to the disease—such a
 state ought to be avoided by preg.iant women  by the
 useof mil 1 laxatives, as fimtr of su'p'aur.   Fy  a  pro-
 per atteMtioi to the state of the bowels  before  par-
 turition, it 13 '^vobible thio disease m'ght be prevent-
 ed.
   Different opi lions  have  been  eiterta-incl  rm^rsg
 physicians as to the proper mode of treating this dis-
 ea ;e, but I believe  the following his b.en  generally
 successful wliv-a employe !  i i time :
   Bleed acco-ding, to  the  strength and  oiher cir-
 cumstances, and  if necessary it shou'd be  repeated.
 The propriety of vomiting  his been called  i l ques-
 tion by som », bit 1 think it in this,  as in most  o-
 thers, o le of the most powerf-al and.at the sun.1  tima
 a safe remedy, and this was the opinion and practice
 of Dr. D.-nman.  It will be nt'oper to give  it in sm.dl
repeated doses until it has  e Te :t,  eitber of -puking,
purging or sweating,  Lit if the  abdomen  be tumid
i/nd very tend-*r k-so-e,  full vo.niti.ig  may incease
the pain, it will be  tbefore  advisable  to  favor ic  by
plenty of warm drink, and if vident,  check it by a
j'ttle elixir vitro', mint water, or l c lik■*,  a  .spoon
full or two a: a tim^,  cool; bit hi the  fi-st  stages
if this disease, there  is no necessity  f >r  these  pre-
 cautions.   It  may be  proper if  the  fever  sh »uld
pr iwe stubborn t> rep*eu the tartar on the succeed  ng
cl tv, or  what will be bi'ter, a   suilTisnt  quant;:'/  of
Glaubers ialt may be g'ven i.i  sma'l d 'scs  to  em  >!y
 the b *wels, or if the b> ve's be loose,  the sjdts should
\ e g<ven until the st)ob b-cane  watery.   If tbere
 ; e p.in aid tumor of :he abdomen, a-.d cocci.d'y if 
k68       DISEASES OF  WOMEN*.

contined to one parr, a blister plaister  should be  ap-
plied— the diet should be light, or the cooling  regi-
rm n observed, the drink may be cool water or water
and vinegir or spirit of vitiiol.   If  the lax should
prove obstinate, an opiate may be given at night  and
the Salts repeated ir. the day.
  A  strong tendency  to putridity  soon takes place
in this fever,  and it would be thought  that  the bark
would be proper, but it has been thought not to  an-
swer the same purpose that it does in other fevers of
this description ; but I think that when there is no
local inflamation, as of the abdomen,  he.  that  the
bark is proper as a  strengthener against a relapse.—
It frequently happens that this  fever  terminates by
an abscess in some part of  the  body,  which should
be treated as an abscess or phlemon  from any  other
cause.  The  disease is frequently attended with con-
siderable pain and  restlessness,  and it is a  favorable
circumstance that  opium is not  only safe  but  often'
of serviee at any stage of the disease, but more espe-
cially in the advanced.

   There is  another extremely  painful disease to
which child-bed women are sometimes  subject ;  it
consists in a  swelling of the leg and thigh—it comes
en sooner or  later, sometimes in three or four  days
after delivery, and may come  on two or three weeks
after.
   The primary cause of the disease is  no doubt in the
titerus, or 6ome of the parts about, but what the  pre-
cipe  nature of that state may be, we bnow not, but it
appetrs probable from the  appearance of the diseased
parts, that it is a diseased  state of  the lymphatics,
perhaps from obstructions.

   From the rare occurrence of the disease,  and con-
sequently che few  cases I  have  met  with, I have had
little opportunity of obsetving the state of  any  one
case  in its commencement.  According to writers
the  women  generally become  very  irritable, with
low spirits, seme transient pain is felt in the uteru«, 
           DISEASES  OF WOMEN.        169

©r the parts about—a pain sometimes is  feh in the
calf of the leg, but sometimes it is in the groin, run-
ning down the limb, it  soon begins to swell,  feels
hard,and looks pale, and as the swelling advances the
skin has the appearance of being stretched hard.  In
this  disease the lochial  discharge  is almost always
disturbed, sometimes entirely suppressed, but not al-
ways, and sometimes it is fetid.  The  patient in gen-
eral  has no power to move the limb,  and is apt  to
faint upon the least motion.  The  disease  will "not
abate or go off suddenly, and it seldom  entirely leaves
the limb in its natural size and appearance again,  it
is also a long time before it gains its usual  strength.
From what has been said, it will be easily known.
   I  shall now proceed to state whit  I consider  the
proper course or method of cure, and  in this I must:
beg leave to differ in  a messure  from the ordinary
mode, which I consider as too inert.
   The bowels should be kept regular with  cream of
tartar—small doses of  calomel should  be given,  but
not  sufficient  to er.cite  any  salivation- -the  limb
should be rubbed well with  mercurial ointment  and
bathed with a strong decoction of Jamestown  weed.
If there be much fever or the complexion be not very
pale, if the pulse be hard and quick, a light bleeding
will be proper—if much pain, opium will be cf  ser-
vice and safe ;  in what cases I have met  with, I harve
found it necessary and to be of great service,  and in the
mean time the spirit  of vitriol  should be given in
doses of from 15 to ao drop- four or five times a day ;
the drink should be cool and much heat avoided.  In
those cases which I have met with, the  warm reej-
rhen or mode of treatment had  been observed,  and
 the patients had a  great desire for  cool  drink, from
 which they had  been  debared.
   A more powerful mode of applying  the Jamestown,
 is to crind tlie dry seed  fiae and ste-p them in whis-
 key or other spirits and apply clothes wet  with  it to
 the parts, but if any  giddiness or blindness  should
 come on, it should be  discontinued a  while, or for a-
  bout uventyfour  hours, and then applied ag:»in,—
                    Vv 
*?0
DISEASES OF WOMEJf.
I have known but cne c^se in which it proved fatal*
and in that a part of the placenta it was supposed was*
left, a.d when I saw  her 1 believed the uterus to be
in a dead state.
   It seldom happens  that  the  lochial discharge be
ent'nely suppressed but it brings  on  an  inflamation
of the uterus and a  fever  and other diseases,  and
ought to be brought on ?gain if possible— calomel in
a dose sufficient to move the bowels, by the  assist-*
ance of glysters, should be given, 6 or 8 grains is ge-
nerally  sufficient j but if it should not have the  de-
sired effect, it  should be assisted by cream of tartar—
the calomel should beogiven in the morning and  the
glysters and cream of tartar given in the afternoon;
if the bowels ate emptied by night, 2$  or  30 drops
of laudanum should be given at night—warm  fomen-
tations  to the belly will also be of service.
   A putrid lax has been mentioned as a frequent at-
tendant on purperal fever, but it  is not always at-
tended with fever, and may be the  Consequence  oE
costiveness.  Child-bed women are frequently with-
out a stool for several days, and in that case if there
should be any disposition to fever^ it will  increase
the evil or may bring on the lax.   It will always be
proper to avoid  any  thing of the kind, by  giving
cream of tartar  in small repeated  doses  after  the
third or fourth day, and especially if any fever or un-
easiness should be felt, but  as it  is a very common
thing for women to go six or eight days  withput any
inconveniency, no danger should be  apprehended if
she feel perfectly well, but small quantities of cream
of tartar will nevertheless be of service, and a secu-
rity against fever and lax.
   Another troublesome circumstance sometimes oc-
cur and may prove dangerous to  child-bed  women,
which is a falling down of the vagina, or as it is ter-*
med, of the womb, which may also happen, but is not
so common as  the other.    The  best remedy is to
keep it back by a bandage, and some folds  of cloth
after bathing with oak bark and allum.   Weakness is
irsry commonly the cause, and if not the cause, is 
DISEASES  OF WOMEN.
 Commonly the consequence, and therefore  strength-
 ening medicines will be of service,  as  bark, turpen-
 tine, iron, bitters, &c

         CEASING  OF THE MENSES.

   Between forty-five and fifty years of age the men*'
 ses generally cease, at which time  women  are gen-
 erally troubled with excessive flooding, or some other
 disease, which require attention.  If the discharge be
 immoderate, opium is the proper remedy—if any o-
 ther disease, a purge  will give relief.   Ulcers in the
 legs frequently happen, and physicians  often  advise
 the  not healing them up, but this I think very impro-
 per ; as it is an unnatural discharge it ought to be
 stopped, and purging is one of the most safe and  ef-
 fectual  means for removing  it.   For  more on thi*
 head see ulcers.

                    WHITES.

   This  disease consists in a discharge of matter from?
 the uterus, which is generally white—if it  be consi-
 derable it is very weakening,  and  is  attended with
 a pain and weakness in the back.    Sometimes the
 discharge is hot and accrimonious,  eroding the  parts
 over which it passes—it is not always  easy to  dis-
 tinguish it from the venereal disease, but if mild it is*
 not attended with inflamation—the discharge is not
 constant;  on the contrary, in the veneieal disease,
 the discharge is constant, and after it has continued
 some time is  always attended with heat and soreness,
or itching of the external parts.  Women are liable
to it at  all ages after the menstrual discharge  uke*
place, but more commonly after child-bearing—preg-
nant women are frequently subject to it,  and women
about the time  of cessation of the menses.
   If there be any fever, a puke will  be very proper,
 and if that should not be sufficient to remove the fe-
 verish symptoms, it may be proper to give a gentle
 purge at thiiv.., ai.d after that 5ive tbespiiitof vitriol 
*7s
DISEASES OF WOMEN.
and bark, or some preparation of iron—the  spirit of
vitriol and bark should be given three times  a day in
doses of 15 or 30 drops of vitriol, and a tea spoon as
full as it can be taken of the bark* The balsams, as bal-
sam copaiva,  or even common tupentine is  of great
service—a cerecloth applied to the back is also very
good.   The balsam may be taken in doses  of  from
15 to 20 drops once a day.   Astringent injections
have sometimes been employed,  but I have seldom
found them necessary except where it was occasioned
by the  venereal taint.
   The disease sometimes prove obstinate and it  may
take two or three months to remove it, but the pa-
tient should not be discouraged but persevere in the
Temedies above prescribed, and they will always suc-
ceed in  time.
   Ther. is no necessity for any regulation as to diet. 
DISEASES OF CHILDREN.
  The first thing to be taken notice of  in children is
the state of the bowels—they are frequently subject
to costiveness or lax.   In order  to  enable  children
to take medicine early, ihey should be learned to eat
spoon victuals as soon as they are born, as it  is dif-
ficult to get children to take medicine that have  not
been accustomed to take  spoon victuals;  but  the
first and  most natural food for a child is the  mother s
milk.  When a child is horn  without any  injury it
will in a short time fall to sleep and sleep for seveiat
hours, it wiil then foF  the first  time wake hungry,
and should be put to the mother's breast; if she has
no  milk,  the  child should be fed  with a little  sweet
milk and water sweetened with .brown sugar, and put
to suck the mother from that time, which will  seldom
fail to bring the milk in a short time.  The practice
of giving new born children bacon, butter, he. for the
first, is improper.  The milk of the mother is at first
laxative, but serin looses that property ; sugar is also
a laxative and innocent, and may be a substitute with
other milk  for that of the mother until she shall give
enough.   By feeding  a child  I do  not mean that
feeding should be substituted for the mother's milk,
but to give them a habit of eating, so that  in  case of
sickness  they may take medicine  the  better.   Dr.
Reece thinks that nurses often injure their children
by  over feeding them, it being  the  common  method
of quieting them.
   Children are more subject to  acidity than  adults,
and is a common cause of their complaints.  In case
of  diseases of the bowels, as costiveness, vomiting,
lax, or wind, a little magnesia should be given in the
form of pap  with milk, it  is  entirely  inoffensive—if
acidity abound, it will destroy it, and if more is given   \
than sufficient it will pass off without  any  injury.
    A child should always be weaned frcm  the breast
gradually. 
174      DISEASES OF CHILDREN.

           VOMITING ArvD  LAX.

  This disease is called  cholera infantum by  soma
medical writeis, but  with  what  propriety I shall
not  decide.   L'r.   Rush takes  notice  of  it  and
seems to suppose it incident only to children in large
tov.nsand says carrying them into the country is the
best remedy, but in  Kentucky it is a  very  common
disease  and the children of no situation  are  exempt
from it.  They are sometimes attacked with it a few
days after they are born, and the  younger the child
the greateisthe danger.   It is  not always  attended
with vomiting, but this sometimes is violent and con-
tinues for a great length of time.  The disease pre-
vails most in warm  weather, and will sometimes con-
tinue for many months.
   For the vpmitirig give magnesia and a few drops'
of laudanum, and repeat it from time to  time  as oc-
casion may require—if it should prove obstinate give
a few grains of calomel, a grain for  every year that
the child is old until four or five—a little cinnamon
or mint water may  also  be given ; these will seldom
fail to stop the vomiting, but if it  should  not, a blis-
ter should be put upon the stomach.
   When the disease consists in a lax only, salts  is
the best remedy—it should be given  in  very small
doses, rot sufficient to purge—it should be dissolved
in a little cool water and given immediately,  as the
child is generally drouthy and will take it in cool wa-
ter very well.  Astringents should be given in the
afternoon, as logwood tea, or gum kino, but the kino-
is more di-agrecable—an opiate should be  given  at
night, it is  best inglyster—magnesia is  also  of  ser-
vice, or a weukliiiic water.

                    WORMS.

   The  origin of worms in an animal body- is not un-
derstood— it is, thought by some that green fruit and
 the like is the cause of worms, and that they  are nt
 lea&t taken into the stomach with  the  food, but this 
          DISEASES  OF CHILDREN".     *7S

  Is mere conjecture—we  know  nothing about their
  generation—the whole creation swarms with  animal
  life, and animate beings of an infinite variety of mag-
  nitudes—ail are first formed in a  state  of ovum  or
  embryo, but where or in what  matter worms that
  live and thrive only in an animal are to be found is
  unknown.  There are several kinds found  in the  hu-
  man body, and it appears that a considerable number
  may exist without indacing any sickness or disease,
  but if any other disease  should happen and take awyy
  the appetite, the worms will  then be injurious  ; if
  they abound over-much, they are highly injorious  and
  the cause of the death of many children.   I believe
  children much more subject to worms in the atlantic
  states than in  the western  countries.
    The signs of worms  have been  considered very
  numerous,  among which are the  following :—A bad
^'breath in the morning,  itching at the nose, moaning
"'and grinding the teetn in sleep, the appetite  is irre-
  gular, sometimes voracious and sometimes bad, thirst
  especially in the morning,  the belly is sometimes, too
  loose and at other times bound, a tumid belly  and  a
  pale countenance  is a very certain sign,  but  some-
  times children appearing the most heahhy will have
  a great many worms.
    Worms are  of various kinds, but  the most common
  is the round worm and ascarides.   The round worm
  occupies the stomach and small guts, the  ascarides,
  which are small v/hite worms,  are chiefly found in
  the rectum, or great gut, and are sometimes found in
  vast numbers, but chiefly in adults who live an inac-
  tive or indolent life.
    The tape worm I have never seen,  and of  course
  could not support the character of a worm quack.
    There are a vast number of of medicines consider-
  ed remedies in worm cases, while  the  shops  abound
  with worm destroying lozenges; every old wife has
  her nostrums, many of which will answer the  pur-
  pose in some cases very well, but different cases re-
  quire different treatment.
    Calomel is the most certain,but where there  is r*a 
i"7S       DISEASES OF CHILDRINY

fever, and especially if the child look pale and has a
large belly, iron, either in filings  or  rust,  is  better,
but my method is  to combine the two,  according to
the case.  If the child be florid,  or  of  a  good com-
plexion, and especially if any fever,  calomel alone is
the proper remedy—it should be  given alone with
any proper vehicle at night, in doses of from two to
four or six grains, according to the age  of the  child,
and a purge of jalap or castor oil every other morning
to carry it off, arid repeated every night for several
nights and days, after which iron or bitters will be
proper to prevent  the  production  of  another  set,
which will be the case if the  stomach be lefE  weak.
When the child is pale or belly large, iron itself is    '
the best remedy that I know of, and  I think the filings
the besb but the rust may do very well. ,  The dose
of filings should not be quite so large as that  of the
rust,  The iron should be given in the morning  in a .
little sugar or honey, and it should be repeated every
jnorning for ten or twejve days, or according to cir-
cumstances.  It is a very" good method to mi's calo-
mel and iron together, and then,  it  should be given
upon an empty stomach, and the  child should have
something to eat about an hour  after.   When calo-
mel is given, it is necessary to be-  careful that  the
child drink no large quantity of any thing cold  at a
time, for a few days afterwards.
   There are a great number of things that vrill carry
off worms at times, as the jerusalem-oak  seed, givcri
in large quantities, bears foot, See.—when these are
employed, iron or bitters should  be given afterwards
to strengthen  the stomach—lime water is  also  con-
sidered very good to cleanse the bowels and preven-
tive generation of  worms.  To a child  of two years
old, two tablespoon.fulls of lime water in twice or
three times that  quantity of other water   a little
sweetened mny be given twice a  day.
   For a'scarides, or the little worms in  adults, the
flour of sulphur given in doses of half a drachm twice
a day for two or three days will be proper.   A strong
des-j of calomel, as 15 or  2.0 grains,  will  £erurally 
         DISEASES OF CHILDREN.      17?

carry them off; but after such doses it will  be^ pro-
per to be careful not to get cold, and to purge it  off
Well to prevent it from affecting  the mouth,  &c.—
As these worms only inhabit the rectum, they may be
destroyed by glysters w.ith pretty strong lime water,
tobacco smoke, lintseed oil, a strong decoction of the
Carolina pink root, assafoetida,  copperas water, or
any other substance which would kill them when out
of the body—the glysters should  be  retained as long
as possible.
   1 have thought it probable that ascarides may some-
times occasion piles, from their irritation^ as I have
known persons troubled with piles  discharge great
humbers upon using flour of sulphur.

                   THRUSH.

   This  disease is well .known.   It consists in a num-
ber of exudations upon the surface in the mouth, and
is not uncommon for such appearances to be seen a-
bout the annus, and is thenlsaidto have gone through
the child, and  it *is probable that  the whole  in-
ternal surface of the intestinal canal may be in a dis-
eased state.
   It has been thought by some to be  owing  to  the
child living too much upon vegetable food, as pap, he.
but those who never are fed but with the milk of the
mother, are also subject to it.
   If the child be bad, it will be necessary to  give
magnesia, and if costive and the magnesia should  not
be sufficient to lpbsen the belly, it will be necessary
to give  a small quantity of castor oil or three or four
grains of jalap, and then to wash the mouth well with
a strong solution of borax ;  and if the disease should
then be bad, or appear about the  annus, cause the
child t# swallow two or  three tea  spoon-fulls of  it
sweetened, two or three times a day until well.
X 
*7«       DISEASES OF CBILDRINV

                RED  GUM.

  Children are frequently subject to eruptions  over
different parts of the body which is  called red  gum,
and is frequently thought to be the itch ; it  is  most
common about the forehead, and children  of a full
gross habit are more liable  to it than weakly chil-
dren.
  Dr. Reece seems to think it often owing to impro-
per treatment, as washing  them when young with
spirits, soap, Sec. but however improper it may be
to apply such strong stimulants to the tender  skins
of infants, I am not of the opinion that it is owing to
that cause, but rather to too full diet,  heat, &c.
  A gentle purge-will generally abate the eruptions-,
but if that be not sufficient, an  emetic and  a  spare
diet, or starving in ameasure, will soon  remove  the?
complaint.  A small quantity of tartar given once or
twice a day, not sufficient to excite  vomiting, or but
rery slight, will scarcely fail.

     INFLAMATION OF  THE BREAST.

  From observation I  am inclined  to believe  that
children are more subject to pleurisy or inflamation
of those parts than adults, and that many die with it
while the cause is scarcely known.
  Whenever a child  has a small cough, draws its
breath quick with a ketch as-if  ih  misery, or cries
when it coughs* an inflamation of the breast is to be
suspected.
  The same treatment as in a like disease  in adults
will be proper, viz. bleeding,  blistering,  nauseating
doses of emetics, &c.   If costive, purge  with calo*
mel; and if it should not pass off well, give a little
jalap after it, and repeat according to circumstances*. 
 an  ,n.  ■———■■■.....  .....11 11 «i 11 ■■« 11 in m  n una

                  SURGERY.
               •
  Those diseases which are on the surface and  are
to be cured chiefly by external applications or opera-
tions belong  to surgery, which in Europe belong to
a separate branch of the science  of physic, and is
practised by men making a profession of it only,  but
in the greater part of the United States every physi-
cian practices surgery also, and a  separation of the
science I think unnecessary, and that every branch of
the art of removing the diseases  of the  human body
should be understood and practised by every physi-
cian.

        INFLAMATORY TUMOURS,

  Inflamations may proceed from various causes and
in any part of the body.  They are known by heat
and pain, with redness in the skin, swelling, he.   If
the inflamation lie deep among the muscles, there
may be little  inflamation upon the  surface.  There is
frequently a pulsation or throbing in the part.   The
inflamation sometimes begins in the periosteum,  or
skin that covers the bone, and destroying that form
an absces, it is then called a white swelling.
  A common inflamation terminates  either by reso-
lution, supuratioq, or  gangrene.    Resolution  is  in
most cases to be prefered, but  when an inflamation
happen in fevers, it is called a  critical  termination
of the fever, and  generally  removes  it.-    If  it
is thought proper to scatter the inflamation (as it  is
usually called) the best application is a poultice  of
corn or other meal well  boiled, pretty soft and large,
and applied as hot as it  can well be borne.   It  is
thought by some to be better if made with a strong
decoction of oak bark or vinegar—it should  be re-
newed twice a day or oftener.  Every good wife has
her formulae to scatter and another to  ripen inflama-
tory tumours, but such  distinctions  are founded in
 ignorance and  error.   Heat  and  moisture  applied
 y.ill resolve an inflamed tumour if capable of resolu- 
*5:
5URGERY.
 tion, if not, it will favor the supuration. ^ It  has be-
 come a favorite practice with many physicians to ap-
 ply cold and cooling applications to inflamations, such
 as cold water, ice, a solution of the sugar of lead, &c.
 but from what trials I have had of this course,  I am   ^
 inclined to think it doubtful—it may fiequently re-    '\
 tardti.e progress, and when but slight may prevent it
 from progressing any farther,  but. they will ,often
 render the tumour hard and indolent, and  it will  be
 disposed to remain so for a long time.
   There is nothing that will abate local inflamation
 more than bleeding, purging and small repeated do-
 ses of  tartar emetic.  Where these means' fail of re-
volving the tumour, a supuration  may-be expected,
 for if they be employed at all in time they will pre-
 vent gangrene.   A  supuration will be  easily per-
 ceived by the form of the part and some part becom-'  .'
 ing more pale, but if the matter lie deep  there may
 be no  visible paleness in  the fikin—upon examining
 the part by pressing upon it with  the  finger  some
 part will be found  softer and give way easy and rise
 again  like a spring or bladder full of wind—it will
 then be proper to open it, the best method is  with a
 lancet or  knife, and it is better to make  the  incision
 too  large than too small, it should be made  length-
 wise wdth the limb or muscle, for if it be  made trans-
 verse, the wound will gape wide open—if the opening
 be made sufficiently large it will be  unnecessary  to
 put a  tent or any thing in it to keep it open—it may
 be dressed twice a day with a soft poultice or  com-
 mon plaister to keep the air out,  and nothing  more
 will be necessary.     *           <

             WHITE SWELLINGS.

   A common white swelling differs but  little from a
 common  inflamation, except its  beginning  for the
 most part in the periosteum,  and the injury which it
 so generally does to the bone, but this is  not  always
 the case, for some are only among the muscles and
 joembranes.  These for the most  part arise from  % 
SURGERY.               181
 diseased state of the system, and if resolved, or a su-
 puration should be prevented, without proper medi-
 cal treatment, a person is seldom healthy for a long
 time afterwards.
   Upon the first symptoms of a  white swelling,  it
 will  always be necessary to purge and give the bark,
 alder bark, or other  tonics, as bitters, &c. and poul-
 tice as in the case of common inflamations—if it  su-
 purates, the abscess  should be washed out twice eve-
 ry day with lime water or a solution of blue vitriol—
 a  scruple, to the quart, of the vitriol will make a ve-
 ry good  wash-r-these washes will prevent the bone
 from corrupting and make it heal with as much ease
 as the softer parts,  lfthe bone  be much  corrupted
 Or affected, as sometimes happens, as  the disease fre-
 quently  begins in  the bone especially  in the  spongy
 heads near  the joints, it then requires a great deal of
 skill and knowledge  of the  parts  to manage  it with
 safety and certainty,  while manuel operations  are
 often necessary that  require more skill  than the  am-
 putation of a limb, and for which few of our  modern
 physicians are competent, and yet I have known con-
 siderable cures performed by bold quacks with caus-
 tics.  The main or essential  points in these  are to
 remove the dead parts  of the bone and apply lime wa-
ter, lie, ot a solution of blue  stone  to  the bone to
 make it cast off the deat#parts> and heal—in doing
this it will generally  be  necessary  to lay the bone
bare with caustic, in  doingwhich  it will be proper to
avoid injuring the tendons", nerves or  arteries__if a
tendon should be destroyed, it is troublesome to  di-
gest off and  may injure some part.  If a large nerve
be destroyed it will render some  part  insensible, or
may cause a loss of the use of a limb, or  even  a mor-
tification of the member.   If an  artery should be
destroyed the consequences may be equally as bad or
 worse, and might endanger the life  of the patient by
 a sudden hemorhage.    A person  who may think
 proper to und» rtake  the cure of old ulcers wi'th cari-
 ous bones that is not skilled in anatomy, should work
 slow and careful by applying pledgita of tow  or  lint 
t'dz
SURGERY.
vet with lime water, blue stone, he. to the part and
wash out the ulcers with  a  strong syringe twice a
day, and by that means may often cure the worst  of
ulcers of that kind where there are no  dead bones in-
volved  in others so   that  they cannot make their
escape—a hot iron (called  an actual cautery) is an
excellent application  to rotten  bones,  and is to be
preferred where caustic cannot  be conveniently  ap-
plied, as in the mouth, he.

                   ULCERS.

  An ulcer is a disease of the softer parts of the bo.
dy by erosion or  a wasting or eating away  of th'e
parts.   The cause and distinctions of ulcers are va-
rious, and the treatment must be varied according to
circumstances.    The most obstinate and common
ulcers, except cancerous, or schrophnlus,  is  in  the
iegs, owing to a circumstance that ought  always tp
be kept in view during the  cure, viz.  the  pendulout
position of the part.   Whenever  inflamation or dis-
ease takes place in any part of the body an obstruc-
tion of the free circulation of the blood through the
part takes place, which is still  further increased by
the pressure of the blood in the lower  extremities,
and this obstruction and weakness is very apt to re-
main after the ulcer is healed,  and the blood remain-
ing in the smaller vessels longer than it ought, parts
with its oxygeneso far as to have  a  black  appear-
ance and gives the parts a livery color, and  for the
want  of the oxvgene  the part is not so well supplied
with the essential ingredients of animation, and there-
fore the less able  to remove the cause  of disease.—*
  A sore in the leg may  as easily be  cured as  in any
other part of the body by proper management ;  and
it is something  truly  strange that physicians  so fre.
quently fail in curing them, but it seems that too ma-
ny are entirely  ignorant of  the  cause, as they very
commonly seem to depend  upon  correctors  of  the
peccant humors that they suppose to  abound, when
in fact no sue!: humors exist. 
                  SURGERY.

  fn the cure of ulcers of the legs, there are the fol-
fowinethings necessary to be kept in  view :  hirst,
to prevent or press back the fluids that tau upon thef
part by proper bandage—in the next place  to dram
the humors or super-abundince of fluids off  at tnne*
by purging; and lastly, to dr?ss the ulcer  in other
respects with moderately astringent and drying ap-
plications, as lime water, sugar of lea I, lint,  &c.
  Bandages  are necessary  in almost  all wounds or
sores in the  lower extremities,  and however great
the  swellingand inflamation be.it will be safe to re-
pell the swelling by proper  bandage^.  There are two
methods of applying bandages, the one is with a strap
of linen about an  inch and a half wile,  and long e-
nough to wrap the foot and leg up  quite  above the
diseased or swelled part ;  the other method is- with »
laced stocking ; it should be made of strong linei*
and lace up before, the  holes should not be over an
inch apart, the dressing laid  smooth  and a  piece  of
thin leather  laid along under the face  holes to  pre-
vent the-dressing from wrinkling up under it ;  after
the dressing has been put on,  and the lace in,  drav/
it moderately tight, beginning at the toe.   It  will-
fee I somewhat inconvenient at first a while, but in a-
few days it will become quite easy,  and  at  last  the}-
patient will  feel aukward without it.
  When a bandage is used, begin to wrap at the toe
if the sore be in the foot or  below the  ankle  joint,
and if above the ankle joint  begin  on  the  ankle  or
below the ulcer and swelling and wrap it  upwards,
letting it lap over every time and draw  it as tight aai
can be borne with ease, and its tightness may be in-
creased at each dressing until it press all the swelling
and black or liver colour away—it  should be contin-
ued for some lime after the ulcer is entirely well.
  The rest of the treatment of ulcers irftfie feet and
legs are various  according  to circumstances—the
lips and parts about sometimes grow hard  and thick,
and are then called callous  and will  not  heal  well
until the hardr.ess b: destro . ed with caustic.  Somo
 arre toe drv and others too mcist—if tV.tre  be nqulU- 
I 04
SURGEilf.
charge, or but very little, in such  warm application!
as a turpentine plaister.  Sometimes the ulcer is too
moist, or discharges a thin watery fluid instead of ijjj-
good dus—bark and other strengthening medicine  is '<■/'
then necessary.   The black alder bark is  excellent,  %■
both in decoction inwardly and to bathe the part in.  %,
In most cases dry lint is the best application,,*  An
easy way to make the lint is to boil tow in a clean lie,    jj
and then  wash it out in fair water, dry it fjnd card it
well.  :
   In the  cure of ulcers in whatever part of the body
they may happen, the following, rules are  to be ob-
served :  If the bones are unsound, lime water and a
solution of blue vitriol are to be used alternately  a
week  at a time.  If the ulcer be  too dry and  appear
weak and pale^ the bark should be given inwardly and
the ulcer washed with a solution of corrosive subli-
mate and sal amoniac, a scruple of each to  a quartof
water—if it give pain, make it weaker by adding wa-
ter.  If the discharge be too great, it may be suspect-
ed that the bone is unsound, if not, a light diet or even
purgingAvill be necessary.  Whenever it is intended
to heal up an  ulcer, a purge should  be given once  in  ♦
ten or twelve days, except the patient be weak or the
ulcer be dry ;  in that case, a full diet, barks, or other
strengthening medicines will  be proper,  and  warm
applications to  the  part.   In  dry  ulcers without
swelling  or inflamation, bandages are not proper, but
in all others, especially in the legs and feet, bandages
are of more service  than all the cirugs'beside,  and  it
is proper  if  the patient  is  able  to go about at all,
to  use the limb and as  much  exercise as he is a-
b!e without mucl) injury.  A compress, or some tow    .j
or a little bolster, should be put under the bandage to
make it press the ulcer pretty tight.                   \
   Women after the ceasing of the   menses, are fre-     '
quently subject to ulcers about the  legs and  ankles,
which are very commonly painful and hard to heal,
and it is  a  common notion that it is improper .to heal    S
them as they preserve the health.   There is scarcely
any tiling more disagreeable than an ulcer,  and esne- 
                   SURGERY.     -,,         it$

 tidily as a companion for life ;  and it is  we'I know!
 that the longer an ulcer is permitted to continue, the
 worse and the hauler to cure, while the/ m,iy always
 be certainly and safjly  cured  while recent, and in
 thie case nothing more is necessary than  merely to
 increase the natural discharge  or lover  the system
 bv aj|uurge'of jalap, to which a little calomel rrt ty be
joined; and this should be  repeated  at  intervals of
from nine to  fifteen days until the ulcer is well,  and
a little before  the full oT the moon for two or three
months afterwards ; and in all cases of ulcers that
have been o£ any length of stanelin'g, it  will be pro-
 per to purgPat times for some months afterwards,
 but more especially if it should look like breaking out
 n^ain, or if a fever or any other disorder should com*
 on.
  In the ciJre of ulcers from  the venere.il disease,
the solution of corrosive sublimate and  sal  amoniac
is the most proper wash,  as also for venereal  ulcers
in the mouth,  and is one of the  most poverf.u reme-
dies for ulcers in the mouth fro n whatever cause.

                   SCIRRHUS.

  Scirrhtis are" hardened glands, and mayihippen in
any part of the body where  there are  gla'ids and are
known  by  their  hardness — they  frequently be?in
Small and increase to a considerable  bulk.   A  true
scirrhus is without sense, except it terminate in  can-
cer, w'hifh  is frequently the case.  It is certai.i  that
the limits between scirrhus and cancer are but very
imperfectly marked, but it is known that ait scirrhus
do not terminate in  carictjf, aUbough they  ulcerate.
 It frequently happens that  they terminate in cancer,
 and it is very difficult, to  distinguish  them from  a
 true cancer aLttll times before tney  sup'irate, but a
 scirrhus mayjpappen upon a Urge  portion.  I  oncd
 saw the \^ole arm, hand  and  tlie  parts  about  the
 breast become scirrliusjBfcter the extirpation of acan-
 re.rousj^rcast.  The swelled  leg-,  mention* J under
 the  diseases of women, hi; vrvy much  the anneur-
                     V 
*86               SURGERY.
ance of scirrhus.  Some scirrhus are of a purple  or
liver color, but when they are round or  uneven, of a
livid or lead color,  with enlarged  veins stretching^
from it in every direction, they may be called  can-
cer, as they never fail to terminate in inveterate can-
cer.
  This is one of those diseases to which mankind are
liable that frequently set our art at defiance, but this
is not always the case.
  There are two medical courses that  may be pursu-
ed ;  the first is resolution, the other is  extirpation.
A true or insensible scirrhus will seldom if ever re-
solve or supurate well, but if they are sore or painful
to the touch, they may for the most part be brought
to supurate well, if not disperse.   For  this purpose
a great number of drugs have been recommended, as
the hemlock, night shad, (belaedonna,)  hen bane, (hy*
bsiamus,) lauro, cerasus, digitalis, and almost all tni
poisonous plants and substances known.   I  have
myself tried some of them, but I believe none pos-
sess more power than the Jamestown weed  (stramo-,
nium) in England called thorn apple, and as it  is an
indigenous plant and to be had at all times in  almost
if not quite every part of the United States, it is to
be prefered.  A poultice should be  applied  to the
part of the green leaves, made by roasting in hot em-
bers, or the seed ground  fine and sprinkled  over a
poultice of corn meal and appljed warm, and  renew-
ed from time to time.  A tincture should  be  made
by steeping a quantity of the seed ground in  spirits
and  strained—of a saturated tincture a  person may
take frotnten to fifteen drops, and the dose increased
two or three drops at a tinae until some diziness and
blindness be perceived.   I have taken  this tincture
in a dose of forty drops, which induced  a  swimming
of the head, a blindness and staggering like  drunk-
eness, wkh great drouth but without any sickness at
the  stomach ; the blindness from  such  a, dose will
last for 24 hours or more ;  two smaller doses  a day
will be better than one large one.   I have known the
jamestown to resolve gr supurate swellings of a long 
SURGERY.
187
standing that had every appearance of becoming can-
cerous, and it ought to be persisted for. several weeks
or even months.  Where a long course of medicine
is necessary, it is always best to change  a medicine
at times for others of the same class and  where the
disease should prove obstinate and cannot be remov-
ed by extirpation, hemlock or some other of the same
class of plants may be  substituted at times.   If  it
supurate it should be washed out alternately with a
decoction of Jamestown and lime water, or the cor-
rosive sublimate solution until healed.
  The next method of treating scirrhus tumours,  is
by extirpation, but I should always prefer treating
them at first a while as above, but if in the mean time
they should increase in bulk it will be proper to ex-
tirpate them immediately;  and as this ought always
to-be done by an expert surgeon  I  cannot think  it
necessa'ry to give directions for the operation. How-
ever, if the tumour be small and lie shallow and free
from any turgid vessels, it requires but little skill ;
it may be done by caustic, but much  better  by the
knife.   After extirpation if it attempt to form  again
in any of the neighboring parts, the Jamestown should
be industriously employed, and if inflamation, bleed-
ing and purging.

                   CANCER.
                               P
  From what has been  said upon  scirrhus it is not
necessary to treat so full upon cancer, for as observ-
ed above,  it is difficult at firt to distinguisj^a genuine
cancer from scirrhus, but there are two or three ways
in which cancer first make their appearance.  A gen-
uine cancer bogins in a small hard tumour  in  some
part of the body, but most frequently in* the breast
of women— as it enlarges it becomes unequal—sham
burning or darting pains shoot through it—when  it
fixes itself to the skin it is of a purple or lead colour,
the veins are enlarged around it and are  crooked and
largest towards the tumour—these veins and the bo-
dy give it somewhat the appearance  of  a »ea crab 
,83               SURGERY.

called canctr.'or canker in latin, and is a prcper drs-
tii'guishing n.aik in ulcers  supposevi  to  be cancer-
ous.                                  -
   Another ard the most common  form cf  the  com-
mencement ef cancer, isi.i a dry scab or  horny  pus-
tie in the face of ag.-.d people—they  are frequently
the remains qf ringworms, and  will  sometimes  re-
main for years or ter life without any injury,  but if
disturbed by caustic or corrosive applications, never
fa 1 to terminate in the most inveterate cancers,  and
^re berce called  noli me tangere,  that is,  touch me
not, and is a,very'good caution against  the officious
n.ee b.i g with quacks and quack remedies.   When  a
cancer happen  in the leg it is  called lupus, that is a
wolf, from the rapidity  wiih  which it destroys the
part.                                           *'
   The o; ly cure cf cancer is  extirpation, ar.d whick
 ih-iuld alwavs  be done by the  knife if practicable.-*
 'j he vulgar "notion of toots is an error—a cancer  is
 a i aid cartibgtnous substance  of a circumscribed
 5urf.ee, and there are no rtots or any other cancer-
' oussubstance out  of that tun,cur,  except vitiated
juices, and if it  be entirely  extirpated the wound
 will  heal with as  much ease as any other, but if the
 tumour was large or ulcerated, although it might not
 have been very large, the parts about and especially'
 the glardi in the  neighborhood, are veiy liable to be*
 corr.e scirrhus, and always  shculd be checked  upon
 the first appearance of any hardnets, by  the remedies,
 presc; ibed under scinhus.
   If iq any case the amputation  of a  cancer  is at-
 tempted by caustic,"it  should be done a6  speedily as
 poso.bie—c\ ery cancer quack has  his  aicanum for
 this purpose, tie  bash of which  is geneially white
 arsenic or rats bane, and is  generally  esteemed the
 best, but it leaves an ulcer that is hard  to heal.  1  be
 best method ot applying it is thought by soirt, to mix
 it up wini same substance in the form  of  plaister,
 v\':th dock root or any other -  glutinous  substance.—
 The escar or dead part ought always  to be cm out
 and a new plahter or quantity cf  the  caustic appli^.J, 
SURGERY.
iH
 immediately until the tumour is destroyed, and then
 the ulcer should be sprinkled with red precipitate or
 a mixture of red precipitate and burnt alum, for  one
 or two dressings, after which it will then dispose to
 heal.
   There is no disease in this country in which quack
 imposterS does more harm than in pretending to  the
 cure of cancer.  There  are several little tumours
 th#t are particularly considered as cancers by the ig-
 norant and quacks, that have  nothing of cancer in
 them, and would almost universally get well of them-
 selves if let alone ;  but the unfortunate  person has a
 suspicion that such tumour may be a  cancer—he ap-
 plies to son.e person who has had such a cancer  and
 has been cured by some quack, to know whether it is
 a cancer^or not, when intact they are both ignorant
 alike—it is pronounced a cancer, the cancer quack
 also pronounce it one,  applies his caustic, and soon
 has an ugly ulder, lays the bones and tendens  bare—
 the  escar separates, nerves  and fibres  are found
 strong ;   these  are  called  the roots and must be
 drawn out, which is done by giving  the most equi-
 site tor.neiit, like a fiend or fury  he proceeds in  hid
 work until the patient is wearied and flies  from him,
 and applies to some whose muthod of cure  is mora
 mild—the seventh son of the seventh son lays his sa-
 cu-d paw upon  it and whispers settle  pious  tjacula-
culation over it, and b'cls his wondering patient  de-
part in peace and be well, and as bis faith so is it un-
 to him, who now with tbeeye of faith sees the hand
 cf the divine conjurer inflated by the  abstraction of
 the morbjfic matter.  Some  ointment or a'little  lint
 does the work at last, and he is cured.
   It is a thousand  pities  but such as  suppose  they
 ma> have a cancer would consult a physician who  is
 famed  for his honestyas well as skill be fete they  sub-
 mit tbemselve  to be mutilated  by such infernal ig-
 noramuses.   It must be acknowledged that even  in
 consulting a physician, a person is not alwrvs able  to
 escape imposition, for the insatiable  thirst for  mo-
 ;:ey so frequently predominates that they  ar^ too ..-.v.i 
*<;o               SURGERY.

to take advantage of the ignorance and credulity cf
the unfortunate patients to enrich themselves ; but I
think that those who will pay strict attention to the*
following rules will be able  to  escape:   First,  pay
strict attention to the description of the  cancer  and
scirrhus in the  beginning of this  chapter,  as first,
that a cancer scarcely ever  comes on suddenly but is
frequently years without doing any harm—it  either
comes in the form of a hard tubercle, or^gland, of in
a dry scab or horny excrescence on the face, &c.—
Secondly, that it generally has a purple or livid  co-
lour where it affects, and that the veins are enlarged
around it, at least as soon as it becomes ulcerated.—
The last evidence is negative, or that which  shews
those diseases which are so frequently taken for  can-.
cer not to be such.  The diseases which are so fre«.
quently taken to be cancers are the following : Efin-
ictus, tertv.inthus, carbuncle: and  spongoid inflama-
tion.  Epinictus is so  called in the greek  from its
coming in the night—it begins by a blister if it  hap-
pen  where the  skin is thin, but if it happen about the
hands where the skin is thick it arises like a horny
substance, forming a  wartlike substance of a'  liver
eolour, sometimes with considerable  inflamation and
pain.  When it begins by a  blister it  sometimes  con-
tains a bloody water and is  of a dark  colour and soon
rises up  like a wart, and is  very sore  and painful—it
is very common for several to happen about the same
time—they are commonly  called among the  vulgar
cancer warts or cancers, and is the most  common dis-
ease treated as cancer by quacks.   They will  gener-
ally supurate about the base after some time and
come  away without the assistance of  any medicine—
a soft poultice will hasten the separation, and  espe-
cially the Jamestown.   Terminthus differs  very lit-
tle from the former, hut is  less and blacker,  and is
called ttrrninthus from  itsbeing of the colour  of the
turpentine tree—it also soon separates and heals up
 of itself—they both look very ugly at first a  while,
 gleet jor discharge a bloody matter and are very pain,
 fa?, but/ire entirely without danger. 
k
                  SURGERY.               191

  Carbuncle is kind of boil, it comes on  the  spine,
about the joints, neck, or other parts of the  body
where there is no fat—it has  many  heads  but does
not supurate well, the parts below  being membran-
ous are  tough-and do  not  slough  away, the ulcer
continues to spread and is  exceedingly painful, ;and
if not properly treated  will frequently  bring, on a
typhus fever ; and death may be the consequence—>
ti»is by quacks is called a frightful cancer, they apply
their  caustics to it and  the torment suffered is  in.
conceivable.  The Jamestown poulcice will in a short
time digest it out  and it  will heal  kindly;  bat  if
much fever happen it will be necessary to bleed and
give a purge.

                   POLYPUS.

  Polypus is an excrescence  which may happen  in.
any part of the  body,  but most  commonly  in  the
nose.   They are of two kinds, one is  a  fleshy  sub-
stance of a purple or liver colour, the other is more
red and painful.  . These  are generally considered
cancers by the vulgar, and sometimes  make employ-
ment  for quacks.   The first or fleshy polypus has no-
thing cancerous in it, the other is of a  more  malig-
nant nature, and by" improper treatment might ter-
minate in cancer.               ▼-,
  The only remedy in most cases is  extraction ; they
aje commonly small at  the bottom, and  by taking
good  hold of them with a pair of forceps  they  rr*.y be
twisted and drawn out by the root, but  these  opera-
tions in general require a good deal of skill—the rei
polypus sfduld not be  medk-d with but by a skilful
surgeon, except in its first stages,  it may then be
destroyed by applying a strong solution of sal aioo-
niac  to it from time to time, the other will  also give
way while small to the same treatment.       -H 
io*               SUR6ER1?.

         PTERGIUM, OR FLY  WING.         %

  This is a small three-square membrane found upon* *
the eye, spreading from the outer or iner angle,  but
sometimes from other parts of the eyTe tow aids  the
pupit.
  The common method of cure is  extirpation.   It
may  be taken up by a pair of small   pointed forceps
and cut off with a  keen  knife.   The eye should b%
kept from the light a few days  until the  inflamation
goes off.

                  ENCANTKIS.

   This is an excrescence that  arises in the iner cor-
 ner of the ey, and is  onlv removed by extirpation, as
 the above.  These operations  inay be performd by
 any handy person, but great care should be taken not
 to wound;the eye any deeper than  merely to take off
 the  filament.                     »

                 PARONYCHIA.

   This is what is commonly called whitlow, orjoint
 felon.  The signs are too well known  to need any
 descriptidn. / Te^, commonly  come about the fingers
 ends, but  sometimes it comes  in  the  palm of the
 hand, drawing it shut,  and are some times thought to
 be a wonderful cancer by the ignorant.           %
\   When on the fingers it is a common practice to re-
 pel them by wraping the fresh skin that is in an egg
 around  them, which by shrinking will press  back the
 tumour and remove  the disease if applied in due time$
 if not, a Jamestown poultice should be  applied hot
 and renewed twice or three times  a day, and  when
 ripe it should  be  well  opened with the lancet and
 washed oit with a strong lime water twice a day.—
  They will heal up under this treatment as quick and
  safe as any other abscess.
    The great mischief done  by these  little tumcurs
  is by the matter lying upon the boae and corrupting 
                   SURGEItYi               t03

 it, as they like white  swelling  always begin in the
 periosteum and leave the bone naked.

                 PTERYGION.

   This is a fleshy excrescence about the  nail, it  i*
 exceeding sore and painful upon the smallest  touch,
 they frequently follow a whitlow that h. ppens about
 the end of the fingers or toes, and if  no;  cur-d  will
 seldom get well of themselves, but there  are msny
 other causes^ a3 bruises, he.
   The cure can seldom be performed without  des-
 troying the excrescence with some caustic or  corro-
 sive application.  After cutting away the nail, burnt
 alum or red  precipitate may be applied, and repeated
 every day for three  or four days ; if that be not  suf-
 ficient some stronger caustic should  be  applied,  as
 corrosive  sublimate or a bit of common   caustic,  or
 what is less  painful, a hot iron, aft^r which, the place
 wiii heal up  without any further trouble.

            WARTS AND CORNS.

  Warts may be cured by cutting them off and  rub.
bing the place with a piece of blue stone at times un-
 til well.
  Corns may be cured by cuttingiout the  hard  part
 as clean as can well be ddne, and then sticking a pie-ce
 of pretty thick soft leather over it with a hole  exact-
ly over the corn and keeping it on for a few weeks.

                 GANGLIONS.

  Ganglions are small tumours that come upon the
 tendons about the joints of the wrist.   They  may
 sometimes be removed by hard pressure,  or  binding
 a plate of lead upon them, or anoint them  with a lin-
 iment, (directed page  54.) If they give way to none
 of these means, they may be removed with the knife,
 by opening the skin and cutting them out at the base.

                     Z 
t94               SURGERY,

       OPTHALIvIIA, OR SORE EYES.

  Sore eyes is a very common complaint  in  Ken*
tucky—it is the worst towards the fall.  If the dis-*
ease happen suddenly and violent, bleed  and give^
dose of salt1*, and bathe the eyes in cold  water>^,ind
after the inflapftation is over, bathe with  a  weak so^.
lution of the sugar of lead  or white vitriol, or aioint
the edges of the eye lids at night with a  little white
ointment made of the sugar of lead.
  Sometimes the disease will,  without proper treat--
ment, become habitual, and is then more difficult  to
cure and will require a light mercurial  course, and
the use of the sugar of lead ointment for  a considera-
ble length of time ; it will  also be of service to  wash
the eyes  in cold water every  morning—avoid sitting
up late and drinking spirits, live upon light  diet and
persevere in the means for sometime after  the  ejcj
are well..,            /

         TETTEROUS ERURTIONS.

  There are a number of diseased states of the  ski*
partaking of this nature  from  a  common  ringworm
to that of the elephantasis or leprosy, and there are
few diseases which are transmitted more certain  to
posterity.  They always  ought  to  be  cured  upon
their first appearance.  A strong mercurial ointment
is one of the best extern?! applications,  and should
be repeated from time to time until the disease is re-
moved, and every time it attempts to make its  ap-
pearance again  ir. should  be checked immediately.
For  tetters, or even ringworms, when they prove ob-
■tinate, a",  ointment  made of the  corrosive subli-
mate by grinding very fine  and  mixing with  some
common plaister or tallow  is a more powerful reme-
dy—it should be made pretty weak or it will take off
the skin and giv<- p,:in.  But if the  disease be  of a
long standing, or prove violent and obstinate, a  mer-
curial course with frequent purging will be necessary
and may require-six or eight  \vetb  to  remove  the 
                   SURGERY.               f9S
                                             «f—7-^1
 disease effectually; and towards the latter end of the
 course it will be necessary to make use of the tartar
 emetic  in small dos.es as an  alterative, as also the
 elixir of vitriol or nitrous acid.  People  ought to be
 very cautious and not permit these eruptions  to re-
 main long, especially old people, and more especially
 in  the  face,

                SCALD  HEAD.

  Scald, or sore heads in children, are so much of the
nature of tetters, that it  is scarcely worth whde to-
repeat the remedies.  The common practice  of cut-
ting off the hair is improper, for although  the head
may cure up the sooner, it will be  much more sure
to return agjin after the hair grows out.    Frequent
purging is always to be employed in the  cure  of the
scald or scabby head ;  and^fter it has  once  been
cured up, if it should make its appearance again,  a
purge should be given and the parts  anointed  with
the sugar of lead ointment, and repeated until  well.
  This disease  was formerly considered ,as  almost
incurable, but by proper  attention  the wort  cases
may be cured without,cutting off the hair—frequent
purging with jalap, and if the eruptions have any
tetterous appearance, it will be necessary to  give  a
mercurial course, with  tartar and elixir vitriol—
wash the head every dressing with a  lime  water of
half the strength of pure lime, water, viz.  make it as
strong as it can be m«de and  then  put  in  an equal
quantity of common water.   Where lime water can-,
not be had, soap m.iy do, and (then  ar.oint  with the
sugar of lead ointment.

            BURNS  AND  SCALDS.

  Apply as soon as possible spirit of turpentine, and
repeat it as occasion may require —if spirit of of tur-
pentine should not be ready, spirits wiil  answer, or
soft soap—it should be kept warm.  After the  pain
and smuitiii- is over, apply a soft poultice, er auoin:
 
io£
SURGERY.
it with lintseed oil—a cloth dipped in sweet  erean^
or if the burn be deep apply  a poultice of slippeiy
dm bark.

                   WOUNDS.

  Wounds are to be distinguished into two kinds :—
1st. wounds  made with a sharp instrument—zd. con-
tused wounds, or wounds made by a blunt weapon,
as gun shot  wounds.
  A wound  made with a sharp instrument, as an ax,
a sword, he. require but little skill in the treatment.
If it open, bring it tcgether as well as possible  and
fasten it so with good bandages.   Nothing should be
applied but soft lint—the practice of applying sugary
soot, salt, balsams,  he. is injurious—there is no bal-
sam  so good in fresh wcunds as the blood.   If tber$
be no bruise, the dressing should be  kept  on four or
five days before it is taken off; at the second or  af-
ter dressings, if any part lie open it should be  filled
up with a dry lint ar.d a plaister or  paper laid  snug
over it.   It was formerly a  practice to stitch  up
wounds of any size, but this  is rarely practised of
late, except large wounds of the belly, he.    Instead
of sewing, slips of linen may be spread with sticking
pl/ister and laid across.   If the bones  be cut or
wounded it  requires a different treatment—if the in-
jury to bones be great, it will be necessary to  wash
it out with lime water, or  a  weak  solution  of blue
stci.e to prevent the bone from corrupting.
   When there is a great dhcharpe of blood from a
wound which should appear dangerous or she uld con--
tinee so as to weaken the patient,  and the wound be
in a limb, a tight bandage should be made ahove the
wound by a leather strap, and  a  stick through  it to
twist it tight, a piece of leather should he ph ced un-
der it to prevent it from pinchii g the skin, and 1 wist-
ed so haid as to stop the blood, then  \va: h  out  the
wound and slacken  the bandage and the open vessel
may be seen—if it be  an aneiy the blood is of a scar-
let colot and shoots out by spurts—the surest me- 
                  SURGERY.               197

thod is to tie a thread around it  pretty tight, but tins
often requires instruments and a knowledge of their
use ; but what will generally answer very well, is. a
hot iron, of a proper size and shape, but if neither of
these can be used, a stupe of tow dipped in a stroi=g
solution of blue vstriol will  generally succeed—cop-
peras or alum may answer.   In  the manage;:.tnt of a
simple wound, there is often more damage  dote by
improper applications than for the want of medicine.
It is proper to keep them  clean  and  to  dress  them
with dry lint alone, except the  wound should appear
unhealthy.

           CONTUSED WOUNDS.

   Of these wounds we shall take gun-shot for an ex-
ample, for the flesh is always contused, torn and dead
in wounds from  a ball, but not  so  much so from  a
small as a large  one, and still worse from the burst-
ing of a gun.
   The main art in curirig these  wounds, lies in clean-
sing the woUnd at first from lint,  splintered  bones,
or any other extraneous body that  may be earned in
with the  ball ;   also,  if there be any dead  or rag-
ged parts  they should  be  cut  away  smooth—wash
the wound clean, and if any bone be  splintered, be
careful to extract all  the splinters clean.   The
wound after washing clean should be dressed up with
lint and proper bandages to keep it on. If the wound
penetrate the breast, a plaister should be laid over
to keep the  air  from  passing  through  the worn d,
and the  dressing laken  off twice  a day, and the
blood  and    matter  discharged,   and   the., wound
washed out with a decoction  of oak  or  dogwood
bark.
   These  wounds are more  liable  to mortification
than any  other, from the  dead parts within wl ich
must cf course communicate a taint,  if  not guarded
against  by  fiequtnt  washing  v  i;h ant'septics —
But gun-shot and other contused wout.ds are 'gener- 
I
io5               SURGERY.

ally great and dangerous, and therefore a skilful sur-
geon should be employed. *
  All concussions or wounds with great force  upon
the head  are dangerous, and often so when  they ap-
pear but  shglit, and whenever stupor, vertigo, or de-
lirium attend, there is akvays  danger  although the
skull is not broken.   From the rupture of small ves-
sels within the cranium a collection  of blood  takes
place and presses upon the brain, the patient becomes
sleepy or dumb and sometimes delirious.   This is al-
ways attended wkli danger, and according to the de-
gree  of the symptoms so is the danger.  Sometimes:
these symptoms come on immediately,  in  others not
for some  time-- in some  cases the symptoms will
hardly give suspicion of danger long before  the fatal
hour.  Locked jaw is  often  the  consequence of a
stroke upon the head.
  When  the above symptoms follow a wound on the
head, the patient should be bled freely and  a mercu*
rial purge given  once in four or five days,  and  calo*
mel given in small doses to excite  a slight salivation;
but if the symptoms continue violent,  it will be ne-
cessary to open  the cranium  with the trepan, for
which purpose  a regular  physician should be em*
ployed.

   GANGRENE AND  MORTIFICATION,

  A gangrene is the beginning of mortification. Al-
ter a violent inflamation has continued some time, it
blisters and becomes pale, livid cr black, it  is said to
be gangrene, but if the parts be quite dead it is called
a mortification.   I have seen a species of  gargrene
and  mortification commence by the  skin  rising  up
like  roles of wheat dough, the parts remaining hard
and  tumid  beneath,  but gradually became  sorter aa
a complect mortification Lakes place.
   li there be no fever,  or the fever be not high, give
bark ar.d camphire in  substance—half a  drachm  of
Lark and about 15 grains of  camphire,  about four
times in  :\m day—scarrify the parts to the quick and 
                   SURGERY.               f'?>

c."••"!7 tible salt and a poultice of corn rr.e-il over and
rcne.v it twice or three times a diy.   The  practice
was formerly to apply spirits of turpentine hot;  and
spirits can,)-oorated, but every  thing  which give3
pain should be avoided.   1  have always applied fait,
it gives no pair—'die dead parts shrink and  separate
from the living in  a snort  time,  leaving the living
sound and clean—wheiever the dead pans be^in  to
separate it  shoold bj  washed  out clean  at every
dressin r with a decoction  of oik or dog voo 1 baric
and sah, but as thi  separation Becomes  more  com-
ple»t the salt may be discontinue I,  but the  p-sultice
co tinned until the dea  1 parts has separated,  and
%hen wasn with lime water and dress with dry lint.

                     BITES.

  It frequently  happens that men  in  fighting bite
each  others  fingers, which is  commonly  attended
with bad c-onseq..iehcess,  and sometimes  mortifica-
tion.   Such wou.ids are to be considered as contused
wounds, and commonly wi.th'great  injury to  the
bone, the periosteum being bruised,  and  often being
destroyed leaves the bone bare.
  Dress it from the first with a poultice—wash  it
well with lime water or a solution of blue virri I—if
the infUmation run high, bleed and giv; a pu ce, and
if the pain and inftamacion  still  continue, give small
Aoses of tartar emetic.

                 FUAuTuivivo.

  When a bone is broke, the first thing *s to place it
 together again and secure it v.« it proper bandages to
 keep it in us proper  position  until  well.   When a
 bone is broke and cbe ends slip past each of.her,  the
 muscles oft^u contract and it requires  considerable
 extension to bring the  ends trevther  apain—if the
 muscles be sr.ron.* and it cannot be  placed by exten-
 sion, bleeding plentifully will be of great service---
 To deicribs every motion n.-ce.;:sa»,y in setting a bio- 
ioz               SUUGERY*.

ken bone, would far exceed the  limits assigned tlds
work; but the following rules will geneiaily  an-
swer:  Place the limb in its right  position,  let one
man extend or stretch it  lengthwise, while  another
place the two ends of the bone together, and then ap-
ply a bandage.   The best way to make a bandage  is
to take a piece of soal  leather, soak it,  and  while
wet let it be put upon the limb of a sound  person  a-
bout the same size until nearly dry, when it is  to  be
taken off and put upon the broken limb and kept  on
until it be so strong as not to  need it any  more.   If
the parts should itch, inflame or excoriate, the  band-
age should be loosened and the parts rubbed  gently
niith a solution of the sugar of lead.   It is a common
practice to keep the limb wet with vinegar—the vin-
egar can have very little effect upon the  bone, if it
had, it would be injurious, as it would weaken it—it
is also applied to sprains, but with a worse effect.—
A broken bone requires  no application but  the  band-
age, and the sugar of lead lotion in the case of exco-
riation.  I'have known joints kept weak a  long time
by the constant use of  vinegar.  To strengthen  a
bone or joint, spirits of turpentine is the best  taken
inwardly, and a plaister  outwardly.   If pain  and in-
flamation run very high, it may be necessary to bleed,
and a spare diet will be best, on two accounts : as it
will be a means of preventing inflamation, and render
the inconveniency of the stool the less necessary.
   It generally requires from 16 to 25 days  and  some*
times longer for a  bone to come  strong  euough  to
move with safety.

                  LUXATIONS.

   To reduce a luxated  joint  requires rather more
ingenuity than a broken bone, but where there is  no
great force necessary,  neither requires  much, and
both are oftener performed by handy persons tb o by
professed surgeon.
   The dislocated jtw, shoulder, elbow and hip ait r.!.e
most difficult. 
                  "SURGERY".              lot

  Theliixation of the lower jaw is  known  by its
hanging down, and the patient is unable  to shut his
mouth.   In order to reduce it, put  the thumbs upon
the jaw teeth and the fingers under  the  jaw, press
the hinder part of the jaw down  and  raise the  fore
part up, and bring the foreteeth together.

                 SHOULDER.

  The shoulder is known to be out of place by a hol-
low on the top and the head may be felt  under the
arm, and the elbow cannot be brought so close to the
body as the well one.      ...
  The best way to reduce the shoulder, is for a strong
man to put a girt around his shoulders and under the
arm close up, ahd then place his  hands on  the shoul-
der  against the  shoulder blade  and  collar bone,
in the mean  time another person sits on  the other
side and holds the arm down as  close to the  side  as
may be and the hand is held forwards, when  he that
is to reduce it draws the head of the  shoulder  bone
out, and at the same time pushes  with his hands a-
gainst the blade, he.  The intention being  to raise the
head of the humerus or arm bone out from  the blade
and at the same time to press the shoulder down into
its proper place.

                   ELBOWr.

  The elbow may  be  put out of place   two ways.,
backwards, and forwards.  If it be luxated forward,
the arm hangs out, and  a knot on the inside and hol-
low on the outside where the elbow should be—if it
be luxated to the contrary, or backward,  the cavity
will be on the  inside and the arm crooked.
  In order to  set  it three  persons  are  necessary,
one to  hold the arm above the  elbow,  another the
hand, these  are to pull the joint apart,  while a third
presses on the inside of the arm, bending  the elbow
so as to bring  the hand  towards the breast.   If the
luxation be to  the contrary, the  same number of per- 
SURGERY.
sons are necessary, and the surgeon's part in setting
the arm is merely to assist in*guiding the joint  into
its proper place.

   The signs and the operations for  the hip is nearly
the same as that of the shoulder, while the rest will
be easily understood and  performed by any handy
person.
   The reduction of the hip generally requires consi-
derable force as well as some skill.  If the  hip be
luxated forward,  the head of the bone may be felt in
the groin, or a little below, 'the knee wiil be turned
outward and the leg will appear longer.  If it be out
backward,  the  toes will  be  turned  inwards  and
the leg will  appear shorter-
   If it be out forwards, the patient  should be laid on
his back and a pin  go into the table in his crotch,
wraped with  cloth to keep it from  hurting,  a girt
is to be put round the  inside of the thigh to  draw
outward by ; the leg should be placed in  its right po-  «
sition,  and the knee  brought up toward the  belly,
while the head of the bone is drawn outward into its
place.
   If the luxation be backwards, the patient must be
laid upon his belly, the  thigh  must be drawn  down
with considerable  force, while the leg is bent  back
and held in its right position untill  the joint is in.
   The patient ought to keep his  bed for  some days:
untill the inflamation  goes  off, for if it should  slip
out again it will be much worse than at  first.
   If the muscles should be very strong  and the  re-
duction thereby rendered difficult, plentiful bleeding
will always be of service. 
 A  COMPENDIUM OF ANATOMY,

              ••    OR

A CONCISE DESCRIPTION OF  THE   CONSTI-
    TUENT PARTS OF  THE HUMAN  BODY.
  It is scarcely possible to understand Medical lan-
guage, "or to'form any correct  idea of the  seat and v5|j
cause  of diseases  without some knowledge  of the  -*v
seat and office of the parts concerned; I  have there-
fore thought it necessary to subjoin a short descrip-
tion of the principal constituent parts of the human
body,  those who may wish to gain a more general
knowlege may consult Cheselden? Bell, &c.
  The constituent pats of the human  body are,
Bones, Muscles,  Tendons, Cartilages,  Ligaments,
Membranes,   Fibres,  Arteries,  Veins,. Glands,
Lymphaeducts, Lacteals,  and Nerves.

  The bones  serve to give shape and strength to the
body, and their form and  strength is  adapted with
wonderfull  ingenuity to the various  purposes for
which they are intended.
  The cranium, or scull  bone is composed  of ten
pieces, the joints  are called  sutures ;  os  frontis, or
forehead bone mikes the fore part of the head and is
joined to the  bones of the face by  a  suture which
runs across thro the sockets of the eyes, it joins two
large bones which make up the  greatest part of the
head on each side by a suture that runs across from
ear to ear; these bones are called parietalia, and are
divided by a  suture that runs from the front bone  to
the back of the head where it divides leaving another
pre.tty large  bone called  occipitis,  thro which  the
spinal marrow, or rather brain passes—there are two
small rounb bones that lie immediately under the ear 
                 ANATOMY              Lao*];

and are about the size of the ear, they are called osa
temporum, or temporal bones ; the rest of the bones
are small and  seated in the lower and fore part of
the head  over the palate he.
  There  are sixteen bones  that belong to  the  fece
besides the lower jaw.
  The bones of the trunk of the body are the spine,
or the back bone, which is  composed of twenty  four
vertebra   or joints,  besides  the  os sacrum   and
coccygis  or termination of the back bone, seven bone.*
compose  the neck, twelve the back, and five the  loins
the os saccrum  is generaly  five  or six bones, the,
coccygis is four.
  The ribs are twelve on each side, the seven upper
are called the true ribs , and.the five lower, are call-
ed bastard.  They serve to defend  the heart, lungs,
stomach  and liver from external injuries, and to as-
sist in breathing: the ribs of  children when young
are very tender, and ought to be handled very  care-
full :  the sternum, or breast-bone is generally  made
up of three or more ; to this the true ribs are fastened
   The ossa innominata,  or the nameless bones, are
in young persons made up  of three, the upper which
make the hips are called  ilium from their inclosing
the small guts called in latin ilia ; the hinder and
lower pa't is called ischia,  and the  lower part where
they,meet before, are called os pubis.
   The bones of the upper limbs are the clavicle or
 collar bone,  scappula,  or  shoulder blade, the os hu-
 meri or  upper  arm bone, the radius, the large arm
 bone, the ulna or little arm  bone,   there  are  eight
 bones in the wrist called carpi, the four bones of the
 hand are called  metta carpi &c.
   The bones of the lower  limbs  are the os femoris,
 or thigh bone, the tibia, or greater leg bone,  the fibu-
 la or little leg bone, patella  or knee pan.
    The foot is composed of a number of bones like
 the hand, the uprer part of the foot is called tarsus
 and is composed of seven bones called tarsi;  the foot
 is  composed nfk bone called mettatarsi, the largest
 of the  tarsal bones is called astragalus, and supports. 
                 A NATOMY:             Jp&&;

tfce tibia, and  is supported by the os  calcis or heel"
bone.
  Children are sometimes born with their feet  turn-
ed inwards, and without proper management are crip-
ples lor life, but  with right management and  care
may be brought to walk very well.*>—The only  way
is to make a boot or stocking of about  half taned lea-
ther,  have it well soaked, put it on  another  small
child till  dry, when the feet are to be placed right and
the boot  laced on  and kept on untill  it is able  to.
walk well, they are to be left open before and.a lace
put in.

  Dinases cf the bones.  The bones are subject  to
disease from other causes  besides breaking:   The.
roost common  is occasioned by white swellings ; it iff
doubtfull whether white swellings generally begin/in
the bone or  in the periosteum, and  by destroying
that corrupt the  bone,  but often begins in  the bone
enlargingit, and.corroding away the inside,this most
frequently happens in the jaws, it is called spina ven-
tosa.  when a  white swelling happens  on a hard bone
the diseased part is  easily made  to  separate,  but
when it happen in the spongy  parts it is more diffi-
cult to cure, and  it  is said  sometimes to  cause  so
great a discharge as to cary off the patint in epite of
all remedies, but  such a case I have never seen.
  Since  printing the  treaties on white  swellings I
have   had two cases  of that  disease in   the first
stages, both  were  resolved by giving a puke,  and
then giving small doses cf tartar at intervals of two
or three  hours thro the day, and apply ingwie James-
town poultice to the  part.
   The veneral disease, when of longstanding will af-
fect the bones with  nodes and  roteness, especially
the harder parts, as  the  bones of the  hands, arms,
head he. sometimes eroding the bone cr raising it up
i{i  knots which become crumbly like sand.
   There is a  disease mentioned by writers under the
 name of moiiter  osibus, that n, softness of the bones
in  which the bones loose their hardness and become 
[ao6]
c
soft like a cartilage, and the patient dies a miaerabU
death, as there has been no remdy discovered.
  The method of curing the diseases of the bones has
been pointed out under their proper heads; the main
point being in the dressing: a bone should always be
dressed with dry lint, or wet with spirits or lime wa-
ter only, if the bone be unsound it should be washed
with lime water or a weak lie, and toutched with blue
stone, greasy applications always foul the bone and
cause it to corrupt.

                  MUSCLES-

  Muscles are the different portions of flesh  which '
by contracting give the various motions to the dfler-
ent parts of the body, they terminate in tendons, or
sinews and are.connected- to the bones, or passing o-
ver a joint, connect two muscles together and the
size and number is suited to the different motions of-
the part.  About the neck  there are a vast number
which are employed in giving motion to the head, a
considerable number to the tongue, and still more to
the eyes—Such as serve to close certain orifices are
called spincter muscles, such are those of the mouth,
the annus, the neck of the bladder he. they are  cir-
cular and lie  round the part like a ring which by
contracting close the orifice.
  From what has been  said some idea may be formed
of the muscles but from the vast number which form
the body it is  impossible to  acquire an  accurate
knowlege of them  in general from any limited trea^
ties.
  The muscles are endued with a high degree of sen-
sation, and are subject to great pain in inflamation &c
There are some diseases which  cause great contrac-
tions of the muscles, many  nostrums are celebrated
among the vulgar for curing  these,'as ointments &c.
but the only remedy which I know of is to  cure the
disease upon which it depend;, and then the contrac-
tions scon goes off. 
                 ANATOMY.             [207]

                  TENDONS.

   From what has been said above it is unnecesary to
 say much upon the tendons ; they are the terminati-
 ons of the muscles which are given that form for the
 more convenient insertion in the bones, and for pass-
 ing over the joints ; they are scarcely subject to dis-
 ease  except from injuries.  It has been a question
 with some whether the tendons are  sensible or not,
 but any  person who  has a wound in a tendon will
 perceive  upon toutching, or cuting, a deep pain of a
 peculiar kind.

                 CARTILAGES.

   A cartilage is what is usually called gristle, they
 serve to cover the heads of the bones  at  the joints
 with a smooth white coat, and  also to connect others
 together in a strong, yet flexible manner, as the ribs
 to the breast bone  &c.

                 LIGAMENTS.

   Ligaments are of the same substance as the sinews
 and serve to tie the joints together and some  other
 purposes; there is a ligament which is inserted in
 the heads  of the bones and help to hold them together
while"  trie joint is mostly  surrounded with them,
when  a joint is dislocated the middle ligamen is com-
 monly broken and makes it always easier  to  be put
 out again.

                MEMBRANES.

   A membrane is  a thin strong substance that serve
 various purposes, but chiefly as a lining to the cavi-
 ties and to separate part9, as the muscles  which  are
 covered with a fine membrane  ; they  are generaly of
 a tenclinou substance: the following  are some of the
 principal  membranes. 
tao8j             Anatomy.

                DURA  MATER,

  Is a strong membrane that lines the inside of the
scull and saves the life of thousands  by preventing
Jujuries  to the brain when  the scull is  b.-okeu, it is
easily separated by a stroke upon the head, but join-
ing at the sutures passes through between the  bones'
cannot be separated there.

                PIA  MATER.

  Is a fine tender membrane  that cover, and closely
adhere to the brain, and penetrating  thro it,  divide
it into  lobes he.  A w6und breaking this is always;
Considered mortal, for however small, the brain will
continually keep working out until the patient dies—
Wiseman in his  treaties on surgery gives  an account
of a man who was shot thro the head that lived se-
venteen days, and walked a considerable, distance
on the fifteenth day but died on the seventeenth ho^
ling like a dog.

                   PLEURA.

   Is a fine, strong membrane which lines the  cavity
of the breast, and meeting in the middle  forms the
mediastinium, which divides  the breast in two parts;
An  inflamation of this membrane is  attended with
considerable pain,  and  is Called pleurisy,  sometimes
an inflamation of this membrane and diaphram is at-
tendedwith  considerable pain in the head, and has
been  termed by some of the ancients, head  pleu-
risy  and hence the term head pleurisy is applied by
the vulgar to every violent head ach:—The  strong
membrane which covers  the heart is called pericar-
dium, or heart purse.
   There are several  diseases of the  breast  besides
those mentioned, inflamation frequently  csuse the
lungs to adhere  to the  pleura, there  is sometimes  a
collection of water in the cavity of  the breast, and
is called hydrothorax he. &c. 
                  ANATOMY.

               PERITONAEUM.

   The strong-membrane which  lines the cavity of
 ,he abdomen is* called the peritonaeum^ it also inclo-
ses and covers the parts contained;
   A  rupture  of this  membrane  is a very common,
 troublesome, and sometimes fatal accident ; in men
 it generally happens about two or three inches above
 the os pubis, £ind on one side, being the place where
 the spermatic vessels pass out—in women  it is a
 more rare disease.   When a rupture first happens it
 may be pretty certainly cured, but the enormous ex-
 pence ot'nve or sit'dollars generally deter  the un-
fortunate patient from attempting any thing  more
 than present relief; this in  parents i3  unpardona-
 ble, especially when  it is known that in  children it
 can most certainly be cured.
   The only certain remedy is a steel truss made with
 a bolster to fit snug,  and  press  upon the part, and
 worn for a twelve-month or more; this will  scarcely
'fail to perform a permanent cure, but if it should fail
 (which it may if not employed ia time) it will be ne-
 cessary to wear it  constantly,  and by  habit it will
 soon come to be but little inconvenience.

                  OMENTUM.

   The fine membrane that hangs like an apron over
 the guts, is called omentum, or cawl, it is connected
 to the stomach, spleen, diaphragm-&c.  It serves  as
 a washer to prevent the  attrition of the bowels  a-
 gainst the peritonaeum.—it saves the life of many by
 sheathing  the point of a knife when stabecl.

           ARTERIES AND  VEINS.

   Arteries are  the blood vessels which  convey the
 blood from the  heart to every part of the body ; they
 are stronger, more firm, and whiter than the veins—
 they begin large at the heart  and  branch out until
 thev terminate incxtreemly fineves sells tr.l arc then
                     Bb
[>od] 
[sio]             ANATOMY.

called  capilarier., they  then unite with  the  veins
which receive the blood and convey it back to  the
heart:—The heart  is the center and  source of  the
circulation, and in all the hot blooded*animal« is dou-
ble and carries  on a double  circulation as follows—
  The veins meeting as they  proceed  from  every
part of the body form two large trunks which  enter-
ing the heart on the right side, forming the  auricle
or ear,  one  trunk is called vena  cava descendans,
and the other is  called vena cava asscendans—the
blood passing to the heart by these, is pressed  into
the ventricle, or cavity  of the heart, which contract-
ing force it into the lungs by the  pulmonary artery,
it from thence returns to the left auricle, by the pul-
monary veins and is pressed into the  left  ventricle*
which  contracting drives the blood out by the great
artery,  by which' it is distributed to every part of the
body, the aorta asscendans, (great asscending arte-
ry) leaves the heart at the upper part  and asscending
a short distance divides into two branches, one  con-
continuing its course upwards,  is distributed to hearT
and superior parts of the body ; the other branch de-
scending, commences aorta descendens, and is distri-
buted in the lower parts of the  body and extremities,
so that there is two circulations  continually going
on; by one the blood merely passes through the lungs
by the  other it »asses through every other part  of'
the body; by the circulation   through the lungs it
is charged with oxygene from the  air, which gives it
a bright scarlet color- which it looses before it re^
turns to the heart again, hence the blood from an ar-
tery moy always be distinguished from that of  a vein.
   The circulation of the blood was never understood
untill  about  the year 1619. Dr  Harvey  disCcvered
that it circulated as above, his discovery met  with
violent opposition for sometime, but by frequen expe-
riments was established past controversy ; this 'dis-
 covery has  effected a great change in the practice of
physician.:, but not so  suddenly as might have  been
 t:;pected,  a-d such  is ;;he powerfull'influence of cus-
 tom that mi'.ny  physicians to the present day, in ?
                             .IT 
ANATOMY.
[a»l
measure are governed by ancient customs which have
not the least shadow of rsason to support them.
  The ancients, and even some modern physiologists
suppose the blood to be alive, but if it possesses evi.
dence of life  more than the chyle, or aliments we eat,
I know not wherein it is to be discovered ; it appears
to me that the blood is  merly a vehicle to convey the
chyle into the system and as a fluid in which the dif-
ferent  material for  the  support of animation  is pre--
pared and applied—hence if blood  be drawn an hour
after eating a full meal, when the blood cools a milky
serum  will  be seen upon the top, in two or  three
hours more this fluid becomes yellow, and in an hour
or two more it intirely disappears, being applied to
the various purposes of nutrition he.
  The blood when  it returns from the lungs is  of a
bright scarlet color, and is said to  contain little bub-
bles of air, which I  suppose to be oxygene not yet
incorporated, hence they are  called arteries  or air
vessls,—the ancients used to  call  them the leaping
veins,  calling the wind pipe  only-an artery.
  The blood by the ancients was often'thought to be
in fault and the cause of disease, and such is the lan-
guage  of the vulgar to this day ( for there is scarcely
an opinion among the knowing vulgar but what  was
held by the ancients) but this is the case in but few
diseases,  except as a  veh.cle it may  cary noxious
gases into the system,  which even may act as a tain:
upon the  blood it self,  but whoever will attend to the
sudden changes which  frequently  take place  in the
appearance of the bleed, wiil  soon be convinced that
the diseases of the blood *is not very permanent, or
of long duration.
   In pleurisy, and other diseases of the lungs, the
blood, "upon  standing untill cold,  will have  the ap-
pearance of pus in  it;  in fevers, the gluten separates
and forms a tough  coat over  the  top, while the  red
part is of a darker color, and settlts to the bottom.
   An over quantity of blood, has  been considered as
 a disease or the  cause of disease,  and is  called  ple-
 thora—-this I think an error. 
i»]
ANATOMY.

 GLANDS.
  The gdancb are what is usuallv called kernels, the
liver, the kidnies, and the  pancreas  are the largest,
the glands  are very numerous, and found in almost
every part  of the body,  their use is to secrete  from'
the blocd  various  fluids, the liver secretes the bile..
the kiduies, the urine, the salivary glands the spiltls
he.  An artery, and a nerve supply blood and sensa-
tion,  while the gland  separates from  the blood  its
proper fluid.
  The liver is the largest gland, and is seated in the
right hypochondrium,  its office is to  separate an al-
most incorruptible fluid called bile, or gall, which  in
part is  deposited  in the  gall  bladder, from  which
there is a duct or passage leads to the gut and enters
it a few inches below the stomach ; another duct pro-*
ceeds from the li*/er and joins  it before it enters the**-
gnt.  Through,these the bile pass, and mixing with:
the aliment prevent it from becoming putrid before
the chyle be separated from it—The quantity of bile
stcreeted by the liver in a given time is intirely un-
known, but some suppose that a pound  and an half
may be secreeted to every meal we eat, but this  I am
inclined to think too  large a  quantity—There is a
round cord that goes  from the navel to the liver
which it enters at a small slit at the lower edge, this
was the artery and vein which conveyed  blood,  to
and from  the child while in embryo, but now be*
ing  no longer of use forms a simple cord.1
   The liver is supplied with blood by a vein instead
of an artery, it arises from all the branches of the cctf-
lic,  ( an artery that puts offjust below the diaphragm
and is distributed to the pancreas,  spleen, stomach,
liver, he.) except those of the liver, which uniting,
form a large trunk,  is called vena porta, it then enters
the  liver and is  distributed to every part, and has its
blood collected and brought back to the cava by its
venous branches in the liver.
   This vein carrys the blood into the liver like an
 aite'y> but not with that violent impulse with which
 
                 ANATOMY.              [213J

  is driven by an artery ; it moves slow, is black and
 nick, being deprived of its oxygene before  it per-
 orms its enTrce in the liver.
  The diseases of the liver are, inflamation, scirrhus
and an obstruction  of the bilary duct producing jaun-
dice.
  Pancreas,  or  sweet-bread, is  a very large  gland
seated in the back  part cf  the body just below the
diaphragm ; it has a duct  that enters the  gut not far
from that from the  liver, by which  it passes a large
quantity of fluid to  the guts which dilute the aliment
An obstruction of this duct by scirrhosities would be
attended  with  great  and obstinate  costiveness.—
   Kidnies the kidnies  art seated in the back  about
the insertion of the short ribs,  one  a little  lower
than  the other:— Their effice is to separate  the 11-
rine from the blood, which is then  conducted to the
bladder by the ureters, which are  tv/o small  tubes,
of  the size of a goose  quill, they enter the bladder
near the neck—One of the most painfull  diseases to
which mankind is  subject if, the descent of a  stone
through these to the bladder.
   Renal glands. 2re two ghr.ds  seated a small  dis-
tance  above the kidnies ;  thcjr use  is unknown, they
are nearly as  large in an infant as an adult,  from
hence it appears probable  that  they are  orly of  u?e
while in embryo—they contain a sooty black matter.
   Salivary glands, are seated under the tongue, j«\vs
 &c. and a larp-e one under each  ear, called  the paro-
 tid glands, they are of tie kind  called corg'on t • ate.
 beirg composed of a great many small ones, (a g!s; d
 composed of but one bedv  beirg called  cr rgh Laic)
 these glands secrete saliva ,v. hich they pour into  ti;e
 mout,h b« their prrper duct:—a {cntagicus  (i'scate
 of these glands U called the mumps".
    When  an obstruction  happens  in  si-.y  cf these
 o-lands a  tumour is formed remaining z. substance ve-
 rv much  like the  wh tc cf an egp—They  :;re very
 d'iiTcult to cure fo as  t^ prevent it  frc m  returning a-
 ;>in without destroying the  gland  with caustic* 
[2i 4]             ANATOMY.

  Tonsils,  cr, almonds  of  the  ears,  arc  two small.
g'.ar.ds,  one on each  side  oposite  the  rapt of  the.
tongue ; they are about the, size of an hazLe.r.ut,  but
frequently larger, they have an opening on the inside
which nay be seen by inspection thro  which they
disch.<ri;e saliva—These glands are very subject to
inflamat'on from cold, alum held in the mouth is then
of service—They are also subject to  a  disease  of a
different kind, in wdnich they gradually  enlarge, the
only remedy  is extirpation.   I  once had  a patient
who had been troubled wich this disesse for several ■
years; from the root of the tongue half way to the tip
and down the windpipe as far as I could see was co-
vered with goblets of fat, I cut it  all out as far down
as I could reach, as also the tonsils, but it soon grew
out again and choak^d him to death.
  Lymphatics  Are the  glands  situated  about  tht-j
large blood vessells and in the groins and armpits-  *
  The  diseases of the glands are chiefly two, scir-
rhus and struma, or kings evil, called also schrophula,

                  LACTEALS

   Are so called from lac, being the name for milk in
latin, frenn the appearance of the fluid they contain,
being of a milky appearance ; they begin in the smalldj^jk^.
guts, and pass thro the  mesentery  [the  membrane
which connect the guts together and tie them to the
back] and then uniting  become larger, enter the re-
ceptaculum chyli, cr the receptacle of the milk [from
chyle, milk in greek] their  office  is to drink up the
fluid substance of the aliment intended for the nutri-
 tion, and  support of ihe body—The receptaculum
 chyli is a little sauaabout two thirds of an inch  long
 a'nd one third thi«J?v. hen empty, from which there is
 a tube, called the thoracic duct,  which  passing thro   '\
 the diaphragm close  to the back,  it proceeds up be-
 hind the pleura,  proceeding up, it by several turns,
 enters  the subclavian vein on the upper and posteri-
 or part—it has a number  of valves in it to prevent
 the chyle from passing back again. 
ANATOMY.              [115]
                   LUNGS.

  The lungs  are  divided  in  two lobes, one on each
Side separated by the  mediastinum,  which is  only a
continuation  of the pleura.
  The asperia artery, or wind pipe d'vid :s off into.a
vast nu noer of little b^anches^ and beiig -ubd'v .Led,
form an infinite number of little  air  ceils winch are
inflated, or blown up at every inspiration, a quantity
of moisture is thrown out, and a quantity of oxygene
absorbed, and mixes with the bhjod and carried into
the system to answer some importance purpose in the
process of animation.
   "^|e lungs are very subject to disease, and particn-
larly'fcefisiimptiorv, one  of che mogt obstinate, and fre-
quently fatal— I once  opened a  man that died of a
 cosumption of the  lungs, in whotne the left lobe was
 intirely wasted,  and what cavity "there was, was in-
 tirely full of puss ; the pericardium, or heart purse
 was half an  inch  thick, and  adhered to theheart,
 both the heart  and pericardium was of a white,  ani
 spongy texture, there being scarcely any appearance
 of muscular texture about it.  It was surprising that
 •a person should live  at all in such a state : the heart
 is one of the mo-t  sensible parts  of the body, it  is
 highly sensible  to the  'stimulus of the blood, the pas-
 sions make  a very sensible impression upon it, parti-
 culiarly  sexual love and anger, increasing the stroke
 both in number and force.

             ALIMENTARY CANAL.

    Oesophagus,  or gu'e», is the berirung, it is  nothir.--
  different from that of brutes, and therefore needs no
  description.
<   Tl|e storhiach is seated just undb-r the diaphragm op
  the left side, and somewha-.'rose idoler. an <..::, but '«
  lon~;r in proportion, and cm,<W., hollow on  the upcr
  side like a now wh.-r? the swallow erle;-* and the g'-.t
  come? out.   The orifice where the gulet enters h
   -ailed cardi, and N.-ncc t\e d"nease c-umoHy calk'-1 
{lUiJ
ANATOMV.
heait-burn or carditis, from its lying just under tbt
heart:— The orifice where the gut come* oit is call-
ed pylorus, the gut is than calleu  daode mm, there b
a valve near the mouth which prevents thj aliineil
from returning, but in ruptures and in vomiting, »
gives wa/, a.ii the caceius  of the whole intestinal
canal is rejected by the mouth.
   After duodenum the guth Called jejunum, from its
being found  almost  always  empty, it is  then  called
ilia, and  lies-below the navel, the  jejunum  lying  a-
buv,\ and about the navel.
   Caecum or, blind gut,  where it enters the colon,
which is near the begining,  it is not larger than a
pipe stem.                                   ^
   Colon, is the great gut, it begins at the uppe'f*edga
of the right hip bone (os ilium,)  and after ascending-
untill just under  the stomach, it then turns to  the
left it descends in$o the  pelvis.  Rtcturii, or straight
gut, is a continuation of the colon down  to the anus.
   Mesentery,  is the membrane  which  begining od
the loins about four  inches  wide is extended to th«
whole length of the  guts, which  is generally about
thirty foot long, it serves to hold  the guts  in their
proper place, and  for the  blood vessels,  lacteals &c,
to  pass  by.
                                     »
              NERVOUS SYSTEM.

   We now come  to describe  the  seat and  sourse of
 the vital principle ;  the brain and  nerves.
   All the parts hitherto described  are ass:gned theiV
proper  offices in the system, and  are  well  under-
stood, but vhether the brain and spinal marrow, is
of the nature and office of a gland,  ai-.d secretes some,
fine etherial'fluid, called animal spirits, which  like
a participle,  or medium join ap immaterial, thinking
being, to the material system, or body :  Or whether
it is. a  portion of duly  organised matter,"aud- kept
in  a state of sensibility, by  some kind  of annimo,
chemical process, which is continually  going o.:, is
a  deubtfull problem among  nietapbvsicians;  A[  s,-9
m 
V                  ANATOMY.             [a 17]

'• V            *                                ==*
    know is,that ceriain processes are continually going
    on in tne other parts of the system, and are necessa-
    ry to-supply the  wajte,  a-id  keep the  different
    parts in a proper  state  for the  vital  function",
i    hoc if any such thing as  secretion is performed the.
    matter secreted is  imperceptible to our senses,'but
    that  the brain is the source of sensation and thought
    is  easily  demonstrated  by many experiments, and
    that, that power or property does depend upon a due
    organization of parts, but  what the  particular mode
    of being in  the ultimate particles ofthat system  or
    oigauised state is, we know  no  more than we do of
    the mode of existence of that being who is the origi-
    nT fountain, or source of ail life and being,  or the
    difference in the ultimate particles, {if such there
    be) of all other forms of matter.
       The* brain is divided by thin membranes into six:
    parts, the  two upper are hemispheres, and are called
    the  cerebrum, the four lower called the cerebelum-
       'Wounds in the uppjsr part do not always cause in-
    stantineous death,  but  a wound in the lower, howe-
    ver  small cause suden death.
       The brain appear to be  composed of two parts, an
    outer, and an iner;  the outer is called the cortical,
    (from cortex,*bark) and the ine^ the medular part—
    From the iner part arise a number of fine, white, soft
    threads, and are called nerves, and after leaving the
   . brain  become more firm  and strong: there are ten
    pair arise frrfm the,brain within the scull, and thirty
    pair from the spinal marrow, those of the head are
     called encephalon i. e. of the head—The  first of ths
     ten pair are called the olfactory, they go to the nose
     and furnish the sense of smelling, the second pair
     crosses  each other and go to the eyes, and are spread
     in the bottom of the eyes,  forming that fine  black
     membrane called the retina, these are called  the op-
      tic  nerves, and give the sense of seeing; another pair
      go  to the  ears and furnish the sense of hearing, they
      are called the  auditory nerves, others  pass to  thd
      tongue, face &c. those which leave the spinal mar-
      row go off on each side,  and are ditributed to every
                          C,c 
£*i8]             ANAT0MT.

part of the body.  -
  By pressing upon  a nerve for tome time, the  ^
to which it gives sensation becomes numb, as in i*
ing in a position for some time in which the nerve is
compressed/ the leg becomes numb, and is slid to be
asleep.  .
  The nerves, altho subject to disease, seldom she^f
much signs after  death, the diseases of the nervous
iystem, like those of the mind, in which it is ofte&
only apparent, are invissble—-The diseases  of this
•ystem of vessels,  or whatever  they may be  called,
are various, and are treated of under the title of nerv-
ous diseases) which see.
fINI|
1*  '

 
 INDEX,
        TO
THE  WHOLE.
A
                Page
    BORTION,   163
Aloes,              6
Alder bark,        15
Alum,             20
Anatomy,     103
Apoplexy,        144
Alimentary canal,  215
Ammoniac, salt,    46
Animal poisons,   158
Arsnic,            49
Astringents,         19
Assafoetida,         42
Ascites,          X16
Asthma,          150
Arteries & veins,  ao6
Apthts,            177
       v  b
Bark, Peruvian,
Bark, Alder,
'Bark, DogwOod,
Bark, Oak,
Balsam copaivi,
Beaver sjtone,(Castor)43
Bites,          < >*199
Blistering plaster,    53
Bleeding,           62
Bleeding at the nose 109
—From the lungs,  119
 Brain, ind. of,      7.8
11

3
41
Burns 8c scalds,	l9$
c -'	
Cachexy, see dropsy	
Calomel, 4	a*
Castor,	43
Castor oil,	3
Camphire,	44
Caustic, common,	5«
Lunar,	5*
Carbonated lime,	.54
Catarrh, or cold,	106
Cancer,	189
Cartilages,	107
Cholera morbus,	98
Child-bed Women,	165
Chin cough,	15*
Children, diseases of,	173
—Vomiting St lax,	»74
—Worms	?74
—Inflamation of	
the breast - •	178
Cram p Colic	'\% ,fH
Convulsions	166
Consumption	129
Croup	IO?
Ceruse	49
Cinnamon	45
Copavia <r.	.41
Corrosive sublimate	aS
 
Txio]
INDEX.
	Page		Page
Cream of tartar	3	Gangrene.	298 k
Columbo root	U	Galls,	J9
Cramp of the stomach,		Gout,	102
	"156	Glauber's salt,	2
D		Gleet, ! see vene.-	
Dance, St. Vitu's	146	Goribrrhccea j real	dis-
Diabetes,	114	ease.	*
Diarrhoea,	P7	Gum guiaicum,	43 j
Diseases of women,	160	Glands,	^12 /
——of Children,	17a	** '& „	<-r f
Dogwood bark,	*T	Harts-horn, *v^.-j	46
■Dqses, standard for5	57	Hemlock,	36
Dropsy,	i»5	Hemorhages,	IOO
■ of the breast,	118	Heart, palpitation of 147	
of the head,	119	Hydrophobia*	I58
———of the belly,	116	Hypochondriasis,	lr
Dura mater,	218	Hysterics,	14-
E		I	
Emetics, 7	—10	Inflamation 1 of the brain, J	«
Emplasters,	5l		79
Elm,	5-	----Pneumonia,	80
Erysipelas	105	----of the Tonsils,	-8a
Epilepsy,	145	----of the Stomach	» 9°
Encanthis,	192	----of the Bowels,	9l
F		.........of the Liver,	?2
Flies, Spanish,	39	----of the Kidnies,	94 f
Fox glove,	47	Inflamatory tumors,	179 <
Fevers,	65	Influenza,	106
——method of cure in,7a		Incontinence! of urine, j	
——Typhus,	76		114
—<—Scarlet,	77	Incubus, or! night mare, j	_*_!_
■pr—Purperal,* ,	166		*51
J-—Intermiting,	7*	Ipecacuanha,	10 *
Fluxes,	96	Iron,	*5 .
Flooding,	162	: j	J '*
Fly-wing,	192	Jaundice,	134
Fractures, *A-	199	Jalap,	1
Fluor albus,	178	James town weed,	3*
>VQ		K	
Ganglions,	193	Kine pox,	38
 
Xings evil,
           L
Lacteals,
Lime water,
Liniments,
Lime, carbonated,
Lientery,
Lquid measure,
Ligaments,
Logwood,
Lead, sugar of,
Lead, white,
Locked jaw,
Lunar caustic,
Lungs,
Luxation of !
the shoulder J
&
INDEX.
 Page
 121-  Nitre,
      Nettle rash,
 314  Nervous diseases,
  22  —System,
  54            O
  54 Oak bark,
  97 Oil, Castor,
  $5 Ointment, mercurial,
2©7 Oil of turpentine,
  19 Ointment of sugar !
21 of lead,
s
Page
  48
 ■°5

 3,16

  18
   S
  28
  41
  53
 49
151
 5?
214
200
    o(f the shoulder,  201
----of the elbow,     ib.
    ■of the. hip,      203
           M
Mad  dog, bite of,    158
Magnesia alba,       23
Mania or madness,  149
May-apple root,       5
Malignant soe throat, 82
                     55
                     84
                    137
                    161
                    162
                    171
                    159
                    207
                     24
                     28
                     29
                     28
                    ao6
                    198
}
Measures,
Measles,
Melancholy,
Menses, suppres
sion of,
—difficult,
     ceasing of,
——retention of
Membranes,
Mercury,
----Ointment,
     yellow,
———corrosive subl.
Muscles,
Mortification,
—of resin,          5J
Opium,             30
Opthalmia,         194
Omentum,         209
          P
Palsy,  (           143
Palpitation  ">
of the heart, J      X4'
Paronychia,        192
Peruvian bark,       11
Peritonaeum,       209
Pill, mercurial,      27
Phrenzy,            79
Pia mater,         ao8
Plaster, sticking,     52
t-blistering,        53
Pleurisy,            80
Pleura,            ao8
Pox,  small,          86
—Kine,             88
Precipitate, red,     29
Purgatives,        1—6
Pterygion,         19a
—on  the eye,       195
Preparations,        51
Polypus,           191
Pleura,            208
Pneumonie inflamation8«
          Q
Quinzies,            8a 
>V
fi^a]
R
INDEX,
P«ge
Rfeeubarb            5
Rheumatism.        99
Red gum,          178
Regimen,           59
Red precipitate,      29
Rickets,           1 ao
Ringworms,        199
Root columbo,       14
----Snake,          43
—1—Mayapple,        5
Rosin plaster of,     53
            S
Salt, Glauber**        a
—Petre,            48
Sal. Ammoniac,      46
Salves,              51
Sassafras,           45
Scarlet  fever,       77
Sehrophula,        iai
Scurvy,            133
Scirrhus,          185
Scald-head,        195
Small pox,          86
Snake root,         43
Sore eyes,          194
—fforoat, malignant, 8a
Spanish fiies,        $q
Stramonium,        36
St. Vitu's dance,    146
Stone, or gravel,    135
Sticking plaster,     52
Stimulants,-        34
Sublimate, corrosive, a8
Sugar of lead,       21
w-j —ointment of,    53
Sup. of the menses,
Surgery,
Swelling, white,
          T
Tartar, cream of,
Tartar enjptic,
Tetters,
Tendons,
Tetanus,
Thrush,
Tonics,      •» '
Turpentine," ...
Tumours,
          V
Ulcers,
          y
Paer
 ^i
 179
 I8f

   3
   7
 *94
 207
 151
 177
   it
   4.1

 x8»
Venereal diseese,    xa$
Vitriol, blue,       *"  ^0
—white,            40
          W
Water, lime,         %i
Warts Sc Corns,     193
Weights & measures, $$
White Vitriol,
White lead,
White walnut,
Whites, in women,
Women, diseases of,
Worms,
Wood, log, or !
campechense, J
Wounds,
—contused,
          Y
Yellow  mercury,
 49
  ib
  5
178
i6e>
J74

 19
196
X97

 *9 
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