THE

 b    I    S    E    A   S    E
           INCIDENT   TO

 ARMIES,
              WITH   the
 METHOEi   of  CURE.
       Tranflated from the Original  of
 Baron  VANSWIETEN
 Phyfician to their IMPERIAL  MAJESTIES.
              To which are Added ;
 The nature  and  treatment,
                     of
 GUN-SHOT  WOUNDS.
 By JOHN R ANBY, Efquire; Surgeon genera^
       to  the BRITISH  ARMY.
                   Likewife,
 <OME  BRIEF  DIRECTIONS,   TO  BE
      OBSERVED BY SEA  SURGEONS
           IN  ENGAGEMENTS.
                    Alfo,
  PREVENT AT I V E S of the 8 C U R V Y at S 2 A.
By  WILLIAM NORTHCOTE, Surgeon,
 M A K Y  YEARS  IN  THE  SEA-SERVICE.
Puonihed>  for theUfe of Military, and Naval Surgeon
 ________    IN  A M E R I  C A.

          PHILAD^% P^I I A:
Printed,  and Sold, b/*JL BELL,? in  Third-Stres',

 

f 
The AMERICAN EDITOR,
     to  the  PUBLIC.

A GENTLEMAN of the Faculty
     in the City of Philadelphia, who
     was  one of  the  Surgeons,  in the
Military  Service laft  War; and who  is
defirous  of affording  every  help  in his
power, towards a fuccefsful termination of
the prefent American Meafures, for the
Defence of Liberty.  Being of opinion,
that  the Publication  of  the   following
excellent  Traces  will  be  attended   with
the moft falutary influences,  in the pre-  j
fervation  of  the lives  of  many of  thofe
valuable Citizens of  America, who,  as
Soldiers  and Sailors, are now  contending
for the mighty Prize of Freedom :  And |
would at  the fame  Time, communicate
worth and dignity to  the Military and Naval •
Practitioners in  the  Art of Healing,  was *
generoufly pleafed to beftow? and recom-j
mend it  to the notice of the Editor,  whok
humbly  apprehendeth,  that the intereft of
the Public, will  be   truly ferved  in thejr
purchafing, as well  as his private  intereft i
 in felling, and  by fuch favors  which reci-
 procally gratify, the obligations are,  at tht
/ame time, fettled and  continued.
                                       i 
 Lately Printed, and now Selling by ROBERT BELL,
       in Third Street, PHILADELPHIA.
                (Price Five Dollars.)

 LECTURES

                  ON   THE

 MATERIA MEDICA,

             AS  DELIVERED

   By WILLIAM CULLEN, M.  D.

 Profeffor   of  MEDICINE  in  the  Uniyerfitj
             OF  EDINBURGH.

    Now Publifhed by Permiffion of the AUTHOR,

 And with many CORRECTIONS from the Collation of
<      different MANUSCRIPTS by the EDITORS.
)
      N B.    The  whole  of the  European  Editor's
  EMENDANDA.  which they inferted at the end, is
\ carefully  inferted at each proper place, throughout the
 i body of the Work,in this  American  Edition.
          M E M O k A N D U M.
This excellent Work, contains the very cream of Phyfic,
  and is abfolu'.ely neceffary for  all American Phyficians,
  \vho  wiih to  arrive at  the top of their Profeffioii.' 
THE    PREFACE

              TO   THE

   DISEASES

          INCIDENT  TO

   ARMIES.

     THE great and frequent inconvenience?
      attending a military  life, are of fuch
      a nature, as to make the greateft ha-
vock  even among  the moft robuft confti-
tutions.   It is  not, therefore  furprifing,
that an Army is  feldoirj or ever without a
great number of nek.
   Neverthei.ess, it has been obferved,
that the diftempers moftly prevalent among
the Troops are  not in number very confi-
derable.
   We have,  for  this reafon, thought  it
fufficient  to fpeak of thofe, who(e attacks
the foldier is  moft fubjecl: to, to  defcribe
them in fuch a  manner,  as  they may be
diftinguilhed from one another by certain
figns j and at  the fame time to give an ac-
count of fuch fymptoms as charaderife the
decreafe  or increafe of each diforder; and
laftly, to  fpecify the medicines  proper for
the cure of the fick, and the  diet  they arc
fo obfei ve«                   %
                                     It 
     6      PREFACE.'

       It will be percefved, that, in our little
     Effay on this  fubjea,  it was equally pe-
     cefiary to  be fhort,  and to  endeavour  to
     avoid being obfeure.
       This Work, however, no wife regards
     the Phyficians, who, mafters of their art,
     and in daily pra&ice, ftand in no need  of
     the afliftance of thefe firft elements.
       But it often happens, in an army,  that
     the number of fick is  fo great,  and they
     are  difperfed in  fo many different places^
     that it is impoflible the phyficians ftiould
     go every where, and give their attendance
     to each individual.  In  fuch  cafes, necef-
     fity obliges the fick to be entrufted to per-
     fons who cannot  be expected to have the
     fame knowledge with thofe of the profef-

*      For  the ufe of fuch practitioners,  not
     fufficiently instructed,  this  fmall Tract is
     defigned, that, by the figns  exactly defcrib-
     ed,  they may underftand the nature of the
     diftemper,  the conduct they are to obferve,
     and the remedies proper to be administered.
        At the end  are inferted  the Recipes or
     prefcriptions  referred to in  the courfe of
     the Work.  They are  rendered as fimple
     as partible, and preference given to thofe
     medicines that are eafitft  to be procured,,
     and e*iieft to be prepared.
                                           Jt 
       PREFACE.      i

  It may not be  amifs. to  premife fome
obfervations, by means of which, ficknefs
may in fome degree be prevented, and the
health of  the  foldicr preferved*   We are
fenfible, that,  in time of war,  it is not al-
ways poflible to obferve exactly all what we
are going to fay j  but  it cannot but be of
ufe to know what is  moft  advantageous,
that it may be put in practice, at lead when
circumstances permit.
   Firfi.   The foldier frefli lifted, and torn
at once from his family, no  fooner lofes
fight of his village, but he becomes melan-
choly ;  and  tho'  a  robuft  hufbandman,
finds himlelf fcarce able to bear the fatigues  ,,
and  inconveniences of a military life.  It
were to be wifhed, that he could be ufed,
little by little, to this new kind of life;  but
in the mean  time nothing  is better,  than
to  procure him all  kinds  of  amufement
and diverfion.
   Second.  Garden fluff and frefh%eens
are a wholefome nourifhment for the fol-
dier j ripe fruits are equally good, and never
hurt but  by their abufe j but unripe  and
acrid fruits are very hurtful.    The ufe  of
garden ftuft and  fruit  prevents the  fcurvy,
and even cures thofe  already attacked with
 it.
   Third.  The choice  of water  is effcn-
                                     tiah 
    8       PREFACE.

    rial:  If there is  none to be found  abfo-
    lutely pure, the preference  is to be given
    to that  lead  loaded  with heterogeneous
    parts.   There is an eafy way to  diftingaifh
    water that  is  pure, from that which is lefs
    fo,  by means ofoleurti tart art per deiiquivM,
    If you let fail a few drops of this in a glafs
    of water, if not pure,  it becomes inftantly
    thick, and  milky, whilft the fame opera-
    tion produces only a  frnalt cloud in  that
    which is more pure*
     River water mould not be drawn near
    the banks 5  that which is in the middle of
    the ftream  is  always belt.
     Sometimes,  indeed,  Troops are re-
   duced to the fad neceflity of drinking bad
   water; in which cafe it may be  much cor-
   rected, by  mixing  a  certain  quantity of
   vinegar.   Six  ounces,  mixed   with  three
   quarts of water, will render the  drink even
   more agreeable.
     The  water  may alfo be rendered lefs
   hurtful by fteeping in it fome pieces of the
   root of the calamus aromaticm.  This root is
   found every where, efpecially  in marfhy
<   places, where commonly the water is worft.
     Fourth.  The  foldier ought  to be well
   clothed and covered ; his  fixes  of a thick
   and  ftrong  leather,  and  the thread they
   arc  fewed  with well  covered  with wax :
                                         If 
PREFACE*
if all the feams could be well waxed the
water would be prevented from penetrating.
   Fifth.  JPamps ought to be pitched on
a  dry  fim, fls much  as  pofiibie.  That
which$f$pears fuch is fometimes quite the
reverfekbecaufe the waters are but at a little
diftanwbelow the fur face.   It is, however,
very eafy  to  know that, by digging the v
ground, or even merely by examining the
wells of the neighbouring villages
   If the water is high in the wells, the*
foil is  damp, sNif the water is  low,  the
foil is dry.
   It would like wife be proper to avoid the
neighbourhood of  thick   forefts;  they
prevent the wind  from penetrating,  and
render  the  air of the circumjacent  parts
damp and clofe.
   Bur if there is a neceffity of encamping
In a di\mp ground, the foldiers muft* have
their  ftraw  changed  oftner  than  ufual.
The cfiicers will  be  much benefited bjf
fpreadiog a waxed cloth undet their bed.
   In times of rain, the tighter the tents
are extended, the lefs it penetrates: fmaH
trenches  dug  round  the tents  contri-
bute to the drynefs  of  the  fpot where the
foldier lies,  becaufe they receive  the water
that falls from above.
   Sixth.  When  an army remains long
                                      in
                   B 
PREFACE.
 In  the fame camp, the unwholefome ef>-
 iluvia from fo many bodies always occafion
 ikknefs,  unlefs there happen to be violent
 and  frequent winds.  Thefe  ejahalations
 are moftly to be feared in  a hot and moift
 air.   The  changes of camps  oqgthis ac-
 count, contribute much to the  health of
 the  foldier,  more efpecially  when  the
 bloody flux  prevails.   Hence  arifes  one
 reafon the more for  avoiding the neigh-
 bourhood of thick forefts, which prevent
 $he free paflage of the  winds.
    Seventh.  Nothing is more prejudicial
 to the foldier, when  heated with  work,
 than to  ftrip,  expofe  himfelf to the cool
 air,  and greedily drink cold water,  and ef-
 pecially well-water, which commonly is
 very much fo.  River water is lefs huriful,
 as the rays pf the Sun,  to  which it is con-
 ftantly expofed, prevent its being fo cold.
    Eighth.  Care rauft be taken, duiing
 the  great  heats, that  the foldier on duty
, mould remain  expofed to the heat of the
 Sun as little as pofljble, and that he  avoid
 ileeping there.  1 he  cuirafliers^ efpecially,
 when once their cuirafs is thoroughly heat-
 ed,  are thofe who fuffer moft by the fun.
    'Ninth.  Neatness connot be too much
  infiftcd   on.   Let  foldiers    frequently
  Wa§* their hands, their face, and their feet;
                                     and,. 
PREFACE.
and, if the feafon permits,  let them bathe
as much as poflible in running water.
  Tenth. GrI at care ought to be taken not
Jtolodge mWy men together in a fmall fpace;
and if it cannot be  avoided, let the air be
at leaft renewed as often as it can,  whether
thofe who lodge together are in health or
ficknefs;  for from  hence arife  the moft
<kngerous, and even  the  contagious  dif-
tempers.
   Eleventh. The bread ought to  be well
baked, and made of good and pure flour;
for it is certain, that  very  dangerous  dil-
tempers are occafioned by mufty or fpoiled
f}read.
0 r 
THE
  CONTENTS.
                                           Page
    PR E F A C E by way of INTRODUCTION,     s
      Of COUGHS,           '•■*           14
 Of a Sore THROAT,-            \..         15
 Of the P L EUR IS Y,                       19
 OfaPERJPNEUMONYi     A        37
 Of the RHEUMATISM,andRHEUMATl|l>AiNS, 39
 Of Intermitting FEVERS,                   44
 Of Spring  INTERMITTENT S,         46
 Of Autumnal INTERMJTTENTS,       5 j
 Of Quartan FEVERS,                      55
 Of the J A U N D I C E,                       56
 Of the D R O P S Y,                          sg
 Of V O M  I T I N G,                         ^
 OftheCOLERA  MORBITS,             6e
 Of a  DIAR RHCEA,           .           gy
 Of the D Y S E N T E R Y,                     66
 Of an Inflammation of  the INTESTINES   7?
 OfthePHRENZY,                           *
 Of the Haemorrhage of the N O S E,              to
 Of a continued FEVER,                      g^
 Of the SCURVY,                           g
 Of the GANGREtJE,                      J?
Of the  LUES  VENE RE A,               o?
 Of the I T C H,                              q
OfWORMS,                              ~
RECIPES  or  PRESCRIPTIONS,    ,0?
Extracts from   Northcote,  Ranby,  and  Lind,
            On the  following Subjects.
Of WOUNDS of  the  VEINS, ARTERIES
  NERVES, and TENDONS,  with obfervation.  „J
Of G U N-S H O T  W O U N D S, their Nature and
  treatment; -.-ith obfervatfons.
DIRECTIONS  for  SURGEONS,  prev'i-
  ous  to, and in E N G A G E M E N T S
PREVENTATIVES of the SCURVY at  SEA.    ,J
RULES  for preferving  HEALTH,  i& WARM
  andCOLD  CLIMATES..             ,JJ 
OF   THE
D   I  JS   EASES

              OF  THE

      A      R      M      Y.

  IF the troops encamp in the fpring, efpeci-
     ally early in the feafon, there  will in*
     fallibly be many fick.  The Difeafes,
that principally prevail  at  that  time, are;
very troublefome Coughs, fore Throats,Pleu-
tifies, Peripneumonies, and Rheumatifms.
   These Diftempers, tho' not contagious,'
do not admit of much  motion in  the Pa*
tients, wherefore  it fhould  be endeavoured
to have the Hofpitals nigh hand, and, if the
ftate of the Diftemper requires it,  to bleed
the Patient, before he be moved, the delay
of which may produce very troablefome,jC£
confequences.                            WK
   Sometimes alfo intermitting Fevers pre-
vail during this  feafon, but they generally
are lefs obftinate  than thofe that happen in
Autumn.   In  Spring they are commonly
Tertians,  or Quotidians, but feldom Quar*-
tans,   unlefs  in  thofe fubjects,  who have
been  before attacked during  the  Winter,
and in whom, properly fpeaking,  they are
only Relapfes.
                 C             COUGHS 
  14      DISEASES


          COUGHS,.

      COUGHS are more troublefome than
       dangerous:  but if they continue any
       of time, and are neglected, tfiey fome-
  times degenerate into a Pbthifis Fulmonaliu
     Let the Patient make  ufe of the receipt
  No.  i. for his common drink,  and drink it
  luke-warm ; it will  be of fervice  to add a
^fourth  part of new milk.
     The Patient  muft  abftain  from wine,
  from fait and acid food.   Rice, and barley
  broth,  and new  milk, with the yolk of an
  egg,  will be fufficient nourishment.
     If the Cough becomes  too violent and
  troublefome, fo as to   prevent the Patient
  from fleeping, he may take the prefcription
  No 2.
     If the Cough is attended with a Fever,
.'^bleeding will be neceflary to prevent an In-
  flammation,   which is  then to be appre-
  hended.
    When the Cough diminifhes,  and the
  excretions, which before were without con-
  fidence, become  thick, and are  eafily ex-
  pectorated,  the diftemper is at an end.
Sore 
          er  the   ARMY,      15
                               V
        Sojke  THROAT,

  IF the action either of fwallowing or reffri-
   ration  fufTer an impediment,  attended
   with fenfible pain,  and the caufe is in the
neck, or throat, the diforder is called a fore
Throat, (Angina.)
  It is  a  very dangerous  diftemper,  and
fometimes even mortal; it is known to be
fo,  when refpiration is greatly  impeded,
the  voice extremely  fharpcned,  and the
anxiety very confiderable.  A large bleeding
is immediately  requifite, and cupping gjaf-
fes are to be applied, around and on the nape
of the neck, which often give inftant relief:
the drink  No. 1. muft be kept constantly in
the mouth warm ; and  the poultice No. 3.
applied, and  continued  hot  on the neck,
night and  day.
  If the Patient can fwallow, let him  takf
every hour a cupfull of the drink No. 1. made
hot,  with  the  addition  of  tw-"*ity grains of
purified nitre to each  pint.   If the rednefs
appears on the neck or breafl,  the  Patient
often recovers.  Otherwife  this Difeafe  is
frequently mortal;  but  it  is not common.
The following fpecies is  much more  fre-
quent.
  One  of the  tenji/s, grows  red, fwellcd,
                                     and 
16
DISEASES
 and painful, and  the  pain commonly ex-
 tends itfelf  to the internal  part of the ear of
 the  difeafed fide.  In a day  or  two, the
 Difeafe attacks the gland of the  other Jide,
 while  the fwelling  difappears from that
 which  was  firft affected.   Sometimes the
 pulfe is hard and quickened, and  fometimes
 not at all
   In the firft cafe,  the urine appears of a
 deeper colour than it is in health  ; bleeding
 is then neceflary; and if the rednefs, fwelling
 of the throat, and difficulty of breathing do
 not give way, it will be proper to repeat it.
   In the  fecond cafe, viz. if the pulfe is na»
 turalf there is no necefiityfor bleeding, un-
 lcfs the Patient be of a replete habit.
 •  The nourifhment muft  be reftrained to
light broth, to which may  be added rice or
 bailey creqpt.
   Let the  Patient  take  a tea-cup of the
 drink No. 4. every hour,  warm,  unlefs he
 fleeps:  and let him often keep in  his mouth
 fome of the medicated tea, No  5.  warm,
 with which he is alfo to  gargle his  throat.
   Next  day let him  be  pureed with the
 draught No. 6. which, if the diforder does
 not abate,  he may take it  again  after two
 days, continuing,  in the mean time,  the ufe
 of No. 4. and No. 5.  till he  can fwallow
                                    freely 
op   the  A R  MY.
*7
freely,  and the  rednefs hath  difappeared
from  the  infide of the throat.
   If ihe diforder has continued too long, be-
fore relief was applied, or the inflammation
is  too eonfiderable, (to give way,)  fuppura-
tion will enfue.
   That  there will  be  a  fuppuration is
known, by the fwelling and  rednefs in the
throat continuing above  three days, without
any abatement.   In this cafe, the Patient is
to  keep continually  in his mouth fome of
the decoction No. 7. warm, which likewife
may be lightly injected into his throat.
   The cataplafm No. 8. is to be applied, and
kept night and day round about  his throat.
   If the fwelling of the throat then begins
to grow foft, the abfcefs will foon burft : if
there appear a little fpot elevated  and white,
the concealed  lancet (pharyngotomus) may
with  all fafety be  ufed,  to give, by  this
means, a freer ifiue to the pus.
   The abfcefs being either broke ofitfclf or
opened by the lancet, the  gargarifm No. 9.
muft be frequently ufed,  and the  cure will
foon  be compleated.
   When it happens  that the fwelling pre-
vents deglutition entirely, a glifter of twelve
ounces of new milk and fix ounces of barley
water is to be adminiftered every four hours,
which  the Patient muft retain as long as he
                                   poflibly 
 18        DISEASES

 poflibly can.  By this means he may be fuf-
 tained till the abfcef& breaks.
   There  is ftill  another  fpecies of  fore
 throat, whkh,  in  the beginning, is  eafily
 cured,  but by neglect degenerates into a fort
 of mortification, and corrodes  all the parts
 attacked, caufing  at the fame time a moft
 horrible ftench.
   There appears on the tonfils,  on the pa-
 late, on both fides of the interior part  of the
 mouth, or within the lips, one  or  feveral
 white fpots, fometimes yellowifh, and even
 brown, according as the diforder  is more or
 lefs violent.  The places  round thefe fpots
 are much inflamed and  painful.   It fome-
 times happens that the patient has no fever;
 and the  fwelling is never fo confiderable in
 this cafe, as in the before defcribedfore throat.
   The laft fpecies generally goes off  pretty   G-
 foon, by rubbing every two hours lightly the
 parts  affected  with a pencil  dipped in  the
 mixture No.  10. and ufing for a gargarifm
 a  fimple  infufion of elder  flowers.  It is
proper the  Patient fhould drink fome cups
of the fame infufion about four times a day.
   It is to be obferved, that the faid fpots in-
creafe very fuddenly, when the  ftench  of
the mouth is great:  in that cafe,  the quan-
tity of fp. JaL mar.  muft be augmented, to
ftop the progrefs of this evil.
                                    The 
of   t.h«  ARMY.        ig
       The  PLEURISY.

    THE Pleurify is known by a fharp pain,
     and ftitches,  felt in the breaft, and at-
     tended with  a fever.
  This pain is increafed by infpiration, and
leflened by exfpiration, and by holding the
breath j the pulfe is generally hard, as in all
acute and inflammatory difeafes: in violent
Pleurifies the  pain is  fometimes  fo fharp,
that the Patient fcarce dares to draw  his
breath,  the  face grow6 lived, and he feels
himfelf juft fuffocating ; in  this  ftate the
pulfe is fmall and low.
  The Cough is almoft continual, but inter-
rupted by the  violent pain: in fome cafes,
this Cough is  dry, without any  excretion j
in others it is,  from the beginning, attend-
ed with excretions; lefs danger is  to be ap-
prehended in the laft cafe than in the firft;
   Tho' the fides of the breaft are moft com-
monly attacked in this diftemper, yet the
anterior and pofterior parts may be equally
affected.
   If the pain  is moft  fenfibly  felt  exter-
nally,  and  chiefly upon touching  the part,
the diforder is commonly named a falfe Pleu-
rify, and is to  be treated as follows:
   Bleeding is the firft and chief remedy :
                                       let 
30
DISEASES
 let twelve ounces of blood,  or even more,
 if the fubject is replete and robuft, be taken
 from the arm,  on the fide where the pain
 is.   While the vein is open,  let the patient
 refpire ftrongly, and cough.  Bleeding com-
 monly leflens the pain, and fometimcs  car-
 ries it off altogether.
   Some hours after the bleeding, the glyfter
 No. 11.  ought to be given.
  Flannels dipt in the fomentation No.i2#
 are to be confiantly  applied  to the place
 where the pain  is felt; and as  it would be
 troublefome to  apply  this topic during  the
 night, a plaifter  of Labdanum, fpread on
 leather or  linen,  may  be applied  in its
room.
  In the morning this plaifter muft be taken
off, the part rubbed with the ung. althece and
the medicine No. 12.   Let the  patient  take
every half hour, if he  be awake,  a fpoonful
of the  mixture No. 13.   and drink after it
a warm cupfull  of the decoction No. 1. to
each  pint of which  one  ounce of honey
fhould be added.
  It often happens,  that  the pain, which
after bleeding was much  leffened,  or quite
ceafed, returns with as much violence as at
firft: in this cafe a fecond bleeding is  ne-
ceffary, but commonly not fo large as the
firft, which always ought  to be very copi-
                                   ous : 
         op  the  ARMY.       2%
                                     ■- **.
ous: if after this the pain  ftill returns very
fenfibly, you muft bleed a third time,  and
iometimes even a  fourth,  according to the
violence of the diftemper.
  It muft,  however, be obferVed,  that
flight remains of pain, and fuch as but little
impede  refpiration, do  not  require  jfrefh
bleedings:  the  Patient might by them be
too much weakened, and rendered languid
a long time after.
  Bleeding, therefore,  muft Only be re-
peated in thofe cafes where the pain is vio-
lent enough to obftruct the breath  confider-
ably; the velocity of the pulfe,  increafed
commonly at tfy# fame time, fhows the ne*
ceflity for this evacuation.
  It is a good fign, when  the pain changes
its  place,  and affects the  clavicles,   the
fhoulder-blades, the fhoulders and back;
and that this hew  pain requires no  bleeding.
Thefe changes generally  happen about the
fixth day: it il then fufficient to chafe the
parts in  pain lightly, and then anoint them
with the ung. alth.
  Let  the nourifhment be light,  and con-
fift of thin broth,  roafted apples,  and well
fermented  bread:  the decoction No.  i. or
plain barley water with one fourth of new
milk, may ferve  for  common drink.   If
the  belly be conftipated, the glyfter  No.
n. may be repeated.
                   D                 As 
DISEASES
   As foon as refpiration grows eafier, and
the pain is confiderably  diminifhed,  it will
be fufficient to give every two hours a fpoon-   ./
ful of No. 13. with a cupfuil of the de-
coction  No. 1. warm after it.
   But  if, notwithstanding feveral bleed-
ings,  the pain continues, without  any fen-
fiblc diminution ;  and above all, if the rat-
tling of the breaft, and want of  expecto-    •
ration fhew the lungs  to be filling, a blifter
is to be applied to each calf of the leg.
   A  fharp blifter applied  on the painful    j
part has often been attended with very good
effects,  even  when repeated  bleedings had   . 1
procured no ceffation of the pain of the fide.
   Care muft be taken in this,  as well as
in  all inflammatory  diftempers,   that the    ,
Patient  be not  kept  too hot, and that the
air be often renewed.      \
*■  When the illnefs begins to grow milder,
by the  ufe of the above  medicines,  frefh  .  <
fymptoms  will  appear,  which  fhow the    >
morbific matter is concocted, and ready to    [
be expelled.
   Great care  muft  then be taken,  not to
prevent its courfe, but, on the contrary, to
facilitate it by  all the  means that art can
fuggeft.
   Bleeding piles are of  fervice; a  white,
rcddiih, or fomctimes a brownifh fediment
                                       in 
OF   THE  ARMY.        2%
in the urine is a favourable fymptom: to
encourage  its  continuance,  the fick muft
drink plentifully.
   If  in the progrefs of the diftcmper,  after
the fymptoms grow milder, the excrements
are yellow, and bilious, it is a good fign;
but at the  beginning it affords but a bad
prognoftic.
   In  general this  difeafe is  carried off by
expectoration, efpecially if  the excretions
are plentiful and diminifh the pleuritic pain,
and above all,  if they are ripe and refemble
pus.   Sometimes they are glewy, tenacious,
and fanguineous;  but there is  nothing to
fear  from  them,  if the pain  abates, the
fever  diminifties,  and  rcfpiration becomes
more free.   Be cautious, however, not to
repeat the  bleeding,  which,  under thsfe
circumftances, muft be  prejudicial.  Some-
times the excretions are ydlowifh, and mix-
ed with ftreaks of  blood, and this alfo is a
favourable  fign.
   Lastly, it may be  laid  down as a ge-
neral  rule, that expectoration is to be efteem •
ed a happy fymptom ; whenever the excre-
tions are thrown off with eafe, they diminifh
the pain and f-ver,  and render  the rtfpira-
tion eafier.
   In  fuch  a ftate of the expectoration, the
mixture No. 13. muft belaid afide, and the
                                  Unit us 
DISEASES
linctus No. 14. fubftituted in its place; two
fpoonfuls of which are to be given once in
an hour, and  leifurely fwallowed, with  a
cup of the decoction No. 1. warm after it.
  If the expectoration does not continue,
but fuddenly flops, and  there c©mcs on a
rattling in the breaft,  attended with anxiety,
the danger is v^ry great; blifters on the legs
muft be  applied immediately, the powder
No. 15. be^iven every four hours, and the
warm decoction No. 1. fweetened with a
little honey, be  drank plentifully, till the
fpitting comes  on  again,  and the breaft is
relieved.
  There  comes on fometimes, but  not
often, a  painful fwelling behind the ears,
or on the thigh?, which pain is followed by
a diminution of  that of  the breaft: in this
cafe, the immediate  ufe of the cataplafm
No. 8, or fuch like,  is neceflary, to ripen
the fwelljng, which  is to be opened with a
lancet,  as foon as it comes to a  head,  and
be drtffed afterwards  as an ulcer.
  The violence of the diftemper may.be
fo great,  that the moft efficacious remedies
are infufficient to overcome it, and to expel
the morbific matter.   In this cafe, fuppu-
ration,  which  is always dangerous, comes
on,  and moft commonly the ilinefs degene-
rates into a LO^uiixiption, unkfs means he
                                   found 
        op   the  ARMY.       2$

found to evacuate the already formed pus.
  That this is the ftate of the cafe, may
be known by the following fynaptoms.
  The pain is ftubborn, and yet lefs violent
than at the beginnings it is attended with
a dry cough, or  with unripe excretions 5
there is a continual quicknefs of  the  pulfe,
which encreafes towards night,  or when-
ever the patient takes any nourifhment; the
cheeks and  Hps become  red; he has fre-
quent fhiveringsand night-fweats; the urine
is  frothy  and pale,  and he  foon becomes
extremely weak and  lean.   The abfcefs,
formed in the lungs, is fometimes  evacuated
by excretions:  when  they begin to appear,
and are  purulent,  the  infufion   No. 16.
fwcetened with a little honey, is to be given
every hour :  broths, in which frefh chervil,
lettuce,  and parfley roots, are boiled,  may
ferve for nourifhment; and for drink,  bar-
ley water, with a fourth part of new milk,
both to be continued till the purulent mat-
ter is quite evacuated.
   But this does not always happen; the
pus is often  formed in a bag; and in that
cafe it muft be attempted to  draw out this
collection of matter.
   A small plaifter applied,  and made to
ftick clofcly to the moft painful place, will
be very proper in the beginning of the il I—
                                    nefs; 
2S      DISEASES
 nefs; becaufe  if the Pleurify fhould dege-
 nerate into an abfcefs, the collection of mat-
 ter will point towards that place.
    When  an Abfcefs is known to be form-
 ed, by the figns that have been defcribed,
 the marked  place  is to be corroded  by  a
 light cauftic; and when open, care muft be
 taken to keep up the fuppuration.  In fuch
 a cafe,  there is reafon to hope, as the refift-
 ance  is  the leaft at this place, that the mat-
 ter collected will take its courfe, and  be dif-
 charged by it; for thefe collections  are of.en
 lodged between the Meura and the adjacent
 parts.
   For the fame reafon, a feton on the fpot
 is  fuccefsfully ufed; and  the pus has often
 been feen to difcharge through  fuch a paf-
fage procured by art.
  If the matter contained in the abfcefs can-
not be drawn to the external parts,  it will
occafion a fwelling  of  the Pleura towards
the cavity of the breaft ; whereby the lungs
will bs oppreffcd, the anxiety daily  increafe,
the Pleura  burft, all the iymptoms fudden-
ly difappear, but come on again foon, and
the pus  fall into  the cavity of the breaft.
  Under  thefe circumftances,  no  other
methed  can be  ufed but the Paracenthefis,
to  difcharge the breaft from the pus there
lodged,  and prevent a mortal conlumption.
                                During 
or   the  ARMY.
27
  During this laft trial, the ufe of the me-
dicine  No.  16. is to be continued.  If,
during the courfe of the diftemper, the pa-
tient can get no fleep,  a pint of the emul-
fion No. 17. is to be adminiftered,  to which
may occafionally be added an ounce of the
fyrup of white poppies, or more if neceiTkry*

    PERIPNEUMONY.

     THIS Diftemper is, properly  fpeaking,
     an inflammation  of the  lungs: it is
     dangerous, and even more fo than the
Pleurify itfelf, which fometimes degenerates
into a Peripneumony,  when the  patient is
forced, by excefs of pain, to  keep  in his
breath.
   A difficulty of breathing,  the load
and oppreffion of the breaft,  and an acute
and continual  Fever, indicate a Peripneu-
mony.   In this diftemper the patient feels
no pain;  or  if he  does  complain of any,
it is of fuch a dull one as diftinguifhes the
Peripneumony  from the Pleurify;  which
laft, in infpiration, gives the patient  a very
acute pain.
   The pulfe is not fo hard in the difeafe we
are now defcribing, as in  the  Pleurify and
other inflammatory diftempers  ; but, on the
contrary,  is generally found  much fofter.
                                      If 
28       DISEASES
   If  the  Peripneumony is  violent,  there
 immediately comes on a great weaknefs, the
 pulfe  becomes  fmall, foft,  unequal j  the
 refpiration is fhort, frequent, difficult, and
 accompanied  with a continual  cough ;  the
 patient cannot lie down for fear of fuffoca-
 tion, but is obliged to fit upright in his bed ;
 his face,  eyes,  tongue,  and lips, become
 red and inflamed : thefe fymptoms are fol-
 lowed by an infupportable anxiety, and foon
 after by a delirium, and death.
   All the figns, therefore,  that we have
 recited, give us a very bad prognoftic.
   A greater hardnefs  in the pulfe, a left
 difficulty in breathing, more  eafe in  lying
 down, lefs  rednefs and fwelling in the face*
 the eyes, and the lips, are, on the contrary,
 favourable fymptoms.
   This diftemper requires immediate help,
 for very foon it brings  the patient into evi-
 dent danger.
   You muft  begin by a  large bleeding in
 the arm, and repeat it  in  the fame manner
 as in a Pleurify, if the anxiety and difficulty
 of breathing do not diminifh.  If the blood,
 when drawn,  remains fluid and  thin, and
fcarce  coagulates at all,   and if after the
 bleeding the refpiration is not freer,  it is a
 bad fign, which indicates,  that the thicker
 parts  are retained in the  lungs,  and the
                                 thinner 
         or   the  ARMY.       29

thinner only  difcharged.    In  this  cafe,
a frefh bleeding would produce no effect,
and  only  evacuate that part of the  blood
which is Ieaft  thick, and could  ftill have
made  its way thro' the lungs.
  Some hours after the bleeding, it will be
proper to give the glyfter No. 11.  Fomen-
tations, ointments,  and plaifters,  may be
applied to the breaft,  but it muft n©t be ex-
pected that thefe fort of things  will be attend-
ed with as good fuccefs as  in  the Pleurify.
  It will be better to apply frequently  to the
patient's  mouth   and  noftrils,  a linen or
fponge foaked in warm water,  the vapours
of which may, together with the air, enter
by infpiration into the lungs.
  The diet ought, as in the Pleurify,  to be
extremely light, and the broths ftill thinner.
  Let the common  drink be the decoction
No. 1. or  barley-water; but inftead of min-
ing milk with it,  add to each  pint half an
ounce of pure honey.
  While the patient is  awake,  let  him
take every half hour a  fpoonful of No. 13.
and drink after it a Warm cup of the decoc-
tion No. 1.
  If, on  the ufe  of thefe  medicines, the
anxiety diminiflies,  the refpiration  becomes
freer,  the Fever lefs violent, the pulfe more
vigorous and equal,  the tongue moift,  and
                    E                every 
3o      DISEASES

every part of the body, even to the extre-
mities, of an equal heat ;  if,  above all,  the
fkin is moift and foft, we may  hope for the
beft,  and  nothing more is required than  a
continuance of the fame means,  as the in-
flammation of the lungs is beginning to be
refolved, and gradually to decline.
  But  things feldom take this  turn, unlefs
the diftemper is  not violent,  the folid parts
are fupple, and relief has been applied from
the beginning.   It oftner happens, that the
matter of this Difeafe is evacuated by expec-
toration.
   The fpitting muft, therefore, be carefully
attended to; and it is a very bad fign, when
at the fame time the patient does not expec-
torate at all, and has a difficulty to breathe,
with  a rattling in his throat.  The  fpittings
are good,  if discharged fpeedily,  copioufly,
and eafily.  They fhould be of a proper con-
fidence; lbmetimes they appear yellow, and
ftreaked with a little blood ;   which ought
to give  no uneafincfs,  for excretions of this
fort are always good,  and  grow white  in
time.
   The effect they produce is remarkable, by
th^ diminution  of anxiety,  the freedom  of
rtfpiration,  and the alteration  in the pulfe,
which grows ftronger and fuller.
   Let the patient,  at that time, take two
                                      tea- 
of   the   ARMY.
S1
 tea-fpoonfuls of the linctus No. 14. and after
 fwallowing  them foftly, drink a cup of the
 warm decoction No.  1.
   Nothing more is to be done under thefe
 circumftances;  and  bleeding, purging,  or
 exciting fweats, Would be detrimental.
   We ought  chiefly to,guard  againft  the
 cold air, and cold drinks, for either the one
 or the other will flop  the expectoration, and
 thereby  throw the patient into imminent
 danger.
   If  a fuppreffion of the fpitting  fhould
 happen*  and the anxiety be followed by the
 rattling of  the throat, blifters  are  to be ap-
 plied  to the legs, the  powder No.  15. is to
 be given  every four hours, and the fame de-
 coction No.  i. be ufed as was ordered  for
 the Pleurify.  The patient is alfo  to infpire
 by  the mouth  and noftrils the vapour  of
 warm water.
  It fometimes happens,   that,  during the
 courfe of the diftemper.; the patient voids by
 ftool a yellow and bilious matter, and is re-
 lieved by it.  This is  alfo a favourable fign^
 as has been  obferved, in fpeaking of the
 Pleurify.
  A  large  and  thick  fediment  in the
 urine, at firft red, afterwards turning white,
is likewife  a good fymptom.   When this
happens, the patient muft  drink plentifully
                                       3S 
3«       DISEASES

as in the Pleurify.  Neverthelefs, it rarely
happens that the  caufe of the  evil is  dif-
charged  merely  by  urine;  the  fpitting,
which generally comes on about  the  fame
time, contributes  greatly  to the entire  cure.
   When the patient, by  the means of thefe    ^
evacuations, begins to find his breaft difen-
gaged, he  may have his broth fomewhat
ftronger; but he  fhould conftantly take  but
little at a time and  often, that the  lung!    \
may not afrefh be overcharged by a chyle,
both too crude  and too copious.  Sometimes    \
a plentiful bleeding of  the  nofe gives relief
to the patient; but this feldom happens.
   If none of the  evacuations here defcribed
are obferved within the fpace of a fortnight*
if the Fever continues pretty ftrong, and the    )
Cough dry; if the heat extends to the ex-
tremities of the body ;  if  the  pulfe is quick,
foft, and wavering ;  if a difficulty of breath-
ing and fhiverings accompany  thefe fymp-
toms ; if the  cheeks and lips are red,  the
thirft great, and, laftly,  the Fever ftronger
towards night, it is certain that the inflam-
mation is turning to  an Abfcefs.
   The indications  of an  Abfcefs already
formed in the  lungs, befides the fymptoms
already defcribed, are as  follow:  A  dry
continual obftinate cough,  which increafes
when the fick moves,  or takc« any nourHh-
                                   ment; 
        of   ths   ARMt       33

ment; he can only lie on the affected fide,
without its being poffible for him to lie oa
the other ; he has periodically a little con-
tinued Fever,  which augments  whenever
he  eats,   drinks, or ftirs, and  is  attended
with a rednefs of the lips and cheeks ; he
has  no appetite,  but a violent  thirft, and
complains of night-fwcats, efpecially of the
head, and the upper part of the  breaft; the
urine is fpumous, he is greatly emaciated,
and  extremely weak.
   While the Abfcefs remains  whole, the
purulent tumor increafes more and more; it
preffes upon  thofe parts of the langs which
as yet are found ; it obftructs the refpiration,
and,  after the moft  terrible  anxieties, fuffb-
cates the patient.
   It is therefore eflential, that  the Abfcefs
fhould break, and be maturated, in order that
the pus be evacuated. But it may happen to
break in  fuch a manner, as to difperfe the
matter into the breaft, and occafion an Em-
pyema, which almoft  always proves  mor-
tal.   This is known to  be the cafe,  by the
fudden  diminution  of all  the fymptoms,
fometimes attended with flight faintings, and
the  total fuppreffion of purulent fpittings*
k is becaufe  the Abfcefs  is  in  effect burft,
that the fymptoms proceeding from the dif-
tcntion of the   purulent bag  immediately
                                    ceafe: 
 34        DISEASES

 ceafe;  but the matter fpread in the cavity
 of the breaft, growing every day  more co-
 pious, and more acrid, foon occafions new
 fymptoms, worfe than the preceding ones.
   The Paracenthefis is  the only means of
 help left; but as the ulcer has already cor-
 roded the fubftance  of the lungs,  the  fuc-
 cefs  will be very doubtful:  and even  tho'
 the pus is evacuated, the fick perfon gene-
 rally dies after the operation.                  .
   Much more is it  to be wifhed, that the  A
 Abfcefs may break in fuch a manner,  as to
 let the pus fall into the bronchi or air veffels
 of the lungs,  that fo it may be evacuated by
fpitting.
   When  this happens, it  is to be  feared,
left the bronchi be totally filled and flopped
by the quantity of pus fpreading  itfelf in-
ftantiy,  and all  at once,  and  oceafioning
thereby  a  fuffocation:  but if the pus  that
falls in thefe  veffels can ftill be difcharged,   t
the patient often recovers, tho' the purulent
confumption is always to be apprehended.
  The following are the principal fuccours
which art has found out to forward the open-
ing of the Abfcefs into the bronchi, and the
evacuation of the pus by expectoration.
   As foon as the  fymptoms of an Abfcefs,
as  defcribed above, are perceived, let  the
fick infpirc  continually by  the mouth  and
                                 noftrils y   * 
         of   the  ARMY.       35

noftrils the vapour of warm water, to foften
and relax the parts.
  Let him take fatter broth', and in larger
quantityj than before, that the ftomach being
filled,  the defcent of the diaphragm may be
more difficult,  and the Abfcefs more com-
preffed.  The  patient  muft be  excited to
cough, by  applying warm vinegar to his
noftrils, or to cry with a loud voice.   This
may procure a chance of breaking the Abfcefs,
which, if the ftrength of the fick perfon
can bear it,  may be ftill forwarded by giving
him an  airing in  a carriage, on  a rough
road, where he may be well fhook.
   As it is  impoffible to  know exactly the
moment when  the Abfcefs will break, you
muft repeat,  from  time to time,  the at-
tempts here defcribed.
   If,  when  the  Abfcefs is  broke, the ex-
cretions  are purulent,  wThite, and  fmooth;
if the fever difappears, or dimrnifhes confi-
dcrably ; if the appetite returns, the thirft
ceafes, and, laftiy, the excrements are folid
and natural,  there is  reafon to hope that
the fick  will  recover.
   If,  on the  contrary,  the excretions are
ftained of different colours,  with  a bad
fmell; if the fever doth not ceafe,  or, hav-
ing ceafed, returns again ; if the thirft re-
                                   mains 
$6         DISEASES

mains, and the appetite doth not increafe, h
is to be feared the patient will fink under it.,
   When the Abfcefs  of  the lungs dis-
charges itfelf  by means of purulent ex-
cretions,  a little  rice,  or  oats  boiled  in
milk,  affords an excellent  nourishment;
but care muil  be taken, that the fick take
not  too  much  at once,  but little and
often.
  The  infufion  No.  15. with a third part
milk and  a little honey, will be  a proper
drink.   He is to take thrice a day the pow-   }
d« No. 18. and  as the lungs have been fa-  y •
tiguecf by a continual cough during the day,  .j
fome relaxation ought to be procured in the  ' j
night; wherefore let the patient take two
pills No. 19.
  If he is iomewhat coftive, it is not amifs,
but if he remains fo feveral days, the glyfter
No. 11. is  to  be given.   If the excretions
diminifh little by little,  appetite comes on,
ftiength increafes, and the patient gets rid
of his fever, a quick cure may be expected.
  When the excretions  are  confiderably
lcfiened, the powder No.  18. and infufion
No. 16. are no more to  be ufed; inftead of
which,  three fmall fpoonfuls of the linctus
No. 20. and after it three cups of  the infu-
fion No. 21. may be taken thrice a-day.
   If,  notwithstanding  this, the cofcgh re-
                                   turns   , 
       of  the   ARMY.        i7

turns  ftronger  towards  night, the patient
may  continue  to  take  the  piHs  No.  19.
Which otherwife are alfo to be left off.
   If,  after the Abfcefs  in the lungs hath
begun to  be  evacuated  by excretion, this
evacuation fhould fuddenly flop, an extreme
anxiety fucceeds, together with a rattling in
the breaft, and  the fick  is in  very imminent
danger.  This accident is~ommonly caufed
by the imprudent admiflion  of cold air,  or
by fome violent emotion of the  mind, as
anger, fear,  or fuch like.
   A  speedy relief  muft be  given,  by
caufing the patient to infpire the vapour of
warm water,  both by the mouth and nof-
trils,  making him drink  freely of the warm
infufion No.  16. and giving him every four
hours the powder No.   13. until  the breaft
be difengaged,  and expectoration  comes on
again ; after which the ufe of the  powder is
to be difcontinued.
   It will be of fervice  ttf apply  blifters to
the calves of the legs,  as has been recom-
mended in the Pleurify.
   When the  purulent matter is reforbed
by the veins, it fomctimes occafions a fud-
den dcpofit of matter in ether parts of the
body, and there caufes an abfcefs,  viz. about
the  ears, the arms, or thighs.   The  load
of the breaft ceafes at the fame time;  and
                   F                 th* 
3&      DISEASES

the fame remedies are to be ufed, and the
fame  rules obferved, as in the cafe  of an
Abfcefs after a Pleurify.                     4
  As the inflammations of  the external   J
parts  may  degenerate into fchirrous hard-
neffes, the fame accident is to be feared in
inflammations of the internal  parts: for af-   ^
ter  a Peripneumony, there  fometimes  re-   ,
mains in the lun£5 a fchirrous  and callous   |
hardnefs,   in  which   cafe  there   is  al-   |
moft  always an  adhefion  to the Pleura*
Refpiration continues in that cafe difficult   *
for  the  reft  of  life, attended with a little   ,
cough,  chiefly after  meals, and after exer-   v!
cife;  and there  is no appearance of any of   ^
the indications of an Abfcefs we have been
defcribing.  This accident  can  rarely be
got the better of;  and the  little relief that   >
may be afforded is fcarce to be expected in
a military life,  unlefs it  be for  the cavalry,   .'i
by riding on horfeback.
  Lastly, if  the  Peripneumony  be fo
violent, that the remedies  have no  effect,   )
gangrene and death are the confequence.
This is forefeen, when the ^tient  labours
with  intolerable anxiety, facing into  ex-
treme and fudden faintneffes, with an  un-
equal, feeble,  and very quick  pulfe,  and
the excretions without confiftence, ftinking
and black.  All thefe figns indicate a fpeedy
and inevitable death.              RHEU- 
of   the   ARMY.
3*
(RHEUMATISM,  and  RHEUMATIC
               PAINS.

     THE general caufe of the Rheumatifm
      is the fudden expofition of the body
      to the  cold  after being confiderably
heated,  either by work or the weather ;  ef-
pecially if  a perfon, being overcome by the
heat, throws ofthiscloaths, and refts him-
felf in a damp and cold place,
  The foldier is moft frequently liable to
this diforder, when heated by fatigue,  and
expofed to rain, he is obliged to wear  his
wet cloaths, without changing them.
  The cold nights, which in Spring and
Autumn fucceed very warm  days, are alfo
a caufe of the Rheumatifm. This diftemper
begins with an univerfal fhivering, followed
by heat, thirft, uneafinefs and fever. After  a
day  or two, and  even fometimcs  fooner,
the patient feels a fharp pain, not confined
to one place, but  moving from one limb to
another, viz, at,  the  wiifts, the fhoulders,
the knees; a* 1 fo different parts of the bo-
dy are in  this manner fucceflively affected;
and the articulations,  that are attacked, be-
come red  and fwelled.
   Sometimes, in this diforder,  the ten-
dinous expanfiens covering the  mufcles are
                                attacked, 
4o       DISEASES

attacked, and occafion an excefilve pain on
the leaft motion of the part affected.  Somc^
times the Fever ceafes in a few days, though
the pain continues.  In general, it is  a
very troublefome diforder, efpecially  when
it attacks the loins,  as'the fick is then con-  $
fined to a fupine pofture, without motion,
and, as it were, like a log.   It often panes,  -j
from the loins to the hips, or upper joints
of the  thighs; where, if it  remains long   j
fixed, the cure becomes very difficult.       g
  When the  pain  fuddenly  and  often   f
changes from  place to place, it is   to be   j
feared trfat the caufe of the iilnefs will be   ;
drove inwardly,  and attack  the lungs or
brain,  which would be attended with  the   |
greateft danger.   This  accident  is  difco-   '<
vered by a delirium, or a violent oppreffion
of the breaft, fucceeding a ceffation of pain   ■'
in the extremities.                         •. i
  Tins difeafe is feldom mortal; but  the  1
violence of the pains, and their  continua-
tion upon an  improper treatment,  iuduce
us to employ quick and efficacious  reme-
dies.   When the diforder  is negle&ed,  it  $
often happens, that  the articulations are de-
prived  of motion,   and  there remains for
life  an incurable   ftiffhefs  of   the  joint.
(Anchylofa.)
  1 he method  of  treatment h a$ follows,
                                  Take 
        of  fhe  army:       4*

  Take ten ouncas of blood from the arm
iof the affected fide.
  Let  flannels, imbibed in the  warm fo-
mentation No. 12. beconftantly applied to
the part in pain.
  The  diet ought to be light, confuting of
fmall broth, with decoctions of barley, oats,
or rice,  and with roafted apples.
  For  common drink, ufe the decoction
No. i *  or barley-water with  a fourth part
milk.
  Two fpoonfuls of the mixture No. 22.
with a cupfull of the infufion No. 23. warm,
may be given every hour,  unlefs the pa-
tient be afleep.
   The following  day  let him  have the
glyfter No. 11. and conftantly continue the
medicines No. 22. and 23.
   If the  pain doesfiot give way, and the
Fever continues, the  bleeding is to be re-
 peated  the next day,  the fomentation Nb.
 12. and the medicines No. 22. and 23. are
 to be continued ;  after which, the follow-
 ing morning,  let the  patient take the purge
 No. 6. omitting during this  day the ufe of
 No. 22, and 23. and taking at  night  the
 anodyne draught No. 24.   Let him after-
 wards continue two days longer the ufe of
 No. 2«.  and 23.  and on the third day re-
peat 
42     DISEASES

peat the purge No: 6.  and  at  night the
draught No. 24.
   By this method, we commonly get  the
better of this  diforder.   If a good deal of
a  brick  coloured  fediment appears  in the
urine, attended  with  a general  breathing
fvveat, it is  a good fign.
   It will then be fufficient to compleat the
cure, to keep the patient warm in bed, and
make him take the decoction No. 23.
   But if, after the ufe of thefe  rcmedi«6,
the pain ftill continues, and  the  part af- m
fected grows red, leeches are to be applied  ^j
upon it.
   Sometimes the Fever ceafes, the patient
appears recovered,  but the pain  ftill roves
from one joint to another : in this cafe, led   j
the patient take half a drachm of Venice foap
made into pills, morning, noon, and night,  /j
drinking after it  fix ounces of the infufion   *
No 23. made  warm.   He muft  be  kept,
from the cold, and the articulations  lightly
rubbed with a piece of dry flannel.
   It happens likewife  fometimes, that the
patient,  tho'  otherwife  recovered,  has  a
fixed pain left about the articulation of the
hip.  Apply, in that  cafe a blifter,  about
thefizeofa crown piece, upon  the part
for twelve  hours,  then  take it  eff,  and
                                  pierce 
        of  the  ARM Y.        43J *

pierce  the bladder it has raifed, that the
lymph amaffed may flow out, and cure the
wound  by means  of the  plaifter,  called
empl. dllum coSlum.
  Eight days after the place where the
blifter was applied is healed, apply another,
and proceed as before, and if the pain is
then not eikirely vanifhed,  this operation
may be repeated four times:  Obferve, when
you. take off the blifter,  only to pierce the
veficle,  and not take the epidermis, for the
place thus made  bare, would bexxtremely.
painful, and without any advance towards
the cure.
  Those who have fuffered of this difor-
der in Autumn,  muft take care, during the
following winter, not to expofe themfelvcs
tc> the cold, and the injuries of the feafon,
for (hey would certainly have a relapfe.
  When by the pain continuing long fixed
in the fame place, the affected articulation
begins to ftiffen, let the  part be twice a day
held over the fteam of hot water, then well
wiped with hot  linen, lightly rubbed, and
anointed with ung. althea.
Intermitting 
 •44     DISEASES


    Intermitting  FEVERS.

  A Fever is known by aquicknefs of the?
       pulfe, ufually attended with laffitude,
       languor,  weaknefs,  thirft, and feve-r  ■
  ral other fymptoms.
    When after a fit of fe vera! hour9,  it fen-
  fibly  diminifhcs, with all  its fymptoms,' ';4
  and at laft  abfolutely  ceafes, but in  fuch a
  manner as^to return again,  it  is called an
  Intermitting Fever.                       ^
    This Fever  has different  appellations,
  according to the length of the interval be-   j
  tween the fits.
    If  it returns every day, it is called a-  I
  Quotidian ; if there is a day between each
  fit, it is called a Tertian; if  the return is
  after two days free, it is named a Quartan.
^  The Intermitting Fever comes on  with  »]>
  gaping, laffitude,  debility,  colds, fhiver-
  ings,  tremblings, palenefs of the cxtremi-  j
  ties, anxieties,  ficknefs, and fometimes vo-
  mitting. The pulfe is feeble  and fmall, and
  the thirft pretty  gceat.  Heat  fuccecds af-
  ter fome time;  it infenfibly augments till it
  becomes extreme.   The body then grows
  red, the anxiety diminifhes, the  pulfe is
  fuller and ftronger, the thirft exceffive, and
  the patient  complains of a violent headach,
                                      and 
                  p

        of   the  ARMY.       45

and pain iri all his limbs;  laftly, a general
fweat fucceedsj all the defcribed fymptoms
diminifh,  and the patient often falls into a
fleep, aftet which he wakes without Fever, V ^
his pulfe is natural, and there  remains  no-  "'"
(thing but laffitude,  and weaknefs.  Some-
times  during the hot  fit  of   the  Fever,
bilious matters are thrown up  with  a per-
ception of relief.
   The urine after the Fever, of during the
fweat, is  reddifh and frothy;  and as  foon
as it is cold, there appears on the top a peli-
cle, adhering to theafides of the vcffel, at the  -
bottom of which is depofed a  fediment, in
colour refemblirig pounded brick or bole ar- •
moniac.
   This  appearance  is, however,  feldom
 obferved  in  any other but autumnal inter-
 mittent fevers, and it is more fo after feve-
 ral paroxyfms. In the fpring Intcrmittents,
 the urine is  commonly lefs red, and rather
 yellowifh, a  cloud forms in the middle, and
 it depofcs a white fediment, which is a good
 fymptom.                      4-
    Of the two  fpecies of Intermitting Fe-
 vers we have juft mentioned, the vernal ones
 are eafier cured than the  autumnal ones,
 which are attended with more troublefome
 fymptoms.
    The Intermittents which   prevail  from
                 G             February 
*
 46       DISEASES

•rfebruary to  July,  are called Vernal;  and
 thofe that begin in  the latter end of Julyi
 or beginning of Auguft, and ceafe  at the
 end of January, or fometimes ffeoner,  are
 called Autumnal Intermittents.
   After the long  and violent heats  of the
 fummer, if the troops have been much fa-
 tigued,   there  will be  many Autumnal
 Fevers,  and  of the moft dangerous  kind;
 efpecially if the military operations require
 camping in marfhy  places.
   In September and October the  number-
 of thefe Fevers is commonly very confider-
 able, but there  is   great hope  to  fee that
 number diminim at the fall of the leaf, ef-
 pecially if the winds blow any thing hard.
 It As there  is  a great difference  between
 the Spring and  Autumn Fevers, and as the
 method of treating them often differ much,
 we fhall treat feparately of each.

  Spring INTERMITTENTS.

 (VPRING Intermittents are generally Ter-
 O  tians, very  often of a kindly fort y fome-^
     times double Tertians, but feldomer
 than in  Autumn.
   We call that Fever  a double  Tertian,
 Where a frefh  paroxyfm comes  on  every
                                    day,
r 
        of  the   ARMY.       47

/day, but the fit is generally flighter-on the
alternate days?                       *-
   During the paroxyfm, it willbe fm-
cient  to take  a large quantity of any diWfy
ing liquor, made agreeable to the palate,
but  always  warm,  fince  cold  draughts
would be hurtful.
   The patient may  therefore drink of the
ptiian No. 25. keeping himfelf quiet and in
a moderate degree of heat.
   The fit moft commonly  goes off by an
univcrfal fweat, which muft  be  kept up by
warm drink, but ought  not to be  rendered
exceflive by  too much  covering,  or Other
means that provoke heat.
   Just at this  time, viz. on the  going cff
of the fit, or as foon as it is  over,  the pa-
tient  muft have a mefs of broth with fome
lemon juice, or cream   of tartar  in  it, to
make it  acid.
   The intermediate days that are free from
Fever, he may take food fomewhat  more
folid,  viz. a little meat,  provided  the flefh
be of  young animals :  beef will not  hurt,
fo it  be but tender,   but  all forts of £$ are
to be avoided.                        "' '  •-
   Nothing is to be eft near the timethr^
the return of the paroxyfm is  expected ;  the.  $
Bourifhmcnt then taken would loud the fto-
                                   macf} 
4.8          DISEASES

mach during the fit, and caufe a  bad  di-
gsftion.
  Four hours, however, before the fit, the
patient may take fome light broth.   As in
ipring Agues, the paroxyfms commonly an-
ticipate the time they  fhould  return  at,
regard muft be had thereto in the taking of
nourifhment.
  If the day the patient is without Fever
be ferene, it will be proper  for him to  ufe
a little exercife; but not  to  laffitude ;  he
ought likewife to endeavour  to fleep rather
more than  ufual.
  It is to be  remarked,  that thofe fpring
Agues often turn to inflammatory diforders;
efpecially in young  and fanguine fubjects :
bleeding is therefore proper, efpecially if
the fick have a rednafo  in the face,  a vio-
lent head-ach,  or feel fome pain on the fide
of the breaft.
  If  attended with  frequent flatulent erup-
tions, if the tongue is, charged,  a bitter tafte
in the mouth, or a light vertigo, it will be
proper to give him an emetic.
   Let him take four hours before the  re*
turn of the fit the powder No. 26. or No.
27. if of a weaker conttitution, as  foon as
lie  ihr.ll have vomited, let him drink warm
water plentifully }  he will foon throw it up,
..r.u^vemit afrefn ; he then  muft repeat his
                                drinking, 
         of   the   ARMY.      4-9

drinking,  and, go on in  this manner till
what  is to be thrown off his ftomach,  be
diluted, and  his vomiting made eafy.
   After vomiting feveral times, the wa-
ter drank commonly ftays one hour:  <ifter
the vomiting hath  ceafed, let the patient
have the potion No. 24.  and fo wait for the
paroxyfm,  during which  let him take the
ptifan  No. 25.  obferving the rules before
laid down.
   If he complains  of pains crofs his back,
of grumbling or wind in his bowels,  if his
belly is fwelled or hard, he muft be purged
 in the following manner.
   Eight  hours before the return of  the
 fit, let him take the purge No. 28. and fix
 hours after he hath taken it,  that is, two
 hours before the fit,  give him the draught
 No. 24.
    If  the  fymptoms, that gave occafion to
 the purge, or ' the  vomit, continue, thefe
 remedies may be repeated, which  however
 is but feldom the cafe  in fpring Fevers. x
    Observe,  that fometimes emetics  do
 not evacuate only  by vomit,   but by ftool
 alfo, and that purges act likewife fometimes
 by vomit.   There is  nothing to be feared
 when this happens, fince the only object of
 thefe remedies is to evacuate  the ftomach
 apjd inteftines.   After the bowels are thus
                                 cleanfed, 
5o     DISEASES

cleanfed,  let the  patient take every tw<*
hours a fpoonful  of the mixture No.  29.
drinking after it a cup of camomile flower
lea.   This remedy muft not be ufed in the
paroxyfm,  but only  whilft the  patient  is
without Fever,  nor fhould he be waked to
take it.
   This is the method of treating  Spring
Fevers: and there  is feldom a neceffity for
ufing the bark.
   If after   the third or fourth  paroxyfm,
ulcerated puftules break out about the nofe
or lips, it  is a good fign, and  the fever
quickly ceafes: but  tjlis is not  ic fure  in
Autumnal  Fevers.
   It fometimes happens,  tho' rarely, that
after feven  or eight  firs, the Spring Fever
dees not ceufe,  nor  even confiderably di-
minifh, and that, en  the contrary,  the  fit, r,..•
bee me bnger and ftronger.    This is par-'
ticularly the  cafe,  where the patients are
fubject to fweat copioufiy, as fcon as they
?.:e in bed.  Here  the  bark  becomes  ne-
ceffary.
   Let  him take every  three  hours  while
the Fever  is off,  one of  the powders
No. 30. in fome  wine.                   ■*■.]
   This  method  will foon  complete  the
cure;  and as in  the fpring  the  weather
grows better every day, there is  but little
fear of a relapfe.              A U T U M- 
         6?  the   ARM Y.       $it


 AUTUMNAL  INTERMITTENS.

    HESE Fevers are more obftinate than
     thofe in the fpring ; and of thefe the
     worft fort happen  commonly after a
very hot fummer.
  They are alfo harder  to be known ;  for
when they firft begin, the fits are fo long,
and the returns fo frequent,  that they feem
continued Fevers, with little or no intcr-
miffiqn.
  Sometimes the  Fever  abates  a little,
and then returns in  a few hours, after a
light fhivering.  It is  only when it begins to
give way its  character is firft known; it
then appears  that the diforder is a  true  in-
termittent.  Thefe  Fevers,  which at firft
appear to be continued, often  degenerate
into Quartans.
   Sometimes thefe Fevers, which in  the
beginning  did intermit, after long  and  re-
doubled paroxyfms,  are changed into dan-
gerous continued Fevers.
   These  Fevers are always bilious;  the
ftomach and inteftines are filled with putrid
 matter,  which muft be  difrfiarged without
 delay ; to poftpone it would be detrimental.
   Let the patient take the emetic No.  26.
 ©r  27. having regard, on  this occafion, to
                                   what
T 
 52       DISEASES

 what has been faid on the fubject of inter-
 mitting Spring Fevers.
   If the  fkin of the face is  tight an^red, .
 the eyes inflamed, and the heat great and
 general throughout  the  body,   a  bleeding
 muft precede the vomit.
   On the contrary,  if the face is fhrunk
 and pale, and the pulfe not  full,  bleeding
 would hurt, and muft be refrained from.
   The vomit muft be given in the inter-
miffion of the  Fever 5 or if it does  not  $■
ceafe entirely,  that inftant is to be chofen
when it is leaft violent.
   Sometimes alfo,  in  an Autumnal Fe^
ver,  it is neceffary to repeat the vomit, that
is, when the  naufeous ficknefs, the bitter
tafte of the mouth, and the foulnefs of the
tongue, continue.
   Th.e day the patient takes  no vomit,  let
him  drink the decoction No.  25. adding an
ounce of the oxymel No.  31. to every pint
of the decoction.
   After the firft or fecond  vomit,  the
powder No. 32.  is to be taken every four
hours.
   This method will commonly fucceed in
thefe Fevers ; and if before, they were con-
»nued, they will become intermittent,  fo
that  there  will  be  a confiderable interval
from one paroxyfm to another, let  the pa-
                                   tient 
OF   THE  ARMY.
si
iient then take the mixture No. 29. follow-
ing the directions given under the head of
Spring Intermittents.
   The food  fhould  likewife be  the fame
as in  thefe Fevers;  broths  made pleafant
with  juice of lemon,  or  cream of tartar,
roaftcd apples or pears, and well fermented
bread, ought to be  the principal nourifh-
ment.   When he  begins to  recover a little
more  ftrength,  ydu  may  add fome flefh
meat, either  veal or lamb: a little wine
taken  moderately to recruit his  ftrength
will do no harm.
   But as in  Autumn the  days are  conti-
nually growing colder, the recovering pa-
tient muft guard with care againft the incle-
mency of the weather, otherwife a  relapfe is
much to be feared.
   Let him alfo for a fortnight, on  his re-
covery, take the quantity of a nutmeg of the
electuary No. 33. in the morning fafting,-
an  hour before dinner, and an hour after
fupper.
   When he  has been a month without fe-
ver, give him the pills No. 34. in the morn-
ing fafting; repeat them  a fecond time in
eight  days,- and a third time in eight days
more.
   If,  after the ufe of the emetic,  and other
remedies here defcribed, the fever  fhculd
                  H                'ftH* 
■<4     DISEASES

ftill continue, without any diminution  of
the paroxyfms, and  if the  patient grows
weaker, the ufe of the bark becomes ne-
ceffary: this  happens more frequently  in
Autumnal, than in Spring fevers.
   The powders No. 30. muft then be made
ufe of, as  in  Spring fevers, and in a  fort-
night  be again repeated.
   If  the  eyes  grow yellow, the fick feel
great anxiety  at the  orifice of the ftomach,
and the urine  is icterical,  you muft  then
(unlefs the extreme weaknefs of the patient
forbid) leave  off the ufe of the bark during
the fpace of a fortnight;  inftead of which,
for fome days give him two fpoonfuls of the
mixture No.  35. every  three  hours,  till
thefe  fymptoms are  abated:  the fever will
return ; but during  this  interval,  the fick
having recovered ftrength, will  better fup-
port  ir, and  it foon will abfolutely  leave
him.
   If the  ufe of the bark in this  cafe was
obftinately purfued,  it would bring on  fome
chronical  and obftinate diforder.   It  muft
be obferved,  that when the fever has  been
driven away by the  bark, the pills No. 34.
axe not to  be  made  ufe of,  for commonly
they bring it on again.
   It  fomctimes happens, that  thefe fevers
?.:e from  the beginning attended  with the
                                    worft 
*
        of   the  ARMY.       '5$

worft of fymptoms,  an unequal  pulfe, a
cadaverous countenance, frequent faintnefs,
and cold fweats.   In  fome fubjects,  thefe
fymptoms are attended with a cardialgia,  or
violent pain  of the ftomach, and in others
with a fleepy heavinefs, fometimes  fo pro-
found that the patient can fcarcely be waked.
  In this cafe the bark muft be immediate- <
ly given; for it  is to be feared another fit
could not be  bore.  The prefcription No.
30. may be ufed.             •?■;■, v
  If by this means the fever being fuppreff-
cd,  the face becomes of the colour  of wax,
and anxieties about the orifice  of  the fto-
mach are complained  of, let  the  remedy
No. 35. be ufed in the manner before ex-
plained.                         .,,

    Qjj ART an  FEVERS.

     THE firft  thing to be  Gbferved is, that
      bleeding is fcarcely  ever proper  in
      thefe fevers.
   Let the patient take the emetic  No. 26.
or 27. before  the fit comes on, following
the method prefcribed  in  the Spring  Inter-
mittent^.                         -: t
   Before the  next paroxyfm, give him
the purge No. 28. and then the quantity of
a nutmeg of  the electuary No. 36.  which
                                      nc£
                                        v 
56     DISEASES

he muft leave off while the fever fit is  on
him.
  If, after eight fits, the fever  does not
diminifh, and the patient grows  weak,  he
muft  take the  powders of bark  No. 30.
obferving what has been before faid on that
fubject.
  Eig4t days after the fever has  left him,
the fame powders No. 30. are to be repeat-
ed, and a third and laft time at the end of
a fortnight^ by which means  there will be
not fear 6f*a relapfe.
  In the intermediate days of the paroxyfms,   j
the fick may be indulged with more wine
and a freer nourifhment, in this fort of fever^;'T|
than in any. other.                          >■

     Jtiie   J A.U NDIC E.

    AF T E R a Fever, that hath continue^
      for a length of time, and above all,
      after  an Autumnal Fever,  fometimes
the hypocondria remain hard and tenfe,  ei-
ther  with or without a dull pain; the  pa-
tient feels after his meals an«nxiety, which
fometimes is followed. by vomitings ;  the
white^pf the eyes grows  yellowifh;  the
urineTs tinged  of an obfcure yellow,  and
this colour quickly fpreads over the fuper-
^cjes of the body.                         £
                                   This 
        of   the   ARMY.       57

 This illnefs is alfo a common conftquence
of bad nourifhment; and the foldier is moft
fubject to its attacks, when a fcarcity of pro-
vifions hath obliged him to live on meats of
difficult digeftion.
   Let the patient take every three hours
four  fpoonfuls  of  the mixture No. 35,
drinking after it four ounces of the decocti-
on No. 37. which may any where be eafily
prepared.
   Night  and morning let him have half
a drachm of Venice  foap in pills,  and his
right hypocondrium be rubbed with flannel
every morning, for a quarter of an hour,
while fafting.
   This method, followed  fome days,  ge-
nerally renders the body open, and procures
relief j but  it muft  be continued  till  the
urine recovers  its  natural colour, and  the
yellownefs difappears from the eyes and the
(kin.
   If the body is ftill coftive after having
ufed thefe medicines fix days, you muft give
the pills No. 34. in  the  morning,  and all
that day abftain from the ufe of the other
medicines, which muft be refumed the  fol-
lowing days.
   Exercise is excellent in this diftemper,
above all  in open air, if the weather per-
mits.
                          Farinaceous 
55        DISEASE  8

  Farinaceous and glairy food  is to be
avoided, and broth wherein are boiled cher-
vil, forrel, lettice, endive, or fweet fucco-
ry,  is proper  to be ufed.

        The   DROPSY.

      WHEN the aqueous part of the bloo^:
       is amaffed together, and  retained in
       any cavity of the body  greater or  •£
kfs, this difeafe is called a Dropfy.
  The denominations of it  are different,
according to the parts of the body affected.
  If the water is detained in  the adipofe
membrane,  and  thereby  caufes a  general
fwelling,  it is called Anafarca.  The fwel-
ling generally begins in the inferior parts,
and gains  infenfibly  the whole  body;  the
eyes are languid,  the face and body fallow,
the urine in fmall quantity, and  the patient
never fweats.   On preffing the fwelled part,
it pits.  The fwelled parts, and  chiefly the
thighs and feet, are  always very cold.  :    '
  It is common  enough  in  the Army for
this difeafe to fucceed intermitting  Fevers
of long duration, efpecially in autumn and,/:{
winter.  The  foldier  is alfo  fubject to it,
when after having fuddenly drank a quantU
ty of cold water,  he refts  himfelf in a cold
place : it  is alfo frequently the confequence  S
i.M 
       of   Tne  A  R  M Y.        5$

of a confiderable lofs of blood,  either from
wounds,  or bleedings too often repeated.
   When  the  Anafarca comes on  after a
long  Intermittent  Fever,  evacuations are
not extremely neceffary; but it is common-
ly cured  by giving thrice a day, viz. in the
morning rafting,  one hour  before  dinner,
and one hour before ft oper,  two ounces of
the prepared wine  No. 3$.
   To finifh the cure, the patient muft be
kept warm, either by the natural heat of the
air, or by an artificial one; he ought\to be
well covered in  the night, keep to dry food,
fuch as meat or fifh roafted; his drink fhould
be little and pure,  and as much exercife be
ufed as his ftrength will admit of.
   It will be found ufeful to rub the fwelled
parts-with warm  flannels, as often as you
can.  If the'patient voids urine in larger
quantity, ana* begins  to fweat  in bed, and
the fwelled parts  come down, il is a very
favourable fign.         *          f
   After  the  fwelling  hath  difappeared,
there remains fuch a relaxation in the parts  ,
as threaten a relapf:;  this may be prevented
by caufing the  patient  to  wear his  cioaths
ftraiter than ufual,  and rolling  his legs.*'
and thighs with bandages.   Bodily  exercife
in the open air, and  warm weather, does
infinite good.
                                      In 
6o      DISEASES

   In this manner generally the Anafarca   :
that fucceeds  Intermittent Fevers  is cured   |
happily enough.   But when this diftemper
proceeds from other caufes, it often is more
obftinate,  and  requires large evacuations of
the ferous humour;   Many ways  are tried   <
to procure thefe evacuations, but experience
fhews the remedy No. 39. to  be  fure and   V
efficacious.  The patient is to take a fjpoon-
ful of this in the morning; or if, as it fomer  flj
times does, it brings  on  a vomiting, only   ,j
half a fpoonful.  The moft common effect
is, however only a fimple ficknefs.
   The urine after the ufe of this remedy-j
comes away in large  quantity,  and  afford^
a  confiderable relief.  It feldom purges;
but if it fhould, does no harm;
   This medicine is to be taken every day,v
till all the ferofities are evacuated,  and the
fwelling of the body  entirely come  down;
If the dofe'is not efficacious enough in robuft
conftitutions, it  fhould be  infenfibly aug^  ***
mented till it procures a large difcharge by   M
urine.  When the patient is on the recovery,-   *
the fame regimen muft be Obferved as has
been juft defcribecb
   Sometimes the  extravafated lymph is
accumulated in  the  lower belly,  and the
quantity increafes fo much as to caufe it to
iwell exceffivcly.  When fo, by preffing
                                   wkfci 
        OF   THE   ARM Y.\      6t

with one hand on one fide of the belly, and
ftriking on the other with the other hand,
the fluctuation  is felt,  and water is found
to abound.
   When  the  diftemper  is  recent,  it  is
cured often enough only by  the ufe of the
remedy No. 39. but if the  flux of  urine
does not come  on  in fome  days, nor the
fwelling  of the belly diminifh, hafte muft
be made to draw off the water by the punc-
ture.   The operation is fafe,  and  fure e-
nough ;  but  if attempted when the difeafe
is more inveterate, it is lefs efficacious.
   It will be proper, as much as jjpffible^'
to draw off all the water all together at once;;
which  may  be done fafely,  by  ftraiten-
ing the patient's belly with a  bandage, by
little and little, and more and  more, as the
water  runs off: the faintings and  other
accidents will,  by  this means, be avoided*
   After the  evacuation  procured  by the
puncture,  the belly  muft  be  bound  tight
with rollers, and  the  patient obferve the
diet we have defcribed above.
   The ufe of the  remedy No. 38. will be
very proper here.  Sometimes the belly
fwells again, and the puncture is then  to
be repeated.
   As  it fometimes, though  but  rarely,
happens, that the  fwelling.of the belly  ia
                    I              caufed 
62       DISEASES

caufed only by wind, and  not at  all  by a
collection  of lymph,  the  moft fcrupulous
attention muft be  ufed  in obferving what
the cafe is,  becaufe in  this  laft the punc-
ture is fcarce ever of ufe, and, on the con-
trary, generally accelerates death.
  This laft difeafe is called Tympanites, or
Dropfy of the  Belly.
   ift. Generally the belly is not fo ex-
ceffively fwelled  as in the Dropfy.
   2d. The  belly appears elevated before,
and depreffed on  the lateral parts.
  3d. When  the belly is ftruck,  the mo-
tion of water is not felt,  but it gives a found
fomewhat refembling that of a drum.
  4th. Tho' the fick  lie  on either of his
fides,  the  form of  the  belly  remains thei>
fame, the fkin of which is white, extend-
ed, and elaftic.
  5th. Costiveness, and gripings about
the navel, often precede this diftemper.
   6th. The body of the patient is  lighter J
than in a Dropfy of the Belly,  where the
collection of water  confiderably augments
the weight.
   Upon the whole, this diftemper is more
dangerous  than the other,   and  is  often^
mortal.
   The  cure may be attempted  in  the fol«*
lowing manner.  Let the patient's belly bes\%
                                 rubbed 
          of   the   ARMY.      63

rubbed  with  flannel, for a  quarter of an
hour  at a time,  twice  a day ;   and after
each friction, let it be anointed with the li-
niment No. 40. and for fcveral days let him
at night take the powder No. 41.
   If the   wind begin  to pafs by  the anus,
and  the belly grows lefs,  there is room to
hope a cure.
   It happens fometimes,  that the lymph
collects in the cavity of the breaft ; and it
has been  often obferyed, that foldiers are
fubject to  this kind of Dropfy, when, after
having been heated  by work, and all in  a
fweat, they fuddenly expofe  themfelves to
the cold,   and greedily drink cold water.
   This difeafe  is  known by  the preceding
caufes, by the difficulty of breathing, efpe-
cially when the patient begins to fleep, and
by a dry cough; he cannot lie down,  but is
obliged to fit up in his bed, his body  bent
forward?,  and has commonly  his feet fvveU
led at the  beginning of this diftemper.
   It is  obferved, that the breaft  is fome-
times difengaged when the fwellings of ths
legs and  thighs become very  confiderable;
and that,  on the  contrary, the breaft  be-
comes more oppreffed, when  this  fwelling
fuddenly difappc^rf.
   This fort of Dropfy, efpecially if not in-
          *      •       .'•».'      veterate 
64      DISEASES

veterate, is often fuccefsfully cured by  the
ufe of the  remedy No. 39.
  If this does not anfwer, nothing remains
but the  piinaure; but  we  find by expe-
rience, that this is but a  doubtful  means,
and not always attended with fuccefs.


        VOMITING,

     OU R  prefent inquiry does not regard
      thofe Vomitings that  attend   other
      diftempers,  as  Fevers,  nephritic^
Cholics,  &c. but only thofe occafioned by ; j
bad food,  and a loaded ftomach.
  The  fureft remedy,  in this  cafe, is to
caufe a large quantity  of warm   water
to be drank, to   render the  vomiting  and, /{!
evacuation of foul matter eafier.           '*
   If after  this there remains any naufea, or
that the tongue   be  loaded  by a pituitous
glairy  matter, a  light emetic,  fuch as  No. -
27.  fhould be given, and  the fame regi-
men obferved as  prefcribed in Intermittent
Fevers.
   When  the patient has  done vomiting,
let him take too fpoonfuls every three hours
cf the mixture No. 42. and on the evening,
of the day he takes his vomit, let him have
the draught No.  24.
                          COLERA 
         ef  the  ARMY.      6$


   COLERA   MORBUS.

  IT is a fudden and immoderate evacuation
    of the humours,  both  upwards and
    downwards.
   Tho* this may happen, at all  times of
the year,  in confequence^of overcharging
the ftomach, and a crapula ; yet it is moft
frequent towards the end  of the fummer,
and beginning of the autumn.   It is often
occafioned in fummer by eating too much
fruit,  drinking  putrid  water, or  a great
quantity of new and  fweet  wine, called
Mufi.
   The violence of this diforder is fuch as
to reduce the ftrongeft man in a few hours,
and fometimes to carry him quite off in the
fpace of twenty-four hours.
   The  thirft is  commonly violent, the
anxiety great, the pulfe quick, fmall, and
often  unequal.   The  patient  has cold
fweats; his face is  wan  and cadaveroui,
and his extremities cohL
    The thighs or hancfs' are  attacked with
 fpafms, and fometimes both together ;  all
 thefe fymptoms are foon followed by con-
 vulfions,  and by death,  unlefs prevented by
 the moft fpeedy  and efficacious remedies.
                                 Every 
 16     DISEASES     ,  .,;

   Every emetic and purge is to be avoid-*
 ed, for the  moft gentle are hurtful in this
 cafe.   The patient muft be continually tak-
 ing chicken or veal  broth, made fo light as
 fcarcely to have the  tafte  of meat; or,  in-
 ftead of thefe, panada.  A glifter of either
 of thele drinks is likewife to  be given,  in
 order to difcharge  all acrid and  irritating
 matter from  the inteftines.                   <
   After this method has been continued  •
for three or  four hours, a  fpoonful of  the   -
mixture No. 43. is  to be given every half  .'
quarter of an hour, till  the vomiting and
loofenefs are either flopped, or confiderably
diminifhed.                               -^
   When  the patient begins  to be fome-  ^
 what better, it  will be fufricicnt for him to
take only every  three  hours a fpoonful   of *iy
 the fame medicine,  till he has taken it  all."
  Though  the  vomiting  and  loofenefs .#•;
fhould  by this means be entirely  ftb^ped, .*.
let the patient ftill continue, for four  days* *31
to take three fpoonfuls of the fame remedy*  '..-
No. 43. every night and morning.
  The  beft food,  on thefe  occafions, is  .
 vtal broth with rice in it,  taken  little  at a™
time, and often.                         .-^
   When it happens that the fick lies long €
 without help, and  has  had thefe evacua-
tions for feveral hours, and confequently is^
                                  grown „.# 
        of   the   ARMY.       6f

 grown very we*k, and efpecially if he feels
 fpafms'in  his thighs or hands, you muft
 immediately recur to the  mixture No. 43.
 in the  manner above defcribed.

       A   DIARRHOEA

        WHEN the  ftools  are  liquid, and
        more frequent than  ufual, the dif-,
        order is called a Diarrrhcea.
    The pains and gripings of the belly are
 not  violent in this diftemper;  which  by
 this  principally is  diftinguifhed  from the
 Dyfentery,  which we  fhall treat of after-
 wards.
    As  the  Diarrhoea fomctimes ferves for
 the evacuation of bad humours, it follows*
 that  it is  not always  hurtful, and  that it
 may even be advantageous.
   * It is of  fervice  when  it ,does  not affect
 trie ftrength, but, on the contrary,  renders
 the  body  more  light and alert.   On the
 other  hand, lit  is  hurtful when it brings
 .^.onlangour and weaknefs.
**'  The Diarrhoea, that at firft appeared fer-
 viceable, may become detrimental, by its
 . too  long dpration,  viz.   if it  lafts four or
 five days;   for then*Q|Crbody is worn out
  by too long a flux,  tne inteftines excoriate,
  a lively  pain  of  the  lower  belly,  with
               .*                  gripings, 
68       DISEASES

gripings, fucceeds, and the  Diarrhoea de-
generates into a Dyfentery,
 ' When the Diarrhoea requires any reme-
dy,  you may give the powder No. 44.  and
it night the potion No. 24.   Veal broth
with rice,  and millet boiled in milk to a
thicknefs, are  proper food for the fick.
  If the Diarrhoea does  not flop  in  two
days, the powder No. 44.- and potion No.
24. muft  be  repeated, and  again  in  two
days, if it fhould fo long continue.
  To avoid a relapfe,  let the  patient, on
his  recovery, for four nights  fucceffively,
take the bolus No. 45.
  Care  muft be taken  that he be well  co-
vered  and  cloathed,  and  guarded  againft
the injuries of cold air.

    the   DYSENTERY.

    ADiarrhoea too long neglected ofterf
       degenerates into a Dyfentery.

  But it moft commonly happens, '..that it
is not  preceded by that  diforder;  and inM
the army it reigns during the heat  of fum-' J|
mer, and the  beginning of autumn.
   A flux of the b$kt attended with  vio-
 lent gripings, and very painful ftrainjngs for  <■'
 ftool, is called a Dyfentery.
                         '*         The 
           of   the  A R M Y.        6g

     The  ftools are not  always accompanied
   with blood,  as feveral phyficians have pre-
   tended,  who therefore have called this dif-
   order the bloody flux.
     Nevertheless, the faecal matters are
   often  reddifti and  bloody,  efpeciaUy if the
   diforder has  lafted any time.
     This diftemper  chiefly prevails among
   the troops.   The caufes that produce it are
   as follow :
     The bile grown acrid  by the great heats
   and the fatigues of war; efpecially if the
   foldier,  when heated,  fuddenly  expofes
   himfelf  to cold air, or fleeps in his cloaths,
   foaked with  rain : for which  reafon it is
*  often  brief in places, wnere cold nights
ft  fucceed  to hot days.
      Stagnating,  or  marfh  water  for
   common drink.
     Meat, or fifh, beginning to be tainted,
   mufty bread, or bread made of mufty com
 *  for  food.
     Sure  and reiterated  obfervations con-
   vince  us,  that fummer fruits fcarce  ever
   caufe  the  Dyfentery;  but the excefs  of
   them  may do hurt.
     This  diftemper proceeding  from  the
   caufes juft defcribed,  foon infects a whoio
   army : \\jft healthy foldiers are  more efpe-
   cially  infected by the putrid  exhalations  of
                     K                 the 
70         D  I  S E  AS  E $

the fcecal matters, if they ufe the fame bog*  j
houles as the fick.       --:                 ^
  This point muft  therefore  be caJefully
attended to,  when the  Dyfentery prevail*
among the troops: it  would  be proper to
dig deejp trenches to  ferve for necefTsrie*  j
for the fick foldiers,  to cover feveral times*  |
in a'day the faecal matters with earth,  and  H,
to have other trenches referved altogether
for thefe in health.
  To change the camp often would alfo be  !
a proper means to flop the progrefs of this*
diforder; and by what  has been faid  re-
lative  to  the caufes,  it will  appear necef-
fary to take all poffiblc care to avoid them. ^
  The manner   of treating the Dyfentery£l
is as follows i-                            4
  If the fick is of a  fanguine  habit,  and  j
has great heat all over his  body,  or much
Fever, he  muft  lofe eight or ten ounces-
of blood from the arm; but thefe fymp-  •
toms are rarely met with.
  As  the  Dyfentery is   feldom attended*^
with a Fever,  and then   bleeding is  of no • ;
ufe,  it will be fufficient  to give the patient  !
the powder No.  46.  in  wine.              ;
  After  the firft  vomiting  occifioned by  i
the powder,  he  muft drink warm  water
with a little honey in it; this  vffill  excite
&cfh  vomiting; after  which  he is ftill to
                                      be 
         OF  the  ARMY.      71

he plied with warm water till  he brings it
up as c car  as he drank it.
   After the patient ftiall have  refted two
hours from  his laft vomiting,  you may give
him fome  fmall  flices  of  toafted bread,
foaked in four ounces  of cold wine; and
to make  it  pleafant,  a  little  cinnamon
and fugar may  be  added.  At  night let
him take the pijl No.  47.
   The fame remedies -are to be  repeated  t
next day ;  and if the diforder is  not entire-
ly, or much abated,   the third clay again.
   But if the diftemper is confidcrably di-
 mifhed,  it  will be  proper to leave a  day's
 interval between the ufe of thefe remedies,
 before they are given  a third  time.
   Experience has fhown, that inftead of
 the powder No. 46.  that No.  48.  with
 the pill No. 47. at night, has been given
 with good  fuccefs.  This muft  alfo b; re-
 peated three  times,  leaving the interval oi
 one day, except the Dyfentery  fhould flop
 fooner.   If the remedy No. 48. be too
 weak  for  robuft  conftitutions,  the defe
 may be increafed to ten  or  twelve grains.
 After thefe evacuations, the ptient  may,
 for feveral  days, take at morning, noon, and
 night, one drachm of the electuary No. 49,
    His drink muft be two parts  in three  of
 barley or millet water, and one of new milk;
 and this i6  to be ufed in large quantities.
                                     For 
 p     DISEASES

   For  food, milk  thickened witrj barley,
 oats, millet or  rice,  may  be  given;  and,  ;
 when  the exceflive  ftench of the  ftools  is
 fomewhat'abated,  meat broth thickened  !
 with the fame pulfes.
   But if the  malignity or duration  of the
 diftemper fhould have, in a manner,  anni-  ,
 hilatsd the ftrength of the patient,  evacuat-  ,
 ing medicines  muft be laid afide, as he is ■[[
 already but too weak.      R               .&
   This is  known  to be the cafe, by the^j
 violence of the gripings  and  ftrainingS, by
 the vacillating  fmall  pulfe,  by  the  pale
 countenance, by the naufeating  all food, Jf,
 and by an unextinguifhable thirft.
   Let  the pctient take every hour  one  '.
 ounce of the medicated wine No. 50. and  1
 night and morning  the pill No. 47.         i
   As the bad fymptoms begin to difappear, ^
 and ftrength to  come again,  let the pow-
'de: No. 44. be taken in the morning,  and
 in the evening,  the Pill  No.  47.  to be re-
 peated  thrice,  with one day's  interval,  if
 the diforder be not over fooner.
   For  fome days after, let the  patient  take '
 ene drachm of the electuary No. 49. thrice
 a day.  "'
   Sometimes the  interlines  having  been
 excoriated, by the frequent paflage of acrid
 matters, the patient is very  much incom-
 moded  \vith a continual  inclination to go
                                     to 
OF   THE   ARM  Y.
73
to ftool, tho' he avoids little or nothing : in
this fituation he is to  have the glyfter No.
51. and to retain it as  long as pouible.
   If, after  the evacuations,  there fhould
remain fuch like  pains in the lower belly,
the patient would receive great  relief, by
fwallowing, every day, an egg boiled foft,
with a little frefh  butter.
Inflammation  of the INTESTINES.

    AN Inflammation of the  Intes-
       tines, a very dangerous diftemper,
       often arifes from the fame caufes .as a
Dyfentery.
   It is difcovered by a violent pain of the
lower  belly, which often  increafes .upon
the touch ;  by the fwelling of the belly,  by
vomitings,  and by  conftipation.   Thefe
fymptoms are attended,  at the fame time,
with an  acute and continual  Fever,  and a
violent heat:  the pulfe is hard, the urine
clear,  and  of a bright red, and there is a
fudden proftration of ftrength.
   If the fymptoms are violent,  moft com-
monly death is foon the confequence. Be-
fore  the  patient  expires, the pain ceafes ;
but the extremities become cold and livid,
the face cadaverous, the pulfe fmall, quici:, 
74        DISEASES

and unequal.   All  thefe are figns  of ap-
proaching death ; altho' the fick, and thofe
about him,  are apt to draw an happy omen
from the ceffation of pain.
   Copious bleeding is immediately to be
had recourfe to, and repeated boldly if the
pains do  not go off, or remit confiderably ;
or if they return again.
   Let the patient take the glyfter No. 52.
three or four times in a day.
   His  belly muft be eonftantly fomented   $
with flannels  fleeped  in the  fomentation   J
No. 12.
   The caul of an animal frefti killed fome»
times produces a good effect.
   Let the  patient take every half hour a
warm cup of No. 53.
   It i6 a good fign if the pulfe becomes
equal,  and  remains fo, if  the pain dimi-
nifhes,  the fick break wind downward, and
the glyfter  bring  away  with   it  fcecal
matter.
   Sometimes,   notwithftanding  fcveral
plyfters,  the belly remains obftinately con-
itipatcd : in this  cafe the fumes of tobacco
injected thro' the anus have produced very
good effects.
   The  drink is to be warm barley water,
and tight broths the  whole  nourifhment,
                                   until 
OF   THE  ARMY.         ff
until  three  days  after, the  diforder {hall
have entirely ceafcd.
  An0 even then  it will be  neceffary  to
obferve an  exact  diet  for fome time,  left
the Interlines, irritated anew by acrid food,
occafion a relapfe.
  This diftemper is indeed  fo violent, that
if it does not quickly give way to proper
application,  it degenerates immediately in-
to a mortal  gangrene.   But, by the caretui
ufe of the above recited remedies, one may
hope to refolve  the  Inflammation  of the
Inteftmes.
   If this method has begun to be ufed too
late,  if the  diftemper lafts,  without grow-
ing worfe,  three  or four days, and a dead
pain  fucceeds to the  acute  pain  of the
lower belly ;  if at the fame time the patienr.
feels an unufual heavihefs, and has wander-
ing  fhiverings  all over his  body,  ix  is
certain there is an Abfcefs forming.
   In which cafe he muft have the  fomen-
tation  No.  12.  eonftantly  applied on  his
belly during the  day, and at night a plaifter
of labdanum.
   If the Abfcefs feems to be ready to pierce
externally,  which may be if the Interlines
adhere to the peritoneum, it muft be open-
ed to difcharge the pus,  But this cafe fel-
dom happens,
        11                             If 
 76         DISEASES
                                            f
   If  the  Abfcefs  breaks  in  the cavity of
 the lower  belly,  the  confequence is much
 to  be feared,  unlefs the  matter can  be
 drawn off" directly, which  is very difficult
 to  be done : nor is it eafy to judge  of the
 exiftence of tfyis cafe, becaufe  the quantity
 of  matter from  out of this Abfcefs is not
 confiderable enough to caufe any remarka-%vij|
 ble fwelling of the belly.                '  ^f(
  The pus is more frequently evacuated l?y  J^
 the anus:  the glyfter  No. 52. repeated fe- " ■;,
 veral  times, after fuppuration is perfected,    ,
 facilitates its courfe. By the fmoothing of
 the internal coat of the inteftines the evacu-
 ation  of the  matter  becomes  eafier that
 Way.
  After  the  pus  is evacuated, whether
 alone or with the excrements,  the  patient
muft drink plentifully of the decoction No.
 16.  fweetened with honey, and is  to take    >j
the powder No. 18. three  times a day.
  Let  endive, lettice,  chervil,  or fuch
like tender herbs, be  boiled in broth  for    .
his  food ;  but it  muft be  ftrained thro* a
fieve?  left any  thick fubftances fhould col-
lect into a mafs in the  inteftines.
  Let him continue this method for three
days after the pus fhall have ceafed palling
thro' the anus > and  by degrees he may re-
turn to his  former way of living.
                           PHRENZY.
•  / 
A
           OF  the   ARMY;      77

           P H R E N  Z Y.

       Phrenzy is a continued delirium, at-
       tended with an acute  Fever.  1( is
       thereby diftingoifhed from  the Deli-
 rium, which  is fometimes obfcrved in the
 height of intermitting Fevers, and which
■jbifhef with the fit.
i   iAu extreme heat, and a violent  inflam-
. mjjory head-ach, commonly  precede  the
Phrenzy: the  eyes and face  are red;  the
 patients,  when afked queftions,  anfwer
 with ferocity ;  they pluck the  knap of their
  cover-lids.             •
    The more frequent caufes of this diftem-
  per  are,  the violent  heat of the fun,   to
  which the  foldier  is expofed,  efpecially if
  bare headed,  fleeping in that  condition,
  long watches,  extreme emotions of anger,
■> excefs of wine,  brandy, or other fpirituous
  liquors.
    In this diftemper the pulfe contrnonly is
  quick, and refpiration ftrong,  and*not fre-
  quent.
    A Phrenzy is very dangerous,  and often
  occafions fudden death, for it is  a  true in-
  flammation  of the meninges, and fome*
  times even of th^ brain itfrlf.
    Greenish  vomitings,  frequent  fpitting,
  ftii wings-, icrufde aqueous and pale urine,
           C^,     L     .     convulsions,

 A1-         ■■  '■ 
78      DISEASES

convulfions, and no  thirft, are bad  ngns?  '
bleeding piles, a flux of the belly,  a copi- I
ous haemorrhage of the nofe,  give relief to |
the patient.                        • **•   t?
   Pain of the breaft, or of the lower parts, 1
is good in this illncfs: a ftrong cough coming
on, fometimes alfo gives eafe.
   Bleeding here isefTentially necefiaryi^flt
fhould be large,  and chiefly in the foolg if
the Fever and heat continue, it muft bi|re-
pcated : and it will be right, after the fTrrF1' ''
bleeding of the  foot,  to open one of the
jugulars.                          t       ,
  The bleedings muft  be repeated, till the *
extreme heat and the violence of the Deli-
rium are abated.  While  the patient does  ,
not fleep, he muft take every hour a cupof  i
the remedy No.  54.  warm.           ^     ^
  For  his common drink, the  decoction
No. 25. may be ufed,  and night and morn-0
ing the glyfter No. 11.  be given.
   If the hemorrhoids fwetl, let leeches be
applied.                                   ,
 * It  will be proper to fhave the patient's  '{
head,  and to make him  rinfe his  mouth •;
often with warm water  : let a comprefs dip-
ped in oxycrate, or vinegar, and water, in  :
equal quantities, be applied on his forehead:
frefh and  temperate air is  moft proper for  \
him,  and he ought to be kept fitting  up- 
           of   the  A R M Y.     79

  right in his. bed, with  his head  raifed as
  much as poffible.
  «V. It would be alfo proper to make him  rife
  twice a day, to fet  him in an  arm chair,
  and  bathe  his feet in warm water.   After
  the night bathing, the pafte No. 55* fhould
  be applied to the foles of his feet, and lie on
  till morning.
w$  43uring the whole  time of the illnefs,
  he muft be confined,to  plain barley water,
  or water gruel.    g
     If, aft^r the ufe*of thefe remedies,  the
  Fever begins fenfibly to grow lefs,  and  the
  Delirium to wear off,  but the patient can
  get no fleep?1 let him  have the emulfion
  No.  17. at night, with the addition  of an
  ounce and a half of fyrup of white poppies,
     But anodynes muft be carefully avoided,
  while the illnefs continues in its force.
     At  the beginning of this dangerous dif-
  temper, all the remedies here recited muft
  be  vigoroufty  employed :   but  when  the
  heat and Delirium  are  confiderably dimi-
  nifhed, bleeding and glyfters are no longer
  neceffary,  the  drink No. 25. will be  furii-
  cient, and the nouriihment may  be a little
  ftronger.
     Notwithstanding the diminution of
  the fymptoms, it happens often enough, that
  the Delirium  does  not entirely give  way :
                                       but 
8s       DISEASES
but commonly it decreafes infenfibly, efpe-  ^
daily if  feveral  times a day, and as much  j
as his ftrength will permit, the patient is
made to  fit up  in an arm  chair with his  \
body upright.

          '  v
H IE, M O R R PiA G E  of the N O S E."' '*

     AS Bleeding  of the  Nofe  is a  pretty '
       Common  fymptom in ardent Fevers, V
       aim oft  always^iving  relief,   and  ,
fometimes even  curing the diftemper, it is ^
eafily apprehended, that it muft not be too , 5
lightly flopped.
   But fometimes the Bleeding of the Nofe
is fo violent, both in  fick perfons, and in
thofe who are in health, thatJ>odily ftrength  '.
is fo wafted, as to bring  on total faintings,
fo that even death may enfue.  c
   In this cafe, the too violent Haemorrhage '
rnuft be  flopped.  To judge when  this ",.
ought to be done, requires a little attention
to the following confederations.
   While the pulfe keeps full, and the heat
of the body  is every where equal, even to
the  extremities,  and the  lips  and the face
keep their red  colour, there is no fear from
the Haemorrhage, was it even violent.
          'r   -                     But 
     u  of   the  ARMY,       $r

   But when the pulfe  begins to undulate,
and the face and lips grow pale,  it is time
to flop the bleeding.
   The means of flopping it are,  applying
bandages to the arms and thighs of the  pa-
tient, becaufe the veins being thereby com-
preffed,  the  reflux of the blood  to  the
heart is in lefs quantity. Tho rJasmorrhae.
flopped, the bandages are not to be loo'
ed all at  once,  but  fucceffively  out
another,  in fuch a  manner a  to  lr
fpace of  a quarter of an hour  bet,"
loofening of each bandage.
   If,  by the application of the '
the manner defcribed,  the Haev.
not  flopped, or  if it  comes  on  ..-.•
taking them off, the following  memo-..
to be ufed:
   Let a tent of lint,imbibed in  the,ftyptic
No. .56. be put up that noftril from which
the blood came.  If fome lint dipped in the
ftiptic be wrapped  round a quill,  it will be
eafily introduced  up the nofe: at firft, for
about half an inch, it muft be put up ho-
rizontally, then railing the quill  Jifenfibly,
it is to be pufhed gently, and by this means
the lint introduced as far  as poflible with-
out hurting the adjacent parts. Afterwards,
by gently compreffing the noftrils, the quill
may  be withdrawn, and the lint  left in ihe 
&,       DISEASES

tiofe, where  it is to remain  for a day or
two, till it falls out of itfelf.
  The agaric of the oak is alfo an  eflica-^
cious remedy for flopping the bleeding.
Some of the powder No. $j; may be blown
through a quill into the patient's noftrils,


      A Continued  FEVER.

A FEVER, that  lafts from the moment
       of the firft accefs, without  interrup-
       tion, to the end  of the difeafe,  is
called a continued Fever.
   The principal  caufes of Fevers  of this
fort in an Army,  are, exceflive fatigue, and
 extrtme laffitude, which is its confequence,
 efpecially during the heat  of fummer, if
the foldier is under the  neceffity  of endur-
ing thirft,  or drink  too  much fpiritous li-
 quors.
    For the moft fluid and lighteft parts of
 the blood being by thefe means loft ;  what
 remains, grown more thick and acrid, is in
 a ftate to occafion great: difbrders, and above
 all inflarfmatory ones,  becaufe the mafs of
 humours fo thickened  is now greatly  dif-
 pofed to inflammation.
    When a Fever of this fort produces a
 topical inflammation, the cifcafc takes  its
                                    name 
        of  the   ARMY.       $3

fi*me from the part affected : for the Pleu-
rify, Peripneumony, Phrenzy, fore Throat,
i^uinzyj  Inflammation of the interlines,
are oiten  preceded,  and always accompa-
nied with a continued Fever.
   But when it happens that  fome of the
above  recited caufes occafion this  Fever,
and that it affects no part in particular, it is
tailed  fimply a Continued Fever.
   This Fever is known by the caufes that
precede it, by the  vigour  of the time of
iife, and a hot and fanguine constitution, by
a hard and quick pttlte, and chiefly by its
 extreme heat, which burns, as it were, the
 fingers of him who touches it.  The urine
is red, thick, turbid, the  tongue  dry, the
 thirft  great;  often an intolerable pain of
 the head,  and an obftructed refpiration.
   This difeafe, always dangerous,  is more
 or  lets fo according to  the violence of the
 defcribed  fymptoms.
   Large bleedings are necefTary in the be-
 ginning,  which are to be repeated till the
 great heat and drynefs  of the tongue begins
 to abate.  Barley water is the common and
 proper drink ; but to every  pintihoild be
 added an ounce of the remedy Nfe. 31. of
 which let him take  largely;  let  there be
 given  him every two hours a cup of the de-
                                  coction 
 g4      D  I  S  E  A iS  E  S
                            r
 coction No. 54. and twice a day the glyfter^i
 No. 11.                                 '' *
   This method is to be continued till the   *
 decline of the diftemper, which is known
 by the diminution of heat, of the quick*
 nefs of the pulfe, and of thirft ;  by the hu-
 midity of the mouth and  tongue, by  the
 urine being  not fo  high  coloured, and by''■• ,i
 the fediment it then depofes.  The  fame
 regimen to be obferved as  in the Pleurify.
   As the difeafe grows milder,  the decoc-   _
 tion No. 25. will be  fufficient for common  . 1
 drink,  and  let the  diet be gradually aug-  **
men ted till he is quite welt.
   It is highly  neceffary  to' obferve,  that
there is  alfo  another  fort  of Continued
Fever, without an inflammatory thicknefs
of the  blood, but rather occafioned  by a
putrid  diffolution of the humours.   This
laft fort is much worfe, and more dange-   «.
rous than  the other, and very often  this  ^
Fever proves contagious.
   This happens moft frequently, when,
 during the  great heats*  the Army is en-
 camped in marfhy  places; for then  they
 refpire an air corrupted with  bad effluvia.
 This   fort   of Fever prevails  alfo  very
 much, where many men, even were they
 healthy, are  lodged  together in  a narrow
 fpace,  where the air cannot  be renewed
                                   ofteri 
           or   the   A R  M Y. *      8$

    bften enough.   Ships of war and hofpitals,
    where  the  fick and  wounded are much
   ftraitenedj are  frequently vifited  by  thefe
   Fevers, efpecially if the air cannot be re-
   frefhed often enough; becaufe the air then
   to be refpired is fo corrupted by the  effluvia
   from the bodies, the flink of  the  excre-
   ments,  and  the putridnefs of the gangrened
   parts, that  it engenders a very  bad,  and
i,vtruly putrid  Fever,  which foon grows con-
jjj> tagipus;  It   is  therefore fometimes called
   the Jail or Hofpital Fever.  Its particular
   fymptoms fhould   be  exactly  defcribed,
   thereby to know this diftemper.
      It begins by a fhivering, followed by a
   heat, but  not violent;   foon  after,  the
   fhivering again, after which the heat,  and
   fo the fhiverings and  heat alternately.
      Total lofs  of appetite, .fleep diflurbed,
   and  without refrefhment,  a heavy pain of
   ahe head, affecting efpecially  the anterior
   part: the pulfe is  almoft  as in a  natural
   ftate: the fkin  is not  always very'dry :  the
   fick languifh on in this manner fome days,
   without being able  to attend their bufinefs,
   yet without  being   obliged  to  keep their
   bed.  The  tongue is feldom  dry; it is
   more,commonly foft, moift, and covered
   with a ^>;t of cruft of yeliowifh greed.
   The patient dozes much,  fleeps little,  and
   feems quite  abforbed in profound reveries:
                      M                 in 
86          DISEASES
in the progrefs of the illnefs, comes on  aH
trembling of the  hands, hardnefs or hear-
ing, and  dimnefs of fight;  the pulfe be-
gins to grow feeble,  and the patient is  de-
firous  of cordials  and  wine.   Towards
night, all the fymptoms grow worfe : laftly,
at different times during the courfe of this
diftemper, there appear purple fpots of an
irregular figure.
   The following fymptoms are confidered'
as mortal: A fudden proftration of ftrengrhyj
weaknefs  of the  fight:   the pofture of thi
fick,  ftretched on his back,  and  drawing
up his knees to him; reiterated efforts to
get out  of bed, black aphthae, livid pete-
chias,  and  ftripes  alfo  livid,  reffcmbling
the blow of a whip  fpread over the body;
the flux of the belly, with lead coloured
or blackifh ftools, weaken the patient more>
and more.
   Deafness is net a bad fymptom in  thi*
diftemper. Nay, it has been obicrved, that
patients on their  recovery are apt to grovf
deaf,  and  that fometimes they  have an
Abfcefs  in the conduit of the ear.
   Bilious ftools,  thick urine,  a moift
tongue,  are  good omens, efpecially if the
patient keep  up his ftrength.
   A number of  little red  puftule:-, or
white and elevated miliary ones, are good*
                                      *f
                                      31 
          OF  the   ARMY.       ,87

if at the fame time expectoration is eafy, and
the urine depofes a thick fediment.   Laftly,
it is counted a good fign, when an eafy fweat
comes on,  and relieves  the pitient, or the
parotids  fwell, or  there appear wjhite ap-
tha?.
   As the caufes here recited indicate that
all  things  tend  to putrefaction,  and that
the ftrength is extremely exhaulted, bleed-
ing can feldom be  of ufe,  unlefs in replete
habits, and that but once: for large bleed-
ings abate the ftrength immediately, and
occafion  a Delirium.   It is very neceffary
that the  air be often renewed.
   In cafe of a naufea,  or  weight felt about
the  region  of the ftomach,  or that the
tongue be covered  with a yellowifh green
cruft, the  patient  muft  take  the  emetic
No. 27.  and after  the firft effect of this
powder,  let him drink plentifully of warm
water, that he may vomit  afy, which is
to be repeated,  as has  been faid in the  ar-
ticle of Intermittents.
   The  evening  after the emetic,  let  the
patient take the bolus No. 58. and drink
after it fix ounces of the  whey No. 59. If
milk cannot be procured,  the decoction No.
 25. may be fubftituted in  its room,  obferv-
ing to add two ounces of wine,  and half an
ounce of oxymcl, to every pint.  This whey,
                                       or 
 8$        DISEASES

 or decoction, may ferve for common drink,  .
 efpecially as the fick are fond of vinous and
 comforting drinks, and that thefe drinks are
 fuitable to this diftemper.               ■,.,, j
   Let him take every fix hours the powder* *
 No. 60. with fix ounces of the above whey,
 or decoction.                              1
   Death, preceded by  great anxiety and  ;
 convulfions, is often the confequence of exT  1
treme languors, when the purples difappear,  ^
or the  miliary  fpots ftrike  in: in  which  I
cafe a fpoonful of the mixture No. 61. is to
be immediately given, with three ounces of
the whey or decoction No. 25.  to be repeat-
ed every three hours till he finds eafe,  and
the purples appear again,  or the miliary fpoti*;' jjj
rife; after which the  fame remedies arc to
be continued every four hours only.  If, in
confequence  of  this method,  an  equal  /
breathing fweat comes on through the whole  \
body, the patient finds great eafe thereby. \1
If the belly is conftipated, let  the glyfter No.  »
52. be given.
   It is proper to difcharge the patients from
out of the hofpital, as foon as they begin to
recover, that they may breathe a purer  air;
otherwife  a relapfc  is much  to be  feared,
 which is feldom or never got over.
The 
           OF   THE   ARMY.       89


          The  SCURVY

        THIS  is a common  diftemper, and  of
         difficult cure,  more efpecially in fieges
         and unhealthy places, where fome-
i   times the  troops are obliged to take up their
   winter-quarters.
     It begins  by a numbnefs of the limbs,
   with an unufual laffitude of the whole body:
i   after  walking, the  limbs and  mufcles feel
   quite fatigued, and,  as it were, broken.   In
   the increafe of the diftemper, refpiration be-
   comes fhort  and  difficult; fometimes  the
   thighs fwell;  at firft the face is pale, then
   grows brown, aqd the fkin is flained with
   lpots of different colours, the mouth begins
   to  fmell, the teeth  loofen in  the fockets,
   the  gums fwell, itch,  grow painful, and
   bleed on the leaft touch ; laftly, wandering
   pains affect different parts of the body.
     In the progrefs of the diftemper,  the gums
   putrify and  exhale an horrid  ftench;  the
   teeth grow yellow,  then black and carious.
   Sometimes  happen  violent hemorrhages;
   very bad conditioned ulcers break out, efpe-
f   cially on  the thighs; the patient feels vio-
   lent and painful fhootings in all  his limbs,
   which increafe in the night, and  the body
   is covered with black fpots.   At this period
                                        the 
90
DISEASES
the diftemper fuddenly grows worfc, Fevers
corns  on of different  kinds,  every  thing
grows  quickly putrid, and mortal haemor-
rhages  break out of the mouth, the nofe, or
about  the anus;  the vifcera putrify; and
faintings fucceed,  which are  foon followed'
by death.
  This diftemper is  frequent in winter
quarters, from the following caufes.
  Noisome  vapour?, arifing from marfhy
grounds  and ftagnating  waters, inaction,
fcarcity of greens and vegetables, drinking
of corrupted  and  ftagnating waters, the ufe
of falted and fmoaked flefh and fifh, and of
cheefe  too old and acrid ;  damp and low
lodgings, and not being open to the courfe
of the winds.
  Fear and forrow alfo occafion  this dif-
order,  and increafe it  in thofe  already at-
tacked  with  it.  By that, and by bad. food, $
ii often  makes fuch  ravages  in  befieged
places.
  Experience (hows,  that the humours
in this difeafe  are  not  only  putrid and
acrimonius,  but alfo condenfed.
  Therefore,  in the cure, care muft be
taken  to attenuate the vifcofity of the hu-
mours, and  to prevent or  correct putre-
faction.
  We arc to lend all  the affiftance  of art
                                     to 
       OF   The  ARMY.        qi

to prevent,  or avoid the caufes of this evil,
and thereby preferve the foldier from the
ravages of this diftemper.
  First, by correcting the impure waters.
This  i6 done by mixing two ounces of vi-
negar, and  two ounces  of brandy,  to every
pot of  water.   For  want  of thefr, fome
fliers  of calamus aromaticus may be fteeped
in the water.   This is a fort of reed, very
common, growing almoft every where,  in
fuch  low,  marfhy,  and damp grounds,  as
are moft fubject to the Scurvy.
   Strong purges, vomits, and bleeding,
do no fervice in this diftemper.
   But as  bad nourifhment  is one caufe
that produces the fcurvy, the  ftomach and
interlines muft be cleared, and evacuated,
which  is eafily done,  by gentle and reite-
rated purges,  fuch as  No.  34. to be taken
three times, with the interval of a day  be-
tween each.                    A*
   The food fhould be broth, with chervil,
forrel,  fpinage,  lettice, endive,  fuccory,
cabbage,  efpecially  red cabbage,  young
nettle buds and tops,  or any other fort of
tender herbage, boiled in it; the preference
to be given to thofe eafieft  to come  at.    ~;
   Fruit  quite ripe,  ufed moderately, al-
ways produces a good effect: but if neither
fruit  nor greens can be procured, the  pa-
                                   tient 
 9z       DISEASES

 tient muft have his broth with barley, oatsj
 or rice; he  may  eat  likewife a little veal,
 or fowl, but it muft be moderately.
   After the ufe of light purgatives,  anti-
 fcorbutics will be proper, but which are to
 be varied according to the different confti-
 tution of the patient.
   If he feels  himfelf cold,  his face  pale,
 his legs fwell, and his thirft is not great,
 let him take two ounces, that is, about a
 tea-cup of the decoction No. 62*  thrice a
day.
   If he is hot, his pulfe feverifh, his thirft
great, his breath bad, his gums bleeding '
and half putrid,  the  decoction No. 62 is :;
not fo proper as No. 63.  to the quantity of
three ounces thrice a day.
   Ripe fruits, and roafted apples and pears,
eafy to be procured,  are   alfo very  proper.
   *H|^ remedies  are to  be continued a
great^lhile. When the limbs move eafier,
and  the  pain diminifhes, the  difternoer
grows  better,  and then exercife and good
food will be  fufficient to compleat the'cure.
To carry of  all relicks, it  will be proper, on
 recovery, to take fifty drops ofTthe elixir
No. 64. in wine and watery equal quan-
 tities,  thrice a-day.
   Altho'  it be  certain, that when the
 diftemper is at  an   end,  the fymptoms
                                   ought 
             of  the  ARMY.      93

    ought  likewife to ceafe;  yet it is no lefs
    true, that after the  fcurvy, we  often fee
    thofe who have been attacked by it fubject
    to ulcers of  the  gums, lips, infide of the
    cheeks, and of the palate, which  foon
    fpreadj and  corrode  thefe parts, and  in  a
    little time turn to a gangrene.  Thefe ul-
    cers often deceive thofe who do not rightly
    underftand them:  they  appear in form of
I   white or yellowifh fpots, red, and inflamed
 \   round  the border, and often very painful.
    A great ftench accompanies them, and the
    fpittle,  which comes in  plenty, is  alfo of
    a bad fmell.   This  evil requires an imme-
    diate remedy, otherwife all would foon be
    infected  with  a  gangrenous putrid  hu-
    mour,  the  teeth  would  fall out of the
    fockets, the  jaws would  be affected, and
    entirely corrupted.
      But this  diforder is eafily got the  better
    of, by touching the parts lightly and often in
    the day with a little lint dipped in the pre-
    paration No. 65. Little comprefFes, imbued
    with the fame, may alfo be applied between
    the gums and lip,  and renewed from time
    to  time.
#.     Care muft be taken not to rub the part*
    affected too  much, as is  the  bad cuftom of
    fome,  for the evil and pain is thereby aug-
    mented.
                         N              If 
94      DISEASES

  If the ftench is great, and the ulcers ex^
tend themfelves  rapidly,   the  quantity  of
fpirit  of fea fait  is to be augmented,  till
you get the better of the gangrenous cor-
ruption.

       The  GANGRENE.

     AS mention has  been made of the gart-  ,j
     grane, it may be here proper to take*  »''
     notice, that the bark taken internally
is a moft efficacious remedy for  this dif-
temper, whatfoever part is attacked.        *
  The patient is to take every four  hours
one of the powders No.  30. till the gan-
grene  begins to  feperate from  the  found
parts, and a good  fuppuration comes on':  lj
at  which tjme it  will be fufricient for him
to  take them  twice a-day till the ulcer is  . *
mundified.
  The bark is  equally proper, when the  ;
fcorbutic ulcersvof the inftde  of the mouth '1
threaten to gangrene.                     .

    LUES    VENEREA.

    VEnereal diforders are always caufed  i
     by contact,  communicated  by the''
     infected to, even, the foundeft bodies.
                                   Thi* 
            of   the   ARMY.       95

       This contagion  produces many different
    diforders, which, according to the different
    parts of the body where it fixes, go under
    different  denominations.
       Small ulcers appearing at the extremi-
    ty  of the penis, or  on the prepuce,  are
    called venereal  fhancres:  if  the nervous
    papil'ae of the genital parts form little eleva-
    tions  Ike  warts, they  are called  venereal
    verrucas:  if the internal fuperficies of the
    urethra is affected, there arifes a difficulty
    and pain in  making   water,   named  a
    ftrangury,  and a running  of a yellowifh,
   ^greeniih,  or  fometimes brownifh  matter;
    it is then called a gonorrhoea; if fwellings
    in the groins, buboes.
       When the virus having gained the blood
    circulates with ihe humours, where-ever it
W  flops, it produces evils of different kinds,
    for inflance,  puftules,  and  fpots upon the
    fkin, that fometimes degenerate into filthy
    crufts:  ulcers  in  the  adipofe membrane,
    not giving way in the  leaft to fuch medi-
    cines as are proper in other  ulcers; which
    corroding  the adjacent  parts, leave  pro*-
    found and frightful cicatrices: thefe ulcers
^   no fooner difappear from one  place, but
    they  quickly  fhow  themfelvcs again  in
    fome neighbouring part.
       Tke  throat moft frequently,  and ths
                        W              roof 
96      DISEASES

roof of the mouth, are corroded little  by
little by this diftemper: there appears in
thefe  parts  a   fpot,  refembling  bacon ;
the voice becomes hoarfe,  the action of
fwallowing  is attended with  pain, and the
fpot we fpoke of gaining  ground by  little
and little, deflroys all the foft parts, and at
length attacks the bones of the palate and
mouth;  which  grow  rotten  and fall in,
and leave for the reft of life  a deformity,
for  which there can be no remedy.          ■
  Thls  diftemper, efpecially if it is inve-
terate,  attacks  alfo -the bones, and caufes
fwellings on them, which if foft, are called
tophi or gummi; ,if hard,  nodes or vene-■'.#
real exoftoies;  whence  enfue very bad ca-
ries, with  intolerable pain,  worfe  in the J
night,  the warmth of the bed increafing it;
but rather eafier in the day.                1
  Whs$ the  bor.es are corroded  even to
the marrow, the cure is extremely difficult,]]
zrA tho' cured  in  appearance, it often re-^
turns.
  1 h 16 diftemper may Jje eafily known by
the defcribed fymptoms.
  1 he following is a fafe method of treat-
ing it.
  Let the patient tr,ke, night and morn-
ing, one fpoonful of the medicine No. 66; \
drinking after it a pint of barley water with
                                  a  third i 
        of   the   ARMY.       97

a thifl&W milk in  it, ufing the fame for
his common drink : if milk  is difficult to
get, the decoction No.  67. may be fubfti-
tuted  in its room.
   This  medicine  gives  no manner of
trouble to the patients; to fome it procures
fome  light ftools, but -this feldom; in others
it works by urine and fweat.  Its ufe may he
continued with the greateft fsfety till all the
fymptoms  of the ..difeafe  have abiolutely
difappeared.      '*'
   If  the weather is mi?d and temperate,
the  patient  may go out; but  in cold and
damp weather, it is better he  fhould  keep
his room.
   If the medicine feems to act too flow in
 robuft habits, or when the diftemper is in-
 veterate, the dofe  may be augmented to a
 fpoonful and a half: and if in fome days the
 fymptoms do not  diminifh,  two fpoonfuls
 may  be  given every night and morning, in
 all four  fpoonfuls a-day.
   The  time the patient  i-s to continue the
 ufe of this  medicine, cannot be exactly li-
 mited :  often, if the diftemper is not very
 bad, the cure is performed in three weeks ;
 if inveterate, it takes up more time.  But
 it may certainly be ufed along while without
 the leaft inconvenience;
    When the ulcers cleanfe,  and cicatrize,
                                    when 
98        DISEASES

when the rotten parts of the bone fcparate
and  fall off, and  when  the tumours and
nodurnal pains  diminifh,  the  diftemper
gives way to the remedy.
  As to  the  regimen of the diet,  let  the
patient have broths with barley,  rice, or
oats, or tender greens, his flefti meat  lean,
milk diet, and ripe fruit.
  Fat and fmoaked or falted meat,  efpe*  >.
cially bacon, are bad.                     ;■
  The following remark is neceffary  to be  ",
attended  to.  SoraJfctimcs a falivation comes  .}
on from  the ufe of tjiis  medicine,  but this  :
is but feldom, and almoft only to thofe who  \
have  before made ufe of  mercury, either
internally or externally: neverthelefs, fali-
vation not being neceffary  to the cure, the
ufe of the medicine No.  66. is to be left off
immediately on the firft figns of a fpitting  \
coming on.
  But the decoction No. 67. may be ftiU
continued.
  The  figns of  an  approaching falivation
are as follow.
  The  gums begin  to fwell, to grow red,
to itch, and become painful, and  the breath
to fmell  ill.  As  foon as  thefe  fymptoms
are remarked, the ufe of the remedy No,   •
66. muft, as  has  been  before faid, be fufr
pended :  but if in eight or  ten  days thefe
                               fymptoms 
           of  the   ARMY.      gf&

   fymptoms difappear, and the patient is not
   cured,  it may again be ufed.
     If he has a gonorrhoea,  he muft drink
   plentifully of the decoction No. 67. to take
   off the acrimony of the  urine 5  he  may
   bathe  the penis thrice a-day, for a quarter
   of an hour at a time, in equal quantities of
   water and milk warm.
     If, by fuppreffion of the gonnorrhcea, or  ,
   from  any other caufe, a tcfticlc becomes
 <  fwelled and painful, and the fcrotum red ;
   let him be bled immediately,  the fomenta-
   tion No.  12. applied to the tefticle, and let
   him drink plentifully of the decoction No. 1.
   adding twenty grains of nitre to each pint.
   After   the  rednefs,  fwelling,  and Fever,
   which often  attend fwelled  tefticles, are
*"  appeafed,  it   will   be proper  to make
   ufe of the remedy No. 66.
     If venereal buboes  grow hard, a plaifter
   of galbanum is to be applied.


           The    ITCH

     IS a very troublefome diftemper to armiesfc
      and immediately fpreads by contact, un-
      lefs the affected foldiers are feparated
   from  thofe who are well.
     Though all the external parts of the
                                      body 
  loo      DISEASES

  body may  be affected, yet the  Itch  moil
  commonly fhows irfelf firft on the hands^
  principally between the  fingers :  firft ap-
  pears a puftule, or  two,  full of a fort of
  clear  water, which itch  extremely: when;.
  thefe puftules are broke by fcratching, the
  water that iffues  out  communicates the.
  diforder to the neighbouring parts.  It is
 not eafy in the beginning  to diftinguifh the
 Itch,  unlefs one is well  acquainted  with
 this  diforder :  but  in  its progrefs  the
 puftules augment both in number and  fiz^^
 and when opened by fcratching, a difguft-
 ful cruft is formed, and the evil gains the
 fuperficies  of the whole body.
   Hitherto the Itch hath  its feat be-
 tween the  epidermis and  the fkin; but if
 it continues long,  it makes way through the
 fkin into the  membrana adipola, where it
 forms  fmall ulcers, commonly in  great
 number.   This fort of Itch is the  naftieft
 and worft,  and at the fame time extremely..
 contagious.
  It is  to be  treated  in  the  following
 manner.
  The body is to he kept  clean, and linen
 often changed : if the feafon of the year per-
 mit,  they muft baihe, and  in  waters  im-
pregnated  with  fulphur,;  if they can :  if
they cannot, experience fhews, that to bathe
                                     in 
       of  the  ARMY;       ioi

in running water will  be of fervice.   The
fhirt, breeches, and flockings,  are  to  be
fcented with brimftone before they are put
on :  but  this fumigation muft be made in
the open air,  left the fulphurous vapours
fhould do hurt, if taken in by refpiration.
  Let the patient take the purging powder
No. 68. in the morning fafting,  and  repeat
it every  eight days.
  On  the intermediate days, let him take^
morning, noon, and night, one of the pow-
ders No. 69.
  Let the parts affected be anointed every
night with the ointment No. 70.
  If the Itch covers both the whole body
and all the  limbs, they muft not all be a-*
nointed together at once; but you may be-
gin by the hands, and the arms; continue
the next day by the feet, legs, and thighs,
and the third day the body; the  fourth day
to begin again by the  hands and arms, the
fifth the feet,  &c. and  fo on to the entire
 cure.
 v When the puftules are dry, the crufts fall,
and the ulcers difappear and return no more*
 the  patient is well.
   Some fpots will,  indeed, remain  on.the
 fkin,  but thefe marks wear off infenfrelyi
 and in time quite difappear.
   The  patient muft abftain from all man-
 ner of fait food during the cure.
                 O           WORMS. 
103
DISEASES
          W   O   R   M  S.

   SOLDIERS  are frequently troubled1
    with worms.  Bad food, unwholefome
    water, and other caufes engender them,  \
Vertigoes,  naufea, fudden fwellings of the  j
lower belly, efpecially after meals, the heart-  '
burn, grumbling in the bowels, and trouble-  i
fome itching of the nofe,  are indications of  4
Worms.   Some have a voracious appetite,.  3
others lofe it entirely : the face is pale, and  t
funk.
   But all  the  figns here defcribed are not  r
all found at the fame time in each  patient j
but the more of them are difcovered, the
more certainty we have of the diftemper.
   But, after all,  the moft convincing fign  •
is, when the fick void  Worms, by vomit
or ftool.
   All the cure confifts in expelling  them
out  of the body, but this  is not eafy ; for  \
Worms  are found to ftick,  as it were,  to
the  Intcftines,  fince otherwife  they would
come away with the excrements.
   It will, therefore, be proper,  in  order
to get  the better  of them, for a couple  of
days to give the  patient  fomewhat,   that
by its fmell may, in feme manner, in-
                                    fect 
OF   the   ARMY.      103
feet the inteftines j after which  to  give  a
a rough purge.
   Let the patient take five grains of afa
fcetida in pills every three hours, for two
days.
   The third day let him hare the purging
powder No. 71. in the morning fafting,
taking after it a  light  broth,  to be conti-
nued  from time to time, till the medicine
has done working.
   If,  after this procefs, the fymptoms do
not difappear, in eight days time the whole
muft be repeated.
RECIPES, 
         RECIPES.

Treatise  on the referred toy in the  N

               foregoing

DISEASES   of   the  ARMY,

j. '"pAKE of the fpecies for the pectoT
    "■*   ral decoction three  ounces.   Boil
in a fufficient quantity of water for half an
hour,  to ftrain  three pounds.
   2. Take of the mafs for pil. cynogloff^j
eight grains.   Make two pills for a dofej^j
   3. Take of the fpecies for the emolli-  ,
ent decoction fix ounces.  Boil in fuffici-  J
ent water to the thicknefs of a cataplafm,
adding  towards  the end  muftard  feed
bruifed  one ounce,  for  a  poultice.
   4.   Take flower  of" elder  one ounce.  *
Let it juft boil up i|i a fufficient  quantity  l
of  water  in  a clofe veflfel: then  digeft  ;
warm for half an hour ; ftrain two pounds. .$
To which add,  rob of elder one ounce and
a half, pure nitre  forty grains. Mix.
   5. Take flower  of elder,  and red  rofes,
of  each  half an   ounce,  pure nitre one
drachm.  Mix.   Infufe a pugil of this in
warm water for tea.
   6.  Take  leaves of fenna  fix drachms,
water  fcurvy grafs  two  drachms, agaric  J
pne  drachm,   tamarinds  half  an ounce.
                                    Boil 
           RECIPES.     105

 Boil for,, a quarter of an  hour,  in  water
 enough ;  ftrain two  ounces, add fyrup of
 rhubarb half an ounce.  Mix for a draught
 to be taken at once.
   7. Take of  the fpecies  for emollient
 decoction  four ounces.  Boil for half  an
 hour  in  water  enough  to ftrain  three
 pounds.
   8. Take of the refidue  after the ftrain-
 ing of the laft, at will, add meal  of lint-
* fead, oil of  lintfeed,  of each two ounces.
 Mix for a cataplafm.
   9.  Take  flowers  of red  rofes  two
 pugils, agrimony one handful.  Mix.  In-
 fufe like a tea for a gargarifm.  Add  a little
 honey.
    10.  Take  honey of  rofes half an ounce,
 fpirit of fea fait,  twenty drops.   Mix.
    11.  Take  fpecies  for  the  emollient
 decoction two ounces.  Boil in water fuf-
 ficient,  for half an hour; ftrain one pound.
 Add fimple oxymel two ounces,  pure nitre
 one drachm.  Mix  for a glifter,
     12.  Take  fpecies for emollient  decoc-
 tion three ounces.   Boil an hour in water
 fufficient ;  ftrain  four pounds.   Diffolve
 Venice  foap two  ounces.  Mix for a fo-
 mentation.
                                13. Take 
  IC6     recipes:

    13.  Take pure nitre one drachm and a
 half, crabs claws two drachms,  fyrup  of
 wild poppies  two ounces, barley water ten
 ounces.  Mix.
    14.  Take oil of fweet almonds, or, in-
 ftead  thereof, beft olive oil, two  ounces,
 one yolk of an egg;  to them well beat up,
 add  pure  honey  one ounce,  Mix  for a
 linctus.
    15.  Take kerrnes  mineral  three grains,
 crabs claws twenty grains.  Mix.       J»
    16.   Take Paul's  betony,  agrimonj^
 ground ivy,  golden  rod,   of each  equal
 parts.   Infufe in warm water for tea.
    17.   Take  cucumber  feed  half  an
 ounce,  fweet almonds  blanched  No. 8,
 bitter ditto No. 2.   Mix with barley wa-
,s ter one  pound:  ftrain  for  ufe,  for  an
 cmulfion.
    18.  Take myrrh fifteen grains,  crabs A
 claws half a drachm.  Mix for a powder.
    19.  Take  of the  mafs for pills  of horer
 hound fix grains.  Make two pills.
    20.  Take  balfam capivi half a  drachm,  ;
 a yolk of an egg.  To them, well rubbed^
 in a glafs mortar, add pure honey one ounce.
 Mix.
    21.  Take  coltsfoot, fcabious,  tops of
 St. John's wort,  of each one handful;
                               powdered 
            RECIPES.    k>/

  powdered liquorifh two ounces. Mix. Infufc
  for tea.
     22. Take pure nitre one drachm, crabs
  claws two drachms,   fyrup  of  marfh-
  mallows   one ounce,  barley water  ten
  ounces.   Mix.
     23.  Take  rafping  of   faffafrafs two
  ouno*s, of the three faunders, of each two
  drachms,  powder of liquorifh one ounce.
  Mix. Infufe for tea.
     24.  Take liquid laudanum  of Syden-
  ham, fifteen drops,  fyrup   of  diacodium
  half an  ounce,  barley water  one ounce.
  Mix for a draught.
     25. Take of the fpecies for the antefe-
  brile decoction  three  ounces.    Boil  for
  half an hour, in a clofe veffel, in fufficient
  water ;  ftrain four pounds for ufe.
     26. Take tartar emetic  fifteen grains,
  a  powder for one dofe.
     27.  Take root of ipecacuanha half  a
  drachm,  a powder for one dofe.
     28.  Take  powder  of carnachini  forty
l  .grains,   t%
     29. Take fal. .polychrcft  two drachms,
  tartar of vitriol one drachm, fyrup of five
  opteing  roots two ounces,  barley  water
  half a pound, diftilled water of lemon peel
  two ounces.  Mix.
*   .   ■                           30. Take 
 io8     RECIPES.

   30.  Take  finely powdered  bark one
 ounce,  to  be  equally  divided into twelva
 papers.
   31. Take purified honey three pounds  ,
 beft wine vinegar, one pound.   Mix.
   32. Take cream of  tartar  forty  grains,  *
 fal. polychreft twenty grains. Mix. Several
 of thefe dofes  to  be given as occafioa,may  1
require.                                  '
   33. Take theriaca diateffarion, conferva  ,
of wormwood, of each one ounce.  Mix.,
   34.   Take   pill,  rufii  thirty grains,
Make feven pills.                          j
   35.    Take oxymel  of  fquills  two;
ounces,  fal. polychreft two  drachms, vitri-  ;
olated tartar one  drachm, common water
eight ounces,  fpirit  of mint half  an ounce.
Mix.
   36. Take fah  polychreft two drachms,  '
tartar of  vitrio1 one drachm,  theriaca dia-
teffar. three ounces, fyrup  of five opening  -
roots, enough  to  make an  electuary.     —
   37.  Take  dog  grafs half  a  pound,!
dandelion, with leaves and all, four ounces^!
Gut and bruife  them, and  boil  in a fuffici
cient quantity of common water,  or whey
if conveniently to-be had, for half an hour;
ftrain by  ftrongly  prefiing two poipnds-  5
Add pure honey three ounces.   Mix.
                                    38,' 
        R E  G  I  P  E  S<      loj

  38. Take tops  of common wormwood
two ounces, roots of calamus aromaticus*
gerttiah,  imperatory, of each  one ounoe,
bay berries one ounce and a half, juniper
berries three ounces, wild carrot feed oae
ounce.   Cut,  bruijfc, mix.   Infufe warrri
in a clofe  vafe, in,  either good  wine  or,x,
rneai, .  eight  pounds,  for  twenty  four
hours.
   39. Take  fquills  frefh half an  ounce*
Infufe in good wine two pounds.
   40. Take camphor  one drachm.   Dif-
folvc,  by rubbing it with oil of  fweet al-
monds one ounce, in a mortar.
   41. Take diftilled oil of annifeed gutt. 4*
 white fugar forty  grains, powdered rhu-
 barb fifteen grains.   Mix for a powder.
   42. Take diftilled water of  mint eight
 ounces,  fpirit of mint half an ounce. Mix.
   43. Take  diftilled cinnamon  water one
 ounce,  barley water half  a pound, pure
 opium three grains, crabs claWs one drachm
 and a half, fyrup of white poppies half an
 ounce.   Mix.
   44.  Take  beft  rhubarb  one drachm*
 citrine  myrabalans  half  a  drachm.  Mix
 for a powder.
    4 c. Take Venice treacle one drachm, for
 a bolus. .  • /
    46. Take  ipecacuanha 'forty  grains in £
 powder,
                     P                47* 
120
RECIPES-
  47. Take crude opium one grain in a pil^  t
  48.  Take waxed glafs of antimony eight   .,
grains in powder.
  49.  Take  bole armoniac  fix  drachms,
gumm. a*abic. one drachm, Venice treacle
one ounce and a half,  fyrup  of wild pop-
pies, enough to make  an electuary.
  50.  Take good wine half a pound,  bar-
ley  water one pound and a half, cinnamon
water one ounce, white fugar fix drachms.
Mixr
  51.  Take pure turpentine two drachms,
one yolk of an egg.  To them, well mix-
ed,  add Venice treacle  half an ounce,  pure ^
milk five ounces.  Mix for a glyfter.
  52.  Take fpecies for emollient decoction
two ounces.  Boil  in water  enough  for  1
half an  hour; ftrain ten ounces,  add  lint-
feed oil two ounces.    Mix for a glyfter.
  53.  Take  leaves  of marfhmallows  two
handhils, roots of ditto one ounce,  bruifed
lintfeed two drachms. $oil half an hour
in  water enough to  ftrain three pounds.
Add, pure nitre  one  drachm, pure honey
three ounces,  Mix.                    a
   54.  Take tanaarinds three ounces.   Boil
a quarter of  an  hour  in  water enough to
ftrain three pounds.   Add, pure nitre one
drachm, honey two ounces.   Mix.
   $5. Take meal of muflard feed one ounce,
limfccil one  ounce  and a half, beans  one
ounce,  common fait two drachms, vinegar • 
          RECIPES.       in

'   enough  to  make a pafte, to be applied to
   the foles of the feet.
      56. Take white vitriol one drachm, com-
   mon water one ounce.  Mix.
      S7* 1 ake agaric of the oak,  powder it.
      58. Take Venice  treacle one  drachm,
   fait of hartfhorn  ten  grains.   Mix  for a
   bolus.
      59. Take new milk two pounds,  gene-
   rous white  wine  four ounces,   BoTI for an
   inftant;ftrain the whey from the curdfor ufe.
      60. Take Virginia ferpentine root, con-
   trayerva root, of  each ten grains, bark half
   a drachm, camphor four grains.  Mix for
   a powder.
      61. Take camphor one drachm. DifLIve,
   by rubbing ir?a mortar, and  dropping on
   fpirits of wine rectified, twenty drops. Add,
   white dry fugar two ounces, rub them well
   together, pour on white wine vinegar ten
   ounces.   Mix.   Keep in a well flopt  glafs
   vafe for ufe.
      62. Take  Jborfe-radifh root,  frefh  ga-
r   thered and fliced thin, four ounces,  leaves
'  * of fcurvy-grafs frefh  gathered, marfh tre-
   foil, of each twohandtult^age, one hand-
   ful.  Cut, mix; infufe  in generous wine
   fix pounds, in a clofe veiTel,  with a gentU
   heat, for twenty-four hours; ftrrJn for ufe.
      63.  Take  root of  fharp pointed  dock,
    polypody of the oak, of each half an ounce,
    chryftals of tartar three drachms.  Boil for 
ii2     RECIPES. ,-

half an hour in milk three pounds ;  ftraint
Add,  honey, one  ounce  and a half. Mix
  64  Take  fpirit  of  fcurvy-grafs  two
ounces,  elixir  proprietatis   Paracelfi  one
ounce.  Mix.
  65  Take fpirit of fea  fait  one drachm,
honey of rofes one ounce and a half, com-
mon water five ounces.   Mix.
  66.  Take corrofive   fublimate  twelve
grains,  rectified  malt  fpirit  two  pounds.
K, ep  in a clean glafs vial, till the mercury
hath voluntarily  diffolved.
  6y.  Take root of marfhmallows two.
ounces;  Boil in a fufficient quantity of wa-
ter for an hour, adding near the end pow-
dered  liquorifh  one  ounce^  Strain four
pounds.                  ^
  68  Take fcammony fifteen grains, fine
fugar  ten  grains,  Ethiops mineral  twenty
grains, diaphoretic antimony twenty grains.
Mix  for a powder.
  69. Take flower of fulphur thirty grains,
Ethiops mineral ten grains.Mix for 21 dofes.
  70  Take  Ethiops  mineral one  ounce, ^«
hog; lard three ounces. Mix for an ointment.
  171.1 akeTuibfth mineral five grains, root
pf ialap forty grains, fineft white fugar twen-
ty grains.   Mix  ;^ rub to a very fine pow-
der in a glafs mortar.

    END  OF  THE   RECIPE S,^, 
EXTRA CT  S

          FROM  THE


 MARINE  PRACTICE


              O F


PHYSIC and SURGERY.


WITH SOME BRIEF DIRECTIONS TO BE
    OBSERVED BY SEA-SURGEONS
       IN  ENGAGEMENTS,  &C.
                        *
By WILLIAM NORTHCOTE, Surgeon,
 MANY  YEARS  IN  THE  SEA-SERVICE.
          *                ./;
             Including,
The nature and  treatment,
               of
 GUN-SHOT  WOUNDS.

By JOHN R A NB Y, Efquire; surgeon general
     to the B R I T I S H ARMY.
                           i


       PHILADELPHIA:
 Printed, and Sold,  by R. BELL,  ia Third-Streefr*

            MDCCLXXVL 
 
    OF  WOUNDS  OF  THE  VEINS,
   ARTERIES, NERVES, AND TENDONS;
      WITH  OBSERVATIONS.
     IN Wounds of the Veins, the blood flows
      with a fmooth even ftream, of a grofs
      conliftence and dark color ;  and is ordi-
   narily reflrained by the common methods,
■ *  fuch as dry lint,  ftyptics,  &c.
      If an Artery is wounded, the blood flows
-   impetuoufly  and per  faltum, and is of a
   florid color ; to fupprefs which, if the ori-
'*.   fice  be acceffible, make a ligature  on  the
   Artery with  a crooked needle  and waxed
   thread, which is  the fureft and  beft me-
   thod : but the haemorrhage may be fup-
   prefTed by the torniquet,  till the  ligature
   can be made*  If it  be not  acceffible,  and
   the Artery runs  along the  fide of a bone,
   apply a fuitable bandage,  compreflcs, or
   bolfters.   It is not neceflfary to comprefs it
   fo much as totally to preclude the acceflion
   of any blood, but only to impede its efflux,
   and retain the thrombus, fo as to grow to
.!'»  the fides of  the  divided  arterial coats.   It
   requires great judgment, however, not to
3;  let the compreffion be too fmall, to prevent
    an Aneurifm.   But  if theywounded artery
   lies within a bone which  "prevents its late-
    ral compreffion,  the only means  remaining
    is  to apply dry lint, and retain it forcibly
    againft the divided orifice. Neither ftyptics
    nor  cauteries  fhould ever be ufed to fup-
    prefs an haemorrhage when ligature or com»
    preffion can take place.
      If a large  Nerve be totally divided, at 
    WOUNDS op the VEINS, feci
 firft it caufes excruciating pain and inflame
 mation by contracting and  ftrctching the
 other  branches  communicating with it$
 afterwards the part becomes paralytic, and
 either fades  by an atrophy,  or is confumed
 by a mortification,  For the arteries being
 no longer able to  propel their contained
 fluids, for want of the Nerves which fup-
 ply their coats,  the humors are accumulate
 ed, ftagnate, corrupt, and mortify the part.
 But if the Nerve (or even a Tendon) be only
 half divided, there follows a continual and '
 flow laceration, a fpreading  inflammation*;
 excruciating pain,  fever, delirium, convul^
 fions, &c. with a gleet, or thick ferousr
 difcharge; which fymptoms are in propor1
 tion more violent as the Nerve  is more di«*
flended or ftrctched.
   In order to the cure,if the Nerve lie cove- '\
 red, under the fkin and membrana adipoftj*"
 dilate the Wound,  that the medicaments
may penetrate to the part. Drefs with balf. -
peruv. warm (dropped  in) a  pledget  of
foft digeftive, and  an emollient  poultice;
with a proper bandage  to take oflfthe diftea4:
tion.   Wounds^of the Tendons and Liga-
ments are to be dreffed after  the fame man*,,
ner, only the applications fhould be  more
drying.
   In the  ufe of thefe, if the patient feel the
heat of the topics  moderate, then they are
rightly fitted: if the  part itch  and fmart,
and the aperture become wider, the topics
are ftronger  than they  ought to be.   Q F 
fc)F  GUN-SHOT  WOUNDS,
their NATURE and TREATMENT;
  with   OBSERVATIONS.

if/^tUN-S HOT Wounds,  of all others*
 VJT are more complicate, and much more
       difficult of cure,  than  an iucifed
Wound,   even  with  lofs   of fubftance:
becaufe here the fibres and veffels  being
lacerated,  their  juices extravafated,   and
their  texture  deftroyed,  a  large digeftion
or fuppuration is neceffary  to remove the
injured  parts,  before  the Wound can be
incarned and healed j and hence  alfo the
fymptoms of inflammation, pain,  &c. are
commonly   more violent   in  Contufed
Wounds."
   " They are more or lefs  dangerous, ac-
cording to  their extent, and  the part in
which they are feated. Thofe which extend
into the bones, vifcera, or joints, are of the
worfe  kind;  and efpecially when any of
the wadding, cloths,  or fplinters  are car-
ried into the part together  with the  ball;
for the confcquences, in thefe  cafes, muft
be  inflammations, gangreges, caries,  &c.
which make an  amputat^n^eceffary.  But
Gun-fhot Wounds in  the cranium  are
above all the  moft malignant  and fatal;
though even here we  have often furprifing
                     P          inftances 
118  GUN-SHOT  WOUNDS,

in fiances of cures made by art and the ef-
forts of nature, when the cafe has appeared
to be defperate."
   ♦The following method is extracted from
Mr.  Ra;>b;'s  excellent Treatifc on Gun-
fhut  Wounds,  whofe penetrating judgm* nt,
and great experience in fuch cafes, muft be
univerfally acknowledged."
   "  The firft intention,  in regard of acci*
dents caufed by a mufket or  piflol ball, is,
if pofiible, to  extract  the  bail,  or any
other extraneous body that may  be lodged •;■
in the wounded part.  And whenever thefe
cafualties arc  attended with a great  efTu-
fic n  of blood,  from  the rupture  of  fome
confiderable arterial veffrl, it will be  abfo-
lutely  neceffary, with all imaginable dif-
patch, to reftrain the bleeding  by taking
up the artery  with the*  needle ; and,  at
the fame time,  to  be particularly careful
that   ycur hold  proves   no  way  elufive.
There is no depending on any applications,
however ftyptic, ofi thefe occafions."
   " In order to get at the  ball, or any  other
foreign  matter t;.st infefts  the  wound,  I
would aovife  probing or poking to be ufed
&s fparinr^ly^s ppifiblo ;  having eonftantly
'experienced,  through' the whole  courfe of
my  attendance  in ihefc  cafes,  that fuch a
j&ethcc! is  highly dctrimcntul '.o the patient: 
     GUN-SHOT   WOUNDS.  119

  and, indeed, where  probing is neceftkry,
  I Would always pr^r the finger as the  b--ft
  and trued probe.'
     " If a ball, or any other body hapoens
  to be  lodged near the  orifice,  or is io ind
  by the touch to lit under the fkin,  though
  at  fome  diflance from  t\\c  m-;uthoftne
 1 Wound j  in the  firft  cafe  it  is requinte
  immediately  to  re.novy fuch extra/ieous
  matter ;  and, on the other occafion, to cut
  upon  it, and take it  out.   But when  it is
  funk deep, and  lies abfolutely  beyond the
  reach of the finger,  I could  never bring'
  myfelf to thruft thofe long  forceps  the
  Lord  knows where,  with fcarce any  pro-
   bability of fuccefs."
     "  A great number of inftances have oc-
  curred to me, where balls have been quietly
   lodged in the bedy j  till, after  many ye/rs,v
   they have we'ked themfeives  a pafTigc to-
t   wards  the  furface, and were coiitequently
   very eafily extracted,   In cafe the wound be
■.  occafioned by a  mufket or piltol fhor, ?nd
   confequently but fmall, it will be neceffary
^ to dilate it immediately: yet,  I  think,  in
   Wounds near a joint, or in  v&y membra-
   nous  or tendinous  pares,  trfe knife,  as
   well as  forceps,  fhould be put-under fome1
   reuraint; nor  any  more  opening made,
                                       than 
120  GUN-SHOT WOUNDS.

than what is abfolutely requifite for the^free
difcharge of the matter lodged within."
  " Wounds in the joints are always dan-
gerous,  let them  proceed  from whatever
caufe, whether a  bullet, or  any cutting   /
instrument* and membranous  or tendinous
parts muft undoubtedly fuffer from their   j
being thus expofed to the very feniible im-
preflions of the air.  I could produce many    ,
in fiances of balls going through  mufcular.
parts, and  the Wounds being healed with   j
very little trouble.  And  I  have  known
Wounds of the fkull  from a broad-fword
(both tables having been cut through,  and
a considerable  piece loofened) which were
fuffered  to bleed for feveral hours,  and   k
did well j  nor were attended, at  leaft very
feldom,   with any feverifh   complaint;  v
which was  probably owing  to  the great^j
quantity of blood loft immediately after the
part? had been injured.  If the  ball has gone  *
quite through, both orifices are to be wid-
ened (if in a part  where it can be done with
fafety) and particular care is to be taken to
preftrve  both openings,  that   efpecially  *,
 which  is  the  moft depending.  No tents. *J
 are to be made ufe of, where there is any
 poffibility of avoiding them ;  and I would,
 in  general,  recommend  light,   eafy dref-
 fings, with a flight, moderate bandage, juft
                                fufficieni 
     GUN-SHOT   WOUNDS.  12?

  fufficient to keep them on the part.  Thin
  flannel  is  what I would prefer,  in cafe it
  can be got."
     " Where the  wounded perfon has  not
  fuffered any great lofs of'blood,  it will be
  advifeable to open a  vein immediately,  and
  take from  the arm  a very large  quantity,
  and  to repeat bleeding*,  as  circumflances
  may require, the fecond, and even the third
  day.   This  timely precaution  will  pre-
  vent a good deal of  pain and inflammation,
  forward the  digestion, and  contribute to-
  wards obviating a long train of compli-
  cated fymptoms, that are wont otherwife to
  interrupt  the cure, miferably harrafs  the
  poor patient,  and  too often endanger  his
  life."
     " rFor the  firft  twelve days  it will be
  proper to  obferve a cooling regimen,  both
  in refpect of medicines  and diet : and as,
  in circumflances of this kind, it is necefiVy
   that the body fhould by all means be open,
*   a ftool fhould be every day procured, either
   by emollient  clyfters,  or  fome gentle  lax-
   ative.  Whatever application is of a  hot,
   fpiritous nature, I find remarkably injurious
   on thefe occafions,  and what no wounded
   part  can in any degree bear."
♦  *«« Let the  firft  dreffing  be  with  lint,
   dry, or moistened with a little  oil,  and a
                                        very 
122  GUN-SHOT   WOUNDS;

very light bandage ;  the next  with  a  di-
geftive warmed, and  over  it the bread and
milk  poultice,   mixed with  a  fufticient
quantity  of oil  to keep  it  moift:  and,
where there is a great tcnfion,  and  the
Wound large, a fomentation.   This courfe
is to be continued  till  the fore is clean ;
and then  it is to  be  healed according  to
art."     <          ■
  " This method will commonly promote
a conftant, eafy   perforation,  abate  the
pain, very much  facilitate the digeflion^
and remove all danger  of  any  approaching
inflammation.  What  induces me to moi-
ften the lint  with oil, is  the  eafe that  is
procured to a Contufed Wound from fuch
an application,. in corrtparifon  with one of
an  abforbent, drying  difpofition ;  which,
infleed of giving  free liberty to the fanious
blood  to dilcharge itfelf,  and  confequently
preventing  an  inflammation by unloading
the part, would poffibly obftruct the mouths
of the capillary veffels, and hinder  nature
from  getting rid of  that incumbrance,
which fhe endeavors to throw off."
   "  Should an  inflimmatien  feize  any
part,  through the lodgment of a bullet,  or
any other foreign body,  that could with
 iafety have been more immediately extractn^fc
 ed; all  attempts for  diflodging  fuch ex-
                                 traneous 
     GUN-SHOT WOUNDS.   123

  traneous  matter  fhould  be postponed,  till
  the fweUh'g has  in fome meafure fubfided,
  and  the  inflammatory  difpofition  of  the
  fibres is nearly vanifhed :  unlefs the bail,
  or other extraneous  body,  lies at no great
  distance from the orifice  ; and  there is,
  On that account, a  certainty of  removing
  this  incumbrance,  without any  material
  trouble to the  patient."
    u  If a Wound be  of fuch a defperate
  nature, as to require amputation (which is
  often the cafe, when it happens  in  any
  particular joint) it would certainly be of
  coftfequence to perform  the operation  im-
  mediately as foon as the patient is  brought
  down ; left by delaying  it an inflammation,
  which  one  may very  reafonably  expect,
  fhould  obflruct a work that ought rarely to
  be entered upon during the continuance of
  fo calamitous  a circumftance as that of  a
  fmart engagement.    The  neglecting  this
  critical juncture  of taking off a limb fre-
  quently reduces  the  patient  to  fo low  a
  ftate, and  fubjedts the  blood r.nd juices to
  fuch  an alteration, as muft unavoidably ren-
  der the fubiequent operation, if not entirely
  unraccefsful, at  least exceedingly dubious.
  And  in Wornds even where no amputation
$Hs required,  it is  equally  advifeable net to
  defer the care neceffary to be taken  of them$
                                      left, 
    I24  GUN-SHOT  WOUNDS,

   left, by the parts being  expofed to the air;
   there might arife a feries of very dangerous
   fymptoms/' ^ v
     " Wounds that border on any consider-
   able artery are very apt to bleed afrefh upon
   motion, or a return of a free circulation  of
   the blood  into the part which was inter-
   rupted  at firft by the  violence of the injury
   offered  itj and  this  is  almoft always the
   the cafe, when the flough begins  to fepa-
   rate : for which reason one fhould  never
   attempt to remove'it by force -, but wait*
   with patience,  till there be a perfect fepa-
   ration of this  flough  -, nor  be in the leaft-
   wife {hocked  at  the  accident of  arteries
   thus opening  themfelves,  which  a  very
   moderate experience  will  convince one to
   be almoft inevitable. The patient frequently
   gives warning of what is coming upon him,
   by complaining of a great weight  and ful-
   nefs in  the limbs, which  are ever accom-
   panied with more or lefs pulfation in them*
   an infallible prognoflic of the confequences.
   Let the Wound afflict  whatfoever part, if
   thefe complaints attend it,  I inftantly en-
*f join bleeding and the bark."
     " I  have known   feveral  instances  of
   perfons lofing their lives from  the starting!
   of an artery   before the   furgeon could^
   reach them >  particularly where there hasf
                                  preceded 
   GUN-SHOT WOUNDS.   i2|

preceded an amputation. And I dare affirm,
the quantity  of blood loft in fome cafes,
which I have obferved to kill, has not a-
mounted to  twelve ounces -,  which  I do
not know how  to account for otherwife,
than by the drain  which  had been made
from  the mafs of blood  both before and
during  the operation;  whence  a fudden
gufh, though of fo moderate a portion of
blood,  after the  great  quantity  already
loft, gives  a check to  the circulation, and
caufes immediate death."
   " This  reflection,  I think,  ought to be
a leffon to  every practitioner,  to be parti-
cularly intent on the  faithful difcharge of
his duty  in  regard of tying the veffels.
Repeated  bleedings in the beginning dr*aw
after  them many advantages : they  gene-
rally  prevent, and always  leffen,  any feve-
rifh attacks,  and feldom fail to obviate
impofthumations."
   «  The body muft ever  be kept in  a lax-
ative ftate; and, when pain puts it on the,
rack,  immediate recourfc must be had to
the fovereign and almost  divine powers of
opium ; next to  this I  likewife  add the
bark,  a medicine which no  human elo-
quence can  extol with  panegyric propor-
 tioned to its ineftimable virtues.   Of fuch
incomparable  benefit is  it  to  mankind I
             *~\    Q_             A have 
i26   GUN-SHOT WOUNDS,

I have known it procure  reft, if given iff
large  dofes, when even  opium  had  been
taken without any  manner  of effect.
  "  In all large Wounds,  efpecially thofe   ■'
made by a cannon-ball, there is  eonftantly
a great laceration of the membranes, and "*,
parts  endowed with an exquisite ffenfation.
Thefe are ever  attended with an excrucr-   jj
ating pain, and a difcharge of a gleety mat-   ?
ter ;  which,  if not restrained* proves often   ..?
of the laft confequence."
  "  In this unhappy state, the bark, given
in dofes  of a drachm each, and repeated  ^
every three  hours (or oftener,  if the fto-   ^
mach will bear it) furpfifingly repairs the   ■
breach made in the constitution by  thefe   i
terrible accidents.  Elixir  of vitriol taken   V
three  times a-day, in  a glafs of water, I find
to be of lingular  benefit,  and  to  prove a
very  good affiftant  to  the virtues of thfr
bark.  And if the body be collive, to each
dofe of the bark  I add four or five grains of
rhubarb, till that inconvenience is remedied.
Should the bark run off by more than four
or five fucceffivc flooh, I take care to check
this  effect of it by ordering two or  three
drops of  laudanum, or  two fpoorsfuls o£
the diafecrdium  mixture  along with  it,
svery time it is  given".
                               "  Where
>     f: 
   GUN-SHOT WOUNDS.   127
                        «
   " Where the fore difcharges a confider-
aole quantity  of gleety matter, is  flabby,
looks  pale and gloffy  (which appearances
are ever confequcnt  to a lofs of fubftance)
the bark continually relieves the pain that
is predominant in this  cafe,  thickens the
matter,  leffens its  quantity,   and  quite
changes the complexion of the Wound."
   "  It is  very common in cachectic and
fcorbutic  conftitutions (which  latter  too
much aboHnds in fea-faring people, efpe-
cially in long voyages) for afore,  the firft
eight or ten days after taking off the limb,
to promife  all  imaginable fuccefs:  fron>
which time  It frequently begins  to gleet
 prodigioufly,  looks pale, gloffy, and flabby;
 and  this  gleetirig, if  not checked,  foon
 proves mortal.   In exigencies of this kind,
 the bark hardly ever fails  to procure relief,
 and  works an apparent change in a very
 (hort fpace of time; fometimes in twelve
 hours."
    From what has been  here  faid by Mr.
  Ranby, it is evident that the  bark  is one
  of the beft remedies in contracting the vei-
  fels, and reftoring their due action  upon the
  blood,  when too  great a quantity  of that
  neceffary  fluid has been  loft  by  a prof ufe
  hsemorrha&c, provided the wounded veilels 
128  GUN-SHOT  WOUNDS.

are previoufly  clofed  up,  or well fecureii   \
from a return of the haemorrhage.
   Jt alfo not only fecures the moft tender
folids and fmall veffels from being diffolved   j
by the acrimony  of any matter abforbed,   j
and returned into the whole mafs of blood,
from  large  Wounds  or  latent abfeeffes;   i
but it likewife preferves the texture of the    ■
blood itfelf from being too much  broken,   J
or rendered  too watery  from the  fame  .-\
caufe,  which  would  otherwife inevitably   ,\
produce  a  fatal  and  colliquative  hectic^
But where  there is too great  a fulnefs, or  \j
too great a ftrength and contractile force of  •'.»
the folids, and an  inflammatory  tenacity   j
or fizinefs  in  the blood, it may  occafion
obstructions,  pains,  inflammations,   and
their  confequences,  unlefs it be timely
laid  afide  upon  the  appearance  of fuch
effects*
SOME 
SOME  BRIEF  DIRECTIONS
   PREVIOUS  TO,  AND   IN
      ENGAGEMENTS,  &c.

     THE value of an able furgeon, and the
      neceffity of his affirtance, never more
      plainly  appears  than  in  dangerous
wounds received in an engagement or battle;
where many brave men  muft unavoidably
perifh from lofs of blood and  other caufes,
unlefs  restored and  fnatched, as  it were,
from the jaws of death by the flcill of their
furgeon.  And  no doubt, the  better opi-
nion the officers and men conceive of their
furgeon, the more fpirits they have for the
action ; being confident, the woueds,  6cc.
they may chance to receive will be properly
treated, and their lives  (if  poffible)  pre-
 fcrved.  Therefore a furgeon of a man of
 war fhould have every thing needful,  in  a
fufficient quantity, always by him in readi-
 riefs (but more particularly in time of war)
 placed in fome kind of box  or  drawer by
 themfelves.  His capital inftruments  fhould
 be  constantly  kept' clean, bright, and in
 good  order.   His apparatus  fhould  conflft
 of  feveral  tourniquets  (of  which  PeuYs
 fcrew tourniquet  is  the moft convenient,
 as the patient can easily  manage it himfelf,
 after it is fixed) crooked needles  of all fizes,
 threaded with proper flat ligatures, in  pro-
 portion to the needle ; a large  quantity of
                                  portion 
 J30     DIRECTIONS  * or

 fcrapcd (fhort) lint, fome mixed with fl6ur
 in a bowl;  double and fingle headed rol-
 lers (or bandages) of all breadths and lengths,
 in good flore; for flight wounds and con-
 tusions, thofe made of bunting (the fly- part
 of an  old  ensign)  will  be fufficient; but
 for cafes of more confequence, fuch as  am-
 putations,  fractures,   difloeations, &c. the
 linen rollers muft be  ufed.  He  ought to
 be furnifhed with common  needles  and
 thread, with pins  in  plenty; pledget6 of
 tow,  of what fizes he pleafes; after they
 are made,  they mqy  be wet with water, or
 oxycrate, on  the  fame board, and dried
 either by the galley-fire or in the fun.  By
 this means he may  the better lay them to-
 gether (in  a drawer or box)  without in-»
 tangling,  and they are both  much better
 and readier to fpread,  when wanted, with
 any cerate, ointment,  or  liniment.
   Splints of all fizes muft alfo be at hand,
 and when  ufed  armed with  tow,  or old
 linen  cloth; likewife bolsters, or compreffes
 of cloth,  or  coarfe tow; but thefe may
 be readily  made as  occafion requires.  To
 the above  add yards  of  incle,  or   flrong
 tape,  to fecure  your fplints  in  fractures,
 and for other ufes.  Ey this method  a fur-
geon will  always be provided againft every
accident which may befall his Crew.
                                  Whwi 
        SEA  SURGEONS.      131

      When the enemy is in fight, and you are
   like to come to an action,  as foon as alt
   hands are called to  quarters (if your cock-
   pit is not fufficiently large) you  muft defire
1,...*■ the firft lieutenant,  with the  captain's per-
   miffion,  to order the carpenters  to lay a
   platform  for your  wounded  men ; if the
   cables will not  be  wanted, in  one of the
   cable tires, or otherwife in the after-hold,
4 by clearing of all manner of  lumbei; out of
<i> the way.   On  the  top of a frnooth  and
   even tire calk,  let there be deals or planks
   laid clofe together,  over  them an old  fail,
:   and upon that Come feamen's  bedding from
,   the purfet's ftorc-room  (for which you are
   to have the captain's order,  if he will not  «
   otherwife deliver them)  ready made up,
   and  laid one  by  another to  place  your
   wounded men  en   after  they are  dreft,
   that they may lie quiet without being dif-
   turbed.                                   £'
      If the fhip be  fmall,  and there is  no  \ \
-.■ cock-pit, or fuch as you have not room to
   perform your operations  in, you muft, as
   near the  after hatchway as  is  convenient,
   have fome calk  removed  out (if  there be
   not height enough  for you to ftand upright
   on the platform) that you may have a place
   of eight,  ten, or twelve feetJiquare, to re-
   ceive and drefs^ your wounded men,  and
                                      from 
,32    DIRECTIONS   for

from thence to hand  them to their beds: .
on one fide of this place let there be fixed
a chest of a  proper height if you have no  ■
other convenient feat) to perform your ope-
rations upon ; and on another juft by (or,
table) lay all your apparatus, fuch  as your/^
capital instruments, needles,  ligatures, lint,
flour in a bowl, flyptic, bandages,  fphjits,
comprefles,  pledgets  fpread  with  yellow-
bafilicon, or fome  other proper digeftive;
thread,  tape,  tow,  pins,  new and old
linen  cloth, a bucket of water to put yourj
fpunges  in, another  empty  to receive the
blood  in  your operations;  a dry  fwab or
two to dry the platform  when neceffary $
awater-cafk full  of  water  near at hand^
with  one head knocked  in, in readinefs
for dipping  out occafionally as it  may  be
wanted. You muft alfo have  near'you your
ung. bafil.—e gum. elem.—fambucin ;  ol.
Hn.*—olivar. c.—terebinth ; balf. terebinth;
tinct. ftyp.—thajbaic ; fp. c. c.  per  fe.—
vol.  aromat.—lavend. c.  Wine,  punch,,, or
grog, and vinegar in  plenty.
   A number of large candles fhould be im-
mediately  lighted, as foon as the engage-
ment begins, not forgetting to have your
mates and afliftants  properly instructed in
wtiat part  they  are to act,  that every one
may know his ftation, and  what he has to
                                     do, 
     SEA  SURGEONS.     133

fco prevent  confusion  in  time of  action.
Here it is  neceffary  to obferve,  that the
furgeon fhould always take peculiar care to
defire the firft officer to quarter a fufficient
number of hands with him in the cock-pit,
that he may want  no affiflance in the day
of battle, however bloody the engagement
may be.
   All things being ordered,  and  placed as
above  in readinefs, and the  furgeon's and
purfer's cabbin beds made up, to  receive
the captain, or any of his commission of-
ficers,  who may chance  to  be Wounded 3
if you have any fick  on  board,  that can-
not ftand to their quarters, let them be put
down with  their hammock and bedding into
the hold, fore cockpit, or fheet cable  tier,
out of the  way before the aftion begins 3
but be fure to keep your platform entirely
for the' wounded  men.  Let one of your
mates or affiftants go to them now-and-
then to fee how  they are;  or  elfe order
one of  the ftouteft of the convalefcents to
come to you  at times,  if he is able, and
acquaint you if any of them  are Worfe, and
in cafe  of  faintncfs, to give them a little
cordial, which he ihould have by him for
that purpofe.
   When the action is begun, if more than
©ne wounded is  brought down at a time,
                  R        *      always 
i34   DIRECT IONS   for

always firft take care of him who is in the
moft  immediate  danger;  but otherwffe
drefs them as they come, without diftinc-   j
tion :  if any is brought  down  with a  limb   {j
off, or a violent haemorrhage, and you hap-   j
pen to be in the  midft of an  amputation,   1
or other capital  operation, and cannot that   1
inflant attend, order your mate or affiftant   \
(for the prefent) immediately to fix  a  tour-   .,
niquet on the part,  to  restrain the  flux of   g
blood from being  fatal  to the  patient, and   -\
do what elfe you may think neceffary,  till
you have finifhed the operation you were  ;j
about, and laid  the patient in bed.        r :.m
   Never encourage  thofe  to  flay  below  M
(after their' wounds, &c. are   dreft)  who   ]
have been but little hurt,  but infift on their    ■
going up again to  their quarters, otherwife
threaten to report them when the engage-
ment  is over.  1 have many times  known  "j
cowaidly lubbers come tumbling down the   }.
ladder with  moft  violent  groans and com-   i
plaints, though  at the fame time they have
received  little or no  hurt; and all  1 could
do or iay  would  not prevail  on them to
rnake a ieccnd  trial  of their courage, nor
go up again  till the action wss all  over.
Nay, 1 have been told  (by thofe quartered
at the fame gun)  that  feme dastardly-fel-., :
lows have  actually put their feet, or flood.
                                     in 
    SEA   SURGEONS.     135

in the  way of the carriage,  on purpofe to
be hurt,  that they might  have a plaufible
pretence for  going down to  the doctor;
which I muft own  I have great  reafon to
believe, having fometimes met  with fuch
contufions in the  legs and feet, occafioned
(according to their own confeffion) by the
carriage,  but at the fame time fo flight as
was fcarce  worth  mentioning;  though
fometimes  very  violent,  at  other times
there was fcarce any injury or contufion to
be  perceived^  notwithstanding  the moft
grievous complaints of pain and uneafinefs.
   When you are entering on any  capital
operation, you fhould uie your utmost en-
deavours to encourage  the patient (if he is
fenfible) by promising him, in  the fofteft
terms, to treat him tenderly,  and to finifh
with the  utmoft expedition ; and indeed
you fhould ufe expedition but not hurry :
you fhould not make  more hafte than th~
cafe requires, nor cut lefs than is neceffary,
or leave any mifchief unremedied ; for the
neglecting this  critical juncture of taking
off a limb,  frequently reduces the patient
 to fo  low a ftate, and  fubjects  the blood
 and juices to  fuch an alteration, as  muft
 unavoidably render the  fubfequent opera-
 tion,  if not  entirely  unfucceisful,  at leatt
 exceedingly  dubious.    Therefore,  it  a
                                  wound 
j36    DIRECTIONS  fok

wound be of fuch a defperate  nature as te
require  amputation (which is often  the
cafe  in  fea  engagements)  it is certainly,
of confequence to perform  the operation  ;;:j
immediately as foon as the man  is  brought
down:  and in  wounds,  even where nq
amputation  is required,  it  is  equally  ad-
vifeable not to defer the care  neceffary to
be taken of them.                          j
   In regard to the wounded,  you fhould   j
act in all refpeds es if  you were  entirely
unaffected by their groans and complaints $
but at the fame time I would have you ber  p.
have  with fuch caution, as not to proceed
raftily or cruelly, and be  particularly care-
ful to avoid unneceffary pain.
   When the action is all over, you are then
to go round your patients,  and examine if
the  wounds have bled  any thing confider-
ab.y  since  they  were  dreft;  and  if  the  :';
{-.semcrrhage  ftill continues,  remove  the/, j
dreffings very gently and carefully,  and ap-, M
ply irefh ones.                            m
   It is not improper here  to remark tha$  ' ^
the   tourniquets   fhould ftill  remain  on,
thv fc "patients,  who have had their  limbs,
ampuraud or fhot off; that they  may be
always  in  readinefs, in cafe of a frefh hae.r
mo rhage; and in c»ie there be no affiftant
preitnt  when it happens, the patient fhould 
         SEA   SURGEONS.    137

   be irtftructtd himfelf how to tighten it,  \f-
   he feels the  wound  bleeding, before help
|   can be procured.   YjU are likewife to fee
*   that  their wounded limbs, &c. lie eafy, and
   as they ought; and  that the patients  are
   fupported with proper diet  and  medicines
 V fuitablc to the fymptomatic  fever,  &c. as
   mentioned  under the   various  heads  in
   Northcote's Marine  Surgeon,
     As foon as poffible after the engagement
"t is ended,  and your wounded are all taken
*  proper care of, acquaint the captain how
  ' many there  are wOunded, and  the nature
Sf? of their wounds,  if they are like to prove
   mortal, &c.  And defire he will pleafe to
   order cradles forthwith to be made, as ma-
»   ny as you think  neceffary,  wherein  your
   wounded men muft be  placed,  with their
   bedding,  in  a proper birth  by themfclves.
  1 The cradles  are   firft to be well cieated,
> fTand fecured  to the deck and fides of the
• V fhip, placed fo, as that  you may easily go
   between to drefs the people.
      As foon as the  fhip arrives in  a harbour,
   the fick and  wounded muft be immediately
   fent  on fhore, where their cures  will be
   perfected in  a much fhorter time than  it is
   poffible on beard in an io/alubrijos air,
   and  on fuch diet only  as the fhip  affords.
      It is neceffary   the furgeon of the  fhip
                                      ihould 
\
138   DIRECTIONS  for

fhould give  a more particular account of
patients fent to  an hofpital, than is  the
common practice  in the navy, of merely
filling up a  fick ticket  with the general
name of a  difeafe, &c.  He ought to ac-
quaint the furgeon, or  his affiftant at the
hofpital, of the peculiar constitution of the
patients, the manner they have been treated
from firft to laft,  the fymptoms,  &c. that
have occurred ; and what  ever other cir-
cumstances he fhould be informed  of, in
order to enable  him  to perform a  more
fpeedy cure.
PREVENTATIVES of  the SCURVY  \
           at   SEA,  &c.

     TH E beft method of preventing  th*
      Scurvy at Sea is a liberal ufe of acid»
      (particularly thofe of vegetables) and
to avoid eating the fhips fait provifions as
much  as poffible,  to  ufe  fridion daily,
either  with a flefh-brufh  or coarfe cloth.
Proper exercife, dry lL;en, and cleanlinefs,
not a little contribute to health.
   It appears from  many repeated experi-
ments of Dr. Lind,  and a number of Sur-
geons  in  the  royal navy, that of all acids,
oranges and lemons have the beft effect in
                              preventing 
         SEA  SURGEONS,    139

    preventing and  curing the Scurvy (the lat-
    ter I fhall here  omit mentioning, it being
    already laid down  in  the Marine Surgeon,
ft   Vuh 11. Chap. VIII. Sed. VI. Art.. Scurvy,
    to which the reader is referred).   Oranges,
    in my opinion,  are better than lemons, for
    by thefe Lord Anfon's people were fo fpeed-
    ily and furprizingly recovered at the ifland
    of Tinian.  It is certain, when  they are
t>.  properly and fufficiently  ufed, they are an
    infallible  cure in every stage and fpecies of
l.  the Scurvy, if there is any degree of natu-
    ral strength  left;  and  where a diarrhoea,
    lientery, or dyfentery are not joined to the
I    other fymptoms.   Some are apt to think
'•■   tamarinds, vinegar, fpirit of fait, elixir of
j,   vitriol, and other  acids of the  fame kind,
    will do as well  ; but experience (that beft
    of masters) plainly fhews  the  contrary;
    and  though acids  agree  in certain proper-
    ties,  they differ widely in others.  When-
    ever  thefe fruits are given without  fuccefs,
    you may  be fully  affured the difeafe is not
    the Scurvy ;  for in the real genuine  Scurvy
    they were never yet known to  fail. How-
    ever it is neceffary  alfo to obferve that frefh
'    vegetables of all kind  prove a great relief
$.   to fcorbutic patients when fet on fhore. .«
*     But as oranges  and lemons  are  apt  to
    fpoil in keeping, there is now {0 be  had  an
                                    excelftnt 
 i4o   DIRECTIONS   for'

 excellent quinteffence of thefe fruits, which
 may be  Very advantageoufly ufed as a fuc*
 cedaneum, being  but  little inferior to the
 recent juice.
   When you are in countries where oranges
 and lemons  grow  fpohtaneoufly, and can
 be procured in  great plenty at  a  fmall ex-
 pense, 1 fhall here (hew how to bring  their
juices, by a very eafy method,  into a fmall
 quantity without prejudice to their virtues;
   Let the juice  of thefe fruits  be   well
 cleared from the  pulp, and depurated by
 Handing fome time ; after which it may be
 poured off from the grofs fediment:  let it
 then be  poured into any  clean open veffel
 of china or ftone  ware, which fhould be
wider at the top than at the bottom,   that
it  may evaporate   more readily.   A china*
bafon or punch bowl is  most proper on
account of the  form.  Put this into a  pan':
of water over a clear fire;  let the water
come almoft to boil, and  continue nearly
in  that ftate,  with  the bowl  full of juice in
the middle of it,  till the  juice is found of
the consistence of a thick fvrup  when cold;
The flower  the evaporation of the juice is,
the better; that is,  it ought to continue
twelve  or fourteen  hours over the  fire:
when it is cold it  is  to be corked up  in a
bottle for ufe. 
      SEA   SURGEONS.     i4t

   Two dozen of good  oranges, weighing
five  pounds  four  ounces, will yield one
pound  nine  ounces and a hdf depurated
juice ; and when evaporated there wiil re-
main five cunces of extrad, which in bulk
will be equal to lefs than  three  ounces  of
water:  fo that twelve dozen of oranges  or
lemons may be put into a quart bottle, and
preferved good feveral years.   When this is
mixed with water,  and  made  into punch,
few are able to diftinguifh it from the frefh
juice mix^d up in the fame manner.
   However,  when the frefh  fruit can  be
had, the fragrancy of the peel  may contri-
bute fomewhat to the cure of the Scurvy;
and when thefe are wanting, the fame thing
may be obtained from a few drops of their
chymical eff-nce, or the aromatic oil con-
tained in their  finds; and if a fmall quan-
tity of this be  added to the extrad, it will
give it the imell and fragrancy of the frefh
fruit  in  great perfedion: or rather  add a
little of the outer peel  to the extrad, a lit-
tle before it is taken off the fire, and then
the niceft tafte  will not  be able to diftin-
guifh the difference between the frefh fruit
and this.  The virtues of this  extrad, thus
made, lie  in  fo  fmall  a compafe, that  a
quart bottle full will ferve one man at lea
                  S              feveral 
j 42    DIRECTIONS  for

feveral years.  In making of it there is lit-
tle or nothing flies off but the water.
  It will likewife be of great ufe to all fea-
fating people to have always  with  them,
bullace,  floes,  wild-plums,  hips,  elder-
berries, goofe-berries,  and  the like, pre-
ferved In bottles, in the fame manner as the
paftry-cooks keep  the  latter.   Cabbage,
French beans, &c.  may  be preferved by
putting them in clean dry flone pots or jars,
with a layer of fait at  the bottom,  then a
thin  layer of the vegetable covered with
fait, and fo alternately till the pot is full;
then the whole muft be preffed down with i
a weight, and its mouth quite flopped with
a cork or timber plug,  well pitched over,  f
that no air  or moisture may  enter:  thus
the vegetable  may be kept frefh and green
for a whole year.
   At the time  of ufing,  the  fait is to be
wafhed off with warm water.   This is the
manner by  which they preferve that never-
failing   remedy  Greenland  fcurvy-grafs.
Every common failor  fhould   alfo  lay in a
 flock of onions  and mustard, for they are
 a oreat  preservative  at fea.   The  Dutch
failors  are  preferved  from the Scurvy by
pickled  cabbage.  It   muft  be  obferved,
likewife, that a foup of boiled cabbage and
 unions will cure-an adventitious  bcurvy  in
                                      its 
      SEA   SURGEONS.   143

its firft stage, either at land  or fea, in any
part of the world ; and what will cure will
prevent.
   Salt provisions  fhould  always be  eaten
with plenty of vinegar, mustard, and onions,
but as little of  the meat as possible,  efpe-
cially when the Scurvy begins to make its
appearance in the fhip.   Thofe who have
been  weakened by long  illnefs  fhould be
more particularly guarded againft the Scur-
vy, by living on boiled bifcuit, with  a few
drops of the  quinteflence or extrad of le-
mons or oranges, and a  fpoonful of wine ;
as alfo oatmeal and rice gruels,  flummery,
ftewed  barley,  with  raifins  or currants,
fago, and  wine, 6cc.   But  more particu-
larly  pickled, green cabbage or  beans,  as
before mentioned,  and fmall onions boiled
with the portable fuup made weak.  Mcft
of their food ought to be acidulated with
orange  and lemon juice,  their quinteffence
or extrad.
   The  infpiffated juice of turnips (a thing
very  easily and  cheaply procured) is a:i ex-
cellent  kind of ingredient in foup for fea
ufe.  The water-dock-  (hydrob.pathum)
the  berries  mentioned  above,   and crab
apples;  alfo  apples,  peart,  or  any  other
fruit, cither preferved with coarfe  fugar
(by being boiled in it) or elfe brought to a 
 J44  I DIRECTIONS  for

 rob or extrad,  by boiling  their  expreffed
juices, &c.  as already laid  down  for that
 of lemons and oranges, by  which means it
 may be kept good  through  the  longeft
 voyages. Apples,  pears, &c. when well cho-
 fen, and well packed in dry tight calks, will
 keep very good for two  or three months ;
 or they may otherwife be cut in flices,  and
 put upon  firings in dry weather,  By which
 they will  be dried  without  lofing their
 flavour or tafte; they are  then to be care-
 fully flowed in very dry  boxes,  and aired
 fometimes to prevent their  mouldering or
 being damaged.
   Good wine may be made by fermenting
 the  before-mentioned extrads with water
 and fugar; bullace and floes are  preferable
 to any other (oranges and lemons  excepted)
 being a noble antifeptic astringent.         /
   Poor people that  winter in Greenland,
 under vaft difadvantages in  point  of air and
 diet, prefcrve themfeives  from the Scurvy
 by fpruce beer.
   1 he common beer brewed for  the ufe of
 fhips fhould  b= imbittered with  wormwood,
 chamomile fljwers, or even gentian, rather
 than by means  of hops ; and  by the for-
 mer it  will keep longer than with the latter,
 without acquiring any bad property,  and
 have full as agreeable a tafte; but it fhould be
                             plentifully 
     SEA  SURGEONS.     145

plentifully  impregnated  with thofe ingre-
dients.
  The fhrub black fpruce of America makes
a moft wholefome drink, and affbrds a bal-
fam fuperior to moft turpentines; it  is of
the fir kind.  A simple  decodion  of the
tops, cones,  leaves,  or  even of the green
ba.k, cr wood  of thefe,  is  an  excellent
ahtifcorbutic; but perhaps it is much more
fo when fermented, as  in making fpruce
beer, which  may  be brewed (refh  every
two or three  days.   It  is to be made by
pouring boiling water  on thetfops, cones,
lepves, bark, or wopd of the fpruce, or any
other fir, dried  or green ; the latter may be
easily carried in bags at fea: but when  thefe
cannot be had1,  a little turpentine or  wormr
wood  may be  fubftituted; which  ever be
ufed, it is then to be fermented by the addi-
tion of a proper quantity ofmolaffes, which,
by its diaphoretic quality, makes it a more
fuitable  medicine.
   Again,  when fpruce  cannot be  had,
the common fir-tops ufed for fuel in the
fhip fhould be  firft boiled  in water, and
then the decodion be fermented with mo-*
laffes ;  to  which  may  be added  a  fmall
quantity of wormwood  and  root of horfc-
radifh (when it can be got); the frefher it
is drank the better.   When other things
                                     are 
146    DIRECTIONS  for

are wanting, tar-water may be  fermented
in the fame manner.
  A drink may alfo be brewed the f ime way
from the faffafras chips, or from the branches
or berries of the juniper plant: for if  the
henefit is fuppofed to depend (as it certainly
does) upon the fermentative quality, or to be
derived from an  acefcent, antifeptic, corro-
borative, and balfamic virtue  in the reme-
dy,  what  is more liberally endowed with
thefe qualities than  thefe fubftances I have
mentioned ?
  Besides frefh and preferved fruits,  vege-. -
tables, and  the  drinks  ^bove  mentioned, "
fermented liquors of all forts  are good, but
more particularly cyder ; among  thefe are
included many  wines of every  kind ; or
the juices of  fruits  (already taken  notice
of) may be fermented  with ale, &c.
   The late  very learned and juftly cele-
brated  Dodor  Huxham fays,   " Let  all
fhips,  that are to proceed on a long cruife
or   voyage, be  fupplied with  a  fufficient
quantity  of found  generous cyder;  the
rougher,  provided  it  is perfedly  found,
the  better."
   If apples are found of fuch  vaft fervice
in the Scurvy, furely the juice  of them,
when  become a vinous liquor,  cannot but
                                      be 
      SEA   SURGEONS*     147

be very falutary, and feems exceedingly well
adapted,  as a common drink, to corred ?>y
its acidity the alcalcfcent, putrefying quality
of bad, corrupted provisions.   This cyder
fhould be at leaft three  months  old before
it is ferved in,  and quite fine ;  if it be too
new, and foul,  it  is apt to  give fevere
colics: it fhould be racked off (once at
leaft) from its grofs ley into good and fweet
veffels, which will contribute to its becom-
ing fine, and prevent it from growing ropy,
in which  ftate it is good for nothing: but
if fome of it fhould turn to vinegar, which
may frequently happen,  it will ftill be very
ferviceable ; but it  is  found,  when  well
managed, to keep good  and found  even to
the  Indies.   Every  failor  fhould have at
leaft a pint  of cyder a day, 'besides beer
and  water.
   The prize wines,  which are commonly
low  and thin,  and, very  frequently fpoil by
keeping,   might be difliibuted  among the
fhip's company (efpecially in want of cyder)
to very good purpofe.
   The   ventilators   fhould be  eonftantly
worked,  once  a day at leaft; and  the decks
frequently wafhed or fprinkled with  vine-
gar.  In cafe of slinking  water, lemon juice,
elixir of vitriol, or vinegar fhould always
be  mixed with it,  which will render  it
                                  much 
148   DIRECTIONS  for

much lefs unwhclefome.  A fmall drachm
of garlic brandy, or the  tindure of bark,
taken in  the mornings fafting, snd when'
going on the night  watch, is  a great pre-
fervation.   See the  next Chapter on the
Prefervation of Health, &c.
  Cream of tartar,  being  the effential ve-
getable fait of  wine, is a very  proper  fuc^'
cedaneum  when  fruit  is  wanting;  and
orange or lemon  petl (or its effence)  will
greatly improve the flavour : besides cream
of tartar is the  moft grateful of  all acids,
fubftitutcd in the room of  the  juice of le-
mons and oranges,  and beft adapted to the
constitution of mariners: it is alfo the cheap-
est;  for an allowance of the  eighth  part
of an ounce a day will not cost the govern-
ment much  more than one milling yearly
for  each  man,  or eighteen pence at mofV
Two pounds and a half of cream of tartar
will be fufficient  to acidulate an  hcgfhead
of water;  this, with rum and fugar,  will
become a falutary composition of a cooling, ''
ftrengthening, antifeptic,  and diuretic  na-
ture ; for there is nothing  more repreffes
the  inflammatory and intoxicating power
of fpirits than  acids.  Such a liquor would
prove infinitely more whoelfome than the
grog, wherewith the  navy is commonly
                                  ferved 
        SEA   SURGEONS*    149

,  ferved  when fpirits are ufed,  both in the
  Eaft and Weft Indies,  and elfewhere.
     The officers and men (that can afford it)
  fhould always carry to fea a very considerable
  quantity of pickles of different kinds,  par-
  ticularly onions ;  and preferves and extrads
  of all acid fruits, fuch  as floes, bullace, dam-
  fons, &c.  They muft all be properly pre-
  ferved in glafs bottles  or flone jars well tied
  over; glazed earthen  veffels are  very dan-
  gerous cither for preferves or pickles^
v:   Allowing cyder, &c. to the fleet, in-
ly'deed, may be  deemed a  very  expensive
1| project; but where the lives  of fo  many
m. brave and  ufeful people are in the cafe,  I
'think (as Dr. Huxham very humanely  ob-
;  ferved) the cofi fhould  by  no  means come
■  into competition  with  the  advantage that
k  may be  received  frorri it.  The  Romans
v eonftantly carried with them vinegar  and
/ wine in  their  fleets and armies, and  tho
f  common  foldier and failor daily partook of
?  both;  nay, they were at many other con-
;  fiderable expences to preferve the health of
|  their armies, &c.  Now,  if that  glorious
*  prudent people thought the life  of a Ro-
  man foldier fo  valuable, and were at fuch
f> expence to preferve it, why fhould not we
k  have as  much  regard to that  of a Britifh
                     T             failor;. 
l5o   DIRECTIONS   for

failor, who is altogether as  brave,  and as
ufefui to the Common wealth ?           j
   It is neceffary here alfo to remark, that ,a
the ufual met) od of impreffmg feamen on
their return from long and tedious voyages^
void of neceflaries, chagrined at not feeing j
their friends and families, and moft com-
monly in a bad  ftate of heakh,  and  not
allowed  time and opportunity to recover |
it,  hath  been the bane of thoufands: and
I moft heartily wifh, for the honor of the  |
nation and the good of the  public,  that a
method  of manning  our  fleet could  be j
found out more consistent  with  common^
humanity  and  Britifh liberty;  and  like-^
wife to  have it ferved with more  whole-"
fome provision,  better beer, and a fufficient
quantity of found generous cyder on board
every fhip, to be ufed at difcretion, and as
neceffity required ;  from the foregoing re- J
 marks it is evident what advantages would!!
accrue from it»                          *
RULES? 
    RULES FOR  PRESERVING  HEALTH,
     IN WARM, AND COLD CLIMATES.BY

   DOCTOR LIND,  and SURGEON NORTHCOTE.

        HEAT itfelf is not  fo  prejudicial to
         Health as is generally imagined ; but
         when joined to moisture it is remark-
    ed,  that  it  occafions  the moft fatal  dif-
    tempers in all warm climates.
      When a fhip rides at anchor near marfhy
    ground or fwamps, and the wind blows di-
    redly from thence in hot weather, the  gun
::p ports ought to be kept fhut; and if fhe rides
    with her head  to the wind, a thick  fmoke
    fail fhould be eonftantly kept up to the fore-
    mast, to carry  up the fmoke of the galley,
    and prevent its coming aft over the fhip : at
?|i, fuch  times the men fhould be  ihjoined to
: <  fmoke tobacco, and the fhip fliould often be
    fumigated with it,  as well as with pitch
    and tar ;  the method of procuring tobacco
    to be fo ufed,  without  any additional ex-
    pence to the  government,  is, instead of
    burning the great quantities every year feiz-
    ed by the coftom-houfe and  excife-officers,
    to order it to be preferved, and fent to the
I   dock yards to  fupply the fhips destined for
    foreign voyages; it may be either added to
 l  the boatfwain's or carpenter's stores,  in fuch
 I   large quantities as may bethought convenient
 1   -for the above  ufe of fumigating : to prevent 
152     DIRECTIONS   in

abufe, it fhould never be ufed without the
captain's order, and  always  iffued out by
wrigHt ; it would  likewife be proper  that
centinels fhould attend the  burning it to
prevent embezzlement, which precaution
in my opinion would be of infinite advantage
 on many occafions, and a much more  pru-
 dent way than the  prefent method of con-
fuming it, without the leaft benefit accruing
 to any individual.
   Boats crews and  men employed on fhore,
 being moft expofed to the open air,  fliould
 he often relieved,  and never fuffered to fleep
 on fhore,  not  even in tents or otherwife, if -)\
 to be avoided ; but  fhould always be oblige&i|
 to return and lie aboard  at night: but when
 this cannot be complied with, and men are
 obliged to  remain  on fhore, their tents
' fhould  be very  clofe, and  ereded on the
 dryeft fpot they can find, that is, upon dry
 fand, gravel, or chalk, near the fea fhore.
 The negroes,  and fome of  the Indians on
 the coaft of Guinea,  both of whom fleep on
 the ground, have eonftantly a fire producing
 a litde  fmoke  burning in the huts where
 they fleep, which  correds the  moisture of
 the night,  and renders the damp of the earth
 lefs noxious;  therefore if your tent is made
% on the grafs, and at a distance from the fea-
 fhore, it  will be neceffary  to obferve" the
 fame rufc: the door of the  tent fhould  be
 ipwards the fea, and the back pap fecured 
   WARM AND  COLD  CLIMATES.  I53

by double canvas.   All old forfaken houfes,
caves, and fuch like places, fhould be  well
purified with large fires;  the  men fhould
never  fleep on  the ground, but in  their
hammocks, and be very well covered; every
morning and evening  they fhould take a
dram of the fpirituous tincture of the bark :
likewife the officers and  men,  when  on
fhore, fhould be  allowed a more plentiful,
but not immoderate ufe of vinous liquors.
   Dr.  L1 n d fays,  that people  coming -
firft  from  a  cold into  a  hot  climate,
arc   apt  to  have  plethoric,  fymptoms
(which in general I have found to be the
cafe in many fouthern voyages,  with fome
few exceptions) a pain of the head, giddi-
nefs, a fenfe ot the weight, and fulnefs pf •*
the  breaft, and  fome are apt to be feized*
with ardent fevers and diarrhoeas,
   All praditioners have obferved, that new
comers into warm climates are at firft liable
to  fevers tending to the ardent  kind, and
are  very  fubjed  to fevers of the remitting
and intermitting kind, which  are  the en-
demics of all warm countries at certain fea-
fons of the year; and after fome t^pe they
are apt to fall into fluxes, the yellow-fever,
and othe difeafes depending on a putrefeent
 ftate of the juices.
   Nothing has been found to be more pro-
 dudive of difeafes  in thofe warm climates,
than indulging freely in the ufe of fpirits and
% 
 ir4      DIRECTIONS  IN

 other  ftrong  fermented liquors, lying on
 the ground, being expofed to damps and
 dews,  and working hard, or ufing violent
 exercife in the heat of the day.    '
   The moft  dangerous difeafes  in intem-
 perate climates, and voyages to the fouth-
 ward,  proceed from a continuance  of hot,
 moift, clofe weather, or from heavy rains,
 common  at fome feafons of the year be-
 tween  the Tropics ;  at  firft a few of the
 men are feized with the bloody-flux, which
 is fucceeded by a malignant fever of the
 remitting or intermitting kind,  but  moft
 commonly it is like a double tertian :  this is
 epidemic  between the Tropics,  and is the '*i
 autumnal  fever of all hot  countries; the  it
 fafety  of  the  patient entirely depends on
 the fever's intermitting,  or at leaft on  its
 remitting  fo much as to  allow an opportu-  '■'
 nity of throwing in the bark, which is the
 only fovereign remedy in thefe fort of ma-  ,.
 lignant fevers,  though they  put  on differ-
 ent appearances.
  TThe bark rnight be made extremely pa-  A
 latsble  by infusing it in fpirits with orange
 peel, ajjji  |he  billious fever and the bloody  -i'j
 flux might be prevented by it: four ounces
of  bark  and two ounces of dried orange
peel will be fufficient for a gallon of fpirits;   t
and two ounces may be allowed  each man
a day  when there  is an apprehension  of
thefe malignant difeafes: it will  be beft to  it 
    WARM AND  COLD  CLIMATES.  ir,£

take half in the morning on an empty fto-
mach, and the  other half when they  are
called out to their night watch.
   The bark  is an  excellent medicine for
failors on  many accounts,  it  being  the
greatest  antileptic taken inwardly  of  any
yet difcovered ; but as it is a very expensive
drug in England, it is not to be fuppofed
that  fhips will  carry fuch  a  quantity of
it as to be of common benefit to the whole
crew : though this may unhappily be the
cafe for the poor feamen, yet they  may be
fopplied at the cheapest rate with a medicine
of nearly equal goodnefs and efficacy from
our own foil, and if  prudehtly  employed,
the fcurvy, that  maritime pestilence,  will
feldom  or never make its alarming  appear-
ance among a fhip's crew on  long and dan-
 gerous voyages, proper care  with regard to
 cleanlinefs and provisions  being obferved ;
 the medicine here  recommended to their
 ufe is the fine bark of the Englifh oak,
 which is easily preferved, and may becon-
 venicntly taken in the quantity of a  drachm
 at a time, occafionally  in powder,  extrad,
 decodion,  or tindure.  In  intermittents
 (for  poor people) it has been  frequently
 ufed with fuccefs.
   It is  neceffary to  obferve, that in fultry
 climates,  or during hot  weather  in  all
 places fubjed to great rains,  where the
 country  is over-run by thickets, fhrubs, or 
 I56    DIRECTIONS  IN

 woods,  efpecially  if there are marfhes  of
 ftagnating  waters  in the  neighbourhood!
 (which are exceedingly  pernicious to the
 health  of all  Europeans)  the  malignant
 difeafes  above-mentioned   may  justly  be
 dreaded:  the  fens and marfhes  even  in
 England are bad for strangers.
   The fhip fliould never  lie fo near the
 fhore, as that  the  mountains (if  there  be
 any) may  intercept the fea breezes (or  in   )
 the  fea  term,  fhe  fhould   never  be  land._i
 lock'd); the fame precautions are neceffary,l^
 in places,  either during  or foon  after the
 rainy feafon : in hot climates wind-fails  in   *
 in the day-time fhould  eonftantly be kept  ijj
 up,  and  at fea  in the night likewife; the
 ventilators  fhould be continually  worked,
 and  the lower deck ports kept open, when
 the weather will permit, from fun  rising to
 fun-fet;  the decks muft  be  kept, clean
 fcraped and  wafhed,  but  the latter never
 after  fun-fet.   When  ficknefs  begins on*
 board a fhip, the fick fhould immediately
 be removed as  much  as conveniently may
 be from  the found; the fick-birth fhould
 be as airy as poffible, without exposing the
 fick to catch cold, and always kept as clean
as  may  be; the centinels  over  the  iick
 fhould eonftantly empty and wafh the buc-
kets  which  the fick  make ufe of every
watch.
  The fhip (particularly a new one) fhould 
  WARM AND COLU V.1.1MATES.    157

be every day fumigated with the fleams o£
tar  or pitch,  and in wet, damp weather,
fires often  lighted  between  decks,  with
proper centinels over them to prevent any
danger.
  To boil vinegar between decks or in the
hold fills the whole cavity of the hull with
a vapour that is falutary and antifeptic to a
very great degree; and  this  may perhaps
be the beft way of ufing vinegar to prevent
a corruption of the air, or the fpreading of
difeafes ;  fumes of tobacco (as already men-
tioned) may be employed to the fame pur-
pofe with good fuccefs.
  The cloaths of the fick  and the  fick
birth ought particularly  to  be fumigated ;
their foul cloaths fhould always be inftantly
fprinkled with vinegar, or tied  to a  rope
and plunged into the fea, to  wafh them
from all feeds of contagion ; vinegar fhould
alfo be  difperfed plentifully every where-
through the fhip, cloths dipt in it hung up
in all  parts, and  frefh vinegar frequently
fprinkled upon them, to keep the vapour
of it continually afloat, but  efpecially the
fick birth ought to be daily  well  wafhed
with vinegar.
   The ufe  of cold bathing-tubs under the
fore caftle,  and bathing in the fea early in
the morning, have  been found  extremely
beneficial in hot countries, for this pradic*
                     V 
 I58      DIRECTIONS  IN

 not only  braces up the fibres,  and contri-
 butes to health but cleanlinefs likewife, and
 p-omotes  perforation;  but then the people
 fhould not flay too long in the water, nor
 go in when overheated with work or liquor,
 nor when the ftomach is full, or there is
 an eruption with a prickly heat on the fkin.
 Diarrhoeas and other  complaints,  the  ef-
 feds  of great  heat, have  been cured by  •
 bathing,  and their returns prevented.
  Wine is the beft of all cordials in the de-
 cline  of fevers, (provided it is found  and
 good) and is a much better restorative than
 rum,  or any  other fpirits however  mixed  j
 or prepared; it  is  likewife  an  excellent ^
 means to  prevent infedion;  fome cafks of
 Madeira Wine  (which  keeps good in all
 climates)fhould be preferved  for the ufe of
 the fick in thefe voyages.
  The  fvvallowing large draughts of undi-
 luted fpirits has always the moft fatal con-  ^
 fequences in every climate; but when they
 are converted  into punch,  they  become
 very fal Mary,  preventing difeafes which a-
 rifc from hot and moift weather, and  the
 tendency to corruption  in the animal fluids,
 which  is  eonftantly induced thereby; as
 cleanlinefs alone greatly  contributes  to
health,  it  may  not  be amifs to propofe,
that when at fea, the  feamen and marines
 fhould be  mustered   when  the feparate
watches are called every Sunday, and  pafs 
      WARM AND  COLD  CLIMATES.  159

   in review by the  officer of the watch, and
   thofe that are then dirty, having a foul fhirt,
   troufers, &:.  fhall have their allowance of
   liquor, whether  beer,1 wine, or grog, ftopt
   for that day (by the cajStains  crder); for
   the fecond offence to ftand in the pillory on
   the quarter-deck, and  for  the  third,  to
   receive a dozen lames at the gangway : the
   fame notice might be  taken of their ham-
   mocks,  when  the captain thinks proper to
   have them examined;  by this method the
   people would always be wholefome  and
   clean,  and  confequently much  healthier,
   for in every  fhip, there  are a number of
   dirty lubbers, particularly among the waste
   guard  and  marines ; and the cooks mates
   and  his  attendants  are generally  as  bact^
   as any.
      I fhall here only mention  that when men
   are feized with inflammatory fymptoms on
   entering into  warm climates,  they may
   be blooded freely;  afterwards they do not
I  eafily bear fuch  copious  evacuations, but
   rather require to have them made in fmaller
   quantities,  and very early and frequent, as
   inflammations make  a rapid  progrefs in
   warm countries.
      Dodor Lind   fays,  many praditioners
   difapprove  of bleeding in  thofe countries
   which lie under the torrid  zone, on a fup-
   pofition that the blood is too much diffulv-
   «d,  but he  thinks  (very juftly)  tha- this 
l6o     DIRECTIONS  IN
rule will admit of  many exceptions, and
that failors  being strong and expofed  to
greater vicissitudes of  heat  and cold, and
more exceffes and 'other accidents,  bear
freer bleeding in general  than any other fet
of people.   After fome time the difeafes  in
thefe  warm  climates  tend  to  the putrid
kind, and then muft be treated as fuch.
  In warm climates the fhips are generally
moft  healthy at fea, where the air is dry
and ferene,  and the  heat  moderated  by
refreshing breezes.

 RULES  FOR   PRESERVING   HEALTH,
      IN  COLD   CLIMATES.

  IN northern climates and channel cruiz-
    ing,  though the cold  is intenfe, yet  if
    the air is pure and dry and the  men are
well cloathed, there are  few difeafes; but
when  the weather  is  unfettled, cloudy,
wet and rainy,  the ufual confequences are
colds,  attended  with feverish and inflam-
matory  fymptoms,  and  efpecially  rheu-
matic, pleuritic, and peripneumonic com-
plaints ;  thefe laft require plentiful evacu-
ations, but chiefly bleeding, which, when
timely and  freely ufed,  will prevent con-
fumptions and chronic rheumatifms.
   When  the men are  almoft  eonftantly
wet and chill from  bad  \ 'eather,  and un-
dergo an uncommon degree of  fatigue, it 
    WARM  AND COLD CLIMATES.   l6l

 will be proper to let them .have the follow-
 ing mixture,  viz. a pint of (mail beer, and
 a quartern of brandy fweetened  with rao-
 Jaffes, to which  may  be added  as  much
 vinegar  as  will render the mixture palata-
 ble ;  or, inftead of the laft,  cream of tar-
 tar ;  this the Ruffians call afibetten.   Dry
 beds and cloathing are moft neceffary arti-
 cles ;  for it is obfervable that  the  moft
 naked  ragged fellows  are principally  at-
 tacked with winter difeafes.
    The  fcurvy is a difeafe common in  the
 winter and fpring; the method  to prevent
 which is already laid down in the preceding
 fedion,  and to which the reader is referred.
    Dr Lind  fays, the moft  proper cordial
 dram a  failor can ufe in the winter is gar-
 lic brandy, for a fmall quantity  of it, not
 only  warms the ftomach,  but  keeps the
 breaft,  kidneys, and fkin free from obstruc-
 tions ;  but neither this nor  any other dram
  fhould  be  given to a man almoft chilled to
 death with cold,  having  his limbs   quite
  benumbed, and  their extremities froft bit
  (as it is called) ; for, in this cafe, it has
  often proved fatal; but he fhould be im-
  mediately put into a  warm  bed, and have
  fome warm gruel, fage tea, or  lome  fuch
  diluting liquor, given him  ; after which a
  dram may be allowed, when it will prove
* lefs dangerous,  and more beneficial. 
j6z     DIRECTIONS  IN

  Avery remarkable cafe to this purpofeis
related by Hildanus, viz. a man was found
quite stiff and frozen all over;  he was  put
in:o cold water,  and  immediately the  icy
fpicula were difcharged from all parts  of
his  body,  fo that he  feemed covered with
an icy cruft;  he was then  put into a warm
bed,  took  a  cordial  draught,  and  a
plentiful fweat  followed;  after which  he
recovered with  thelofs of the  laft joints of
his  fingers and toes.  De Gangrana, chap.
XIII.
  People who are benumbed with cold in
frofty weather^  ought never to be brought
immediately near a fire ; for that has been
found either to caufe immediate  death,  or
gangrenes of the extremities.  Any kind   ,
of fruit  frozen, when put immediately  to
the  fire, will  turn foft and rot; but if put
into cold water, it  throws  out the  icy
fpicula,  and recovers  fo as to  be almost as
good as before,  which, proves the above  :*<J
method ufed with the man to be right.
  In  cold rainy weather,  tea made with
fage, faffafras, or a few roafted juniper ber-
ries,  with the  addition of a little garlic
brandy, will be  very beneficial ;  likewife a
man will  never be fo liable  to catch cold
when he  is wet upon the deck, and ufes
exercife, as when he is below in his wet
cloaths, or fbq s  in them, or in  a damp
bed;  when he goes  upon deck  he fhould 
       WARM  AND COLD CLIMATES.^   l6j

    eat a bit of bifcuit, and drink a little afhbet-
    ten,  and then  the weather  will  probably
    have but little power to alter his health for
    the  worfe.
      When a failor happens to be dead drunk,
    his  head fhould be raifed, and  a fpungc
    dipped in vinegar fhould be held to his nofe ;
    and if he can drink, he fhould have warm
    water mixed with vinegar;  bleeding  will
    likewife be  proper, and a gentle emetic
    which operates  fpeedily,  fuch   as  the
    oxymel. fcillitic. fal vitriol. &c.
;      Likewife dipping the feet in cold water
    will take off the preffure from the brain ;
    and folutive clysters will abate trie diften-
"...  fion ; it is but too  well known how many
k.  people lofe their lives by exceffive drinking,
    and fpirituous liquors; the fame treatment
    will be ufeful after a large dofe of opium.
,      Thefe methods here laid down (chiefly
/   taken from Dodor Lind) but partly from
!v  others, I have pradifed for many years  in
    the royal navy;  and with the bleffingof God
    (it has in general been attended with great
    fuccefs; tor which reafon I  can  the more
.f    flrongly recommend it; if it be true, as was
    pubhlhed  in December  1760, taken  as is
':    fuppofed from returns made to the Houfe of
    Commons, that of 185,000 men, raifed for
    the fea-fervice during the late war, above
    130,000 pcrifhedby difeafes; and that two
    thirds of this number  may be fafely charged 
j 64     DIRECTIONS,   &C.;

to the account of difeafes that take their rife
from putrefadion;  finely every  motive of
policy and humanity fhould  excite  men to
endeavour at finding out fomewhat to check
that fatal and deftrudive diathesis; for if fea-
men could be preferved  free  from it other
kinds of difeafes would feldom endanger
them.
             FINIS.
                     Philadelphia, May 6th, 1776.
Shortly will be Publifhed  by  ROBERT  BELL,
              in Third Street,
        A  NEW  EDITION  OF
    PLAIN    CONCISE
PRACTICAL  REMARKS,
            ON THE TREATMENT OF
WOUNDS  and  FRACTURES;
     to which is  Added,  An APPENDIX,
O N
CAMP  and  MILITARY  HOSPITALS;
              PRINCIPALLY
Defigned, for the Ufe of young Military  and Naval
      Surgeons  in NO RTH-A MER IC A.

"      By  JOHN  j O N t S, M. D.
  Profeflbr of Surgery, in King's College, New York.
  N. B.  At faid Bell's  next door to St. Paul s Chutch
in Third Street  Philadelphia;  Are  now felling,
   SLMES's  MILITARY GUIDE,  two  volumes,
       in neat bindings, price three dollars ;
     Alfo, great variety of new and old BOOKS ;
    Likewife, all  the nevveft political Pamphlets;
   Either for, or againft, INDEPENDENCY.