UNITED STATES OF AMERICA
► .  •  v
FOUNDED  1836
WASHINGTON, D. C.
OPO  16—67244-1 
  DUE IWU WMHU I HUM LAST DATE
SEP 30 1S58 
 
         ABERJ^ETHY'S


FAMILY   PHYSICIAN;

  -------         OR,


     READY  PRESCRIBED,

IN CASES OF ILLNESS AND ACCIDENT, WHERE MEDICAL
       ATTENDANCE IS NOT DESIRED OR
           CANNOT BE PROCURED.
CONTAINING
  The Causes, Symptoms and Treatment of Diseases,


THE PROPER REMEDIES IN BURNS, CONTUSIONS,

     POISONING, AND ALL VARIETIES OF

         PHYSICAL CASUALTIES.

               FORMING


       A COMPLETE  GUIDE


TO THE RETENTION AND RECOVERY OF HEALTH.


           SECOND AMERICAN,

      FROM THE THIRTIETH LONDON EDITION.


             RBVI3ED AND EKLARGED .        ' >^

      BY H.  BOSTWICK,  M.D.




           i '              t1


             NE"W  YORK:


      STRINGER & TOWNSEND.


                 1849.      AH2IEX
JOSEPH lord:
 BOOKSELLER, »
 19 Philip street, : 
WBA
 PvHfen
 \Si9
Entered according to act of Congress, in the year 1843, by Jamh
  Mowatt, in the Clerk's office of the District Court of the Sou
  them District of the State of New-York.
Ann St.

Stereotyped by Chas. Hobbs, 111 Pulton St 
PREFACE TO THE AMERICAN EDITION.
  It has frequently been questioned whether medi-
cal  instructions of a general nature, for the use of
unprofessional persons, were not as likely to do harm
as good.   And so, in regard to the imparting of re-
ligious information—many  worthy  persons  have
doubted whether the reading of the Bible should not
be  confined to those, who have been qualified by
education to expound its mysteries.
  In  both these  cases, the we  has been argued
against because of the abuse.   It is far from our in-
tention to undervalue the importance of the attend-
ance of an  intelligent physician  in all  instances,
where a  powerful medicine is to be  administered.
It would  be an infinite task to draw up a list of pre-
scriptions applicable to all varieties of cases.   But
it seems to us, that the usefulness of a popular man-
ual like  the present,  especially in villages, or at
sea, where much delay must occur before medical
assistance can be  procured, does not admit of a
question.
  Care has been taken to compare Dr. Abernethy's .
prescriptions with  those of the best modern En-
glish  and French physicians ;  and, in  some  in- 
4
PREFACE.
stances, alterations and additions have  been made.
In rendering himself intelligible to the humblest ca-
pacities, the author has-been considered remarkably
successful.  His work is eminently a popular one.
It is the most prized of all the compendiums of do-
mestic medicine in England ;  and the low  price at
which it is now, for the first time,  afforded by the
American publishers, will be likely to place it in the
possession of every family in the land.
                      H.  BOSTWICK, M. D.
                                504  Broadway. 
(5)
CONTENTS
A.. DISEASES OF THE DIGESTIVE ORGANS

 I. HEALTHY STATE OF THE ORGANS OF DIGESTION
   1.  The Mouth and its Functions
   2.  The Stomach and its Functions
   3.  The Liver, the Pancreas, and  their Functions
   A.  The Intestines, the Mesentery, and their Functions
   5.  The Kidneys and their Functions

 II.—DISORDERS OF THE ORGANS OF DIGESTION
   1.  Tooth-ach
   2.  Nettie-Rash
   3.  Indigestion
   4.  Perverted Appetite
   5.  Heartburn
   6.  Wind or Flatulence
   7.  Colic or  Belly-ach
   8.  Costiveness
   9.  Dysentery or Bloody Flux
  10.  Looseness or Diarrhoea
  11.  Bile Flux or. Simple Cholera
  12.  Spasmodic Flux or Malignant Cholera
  13.  Jaundice
  14.  Gall-Stones
  15.  Worms
    Thread-Worms or Ascaridcs
    Round-Worms
    Tape-Worm
  16.  Piles
  17.  Fistula  .
            a3 
VI
CONTENTS.
                                                 FAOI
  18. Immoderate Urine, or Diabetes        .      .    33
  19. Gravel and Sand in the Urine  .      .      .34
  20. Stoppage of Urine  from Stone in the Bladder   .    36

B.—DISEASES OF THE ORGANS OF BREATHING  37

 I.—HEALTHY STATE OF THE ORGANS OF BREATHING  -      "
   1. The Lungs      .----«
   2. The Chest.....38
   3. The Nostrils and Windpipe    -                  39

 II.—DISORDERS OF THE ORGANS OF BREATHING      -      *'
   1. Cold in the Head      .     ...    40
   2.- Loss of Voice   -----    42
   3. Cough  --:---«
   4. Stomach and Liver Coughs                       "
   5. Winter Cough   ------
   6. Asthma                            ;      -    45
   7. Convulsive  Asthma    -      -       -           47
   8. Consumption of the Lungs    -       -           44
   9. Hooping Cough  -----     54
  10. Croup or Closing      -     -       -      -    55


C—DISEASES OF THE BLOOD  -       -           56

 I.—HEALTHY STATE OF THE ORGANS OF CIRCULATION       "
   1. The Veins and Arteries                           "
   2. The Heart            ....     57
   3.  The Course of the  Blood                          «
   4. The Source of Animal Heat    .       -      -     59

II.—DISORDERS OF THE BLOOD AND THE CIRCULATION        "
   1. Fever   ----..«
   2. Ague and Intermittent Fever  -       -      -     60
   3. Typhus Fever   -      ....     61
   4. Scarlet Fever   -----     63
   5. Putrid Sore Throat or Malignant Quinsey     -    64
   6. Measles        ----.«
   7. Influenza       -      -     -       .      -     65
   8. Rose, Erysipelas, or St. Anthony's Fire       -     66
   9. Small Pox and Vaccination                       « 
CONTENTS.
Vll
                                                 nam
  10. Chicken-Pox or Niries  -      .      -          69
  II. Itch......"
  12. Tetter or Ring-Worm of the Face, and Shingles     "
  13. Ring-Worm of the Hair and Scald-Head       -    71
  14. Common Scurvy and Scorbutic Eruptions      -    , "
  15. Inflammation   -      -      -      -          72
  16. Inflammation of the Throat in a Common Cold     73
  17. Sore Throat and Common Quinsey    -      -     «
  18. Inflammation of the Lungs and Pleurisy       -    74
  19. Inflammation of the Stomach   -      -      -    75
  20. Inflammation of the Liver     -      -  .   -
  21. Inflammation of the Bowels    -      -      -    76
  22. Inflammation of the Urinary Organs   -      -    77
  23. Rheumatism, or Inflammation of the Joints
  24. Slight Rheumatism, or Fidgets  -      -      -    78
  25. Gout    ------    79
  26. Scrofula or King's Evil -      -      .      -    80
  27. Rickets and Curved Spine     -      -      -    81
  28. Sea Scurvy    -----    82
  29. Cancer  -     -      -      -      - .     -
  30. Dropsy  -------
  31. Water in the Chest                            83
  32. Water in the Head                             *

D.—DISEASES OF THE NERVES       -      -    84

 I.—HEALTHY STATE OF THE BRAIN AND NERVES

 H.—DISORDERS OF THE BRAIN AND NERVES  -      -    85
   1. Inflammation of the Brain     -
   2. Face-ach and Tic-Doloureux   -
   3. Bilious and Sick Head-ach     -      -      -    86
   4. Nervous Head-ach     -      -      -      -    87
   5. Swimming of the Head and Giddiness  -      -    88
   6. Apoplexy and Palsy                            "
   7. Epilepsy or Falling Sickness   -      -      -    90
   8. Fainting and Syncope                           "
   9. Convulsive Fits of Children    -      -      -    91
  10. Hysteric  Fits                                   "
  11. Nervous Complaints   -      -      •      -    92
  12. Locked Jaw    -      -      -      *      -   93
E.—ACCIDENTS AND THEIR TREATMENT  -    94 
•in
CONTENTS.
                                                     nam
   I.—APPARENT DEATH        -       -      -      -    94
    1. Drowning       ...                   «
    2. Hanging and Strangulation      -      .      -    96
    3. Suffocation, or Choking from Gas      -            «
    4. Stroke of Lightning      -       -      -      -    97
    5. Exposure to Intense Cold                           «
    6. Choking from any Substance in the Gullet      -     98
    7. Choking from any Substance in the Windpipe   -      ««
    8. Drunkenness    -      ....     99

  11.—poisoning      -      -      .      .             «

   1. Poisons producing Mortification         -       -    100
   2. Poisons acting through the Blood       -       -    102
   3. Poisons affecting the Nerves    -                 105

  III.--INJURIES TO THE SKIN         -                 106
   1.  Burns and Scalds                                  «
   2.  Grazed or Ruffled Skin  -                         108
   3.  Galling, Excoriation, and Chafing                   «
   4.  Cuts and Wounds       -                         109
   5.  Blows, Bruises, and Contusions  -       -      -    110
   6.  Parts Frost-bitten      -      .       _      -    111
   7.  Chilblains and Kibes    -.-.<«

 IV.—MISCELLANEOUS INJURIES       -       -      -   112
   1. Sprains   -                    .      .            «
   2. Ruptures       .      .      .      .      -   113
   3. Limbs Dislocated       -      -      _      -   114
   4. Broken Bones   --...«<
   5. Substances getting into the Eye        -      -   115
  6. Inflammation of the Eyes                           «
  7. Substances getting into the Ear  -      -      -   116

NOTES BY THE AMERICAN  EDITOR  -      -   117 
             ABERNETHY'S

FAMILY   PHYSICIAN.
      DISEASES  OF THE DIGESTIVE  ORGANS.

  In order to explain the diseases or derangement occur-
ring in  the organs of digestion, it will  be necessary to
give a brief and plain  sketch of these organs and their
functions in a state of health.

L—HEALTHY STATE  OF THE  ORGANS  OF  DIGES-
                       TION.
  The due digestion of food and drink is of importance
from infancy till adolescence, to supply materials for the
increasing growth of the body, and afterwards to make
good the wear and waste continually going on in all its
parts.
  One proof of the wearing of the body must have been
observed by every one.   On combing the hair, a great
number  of white scales fall  from the  head;  and  in
wearing black silk stockings, they are often found cov-
ered on the inside with similar  scales.  These scales
are portions of the thin and insensible scarfskin, which
has been worn and detached from its place.  In cutting
           a5 
10       DISEASES OF  THE DIGESTIVE  ORGANS.
our hair  and nails, we remove part of what is superflu-
ous ; but the loss is  immediately supplied again from
the blood.
  In all the interior parts of the body, the same process
of wearing is going on as we have just exemplified in
the case of the skin ; but as the scales, or the minute
portions  of fluid, cannot be thence removed, like the
scales of the head or the sweat of the brow, a system of
ve.-sels, called by anatomists the absorbents, is contrived
to act the part  of scavengers, and clear  the body of its
waste.
  These absorbents  are found in all parts of the body.
They run, like  the veins, in the direction of the  heart,
uniting  in  a common  canal, which enters  the ves-
sel that carries  the digested food into the blood, where
all the refuse and rubbish of the body, collected in their
course, are emptied.  This waste must accordingly pass
into the blood ;  and  it is carried with it directly to the
lungs, and removed by the breath and the bowels.  The
breath and  the bowels become  loaded with much im-
pure matter, thus carried off from the blood in the lungs
and the intestines.
  As the fresh blood, prepared from digested food, is
indispensable in supplying this wear and waste, the im-
portance  of keeping  the stomach and other  organs of
digestion in a healthy state, will be obvious.

  1.  The Mouth and its Functions.—For the purpose
of reducing our  food,  after it is cooked, into the form of
a pulp or paste, we are provided with an apparatus
more complete  than those who have not examined the
subject can conceive.  The teeth are admirably adapted
to grind the food; and  the tongue, with its flexibility 
THE STOMACH AND ITS FUNCTIONS.        11
and  its endless motions, to turn it in the mouth, while
it  is mixed with a  fluid supplied in abundance from
several pairs of fountains or glands in the vicinity, from
which pipes or ducts are laid, and  run into the mouth.
   The whole surface, indeed, of the mouth and tongue
as well as the other  internal parts of the body, give out
more or less moisture ; but this is not  enough for the
purposes of mixture with the  food in  eating, without
the fluid, popularly termed spittle {saliva), prepared by
the fountain-glands.
   When the food has been properly masticated,  com-
minuted, and  mixed with saliva,  it is prepared for the
subsequent process of digestion in the stomach; but  it
is most  important  to remark, that  if it is not tho-
roughly  mixed with the  fluid  in  the mouth, it will be
unfitted  for digestion,  and will probably derange the
 health.  So indispensable is this, that serious diseases
 arising from indigestion, have  been cured simply by or-
 dering the food to be eaten slowly, and carefully mixed
 with the saliva.  It is worthy of  remark, that no kind
 of drink will supply the place  of this singular fluid.

   2. The Stomach and its Functions.—When food has
 been well chewed and mixed with the saliva, it is fitted
 for the rather complicated process of swallowing.   The
 gullet ((esophagus), which conducts it to the stomach, is
- a flexible  membranous tube, plentifully supplied with a
 mucous fluid; so that if the food has not been moistened
 sufficiently in the mouth, it may not be interrupted in
 its descent by being too dry, while the contracting mus-
 cles force it onwards into the inlet of the stomach  so
 powerfully, that the process  cannot be stopped when
 once begun, even by an effort  of the will.
              A6 
 12       DISEASES OF THE DIGESTIVE ORGANS.

   The fluid of the stomach is somewhat similar to the
 spittle of the mouth, being thin, transparent, without
 smell," and almost without  taste.  Besides its high di-
 gestive power, which sometimes acts on the stomach
 itself after death, it has the  property of rendering, in a
 short time, the most tainted and putrid substances per-
 fectly  sweet.  Dr. Fordyce forced dogs to eat meat which
 was putrid and rotten, and on killing them, a little af-
 terwards, he found the putrescency quite corrected.
   Another fact of great importance is, that the stomach
 is incapable of digesting  food when it is diluted with
 water, or other similar fluids, which must all be remov-
 ed before digestion can proceed.
   It is necessary  to  remark here, that there is not a
 more pernicious, vulgar error, than that which ascribes
 rich nourishment to beef tea, mutton broth, and other
 strong soups; for  no  digestion  can  go on while the
 stomach  is full of liquid.
   When all unnecessary liquids are removed,  the more
 solid parts of the  food are reduced  to a thick grayish
 paste,  termed chyme, which is moveTI along to be pass-
 ed out of the stomach into the chyle-gut, and mixed
 with  bile and pancreatic juice, as  shall now be ex-
 plained.

   3. The Livee, the Pancreas, and their Functions.—
 Near to the stomach, below the edges of the ribs on the
 right side, and immediately under the great fleshy parti-
 tion between the chest and the belly, termed  the midriff
 (diaphragm), lies the liver, a large,  solid, dark-colored
 gland,  of a close and delicate texture.  The office of the
liver is to prepare bile from the blood, with which view
a large canal or vein full of dark-colored blood  runs into 
            the liver and its functions.         13

it, but soon divides in the liver itself into innumerable
branches, in the manner of a tree  branching from a
trunk, whose roots are placed, as Galen well remarked,
in the belly.
  This great bile canal issues from the lower and con-
cave  surface of the liver, and conveys the bile either
immediately into the intestines below the stomach, or
through another canal which joins it, into the gall-blad-
der, or store cistern, and long bag, or pouch, of the shape
of a pear, adhering  to the lower  surface of the liver,
where it  is improved in quality, and acquires consist-
ence, bitterness, and a deeper yellow color, by the loss of
its more fluid and watery parts, which pass out through
the coats of the gall-bladder.
   The pancreas is a rather large- gland  lying under the
stomach, and serves to  separate from the blood a fluid
named the pancreatic juice, of a mild bland nature, very
similar to the  spittle of the mouth.  The blood runs
 through this in branching vessels, and the fluid separated
from it goes into a number of little canals, which unite
in a single large one, in form of the plumelets of a quill
uniting at the stem.  The pancreatic juice, being very
mild, is probably intended by Providence to correct the
 acridness of the bile.
   As soon as the digested aliment has passed the outlet
 of the  stomach, it is received into the first intestine,
 which  may  be appropriately termed  the chyle-gut.
 Here it meets and becomes mixed with the bile and the
 pancreatic fluid, which seem to  act as powerful chemi-
 cal agents, in beginning its conversion  into new blood.
    The  useful parts of  the aliment, termed chyle in a
 word, are, by these agents, chemically separated from
 the useless—the useful  taking much the appearance of 
 14       diseases of the  digestive organs.

 cream, being spread over the linings of the intestines to
 be sucked up by the mouths of innumerable  minute ca-
 nals, termed lacteals, that open there;  while  the useless
 parts or excrements are thrown  into the middle of the
 intestines as refuse, to be carried along the bowels and
 discharged by the vent.

   4. The Intestines, the Mesentery, and their Func-
 tions.—The aliment remaining for a short time in the
 chyle-gut,  and afterwards  passing  rapidly  therefrom,
 leaves a space in the gut beyond rather empty, which
 may be termed the lank-gut, and  this leads to the small
 intestine, distinguished by the velvet-like lining caused
 by the mouths of the little canals already described.
   The intestines terminate, in the vent (anus) by a short,
 straight, and  small canal, which  may be termed vent-
 gut (rectum), the outlet of which is  kept shut by three
 muscles.   The little canals termed  the lacteals are so
 numerous all over the inner surface of the bowels, that
 the cream-like chyle which is missed by one get is readi-
 ly caught by  others, and  carried along a membrane
 termed the mesentery.   This membrane is  bestudded
 with little glands, through which the canals  pass, in
 their way to the blood.   The caul is a large membrane
 hanging down over the stomach  and bowels  for storing
 up fat.

   5.  The Kidneys and their Functions.—The stomach,
as we have seen, cannot well digest food when it is too
fluid, and  healthy blood ought not to be too  fluid.   In
order,  then, to  remove any superfluous fluid in  the
stomach and in the blood, there exists in the body a con-
trivance similar to the  by-set of a mill-stream, or  th* 
toothach.
15
waste pipe of a dye-work or brewery, for carrying off
the fluid that is not wanted, and which might prove in-
jurious.  One portion of the superfluous fluid is carried
off through the pores of the  skin by perspiration ; an-
other from the lungs by breathing; but the more obvi-
ous than either of these two, is that which is carried off
through the kidneys and bladder in the form of urine.
   We have two kidneys  for separating from the blood
that passes through them the superfluous fluid and other
matters which constitute urine.  The blood which is
thus freed from its superfluous fluids is returned to the
general circulation, while the urine is carried off from
the basin by a long pipe from each kidney, termed  a
ureter, into the bladder, to be afterwards evacuated.  It
is worthy of remark, that the outlet of the  bladder is
always kept shut by a peculiar muscle, which, when
the urine accumulates, is forced to give way and  permit
its escape.

II.—DISORDERS OF  THE ORGANS  OF DIGESTION.

   Having thus described the organs concerned in diges-
 tion, from the entrance of the food into  the  mouth till
 the  jseful parts  are taken up by the lacteals, and the
 useless are  ejected through the bowels, the skin, the
 lungs, and the bladder, we shall next consider the dis-
 orders to which  these several organs are liable, begin-
 ning at the mouth.

   1. Toothach.—When toothach evidently arises from
 a decayed or hollow tooth, and the patient is unwilling
 to have it extracted, a bit of opium, or some cotton wooi
 soaked  in laudanum, may be plugged into the hollow 
16       diseases of the digestive  organs.
 Camphor, dissolved in oil of turpentine, is also a favoriti
 remedy, by the following solution :  Put two drachms ol
 camphor into an ounce of the oil of turpentine, and let it
 dissolve, when it will be fit for use.
   Cajeput oil is another valuable  remedy for allaying
 the pain when put into the  hollow of the tooth.   The
 most effectual, however, of all remedies, is the putting
 of a red-hot wire  into the hollow, which will destroy
 the nerve, and prevent the return of pain.
  If an external application is  preferred, the following
 liniment may be rubbed on the outside of the jaw :
  Liniment.—Take an ounce of spirit, of camphor; three
 drachms of liquid ammonia, or hartshorn ; ten drops of
 essential oil of bergamot: mix them in a phial for  use.
  If the gums are spongy or tender,  and apt to bleed,
 the following wash, occasionally applied, will be found
 useful:
   Wash.—Take half an ounce of tincture of myrrh;  two
 ounces  of tincture  of Peruvian bark: mix  them  in a
 phial for use.
  A blister  placed  behind the ear, or burning the lap
 of the ear with a cloth dipped in boiling  water,  will
 often remove the pain entirely.

  2. Nettle Rash.—This disease arises from some dis-
 order in the stomach caused  by eating fish,  fruit, or
 something that disagrees.  It readily gives way  to a
 cool regimen, and keeping the body  open with  mild
 laxatives, as phosphate of soda, or cream of tartar.

  3. Indigestion. — Causes and Symptoms. — Delicate
 persons, particularly females, tradesmen, accountants, or
 literary men much  confined in-doors,  and sitting most
 commonly in a stooping position so as to press on the
 stomach and bowels, will  at times feel their food lie
heavy, like  a  load, upon  the stomach, and this  may
probably be accompanied with flatulence and belching;
but the inconvenience  may only be  temporary, and may
go off in a day or  two.   When these symptoms have
begun to recur once a month or once a week:, the com- 
INDIGESTION.
17
plaint is certainly fast forming into a state of difficult
cure.  The mouth becomes clammy,  the tongue white
or brownish ; the appetite is impaired ; there is consid-
erable thirst; and the feet are apt to be cold, even when
the weather  is not uncomfortable.  Pains in  several
 Jiarts of the chest, somewhat like rheumatism, are often
 elt, or even in the shoulders, the arms, and the^loins—
all depending on the derangement of  digestion.  The
mind becomes also very fretful and irritable.
  Treatment.—The first thing to attend to is early
rising; that is, at five or six o'clock in summer, and
never later than seven in winter, going  to bed precisely
at the same hour every night; having all meals pre-
cisely at  the  same hour every day, with no lunches be-
tween meals, and as much active  exercise in the open
air as can be taken without fatigue or perspiration. The
more simple the diet is, and the less strong the drink is,
the better.
  Medicines.—All drugs are far inferior  to what has just
been recommended ; but for those who  cannot, or think
they cannot, do without medicine, the first thing indis-
pensable to be done, is to clear the stomach and  bowels
by an emetic.
  Emetic.—Take twenty grains of ipecacuanha in pow-
der, one grain of emetic tartar;  mix in  a table-spoonful
of warm water:  after it  begins to operate, walk about
before  a good fire; and work it  off with lukewarm
camomile tea.  Afterwards take the following pills:
  Laxative Pills.—Take five grains of gum mastic, five
grains of conserve of roses, fifteen grains  of the best
aloes, as much syrup of wormwood as to make a paste,
which you may divide into half-a-dozen pills;  one to be
taken occasionally two hours before dinner or supper.
  As a variety—for the bowels soon get used to a medi-
cine when  it is continued for some time—you may try
the following:
  Rhubarb Pills.—Take  one drachm of the best pow-
dered rhubarb, half a drachm  of common syrup, five
drops of oil of carraway; mix  and divide into  twenty
pills, from one to three  for a dose,  according  to  the
strength of the bowels. 
18       DISEASES OF THE DIGESTIVE ORGANS.

  If you do not like pills, or if you wish to change them
for another form of medicine, try the following
  Draught.—Take two drachms of the crystals of car-
bonate of soda, a drachm and a half of cream  of tartar,
five ounces of pure soft water.   Let it stand in a corked
bottle for three days, when it will be fit for use ; a wine-
glassful to be taken as the patients find occasion foi it.
This is best in the morning, after having taken pills the
night before.
  When you find yourself improving  from this treat-
ment, and are relieved in a good measure from the  load
and oppression of stomach, you  may then begin by de-
grees to try a course of the following pills  :
  Strengthening Pills.—Take one drachm  of myrrh, and
rub it up with half a drachm of carbonate of soda; add
half a drachm of sulphate of iron, and half a drachm of
sugar.   Make  into a mass in a mortar, and divide into
thirty pills, two to be taken thrice a day.

  4. Perverted Appetite.—In consequence of acid form-
ed in the stomach, and other derangements, an occur-
rence frequently attending pregnancy, a desire is felt of
eating cinders, chalk, and other  substances.
  Remedy.—Small doses of ipecacuanha, such as ten
drops of ipecacuanha wine twice a day, in  a glass of wa
ter or a cup of camomile tea, will do good.

  5. Heartburn. — Symptoms. — The disorder termed
heartburn does not  affect the  heart, but the stomach,
with a sort of burning pain, so severe, in some cases, as
to cause the eyes to water. It is caused in most cases by
overloading the stomach, and rendering it a sort of brew-
ery of vinegar; though it may arise from the powers of
the stomach being too feeble to  digest what is eaten.
  Treatment.—When the acid  depends on a mere fer-
mentation of the food, it may  in a great measure be
prevented by using food not easily  fermentable, such as
beef and biscuit, avoiding vegetables, and taking mag-
nesia and  liquor of  potass.   But  sometimes a patient
may be tormented with acid,  eat what  he  will; and 
colic, or belly-ach.
19
e  m though he abstain from food altogether, it will not
p *vent for an hour the formation of the acid, and the
al-alies only procure a short respite from the burning or
gnawing which it occasions.  In this case may be tried
a rather singular, but a very powerful remedy.
  Pills.—Take thirty grains  of fresh ox-gall; same
quantity of assafoetida.  Make into one dozen pills, and
take from three to four thrice a day.  Their good effects
will appear in a few days.
  The acid of heartburn may be neutralised by any of
the alkaline earths;  but it requires a continued applica-
tion of such remedies, and  the  patient may consume a
wagon-load of magnesia without being cured.  The pa-
tient should therefore take the following pill:
  Soda Pills.—Take half a drachm of dried  carbonate
of soda, same quantity of extract of gentian; beat them
together, and divide  into twelve pills, of which two or
three may be taken twice or thrice a day.
  Acids  sometimes are useful, particularly nitric acid,
in the dose of five drops, every three or four hours, in a
glass of water.   It is also important to keep the bowels
open with small daily doses of epsom salts, or rhubarb
pills.

  6. Wind in the Stomach  and  Bowels, or  Flatu-
lence.—Symptoms.—This arises from the same causes
as heartburn, which it frequently accompanies, and is
very teasing and distressing.
  Remedies.—Together with what has been recommend-
ed under heartburn, the following may be tried:
  Draught.—Take half a drachm of tincture of castor;
one  drachm of  aromatic spirit of hartshorn;  twelve
drachms of camphor mixture; and one drachm of syrup
of orange-peel; mix  for a draught to  be taken  twice a
day: or take half a drachm of the liquor of carbonate of
potass, an ounce of the infusion  of gentian, a drachm of
the tincture of cascarilla ; mix for  a draught, to be re-
peated as occasion requires.

  7. Colic, or Belly-ach.—Symptoms.—Griping pains 
20        diseases of the digestive organs.

in the bowels, chiefly about the navel, accompanied with
costiveness, head-ach, nausea, and often with vomiting.
  Remedies.—When the symptoms are very urgent, two
drops of croton oil, rubbed up with an ounce of mucilage
of gum tragacanth, and sweetened with sugar, may be
taken every four hours, or oftener.  In slighter  cases,
the fallowing
  Draught.—Take  six drachms  of   castor oil,  two
drachms of tincture of senna, and mix.  When there is
much wind, and no apparent inflammation, a glass  of
brandy or  other  spirits  may be taken, or the following
  Pills.—Take one drachm of compound extract of colo-
cynth, three grains of opium, six drops of oil of nutmeg;
make a mass, and divide into twelve pills, two to be
taken every hour ;  or the following
  Draught.—Take one  scruple of rhubarb in powder,
half a drachm of spirit of anise, one ounce of cinnamon-
water, and a half or one drachm of tincture of jalap;
mix, and take immediately.

  8. Costiveness.—Causes and Symptoms.—This is no
less common a complaint than it  is  often obstinate and
unmanageable.  It arises chiefly from  the stagnation  of
blood in the lower parts of the body and bowels.  The
symptoms are uneasy feelings of weight and obstruction,
often with wind and belly-ach.
  Remedies.—Whatever tends to quicken the stream of
the blood,  in its return to the heart, will, In such  cases,
relax the obstructed intestines, and  promote  their mo-
tion.  Above all things, then, walking should seem  to
be useful  for this purpose ; riding on  horseback is also
good.  As to diet, brown bread, eggs, very soft boiled,  or
beat up  raw, and all sorts of vegetable  food, particularly
potatoes, carrots,  and parsnips,  and  also apples  and
other fruits, with plenty of sugar, are good;  but hard-
boiled eggs, roast or salt beef, ham, tongue, fish, &c,
ought to be eaten sparingly ;  and no drink stronger than
table-beer  should  be taken, and  chocolate, rather than
tea  or coffee.  Butter also, and fat meat, provided al-
ways that the stomach can digest them, are useful. 
   *•        DYSENTERY, OR BLOODY FLUX.          21

  Those medicines are most powerful which act either
as a stimulus to the liver or the bowels; such as  one
blue pill every night, with half a pint of decoction of
sarsaparilla every day.  The bowels may also be stimu-
lated directly by aloes, or rhubarb, or croton oil.
  Pills.—Take two  drachms  of  socotrine aloes,  two
drachms of gamboge, thirty drops of oil of anise, a suffi-
cient quantity of simple syrup; mix, and make into five
dozen pills;  one or  two to be taken at bed-time.  Or,
take sixteen  grains of socotrine aloes, eight grains of
myrrh, four grains of saffron, fifteen grains of antimonial
powder, fifteen grains of guaiac, a sufficient quantity of
spirit  of wormwood;  mix, and make  into eighty-two
pills, one or  two for a dose.  Or, take  fifteen grains of
Castile soap, two drops of croton oil; make into three
pills, one to  be taken every two  hours  till  effectual.
This  should  never  be used till all other means have
failed, as it is a very strong and irritating medicine.
  Mr. Locke judiciously advises those of a costive habit
to go regularly to the water-closet every day,  an hour
after breakfast, and make an  effort, whether they  suc-
ceed or not.   We should  advise the  same to be done
both  morning  and  evening, for at least  a month; we
have known  it succeed when all other means have fail-
ed.  There  is  nothing better, in a  costive habit, than
eating two, three, or half-a-dozen good  figs,  between
meals.  When exercise cannot be  had, the flesh-brush
should be used morning and evening; and friction over
the belly and stomach, with warm  flannel  or calico.
The warm water enema, or lavement, now  so much
used,  is very apt, when used to excess, to weaken the
bowels ; in moderation it may be tried, when other re-
medies fail.

  9. Dysentery, or Bloody Flux.—Causes and Symp-
toms.—This alarming disorder seems to  be communi-
cated  by infection, but may be caused by cold, night air,
damp, or bad diet.  It begins with looseness of the belly,
chilliness, loss of strength, a quick pulse, great thirst,
and an inclination to vomit.  When the patient goes to 
22       DISEASES OF THE DIGESTIVE  ORGANS.

stool, he feels a bearing down, as if the whole bowels
were falling out.  It may be distinguished from a com-
mon looseness by the acute pain of the bowels, and the
blood which generally appears in the stools; and it may
be distinguished from bile flux (cholera morbus) by its
not being attended with  such violent and frequent fits ol
vomiting.
   Treatment.—Cleanliness contributes greatly to the re-
covery of the patient.  Every thing about him should be
frequently  changed.  His spirits  must be kept  up in
hopes of a  cure ; for  nothing tends more to render any
putrid  disease mortal than fear.  The greatest attention
must be paid to his diet.  Apples boiled in milk,  water-
pap, and plain  light pudding, with broth made  of the
gelatinous parts of animals, such as  sheep's head,  may
be  eaten.  When they cannot   be  had, barley-water
sharpened with cream of tartar may be drank, or a de-
coction of barley and tamarinds ;  two ounces of the for-.
mer and one of the latter may be boiled in two quarts
of water to  one.  Water-gruel,  or  water wherein hot
iron has been  frequently quenched,  may  be drank in
turns.
   Medicine.—At the beginning of this disease, an emetic
of a scruple, or at most half a drachm of ipecacuanha,
may be given ; and the day after, half a drahm or two
scruples of rhubarb must be taken.  This dose may be
repeated every other day for two  or three times.  After-
wards two or three grains of ipecacuanha in  powder
may be mixed in a table-spoonful of the  syrup  of pop-
pies, and  taken three  times a day.   If  the patient be
much  reduced, along  with enemeta, or  injections of
 starch and nourishing broth, give the following
   Draught.—Take ten drachms of infusion of quassia,
one drachm  of tincture of Columbia, and twelve drops
of tincture of sesqui-chloride of iron: mix, and  take at
mid-day.

   10.  Looseness,  or Diarrhcea.—Symptoms.—When
there  are  frequent stools not of a  high yellow color,
with no fever or bearing-down pains, it is simple loose- 
BILE FLUX, OR SIMPLE CHOLERA.         23
ness, and is not contagious nor dangerous, unless it in-
crease or continue so long as to weaken the patient.  It
often occurs on change of residence, from the nature of
the water or the air.
  Treatment.—It is an important caution not to stop the
complaint too suddenly by astringents ; but rather to aid
nature by small doses of rhubarb, such as one or two of
the compound  rhubarb pills ; or as much sulphur as will
lie on a shilling, in a little honey or treacle. When it
does not go off readily, try the following
  Draught.—Take one ounce and a half of chalk mix-
ture,  one drachm of tincture of catechu, and  fifteen
drops of  laudanum; to be taken every three  or four
hours.  Or, a  pint of new milk maty be boiled with two
drachms of alum, and the whey  drank.

  11. Bile Flux, or  simple Cholera.—Causes  and
Symptoms.—Unusually hot sultry weather, or  sudden
cold or  damp  succeeding to heat, and checking the per-
spiration, and  consequently the manufacture ofbile, will
be followed by a violent re-action, and is the most fre-
quent cause of bile flux, a superabundance  of bile being
poured  into the bowels, which  irritates them strongly,
and produces  gripes, purging,  and  vomiting, often of
pure bile.   " The bile," says Celsus, " bursts forth, both
upwards and downwards; at first like water, afterwards
as though fresh flesh had been washed in it."
   Treatment.—The great secret of successful treatment
consists in taking care that, whilst we assist nature to
expel the bile, the patient's strength to sustain the con-
flict  must  be most carefully watched and supported.
Our first object, therefore, must not be to stop the purg-
ing and vomiting, unless these are very exhausting; but
to assist nature in clearing away the superfluity of the
bile.  All astringent and  binding medicines, then, and
all emetics and purgatives, are to be avoided, as tending
to augment the irritation, or to spur on the liver to throw
 out more bile.  If the evacuations be lumpy or  unnatu-
 ral in color, a small dose of castor oil, or any other mild
 laxative, may be useful, or, what is even better, a mode- 
 24       DISEASES OF THE DIGESTIVE ORGANS.

 rate use of mild fluids to "dilute and wash out the sto-
 mach  and bowels.  For this purpose,  weak chicken
 broth; toast and water,  made with oat  cake  toasted
 quite brown, and boiled in water till it is of the color of
 coffee; spring water with the chill taken off;  or cold
 and fresh water from the fountain, have been given with
 great success.   Linseed tea or barley-water, with a little
 gum arabic and barley-sugar in it,  is  also good, and
 better still if made  with  spearmint, or peppermint tea
 from the  green leaves, fresh gathered.   Solid food is
 seldom or never relished by patients, and ought not to
 be pressed upon them.
   There  is  danger,  however, in giving too much of
 these warm drinks, as they tend to increase the  flow of
 the bile;  and  if the discharges are  very violent, they
 ought to be entirely prohibited, and some  authorities say
 they ought not to be given at all, except  before the flux
 appears, and recommend opium as a specific that acts
 like a charm.  According to  this view,  the  following
 mixture may be tried:
   Mixture.—Take twenty drops of laudanum,  twenty
 grains  of Epsom salts,  dissolved in a sufficient quantity
 of peppermint-water.  Mix, and repeat every two hours
 till relief is obtained.
   In the case of much pain or sickness, when this mix-
 ture would be  too fluid for the patient, the most eligible
 remedy for the griping and spasm is the  following
  Pill.—Take  from  one  to two grains of opium, from
 three to five grains of chloride of mercury or calomel.
 Make into a pill, and follow it, if necessary, every hour
 afterwards, with half a grain of opium and one grain of
 calomel, till the vomiting  and purging abate, which will
generally be the case in From half an liour to three hours
from the first dose.
  This treatment will generally cure the patient in two
 or three days.  Should any weakness remain trouble-
some after the  disease has been subdued, it will be of
advantage to take a few doses of the compound rhubarb
pill, or the following
  Draught.—Take one ounce and a half of infusion of 
SPASMODIC FLUX.
25
cascarilla, three drachms of tincture of Columbia, one
drachm of compound tincture of cardamums.   Mix for a
draught thrice a day.

  12. Spasmodic Flux, or Malignant Cholera.—This
disease has within the last few years spread terror and
death  through  every country, from India in the east to
Europe and America in  the west; and, though it occa-
sionally abates  or disappears, it often again breaks forth
among the people with fresh alarm. It is much disputed
whether or not it be infectious.  Most probably it is not
so, and much less  is it  spread, as alleged, by insects;
but, so far as practical caution is concerned, it is best to
act as if these seer>ing fancies were actual facts.
   Symptoms.—Malignant cholera sometimes  suddenly
attacks people in good  health, without any notice of
its approach; but the patient  is usually  affected with
nausea, or slight irritation of the bowels, or pains  and
cramps in the legs;  but  very often there is no warning
at all.  On  awaking out of sleep, though having gone
to bed in health, the patient is all at once most violently
affected with spasmodic pain  in the bowels, sickness,
and purging; and the pulse is hardly to be felt.  A per-
son may be well at breakfast, and may die before noon;
or have been out at night, and be attacked with cholera
at day-break.                        '
   In the worst cases of all, there is neither vomiting
nor purging, the stomach and  bowels seeming to have
lost all power.                     .
   Treatment.—When it is pretty obvious that an attack
 has commenced, the best thing that  can be done, in the
 first hurry, is to get some warm and comfortable drink
 prepared, such as  hot brandy and water, which is the
 best of all;  to place a good blanket close to the fire, until
 it is quite warm; to undress  the patient, from head to
 foot, before a fire ;  to drink the brandy and water, whilst
 the feet, legs, hands, and arms, are  briskly rubbed, and
 then  to roll the hot blanket completely up to the chin.
 Even the head should be warmly covered  up, only leav-
 ing room to breathe.
           B 
26       DISEASES OF  THE DIGESTIVE  ORGANS,
  In  all  this there is nothing  required  (except  th«,
brandy) which is not to be found or which may not be
managed in any house or cottage.   If there is no brandy,
hot tea, or even hot water, will be better than nothing,
if the patient  can keep it  down.  Along  with  the  hot
drink, whether brandy or tea, a  solution of opium in
spirit, that »y laudanum, is the best medicine for a chol-
era patient; the usual dose is from thirty drops to forty.
In a case of cholera thirty or forty drops should be given
at first in the brandy and water.  If the  edge of the
laudanum bottle is made wet on one side, it will be easy
to drop it  out, drop by  drop, into an empty glass;  if it
runs out too fast, the dropping must be done over again,
until done properly, as too much  might be fatal.   For
persons so situated as to have  no means now of getting
medical advice  for several  hours, some rules must be
laid down.
  In order U> restore the cirettlatioo of blood in the skinr
and bring back its warmth, strong rubbing of the body
with the hand, o* with hot coarse towels, or with equal
parts of mustard and flour,  or with  embrocations con-
taining camphor, such as  camphor liniment; bottles of
hot water, wrapped  in flannel, applied  to  the  soles of
the feet, to the pit of the stomach, under the arms,  and
under the joints of the knees;  a hot  bath may  be pre-
pared (though when the strength  is much reduced  this
is not safe), and  the patient placed in it, and kept there
a quarter  of an hour,  then well rubbed  and dried,  and
placed in the hot blankets  ; or  heat in the form of either
vapor from hot water introduced under the blankets, or
produced  by  burning spirits under the  bed-clothes* or
bags of hot sand, hot bran, hot oatmeal,  or hot air, may
all be advantageously tried.
  The other remedies which have  been  tried are bleed-
ing either with lancet or leeches over the stomach; cal-
omel in the dose of twenty grains; cajeput  oil in the
dose of twenty drops on lump sugar; Cayenne pepper
in doses of twenty grains; and ether in the dose  of a
tea-spoonful. 
JAUNDICE.
27
 13. Jaundice.—Causes.—As cholera or bile flux is caused
by a too great flow of bile into the bowels, the deficien-
cy or stoppage of the due flow of bile produces jaundice,
in which the blood, becoming loaded with the yellow
bile, tinges the skin and whites of the  eyes with a yel-
low hue, more or less deep in proportion to the obstruc-
tion.  Violent passions,  strong  purgatives or emetics,
catching cold, and the like, are apt to bring on jaundice.
  Symptoms.—Jaundice begins with a feeling of excess-
ive weariness, and  great aversion to every kind of mo-
tion.  The skin becomes dry, with a kind of itching or
pricking pain over  the whole body; the stools are of a
whitish or clay color ; and the urine is yellow or reddish,
and dyes things dipped into it.  The breathing is  diffi-
cult, and there is unusual oppression of the breast, heat
in the nostrils,  a bitter  taste  in  the  nostrils,  a  bitter
taste in the mouth, loathing of food, and sickness at the
stomach.  It has been erroneously said that objects.ap-
pear  to the eye of  a  yellow color.   If the patient be
young,  the disease  is  seldom  dangerous; but in old peo-
ple it often proves fatal.   The black jaundice is more
dangerous than the yellow.
   Treatment.—The diet should be cool, light, and di-
luting ; much exercise, such as walking, running, dan-
cing, and even jumping, are likewise  proper, provided
there be no pain.   No medicines are more beneficial in
the jaundice than vomits,  especially where it is not at-
tended  with inflammation.  Half  a drachm of ipecacu-
anha in powder will be a sufficient dose  for an adult,
and it may be wrought off with weak  camomile tea, or
lukewarm water.   The belly  must likewise be kept open
by mild purgatives, such as the following
   Pills.—Take  socotrine aloes ana* rhubarb in powder,
 of each  two drachms, Castile soap an  ounce ; beat them
all together, with a little syrup, into a proper consistence
for pills ; let  them be formed into pills of an  ordinary
 size, and five or six of them taken twice or thrice a day.
 They must be continued for  some time, and the quanti-
 ty regulated by  the  patient's stools, of which he ought
 at least to have two  every day.
            B2 
28       DISEASES of the digestive organs.

  When the jaundice is obviously caused by the harden-
ing or inflammation of the liver, it must be treated as
directed under that head; when it is caused  by gall-
stones, as under:

  14.   Gall-Stones.—Causes and  Symptoms.—In the
gall-bladder are not uncommonly formed hard masses
of bilious matter, termed gall-stones, which get into the
duct or passage  from the gall-bladder to the bowels,
causing sharp and violent pains, which cease for a time,
and then return again.  Great irritation at the  stomach
and frequent vomiting will attend, and the patient will
experience an increase of the pain after eating.
  Treatment.—It  will be advisable, in  full habits, to
take away a quantity  of blood, proportionable  to the
ftate of the pulse  and the severity of the pain, and then,
having adopted this step, the sufferer should be put into
a warm  bath, till some  degree of fainting  is  excited;
then removed to the bed, and an opiate taken,  which
may be repeated every four or six hours till ease  is pro-
cured.  Lime-water and milk in equal proportions has
by some been recommended to be given  in doses of an~
ounce.   A mild course of mercury will tend  to prevent
the formation of gall-stones.

  15.  Worms.—Causes and Sorts of Worms.—Worms
chiefly affect those who are subject to indigestion, ner
vous ailments, and disordered bowels, whatever be the
age or  sex.
  Upwards of sixteen species of worms have  been found
in the  human intestines ; but three only are general,—
the maw-worms or thread-words (Ascarides  or Oxyuris
vcrmicularis),  the round (Ascaris lumbricoides) and the
tape worms, one the broad tape-worm (Tccnia lata), and
the two-fanged tape-worm (Tcenia Solium).
  Symptoms of Thread Worms.—The most certain sign
of the thread-worm is an itching of the fundament and
lower intestine, which is often distressing and almost in-
tolerable.  The disturbance produced here is communi-
cated by the nerves to all parts of the body, occasioning 
WORMS.
29
a crowd of disorders  of the bowels,  the  stomach, and
the head, such as headaches, giddiness, loss of activity,
frightful dreams, &c.
  Remedies.—As strong purgatives, now so fashionable
and so  destructive to health, such as the quack  trash
called worm-cakes, worm-nuts, and worm-lozenges, are
all bad, the first aim must be to get rid of the slime of
the bowels on which the worms feed; for, if they are
deprived of their food they must inevitably die.   Now
it is clear that purgatives, as they make the stools more
watery,  only increase  the slime, and of  course supply
the worms with more food.   It will  be more effectual
to try the following
  Mixture.—Take one ounce of good quick-lime,  a pint
and a half of rain water;  pour the water  over the lime,
cover it  up for an hour in a pipkin,  then pour off the
water into a bottle, and keep it corked for use.   For a
child, a wine-glassful is to  be taken thrice a day, in a
cup of camomile tea,  or  to make it more palatable, in
beef-tea or other soup.  Double this  dose, or more,  for
a <*rown person.  An over-dose will do no harm.
  If this be continued for a month or six weeks, the
worms will disappear, and the health and strength will
be rapidly improved.   It may be necessary, perhaps, to
<rive  a  little  Epsom  salts and senna,  once  or twice a
week, though this depends  upon the state of the bow-
 els.  If the itching of the fundament  is very troubld-
some, inject in the usual way a little of the lime-water
 mixed  with beef-tea, which will kill every worm it
 touches. Even cold water  will be effectual if thus m-

JeCRue  tansy, worm-seed, angelica, and all bitter herbs.
 are good against worms, but only because they strength-
 en the bowels.   None of them  are so effectual  as  the
 above •  but any of them may be taken with advantage
 "nthe'formof tea,  along with it   Turpentine, as di-
 rected  below for tape-worm, may be tried with  success

 "lyt^omrfrZ Round Worms.-^e round[worm
 though by no means rare, is less  common than  the

         b3 
30       DISEASES  OF THE DIGESTIVE ORGANS.
  thread-worm.   The  symptoms are not much different
  from those of the thread-worm preceding,  except  the
  young worms get into the stomach, when nausea, retch-
  ing, and other marks of irritation, will ensue; and often
  nervous affections, such as convulsions and epilepsy.
    Treatment.—Nearly the  same  remedies  as recom-
  mended for thread-worms may be employed.  Turpen-
  tine, as for tape-worms, is the most powerful medicine.
   Symptoms of Tape-Worms.—Tape-worms, as we have
  said, are of two species, one without, and one with  two
  fangs, by which they lay hold of and adhere to the in-
  testine.  Both species have been found  from  twenty to
  thirty, and even two hundred feet long.  When a tape-
 worm  exists in  the bowels, it is usually  accompanied
 with great weakness and debility, with painful  and
 alarming cramps and spasms.
   Treatment.—Ycry many remedies have been proposed
 for  expelling the tape-worm from  the bowels, though
 none of them can be relied upon as infallible.  One'of
 the most celebrated, the receipt for which was purchas-
 ed at a large sum by the French government, is the fol-
 lowing
   Mixture.—Take three drachms of recent male fern-
 root, powdered;  a table-spoonful of honey.   Mix, and
 take in the morning—a supper of panada having been
 taken the night before, and the bowels been prepared by
 an emollient clyster.  This  is to be followed in two hours
 by the following
  Bolus.—Take twelve grains of calomel, twelve grains
 of scammony, five grains of gamboge.   Make a  bolus
 with syrup or mucilage.
  This  is indeed a purgative bolus with a vengeance '
 and we should be very apprehensive of  the life of any
 weakly patient who should take it.  We have  little
doubt, however, that it will kill and dislodge any tape-
worm, though the sufferer will run the hazard of inflam-
mation of the bowels, from its violent operation   This
remedy has now fallen into discredit, and probably from
these very reasons.  The most popular remedy for taDP-
worm, among  medical men at present, is the rectified 
PILES.
31
oil of turpentine, which is a very powerful remedy, and
ought n<ever to be omitted in obstinate cases.
  Mixture for an Infant.—Tike from half a drachm to
a tea-spoonful of the rectified oil of turpentine, a table-
spoonful of new milk, a tea-spoonful of honey.  Mix for
a dose.   A child twelve years old  may take from three
to six tea-spoonfuls of  the turpentine.
  Mixture for an Adult.—Take frcfli one to two ounces
of rectified oil of turpentine, an  ale-glassful of pepper-
mint water, two or three tea-spoonfuls of honey.  Mix
for a dose, to be repeated every eight hours, till it expels
the  tape-worm.  Three  or four doses arc usually ef-
fectual.

   16. Piles.—Causes.—A large portion of all the blood
in the  body is continually jetted  by the heart to  the
bowels, and to the lower  extremities; and unless the
whole of this blood return as speedily and freely as it
flowed  hither, it must perforce stagnate, accumulate,
and produce disorder.  In the stronger parts of the body,
such as the arms, this increase  of blood usually gives
additional strength, but in  the weaker parts it is certain
to overcome them, and produce  inflammation and other
disorders; and such is the cause of piles.  A sedentary
occupation, writing and the like, not only obstructs the
free return of the blood from the bowels and lower ex-
tremities, but drives too much blood to the  parts about
the seat and fundament.   Now,  as the termination of
the intestine called the vent-gut (rectum) is the weakest
part in  the  vicinity, it is overpowered by the  supera-
bundance of blood, Avhich either swells out the  veins or
bursts them.  In the  latter case, the blood which es-
capes from the veins frequently does not get through
the skin, but is  confined, and forms swellings:  when it
docs get through the skin, it forms what are called the
bleeding piles ;  and the blood lost in this way is some-
 times almost incredible.  Aloetic purgatives, such  as
 most of the quack pills in vogue are composed of, cause
 piles for the  same  reason.  All obstructive diseases in
 the liver and bowels will also prevent the return of the
             s4 
32       diseases of the digestive organs.
blood, and give rise to piles;  and hence piles are com-
mon with pregnant women ; above all, costiveness; for
the hardened feces which collect and accumulate in the
bowels, press upon the veins  and obstruct the return of
the blood.   The evil is increased also by deficiency of
bile.
  Symptoms.—The4rrst sign of piles is a dull, peculiar,
and  sometimes very distressing pain about the funda-
ment ;  felt  more particularly when  at stool, or in case
of occasional costiveness.  At first, perhaps, little notice
is taken of this, till the pain increases  so  much in se-
verity and frequency, that  it compels  attention.  One,
or a number of little  tumors of various shapes and sizes,
from that of a wart, or the end of your finger, to that of
an egg, now make their appearance, caused by obstruct-
ed blood swelling  out  the veins, or  escaped from  the
veins, and swelling out the skin.  Besides  these symp-
toms of piles, the head is usually affected with pain and
giddiness; there is nausea of the stomach,  and pains in
the loins.
   Treatment.—Some very ignorant physicians have con-
cluded  that piles, and particularly bleeding piles,  are
very beneficial to health, and ought therefore to be borne
with and encouraged, rather than cured.  This is non-
sense.   The first thing to be done in the cure is to dis-
cover the cause.  A  hard seat will occasion more pres-
sure than a soft one,  and consequently a greater rush of
blood to the parts.  At  intervals of leisure, lying in a
recumbent posture on a sofa will aid  the return of  the
blood.   Above all, the bowels ought to be kept regu-
larly open;  but no  medicine  in which there is aloes
ought to be taken for that purpose.  Dinner pills and all
quack antibilious pills are therefore improper.  Where
there is much costiveness, we recommend the following
  Pills.—Take twenty grains of the compound rhubarb
pill, thirty grains of blue pill mass, ten grains of extract
of colocynth ; mix, and divide  into one dozen pills, one
or two for a dose, at  bed-time, occasionally.
  If the costiveness is les3 obstinate, the best opening
medicine which has hitherto been discovered is sulphur. 
IMMODERATE DISCHARGE OF URINE.       33
We recommend the sulphur  combined as in the fol-
Lowinff
  Electuary.—Take one  ounce  of flowers of sulphur,
half an  ounce of cream of tartar, a sufficient quantity
of honey.  Mix, and take a tea-spoonful thrice a day.
It will very much  improve it to add  twenty drops ot
balsam of popaiva to every dose, according to the prac-
tice of the celebrated Dr. Cullen.
  When the piles are painful  and  inflamed, add two or
three tea-spoonfuls  of laudanum  to a tea-cupful of warm
milk ; soak a sponge with it,  and apply n to the parts;
or a common poultice, with a tea-spoonful of laudanum
to it,  will give  great relief.  An  excellent remedy for
the pain of the piles is the              .
   Boustie.—Take a roll  of cotton the thickness of the
finger, a quantity of butter of  chocolate, a very little
spermaceti ointment. Roll the  cotton  in these,  in form
of a cone or a cylinder, and introduce it into the  rectum.
   In  all cases where there is much hardness, inflamma-
 tory  heat, and irritation, half  a dozen or a dozen of
 leeches ought to be applied around the fundament, and
 followed by a common poultice. After the  irritation is
 Slayed, injections  of cold water, or a weak solution of
 sulphate of zinc, will tend to strengthen the parts.  In
 dangerous cases of bleeding, a  few doses of the  disul-
 phate of quinine, in the quantity of three or four grains,
 Kas succeeded, when every other means had failed.

   17. FiSTULA.-This is caused by the piles described
 in the preceding article  breaking, and forming sores in
  h  vent-CTt rfctum).   It will  be indispensable to keep
 the tow^opefwith mild laxatives,  such as castor-oJ
 manna or flowers of sulphur.  Iys rarely cured but by
 surgical treatment.


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          b5 
34       DISEASES OF THE DIGESTIVE ORGANS.

of fever ; the mouth is dry, and yet there is frequently
a frothy spittle; the strength fails; the appetite decays;
the flesh wastes away, and  the sufferer is reduced to
skin and bones.
  Treatment.—Everything  that  stimulates  must  be
avoided; solid  food  should  be chiefly taken—such as
rice, sago, and salep, with milk;  of animal substances,
shell-fish are to be preferred.   If the sufferer be not too
much weakened by  the  disease, gentle purges of rhu-
barb,  with  cardamom-seeds  infused  in wine, may be
taken in such quantity as to keep the belly gently  open.
The sufferer must next have recourse to astringents and
corroborants.  Half a drachm of powder made of  burnt
alum, and the gum called dragon's blood, may be taken
four times a day, or oftener, if the stomach will bear it.
The alum must first be melted in a crucible;  afterwards
they may be both pounded together.  Along Avith every
dose of this powder, take a tea-cupful of the tincture of
r»ses.
  Incontinence of urine (a disease distinct from diabetes)
may be mitigated by the use of astringent and strength-
ening medicines.  It is difficult to cure.

  19.  Gravel and Sand in  the Urine.—Causes and
Symptoms.—Weak or disordered digestion, from seden-
tary occupation, is most frequently the cause of gravel
and sand in the urine, which seems to be formed in the
kidneys, passing thence with the urine along the urinary
canals, termed ureters, into  the  bladder.  Now, when
the gravel is, as usual, full of sharp angles, it must fret
and cut the  tender inner surface of these  canals,  occa-
sion great  pain in the  loins, where the canals lie, and
must often draw blood, and consequently produce bloody
urine.  The irritation thus produced commonly extends
to the stomach, causing nausea, sickness, and vomiting,
and to the head, inducing headach and giddiness  ; and
the two organs thus wage alternate  war with  one an-
other, till the poor  sufferer has his life dreadfully embit-
tered.  This is the common progress of repeated fits of
the gravel,  as they are called.  If the sand or gravel is 
          GRAVEL AND SAND IN THE URINE.        35

of a white color, it is chiefly composed of lime; if red,
it is an acid usually in a chrystallised state, whether it
incrust the sides of the pot-ae-chambre with a red sedi-
ment, or be passed in grains with sharp angles.  It is of
the utmost  importance to distinguish those two sorts,
the white and  the red, as they require very opposite
treatment.   The white is neither so common nor so ob-
stinate as the red.  The red, being itself an acid,  obvi-
ously arises from too much  acid in the body, caused by
drinking wines, spirits, and malt liquors; and by  mak-
ing a long  interval between breakfast and  dinner, and
then overloading the stomach  beyond what it can di-
gest.
  Remedies for  While Gravel.—For  the white  gravel,
calcareous sand, or lime, acids  must be taken; and for
this purpose may be  tried the following
  Draught.—Take one tea-spoonful of lemon-juice, an
ale-glassful of decoction of pareira ;  sugar and pepper-
mint-water  to taste.   Mix for a dose, to be frequently
repeated.
  In order to be satisfied with the efficacy of this remedy,
pour some of it on the white gravel,  and it will quickly
dissolve.
  Remedies for Red-Gravel.—We recommend for tne
red gravel  a rigid abstinence from acid food and drink,
such  as sour fruits, cider,  and champaign; and, as a
medicine, magnesia, in the do&e of a tea-spoonful  night
and morning.  We are of opinion, however, that a more
powerful medicine than the magnesia will be found in
the following
   Mixture.—Take two ounces of pennyroyal or cinna-
mon-water, two  ounces of gum-arabic mucilage, an
ounce and a half of clarified honey, three  drachms of
liquor of potass, forty drops of wine of opium; mix, and
take two table-spoonfuls twice  a day in a cup of barley-
water.   There may  be added to each dose, with great
advantage, two tea-spoonfuls of the  compound spirit of
juniper, or twenty grains of nitre.
   If this is found to irritate the stomach too much, try
magnesia,  or a steady course of good soda-water,  at the
        B« 
36       DISEASES  of  the digestive organs.
 rate of at least two bottles a-day.   If this be too expen-
 sive, try the following
   Pills.—Take  six grains of dried  sesquicarbonate of
 soda, four grains of hard soap, and a sufficient quantity
 of calumba-root  in powder, to make two pills, one to be
 taken night and morning, for some weeks.  These may
 be usefully varied by using  carbonised potass for  the
 soda, and extract of uva ursi  for the calumba.
   When a fit of the gravel makes its attack with vio-
 lent pain, the warm bath must be immediately procur-
 ed ;  and, if that  do not relieve, some blood may be taken
 from the arm, and forty drops of tincture of opium given,
 with plenty of gruel or barley-water. Fomentations also,
 applied to the loins bp a thick flannel roller, and that
 confined by a linen or calico  one above it, will, in most
 cases, give instant ease.

   20. Stoppage  of Urine, and Stone in the Bladder.—
 Causes and Symptoms.—The urine may be stopped in
 the bladder by various causes ; such as a piece of gravel
 larger than those just  described, and termed a stone,
 which may be even as large  or larger than a nut.  Ob-
 stinate costiveness may also stop the urine  by the pres-
 sure of the hard  contents of the vent-gut on the bladder;
 and the same may also arise  from palsy  of the neck of
 the bladder.  In all  those  cases  there is excruciating
 pain, which can only be relieved by the discharge of the
urine.
  Remedies.—In extreme pain, it may be partially alle-
viated by the warm bath ; but the most effectual relief
is given by drawing off the water  with a catheter. 
  B.—DISEASES  OP THE ORGANS OF  BREATHING.

  In order to explain the diseases or derangement occur-
ring in  the organs of breathing, it will be necessary to
give a brief  and plain sketch of these organs and their
functions in a state of health.

     I.—HEALTHY STATE OF THE ORGANS OF
                    BREATHING.

  We have already seen (page 13)  that the digested
food, in a form similar  to cream, is carried from the in-
testines along the mesentery, or webb, in innumerable
little canals, which we shall how follow in their course,
till they meet in one common  canal, and empty their
contents, which have received a slight tinge of red in
their passage, into one common reservoir, about the  size
of a pea, situated near the back-bone below the edge of
the midriff.   The prepared  aliment  is in this manner
introduced in small quantities into the blood of one of
the veins, where it  loses its white tinge, and is carried
forward to be farther prepared in the lungs.

   1.  The Lungs.—The lungs, which fill a great portion
of the chest, are composed of a soft, spongy, elastic  sub-
stance, produced by a mass of small cells or vesicles,
similar to the cells of a sponge.  On the walls of these
cells are innumerable minute branches  of blood-vessels,
closely interwoven, and separated from the cavity of the
cell by a membrane less than the one hundredth of an 
38     diseases of the organs of  breathing.

jnch in thickness, and pervious, if not to the air, at least
to a portion of its constituents, when introduced into the
cells by the air-tubes which run into  them from the
windpipe, and which, before coming to the cells, branch
off from the main windpipe, and from each other, like
the branches and twigs of a tree.  The windpipe itself
lies in front of the gullet, commencing at the back part
of the  mouth ; and is not composed, like the gullet, of
soft yielding  membrane, which might allow it to be
closed by  external pressure; but  constructed of stiff
gristly rings, united by  membrane, which  permits  of
slight  extension.   The gristly portion disappears in the
more minute branches, each of which ends  in a single
bulb, much more  numerous in young than  in old ani-
mals,  as they become filled up by disease, and also as
age advances—and hence the  oppressed  breathing  of
old people.

   2. The Chest.—The chest, where the lungs, with the
heart, are situated, is separated from the belly, contain-
ing the stomach, liver, and  intestines, by a broad mus-
cular partition, called the midriff, which has passages,
however, for the gullet and blood-vessels.  The midriff,
when depressed, acts similarly to the sucker of a pump,
or rather the valve of a pair of bellows, drawing in air
from the  mouth  through the windpipe, to distend the
lungs; the dimensions of the chest being by the same
means enlarged.  When the depressed midriff again is
raised up,  the air in the cells of the lungs is forced out,
in a similar way to water being  forced out of  a sponge
when it is squeezed.
,  The chief agents in the process of breathing are the 
      disorders of the  organs of breathing.    39

midriff and  the ribs,  together with the windpipe and
lungs, already described.

  3. The  Nostrils and Windpipe.—The air is  ntro*
duced  into  the lungs partly through the mouth, but
chiefly through the nostrils, consisting of two channels
outwardly; but these  unite into one near the back part
of the mouth, where it opens  immediately over the en-
trance into the windpipe.  Contrary to vulgar opinion,
the nostrils  are quite cut off from  all communication
with  the  brain, by a  partition of bone  as thick as the
board of a book, while they are partially separated from
the mouth by a curtain of a thick fleshy and glandular
skin or membrane, which is partly stretched, and partly
hangs down, at the back part of the mouth.  To this
curtain is hung a little weight, of the form of a grape,
which may be seen on opening the mouth pretty widely.
It seems to be designed to guard the back part of the
throat, and make the  curtain  hang steadily.  The  little
weight, when  inflamed by cold, hangs  lower down, ob-
structs swallowing, and is in  such cases well known by
the name of tiie pap in the throat.   The fleshy partition
or curtain is pressed  back by the morsel in the act of
swallowing, and covers  the  hind  part of  the  nostril.
Sometimes, however, particles of food get up behind the
curtain into the nostril, and occasion sneezing.


H.—DISORDERS OF  THE ORGANS OF BREATHING.

   Having thus described the organs of breathing, from
 the mouth, nostrils and windpipe, to the lungs, the mid-
 riff and the ribs, which  are put in motion each breath 
40     diseases of the organs  of  breathing.
 we draw, we shall next consider the disorders to which
 these organs are liable, beginning with the nostrils and
 the parts immediately connected with  them.

   1. Cold in the Head.—Causes and Symptoms.—The
 nostrils are lined with fine, delicate, and easily-irritated
 skin, like that which lines the inside of the cheeks.  In
 consequence of the  contraction of the blood-vessels of
 the feet, or of any other part of the  body, by the appli-
 cation of cold, the  superabundant blood, which cannot
 find  a passage where it was wont to flow, is  thrown
 upon the weakest or most  sensitive organ of the body,
 into which  it can most easily push its  unwelcome way.
 In the case of a cold in the  head,  the  superabundant
 deluge of blood is thrown into the lining of the  nostril,
 swelling  the parts  and narrowing the passage, and, of
 course, causing a difficulty of breathing, and a  painful
 feeling of distension or bursting, which extends over the
 forehead, and causes severe headach—all  from  the ex-
 tra quantity of blood pushed  into the blood-vessels.
 The same lining of delicate skin goes up from the nos-
 trils  into the hollow hi the bone of each eyebrow, and
 back to the internal ear and upper  part of the  throat;
 and the deluge of blood, driven thither by cold, spreads
 along the membrane like water through blotting-paper,
 and the ears are involved in the pain, while the throat
 becomes raw and sore, and the voice rough, husky, and
 hoarse.  This is the first stage of inflammation.  "
  The mucus by which the nostril is moistened in a state
 of health is all filtered  from the blood; but the swell-
 ing, produced by the overflow of blood, at first  presses
 upon these  canals,  and obstructs them, and hence,  at
 the beginning of a cold in the head, the nostril is usually
 drier than natural;  or,  from the  smaller bore  of the
 canals, allows only thin watery matter to pass; but in a
 short time the little canals exert themselves to overcome
the pressure of the  surrounding blood-vessels ; and the
aTuTnVite™ succe?,sful m regaining their proper width,
a quantity of mucus flows into the nostril, proportioned 
COLD IN THE HEAD.
41
to the increase  of the blood from which it is filtered.
Every person who has ever been affected with a cold can
witness to the truth of this history.
  Remedies.—The sooner the increased tide of blood can
be drawn from  the nostrils, forehead and  throat, the
more powerfully will be prevented the cold from sitting
down, as it is called ; that is, establishing the inflamma-
tion, and the swelling of the blood-vessels, which after
a space will not, even by the withdrawal of the blood,
return!to their  healthy calibre.  This maybe accom-
plished in  three ways;  either the accumulated blood
may be drawn off  by  leeches, a dozen or so, applied  to
the forehead and  roots of the  nostrils, or driven down-
wards, by applying cold water to the face and forehead,
and plunging the feet in warm water, into which a hand-
ful of mustard has been thrown. The cold water makes
the blood-vessels contract, and  the warm water  to the
feet  makes  the  blood-vessels there  expand, to receive
what has been withdrawn  from the  head.  The third
way is to take  brandy, whiskey, wine, or other liquor,
hot, which in the first stage will so increase the tide  of
the blood, as to force open the obstructed vessels.  This
last  remedy, after  the first two  days of disorder, will  do
more harm than good.                           .  .
   When the throat and ears are  much affected,  it is
best to draw off  the blood to the outer  skin, by wrapping
up the throat in  warm flannel by day,  and at night wear-
ing a woollen night-cap, with a lamb's  wool  or fleecy
hosiery stocking wrapped round the throat,  and pinned
to the night-cap ;  but it is necessary that it be done the
very first night the cold  is felt coming on ; because,  by
delay,  the disease gets  too powerful for this simple
remedy.                    .....   .„  •    -.  r
   When a cold is once established, it will, in spite of
remedies, run a course of about ten days or a fortnight,
and will then usually subside, whether remedies be used
or not,—a circumstance which  often gives the credit to
particular medicines for a cure  which is  m truth due to
nature. 
 42      diseases of the organs of breathing.

   2. Loss of Voice.—The consequence of a cold spread-
 ing from the head to the top of the throat sometimes
 produces the very distressing though not dangerous com-
 plaint of loss of voice.
   Remedies.—Stimulant substances, or a mixture of two
 scruples of saltpetre with an ounce of the rob of elder-
 berries : a tea-spoonful allowed to dissolve in the mouth
 four or five times a day may be tried.

   3. Cough.—It is of great  importance to ascertain the
 cause and the seat of a cough; for otherwise the $ure is
 out of the question, unless it be stumbled upon by acci-
 dent.  What is a  cough ? it may be asked.   We an-
 swer, that it is an effort of  the lungs, the windpipe, or
 the midriff, to "throw off some offensive matter,  or to
 relieve some irritation ; in the same way as sneezing is
 an effort to expel snuff from the nostrils, or to got rid of
 too much blood driven thither in consequence of a cold.

   4. Stomach and Liver Coughs.—Causes.— The  mid-
 riff  or  diaphragm,  that is,  the  broad  fleshy partition
 which separates the lungs and the  heart from the liver
 and the stomach, and which  moves upwards and down-
 wards every time  we breathe, is always in every case
 one of the chief agents in producing  cough.  When we
 consider, therefore,  how many disorders of the stomach
 and liver there are which would cause this irritation, we
 cannot be surprised at the  frequency of stomach and
 liver coughs, nor at their  being often mistaken, even by
 those who ought  to know better, for consumptive and
 asthmatic coughs; and patients have accordingly been
 thrown into dangerous, though groundless, alarm.  One
of the most common causes  of  stomach cough is indi-
gestion.  The remedies for this  sort of  stomach cou^h
are the same as those we have recommended for nervous
indigestion ; for, as soon as this is cured, the cough will
to a certainty, disappear.                            '
  Another and  no less troublesome  variety of stomach
cough arises when the  lower portion of the  stomach
feels tender, sore, or painful to the touch, when the fin- 
STOMACH AND LIVER COUSHS.
43
ger is pressed upon the part, which is a spot about the
size of a shilling, at the bend of the ribs, on the right
side.
  Distinguishing Signs.—Medical men, in order to dis-
cover the cause of dry cough, make the sufferer draw in
a very full breath, and observe minutely whether it ex-
cites cough or pain in any part.  If this pain be seated
In the lungs, the cough is then determined  to be con-
sumptive or  catarrhal; but  if  it produce a sharp pain
under the ribs on the right side, extending towards the
back  or across by the stomach, then it is  determined
that the liver or stomach is diseased.  In coughs  arising
primarily from the lungs, the skin is generally clear and
well  colored; whereas, when the  liver or  stomach is
affected, or where there is bilious derangement, the skin
is harsh and  dry, and almost always more or less tinged
with yellow.  In liver or stomach cOBgh, the breathing,
though hurried in the evening, on account of the acces-
sion of fever and the accumulation of phlegm, is gene-
rally calm and natural in the morning, which is  not the
case in consumption.   The  stools also  in consumption
are usually healthy, whilst in liver complaints they are
uniformly unnatural in consistence, color, or smell.
   Remedies.—As  this sort of cough is only a symptom
of disordered liver or stomach, we must refer  for the
mode of cure to those complaints.  For immediate  re-
lief of the cough, if it is hacking and troublesome, no-
thing will be more effectual than the warm bath, or the
following                    m
   Pill.—Take one grain of opium, three grams of chlo-
 ride of mercury, one grain of extract of rhubarb.  Make
 a pill, to be taken on going to bed, and follow it in the
 morning with a cup of senna tea.  Leeches or a blister
 will sometimes prove almost  immediately effectual in
 removing  the cough.  In  addition,  we  should insist
 strongly on an issue or perpetual blister over the painful
 nart; or, if  that is inconvenient or disliked, try the fol-
 lowing                      „_      ,    . ,   ,  ,
    Plaster.—Take four ounces of Burgundy pitch plaster,
 half a drachm of euphorbium, a sufficient quantity of 
44     DISEASES OF THE ORGANS OF BREATHING.

common turpentine.  Melt the Burgundy pitch plaster,
add  the  euphorbium in fine powder, and, by means of
the turpentine, make the whole into a proper thickness
for spreading on leather.

  5. Winter Cough.—Causes.—Sneezing will explain
winter cough on the same principle as we have already
explained stomach and liver coughs.  There is another
sort of cough, arising from a different cause, which may
also be explained by sneezing.  When the nostrils are
very dry, or when they are inflamed, as in the instance
of a common cold, sneezing is excited by the  irritation,
when  there is  really nothing to get rid of.   The very
same is  the  case in coughing; for if the throat or the
lungs become too dry, or are inflamed in consequence of
a cold, or any other cause, they will cause the midriff'to
assist them in coughing, the  same as if there was really
a quantity of phlegm to be expelled.  As there is none,
the cough of course only increases the irritation, and
will continue either till the strength be exhausted, or
till something is done to blunt or lull the feeling of the
nerves.  This explains what is  termed a dry cough.
  Treatment.—As it is easier  to  prevent or  alleviate
than to cure this complaint, whether it be a spitting or
a dry cough, we must begin by attending to the diet
and regimen of the patient.
  The food, both  at breakfast and dinner, should be
chiefly solid animal food, of the lightest sort, such as
good  mutton, roasted or in chops, veal, fowl,  &c, with
biscuit instead  of bread.  New bread, in particular, is
extremely improper; and even stale bread, in many con-
stitutions, is liable to ferment on the stomach, and give
rise  to flatulence and  eructations.  Strong liquors and
all such as become  easily acid on the stomach should be
avoided.  All liquid substances should be used sparingly.
  The exercise  most beneficial is moderate walking ot
riding.  The dress  should be regulated, as in all  invalid
cases, by the state of the weather.   Cold changeable
weather, with east and north-east winds, must be care-
fully guarded against by silk and woollen clothing.   In 
ASTHMA.
45
winter, many recommend flannej to be worn next the
skin; but we cannot admit this  as a  general rule:  at
the same time we admit that  there are cases in which
the continued irritation of flannel on the skin may  be
advantageous, on the. same principle that perpetual  is-
sues are often  requisite  to ward off diseases.  If the
cough is so troublesome as to require immediate relief,
some anodyne medicine may be taken, but as sparingly
as  mav be, for all  such often aggravate  the  causes,
thougli  they relieve the symptoms. The, following may
be  tried:
  Drops.—Dissolve sixteen grains of acetate of morphia
in  one  drachm of spirits of wine, four drops of acetic
acid, and one ounce of distilled water ; add from ten to
twenty  drops, taken in a cup of coffee, as strong as it can
be  made—will often relieve the cough, and give almost
immediate ease, if it-be not inflammatory.

   G. Asthma.—Causes.—The causes of asthma are very
nearly the same as those of winter cough, and the chief
difference of the disorder is that asthma is more violent,
and comes on in fits.                            .
   Symptoms.—A fit of asthma is always ushered in by
weariness, languor, and a disinclination to motion, with
wind in the bowels, loss of appetite,  oppression of the
stomach, sickness,  nausea,  a weight over the  eyes,
headach, &c.  These are the immediate  forewarmngs
of an approaching fit, which usually makes its attack
 about the middle of the same night, or the night follow-
 in" the above symptoms, when the sleep is deepest; it
 may also occur during the day,  but this is not so com-
 mon.                             ,  ,.     _  4  .
    The patient's first sensation is a feeling of straitness
 of the chest, as  if it were forcibly  and distressingly
 bound with cords, which force:, him to sit up erect,  and
 to struggle for breath, as if he  were upon the point of
 death from suffocation-.                            .
    The struggle for breath affects the stomach, which
 becomes faint and  often throws up a greenish-yellow
 froth or slime,  produced by  the agitation,  while a 
46     DISEASES OF  THE ORGANS OF  BREATHING.

sweat breaks out about the forehead and neck.  The ef-
forts to speak or to bring up  phlegm during  the fit are
very distressing.  The  relief is almost always in pro-
portion  to  the quantity of phlegm  expectorated.   But
though  the fit  usually  subsides in a  few  hours, the
tightness of the chest and the difficulty  of breathing
continue, aud even on the second or third day the pa-
tient cannot move without great uneasiness.
  Marks of Danger.—The appearance of a fit of asthma
gives the alarm of fatal danger ; but it is seldom rapidly
fatal, and may haunt the unfortunate patient to an ad-
vanced old age ; though the frequent return of the fit
may lay the foundation of  gout,  water in the chest,
dropsy, apoplexy,  consumption, and inflammation of the
lungs.  When the  fit  is about to prove fatal,  the face
and lips become livid, or pale and swollen;  the hands
and arms also swell, with a loss of feeling bordering on
palsy.   The legs become dropsical;  and  suffocation
from inability to continue the struggle to get up the
phlegm closes the scene.
  Treatment.—Cold and damp air, particularly in those
who are full of blood, and at  the same time, of compar-
atively weak constitution, ought to be most carefully
avoided.  Those who inherit asthma from their parents
ought to be  particularly careful  of their dress and of
their living.  It very often arises from indigestion and
bile, in consequence of  the flatulence thereby produced
pressing upwards and diminishing  the capacity of the
chest.  For a similar reason  corpulence is a  frequent
cause of asthma.
 .As medicines for immediate relief the following  may
be tried.
  Mixture.—Take half an ounce of squill vinegar;  an
ounce of spirit of nitric ether; an ounce of oxymel; six
ounces of peppermint-water ; one drachm of  tincture of
foxglove; and one drachm of laudanum ; mix, and let a
table-spoonful be taken three or four times a-day.
  Draught.—Take twenty drops of compound  tincture
of benzoin; with equal quantities of milk of  almonds
and milk of ammonia, and  enough of mucilage of gum 
CONSUMPTION OF THE LUNGS.
47
arabic to make a draught, to be taken every four hours
when the expectoration is in great quantity.

  7. Convulsive Asthma.—Symptoms—The  chief dif-
ference of this from the preceding consists in the fit be-
ing more sudden and of shorter duration,  while the
cough is but slight and the expectoration scanty.
  Treatment.—Blood-letting under the advice of a med-
ical man (not otherwise) is often useful.  The following
may be tried by way of alleviation.
  Draught.—Take thirty  drops of rectified ether; ten
drops of laudanum; twelve drachms of camphor mix-
ture; and one drachm of syrup of saffron; mix  for a
draught every  six hours.
  PUls.—Take three grains of extract of henbane; four
grains of extract of hemlock ; make  two pills,  to be ta-
ken every six hours with the common saline draught.

  8. Consumption  of the Lungs.—Causes.—As to the
chief cause of consumption- of the lungs, a disease which
carries off about one-sixth, some say one-fourth.of the
population  of this country,—hereditary predisposition
seems to be  the principal, but how this operates in grad-
ually destroying the substance of the lungs is not under-
stood.  It is only known that little whitish cheesy-like
tubercles, from the size of a small pin's  head to that of
a pea, begin to form during a cold, and afterwards burst
and form incurable ulcers or  sores, that gradually en-
large.
  Consumptive Age.—On the average of numerous ca-
ses, it  appears that,  of those who die of consumption,
about a third are under fifteen ; about a fourth between
fifteen and thirty; above  thirty more than a half; and
above forty,  about a third ; the greater  number of fatal
cases beyond forty occurring  among the poor, and be-
tween  fifteen  and thirty among the middle and upper
ranks.
  Marks of Consumption just  beginning.—The first
feelings of the sufferer are very slight, but on that ac-
count, the more  insidious.  Perhaps the earliest of the 
48      DISEASES OF THE ORGANS OF BREATHING.

symptoms, even before the lungs are the least affected,
and  before  there  is any  cough, is  an unusually clear
pearly lustre in the white of the eye,  and more particu-
larly in the  teeth, while the skin  also becomes more
clear and delicate, and the fingers become  more slender
between the joints.  The sufferer is, when thus affected,
coatinually   catching fresh colds from no appparent
cause ;  and  if care is taken, at this stage of consump-
tion, to avoid or ward off these slight colds and coughs,
which so often recur, it may be prevented from advanc-
ing.   It is, indeed, a strong mark of beginning consump-
tion  when the patient is very liable  to colds.
  Marks of Consumption begun.—When the lungs begin
to be affected, the first feeling of the sufferer is unusual
languor and disinclination to  move; while the  breath
is drawn with less ease, and more shortly and hurriedly
than formerly.   This is often  not perceived,  unless  in
going up a stair  or rising ground, or  on walking briskly,
or on using any exertion of the body.  Still there may
be no cough, and  the pulse may be quite natural, but
easily excited beyond this by  quick walking, exertion,
or drinking beer, wine or spirits, which have little effect
on the pulse of a strong healthy person.
  The next  symptom is cough,  which  is  at first very
trifling, and  not  nearly so troublesome  as  that from a
common cold, and  is seldom complained of, though the
weakness  and languor of the body become distressing.
The  cough is short and dry, and drowsiness, giddiness,
and  headache are experienced. If the cough excites
vomiting or retching, it is  a still more certain mark of
begun consumption.  Still nothing is spit up, or, if any-
thing, only a kind of frothy mucus, not from the lungs,
but from  the top of the  throat and back  part of the
mouth.  If  this  taste saltish it is an unfavorable sign.
Sometimes there will appear in it a streak of blood, or a
small clot of blood like a pin's head.  These particles
of blood are  often so small as to escape  observation  for
weeks together.  What is spit up should,  therefore, be
examined with a magnifying glass.
  The symptoms still increasing, there is a feeling of 
CONSUMPTION.
49
oppression or straitness about the chest and lungs, and
usually, though not always, a sharp "pain in  the breast
or side, which, on drawing in a full breath, is increased
—catches the breath, as it is usually expressed, and in-
stantly excites the cough.  This pam, or, when there is
no pain, the uneasiness in the chest, is usually worse or
lying down.  The spirits now become low, the counte-
nance  sad, the appetite impaired,  the tongue  usually
white, and there is generally  considerable  heat and
thirst,  the face flushes  after eating, and the palms of
the hands burn.
  This may be called the first and  more hopeful stage
of the  disease, though the symptoms in the  last para-
graph are much  less manageablp,  and more alarming
than any of the preceding.
  Marks of confirmed Consumption.—The disease now
assumes its genuine aspect.  1 he flesh gradually wastes
away,  and the  skin,  teeth, and the  whites  of the eyes
become more and  more  pure  and pearly;  while the
cheek
            -----------assumes the rose's bloom,
            The hue that haunts it to the tomb.

   The sad dejected look of the countenance of  the first
stage now brightens into a sepulchral smile, and the de-
luded patient will tell you that he is " getting better ev-
ery  day—rapidly gaining strength—and growing fat
again ;" nay, he even seems very anxjous to confirm you
in this, and is jealously afraid lest you should doubt his
word.  This fatal deception is strengthened  by the re-
turn of the appetite and the clean tongue,  which often
continue Until death. The pulse and cough  increase in
frequency, and what is spit up is different in different
cases,  either watery like whey, with  occasional streaks
of blood, or livid,  deep  black,  light brown,  or  light
green ; in form, either flattened or round; in consistence,
lither  hard or soft;  in odor,  either fetid or  without
smell.   The oppression of the chest, from being occa-
sional, becomes now a constant weight; the patient can
only lie with  ease on the side affected; and his breath-
ing is  often accompanied  with a ticking  like that of a
           c 
50     DISEASES OF THE ORGANS OF BREATHING.
 watch.  The nose becomes sharp, the  eyes sink,  th«
 body shrinks, the back-bone projects,  and the shoulder-
 blades stand o»t like the wings of a bird.  Such is  the
 usual tram of symptoms that precede the third and fatal
 stage, which, on an average, proves fatal  in about nine
 months from the first alarm;  although hi some cases, it
 is more speedily fatal, and in  others it may continue for
 several years.
   Marks of Danger.—As it is of great importance, in so
 insidious a disease, to be certain  of its  nature,  several
 tests have been  proposed, to  distinguish between ordi-
 nary phlegm or  mucus, and genuine pus  ; that is to say,
 matter from an ulcer of the lungs, as spit up after cough-
 ing, in colds, coughs and consumption.  If merely phlegm
 or mucus is spit up, the hope of safety is greater; if
 pas,  that is,  the  matter of an ulcer, it is, to  say the
 least, a strong reason of alarm.  To decide this question,
 an intelligent physician  should always be called in, or
 much unnecessary alarm may be produced.
  Preventives.—As this  disease,  when it advances to a
 certain stage, is incurable, it becomes important  to use
 every means  to ward  off  its approach, particularly in
 those who have the marks already described.  Sudden
 changes in temperature, especially when  the  body is
 heated, should be  guarded against by avoiding currents
 of air, and by covering.  Young persons with such hab-
 its should also be  led to adopt early hours, both for re-
 tiring to rest, and of rising in the morning; to take dai-
 ly exercise ; and their  diet should be of a mild, but nu-
 tritious and invigorating quality.
  Early Treatment.—If, in spite of precautions to guard
 against cold, and to atterul to diet, the disease makes its
 attack, the appearance of the first symptoms should be
 the signal for alarm ; for, bat too often, k runs on to the
 second stage, and becomes established Before it is even
suspected.
  When  there is first  observed an oppressive languor
and listlessness,  and particularly a feebleness on  going
up a stair or rising ground, accompanied with the pearly
lustre of the teeth  and  of the white of the eyes,  then i* 
CONSUMPTION.
51
the time to be on the alert, and to stop short if possible,
the ambuscading march of this fatal disease.  We can-
not too strongly urge patients, who are in this  state, to
shun  quackery, in all its forms of balms, balsams, and
lozenges; for much more will  depend on themselves,
and on their friends, than on medicines, particularly in
this dangerous form.
  We should recommend  that the diet should  be mild,
and ought chiefly to consist of milk and well-boiled veg-
etables, or farinaceous matters, such as sago, arrow-root,
and the preparations of Iceland liverwort, from  which
the greater part of the bitter principle  has been extract-
ed.  So  far as  meat is  concerned,  the diet should be
chiefly confined  to  the  white  meats, such as  rabbit,
chicken, and veal; avoiding beef, mutton, pork, and all
fat, salted, and high-seasoned meat; because the white
meats supply less blood than the red, and have therefore,
less chance to stir up inflammation, which always arises
from  an overflow of blood in the part inflamed.  Salted
and  high-seasoned  meats, again,  are too  stimulant;
and  fat or  butter is also apt  to derange the  stomach.
Greens  and  watery vegetables are also  bad.  Wheat,
rice,  and potatoes, are better.  Biscuit  is better than

   When ass's milk can be obtained, it is  to be  preferred
to every other kind of milk ; but if this cannot be read-
ily procured, a good substitute for it is an admixture of
soda  water and hot cow's milk, moderately sweetened.
The  periods of taking food  should not be so distant as
in a  state of health; but the quantity taken at one time
should not be oppressive to the stomach.  As the  dis-
ease  advances, and the debility increases, the diet is re-
quired  to be of a more generous kind; and, m this stage,
beef-steaks, porter, and gymnastic exercises, may in some
 cases prove  serviceable.      __
   The atmosphere, in which a consumptive person re-
 sides, should, in all the Btages of the disease, be mild,
 dry,  and equable,  in respect to temperature ; and it this
 cannot  be  secured in the country of his residence,  it
 should either  be sought for early abroad,  or produced ar.
         c2 
52     DISEASES OF THE ORGANS OF BREATHING.

tificially  at  home.  The  exercise of the consumptive
should be moderate and regular;  and be taken in the
morning, when the strength  is most  capable  of being
exerted without exhaustion.   Carriage  exercise, riding
on horseback, sailing, and swinging,  are the  kinds of
exercise best adapted to the consumptive.
  To draw the Disease off from the Lungs.—In order to
draw the disease off from the lungs, first attend to the
skin,  and get the  disease (to speak  popularly) to the
outside as  soon as possible, by  bringing the infected
blood  to the surface.  Blistering is  the most violent
means for this purpose; but it is not perhaps  in all ca-
ses more powerful than  constant and long-continued
friction with the flesh-brush, and bathing  the whole
body with warm vinegar, at least twice a day.   This, if
properly persevered in, will draw a surplus of blood to
the skin, and will, of course,  prevent it from  accumu-
lating in  the lungs,  and thus causing inflammation and
cough; or,  if need be,  the blister may be tried  along
with  these;  or a warm  plaster  on the breast.   Dr.
Combe strongly recommends  sea-sickness for  this pur-
pose.   A sea voyage is consequently often wonderfully
efficacious in these cases.                             ,
  The next channel by which the surplus blood may be
drawn off from  the lungs is the bowels.  A dose, for ex-
ample, of Epsom salts and senna,  will stimulate the in-
ner coatings of  the intestines, in  the  same way as the
flesh-brush,  or  the warm  vinegar, stimulates  the skin.
An increased stream of blood will consequently flow to
the bowels, and will throw off parts of its water in the
same way as it does in perspirations by the skin.  The
stools will, of course,  become more liquid and copious,
and the blood will be partly diminished in quantity, and
partly enriched  in quality, by  this loss of its water, car-
ried off by stool.  Violent purgatives, however, must
be avoided, as the general strength will be much injur-
ed by them, and the disease will be accelerated.
  For this reason we strongly deprecate bleeding from
the arm in a beginning consumption, unless under pe-
culiar circumstances.  A large proportion of those who 
CONSUMPTION.
53
die of consumption have, by the lancet, at the beginning
of the  disease, been weakened,  beyond the chance of
recovery, by draining their best blood, the loss of which
relieves the lungs for a time;  but  which their  powers
of digestion must be unable to replace, when it is again
wanted to support their sinking strength.
  This caution, however,  applies  less strongly to  th%
loss of blood by leeches; for two or three dozen  leeches
on the chest must empty many of the vessels in the vi-
cinity,  which will naturally shrink,  and contract  their
diameter ;  and they may probably  remain so.
   To ward off or relieve the Cough.—When there is ex-
pectoration with  a consumptive cough,  the cough is
caused, as we have already shown, by the phlegm ac-
cumulating in the lungs, and producing irritation.   The
natural anxiety to clear the throat and lungs from all
obstruction, in order that  the  pure air may reach and
purify the blood, gives rise to  repeated efforts to throw
off this phlegm—and such efforts are made by coughing.
Now,  in  whatever  proportion  we can  remove  this
 fihlegm, we shall in the same proportion diminish or re-
 ieve the  cough,—an object of great importance,  even
when the disease is quite  incurable.  Unfortunately we
have no means of acting directly on the lungs, as we
have of acting on the stomach, or  the process might be
easy.  The purpose, indeed, can  be aided a little by in-
haling the steam of water, which will dilute the phlegm,
and  render its expulsion  more easy; but the  effect in
this  way cannot be great.  We  must, therefore,  have
recourse to indirect means; by far  the most powerful of
which is  the rather unfashionable  prescription of an
emetic.  Those who have felt  the  harassing of a con-
sumptive   or  catarrhal cough—which  exhausts  the
strength, deranges the stomach,  and often brings on se-
vere headache, to say nothing of its threatening to prove
fatal—will easily  be  persuaded to make trial of the fol-
lowing                                    .      .
   Emetic—Take from twelve to twenty  grains of ipe-
cacuanha in powder, a table-spoonful of the infusion of
camomile flowers; mix, and take immediately, any time
        c3 
54     DISEASES OF THE ORGANS OF BREATHING.

between  five and seven o'clock in the morning, in bed.
This dose may be diminished or increased, according to
its effects ; one, or, at most, two operations will be suffi-
cient.  The operation will, in most cases, be over with-
in the hour; after which the patient should take a short
sleep; and, on awaking, may have breakfast in bed;
and afterwards, if able, may rise'and take his morning
exercise.  The effect should be to prevent, or greatly re-
lieve, the cough during the day ; but, if this again prove
troublesome at night,  the emetic should be repeated an
hour  before bed-time, in  the same quantity as  in the
morning.
  It will always be important to avoid all inflammatory
food, violent exercise,  and  too warm clothing ;  to apply
two dozen leeches over the chest,  and, as soon  as the
bleeding  is over, to put a blister over the part; to be re-
peated as often as it  is found necessary.  One  of the
mildest and least  inflammatory articles of diet for the
consumptive is milk, and its several preparations, pro-
vided always that it be used judiciously;  for milk may
be taken  improperly, so as by deranging the stomach,
to aggravate rather than do good to the disease.
  Women's milk is the lightest, and next that of asses;
and if neither can be  had, the milk of goats, ewes, or
cows.
  When the milk of cows is used, it should always be
allowed to stand till  the  cream can be  removed; or,
when drank warm from the cow, that which is  first
drawn from the udder is  the best, as it contains least
cream; for this  is always  hurtful.   Butter-milk has
been found excellent in the first stages of consumption,
when drunk fresh and in some quantity.   If it disagree,
it may be taken at first in small,  and afterwards in in-
creased quantities.

  9.  Hooping-Cough.—The danger of hooping-cough is
always greater, the younger the patient happens to be.
It is also more  dangerous in weakly  children than in
the robust.  When there is much  feverish heat and dif-
ficulty of breathing,  with little discharge  of phlegm 
CROUP, CR CLOSING.
55
after the fit, and when the fit exhausts the patient much,
and  leaves him breathless or fatigued, it is a bad sign,
and danger may be apprehended.  When  death-is ap-
proaching, the feet  are observed to swell.   When  the
hands and feet are not chilly, the  skin  comfortable,
warm and moist, the bowels  "open, the  urine copious,
easy and abundant  expectoration, and  free  vomiting, or
moderate bleeding  from the nose, at the end of the fit,
the patient may be  said to be in a favorable state.
   Treatment.—It may be important to remark, that as
the disease is very uncertain in its termination, the cure
effected  by nature is by the ignorant  too frequently at-
tributed to some quack nostrum.  Roche's  embrocation
is the most extensively  used of all the hooping-cough
nostrums;  but, though  safe, it has  but small efficacy,
and  can do little good beyond making the skin  some-
what red; and that can  be done much easier with a
little scraped horseradish, or  table-mustard, spread on
the chest, and left on for fifteen  or twenty minutes.
The following is the mode of making the nostrum.
   Roche's Embrocation.—Take one  ounce of oil  of  am-
ber, two ounces of  olive oil; mix, and scent it strongly
with oil of cloves ;  keep in a phial  for use.  It may be
rubbed  on the chest, in any  quantity, twice or  thrice
a day.

   10. Croup, or Closing- — Symptoms. — Croup is an
inflammation of the windpipe, and happens only to chil-
dren.  It is  marked by  the  child's  breathing  being
longer than  natural, and accompanied by a particular
wheezing sound ; a sharp ringing or barking noise  also
distinguishes the cough attendant on this affection.
   Treatment.—In this  disease the  life of  the child de-
pends on immediately obtaining the best possible aid;
since, most probably, it will otherwise perish in a very
few days.  If the  attendance of a medical man is una-
voidably delayed, and the disease is plainly marked, ap-
ply from two to four leeches over the chest, and a blister
to each side of the neck, and give the wine of ipecocuana,
a little until it vomits.
         ci 
          C—DISEASES OF  THE  BLOOD.

   In order to  explain the diseases or derangement oc-
curring in the blood, and the vessels which carry it, we
must endeavor to give a brief and  plain sketch of its
circulation, and its uses, in a state of health.

I—HEALTHY STATE  OF  THE ORGANS OF CIRCU-
                     LATION.
   We have already shown above, (page 13,) that  the
aliment, separated from the digested food by the agency
of the bile and the pancreatic fluid,  is carried from the
intestines by numerous minute vessels which unite into
one, and go on  straight  without any circuitous turn,
pouring its contents into a vein that runs  under  the
shoulder-blade, to be forwarded to the heart.

   1. The Veins  and Arteries.—The veins  are  blood-
vessels, of various sizes, which run from all parts of the
body towards the heart; but never go from the heart to
any part of the body.  This may easily be proved by
pressing the finger on any of the veins which may be
seen swollen with blood on the back of the hand, when
the blood will instantly  be observed to fill the part
farthest from the heart; whilst between  the  heart and
point of pressure the vessel will appear empty of blood.
How then, it may be asked, is the blood, which is thus
poured by the veins into the heart, returned to the body ?
This is accomplished, not by veins, but by means of an- 
THE COURSE  OF  THE BLOOD.
57
other set  of blood-vessels, called arteries, which con-
stantly carry out from the  heart the blood that the veins
as constantly return to it.

  2. The Heart.—The heart is a strong muscular ves»
sel, formed not unlike a sugar-loaf, placed in the chest
towards the front of the lungs, the point of which rests
on the midriff  or partition-muscle of the chest.  It is
lodged, in all cases, in a membranous bag, whose interior
is moistened with a watery fluid.  In the heart are four
chambers, which have  communicating valves or doors
that open and shut, by the nicest mechanism, according
as they are wanted.

  3. The Course of the Blood.—We are now prepared
to trace the circulating current of the blood in  its won-
derful course, as discovered by Harvey, about two hun-
dred years ago.  The vein in which the prepared ali-
ment becomes mixed with the  blood, in passing to the
heart, is joined by all  the  veins from the upper .part of
the body ; the whole  forming one letrge vein, which, as
it  approaches the  heart,  is defended  by  a  valve, and
unites with another large vein that brings all the rer
turned blood from the lower part of the body.
   These two veins, from  the  two extremities of the
body, empty their blood into the first chamber or reser-
voir of the heart, situated  in front, and  in some animals
on its left side; and when this  is full, it bursts open
the doors or valves of the second chamber, empties itself
into it, and the doors  immediately shut behind it, and
prevent its return.  This second chamber, whose inte-
rior is in form of a pyramid, and has fleshy columns or
            c5 
58
DISEASES OF THE BLOOD*
pillars stretching across it, being now full, its sides con«
tract, and throw the blood  with a forcible jet upwards
into a large canal—not a vein, but an artery.   The out-
let here is also guarded with valves, which, when  the
jet of blood has passed, become shut to prevent its re-
turn ; and it is then  carried forward to the lungs, to be
distributed through  their minute cells, and exposed to
the air, for the purpose of changing its color from dark
to bright red.
  As soon as the blood has undergone this change in
the lungs, it is passed back again to the heart by a nura«
ber of minute veins,  which Unite into four large ones,
and these empty their contents into the  third chamber
of the heart, which has fleshy pillars crossing it similar
to those in the second chamber.  From this third cham-
ber the blood is carried forward to the fourth chamber
which, when it is full, strongly contracts its  sides, and
throws  its blood with a jet into the large artery that
branches out to all parts of the body ; the branches be-
coming more  numerous and more minute as they pro-
ceed, till at length they become so small as to elude our
sight.  They refuse, when  so very small, to admit the
red part of the blood—at  least we cannot discover it;
and here we are compelled to confess our limited pow-
ers  of investigation;  thus far can we go, and no farther.
  We have said that the veins return the blood to the
heart, and they begin hair-like and minute, in the same
way as the arteries terminate ; but we cannot, in any
instance, trace the red blood going from the ends of the
arteries into the ends of the veins; for the terminations
of the arteries do not contain red blood, but a pale rose-
ate fluid; and it is only after they increase in size, that 
FEVER.
59
this red blood is discovered in the veins.  How then does
the red  blood pass from one canal into another ?  How.
does it pass from the arteries to the veins ?  We cannot
tell; we must acknowledge our ignorance.  One thing
we know—that the  blood supplies nourishment to the
body, which would otherwise be daily wasted.

   4. Source of Animal Heat.—When the dark blood
of the veins is changed, by the fresh air taken into the
lungs by breathing, into the bright scarlet blood of the
arteries, the latent or insensible heat of the air is forced
out, and part goes off with the moisture of the returning
breath, while part is communicated to the scarlet blood
to be distributed throughout the body, previously in part
robbed of its heat by the dark blood of the veins, which
is always colder  than  the scarlet blood.  This explains
the  coldness and chills produced when the blood does
not  circulate freely, and the hot feelings produced by its
 too  rapid circulation.

 II.—DISORDERS OF THE  BLOOD AND THE CIRCU-
                       LATION.
   Having thus described  the changes undergone by the
 llood, and its circulation  through  the body, from the
 heart  to  the  minute hair-like vessels where it escapes
 our minutest search, we  shall now g<i on to consider the
 disorders to which it may be liable, beginning with fever
 and inflammation.

    1  Fever. — Earlier  Symptoms and  Treatment.--
 Whenever cold shiverings are experienced, there wil
  be the greatest reason  to suspect that it  is the  first
            C6 
60
DISEASES OF THE BLOOD.
symptom of some disease of a dangerous kind.  If heat
succeeds, lose no time, but immediately go to bed, and
employ means to promote a free perspiration, and sup-
port this for at least twenty-four  hours.   Should per-
spiration not be produced by these means, it will then
be right to take about twenty drops of antimonial wine,
every hour, until  the  effect  wished  for  is produced.
Should  the shivering return,  on the second,  third, or
fourth day, and be succeeded by heat and then by per-
spiration, an ague or intermittent fever has taken place,
requiring at least three-quarters of an ounce of bark to
be taken before the period of time in which it made its
second appearance has again elapsed.
  If the means recommended have been employed un-
successfully, the cold shiverings being followed by con-
siderable heat, and  pain  in the head, loins, and limbs,
be assured  that a fever is establishing itself. If an acute
pain of  any part succeeds, with  or  without the other
symptoms just enumerated, there will be great reason
to suspect  that inflammation is forming;  and  if these
pains do not  subside, as the sweat  contmues, life may
be at a risk, and may only be saved by timely bleeding
and the adoption of vigorous measures.  The degree of
danger,  in  these cases, must  of course depend on the
violence of the  attack and the nature of the  affected
part.  In general this  may be judged by the degree of
pain, and by the magnitude of the other symptoms.

  2.  Ague and Intermittent  Fever.—Causes.—The
immcdiate«cause of ague and remitting fever is supposed
to be something in the  air, termed miasma, or effluvium,
but nobody ever proved this by analysing the air. Such
fevers,  however,  prevail in  low  marshy countries,
abounding with wood  and stagnating water; but they
prove most fatal in places where great heat and mois-
ture  are combined.  No age, sex, nor constitution, is ex-
empt from the attack of this fever; but it chiefly seizes
persons  of a relaxed habit, who live in low dirty habi-
tations, breathe an impure stagnating air, take little  ;x-
ercise, and use unwholesome diet. 
TYPHUS FEVER.
61
   Symptoms.-—The first symptoms arc generally yawn-
ing, stretching, pain and giddiness in the head, with alter-
nate fits of heat and cold.  There -is a pain about the
region of the stomach, the tongue is  white, the eyes and
skin frequently appear yellow, and there are often bilious
symptoms.  But all the  symptoms of this disease vary
according to the situation, the season of the year, and the
constitution of the patient.  They may likewise be greatly
changed by the method of treatment.
   Treatment.—The first thing to be  done is to take an
emetic.  Take  twenty grains of ipecacuanha, and  three
grains of tartar emetic.   Mix it well in half a tumbler of
warm water, and take a tablespoonful every minute until
vomiting takes place.  One hour after, take ten grains of
calomeCten grains of rhubarb, ten grains of jalap.   Mix
them together, and take it.  After the bowels have been
purged, then commence  with  the pills below.  I have
known several  cups  of very strong coffee to  cure the
ague, after other remedies had failed.   If everything here
 recommended fails, take Fowler's  Solution, commencing
 with two drops three times a day, and gradually increase
 the dose to five drops, for a grown person; for children,
 it must be given in much smaller doses.  Profuse sweats
 must not be promoted, except with great  caution, as by
 this means the patient may be  so  much weakened aa to
 render the disease dangerous, and the cure  difficult.
    Pills.-—Take fifteen grains of disulphate of quinine, the
 same quantity of extract of camomile flowers, beat into a
 mass with syrup, and make into six pills; one every three
 hours  for at least  two days, or two  every six hours tor a
 week or a fortnight; or          „,.,,*»
    Syrup.—Take sixteen  grains of disulphate of quinine,
 half a pint of syrup; mix, and take three  large  spoonsful
 every five hours.   Six spoonsful of this have been known
 to stop the progress  of agues and intermittents.

    3 Typhus  Fever.—This fever  is variously termed,
 putrid, malignant,  pestilential,  goal,  camp, epidemic, and
 (when the skin has purplish specks)  spotted fever.
    Causes—This  disease arises from unwholesome, pu- 
62
DISEASES OF THE BLOOD.
trid, or stagnating air.  It does not appear to be infec-
tious ; but it is sometimes epidemic, from some atmos-
pheric or terrestrial cause.  The character of the disease
arises from the constitution of the patient, and is not the
effect of any specific poison;  hence, what will produce
inflammatory  fever in one constitution, will produce
typhus in  another.  Fear has a prodigious effect in
spreading this fever.
  Symptoms.—The first  thing  observed  is generally a
remarkable loss of strength without any apparent cause;
the mind is greatly dejected, and  full of apprehensions.
There  is nausea, and sometimes vomiting of bile; a
violent pain in the head, about the region of the stomach,
and in the back and loins; the  tongue is at first white,
but afterwards it appears black and chapped, and the
teeth are covered with a black crust.   The duration of
typhus fever is extremely uncertain ; sometimes it ter-
minates between  the Seventh and fourteenth days, and
at other times it is prolonged for five or six weeks.   The
most favorable symptoms are, a gentle looseness  after
the fourth or fifth day, with a warm mild sweat.  These,
when continued for a considerable time, often carry off
the fever, and should  never  be  imprudently stopped.
The unfavorable symptoms are, an excessive looseness,
with a hard swelled belly, large black or livid blotches
breaking out upon the skin, thrush in the  mouth,  cold
clammy sweats, change of voice, a wild  staring of the
eyes, and a constant inclination to uncover the breast:
involuntary  stools,  attended with coldness of the  ex-
tremities, are generally the forerunners of death.
  Treatment.—The first  thing  to be done is to give an
emetic, which, by evacuating  the  stomach and bowels,
produces an equal distribution  of blood over the body,
promotes the  different secretions, and  generally  suc-
ceeds in abating the  symptoms; a table-spoonful of
yeast should be given twice a day, which affords more
relief thfta any other  medicine, by cooling the body,
abating  the thirst,  and  diminishing irritability.   The
sick-room  should be well ventilated, and  often fumi-
gated.  Washing the body with cold vinegar when the 
SCARLET FEVER.
63
skin is hot and dry, and the application of it to the scalp
and forehead, by means of folds of linen, have proved
very beneficial.  The food should  be principally weak
veal broth, thickened with a little arrow-root or oat-
meal;  and the drink, mint-tea or  barley-water, with
lemon-juice.  If, on the fifth or sixth day of the disease,
the patient be  evidently in a sinking state, a more nu-
tritious diet  may be allowed, and the strength of the
patient supported. Broiled beef-steaks, with biscuit, and
good porter for drink, will be important in all stages of
the disorder,  particularly in the stage of recovery, pro-
vided the stomach will bear this.

  4. ScarleT Fever.—Causes and Symptoms.—This ap»
pears to be infectious, similar to typhus, though we are
ignorant of the  nature, and cannot even  prove the ex-
istence of What is learnedly termed miasmata, said  to
produce it.   It begins with  chilliness and shiverings,
and the whole  skin becomes covered with  partial in-
flammations, more numerous, larger,  and redder, than
those of the measles.  In two or three days they disap-
pear, succeeded by scalings of  the scarf skin, like bran
dispersed over the'body, which fall off and appear again
two or three times successively.
   Treatment.—In mild cases, nothing more  is required
than to observe a low diet, and to avoid a cold air and
cold drink.   Barley-water, acidulated with tamarinds or
lemon-juice, may be drank.  The best medicine is the
 following                                     „
   Mixture.—Dissolve two drachms of carbonate ot am-
 monia in five ounces of water ; two tea-spoonfuls every
 two, three, or four  hours, with cold water  to drink at
 pleasure; or the following                ■,-   ,  j •
   Draught.—Take four grains of camphor, dissolved in
 half a drachm of rectified spirit of wine; six  drachms of
 pure water,  and as much cinnamon water; fifteen grams
 of carbonate of ammonia, one drachm of syrup of lem-
 on-peel ; mix  for a draught, to be  taken every fourth

  °Belladonna, in small doses, has been used with great 
64
DISEASES OF  THE BLOOD.
success in scarlet fever.  Many Homoepathic physicians
have employed  this drug with good results, in aggra-
vated cases.

  5. Putrid  Sore Throat, or Malignant Quinsey.—
Causes and Symptoms.—The causes of this dangerous
and fatal disease  are  probably the  same or similar to
those of scarlet  fever.   The earlier symptoms are also
the same; but the alternate chills and heats, pain and
heaviness, the expression of anxiety in the countenance,
are  soon succeeded by slight swelling of the  throat,
which rapidly spreads  over the inside of the throat, bus
a high florid, or bright crimson appearance, somewhat
shining or glossy, and soon  attended with whitish spots,
which terminate in ulcers ;  the tongue becomes foul, the
breath exceedingly offensive, with  general irritation  or
delirium. There  is a partial or general crimson color
of the skin, or an eruption of small pustules, the early
appearance of AVhich is a favorable omen.
  Treatment.—The early application of a blister to the
throat, and the use of an acid gargje, will tend greatly
to abate  the inflammation,  and the consequent ulcera-
tion.  When the diseased parts begin to suppurate, the
patient  should be supported with  strong beef-tea and
arrow-root jelly.  The  spirits should be exhilarated by
inspiring a confidence of recovery, and by keeping from
him everything  that is  likely to depress  them.  Cold
water  applied to the  head, and even to the surface  of
the body, if the skin be  dry, is a very important remedy,
and  should be frequently  employed.  The  same  pre-
scriptions already mentioned for scarlet fever, with burnt
Port wine and other cordials, should be given.

  4. Measles.—Causes and Symptoms.—Measles arise
from the same or similar causes as scarlet fever.  The
disease commences with the running of water from the
eyes and nostrils, sneezing  cough, and  swelling  of the
eyes and face, with occasional shivering, cold  in the
back, and drowsiness; an eruption  first appears behind
the  ears on the  third  or fourth  day, spreading  down- 
influenza.     «            65s
wards to the neck and forwards to the chin, mouth, and
forehead, but seldom shows itself on the body till a day
or two after.  The eruption speckles the skin somewhat
like the bites of fleas, and is of a crimson color, and not
scarlet, as in scarlet fever. The crimson specks of mea-
sles arrange themselves in  groups of irregular circles,
or crescents, and leave the skin between them of its
natural color, which never occurs in scarlet fever.  The
great  danger in measles does  not arise from the abun-
dance of the eruption, the severity of the fever, and op-
pressed breathing, nor  the violence of the cough ; but
almost wholly from the  secondary inflammation that
comes on, or rather is aggravated, after the fever and
the eruption have gone off, which usually happens in
nine or ten days.   Weakly children, of course, cannot
bear to lose enough of blood  to  subdue this, and die.
Many children, also, have this secondary inflammation
produced, or increased, by  cramming them  with too
strong  food when they are  beginning to recover, with
the false  notion of strengthening them.   It is  no less
absurd to dose the little patients, after  measles, with
purgatives,  provided, that their  bowels are in proper
order.  The same medicines as those recommended for
scarlet fever will he useful; and, if the cough be trouble-
some, recourse may be had to  the means recommended
under " Cough."

  7.  Influenza.—Causes and Symptoms.—This is caus-
ed, like measles,  either by some  peculiar state of the
air, or by infection. The symptoms are much the same
as in measles, except the eruption of the  skin.  It gene-
rally begins with  a sense of stoppage in the nose, a dull
pain, and a sense of weight in the forehead, and a stiff-
ness in the motion of the eyes;  and, soon after, a dis-
charge of a thin fluid  from the nose, and  often from the
eyes,  with  frequent  sneezing.   There  is also  some
hoarseness, and a  sense of roughness in the throat, with
difficulty of breathing;  a feeling of straitness  in the
 hcst,  and cough.  The principal difference observed 
66
diseases of  the blood.
between a common cold and influenza is the debility and
prostration of strength in the latter.
   Treatment.—Similar treatment to that recommended
for measles will be advisable; and if the throat  and
chest are much affected,leeches or cupping may relieve,
particularly Tf followed by a blister.

  8. Rose,  Erysipelas, or  St.  Anthony's  Fire.—
Symptoms.—This is sometimes epidemic, particularly
in goals and hospitals.   It begins with cold shivorings,
succeeded by drowsiness, confusion, and often delirium.
After the first, second,  or third day of the fever, redness
of the skin appears, sometimes on the legs,  but general-
ly on the face,  gradually spreading  over the neck  and
scalp of the head, which becomes turgid, and the  eye-
lids often so swelled as to close the eyes entirely:  blis-
ters of larger or smaller sizes commonly appear, contain-
ing a clear watery fluid.
   Treatment.—When the head is much disordered, the
feet  should be put into warm water  for ten or fifteen
minutes, and a  blister applied to the  nape of the  neck.
If these fail to afford relief,  the head should be shaved,
and a large blister applied  to the scalp, and mustard
poultices to the feet.  The same medicine  is to be giv-
en as for scarlet fever.

  9. Small-pox.—Causes and Symptoms.—This dread-
ful disorder is  caused  by the communication of infec-
tious matter.   Children seem listless and drowsy for a
few days before the small-pox appears.   About the third
or fourth day from the time of sickening the  small-pox
begins to appear like flea bites, and are soonest discov-
ered on the face, arms, and breast.   The  most favora-
ble symptoms are a slow eruption, and an  abatement of
the fever as soon  as  the  pustules  appear.  Pustules
which are distinct with a florid red basis, and which fill
with thick purulent matter, first of a whitish, and  after-
wards of a yellowish color,  are the best.
  A livid brown color of the  pustules is an unfavorable
symptom; as also when they they are small and flat, 
SMALL POX.
67
with black specks in the middle.  It is likewise a very
bad sign when they run into one another.
  Treatment.—In the  early stage of small-pox, when
the symptoms run  high, we may, in* addition to expos-
ing the patient freely to cool air, recommend wash-
ing the body  partially,  or generally, with cold water;
for the cold bath seems not only to moderate the febrile
symptoms, but likewise to diminish the number of the
pustules, and greatly lessens the danger of the disease.
The temperature of the patient's chamber  should al-
ways be such that he may experience  no disagreeable
degree of  heat, but rather a sensation of cold, and ex-
cept he  complains of being chilly, we need not be afraid
of carrying the cooling regimen too far.   He  should lie
on a mattress, covered only with a  few bed-clothes; a
feather-bed  being  apt to occasion too great an accu-
mulation of heat.   If  convenient,  he  should have an
apartment to himself,  as  the  heat of a crowded room
is sure to  prove  injurious; and his body linen, as well
as that  of the bed, should be  shifted  frequently.   One
in every ten or twenty has been found  to  die of the
small-pox coming spontaneously, or in the natural way;
and about one in two hundred of those who receive it
by inoculation.  The number and the malignity of  pus-
tules will often depend on the treatment at first adopted.
If the room be considerably heated, the patient kept in
bed  under a  load of bed-clothes,  and  plied with heat-
ing drinks, such as white-wine whey,  the* crop of  pus-
tules may be expected to be so great, that the powers
of the patient will be exhausted before they are ripened
and cleared off.  Care  should be taken not to break the
pustules,  which causes deeper scars.   If the itching is
great, a liniment of cream,-mixed with magnesia, will
allay it.   The medical treatment ought to be similar to
that of typhus fever, taking care not to give violent pur-
gatives.
   Vaccination is now commonly resorted to, as a means of
inducing,  by proxy as it were, a mild form of disease.
  Of its  efficacy, there are too many million proofs to
permit us to doubt. 
68
diseases of  the blood.
   Of  its efficacy, there are  too many million proofs to
 permit us to doubt.
   The vaccine matter taken from a vaccine pustule nine
 days after its appearance, and which ought then to  be
 perfectly transparent, on being inserted under the skin,
 will  produce on  the third day afterwards a small  red
 spot;  on the  fifth day the other arm, from the one first
 vaccinated, ought also to be vaccinated; and, if the first
 has been perfect, both pustules  will ripen precisely at
 the same time ; if this does not take  place, the constitu-
 tion has not been properly affected,  and it must be re-
 peated : a simple and easy test which ought never to be
 neglected.  On the sixth day the pustule becomes discol-
 ored in the centre.  On the tenth  day both the pustules
 will be perfect, aad should have a dimple in the centre,
 and not be raised like  a common pimple.  A complete
 test of perfection is, that when pricked with a needle,
 the contents are not all  let  out, as in a common pimple;
 and for this good reason, that the vaccine pustule is com-
 posed  of  many bags, or cells, that do not communicate
 with one another, while the common pimple has but one
 bag, or  cell.   This allows,  also, matter to  be  taken
 without destroying the vaccine pustule.  Another mark
 of the  genuine vaccine pustule is, that its shape is circu-
 lar or oval, and the margin never irregular and jagged ;
 while  the outer margin is deeper red than the  space
 within it, and-between it and the centre.  It should dis-
 appear about the thirteenth day, and  the scab fall off in
 a fortnight.  If the pustules  want  these  characters on
 the ninth or tenth day,  and look like  a common pimple
 or an inflamed  sore, it  will  afford no protection from
 small-pox, however severely it may affect the patient
 with fever.
  The scar (cicatrix) left by the vaccine pustule, if gen-
 uine, must be distinct,  circular, and full of little pits or
 dimples, spreading in rays, or lines, from the centre to
 the circumference, and  so small that it can be covered
with a pea.  On the contrary when  the  scar is large,
irregular, and without the little radiated pits or dimples,
secondary small-pox, if  it do  occur, has a chance  to be
severe.  The idea is gaining ground that the protecting
influence  of vaccination wears out in ten or in nfiftee 
               tetter and ringworm.            69

years ; but, if it does, (and  this is far from proved, and
very doubtful,) repeating  the vaccination, and renewing
the insurance, is easy.

  10. Chicken-pox, Swine-pox, or NmLEs.—Symptoms.
 - The eruption termed chicken-pox  may  be easily dis-
tinguished from small-pox by there being little fever, by
the pustules appearing first on  the back, by the appear-
ance on the second day of a small watery bladder on the
top of each, and by its ending in three or four  days.
It requires no peculiar treatment, but a  little confine-
ment, with a cooling diet.

  11. Itch.—Causes and  Symptoms.—The itch is caus-
ed by infection,  communicated by contact,  not by in-
sects, as usually  said, and generally appears first be-
tween the fingers, or about the larger joints, in the form
of small watery pimples,  accompanied by intolerable
itching.  When these are broken, sores and scabs suc-
ceed, and spread to all parts of the body.
   Treatment.—Sulphur  is  a specific in this  disorder;
and the cure should  begin  by the patient taking every
night  and  morning as  much  of the flour  of  brim-
stone and cream of tartar, in a little treacle or new
milk, as will keep the belly gently open.  He should
beware of catching cold,  should wear more clothes than
usual, and take every thing warm.  The parts most af-
fected may be rubbed with the following
   Ointment.—Take of the flour  of sulphur two ounces;
crude sal-ammoniac,  finely powdered, two  drachms;
 hog's-lard or butter, four ounces; and a scruple or half a
 drachm of the essence of lemon, in  order to take away
 the disagreeable smell.  About  the bulk of a nutmeg  of
 this may be  rubbed upon the  extremities at  bed-time,
 twice or thrice a week.  It is  seldom necessary  to rub
 the whole body ; but, when it is, it ought not to be done
 all at  once, but by turns, as it is dangerous to stop too
 many pores at the same time.

   12. Tetter and Ringworm  of the Face.—Causes
 and Symptoms.—This  does not  appear, like ringworm 
70
DISEASES  of  the blood.
of the head, to be contagious, but to arise in young peo«
pie from colds, and slight derangements of the stomach.
Tetter is generally preceded by headach, pains  in  the
limbs,  slight shivering, alternating with  flushes, and
other feverish symptoms.  A sort of stiffness and ting-
ling  pain, with slight itching,  soon begins to be  felt
where the tetter,  or ringworm, is about to appear, and
the  part soon  becomes red and  inflamed.   Little blis-
ters, or vesicles, then appear in  clusters upon  the in-
flamed part, which is very often upon the edge of the
upper and under lip,  and at the angle of the mouth.  It
is also  very common on the tip or sides of the nose,
und sometimes on the chin.  At  first the .little blisters,
or vesicles, contain a transparent fluid ;  but in the course
of twenty-four  hours,  it becomes muddy, turbid, and
  ellowish white ; and,  at last,  is changed into  thick
  rownish yellow  matter, and forms thick dark  crusts.
If these are picked off, a kind of viscid, gummy,  trans-
parent  matter  succeeds, and encrusts  the part anew.
If it  is let alone,  the  swelling subsides, and in four or
five days the crusts begin to fall off; the whole duration
of the eruption being about ten or twelve days.
  Treatment.—As the  disorder  always runs a regular
course, it is not only  useless, but hurtful, to attempt to
stop it after the blisters have appeared ; because it is im-
possible t.o stop them from forming, and any application
intended for the purpose, will only make them longer of
healing.  When the stiffness of the parts, however, gives
warning of the approach of tetter, it may sometimes*be
prevented by stimulants, such as Eau de Cologne, or tlKe
following
  Wash.—Put into a  phial,  containing half a  pint ot
brandy, as  many  strawberries as it will hold ; cover the
mouth with a piece of bladder, let it stand for a week in
the sun, and then strain it through a linen cloth;  put in
more strawberries, as at first, and add  half an ounce ot
camphor; apply a pledget of linen, soaked in this, to the
parts.
  The tingling, smarting, and burning  heat, when very
troublesome, may be reduced by sugar-of-lead water, or
wateY m which a little nitrate of potass  has been dissolv-
 
common scurvt.
71
ed.   If the little vesicles, or blisters, however, are rude-
ly broken, the  sore that follows  is longer of healing.
But if each individual vesicle be carefully picked with a
needle, and the fluid evacuated before it becomes milky
or colored, the  pain will be  diminished, and the irrita-
tion sooner reduced.
  When a similar disorder is found on other parts of the
body, it is termed shingles,ani may be cured by bathiDg
the parts with one drachm of sulphuric acid, in a quart
of water; or by boilmg an ounce of quicklime, and half
an ounce of flowers of sulphur, in six pints of water, and
applying cloths dipped in it to the shingles.

  13.—Ring Worm of  the  Hair and Scald  Head.—
Causes and Symptoms.—This appears to be caused by
slight scratches neglected, or by infection, and consists ol
scabby  eruptions at the root  of the hair.   When  the
scabs are once formed, they confine the acrid matter un-
der them, which frets  and irritates the skin, and tends
to spread the disease.
   Treatment.—The first thing indispensable to the cure,
is carefully loosening the dried scabs, and picking them
away.  Soap  and warm water is the best thing for this
purpose, and ought to be carefully repeated both morn-
ing and  evening.  A single neglect will lose  all the
ground  previously gained.  All the hair  which will
come away without pain  ought, also, to be removed;
 then try the following
   Wash.—Take half an ounce of sulphate of potass, one
 pint of lime-water, one ounce of soap liniment, mix and
 make  a lotion, to  be applied twice or thrice  a day.
 Formerly, a wash of tobacco was held in much esteem;
 and lately the  water obtained  at  the  coal-gas works
 has been highly spoken of, but  all remedies are  often
 found unavailing.  Perhaps the most certain method  m
 obstinate cases is touching the parts daily with nitrate oi
 silver or lunar caustic.

    14.—Common Scurvy and  Scorbutic Eruptions.--
 Causes and Symptoms—Most of the pimply and scurfly 
72
DISEASES of  the blood.
eruptions on the skin are caused by obstructions in its
pores or by disordered digestion, and are sometimes very
obstinate.
   Treatment.—In all such eruptions, abstain from strong
liquors  and spices, or high seasoned food, while the bow-
els should be kept  gently open by small daily doses of
Epsom  salts or the compound  rhubarb pill. * A weak
wash of nitrate of silver is the best application.  Vapor
and sulphureous baths, or steam directed to the parts af-
fected, may do good.  All advertised nostrums, such as
cold cream, kalydor, and the like, should be avoided.

   15. Inflammation.—Symptoms.—Very small hair-like
vessels  have been above  described at the farthest trace-
able point of the veins and arteries, so small  that the
blood in them is no longer observed to  be colored,  but
clear and  limpid like the watery matter which may be
seen oozing  from a cut after  it has ceased to bleed.
Now by a blow, a bruise, or some such cause, the cir-
culation of the blood through these small  hair-like ves-
sels may be wholly or partially stopped ; and, if this ob-
structed blood is pushed on by  the  fresh tide of blood
from the heart, it will, of course, proportionably bulge
out these  small vessels.   As it is the blood  from  the
heart, which distributes fresh heat through the body, it
may be  easily inferred, that the heat of an inflamed part
will increase with the greater portion of scarlet blood;
and that the pushing and  bulging will cause considera-
ble pain, along with a hardened feel of the parts.  If the
inflammation is extensive  or  violent,  it  irritates  the
whole system, makes the heart and the pulse beat quick-
er, and brings on the state called fever.
  Progress and Termination.—The inflammation thus
described, either goes on till the circulation in the  ob-
structed hair-like vessels gradually returns to its healthy
state; or it produces suppuration in the parts in the form
first of an abscess, and secondly of an ulcer ;  or it destroys
the parts altogether, called gangrene and mortification ;
or it continues  in a  slow,  languid  sort of state, called
chronic  inflammation.
   Treatment—All inflammatory disorders must be treat 
SORE THROAT AMD QUINSY.
73
ed so as to draw off the  tide of blood from the heart
pressing towards the affected parts, and by restoring to
such parts their natural color  and their natual heat.
Hence taking away blood by leeches, and using only such
diet and drink as are light, cooling, and not liable to in-
crease the action of the heart, will be  advisable.
  We shall now briefly notice inflammations of the  sev-
eral organs.

  16.—Inflammation of  the Throat in a Common
Cold.—Symptom* and Treatment.—In  a common cold,
the upper part of the throat, the curtain (velum palati)
between the back-nostrils and the mouth, and the wind-
pipe, are all more or less inflamed, and produce a sort of
tickling, which occasions a frequent troublesome cough.
This may, in general, be  removed by drinking freely of
treacle posset, vinegar or orange whey, barley water or
gruel, but without having recourse to  any considerable
increase of bed-clothes, or  of the temperature of the
room. Bleeding, in general, is not necessary ; but should
tightness of the chest, pain in the side or in any part
of the breast, or should shortness of breathing come on,
the attempt to treat this disease without regular advice,
may sometimes occasion its termination in consumption.
When  cough continues, and does  not  yield in  a mode-
rate time to sipping barlev water, made thick and sweet-
ened by the addition of figs and raisins; or by occasion-
ally taking some softening mixture, such as a mixture of
equal parts of honey and oil, with  a little lemon juice, it
may be suspected to depend on some  serious  diseased
state of the lungs.

   17.—Sore Throat  and  Quinsy.—Symptoms.—This
disorder begins with tightness of the throat and pain on
swallowing.  As the swelling and inflammation increase,
the breathing and swallowing become more difficult, the
pain affects the ears,  the  eyes generally appear red,
and the face swells.  The patient  is often  obliged to
 keep himself in an erect posture, being in danger of sut-
 focation:  there is a constant nausea,  or inclination to
D 
 74             diseases q£ the blood.

 Vomit.  Though the pain in swallowing be very great,
 yet, while  the patient breathes easily, there is not  so
 much danger.  An external swelling is no unfavorable
 Symptom;  but if it  suddenly  falls, and the disease af-
 fects the breast, the  danger is very  great.  A frothing
 at the mouth, with a swelled tongue, a pale and ghastly
 countenance,  and coldness of the  extremities, are fatal
 s-ympioms.
   Treatment,—The throat ought  to  be rubbed twice  or
 thrice a day or oftener, with a little of the volatile lini'
 ment composed of equal parts of olive oil and hartshorn.
 This seldom fails to produce some good effects.   At the
 Same time,  the neck ought to be carefully covered with
 wool or flannel.  Blistering upon the neck or behind th«
 ears is  very beneficial; after the plasters are taken off,
 the parts ought to be  kept running by the application of
 Savlne  oidtrflent, till  the inflammation is gone ;  other-
 wise, upon their drying up, the patient will be in danger
 of a relapsei  When  the patient has  been thus treated,
 suppuration seldom happens.
   Gargles  for the throat  are likewise very beneficial.
 They may be  made by  adding  to half a  pint of barley-
 water two of  three spoonfuls of honey, and the same
 quantity of currant jelly.   The gargle  may be made
 more cleansing, by adding to ita tea-spoonful of the spir-
 it  of sal-ammoniac.  There is no  disease wherein the
 benefit of bathing  the feet  and legs in warm water is
 more apparent,

   18.—Inflammation  of The Lungs  And Pleurisy,-*-
 Symptoms and Treatment.—Inflammation  of the  lungs
 is  known by shortness of breathing, tightness and slight
 pain across the chest, with fever. In children this disease
 may always be dreaded, when their breathing is quicker"
 than natural;  especially if accompanied with wheezing,
 and with increased heat of the skin.  Whether  in chil-
 dren or in others, the disease  never  happens without
danger ; if neglected, its termination wUl most probably
 be in consumption.  Obtain, therefore, the best advice
directly; but if prevented in this, lose not too much time 
inflammation of the liver.
75
In Waiting, but apply one, two, or more  leeches to the
chest of the child, according to its age»  Produce sweat.
ing as soon as possible, by giving four grains of Dover's
powders,  followed by warm  tea; cover the child With
blankets, and give a weak solution of tartar emetic, so as
to produce nausea.   To  a grown person, apply a blister
over the seat of pain,-and Weed freely from the arm. open
the bowels,  give  the solution above, produce  sweating*
and dress the blister after it has been on eight hours with
eavin ointment.   When the pain is acute, and it is difficult
to take a long breath, it is pleurisy, or inflammation of the
membrane lining the chest.

  19. Inflammation  of  the Stomach.—Symptoms and
Treatment.—This disease is pointed  out by an acute pain
rather towards the pit of the stomach, or just beneath the
ribs on the left side, accompanied by the vomiting of every
substance immediately on  being  swallowed. But as the
stomach is so irritable and tender, there must be particular
care that  only the most mild liquors, and  those in very
small quantities, be taken.  It must in every other respect
be  treated aa inflammation of the lungs.

   20.  Inflammation of  the  Ltver.—Symptoms.—This
disease  usually  commences with  depression  of  mind,
disturbed sleep, frightful dreams, and irritation of temper,
succeeded by cold  shiverings, dull, wearied paia  in the
small of the back, and frequently headache,  giddiness,
and stiffness of the eyes.  These cold shiverings arc suc-
ceeded by  disagreeably hot flushings, the tongue dry,
 white, and furred, and the mouth clammy,  attended with
 great thirst and  dry skin.  The breathing and the pulse
 are quickened and irregular, and there is  general  weak-
 ness, loss of strength, and uneasiness all over the body
 Under  the  margin of the  ribs, on  the right side, where
 the liver  lies, there is tension  and a sharp pain, usually
 increased on pressure;  but never going off like the pain
 From flatulence or wind in the bowels, and often shooting
 backwards  to the  spine, and upwards to  the shoulder*
d2 
76
DISEASES of the bluou
blade and collar-bone, and  rendering it uneasy or painful
for the patient to lie on the left  side.  After an attack
of acute  inflammation  has subsided,  there may still  re-
main a few embers of  it to keep  the  liver too hot for a
state of health, and this state of things may continue and
increase  for years without proving fatal, or  even  con-
fining the patient to his room.  It ia a much more common
case, however,  that the disorder  steals  insidiously  on
the patient, putting on the mask of almost  every other
disease.
   Treatment.—Take twelve  ounces of blood from the.
arm, and apply a blister over the liver.  Give small dosea
of aconite,  or  a  solution of tartar emetic, to  keep up a
nausea, and open the  bowels with  the  draught below.
Should the disease become chronic, the skin ana the white
of the  eyes become yellow; take  one blue pill night and
morning, (with warm  bath?,)  until the gums become a
little sore.
  Draught.—Take  ten drachms  of infusion  of senna,
three drachma of Epsom salts, one  drachm of  tincture of
senna,  same quantity, of syrup of mulberries,  mix for a
purgative draught; to be repeated  every four hours till it
operates.
  21. Inflammation  of the Bowels.— Symptoms and
Treatment,—If sharp pain be felt lower than the stomach,
attended with almost constant sickness and  obstinate cos-
tiveness, inflammation of the bowels is to be apprehended,
which, unless powerfully opposed,  must terminate fatally
In two or three days.  The best advice  must therefore be
obtained as soon as possible; bleeding and the warm bath
being employed in  the meantime.  Be  careful, whenever
symptoms arise like these, that no heating cordials, spices,
or spirits be taken, under the expectation of lessening the
pain; since just  the contrary effect must  be produced  by
them.                                               ' 
RHEUMATISM.
77
  22. Inflammation of  the Urinary Organs.-— Symp-
toms and Treatment.—If  the pain be  felt in the loins, or
in a  directions from the loins towards the lower part of
the belly, with  frequent vomitings, inflammation of the
kidneys, the organs by which the urine is separated from
the  blood, or  inflammation of the ureters,  the vessels
which  carry  the urine  to the bladder,  has  most likely
taken place.  If the pain is seated  at the bottom of the
belly,  with  great  tenderness on pressure, and  difficulty
in voiding  the  urine, it  may be concluded that inflamma-
tion of the urinary bladder has come on.  Bleeding and
the warm bath  may be  had recourse to; and these two
most powerful  remedies must be aided by abstaining
from food, and by emptying the bowels  by some cooling
physic.

   23.  Rheumatism  or  Inflammation of the Joints.—
 Symptoms.—The  first hints of an attack of rheumatism
are  weariness, languor,  a cold feeling about the  small of
the  back, succeeded by at first  shifting pains in the limbs
 and joints, which  afterwards fix in the  knee, the ankle,
 the  shoulder, or any of the larger joints,  and rarely in tlio
 toes or fingers, as  gout does, by which it is for the most
 part easy  to distinguish the two  disorders.   The joint
 attacked becomes distressingly painful,  swollen and red,
 and the  warmer it is kept it grows the worse, the heat of
 the  bed usually increasing the pain.   From this fact the
 absurdity is  obvious of wrapping up the parts with flannel
 on  all occasions,  as is  usually done. The  feverishness
 and thirst seldom continue violent  above two  or three
 weeks, and often not so  long.
   Treatment.—The first object then must be  to open the
 pores of the skin, and for this purpose  nothing is supe-
 rior to the warm bath, or the vapor bath, followed  up by
 ten grains of Dover's powder.   After a copious sweating
 dry the body and  put on flannel, and take hydriodate of
 potass twenty  grains, four  ounces  of  water,  and four
 ounces of the tincture of colchicuro,  mix them  together, 
78
DISEASES OF THE BLOOD.
and take a tablespoonful  three times a day, directly after
eating, and avoid while taking it all acids.
  The wet sheet will often cure.  If the case is obstinate,
try it.  Wrap the naked body in a sheet wet with  cold
water, then wrap  over this  many blankets, and in a short
time it will  produce copious sweating, and  great relief.
For external  applications, nothing  is better  than  opodel-
doc or soap liniment; these articles, well  rubbed in  with
a piece of flannel  once  or  twice a day, will be of great
service.  The body must always bo  well  clothed in  flan-
nel, and the feet kept perfectly dry.
  P. SL—Frequent bathing  with cold water is a good pre?
ventive against rheumatism.


  24. Slight Inflammation  of  the  Joints,  popularly
termed  Nervous Rheumatism and Fidgets.— Causes
and  Symptotns.—Several writers have erroneously  con-
cluded that this disorder arises from an overflow of ner-
vous  power  in the  parts  affected, which gnawa  at tho
limbs to put  them in motion, in  order  that it may ho
properly used;  but whoever takes  exercise, in hopes
of removing  the  fidgets,  will find that it  infallibly in-
creases the complaint; while rest, and firmly reaistiug any
propensity to change the position of the jimbs, will  cure
it for the time.  The cause  then is  clear, that tho fidgets
arise from the fatigue  and an accompanying inflamma-
tion, and  not from the  rest of the muscles and nerves
affeeted.
  If a delicate lady sit all day at her work-tablo, or spend
eight or ten  hours' in practising on the  harp or piano-
forte, she has every chance  of having a  severe fit of fid-
gets, both in  the arms and  legs, during the evening; and
a literary man who studiea long hours will be similarly
affected:  because, though  tho muscles and nerves have
not been in  very  active  motion, they have  been more
fatigued than if they had been kept on the stretch.  That
this  keeping  on the stretch  is more painful  than violent
exercise,  can be  proved instantly by holding the  arm
stretched from the body for ahout  ten  or fifteen minutes, 
GOUT.
79
wnicn will infallibly produce a fit of the fidgets even in
the most robust, and this disproves irrevocably and irre-
sistibly  the erroneous explanation of the doctors, who
say fidgets are caused by rest.
  Treatment.—To cure the immediate fit which is often
very distressing, rest is  decidedly  the  most powerful
means.   Lying on the back on a sofa, and keeping  the
limbs immoveable, will often be effectual in about  half
an hour or less : if a more immediate remedy be wanted
we recommend the following
  Mixture.—Take half a grain  of acetate of morphia,
two ounces of clarified syrup, mix and take a tea-spoon-
ful as occasion requires : but not oftener than once every
three hours.   Twenty drops of laudanum will also do,
when the patient is not bilious.  These means will  cure
any single fit of fidgets, but when the fits are frequent.and
distressing, the cause must be discovered and removed ;
and as the disease depends much on weakness and relax-
ation in the tone of the parts, which causes the blood-ves-
sels to  become loaded, nourishing diet  must be taken,
avoiding slops, soup6, white meat, and watery vegetables,
and persevering in exercise and the use of the flesh-brush.

   25. Gout.—Causes.—All  the  blood in the great toe
comes directly from  the heart, and as soon as it has done
its duty in repairing what has been worn in the skin,
the muscles, and the bones,, it must return to the heart
through the small hair-like vessels into the veins, and if
these vessels  be obstructed, so as to prevent  the return
of the blood, and more  blood flows to the toe than  they
can admit, the portion of blood which cannot make its
way must be  stopped in its course. Now the accumula-
ted blood must 6well out the vessels of the toe where it
is  imprisoned ; and hence  the  whole toe will become
swelled  and  enlarged, while  the  unusual pressure this
causes will stretch  the nerves and produce great pain.
Gout is brought on by cold and damp in this way.   The
skin becomes red on applying to  it a piece of ice, by
producing a contraction m the small vessels, preventing
the blood from flowing through  them, and of course
           p4 
80
diseases  of  the blood.
causing its accumulation in the larger vessels, where its
progresses arrested, for as  heat expands bodies, so cold
contracts them ;  but if the  contraction  caused  by cold
can be  speedily removed,  no fit of gout  will  follow;
damp acts precisely like cold.   Some patients are almost
certain of an attack if they are exposed to the east wind,
or foggy weather ; if they stand on a damp pavement,
or put on damp stockings.
  Symptoms.—The attacks  sometimes come on  sudden-
ly, but are generally preceded  by indigestion, flatulence,
loss of appetite, cramp in the stomach,  and sometimes
by headach, stupor, numbness, a sense of pricking in the
thighs and legs.
   Treatment.—Every patient  must be treated, during a
fit of the gout, according to his constitution ; that is, the
 J'oung must be reduced by purgatives, local bleeding, and
 ow and cooling  diet; while the old or  feeble must be
supported by a more tonic and generous treatment.  In
every severe case the following should be tried.
   Mixture.—Take one grain of acetate of  veratria, one
grain  of acetate of morphia, six ounces of clarified syrup,
mix very carefully, and take a tea-spoonful every hour,
or every two  hours, till the  pain  abate, which it  will
usually  do in the course of  the night: and the fit will
be completely removed without the least danger.  This
medicine must be followed by  a dose of Epsom salts and
senna in the morning, and in  the old or feeble, with a
few doses  of  disulphate of quinine, in  the young and
robust, with extensive leeching to the part affected.  The
only bad effects from gout medicines arise from trusting
too much to them, and indulging  in strong drink, and
rich  dishes, instead of abstaining.  A fit  of gout, it is
said, will be quickly  removed by what is  called moxa,
namely a pencil  of flax, cotton, or other combustible set
on fire, and put upon the part  in pain till it burns into a
sore.

  26.  Scrofula  or King's Evil.—Causes and Symp-
toms.—The usual cause is hereditary taint or whatever
may reduce or impair the health.  But  in all its forms 
              rickets and  deformities.    .        81

of swelled glands in the neck, bad ulcers and sores, and
white swellings of the joints, it is mainly produced by a
disordered state of general  health, and  particularly of
the stomach.
 ^Treatment.—In this serious disorder  the diet should
be generous, the open air, clear, dry, and bracing. Strong
purgatives are to be avoided: if the  body be  regularly
open it is sufficient.   Salt water bathing is very efficaci-
ous, so is salt water taken as a purge.
  As the superabundance of acid is evidently one of the
chief causes  of scrofula,  chemistry  tells us the  best
remedy will be alkalies to destroy the acid.  The follow-
ing may be tried.
  Mixture.—Upon  two ounces of fresh quick-lime pour
three pints of soft water, cover  it up  close for about an
hour and pour off the water, which is to be strained and
kept in a bottle closely  stopped. For a child, three
table spoonfuls to be taken four  times a day, in a cup of
dandelion or "beef-tea.  For  an adult, twice"or thrice this
dose. *

   27.  Rickets, Curved Spine and Deformities.—Causes
and Symptoms.—Improper  food  and  improper  confine-
ment produce  in the  bones a similar  disorder to that
termed scrofula in the flesh.  Prior to any  twist of the
spine, there is a feeling of general weariness and fatigue
from the slightest exertion, with listless inactivity,  and
a disposition to stoop, while  the  manners become care-
less, ungraceful, and spiritless.
   Treatment.—Besides attending to  air,  exercise,  and
nourishing diet, it is  necessary to attend most  carefully
to the stomach and bowels, as the prevalence of acidity
or costiveness will render all other exertions useless. To
prevent  costiveness,  we should recommend  the  fol-
lowing
   P,//s.—Take twenty grains of powder of jalap, ten
<rrains of blue-pill mass; a  sufficient  quantity  of syrup
of bucKthorn ; mix, and divide into six pills , one every
second or third night, and a wine-glassful of  senna tea
on the following morning.
         1)5 
S2
diseases  of  the blood.
  The acidity which gives rise to sout belchings, heart-
burn, gripes, disordered bowels, and frequently  to  un-
natural hunger, is to be combated chemically by  the
following
  Powder.—Take from two to three grains of trisnitrate
of bismuth, four grains of magnesia, half a grain of ipe-
cacuanha in powder, ten grains of cinnamon in powder;
mix, and divide into twelve papers ; one to be taken three
or four times a day.

  28. Sea Scurvy.—Causes and Symptoms.—This does
not, like the preceding, depend so much  on original con-
stitution as  on improper diet, particularly a long con-
tinued  course of salted meat without fresh vegetables,
along with despondency,  all of  which are  increased by
cold  and moisture.  In this disease, there  are pale and
bloated complexion, spongy gums, livid spots  on the
skin, offensive breath, swelling of,the legs, foul ulcers,
fetid urine, and extremely offensive stools. In its last
stage the joints become  stiff, the  tendons of the legs
rigid, there is bleeding at different parts of the body ; at
length,  violent purging  or dysentery comes on,  and
proves fatal.
  Treatment.—The most important agent in the cure is
the excitement of hope, and next to that fresh bread or
fresh vegetables, or where these cannot  be had sweet-
wort, lemon-juice, vinegar,  pickles, sour-krout, and the
like.

  29. Cancer.—This complaint calls for the immediate
intervention of the surgeon.  Hemlock is a favorite drug
in use; and the knife in proper hands may be applied;
but never, unless the prospect of a  subsequent  healing
is manifest.
  The patient must refer wholly to his surgeon, we repeat.

  30. Dropsy.—Causes and Symptoms.—This  is often
brought on by hard drinking and irregular  living, it also
follows fevers  and other severe disorders.   It  begins
with a swelling of  the feet and ankles towards night, 
WATER IN THE HEAD.
83
and the parts, if pressed with the finger, will pit.  The
swelling gradually ascends towards the belly, and after-
wards the  breathing  becomes  difficult, the urine  is in
small quantity, and the thirst great  To these  succeed
torrlor, heaviness, a slow wasting fever, and  a  trouble-
some cough is generally a fatal symptom.
  Treatment.—If the  fluid  be seated in the cavity of the
belly, it should be drawn off by an expert surgeon.   Ex-
ercise is  highly useful.  It will be important to keep the
bowels regularly open, by geutle doses of rhubarb.  Di-
uretic medicines are  very  useful, such as the tea made
of broom tops, a cupful twice a day ;  or squills in the
form  of pill or of oxymel ;. or nitre, two scruples in
twelve ounces of hot water, with syrup of orange peel, a
cupful every two  or three  hours will do  good.   Fox-
glove is one of the most powerful remedies.  Cream of
tartar  in drachm doses every two or three hours, is also
excellent.

  31.—Water in the  Chest.—Symptoms.—This gen-
erally comes  on  in  advanced  life, with  difficulty of
breathing,  particularly  on  motion, apd when in a  hori-
zontal posture; sudden startings from sleep, with anx-
iety,  and palpitations at  the heart, irregularity of the
pulse, cough,  paleness of visage, dropsical swellings of
the legs, thirst, and a  diminution of urine, which is high-
colored,  and,  on  cooling, deposits a pink  or red  sedi-
ment.   There is  a sensation of water in  the chest, on
certain motions of the body, as if the heart were mov-
ing in a fluid.
  Treatment.—This  being only a species of dropsy, is
treated in  the same way.  Fox-glove is by far the best
medicine, but requires to be taken under skilful advice.

  32.—Water  in the head.— Treatment.—No medi-
cine has hitherto been found sufficient  to carry  off a
dropsy of the brain;  those generally used  are purges
of rhubarb, or jalap,  with  calomel; and  blistering plas-
ters applied to the neck, or back of the head.
d6 
          D.—DISEASES OF  THIS  NERVES.

  In order  to explain  the diseases  or  derangement oc-
curring in the organs of sensation and motion, it will be
necessary to give a brief and plain  description of these
organs.   •
    I.—HEALTHY STATE OF THE BRAIN AND
                     NERVES.

  The brain is encased in the strong bones of the skull,
and is farther enveloped in strong membranes ; the out-
er, smooth  and without elasticity;  the inner, very soft
and delicate.  The substance of  the brain and spinal
chord is, like the  blood, composed of minute globules ;
and the  whole mass of these is  composed of two sub-
stances: one, grey, which  in the  brain is situated exte-
rior to the other, which is white ; but in the spinal chord,
the white is situated exterior to the  grey.   The peculiai
organs,  termed  nerves, are white,  soft, and  threadlike
chords, running to all parts of  the  body, and becoming
smaller  and more branched, as they are  more distant
from the brain and spinal chord.
  Formerly, all the nerves were  supposed  to have only
the function of sensation ; but Sir  Charles Bell has prov-
ed, that some only are  endowed  with  this function,
while others are  appropriated to the production of vol- 
pace-ach and tic doloureux.          85
untary motion.   Besides the nerves connected with the
brain and spinal chord, there is a system of numerous and
extensive  nerves, which are only connected with the
other nerves by very small  twigs;  and the system is
therefore considered as being partly independent of the
others.  This partially independent system of nerves is
termed the ganglionic system;  and the whole is some-
times also called the great sympathetic  nerve, or the in-
tercostal nerve.  This last is very important in its con-
nection with the organs of the chest and bell|^
   H.—DISORDERS OF THE BRAIN AND NERVES.

   We shall now proceed to consider the disordered state
 of the organs just described.

   1  Inflammation of the Brain.—Symptoms and Treat-
 ment.—If a patient be affected with  severe pain in the
 head, light-headedness, fever, redness of the  eyes, and
 impatience at viewing much light, or hearing loud noi-
 ses, succeeded by shiverings ; inflammation of the brain,
 or its membranes, may be feared to exist.   This must
 be followed with death in a very few days, if not oppo-
 sed  by the exertions of some skilful  person.  Bleeding
 profusely, blisters, the strictest regimen, and proper me-
 dicines, must be here employed with that degree of firm-
 ness aad decision, which cannot be hoped for, bat where
 they are directed by a person of real skill;  and where
 the  attendants  are  impressed with  the  danger of the
 smallest deviation from orders.

     2   Facb-ach and  Tic  Doloureux.—Causes  and
 Symptoms.—This is supposed to be caused by some in-
ternal pressure on the nerves of the face, and consists ot
 great pain, often amounting to torture in the cheek, up-
 per lip, tongue, ear,  and over the face. 
8'j
diseases of the nerves.
    Treatment.—Those who  are subject  to  face-ach,
ought to attend to their diet, and keep their bowels re-
gular, and wear at night a woollen nightcap, with flaps
over the ears.   When  the disorder amounts to tic do-
loureux, it will be necessary to burn a small space un-
der the ear  of the side affected with nitrate of silver;
and to take, twice a day, from a scruple to a drachm of
sesquioxide  of iron,  made into pills, with conserve of
 orange-peel.   And see that there are no decayed or aching
 teeth.  If there  are  any old roots of teeth, have them
 taken out.
   3.  Bu^us anjb Sick Head-ach.—Causes.—This is  a
very common and very distressing complaint, which is,
however,  in^general, self-procured,  and may readily be
prevented by avoiding the  causes.  You cannot possibly
escape a severe attack of bilious head-ach, if you indulge
beyond  due measure,—mark, we Say,  due measure,  in
eating ; while indulging in drinking, smoking, or other
sensual indulgences,  has an  immediate effect upon the
liver, by seading to it a deluge of blood from  all parts
of the body.   Now, the office of the liver being to sepa-
rate bile from  the blood, the instant the deluge of blood
is  driven to the liver,  by the weight of what has been
eaten and drunk in the stomach, the liver drains off a
gush  of bile, which falls  into  the  bowels.  Then the
nerves which come from the head to the stomach, liver,
and bowels, are fretted and irritated by the  same load
of bile,  and send the pain along the twigs of the nerves,
which all  meet in the central mass of the brain, till the
junction of all the little pains forms one very severe pain ;
and the head-ach is confirmed and intolerable, by its com-
panionship with the liver.
   Symptoms.—Bilious  headach rarely affects the whole
head, but usually a particular part, such as the forehead,
extending over one or both eyes, or confined to one side
of the head.  It   goes  off sometimes in  two  or three
hours ;  and sometimes  it continues for a day and a night.
This differs  from the sick head-ach, depending upon the
stomach,  by being more throbbing and violent;  while
the sick head-ach  is rather attended by a confused and 
NERVOUS HEAD-ACH.
87
stupid feeling, and a temporary dimness of sight.   The
usual bilious symytoms wuTat once distinguish it.
  Treatment.—The first thing to remove the head-ach,
is to get rid of the bile, which  has caused it by its at-
tacks on the twigs and branches of  the nerves, and the
companionship of the  liver with the head.   We should
recommend an emetic at night,  and the feet bathed in
warm water.  If the head-ach still continues on the next
morning, we should recommend the following
  Draught.—Dissolve one ounce of Rochelle salts in a
single glassful of senna tea, and add  twelve grains of
carbonate of potass ; mix, and take an hour befow break-
fast ; or, for immediate relief the following
  Draught.—Take twenty to thirty drops of laudanum,
a cup of the strongest  coffee you can make, a tea spoon-
ful of compound  tincture of cardamoms ; mix, and take
immediately with sugar; the coffee  is indispensable.
This treatment will usually do for a sudden fit of bilious
head-ach ;  but those subject to the complaint, may try a
course of the following
  Pillt.—Take twenty grains of blue pill, twenty grains
of extract of taraxacum, twenty grains of compound aloe-
lic pill; make into a mass, and dvide  into twelve pills.
One or  two pills every night; and  occasionally  the
 draught next morning.   Sometimes a few drops of harts-
 horn will cure  a headache like a charm.
  4. Nervous  Head-ach.—Head-ach whether affecting
the external or  internal part of the head, is almost al-
ways owing to the circulation of the blood in the exter-
nal or internal carotid artery.  That which  occurs from
indigestion, or disorder of the stomach and  bowels, is
usually of the  first kind.  It  often extends itself to the
muscles of the neck, and is accompanied with a flushing
of the face, and a strong beating of the blood vessels,
going to the brain, and their  branches, which run tt/the
face and  temples.   Whatever  be  the more  remote
cause, the pain,  whether affecting  the outer or innei
part of the head,  is usually accompanied with  such  a
current of blood  towards the brain,  heat of die head,
coldness of the feet, and other circumstances, as indicate 
8S
DISEASES  OF THE NERVES.
 plainly its more immediate cause to be this excessive
 flow of blood to that part.   Thus, it is usually increas-
 ed by heat, stimulating food and drink, by exercise, and
 by every other cause, which excites additional force, or
 quickness in the beating of the heart.
  Treatment.—This head-ach is diminished by whatever
 diminishes the beats of the heart, and changes the cur-
 rent of blood  to some other part, or directly diminishes
 it to the head.   Hence it  is relieved  by cold applied to
 the head ; and  when external by a Arm  bandage round
 the brow: by rest;  by  blood-letting, under certain modi-
 fications,;  sometimes by  warmth, applied to the feet;
 and by pressing upon one or both carotids.

   5.  Swimming of the Head and Giddiness.—Symptoms.
 —There are at least two different species  of giddiness,
 or vertigo.  The first is characterised by  a feeling of
 quick rotation in the inside  of the head ;  and it is this
 which precedes  epiletic,  paralytic,  and apoplectic at-
 tacks.  In a moment after its commencement the patient
 is often seized with nausea, and  sometimes with vomit-
 ing;  and at other times, almost immediately falls sense-
 less.   Another species is distinguished by a feeling as if
 objects were becoming dark, when,  after stopping, the
 patient suddenly rises up into  the erect posture.   It is
 rarely, if ever,  accompanied with sickness,  and ought
 rather to be called  swimming  than giddiness.  In  gid-
 diness, there is a greater jet of blood to the brain than is
natural;  but the sensation in swimming arises from the
 want of a due current of blood in the brain.
   Treatment.—True giddiness may be relieved by blood
 letting, and pressure upon the blood vessel; while swim-
 ming is increased by the compression, and is actually si-
 milar to the feeling which precedes fainting from blood-
 letting.

  6.  Apoplexy and Palsy.—Causes.—Apoplexy is cau-
 sed by the bursting of some blood-vessel ofthe brain on
 which the blood is thrown  and  presses ;  and may arise
 from grief, low spirits, over-eating, over-drinking, sud 
APOPLEXY  AND PALSY.
89
den falls, or jars, and the like.   Those  who are corpu-
lent and short-necked, are most liable,  though it is not
confined to such.
  Symptoms.—There are two sorts .of apoplexy. In one
of these, a person, apparently in the full glow of health,
suddenly drops down, or falls from his chair, and lies as
if overcome with a heavy  sleep, which is accompanied
with snorting, or stertorous breathing. The countenance
is.turgid with blood, and of a  reddish purple hue; the
eyes are bloodshot, and seem  as  if starting from their
sockets ; and their pupils  are  either  greatly dilated, or
very much contracted;  whilst foam,  or frothy saliva, is
blown from the  mouth  with every exspiration.  In the
second form, the attack is preceded by pain in the head,
sickness, sometimes arising  to vomiting  and faintness ;
and the person falls down, as  in a swoon,  in Avhich
state he dies;  or, he recovers  his sensibility for a short
time, but complains of intense  head-ach, and gradually
sinks  into a stale  of lethargy,  from which  he never
awakes.   In this form, the face is pale  and shrunk; and
if the individual survive, one side of  the body generally
becomes paralytic.
  Treatment.—In. both these forms of apoplexy, the first
thing  which should be  done, is to untie the neckcloth,
and to remove every source  of pressure from the throat
of the sufferer : the next, to carry him into the open air,
 or a cool spacious room, and to place him  in a sitting
 position, so as to favor the return of  the blood from the
 head; taking care, however, that the head neither falls
 upon the breast, nor  is thrown backwards;  either  of
 which positions is apt to place the muscles in such a state
 as to present an obstacle to the descent of the blood. To
 divert the blood still more to the lower extremities, and
 restore its balance over the body, the feet and legs should
 be placed in very hot water, and rubbed with mustard.
 If professional assistance cannot be procured, the life of
 the patient may sometimes be preserved, by making a
 cut with a sharp penknife, on  the temple, immediately
 before the upper part of the ear, on a line with the out-
 er angle of the ear, down to the bone, so as to divide the
 temporal artery;  and there need be no fear of too great
 a loss of blood  taking place. 
90
diseases of the nerves.
  7.—Epilepsy  or  Falling  Sickness.—Causes  and
Symptoms.—This, like the preceding, is caused by some
disordered state of the brain, causing a violent  convul-
sive  contraction of the muscles of the extremities, the
eyes, the tongue, the lower jaw, and  the bladder,  at-
tended with foaming at  the mouth, and total  loss  of
sensation, and ending in a state of insensibility,  and ap-
parent sleep.   The fit often attacks suddenly,  but  for
the most part, is preceded by a pain in the head, weari-
ness, and dimness of the eyes.
  Treatment.—During the fit, care should be taken that
the  patient do not injure himself by biting his  tongue,
and  the like, by  the violence of  his  struggles.   Ilia
clothes  should be generally  loosened, and his head ele-
vated, with a  piece  of wood between the teeth.  No
cup or glass  ought to be given him to drink from, till
the convulsive delirium has  subsided, as  he will be apt
to bite a piece from such vessels, and injure his mouth.
When it has been caused by drinking itrong liquors, an
emetic will always remove the fit.   Bleeding is also, in
many cases, of advantage;  but this must depend on the
circumstances.

  8.—Fainting or Syncope.—Causes and Symptoms.—
This originates from an irregular or defective perform-
ance of the functions of the brain ; the  pulse stops, or
can scarcely be felt, the action of the heart and  lungs ie
feeble and imperfect, and the utterance is gone.  It may
arise from exhaustion, such as, after fatigue, long fast-
ing,  from acute pain, or from some sudden  passion, oi
by the flatulence attending  indigestion.  The fit gener-
ally  ceases after  a few minutes, when  the person be-
comes sensible of what is going on around him.
   Treatment.—When a person is seized with a fit of this
nature, he ought to  be conveyed  into the free  air, and
cold water be sprinkled on his face, and poured down
his throat.  Pungent odours should also be held under
his  nose, such as aromatic vinegar or hartshorn.  He
should  be laid in a lying  position, and the feet and
hands rubbed with spirits, or any strong stimulant.  As 
hysteric  fits.
91
soon  as  he can swallow, recovery will be expedited by
taking a glass of wine,  or spirits and water, or fifteen
drops of ether, and the aromatic spirit of hartshorn.

  9. CoNvuLsrvE Fits of Children.—Causes and Symp-
toms.—The convulsive fits of children may be induced by
a disordered state  of the bowels, or by teething: or may
make their appearance  towards the fatal  termination of
chin-cough, or water in  the  head. The  convulsive mo-
tions are extremely rapid, the hands and legs  being agi-
tated in every direction, tho body bent back, tho features
distorted, the eyelids either open, or opening and shutting
rapidly, and eyes either  fixed or  rolling in their sockets.
The duration of this fit is from a few minutes to several
hours.
   Treatment.—Put the child into  a warm  bath, having in
it a handful of ground mustard; rub the child  constantly,
and give it an injection as  soon as possible, composed of
Bweet oil,  soft soap, molasses and warm water.

   10. Hysteric Fits.—Symptoms.—The  hysteric fit sel-
dom comos on without  some premonitory  signs, such as
palpitations, flatulency,  sickness,  depression  of spirits,
and the  like.   A sense of fulness, or pain, is  felt in the
left side, which gradually mounts up  to the throat, occa-
sioning the feeling of a hall being there, threatening suf.
focation.  The patient then falls  down, and the eonvul,
sive action commences.  The body is twisted, the hands
aro clenched,  and beat incessantly against the  breast;
the person rolls on the ground,  and screams  and laughs
 involuntarily.  When the fit ceases, the patient continues
for some time in a stupid and half-insensible state.
  .  Treatment.—During the fit, cold water, vinegar, or Hun-
gary water, may be sprinkled on the face;  pungent appli-
cations made to the nostrils, and warm friction applied to
the extremities.  If the  patient can swallow,  half a tea-
 spoonful of opium and ether, or a teaspoonful  of the aro-
 matic volatile  spirit, in any aromatic distilled  water, may
 be administered. 
92
DISEASES  OF THE NERVES.
  11. Nervous Complaints.—Symptoms.—In what are
vaguely termed nervous complaints,  almost no two in-
dividuals have  the same feelings ;  but generally the pa-
tient is  annoyed with  flatulence,  frelfulness, and fears
of imaginary evil; and  uncomfortable heat,  attended by
flushings  of the face.   The  deceptive colour  of the
cheek, indeed,  is always attended by  this  most disa-
greeable feeling of heat even in the coldest  weather.
Along with  such symptoms there will almost uniformly
be a chilness, or coldness of the feet.   Sometimes they
will be cold and  dry, as if exposed to  frost;  at other
times, they  will feel as if they  were plunged in cold
water;  and again they will be drenched in cold perspi-
ration.   The nerves being  feeble,  weak, and  irritable,
are very liable to be affected by slight causes ;  and from
their close connection with  the mind, through the brain,
are apt to produce low  spirits, agitation,  irritation and
fear; the patient will start violently and be alarmed at
the shutting of doors unexpectedly.; even the accidental
fall of a piece  of money, is felt to be disagreeable ; he
can scarcely eat his dinner  in  comfort,  for  the grating
sound of carving and removing ; the face will flush, the
eyes sparkle, and the whole frame will be  thrown into
agitation, by the jarring of a door-bolt, or  the sudden
barking of a dog.
  There is  often a  sensation of sinking and faintness,
which comes upon the sufferer, particularly  when in  a
crowd, or from the fatigue of standing or walking for a
considerable time, without having  taken  anything into
the stomach.  The horror of nightmare is  precisely to
the night, what the  feeling of sinking is to the day ;
but the  sensation called  nightmare is even more dread-
ful than the sinking felt when awake.
  Treatment.—The nervous are usually advised, in po-
pular medical works, to strengthen  themselves by wine,
bark, steel, cordials, and, above all, cold bathing;  but
but these  have  a great chance,  in many cases,  of doing
more harm than  good.   But tepid and warm  bathing
are excellent when not  repeated more than  once every
two days, or about twice or thrice  a week.  When the 
LOCKED JAW.
93
warm bath cannot be conveniently procured, bathing the
feet and legs in warm water, every night at bed time, is
an excellent substitute.   The  diet must be  light and
palatable, and the patient may judge pretty Well of his
improvement,  by his relish for under-done  beefsteaks
and ale.  Flannel we consider very bad when worn next
the skin.  The irritation, indeed,  of flannel thus wom,
has often aggravated,  if not produced, the very disease
it has been put on to prevent  or cure ; though flannel
and silk be invaluable, when worn over the linen.
  It is absolutely necessary to keep the bowels regular-
ly  open, and to destroy acid and flatulence ;   for which
purpose try the following "
  Pills.— Take twelve grains  of chloride of mercury,
forty-eight grains of compound  extract  of colocynth;
make into a dozen pills ; one pill for a dose at bed-time;
and, if not effectual, another on 'the following morning.
For destroying the acid, the following are good.
   Lozenges.—Take four ounces of prepared carbonate of
lime, one drachm of  nutmeg  in powder, one  ounce  of
gum arabic, four ounces of Tump  sugar ;  rub them to-
gether in a mortar, and form a  paste with water; roll
it out into proper thickness, and divide into lozenges
with a silver thimble, or the like ; or the effects of the
following may be tried.
  Pills.—Take twelve grains  of disulphate of quinine,
twenty-four grains of  ammonia-chloride of iron, twenty-
four grains  of extract of gentian ;  make  into  twelve
pills; one or two for a dose, twice or thrice a day.

  12.—Locked Jaw.—Causes and Symptoms.—This is
one of the most dreadful of nervous disorders.   It rarely
occurs, except in consequence of severe injuries ;  such
as  broken limbs, amputations and the like; and is most
prevalent in hot climates.
  The disease comes  on, though sometimes suddenly,
for the most part  gradually, with an  uneasy stiffness  in
the back part of the neck, and about the shoulders, to-
gether with a difficulty  of swallowing, followej by  a
violent pain about the chest, which strikes through  to 
94        ACCIDENTS AND THEIR TREATMENTi
the back-bone.  The muscles of the under jaw become
affected with a spasmodic contraction, and the teeth are
so firmly pressed together, that they cannot be opened
by any force.  As the  disease advances, every organ of
motion becomes affected ; the eyes are stiff and immov-
able in their sockets. The countenance is hideously dis-
torted and expressive of great distress.   The  whole bo-
dy, during the fit, becomes as rigid as a piece of iron.
  Treatment.—Every powerful remedy,  the  hot bath,
the shower bath,  opium', mercury, tobacco,  &c>, have
been tried in Vain.
     E—ACCIDENTS AND THEIR TREATMENT,

  Accidents frequently  prove fatal,  merely  because
proper preventive means are not employed.  No person,
indeed, ought to be  looked upon as killed by a fall, &
blow, or the like, though  apparently  deprived of life.
In all such cases, the  first thing to be  done is to ascer-
tain the cause, the nature, and  the extent of the evil;
particularly whether the  important organs of the sto-
mach, the lungs, the brain,  the  heart, or  any  large
blood-vessel, be fatally injured.  The following details
will, we hope, be found useful.

              I.—APPARENT DEATH
  In this case  there is, or appears to  be, a suspension
of all the functions, both of the body and of the mindi

  Drowning.—When a person has remained  Under wa»
ter for fifteen, twenty, or more minutes, he is suffocated
for want of air, and the face appears swelled, and of a
livid purple, from the  stoppage of the blood in the veins.
  In rare instances, recovery has been effected after
longer sifbmersion than  twenty  minutes.  The heat of 
DROWNING*
93
the body, and the clearness and motion of the pupils of
the eyes, ate the chief symptoms of life.  As death does
not ensue from  water rushing into the windpipe  and
lungs according to vulgar opinion, but from the want of
air, it is most absurd to hang Up the body by the  heels,
as is often  ignorantly done, to let water run out; for
little or no water is swallowed in drowning*
   Treatment.—The  body must be carefully removed,
laid on the  right side, on a plank, with the head rather
raised, and without jolting, to the nearest house, or to a
warm and dry situation.  When the  Weather is warm,
have the windows open ; when cold have a good firei
If the body is to be carried far, it must be quickly strip-
ped, rubbed dry,and covered with the spare clothes of
the byestandeis. to prevent evaporation, and the cold
which this would occasion.  To restore heat,  place it
between Warm blankets,  and keep up the  temperature,
by application of dry heat in every possible Way.  Wa-
ter extinguishes life as it does fire,  by keeping off the
ttir ; therefore,  restoring  air to the lUngs by inflation, is
the means most to be relied upon, and should be com-
menced without a moment's delay, and continued, per-
severingly, during several  hours.  This is best accom^
plished by pressing the tongue of the patient downwards
and forwards, and passing a small curved tube into the
windpipe, and  attaching a pair of bellows to it; or, in
the absence of  these, an  assistant must blow into it, to
distend the lungs, which may then be emptied by pres-
sing on the chest or belly; expedients which should be
done alternately, so as to imitate natural respiration,
If oxygen gas  could he  used Instead of common air,  it
would be much preferable.
   Frictions with  warm flannels, ought to b.e going on
the while,  and stimulating vapors may be applied to
the nose.   Warm injections (enemata) of salt and mus«
tard, or of brandy and water, may be thrown up into the
bowels, and warm spiced wine got into the stomach, by
means of a flexible pipe and syringe ; but this  is not to
be attempted without such assistance, till the patient
^an swallow.   Bleeding  is a doubtful remedy, but has 
 96        ACCIDENTS and their treatment.

 been occasionally had recpurse to when the countenance
 was very dark, and the limbs warm and flexible.
   Recovery.—The first signs of returning animation are
 sighing, gasping, convulsive twitching of the limbs, and
 slight  pulsation of the heart.   When  these symptoms
 make  their appearance, the efforts, instead of being re-
 mitted, should  be redoubled,  for four or five  hours,
 since all danger is not  yet passed ; many having  per-
 ished,  from neglect, in the after-treatment.  These fa-
 vorable appearances ought, therefore, to be encouraged,
 by giving,  occasionally, as the  person will now be ca-
 pable of swallowing, a spoonful of wine, and  a little
 food of the lightest  description.  The sufferer should
 also be placed  in  a  warm bed, and should enjoy the
 greatest nanquillity.

   2. Hanging  and Strangulation.—After the  rope
 has been removed, the same  means are  used as in
 drowning; only,  although rubbing is  proper, there is
 no occasion for heating the body, and bleeding may be
 more frequently necessary, particularly from the jugular
 vein.

   3. Suffocation or Choking from Breathing certain
 Gases.—The  sorts of  gas  which cause  suffocation
 when breathed, are nitrogen or azote, carbonic acid gas,
 hydrogen gas, and chlorine.
   Treatment.—A person  in a state of suffocation, from
any of  these causes, ought to be removed,  in the  first
place, into the open air; and his clothes being taken off,
he should be  placed on his back with  his head  some-
what elevated.   The coldness of the atmosphere, even
in winter, ought to form no obstacle, nothing being more
pernicious in such a case than placing the patient on a
warm bed in a warm room.  If the patient can swallow
cold  acidulated liquids, such as vinegar and water, or
lemonade, they should be plentifully  given.  The  face
is to be bathed, with vinegar, and the whole body is to
be sponged with vinegar and water, and rubbed  with
clothes dipped in  any spirituous liquid.   Rubbing with 
exposure to intense cold.           97
the flesh-brush may afterwards be employed.  Aroma-
tic vinegar, or any strong-smelling stimulant,  may  be
held under the nose.   But the most important part of
the process is inflation of the lungs.  This may be done
either with a pair of common  bellows, or, what is bet-
ter, with the double bellows, employing oxygen if it can
be had in place of atmospheric air.  Bleeding has been
recommended when the countenance  is livid, the lips
swollen, and the eyes protruding; but probably, if per-
formed, no blood will flow.                         .
  Recovery.—When symptoms of recovery make their
appearance, the person is  to be placed in a warni bed,
the windows of the room being opened.  A spoonful  of
good wine may be given from time to time.

  4. Stroke of Lightning.—When the body  is struck
by  lightning,  death is often,  though not  always, the
consequence.  In such cases the skin appears pale, the
limbs flexible, t,he blood uncoagulated, and the system
retains its warmth even long after death has taken place.
   Treatment.—Stimulants of the most active kind will
be found of great service.   Electricity promises to be es-
pecially useful.   But,  perhaps,  the best remedy is  to
dash cold water over the  whole person of  the sufferer,
commencing with the head.

   5. Exposure to Intense  Cold.—Exposure  to great
decrees of cold brings on an irresistible desire to go to
sle°ep ; but as this arises from the  incipient freezing of
the blood, if it be indulged in, it will most probably end
in the sleep of death.                             ..
   It is  best to commence with rubbing the body with
ice-water or snow.  This may be succeeded by water of
the usual  temperature, gradually and slowly raising it
till it reaches the natural  heat of the body.  If conve-
nient, immersion in sea-water or salt-water is to be pre-
 ferred,  the same caution being used in  raising its  tem-
 perature.   When  the breathing  is  apparently  gone,
 blow into the lungs as in drowning.
   After the body has been thus gradually restored to its 
98       ACCIDENTS AND THEIR TREATMENT.

natural heat, it is to be conveyed to bed, in a moderately
warm room,  and to be  rubbed  either with the  flesh-
brush, or, what is better, with the  warm hand, several
being engaged in this operation at the same time.
  It is customary among the  Canadians, in travelling,
when one of their number falls  into this condition,  to
bury him in the snow,  which being warmer than the
surrounding atmosphere, keeps him in a state of gentle
warmth till the following morning,  when they return to
relieve him.

  6. Choking from any substance in the Gullet.—If d
splinter of bone, a bit of Wood, or  hard bread-crust, a
pin or the like, is accidently swallowed and sticks in the
gullet, it is most readily removed by vomiting, excited
by tickling the back part of the throat or fauces; or a
large goose or  swan quill may  be introduced into the
throat, and twirled round.  By this  means the substance
will be  disengaged  and fall -down into the stomach;
sometimes  it may be carried down by a plentiful draught
of water.   Even after the substance  is removed, a rough-
ness remains, which makes the patient think that it is
still there.
  If the obstructing substance is large, it may not only
obstruct the passage, but also, by pressing on the wind-
pipe, produce the most urgent symptoms of suffocation.
In such a case,  the first endeavor ought to be to attempt
to extract  the  substance by  the mouth,  if it is within
reach ; but if not, an instrument termed a probang, com-
posed of a piece of whale-bone, So thin as to be pliable
and yet to  have some firmness, with a bit of sponge at-
tached to the end of it, must  be pushed  down, over the
opening of the windpipe at the back part of the mouth.
In some cases it is even necessary to cut down to the
gullet, and in that manner extract the substance; and
this may be done with very little danger.

  7. Choking from any  substance in  The  Windpipe.
—Every  morsel that is swallowed slides slowly over the
top of the windpipe, but  is prevented from getting into 
poisoning.
99
it by a moveable sort of lid which the  passing morsel
shuts down.  The only way in which  anything  swal-
lowed can get under this  lid, is during  the lifting of it
by incautious breathing while  swallowing, an accident
very common among children.
  Remedies.—The common effort of nature in coughing
usually  drives  out any substance from the windpipe;
but if a blade of grass, a fish-bone, a pea, or the like,
get into the windpipe, and danger is urgent, the only
chance is cutting into the windpipe,  which  may, with
no great  hazard, be done with a penknife.

  8. Drunkenness.—When  a person is intoxicated so
far as to  have become  insensible, he should be placed
in a large room, to which the air is  freely admitted,
and should be  allowed to remain  in a lying position,
with his head to one  side, to favor  vomiting, which
should be excited by tickling the back part of the throat
with a feather, or it that fail, by an active emetic.  This
should be succeeded by an injection of common salt. If
the nausea and vomiting continue after the  stomach is
evacuated, effervescing draughts of soda  or seidlitz wa-
ter should be employed.

                   II.—POISONING.
   As most poisons when taken in any  quantity, are ei-
ther speedily fatal or produce  derangements out of the
reach of cure, often  before medical assistance can be
obtained, a  few plain directions become consequently
very important in a work like the present.   The stom-
 ach-pump is certainly  the most ready and most effectu-
 al means of remedy, when it is at hand, though it is not
 every one that can use it; but when  a  stomach-pump
 cannot be procured, recourse may be had to other  mea-
 sures.  Nothing can be effectually tried, however, Un-
 less the sort of poison which has been taken be first as-
 certained, and this,  unfortunately,  cannot  always be
          e2 
100       accidents and their treatment.

done.  It will be convenient  to arrange poisons accord*
ing to their effects in producing mortification,  in acting
through, or in affecting, the brain and nerves.

  1. Poisons pboducing Mortification.—Poisone cf this
class act by destroying the lining membrane of the stom-
ach and bowels,  in a similar  manner as the skin may
be  destroyed by caustic  or a hot iron;  and when the
other coat of the stomach has  been thus injured, morti-
fication comes on and soon  ends in death.
  Names of these Poisons.—Oxalic  acid, sulphuric acid
or oil of vitriol,  nitric acid or aquafortis, hydrochloric
acid or spirit of salt,  ammonia or hartshorn, potass, so*
da, nitrate of silver or lunar caustic, verdigris, bichlo-
ride of mercury  or corrosive sublimate, gamboge, (the
basis of Morrison's pills), Croton oil, and cantharides.
  Symptoms from the four Acids.—Acrid burning taste,
acute pain in the throat, stomach, and bowels; frequent
vomiting of bloody fluid,  which effervesces with chalk,
and reddens litmus paper ; hiccup ; copious stools, more
or less bloody ; tenderness of the belly ;  difficult breath-
ing ; irregular pulse; excessive thirst, drink increasing
the pain, and seldom  staying down; frequent but vain
efforts to make water; cold sweats,  altered countenance,
convulsions and death.
   Treatment.—Mix an ounce of calcined magnesia with
a quart of water, and give a glassful every two minutes.
Soap,  or chalk and  water, may  be used till magnesia
can be procured.  Chalk  with  water  is preferable to
magnesia, if oxalic acid has been taken.  Vomiting is to
be excited by  tickling the throat;  and gruel or  barley-
water to be taken after the poison is got rid of: the re-
turn to solid food must be very gradual.
  If vitriol has been  swallowed, neither water alone, nor
calcined magnesia with water, should be given ; but the
common carbonate of magnesia  may be  given  freely
when mixed with water.   There is too much heat gen-
erated in the stomach if the  above cautions be not at-
tended to. 
          POISONS PRODUCING  MORTIFICATION.      101

  Symptoms from the three Alkalies.—The taste acrid,
urinous and caustic; great  heat  in the throat; nausea,
and vomiting of bloody matter, which changes syrup of
violets  to green,  and  effervesces with the acids if die
carbonated form  of the alkali has been taken ; copious
stools, acqte pain of the stomach, colic, convulsions, de-
rangement, and death.
  Treatment.—Vinegar and other vegetable aeids must
be given largely to neutralize the poison.
  Symptoms from Verdigris,  Lunar Caustic, and Coro-
sive Sublimate.—Taste acrid and metallic; tongue dry
and parched ;  tightening or burning  pain of the throat;
metallic belehings; severe vomitings, or fruitless efforts
to vomit; dragging at the stomach, dreadful cholic, fre-
quent  black bloody stools, with straining; belly and
stomach distended ; pulse quick, small and hard ; hunt-
ings,  great debility,  difficult breathing,  cramp,  cold
sweats" intense head-ach, giddiness, insensibility, con-
vulsions, and death.
   Treatment.—Whites of eggs must be mixed with wa-
ter, and one given every two  or three minutes to pro-
mote vomiting, and to lessen the virulence of the poi-
son.  Milk, in large quantities,  gum-water,  or linseed
tea, sugar and water, or water itself, at about  80 deg.
of Fahrenheit's thermometer.  Gluten, as it exists in
wheat-flour, decomposes corrosive sublimate, and should
be given mixed with water.
   For  lunar  caustic  a table-spoonful of common  salt
must be dissolved in a pint of water, and a wine-glassful
taken every two  minutes,  to decompose the poison ;  af-
ter which mucilaginous drinks may be given, or purga-
tives may be administered.
   Symptoms from  Gamboge, Croton  Oil, and  Can-
tharides—The effects of these, and also of monkshood,
mezereon, and buttercup,  are nearly the same, namely,
nauseous odor of the breath, aerid taste, burning heat in
the throat, stomach and belly ; frequent vomitings, often
bloody, with copious bloody stools;  excruciating pam in
 the stomach ;  heat in  the bladder, and stranguary  or
 retention of urine; frightful convulsions, delirium, and
 death.         e3 
102       ACCIDENTS AND THEIR TREATMENT.
  Treatment.—Vomiting must  be excited by  drinking
sugar and water, milk, or linseed-tea very freely.  Emol-
ient enemata or glysters should  be administered; and if
symptoms of inflammation  of the stomach, kidneys, or
bladder supervene, they must be subdued by bleeding.

  2.  Poisons entering into and acting  through the
Blood.—Poisons of this class do not produce deleterious
consequences unless they are  introduced into the blood,
and then they  affect the heart, the brain, and the organs
of digestion.
  Names of these Poisons.—Arsenic, prussicacid, poison-
ous reptiles, poisonous fish, bite of a mad-dog, opium,
hellebore, henbane, hemlock, tobacco, and most of the
vegetable poisons.
  Symptoms from Arsenic—A rough taste in the mouth,
foetid breath, slavering, tightness of the throat; hiccup,
nausea, and vomiting  of brown or bloody  matter;  anx-
iety and faintings,  heat and violent pain at the  pit ol
the stomach, stools black  and  offensive; pulse  small,
frequent, and  irregular; palpitations;  great thirst and
burning heat; breathing difficult; urine scanty, red, and
bloody; delirium, convulsions of an epileptic character,
and death.
  Treatment.—Vomiting must  be excited or encourag-
ed by large  draughts of sugared-tea, linseed-tea or other
emollient fluids.  Lime-water, or chalk and water, may
be drank freely if the  arsenic has been  taken in a liquid
form.  Fat, oil, vinegar, charcoal powder, and vegetable
decoctions, which have been  recommended, are not  to
be relied on.  Inflammatory symptoms are  to be com-
bated by bleeding from the arm and by leeches, foment-
ations, and frequent emollient glysters,  as the symptoms
may demand.
  Effects of Prussic  Acid, termed by  Chemists Hydro-
cyanic Acid.—Prussic acid  has  a strong  odor  of bitter
almonds, and  is contained in  almonds,  cherry  stones,
peach kernels, and laurel and bay-leaves.   It is the most
violent of poisons, producing almost instant death, when 
POISON IN  THE BLOOD.
103
applied even in small quantities to the surface of the
body.
  Treatment.   If prussic acid has been taken, emetics,
such as a scruple of sulphate of zinc made into a bolus
with confection of roses, are to be given with  as  little
delay as  possible;  and after their operation,  oil  of tur-
pentine,  hartshorn, brandy, and other stimulants, capa-
ble of rousing the system, should be perseveringly em-
ployed, with warmth,  friction, and; blisters, to the soles
of the feet  and the pit ofthe.gtomach.
  Symptoms from the bile ofa^Serpent.—A sharp pain is
felt in the wounded part, which soon extends over the
iimb*or body ; great s.^jing, at first hard and pale, then
reddish,  livid, and,mortffied in  appearance ; huntings,
vomitings, convulsions*  and sometimes jaundice ;  pulse
small, frequent  and irregular; breathing difficult; cold
sweats, followed by disturbance of the intellectual fac-
ulties ; the sight fails, and the intellectual faculties are
deranged ; inflammation, and often  extensive suppura-
tion and gangrene, or mortification,  terminate in death.
   Treatment.—A moderately tight bandage must be ap-
plied above the bites, and  the wound left to bleed, after
being well washed with warm water; a red hot iron,
or lunar caustic, must then be applied freely to it, and
afterward  cover it with lint, dipped in equal  parts  of
olive oil, and spirits of  hartshorn.  The  bandage must
be removed if the inflammation be considerable.  Warm
 diluting drinks, and small doses  of ammonia  or  harts-
 horn, will cause perspiration; cover up the patient in
 bed, and a little warm wine may be given occasionally.
   Symptoms from Poisonous Fish.—At the short interval
 of an hour or two, and often in much less  time, after
 eating stale fish, a sense of weight at the stomach comes
 on with slight giddiness  and headach, heat about the
 head and  eyes, and considerable thirst; often an erup-
 tion of the skin (termed nettle rash), and in some cases
 death has happened.    #                      •  ,„„ ™
    Treatment.—An emetic should be  speedily given, or
 vomiting may be excited by tickling the throat with the
 finger, and taking large draughts of warm water.  Af-
             e4 
104        ACCIDENTS AND THEIR TREATMENT.

ter fun vomiting,  an active purgative  should  be given,
to remove any of the noxious matter that may have
found its way into  the  intestines.  Vinegar and water
may be drank after the above remedies have  operated,
and the body may be sponged with the same.  Water
made sweet with the same, to which ether may be add-
ed, may be drank freely.  If spasms  ensue, laudanum
in considerable doses is necessary.
  Symptoms from the Bite of a Mad Dog.—At an uncer-
tain interval after the bite as of a dog, a cat, or  any other
rabid animal, between the twentieth day and the third or
fourth months,  pain  or uneasiness occurs in  the bitten
part,  though the wound may  have been long  healed.
Anxiety, uneasiness, languor, spasms,  horror,  disturbed
sleep, and difficult breathing succeed, and are  soon very
much increased; violent  convulsions affect the  whole
body, hideously distorting the muscles of the  face ; the
eyes are red and protruded, the tongue swells,  and often
hangs out, and clammy  saliva flows from  the mouth ;
there is pain in the  stomach, with bilious vomitings, a
horror of fluids; all becoming worse till the sufferer is
relieved by death.
   Treatment.—It" is doubtful if hydrophobia  has ever
been cured, and almost  every remedial agent  has been
tried without success.  The bitten part should be com-
pletely cut out,  or cupping-glasses applied over it, even
after it has healed, if the symptoms have not  yet come
on; the part should then be immersed in warm water
or washed with it as long as it will bleed, and after the
most persevering washings, caustic should be applied to
every part of the surface, and  then the wound covered
with a poultice and suffered to heal.
  Symptoms from Hemlock, Laudanum, Nightshade, and
most Vegetable Poisons.—The common effects of narco-
tic poisons are stupor, numbness, heaviness in  the head
inclination to vomit, slight at first, but afterwards insup-
portable ; a  sort of intoxication, a stupid  air,  the pupil
of the eye dilated, furious or lively delirium, sometimes
pain, convulsions of different parts  of the body, or palsy
of the limbs ; the pulse variable,  but  at first  generally 
105      POISONS WHICH  AFFECT THE NERVES.
strong and full;  the breathing quick, and great anxiety
and  dejection, which, if not speedily  removed, soon
ends in death.
  Treatment.—The principal object in the treatment of
persons under the  influence of narcotic  poisbns, is  to
rouse the sensibility so as to render the stomach alive to
the irritation of emetics, and the action of other stimu-
lants.  Late experience has proved that this is best ef-
fected by repeatedly  dashing cold water over the head
and  neck,  whilst  the rest of the body is kept dry and
warm.  Applying  hartshorn  (liquor ammonia,)  to  the
nostrils by means of a feather,  introducing a drop or
two of it mto each eye, and the application of a mustard
plaster over the stomach, have been attended with good
effects.  Four or five grains of tartar emetic, or from
ten to twenty of the sulphate of zinc, should be got into
the stomach every quarter of an hour, and vomiting as-
sisted by irritating the throat with the finger; active
purgatives may be given after the vomiting  has ceased.
When as much as possible of the poison has been ex-
pelled, the patient may drink,  alternately, a tea-cupful
of strong hot coffee, or vinegar diluted with water.  If
the heat of the body declines, warmth and frictions must
be perseveringly used.  Vegetable acids are on no ac-
count to be given before the poison is expelled, and it is
desirable that but little fluid of any kind should be given.
  Symptoms from poisonous Mushrooms and Ketchup.—
Nausea, heat and  pain in the stomach and bowels, with
vomitino- and purging; thirst, convulsions, huntings;
pulse small and frequent;  delirium, dilated pupil  and
stupor, cold sweats, and often death.
   Treatment.—The stomach and bowels must first be
cleared by an emetic of tartarized antimony, followed
bv frequent doses of Glauber's or Epsom salts, and large
stimulating injections or enemata.  After the poison is
evacuated?ether may be given with small quantities of
brandy and water, but if inflammatory symptomscome
on these should be omitted.

   3. Poisons which affect the Nerves.—Poisons of this
              e5 
;06
INJURIES TO THE SKIN.
class  act  chiefly upon  the nerves, and, through  the
nerves, upon the brain.  The chief of these are tobacco,
ardent spirits, essential oil of almonds, Croton oil, cam-
phor,  opium and laudanum, and lead.
 . Symptoms from Lead.—When lead in  the  form  of
sugar of lead, red  lead, or the leading of earthenware, is
taken, it produces an astringent metallic  taste ; tighten-
ing of the throat; pain in the region of the stomach; ob-
stinate,  painful, and  often  bloody  vomitings;  hiccup,
convulsions, and death.  When taken in small, long con-
tinued doses, it produces painter's cholic, distressing cos-
tiveness, and paralytic symptoms.
  Treatment.—Glauber s or Epsom salts, dissolved in a
good'deal of water, should  be  taken freely, along with
sulphuric  acid; bleeding must be used if symptoms re-
quire  it; and castor oil, either with or without opium, to
clear  the bowels, assisted  by  frequent emollient  glys-
ters.  The warm bath should not be omitted.
  Symptoms from  Tobacco.—Great nausea, prostration
of strength, universal tremor, violent vomiting and head-
ach, cold sweats, convulsions, fainting, and death.
  Treatment.—Evacuate the stomach, if the poison have
been  swallowed, by an emetic, and then give castor oil
or the black draught;  vegetable acids, such as vinegar
and lemon-juice, may then be.advantageous; but if the
patient is  very low, strong stimulants, such as  brandy
and camphor, cold water dashed over the body, and mus-
tard poultices to the soles of the feet, may be tried.
           III.—INJURIES TO THE SKIN.

  The superficial injuries which it may be useful to no-
tice here are  burns and  scalds, ruffled .skin, cuts and
wounds, knocks and bruises, frost-bite, and stings from
wasps and bees.

  1.—Burns and Scalds.—Accidents  from fire or hot
water are so sudden, and often so dangerous or injurious, 
BURNS  AND SCALDS.
107
that it is important for every body to know something of
the treatment.  There are three plans followed by med-
ical men of different opinions;  one recommending cold,
another hot, and a third, oily applications; each has ad-
vantages and disadvantages.
  In slight cases, it is a common and not a bad practice,
to hold  the burnt part to the fire as long as it can be en-
dured.  In more severe cases, the part is freely bathed
with a  piece of linen dipped in heated spirit of turpen-
tine, or any sort of spirits of wine, such as gin or whis-
key, and then covered with a liniment  composed of one
part of  oil of turpentine and  two parts of basilicon or
resinous ointment.  At first this will cause some smart-
ing, but in the course  of an hour or two it gradually
abates,  and the patient feels comparatively easy.  Should
blisters have  risen, or the skin been removed,  and the
part be raw, the  treatment is the same ; since, in both
cases, equal relief will be experienced.
   The  first dressing should continue on for twenty-four
hours, when it may be bathed with something  milder,
as common spirits, vinegar, or tincture of opium, a little
heated  ; and it should  be dressed with Turner's cerate,
or sugar-of-lead ointment.   If the bum is extensive,
care skould be taken not to expose more than a small
part at a time  to the air.  If blisters  have  risen, they
may be opened with a needle.
   When a raw or red surface is the consequence of such
an accident, the best application is finely powdered chalk
dusted  over the surface, and covered with a dressing of
simple ointment, or fine cotton wool, or unglazed wad-
ding, wrapped over it,  which is- also  good  in blistered
bums and scalds.  In  severe cases, where a part is so
 injured that its  vitality is destroyed, warm poultices,
 smeared with  camphorated oil, are to  be frequently ap-
 plied.  In mild cases, on the contrary,  Avhere the injury
 is more superficial,  bathing the parts  once with  the
 heated spirit of turpentine, and  then  dressing with the
 liniment formerly mentioned, is all that  is required.
   In the inflammation and fever  excited by burns, bleed-
 ing and strong purgatives are improper; and it will be
             e6 
108            INJURIES TO THE SKIN.
best to give from thirty to fifty drops of laudanum ; or,
when there is great torpor and sinking of the system,
even brandy and other strong stimulants have been found
useful.  This treatment is to  be continued till the sur-
face begins to secrete matter, when a mild cooling regi-
men is to be instituted.
  In applying the turpentine  externally, care must be
taken not to continue it too long, since it may produce a
secondary inflammation.  This accident, when it takes
place, is easily remedied by an emollient poultice;  a
dressing, spread with simple ointment, being interposed
between it and  the inflamed  surface.   Some surgeons
prefer bathing the parts with vinegar, in place of the
spirit of turpentine.
  Emollient Treatment.—This plan is intended to soothe
the pain, and  protect the parts  from the air.  It consists
of oily or soapy applications, of which that employed at
the Carron Iron Works, called Carron oil, is the best.
It is made by mixing equal parts of linseed oil and lime
water.
  When any of these plans of-treatment has been once
adopted, it ought  to  be continued without changing to
another, otherwise bad consequences may ensue.

  2. -Grazed or Ruffled Skin.—If the skin be rubbed
off  by a stone, a piece of wood, or any other substance,
the first thing necessary, is to remove all sand  or dirt
from the wound by milk-warm water;  then  to bathe it
with  spirits and  water, till  the pain  has  somewhat
abated; and, to defend the tender surface from the ex-
ternal air, a piece of dry lint or cotton wool laid over it.
When this comes off, which should be delayed  as long
as possible, if there should be any swelling or pain from
inflammation, a poultice should be applied ;  if there be
none, it may be dressed with amy simple cerate. But,
before this, all greasy and oily applications are improper.
Lotion or ointments, containing sugar of lead, are to be
avoided, since the lead may be absorbed, and produce
mischief.

  3. Excoriations  and Chafing.—When  the skin is 
cuts and  wounds.             109
galled by riding, or, in infancy, by inattention to clean-
liness, it ought to be bathed with warm milk and water,
to clean it, and afterwards with cold water to wash off
the milk and remove  the inflammation.   Fine  fuller's
earth, moistened with  water or spermaceti ointment, is
good for anointing the parts.   When there is much in-
flammation, a bread and water poultice may be necessary.

  4. Cuts and Wounds.—When  the  skin is injured by
cutting or piercing, all rust, splinters of wood, and the
like, should  be washed out; and if the  bleeding does
not stop of its own accord, it may be necessary to bathe
the part with cold water, or touch it with some turpen-
tine, or compound tincture of benzoin; though this will
retard  the healing.  What  is  of most importance,  is
bringing the edges of the wound nicely together, and
keeping them so by slips of sticking-plaster and a band-
age.  In slight cuts, this mode will  cause them to close
in forty-eight hours, or less.
  The first dressing  ought  to continue on for  at least
two days, after which it may  be  removed,  and  lint ap-
plied.  If any part of the first dressing sticks so close as
not to be removed with ease  or safety to the patient, it
may be allowed  to continue, and fresh  lint dipped in
sweet oil laid over it.  This will  soften it, so as to make
it come off  easily at next dressing.  Afterwards, the
wound may  be dressed twice a day, in the same man-
ner, till  it be quite  healed.  Those who are  fond  of
salves, or ointments, may, after the wound is  become
verv superficial, dress  it with  the yellow basilicon oint-
ment; and  if fungus, or what is  called proud  flesh,
should rise in the wound, it may be checked, by mixing
with the ointment a little burnt alum. When a wound
is greatly inflamed,  the most proper application is  a
poultice of bread and milk, softened with a little sweet
oil or fresh butter.  This must be applied instead of the
plaster, and should be changed two  or three times a day.
   When  a wound penetrates into the  breast or the
 Dowels, or where any large blood-vessel is cut, a sur-
geon ought to be immediately called, otherwise the pa- 
110
INJURIES TO THE SKIN.
tient may lose his life.  But if the discharge of blood is
so great, that if it be not stopped the patient  may die
even before a surgeon can arrive, if the wound be in any
of the limbs, the bleeding may generally be stopped by
applying a tight bandage a little above the wound ;  such
as a  strong broad  garter, or a silk hankerchief, slack
enough to admit easily a small piece of stick to be put
under it, which must be twisted till the bleeding stops.

  5. Blows, Bruises, and Contusions.  Bruises are often
productive of worse consequences than cuts or wounds.
In slight bruisesrit  will be sufficient to  bathe the part
with warm vinegar, to which a little brandy or rum may
be added;  and to keep  cloths wet with this mixture,
constantly applied to it.  This is more proper than rub-
bing it with brandy, spirits of wine, or other ardent
spirits, which  are commonly used  in such cases.  In
some parts of the country, the peasants apply to a recent
bruise a cataplasm of fresh cow dung with very happy
effects.   Scraped briony root is also good.
  When a bruise  is very violent, the patient ought im-
mediately  to be bled, and put upon a proper regimen.
His food should be light and cool, and his drink weak
and of an opening  nature;  as  whey sweetened  with
honey, decoctions of tamarinds, barley water, cream of
tartar, whey, and the like.  The bruised part must be
bathed with vinegar and water, as directed above; and
a poultice, made by boiling crumbs of bread, elder-flow-
ers, and camomile flowers, in equal quantities of vinegar
and water, applied  to  it.  This  poultice is peculiarly
Eroper when a wound is joined to the bruise.  It  may
 e renewed two or three times a day.
  As the structure of the vessels is totally destroyed by
a violent bruise, there often ensues a great loss of  sub-
stance, which produces  an ulcerous sore, very  difficult
to cure.  If the bone be affected, the sore will not  heal
before the diseased part of the bone separates, and comes
out through the  wound.   This  is often a very  slow
operation, and may  even require several years to be com-
pleted.  Hence it happens, that these sores are frequent- 
chilblains and kibes.
Ill
ly mistaken for the king's  evil,  and treated  as such,
though, in fact, they  proceed  slowly  from the injury
which the solid parts received from the blow.
  Patients in this situation  are pestered with different
advices.  Every one who sees them proposes a new re-
medy, till the sore is,  in a manner, poisoned with vari-
ous and  opposite applications, and is often at length
rendered absolutely incurable.

  6. Parts  Frost-Bitten.—Frost-bite  is in some mea-
sure similar to a bad bruise.  On exposure  to freezing
cold, a part becomes literally frozen, and the circulation
and feeling are destroyed. • When a limb in such a slate
is suddenly brought near a fire, the certain consequence
is a  slow inflammation,  ending  in almost immediate
mortification.   To prevent therefore all sudden increase
of temperature, the limb should be plunged in ice water,
or rubbed with snow.  Then gradually, by  almost  im-
perceptible degrees, the heat may be raised till it reach
the natural warmth of the  blood. The person should
be laid in a room without a  fire, and should be  covered
with no more than  his usual allowance of bed-clothes;
nor ought anything heating  or stimulant to be  adminis-
tered internally, but the  system  allowed gradually to
recover.                                          .
  When the  hands or feet are greatly benumbed with
cold, they ought either to be put into cold  water, or rub-
bed with snow, till  they recover their natural  warmth.
Every person must have observed, when his hands were
even but slightly affected with cold, that the best  way
to warm them was by washing them in cold water,
and continuing to rub them well for some  time.

  7.  Chilblains and Kibes.—Causes and Symptoms.—
Children and old people, or  those who are weak  and
delicate at any age, particularly females, are most sub-
ject to chilblains, which arise from deficiency of vigour
in the fibres of the feet, the  hands, and sometimes even
the nose, ears, and  lips, from exposure to  great cold, or
currents of cold air.  At first there is redness,  swelling, 
112
miscellaneous injuries.
a sense ot tingling, intolerable itching, which is increased
by  heat.  As  it proceeds, the part becomes  blue, and
the painful itching excessive. Then little vesicles arise,
burst, and leave the part sore and ulcerated, often eating
deep into the flesh, and even to the bone;  and in  this
stage the sores or kibes are extremely  obstinate  and
difficult to be cured, and mortification may ensue.
  Treatment.—To prevent chilblains, never run  rashly
to the fire when the hands or feet are very cold ;  nor ex-
pose the hands and feet suddenly to cold when they are
warm and perspiring; as in either case, chilblains  will
probably arise.   To strengthen the parts, take a quantity
of alum, make a strong solution of  it in cold water, and
bathe them with  it night and  morning.  The  water
caught from oysters, while opening them, is also good;
and the following
  Wash.—Dissolve two drachms of acetate of lead, in
half a  pint of cold water ; add a glass of good rum or
brandy; mix, till  it becomes of a  uniform  white; dip
linen cloths in  it, and apply them to the parts, renewing
them frequently during the day. This is often sold high,
as a quack medicine.
         IV.—MISCELLANEOUS INJURIES.

  1. Sprains—Sprains are most common in the ankle
and  the wrist, the  soft parts around  the joints being
6tretched,  and sinews sometimes more  or less torn.
When a part has been sprained, there is  felt at first a
sense of weakness, with more or less pain, which gradu-
ally becomes more acute, in proportion to the inflamma-
tion produced. The joint then becomes  swollen  and *
tense, and the surface red, and warmer  than natural.
If it be neglected, or if the person be unhealthy, it may
lay the foundation of a white swelling.
  Treatment—In a recent sprain, inflammation may be
partly prevented by a lotion, composed of  one part of
spirit of wine, one of laudanum, and three of cold water.
The part also may be  supported by a  moderately tight 
RUPTURES.
113
bandage,  and perfect rest to the limb in the horizontal
position, should be allowed.  But if inflammation  does
come on, then the bandage must be withdrawn ;  and in
place of the above lotion, a warm one of sugar-of-lead
water may be used.  It is always proper to apply a good
many leeches, to bleed from the arm, and to take Epsom
or Glauber salts.  In bad cases, a blister will in general
perfect  the cure.  The stiffness which  sometimes re-
mains may be removed by rubbing, and the like.

  2. Ruptures.—Causes  and Symptoms.—In children,
rupture may be occasioned by  excessive crying,  cough-
ing, vomiting, or  the like.   In grown people, it is com-
monly the  effect  of blows, or violent exertions  of the
strength ;  as leaping, and carrying weights.  In both, a
relaxed habit, indolence,  and an oily or very moist  diet,
dispose the body  to rupture.
   Treatment.—On the first appearance of a rupture in
an  infant, it ought to be laid upon its back, with its  head
very low.  While in this posture, if the gut does not re-
turn of itself, it may easily be put up by gentle pressure.
After it is returned, a piece of sticking  plaster may be
applied over  the part, and a  proper truss or bandage
must be constantly worn for a considerable time.   The
child must, as far as possible, be kept from crying, and
from all violent  motion,  till the rupture is quite healed.
   In grown persons, when the gut has been forced down
with great violence, or happens, from any cause,  to be
inflamed, it is often very difficult to return it, and some-
times quite impracticable without a surgical operation.
In ordinary  cases, after the sufferer has been bled he
must be laid upon his back, with his head very low, and
his lower extremities raised high with pillows.  In this
situation, flannel-cloths wrung out of warm water, must
be applied for a   considerable  time.  If this should not
prove successful, recourse must be had to pressure.   li-
the tumor be very hard,  considerable force will be ne-
cessary ; but it is not force alone  which succeeds  here.
After the  gut has been returned, a truss or bandage
must be worn. 
114
MISCELLANEOUS INJURIES.
  3. Limbs  put out  of  Joint  or Dislocated.—Limbs
when put out of joint are most easily managed the mo-
ment after the accident,  before inflammation and swel-
ling take place, and consequently often before a surgeon
can be procured.   The marks  of a  limb being really
out of joint are a change in  the form of the joint, a
lengthening or shortening of the limb,  and an incapa-
bility of motion.  In detecting  the  accident,  great as-
sistance may be derived from comparing it with thejoint
of the opposite side.
  Treatment.—The limb  must be forcibly pulled to coun-
teract the drawing of the muscles;  the  extending force
is to be gradually increased, and is to be applied at  first
in the direction in  which the  bone may  be displaced ;
but by degrees, it is to be brought to a line parallel with
the centre axis of the  socket.    At the same time, some
one is to endeavor to raise the head of the bone over the
edge of the cavity.

  4. Broken Bones.—If a person be found lying on the
ground speechless, do not hastily endeavor to raise him,
but first search whether  any  of the  limbs are broken,
lest in raising him  the injury be increased by the  ends
of the broken bone  being forced through  the flesh  and
skin.  If the thigh or leg be broken, attempt not to raise
him till some mode has been provided of conveying him
to his bed, remembering  that being laid o:i a doo'r or a
shutter, and thus conveyed by two or four men, he will
suffer much less injury than if conveyed  on any kind of
carriage.  If the arm be broken in the upper part, let it
be supported in a sling, with the palm of the hand turned
to the body.  If the person continues senseless, the head
has probably received  some serious  injury, demanding
great care in his removal, and  the immediate attention
ot some experienced surgeon.
  If after a blow, by a fall  or  otherwise, on  the side,
considerable pain is felt, and the breathing rendered  dif-
Jicult, it is almost certain one or more of the ribs is bro-
ken.  Free bleeding and absolute rest  will be demanded
in this case,  which very frequently  terminates fatally 
INFLAMMATION OF THE EYES.
115
from want of being treated from  the first with that de-
cided firmness it demands.   Nothing is more  frequent
than to see persons, after an  accident of this kind, expo-
sed to the air, and even endeavoring to  follow their usu-
al occupations ;  whereas  the most strict confinement to
the house or bed ought in these cases to be adhered to.
  Broken bones in young persons become united from the
twenty-eighth to the thirtieth day :  in adults  from the
thirtieth to the  thirty-fifth: and  in  the aged,cfrom the
thirty-fifth-to the fortieth day.

   5. Motes, Sand, and  other Substances in the Eyes.
—When an insect, a grain of sand, or any similar sub-
stance lodges on the surface of  the  eye, the necessary
consequence must be pain and acute inflammation, ter-
minating, if neglected, in obscurity and  dimness of sight,
and even loss of vision.   The substance may either lie
loose on the surface, or, havingnpenetrated the outer coat,
may there remain fixed.  In the former case, it is easily
removed by means of a camel-hair pencil dipped in oil,
or, what is better, a piece of paper rolled into the size ol
a quill and softened in the mouth.  When the substance
is fixed in the coats of the eye, then a surgical operation
may be necessary to remove  it.  This accident is frequent
among smiths, and is known among them by  the name
of a fire in the eye, some one of the craft being usually
celebrated for removing it,  employing for  that purpose
 his nail, his tongue,  or the  first rude instrument that
 may come within his reach.

   6. Inflammation of the Eyes.—Causes.—In the case
 of fine sand or the  like floating about in  the air, as  in
 E°ypt, it gets  into  the eyes, and produces redness and
 inflammation,  which often  arises also when no  such
 cause can be traced.                       ,
    Treatment.—Eye-waters  and ointments, with other ex-
 ternal  applications, do mischief twenty times for once
 they do good;  and hence we ought to be very cautious
 how we use such things. Bleeding is always necessary,
 and this as near the part affected as possible.   Leeches 
116
M iscellANE0US INJUR IF.8.
are often applied to the temples, or under the eyes, with
good effect.  In obstinate cases, it will be necessary to
repeat the operation several times. The patient may take
a small dose of Epsom salts and cream of tartar, every
second or third day,  or a decoction  of  tamarinds with
senna; or gentle doses of rhubarb and nitre, or any other
mild purgative will  answer the same  end.   If the in-
flammation does not yield to these evacuations, blister-
ing plasters must be applied to the temples, behind the
ears, or upon the neck. When it is of long standing and
obstinate, the  golden ointment, that is, the ointment of
the nitric oxide of mercury, or Singleton's, which is
equal parts of lard and orpiment, will do good.

  7. Peas, Insects, and other Substances in the Ear.
—The opening into the outer ear, as  far as the drum, is
only about half an inch,  and is defended by a sort of
down as well  as a sort of wax.  Peas, bits of slate pencil
among boys at school, and other things, sometimes get
into the ear, and give no  little uneasiness.  They may-
be extracted by means of a small pair of forceps, having
previously injected some of the  oil of  almonds.  Occa-
sionally, ants and  caterpillars have  found their way in,
and even insects have been known to deposit their eggs
there. We sometimes succeed in removing them, by in-
troducing into the ear a piece of lint dipped in honey.
Camphorated  oil may also be tried.. 
CHOLERA!
       SIMPLE* DIRECTIONS
                 FOR THE

Prevention,  Arresting, and Treatment
                   OF

         ASIATIC CHOLERA.
   Doctor  McCormick, of  the  United States
Army, and one of the gentlemen constituting Gen.
Taylor's suite while on his way to Washington,
is the  author of the following remarks on the pa-
thology  and treatment of  cholera.  They were
originally written  and transmitted, in a  private
letter, to a friend at the North, who, knowing that
Dr. McCormick's experience in the treatment of
cholera embraced the visitation of that disease at
Washington, in  1832,  and  recently at New Or-
leans, very  naturally desired  to learn his views
with regard to the best mode of treating it.  An-
                      117 
 118             SIMPLE DIRECTIONS
 other of the gentlemen  accompanying Gen. Tay*
 lor, who was aware that Dr. McCormick had com*
 mitted  his  views on the subject to writing, and
 desirous to  see them in print, applied to the Doc-*
 tor for  a copy.   It will be found annexed :

   Cholera has four distinctly marked stages t

   1st. Loose dejections.
   2d. Watery discharges by the stomach, bowels
 and skin.                                      i
   3d. Corpse-like coldness,  and blueness of the
 skin or collapse.
   4th. Reaction,  choleric fever,  a state strongly
 resembling  Typhus.

   The first  consists  in  a simple  looseness of the
 bowels—the dejections  being frequent, and more
 or less copious, and then  the consistence decreas-
 ing with each  evacuation, until  it arrives at the
 next  plainly marked stage of the disease.  The
 second  period: the  evacuations  now consist of
 little  else than a watery fluid.  With these dis-'
 charges the  thirst is always intense, and the voice
 begins to fail.   The  stomach  becomes involved,
 pouring forth the same watery fluid in greater of
less abundance, and ushered in with this evacua-
tion from the stomach, bowels and skin; and appa-
rently intimately connected  with it is seen  the 
fOR THE TREATMENT of CHOLERA.
119
rriost painfully distressing phenomenon of this ter-
rific malady—the cramps and spasms—causing the
patient at times  to writhe in agony, giving forth
every expression of pain that human torture could
provoke.

   The third  period follows, and consists of col'
lapse.  This seems naturally explained by the waste
of the watery portion of the blood and the great
 exhaustion of the nervous system, so  intimately
connected with it,  and with the violent  cramps
and spasms.   The voice has become more feeble,
the watery evacuations  cease, the  agony is oVer(
for the spasms havd also ceased, and the  patient
 lies indifferent,  apathetic, fearless, and craves only
 drink.  The thirst continues intense, becomes in-
 satiable, and seems  to* exist  in  a  direct ratio  to
 the quantity of watery fluid poured forth by the
 discharges, and to depend thereon.   It seems to
 arise from an instinctive desire and urgent  demand
 to supply the waste and drainage of the  system.
 The whole body shrinks, the features become con-
 tracted, pointed, peculiar, (choleric countenance,)
 the eyes deeply sunken in their sockets, balls rolled
 upwards, or natural, expressing great suffering, ot
 total  indifference.   The skin is as cold as a corpse,
 and moist, of a bluish hue,  varying  both  m inten-
 sity of color,  and extent of surface it occupies; 
 130             SIMPLE  DIRECTIONS
 the hands and feet particularly are shrivelled and
 corrugated, and greatly shrunken, having  lost at
 least one-third of their  bulk, and  look  as if long
 macerated in water, (like a wash-woman's hand,)
 the pulse is scarcely discernible or extinct, and the
 action of the heart  feeble;  the  air enters the
 lungs, but respiration is laborious, with a sense of
 suffocation  from  the changed  condition of the
 blood, that prevents the full vivifying influence of
 the air on it—the spisaidity being such, that it does
 not flow in its usual channels,  which expose so
 great a surface to the action of the air throughout
 its minute and  abundant  capillaries.  The  voice,
 enfeebled and  greatly  diminished,  has  become
 husky and nearly extinct, and the demand it makes
 is still for cold drinks—ice water.   They complain
 of being parched, burning up, and yet the whole
 surface is icy cold, and possesses an exalted sensi-
 bility: sinapisms, blisters, &c„  are loudly com-
 plained of as burning  like  fire—insupportable;
 even the  hand of a healthy person, brought in con-
 tact with a collapsed cholera patient, I have heard
 loudly complained of  as burning.  The tongue is
 cold, broad, flat  and  dry, or mucous and pasty;
the abdomen retracted.   In short, the whole body
has become collapsed.   The blood, changed in its
 character, deprived of its water portion, no longer
traverses its accustomed  rounds, but  collects in 
          FOR THE TREATMENT OF CHOLERA.      121
the heart and veins, especially the larger  trunks,
in undue quantity.   This change of place, arising
from a change in the spissidity of the blood, gives
rise in  its turn  to  other  changes.  There  is no
arterial blood;   there  is  no  secretion, perhaps,
except that of bile, for, as before stated, the  blood
has forsaken the arteries, and  retreated into the
veins*

   ThoUghout all this  frightful  havoc of the phy-
sical frame, the  mind  moves calmly, clearly, self-
possessed, and begins to feel the destructive influ-
ence, or  is gone (with  but few  exceptions, only
when the  brain has to be supplied with aerated
blood—*-only  when  the individual  is  in  articulo
mortis.

   The fourth stage  seldom occurs.   But when  an
individual becomes  collapsed and lives through it,
the fourth stage is present; it  is one of reaction,
resembling typhus.

      «.            TREATMENT.

   It is always of great, and sometime even of vital
 importance,  that the patient should lie in bed.

   In the first stage give calomel and opium, accord-
 ing to the nature and frequency of the stools. 
122
SIMPLE DIRECTIONS
   I have usually commenced  in ordinary cases
by giving one  of  the  following pills after  each
loose evacuation, viz 2 calomel thirty grains, pow-
dowered  opium six grains;  mix intimately,  and
divide into six pills.

   In this way, in the  course of a few hours, you
will probably give twenty grains of calomel and
four cases of opium, which, in ordinary cases, will
generally prove sufficient, and even in most severe
cases you will have administered as much calomel
as will be necessary.

   When this has proved sufficient, the evacuations
will have become far less frequent, and changed
in character,  especially in  consistence.   In  this
early stage the danger is greater the more frequent
and the thinner, or more liquid and watery the
stools may become.   You can continue, therefore,
to give  one of the  calomel and  opium pills  after
each  evacuation, if of  this character,  until  the
whole six are taken;  and if  the passages still con-
tinue, it becomes necessary to continue the opium
as follows :

  Powdered opium, six  grains; powdered cam-
phor, twelve grains ; mixed  intimately, and made
into «ix pills,  giving  one  of the  pills after each
evacuation.   Rest in bed, fomentation or flaxseed 
FOR THE TREATMENT OF CHOLERA.      123
poultices  applied  to  the  abdomen, and mustard
plasters and  warm mustard foot-baths prove also
highly beneficial.

  When the attack is sudden  and  severe, give at
one  dose twenty  grains of calomel  and two  of
opium, and repeat the opium and camphor pills as
directed, and use the  sinapisms, poultices, &c.
  In the second period, when the watery evacua-
tions set in, they either resemble in fluidity and
color a mustard foot-bath, or  are of a rice-water
character, with a white powder settling at the bot-
tom of the vessel, or  watery,  with white flocculi
or flakes  interspersed in  it, making it somewhat
turbid, looking  like  whey.  The voice  fails also,
 and cramps or spasms come  on  in the legs, arms,
 and sometimes in the bowels.

   The case is now extremely urgent, and unless
 the  watery discharges can be arrested, the patient
 must pass into  the collapse,  from which there is
 little if any hope.
   I have been in the habit of giving sugar of lead
 and opium in the following way, in pills:

   Sugar of lead, one drachm; powdered opium,
 twelve  grains;  mix intimately,  and make  into
 twelve pills,   tiive one alter every watery evacuo- 
124             simple  Dntr.cTio'js
tion, and if these are copious, oftener, or in larger
doses, say two pills at.a time.

  Or it may be given by injection, thus :

  Take sugar  of  lead  one drachm ;  dissolve in
water six ounces, (three wineglasses full,) and add
a teaspoonful of laudanum, and give  half us an
injection, and repeat as  may be necessary.

  To allay the distressing nausea, vomiting, and
insatiable thirst, (in this  and the following stage of
collapse,) use—

  Crcesote,  four drops; mucilage of gum arabic,
or flaxseed tea, one tablespoonful, shake well toge-
ther, and give a teaspoonful four or five times every
day, or oftener, as may  be necessary.

  As in this  stage  they are about  to pass  into
collapse if it is not stopped, the use of stimulants
soon becomes necessary.  I have used champagne
brandy  toddy and carbonate of ammonia,  as fol-
lows :            /

  Carbonate of ammonia, two drachms; powdered
gum  arabic, two  drachms; water,  three wine-
glasses full;  mix, and give a  tablespoonful every
fifteen <ninutes or  half-hour, as may be necessary,
using at the same  time  the brandy or wine alone 
         FOR THE TREATMENT OF CHOLERA.      125
Direct sinapisms  and blisters over the  pit of the
stomach and to the extremities.  The spasm9 are
sometimes  distressingly  severe  in this  period.
They ate greatly relieved by friction with No. 6,
(Thompsonian remedy,) heated and used as a lini-
ment, or red pepper and whiskey heated together.

  In the collapse little can be done except giving
the croesote mixture, a teaspoonful every two or
three hours, and using the stimulants above-named
as freely as they can be  borne.  Apply blisters
and sinapisms, and give warm chicken-broth either
by mouth or as an injection.   Give also as a stimu-
lant the following:

   Powdered camphor, two  drachms;  Hoffman's
anodyne, two ounces; mix from a teaspoonful to
a tablespoonful at a dose, and repeat according to
the effect.

   This remedy, in the dose a teaspoonful three or
 four times a day, in half a wineglass full of cold
 water, is an  excellent remedy, in the premonitory
 and forming stage, for the looseness and griping.

   The fourth period is treated like typhus.

   In all the  foregoing it will  be  seen  that opium
 is the great remedy, and the calomel and sugar of 
126
SIMPLE DIRECTIONS
lead its main adjuvants.   Their action, to my mind,
in affording relief, is easily explained.
  From  careful examination of the symptoms of
the disease, it is readily seen that its first manifes-
tations are all referable to  the alimentary canal;
there is an  exalted  sensibilty  of the stomach and
bowels at the first outset—an uneasiness that very
speedily results  in loose dejections;  an irritation
seems to be  set up  throughout  the  alimentary
canal, the peristaltic movements become  rapidly
increased—the  secretions  are  profusely  poured
forth, becoming thinner and thinner, while the irri-
tation augments until it resembles somewhat that
caused by the hydragogue cathartics, such as ela-
terium, but which in its action far outstrips them
in effect.  When it  arrives at its  height,  the dis-
charges consist solely of the watery portion of the
blood, separated from it throughout the whole ex-
tent of the intestinal tube.

   That the cause of this disease is poison, I cannot
decide   It certainly does .not enter the blood, or
if it does, opium is a certain antidote to it.   It
Beema more reasonable to me to regard  it as acting
on the nervous system  at  large—in a  way some-
what analagous to fear, causing a reflux of blood
on internal parts, looseness and  relaxation of the 
         FOR THE TREATMENT OF CTIOLERA.       127
bowels, and sphincters,  and a  sensation of faint-
ness and sinking.
  There is no  disease milder  in  its first attack—
none more frightful and fatal if neglected.   Like
a hay-rick on fire, at its  outset a grasp of the hand
may extinguish it—neglected a few moments, de-
struction is inevitable. 
 
NOTES
BY  THE  AMERICAN  EDITOR.
  1. Dysentery-.—In the month of September, 1843, H.M. W., Esq., of
the city of New-Vork, placed his youngest  son, fifteen months old,
under my care, after he had been abandoned by the physicians who
first treated him.  They considered his case  a hopeless one. I found
the child reduced to a skeleton.  The intestines had lost all power to
retain any thing. The discharges from the boweU were bloody, very
otfensive, and incontinently ejected.  Such had been the state of this
child's bowels for three days previous to my seeing it.  My mode ol
treatment was  as follows :—Calomel, one eighth of a grain;  pulv.
ipecac, grains 2;   sulphate  of quinine, grains 2;  pulv.  doveii,
grains  3; prepared chalk, grain? 4.  These  powdeis  were mixed to-
gether and  divided into six portions, one of which was given every
four hours.  At the same time, I used an injection composed of tha
following articles: Chloride of lime, 30 grains to 8 ounces of water,
adding to it tincture of opium  one tea-spoonful. Of this I injected
three or four times the first day.  The day following I increased  the
lime 10 grains.  This treatment acted like a  chaim.  The discharges
were changed from a  bloody mucous to  mucous.   Second  Day's
Treatment.—Made a strong decoction of black tea, added to it pul-
verised gum-arabic two table-spoonfuls, one tea-spoonful of lauda-
num ; injected three times a day, and, at the  same time, gave pulver-
ised rhubarb, grains 4; sulphate of quinine, grains -2,  pulverised cin-
namon, grains 4; prepared chalk, grains 4 ; sugar of lead, grains 3:
mixed together anil divided into 8 powders.   Gave one in molasses
every three hours.  To produce sleep, when necessary, I gave pulv.
doveii, grains 4.  The diet during the treatment consisted of flax-seed
tea, arrow  root, and calves'-feet jelly.  By this treatment the patient
was thoroughly cured, although his  life had been despaired of, and
his case appeared incurable.


  2. DiscHARfiE  krom the Ear—Miss C. applied to me in  June, 1843,
and stated  that she had been afflicted with  a very troublesome and
offensive discharge from  her  left ear for ten years.   She had tried
many remedies, and adopted the prescriptions of many skilful physi-

L TrVTi Jin".—ordered her bowels to be opened witn a dose of salts.
Thcdav  alter, z*vo her tho compound preparation of sarsapanlla.
To every eight ounces I added one grain ol corrosive sublimate—« 
130        NOTES  BT  THE AMERICAN E1JITOR.
tea-spoonful of the mixture to be taken four times a day, and con-
tinued until a cpi erish taste was felt in the mouth.  Every other
day I applied cauniic to a fungus growth ot flesh growing in the bot-
tom of the ear.   Alter  six or eight  aj plic tions, I made use of the
following injection :—Caustic, -26 giains to an ounce of water, inject-
ed with a glass syringe into the ear once every day for several days,
when all the  discharge ceased.  I then injected, every thud day, a
tolerably strong  soluUon of alum water;  and in  two weeks the ear
was well.

  3. Painful and Irreoi'lar Menstruation.—Females, residing in this
cold and changeable climate, are so frequently troubled and alarmed
in consequence of a partial or total suppression of the menstruating
process, that 1 consider it th*duty of every physician  to give them as
much light on the subject as  practicable.  Almost all females, par-
ticulaily motheis, are well acquainted with the  symptoms which ac-
company irregular and painful menstruation.  1 will only give a few
of the most prominent.  Severe pains in the back, loins, and lower
part of the abdomen, are usually felt six or eight hours previous to
the appearance of the menstrual discharge.  Sometimes the catauie-
nia will begin to flow quite freely, and without much pain, and, all
of a sudden, they will be arrested, an'! the pains will  come on more
violently than ever in the hips, loins, back, and thighs, with a very
great bearing  down in the pelvis.  Sometimes a very slight  discharge
will continue for several days, accompanied with the most excru-
ciating pains in those parts of the body already mentioned.  Females
are not unfrequently thrown into a high state of fever, or experience
sickness of the stomach, vomiting, dizziness and  pain in the head.
As  the application of cold is most commonly the exciting cause to
the interruption of the menstrual discharge, females  should be very
careful not to expose themselves to cold thinly clad, or get their feet
wet, just before their courses  are  expected.  But should  such a state
of things occur as has been described above, no time should be lost In
resoiting to the means best adapted to the restoration  of health.
  In the first place, the most simple and palliative remedies should
be resorted to, unless  there is high arterial excitement, and contrary
symptoms are indicated.  One ounce of salts should  be  taken, ana,
after it has commenced to operate,  bathe the  feet in warm water,
with half a handful of mustard added to it.  Then  let the patient be
placed In bed, covered with several blankets, and drink freely of hot
teas or hot lemonades ;  and, if free  perspiration can be induced, the
desired object will  usually be obtained.  Should  these applications
fail, take pulv. doveri, grains 28; camphor, grains 16: mix, and di-
vide into five powders. Take one in molasses every two or three
hours. Warm hip baths are often very useful; bathing the whole
body in warm water is better.   I have known  dancing  in  a warm
room to bring on a profuse discharge, after many remedies had failed.
Horf-back  riding is frequently resorted to with  succet.8.  The fol-
lowing prescription will, not unfrequently, be serviceable:—Muriate
tinct. of fern.  Commence by taking five drops three times a day, and
increase the dose every day three drops, until it amounts to 30 or 36
drops at a dose.  Aloetic pills are frequently very effective—three
taken every third or fourth night. The  sulphate of iron, 1 grain
to a pill, made up with soap and a few drojis of the oil of c innamon.
is a  good prescription.   Two or  three of these pills, takea everj 
NOTES  BY  THE AMERICAN EDITOR.
131
Other flight for several  weeks, have  frequently restored  difficult
menstruation.   Should there be a hard full pulse, with  sickness at
the stomach, fever, vomiting, pain and dizziness in the head, no lime
should be lost in  relieving the patient  of trom fifteen to twenty
ounces of blood ; and, in this most distressing complaint, I am con-
vinced, from experience, that blood should  be drawn from one or
both of the feet, in preference to the  arm.  To obtain the  greatest
benefit from blood-letting  in such cases, a large oiifice should be
made in one of the  veins on Ihe foot,  (being careftil not to wound
the tendons beneath,) and  placing it into warm water,  so that the
lequind quantity could  !>e obtained as  quickly as possible.  The
bowels should then be freely opened with a dose of salts, the patient
placed in bed, and the following administered:—Take lart. emetic,
grains 3; water, 8 ounces :  a table-spoonful to be taken every twenty
or forty minutes.  After all excitement has been allayed, and  some
time has elapsed without any appearance of the catamehia, the fol-
lowing prescription will  most usually bi ing it on:—
  Receipt— Infus. cascarillse, 1 1-2 ounces ; tinct. 3ibinas, comp.» 1
drachm ;  au.  pimentae,  1-2 an  ounce ; syrup of ginger, 1 drachm :
take a tea-spoonful everv four hours.   Pills composed ot myrrh and
aloes are among the most useful purgatives in this disease.

  4. Pkecnancy.—In May, 1842, Mrs. J.  consulted me, and stated that
she had heen married nearly three years;  and although  she enjoyed
tolerably good health, anil was regular in her monthly courses, preg-
nancy had never taken place. Her object was, to know  whether
 anv hope of offspring could be held  out to her.   I suggested  hat
 there might be some obstruction at the mouth of the womb, and that
 if such weie the fact, and it could be removed, pregnancy might iul-
 low.  She at once submitted to the operation ot passing a bougie into
 the womb, and, in three weeks after, she became pregnant.
   A Similar Case.—In the early part of January, 1843, Mrs. W.  appli-
 ed to me for advice on  the same subject. I recommended  and per-
 f< rme.l the same operation, and pregnancy soon followed.

   5.  Leucorrhea, &c— Watery Discharges — Purulent.Discharges-
 Transparent  Mucous Discharges —Sanguineous Discharges—White
 Mucous Uischaiges.  Nearly all females aiemoieor less tioubledwith
 discharges of these kinds-differing in consistence and abundance, but
 niwa'vs weakening  to the constitution,  and occasionally ottensive.
 nTs  mpossi^effr me  to go  into all .the  details  relating to those
 rnmi.Hints necirliar to the Female sex, in these short notes  ; but it is
 mS» thit in nine cases out often, these moibid •f^."nsc.n
 niy oj m on            d judicioul course ot treatment, where all
 Ki Unffiee^Thlly  develop  to the physician.
  And it Uves me ereat pleasure to have it in my power to state, fiom
  eS ef « thatlur fe'inales are daily becoming wise on th« subjec ,

  iX5SMeeting, as it^^^^^^^er ^Vl




  child, four years previous to  £»  dale, sw  ru.u               bur_

  &hS^t«lC^^ra"ffi^riS had suffered all this 
*
132         NOTES  SV  THE AMERICAN  EDITOR.

time rather than make her condition known  to a physician.  I made
an examination, and found that the discharge came from the uterus
altogether, and was of a thick  and ropy nature.   For  the treatment
of this case, I made use of a solution of the a et. of flunibi, commenc-
ing with 6 g ains to the ounce,  and  increasing It to 40.  My next in-
jections were of the sulph. copper ; and the  last, a very ftiong solu-
tion of nit.'argent.: all of which I threw directly into the uleius.  I
recommended cold bathing and shower baths, to be taken altematt ly
three or four times a week—at tho fame time  to take intern.lly comp.
linct. of gent., a table-spoonful three times  a day ;  advising her to
take as much out-door exercise, tiding, &c, as she could.  I allowed
her a  generous diet, and kept  the  bowels open with falls, senna,  and
manna.  In twelve weeks aftci  the commencement of th.s treatment,
she had improved in her general health very  moch, and the  dis-
charges were much abated.  I now gave her pills composed of the
carbonate of iron, sabinx, and oil ol cinnamon.   This, together with
the sulphate of  quinine, restored  her to perfect health five months
after I first saw her.
THE END. 
 
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