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    Domejiic  Medicine:


                 OR, A

             TREATISE

                  ON

    THE PREVENTION AND CURE

                  OF


        DISEASES,

  BY REGIMEN AND SIMPLE MEDICINES.

                 WITH

          An APPENDIX,

CONTAINING A DISPENSATORY FOR  THE USE OF
         PRIVATE PRACTITIONERS.

      BY WILLIAM BUCHAN^ M. D.
  FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS,
               EDINBURGH!


       REVISED AND ADAPTED TO THE

Difeafes and Climate of the United States of America,

  BY SAMUEL POWEL GR1FFITTS, M. D.
LATE PROFESSOR OF MATERIA MEDICA IN THE UNIVERSITY
             OF PENNSYLVANIA.
3 3l2cto OEtntion.
             PHILADELPHIA:

PRINTED BY A. BARTRAM, FOR THOMAS DOBSON,
 AT THE STONE-HOUSE N° 41 SOUTH SECOND STREET.
1805. 

C^ 
   Preface  of the  American  Editor,


       lT is  not  neceflary to enter into a de-*
tail of my reafons  for the prefent  publication.
Doctor  Buchan's  Domejiic Medicine has  long
fince  had a place in moft families ; but, al-
though it is one of the moft fenfible and judi-
cious  performances of the kind that has hither-
to appeared,  yet  it is evidently  not adapted
to  the  climate  and difeafes  of the United
States of  America.  I thought this deficiency
might be remedied, and accordingly undertook
the talk ; and although the alterations and ad-
ditions have been very numerous, yet I can truly
fay, none have been made with any other view
than that of rendering the book more ferviceable.
As to medical reputation, I am well aware this
is not the way to obtain it; but if I have fucceed-
ed in  making  this  valuable and popular work
more  intelligible, and confequently more ufeful,
to my fellow-citizens; I (hall be fufficiently re-
warded.
             SAMUEL POWEL GRIFFITTS,
   Philadelphia, 1
  May, 18/A, I795-J
1 
 
PREFACE,

   (Br Dr BUCHAN.J
           VvHEN I firft fignified my intention of
 publifhing the  following meets, I was told  by my
 friends it  would draw on  me the refentment of the
 whole faculty.   As I never could entertain fuch an
 unfavourable idea, I was refolved to  make the ex-
 periment, which indeed came out pretty much as might
 have been expected.   Many whofe learning and li-
 berality of fentiments do honour to medicine, received
 the book in a manner which at once ihewed their in-
 dulgence, and the falfity of the opinion that every phy-
ftcian wifhes to  conceal his art; while the more felfiih
 and  narrow-minded,  generally the moft numerous in
 every profeflion, have not failed to perfecute both the
 book and its author.                            >■
   The reception, however, which this work has met
 with from the public merits my moft grateful ac*
 knowledgmcnts.  As the belt way of exprefling thefe,
 I have endeavoured to render it more generally ufe-
 ful,  by enlarging the prophylaxis, or that part which
 treats  of  preventing  difeafes;  and by adding many
 articles which had been entirely omitted in the former
 impreffions.  It is needlefs to enumerate thefe  addi-
 tions ; I lhall only fay, that I hope they will be found
 real improvements.
                       a t.                   The 
vJ               PREFACE.
   The obfervations relative to Nurfing and the Ma-
nagement of Children,  were chiefly fuggefted by an
extenfive  practice among infants, in  a large branch
of the Foundling Hofpital, where I had  an oppor-
tunity not only of treating  the  difeafes incident to
childhood, but likewife  of trying different plans of
nurfing,  and obferving their  effects.   Whenever I
had it in my power to place the children under the
care of proper nurfes, to iiiftruct thefe nurfes in their
duty, and to be fatisfied that  they performed it, very
few of them died ; but when, from diftance of place,
and  other unavoidable circumftances, the  children
were  left to the fole care of mercenary nurfes, with-
out any ptrfon to inftructor Superintend them, fcarce
any of them lived.
   This was fo apparent, as with me to  amount to
a proof of  the following melancholy fact:  That al-
mofc one half of'the human fpecies perifh in infancy, by
improper management or  ncglecJ.  This reflection has
made me  often  \vifh to  be the happy inftrument of
alleviating the miferies  of  thofe Suffering innocents,
or of rcfcirng  ihcm from  an untimely grave.  No
one,  who has not had an  opportunity of obferving
them,  can   imagine  what  abfurd  and  ridiculous
practices ftill prevail in the  nurfing  and manage-
ment  of infants, and what numbers of lives are by
that  means  loll to fociety.  As thefe practices are
chiefly ovm* to ignorance,  it is to be hoped, that
when nurfes are better informed,  their conduct will
be more proper.
  The application of medicine to the various occu-
pations of life has been in  general the refult of ob-
fervation.   An extenfive practice for feveral years,
in one of the largeft manufacturing'' towns in Eng-
land,  afforded me  Sufficient  opportunities of  ob-
ferving the injuries which thofe ufeful people fuftain
from their particular employments, and likewife  of
       1                                   trying 
PREFACE.
vii
 trying various methods, of obviating fuch injuries*
 The  fuccefs  which  attended  thefe  trials was Suffi-
 cient to encourage this attempt, which I hope will be
 of ufe to thofe who are under the neceffity of earning
 their bread by fuch employments as are unfavourable
 to health.
   I do  not mean to intimidate men, far lefs to in-
 finuate that  even thofe arts, the  practice of which
 is attended with fome degree  of danger, Should not
 be carried on ; but  to  guard  the lefs cautious and
 unwary  againft  thofe dangers wich  they have it in
 their power to avoid, and which they often, through
 mere ignorance,  incur.   As every occupation in life
 difpofes thofe who  follow it  to fome particular dif-
 eafes more than  to others, it is certainly of impor-
 tance to know thefe, in order that people may be up-
 on their guard againft them.   It-is always better to
 be warned of the approach of an enemy,  than to be
 furprifed by him,  efpecially where there is a poilibility
 of avoiding the danger.
   The obfervations concerning Diet,  Air, Exercifc,
 &c.  are of  a more general nature, and have not
 efcaped the attention of phyficians in any age.  They
 are Subjects  of too great importance, however, tc»
 be parted over in an attempt of this kind,  and caii
 never be Sufficiently  recommended.  The man who
 pays a proper attention to thefe,  will feldom need
 the phyiician  ; and he who does not, will feldom en-
joy health, let him employ as  many phyficians as he
 pleafes.
  Though we have endeavoured  to point out the
 caufes of  difeafes,  and to put people  upon their
 guard againft them, yet it muft be acknowledged,
 that  they are often of fuch a nature as  to admit of
 being removed only  by the  diligence and activity
 of the public magiftrate.  We are  forry, indeed,
 to obferve, that  the power of the magiftrate is fel-
                       a  4                   doirt 
viu
PREFACE.
dom exerted in this country for the prefervation of
health.   The  importance of a proper  medical  po-
lice  is  either  not  underftood,  or  little regarded.
Many  things  highly  injurious  to  the  public health
are daily practifed with impunity, while others, ab-
folutely neceffary  for  its prefervation,  are  entirely
neglected.
   Some of the public means  of preferving health
are mentioned in the general prophylaxis,  as the
inflection of provifions, widening the Streets of great
towns, keeping them clean, fupplying the inhabitants
with wholefome water, &c.; but they are paSTed over
in a very curfory manner.   A proper attention tq
thefe would have fwelled this  volume to too large a
Size ;  I have therefore referved them for the Subject
of a future publication.
   In the treatment of difeafes,  I have been peculiar-
ly attentive to regimen.   The  generality of people
lay too much ftrefs  upon  Medicine,  and truft too
little to their  own  endeavours.   It is always  in the
power  of the patient, or of thofe about him to do
as much towards his recovery as  can  be effected
by the phyfician.   By not attending to this  the de-
figns of Medicine are often fruftrated ; and  the pa-
tient, by  purfuing a  wrong  plan of  regimen, not
only defeats  the Doctor's endeavours, but  renders
them dangerous.   I have often known patients killed
by  an  error in regimen,  when they were ufing very
proper  medicines.   It  will  be faid,  the  phyfician
always  orders the regimen  when he  prescribes a
medicine.  I wifh it were fo, both for the honour of
the Faculty and the fafety of their patients: but phy-
ficians, as well as other people, are too little attentive
to this matter.
   Though many reckon  it doubtful whether phy-
fic is more beneficial or hurtful to  mankind, yet all
allow the neceffity and importance of a proper regi-
                                             men 
                PREFACE-               i?
men in difeafes.   Indeed the very appetites of the
fick prove its propriety,  No man in his fenfes ever
imagined that a perfon in a fever, for example, could
eat, drink, or conduct himfelf in the fame manner as
one in perfect health   This part of medicine, there-
fore,  is evidently founded  in Nature,  and is every
way confiftent with'reafon and common fenfe.   Had
men been more attentive to it,  and lefs folicitous in
hunting after fecret remedies, Medicine  had never be-
come  an object of ridicule.
  This feems to  have been the firft  idea of Me-
dicine.  The ancient  phyficians acted  chiefly in the
capacity of nurfes.  They went very  little beyond
aliment in their  prefcriptions;  and  even this  they
generally adminiftered themfelves, attending the fick
tor  that purpofe through the  whole courfe  of the
difeafe ; which gave them an opportunity  not  only
of marking the  changes of  difeafes with  great ac-
curacy, but likewife of obferving the effects of their
different applications,  and  adapting  them  to  the
fymptons.
  The learned Dr Arbuthnot afferts, that by a pro-
per attention to thofe things which are  almoft within
the  reach  of every body, more good  and lefs mif-
chief will be done in acute difeafes, than  by medi-
cines improperly and unfeafonably adminiftered ; and
that great cures  may be  effected in chronic  diftem-
pers,  by a proper regimen of the diet only.   So en-
tirely  do the Doctor's fcntiments and mine agree, that
I would advife every perfon, ignorant of phyfic, to con-
fine his practice folely to diet, and the other parts of
regimen; by which means he may often do much good,
and can feldom  do any hurt.
  This feems alfo to have been the  opinion  of the
ingenious Dr Huxham, who obferves,  that we often
Seek from Art what all-bountiful Nature moft rea-
dily,  and  as effectually, offers us, had we diligence
                                             and 
x               PREFACE.
 and  fagacity enough  to obferve and  make  ufe of
 it ;  that the dietetic  part  of Medicine  is not fo
 much Studied as  it ought  to  be ; and  that, though
 lefs pompous, yet it is the  moft natural method of
 curing difeafes.
   To render the book  more generally  ufeful,  how-
 ever,  as  well  as  more acceptable to the intelligent
 part of mankind,  I have in moft difeafes,  befides re-
 gimen, recommended fome of the moft Simple and
 approved forms of medicine, and added fuch cau-
 tions and directions as feemed neceffary  for their fafe
 adminiftration.  It would  no doubt have been more
 acceptable to many, had it abounded with pompous
 prefcriptions, and promifed great cures in confequence
 of their ufe ;  but  this was  not my plan  ; I  think the
 adminiftration of medicines always doubtful, and often
 dangerous,  and would  much  rather teach  men how
 to avoid the neceffity of ufing them,  than how they
 fhould be ufed.
   Several medicines,  and thofe of confiderable ef-
 ficacy,  may be adminiftered with great freedom and
 fafety.  Phyficians generally  trifle a long time  with
 medicines before they learn their proper  ufe.  Many
 peafants at prefent know better  how to uk fome of
 the moft important articles in the materia ?nedica, than
 phyficians did a century ago ;  and doubtlefs the fame
 observation will hold with regard to others fome time
 hence.  Wherever I  was  convinced  that  medicine
 might be ufed with fafety, or where the cure depend-
 ed chiefly upon it,  I have taken care to recommend
 it; but  where it was either  highly dangerous, or not
 very neceffary, it is omitted.
   I have not troubled the  reader  with an ufelefs
parade  of quotatious  from  different authors, but
have in general adopted their observations where
my own were either defective, or totally wanting.
Thofe to whom I  am moft obliged are, Ramizini,
                                      Arbuthnot, 
PREFACE.
xi.
Arbuthnot, and Tiffo.t ;  the laft of which,  in his
Avis au Peuple, comes the nearefl  to my views of
any author that  I have  feen.  Had the  Doctor's
plan been  as complete as the execution is  maflerly,
we Should  have had no occafion for any new trea-
tiSe of this kind foon j but by  confining himfelf to
the  acute  difeafes, he has  in my opinion omitted
the moft ufeful part of his fubject.   People in acute
difeafes may fometimes be  their  own  phyficians ;
but  in the  chronic,  the  cure muft  ever depend
chiefly  upon the patient's own endeavours.   The
Doctor has alfo paffed over the Prophylaxis, or pre-
ventative part of Medicine, very flightly,  though, it
is certainly of the greateft importance in fuch a work.
He  had no  doubt his reafons  for fo doing, and I
am fo far from finding fault with him,  that I  think
his performance does great honour both to his head
and to his heart.
   Several other foreign phyficians of eminence have
written on  nearly the fame plan with Tiflbt,  as  the
Baron Van Swieten, phyfician to their Imperial Ma-
jefties,  M. Rofen, firft phyfician of  the kingdom of
Sweden, &c. j  but thefe gentlemen's  productions
have never come to  my hand.   I cannot help wish-
ing, however,  that fome of  our diftinguifhed  coun-
trymen would follow their example.  There flill  re-
mains much to  be done on this fubject,  and it does
not appear to me how any man could better employ
his time or  talents, than in eradicating hurtful pre-
judices, and diffufing ufeful  knowledge among  the,
people.
   I know fome of the Faculty difapprove  of  every
attempt of this nature,  imagining that it muft totally
deftroy their influence.  But this notion appears to
mc to be as abfurd as it is illiberal.  People in M-
trefs will always  apply for relief to men  of fupe- 
  xii               PREFACE.
  rior abilities, when they have it in their power ; and
  they will cjo this with far greater confidence and rea-
  dinefs  when they believe  that medicine is a rational
  Science, than when they take it to be only  a matter
  of mere conjecture.
    Though I have endeavoured to render  this  Trea-
  tife plain  and  ufeful,  yet  I found it impoffible to
  avoid  fome terms of art; but  thofe are in general
  either  explained,  or are  fuch  as moft people under-
  stand.   In Short, I have endeavoured  to conform my
v Style to the capacities  of mankind in general;  and,
  if my  readers do not flatter either themfelves or me,
  with fome degree of fuccefs.  On a medical fubject,
  this is not fo  eafy a matter as  fome may  imagine.
  To make  a fliew of learning is eafier than  to write
  plain fenfe, efpecially  in  a Science which has been
  kept at fuch a diftance  from common obfervation.  It
  would however be no  difficult matter to prove,  that
  every  thing valuable in the practical part of Medicine
  is within  the reach of common abilities.
    It would be ungenerous not to exprefs my  warm-
  eft acknowledgments to thofe gentlemen who have
  endeavoured to extend the ufefulnefs of this  Per-
  formance, by tranflating it  into the language of their
  refpective  countries.   Moft of them have not  only
  given  elegant  tranflations of the Book, but have alfo
  enriched it with many  ufeful obfervations; by which
  k is rendered more  complete, and better adapted to
  the climate and the conftitutions of their countrymen.
  To  the learned  Dr Duplanil  of Paris, phyfician  to
  the Count d'Artois, I lie under particular obligations ;
  as this gentleman has not only confiderably enlarged
  my Treatife,  but, by  his  very ingenious and ufeful
  notes, has rendered it fo popular on the Continent,
  as  to occafion its being translated into all  the langua-
  ges of modern Europe.
                                             I  have 
PREFACE.
x'ii
  I have only to add, that the book has not more
exceeded my expectations in its fuccefs,  than in the
effects it has  produced.   Some of the moft pernici-
ous practices,  with regard  to the treatment of the
fick  have  already given place to  a  more  rational
conduct; and many  of  the moft  hurtful prejudices,
which feemed to be quite infurmountable,  have in
a great  meafure yielded to better information.  Of
this a ftronger inftance cannot be  given than in the
inoculation of the fmall-pox.   Few mothers,  fome
years ago, would fubmit to have their children ino-
culated, even by the hand of a phyfician ;  yet no-
thing is more certain; than  that of late many of them
have performed  this operation with their own hands;
and as their fuccefs has been equal to that of the moft
dignified inoculators, there is little reafon to doubt
that the practice will become general.   Whenever
this fhall be the cafe, more lives will be faved by ino-
culation alone, than are at prefent  by all the endea-
vours of the Faculty. 
 
INTRODUCTION.
           1 HE  improvements in Medicine, fince
the revival of learning, have by no means kept pace
with  thofe of the  other  arts.  The reafon is ob-
vious.  Medicine has been  ftudied by  few, except
thofe who intended to live by it as a trade.  Such,
either from a miftaken zeal for the honour of Medi-
cine,  or to raife their own importance, have endea-
voured  to difguife and conceal the art.   Medical au-
thors have too  generally  written  in a  foreign lan-
guage ;  and thofe who were unequal to this tails:, have
even  valued themfelves upon couching, at leaft, their
prefcriptions, in terms and characters unintelligible to
the reft of mankind.
   The  contentions of the clergy, which happened
fbon after  the reftoration of learning, engaged  the
attention  of mankind, and  paved the way for that
 freedom of  thought and inquiry,  which  has fince
prevailed  in moft parts of Europe  with regard to
religious matters.  Every man took a fide  in thofe
difputes ;  and  every gentleman, that he might dif-
tinguifh himfelf on  one fide or other,  was  inftruc-
ted  in  Divinity,  This taught people to think  and
reafon for themfelves in matters of  religion, and at
laft,  in a degree, deftroyed that complete  and abfo-
 lute dominion which the clergy had obtained over the
 minds of men.
   The  ftudy of Law has likewife,  in moft civilized
 nations, been juftly deemed a neceffary part of edu-
 cation.   Every  man ought certainly to know at leaft:
 the laws  of his  own country; and, if  he  were alfo
                                       acquainted 
xvi          INTRODUCTIO N.
  acquainted with thofe  of others, it might be more
  than barely an  ornament to him.
    The different branches of Philofophy have alfo of
  late been very univerfally fludied by all who pretend-
  ed to a  liberal  education.  The advantages of  this
  are manifeft.  It frees the mind from  prejudice  and
  fuperftition ;  fits it for the inveftigation of truth;
  induces  habits of reafoning  and judging  properly;
  opens an inexhauftible fource of entertainment;  paves
  the way to the improvement  of arts and agriculture ;
  and qualiftes men for acting with propriety in the mofl
  important ftations of life.
    Natural Hiftory  is likewife  become an object of
 general attention ; and  it well deferves to be fo.   It
 leads to difcoveries of the greatefl importance.   In-
 deed agriculture, the mofl ufeful of all  arts, is only a
 branch of Natural Hiftory, and can never arrive  at
 a high  degree of improvement  where the fludy of
 that fcience is  neglected.
   Medicine however has  not,  as far as  I know, in
 any country, been reckoned a neceffary part of edu-
 cation.   But Surely  no Sufficient reafon can be affign-
 ed for  this  omiffion.  No fcience lays open a more
 extenfive field of ufeful knowledge, or affords more
 ample entertainment to an inquifitive mind.   Anato-
 my, Botany, Chemiftry, and the  Materia Medica,
 are all branches of Natural Hiftory, and are fraught
 with fuch amufement and utility, that the man  who
 entirely neglects them has but a forry claim  either to
 tafle or learning.  If a man has a turn for obfervation,
 fays an excellent and fenfible writer*, furely the na-
 tural hiftory of his own  fpecies is a more  interefting
 fubject, and prefents  a more ample field  for the exer-
tion of genius, than the natural hiftory of fpiders and
cocklerfhells,

  * Obfervations on the Duties and Offices of a Phyfician.
                 4                            We 
INTRODUCTION.
xv ii
   We do not mean that every man Should become
a phyfician.   This would be an attempt as ridiculous
as it is impoffible.   AH we plead for is, that men of
fenfe and learning Should  be fo  far acquainted with
the general  principles of Medicine, as to  be  in  a
condition to derive from it fome of thofe advantages
with which it is fraught;  and at the  fame time to
ruard  themfelves againft the destructive influences
of Ignorance, Superftition, and Quackery.
   As matters ftand at prefent,  it is eafier to cheat
a man out of his  life than  of a fhilling, and almoft
impoffible either  to detect  or punifh  the  offender.
Notwithstanding  this,  people ftill  Shut  their  eyes,
and take every thing upon truft that  is adminiftered
by any  Pretender to Medicine, without  daring. to
aik him a reaSon for any part of his conduct. Implicit
faith, every where elfe the object of  ridicule,  is ftill
facred  here.  Many of  the faculty are  no  doubt
worthy of all the   confidence that can be repofed in
them ;  but as this  can  never be the character of
every individual in any profeffion, it  would certainly
be for the fafety, as well as the honor of mankind,
to have fome check  upon the conduct of  thofe to
whom they entruft fo valuable a treafure as health.
   Medicine,  however,  needs only  to  be  better
known, in  order  to fecure  the general  efteem  of
mankind.  Its precepts are fuch as every wife man
would chufe to  obferve,  and it forbids  nothing but
what is incompatible with true happinefs.
   Difguifing Medicine not only retards its improve-
ment as a fcience,  but expofes the profeffion to ridi-
cule, and is injurious to the  true interefts of fociety.
An art founded on obfervation never  can arrive at
any high degree of improvement, while it is confined
to a few who make a trade of it.   The  united  ob-
fervarions of all   the ingenious and fenfible part qf
mankind, would do more in a few years towards the
                       b                 improve* 
v u          INTRODUCTION.'
 improvement of Medicine, than thofe of the Faculty
 alone in  a great many.  Any  man can tell when a^
 medicine gives him eafe as well as a phyfician ; and if
 he only knows the name and dofe of the medicine,
 and the name of the difeafe, it is Sufficient to perpe-
 tuate the fact.   Yet the man who adds one fingle^
 fact to the ftock of medical obfervations, does more
real Service to the art, than he who writes a volume
 in fupport of fome  favourite hypothefis.
   Very few of the valuable discoveries in Medicine
 have been made by  phyficians.   They have in gene-
 ral  either been the effect of  chance or  of neceffity,
 and  have teen often oppofed  by the Faculty, till
 every  one  elfe was convinced  of their  importance.
 An implicit faith in the opinions of teachers,  an at-
 tachment to fyftems and  eftablifhed forms, and the
 dread of reflections, will  always operate upon  thofe
 who follow Medicine as a trade.  Few improvements
 are to be expected from  a man who  might ruin his
 character  and family by  even the fmalleft deviation
 from an eftablifhed  rule.
  If men of letters, fays  the author of the perform-
ance quoted above,  were to claim  their right of
 inquiry into a  matter  that  fo nearly  concerns them,
 the good  effects on Medicine  would foon appear.
 Such men would have no feparate interefl from  that
 of the art.  They would detect and expofe affuming
 Ignorance under the mafk  of Gravity  and Import-
 ance, and would be the judges and patrons of modefl
merit.   Not' having  their underftandings  perverted
 i» their youth by falfe theories, unawed by authori-
 ty, and unbiaffed by  interefl,  they  would canvafs
 with freedom the moft universally received principles
 in Medicine, and expofe  the uncertainty of many of
thofe  doctrines,  of which a phyfician  dares not fo
much as fcem to doubt.
I
No 
INTRODUCTION.
xix
   No argument, continues he, can be brought againft
laying  open Medicine, which does not apply with
equal,  if not greater,  force  to religion ;  yet expe-
rience has fliewn,  that fince  the laity  have afferted
their right  of inquiry into thefe Subjects, Theology,
considered  as   a  fcience, has  been improved, the
interelts  of  real religion have been promoted, and
the  clergy  have become a  more  learned,  a  more
ufeful, and  a  more  relpectable body of  men than
they ever were in  the  days  of  their greateft power
and  Splendor.
   Had other medical writers been  as honeft as this
gentleman, the art had been upon a very different
footing  at this  day.  Moft of them extol  the merit
of thofe men  who brought Philofophy out of the
fcheols, and Subjected  it to  the rules  of common
fenfe.  But they  never  confider that Medicine,  at
prefent,  is in nearly the fame  iituation.as Philofophy
was at that time, and that it  might be as  much im-
proved by being treated in the fame manner.  In-
deed, no fcience can  be rendered either  rational
or ufeful, without being fubmitted  to the common
fenfe and reafon of mankind.   Thefe alone Stamp  a
value upon fcience;  and what will  not  bear the tefl
of thefe ought to be rejected.
  I  know  it will  be  laid,   that   diftufing  medical
knowledge among the people  might induce them to
tamper with Medicine, and  to truft  to their own
Jkill inilead of calling in a  phyfician.  The reverie
of this however is  true.  Perfous  who have  moft
knowledge  in   thefe  matter;, are  commonly  molt
ready both to aik and  to follow advice, when it  is
neceffary.   The ignorant are always  moft apt  to
tamper with Medicine,  and have the leaft confidence
in phyfician;.  Inltancei of this are d:;:ly to be met
with amung the ignorant,  who,   while they abso-
lutely refufe  to tak<j  a  medicine  which  has been
                      b  2               {refeibei 
   %x            I N T R O D U T I O N.
   prefcribed by a  phyfician, will Swallow  with greedr-
   nefs any thing that is recommended to them  by their
   credulous neighbours.   Where  men will  act  even
   without knowledge, it is certainly  more rational to
   afford them all the light we  can, than to leave  them
   entirely in the dark.
     It  may  alfo  be  alleged,  that  laying  Medicine
   more open to mankind would leffen their faith in it.
   This would indeed be the cafe with regard to fome ;
   but it would have a quite contrary effect upon others.
   I know many people who have the utmoft dread and
   horror of every thing prefcribed by  a phyfician, but
   who will neverthelefs very  readily  take a medicine
   which they  know, and whofe  qualities they  are in
   fome meafure acquainted with.  Hence it  is evident
   that the dread arifes from  the doctor, not from the
   drug.   Nothing ever  can  or will   infpire mankind
   with  an abfolute  confidence in phyficians, but an
   open, frank, and undifguifed behaviour. While the
/   leaft  Shadow of myftery remains in the conduct of
   the Faculty, doubts, jealoufies, and fufpicions, will
   arife in the minds of men.
      No doubt cafes will fometimes  occur,  where a
    prudent phyfician may find it expedient  to difguife a
   medicine.  The whims  and humors of men muft be
   regarded  by thofe who mean  to do them fervice;
   but  this can never affect the general  argument in
   favour of candour and opennefs.  A man  might as
   well allege, becaufe there are knaves and fools in the.
   world,  that he ought  to take  every one he meets
   for fuch,  and to  treat him accordingly.   A fenfible
   phyfician will always  know where  difguife is necef-
   fary ; but it ought never  to appear on the face of
    his general conduct.
      The appearance of  myftery  in  the conduct of
    phyficians not only renders  their art fufpicious, but
    lays the foundations of  Quackery,  which  is the dif-
                                               grace 
INTRODUCTION.
xxi
 grace of Medicine.   No two characters can be more
 different  than that of the honeft phyfician and the
 quack;  yet they have  generally been very much
 confounded.
   No laws will ever  be able to prevent  quackery,
 while people believe that  the quack is as honeft a
 man, and as well qualified, as the phyfician.  A very
 fmall degree of medical knowledge, however, would
 be fufficient to break this fpell ;  and  nothing elfe can
 effectually undeceive them.  It is the ignorance and
 credulity of the multitude, with regard to medicine,
 which renders  them  fuch an eafy prey to every one
 who has the hardinefs to attack them in this quarter.
 Nor can the evil be remedied by any other means but
 by making them wifer.
   The moft effectual way to deftroy quackery in any
 art or  fcience, is  to diffufe the knowledge of thefe
 among mankind.
   Diffufing medical  knowledge among the  people
 wouia not only tend to improve the art, and to banifli
 quackery,  but likewife to render  Medicine more
 univerfally ufeful,  by extending its benefits to fociety.
 How ever long Medicine may have been known as  a
 fcience,  we  will venture to fay, that many of its moft
 important purpofes to fociety  have either been over-
 looked,  or very little attended to. The cure of difes-
 fes is doubtlefs a matter of great importance ; but the
 prefervation of health is of ftill greater.  This is the
 concern  of every man, and furely what  relates to it
 ought to be rendered  as plain and obvious to all as
 poffible.  It is not to be luppofed, that men  can be
 Sufficiently upon their  guard  againft  difeafes,  who
are totally   ignorant  of their  caufes.  Neither can
 the legiflature,  in whofe  power  it  is  to do much
 more for preferving the public  health than can  ever
be done by the Faculty, exert that power with pro- 
xxii         INTRODUCTION.  x
priety, and to the greateft advantage, without fome
degree of medical knowledge.
   Men of every  occupation  and condition in life,
might  avail  themfelves of  a  degree  of medical
knowledge ; as  it would teach  them  to avoid the
dangers peculiar  to  their refpective Stations ;  which
is always  eafier  than to remove their effects.    Me-
dical  knowledge,  inftead of  being  a  check  upon
the enjoyments  of life, only  teaches men  how to
make the moft  of them.   It  has indeed been faid,
that to live medically is to live miferably :  but it might
with  equal propriety be faid, that to live rationally
is to live miferably.  If phyficians obtrude their own
ridiculous  whims upon mankind, or lay down rules
inconfiftent with reafon or common fenfe, no doubt
they will be defpiSed.   But this  is not  the fault of
Medicine.   It propofes no  rules that  I know, but
fuch as are perfectly confiftent with the true  enjoy-
ment  of  life,  and every way conducive to  the real
happinefs of mankind.
   We  are forry indeed to obferve, that Medicine
has hitherto  hardly  been  confidered  as a popular
fcience, but  as  a  branch of knowledge folely  con-
fined  to a particular fet of men, while  all the reft
have  been taught not only to neglect, but even  to
dread and defpife it.   It will however appear, upon
a more ftrict examination,  that no fcience better  de-
ferves their attention, or is  more capable of being
rendered generally ufeful.
   People are  told, that if  they dip the leaft into
medical  knowledge,  it will  render  them  fanciful,
and make  them  believe  they  have every difeafe of
which they read.  This I  am fatisfied will feldom be
the cafe with fenfible people; and, fuppofe it were,
they muft  foon  be undeceived.   A fliort time will
flit;w  them their error, and a little more reading will
                                          infallibly 
INTRODUCTION.
x>.n
infallibly correct it.   A fingle inftance will Shew  the
abfurdity of this notion.   A fenfible woman, rather
than read a  medical  performance which  would ic-
ftruct her in the management of  her children, muft
leave, them  entirely  to the care and conduct of the
moft ignorant,  credulous, and  fuperftitious  part of
the human fpecies.
  No part of Medicine is of more  general  import-
ance than that which relates to  the nurfing and ma-
nagement  of children.  Yet few  parents pay a pro-
per  attention to  it.  They leave the fole  care  of
their tender  offspring, at the very time when care
and  attention are  moft neceffiry, to hirelings,  who
are either too carelefs  to do their duty, or too igno-
rant to know it.   We will  venture to affirm, that
more human  lives are loft by the  careleffneSs and in-
attention of parents  and nurfes,  than are faved by the
Faculty ; and that the joint and  well-conducted en-
deavours, both of private perfons  and the public, for
the prefervation of  infant lives, would be of more
advantage  to fociety, than the whole art of Medi-
cine, upon its prefent footing.
   The  benefits of  Medicine, as  a  trade,  will ever
be confined to thofe who  are able to pay for them ;
and  of courfe,  the far greater part  of  mankind  will
be every where deprived of them.  Phyficians,  like
other people,  muft live by their employment,  and
the  poor  muft either want  advice altogether,  or
take up with that which is worfe  than none.  There
are not, however, any where wanting weil-diipofed
people,  of better fenfe,  who are willing  to Supply
the  defect  of medical advice to  the   poor, did not
their fear of doing ill often fupprefs their inclination
to do good.   Such  people are  often  deterred from
the moft noble and praife-worthy  actions, by  the
foolifli alarms Sounded in their  ears by a Set of men
who, to  raife  their  own importance, magnify the
                      b 4               difficulties 
XXV
INTRODUCTION.
difficulties of doing  good, find  fault with what is
truly commendable,  and  fleer at every  attempt to
relieve the fick,  which is  not conducted by the pre-
cife rules of Medicine.  Thefe gentlemen muft, how-
ever excufe me for faying, that I  have often known
fuch well-difpofed perfons do much good ;  and that
their -practice, which is generally the refult of good
fenfe and obfervation, affifted by a little medical read-
ing, is frequently more rational than that of the ig-
norant retainer  to phyfic, who defpifes both reafon
and  obfervation, that he may go wrong by rule:  and
who, while he is dofing his patient  with medicines,
often neglects other things of far greater importance.
   Many things are neceffary for the fick befides me-
dicine.  Nor is the perfon who takes care to procure
thofe for them,  of lefs importance than a phyfician.
The poor oftener perifh in difeafes for want of pro-
per nurfing than of medicine.   They  are frequently
in want of even the neceffaries of life, and ftill more
fo of what  is proper for  a  fick-bed.   No one  can
imagine, who has not been a witnefs of thefe fixa-
tions, how  much  good  a well-difpofed perfon may
do,  by only taking care to have fuch wants  Supplied.
There certainly cannot be a  more neceffary, a more
noble, or a more gcd-like action, than to admmifter
to the wants of our fellow-creatures in dillrefs.  While
virtue or religion are known among  mankind,  this
conduct will  be approved ; and while Heaven is juft.
it muft be rewarded !
   PerSons who  do not  chufe  to  adminifter   medi-
cine to the fick,  may neverthelefs direct  their regi-
men.  An eminent medical author has  faid,  That by
diet  alone all the intentions of Medicines may  be an-
fwered*.  No doubt a great many of them  may;
but there are other things befide diet, which ought

                   * Arbuthnot.
          4                                   by 
INTRODUCTION.          xxv
by  no means to be neglected.  Many, hurtful and de-
structive prejudices, with regard to the treatment of
the fick, ftill prevail among  the  people, which per-
fons of better fenfe and learning only can eradicate.
To guard the poor againft the influence of thefe pre-
judices, and to inftil into  their minds fome juft ideas
of the importance of proper food, frefli air, cleanli-
nefs,  and  other pieces of regimen neceffary in dif-
eafes, would be a work of great merit,  and produc-
tive of many  happy confequences.   A proper regi-
men,  in moft difeafes,  is at leaft equal to medicine,
and in many  of them it is greatly fuperior.
   To affift the well-meant endeavours of the humane
and benevolent in relieving diftrefs j to eradicate dan-
gerous and hurtful prejudices ; to guard the ignorant
and credulous againft the frauds and impofitions of
quacks and impoftors;  and to fhew  men  what is
in their own power, both with regard to the preven-
tion and cure of difeafes, are certainly objects worthy
of the phyfician's attention.  Thefe were the leading
views in  compofing and  publifhing the  following
Sheets.  They were fuggefted by an attention to the
conduct of mankind, with  regard  to  Medicine, in
the. courfe of a pretty long practice in different parts
of  this ifland, during  which  the author has often
had occafion to wifh that his patients, or thofe  about
them, had been poffeffed of fome fuch plain directory
for regulating their conduct.  How far he has fuc-
ceeded in his endeavours to Supply  chis deficiency,
muft  be left for others to  determine ; but if they be
found to contribute in any meafure towards alleviat-
ing the calamities of mankind, he will think his  la-
bour  very well bellowed. 
 
CONTENTS.
      PART   I.

Of the general Caufes of
         Difeafes.

         CHAP.  I.
                      Page.
     OF Children           i
     — Difcafed Parents  7
  Clothing of Children   10
—Food of ditto          16
—Exercife of ditto       22
—Bad Effects of unwholefome
  Air upon ditto        32
—Nurfes     .     .     3 +
          CHAP.  II.
Of the Laborious, &c.    39
—the Sedentary     .     48
—the Studious      .    55
         CHAP. III.
Of Aliment             63
         CHAP.  IV.
Of Air     .       •     76
          CHAP.  V.
Of Exercile            82
         CHAP..  VI.
Of fleep      .    •   . .S9
—Clothing       •      ibid.
         CHAP. VII.
Of Intemperance    .    96
         CHAP.  VIII.
Of Cleanliuefs     , .     icz
         CHAP. IX.
                      Page.
Of  Infection      .      108
         CHAP.  x.
Of the Paflions     .    114
—Anger    .    .    ibid.
—Fear     .     .       115
—Grief    .     .      119
—Love    .     •      121
—Religious Melancholy 122
         CHAP. XI.
Of  the common  Evacuations
—Stool	124 ibid.
—Urine	126
—Perfpiration . 128 —being affected by changes in the atmofphere 129 -.Wet clothes . 130 —Wet feet * . . ib.	
—Night Air —Damp Beds —Damp Houfes —Sudden Tranfitions	131 ibid. from
Heat to Cold	»34
      PAR T  II.
       Of  Difeafes.
        CHAP.  XII.
Of the Knowledge  and Cure
  of Difeafes     .       139 
CONTENTS.
CHAP. XIII.
CHAP. XXX.
Page
 Fevers in general
         CHAP. XIV.
 Of  Intermitting Fevers  or
   Agues     .     .     152
         CHAP. xv.
 Of an Acute Continual Fever
                        162
         CHAP. XVI.
 Of the Pleurify
 ------Ballard ditto
 ------Paraphrenias
         CHAP.  XVII.
 Inflammation of the Lungs 175
        CHAP. XVIII.
 Of Confumptions         178
         CHAP.  XIX.
 Of the ilow or Nervous Fever
                       192
         CHAP.  XX.
Malignant, Putrid, or Spotted
168
173
174
   Fever
         CHAP.  XXI.
Miliary Fever
        CHAP.  XXII.
Remitting Fever
       CHAP.  XXIII.
Yellow Fever.
       CHAP.  XXIV.
The Small pox
Inoculation
       CHAP.   xxv.
The Meafles
—Scarlet Fever
—Bilious Fever
       CHAP  XXVI.
St. Anthony's Fire
       chap. xxvu.
Inflammation of the Brain 262
       chap. xxvm.
Inflammation of the Eyes 266
       chap.  xxix.
The Qu'mfey       .    272
—Malignant ditto       279
199

209

214

218

225
237

249
254
*55

257
Page
 283
 287
 291
 Colds and Coughs
 A Common Cough
 Whooping-Cough
        chap.  xxxi.
 Inflammation of the Stomach
                        296
 ------------of the Interlines
                        298
 Of the Colic     .       302
 Inflammation of the Kidneys
                        3°9
 ------------of the Bladder
                        3"
 ■------------of the Liver 313
        CHAP.  XXXII.
 Of the Cholera Morbus,  and
   other exceflive Difcharges
   from  the   Stomach   and
   Bowels    -     .     316
 —aDiarrhoen,orLoofenefs3i9
 —Vomiting      .      322
 —the Vomiting and Purging
   of Children    .      325
       CHAP. XXXIII.
 Diforders of the Kidneys  and
   Bladder      .       328
 Of the Diabetes, or exceflive
   Difcharge of Urine      ib.
 —Suppreffion of ditto    331
 —the Gravel and Stone  333
       CHAP. XXXIV.
 Involuntaty  Difcharges   of
 T,1B1J°.od    •    •      337
 .Bleeding at the Nofe    340
------and Blind Piles  343
Spitting of Blood
Vomiting of ditto
Bloody Urine
------Flux
Cceliac Paffion
       CHAP,  xxxv,
Of theHead-ach
------Tooth-ach
34^
35°'
35i
353
359

360
3&J- 
CONTENTS.
XXIS
                      Page
0\ the Ear-rich     -     368
Pain of the Stomach, &c. 369
       CHAP. XXXVI.
Of Worms       .     -372
      CHAP. XXXVII.
Of ihe Jaundice         378
      CHAP. XXXVIII.
OflheDropfy     .     381
       CHAP. XXXIX.
Of the  Gout      .      3S7
------Rheumatifm      395
         CHAP. XL.
Of the Scurvy    .     400
------Scrophula       405
------Itch      .       410
         CHAP.  XLI.
Of the  Afthma     .     413
        CHAP. XLII.
Of the Apoplexy         418
        CHAP. XLIII.
Of  Coftivenefs     .     421
—Want of Appetite     424
—Heartburn     .      425
        chap. XLIV.
Of  Nervous Difeafes    427
—Melancholy    .     433
—the Palfy      .      438
—the  Epilepfy, or  Falling
  Sicknefs      .       440
—the Hiccup     .     444
—Cr.tmp of the Stomach 446
—the Night-mare       447
—Swoonings           448
—Flatulencies, or Wind 451
—Low  Spirits     .     454
—Hyfieric  Affections    455
—Hypochondriac  Affections
                       459
         CHAP. XLV.
Diforders of the Senfes  464.
--------<f the Eye     ib.
A Gutta Serena        466
A Cataract     .    .    ib.
Shut Sightednef*       467
                      Page
Seeing only at too  great a
  Diftance      .      467
Squinting    .     .    ib.
Spbts or Specks     .    ib.
Bloodfhot Eye    .      ib.
Watery or Weeping Eye 468
Of the Ear      .       ib.
------Tafte and Smell  471
------Touch     .     473
        CHAP. XLVI.
Of a Schirrusand Cancer 474
       CHAP.  XLVII.
Of Poifons      .      480
—Mineral Poifons       481
—Vegetable ditto       483
Bitesof poifonous Animals484
----of the Mad Dog      ib.
----of the Viper        493
——of poifonous Infects'   ib.
----of the Rattle-Snake  495
      CHAP.  XLVIII.
Of  the Venereal Difeafe 496
----Virulent Gonorrhoea 498
—Gleets    .    .     504
—Swelled Tefticle       507
—Buboes    .    .     508
—Chancres     .       509
—A. Confirmed Lues or Pox

General Obfervations    518
        CHAP. XI.IX.
Difeafes of Women      524
Of  the  Menffrual  Difcharge

—Pregnancy     .     534.
—Child-Birth     .     537
—Barrennefs     .     545
          CHAP. L.
Difeafes  of Children    546"
Of the Meconium       548
'—the Apthse or Thrufh  549
—Acidities      .      550
—Galliny and Excoriationj 51
—Stoppage of the Nofe  552 
xxx
CONTENTS.
                      Page
Of Vomiting            553
—a Loofenefs     .      554
—Eruptions      .      t;^
—the Croup or Hives    £58
—Teething     .       561
—the Rickets     .      564
—Convulflons     .      567
—Water in the  Head,  or
  Dropfy of the Brain   569
        CHAP.  LI.
Of Surgery —Bleeding	57i
	?72
.—Inflammations and Abicef-	
fes	575
-—Wounds	577
—Burns	*8i
—Bruifes	58.?
—Ulcers	5*5
CHAP. LII.	
Of Diflocations	189
Diflocation of the Jaw	590
---------of the Neck	59i
---------of the Ribs	592
■of the Shoulder 593
•of the Elbow   594
■of  the Wrift  and
   Fingers       ib.
■of the Thigh     ib.
■of the Knees   595
   INTRODUCTION   657
    Lift of Simples       662
  MEDICAL PREPARATIONS.
Balfams    .     .      664
Bonifies     .     .       ib.
Cataplafms and Sinapifms 666
                      Pa^e
Diflocation of the Ankles 595
---------of the Toes     ib.
        CHAP. LII 1.
Of Broken Bones, &c.   595
—Strains    .     .    599
—Ruptures      .       600
         CHAP.  LIV.
Of Cafualties    .       603
—Subftances flopt between the
  Mouth and Stomach  604
—Drowned  Perfons     610
—Noxious Vapours      614
Effedts of Extreme Cold 616
------------------Heat 618
         CHAP.  LV.
Of Fainting  Fits, and  other
  Cafes which require imme-
  diate Afliftance        619
—Intoxication     .     624
—Suffocation and Strangling
                       626
—Perfons who expire in Con-
  vulfion Fits     .     629
Directions for Recovering per-
  fons fuppofed Dead    634
        CHAP.  LVI.
Cautions  concerning  Cold
  Bathing,  and drinking the
  Mineral Waters        641
Clyfters    .     \      666
Collyria, or Eye-waters   668
Confections      .       66a
Conferves and Preferves   670
Decoctions    .     .    (,ji
Draughts     ,     .     6?4
Electuaries      .       67 c
CONTENTS  of  the APPENDIX. 
                    CONT

                      Page
Emulfions       .       676
Extracts     .       .677
Fomentations    .      678
Gargles     .      .    679
Infufions    .    .     680
Juleps     .     .       683
Mixtures    *     .    684
Ointments,  Liniments, and
  Cerates       .       686
Pills      .     .       689
A GLOSSARY
INDEX
ENTS.                xxxi

Plafters       .         <5g2
Powders     .     .      69^
Syrups    .  .     .    698
Tinctures, Elixirs, &c.   699
Vinegars    ^.     .      704
Waters by Infufion, &c.  70J7
Simple diftilled Waters   706
Spirituous diftilled Waters 708
Wieys    .      .      ib.
Wines    .     .     .   709
Page  712
      717
PART 
 
PART   I.
OF THE GENERAL CAUSES OF DISEASES,
                 CHAPTER  I.

                   Of Children.


           JL HE better to trace difeafes from their
original caufes  we {Hall take a view of the common
treatment  of mankind in the  flate  of infancy.  In
this period of  our lives, the foundations of a good
or bad conflitution are generally laid ;  it is therefore
of importance,  that parents be well acquainted with
the various caufes which may  injure the health of
their offspring.
  It appears from the  annual regiflers of the dead,
that almofl: one half of the children born  in Great
Britain die  under twelve years of age.  To  many,
indeed, this may appear a natural evil; but, on due
examination, it will be found to  be one of our own
creating.   Were  the death of infants a natural evil,
other animals t would be as  liable to die young as
man ; but this we find is by no means the cafe.
  It may feem ftrange that man, notwithstanding
his  fuperior reafon,  lhould fall fo far Ihort of other
                        B                 animals 
OF  CHILDREN.
 animals  in the management  of his young :  But our
 furprife  will  foon ceafe,  if wc  confider that brutes,
 guided by inftincl:, never err in this  refpecl:; while
 man,  trufting folely to art, is  feldom right.  Were
 a catalogue  of thofe infants  who perifh annually by
'art alone exhibited to public view, it would aftonifh
 moft people.
   If parents are above taking  care of their  children,
 others muft  be employed for  that purpofe:  thefe
 will always endeavour to recommend themfelves by
 the appearance  of extraordinary  /kill  and  addrefs.
 By this means fuch a number of unneceffary and de-
 ftructive articles have been introduced into  the diet,
 clothing,  &c.  of infants, that it is no  wonder  fo
 many of them perifh.
   Nothing can be more  prepofterous than a mother
 who  thinks  it below her- to take care of  her  own
 child, or who is fo  ignorant  as not to know what
 is proper to be  done for it.   If  we fearch Nature
 throughout,  we cannot find a parallel to this.  Every
 other animal is the nurfe of its own offspring, and
 they thrive accordingly.  Were the brutes to bring
 up their young by  proxy, they would fhare  the fame
 fate with thofe of the human fpecies.
   We mean not, however,  to impofe  it as a  talk
 upon every mother to fuckle her own child.  This,
 whatever fpeculative writers  may  allege,  is  in fome
 cafes impracticable, and would inevitably prove de-
 finitive both to the mother and child.   Women  of
 delicate conftitutions, fubjecl:  to hyfteric  fits, or other
 nervous affections, make very bad nurfes: ahd thefe
 complaints are now fo common, that it is rare to find
 a womq$ of fafhion free from them ; fuch  women,
 therefore, fuppofing them willing, are  often unable
 to fuckle their own children.
   Almoft every mother  would be in a  condition  to
 give  fuck, did mankind live agreeably to  Nature:
                                              but 
                OF  CHILDREN.              3
but whoever confiders how far many mothers deviate
from her  dictates,  will not be furprifed to find fome
of  them  unable  to perform that  neceffary office.
Mothers who do not eat a fufficient quantity of folid
food, nor enjoy the benefit of free air and  exercife,
can neither have  wholefome juices  themfelves,  nor
afford proper nourifhment to an infant.  Hence chil-
dren who are fuckled'by delicate women, either  die
young,  or continue weak and fickly all their lives.
   When  we fay that mothers  are  not always in  a
condition  to fuckle  their own children, we would  not
be underftood as difcouraging that practice.   Every
mother who can, ought certainly to perform fo tender
and agreeable an office *.   But, fuppofe it to be  out
of her  power,  fhe may, neverthelefs, be  of great
fervice to her child.   The  bufinefs of nurfing is by
no means confined to giving fuck.    To  a woman
who abounds  with  milk,  this is the eafieft part of it.
Numberlefs other  offices are neceffary for a child,
which the mother ought at leaft to fee done.
   A mother who  abandons the fruit of her womb,
as foon as it is  born, to the fole care of an hireling,
hardly  deferves that name.    A  child,  by being
brought up  under the mother's eye,  not only fecures
her affection,  but  may reap  all the  advantages of a

  * Many  advant iges would arife to fociety, as well a<; to in-
dividuals, *rom mothers fuckling their own children.  It would
prevent the temptat on which poor women are  laid under of
abandoning their children to fuckle  thofe  of the lich for the
fake of gain :  by which means fociety lofes many of its moft.
ufeful members, and mothers become in fome i'enfe the mur-
derers of their own ofF-pnng.   I am fure I fpeak within the
truth wi.cn 1 fay; that not one in twenty of thofe childien  live,
who are thus abavdoned by their mothers.   Fur tnis re-»fon no
in uhcr (hould be allowed to fuckle another's child, iiil her  own
is either dead, or lit to be weaned.  A regulation  of this  kind
would lave many  lives among the poorer fort, and could do
ao hurt to the rich.
B2
parent'* 
4              OF  CHILDREN.
parent's  care,  though it be  fuckled  by  another.
How can a mother be better employed than  in fupcr-
intending the nurfery ?  This  is at once the moft de-
lightful  and  important office ; yet  the moft trivial
bufmefs or infipid amufements are  often preferred to
it!  A ftrong  proof both of the bad  tafte and wrong
education of  modern females.
  It is indeed to be  regretted,  that  more care is not
beftowed in teaching the proper management of chil-
dren to thofe whom  nature has defigned for mothers.
This, inftead of being made  the principal,  is feldom
confidered  as any part of female education.   Is  it
any wonder,  when females fo  educated come to be
mothers, that they  fhould be quite  ignorant of the
duties  belonging to that character ? However ftrange
it may appear, it is certainly true, that many mothers,
and thofe of fafhion  too, are as ignorant, when they
have brought a child into the world, of what is to be
done for it,  as  the  infant itfelf.   Indeed,  the  moft
ignorant of  the  fex are generally reckoned  moft
knowing in the bufmefs of nurfing.   Hence, fenfiblc
people become  the  dupes of ignorance and fuper-
ftition  ;  aud  the nurfing of children, inftead of being
conducted  by reafon,  is the  refult of whim and ca-
price *.
  Were the time that is  generally fpent  by females
in the acquifition of trifling accomplifhments,   em-
ployed  in learning how to bring  up their  children;

  *  Tacitus,  the celebrated Roman Hiftorian, complains
greatly of the degeneracy of the Roman ladits in his time, with
regard to  the care of  their offspring.  He fays that, in former
time^, the greateft women  in Rome ufed to account it their
chief g'ory to keep the  houfe and  attend their children; but
that now the young infant was committed to the fok- care  ct
fome p  or Gre i.m wench, or other lr.enial f'ervant—We are
afraid, wherever luxury  and effeminacy  prevail,  there will  be
too much  ground for this complaint.
                                              how 
              OF  CHILDREN.             5
how to drefs them fo as not to hurt, cramp, or con-
fine  their motions ; how to feed them with whole-
fome and nourifhing food ;  how to exercife their
tender bodies, fo as beft to  promote their growth
and ftrength : were thefe made the objects of female
inftruction, mankind would derive the greateft ad-
vantages from it.  But while the education of fe-
males implies little more than what  relates  to drefs
anti  public  fhew, we  have nothing to expect from
them but  ignorance,  even in  the moft  important
concerns.
   Did mothers reflect on their own importance, and
lay it to heart,  they would embrace every opportu-
nity of informing themfelves of the duties which they
owe to their infant offspring.  It is their province,
not only to form the body, but alfo to give the mind
its moft early bias.  They have it very much in their
power  to make  men healthy or valetudinary, ufeful
in life, or the pefts of fociety.
   But the mother is not the only perfon concerned
in the  management of children.   The father has an
equal interefl in their welfare, and ought  to affift in
every thing that refpects either  the improvement of
the body or mind.
   It is a pity that the men fliould be fo inattentive to
this matter.  Their negligence  is one  reafon  why
females know  fo little of it.  Women will  ever be
defirous to excel in fuch accomplifhments  as recom-
mend them to the other  fex.  But men   generally
keep at  fuch  a diftance from even the  fmalleft  ac-
quaintance with the affairs of the  nurfery,  that many
would reckon  it an affront, were  they fuppofed to
know any thing of them.  Not fo, however, with the
kennel or the ftables :  a gentleman of the firft rank
is not afhamed to give  directions concerning the ma-
 iwgement of his dogs  or  horfes, yet would blufh
 were lie furprifed in performing  the fame office for
                       B  3                  that 
6              OF  CHILDREN.
that being who  derived  its exiftence  from himfelf,
who is the heir of his fortunes, and the future hope
of his country.
   Nor  have phyficians themfelves been  fufficiently
attentive  to the  management  of children:  this  has
been  generally confidered as. the fole province of old
women.    Such conduft has  not only caufed  this
branch  of medicine to be neglected, but  has alfo en-
couraged the  other fex to affume an abfolute title to
prefcribe for children in the moft dangerous difeafes.
The confequence is,  that a phyfician is too feldom
called till the good  women have exhaufled all their
fkill; when his  attendance can  only ferve  to divide
the blame, and appeafe the difconfolate parents.
   Nurfes ftiould do  all  in  their power  to prevent
difeafes; but when a child is  taken ill,  fome perfon
of fkill  ought immediately  to be  confulted.   The
difeafes of children are generally  acute, and the leaft.
delay is dangerous.
   Were phyficians more attentive  to  the difeafes of
infants, they  would not only be better qualified to
treat them  properly when fick,  but likewife to  give
ufeful directions for  their management  when well.
 The difeafes  of children are  by no means fo diffi-
 cult to be  underftood as many imagine.   It rs true,
 children cannot tell their complaints;  but the  caufes
 of them  may be pretty  certainly difcovered by ob-
 ferving the fymptoms, and  putting proper queftions
 to the nurfes.   Befide*, the  difeafes  of infants be-
 ing lefs complicated,  are eafier cured than thofe of
 adults. *

    * The common opinion that the difeafes of infants are hard
 to difcover and difficult to cure, has deterred many phyficians .
 from paying that attention to them which they deferve. I can,
 hi wever, from experience declare,  that this opinion is without.
 foundation ; and that the difeafes of infants are neither fo diffi-
 cult to difccver, nor fo ill to cuie, as thofe of adults. 
                OF  CHILDREN.              7
   It is  really aflonifhing,  that  fo little attention
 mould in general be  patid  to  the prefervation of in-
 fants. What labour and expence are daily beftowed,
 to prop an  old  tottering carcafe  for  a  few  years,
 while thoufands of thofe who might be ufeful in life,
 perifh without being  regarded! Mankind are  too
 apt  to value  things according  to their prefent, not
 their future, ufefulnefs.    Through this is,  of all
 others, the  moft erroneous method of eftimation ;
 yet, upon no other principle, is it poffible to account;
 for  the  general  indifference,  with refpect  to the
 death of infants.

               Of Difeafed Parents.

   One great fource of the difeafes of children 1 >,
 the  unhealthinjess  of Parents.   It would be
 as unreafonable to expect a rich crop from a barren
 foil, as that  ftrong and healthy children fhould be
 born of parents whofe conftitutions have  been  worn
 out with intemperance or difeafe.
   An ingenious writer * obferves, that on the con-
 flitution of mothers depends originally  that of their
 offspring.   No one,  who believes this,  will be fur-
prifed, on a view  of the female world, to find difeafes
and death fo  frequent  among  children.   A delicate
 female, brought  up within  doors,  an utter flranger
toexercife and open  air, who lives  on tea and other
flops, may bring  a child into the world, but it will
hardly be fit  to live.  The firft blaft  of difeafe will
nip the tender plant in the bud : or, fhould it ftrug-
gle through a few years exiftence,  its feeble frame,
fhaken with  convulfions  from  every trivial  caufe,
will be unable to perform the common functions of
life,  and prove a  burden to fociety.

                    *  Rouffean.
                       B4                     If 
$             OF  CHILDREN.
   If to the delicacy of mothers, we add the irregular
lives of fathers, we fliall fee farther caufe to believe,
that children  are often hurt by the conftitutions of
their  parents.   A fickly frame may be originally
induced  by hardfhips or intemperance, but  chiefly
by the latter.  It is impoffible that  a  courfe of vice
fhould not fpoil the belt  conflitution: and,  did the
evil terminate here, it would be  a juft punifhment
for the folly of the fufferer.   What a dreadful inhe-
ritance is the gout, the fcurvy, or the king's  evil,
to tranfmit to our offspring 1 how happy had it  been
for the  heir of many a great eftate, had he  been
born  a beggar, rather than  to  inherit his  father's
fortunes, at the expence of inheriting his  difeafes !
   A  perfon  labouring under any incurable malady,
ought not to marry.   He thereby not only fhortens
his own  life, but  tranfmits mifery to others:  but,
when both  parties are deeply tainted  with the  fcro-
phula, the fcurvy,  or the like, the effects muft be
miferable indeed.  Want of attention to thefe things,
in forming connections for life, has rooted out more
families than plague, famine,  or the fword ;  and, as
long as thefe connections are formed from mercenary
views, the evil will be continued. *
   In our matrimonial  contracts,  it  is  amazing fo
little  regard is  had to  the health and form of the
object.    Our fportfmen  know,  that the generous
courfer cannot be bred  out of  the foundered jade,
nor the  fagacious  fpaniel out of  the fnarling cur.
This is fettled upon immutable laws.   The man who
marries  a woman of a  fickly conflitution, and de-
fended  of unhealthy parents, whatever his  views

   * The  Lacedemonians condemned their king Archidamus,
for having married a weak, puny woman : becaufe, faid they,
inftead of propagating a race of heroes, you will fill the throne
with a progeny of changelings.
may 
OF  CHILDREN.
9
may be, cannot be faid to act  a prudent  part.   A
difeafed woman may prove fertile ; fhould this be the
cafe,  the family  muft  become an  infirmary : what
profpect of happinefs the father of fuch a family has,
wefhall leave any one to judge. *
  Such children as have the  misfortune  to be born
of difeafed parents, will require to  be nurfed with
greater care than others.   This is  the only way to
make amends for the defects  of conftitution ;  and it
will often go a great length. An  healthy nurfe, whole-
fome air, and  fufficient  exercife, will do  wonders.
But when thefe are neglected, little is to be expected
from any other quarter.   The defects of  conftitution
cannot be fupplied by medicine.
  Thofe who inherit any  family difeafe, ought to be
very circumfpect  in  their  manner of living.  They
fhould confider well  the nature of fuch difeafe,  and
guard againft it by a proper  regimen.   It  is certain,
that family difeafes have often,  by proper care, been
kept off for one generation ;  and there is  reafon to
believe, that,  by perfifting in the fame courfe, fuch
difeafes might at  length be wholly eradicated.   This
is a fubject  very  little  regarded,   though  of the
greateft importance.     Family conftitutions  are as
capable of improvement as family eftates; and  the
libertine, who impairs the one,  does greater injury
to his pofterity,  than  the prodigal, who  fquanders
away the other.


  * The Jews, by their laws, were,  in certain cafes, forbid tc
have any manner of commerce with the difeafed ; and indeed
to this all wife legiflators ought to have a fpecial regard.  In
fome countries, difeafed perfons have actually been forbid to
marry.  This is  an evil  of a complicated kind, a  natural de-
formity, and political mifchief; and therefore requires a public
confideration.
°f 
IO
OF  CHILDREN.
           Of the Clothing of Children.
   The clothing  of an infant is  fo fimple a matter,
that it is furpriiing how any perfon fhould err in it ;
yet many children lofe their  lives, and others  are
deformed, by inattention to this article.
   Nature knows  no ufe of clothes to an infant, but
to keep it warm.   All that is neceffary for this pur-
pofe, is to wrap it in a foft loofe covering.  Were a
mother left to the dictates of Nature alone, fhe would
certainly purfue  this courfe.   But the bufmefs  of
dreffing an infant, has long been out of the hands of
mothers, and has  at laft become a fecret which none
but adepts pretend to underftand.
   From  the moft early ages, it has been thought
neceffary, that a  woman in labour fhould have fome
perfon to attend her*   This in time became  a bufi-
nefs; and, as in all others, thofe who were employed
in it, ftrove to outdo one another  in  the different
branches of their  profeffion.  The dreffmg of a child
came of  courfe to be confidered  as the midwife's
province,  who  no doubt  imagined,  that the  more
dexterity fhe could fhow, in this article,  the more her
fkill would be admired.   Her attempts were feconded
by the vanity of parents, who, too often defirous  of
making a fhow of the infant as foon as it was  born,
were ambitious to have as much finery heaped upon.
it as poffible.   Thus it came to be thought as  necef-
fary for a midwife to excel  in  bracing and dreffing
an infant, as for a furgeon to be expert in applying
bandages to a broken limb ; and the poor child,  as
foon as it came into the world, had as  many rollers
and wrappers applied to its body, as if every bpne
had been  fractured in the birth ; while  thefe were
often fo  tight,  as not  only to gall and wound its
                                          tender 
               OF  CHILDREN.             11
tender frame, but even to obftruct the motion of the
heart, lungs, and other organs neceffary for life.
   In  moft parts of Britain,  the  practice of rolling
children with fo many bandages is now, in fome mea-
fure,  laid afide; but  it would ftill be  a difficult tafk
to perfuade the generality of mankind, that the fhape
of an infant does not entirely depend on the care of
the midwife.  So far,  however,  are all her endea-
vours to mend the fhape from being fuccefsful,  that
they conftantly operate the contrary way, and  man-
kind  become deformed in proportion to  the  means
ufed to prevent  it.   How little deformity of body is
to be found  among  uncivil-zed.nations ? So little,
indeed, that it is vulgarly believed they put all their
deformed children to. death.    TJh* truth  is, they
hardly know  fuch a, thing   as a deforced  child.
Neither fhould  we,  if wc  followed their example.
Savage nations never think of manacling thair chil-
dren.   They allow them the full ufe of every organ,
carry them abroad in  the open air, warn their bodies
daily in cold water, ccc.   By this  management, their
children become  fo ftrong- and hardy, tlr.u, by. the
time  our puny infants get out of the nurfeV. arms,
theirs are able to fhift for themfelves. *
   Among brute animals, no art is .neceffary to pro-
cure a .fine fhape.  Though many of them  are. ex-
tremely delicate, wh-jn  they, come-into the world,
yet we never  find,them grow crooked far want of
fwaddiing bands.    h  nature lefs generous, to the.

  * A friend of mine, v.hn was fev.ru year? on tr~ coaft. of
Africa, tells me, that the natives neither put any clothes uport-
their children, nor apply to their bodies bandages of ^ny kind,
but lay them on a  pallet, snd fuffer them to tumble About at
pleafitrou; yet they are all ftrair, and feldom hav ■ :-.ny difeafe.
An American need go no further, for cxamole-s of tl- ? ^n-h of
this afiettion;th:m in out.  own cx",t-y.   T^ei'.vjrto ?f the In-
dians arc proverbial. 
 12             OF  CHILDREN.
 human kind ? No : but we take the bufmefs out of
 Nature's hands.
  Not only the analogy of other animals, but  the
 very  feelings of infants  tell  us,  they ought to be
 kept eafy and free from  all preffure.   They cannot
 indeed tell their complaints ; but they  can fhew figns
 of pain ; and this  they never  fail to do, by crying
 when hurt by  their clothes.    No  fooner are they
 freed from their bracings, than  they feem pleafed
 and  happy;  yet,  ftrange infatuation ! the moment
 they hold their  peace, they are again committed to
 their chains.
  If we  confider the body of an infant as a bundle
 of foft pipes, replenifhed with fluids, in continual
 motion, the danger  of preffure will  appear  in  the
 ftrongeft  light.   Nature, in order to make way for
 the growth of children, has formed  their  bodies foft
 and flexible ; and, left they fhould receive any injury
from preffure in the womb, has furrounded the fcetus
 every where with fluids.   This fhews  the care which
Nature takes to prevent  all unequal preffure on  the
 bodies of infants,  and to defend them againft every
 thing that might in the leaft cramp or confine their
 motions.
  Even the bones  of an infant are fo foft and car-
 tilaginous,  that they readily yield to the flighted:
preffure,  and eafily affume a bad  fhape,  which  can
never after be remedied.  Hence it is, that fo many
people appear with high fhoulders, crooked  fpines,
and flat breads, who were as  well  proportioned at
 their birth  as others, but had  the misfortune to be
 fqueezed out of fhape,  by the application  of flays
and bandages.
  Preffure, by  obftructing the circulation,  likewife
 prevents  the equal diftribution of nourishment  to
the  different parts of  the  body,   by which  means
the growth becomes  unequal.    One part  grows too
                                           large,     i 
              OF CHILDREN.             13
large, while another remains too fmall;  and thus, in
time,  the whole  frame becomes  difproportioned and
misfhapen.   To  this we muft add, that when a child
is  cramped in its clothes, it  naturally fhrinks  from
the part that is hurt;  and, by putting its  body into
unnatural poflures, it  becomes deformed by habit.
   Deformity of  body  may  indeed  proceed  from
weaknefs or difeafe;  but, in general, it is the effect
of improper clothing.   Nine-tenths,  at  leaft, of the
deformity among mankind, muft be imputed to this
caufe.   A deformed body is not only difagreeable to
the eye, but, by a bad figure, both  the  animal and
vital functions muft  be  impeded, and,  of  courfe,
health impaired.   Hence, few people remarkably
misfhapen are ftrong or healthy.
   The  new motions which commence at  the birth,
as the circulation of the whole mafs of blood through
the lungs,  refpiration,  the periftaltic motion, &c.
afford another ftrong argument for keeping the body
of an infant free from  all preffure.   Thefe  organs,
not having been  accuftomed  to move,  are  eafily
flopped ; but when this happens, death muft enfue.
Hardly any method could be devifed  more effectually
to  flop  thefe motions,   than bracing the body too
tight with rollers * and bandages.  Were thefe to be
applied in the fame manner to the body of an adult,
for an equal length of  time, they would hardly fail
to hurt the digeflion and make him fick.   How much
more hurtful they muft prove to the tender bodies of
infants, we fhall leave any one to judge.
   Whoever confiders thefe things,  will not be fur-
prifed, that fo many children die of convulfions foon

   * This is  by no means inveighing againft a thing that does
not happen.  In many parts of Britain, and in France, at this
day, a roller, eight cr ten feet in length, is applied tightly
round the child's body, as foon as it is born.           2>
                                             after 
 14             OF  CHILDREN.
 after the birth.   Thefe fits are generally attributed
 to fome  inward  caufe ;  but  in fact,  they oftcner
 proceed from our own  imprudent conduct.   I have
 known a child feized with convulfion-fits, foon after
 the midwife  had done fwaddling  it,  who,  upon
 taking oil the rollers and bandages, was immediately
 relieved, and never had the difeafe afterwards.   Nu-
 merous examples  of this might be given, were they
 neceffan'.
  It would  be far fafer to fallen the clothes of in
 infant with firings than  pins, as thefe often gall arid
 irritate their tender  fkins,  and occafion  diforders.
 Pins have  been  found  flickin? above  half an  inch
 into the body of a child, after it had died of convul-
 sion  fits, which,  in all  probability,  proceeded from
 that caufe.
  Children  are not only hurt by the tightnefs "of
their clothes, but alfo by the quantity.  Every child
 has fome degree of fever after the birth ; and if it be
 loaded with too many clothes, the fever muft be in-
 creafed.   But this  is not  all;  the child is generally ■
 laid in bed with  the mother,  who  is often likewife
 feverifh ; to which we may add the  heat of the bed-
 chamber, the wines,  and other heating things, too
 frequently  given  to children immediately after the
 birth.   When all thefe are combined, which does
 not feldom happen, they  muft  increafe the fever  to
 fuch a degree as will endanger the life of the infant.
  The danger of  keeping infants too hot will further
 appear, if we confider that,  after they have been for
 fome time  in the fituation  mentioned above, they
 are often fent into the country  to be nurfed in a cold
 houfe.   Is it any wonder, if a child,  from fuch  a
 tranfition, catches a mortal  cold, or contract* fome
 other fatal difeafe? When an infant is  kept too
hot,  its lungs,  not being fufllciently expanded, are
 apt to  remain weak and flaccid for "life; hence pro-
                                             ceed 
               OF  CHILDREN.             15
ceed coughs, confumptions,  and other  difeafes of
the breaft.
   It would anfwer little purpofe, to fpecify the par-
ticular fpecies "of drefs proper for an infant.  Thefe
will  always vary in  different  countries, according to
cuftom and the humour of parents.   The great rule
to be  obferved is,  That a child have no more clothes
than are neceffary to  keep it warm, and that they be
quite eafy for its body.
   Stays  are the very bane  of  infants.   A volume
would not fuffice to point out all the bad effects of
this  ridiculous piece  of drefs both  on children  and
adults.   The madnefs in favour of flays feems, how-
ever, to be fomewhat  abated  ; and it is to be hoped
the world will,  in  time, become  wife  enough to
know, that the human fhape does not folely depend
upon whale-bone and bend-leather. *
   I  fhall only add, with refpect to the clothes of
children,  that they ought   to  be kept thoroughly
clean.   Children perfpire  more  than adults ;  and  if
their clothes be not  frequently changed,  they be-
come very hurtful.   Dirty clothes not only gall  and
fret the  tender fkins of infants, but  likewife occafion
ill fmells ; and, what is worfe, tend  to produce ver-
min and cutaneous difeafes.
   Cleanlinefs is  not only agreeable to the eye,  but
tends greatly to preferve the health of children.   It
promotes the perforation, and,  by that means, frees

  * Stays made of bend-leather,  are  worn by all the women
of lower llation, in many  parts of  England.
  I am forry to underftand, that  there  are ftill motheis  mad
enough to lace their d.u filters veiy tight,  in order to ii.,prove
their  fhipL'.  As reafoning would be totally loft  upon  fuch
people, 1  liiall beg leave jift to alk them, why there are ten
deformed women lor one man? and i.kewifs to recommend  to
their perufd a fhort movJ precept, v.'i.lel: forbid- us to rlefum
the human h-dv.
                                                the 
i6
OF
CHILDREN.
 the body from  fuperfluous  humours,  which, if re*
 tained, could not fail to occafion  difeafes.  No  mo--
 ther or nurfe can have  any excufe for allowing  a
 child to  be dirty.  Poverty may oblige her  to give
 it coarfe clothes ; but if fhe does not keep them clean,
 it muft be her own fault.

             Of the Food of Children.
   Nature not only  points out the food proper for
 an  infant, but actually prepares it.   This, however,
 is not fufficient to prevent fome  who think themfelves
 wifer than Nature, from  attempting to bring up their
 children without her provifion.  Nothing can fhew
 the difpofition which mankind  have to depart from
 Nature more, than their endeavouring to  bring up
 children without the breaft.   The mother's milk, or
 that of an healthy nurfe, is unqueflionably the belt
 food for an infant.  Neither art nor nature can afford
 a proper  fubftitute for it.  Children  may feem to
 thrive  for a  few months without the  breaft; but,
 when teething, the fmall-pox, and other difeafes in-
 cident  to childhood,  come on,  they generally perifh.
  A child, foon after the birth, fhews an inclination
 to fuck ;  and there is no reafon  why it  fhould not be
 gratified.   It is true, the mother's milk does not
 always come immediately after the birth ;  but this  is
 the way to bring it: befides, the  firft milk that the
 child can fqueeze out of the breaft anfwers the pur-
 pofe of cleanfing, better  than  all the drugs  in the
 apothecary's fhop, and at the fame time prevents in-
 flammations of the breaft, fevers, and  other difeafes
incident to mothers.
  It is ftrange how  people  came to think that the
firft thing given to a child  fhould be drugs.   This  is
beginning with  medicine betimes, and  no wonder  if
 they generally ended with it.  It fometimes happens,
                   x                      indeed, 
              OF  CHILDREN.              17
incited, that a child does not difcharge the meconium
fo foon  as could be wifhed ; this  has induced phy-
ficians, in fuch cafes, to give fomething of an open-
ing nature to cleanfe  the firft  paffages.   Midwives
have improved upon this hint, and never fail to give
fyrups, oils, &c. whether they be neceffary or not.
Cramming an infant  with fuch indigeftible  fluff  as
foon as it is born,  can hardly fail to make it fick,
and is more likely to occafion  difeafes than  to pre-
vent them.  Children are feldom long after the birth
without having  paffage both  by  flool and urine ;
though  thefe evacuations may  be  wanting for fome
time without any danger.  But if  children muft have
fomething before they  be allowed the breaft, let it
be a little thin water pap, to which may be added an
equal quantity of new milk ; or rather  water alone,
with the  addition of a little raw fugar.   If this be
given without any wines or fpiceries, it will neither
heat the blood, load the flomach, nor occafion gripes.
   Upon the firft fight of an infant, almoft every
perfon is  ftruck with the idea of its being weak,
feeble, and wanting fupport.   This naturally fuggefts
the idea of cordials.  Accordingly wines  are univer-
fally mixed with the firft food of children.   Nothing-
can be more fallacious  than this  way of reafoning,
or more hurtful to infants than the conduct founded
upon it.   Children require very little food  for fome
time after the birth  ; and what they receive fhould be
thin, weak, light, and of a cooling quality.   A very
fmall quantity of wine is fufficient to heat and inflame
the blood  of an infant; but every perfon converfant in
thefe matters muft know, that  moft of the difeafes of
infants proceed from the heat of their humours.
   If the  mother or  nurfe has enough of milk, the
child will  need  little or  no other food  before the
third or fourth  month.   It  will then be proper  to
give it, once or twice  a dav,  a little of fome food
                       C  '                   that 
iS
OF
CHILDREN.
that is eafy of digeftion, as water-pap, milk pottage?
weak broth  with bread in it, and fuch like.   This
will  eafe the mother, will accuftom the child by de-
grees to take food, and will render the weaning both
lefs difficult and lefs dangerous.   All great and fud-
den  tranfitions are  to be  avoided in nurfing.   For
this  purpofe, the food of children ought not only to
be fimple, but  to refemble, as nearly as poffible, the
properties of milk.   Indeed  milk itfelf mould make
a principal part of their food, not  only before they
are weaned, but for fome time after*.
   Next  to milk we fliould  recommend  good  light
bread.   Bread may be given to a child as foon as it
fliews an inclination  to chew ; and it may at all  times
be allowed as much  plain bread as it will eat.  The
very chewing of bread v/ill promote the cutting of
the  teeth,  and the  difcharge  of faliva,  while,  by
mixing with  the nurfe's  milk in the ftomach, it will
afford an excellent  nourifhment.  Children  difcover
an early inclination  to chew  whatever  is put into
their hands.   Parents  obferve the  inclination, but
generally miftake the object.   Inftead of giving the
child fomething which may at once exercife its  gums
and afford it nourifhment,  they commonly put into
its hands a  piece  of hard  metal,  or impenetrable
coral.  A cruft  of  bread is  the beft gum-flick.   It
not  only anfwers the purpofe better than any  thing
elfe, but has the additional properties  of nourifhing
the child and carrying the faliva down to the ftomach,
which is too valuable a liquor to be loft.

   *  I do not wifu to differ from the judicious author, but I
am well perfuaded, that it is in general beft to learn children
to feed a little when very young, and I believe there is no food
fo proper for  them as the hard water bifcuit pounded and
foiled in water, and afterwards adding milk and fugar.
Bread, 
               OF  CHILDREN.              19
   Bread, befides being ufed dry, may be many ways
 prepared into food for children.   One of the beft
 methods is to boil it in water, afterwards pouring
 the water  off, and mixing with the bread a proper
 quantity of new milk unboiled.   Milk is both more
 wholefome and nourifhing this way than boiled, and
 is lefs apt to occafion coftivenefs.  For a child farther
 advanced,  bread may be  mixed in veal or chicken
 broth,  made into  puddings or the like.   Bread is a
 proper  food for children at all times, provided it be
 plain, made of wholefome grain,  and well ferment-
 ed ;  but when enriched with  fruits, fugars, or fuch
 things,  it becomes very unwholefome.
   It is  foon enough to allow children animal food
*vhen they have got teeth to eat it.   They fhould
 never tafte it  till after  they are weaned,  and even
 then they ought to ufe  it fparingly.  Indeed,  when
 children live wholly on vegetable  food, it is apt to
 four  on their  ftomachs ; but, on  the other  hand,
 too much flefli heats the body,  and occafions  fevers
 and other inflammatory  difeafes.   This plainly points
 out  a due mixture of animal  and vegetable food as
 moft proper for children.
   Few  things prove more hurtful to infants,  than
the  common method of fweetening their food.   It
entices  them  to take more than they ought to do,
which makes them grow fat and bloated.  It is pretty
certain,  if  the food of children were quite plain,
that  they  would  never take more  than  enough.
Their exceffes  are  entirely owing to  nurfes.   If a
child be gorged with food at all hours, and enticed to
take it by making it fweet  and agreeable to the pa-
late, is  it any wonder  that fuch a child fhould in
time be  induced to crave more food  than it ought to
have ?
   Children may be hurt by too little as well as  too
much food.  After a child  is weaned, it ought  to be
                     C  2                     feci 
2»
OF
CHILDREN.
fed four  or five times  a  day ; but fhould  never be
accuftomed to eat in  the night;  neither fliould it
have too much at a time.   Children thrive beft with
fmall quantities of food frequently  given.  This nei-
ther overloads the ftomach nor hurts1 the digeftion,'
and is certainly moft agreeable to nature.
   Writers on nurfing have inveighed with fuch ve-
hemence  againft  giving children too much food, that
many parents, by endeavouring to  fhun that  error,
have run into the oppofite extreme, and ruined the
conftitutions of  their children.   But  the  error of
pinching  children in their food is more hurtful than
the other extreme.   Nature  has many ways  of re-
lieving herfelf when overcharged ;  but a child who
is  pinched with hunger will never become a  ftrong
or healthy  man.  That errors are frequently  com-
mitted on both fides, we are ready to acknowledge ;
but where  one child is hurt by the quantity of its
food, ten fuffer  from the quality.   This is the prin-
cipal evil, and claims our ilricteft attention.
   Many  people imagine that the  food which they
themfelves love cannot be bad for their children:
but this  notion  is very abfurd.  In the more advan-
ced period of life we often acquire an inclination for
food, which  when  children we could  not  endure.
Beiides,  there  are  many  things  that  by habit may
agree very well with the ftomach of a grown perfon,
which would be  hurtful to a child ; as high-feafoned,
falted, and fmoke-dried provifions,  &c.  It  would
alfo  be  improper  to feed children with fat  meat*
ftrong broths, rich  foups, or the like.
   All ftrong liquors are hurtful to  children.   Some •
parents teach their children to guzzle ale, and other
fermented  liquors,  at every meal.   Such a  practice
cannot fail to do mifchief.   Thefe children  feldom
efcape the violence of the fmall-pox, meases, whoop-
iag cough, or  fome inflammatory  diforder.   Milk
                                           water, 
OF
CHILDREN.
21
water, butter-milk, or  whey,  are the moft' proper
for children-to drink. If they have aSiy thing ftronger,
it- may be fine fmall beer, or a-little wine mixed with
water.  The  flomachs of  children  can digeft well
enough5 without' the affiftance  of warm flimulants:
foefidea, being naturally hot,  tfrey are? eafily hurt by
every thing of a1 heating' quality.
   Few things are more Hurtful to children1 thairiui-
ripc' fruits.   They weaken the powers of digeftion,
and  four and relax  the- ftomach, by which means it
Becomes a proper neft for  infects.   Children indeed
ffiew a great inclination- for  fruit, and I am apt to
believe,  that  if good  ripe fruit'were allowed them
in proper quantity, it would have no'bad effects.   We
never find a; natural1 inclination wrong, if properly
regulated'.   Fruits are generally of a cooling nature,
and'correct the  heat and acrimonyof the'humours.
This  is; what moft children  require ; only care fhould
be taken  left  they exceed.   Indeed the beft way to
grevent children from  going to excefs  in-the ufe of
fruit,  or eating that which is bad,  is" to allow them
a proper quantity of what is good*'.
   Hoots  which contain a  crude vifeid juice fliould
be fparingly given  to children.  They fill  the body
WitH- grofs- humours,  and tend to  produce eruptive
dlffeafes.   This  caution is peculiarly neceffary for the
pooT ; glacf to-  obtain  at a fmall price what  will fill
the bellies ofr their- children, they fluff them two or
three times a day with crude vegetables.   Children

   * Children are  always fickly  in the fruit feafon, which may
br thu* accounted  for: Two thirds- of the fruit which comes
to market in  this  country is. really  unripe ;. and'children not
being- in a condition to judge for- themfelves, eat whatever they
can lay their hands upon, which often proves, little better than
a poifon to their tender bowels.  Servants, and others who haMte
the care of children fhould be- ftridtly forbid-to give them any
it n't  without the knowledge of their parents.
                       C 2                      had 
 2*             OF  CHILDREN.
 had better eat a fmaller quantity of food which yields
 a wholefome nourifhment, than  be crammed  with
 what  their  digeftive powers are unable properly to
 aflimilate.
   Butter ought likewife  to be fparingly  given to
 children.   It both relaxes  the ftomach, and produces
 grofs  humours.  Indeed,  moft things that are fat
 or oily, have this effect.   Butter, when  falted, be-
 comes ftill more hurtful.   Inftead of butter, fo  libe-
 rally given  to children in  moft parts of Britain, we
 would recommend honey.  Honey is not only whole-
 fome, but cooling,  cleanfing,  and tends to fweeten
 the  humours.   Children who eat honey are feldom
 troubled with worms:  they  are alfo  lefs  fubject to
 cutaneous difeafes,  as itch, fcabbed head, &c.
   Many people err in thinking that the diet of  chil-
 dren ought  to be altogether moift.   When children
 live entirely upon  flops, it relaxes their folids,  ren-
 ders  them  weak, and  difpofes them  to the rickets,
 the  fcropula, and  other  glandular diforders.   Re-
 laxation is one of the moft general caufes of the dif-
 eafes  of  children.    Every  thing therefore which
 tends to unbrace their folids, ought  to be carefully
 avoided.
   We would not be underftood by thefe obfervations
 as confining children to any particular kind of food.
 Their diet may be frequently varied, provided always
 that fufficient regard be had  to fimplicity.

            Of the  Exercife of Children.

   Q£ all the caufes which  confpire to  render the life
 of man fhort and miferable, none has greater influ-
 ence tljan the want  of proper exercise : healthy
 parents, wholefome food,  and proper cloathing, will
 avail little,  where  exercife is  neglected.   Sufficient
,cxercife will make up for  feveral defects in nurfing;
                                               but 
              OF  CHILDREN.              23
but  nothing can  fupply the want  of it.   It is abfo-
lutely neceffary to the health,  the growth,  and the
flrength of children.
   The  defire of exercife  is coeval  with life itfelf.
Were this principle attended to, many difeafes might
be prevented.  But,  while indolence and fedentary
employments  prevent two-thirds  of  mankind  from
either taking fufficient exercife themfelves, or giving
it  to their children, what have we to  expect but dif-
eafes and  deformity  among  their offspring ?  The
rickets, fo  deftructive  to  children, never appeared
in Britain  till manufactures began to flourifh,  and
people, attracted by the love of gain, left the coun-
try to follow fedentary employments in great towns.
It is  amongft thefe people that this difeafe chiefly
prevails,  and  not only deforms, but kills many of
their offspring.
   The  conduct  of other  young animals fhews the
propriety of  giving  exercife  to  children.   Every
other animal makes ufe of its organs of motion as
foon as  it can, and many of them,  even when under
no neceffity of moving in  queft of food, cannot be
reftrained without force.   This is evidently  the cafe
with the calf, the lamb, and moft other young ani-
mals.  If thefe creatures were not  permitted to frifk
about and take exercife, they would foon die or be-
come difeafed.   The  fame inclination appears very
early in the human fpecies; but as  they are not able
to take exercife themfelves, it is the bufmefs  of their
parents and nurfes to affift  them.
   Children  may  be exercifed  various ways.   The
beft  method, while they are light, is to carry them
about in the nurfe's  arms*.  This gives  the  nurfe

  * The nurfe ought to be careful to keep the child in a'proper
pofition ; as deformity is  often  rhe confequence of inattention
to  this circumftance.  Its fituation ought alfo to be frequently
                      C 4                     a:? 
24              OF CHILDREN.
an opportunity of talking to the child,  arid of point-
ing out every thing that may pleafe and delight its-
fancy.   Befides, it is much  fafer  than twinging an
infant in  a machine, or leaving  it  to' the care of fuch
as are not fit to  take care of themfelves.   Nothing
can be more  abfurd than to fet one  child to keep
another: this conduct has proved fatal to many in-
fants, and has rendered others miferable for life.
  When children begin to walk,  the fafefi and  beft
method of leading them about, is by the hands.  The
common  way, of  fwinging  them in leading firings
fixed to their  backs, has  feveral  bad  cofrfequericetf.
It makes them throw their bodies  forward,  and prefl
with their whole weight upon the ftomach and breaft j
by this means the breathing is obftructed,  the breaft
flattened, and the bowels compreffed; which  muft
hurt the  digeftion,  and occafion confumptions of the
fungs,  and other difeafes.
  It is  a common notion,  that  if children are fet \
upon their  feet too foon,  their legs will Become
crooked.  There is reafon to believe,  that the very
reverfe  of  this  is  true.    Every member  acquires
ftrength in  proportion as it  is exercifed.  The limbs
of children are weak indeed, but  their  oodies  are
proportionably light; and had they fkill  to  direct
themfelves,  they would foon be able to fupport their
own weight.  Who ever heard of any other animal
that became crooked by ufing its legs too foon ?  In-
deed, if a child is  not permitted to  make any ufe of
its legs till a confiderable time after  the birth, and be
then fet  upon them with its whole weight at otice,
there may be fome danger; but  this proceeds entirely
from the child's  not having  been  accuftomed to  ufe
its legs from the beginning.

changed.  I h,ive known a child's leg bent all on one fide, by
the nurfe carrying it conftantly on one arm.
                                         Mothers 
              OF  CHILDREN.              25
  Mothers of the poorer fort think they are great
gainers by making their children lie or fit while they
themfelves work.  In this they are greatly miftaker..
By neglecting  to  give their children exercife, they
are obliged to keep them a long time before they can
do any thing for  themfelves,  and to fpend more on
medicine than would have paid for proper care.
  To take care of  their children,  fs the moft  ufe-
ful  bufmefs  in  which even  the  poor  can be  em-
ployed : but  alas !  it is not always in their power.
Poverty often obliges them to neglect their offspring,
in ord'er^o  procure  the neceffaries of life.   When
this is  the cafe, it  becomes  the  interefl as  well  as
the duty  of the public to affft them.   Ten thoufand
times  more  benefit  would accrue to  the flate,  by
enabling the  poor to bring up their own children, than
from all the  hofpitals* that ever  can be erected  for
that purpofe*.
   Whoever  confiders the flructure  of the human
body will foon be convinced of the  neceffity of exer-
cife for the health of children.   The  body  is com-
pofed of an  infinite number of tubes, whofe fluids
Cannot be pufhfd on without the action and preffure
of the mufcles.  But, if the  fluids  remain inactive,
obftructions  muft happen, and the humours will  of
Courfe  be vitiated,  which  cannot fail  to  occafion
cftfarfes.   Nature has  furnifhed both  the  veflels

  *  If it were made the intereft cf the  poor to keep their chil-
dren alive, we fhould lbfe very few of them. A fmaii premium
given annually to each poor family, for every child they have
aliVe at the year's end, would fave more infant lives than if the
whole revenue  were  expended on  hofpitals for this purprfe".
This would make the poor efteem' fertility a bleffing; whereas
many of them think it the greateft curfe Cnat can befal them-;
and in  the place of wiflvng their children to live; fir far does
poverty get the better of natural affection, that tbey are often
very happy when they die.
which 
26
OF
CHILDREN.
 which carry the blood and  the lymph with nume-
 rous valves, in order that the action of every mufcle
 might pufli forward their  contents  ;  but  without
 action, this  admirable contrivance can  have no ef-
 fect.  This part of the animal  ceconomy proves to
 a demonftration the neceifity of exercife for the pre-
 fervation of health.
   Arguments to  fliew the  importance of exercife
 might be drawn from every part of the animal ceco-
 nomy ; without exercife, the  circulation of the blood
 cannot be  properly  carried  on,  nor the different fe-
 cretions duly performed ; without exercife, the fluids
 cannot be properly prepared, nor the folids rendered
 ftrong or firm.   The action  of the heart, the motion
 of the lungs, and all the vital functions, are  greatly
 affifted by  exercife.   But to point out  the manner
 in  which  thefe  effects  are produced,  would lead
 us farther  into  the  ceconomy of the  human  body,
 than moft  of thofe  for whom this treatife is  intend-
 ed would be able to follow.   We  fhall therefore
 only add,  that, where exercife is neglected, none of
 the  animal  functions can be duly performed ; and
 when this is the cafe, the whole conftitution muft go
 to wreck.
   A good conftitution ought certainly to be our firft
 object in  the management  of children.  It lays  a
 foundation  for their being ufeful and happy in life j
 and whoever neglects it, not only fails in his duty to
 his offspring, but to  fociety.
   One very common error  of  parents,  by which
they  hurt the conftitutions  of their children,  is the
fending them too  young to  fchool.  This is often
done folely to prevent trouble.   When the child is
at fchool, he needs  no keeper.  Thus  the fchool-
mafter 'is made the nurfe ;  and the  poor child is
fixed to a feat feven  or eight hours  a day,  which
time ought  to- be  fpent in exercife and  diverfions.
                                          Sitting 
              OF  CHILDREN.              27
Sitting fo long  cannot fail to produce the worft ef-
fects upon the body ;  nor is the  mind lefs  injured.
Early application  weakens  the faculties, and often
fixes in the mind an averfion to books, which conti-
nues for life*.
   But fuppofe this were the way to make  children
fcholars,  it certainly ought not to be done at the ex-
pence of their  conftitutions.  Our  anceftors, who
feldom went  to fchool very young, were  not lefs
learned than  we.  But we imagine the boy's edu-
cation will be quite marred,  unlefs he be carried to
fchool in his nurfe's arms.   No wonder if fuch hot-
bed plants feldom become either fcholars or men !
   Not only the confinement of  children in  public
fchools,  but  their  number,  often  proves  hurtful.
Children are much injured by being kept in crowds
within doors j their breathing not only  renders the
place unwholefome, but if any one of them happens
to be difeafed,  the reft catch  the infection.   A An-
gle child has  been often known to communicate the
bloody flux, the whooping-cough, the itch,  or other
difeafes, to  almoft every individual in  a numerous
fchool.
   But,  if fafhion muft prevail, and infants are to be
fent to fchool,  we would recommend it to  teachers,
as  they  value  the  interefts of fociety, not to con-
fine them too  long at a time, but allow  them  to
run about and  play at fuch active diverfions as may
promote their growth, and ftrengthen their conftitu-
tions.  Were boys, inftead of being prevented from

   * It is undoubtedly the duty of parents to inftrucT: their chil-
 dren, at leaft till they are of an age proper to take ibme care of
 themfelves. This would tend much to confirm the ties of pa-
 rental tendernefs and filial affection, of the want of which there
 are at prefent fo many deplorable inftances.  Though few fa-
 thers have time to  inftrucT: their children, yet moft  mothers
 have j and furely  they cannot be better employed!
                                           running, 
2*
OF  CHILDREN.
running, riding, fwimming, or the like, encouraged1    |
to employ a proper part of their time in thefe manly*
and ufeful  exercifes4, it would1 have  many  excellent-    1
effects.                                               1
   An effeminate education will infallibly1  fpoil the    J
beft natural conftitution ;  and  if boys are brought
up in a more delicate manner than even- girls ought t<*
be, they never will be men.
   Nor is^ the common education1 of girls lefs1 Hurt-
ful to  the conftitution than  that of boys.   Mifsr is.
fet down  to her frame before fhe  can put  oil' her
clothes;  and* is taught to' believe,  that  to excel' at
the needle is the only thing that  can entitle her tb
general efteem.  It is unneceffary here* to infift upon  •
the dangerous  confequences-  of obliging  girte to fit
too much.  They are pretty well" known,  and are    \
foo often felt at a  certain  time of  life.   But fup-
gsofing  this  critical  period' to be got over,  greater
dangers ftill await  them when they  come to  be mo*-
fliers.   Women who have been early ateuffomecT to
a fedentary life, generally run great hazards in child*.
bed ;  while thofe Who* have been ufed to- take fufflk
cient exercife,  are  feldom in any danger.
   One hardly meets with a girl who can  at the fame
time boaft of early performances by* the needle,, and
a  good conftitution.   Clofe  and early confihetneHt
generally oecafions indigeftions, head-achs, pale' com*-    J
flexions,  pain  of  the ftomach,  lofs of appetite,   < I
coughs', confumptions  of  the lungs,, and defwm%    I
of body.  The laft of thefe indeed is not to bewotf-  .  I
dered at,  confidering the aukward poftures in which
girls fit at many kinds  of needle-work, and-tfre de-
licate  flexible  ftate of  their bodies in tne ea»Iy pe-
riods of life.
   Would  mothers,  inftead of having their  daugfa.
ters inflnicted  in many triflifig accomplifhments em-
ploy them in plain work  and' houfewifery,  arid* af-
                                              low 
              OF  CHILDREN.              29
low  them fufficient  exercife in  the open air,  they
would both make them more healthy mothers, and
more ufeful  members of fociety.  I am no  enemy
to genteel accomplifhments, but would have them
only confidered as fecondary, and always difregarded
when they impair health.
   Many people  imagine  it  a great  advantage for
children  to  be  early  taught to earn their  bread.
This  opinion  is certainly right,  provided they  were
fo employed as not  to hurt their health or growth ;
but,  when thefe fuffer, fociety,  inftead of being be-
nefited, is a real lofer by their  labour.  There are
few  employments, except fedentary ones, by which
children can  earn a livelihood;  and if they be  fet
to thefe too foon, it ruins their conftitutions.  Thus,
by gaining  a  few years from childhood, we gene-
rally lofe twice as many in the latter period  of life,
and  even render the perfon lefs  ufeful while he does
live.
   In order to be fatisfied of the truth of this obfer-
vation, we need only look into  the great manufac-
turing towns, where we fhall find a puny  degene-
rate race  of people,  weak  and  fickly all their  lives,
feldom  exceeding the middle period of life;  or if
they do,  being unfit for bufmefs  they  become  a
burden to  fociety.  Thus  arts and manufactures,
though they  may  increafe  the  riches of a country,
are by no means favourable to the health of its  in-
habitants.   Good  policy would therefore  require,
that  fuch people  as labour during life,  fhould not
be fet too early to  work.   Every perfon converfant
in the breed  of horfes, or other working  animals,
knows, that if they be fet to hard labour too foon,
they never will turn out  to advantage.    This is
equally true  with  refpect  to the human fpecies.—
Weakly children fhould always  be  put apprentices
to trades which require their being moftjy out  cf
                                           doors $ 
3*
OF  CHILDREN.
 doors;  the contrary practice  is, however,  too  com-
 mon.
   There are neverthelefs various ways  of employ-
 ing young people without hurting their health.  The
 eafier parts of gardening, hufbandry, or any bufmefs
 carried  on without doors, are  moft proper.  Thefe
 are employments which moft young people  are  fond
 of, and  fome parts of them may always be adapted
 to their age, tafte, and ftrength*.
   Such parents, however,  as are under the necef-
 fity of employing their children within doors, ought
 to  allow them fufficient time for active diverfions
 without.  This  would both  encourage them to do
 more work,  and  prevent  their  conftitutions  from
 being hurt.
   Some imagine,  that exercife within doors is fuf-
ficient ;  but  they  are greatly miftaken.   One  hour
fpent in running,  or any  other  exercife without
 doors, is worth ten within.   When children cannot
go abroad, they may indeed be  exercifed  at home.
 The beft  method of doing this,  is to make  them
run about  in a long room, or  dance.    This laft
 kind of exercife,  if not carried to excefs,  is of ex-
cellent fervice to  young people.   It  cheers  the fpi-
rits, promotes perfpiration,  ftrengthens  the limbs,
 &c.   I  know an eminent phyfician who ufed to fay,
that he made his  children dance, inftead of giving
 them  phyfic.  It were well  if more people followed
 his example.
   The cold bath may be confidered as an aid to
 exercife.  By it the body is  braced and ftrengthen-
cd ; the circulation and  fecretions promoted  ;  and,

  * I have been told  that in China, where the police is the beft
in the world, all the children are employed in the eafier part of
gardening and hufbandry ; as weeding, gathering ftones off the
land, and fuch like.
2
were 
OF  CHILDREN.
3«
were it conducted with prudence, many difeafes, as
the rickets, fcrophula, &c. might thereby  be pre-
vented.   The ancients, who took every method to
render children hardy and robuft, were no flrangcrs
to the ufe of the cold bath ; and, if we may credit
report, the  practice of immerfmg children  daily in
cold water muft have been very common among our
anceftors.
   The greateft objection to the ufe of the cold bath
arifes from the fuperftitious  prejudices of nurfes.
Thefe are often fo ftrong, that  it  is impoffible to
bring them to  make a  proper ufe  of it.    I have
known fome of them who would not dry  a child's
fkin after bathing it, left it fliould deftroy the effect
of the water.   Others  will even put cloths  dipt in
the water upon the child, and either put it to bed,
or  fuffer  it to go  about in  that condition.  Some
believe that the whole virtue of the water depends
upon its  being dedicated to a particular faint: while
others place their  confidence  in a  certain   number
of dips,   as  three,  feven,  nine, or  the  like ;  and
the world could not perfuade them,  if thefe do not
fucceed,  to try it a little longer.  Thus, by the whims
of nurfes, children  lofe the benefit of the cold bath,
and the hopes of the phyfician from that medicine are
often fruftrated.
   We ought  not,  however, entirely to fet  afide the
cold bath, becaufe  fome nurfes make a wrong ufe of
it.   Every child, when in health, fliould at leaft have
its head  and extremities  daily wafhed in cold water.
This is a partial ufe  of  the cold  bath,  and is better
than none.   In winter, this may  fuffice ; but, in the
warm feafon,  if a child be relaxed,  or feem to have
a tendency to  the rickets  or  fcrophula, its whole
body ought to be  frequently immerfed in cold wa-
ter.  Care, however, mufl be taken not to do this
when the body is  hot, or the ftomach full.   The
                                             child 
 3*              OF  CHILDREN.
 child fhould be dipt only once at a time, fhould be
 taken out immediately, and have its fkin well rubbed
 with a dry cloth.

  The bad Efeels of unwhdefome Air upon Children.
  Few  things  prove more deftructive to children
than confined  or 'unwholefome air.   This  is  one
reafon why  fo  few of thofe  infants,  who are  put
into hofpitals,  or parifli  workhoufes, live.  Thefe
places are generally crov/ded  with  old,  fickly,  and
infirm people ;  by which  means the air is rendered
fo extremely pernicious, that it becomes a poifon to
infants.
  Want of wholefome air  is likewife deftructive to
many of the children born in great towns.  There
the  poorer  fort of  inhabitants  live in  low, dirty,
confined houfes, to which the  frefh air  has  hardly
any accefs.  Though grown people, who are hardy
and  robuft, may live  in  fuch fituations,  yet  they
generally  prove  fatal  to  their offspring,  few of
whom  arrive at  maturity,  and thofe who do are
weak and deformed.  As fuch people are not  in a
condition  to carry  their  children  abroad into  the
open air,  we muft  lay our  account with lofing the
preater  part of them.  But the rich have not  this
excufe.   It  is their bufmefs to fee that  their  chil-
dren be daily carried abroad,  and that they be kept
in the open  air for a fufficient time.  This will al-
ways fucceed  better if the mother goes along with
them.   Servants  are often  negligent in thefe  mat-
ters, and  allow a child to  fit  or lie  on  the  damD
ground, inftead of  leading  or carrying it  about.
The mother certainly needs air as -well as  her  chil-
dren ; and how can fhe be  b:tter employed than in
itttending  them ?
i
A very 
                 OF  CHILDREN.              33
   A very  bad  cuflom prevails, of making children
 fleep in fmall apartments, or crowding two or three
 beds into one chamber.   Inftead of this, the nurfery
 ought  always to be the largeft and beft aired room
 in the  houfe.   When children are  confined in fmall
 apartments, the air not  only becomes unwholefome,
 but  the heat relaxes  their folids,  renders  them de-
 licate,  and difpofes  them to colds  and many other
 diforders.   Nor is the  cuflom of wrapping  them
 up too clofe in  cradles lefs pernicious.   One would
 think that  nurfes  were  afraid left  children  fhould
 fuffer by breathing free air, as many of  them ac-
 tually cover the child's face while  afleep, and others
 wrap a covering over the whole  cradle, by which
 means the  child is  forced  to breathe  the  fame air
 Over and over all the time it fleeps.   Cradles indeed
 are  on  many accounts  hurtful to  children, and  it
 would be better if the ufe of them were totally laid
 afide. *
   A child is generally laid to fleep with all its clothes
 on; and if a  number of others are heaped above
 them, it muft be overheated ; by which means it can-
 not  fail to catch cold on being taken out of  the


  * It is amazing how children efcape fuffocation, confidering
 the manner in which they are of en rolled up in  flannels, &c.
 i lately attended an infant, whom I found muffled up over head
 and ears in many folds of flannel, though it was in the middle
 of June.   I begged for a little free air to the  poor babe ; but
 though this indulgence was granted during my ftay,  I found it
 always on my return in the fame fitttation.  Death, as might be
 expected, foon freed the infant from all its mileries ;  but it was
 not in my power to free the minds of its parents from thofe
 prejudices which proved fatal to their child.
  I was very  lately called to fee an infant  which was faid to be
 expiring  in convulfion fits.  I defired the mother to ftrip the
child, and wrap it in a loofe covering. It  had no nlore con-
 Tulfion fits.
D                  cradle, 
3+            OF  CHILDREN.
cradle, and expofed in the open air with only its ufual
clothing, which is too frequently the cafe.
   Children who are kept within doors all day, and
fleep all night in warm clofe apartments, may, with
great propriety,  be compared to plants,  nurfed in a
hot-houfe,  inftead  of the  open air.   Though fuch
plants may, by this means, be kept alive for fome time,
they will never arrive at that degree of ftrength, vi-
gour, and  magnitude, which they would have  ac-
quired in the open air, nor would they be able to
bear it afterwards, fhould they be expofed to it.
   Children brought up in the country, who have
been  accuftomed to  open  air,  fhould  not be  too
early fent to great towns,  where  it is confined and
unwholefome.  This is frequently done  with a view
to forward their education, but  proves very hurtful
to their health.  All fchools and feminaries of learn-
ing ought, if poffible, to be  fo fituated as  to have
frefh, dry, wholefome air,  and fhould never be  too
much crowded.
   Without entering into  a detail of  the particular
advantages of wholefome air to children, or of  the
bad confequences which proceed  from the want of
it,  I  fhall  only  obferve, that,  of feveral thoufands
of  children which have been  under my care, I do
not remember one inftance of  a fingle child who
continued healthy  in a clofe confined  fituation ;  but-
have  often known the moft obftinate difeafes cured
by removing them from fuch a fituation to an open
free air.
                      Of Nurfes.

   It is  not here intended to lay down rules for the
-choice of nurfes.    This would be wafting  time.
Common fenfe will  direct every one to chufe  a wo-
                                             man 
               OF  CHILDREN.            35:
man  who is healthy, and has plenty of milk. *   If
fhe be at  the fame time cleanly, careful,  and good-
natured, fhe can hardly fail to make a proper  nurfe.
After all,  however,  the  only certain  proof of a
good nurfe is an healthy child upon her breaft.   But,
as the mifconduct of  nurfes  often  proves fatal to
children, it will be  of importance  to  point  out a
few of  their moft baneful errors, in order to roufe
the attention of parents,  and to make them look
more ftrictly into  the  conduct of  thofe  to  whom
they commit the care of their infant offspring.
   Though  it admits of  fome  exceptions, yet  we
may lay it down as a general rule, that every  woman
who nurfes for  hire fhould be carefully  looked after,
otherwifefhe will not do her  duty.   For this  reafon
parents ought always to have  their children  nurfed
under their  own eye,  if poffible ;  and where this
cannot  be done, they fhould be  extremely circum-
fpect in the choice  of thofe perfons to whom they
intruft  them.  It  is folly to imagine that  any wo-
man,  who  abandons her own  child to  fuckle  an-
other for the fake of gain, fliould feel all  the affec-
tions of a parent towards her nurfling ; yet fo necef-
fary  are thofe affections in  a nurfe, that, but  for
them, the human race would foon be extinct.
   One of the moft  common  faults of  thofe who
nurfe  for  hire,  is to  dofe  children with  flupefac-
tives, or  fuch things  as lull them  afleep.    An in-
dolent  nurfe, who  does not give a child fufficient
exercife in the open air to make it fleep, and does
not  chufe to be difturbed by it in the night,  will
feldom fail to procure  for  it a dofe of  laudanum,
 diacodium, faffron,  or what anfwers  the fame pur-

   *  I have often known people fo impofed upon, as to give an
 infant to a nurfe to be fuckled, who had not one drop of milk
 in her breaft,
                        D  2                 pofe, 
36.             OF  CHILDREN.
pofe, a dofe  of  fpirits,  or other  ftrong  liquors.
Thefe,  though they be certain  poifon to infants, are
every day. adminiftered  by many who bear  the cha-
racter of very good nurfes. *
  A nurfe who has not milk enough is apt to  ima-
gine that this defect may be fupplied by giving the
child wines,  cordial waters,  or other ftrong liquors.
This is an egregious miftake.   The only thing that
has any chance to fupply the  place of the nurfe's
milk, muft be fomewhat nearly of the fame quality,
as cow's milk, afs's milk,  or  beef tea,  with good
bread.   It never can be done by the help of ftrong
liquors.  '  Thefe, inftead of  nourishing an infant,
never fail to produce the contrary effect.
  Children are often hurt by  nurfes fuffering them
to cry long  and  vehemently.   This ftrains  their
tender bodies, and  frequently occafions ruptures,
inflammations of  the throat, lungs, &c   A child
never continues to  cry long  without  fome caufe,
which might always be difcovered  by proper atten-
tion ', and the  nurfe who can hear an infant cry till
it has  almoft fpent itfelf, without endeavouring  to
pleafe it, muft be cruel indeed, and is unworthy  to
be entrufted with the. care of an human creature.
  Nurfes who deal much in medicine are always  to
be  fufpected.  They truft  to  it,  and neglect their
duty.   1 never  knew  a good nurfe who  had her
Godfrey's  cordials,  Daffy's elixirs,  &c.  at hand.
Such generally imagine, that a dofe of medicine will
make up for all defects  in  food, air, exercife, and
cleanlinefs.   By errors  of this  kind, I  will venture
to fay,  that one half of the children who die annu-
ally in London, lofe their lives.

  * If a mother, on vifiting her child at nurfe, find it always
afleep, I would advife her to remove  it immediately, otherwife
it will foon fleep its laft.
Allowing 
               OF  CHILDREN.             37
   Allowing children to continue long wet, is another
very pernicious cuflom of indolent  nurfes.   This is
not only difagreeable,  but it galls  and frets the in-
fant, and, by relaxing the folids,  occafions fcrophu-
las, rickets, and  other difeafes.   A dirty  nurfe is
always to be fufpected.
   Nature often attempts to free the bodies of chil-
dren from bad humours,  by throwing them upon
the fkin: by this means  fevers and other difeafes
are prevented. Nurfes are apt  to  miftake fuch cri-
tical eruptions for an  itch, or fome other infectious
diforder.  Accordingly they  take  every method  to
drive  them  in.   In this  way  many  children  lofe
their  lives;  and  no Wonder,  as Nature is oppofed
in the very method fhe  takes to relieve them.   It
ought to be a rule, which every nurfe fliould obferve,
never to flop any eruption without proper advice,  of
being well affured that it is not of a critical nature.
At any  rate, it is  never to be  done without previous
evacuations.
   Loofe floors is another method by which  Nature
often prevents or carries  off the difeafes of  infants.
If thefe proceed too far,  no doubt they ought to be
checked ; but this is  never to be done without the
greateft caution.  Nurfes, upon the firft appearance
of loofe flools, frequently fly to  the ufe of aftrin-
gents, or fuch things as bind the body.   Hence in-
flammatory fevers, and other  fatal difeafes, are  oc-
cafioned.  A  dofe of rhubarb, a  gentle vomit,  or
fome other evacuation, fliould generally precede the
ufe of aftringent medicines.
   One of the greateft faults of nurfes is, concealing
the difeafes  of children  from their parents.   This
they are extremely ready to do,  efpecially when the
difeafe is the effect of  their own negligence.   Many
inftances might be given of perfons who have been
rendered lame for life by a fall from  their nurfe's
                       D 3                 arms, 
38             OF  CHILDREN.
arms,  which fhe,  through fear,  concealed  till  the
misfortune was  paft cure.   Every  parent who in-
trufts a nurfe with the care of a child, ought to  give
her the ftri&eft charge not to conceal the moft trifling
diforder or misfortune that may befal it.
  We can fee no reafon why a  nurfe, who conceals
any  misfortune  which happens  to a child  under her
care, till  it lofes its  life  or limbs,  fliould not be
punifhed.   A few examples  of this  would fave the
lives of many  infants; but  as  there is little reafon
to expect that  it ever  will be  the. cafe,  we would
earneftly recommend  it to all  parents  to  look care-
fully after their  children, and  not to truft fo valu-
able a treafure entirely to the hands of an hireling.
  No  perfon ought to  imagine thefe things unwor-
thy of his attention.   On the proper  management
of children depend  not only their health and ufeful-
nefs in life, but  likewife the fafety and  profperity of
the  flate  to which they belong.   Effeminacy  ever
will prove the  ruin of any flate where it prevails ;
and, when its foundations are laid in infancy, it can
never afterwards be wholly eradicated.   Parents who
love their offspring,  and wifh well to their country,
ought therefore, in  the management  of their  chil-
dren,  to avoid every  thing that may have  a tendency
to make them weak or effeminate, and  to  take every
method in their power to render their conftitution?
ftrong and hardy.

             -----—By arts like thefe
     Laconia nurs'd of Id her hardy fons ;
     And Rome's unconquer'd legions urg'd their way,
     Unhurt, thro' every toil and every clime. *

                   $  Armftrong.


                                            CHAP, 
C  39  3
                   CHAP.  II.


  Of the Laborious, the Sedentary, and the Studious.


           1 HAT  men  are expofed  to particular
difeafes from the occupations which  they  follow, is
a fact well known;  but  to remedy this  evil is a mat-
ter of fome difficulty.  Moft people are under  the
neceffity  of following thofe employments to which
they have been  bred, whether they be favourable
to health or not.    For this reafon, inftead of in-
veighing,  in a general  way, as fome  authors have
done, againft  thofe  occupations  which are hurtful
to health, we fhall  endeavour to point out the  cir-
cumftances in each  of them from  which the danger
chiefly arifes,  and to  propofe the  moft  rational me-
thods of preferving it.
   Chemifts,  founders,  forgers,  glafs-makers,  and
feveral other artifts,  are hurt by the  unwholefome
air which they are  obliged to breathe.   This air is
not only loaded  with the noxious exhalations arifing
from  metals and minerals, but is fo charged with
phlogifton  as  to  be  rendered  unfit for  expanding
the lungs fufficiently, and anfwering the other  im-
portant  purpofes of refpiration.    Hence proceed
afthmas,  coughs and confumptions of  the lungs, fo
incident to perfons who  follow thefe employments.
   To prevent fuch confequences,  as far as  poffible,
the places where thefe occupations are carried on,
ought to  be conftructed in fuch a manner as to dif.
charge the fmoke and  other exhalations, and admit
a free current of frefh air.   Such artifts ought never
                       D 4                    to 
 40  OF THE LABORIOUS, THE SEDENTARY",
 to continue too  long at work ;  and when they give
 over, they fhould fuffer themfelves to cool gradually,
 and put on their clothes before they go into the open
 air.   They ought never to drink large quantities  of
 cold, weak, or watery liquors, while their bodies
 are hot, nor to indulge in  raw fruits, fallads, or any
 thing that is cold on the ftomach. *
   Miners, and all who work under ground, are like-
 wife hurt by unwholefome  air.   The air, by  its flag-
 nation in deep mines, not only lofes its proper fpring
 and other qualities neceffary  for  refpiration, but is
 often loaded with fuch noxious exhalations as to be*
 come a moft deadly poifon.
   The two kinds of air which prove moft deftructive
 to miners, are what  they call  the fire damp, and the
 choke damp-,  In both cafes  the air becomes a poifon.
 The danger from the  former may be obviated by
 making it explode before it accumulates in too great
 quantities; and the latter  may be generally carried
 off by  promoting a free circulation of  air   in the
 mine.
   Miners  are not  only hurt by  unwholefome air,
 but likewife by the particles of metal which  adhere
 to their ikin, clothes, &c,   Thefe -are abforbed,  or
 taken up into the body, and occafion palfies, verti-
 goes, and other nervous affections,  which often prove
 fatal.  Fallopius obferves,  that thofe who work  in
 mines of  mercury feldom  live  above three or four
 years.   Lead, and feveral other metals, are likewife
 very pernicious to the health.
   Miners ought never to  go  to work faffing, nor
 to continue too long at work.  Their food ought
to be nourifhing,  and  their liquor generous : nor
thing more certainly  hurts  them than living too low,

  ¥ When perfons heated with labour have drunk cold liquor
iJjey ought to continue at work  for fome time after.
4
They 
              AND THE STUDIOUS.           41
   They fhould by all means avoid coftivenefs.   This
 may either be done by chewing a little rhubarb, or
 taking a fufficient  quantity of fallad oil.   Oil not
 only opens the body,  but fheaths and  defends the
 inteflines from the ill effects of the metals.  All who
 work in  mines or  metals ought  to  wafh carefully,
 and to change their clothes as foon as they give over
 working.   Nothing would tend more to preferve the
 health' of fuch people  than a ftrict,  and almoft reli-
 gious regard to cleanlinefs.
   Plumbers, painters,  gilders,  fmelters, makers of*
 white  lead, and  many others  who work in metals,
 are liable to the fame  difeafes as miners, and ought
 to obfcrve the fome directions for  avoiding them.
   Tallow-chandlers, boilers of oil,  and  all  who
 work in putrid animal fubftances,  are likewife liable
 to fuffer from  the unwholefome fmells or effluvia of
 thefe  bodies.  They ought to  pay the fame regard
 to cleanlinefs as miners;  and when they are affected
 with naufea, ficknefs, or  indigeftion, we would ad-
 vife them to take a  vomit or a  gentle purge.   Such
 fubftances ought always to be manufactured as foon
 as poffible.   When long kept,  they not only become
 unwholefome  to  thofe who manufacture them,  but
 likewife to  people who live in the neighbourhood.
   It would greatly  exceed the limits of this part of
our fubject, to fpecify the^ difeafes peculiar to perfons
 of every  occupation ;  we fhall  therefore confider
 mankind under the general claffes  of Laborious, Se-
 dentary, and Studious.

            THE  LABORIOUS.

   Though  thofe who follow laborious employments
 are in general  the moft healthy of mankind, yet the
 nature pf their occupations, and  the places  where
                                             they 
 42   OF THE LABORIOUS, THE SEDENTARY,
 they are carried on, expofe them more particularly
 to fome  difeafes.   Hulbandmen, for  example, are
 expofed to all the viciffitudes of the weather, which,
 in this country, are often very great and  hidden,
 and  occafion colds, coughs,  quinfies,  rheumatifms,
 fevers, and other acute diforders.  They are likewife
 forced  to work hard,  and often to carry burdens
 above their  ftrength, which,  by overftraining the
 veffels, occafion afthmas,  ruptures,  pleurifies, &c.
  Thofe who labour without doors are often afflict-
 ed with intermitting fevers or agues,  occafioned by
the frequent viciffitudes of heat and cold, poor living,
bad  water,  fitting or lying on the damp ground,
 evening dews, night air, &c. to which they are  fre-
 quently expofed.
  Such as bear heavy burdens, as porters, labourers,
 &c. are obliged to draw in the air with  much greater
force, and alfo to keep their  lungs  diftended  with
more violence than  is neceffary  for common refpira-
tion :  by this means the  tender veffels of the lungs
are overftretched, and often burft, infomuch that a
fpitting of blood or fever enfues.  Hippocrates men-
tions an  inftance to this  purpofe,  of a man, who,
 upon a  wager, carried an afs ; but  was foon  after
feized with  a fever,  a  vomiting of blood,  and a
 rupture.
  Carrying  heavy burdens is  generally the effect of
 mere Iazmefs, which prompts people to do at  once
 what fhould  be  done at twice. Sometimes it proceeds
 from vanity or emulation.   Hence  it is,  that the
 flrongeft men are moft commonly  hurt by heavy
 burdens, hard  labour, or feats  of activity.    It is
 rare to find one who boafts of his ftrength without
 a rupture, a fpitting of blood, or fome other difeafe,
 which he reaps as the fruit of his folly.  One would
 imagine,  the daily  inftances we have, of the  fatal
                                           effect? 
             AND THE STUDIOUS.           43
effects of carrying great weights, running,  wreft-
ling, and the  like,  would be  fufficient  to  prevent
fuch practices.
  There are indeed  fome employments which ne-
ceffarily require a great exertion of ftrength, as por-
ters, blackfmiths, carpenters,  &c.    They fliould
never exert their ftrength  to the utmoft, nor work
too long.   When the mufcles are violently ftrained,
frequent reft  is neceffary, in  order that they may
recover their  tone ; without this, the ftrength and
conftitution will foon be worn  out, and a premature
old age be  induced.
   The  eryfipelas, or St. Anthony's fire, is a difeafe
very  incident to the laborious.  It is occafioned by
whatever  gives a fudden check to the perfpiration,
as drinking cold water when the body is warm, wet
feet, keeping on wet clothes, fitting or  lying on
the damp  ground, &c.   It is impoffible for  thofe
who labour without  doors always to  guard againft
thefe inconveniences; but it  is  known  from  expe-
rience,  that  their ill confequences might often be
prevented  by  proper  care.
   The iliac paffion,  the cholic, and other complaints
of the bowels, are often occafioned by the fame caufes
as the eryfipelas; but they may likewife proceed from
flatulent and indigeftible food.  Labourers frequently
eat unfermented bread, made  of peas,  beans, rye,
and other windy ingredients.    They  alfo devour
great quantities of unripe fruits, baked, flewed, or
raw,  with various kinds of roots and herbs,  upon
which  they often drink four  milk, flale fmall beer,
or the like.   Such a  mixture  cannot fail to fill the
bowels with wind, and occafion  difeafes of thofe parts.
   Inflammations, whitloes, and other difeafes of the
 extremities, are likewife common among thofe who
 labour without doors.  Thefe  difeafes are often at-
 tributed to venom, or fome kind of poifon j but they
                                             gene- 
 44  OF THE LABORIOUS, THE SEDENTARY,
 generally proceed either from hidden heat after cold,
 or the  contrary.  When labourers, milk-maids, &c.
 come from the  field, cold  or wet, they run to the
 fire, and often  plunge their hands in warm water,
 by  which means the blood and other humours in
 thofe parts are  fuddenly expanded,  and, the veffels
 not yielding fo quickly, a ftrangulation happens, and
 an inflammation or a mortification enfues.
  When fuch perfons come home cold,  they ought
to keep at a diftance from  the fire for fome time, to
wafli their hands in cold water, and to rub them well
with a dry cloth.  It fometimes happens, that people
are fo benumbed with cold, as to be quite deprived
of the ufe of their limbs.   In this cafe,  the only re-
medy is to rub the parts affected with mow, or where
 it cannot be had, with cold water.  If they be held
near the fire, or plunged into warm water,  a morti-
fication will  generally enfue.
  Labourers in the hot feafon are apt to lie down
 and fleep in  the  fun.  This practice is fo dangerous,
 that they often wake in a burning fever.   Thefe ar-
 dent fevers, which prove fo fatal about the end of
 fummer and beginning of autumn,   are  frequently
occafioned by this means.   When  labourers  leave
 off work, which they ought always to do during the
heat of the  day, they fhould  go home,  or, at leaft,
 get under fome  cover, where  they may repofe them-
 felves in fafety.
   Many people follow  their  employments  in the
 fields from  morning till night, without  eating any
 thing.   This cannot fail to hurt their health.  How-
 ever homely their fare be, they ought to have it at
 regular times;  and the harder they work, the more
 frequently they fhould eat.   If the humours be not
 frequently replenifhed with frefh nourifhment, they
 foon-^roduce fevers of the very worft kind.
Many 
             AND THE STUDIOUS.           45
  Many peafants are extremely carelefs with refpect
to what they eat  or drink, and often,  through mere
indolence, ufe unwholefome food, when they might
for the fame expence have  that which is wholefome.
In fome parts of Britain, the peafants are too care-
lefs even to take the trouble  of dreffing their  own
victuals.   Such people would live upon one meal
a-day in  indolence,  rather than labour, though it
were to procure  them the greateft affluence.
  Fevers  of a very bad kind  are often occafioned
among labourers by poor living.  When the  body is
not  fufficiently  nourifhed  the  humours become vi-
tiated, and the  folids weak ; from whence the  moft
fatal confequences enfue.   Poor living  is likewife
productive of many  of thofe cutaneous difeafes fo
frequent among  the lower clafs of people.  It is re-
markable  that cattle, when pinched in their  food,
are generally affected with difeafes of the fkin, which
feldom fail to  difappear, when they are put upon >i
good pafture.   This  fhews how much a good  flate
of the humours depends upon a fufiicient quantity of
proper nourifhment.
  Poverty not only occafions,  but aggravates, many
of the difeafes of the laborious.   Few of them have
much forefight;  and, if they  had,  it is feldom in
their power to fave any thing.   They  are  glad to
make a fliift to live from day to day ; and, when any
difeafe overtakes them, they  are miferable indeed.
Here the  god-like virtue of charity ought always to
exert itfelf.  To relieve the induflrious poor in  dif-
irefs, is furely a moft  exalted act of religion and
humanity.  They alone, who are witneffes of thofe
fcenes  of  calamity,  can form an idea of what num-
bers perifh in difeafes,  for want of proper affiftance,
and even for want of the neceffaries of life.
  Labourers  are often  hurt by a foolifh emulation,
which  prompts  them to vie  with one another, till
                                             they 
46   OF THE LABORIOUS, THE SEDENTARY,
they overheat themfelves  to fuch a degree as to  Oc-
cafion a fever, or even to drop down dead.  Such as
wantonly throw away their lives in this manner,  de-
ferve to be looked upon in no better light than felf-
murderers.
  Sailors may alfo be numbered among the laborious.
They undergo great hardfliips  from change of  cli-
mate, the violence of weather, hard labour, bad pro-
vifions, &c.   Sailors are of fo great importance, that
too much  pains can never be bellowed in pointing
out the means of preferving their lives.
  One great fource of the difeafes of fea-faring peo-
ple is excefs.  When they get on fhore, after hav-
ing been long at fea, without  regard  to  the climate,
or their own conftitutions, they plunge headlong in-
to all manner of riot, and often perfift till  a fever
puts an end to their lives.   Thus  intemperance, and
not the climate,  is often the caufe why fo many of
our brave failors die on foreign coafts.   Such peo-
ple ought not to live  too low ; but they will find
moderation the beft defence againft fevers, and many
other maladies.
  Sailors, when on  duty, cannot avoid  fometimes
getting wet.  When this happens they fhould change
their clothes  as foon as they  are  relieved, and take
every method to reflore  the perfpiration.   They
fhould not, in this cafe,  make too free with fpirits
or other ftrong liquors, but fhould rather drink warm
teas, and go immediately to bed, where a found fleep
and a gentle fweat would  fet all to rights.
  But the health  of failors  fuffers  moft from  un-
wholefome food.   The conftant ufe of faked provi-
fions vitiates their humours, and occafions the fcurvy,
and  other obftinate maladies.   It is no eafy matter
to prevent  this difeafe in long voyages ;  yet much
might be done towards effecting fo defirable  an end,
                                            were 
             AND THE STUDIOUS.           47
were due pains beftowed for that purpofe.   For ex-
ample, various roots, greens, and fruits might be
kept a long time at fea, as onions, potatoes, cabba-
ges, lemons, oranges, tamarinds, apples, &c.  When
fruits cannot be kept, the juices of them, either frefh
or fermented,  may.  With thefe all  the drink, and
even the food  of the fhip's  company,  ought  to be
acidulated in long voyages.
  Stale bread and beer likewife contribute to vitiate
the humours.  Flour will  keep for  a long  time on
board, of  which frefh bread might  frequently be
made.   Malt too might be kept and infufed with
boiling water at any  time.   This liquor, when drank
even in form  of wort, is very wholefome,  and is
found to be an antidote againft the  fcurvy.   Small
wines and cyder might  likewife be  plentifully laid
in;  and fhould they turn four,  they would ftill be
ufeful as vinegar.   Vinegar is a great antidote againft
difeafes, and fhould  be ufed by all  travellers, efpe-
cially at fea.  It  may either be mixed with the water
they drink, or taken  in their food.
   Such animals as can be kept alive, ought likewife
to be carried  on board, as  hens, ducks,  pigs, &c
Frefh broths  made of portable foup, and puddings
made of peas,  or other vegetables ought to be ufed
plentifully.  Many other  things  will readily  occur
to people converfant in thefe matters, which would
tend to  preferve the health of that brave and ufeful
fet of men. *


   * The celebrated Captain Cook, has fhewn how far, by
proper care  and attention, the difeafes formerly fo fatal to fea-
men may be prevented. In  a voyage of three years and eighteen
days, during which he  was  expofed  to every climate, from
the 5 20 north to the 710 of fouth latitude, of one hundred and
eighteen men compofing the  fln'p's company, he loft only one,
 who died of ^.phlhfts pulmonalis.  The principal means he ufed
 were, to preferve a ftrift  attention to cleanlinefs., to procure
                                           abundance 
48  OF THE LABORIOUS, THE SEDENTARY,
  We have reafon to believe, if due attention were
paid to the diet, air, clothing, and above all things
to the cleanlinefs of fea-faring people, they would be
the moft healthy fet of men in the world ; but when
thefe are neglected, the very reverfe will happen.
  The beft medical antidote that we can recommend
to failors or foldiers,  on foreign coafts, efpecially
where dampnefs  prevails,  is the  Peruvian  bark.
This will often prevent fevers,  and other fatal  dif-
eafes.   About a drachm of it may be chewed every
day ;  or if this fliould prove difagreeable, an ounce
of bark, with half an ounce of orange peel, and two
drachms of fnake-root coarfely  powdered,  may be
infufed for two or three days in an Englifh quart of
brandy,  and  half a wine  glafs of it taken twice or
thrice a-day, when the  ftomach is empty.   This has
been found to be an excellent antidote againft fluxes,
putrid, intermitting, and other  fevers, in unhealthy
climates.   It is  not material in what form this medi-
cine is taken.   It may either be infufed in water,,
wine,  or fpirits, as recommended above,  or made
into an  electuary  with  fyrup of lemons,  oranges, or
the like.

             THE SEDENTARY.

   Though nothing can be more contrary  to the na-
ture of man than  a fedentary life, yet this clafs com-
prehends by far the greater part of the fpecies.  Al-
moft  the whole female world, and in manufa&urmg
countries, the  major part of  the males, may be rec-
koned fedentary. *

abundance of vegetables and frefh proviHon,, efpecially good
water, and to allow his people fufficient time fur reft.
   * The appellation of fedenta,y has generally been given or ly
ro the ftudious ; we can fee no re,fon, however, for reilr^ng
a to them alone.  Many artificer;- may, *itn as much proi-nety, 
              AND THE STUDIOUS.           #
   Agriculture,  the firft  and moft  healthful of ah
 employments, is now followed by few who are able
 to carry on any other bufmefs.   But thofe who ima-
 gine, tljat the culture of the earth is not fufficient to
 employ all its inhabitants, are greatly miftaken.  An
 ancient Roman, we  are  told,  could maintain his
 family from the produce of one acre  of ground.  So
 might  a modern Briton, if he would be contented
 to live like a Roman.  This fhews what an immenfe
 increafe of inhabitants Britain might admit of,  and
 all of them live by the culture of the ground.
   Agriculture is the great fource of  domeftic riches.
 Where it is neglected, whatever wealth  may be im-
 ported from abroad, poverty and mifery will abound
 at home.   Such is, and ever will be,  the fluctuating
 flate of trade and  manufactures, that thoufands of
 people may be in full  employment  to-day,  and in
 beggary to-morrow.   This can never happen to
 thofe who cultivate the  ground.   They can eat the
 fruit of their labour, and  can always, by induftry
 obtain, at leaft, the neceffaries of life.
   Though fedentary employments are neceffary, yet
 there feems to be no  reafon why any perfon fliould
 be  confined for life  to  thefe alone.    Were fuch
 employments  intermixed with the more active  and
 laborious, they would never do hurt.  It is conftant
 confinement that ruins the health.  A man may noc
 be hurt by fitting five or fix hours a-day ; but if he
 is obliged to  fit ten or twelve, he will foon become
 difeafed.
  But it is  not  want of exercife alone which hurts
 fedentary people ; they likewife  fuffer from the con-
fined air which they breathe.   It is very  common to

 be denominated fedentary as the ftudions, with this particular
 difadvantage, that they are often obliged to fit in very awkwai d
 poftures, which the ftudiou* need not do, unlefs they pteafe.
                        E                     fee 
59   OF THE LABORIOUS, THE SEDENTARY,
fee ten or a  dozen  taylors, *  or Haymakers, for
example,  crowded into one  fmall apartment, where
there is hardly room for one perfon to breathe freely.
In  this fituation they generally continue for  many
hours at a time, often with the addition of feveral
candles, which tend  likewife to wafte the air, and
render it lefs fit for refpiration.  Air that is breathed
repeatedly, becomes  unfit for expanding the lungs.
This is one caufe of the phthifical coughs, and other
complaints of  the breaft, fo incident  to fedentary
artificers.
   Even  the  perfpiration from a great number of
perfons pent up  together, renders the air unwhole-
fome.   The danger from this quarter will be greatly
increafed,  if any one of them happens  to have bad
lungs, or  to be otherwife difeafed.   Thofe who fit
near him,  being forced to breathe the fame air, can
hardly fail to be infected.  It would be a rare thing,
however, to find a dozen of fedentary people all in
good health.   The danger of crowding them toge-
ther, muft therefore be evident to every  one.
   Many of thofe who follow fedentary employments
are conftantly in a bending pofture,  as  fhoemakers,
taylors, cutlers,  &c.   Such a fituation  is extremely
hurtful.   A  bending pofture obftructs  all the vital
motions, and of courfe muft deftroy the health.   Ac-
cordingly we find fuch artificers generally complain-
ing of indigcftions, flatulencies, head-achs,  pains of
the breaft, &c.

  * A perfon of obfervation in that  line of life told me, that
moft taylors die of confumptions; which he attributed chiefly
to the unfavourable poftures in which they fit, and the unwhole-
fomenefs of thofe places,  where their bufmefs is carried on. If
more attention was not paid to profit, than to the prefervation
of human lives, this evil might be eafily remedied ; but, while
mafters mind only their own interefl,  nothing will be done for
the fafety of their fervants.
The 
             AND THE  STUDIOUS.           51
   The aliment  of fedentary people, inftead of being
pufhed forwards,  by an erect pofture, and the action
of the mufcles, is in a manner confined to the bowel*.
Hence indigeftions,  coftivenefs,  wind,  and  other
hypochondriacal affections, the conftant companions
of the fedentary.   Indeed, none  of the  excretions
can be duly performed, where exercife is wanting ;
and when the matter, which ought to be difcftarged
in this way, is retained too long in the body, it muft
have bad effects, as it is again taken up into the mafs
of humors.
   A bending pofture is likewife hurtful to the lungs.
When this organ is  compreffed,  the air cannot have
free accefs into all its parts, fo as to expand them
properly.    Hence  tubercles,  adhefions,  &c.  are
formed, which often end in confumptions.   Befides,
the proper action of the lungs being abfolutely necef-
fary for making good  blood, when that organ fails,
the humors foon  become  univerfally depraved, and
the whole conftitution goes to wreck.
   Sedentary artificers are  not only hurt by preffure
on the bowels, but alfo on the inferior extremities,
which  obftructs the  circulation in thefe parts, and
renders them weak and feeble.  Thus  taylors, fhoe-
makers, &c. frequently iofe  the  ufe  of their legs
altogether:  befides, the blood and humours are, by
flagnation, vitiated, and the perfpiration is obftructed :
from  whence proceed the  fcab, ulcerous fores, foul
blotches, and other  cutaneous difeafes, fo common
among fedentary artificers.
   A bad  figure of body  is a very common confe-
quence of clofe application to fedentary employments.
The fpine, for example, by being continually bent,
puts on a crooked fhape,  and generally  remains  fo
ever after.   But a bad figure of body, has already
been obferved to be hurtful  to health, as the vital
functions are thereby impeded.
                      E  2               A feden- 
$2  OF THE LABORIOUS, THE SEDENTARY,
   A  fedentary life feldom  fails to occafion an uni-
versal relaxation  of the folids.   This is  the  great
fource from whence moft of the difeafes of fedentary
people flow.  The fcrophula, confumption, hyfterics,
and nervous difeafes, now fo  common,  were very
little known in Great Britain,  before fedentary arti-
ficers  became fo numerous : and they are very little
known ftill among fuch of our people as follow  active
employments without doors, though in great towns,
at leaft two-thirds of the inhabitants are afflicted with
them.
   It is  very difficult  to remedy thofe evils, becaufe
many who have been accullomed to a fedentary life,
like  ricketty children, lofe all inclination for  exer-
cif©; we fhall, however, throw out a few hints, with
refpect to the moft likely means for preferving the
health of this ufeful  fet of people, which fome of
them, we  hope,  will  be wife enough to take.
   It has he^n already obferved, that fedentary arti-
ficers  are  often h»rt by their bending pofture.  They
ought, therefore, to ftand or fit as erect as the nature
of their employments will permit.   They fhould like-
wife change their pofture frequently, and fhould
never fit too long at a time, but leave off work,  and
walk, ride,  run, or do any thing that will promote
the exercife  of the vital functions.
   Sedentary artificers are generally allowed too little
time for exercife ; yet,- fhort as it is, they feldom em-
ploy it properly.  A journeyman  taylor, or weaver,
for example, inftead of walking abroad for exercife
and frefh air, at  his hours of leifure, chufes often to
fpend them in a  public houfe,  or in playing at fome
fedentary  game, by which he generally lofes both
his time and his money.
   The awkward poftures in which many fedentary
artificers work,  feem rather to be  the effect of cuf-
tom than  necvfiity.     For example, a  table might
                                          furelv 
              AND THE STUDIOUS.           jg
 furely be contrived  for ten or a dozen taylors to fit
 round, with liberty for their legs either to hang down,
 or reft upon a foot-board, as they fhould chufe.   A
 place  might  likewife be  cut out for each perfon, in
 fuch a manner, that he might fit as conveniently for
 working as in the prefent mode  of  fitting crofs-leg-
 ged.
   All fedentary artificers ought  to pay the moft reli-
 gious regard to cleanlinefs.   Both their fituation and
 occupations,  render  this highly neceffary.   Nothing
 would contribute more to preferve their health, than
 a  ftrict attention  to  it;  and fuch of them as neglect
 it, not only run the  hazard of lofing health,  but of
 becoming a nuifance to their neighbours.
   Sedentary people  ought  to  avoid  food  that is
 windy, or hard of  digeftion, and  fliould  pay the
 flridteft regard to fobriety.   A  perfon who  works
 hard without doors, will fooner throw off a debauch ;
 but one who fits, has by no means an equal chance.
 Hence it  often  happens,  that fedentary people ar$
 feized with fevers after hard drinking.   When fuch
 perfons feel their fpirits low, inftead of running to the
 tavern for relief,  they  fhould ride  or walk in the
 fields.    This  would  remove the  complaint more
 effectually than ftrong liquor,  and would never hurt
 the conftitution.
   Inftead  of multiplying   rules for   preferving the
 health of the fedentary, we fliall recommend to thera
the following general plan,  viz.  That every perfon
 who follows  a  fedentary  employment fliould  culti-
vate a. piece of ground  with his  own  hands.   This
he might dig, plant,  fow, and weed,  at leifure hours,
ib  as to make It  both an exercife and amufement,
while  it produced many  of the  neceffaries of life.
 After working an hour in a garden,  a man will re-
 turn with  more keennefs to his  employment within
doors, than if he had been all  the while idle.
                       E  3            Labouring 
54  OF THE LABORIOUS, THE SEDENTA RY,
   Labouring the ground  is every way conducive to
health.   It not only gives exercife to every part of
the body, but the very fmell of  the earth and frefh
herbs revives and cheers the fpirits, whilft  the  per-
petual profpect of  fomething  coming  to maturity,
delights and entertains the mind.  We are fo formed
as to be  always pleafed with fomewhat in  profpect,
however diftant, or however  trivial.    Hence the
happinefs that  moft men  feel in planting,  fowing,
building, &c.  Thefe feem  to have been the  chief
employments of the more early ages:  and,  when
kings and conquerors cultivated the  ground, there
is reafon to believe, that they knew as well wherein
true happinefs confuted as  we do.
   It  may  feem romantic to recommend gardening
to  manufacturers in great towns;  but  obfervation
proves that the plan is very  practicable.    In the
town of Sheffield, in Yorkfliire,  where the great
iron  manufactory  is carried on, there  is  hardly  a
journeyman cutler,  who  does not poffefs a piece  of
ground,  which  he cultivates  as a garden.    This
practice  has many falutary  effects.  It not only in-
duces thefe people  to take exercife without doors,
but alfo  to eat many greens, roots,  &c.  of their
own growth, which they would never think of pur-
chafing.     There can be no  reafon  why manufac-
turers in any other town in Great Britain, fhould not
follow the fame plan.  It  is indeed to be regretted,
 that in fuch a  place as London, a plan of this kind
 is not practicable; yet, even  there, fedentary  artifi-
cers may find opportunities of taking  air and  exer-
 cife, if they chufe to embrace them.
    Mechanics are too much  inclined to crowd into
 great towns.   The fituation may  have fome advan-
 tages ; but it has likewife many difadvantages.  All
 mechanics who live in the country, have it in their
 power to cultivate a piece of ground ;  which indeed
        *                                    moft 
              AND THE STUDIOUS.           55
 moft  of then do.  This not only gives them exer-
 cife,  but enables them  to live  more comfortably.
 So far, at leaft, as my obfervation extends, mechanics
 who  live in the  country are far  more  happy  than
 thofe in great towns.   They  enjoy better health,
 live in greater affluence, and  feldom fail to rear a
 healthy and numerous offspring.
   In  a  word, exercife without doors,  in one  fhape
 or another, is  abfolutely neceffary to health.  Thofe
 who  neglect it, though they may for  a  while  drag
 out life, can hardly be faid to enjoy it.  Weak and
 effeminate, they languifh for a few years,  and  foon
 drop  into an untimely grave.

              THE  STUDIOUS.
   Intenfe thinking  is fo deftructive to health,  that
 few mftances  can be produced of fludious perfons
 who  are ftrong and healthy.   Hard  fludy always
 implies  a fedentary life; and when intenfe thinking
 is joined to the want of exercife, the  confequences
 muft  be bad.  We have frequently known even a
 few months  of clofe application  to fludy, ruin  an
 excellent conftitution, by inducing a train of nervous
complaints, which could  never  be removed.   Man
is evidently not formed for  continual thought, more
than  for perpetual  action,  and would  be as  foon
 worn  out by the one as by the other.
   So great is the power of the mind over the body,
 that,  by its  influence, the whole  vital  motions  may
 be  accelerated or retarded, to almoft any degree.
 Thus  cheerfulnefs and  mirth  quicken the  circula-
 tion,  and promote all the fecretions;  whereas fad-
 nefs and profound  thought, never fail   to  retard
 them.   Hence it  would appear, that even a degree
 of thoughtieffnefs is neceffary to health.   Indeed,
 the perpetual thinker feldom enjoys either health  or
                      V 4                fpirits ; 
56  OF THE LABORIOUS, THE SEDENTARY,
fpirits; while  the perfon, who can hardly be faid t©
think at all, generally enjoys both.
  Perpetual thinkers,  as  they  are  called,  feldom
think long.  In a few  years they generally become
quite ftupid, and exhibit  a melancholy  proof how
readily the greateft bleffings may be abufed.  Think-
ing,  like every thing elfe,  when  carried  to extreme,
becomes a  vice:  nor can  any  thing afford a greater
proof of wifdom,  than for  a man  frequently  and
feafonably to unbend his mind.  This may generally
be done by mixing in cheerful  company, active di-
verfions, or the like.
   Inftead of attempting to inveftigate the nature of
that connection which fubfifts  between the mind and
body,  or to inquire  into  the manner in which they
mutually affect each other, we  fliall only  mention
thofe difeafes  to which the learned  are more pecu-
liarly liable, and  endeavour to point out  the means
of avoiding them.
   Studious perfons  are  very fubject to  the gout.
This painful  difeafe in  a great  meafure proceeds
from indigeftion,  and an obftructed perfpiration.  It
is impoffible that  the man who fits from morning till
night fhould either digeft  his  food,  or  have any of
the fecretions  in due quantity.   But when that mat-
ter,  which fliould be thrown off by  the fkin, is re-
tained  in  the  body,  and  the  humors are not duly
prepared, difeafes muft enfue.
   The ftudious are likewife very liable to the  flone
and  gravel.  Exercife  greatly  promotes both the fe-
cretion and difcharge  of  urine ; confequently  a fe-
dentary life muft have the contrary effect.   Any one
may be fatisfied of this by obferving, that he paffes
much more urine by day  than in the night, and alfo
when he walks or rides, than when he fits.
   The circulation in the liver being flow, obftructions
in that organ can hardly fail  to be the confequence
                                               of 
             AND THE  STUDIOUS.            $1
 of inactivity.  Hence fedentary people are frequently
 afflicted with fchirrous livers.   But the  proper  fe-
 cretion  and difcharge  of  the  bile is fo neceffary a
 part of the animal  ceconomy, that where thefe are
 not  duly  performed,  the health muft foon  be im-
 paired.  Jaundice,  indigeftion, lofs of appetite, and
 a wafting of the whole body, feldom fail to be the
 confequences of a vitiated flate of  the fiver, or ob-
 ftructions of the bile.
  Few difeafes  prove more fatal to  the ftudious than
 confumptions of the lungs.  It has already been ob-
 ferved, that this organ cannot  be duly expanded in
 thofe who do not take proper  exercife;  and where
 that is the cafe, obftructions and adhefions will en-
 fue.    Not  only want of exercife,  but the pofture
 in which  ftudious  perfons  generally fit, is  very
 hurtful  to  the   lungs.   Thofe who read  or write
 much  are  ready to  contract a  habit  of bending
 forwards,  and often prefs with  their breaft upon a
 table or bench.  This pofture  cannot  fail to  hurt
 the lungs.
  The  functions of the heart may likewife by this
 means be injured.  I remember to have feen a  man
 opened, whofe  pericardium  adhered to the  breaft-
 bone in fuch a  manner as to obilruct the  motion  of
the heart,  and  occafion his death.   The  only  pro-
bable caufe that could  be affigned for  this fingular
fymptom was,  that the man,  whofe  bufmefs was
writing, ufed conftantly to fit in a bending pofture,
with  his breaft  preffing upon  the  edge of a plain
table.
  No perfon can enjoy health  who does not  pro-
perly digeft his  food.    But intenfe thinking and
inactivity never  fail  to  weaken  the powers of digef-
tion.   Hence the humors become crude and vitiated,
the folids weak  and relaxed, and the whole  confti-
 tution goes to ruin.
                                           Long 
 5§  OF THE LABORIOUS, THE SEDENTARY,
   Long and intenfe thinking often occafions grievous
 head-achs,  which  bring on  vertigoes, apoplexies,
 palfies, and  other fatal diforders.   The beft way to
 prevent thefe is, never to fludy too long at one time,
 and to keep the  body regular,  either by proper
 food,  or  taking frequently  a little of fome opening
 medicine.
   Thofe who read or write much are often afflicted
 with fore eyes.   Studying  by candle-light is  pecu-
 liarly hurtful to the fight.  This  ought to be  prac-
 tifed as feldom as poffible.   When it  is  unavoidable,
 the  eyes fhould  be fhaded,  and the head fhould not
 be held too low.    When  the eyes are weak or
 painful, they fhould  be bathed  every night  and
 morning in cold water, to  which a  little brandy
 may be added.
   It has already been obferved, that the excretions
 are  very defective in the ftudious.   The  dropfy is
 often  occafioned by the  retention of thofe humors
 which ought to be  carried off in  this way.  Any
 perfon may obferve, that fitting makes his legs fwell,
 and  that this  goes off by exercife; which clearly
 points out the method of prevention.
   Fevers,  efpecially of the nervous kind,  are  often
 the effect of  fludy.   Nothing  affects the  nerves fo
 much as intenfe thought.    It in a manner unhinges
 the  whole human frame,  and not  only hurts the
 vital motions, but diforders the mind itfelf.  Hence
 a delirium, melancholy,  and even madnefs,  are  of-
 ten the effects of clofe application to fludy.  In fine,
 there is no difeafe  which can proceed  either  from a
 bad  flate  of the humors, a defect of the ufual fecre-
 tions, or a debility of the nervous fyftem, which may
 not be induced by  intenfe thinking.
   But the moft afflicting of all the  difeafes which
attack  the ftudious is the hypochondriac.   This dif-
 eafe feldom fails to be the companion of deep thought.
                                               It 
             AND THE STUDIOUS.           59
It  may rather be  called a complication of maladies
than a fingle one.  To what a wretched condition
are the beft of men  often  reduced  by it!   Their
ftrength and appetite fail; a perpetual gloom hangs
over their minds;  they  live in the conftant dread of
death, and are continually in fearch  of relief from
medicine, where,  alas ! it is not to be found.   Thofe
who labour under this diforder,  though  they are
often  made the fubject  of  ridicule, juftly claim our
higheft fympathy and compaffion.
   Hardly any thing can be more prepofterous than
for a perfon to make fludy his fole bufmefs.   A
mere  ftudent is feldom an ufeful member of fociety.
He often neglects  the moft important duties of life,
in order to purfue fludies  of a very trifling nature.
Indeed it rarely happens,  that any ufeful invention
is  the effect of  mere fludy.   The  farther men dive
into profound refearches, they generally deviate the
more  from  common fenfe,  and too often  lofe fight
of it altogether.   Profound fpeculations, inftead of
making men wifer or better,  often render them ab-
folute fceptics, and overwhelm  them  with  doubt
and uncertainty.   All  that is neceffary for a man to
know, in order to be happy, is eafily  obtained; and
the reft, like the forbidden  fruit,  ferves only  to in-
creafe his mifery.
   Studious perfons, in order to relieve their  minds,
muft  not only  discontinue to read and  write,  but
engage in fome employment or diverfion, that will
fo far occupy the thoughts as to  make them  forget
the bufmefs of the clofet.   A folitary ride or walk
are fo far from relaxing the mind, that they  rather
encourage thought.   Nothing can divert the  mind,
when it goes into  a train of ferious thinking, but at-
tention to fubjects of a more  trivial nature.   Thefe
prove a kind of  play to the mind, and confequently
relieve it.
Learned 
 60  OF THE LABORIOUS, THE SEDENTARY,
   Learned men often contract a contempt for what
 they call trifling company.   They are afliamed to
 be feen with any but philofophers.    This however
 is no proof  of their being philofophers  themfelves.
 No man deferves that name who is afhamed to  un-
 bend his mind, by affociating with the cheerful  and
 gay.   Even  the fociety of children will relieve the
 mind,  and expel the gloom which application to fludy
 is too  apt to occafion.
   As  ftudious  people are neceffarily much within
 doors,  they  fhould  make  choice of a  large  and
 well-aired place for fludy.    This would not  only
 prevent  the  bad effects which attend confined  air,
 but would cheer the fpirits,  and have a moft happy
 influence both on the body and mind.  It is faid of
 Euripides the tragedian, that he ufed to retire to a
 dark  cave to  compofe  his  tragedies, and of De-
 mofthenes the Grecian orator, that  he chofe a place
 for fludy where nothing could be  either heard or
 feen.   With all deference to fuch venerable namesj
 we cannot help condemning their  tafte.    A  man
 may furely think to as good purpofe  in  an  elegant
 apartment as  in a  cave ;  and may have as happy
conceptions where the all-cheering  rays  of  the  fun
render the air wholefome, as  in places  where they
never enter.
   Thofe who read or write much fhould be very
attentive to their pofture.   They ought to fit  and
fland by turns, always keeping as nearly in an erect
pofture as poffible.   Thofe who dictate,  may  do it
walking.   It has  an excellent effect  frequently to
read or  fpeak aloud.  This not only exercifes  the
lungs,  but almoft the whole body.   Hence ftudious
people are greatly benefited  by delivering difcourfe9
in public.  Public fpeakers,  indeed, fometimes hurt
themfelves by overacting their part  ; but this is their
own  fault.   The martyr to mere vociferation merits
not cur fympathy.
                                            The
\ 
AND THE STUDIOUS.            61
   The morning has,  by all  medical writers,  been
reckoned the beft time for  fludy.  It is fo.   But it
is  alfo the moft proper feafon for exercife,  while
tiie ftomach is empty,  and  the fpirits refrefhed with
fleep.  Studious people fhould  therefore fometimes
fpend the  morning  in walking,  riding, or  fome
manly diverfions without doors.   This would make
them return to  fludy with  greater alacrity, and
would be of more  fervice than twice the  time after
their fpirits  are  worn out  with fatigue.   It  is not
fufficient to  take diverfion  only when we can think
no  longer.   Every ftudious  perfon  fhould  make it
a part of his bufmefs, and fhould  let  nothing in-
terrupt his  hours of recreation  more than thofe of
fludy.
   Mufic has a very  happy  effect in  relieving the
mind when fatigued with fludy.   It would be well
if every ftudious perfon were fo far acquainted with
that  fcience  as  to   amufe  himfelf  after   fevere
thought, by playing  fuch  airs as have  a tendency
to raife the fpirits,  and   infpire  cheerfulnefs and
good humour.
   It is a reproach to  Learning,  that any of her vo-
taries, to relieve the mind after fludy, fliould betake
themfelves to the ufe of ftrong liquors.  This, indeed,
is a remedy ; but it is a defperate one,  and always
proves deftructive.    Would fuch  perfons,  when
their fpirits  are low, get on horfeback, and ride ten
or a dozen miles, they would find it a more effectual
remedy than any cordial medicine in the apotheca-
ry's fliop, or all  the ftrong  liquors  in the world.
   The following is my plan, and I cannot recomh
mend a better to others.   When my  mind is fa-
tigued with fludy, or other ferious bufmefs, I mount
my horfe, and ride ten or twelve miles into the coun-
try, where I fpend a day, and fometimes  two, with a
                                          cVeri-ul 
 62          OF THE LABORIOUS, &c.
 cheerful friend; after which I never fail to return
 to town with new vigour, and  to purfue my fludies
 or bufmefs with frefh alacrity.
  It is much to be regretted, that learned men, while
 in health, pay fo little regard to thefe things! There
 is not any thing more common than to fee a mifera-
 ble  object  over-run with nervous difeafes, bathing,
walking, riding,  and, in a word, doing every thing
 for  health  after it is gone;  yet, if  any one had re-
commended thefe things to him by way of preven-
tion, the advice would,  in all probability, have been
treated  with contempt, or, at leaft, with neglect.
 Such is the weaknefs and folly of mankind, and fuch
 the want of forefight,  even in thofe who  ought to
 be wifer than others!
  With regard to  the  diet of the  ftudious, we fee
no reafon  why they fhould abftain from any kind of
food that is wholefome, provided they ufe it in mo-
deration.   They ought, however, to be fparing in
the ufe of every thing that is windy, rancid, or hard
of digeftion.   Their fuppers fhould  always  be light,
or taken foon  in the evening.   Their drink may be
 water, fine malt liquor, not too ftrong, good cyder,
and wine and  water.
  We fhall only obferve, with regard to thofe kinds
 of exercife which are moft proper for the ftudious,
that they fhould not be too violent,  nor ever carried
to the degree  of exceffive fatigue.   They ought
likewife to be frequently varied fo  as to give action
to all fhe  different  parts of the body ; and fliould,
as often as poffible, be taken in the open  air.  In
general, riding on  horfeback, walking, working in
 v garden,  or  playing at fome active diverfions, arc
riie  belt.
  We would likewife  recommend  the  ufe  of the
cold bath to the ftudious.   It will, in fome meafure,.
                                           fuppry 
OF  ALIMENT.
63
fupply the place of exercife, and fhould not be ne-
glected  by perfons of a relaxed habit, efpecially  in
the warm feafon.
  No perfon ought either to take violent exercife,
or to fludy  immediately after a full meal.
                  CHAP.  III.

                   Of Aliment.

          UNWHOLESOME  food,  and irregu-
larities in diet, occafion many difeafes.  There is no
doubt  but  the whole  conftitution of body may be
changed by diet ajone.   Nor are its effects upon the
folids lefs confiderable.   They may be braced or re-
laxed, have  their fenfibility,  motions,   &c. greatly
increafed or diminifhed, by different kinds of aliment,
A very fmall attention to  thefe things will be  fuffi-
cient to fhow, how much the prefervation of health
depends upon a proper regimen of the diet.
   Nor  is an attention to diet neceffary  for the pre-
fervation of health only :  it   is likewife of  impor-
tance in the cure of difeafes.   Every intention in the
cure of many difeafes, may be anfwered by diet alone.
Its effects,  indeed,  are  not always fo quick as thofe
of medicine, but they are generally more lafting:
befides,  it  is neither fo difagreeable to the patient,
nor  fo  dangerous as medicine, and  is  always  more
eafily obtained.
   Our intention here is not to enquire minutely into
the nature and  properties of the various kinds of
aliment  in  ufe  among  mankind; ncr to fhew their
                                             effects 
 64              OF  ALIMENT.
 effects upon the different  conftitutions of the human
 body ; but to mark fome of the moft pernicious er-
 rors which people are apt to fall  into, with refpect
 both to the quantity and qualities of their food, and
 to point out their influence upon health.
   It  is not indeed an  eafy  matter to afcertain the
 exact quantity of food proper for every age, fex, and
 conftitution:  but a fcrupulous  nicety here is by no
 means neceffary.   The belt  rule is to avoid all ex-
 tremes*   Mankind were never intended to weigh
 and meafure their food.   Nature teaches  every crea-
 ture when it has enough ; and the calls of thirft and
hunger are fufficient  to-inform  them  when more is
 neceffary.
  Though moderation is  the chief rule with regard
to the quantity, yet the quality  of food merits a far-
ther confideration.   There are many ways by which
provifions may be rendered unwholefome.   Bad fea-
fons may  either  prevent  the ripening of grain,  or
damage it afterwards.  Thefe,   indeed,  are acts of
Providence, and we muft fubmit to them ; but  fine-
 ly no punifhment can be too fevere for thofe who
fuffer provifions to fpoil by hoarding them,  on  pur-
pofe to raife  the price, or who promote their  own
fuppofed  intereft by  adulterating the  neceffaries of
life. *
  Animal, as well as  vegetable food, may be render-
ed unwholefome, by  being kept too long.   All ani-
mal  fubftances have  a  conftant  tendency to putre-
faction ; and, when that has proceeded too far, they

  * The poor,  indeed, are generally the firft who fuflfer by
nnfound provifions ; but the lives of the labouring poor are
of great importance to the  ftate : befides, difeafes occafioned
by nnwlv kf me food often prove infectious,  by which means
they reach people in every ftation.  It is therefore the intereft
of all to take care that no fpoilt provifions of any kind be ex-
pofed to idle.
4
no 
               OF ALIMENT.               65
not only become  offenfive to the fenfes, but hurtful
to health.   Difeafed  animals,  and fuch  as die of
themfelves, ought never to be eaten.   It  is a com-
mon practice,  however, in fome grazing  countries,
for fervants and poor people to eat fuch animals as
die of any difeafe, or are killed  by accident.   Pover-
ty, indeed, may oblige people to do this;  but they
had better eat a fmaller quantity of what is found and
wholefome: it would both afford a better nourifh-
ment. and be  attended with  lefs danger.
   The injunctions given to the  Jews,  not to eat any
creature which died of itfelf, feemed to have a ftrict
regard to health ; and ought to be obferved by Chrif-
tians as well as Jews.   Even  thofe which die by acci-
dent muft  be hurtful, as their blood is mixed with
the flefh, and foon turns putrid.
   Animals which feed grofsly,  as tame ducks, hogs,
&c. are neither fo eafily digefted, nor afford fuch
wholefome  nourifhment as others.   No animal can
be wholefome which does not take fufficient exercife,
Moft of our flailed cattle are crammed wi h grofs
food,  but not  allowed  exercife nor free  air;  by
which  means they indeed grow fat, but their juices
not being  properly prepared or aflimilated, remain
crude  and  occafion  indigeftions,  grofs   humours,
and oppreffion of the fpirits,  in thofe who feed upon,
them.
   Animals are often rendered unwholefome by being
over-heated.   Exceffive heat caufes  a fever, exalts
the animal  falts, and mixes the blood fo intimately
with the flefh  that it cannot be feparated.    For this
reafon,  butchers fhould  be  feverely  punifhed  who
over-drive  their cattle.   No perfon would chufe  to
eat the flefh of  an  animal which had died in a  high
fever ; yet that is the cafe with all over-drove cattle ;
and the fever  is  often raifed to the degree of mad-
nefs.       *
                       F                      B\Jk% 
66
OF ALIMENT.
   But this is not the only way by which butcher*?
render meat  unwholefome.   The abominable cuf-
tom of filling the cellular membrane of animals with
air, in order to make them appear fat, is every day
practifed.   This not only fpoils the meat and ren-
ders it unfit for  keeping,  but is fuch a dirty trick,
that the very idea of it is fufficient to difguft a perfon
of any  delicacy, at  every thing  which comes from
the fliambles.   Who can bear the thought of eat-
ing meat which has  been blown up with air from the
Kings  of a dirty fellow, perhaps labouring under the
very worft of difeafes ?
   Butchers have likewife a method of filling the
cellular membranes of animals with  blood.   This
makes the meat  feem fatter,  and  likewife  weigh
more, but is notwithftanding a very pernicious cuf-
tom,  as it both renders the meat unwholefome and
unfit  for  keeping.   I  feldom fee a piece  of meat
from the fliambles,  where the blood is not diffufed
through the cellular texture.  I  fhall  not  fay that
this is always the effect of defign  ; but I am certain
it is not the cafe with animals  that  are killed  for
domeftic ufe,  and  properly  blooded.   Veal  feems
to be moft frequently fpoilt  in this  way.   Perhaps
that may in fome meafure be owing to  the practice
of carrying calves from a great diftance to market,
by  which means their tender flefh is bruifed, and
many of their veffels burft.
   No people in the world eat fuch quantities of ani-
mal food  as the Englifh,  which is one  reafon why
they are fo generally tainted with  the fcurvy and its
numerous  train  of  confequences, indigeftion, low
fpirits, hypochondriacifm, &c.    Animal food was
furely defigned for man, and, with a proper mixture
of vegetables,  it will be found the moft  wholefome;
but to gorge beef,  mutton, pork, fifh, and  fowl,
twice  or thrice a day, is  certainly too  much.  All
                                             wh« 
               OF  ALIMENT.               67
 who value health ought to be contented with making
 one  meal of flefh in the twenty-four hours, and this
 ought to confift of one kind only.
   The  moft obftinate fcurvy has often been  cured
 by a vegetable diet; nay, milk alone will frequently
 do more in that  difeafe than any medicine.  Hence
 it  is  evident,  that if vegetables and milk were more
 ufed in  diet,  we  fliould have  lefs fcurvy,  and  like-
 wife fewer putrid and  inflammatory fevers.  Frefh
 vegetables, indeed, come  to be daily more ufed in
 diet; this laudable practice we hope will continue to
 gain ground*
   Our  aliment  ought neither  to be too moift nor
 too dry.  Moift aliment relaxes the folids,  and ren-
 ders the  body feeble.  Thus we fee females,  who
 live  much on tea and other watery diet,  generally
 become weak, and unable to digeft folid food : hence
 proceed hyfterics, and all other dreadful confequences.
 On  the other hand, food that is  too dry, renders
 the folids in a manner rigid, and the humors vifcid,
 which difpofes the body to inflammatory fevers, fcur-
 vies,  and the like;
   Much has  been faid on the ill effects of tea in diet.
 They are, no doubt, numerous; but  they proceed
 rather from the imprudent  ufe  of it, than  from any
 bad  qualities in the tea  itfelf.   Tea is now  the uni-
 Verfal breakfaft  in  Great Britain  ;  but  the morning
 is furely the moft improper time of the day for-drink-
 ing it.   Moft delicate  perfons, who,  by  the  bye,
are the  greateft  tea-drinkers, cannot eat any thing
in  the morning.   If fuch  perfons, after fafting ten
or twelve hours, drink four or five cups of tea with-
out eating almoft any  bread,  it muft  hurt them.
 Good tea, taken in moderate quantity,   not  too
 ftrong nor too hot, nor drank upon an empty fto-
 mach, will feldom do harm ; but if it be bad, which
                      F 2                      is 
6S
OF
ALIMENT.
 is often the cafe, or fubftituted in the room of folid
 food,  it muft have many ill effects.
   The arts of cookery render many things unwhole-
 fome,  which  are not fo in their  own nature.   By
 jumbling together a number of different ingredients,
 in order to  make a  poignant fauce,  or rich foup,
 the  compofition  proves almoft a poifon.   All high
 feafoning,  pickles, Sec. are only incentives to  lux-
 ury, and never fail to hurt  the ftomach.  It were
 well for mankind, if cookery,  as  an art, were en-
 tirely  prohibited.  Plain roafting  or boiling is all
 that the ftomach requires.   Thefe alone are fufficient
 for people jn health,  and the fick have ftill lefs need
 of a cook.
   The liquid part of our aliment likewife claims  our
 attention.   Water is not  only  the bafis of moft li-
 quors, but alfo compofes a great  part  of our folid
 food.  Good water muft therefore be of the greateft
 importance in diet.   The beft  water is that which
 is moft pure, and free from any mixture of  foreign
 bodies.  Water takes up parts of moft bodies with
 which it comes  into contact ;  by this means  it is
 often  impregnated  with  metals  or minerals of a
 hurtful or poifonous nature.  Hence the inhabitants
 of fome hilly countries have peculiar difeafes, which,
 in all  probability, proceed from the water.  Thus
 the  people who live near the  Alps in Switzerland,
 and the inhabitants of the Peak of Derby in Eng-
 land,  have  large tumors or wens on  their  necks.
 This difeafe is generally imputed to the fnow-water;
 but  there is  more reafon to believe it is owing to the
 minerals in the mountains through which the  waters
 pafs.
   When water is impregnated with foreign  bodies,
•it generally  appears by  its  weight, colour,  tafle'
 fmell,  heat, or  fome other  fenfible  quality.'   Our
                                          bufmefs 
               OF  ALIMENT.               6j
bufmefs therefore is  to chufe fuch water,  for  com-
mon ufe, as is lighteft, and  without  any particular
colour,  tafte,  or  fmell.  In  moft places of  Britain
the inhabitants have  it in their power to make choice
of their water ; and few things would contribute
more to health than  a due  attention to this  article.
But mere indolence often induces people to  make ufe
of the water  that is  neareft  to  them, without con-
fidering its qualities.
   Before  water is  brought  into  great  towns, the
ftricteft attention ought to be paid to its qualities, as
many difeafes may be occafioned or aggravated by bad
water ;  and when once it has been procured at a great
expence, people are  unwilling to give it up.
   The  common method of  rendering water  clear
by filtration,  or foft, by expofing it  to the fun and
air,  &c. are  fo generally known,  that it is unnecef-
fary to fpend time in explaining them.   We fliall
only, in general, advife all  to  avoid waters which
ftagnate long in fmall lakes,  ponds, or the like, au
fuch waters often become putrid, by  the corruption
of animal  and vegetable bodies  with which  they
abound.  Even cattle frequently fuffer by drinking,
in dry feafons, water which has flood long in  fmall
refervoirs,  without  being  fupplied by fprings,  or
frefhened  with fhowers.   All  wells  ought to  be
kept clean, and to have a free communication with
the air.
   As fermented liquors, notwithftanding they  have
been exclaimed againft by many writers, ftill unhappily
continue to be the  common drink of almoft every
perfon who can afford them ; we fliall rather endea-
vour to aflift people in the  choice  of thefe liquors,
than to pretend to condemn what cuflom has fo firmly
eftablifhed.   It is  not the  moderate  ufe  of found
fermented liquors which hurts mankind :  it is excefs,
and ufing fuch as are ill prepared or  vitiated.
                  F 3                 Fermented 
70
OF ALIMENT.
   Fermented  liquors,  which  are  too  ftrong, hurt
 digeftion ; and the body is fo far from being ftrength-
 cned by  them,  that  it  is  weakened  and relaxed.
 Many imagine that  hard  labour  could not be fup-
 ported without  drinking ftrong liquors ;  this is a
 very erroneous notion.   Men who never tafte ftrong
 liquors are  not  only able  to  endure  more fatigue,
 but  alfo live much longer,  than thofe who ufe them
 daily.  But, fuppofe ftrong liquors did enable a man
 to do more work, they muft neverthelefs  wafle the
 powers of life, and occafion premature old age.  They
 keep up a conftant fever, which exhaufts the fpirits,
 inflames the blood, and difpofes the body to number-
 lefs difeafes.
   But fermented liquors may be too weak as well
 as too ftrong: when that is the cafe, they muft eu
 ther be drank new,  or they become lour and dead ;
 when fuch liquors are drank new, the fermentation
 not being over, they generate air in the bowels, and
 occafion flatulencies; and, when kept till flale, they
 turn four on the ftomach,  and hurt digeftion.   For
 this  reafon,  all malt liquors, cider, &c. ought to be
 of fuch ftrength as to keep  till they be ripe, and then
 they fhould be ufed.  When fuch liquors  are kept
 too long, though they fhould not become four, yet
 they generally contract a  hardnefs, which  renders
 jhem unwholefome.
   All  families,  who can,   ought  to prepare  their
 own liquors.  Since preparing and vending of \y
 quors become  one of the moft general branches of
 bufmefs,  every method has been tried to adulterate
them.  The great object  both to the makers  and
 venders  of liquor is, to render it intoxicating,  and
 give it the appearance of age.  But it, is well known
fhat  it may be done by other ingredients than thofe
 which ought to be ufed for making  it ftrong.  It
■would be imprudent  even to name thofe things which
          4                                 are 
               OF ALIMENT.             * 7;
are daily made ufe of to render liquors heady.   Suf-
fice it to fay, that the practice is very common,  and
that all the ingredients ufed for this purpofe are of a
narcotic or flupefactive quality. But as all thefe drugs
are poifonous, it is eafy to fee what muft be the con-
fluence of their general ufe.  Though  they  do not
kill fuddenly, yet they hurt the nerves,  relax  and
weaken the ftomach, and fpoil the digeftion.
   Were fermented liquors faithfully prepared, kept
to a  proper  age, and  ufed  in  moderation,  they
would prove  real bleffmgs to mankind.  But, while
they are ill prepared,  various ways adulterated,  and
taken  to  excels,  they  muft have  many  pernicious
effects.
   We would recommend it to families, not only to
prepare their own liquors, but likewife  their  bread.
Bread is fo  neceffary a part of diet, that too much
care cannot  be beftowed in order to have it found
and wholefome.   For  this  purpofe,  it  is not only
neceffary  that  it be made of good grain, but like-
wife properly prepared, and kept  free  from all un-
wholefome ingredients.   This,  however, we have
reafon  to  believe is not always the cafe with bread
prepared  by thofe who make a trade of  vending it.
Their object is rather to pleafe the eye, than to  con-
fult the health.   The beft bread is that  which is nei-
ther too coarfe nor too  fine ; well fermented, and
made of wheat  flour,  or rather  of wheat and rye
mixed together.   Notwithftanding the general idea
of the  fuperiority of fermented  bread, it is certain
that unfermented bread is more wholefome ; witnefs,
the oat-cakes of  the Scotch, the rice of the Eaft-In-
dians, the indian meal of the Indians of  America, the
hard  bifcuit  of wheaten flour.
   To fpecify the different  kinds  of aliment, to ex-
 plain their nature and properties,  and to point out
 their effects  in different conftitutions, would  far ex-
                         F 4                  ceed 
7*              OF  ALIMENT.
ceed the limits of our defign.  Inftead of a detail of
this  kind, which would not be generally underftood,
and  of courfe little attended to, we fhall only men-
tion  the following  eafy  rules  with  refpect to  the
choice.of aliment.
   Perfons, whofe folids are weak and relaxed, ought
to avoid all vifcid food, or fuch things as are hard of
digeftion.  Their diet, however,  ought to  be nou-
rishing ; and they fhould take fufficient exercife in the
open air.
   Such as abound with blood fhould be fparing in the
ufe of every thing that is highly  nourifhing, as fat
meat,  rich wines, ftrong ale, and fuch like.  Their
food fhould confift chiefly of bread and other vege-
table fubftances; and their drink ought to be water,
whey,  or fmall beer.
   Fat  people fhould not eat freely  of oily  nourifh-
ing diet. They ought frequently to ufe horfe-radifh,
garlic, and fuch things as  promote perfpiration  and
urine.   Their drink fhould be water, coffee, tea, or
the like ; and they ought to take  much  exercife and
little fleep.
   Thofe who are  too lean  muft follow an oppofite
courfe.
   Such as are troubled with acidities, or whofe food
is apt to four on the  ftomach, fhould  live much on
animal  food ;  and  thofe who are afflicted with  hot
bilious eructations, ought to ufe a diet confuting chiefly
of acid vegetables.
   People who are affected with the gout, low fpirits,
hypochondriac  or hyfteric diforders, ought  to avoid
all flatulent food, every thing that is vifcid, or hard
of digeftion, all falted  or fmoke-dried provifions, and
whatever is auftere, acid, or apt to turn four on the
ftomach.  Their food fhould be light, fpare, cool, and
of an opening nature.
                                              The 
               OF ALIMENT.               73
  The diet ought not only to be fuited to the age
and conftitution, but  alfo to the manner of life : a
fedentary or ftudious perfon fhould live more fparing-
iy than one who labours hard without doors.  Many
kinds of food will nourifh a peafant very well which
would be almoft indigeftible to a citizen ;  and the
latter would  live upon a diet on which the former
would ftarve.
  Diet ought not to be too uniform.  The conftant
ufe of one kind of food might have fome bad effects.
Nature teaches us  this by  the great  variety of  ali-
ment which fhe has provided for man, and likewife
by giving him  an  appetite for different  kinds  of
food.
   Thofe  who labour under any  particular difeafe,
ought to avoid fuch aliments as have  a tendency  to
increafe it:  for example, a gouty perfon fhould  not
indulge in rich wines, ftrong foups, or gravies, and
fhould avoid  alb acids.   And  thofe who are fcor-
butic, fhould be fparing in the ufe  of falted pro-
vifions, &c.
   In  the firft period of life,  our  food ought to be
light, but nourifhing, and frequently  taken.   Food
that is folid,  with a fufficient degree of tenacity, is
moft proper  for the flate  of  manhood.  The diet
fuited to the laft period of life, when nature is ur on
the decline,  approaches nearly to that of the mft.
It  fhould be lighter and more fucculent than that
of vig6rous age, and likewife more frequently taken.
The beft general rule in the choice of diet is to eat
fuch food as  is agreeable to  the  tafte, and is found
by experience to  be eafy to  the ftomach.   No  one
who is honeft to himfelf need ever be deceived in this
 particular.
   It is not only neceffary for health that our diet be
 wholefome, but alfo that  it be taken at regular pe-
 riods.  Some imagine long falling will atone for ex-
                                             cefs; 
74               OF  ALIMENT.
cefs ; but this, inftead of mending the matter, gene-
rally makes  it worfe.   When the ftomach and  in-   ^
teftines are over-diftended with food,  they lofe their   i
proper tone ; and, by long fafting, they become weak,    ;
and  inflated  with wind.  Thus, either gluttony or    |
fafting deftroys the powers of digeftion.
  The frequent repetition of aliment  is not only ne-
ceffary for repairing the continual wafle  of our bo-   J
dies, but likewife to keep the fluids found and fweet.
Our humors, even in the moft healthy flate,  have a
conftant  tendency to  putrefaction, which  can-only
be r re vented  by frequent fupplies of frefh nourifh- *
ment: when  that is  wanting too long the putrefac-i  Jl
tion  often proceeds fo far as to occafion very danger-»;^H
ous fevers.  From hence we may learn the neceffity^jj
of regular meals.  No perfon can enjoy a good flate'
of health, whofe veffels are either frequently over-'    J
charged, or the humors long  deprived of  frefh fupU.^M
plies of chyle.                                   ""'*-■'  *
  Long  fafting is extremely hurtful to young peo-
ple ; it not only  vitiates their humors, but prevents
their growth.  Nor is it lefs injurious to the aged.'   -J
Many perfons, in the  decline of life, are afflicted with    ,
wind: this complaint  is not only increafed, but even
rendered dangerous, and often fatal,  by long fafting.
Old people, when their flomachs are  empty,  are fre-   'I
quently feized with giddinefs, head-achs, and fainti-
nefs.   Thefe  complaints may generally be removed
by a piece of bread and a glafs of wine, or by taking
any  other folid food  ; which plainly points out  the
method of preventing them.
  It is more than probable  that many  of the fud-'    l
den  deaths, which  happen  in the advanced periods
of life, are occafioned by fafting too long, as it  ex-    ]
haufts the fpirits, and fills the bowels with wind ;  we    :
would therefore advife perfons, in the decline  of life,
never to allow their flomachs to be too long empty.:    j
                                            Many 
               OF ALIMENT.               1$
Many people take nothing but a few cups of tea and
a little bread,  from nine o'clock at night till two or
three next afternoon.   Such may be faid  to fall  al-
moft three fourths of their time.  This  can hardly
fail to ruin the appetite, vitiate the humors, and  fill
the bowels with wind ; all which might be prevented
by a folid breakfaft.                    /
  It is a very common practice to eat a light break-
faft and a heavy fupper.  This  cuflom ought to  be
reverfed.  When people fup late, their fupper fhould
be very light;  but the breakfaft ought always to  be
folid.  If any one eats a light fupper, goes foon to
bed, and rifes betimes in the morning, he will be fure
to find an appetite for his breakfaft, and he may freely
Indulge it.
   The  ftrong  and healthy  do not  indeed  fuffer fo
much from fafting as  the weak and  delicate; but
they run great hazard from its oppofite, viz.  reple-
tion.   Many difeafes, efpecially fevers, are the  effect
of a plethora, or  too great a fulnefs  of the veffels.
Strong people, in high health, have generally a great
quantity of blood  and other humors.   When thefe
are  fuddenly  increafed, by an  over-charge of rich
and nourifhing diet, the veffels become too much dif-
tended,  attd obftructions  and  inflammations enfue.
Hence fo many people are feized with inflammatory
and eruptive fevers after a feaft or a debauch.
   All  great  and hidden changes in diet are danger-
ous.  What the ftomach has been long accuftomed
to digeft, though lefs wholefome, will agree better
with it than food of a more falutary nature  which it
has not been ufed to.  When therefore a change  be-
comes  neceffary, it  ought always to  be made gra-
dually ; a hidden tranfition from a poor and low, to
a rich  and luxurious diet, or the contrary,  might fo
difturb  the functions  of the  body,  as to endanger
health, or even to occafion death itfelf.
                                           When 
76
OF  AIR.
   When we recommend regularity in diet, we would
not be underftood as condemning every fmall devia-
tion from it.  It is next to impoffible for people at all
times  to avoid fome degree of excefs, and living too'
much by rule might make even the fmalleft deviation ^
dangerous.   It may therefore be prudent to vary a
little,  fometimes taking more, fometimes lefs,  than
the ufual quantity of meat and drink, provided always
that a due regard be had to moderation.
                 CHAP.  IV.

                      Of Air.


         UNWHOLESOME air is a  very com-
mon caufe of difeafes.   Few perfons  are aware of
the danger arifing from  it.  People generally pay
fome  attention to what they eat and drink, but fel-
dom regard what goes into the  lungs, though the
latter proves  often more fuddenly fatal than the for-
mer.
   Air,  as well as  water,  takes up parts of moft bo-
dies with which it comes in  contact, and  is often fo
replenifhed with thofe of a noxious quality, as to oc-
cafion immediate death.  But fuch violent  effects .';
feldom  happen, as people  are  generally on  their
guard againft them.  The lefs perceptible influences  \
of bad air prove more generally hurtful to mankind ;
we fhail therefore  endeavour to point out fome of
thefe, and to  fhew from whence the danger chiefly  !
arifes.
Wherever 
                   OF  AIR.                   77
  Wherever great numbers  of  people are  crowded
into one place,  if the air has not a free circulation,
it foon becomes unwholefome.   Hence it is  that
delicate perfons are fo apt to turn fick  or faint in
crowded  churches, ajjemblies,  or  any place where
the air is injured by  breathing, fires, candles,  or
the like.
  In  great  cities fo many things  tend to contami-
nate the air, that it is no wonder  it proves fo  fatal
to the inhabitants.  The air in cities is  not  only
breathed repeatedly over, but is likewife loaded with
fulphur,  fmoke,  and other exhalations, befides the
vapours  continually arifing from innumerable putrid
fubftances,  as dunghills, flaughter-houfes, &c.   All
poffible care fliould be  taken to keep the  ftreets of
large towns open and  wide,  that the air may have a
free current through  them.   They likewife ought
to be kept very clean.  Nothing tends more to pol-
lute and  contaminate the air  of  a  city than  dirty
ftreets.
   It is very common,  in this country to have church-
yards  in  the middle of populous  cities.   Whether
this be the effect of ancient fuperftition, or owing to
the  increafe of  fuch towns,  is  a matter of no confe-
quence.   Whatever gave rife to the cuflom, it is a
bad one.  It is habit  alone, which reconciles us to
thefe things ; by means of which the moft ridiculous,
nay, pernicious cuftoms, often  become facred*.
   Burying  within churches is  a practice ftill  more
deteftable.   The  air  in  churches is  feldom  good,
and the effluvia from  putrid carcafes  muft render it
ftill  worfe.   Churches  are  commonly old buildings

  *  In moft eaftern countries, it was cuftomary to bury the
 dead at fome diftance from any town.   As this practice ob-
 tained among the Jews, the Greeks, and alfo the Romans, it
 is ftrange that the weftern parts of  Europe,  fhould not have
followed their example in a cuftom fo truly laudable.
                                              with 
\i
*8                 OF  AIR.
with arched roofs.   They are feldom open  above
once a week, are never ventilated by  fires nor open
windows, and rarely kept clean.  This occafions that
damp,  mufty,  unwholefome fmell  which  one feels
upon entering  a church, and renders it a very unfafe
place  for the weak and valetudinary.   Thefe incon-
veniences might, in a great meafure, be obviated, by
prohibiting all perfons from burying within churches,
by keeping them clean,  and permitting a ftream of
frefh air to pafs frequently through them, by opening
oppofite doors and windows*.
  Wherever air flagnates long, it becomes unwhole-
fome.  Hence the unhappy perfons confined in jails,
not only contract malignant fevers themfelves,  but
often communicate them to others.   Nor are many
of the holes, for we cannot call them houfes, poffeffed
by the poor in great towns, much better than jails.
Thefe low, dirty habitations,  are the  very lurking-
places of bad air and contagious difeafes.  Such as *
live in them feldom  enjoy good health ;  and  their
children  commonly die  young.  In  the choice of a
houfe, thofe who have it in their power ought always
to pay the greateft attention to open free air.
   The various methods which luxury has invented
to make  houfes clofe and warm, contribute  not  a
little  to  render  them unwholefome.  No houfe can
be  wholefome,  unlefs the  air  has  a free paffagc
through it.   For which reafon, houfes ought daily
to be ventilated,  by opening  oppofite windows and
admitting a current of  frefh air  into every  room.
Beds,  inftead of being made  up  as  foon  as people
rife  out  of them, ought to  be turned  down, and
"expofed  to the frefh air, from the open windows,
through  the  day.  This would expel any noxious

  * One  cannot pafs through a large  church or cathedral,
even in fummer, without feeling quite chilly.
                                           vapour 
                  OF  AIR.                   ?9
vapour, and could not fail to promote the health of
the inhabitants.
   In hofpitals, jails, fliips, ckc. where that cannot be
conveniently done,  ventilators fliould be ufed.   The
method of expelling foul, and  introducing frefh air,
by means of ventilators, is a moft falutary invention,
and is indeed the moft ufeful of all our modern me-
dical improvements.  It is capable of univerfal appli-
cation,  and is fraught with numerous advantages,
both to  thofe in health and ficknefs.   In all places,
where numbers of people are crowded together, venti-
lation becomes abfolutely neceffary.
   Air  which  ftagnates in mines,  wells, cellars, &c.
is extremely  noxious.  That  kind of air is  to be
avoided, as the moft deadly poifon.   It  often kills,
almoft   as  quickly  as lightning.   For  this reafon,
people  fhould be  very cautious in opening  cellars
that have been long fhut,  or going down into deep
wells or pits,  efpecially if they have been kept clofe
covered*.
   Many people, who have fplendid houfes, choofe
to fleep  in  fmall apartments.   This conduct is very
imprudent.   A bed-chamber  ought  always  to be
well aired ; as it is generally  occupied in the nig&t
only,  when all doors and windows are fliut.    If a
fire be kept in it, the danger from a fmali room be-
comes ftill greater.   Numbers have been ftifled when
afleep by a fire in a  fmall apartment, which is always
hurtful.
   Thofe v/ho  are obliged, on account of bufmefs, to
fpend the day in clofe towns,  ought, if poffible, to

  * We have daily accounts of perfons who  lofe their lives,
by going down  into deep wells, and other places where the
air ftagmtes ; all thefe accidents might be prevented, by only
letting down a lighted candle before them, and flopping when
they perceive it go out;  yet this precaution, Ample as it is, is
too feldom cfed.
                                              fleep 
So
OF  AIR.
fleep in the country.  Breathing free air in the night,
will, in fome meafure  make up for the want of it
through the day.  This practice would have a greater
effect in preferving the health of citizens than is com-
monly  imagined.
  Delicate perfons  ought,  as much as  poffible,  to
avoid the air of great towns.  It is peculiarly hurtful
to the  afthmatic and  confumptive.   Such  perfons
fliould  avoid cities as they would the plague.   The
hypochondriac are likewife. much hurt by it.   I have
of en feen perfons fo much afflicted with this malady,
while in town, that it feemed impoffible for them to
live, who, upon being  removed to the country, were
immediately relieved.  The fame obfervation holds
with regard to nervous and hyfteric women*.   Many
people, indeed, have it not  in their power to change
their fituation in queft of better air.  All we can fay
to fuch perfons is, that  they fhould go as often abroad
into the open air as they  can,  that they fhould admit
frefh air frequently into  their houfes,  and take care
to keep them very clean.
  It was neceffary  in former times,  for fafety, to
furround  cities,  colleges, and  even fingle  houfes,
with high walls.   Thefe,  by  obftructing  the free
current of air,  never fail to render  fuch  places damp
and unwholefome.   As  fuch  walls are now become
ufelefs, they ought  to be  pulled  down, and every
method taken to  admit a free free paffage to the air.
Proper attention to Air and Cleanliness, would
tend more to preferve the health of mankind,  than
all the endeavours of the faculty.

  * And yet we often  find thefe difeafes to  prevail in the
country, where a retired life gives rife to them.  The beft rule
in thefe cafes is, to ufe exercife,  whether  in town or country ;
and to exchange the one for the other, according to circum-
ftances.
        4                             Surrounding 
OF  AIR.
it
  Surrounding houfes too  clofely with planting, or
thick  woods, likewife tends  to. render  the air un-
wholefome.   Wood not only obftructs the free cur-
rent of the air, but  fends  forth great quantities of
moift  exhalations, which render it conftantly damp.
Wood is  very agreeable at  a proper diftance from a
houfe, but fhould never be  planted too near it, efpe-
cially  in a flat country.   Many  of  the  gentlemen's
feats  in  England are rendered  very  unwholefome,
from  the great quantity of wood which  furrounds
them.
  Houfes fituated  in low marfhy countries, or near
large  lakes of ftagnating water, are likewife unwhole-
fome.  Waters which flagnate,  not only render the
air  damp, but load it with  putrid exhalations, which
produce the moft dangerous  and fatal difeafes.  Thofe
who are  obliged to inhabit marfhy countries, ought
to make  choice of the drieft fituations they can find,
and to the windward, as the failors fay,  of any pond
or marfli, to live generoufly, and to pay the ftricteft
regard to cleanlinefs.
  If frefh air be neceffary  for thofe in  health, it is
ftill more fo for the fick, who often lofe  their lives
for want of it.   The notion that fick people muft be
kept  very hot,  is  fo common,  that one can.hardly
enter the chamber where a  patient lies without being
ready to faint, by reafon of the hot  fuffocating fmell.
How  this may  affect the fick any  one may judge.
No medicine is fo beneficial to them  as  frefh air.
It is the  moft reviving  of all cordials,  if it be admi-
niftered with prudence'.   We are not,  however,  to
throw open doors and windows at  random upon the
fick.  Frefh air is to be let into the chamber gradu-
ally,  and,  if poffible,'by  opening  the  windows  of
fome  other apartment.
   The air of a fick perfon's chamber may be greatly
frefhened, and the  patient much revived by fprink- 
82            "OF EXERCISE.
ling  the floor, bed, ccc.  frequently  with vinegar,
juice of lemon, or any other ftrong vegetable  acid.
  In places where numbers of fick are crowded into
the fame houfe,  or, which is often the cafe, into the
fame apartment, the frequent admiffion of frefh air
becomes abfolutely neceffary.  Infirmaries, hofpitals,
&c. are often  rendered  fo noxious,  for want of pro-
per ventilation, that the fick run more hazard from
them than from the difeafe.   This is particularly the
cafe when  fevers,  dyfenteries, and other  infectious
difeafes prevail.
  Phyficians,  furgeons, and  others who attend hof-
pitals, ought,  for their own fafety,  to take care that
they be properly  ventilated.  Such  perfons as  are
obliged to fpend moft of their time  amongft the fick,
run  a  hazard  of  being themfelves infected when
the air  is bad.  All hofpitals, and places of recep-
tion  for the fick, ought to have an open fituation, at
fome diftance  from any great town,  and fuch patients
as labour under any infectious difeafe ought never to
be fuffered to come near the reft.
                 C II A P.   V.

                   Of Exercife.


         IViANY people 'ook upon  the neceffity
man is under of earning his  bread by  labour, as a
curfe.   Be this as it  may,  it is evident from the
ftructure of the body, that ex trcife is not lefs necef-
fary than food for the prefervation  of health :  thofe
whom poverty obliges to labour for daily bread are
not only the  moft healthy,  but  generally  the moft
                                            happy 
                OF  EXERCISE.             S;
happy part of  mankind.   Induftry feldom fails to
place them above want,  and activity ferves them in-
ftead of phyfic.   This is  peculiarly the  cafe with
thofe who live by  the culture of the ground.  The
great increafe  of inhabitants in infant colonies, and
the longevity  of  fuch  as  follow agriculture every
where,  evidently prove it to be the moft healthful
as well as the moft ufeful employment.
   The love of activity fhows itfelf very early in man.
So ftrong is this principle, that  an healthy youth can-
not be reftrained from exercife, even by  the fear of
punifhment.   Our love of motion is fureiy a  ftrong
proof of its utility.  Nature implants  no difpofition
in vain.  It feems to be a general law throughout
the whole animal creation,  that no creature, without
exercife, fliould enjoy health, or "be able to find fub-
fiftence.   Every creature, except man, takes as much
of it as  is neceffary.  He alone, and fuch animals as
are under his direction, deviate from this original law,
and they fuffer accordingly.
   Inactivity feldom fails to induce an' univerfal relax-
ation of the folids,  which difpofes the body to innu-
merable difeafes.  When the folids are relaxed, nei-
ther the digeftion,  nor any of the fecretions, can be
duly performed.   In this cafe the wont confequences
muft enfue.   How can perfons, who  loll all  day in
eafy  chairs,  and fleep all night  on beds of down, fail
to be relaxed ? Nor do fuch greatly mend the matter,
who never ftir abroad but in a  coach, fedan, or fucli
like.   Thefe elegant pieces of  luxury are become fo
common, that the  inhabitants of great towns feem to
be in fome danger  of lofing the ufe of their limbs alto-
gether.  It is now below any one to wall',  who can af-
ford to be carried.  How ridiculous would it feem, to a
perfon unacquainted with modern luxury,  to behold
the young and healthy twinging along on the fhoul-
ders  of their  fellow-creatures!  or to'fee a fat car-
                       G  2                  cafe: 
 ?4              OF  EXERCISE.
 cafe, over-run with  difeafes  occafioned  by  inacti-
 vity, dragged through the ftreets  by half a dozen
 horfes *!
   Glandular  obftructions,  now fo  common,  gene-
 rally proceed from inactivity.   Thefe  are  the moft
 obftinate  of maladies.   So  long as  the  liver, kid-
 neys, and other glands, duly  perform  their  func-
 tions, health  is feldom  impaired;  but, when  they
 fail, nothing  cm reftore it.  Exercife is almoft the
 only cure we  know for glandular  obftructions ; in-
 deed, it does not always fucceed as a remedy ;  but
 there is reafon to believe that  it would  feldom fail
 to prevent  thefe complaints,  were it  ufed in due
 time.  One  thing  is certain,  that, amongft thofe
 who take fufficient exercife, glandular difeafes are
 very little known ;  whereas the indolent and inactive
 are feldom free from  them.
  Weak  nerves are the  conftant companions  of in-
 activity.   Nothing  but  exercife and open air can
 brace and ftrengthen the nerves, or prevent the end-
 lefs train of difeafes  which  proceed from a relaxed
 ftate of thefe organs.   We  feldom hear the  active or
 laborious  complain of nervous  difeafes ! thefe  are
referved fur the  fons  of eafe and affluence.  Many
have  been  completely cured of thefe  diforders by
being reduced, from  a ftate of  opulence, to  labour
for  their  daily bread.   Thff. plainly  points out the
 fources from whence  nervous difeafes flow,  and the
 means by which they may be prevented.

  * It is not necelihy, but fafhion, which  makes  the ufe of
 carriages fo common.  There are many people who have not
 exercife erw.jgh to keep their humors wholefome, who yet dare
 r.r.t venture to make a viflt to their next neighbours, but in a
 roicb or fedan, left they fhould be looked down upon. Strange
 that men fhould be fuch fools as to be laughed out of the ufe
 c.{ their limbs, ur to throw away their health, in order to gra-
 tify  a piece of v:;r'ty, or to comply with a ridiculous fafhion !
                                                 It 
                OF EXERCISE.              85
   It is abfolutely impoffible to enjoy health, where
the perfpiration is not duly  carried on ;  but that can
never be the cafe where exercife is neglected.  When
the matter which ought  to  be thrown  off by perfpi-
ration  is  retained in the body,  it  vitiates  the hu-
mors,  and occafions the gout, fevers, rheumatifm,
&c.   Exercife alone would prevent many of thofe
difeafes which cannot be cured,  and would remove
others where medicine proves ineffectual.
   A late author*,  in his excellent treatife on health,
fays,  that  the weak and valetudinary ought to make
exercife a part of their religion.   We would recom-
mend  this,  not only to  the  weak and valetudinary,
but  to all  whofe  bufmefs  does  not oblige  them to
take  fufficient exercife,  as fedentary artificers f, fliop-
keepers, ftudious perfons,  &c.   Such ought to ufe
exercife as regularly as they take  food.   This might
generally be  done  without any interruption to  bufi-
nefs or real lofs of time.
   No  piece  of indolence  hurts the health more
than  the modern cuflom of lying a-bed too  long in
a  morning.   This  is the general practice  in great

  * Cheyne.
  f Sedentary occupations  ought chiefly  to be  followed by
women. They bear confinement  better  than men,  and are
fitter for every kind of bufmefs  which does not require  much
ftrength.  It is ridiculous enough to fee a lufty fellow making
pins,  needles, or watch wheels,  while many of the  laborious
parts of hutbandry are  carried on by the other fex.  The fa<5t
is, we want men for laborious employments, while one half of
the fothcr fex are rendered ufeleis for want of occupations
fuited to their ftrength,  &c. Were girls bred to mechanical em-
ployments, we fhould not fee fuch numbers of them proltitute
themfelves for bread, nor find fuch a want of men for the im-
portant purpofes of navigation, agriculture, Sec.  An eminent
filk manufacturer told me,  that he found women anfwer bettcv
J or that bufmefs, than  men ; and that  he had lately taken a
great many  girls apprentices as filk-weaveri.  I hope his ex-
ample will be followed by many  others.
                        G 3                  rowi":-- 
86             OF  EXERCISE.
towns.  The inhabitants of cities feldom rife before
eight of nine o'clock ;  but the morning  is undoubt-
edly the beft time for exercife, while the ftomach is
empty, and the body re/reflied with  fleep.   Befides,
the morning air braces and ftrengthens  the nerves,
and, in fome meafure,  anfwers the purpofe of a cold
bath.  Let  any one who has been accuftomed to
lie  a:bed  till eight or nine o'clock, rife by  fix or
feven, fpend a couple of hours in walking, riding, or
any active diverfion without doors,  and he will find
his  fpirits cheerful and  ferene  through the day, his
appetite keen, and his body braced and ftrengtnened.
Cuflom foon renders  early  rifing  agreeable,  and
nothing  contributes more to the  prefervation of
health*.
  The inactive are continually complaining of pains
of the ftomach, flatulencies, indigeftions, &c.   Thefe
complaints, which pave the way to many others, are
not to be removed by medicines.  They can only be
cured by a vigorous  courfe of exercife, to which in-
deed they feldom fail to yield.
  Exercife, if poffible, ought always to be taken in
the open air.   When  that cannot be done,  various
methods may be contrived for exercifing the body
within doors, as the dumb bell, dancing, fencing,
&c.  It is not neceffary to adhere ftrictly to any par-
ticular kind of exercife.  The beft way  is to take
them by  turns, and  to ufe that longeft which is moft
fuitable to the ftrength and conftitution.  Thofe kinds
of exercife which give  action to moft  of the  bodily
organs, are always to be preferred, as walking, run-
ning, riding, digging, fwimming, and fuch like.

  * Thofe who live in  the country, however,  in the  neigh-
bourhood of marfhy places, efpe ially, ought never to be cut
of doors, before fun-: ifc nor after fun-fet.
It 
                OF EXERCISE.              87
   It is much to be regretted, that active and manly
diverfions are  now fo little practifed.  Diverfions
make people take more exercife than they otherwife
would do, and are of the greateft fervice to fuch as
are not  under  the neceflity of  labouring for  their
bread.  As active diverfions lofe ground, thofe of a
fedentary kind feem to prevail.   Sedentary diverfions
are of no other ufe but to.confume time.   Inftead
of  relieving the  mind, they often  require   more
thought than either fludy or bufmefs.   Every thing
that induces people to fit ftill, unlefs it be  fome ne-
ceffary employment, ought  to be avoided.
   The  diverfions which afford the beft exercife are,
hunting,  fhooting,  playing at  cricket, hand-ball,
golff*, See.   Theie exercife the limbs,  promote per-
fpiration, and  the other fecretions.   They likewife
flrengthen the  lungs, and  give firmnefs and agility
to the whole body.
   Such  as  can, ought to fpend two or three hours
a-day on horfeback;  thofe  who  cannot ride, fliould
employ the  fame time  in walking.  Exercife fhould
never be continued too long.  Over-fatigue prevents
the benefit of exercife, and, inftead of ftrengthening
the body, tends to weaken it.
   Every man fhould lay himfelf  under  fome fort of
neceflity  to  take  exercife.   Indolence, like  other
vices when  indulged,  gains  ground, and at  length
becomes  agreeable.   Hence many who were  fond
of exercife  in  the early part of  life,  become  quite
averfe to it afterwards.  This is the  cafe of mofl
hypochondriac  and gouty   people, which  renders
their difeafes, in a great meafure,  incurable.

  * GolfFis a diverfion very common in North-Biitain.  It is
.veil calculated for excrcifing the body, and  may  always be
taken in fuch moderation, as neither to over-heat nor faiivue.
It has greatly the preference ovtr cricket, tennis, or any of
thole games which cannot be p'aved without violenre.
                       G 4                    In 
88
OF  EXERCISE.
  In fome countries, laws have been made, obliging
every man, of whatever rank, to learn fome mecha-
nical employment.   Whether fuch laws were defign-
ed for the prefervation of health, or  the encourage-
ment of manufacture, is a queftion of no importance.
Certain it is,  that if gentlemen were frequently  to
amufe  and exercife themfelves in this way, it might
have many good effects.  They would at leaft derive
as much honour from  a few mafterly  fpecimens  of
their  own workmanfhip, as  from  the character  of
having ruined moft of their companions by gaming
or drinking.  Befides,  men  of leifure, by  applying
themfelves to  the  mechanical arts,  might improve
them to the great benefit of fociety.
  Indolence not only occafions difeafes, and renders
men ufelefs to fociety, but  promotes all manner of
vice.   To fay a man is idle, is little better than to
call him vicious.  The mind,  if  not  engaged  in
fome  ufeful purfuit, is conftantly  in queft of ideal
pleafures, or  impreffed with the apprehenfion  of
fome imaginary evil.   From thefe  fources proceed
moft of  the  miferies  of mankind.   Certainly  man
was never intended  to  be  idle.  Inactivity fruftrates
the very defign of  his creation; whereas an active  ,
life is the beft  guardian of virtue,  and the greateft
prefervative of health.
CHAP. 
OF SLEEP AND  CLOTHING.
89
                  CHAP.  VI.


             Of Sleep and Clothing.


         i^LEEP, as well as diet, ought to be du-
ly regulated.  Too little fleep  weakens the nerves,
exhaufts the fpirits and occafions  difeafes ;  and too
much renders the mind dull, the body grofs, and dif-
pofes to apoplexies, lethargies,  and other complaints
of a fimilar nature.  A medium ought  therefore to
be obferved; but this is not eafy  to fix.   Children
require more fleep than  grown perfons, the labori-
ous than the idle, and fuch as  eat and drink freely,
than thofe who live abftemiouily.  Befides,  the real
quantity of fleep cannot be meafured by time;  as
one perfon will be more refrefhed by five or fix hour*
fleep, than another by eight or ten.
   Children  may always be allowed to take as much
fleep as  they  pleafe, but, for adults, fix  or  feven
hours is certainly fufficient, and no  one ought  to
exceed eight.  Thofe who  lie a-bed more than eight
hours may flumber, but they can hardly be faid to
fleep;  fuch generally tofs and dream away the  fore-
part of the night,  fink to reft towards morning, and
dofe till noon.   The beft way to make fleep found
and refrefhing is to rife betimes.  The cuflom of ly-
ing a-bed for nine Or ten hours, not only makes the
fleep lefs refrefhing, but relaxes the folids, and greatly
weakens the conftitution.
   Nature points out night as  the proper feafon for
fleep.  Nothing  more  certainly deftroys the confti-
tution  than  night-watching.  It is great pity that a
practice fo deftruaive to health fhould be fo much in
                                          fafhion". 
  90           OF SLEEP AND CLOTHING.
  fafhion.   How quickly the want of reft in due feafon
  will blaft the moft blooming complexion, or ruin the
  beft conftitution,  is evident  from the  ghaftly coun-
  tenances of thofe who, as  the  phrafe is, turn day
  into night and night into day.
    To make fleep refrefhing  the  folWin,- tilings arc
  requifite: Firft, to  take  fufficient  exercife in  the
  open  air, to avoid  ftrong tea or  coffee ;  next, to
  eat a  light fupper; and  laftly, to  ii r down with a
  mind as cheerful and ferene as poffible.
    It is certain that too much exercife wiii prevent
  fleep as well as too little.  We feldom however hear
  the active and laborious complain of reftlefs n ghts,
  It is the indolent and flothful  who generally have
  thefe  complaints.  Is it any wonder that a bed of
  down fliould not be refrefhing to a# perfon who fits all
  day in an eafy chair ? A great part of the pleafure of
.  life confifts  in alternate reft and motion ; but they
  who neglect  the  latter  can never relifli the former.
,  The labourer enjoys more true  luxury in plain food
  and found fleep,  than is to  be  found in iumptuous
  tables and downy pillows, where  exercife  is want-
  ing.
    That light fuppers caufe found fleep is true even
  to a proverb.  Many  perfons,  if  they  exceed the
  leaft at that meal, are  lure  to  have uneafy nights;
  and, if they fall afleep,  the load and oppreffion on
  their  ftomach and fpirits occafion  frightful dreams,
  broken and  difturbed  repofe,  the  night-mare, &c.
  Were  the fame  perfons  to  go to  bed with a light
  fupper, or fit up till that meal was pretty well di-
  gefted, they would enjoy  found  flee"^, and rife re-
  freflied and cheerful.  There are indeed fome peo-
  ple who cannot fleep unlefs they have eat fome folid
  food at night, but this does  not imply the neceffity
  of an heavy fupper ; befides, thefe are generally per-
  fons who have accuftomed themfelves to this method,
                                                and 
           OF SLEEP AND CLOTHING.         91
And who do not  take a fufficient  quantity of folid
food and exercife.
  Nothing more certainly difturbs  our  repofe than
anxiety.   When the mind is not at eafe, one feldom
enjoys found fleep.   The greateft of human bleffings
flies the wretched, and vifits the happy, the chearful,
and the gay.  This is a fuflicient reafon  why every
man fhould endeavour to be as eafy in his mind as
poffible when he goes to  reft.   Many,  by indulging
grief and anxious thought, have baniflied found fleep
fo long,  that they could never afterwards enjoy it.
   Sleep, when taken in the  fore-part of the night
is generally reckoned moft refrefhing.   Whether
this be the effect of habit or not, is hard to fay ;  but
as moft people  are accuftomed  to  go  early to  bed
when young, it  may be prefumed that fleep,  at  this
feafon, will prove moft refrefhing to them ever after.
Whether the fore part of the night  be beft for fleep
or not, furely the fore-part of the day  is fittefl both
for bufinefs and  amufement.   I hardly ever knew an
early rifer who did not enjoy a good flate of health #.

                    Of Clothing.

   The clothing  ought to be  fuited to the climate.
Cuftom has, no  doubt, a very great influence on this
article;  but no  cuftom can ever change the nature

  * Men of every  occupation,  and in every fituation of life,
have lived to a good old age ; nay fome have enjoyed this bleff-
ing whofe plan of living was by 1.0 means regular : but it con-
fifts with obfervation, that all very old men have been early
rifers.  This is the oily circumftance attending longevity to
which I never knew an exception.
   It may be an unp pular idea, but I believe it to be a juft
one, that fleeping on feather beds  is very prejudicial to the •
health—a good matrafs would be fufficienrly foft for the moft
delicate, and is indifpenfably neceffary in ccniuxpticn, gravel,
and many other difeafes.
C 
92         OF SLEEP AND CLOTHING.
of things fo far,  as to render the  fame clothing fit
for an inhabitant of Nova Zemb.a  and the ifland of
Jamaica.   It is not indeed  ncctffi.iy to obierve  an
exact proportion between the quantity  of c.o'ha we
wear,  and the degree of latitude which we inhabit;
but, at the fame time,  proper attentioi. o^ght to be
paid to it,  as well as  to the opennefs / the country,
the frequency and violence of ftorms, &*
   In youth,  while the  blood is hot and  the  perfp  '■,
ration  free, it is lefs neceffary to cover the b~  :y *.vith
a great quantity of clothes; but, in the  dec ine of
life, when the fkin becomes  rigid and the h> -T.ors
more cool, the clothing fhould be increafed.  Many
difeafes in the  latter  period of life proceed  fru n a
defect  of perfpiration :  thefe may,  in fome meafure,
be prevented by a fuitable  addition to the clothing,
or by wearing fuch as are better calculated for pro-
moting the difcharge from the fkin, as clothes made
of cotton,  flannel, &c*
  The clothing ought  likewife to be  fuited  to the
feafon  of the year.   Cloathing may be  warm enough,
for fummer,  which is by no means fufficient for win-
ter.   The greateft caution,  however,  is neceffary in
making thefe changes.  We ought neither to put off
our  winter clothes too  foon,  nor  to wear our  fum-
mer ones too  long.   In  this country, the  winter
often fets in  very  early with great rigour, and we
have frequently cold weather even after the  com-
mencement  of the fummer months.   It would like-
wife be prudent not to  make  the change all at once,
but to do it  gradually; and  indeed the changes of
apparel in this climate ought to be  very  inconfider-'

  * The ufe of flannel fhirts has become very general in  Ame-
rica : They fliould be changed once or twice a-week—No one
need be afraid of becoming too delicate from the ufe of them.
-•-They have quite a contrary effect.
able, 
          OF SLEEP AND  CLOTHING. '       93
able, efpecially  among thofe who  have paffed the
meridian of life*.
   Clothes often become hurtful by their being made
fubfervient to the purpofes of pride or vanity.  Man-
kind, in all  ages,  feem to have confidered clothes in
this  view ;  accordingly their fafhion and figure have
been continually varying,  with  very little regard ei-
ther to  health,  the climate,  or conveniency: a far-
thingale, for example,  may  be very neceffary in hot
fouthern ciimates, but furely nothing  can be more
ridiculous in the cold regions of the north.
   Even  the human  fhape is often  attempted to be
mended by drefs, and thofe,  who know no better, be-
lieve that mankind would be monfters without its af-
fiftance.   All attempts of this nature are highly per-
nicious.  The moft deftructive of them  in this coun-
try is that of fqueezing the ftomach and bowels into
as narrow a compafs as poffible, to procure,  what is
falfely called, a fine fhape.   By this  practice  the
action of the ftomach and bowels, the motion of the
heart and lungs, and almoft all the vital functions,
are  obftructed.  Hence  proceed indigeftions, fyn-
copes, or fainting fits,  coughs,  confumptions  of the
lungs, and  other  complaints fo common among fe-
males.
   The feet likewife  often fuffer  by preffure.  How
a fmall foot  came to be reckoned genteel, I will not

  * That colds hill more than plagues, is an old obfervation; and,
with regard to this c untry, !t holds ftrictly true. Every perfon
of difcemment, h■ •"•■->'u-, v ill perceive, that moft of the colds
which prove fo r^ftj adtive to the inhabitants of Britain, and we
may add in North America, are owmg to their imprudence in
changing clothes.   A few warm clays in March or April induce
them to throw off their winter garments, without confidcring
that our moft penetrating colds generally happen in the fpring.
It is often neceffary to change ocr clothing feveral times in the
day.
pretend 
 94        OF SLEEP AND CLOTHING.
 pretend to fay;  but certain it is, that this notion has
 rendered many perfons lame.   Almoft nine-tenths of
 mankind are troubled with  corns:  a difeafe  that is
 feldom or never occafioned but by ftrait fhoes. Corns
 are  not only  very troublefome, but by  rendering
 people unable to walk, they  may likewife  be coj^ |
 dered as the remote caufe of other difeafes*.
   The fize and figure of the flioe ought certainly to
 be adapted to the foot.   In children the feet are as
 well fhaped as the hands,  and  the motion of the toes
 as free and eafy as that of the fingers ; yet few per-
 fons in the advanced periods of life  are able to make
 any  ufe  of their toes.  They  are generally, by nar-
 row fhoes, fqueezed all of a heap, and often laid over
 one  another in fuch a manner as to be rendered al-
 together  incapable of motion.   Nor is the high heel
 lefs hurtful than  the narrow toe.  A lady may feem
 taller for walking on her tiptoes, but fhe will never
 walk well in this manner.   It ftrains her joints, dif-
torts her limbs, makes her floop, and utterly deftroys
 all her eafe and gracefulnefs of motion : it is entirely
 owing to fhoes with high heels and narrow  toes, that
 not one female in ten can be faid to walk well.
   In fixing on the clothes, due care fhould be taken
 to avoid all tight bandages.   Garters, buckles, &c.
when drawn  too  tight, not only prevent the free mo-
tion  and ufe  of the  parts about which  they are.
bound, but likewife obftruct  the circulation of the
blood, which prevents the  equal nourifhment and
 growth of thefe parts, and occafions various difeafes.
 Tight bandages about the neck,  as  flocks, cravats,
necklaces, &c. are extremely dangerous.  They ob-

  * We often fee perfons who are rendered quite lame by the
nails  ot their tnes having grown into the flefh",  and frequently
hear  of mortifications proceeding fiom this caufe.  All thefe
 and many other  inconveniences attending the feet, muft  be
 imputed folely to the u.'e of fhorr. and ftrait fhoes.
                                             ftrucl 
           OF SLEEP AND CLOTHING.         9S
ftruct the  blood in  its courfe  from  the  brain,  by
which means headachs, vertigoes,  apoplexies,  and
other fatal difeafes are often occafioned.
   The  perfection of drefs is to be  eafy and  clean.
Nothing can  be more ridiculous,  than  for any  one
to make himicif a flave to fine clothes.   Such an one,
and  many fuch  there  are, would rather  remain as
fixt as a ftatue from morning till night, than difcom-
pofe a  fingle  hair,  or alter the pofition  of a  pin.
Were we to recommend any  particular pattern  for
drefs, it would be that  which is worn by the people
called Quakers.   They are always neat, clean,  and
often elegant, without any thing fuperfluous.   What
others  lay out upon tawdry laces,  ruffles,  and rib-
bands, they beftow upon fuperior cleanlinefs.  Finery
is only  the affectation of drefs, and very often covers
a great deal of dirt.
   We fliall only add,  with regard to clothing,  that
it ought, not only to be  fuited to  the climate,  the
feafon of the year, and the period of life, but like*
wife to the temperature  and conftitution.  Robuft
perfons are able to endure either cold  or heat  better
than the  delicate ;  confequently  may be  lefs  atten-
tive to  their clothing.   But  the precife quantity of
clothes  neceffary for any perfon cannot  be  deter-
mined by reafoning.   It is entirely a matter of expe-
rience,  and every man is  the  beft judge for himfelf
what quantity, of clothes  is  neceffary to  keep  him
warm*.

   * The celebrated Boerhaave ufed to fay,  that  no body fct-
fered by cold f.ive fools and beggars ; the latter not being able
to procure clothes, and the former not having fenfe to  wear
them.  Be this as it may,  I can with the ftriclett truth declare,
that in man) cafes where the powers of medicine h id been tried
in vain,  I have cured the patient by recommending thick fhoes,
a flannel waiftccat and drawers, a pair of under ftockings,  or'a
flannel petticoat, to be worn during the cold leafon at leaft.  I
have known feveral inftance* of lore throat from thin fhoes.
                                             CHAT 
96            OF INTEMPERANCE.
                  CHAP.  VII.


                 Of Intemperance.


         A  MODERN author* obferves, that    I
temperance and exercife are the  two beft  phyficians    m
in the world.  Temperance may juftly  be called the    I
parent of health ;  yet  numbers of mankind act as if    M
they thought  difeafes  and death too flow in their
progrefs, and, by intemperance and debauch,  feem,
as it were,  to folicit their approach.         gft.
   The  danger of intemperance appears  froiWtoie
very conftruction  of  the human body.   Health de-
pends on that ftate of the folids and fluids which fits
them for the due performance of the vital functions ;
and, while thefe  go  regularly on, we are found and
well; but whatever difturbs them, neceffarily impairs
health.   Intemperance  never fails  to  diforder  the
whole animal oeconomy ; it hurts the  digeftion, re-
laxes the nerves, renders the different fecretions irre-
gular, vitiates  the humors, and  occafions numberlefs'  jfl
difeafes.                                           ^B
   The analogy between the  nourifhment of  plants'    I
and animals affords a  ftriking proof Of the danger    I
of intemperance.   Moifture and manure greatly pro-  4
mote vegetation ; yet an over quantity of either will
entirely  deflroy  it.  The beft  things become hurt-
ful, nay deftructive,  when carried to excefs.   Hence
we learn, that the higheft degree of human, wifdom    !
confifts in regulating our appetites and  paffions fo as
to avoid  all  extremes.  It is that chiefly which en-

                    * Roffeau.
       2                                   titles,- 
          OF  INTEMPERANCE.          97
titles  us  to  the character of rational beings.   The
flave of appetite will ever be the difgrace of human
nature.
  The Author of Nature hath endued us with vari-
rious paflions, for the propagation of the fpecies, the
prefervation of the individual,  &c.   Intemperance is
the abufe of thefe paflions; and moderation confifts
in the proper regulation of them.   Men, not con-
tented with  fatisfying  the fimple calls  of Nature,
create artificial  wants,  and  are perpetually in fearch
of fomething that may gratify them ; but imaginary
wants can never be gratified.   Nature is content
with little ; but luxury knows no bounds.  Hence
the epicure,  the drunkard, and the  debauchee, fel-
dom  flop in their  career, till their  money or their
conftitution  fails: then,  indeed, they  generally fee
their error,  when too late.
  It is impoffible to  lay down fixt rules with regard
to diet,  on  account  of the different conftitutions of
mankind.  The moft ignorant perfon, however, cer-
tainly knows what is  meant  by excefs  ; and it is in the
power of every man, if he  choofes, to  avoid it.
   The great rule of diet is to fludy fimplicity.  Na-
ture delights in the moft  plain and fimple food, and
every animal, except  man, follows her dictates.  Man,
alone, riots at large,  and ranfacks the whole creation
in queft of luxuries, to  his own deftruction.  An ele-
gant writer* of the laft age, fpeaks thus of intemper-
ance in diet: " For my part, when I behold a fafhion-
" able table fet out in all its magnificence, I fancy
" that I  fee gouts and dropfies, fevers and lethargies,
" with other innumerable diftempers, laying in am-
" bufcade among the difhes."
  Nor is intemperance in  other things  lefs deftruc-
tive than in diet.   How quickly does the immode-

                    * Addifon,
                        H
rate 
 9&           OF INTEMPERANCE.
 rate purfuit of carnal pleafures, or the abufe of in-
 toxicating liquors, ruin the beft conftitution !  Indeed
 thefe vices generally go hand and hand.  Hence it is
 that we fo often behold the votaries of Bacchus and
 Venus,  even  before  they have arrived at the prime
 of life,  worn out with difeafes, and haftening with
 fwift pace to an untimely grave.  Did men reflect on
 the painful difeafes and premature deaths, which are
 daily occafioned by intemperance,  it  would  be fuffi-
 cient to make them fhrink back with horror from the
 indulgence even of their darling pleafures.
   Intemperance does not  hurt its votaries alone  ; the
 innocent too often feel the direful effects of it.   How
 many  wretched orphans  are to be feen embracing
 dunghills, whofe parents, regardlefs of the  future,
 fpent in riot and debauch what might have ferved to
 bring up their offspring in a decent  manner ?  How
 often do  we behold the miferable mother, with her
 helplefs infants, pining in want, while the cruel father
 is indulging his infatiate appetites ?
   Families are not only reduced to mifery, but  even
 extirpated, by intemperance.  Nothing tends fo much
 to  prevent propagation,  and to fliorten the lives of
 children,   as  the  intemperance  of parents.   The
 poor  man who  labours  all  day,  and  at  night lies
 down  contented  with his humble fare, can boaft a
 numerous offspring,  while his  pampered  lord,  funk
 in eafe and luxury, often  languiflies without an heir
 to his ample fortunes.   Even ftates and empires feel
 the influence of intemperance, and rife or  fall  as it
 prevails.
   Inftead of  mentioning the different  kinds of in-
 temperance, and pointing out their  influence upon
 health,  we fliall only, by  way of example, make  a
 few obfervations on one particular fpecies of that vice>
•&z. the abufe of intoxicating liquors.
Every 
            OF INTEMPERANCE,            $9
   Evefy act of intoxication puts Nature to the ex-
pence of a fever, in order to difcharge the poifonous
draught.  When  this is repeated almoft every day,
it  is eafy to  forefee the confequences^  That  confti-
tution muft be ftrong indeed, which  is able long to
hold out under a daily fever !  but fevers occafioned
by drinking do not always go off in a day ; they fre-
quently end in an inflammation of the breaftj liver,
or brain, and produce fatal effects.
   Though the drunkard fhould not fall by an acute'
difeafe, he feldom  efcapes thofe  of a chronic kind.
Intoxicating  liquors,  when  ufed to  excefs,  weaken
the bowels, and fpoil the digeftion ; they deftroy the
power of the nerves,  and occafion paralytic and con-
vulfive diforders ;  they likewife heat  and inflame the
blood, deftroy its balfamic quality,  tender  it  unfit
for circulation, and  the  nourifhment of the  body*
Hence  obftructions,  atrophies,  drapfies, and  con-j
fumptions of the  lungs.   Thefe  are  the common
ways in which drunkards make their exit.  Difeafes
of this kind, when brought on  by hard drinking, fel-
dom admit of a cure*.
   Many people injure their health by drinking, who
feldom get drunk.  The continual habit  of foaking,
as it is called,  though its effects be not fo violent, ii
not lefs pernicious.   When the veffels are kept con-*
flantly full and upon  the ftretch,  the different digef-
tions can neither  be duly performed, nor the hu-
mors properly  prepared.    Hence  moft people of
this character are afflicted with the gout, the gravel,
fores in the legs,  &c.  If thefe  diforders do  not ap-
pear, they  are feized with low fpirits, hypochondri-
acal affections, and other fymptoms of indigeftion.

   * It is much to be feared that phyficians have too often in*
 eautioufly made drunkards of  their patients,  by prescribing
 fpirits, cr brandy and water, for their drink; which, however,
 wre never neceffary.
                     II 1                Confump* 
ico           OF  INTEMPERANCE.
   Confumptions  are  now  fo  common,  that  it is
thought one-tenth of the inhabitants of great towns
die of that difeafe.   Hard drinking is no  doubt  one
of the caufes to,which  we  muft impute the increafe
of confumptions.   The great quantities of ftrong vif-
cid malt liquor drank by the common people of Eng-
land, cannot  fail  to render the blood fizy and  unfit
for circulation ; from  whence proceed obstructions,
and  inflammations  of  the  lungs.    There  are  few
great ale-drinkers who are not phthifical:  nor is that
to be wondered at,  confidering the glutinous and al-
moft indigeftible nature of ftrong ale.
   Thofe who drink ardent fpirits or ftrong wines run
ftill greater hazard ; thefe liquors heat and inflame
the blood, and tear  the tender veffels of the  lungs to
pieces ; yet fo great is the confumption  of them in
this  country, that  one would  almoft be induced to
think that the inhabitants lived upon them*.
   The  habit  of drinking proceeds frequently  from
misfortunes in life.   The  miferable fly  to it for re-
lief.  It affords them indeed a temporary eafe.   But,
alas ! this  folace is fliort-lived ; and when it is over,
the fpirits fink as much below their  ufual tone as
they  had before been raifed above it.  Hence  a re-
petition of the dofe becomes  neceffary, and every
frefh dofe makes  way  for  another, till the unhappy
wretch  becomes a Have to  the  bottle,  and at length
falls a  facrifice to what  at firft perhaps  was taken
only as a  medicine.  No man  is  fo dejected as the
  *  We may form fome notion of the immenfe quantity of ar-
dent fpirits confumed in Great-Britain from this circumftance,
that in the city of Edinburgh and its environs, befides the  great
quantity of foreign fpirits duly entered, and the ftill greater
quantity which is fuppofed to.be fmuggled, it is computed that
above two  thoufand private ftills are conftantly employed in
preparing a poifonous liquor called  Molafes.  The common
people have got fo univerfally into the habit of  drinking this
bafe fpirit, that when a porter or labourer is feen reeling along
the ftreet;;, they fay, he has got molaffed.
                                          drunkard 
OF  INTEMPERANCE.
IOI
drunkard  when his debauch is gone off.  Hence it
is, that thofe who have  the greateft  flow  of fpirits
when the glafs circulates freely, are of all others the
moft melancholy  when fober, and often put an end
to their own miferable exiftence in a  fit of fpleen or
ill humor.
   Drunkennefs not only proves deftructive to health,
but likewife to the faculties of the mind.   It is ftrange
that creatures who value themfelves  on account  of
a fuperior degree of reafon to that of brutes, fhould
take pleafure in  finking fo far  below them.   Were
fuch as voluntarily deprive themfelves of the ufe of
reafon, to  continue ever after  in  that  condition, it
would feem but a juft punifhment.   Though this be
not  the confequence of one act  of intoxication, it
feldom fails to fucceed a courfe of it.  By a habit of
drinking,  the greateft genius is often  reduced to a
mere idiot*.
   Intoxication is  peculiarly hurtful to  young perfons.
It heats their blood, impairs their ftrength,  and ob-
ftructs  their  growth ;  befides,' the frequent ufe of
ftrong liquors in  the early part of life deftroys any
benefit  that  might  arife  from   them afterwards.
Thofe  who make a practice of  drinking generous
liquors when young,  cannot  expect  to  reap  any
benefit from  them as a cordial  in the decline of life.
   *  It is amazing that our improvements  in arts,  learning,
and politenefs, have not put the barbarous cuftom of drinking to
excels out of fafhion.  It is indeed lefs common in South-Bri-
tain than it was formerly ; but it ftill prevails very much in the
N'Tth, where .this relic of barbarity is miftaken for hofpitality.
There no man is fuppofed to entertain his gueits well, who does
not make them drunk.  Forcing people to drink, is certainly
the greateft piece of rudenefs that any man can be  guilty of.
Suppofed manlinefs, complaifance, or n.eer  good nature, may
induce a man to take his glafs, if urged to it, at a time when he
might  as well take poifon.   The cuftom of drinking to excefs
has long been out of fafhion in France ; and, as it begins to lofe
grcund among the politer part of the Englifh, we hope it will
foon be baniflied from every  part of this ifland.
                       H 3                  Drunk. 
re*            OF CLEANLINESS.
   Drunkentiefs is  not only in itfelf a moft abomina-
ble vice,  but  is  an inducement  to many  others.
There is hardly any crime fo horrid that the  drunk*
ard will not perpetrate for the love of liquor.  We
have  known mothers fell their children's clothes, the-
food that they would have eat, and afterwards even
the infants themfelves,  in order to purchafe  the ac-
curfed draught.
   A  very abfurd argument in  favour of fpirits has,
been  ufed, from  obferving, that  fome  perfons who
made  a very free ufe of them have lived to old age:
we fometimes fee an old  foldier, and an old  failor;
but no one will fuppofe that a military or a fea-faringi
Jife? are favourable to longevity.
                 CHAP.  VIII,

                  Of Cleanlinefs.

         J HE want of cleanlinefs is a fault  which
admits of no excufe.  Where water can be had for
nothing, it is furely in the power of every perfon to
be clean.   The continual difcharge from our bodies
by perfpiration,  renders  frequent change  of apparel,
neceffary.  Changing apparel greatly promotes the
fccretion  from the fkin,  fo  neceffary  for health.
When that matter, which ought to be carried  off by
perfpiration,  is either retained in  the  body, or re-
forbed from dirty clothes, it muft occafion difeafes.
  Difeafes of the fkin are, in a great meafure  owing
to want of cleanlinefs.   They may indeed be caught
by infection,  or brought  on by poor living, unwhole-
fome  food, &c. but they  will feldom continue long
                                           where 
            OF  CLEANLINESS.             103
where cleanlinefs prevails.  To the fame caufe muft
we impute  the various kinds of vermin which infeft
the human  body, houfes, &c.  Thefe may always be
baniflied by cleanlinefs alone, and  wherever they
abound, we have reafon to believe it is neglected.
   One  common caufe  of malignant  fevers, is  the
want  of cleanlinefs.   Thefe fevers commonly begin
among  the inhabitants of clofe  dirty houfes, who
breathe unwholefome  air, take little exercife,  and
wear  dirty  clothes.   There the infection is generally
hatched, which often  fpreads far and wide, to the
deftruction of many.   Hence cleanlinefs may be con-
fidered as an object of public attention.  It is not  fuf-
ficient that I be clean myfelf, while the want of it in
my neighbour affects my health  as well as his own.
If dirty people cannot be removed as a common nui-
fance, they ought at  leaft to be avoided as  infectious.
All who regard their health fliould keep at a diftance
even  from  their habitations.
   In  places where great numbers of people are  col-
lected,  cleanlinefs becomes of the utmoft importance.
It is well known that infectious  difeafes are  commu-
nicated by  tainted air.  Every  thing, therefore, which
tends to pollute the air, or fpread the infection, ought
with  the utmoft care to be guarded againft.  For  this
reafon,  in  great towns, no filth  of any kind, fliould
be. permitted to he upon the ftreets.
   In  many great towns the ftreets  are little better
than dunghills, being frequently covered  with afhes.,
dung, and  naftinefs of every kind.   Even flaughter-
houfes,  or killing fliambles, are often to  be feen in
the very centre of great towns.   The putrid blood,
excrements, &c.  with which  thefe places are gene-
rally  covered,  cannot fail to taint the air, and render
it unwholefome.  How eafily might this be prevented
by active  magiftrate;, who have it always it their
                       H 4                 power 
J04              OF CLEANLINESS.
power to make proper laws relative to things of this
nature, and to enforce the obfervance of them !
   We are forry to fay, that the importance of gene-
ral cleanlinefs does not feem to be fufficiently under-
ftood by  the magiftrates of moft great  towns in
Britain ;  though health, pleafure,  and delicacy,  all
confpire  to recommend  an attention to it.   Nothing
can be more agreeable to  the fenfes, more to the ho-
nour of  the inhabitants, or more conducive to their
health, than a clean town ; nor can  any thing imprefs
a ftranger with a more difrefpectful idea of any peo-
ple than its oppofite.   Whatever pretenfions people
may make to learning, politenefs, or civilization,  we
will venture to affirm, that while they neglect clean-
linefs,they are in a ftate of barbarity*.
   The peafants in moft countries feem to hold clean*
linefs in a fort of centempt.  Were it not for the
open fituation of their houfes, they would  often feel
the bad effects of this difpofition.   One  feldom fees
a farnUioufe without a dunghill before the door, and
frequently the cattle  and their mafters lodge  under
the fame roof.  Peafants are likewife extremely care-
lefs with refpect to change of apparel,  keeping their
houfes, &c. clean.   This is merely the effect  of in-
dolence  and a dirty  difpofition.   Habit may indeed
render it lefs difagreeable to them,  but no habit, can

   * In ancient Rome the greateft men did not think cleanlinefs
an objea unworthy of their attention.  Pliny fays, the Cloaca,
or common fewers for the conveyance of filth and naftinefs from
the city, were the greateft of all the public works ; and beftows
higher encomiums upon Tarquinus, Agrippa, and others who
made and improved them, than on thofe who atchieved the'
greateft conquefts.
 _ How truly great does the  emperor Trajan appear, when
giving directions to Pliny his proconful, concerning the makinjr
of a common fewer for the health and convenience of a con-
quered city ?                            ■       *,«* ^»»
ever 
              OF CLEANLINESS.               10.
ever make it falutar^ to wear dirty clothes or breathe
unwholefome air.
   As  many articles of diet come through the hands
of peafants,  every method fliould be taken to encou-
rage and  promote habits  of  cleanlinefs among them.
This,  for example, might be done by giving a fmall
premium to  the perfon who brings the cleaneft  and
beft article  of any kind to market,  as butter, cheefe,
&c.  and by punifliing feverely thofe who bring it
dirty.   The  fame method  fhould be taken with
butchers,  bakers, brewers, and all who are employed
in preparing the neceffaries of life.
   In camps the  ftricteft  regard fliould be paid to
cleanlinefs.   By negligence in this  matter, infectious
difeafes are  often fpread amongft a  whole army;  and
frequently more die of thefe than by the fword.   The
Jews during  their encampments  in the wildernefs,
received particular inftructions with refpect to clean-
linefs*.  The rules enjoined them ought to be ob-
ferved by all in the like fituation.   Indeed the whole
fyftem of laws delivered to that people has a manifeft
tendency  to promote  cleanlinefs.  Whoever confiders
the nature of their climate, the difeafes to which they
were liable, and their, dirty difpofition, will fee the
propriety of fuch laws.
   It is remarkable that  in  moft  eaftern countries,
cleanlinefs  makes a  great  part of their religion.
The Mahometan,  as  well as the Jewifh religion, en-
joins  various  bathings, wafliings,  and purifications.
No doubt thefe might be defigned to  reprefent in-
ward purity ; but  they were  at  the fame time cal-
culated for the  prefervation of health.   However

   * Thou  malt have a place alfo without the camp, whither
thou fhalt go forth abroad ; and thou (halt have a paddle upon
thy weapon : and it fhail be when thou fhalt eafe thyfclf abroad,
thou lhait dig therewith, and lhalt turn  ba?k, and cover that
which cometh from thee, Sec.  Deuter. chap. xxii. ver. 12, 13.
                                          whimfical 
 106              OF CLEANLINESS.
whimfical thefe wafhings may appear  to fome, few
things would tend  more to prevent difeafes  than a
proper attention to many of them.   Were every per-
fon for example, after  vifiting the fick, handling a
dead body, or touching any thing that might convey
infection, to wafh before he went into company,  or
fat down to meat, he would run lefs hazard either of
catching the infection himfelf, or of communicating it
to others*.
  Frequent wafhing not only removes the filth and  *
fordes which adhere to the fkin,  but likewife pro-
motes the perfpiration, braces the body, and enlivens
the fpirits.  How refrefhed, how cheerful, and agree-'
able does one  feel on being  fliaved, wafhed, and
fliifted ;  efpecially  when, thefe offices  have been ne-
glected longer than ufual.                         ^JM
  The  eaftern  cuftom of  wafhing the feet, thongli'^1
lefs neceffary in this country,  is neverthelefs a very
agreeable piece of cleanlinefs,  and contributes great-
ly to the prefervation of health.,  The  fweat and dirt
with which thefe parts are  frequently covered, can*
not fail to obftruct  the  perfpiration.   This piece of
cleanlinefs  would often prevent  colds  and  fevers.
Were people careful to bathe their feet and legs in
lukewarm water at night, after being expofed to cold
or wet through the day,  they would  feldom experi-
ence the ill effects which  often proceed from thefe
caufes.
  A proper attention to cleanlinefs is no where more
neceffary than  on  fhipboard.   If epidemical diftem-
pers break out  there, no one can be fafe.   The beft
way to prevent them, is to take  care that the whole
company be  cleanly in their  clothes,  bedding,  &c.
When infectious difeafes do break out, cleanlinefs is

  * I know a phyfician, who from habit, feldom or never en-
ters 3»is houfe without wafhing his hands.
                                               th* 
              OF CLEANLINESS.              xo-
the moft likely means to prevent their fpreading :  it
is  likewife neceffary to prevent their returning after-
wards, or being conveyed to other places.   For this
purpofe, the clothes,  bedding, &c. of the fick ought
to be carefully  waflied, and  fumigated with brim-
flone.   Infection will lodge  a long time  m  dirty
clothes, and afterwards break out in the moft terrible
manner*.
   In places where great numbers of fick people are
collected together, cleanlinefs ought to be moft reli-
rioufly obferved.  The very fmell in fuch places is
often fufficient to make one fick.  It is eafy to ima-
gine what effect that is likely to have  upon the dif-
eafed.  In an hofpital or infirmary, where cleanlinefs
is neglected, a perfon in perfect health has  a greater
chance to become fick, than a lick perfon  has to get
well.
   Few  things  are   more unaccountable  than that
neglect, or rather dread of cleanlinefs, which appears
among  thofe  who have the care  of the fick ;  they
think it  almoft  criminal to fuffer any  thing that is
clean to come near a perfon in a fever,  for example,
and would rather allow him to wallow  in all manner
of filth,  than change the  leaft bit of  his linen.  If
cleanlinefs  be neceffary for perfons  in health, it is
certainly more fo for the fick.  Many  difeafes may
be cured by cleanlinefs alone ; moft of them  might
be mitigated by it;  and, where it  is neglected, the
ilighteft diforders are  often  changed into  the mofl
malignant.  The fame miftaken care which  prompted
 people  to  prevent the leaft admifiion of frefh air to
 the fick, feems to have induced them to keep them

   * The beft mode of purifying a bed is to expofe it to an
 heavy rain, then dry it; this does not in the leaft injure the
 feed.
lirtTi 
icS             OF INFECTION.
dirty.  Both thefe deftructive prejudices will, we hope,
be in time entirely eradicated.
   Cleanlinefs is certainly  agreeable to our nature.
We  cannot help approving it in others, even though- *
we fhould not praftife it ourfelves.   It fooner attracts
our regard than even finery itfelf,  and often  gains
efteem where  that fails.   It  is  an ornament to the
higheft as well as the loweft flation, and cannot be
difpenfed with in either.   Few virtues are  of more
importance to  fociety than  general cleanlinefs.  It
ought, to  be carefully cultivated every where ; but in
populous cities it fliould be almoft revered*.
CHAP.  IX.

  Of Infeclion.
M
              ANY  difeafes are  infectious.   Every
perfon ought,  therefore,  as  far as he can,  to avoid
all communication with the  difeafed.   The common
practice of vifiting the fick, though often well  meant,
has many ill confequences.   Far be it from us to dif-
courage any act of charity or benevolence, efpecially
towards thofe in diftrefs; but we cannot help blaming
fuch as endanger their own or their neighbour's lives
by  a miftaken friendfhip or an impertinent curiofity.

  * The ftreets of great towns, where water can be had, ought|i
to be wafhed every day.  This is the only effectual method for£jj
keeping them thoroughly clean ;  and, upon trial,  we are per-
fuaded it will be found the cheapeft.
  Some of the moft dreadful difeafes incident to human nature  J
might, in my opinion, bs entirely eradicated by cleanlinefs.
                                                The 
             OF INFECTION.              io9
  The houfes of the fick, efpecially in the country,
are generally crowded from  morning 'till night with
idle  vifitors.   It is cuftomary, in fuch  places,  for
fervants and young people to wait upon the fick by
turns,  and even to  fit  up with them all night.   It
would be a miracle indeed fhould fuch always efcape.
Experience teaches us the danger  of this conduct.
People often catch  fevers in this way, and commu-
nicate  them to  others, till  at  length they become
epidemic.
  It would  be thought  highly improper, for  one
who had not had the fmall-pox, to  wait  upon a pa-
tient in that difeafe;  yet many other fevers are al-
moft as infectious as the fmall-pox, and not lefs fatal.
Some imagine, that fevers prove more fatal in vil-
lages than in great  towns, for  want of proper  me-
dical affiftance.  This  may fometimes be the  cafe ;
but we are inclined to  think it oftener proceeds from
the cafe above mentioned.
   Were a plan to  be  laid down for communicating
infection,  it could not  be done more effectually than
by the common method  of  vifiting the fick.  Such
vifitors, not only endanger themfelves and their con*
nections, but likewife  hurt the fick.  By  crowding
the  houfe, they render  the air  unwholefome,  and
by their private whifpers and difmal countenances,
difturb the imagination of the patient, and deprefs
his fpirits.   Perfons who are ill, efpecially  in fevers,
ought to be  kept as quiet as poffible.  The fight of
ftrange faces, and every thing that difturbs the  mind,
hurts them.
   The  common practice in  country places  of in-
viting  great  numbers  of people to  funerals,  and
crowding  them into the  fame apartment where  the
corpfe  lies,  is  another way  of fpreading  infection.
The infection does not always die with the patient.
                                           Every 
•fio             OF  INFECTION.
Every thing that comes into  contact with his body
while  alive,  receives the  contagion,  and fome  of
thefe things,  as clothes, blankets, &c.  will retain it
for a long time.  Perfons who die of infectious dif-
orders, ought not to lie long  unburied;  and people
fliould keep as much  as poffible at a diftance from
them.
   It would tend greatly to prevent the fpreading of
infectious difeafes, if thofe  in health were kept at a
proper  diftance from  the  fick.  The Jewifh Le-
giflator,  among many other wife inftitutions for pre-
ferring health, has  been peculiarly attentive to the
means of preventing infection,  or defilement as it is
called, either from a difeafed perfon or  a  dead body.
In many cafes, the difeafed were to be feparated from
thofe in health; and it was deemed a crime, even
to approach their habitations.  If a perfon  only touch-
ed a difeafed or dead body, he was appointed to warn
himfelf in water,  and to keep for fome  time at a dif-
tance from fociety.
   Infectious  difeafes  are  often  communicated by
elothes.  It is extremely dangerous to wear apparel
which has  been wrorn by the difeafed, unlefs it has
been well wafhed and  fumigated, as infection may
lodge a long time in it, and afterwards  produce very*
tragical effects.  This fliews the danger of buying at
random, the clothes which have been worn by other
people.
   Infectious diforders are frequently imported.  Com-
merce,  together  with  the riches of foreign  clime*,, %
brings us alfo their difeafes.   Thefe do  often more  "
than counterbalance all the advantages of that trade,
by means of which they are introduced.   It is to be
regretted,  that fo little care  is commonly beftowed,
either to prevent the  introduction  or fpreading of
iufecrious maladies.  Some attention, indeed,  is ge-  J
                                              rally  1 
OF
INFECTION.
in
neraily paid to the plague; but other difeafes pafs
unregarded*.
   Infection is often fpread through cities, by jails,
hofpitals, &c.  Thefe  are frequently fituated in the
very middle of populous towns ; and when infectious
difeafes break out in them, it is impoffible for the in-
habitants to efcape.  Did magiflrates pay any regard
to the health of the people,  this evil might be eafily
remedied.
   Many are the caufes which tend to diffuft: infection
through populous cities.  The beft advic; that we
can give to  fuch  as are obliged to live in ktrge cities
is, to choofe an open fituation ;  to  avoid narrow,
dirty,  crowded  ftreets ; to keep  their  own  houfe
and offices  clean  ; and to be as much abroad in the
open air as their  time will  permit.
   It would tend greatly to prevent the fp; reading of
infectious difeafes, were proper nurfes evory  where
employed  to take  care of  the fick.    This  might
often  fave  a family,  or even  a whole  town, from
being infected  by one  perfon.   We  do  not  mean
that  people  fhould  abandon  their friends:  or  rela-
tions  in  diftrefs,  but  only  to  put them on their

   * Wtre the tenth part of the care taken to ] irevent the
importation of difeafes, that there is to prevent fm niggling,  it
would  be  attended  with  many happy confeque-. aces.  This
might eatily be done, by appointing a phyfician at. every con-
fiderable fea-port, to infpeft the fhip's company,  pafTengers,
&c. before they came alhore, and,  if any fever c >r other in-
fectious diforder prevailed, to order the fhip to perf Km a fhort
quarantine, and to  fend the fick to fome hofpita I or proper
place to be cured.  He might likewife order all  i he  clothes,
bedding, &c.  which had  been ufed by the  fick  during the
voyage, to be either deftroyed, or thoroughly c kanfed by
fumigation, &c. before any of it were fent a-lhore.   A fcheme
of this kind,  if properly conduced, would preven : many fc«
vers, and other infectious  difeafes, from being b. "rught by
failors  into fea-port towns, and, by  this means d iiFufed all
over thz country.
                                                guard 
»i2             OF INFECTION.
   guard againft  being  too  much  in  company  with
*  thofe who are afflicted with difeafes of an infectious
   nature.
     Such as wait upon the fick  in  infectious  difeafes,
   fhould fluff their nofes with tobacco, or  fome other
   ftrong fmelling herb,  as  rue, tanfy, or the  like.
   They ought likewife to keep their patient very clean,
   to fprinkle the  room where he  lies with vinegar,  or
   other ftrong acids,  frequently  to admit a ftream  of
   frefh air into it, and to avoid the fmell of his breath
   as much as they can.  They ought never to go into
   company  without having  changed their  clothes and
   waflied their hands ;  otherwife, if the difeafe be  in-
   fectious, they will in all probability carry the conta-
   gion along with them.
     However  trifling it  may  appear to inconfideratc
   perfons, we will venture to affirm, that a due atten-
   tion to  thofe things which tend to diffufe infection,
   would be of great importance  in preventing  difeafes.
   As moft  difeafes are in fome  degree infectious,  no
   one fhould  continue long  with the fick,  except the
   neceffary  attendants.  I mean  not, however, by this
   caution, to deter thofe whofe duty or office leads them
   to wait upon the fick,  from fucn a laudable and ne-
   ceffary employment.
     Many  things are in the power of the magiftrate,
   which would tend to prevent the  fpreading of infec-
   tion ;  as the  promoting of public cleanlinefs ;  re-
   moving jails, hofpitals, burying-grounds, and other
   places where infection may be  generated, at  a proper
   diftance  from great towns*;  widening the  ftreets;
   pulling down ufelefs walls, and taking all methods to
   promote n free  circulation of air, through every part

     * The ancients would not fuffer  even the temples of their
   gods, wh-jre  the fick reforted, to be built within the v/alls of
   a city.
                          4                        of 
               OF  INFECTION.            nj
 of the town, &c.   Public hofpitals, or proper places
 of reception for the fick, provided they  were kept
 clean, well ventilated, and  placed in an  open fitua-
 tion, would  likewife tend to prevent the fpreading
 of infection.  Such places  of reception would pre-
 vent the poor, when fick, from being vifited by their
 idle  or officious neighbours.
   We are not, however, to learn, that hofpitals,  in-
 ftead of preventing infection, may become the means
 of diffufing it.  When they are  placed in the mid-
 dle of great towns;  when  numbers  of patients are
 crowded together  in fmall apartments; when there
 is a conftant communication  kept up  between the
 citizens and  the patients, and when cleanlinefs  and
 ventilation  are  neglected,   they become  nefts for
 hatching difeafes, and every one who goes into them,
 not only runs a rifk of receiving infection himfelf,
 but  likewife of communicating it to others.   This,
 however,  is  not the fault  of the hofpitals,  but of
 thofe who have the  management  of them.  It were
 to be wifhed, that they were both more  numerous,
 and  upon a more refpectable footing,  as that  would
 induce people to go into them with lefs reluctance.
 This is the more to be defired, becaufe moft of the
 putrid fevers, fo called,  and other infectious difor-
 ders  break out among the  poor, and  are by them
 communicated to thofe in better circumftances.  Were
 proper attention paid to the firft appearances of fuch
 diforders, and the patients early conveyed to an hof-
jpital, we fliould feldom fee  thofe malignant  fevers,
 which are almoft as infectious as the plague, become
 epidemic.
f
CHAP; 
C  114  1
                   CHAP.   X.


                  Of the Pajfions.


           1 HE  paflions have great influence, both
in the caufe and cure of difeafes.   How the mind
affects the body, will, in all probability, ever remain
a fecret.  It is fufficient for us to know, that there
is  eftablifhed  a  reciprocal  influence  between the
mental  and corporeal  parts,  and that  whatever in-
jures the one, diforders the other.

                    Of Anger.

   The paffion of anger ruffles the mind, diftorts the
countenance, hurries on the circulation  of the blood,
and  diforders the whole vital  and animal  functions.
It  often occafions fevers, and  other acute difeafes;
and  fometimes even hidden death.   This  paffion  is
peculiarly hurtful to the delicate, and thofe of weak
nerves.   I have known  fuch  perfons frequently lofe
their lives by a violent  fit  of  anger,  and would ad-
vife  them to guard againft the excefs  of this  paffion,
with the utmoft care.
   It  is  not indeed always  in  our power to  prevent
being angry;  but  we  may furely avoid harbouring
refentment in our breaft.    Refentment preys upon
the mind, and occafions the moft obflinate chronical
diforders, which gradually wafle  the conftitution.
Nothing fliews true greatnefs of mind,  more than  to
forgive injuries ; it promotes  the peace of  fociety,
and greatly conduces to our own eafe,  health,  and
felicity.                                             >
                                            Such 
               OF THE PASSIONS.            uj
   Such as value health,  fliould avoid violent gufts
of anger, as they would the  moft  deadly poifon.
Neither ought they to indulge refentment, but to
endeavour at all times to keep their minds Calm and
ferene.   Nothing tends fo much to the health of the
body, as a conftant tranquillity of the mind.

                    Of Fear.
   The  influence of fear, both in occafioning and
aggravating difeafes, is very great.  No man ought
to be blamed for a decent concern about life ; but
too great a defire to preferve it, is often the caufe of
lofing it. Fear and anxiety, by deprefling the fpirits,
not only difpofe us to difeafes, but often render thofe
difeafes fatal, which  an undaunted mind would over-
come. *
   Sudden fear  has  generally violent effects.  Epi-
leptic fits, and other convulfive diforders, are  often
occafioned by it.  Hence the danger of that practice,
fo common among young people,  of frightening one
another.   Many have  loft their  lives, and others
have been rendered miferable by frolics of this kind.
It is dangerous to tamper with  the human  paflions.
The mind may eafily be thrown into fuch diforder,
as never again to act with regularity.
   But the gradual effects of fear prove moft hurtful.
The conftant dread of fome future evil, by  dwelling
upon the mind,  often occafions  the very evil itfelf.
Hence it comes to pafs^  that fo many die of thofe
very difeafes, of which they long had a dread, or
which had  been impreffed on  their minds  by fome
accident or foolifh prediction.   This,  for example, is

  * It were to be wifhed, that epidemics might alarm without
caufing terror.  And great advantages would reiult, from
accuftoming young perfons to a fick room :  thus every family
would afford nurfes.
                       I 2                   ©ften 
nS           OF THE PASSIONS.
6tm t|Te cafe  with women  in childbed.   Marty of
thofe who die  in that fituation,  are impreffed with
the notion of their death,  a long time before it hap-
pens ;  and there is reafon to believe, that this irh-
£reflion is often the caufe  of it.
   The methods  taken to  imprefs the minds of wo-
men with the  apprehenfions of the  great pain and
peril of child-birth, are very hurtful.   Very few
Women die in labour, though many lofe their lives
after it; which may be thus accounted for.  A wo-
man, after delivery,  finding herfelf  weak and ex-
haufted, immediately  apprehends  fhe is  in danger;
but  this fear feldom  fails to obftruct the neceffary
evacuations, upon which her recovery depends.  Thus
the fet frequently fall a facrifice to their  own imagi-
nations,  when there would be  no danger, did they
apprehend none,
   It feldom happens, that two or  three women in  a
great town die in child-bed, but their death is foh
lowed by many others.  Every woman of their  ac-
quaintance who  is with child, dreads the fame fate,
and  the difeafe  becomes  epidemical  by the mere
force of imagination.  This  fhould induce pregnant
women to  defpife fear, and by all means, to  avoid
thofe tattling goflips, who are continually buzzing
in their ears the misfortunes of others.  Every thing
that may in the leaft  alarm a pregnant or child-beif
woman,  ought with the greateft care to  be guarded
againft.
   Many women  have loft their lives in child-bed,
by the old fuperftitious cuftom, ftill kept  up  in moft
parts of Britain,  and far  too much in America, of
tolling the parifli bell for every perfon  who dies.
People  who think themfelves in clanger, are very
inquifitive ; and if they come to know, that the bell
tolls for one  who died in the fame fituation with
themfelves, what  muft be  the confequence ?  At any
                                            rate, 
               OF THE PASSIONS.            117
rate, they are apt to fuppofe that this is the cafe, and
it will often be found a very difficult  matter to p§r-
fuade them of the contrary.
   But this  cuftom  is  not pernicious to child-bed
women  only.    It is hurtful in many other cafes.
When low fevers, in which it is diificult to fupport
the patient's fpirits,  prevail, what muft be the effect
of a funeral peal founding five or  fix times a-day in
his ears ?  No doubt  his imagination will fuggeft that
others died  of the fame difeafe  under which he la-
bours.  This  apprehenfion will  have a greater ten-
dency to deprefs his  fpirits, than all the cordials of
which medicine can boaft will have to raife them.
   If this ufelefs piece of ceremony cannot  be abp-
lifhed, we ought  to keep the  fick as  much from
hearing it as  poffible, and from every other thing
that may tend to alarm them.   So far, however,  is
this from being generally attended  to,  that many
make it their bufmefs to vifit the fick, on purpofe to
whifper difinal ftories in their ears.  Such may pafs
for fyrnpathizing friends, but they ought ratner to
be confidered as enemies.  All who wifh well to the
fick ought to keep fuch perfons at the greateft dif-
tance from them.
   A cuftom has long prevailed among phyficians,
of prognofticating, as they call it,  the patient's fate,
or  foretelling  the iffue of the difeafe.   Vanity no
doubt introduced this practice,  and ftill fupports it,
in fpite of common fenfe and  the fafety of mankind-
It may indeed he alleged,  that  the dp&or does not
declare his opinion before the patient.  So much the
worfe.  A fenfible patient had better hear what the
doctor feys than Jearn it  from the difconfolate looks,
&e watery eyes, and the broken whifpers of thofe
ajjput him.   It feldom happens, when tjie doctor
gives an unfavourable  opinion, ,th#  it can  be con-
£eaie# frpm ^he •£#!«#.   The  wy ^.n^irraffm-?;!* 
nS           OF THE PASSIONS.
which the friends and attendants  fhew in difguifing
what he  has faid,  is generally fufficient to difcover
the truth.
   Kind Heaven has, for the wifeft ends,  concealed
from mortals their fate; and we do not fee what
right any man has to announce the death of another,
efpecially if fuch a declaration  has a chance  to  kill
him.   Mankind are indeed very fond of prying into
future  events,  and feldom fail to folicit the phyfician
for his opinion.  A doubtful anfwer, however, or
one that  may tend rather to encourage the hopes of
the fick,  is furely the moft fafe.   This conduct could
neither hurt the patient nor the phyfician.   Nothing
tends more to  deftroy the credit of phyfic than thofe
bold prognofticators, who,  by  the by,  are gene-
rally the  moft  ignorant of the faculty.  The miftakes
which  daily happen in this  way are fo many Handing
proofs  of human vanity, and the weaknefs of fcience.
   We readily admit that there are cafes  where the
phyfician ought to give intimation of the patient's
danger  to fome of his near  connections ;   though
even this ought always to be done with the greateft
caution : but  it never can be neceffary in any  cafe
that the  whole town and  country fliould know, im-
mediately after the doctor has made his firft  vifit,
that he has no hopes of his patient*s recovery.  Perfons
whofe  impertinent  curiofity leads them to queftion
the phyfician with regard to  the  fate of his patient,
certainly deferve no other than an evafive  anfwer.
   The vanity of foretelling  the  fate of the fick is
not  peculiar  to  the faculty.   Others  follow  their
example, and thofe who think themfelves  wifer than
their neighbours often do much hurt in this  way.
Humanity furely calls upon every one to comfort the
fick, and not to add  to their affliction by alarming
their fears.    A  friend, or  even a phyfician, may
often do more good by a mild and fympathizing be-
                                          haviour 
OF THE PASSIONS.
119
 haviour than by medicine, and fliould never neglect
 to  adminifter that  greateft of all  cordials,  Hope,
 when he can do it with confiftency.

                     Of Grief.
   Grief is  the  moft deftructive of all  the paflions.
 Its  effects  are  permanent,  and when it  finks deep
 into the mind, it generally proves fatal.   Anger and
 fear, being of a more violent nature, feldom laft long ;
 but grief  often  changes  into a  fixed melancholy,
 which preys upon the fpirits,  and  waftes  the confti-
 tution.   This paffion ought not to be indulged.   It
 may generally be conquered at the  beginning; but
 when it has gained  ftrength, all attempts  to  remove
 it are vain.
  No  man  can prevent misfortunes in life ; but  it
 fhews true greatnefs of mind to bear  them with fe-
 renity.   Many  perfons make a merit  of indulging
 grief, and when misfortunes happen,  they  obftinately
 refufe  all confolation, till the mind, overwhelmed
 with melancholy, finks  under the load.  Such con-
 duct is not only deftructive to health, but  utterly
 inconfiftent  with  reafon,   religion,  and common
 fenfe.
  Change  of ideas  is  as  neceffary for  health as
 change of pofture.    When  the mind dwells long
 upon one fubject, efpecially of a difagreeable nature,
 it hurts the  whole  functions  of the  body.   Hence
grief indulged fpoils the digeftion  and  deftroys the
appetite ;  by which means the fpirits are depreffed,
the nerves relaxed,  the  bowels inflated with wind,
and the humors, for want  of frefh fupplies of chyle,
vitiated.   Thus  many an  excellent conftitution has
 been ruined by a  family misfortune, or  any thing
 which occafions exceffive grief.
U
It 
 13°            OF THE PASSIONS.
   It is not  probable, that arty  perfon of a dejected
 mind  fhould  enjoy health.   Life  may indeed be
 dragged out for a few years ; but whoever would live
 to a good old  age, muft be good-humored and cheer-
 ful.     This indeed is  not  altogether  in our own
 power ; yet our temper of mind,  as well as our ac-
 tions,  depend greatly upon ourfelves.  We can either
 affociate with  cheerful  or melancholy companions,
 mingle in the  amufements  and offices  of life,  or fit
 ftill  and brood over our calamities   as  we  chufe.
 Thefe, and many fuch  things, are certainly  in our
 power, and from thefe the mind generally takes it«
 call.
   The variety of fcenes which prefent themfelves to
 the  fenfes,  were certainly defigned  to prevent our
 attention from being too long fixed  upon  any one
 object. Nature abounds with variety,  and the mind,
 unlefs  fixed down by habit, delights in contemplating
 new objects.  This at once points out the method of
 relieving  the  mind in  dillrefs.  Turn the attention
 frequently to new obje&s.    Examine them  for fome
 time.   When the  mind begins to recoil, fhift the
 fcene.   By  this means a conftant fucceffion of new
 ideas may be kept up, till the difagreeable  ones en-
 tirely difappear.   Thus, travelling, the ftudy of any
 art or fcience, reading  or writing on fuch  fubjedts
 as deeply engage the  attention,  will fooner  expel
 grief than the  moft fprightly  amufements.
   It has already been obferved  that the body  can-
 not be healthy unlefs it be exercifed ; neither cart the
 mind.   Indolence nourifhes grief.   When the mind
 has nothing elfe to  think of but calamities,  no won-
 der that it  dwells  there.  Few people who purfue
bufmefs with attention,  are hurt by grief.   Inftead
therefore of abstracting ourfelves from  the world or
bufmefs, when  misfortunes  happen,   we ought to
pngagc in it with more than ufual attention,  to dif-
                                           charge 
OF THE PASSIONS.
121
charge with  double diligence  the functions of our
ftatkm,  and  to mi« with friends  of a cheerful and
fecial temper.
   Innocent amufements are by no means to be ne-
glected.   Thefe, by  leading the  mind infenfibly to
the contemplation of agreeable objects, help to dif-
pel the gloom which misfortunes caft over it.   Thejr
make time feem  lefs  tedious,  and have many  other
happy effects. *
   Some perfons, when Overwhelmed with grief, be-
take themfelyes to drinking.   This is  making the
cure much worfe than the difeafe.   It feldom fails to
end in the ruin of fortune, character, and conftitution.

                     Of Love.
   Love is perhaps the  ftrongeft of all the paflions ;
at leaft, when it becomes violent,  it is lefs fubject to
the control either of the  underftanding or will, than
any of the reft.   Fear, anger,  and feveral other paf-
lions, are neceffary for the  prefervation of the indi-
vidual, but love is neceffary for the continuation  of
the fpecies itfelf: it  was therefore  proper that this
paffion fhould be deeply rooted in the human bread*
   Though love  be a ftrong paffion, it is  feldom (b
rapid in its progrefs as feveral of the others.  Few
perfons  fall  defperately  in love  all at once.   Wc
would therefore  advife every  one,  before  he tam-
pers with this paffion, to confider  well the probabi-
lity and propriety of his being  able to obtain the ob-
ject of his love.   When that is not likely, he fliould
avoid every occafion of increafing  it.   He ought im-
mediately to  fly the company of the beloved "object;

  * After all that has been faid, there  is  nothing which can
relieve the mind from grief with fo  much  certa!..r - »< i calm
and humble refignation to the Divine Will,
!») 
 122            OF  THE PASSIONS.
 to  apply his  mind  attentively to  bufmefs or fludy;
 to take amufement; and above all, to endeavour, if
 poffible, to find another  object  which  may engage
 his affections, and which it may be in his  power to
 obtain.
   There is no paffion with which people are fo ready
 to tamper  as love, although none  is more dangerous.
 Some  men make love for amufement,  others from
 mere vanity, or on purpofe to fhew their confequence
 with the fair.   This is perhaps the greateft piece of
 cruelty which any one can be guilty of.   What  we
 eagerly wifh  for we eafily credit.   Hence the too
 credulous  fair are often betrayed  into  a fituation
which is  truly deplorable,  before they are able to
difcover that the pretended lover was only in jefl.
But there is  no jefting  with this  paffion.   When
love has got to a certain height, it admits of no other
cure but the poffeflion of its object, which in this cafe
ought always if poffible and proper to be obtained. *


              Of Religious  Melancholy.

   Many perfons of a religious turn of mind behave
 as if they thought it a crime to be cheerful.  They
imagine the whole of religion confifts in certain mor-
 tifications, or denying themfelves the fmalleft indul-
gence, even of the  moft innocent  amufements.  A

  * The conduct of parents with regard to the difpofal of their
 children in marriage, is often very blameable.  An advanta-
 geous match is the too conftant aim of parents ; while their chil-
 dren often fuffer a real martyrdom betwixt their inclinations and
 duty.   The  firft thing which parents ought to confult in dif-
 pofing their children in marriage, is certainly their inclinations.
 Were due regard always paid to thefe, there would be fewer
 unhappy couples, and parents would not have fo often caufe to
 repent thefeverity of their conduct, after a ruined conftitution,
a loft character, or a diffracted mind, has fliewn them their mif-
 take.
perpetual 
               OF THE PASSIONS.            J23
perpetual gloom hangs over their countenances, while
the deepeft Melancholy preys upon their minds.  At
length the  faireft profpects vanifh,  every thing puts
on a difmal appearance, and thofe very objects which
ought to give delight afford nothing but difguft. Life
itfelf becomes  a burden, and the unhappy wretch,
perfuaded that no evil can equal what he feels, often
puts an end to his own miferable exiftcnce.
  It is  a  great pjty that even religion  fliould be fo
far  perverted, as to become the  caufe of thofe very
evils which it  was defigned to cure.   Nothing can
be better calculated than True Religion, to raife and
fupport the mind  of  its votaries  under every afflic-
tion that can befal them.  It teaches them that even
the fufferings of this life are preparatory to the hap-
pinefs of the next; and that all who perfift in a courfe
of virtue fhail at length arrive at  complete felicity.
  Perfons whofe bufmefs it is to recommend reli-
gion to others, fliould beware of  dwelling too much
on gloomy fubjects.   That peace and  tranquillity  of
mind, which true religion is calculated to infpire, is a
more powerful argument in its favour than  all  the ter-
rors that can be uttered.  Terror may indeed deter
men from outward acts  of wickednefs, but can never
infpire them with that love of God, and real good-
nefs of heart, in which alone true religion confifls.
  To conclude; the beft way to counteract the vio-
lence of any paffion,  is to keep the mind clofely en-
gaged in fome ufeful purfuit.
CHAP. 
[  »*4  ]
CHAP.  XI.
            Of the Common Evacuations.


           A HIj principal evacuations  from the hu-
 man body are thofe by flool, urine, and  infenfible per*
fpiration.   None  of thefe can be  long obftructei
 without impairing the health.   When that which
 ought to be thrown out of the body is too long re»
 tained, it not only occafions a plethora, or too great
 fulnefs of the veffels,  but acquires many qu3fel
 which are hurtful to the health.

             Of the Evacuation by Stool.
   Few  things conduce more to health than  keep*
 ing the body regular.  When the faces lie too long
 in the bowel-, they vitiate  the  humors; and  when
 they are too foon  difcharged, the body is not furfi-
 ciently nourifhed.   A medium is therefore to be de-
 fired, which can  only be obtained  by  regularity in
 diet, fleep, and exercife.   Whenever the body is not
 regular,  there is reafon  to fufpect a fault in one or
 other of thefe.
   Perfons who eat and drink at irregular hours, and
 who eat various kinds of food, and  drink  of feverstl
 different liquors at every meal, have no reafon to ex-
 pect  either that their digeftion will be good, or their
 difcharges regular.  Irregularity in eating and drink-
 ing difturbs every part pf the animal ceconomy, and
 never fails to occafion difeafes.  Either too much or
 too little food will have  this effect.   The former in-
 deed  generally occafions  loofenefc,   and  the latter
                                        coftivenefs; 
            OF THE EVACUATIONS.          125
coftivenefs;  but both have a tendency to hurt the
health.
  It would  be difficult  to  afcertain the exact num-
ber of ftools  which  may be confiftent with health,
as thefe differ in the different periods  of life, in dif-
ferent  conftitutions, and even in the  fame conftitu-
tion under a different regimen of diet, exercife,  &c.
It is however generally allowed, that one ftool a-day
is fufficient  for an  adult, and  that  lefs is  hurtful.
But this, like moft general  rules, admits of many ex-
ceptions.  I have known  a few perfons  in perfect.
health who did not  go to ftool above once  a-week.
Such  a degree of coftivenefs however is not fafe;
though the  perfon  who labours under it may for
fome  time enjoy tolerable  health, yet at length it
may occafion difeafes.
  One method of procuring a ftool every day is to
rife betimes, and go  abroad  in  the open air.   Not
only the pofture in  bed is  unfavourable to  regular
ftools, but alfo the warmth.   This,  by promoting
the perfpiration, leffens all  the other difcharges.
  The  method  recommended  for this purpofe by
Mr. Locke is likewife very proper, viz.  tofolicit na-
ture, by going regularly to ftool every morning whether
one has a call or not.  Habits of this kind may be ac-
quired, which will in time become natural.
  Perfons who have frequent recourfe to medicines
for  preventing coftivenefs  feldom fail to  ruin their
conftitution.  Purging medicines frequently repeated
weaken the bowels,  hurt  the  digeftion,  and every
dofe makes way for another,  till at length they be-
come  as neceffary as daily bread.  Thofe who arc
troubled with coftivenefs ought  rather, if poffible, to
remove it by diet than drugs.   They ihouid likewife
go more thinly clothed, and avoid every thing of an
aftringent or of an  heating nature.   The diet  and
other regimen  neceffary in this cafe  will be  found
                                            under 
i26          OF THE EVACUATIONS.
under the article  Coftivenefs,  where this ftate of the
bowels is treated of as a difeafe.
   Such perfons as are troubled with an habitual loofe*
nefs ought likewife to fuit their diet to the nature of
their complaint.  They fhould ufe food which braces
and  ftrengthens the bowels,  and  which is  rather of
an aftringent quality, as  wheat-bread made of the
fineft  flour,  cheefe, eggs, rice boiled  in  milk,  &c.
Their drink fhould be red port, or claret, and water,
in which  toafted bread has  been boiled,  and fuch
like.
   As  an  habitual loofenefs is often owing to an ob-
ftrudted perfpiration,  perfons affected with it ought
to keep their feet warm, to wear flannel next their
fkin, and take every  other method to promote the
perfpiration.  Further directions  with regard to the
treatment of  this complaint will be found under the
article Loofenefs.

                      Of Urine.
   So many things tend to change both the quantity
and  appearances of the urine, that it is very difficult:
to lay down any determined rules for  judging of
either. *   Dr.  Cheyne fays, the urine  ought to be

  * It has long been an obfervation among phyficians, that the
appearances of the urine  are very uncertain, and very little to
be depended on.  No one will be furprifed at this who confi-
ders how many ways it may be affecled, and confequently have
its appearance altered.  The paflions,  the ftate of the atmo-
fphere, the quantity and quality of food,  the exercife, the
clothing, the ftate of the other evacuations, and numberlefs
other caufes, are fufficient to induce a change cither in the quan-
tity or appearance of the  urine.  Any one who attends to this,
will be aftonifhed at the impudence of thofe daring quacks, who
pretend to find out difeafes, and prefcribe to patients from the
bare  infpetfion of  their urine.  Thefe impoftors, however, are
very common all over Britain, and by the amarfng credulity of
                           4                      the 
/
            OF THE EVACUATIONS,          127
equal to three-fourths  of the liquid part  of our ali-
ment. But fuppofe any one were to take the trouble
of meafuring both,  he would  find that every thing
which altered the degree of perfpiration, would alter
this proportion,  and likewife that different kinds of
aliment  would  afford  very  different  quantities of
urine.   Though for thefe, and other reafons, no rule
can be given for judging of the precife quantity of
urine which ought to be difcharged,  yet a perfon of
common fenfe will  feldom be at a lofs to know when
it is  in either extreme.
   As a free difcharge of urine not only prevents but
actually cures  many difeafes, it  ought by all means
to be promoted ;  and every thing that  may  obftruct
it fliould be carefully  avoided.   Both  the fecretion
and  difcharge of  urine are  leffened by a fedentary
life, fleeping on beds that  are  too foft and warm,
food of a  dry and  heating quality, liquors which are
aftringent and heating,  as red port, claret, and fuch
like.  Thofe who have  reafon to fufpect that their
urine is  in  too  fmall  quantity,  or who have  any
fymptoms of the  gravel, ought not  only to avoid
thefe things, but whatever  elfe they find has a  ten-
dency to leffen the quantity of their urine.
   When  the  urine is  too  long retained,  it is  not
only reforbed, or  taken  up  again  into the mafs of
fluids, but by flagnating in  the  bladder, it becomes
thicker, the more  watery parts  flying  off firft,  and
the more grofs  and earthy  remaining behind.   By
the conftant tendency which thefe have to concrete,
the formation of ftones and gravel in the bladder  is

the populace, many of them amafs confiderable fortunes.  Of
all the medical prejudices which prevail in ihis country, that in
favour of urine doclors is the ftrongeft.  The common people
have ftill an unlimited faith in their fkill, although it has  been
demonftrated that no one of them is able to diftinguifii the urine
of an horfe, cr any ether animal, fro\n that of a man.
                                         promoted. 
 i»3         OF THE EVACUATIONS.
 promoted.  Hence it comes  to  pafs, that indolent
 and fedentary people are  much more  liable to thefe
 difeafes, than perfons of a more active life.
   Many perfons have  loft  their  lives,   and others
 have brought on  very tedious,  and even incurable
 diforders, by retaining  their urine too long, from a
 faMe delicacy.   When  the  bladder has  been over-
 diftended, it often lofes its  power  of  action  altoge-    '
 ther, or becomes  paralytic,  by which  means  it is
 tendered unable either to retain the urine,  or expel
 it properly.    The calls of nature ought never to be
 postponed.   Delicacy is doubtlefs a virtue,  but that
 can never be reckoned  true delicacy,  which induces
 any one to rifk his health or hazard his life.
  But the urine may be in  too great as  well  as too
 final! a quantity.   This may be occafioned by drink-
 ing large quantities of weak watery liquors, by the
 excdSive ufe of  alkaline falts,  or any thing that fli-
 muiates the  kidneys, dilutes the blood,  &c.  This
 diforder  very foon  weakens the body, and induces
 a confumption.  It is difficult to cure, but may be
 mitigated by ftrengthening diet and aftringent medi-
 cines, fuch  as are  recommended  under  the  article
 Diabetes, or exceflive difcharge of urine.

               Of the  Perfpiration.
  Infenfibie perfpiration is  generally  reckoned the
greateft of all the difcharges from the  human body.  ,
It is of  fo great importance to health that  few dif-
eafes attack  us while it goes properly on ; but when
it is obftructed,  the whole frame is foon  difordered.
This difcharge, however,  being lefs perceptible  than
any of  the  reft,  is  confequently  lefs attended to.
Hence it if.,  that acute fevers, rheumatifms,  agues,
&c. often proceed  from obftructed perfpiration be-
fore we a:c aware  of its having taken place.
                        2                      On 
            OF THE EVACUATIONS.          it9
   On examining  patients,  we find moft of them
impute their  difeafes  either to violent colds  which
they had caught,  or to flight ones which had been
neglected.   For this reafon,  inftead of a critical in-
quiry into the nature  of the  perfpiration,  its differ-
ence in different feafons, climates,  conftitutions, &c.
we fhail endeavour to point  out the caufes which
moft  commonly  obftruct  it,  and  to  fhew how  far
they may be either avoided, or have  their influence
counteracted by  timely care.   The want of a due
attention to thefe,  cofts annually  fome  thoufands of
ufeful lives.


            Changes in the Atmofphere.

   One of the moft common caufes of obftructed per-
fpiration, or catching  cold, in this  country, is the
chanp;eablenefs of the weather, or  ftate of the atmo-
fphere.  There is no  place where fuch changes hap-
pen more frequently than  in  Great Britain.   With
us the degrees of heat and  cold are not only very
different in the different feafons of the year,  but of-
ten change almoft from one extreme to another in a
few days, and fometimes even in the courfe of one
day.   That fuch changes muft affect the ftate of the
perfpiration is  obvious  to every one *.

  • I never knew a more remarkable inftance of the uncertainty
of the weather in this country, than happened while I was wri-
ting thefe notes.   This morning, Auguft 14, 1783, the ther-
mometer in the fhade was  down at fifty-three degrees, and a
very few days ago it ftood above eighty.  No one who reflects
on fuch great and fudden  changes in the atmofphere, will be
furprifed to find colds, coughs, rheums, with other affections of
the breaft and bowels, fo common in this country.-------One
would  almoft fuppofe that this,  and many other remarks of the
fame kind, had.been written in America.
K.
The^~~ 
 J3»         OF THE EVACUATIONS.
    The beft method  of fortifying the body againft
 the changes of the weather, is to be abroad every  y;
 day.  Thofe who keep moft within doors are moft  *j
 liable to catch cold.   Such perfons generally render
 themfelves fo  delicate as to feel  even the flightefl
 changes  in the atmofphere, and  by their  pains,
 coughs, oppreflions of the breaft, &c. they become a
 kind of living barometers.

                   Wet  Clothes.

    Wet clothes, not  only by their coldnefs obftruct  *1
 the perfpiration,  but their moifture,  by being ab-
 forbed, or taken up into the body, greatly increafe*,*$m
 the  danger.  The moft robuft conftitution  is not   |
 proof againft the danger arifing from wet clothes;
 they daily occafion fevers, rheumatifms, and other
 fatal diforders, even in the young and healthy.
    It is impoffible for  people  who  go  frequently.  ,-j
 abroad,  to avoid fometimes being wet.   But the
 danger might generally be leffened,  if not wholly
 prevented,  by changing their  clothes foon ; when
 this cannot be done,  they fhould keep in motion till
 they be dry.  So far are many from taking this pre-
 caution,  that they often fit or lie down in the fields
 with  their  clothes wet, and frequently  fleep even
 whole  nights in this condition.   The frequent in-
 ftances which we have of the  fatal  effects  of this
 conduct, ought certainly to deter others from being
 guilty of it.


                      Wet Feet.

    Even  wet feet often  occafion fatal difeafes.   The
 colic, inflammations  of  the breaft and of the bowels,  4
 the iliac  paffion, cholera morbus, fore throat, &c.  are
> often occafioned by wet feet.   Habit will,  no doubt,
                                             render 
OF THE EVACUATIONS.
fender this lefs dangerous;  but it  ought, as far as
poffible,  to be avoided.  The delicate,  and thofe
who are not accuftomed to have their clothes or feet
wet, fliould be peculiarly  careful in this refpect.

                   Night Air.

   The perfpiration is often obftructed by night air;
even in fummer, this ought to be avoided.  The
dews which  fall  plentifully after  the  hotteft day,
make the  night more dangerous  than  when the
weather  is cool.   Hence, in warm countries, the
evening dews are more hurtful  than where  the cli-
mate is more temperate.
   It is very agreeable after  a  warm  day to be
abroad in the cool evening ; but  this is  a pleafure
to be avoided by  all  who value their health.  The
effects of evening dews are gradual  indeed,  and al-
moft imperceptible ;  but they are not the lefs to be
dreaded :  we would therefore advife  travellers,  la-
bourers,  and all  who are much  heated by day,
carefully  to  avoid them.  When  the  perfpiration
has been great, thefe become dangerous  in  propor-
tion.   By  not  attending to this,  in  flat  marfhy
countries, where  the  exhalations  and dews  are co-
pious,  labourers are  often feized  with intermitting
fevers, quinfeys,  and other dangerous difeafes.

                   Damp Beds.

   Beds become damp, either from their  not being
ufed, ftanding in  damp houfes, or in rooms  without
fire.   Nothing is  more to  be dreaded by  travellers
than damp beds, which  are  very common in  all
places where fuel  is fcarce.  When  a traveller, cold
and wet, arrives at an inn, he  may, by means of a
good  fire,  warm  diluting  liquor,  and a  drv bed,
                       K 2                ' have 
132          OF THE EVACUATIONS.
have the perfpiration reftored ; but if he be put into
a cold room,  and laid on  a damp bed, it will be
more obftru&ed, and the  worft  confequences will
enfue.   Travellers fhould avoid inns which are noted     ;
for damp beds, as they would a houfe infected with.
the  plague, as  no man, however  robuft, is  proof
againft the danger arifing from them.
   But inns are not the only places where damp beds    t
are to be met  with.  Beds  kept in private families
for the reception of ftrangers are often  equally dan-
gerous.  All kinds of linen and bedding, when not     \
frequently ufed become damp.  How then is  it pof-
fible, that beds,  which are not flept in above  two or
three times  a-year, fhould  be fafe ?  Nothing is more
common than to  hear  people complain  of  having
caught  cold by changing their bed." The reafon is
obvious: were they careful never  to fleep in a  bed
but what was frequently   ufed, they would  feldom
 find any ill  confequences from a change.
   Nothing  is  more to be dreaded by a delicate per-
fon when on a vifit,  than  being laid in a bed which
is kept on  purpofe  for ftrangers.  That ill-judged
piece  of complaifance becomes a real  injury.   All
the bad  confequences from this quarter might eafily
be prevented in  private  families,  by caufing  their
fervants  to  fleep in the fpare beds,  and refign them     )
to  ftrangers when they come.   In inns where the
beds are ufed  almoft every night, nothing elfe is
neceffary than to keep the rooms well feafoned by
frequent fires, and the linen dry.
   That baneful  cuftom faid to be practifed in many     I
inns, of damping flieets, and prefling them in order     1
to fave wafhing, and afterwards laying them on the
beds,  ought,  when difcovered, to be punifhed with
 the utmoft feverity.  It is  really a fpecies/of murder,
 and will often prove as fatal as poifon  or gun-fhot.
 Indeed,  no linen, efpecially if it  has  been  waflied
                                               ife
\ 
            OF THE  EVACUATIONS.          133
in winter, ought to be ufed  till it has been expofed
for fome time to the  fire ; nor is this operation lefs
neceffary  for  linen waflied  in  fummer,  provided it
has lain by  for any length of time.   This caution is
the more needful, as gentlemen are often exceedingly
attentive to  what they eat or drink  at  an inn, yet
pay no regard to a circumftance of  much more im-
portance*.

                   Damp Houfes.

   Damp  Houfes frequently  produce the  like ill con-
fequences ;  for this reafon thofe who build fliould be
careful  to chufe a dry  fituation.   A  houfe which
flands on a damp marfhy foil or deep clay, will never
be thoroughly dry.   All houfes, unlefs  where  the
ground is exceedingly dry, fliould have the firft floor
a little raifed.   Servants  and  others, who  are obliged
to live in cellars  and funk ftories, feldom  continue
long in  health:  mafters  ought  furely to pay fome
regard to the health of  their fervants,  as well as to
their own.
   Nothing is more common  than for people,  merely
to avoid fome trifling inconveniency,  to hazard their
lives, by  inhabiting  a houfe almoft as  foon as the
mafons, plafterers,  &c.  have  done  with it:  fuch
houfes are not only dangerous from  their dampnefs,
but likewife from the fmell of lime,  paint, &c.  The
afthmas, confumptions,  and  other   difeafes  of the
lungs, fo incident to people who work in thefe arti-

  * If a perfon fufpedls that  his bed is damp, the fimple pre-
caution of taking off the fheets, and lying in the blankets, with
all or moft of  his clothes on, will prevent all the danger.  1
have pracVifed this for many years, and never have been hurt
by damp beds, though no conftitution, without care, is  proof
againft their baneful influence.
                       K 3                    cles, 
134-         OF THE EVACUATIONS.
cles, arc fufficient  proofs of their being  unwhole-
fome.
   Rooms are often rendered damp by an unfeafon-
able piece of  cleanlinefs ;   I mean  the pernicious
cuftom  of wafhing them immediately  before  com-
pany is put into them.   Moft people  catch cold, if
they fit but  a  very  fliort  time in a room that  has
b^en lately waflied; the delicate ought  carefully to
avoid fuch  a fituation, and  even the  robuft are  not
always proof againft its influence*.

        Sudden Tranfitions from Heat  to Cold.

   The perfpiration is commonly  obftructed by sud-
den transitions from  heat  to cold.   Colds  are
feldom  caught,  unlefs when people  have been  too
much  heated.   Heat  rarifies the  blood, quickens
the circulation,  and increafes the perfpiration ;  but
when thefe are fuddenly checked, the  confequences
muft be bad.  It is indeed  impoffible for labourers
not to  be  too hot upon  fome  occafions ; but it is
generally in their power to  let themfelves cool gra-
dually,  to  put on  their clothes  when they leave off
work,  to make choice of a  dry place to reft them-
felves in, and to avoid  fleeping in the open fields.
Thefe eafy rules,  if obferved, would often prevent
fevers and other fatal diforders.
   It is very common for people,  when hot, to drink
freely  of cold  water,  or fmall  liquors.   This con-
duct is extremely dangerous.  Thirft  indeed is hard
to bear, and the inclination to gratify that appetite

  * People imagine if a good fire is made in a room after it
has been waihed, that there is no danger from fitting in it; but
they muft give  me leave to fay th;it this increafes the danger.
The evaporation excited by the fire generates  cold, and renders
the damp more active.
frequently 
            OF THE EVACUATIONS.          135
frequently gets the better of reafon,  and makes us
do what our judgment difapproves.  Every peafant,
however, knows, if his horfe be permitted to drink
his bellyful of cold water after violent exercife, and
be immediately  put into  the liable, or fuffered to
remain at reft, that it will kill him.   This they take
the utmoft care to prevent.  It were well if they were
equally attentive to their  own fafety.
  This may be quenched many ways without fwal-
lowing large quantities of cold  liquor.   The fields
afford  variety of acid fruits and plants, the very
chewing of which would abate thirft.   Water kept
in the mouth for fome time, and fpit  out again, if
frequently repeated,  would have the fame  effect.   If
a bit of bread be eaten  along with a few mouthfuls
of water,  it will both quench thirft  more effectually,
and  make  the   danger  lefs.  When  a  perfon is
extremely  hot, a mouthful  of wine  and water, if
it  can  be  obtained, ought  to be preferred  to  any
thing elfe.   But if any one has been fo foolifh, when
hot, as to  drink freely of cold  liquor, he ought to
continue his exercife at leaft till  what he drank be
thoroughly warmed  upon his ftomach.
   It would be tedious to enumerate all  the bad ef-
fects which flow from drinking  cold  liquors when
the  body  is hot.   Sometimes this  has  occafioned
immediate  death.  Hoarfenefs, quinfeys,  and fevers
of  various  kinds,  are  its  common   confequences.
Neither is  it fafe when warm  to  eat  freely of  raw
fruits, fallads, or the like.   Thefe indeed have not
fo fudden an effect on the body as cold liquors,  but
they are notwithftanding dangerous, and ought to be
avoided.
   Sitting in a warm room,  and drinking hot liquors
 till the pores are quite cjpen, and immediately going
 into the cold air, is extremely  dangerous.  Colds,
 coughs, and inflammations  of  the breaft, are the
                        K 4                 ufual 
136"         OF THE EVACUATIONS.
ufual effects  of this conduct:  yet ^nothing  is  more
common than for perfons who have drank warm li-
quors  for  feveral hours, to walk or ride a number
of miles in the  coldeft  night,  or to ramble about in
the ftreets*.
   People are very apt,  when a room is hot, to throw
open a window,  and to fit near it.   This is a moft
dangerous practice.   Any perfon had better fit with-
out doors than in fuch a fituation,  as the current of
air is directed againft one particular part of the body.
Inflammatory fevers and  confumptions  have  often
been occafioned by  fitting or ftanding thinly clothed
near an open  window.   Nor is fleeping with open
windows  lefs to be dreaded.   That ought never to
be done,  even in the hotteft  feafon, unlefs the win-
dow is at a diftance.  I have known mechanics fre-
quently contract fatal difeafes, by working ftript at
an  open  window,  and  would advife all of them to
beware of fuch a practice.
   Few things  expofe  people more to catch cold
than keeping their own houfes too warm; fuch per-
fons may be  faid to  live in a fort of hot-houfes ; they
can  hardly ftir abroad  to vifit  a neighbour,  but at
the  hazard  of  their lives.   Were there no other
reafon for  keeping houfes moderately cool, that alone
is fufficient:  but no houfe  that  is  too hot can  be
wholefome ;  heat deftroys the  fpring and elafticity
of the air, and renders it  lefs fit for expanding the '
lungs, and for the other purpofes of refpiration.
Hence it is,  that confumptions and other difeafes of

  * The beer houfes in great towns,  where fuch numbers erf
people fpend their evenings are highly pernicious. The breath
of a number of people crowded into a low apartment, widi the ■
addition of fires, candles,  the  fmoke of' tobacco, and  the
fumes of hot liquor, &c. muft not only render it hurtful to
continue in fuch places,  but dangerous to go out of them into
s  old and chilly  atmofphere,
                                               the 
           OF THE EVACUATIONS.          137
the lungs prove fo fatal to thofe who work in forges,
glafs-houfes and the like.
  Some are even fo fool-hardy, as to plunge them-
felves when hot into  cold water.  Not only fevers,
but madnefs itfelf has  frequently been the effer: of
this conduct.   Indeed it looks too like the action of
a madman to deferve a ferious confideration.
  The refult of all  thefe obfervations is, that every
one ought  to  avoid, with the utmoft attention, all
fudden  tranfitions  from heat  to  cold, and to keep
the body in as uniform a temperature  as  poffible ;
or where that cannot be done, to take care to let it
cool gradually.
   People may imagine that too ftrict  an attention to
thefe things would tend to render them delicate.   So
far,  however, is this from being my defign, that the
very firft rule propofed for  preventing colds, is to
harden the body, by inuring it daily to the open air.
   I fliall put  at end to what relates  to this part of
my fubject, by giving an abftract of the juftly cele-
brated advice of Celfus,  with  refpedt to the prefer-
vation  of  health.   " A  man,"  fays he,  " who is
" bleffed with good  health,  fliould  confine himfelf
" to no particular rules, either with  refpect to regi-
" men or  medicine.   He ought frequently to diver-
" fify his  manner of living; to  be fometimes in
" town, fometimes  in  the country; to  hunt,  fail,
" indulge  himfelf  in  reft,  b/ut more frequently to
" ufe exercife.  He ohght  to refufe no kind of food(
" that is commonly ufed ;  fometimes to make one at
" an entertainment, and fometimes to forbear it;  to
 " make rather two meals a-day than one, and always
 u to eat heartily, provided  he  can digeft it.   He
 " fhould be careful in time of health not to deftroy,
 " by exceffes of any kind, that vigour of conftitution
 " which fhould fupport him under ficknefs."
PART 
• 
PART  II.
r------------------■------—


    OF DISEASES.
               CHAPTER  XII.

      Of the Knowledge and Cure of Difeafes.


          1 HE knowledge  of difeafes  does  not
depend  fo  much upon fcientific  principles  as  many
imagine.  It is chiefly the refult of experience  and
obfervation.  By attending the fick, and  carefully
obferving the various occurrences in difeafes, a great
degree of accuracy may be acquired,  both in diftin-
guifhing their fymptoms, and in the  application of
medicines.   Hence fenfible nurfes, and other perfons
who wait  upon the fick,  often difcover a difeafe
fooner  than thofe who  have been  bred to phyfic.
We do not, however,  mean to infmuate, that a me-    *
dical education is of no ufe: it is  doubtlefs of the
greateft importance; but it  never  can fupply  the
place of obfervation and experience.
   Every difeafe  may  be  confidered as  an affem.
blage of fymptoms, and  muft be diftinguifhed by
thofe which are moft obvious and permanent.  In,
ffead, therefore, of giving a claflical arrangement of
                                         difeafes., 
 Ho          OF THE KNOWLEDGE
 difeafes, according to the fyftematic method,  it will
 be more fuitable,  in a performance of this nature, to
 give a full and accurate defcription of each particular
 difeafe as it occurs; and, where any of the fymptoms
 of one difeafe have a  near refemblance, to thofe of
 another,  to take notice of that circumftance, and, at
 the fame time, to point out the peculiar or charac-1
 teriftic  fymptoms  by which it may be diftinguifhed. j
 By a  due. attention to  thefe, the inveftigation  of dif.
 eafes  will be found to be a lefs difficult matter than
 moft people would at firft be ready to imagine.
   A proper attention to the patient's age, fex, tem-
 per of mind, conftitution, and manner  of life, will
 likewife  greatly affift,  both in the inveftigation and
 treatment of difeafes.
   In childhood the fibres are lax and foft, the nerves
 extremely irritable, and the fluids  thin ; whereas in
 old age the fibres  are  rigid, the nerves  become al-
 moft infenfible, and many of the veffels imperviable.
 Thefe and other peculiarities, render the difeafes of
 the young and aged very  different, and of  courfe
 they muft require  a different method of  treatment.
   Females are liable  to many difeafes which do not
 afflict the other fex; befides the nervous fyftem be-
 ing more irritable  in them than in men, their difeafes
require to  be  treated with greater caution.  They
are often lefs able  to bear large evacuations ; and all
 flimulating  medicines  ought to be adminiftered to
 them  with a fparing hand.
   Particular conftitutions not only difpofe perfons to
peculiar  difeafes, but  likewife render it neceffary to
treat thefe difeafes in a peculiar manner.  A delicate
perfon,  for example,  with  weak  nerves, who lives
moftly within doors, muft not be treated, under any
difeafe, precifely in the fame manner as  one who is
hardy  and robuft, and who is much  expofed  to the
 open air.
                                              The 
           AND CURE OF DISEASES.        141
  The temper of mind ought to be carefully attended
to in difeafes.   Fear, anxiety,  and a fretful temper,
both occafion and aggravate difeafes.  In vain do we
apply  medicines  to the body to  remove maladies
which  proceed from the mind.   When this is af-
fected, the beft medicine is to footh the paflions, to
divert the mind from anxious thought,  and to  keep
the patient as eafy and cheerful as poffible.
  Attention ought likewife to be paid to the climate,
or place where the patient  lives, the air he breathes,
his  diet,  &c.   Such as live in low  marfhy fituations
are fubject to many  difeafes which are  unknown to
the  inhabitants of  high  countries.   Thofe  who
breathe the impure air of cities,  have many maladies
to which the more happy ruftics are entire ftrangers.
Perfons who feed grofsly,  and indulge  in ftrong li-
quors, are liable to difeafes which  do not affect the
temperate and abftemious.
   It has  already  been obferved, that  the different
occupations and fituations in life difpofe men to pecu-
liar difeafes.   It is therefore  neceffary  to  inquire
into the patient's occupation,  manner  of life, &c.
This will not only alfift us  in finding out the difeafe,
but will  likewife direct us in the treatment of it.   It
would be very imprudent  to treat the laborious and
the fedentary precifely in the fame manner, even fup-
pofing them to labour under the fame difeafe.
   It will likewife be proper to inquire,  whether the
difeafe be conftitutional or accidental; whether  it
has been of long or  fhort  duration ; whether it pro-
ceeds from  any great and fudden  alteration in the
diet, manner of life, &c.   The ftate of the patient's
body,  and  of the  evacuations,  ought  alfo  to be
inquired into ; and likewife whether he can with eafe
perform  all the vital and animal functions, as breath-
ing, digeftion, &c.
Laftly 
  14*          OF THE  KNOWLEDGE
    Laftly, it  will be proper to inquire what difeafes
  the patient has formerly been liable to, and what me-
  dicines  were moft beneficial  to him ;  if he  has a
  ftrong averfion to any particular drug, &c*.
    As many  of  the indications of cure may be an-
  fwered  by diet alone, it is  always  the firft thing to "
 be attended to in the treatment of difeafes.   Thofe J
 who know no better, imagine that every thing which
 goes by the name of a medicine poffeffes  fome won-
 derful power or fecret charm,  and think,  if the pa.
 tient fwallows enough  of  drugs, that he  muft do
 well.  This  miftake has many  ill  confequences'; it
 makes people truft to drugs, and neglect their own
 endeavours;  befides, it difcourages all attempts^ to
 relieve the fick where medicines cannot be obtained.
   Medicines  are  no  doubt ufeful in  their place;
 and, when adminiftered with  prudence, they may
 do much good ;  but, when  they are put in place of
 every thing  elfe, or adminiftered at random,  which
 is not feldom the cafe, they muft do mifchief.  We
 would therefore  wifh to  call the attention of man-
 kind from the purfuit  of fecret  medicines, to fuch
 things as they are acquainted with.   The proper re-
 gulation  of  thefe  may  often  do much good,  and
 there is little danger of their  ever doing hurt.
   Every difeafe weakens the digeftive powers.  The
 diet ought therefore, in all  difeafes, to be light  and
 of eafy digeftion.   It would  be as prudent for a per-
 fon with  a broken leg to  attempt to walk,  as for one
 in a fever to eat  the fame kind of food, and in  the
 fame  quantity, as  when  he  was in perfect health,  i
 Even abftinence alone will often cure a fever, efpe-
 cially when it has been occafioned by excefs in eating  j
 or drinking.

  * It is,  however,  no uncommon cafe  for a patient to/«/-
pofe that fome particular medicines difagree with him.
In 
           AND CURE OF DISEASES.         143
  In all fevers attended with inflammation, as pleu-
rifies, peripneumonies, &c. thin gruels, wheys, wa-
tery infufions of mucilaginous  plants,  roots,  &c.
are not  only proper for the patient's food, but they
are likewife fome of the beft medicines which can be
adminiftered.
 .  In fevers of a flow, nervous, or putrid kind, where
there are no fymptoms of inflammation,  and where
the patient muft be fupported with cordials,  that in-
tention can always be more effectually  anfwered by
nourifhing diet, and  generous wines, than by  any
medicines yet known.
   Nor is  a proper attention to diet of  lefs import-
ance in chronic than  in acute difeafes.   Perfons af-
flicted with  low  fpirits,  wind, weak nerves,  and
other  hypochondriacal  affections,  generally   find
more benefit from the ufe  of folid food and gene-
rous  liquors, than from  all  the  cordial and  car-
minative medicines which  can  be adminiftered to
them.              *
   The fcurvy, that moft obflinate malady, will fooner
yield to  a proper vegetable diet, than to all the
boafted antifcorbutic remedies of the fhops.
   In confumptions, when the humors are vitiated,
and the ftomach fo much weakened as to be unable
to digeft  the folid fibres of animals, or even to  afli-
milate the  juices of  vegetables,   a diet confifting
chiefly of milk will not only fupport the patient,  but
will often cure the difeafe after every other medicine
has failed.
   Nor is an attention to other things of lefs import-
ance than  to diet.  The ftrange  infatuation  which
has long induced people to fliut up the fick from all
communication with the external air, has done great
mifchief.   Not only in fevers, but in many other dif-
eafes, the patient will  receive more benefit  from
having the frefh air prudently admitted into his cham-
        *                                      ber. 
 144        OF THE KNOWLEDGE, &c.
 ber,  than from all the medicines which can be given    i
 him.
   Exercife  may  likewife  in  many cafes be  confi-
 dered as  a  medicine.  Sailing,  or  riding  on horfe-
 back, for example,  will be of  more  fervice in the
 cure  of confumptions, glandular obftructions, difeafes
 of the ftomach and bowels, &c. than  any  medicine
 yet known.   In difeafes which proceed from a re-
 laxed ftate  of the  folids, the  cold  bath, and  other
 parts of the gymnaftic regimen, will be found equally
 beneficial.
   Few things are  of greater importance in the  cure!
 of difeafes than cleanlinefs.  When a patient is fiif-
 fered to lie  in dirty clothes, whatever perfpires froifl
 his body is again reforbed,  or taken up into it, whicft
 ferves to nourifli the difeafe, and increafe the danger.
 Many difeafes may  be cured by1 cleanlinefs alone;
 moft  of them may  be mitigated  by it,  and in  all of
 them it is highly neceffary both for the patient and
 thofe who attend him.
   Many other Obfervations, were it neceffary, might
 be adduced  to prove the importance of a proper re-
 gimen in  difeafes.   Regimen will often cure difeafes
 without medicine,  but medicine will feldom fuCceed
 where a proper regimen is neglected.   For this rea-
 fon, in the  treatment of  difeafes,  we have always.  .'I
 given  the firft place to regimen.   Thofe who are
 ignorant  of medicine  may confine  themfelves to it
 only.   For  others  who have  more  knowledge,  we
 have  recommended fome of the moft fimple^ but ap-  |
 proved forms of medicine  in every  difeafe.   Thefey
 however,  are never to be adminiftered but by people of
 better underfianding;  nor even  by them  without  the
greateft precaution.
4                                    CHAP. 
C  H5  1
CHAP.  XIII.
                Of Fevers in general.


           x\S more than one  half  of mankind is
 faid  to  perifli  by fevers, it is of importance to be
 acquainted with  their  caufes.    The moft general
 caufes of fevers  are, infeclion,  errors in diet,  un-
 wholefome air, violent emotions of the mind, excefs or
 fupprcffton of ufual evacuations, external  and internal
 injuries, and extreme degrees of heat or cold.  As moft
 of thefe have already been treated of at confiderable
 length,  and their effects  fhewn, we fliall not  now
 refume the  confideration  of  them, but fhail  only
 recommend  it to all, as they would  wifh to avoid
 fevers, and other fatal difeafes, to pay the moft punc-
 tual attention to thefe articles.
   Fevers are not only'the moft frequent of all dif-
 eafes, but they are likewife the  moft  complex.   In
 the moft fimple fpecies  of fever, there  is always a
 combination of feveral  different  fymptoms.    The
 diftinguifhing fymptoms of fever are, increafcd heat,
frequency of pulfc, lofs of appetite,  general debility,
pain in the head, and  a difficulty  in  performing fome
 of the vital or  animal funclions. •  The other  fymp-
 toms  ufually attendant on  fevers are, naufea,  thirft,
 anxiety,  delirium, wearinefs,  wafting  of the flefh,
 want  of fleep,  or the  fleep difturbed and not re-
 frefhing.
   When the fever comes on gradually,  the  patient
generally complains firft of languor or  liftleffnefs,
forenefs of the flefh,  or the bones,  as the country
people exprefs it,  heavinefs   of  the  head,  lofs of
                         L                appetite, 
i4«        OF  FEVERS IN GENERAL.
appetite, ficknefs, with clamminefs  of the mouth;
after fome time,  come on  exceffive  heat,  violent
thirft, reftleflhefs, &c.
   When the fever attacks  fuddenly, • it always  be-
gins with an  uneafy fenfation of  exceffive cold,  ac-
companied with  debility  and lofs of  appetite ;  fre-
quently the cold  is attended with  fhivering,  oppref-
fion about the heart,  and ficknefs at ftomach,  or
vomiting.
   Fevers are divided into  continual, remitting, in-
termitting, and fuch as are attended with cutaneous
eruption or  topical  inflammation, as  the  fmall-pox,
eryfipelas, ccc.   By a continual fever is meant, that
which never leaves the  patient  during  the  whole
courfe of the difeafe, or which  fliews no remarkable
increafe or  abatement in the fymptoms.   This kind
of fever  is likewife divided into acute,  flow,  and
malignant.   The fever is called acute, when its pro-
grel's is quick, and the fymptoms  violent; but when
thefe are more  gentle, it  is generally  denominated
flow.   When livid or petechial  fpots appear,  the fe-
 ver is called malignant, putrid, or petechial.
    A remitting fever differs from a continual only in
 a degree^  It  has frequent increafes and decreafes, •
 or exacerbations and remiflions, but  never wholly
 leaves the patient  during  the  courfe of the difeafe.
 Intermitting fevers or agues are thofe which,  during
 the time that the patient may be faid to be ill, have '
 evident intervals or remiflions of the fymptoms.
    In a fever it is the bufmefs of thofe who have the
 care of the fick, to  obferve with diligence which way
 Nature points, and to endeavour to affift her opera-
 tions.   Our bodies are fo framed, as to have a con-
 ftant tendency to expel or throw off whatever is in-
 jurious to health.  This is  generally done by urine,   '
 fweat, ftool, expectoration, vomit, or fome other eva-
 cuation.
There 
             OF FEVERS IN  GENERAL.         147
    There is reafon to believe, if the efforts  of Na-
 ture, at the beginning of a fever, were duly attended
 to and promoted, it  would  feldom continue long;
 but when her attempts are either neglected or coun-
 teracted, it is no wonder if the  difeafe proves fatal.
 There  are  daily  inftances  of  perfons  who, after
 catching cold, have all the fymptoms of a beginning
 fever ;  but  by keeping warm, drinking diluting li-
 quors,  bathing their  feet  in warm water,  &c. the
 fymptoms in a few hours difappear, and the danger
 is prevented.   When fevers of the goal or hofpital
 kind threaten, the beft method of obviating their ef-
 fects is by one or two vomits.
    Our defign is not to enter into a critical  inquiry
 into the nature and immediate caufes of fevers, but
 to mark  their moft obvious fymptoms, and to point
 out the proper treatment of the patient with  refpect
 to his  diet, drink, air, &c.  in  the different flages
 of the  difeafe.  In thefe articles the inclinations of
 the patient will,, in a great meafure, direct our con-
 duct.
   Almoft every perfon in a fever complains of great
 thirft, and calls out for drink, efpecially of a  cooling
 nature.   This at once points out the ufe of water,
• and other cooling liquors.   What is  fo likely to abate
 the heat,  attenuate the  humors,  remove fpafms and
 obftructions, promote  perfpiration, increafe the quan-
 tity of  urine,  and,  in fhort,  produce every falutary
 effect in an ardent or inflammatory fever, as drinking
 plentifully of water,  thin gruel,  or any other weak
 liquor,  of which water is the balls ? The neceffity
 of diluting liquors, is pointed out by the dry tongue,
 the parched  fkin, and the burning  heat,  as well as
 the unquenchable thirft of the patient.
   Many cooling  liquors which are  extremely grate-
 ful to patients in  a  fever, may be prepared from
 fruits, as decoctions of tamarinds, apple-tea, orange-
                        L 2                 whey, 
148        OF FEVERS IN GENERAL.
whey, and the like.-   Mucilaginous liquors might
alfo be prepared from  marfhmallow roots,  flax-feed,
lime-tree buds, barley, and  other  mild vegetables.
Thefe liquors, efpecially when acidulated, are highly
agreeable to the patient, and  fliould never be denied
him.
   At the beginning of a fever, the  patient generally
complains of great laffitude  or wearinefs,  and has
no inclination to  move.   This evidently fliews the
propriety of keeping him  eafy, and if poffible in
bed.  Lying in bed relaxes  the fpafms, abates the
violence  of  the  circulation,  and  gives Nature an
opportunity of exerting all  her force  to  overcome
the difeafe.   The bed  alone would  often  remove a
fever at the beginning ; but  when the patient ftrug-
gles with the difeafe,  inftead of driving it off, he
only fixes it  the  deeper, and  renders it more dan-
gerous.    This obfervation is  too  often verified in
travellers, who happen,  when  on a journey, to be
feized with a fever.   Their anxie'ty to get home,
induces  them to  travel with the fever upon them,
which conduct often renders  it  fatal.
   In  fevers, the mind, as well  as the  body, fhould
be kept eafy.   Company is  feldom agreeable to the
fick.  Indeed, every thing that difturbs the imagina-'
tion,  increafes the difeafe;  for  which  reafon, every
perfon in a fever ought to  be kept perfectly quiet,
and neither allowed  to fee nor hear any thing  that
may in the leaft affect or difcompofe his mind.
   Though the patient, in a fever, has the  greateft
inclination for drink, yet he feldom has any appetite
for folid  food ;  hence the impropriety of urging him
to take victuals is evident.   Much folid food, in a
fever, is every way hurtful.  It  oppreffes nature,
and,  inftead of nourifhing the patient, ferves only
to feed the difeafe.   What food the patient takes,
fliould be in fmall quantity, light, and of eafy di-
                                           geftion. 
            OF FEVERS IN GENERAL.         i49
geftion.   It ought to be  chiefly of the vegetable
kind, as panada,  roafted  apples, gruels,  and fuch
like.
   Poor people, when  any  of their family are taken
ill, run directly to their rich neighbours for cordials,
and pour wine, fpirits, &c. into the patient, who,
perhaps, never had been  accuftomed to  tafte fuch
liquors when in health.   If  there be any degree of
fever, this conduct muft increafe it, and if  there  be
none, this is the  ready way to  raife  one.   Stuffing
the patient with fweatmeats, and other delicacies, is
likewife very pernicious.   Thefe are always harder
to digeft than common food, and cannot fail to hurt
the ftomach.
   Nothing is more defired by a patient in a fever
than frefh air.  It not only removes his anxiety, but
cools the blood, revives the fpirits, and proves every
way beneficial.    Many patients  are in a manner
flifled to death in fevers, for want of frefh air ; yet,
fuch is the unaccountable infatuation of moft people,
that the moment they think a perfon in a fever, they
imagine he  fhould  be kept in  a clofe chamber, into
which not one particle of frefh air muft be admitted.
Inftead of this, there  ought to be a conftant ftream
of frefh air into a fick perfon's chamber, *fo as to keep
it moderately  cool.   Indeed, its degree of warmth
ought never to be greater than is agreeable to one in
perfect health.
  Nothing fpoils the air of a fick perfon's chamber,
or hurts the patient more,  than a number of people
breathing in it.  When the  blood is inflamed,  air
that has been  breathed repeatedly, will greatly  in-
creafe the difeafe.  Such air, not only lofes its fpring,
and becomes unfit for the purpofe of refpiration, but
acquires a  noxious quality,  which renders it, in a
manner poifonous to the  fick.   The  body linen,  as
                      L 3                   well 
15°        OF FEVERS IN GENERAL.
well as the flieets, fhould be often changed : there
is no cafe where this  is  dangerous,  if the linen is
dry and  warm,  unlefs  when  the patient is too weak
to bear it.
   In the laft flage of fevers, when the patient's  fpi-
rits are low and depreffed, and the fkin  is foft and
pulfe weak, he is not only to be fupported with cor-
dials, but every method fliould  be  taken to cheer
and comfort his mind.  Many,  from a miftaken zeal,
when they think a perfon in danger, inftead of fo-
lacing his mind with the hopes and confolations of
religion, fright  him with the views of hell .and dam-
nation.   It would be unfuitable here, to  dwell upon
the impropriety and dangerous confequences of this
conduct; it often hurts the body, and there is rea-
fon to believe feldom benefits the foul.
   Among common people, the very name of a fever
generally fuggefts the neceflity of bleeding.   This
notion feems  to have  taken  its rife from  moft fevers
in this country having been formerly of an inflam-
matory nature ;  but true  inflammatory  fevers  are
now feldom to be met  with.  Sedentary occupations,
and a different  manner  of living, have  fo changed
the  ftate of difeafes in Britain, that there is  now
hardly one fever in ten,  where  the  lancet is necef-
fery. In  moft low, nervous, and putrid fevers, which
are now fo common, bleeding is really hurtful, as it
weakens the  patient,  finks  his fpirits,  &c.    We
would recommend this general  rule,  never to bleed
at the beginning of a  fever, unlefs there  be evident
figns of  inflammation ; and  where the pulfe fliews
that inflammation is prefent, bleeding is always fafe
and proper.   Bleeding is an excellent medicine when
neceffary, but fhould never be wantonly performed. *

     * See hereafter, the chapter on the Yellow  Fever.
                                                It 
           OF FEVERS  IN GENERAL.         151
   It is likewife a common notion, that fweatftig is
always neceffary in  the beginning of a fever.  When
the fever  proceeds  from an  obftructed perfpiration,
this notion is  not ill founded.  If the patient only
lies in bed, bathes.his feet and legs in warm water,
and drinks freely of water-gruel or any other weak
diluting liquor, he will feldom fail to  perfpire freely.
The warmth of the bed, and the diluting drink, will
relax the univerfal  fpafm, which generally affects the
fkin  at the beginning of a  fever;  it will open the
pores, and promote  the  perfpiration,  by means of
which the fever may often be carried  off.   But,  in-
ftead of this,  the common- practice is, to heap clothes
upon the  patient,  and  to give him  things of a hot
nature, as fpirits, fpiceries, &c.  which fire his blood,
increafe the '  fpafms, and render  the difeafe more
dangerous.
   In  all fevers,  a proper attention fhould be paid  to
the  patient's  longings.   Thefe are fometimes  the
calls of Nature,  and point out  what may be of real
ufe.    Patients are not,  indeed, to  be indulged in
every thing that the fickly appetite may crave ; but,
it is generally right to let them have a little of what
they eagerly defire, though it may not feem altoge-
ther proper.   What  the  patient longs for,  his fto-
mach will generally  digeft; and, fuch things have
fometimes  a very  happy effect.   We fliould, how-
ever,  be  careful to  diftinguifli between a  rational
longing for any thing, and the  incoherent wifhes of
perfons in a delirium.
   When a patient  is recovering from a fever, great
care  is  neceffary to prevent  a relapfe.  Many per-
fons,  by too foon  imagining  themfelves well, have
loft their  lives,   or contracted  other  difeafes  of  an
obflinate nature.   As the body, after a fever,  is
weak and  delicate, it is necefl'ary  to guard  againft
matching cold.  Moderate exercife in  the  or,en  air
                       L4                ^  wiJJ 
152      OF INTERMITTING FEVERS.
will be of ufe, but great fatigue is, by all means, to
be  avoided; agreeable company  will alfo have  a
good effect.   The diet muft be light, but nourifhing.
It fliould be taken frequently, but in fmall quantities.
It is dangerous, at fuch a  time,  to eat as much as
the ftomach may crave.
                  CHAP.   XIV.

          Of Intermitting Fevers,  or Agues.


          Intermitting fevers afford the beft
 opportunity, both of obferving the nature of a fever,
 and alfo the effects of a medicine.   No perfon can
 be at a lofs to diftinguifli an intermitting fever from
-any other,  and the proper  medicine for it, is  now
 almoft univerfally known.
   The feveral kinds of intermitting fevers take their
 names from the period in which the fit returns, as
 quotidian, tertian, quartan,  &c.
   CAUSES.—Agues are   occafioned   by  effluvia
 from putrid flagnating water. This is evident from
 their abounding in rainy feafons,  and   being moft
 frequent in  countries  where the foil is marfhy, as in
 Holland,  the fens  of Cambridgefliire, the Hundreds
 of Effex, &c.  This difeafe may  alfo be occafioned
 by eating too much fruit, by a  poor watery diet,
 by drinking cold liquors, damp houfes,  expofure to
 the fen, evening dews, lying upon the damp ground,
 watching, fatigue,  depreffmg paflions, and the like.
 When the inhabitants of. a high  country remove to
 a low one, they are generally feized with  intermitting
                                          fevers, 
          OF INTERMITTING FEVERS.        153
 fevers, and to fuch  the difeafe is moft apt to prove
 fatal.   In  a word,  whatever  relaxes  the folids, di-
 minifhes the perfpiration, or obftructs the circulation
 in the capillary or fmall veffels, difpofes the body  to
 ap;ues.
   SYMPTOMS.—An intermitting fever generally
 begins with a pain of the head and  loins,  wearinefs
 of the limbs,  coldnefs of the extremities,  ftretching,
 yawning, with fometimes great ficknefs and vomiting,
 to which fucceed  fliivering or  violent fhaking ;  this
 is followed by confiderable heat,  and  a quick,  full,
 hard pulfe, which lafts from half an hour to one, two,
 or three hours.  Afterwards the fkin becomes moift,
 and a profufe fweat breaks out, which generally ter-
 minates the fit or paroxyfm.   Sometimes indeed the
 difeafe comes on fuddenly, when the  perfon thinks
 himfelf in perfect health ;  but  it is  more  commonly
 preceded  by liftleffnefs,  lofs of appetite, and the
 fymptoms mentioned above.
   REGIMEN.—While the fit continues the patient
 ought to drink freely of water-gruel, lemonade, weak
 camomile tea ; or, if hfs ftrength be much reduced,
 fmall wine-whey, fharpened with the juice  of lemon.
 All his drink fliould  be warm,  as  that will aflift ia
bringing on the fweat, and confequently fliorten the
paroxyfm. *

  * Dr. Lind fays, *hat twenty or twenty-five drops of lau-
danum, put into a cup of  the patient's  drink,  and gives
about half an hour after the commencement of the hot fit,
promotes the  fweat, fhortens the fit, relieves the head, and
tends greatly  to remove the difeafe.

  There is no doubt that this remedy will nfeep effectually
remove it—and from one to two grains of opium given an
hour before the  cold fit is expetfed, will alfo flop the fit,
and often cure the difeafe.
Between 
154       OF INTERMITTING FEVERS.
   Between the paroxyfms the patient muft be fup.
ported with food  that is  nourifhing, but  li-ht and
eafy of digeftion, as veal or  chicken-broths, fago,
gruel with a  little wine, light puddings, an^  fuch
like.   He may drink infufions of bitter  herbs,  as
camomile, worm-wood, or centaury, and may now
and then take a glafs of fmall  wine,  in  which  gen-
tian root,  centaury,  or fome other bitter, has been
infufed.
   As the  chief intentions of cure in an  ague  are  to
brace the  folids, and promote  perfpiration, the  a-
tient ought to take as much exercife between the fits
as he can  bear.   If he be able to go abroad,  riding
on horfeback, or in  a carriage, will  be of great fer-
vice.   But if  he  cannot bear  that kind of exercife,
he ought  to take  fuch as his  ftrength  will permit
Nothing tends more  to prolong an intermitting fever,
than indulging a lazy indolent  difpofition.
   MEDICINE.—The firft thing  to  be done in the
cure of an intermitting fever,  is to cleanfe the fto-
mach and bowels.  This not only renders the appli-
cation of  other medicines more fafe,  but likewife
more efficacious.     In  this difeafe,  the ftomach  is
generally  loaded with cold vifcid phlegm, and fre-
quently great  quantities of bile are difcharged by
vomit ; which plainly points out the neceflity of fuch
evacuations.  Vomits are therefore to be  adminiftered
before the-patient takes any other medicine.   A dofe
of ipecacuanha will generally anfwer this purpofe
very well.  Fifteen grains or  a fcruple of the pow-
der will be fufficient for an adult,  and for a younger
perfon the dofe muft be lefs  in proportion.   After
the vomit begins  to operate,  the patient ought  to
drink plentifully of weak camomile-tea.   The vomit
fliould be  taken two or three hours before  the return
of the fit.   Vomits not only cleanfe the ftomach, but
increafe the perfpiration, and all the other fecretions,
                                            which 
          OF INTERMITTING FEVERS.       155
which  render them of fuch  importance,  that they
often cure intermittent fevers withoftt the affiftance
of any  other medicine.
   Purging medicine*  are likewife ufeful  and often
neceffary in intermitting fevers.   A fmart purge has
been known  to cure an  obflinate ague,   after the
Peruvian bark and other medicines had been ufed in
vain.   Vomits however are more fuitable  in this dif-
eafe, and render purging lefs neceffary ;  but if the
patient be afraid to take  a vomit, he ought in  this
cafe to cleanfe the bowels by a dofe  or two of jalap,
or rhubarb.
   Bleeding is proper at the  beginning of an inter-
mitting fever, when exceffive heat,  a delirium,  &c.
give reafon to fufpect an inflammation ; but this ope-
ration  is not very often neceffary.
   After proper  evacuations  the patient  may fafely
ufe the Peruvian bark,  which may betaken  in any
way that is moft agreeable to him.   No preparation
of the bark feems to anfwer better  than the moft
fimple form in which it can be given, viz.  in powder.
   Two  ounces  of the beft  Peruvian bark, finely
powdered, may  be divided  into twenty-four dofes.
Thefe  may either be made into boluffes as they are
ufed,  with a little fyrup  of lemon,  or mixed in a
glafs of red  wine, a cup of camomile-tea,  water-
gruel,  water,  milk  and  water, good lively porter,
or any other drink that is more agreeable to the pa-
tient. *   The Peruvian bark frequently occafions a
ficknefs at ftomach ; this  may often be prevented bv
eating nothing but clear broth.   If  it purges,  add
three or four drops of laudanum  to  each dofe—If it

   *  It has lately  been  obferved, that the red  bark is  more
powerful  than  that which has tcr fome time been in  com-
mon ufe, but it does not agree  fo  well with the llomach :
On the contrary,  the yellow bark ng<ees b-ttcr wih the
llomach, and is equally  efficacious.
                                           renders 
  »5<5       OF INTERMITTING  FEVERS.
  renders the  body  coftive, add five  or fix grains of
  rhubarb to every dofe till it purges.
    In an ague which  returns  every day, one of the
  above dofes may be taken every hour  during the in-
  terval of  the fits.   By this method  the patient will
  be able to  take ten  or  twelve dofes  between each
  paroxyfm.  In a tertian  or third day ague it will be
  fufficient to take a dofe every third hour during the
  interval, and in a quartan every fourth.  If the pa-
  tient cannot take fo large a dofe of the bark, he may
  divide each of the powders into two parts, and take
  one every  hour, &rc.   For a  young perfon a fmaller
 quantity of this medicine  will be fufficient,  and the
 dofe muft be adapted to the age, conftitution, and vio-
 lence of the fymptoms. *
   The  above quantity of bark will  frequently cure
 an ague ;  the patient, however,  ought not to lea.it
 oft taking the medicine as foon as the paroxyfms are
 flopped, but  fliould continue to ufe it till there is
 reafon to believe the difeafe  is  entirely overcome.
 Moft of the failures in  the cure of  this difeafe are
 owing to patients not  continuing to ufe the medicine
 long enough.   They are generally directed  to take
 it till the fits are flopped,  then to  leave it off, and
 begin again at  fom-  diftance of  time ; by which
 means the difeafe gathers ftrength,  and  often  returns
 with as much  violence as before.   A  relapfe may

   * In intermitting fevers of an obflinate nature, I have found
 «t neceffary to throw in the bark much fatter.  Indeed the be-
 nefits anting from this medicine depend chiefly upon a large
 quantity of it being adminiftered  in  a fhort  time.   Several
 ounces of bark given ina few days will do more than as many
 pounds taken in the courfe of fome weeks.  When this medicine
 is intended either to flop a mortification, or cure an obftinate
ague, rt ought to be thrown in as faft as the ftomach  can pot
Holy bear it.  Inattention to this circumftance  has hurt the re-
rotation of one of the beft medicines of which we are in pot
11 lion.                                           *
                                              always 
          OF INTERMITTING FEVERS.       157
always be prevented  by the patient's continuing  to
fake fmall dofes of the medicine for  fome time after
the fymptoms difappear.   This is both the moft fafe
and effectual method of cure.
  An ounce of gentian root, of calamus  aromaticus,
and orange-peel, each half an  ounce, with three  or
four handfuls  of camomile-flowers,   and  an hand-
ful  of coriander-feed,  all bruifed  together  in a mor-
tar, may be ufed in form of infufion  or tea.  About
half an handful of thefe ingredients may  be put into
a tea-pot, and a  pint  of boiling water poured  on
them,   A cup of this infufion drank three or  four
times a-day  #ill greatly promote  the cure.    Such
patients  as cannot drink  the  watery infufion,  may
put two handfuls of the fame ingredients into a bottle
of white wine, and take a glafs of it twice or thrice
a-day.  If patients drink freely of the above, or any
other proper infufion of bitters, a fmaller quantity  of
bark than is generally ufed, will be fufficient to cure
an ague. *
  Thofe who cannot fwallow the  bark in fubftance,
may take it in decoction or infufion.   An ounce  of
bark in powder may be infufed  in a  bottle of white
wine for four  or five  days,  frequently  fhaking the
bottle, afterwards let the  powder fubfide,  and pour
off the clear liquor.   A  wine glafs may  be drank
three or  four times a-day, or oftener, as there is oc-

  * There is reafon to believe, that fundry of our own plant;
or barks, which are very bitter and aftringent,  would fucceed
in the cure of intermittent fevers, efpecially when afiifted  by
aromatics.  But as the Peruvian bark has been long approved
in the cure of .this difeafe, and is now to  be  obtained at a very
reafonable rate, it is of lefs importance to fearch after new me-
dicines.  We cannot, however, omit  taking notice, that  the
Peruvian bark is  very often adulterated, and that it requires
confiderable fkill to diftinguifh between the genuine and  the
falfe.  This ought to make people very cm;:ku*  of whom they
purchafe it.
                                            cafjon. 
 158        OF INTERMITTING FEVERS.
 cafion.   If a decoction be more agreeable,  an ounce
 of the bark, and two  drams  of fnake-root bruifed,
 with an equal  quantity of fait of worm-wood, may
 be boiled in a quart  of water, into an Englifh pint.
 To the ftrained liquor  may be added an equal quan-
 tity  of red wine, and a glafs of it taken frequently.
   In an obflinate  tertian or  quartan,  in the end of
 autumn, or beginning of winter, warm  and cordial
 medicines are abfolutely neceffary. *
   Obflinate autumnal  agues are cured  by blifters to
 the wrifts ; winter agues by  bleeding, if the pulfe
 will bear it:  after thefe the bark to be given, as in
 common cafes of ague.               ^
   As autumnal  and winter agues  generally  prove
 much  more  obflinate  than thofe which  attack the
 patient  in fpring or fummer,  it will be neceffary to
 continue the ufe of  medicines longer  in  the former
 than in the latter.   A perfon  who is feized with an
 intermitting fever in  the beginning  of  winter,  ought
 frequently, if the feafon proves rainy,  to  take a little
 medicine,  although  the  difeafe may feem  to be
 cured, to prevent  a relapfe,  till the  return of the
 warm feafon.   He ought likewife  to take care not
 to be  much abroad in wet  weather,  efpecially in
 cold eafterly  winds.
   When  agues are  not  properly cured,  they often
 degenerate into obflinate chronical  difeafes, as the
dropfy, jaundice, confumption, &c.   For this reafon,
all poffible care fliould  be taken to  have them radi-

  * In obflinate agues, when the  patient is old,  the habit
phlegmatic,  the feafon rainy, the fituation damp, or the like,
it will be neceffary to  mix  with two ounces of the bark, half
an ounce of Virginia fnake-root, and a quarter of an ounce
of ginger, or fome other warm aromatic ;  but when the
fymptoms are of an inflammatory  nature, half an ounce of
ialt of wormwood  or fait of tartar may be adcled  to the
above quantity of bark.
                         2                     cally 
          OF INTERMITTING FEVERS.       159
cally cured, before  the  conftitution  has been  too
much weakened.
  Though nothing is more rational than the method
of treating intermitting fevers, yet,  by fome ftrange
infatuation,  more charms  and whimfical  remedies
are daily  ufed  for removing this,  than any  other
difeafe.   There is hardly an old woman  who is  not
in poffeflion of a noftrum  for flopping  an ague ;
and it is amazing with what  readinefs their preten-
fions are believed.   Thofe in diftrefs eagerly  grafp
at any thing that promifes fudden  relief;  but  the
fhorteft way is  not always  the beft in the treatment
of difeafes.  The only method to obtain a fafe  and
lafting cure, is  gradually to affift Nature in removing
the caufe  of the diforder.
   Some indeed Jry bold, or rather  fool-hardy expe-
riments to cure agues,  as drinking  great quantities
of ftrong liquors, jumping  into a river,  &c.   Thefe
may fometimes  have the  defired effect, but muft al-
ways be attended with danger. *  When  there is znf
degree of inflammation, or the leaft tendency to it,
fuch experiments may prove fatal.  The only patient
whom I  remember to have loft in an intermittent fe-
ver, evidently  killed himfelf  by drinking ftrong li-
quor, which, feme perfon had perfuaded him  would
prove an infallible remedy.  Half an  ounce of the
flowers of fulphur taken  in milk an hour before the
cold fit, will often cure an ague: So will  a ftrong in-
fufion of gentian,  a flannel fhirt, a  change of air ;
thefe are fafe and rational remedies.
   Many dirty things are extolled for the cure  of in-
termitting fevers, as fpiders,  cobwebs, fnuffings of
candles, &c.   Though thefe may fometimes fucceed,

  * Arfenic has of late been recommended as an infall'ble re-
medy in the ague ; but I would advife that  it fliould  be ufed
only under the eye of a phyfician.
                                              yet 
 160 *     OF INTERMITTING FEVERS.
 yet their very naftinefs is fufficient  to fet them afide,
 efpecially, when cleanly  medicines  will anfwer the
 purpofe better.   The only medicine that can be de-
 pended upon, for thoroughly curing an  intermittent
 fever, is the Peruvian bark.   It may always be ufed
 with fafety :  and I can  honeftly declare,  that in all
 my practice I never knew it fail, when combined with
 the medicines mentioned above, and duly perfifted in.
   Where  agues are   endemical,  even children are
 often afflicted with that difeafe.   Such  patients are
 very difficult to cure,  as they can feldom  be prevailed
 upon to take the bark,  or any other  difagreeable
 medicine.   One method of rendering this medicine
 more palatable, is to make it into a mixture with
 diftilled waters and fyrup, and afterwards to give it
 an agreeable fharpnefs with the elixir or fpirit of vi-
 triol.  This both improves the medicine,  and takes
 off the naufeous tafte.  In cafes where the bark can-
 not be adminiftered, the faline  mixture may be given
 with advantage to children. *
   Wine-whey is a very  proper drink for  a child in
 the cold fit of an ague ; to half a pint of which may
 be put a teafpoonful of the fpirit of hartfliorn.  Ex-
ercife is likewife of confiderable fervice ; and when
the difeafe  proves obflinate, the child ought, if pof-
fible, to be removed to a warm dry air.   The food
ought to be nourifhing, and fometimes a little gene-
rous wine fhould be allowed.
  To children, and fuch as cannot fwallow the bark,
or when the ftomach will not bear it, it may be given
by clyfter.   Half an ounce of the powder of bark,
fufpended in four ounces of warm  water, by the
help of two teafpoonsful of gum  arabic, with fix or
eight drops of laudanum,  in the form recommended
by Dr. Lind for an adult, and this to  be repeated

            * See Appendix, Saline Mixture.
                        *                   every 
OF INTERMITTING FEVERS.        161
every fourth hour, or oftener, as the occafion fhail
require.  For children,  the quantity of powder and
laudanum muft be proportion ably leffened.   Children
have been cured of agues, by making them wear a
waiftcoat with powdered bark  quilted between the
folds of it;  by bathing them frequently in a ftrong
decoction of the bark, and by rubbing the fpine with
ftrong  fpirits, or  with, a mixture  of equal parts  of
laudanum and the faponaceous  liniment.
  We have been the more full upon this fubject, be-
caufe it is very  common, and  becaufe few patients in
an  ague apply to phyficians, unlefs in extremities.
There are, however, many cafes in which the difeafe
is yery irregular, being complicated with other dif-
eafes, or attended with fymptoms which are both very
dangerous and very difficult to underftand.  All thefe
we  have purpofely paffed over, as they would only
bewilder the generality of readers.   When the difeafe
is very irregular, or the fymptoms  dangerous, the pa-
tient ought immediately to apply to a phyfician, and
ftrictly to follow his advice.
  To prevent agues, people muft  endeavour to avoid
their caufes.  Thefe have been already pointed out
in the  beginning  of this fection;  we fhail therefore
only add one preventive medicine,  which  may be
of ufe to* fuch as are obliged to live  in  low marfliy
countries, or who are liable  to frequent attacks  of
this difeafe.
  Take a large tea-fpoonful  of good Peruvian bark
three times a-day, in a little water,  or wine and water.
M                 CHAP. 
r  162  3
                 CHAP.   XV.


           Of an Acute Continual Fever.


         1HIS fever is  denominated acute, ardent,
or  inflammatory.   It  moft  commonly  attacks  the
young, or perfons about  the prime or vigour of life,
efpecially fuch as live high, abound with blood, and
whofe fibres are ftrong and elaftic.   It feizes people
at all feafons of the year ; but is moft frequent in the
fpring.
   CAUSES.—An ardent fever  may be  occafioned
by any thing that overheats the body,  or produces
plethora, as violent  exercife, fleeping  in the fun,
drinking ftrong  liquors,  eating fpiceries, a full diet,
with  little exercife, &c.  It may likewife be occa-
fioned by whatever obftructs the perfpiration, as lying
on the damp ground, drinking cold liquor when the
body is hot, night-watching,  or  the like.
   SYMPTOMS.—A rigour or  chillinefs generally
ufliers in this fever, which is foon fucceeded by great
heat, a frequent and full pulfe, pain of the head, dry
fkin, rednefs of the eyes, a florid countenance, pains
in the back, loins, &c.   To thefe fucceed difficulty of
breathing, ficknefs, with an inclination to vomit.  The
patient  complains of great thirft,  has no appetite for
folid  food, and is-refllefs ; and  the tongue, at  the
beginning is generally clean.
   A delirium, exceffive reftleffnefs, great oppreffion
of the breaft,  with laborious refpiration,  ftarting of
the tendons,  hiccup,  cold clammy fweats, and an
involuntary difcharge of urine,  are very  dangerous
fymptoms.
                                                As 
     OF AN ACUTE CONTINUAL FEVER.    163
   As this difeafe is always attended with danger, the
beft medical affiftance ought to be procured as foon
as  poffible.   Nothing can be  more  unaccountable
than the conduct of thofe who have it in their pow-
er, at the beginning of a  fever to procure the beft
medical  affiftance, yet  put it off till things come to
an extremity.  When the difeafe, by delay or wrong
treatment, has become incurable, and has exhaufted
the ftrength of the patient, it is in vain to hope for
much relief from medicine.  Phyficians may indeed
aflift Nature ; but their attempts will prove fruitlefs,
when fhe is  no longer  able to co-operate with their
endeavours.
   REGIMEN.—From the fymptoms of this difeafe,
it is evident  that the blood and other humors  re-
quire to be diluted ;  that the  perfpiration, urine,
faliva,  and all the other fecretions, are in too fmall
quantity ; that the veffels  are rigid, and the heat of
the whole body  too great: all thefe clearly point out
the neceflity of  a regimen calculated  to  dilute  the
blood, correct the acrimony of the humors, allay the
exceffive heat, remove the fpafmodic ftricture of the
veffels,  and promote the fecretions.
   Thefe important  purpofes may be greatly pro-
moted  by drinking  plentifully  of diluting liquors ;
as water-gruel, or oatmeal tea,  clear whey, barley-
water, balm-tea,  apple-tea, &c.  Thefe may be fharp-
ened with juice  of orange, jelly of turrants, rafp-
berries, and fuch like: orange-whey  is likewife  an
excellent cooling drink.  It is made by boiling among
milk and water  a bitter orange  fliced, till the curd
feparates. If no orange can be had, a lemon, a little
cream of tartar,  or a few  fpoonfuls of vinegar, will
have the fame effect.
   If the patient be coftive, an  ounce  of tamarinds,
with two ounces of floned raifins of the fun,  and a
                      M  2                 couple 
 164    OF AN ACUTE CONTINUAL FEVER.
 couple of figs,  may be boiled in three pints of water
 to a quart.  This makes a very pleafant drink, and
 may be  ufed  at  difcretion.  The common pectoral
 infufion is likewife a very proper drink in this difeafe.
 A tea^-cupful  of  it may be taken every two  hours,
 or oftener, if  the patient's heat and thirft be very
 great*
   The above  liquids muft all be drank a little warm.
They may be ufed in fmaller quantities at the begin-
 ning of a fever, but more freely afterwards, in order
 to affift in carrying off the difeafe by promoting the
 different excretions.   We  have mentioned a variety
 of  drinks,  that  the  patient  may  have  it  in-his
 power to chufe  thofe  which  are  moft agreeable;
 and that, when tired of one, he may have recourfe
 to another.
   The patient's  diet muft  be very fpare and light.
 All forts of flefh-meats, and  even chicken^broths,
 are to be avoided.   He may be allowed panada, or
 light breacl boiled in water; to which may be added,
 a  few grains  of common fait,  and a little fugar,
 which will render  it  more palatable.   He may eat
 roafted apples with a little fugar, toafted bread with
jelly of currants,  boiled prunes, &c.
   It will greatly relieve the  patient, efpecially in
 an hot feafon, to have frefh air frequently  let in-
 to his chamber.   This, however,  muft always be
 done in fuch a manner as not to endanger his catch-
 ing cold.
 •It is too common in fevers to load the patient with
 bed clothes, under the pretence of making him fweat,
 or defending him from the cold.   This cuftom is al-
ways wrong, and has many ill  effects.  It increafes
the heat of the body, fatigues the patient, and retards,
 inftead of promoting,  the perfpiration.

           * See  Appendix, Peroral infufion.
                                           Sitting 
      OF AN ACUTE CONTINUAL FEVER.     165
   Sitting upright in bed, if the patient is able to
 bear it, wilf often  have a good  effect.  It relieves
 the head, by  retarding the motion of the  blood to
 the brain.   But this pofture  ought never to be con-
 tinued too long : and  if  the  patient is  inclined to
 fweat, it will be more fafe to let him lie,  only raifing
 his head a little with pillows.  The judicious Syden-
 ham has advifed, with great propriety, to let the pa-
 tient lie on the bed with his clothes on, unlefs where
 we wifh to promote a fweat.
   Sprinkling the chamber with .vinegar  will greatly
 rerrefh the patient.  This ought to be done frequently,
 efpecially if the weather is hot.
   The patient's mouth fhould be often waflied with
 a mixture of water  and  honey, to which a little vine-
 gar  may  be added, or with  a decoction of figs in
 barley-water.  His feet ought likewife frequently to
 be bathed at bed-time, in lukewarm water; efpecially
 if the head is affected.
   The  patient fhould be  kept as quiet  and eafy as
 poffible.   Company, noife,   and every  thing  that
 difturbs the mind, is hurtful.   Even too  much light,
 or  any thing that  effects the fenfes,  ought to  be
 avoided.  His attendants  fhould  be as few as pof-
 fible, and they ought not  io  be  too often changed.
His inclinations ought ratheir to be fosthed than con-
tradicted ; even  the promife of what he  craves will
often fatisfy him  as  much as its reality.
   MEDICINE.—In this  and all other  fevers, at-
tended with a hard, full, quick pulfe, bleeding  is of
the greateft importance.  This operation ought  al-
ways  to be performed as foon as the fymptoms of an
inflammatory fever  appear.   The quantity of blood
to be taken away, however,  muft be in  proportion
 to the ftrength of the patient  and  the violence of the
 difeafe.   If, after the firft  bleeding, the fever fhould
 increafe, and the pulfe become more  frequent and
                      M  3                  hard, 
 166    OF AN ACUTE CONTINUAL FEVER.
 haro%  there  will be a neceflity for repeating it a ft.
 cond,  and perhaps a third, or even a fourth time;
 which may be done at the diftance of twelve,  eigh-
 teen,  or twenty-four hours from each  other, as the
 fymptoms require.   If the pulfe continues foft, and
 the patient is tolerably  eafy  after the firft bleeding,
 it need not be repeated.
   If the heat and fever be very great, forty or fifty
 drops of the dulcified or fweet fpirit of nitre may be
 made into a draught, with three  ounces of common
 water,  and a bit of loaf-fugar.   This draught may
 be given to the patient every three or four  hours
 while the fever is violent; afterwards once in five or
 fix hours will be fufficient.
    If the body is bound, an ounce of Glauber falts
 fliould be  given, after which a  clyfter of milk and
  water with a little  fait, and a fpoonful  of  fweet oil
  or frefh butter in it, ought daily to be adminiftered.
  Should this not have the defired effect,  a tea-fpoon-
  ful of magnefia alba, or cream of tartar may be fre-
  quently  put into his  drink.  He  may  likewife eat
  tamarinds, boiled prunes, roafted apples, and the like.
  After this,  if the fever continues, give the nitrous
  powders.   See Appendix.
     If about the tenth,  eleventh,  or twelfth  day, the
 pulfe  becomes  more foft, the tongue moifler,  and
 the urine begins to let  fall a reddifli fediment, there
 is reafon to  expect a favourable  iffue to the difeafe.
 But if, inftead  of thefe fymptoms,  the patient's fpi-
 rits grow languid, his pulfe finks, and his breathing
 becomes  difficult;  with a ftupor,  trembling  of the
 nerves, ftarting of the tendons,  &c. there  is  reafon
 to fear that the confequences will be  fatal.   In this
 cafe bhftering plafters muft be applied to the head,
 ancles, mfide of the legs or thighs, as there may be
 occafion ; poultices of wheat  bread,  muftard,  and
■vinegar may likewife be applied  to the feles of the
                                              feet. 
     OF AN ACUTE  CONTINUAL FEVER.     167
feet, and the patient muft be fupported with cordials,
as ftrong wine-whey,  negus, fagp-gruel with  wine
in it,  and fuch like.
   A proper regimen is not only neceffary during the
fever,  but likewife after the patient begins to  re-
cover.   Though the body is weak after a fever, yet
the diet for fome time ought to be rather light than
of too  nourifhing a nature.   Too much food, drink,
exercife, company, &c. are carefully to be avoided.
The mind  ought likewife  to be  kept eafy, and the
patient fhould not  attempt to purfue fludy, or any
bufmefs that  requires intenfe thinking.
   If the digeftion is bad, or the patient is feized at
times  with  feverifli heats, an infufion  of Peruvian
bark in cold water will be of ufe.   It will ftrengthen
the ftomach,  and help to fubdue the remains of the
fever.  *
   Thofe who follow  laborious  employments ought
not to  return too foon  to their labour after a fever,
but fhould keep eafy till their ftrength and fpirits are
fufficiently recruited*. •

  * The pure acute continual fever is feldom met with ; how-
ever, as it generally accompanies local  inflammations, fuch as
pleurify, rheumatifm, &c.  I have retained this chapter; more
efpecially as the remarks contained in it are very judicious.
M 4                  CHAP. 
C  »68   ]
CHAP.  XVI.
                 Of the  Pleurify.


          1 HE  true pleurify is an inflammation of
 that membrane  called the pleura, which lines the in-
 fide of the breaft.  There is likewife a fpecies of this
 difeafe, which is called the fpurious or" bqfiard pleuri-
fy, in which the pain is more  external, and chiefly
 affects the mufcles between  the  ribs.  This is, ftrift-
 ly fpeaking,  a rheumatifm.  It is moft frequent  in the
 fpring feafon.
   CAUSES.—The  pleurify may  be occafioned by
 whatever obftructs the perfpiration ; as  cold winds;
 drinking cold liquors when  the body is hot;  fleeping
 without doors on the damp "ground ; wet clothes;
 plunging the body into cold water, or by expofing it
 to the cold  air,  when covered  with fweat,  &c.  It
 may likewife be occafioned by drinking ftrong  li-
 quors ; by the  ftoppage of ufual evacutions  ;  as old
 ulcers, iflues, fweating of the feet or hands,  &c. the
 fudden ftriking  in of any eruption, as the itch, the
 meafles, or the fmall-pox, or by a mifplaced gout, or
 by worms.  Keeping the body too warm by  means
 of fire, clothes, &c. renders it more  liable to this
 difeafe.   A pleurify may likewife be occafioned by
 violent exercife, as  running, wreftling, leaping,  or
 by fupporting great weight, blows on the breaft, &c.
 A bad conformation of the body renders perfons more
 liable to this difeafe, as a narrow cheft, a ftraitnefs of
 the arteries of the pleura, &c.
SYMP- 
             OF THE PLEURISY.             169
  SYMPTOMS.—This, like moft other fevers, ge-
nerally begins with  chillinefs  and fhivering, which
are followed by  heat, thirft, and  reftleffnefs.   To
thefe fucceeds a violent pricking pain in one of the
fides among  the ribs.  Sometimes the pain extends
towards the back-bone, fometimes towards the  fore-
part of the breaft, and at Other times  towards the
fhoulder  blades.  The pain is generally moft violent
when the patient draws his breath.  A diftreffing
cough ufually attends this difeafe.
  The pulfe, is commonly quick and hard, the  urine
high coloured ; and if blood be let, it is covered with
a tough cruft, or buffy coat.   The patient's fpittle is
at firft thin, but afterwards it becomes groffer, and is
often ftreaked with blood.
   REGIMEN.—Nature often endeavours to  carry
off this difeafe by a critical difcharge of blood  from
fome part of the body, or by expectoration, fweat,
loofe ftools, or the like.   We  ought, therefore, to
fecond' her intentions Dy leffening the  force of the
circulation, relaxing the veffels, diluting  the humors,
and promoting expectoration.
   For thefe purpofes the diet, as in the former dif-
eafe, oflght to be cool, flender, and diluting.  The
patient muft avoid all food that is vifcid, hard  of di-
geftion,  Or that affords much nopt"._rhment; as  flefh,
butter, cheefe, eggs, milk, and a b every thing that
is of an  heating nature.   His drink may be whey,
or an infufion of pectoral and balfamic vegetables**
   Barley-watef,  With a little  honey or jelly of cur-
rants mixed with It, or merely fweetened with fugar,
is likewife a  very proper drink in this difeafe.  It is
made by boiliiig  an ounce of barley  in three pints of
water to two* which mi|ft afterwards be ftrained. The
decoction of tamarinds, figs, and raifins, recommended

            * See Appendix, PeSoral infufion.
                                                IB 
 170             OF THE PLEURISY.
 in  the preceding difeafe, is here likewife  very pro-
 per.-   Thefe and other diluting liquors are not to be
 drank in  large  quantities at a time,  but the patient
 ought to keep continually fipping them, fo as to ren-
 der his mouth and throat always moift.  All  his food
 and drink fhould be taken juft warm.
  The patient fliould be kept quiet,  cool, and every
 way eafy, as directed under the foregoing difeafe.
 His feet ought daily to be bathed in lukewarm water;
 and he may fometimes fit up in bed for a fliort fpace,
 in order to relieve his head.
  MEDICINE.—Almoft every perfon knows, when
a fever is  attended  with a violent pain of the  fide,
and a quick  hard pulfe,  that bleeding is  neceffary.
When thefe fymptoms come on, the fooner this ope-
ration is performed  the better ; and  the quantity at
firft muft be pretty large, provided the patient is able
to bear it.  A large  quantity of  blood let at  once,
in the beginning of  a pleurify, has  a much better
effect than repeated  fmall bleedings.   A  man  may
lofe  twelve or fourteen ounces of blood  as foon as
 it is certainly known that he  is feized with a pleurify.
For a younger perfon, or one of a delicate conftitu-
tion, the quantity muft be lefs.  A blifter may be ap-
plied  on the painful part, five or fix  hours after the
bleeding,  if the pain  continues,  and the pulfe does
not require another bleeding.
  If,  after the firft bleeding and bliftering, the flitch,
with  the  other  violent fymptoms, fhould ftill conti-
nue, it will be neceffary, at the diftance of twelve or
eighteen hours,  to  let eight  or  nine ounces more.
If the fymptoms do  not  then abate,  and  the blood
fliews a ftrong buffy  coat, a third  or even a fourth
bleeding may be requifite.  If the pain of  the  fide
abates, the pulfe becomes foTter,  or  the patient be-
gins to fpit freely, bleeding ought not  to be repeated.
                                              This 
              OF THE PLEURISY.            I7i
This operation is feldom neceffary after the third or
fourth day of the  fever.
   There are many things that may be done to eafe
the pain of the fide without bleeding,  as fomenting,
&c. Fomentations may be made by boiling an handful
of the flowers of elder, camomile, and common mal-
lows, or any other foft vegetables, in a proper quan-
tity of  water.   The herbs may be either put  into a
flannel bag, and applied warm to  the fide, or flannels
may be. dipped in the decoction, afterwards wrung
out, and applied to the part  affected, with as much
warmth as the patient can eafily bear.  As the cloths
grow cool, they muft be changed, and great care taken
that the patient do not  catch cold.  A bladder may
be filled with warm milk and water, and applied to the
fide,  if the above  method  of  fomenting be found in-
convenient.  Fomentations not only eafe  the pain,
but relax the veffels,  and  prevent the ftagnation of
the blood  and  other  humors.   The fide may like-
wife be frequently rubbed with a little of the volatile
liniment*.
   Topical  .bleeding has often a very good  effect in
this difeafe.  It  may  either be performed by apply-
ing a number of leeches to the part affected,  or by
cupping, which is both a more certain and expeditious
method  than the other.
   Leaves of various plants might  likewife be applied
to the  patient's fide with advantage.  I have often
feen great benefit from young cabbage-leaves applied
warm to the fide in a pleurify.  Thefe not only relax
the parts, but likewife draw off a little moifture.  To
prevent  a  ftrangury when the  bliftering-plafter is
on, the patient may drink freely of barley-water, or
an emulfion of gum arabic, or quince-feed tea.

           * See Appendix,  Volatile liniment.
If 
 * 7*           OF THE PLEURISY.
   If the patient is  coftive, a purge  of glauber falts
 or a clyfter of thin water-gruel,  or of barley-water,
 in which  a handful of  mallows,  or any other emol-
 lient vegetable has been boiled, may be daily admi-
 niftered.   This will not only empty the bowels, but
 have the effect of a warm fomentation applied to the
 inferior vifcera, which will help to make a derivation
 from the breaft.
   The expectoration, or fpitting may be promoted by
 drinking plentifully of barley-water,  flaxfeed-tea, or
 bran-tea.   If medicines are neceffary, when" the pa-
 tient is not much reduced, give  one  of the nitrous
 powders every two or three hours ; if the pulfe is
 low, one of the volatile bolufes  in the fame time.
 When the cough is  troublefome, ufe the paregoric
 mixture.   See Appendix.
   We fhail only mention one medicine more, which
 fome reckon almoft a  fpecific  in the pleurify, viz.
 the decoction of the feneka rattle-fnake root*.  After
 bleeding and other evacuations have  been premifed,
 the patient may take two, three,  or four table-fpooa*-
 fuls of this decoction, according  as his ftomach will
 bear it, three or  four times a-day.   If it fhould oc-
 cafion  vomiting,  two or three  ounces of fimple cin-
 namon-water may be  mixed with  the  quantity of de-
 coction here directed, or it may  be  taken in fmaller
 dofes.   As this medicine promotes perfpiration and
 urine,  and likewife keeps the body eafy, it may be of
 fome fervice in a pleurify, or any other inflammation
 ©f the breaft.
   No one  will imagine that thefe medicines are all
 to be ufed at the fame time.   We have mentioned
 different things,  on purpofe that people may have
it in their power to chufe ; and likewife, that when
 •ne cannot be obtained, they  may make ufe  of an-

         *  See Appendix, Decofiion of feneka. root.
other. 
              OF THE PLEURISY.            i73
wther.   Different medicines are no doubt neceffary
in the different periods of a diforder ; and where one
fails of fuccefs, or difagrees  with the patient,  it will"'
be proper to try another.
   What is  called the  crifis, or height of the fever,
is fometimes attended with very alarming fymptoms,
as difficulty  of breathing, an irregular pulfe, convul-
five  motions,  &c.  Thefe are  apt to frighten the
attendants,  and  induce them to do improper things,
as bleeding the  patient, giving him  ftrong  ftimu-
lating medicines, or the like.  But they are only the
ftruggles of Nature to overcome the difeafe, in which
fhe ought to be  affifted by plenty  of diluting  drink,
which is then peculiarly  neceffary.  If the patient's
ftrengtn, however, be much  exhaufted  by the dif-
eafe, it will be neceffary at this time to fupport him
with frequent fmall draughts of wine-whey, negus, or
the  like.
   When  the  pain and fever are gone,  it will be
proper,  after the patient has  recovered fufficient
ftrength, to give him  fome gentle purges,  as thofe
directed towards the end of the acute continual fever.
He ought likewife to ufe a light diet,  of eafy digef-
tion, and his drink fhould be butter-milJc, whey, and
•ther things of a cleanfing nature.

         OF THE BASTARD  PLEURISY.

  That fpecies of pleurify which is called the baftard
or fpurious, generally goes  off by keeping wai -n for
a few days, drinking plenty of diluting liquors, and
obferving a  cool regimen.
  It is known by a dry cough, a quick pulfe, and a
difficulty of lying on the affected fide, which  laft does
not  often happen in the true pleurify.   Cometimes
indeed this difeafe proves obflinate, and requh es bleed-
ing, with cupping, and fcarifications of the part <v">f\-
                                           ■  ed. 
 r74       OF THE PARAPHRENIAS.
 ed.  Thefe, together with the ufe of nitrous and other
 cooling medicines, feldom fail to effect a cure.

           OF THE PARAPHRENIAS.

   THE paraphrenias, or inflammation of  the dia-
 phragm, is fo nearly connected with the pleurify, and  ^
 refembles  it fo much in the  manner of treatment,
 that it is fcarcely neceffary to confider it as a feparate
 difeafe.
   It is attended with a very acute fever, and an ex-
 treme pain in the  part affected, which is  generally  J
 augmented by coughing, freezing,  drawing  in the
breath, taking food, going to ftool, making w.ater,
&c.   Hence the patient  breathes  quick, ano^draws
in his bowels to prevent the motion of the diaphragm;
is  reftlefs,  anxious, has a dry cough, an hiccup, and
 often a delirium.   A.conyulfive laugh, or rather a
kind of involuntary grin, is no uncommon fymptom
 of this difeafe.
   Every method  muft be taken to prevent a fuppu-
ration.  The regimen and medicine are in all refpects
 the fame as in the ple*urify.  We fliall only add, that
in this difeafe emollient clyfters are peculiarly ufeful,
 as they relax the bowels, and  by that means  make a
 derivation from the part affected.
CHAP. 
C  »75  ]
                CHAP.  XVII.

   Of a Peripneumony, or Inflammation of the Lungs.

          A S  this difeafe affects an organ which is
abfolutely neceffary to  life, it muft always be  at-
tended with danger.  Perfons whofe fibres  are tenfe
and rigid, who feed upon grofs aliment,  and drink
ftrong  vifcid liquors, are moft liable to a peripneu-
mony.   It is moft fatal to thofe who have a flat breaft
or narrow cheft, and to fuch  as  are  afflicted with
an afthma, efpecially in  the decline of life.   Some-
times the inflammation  reaches to  one lobe of the
lungs only,  at other times  the  whole  of the organ
is affected;  in which cafe the difeafe can hardly fail
to prove fatal.
   When the difeafe proceeds from a vifcid pituitous
matter obftructing the veffels of the lungs, it is called
a fpurious or bafiard peripneumony.   When  it arifes
from a thin acrid defluction on the lungs, it is deno-
minated a catarrhal peripneumony,  &c.
   CAUSES.----An  inflammation of the  lungs u
fometimes a primary difeafe, and fometimes it is the
confequence of other difeafes,  as a  quinfey, a pleu-
rify, &c.  It proceeds from  the  fame caufes as the
pleurify, viz. an obftructed perfpiration from cold,
wet .clothes,  &c. or from an increafed circulation of
the blood by violent exercife,  the  ufe of fpiceries,
ardent fpirits, and  fuch  like.   The pleurify and  pe-
ripneumony are  often complicated ; in which cafe the
difeafe is called a pleuro-peripneumony*.

   *  The fact is, that it is  difficult to diftinguifh between a
pleurify and peripneumony ; and the fame treatment is proper
for both.
                                           SYMP- 
 176          OF A PERIPNEUMONY.
   SYMPTOMS.—Moft of the fymptoms of a pleu-
 rify likewife attend an inflammation of the lungs; only
 in the latter the pulfe is more foft, and the pain lefs
 acute ; but the  difficulty of breathing, and oppreffion
 of the breaft, are generally greater.
   REGIMEN.—As the  regimen and medicine are
 in all refpects the fame in the true peripneumony as
in the pleurify, we  fliall not here repeat  them,  but
refer the reader to  the treatment of that difeafe.  It
may not, however, be improper to add, that the ali-
ment ought to  be more flender and thin in this  than
in any other inflammatory difeafe.  The learned Dr.
Arbuthnot afferts, that even common whey is  fuffi-
cient to  fupport the patient, and that decoctions of
barley,  and infufions of fennel roots in warm water,
with  milk  are  the moft proper  both  for  drmk and
nourifhment.   He likewife recommends the fleam of
warm water taken in by the breath, which ferves as
a kind of internal fomentation.   If  the  patient has
loofe ftools, but is not weakened by them, they are
not to be flopped,  but rather promoted by the ufe
of emollient  clyIters.
   It has already been obferved, that the fpurious or
baflard peripneumony is occafioned by a vifcid. pitui-
tous matter obftructing the  veffels of the lungs.  It
commonly attacks the old, infirm, and phlegmatic, in
winter and wet feafons.
   The patient  at the  beginning is cold  and hot by
turns, has a fmall quick pulfe, feels a fenfe of weight
upon his breaft, breathes with difficulty,  and fome-
times complains of a pain and giddinefs of his head.
His urine is ufually pale, and his colour very  little
changed.
   The diet in  this, as well  as in the true peripneu-
mony, muft be very flender, as weak broths, fharp-
ened  with  the  juice of orange  or lemon, and  fuch
                                             like.
                        i 
             OF A PERIPNEUMONY.           ^%
 like.  His. drink may be thin water-gruel, fweetened
 with honey, or a decoction of the roots of fennel and
 liquorice.  An ounce of each of thefe may be boiled
 in three pints of water to a quart, and iharpened with
 a little currant-jelly or the like.
   Bleeding and purging are generally proper at the
 beginning of this difeafe.  It will  be  fufficient to
 affift the expectoration^ by feme of the medicines re-
 commended for  that  purpofe  in the pleurify,  as the
 folution of gum  ammoniac  with oxymel  of fquills,
 &c.   Bliflering  plafters have generally a good effect,
 and  ought to be applied pretty early.
   If the patient does not  fpit,  he  muft  be bled
 according  as his ftrength will permit,  and  hrve a
 gentle purge  adminiftered.   Afterwards  his body
 may be kept open by clyfters, and the expectoration
 promoted, by taking every four hours  two table-
 fpoonfuls of the iblution mentioned above.
   When an  inflammation of the  bread  does not
 yield to bleeding, bliflering, and other evacuations,
 it commonly ends  in  a  fuppuration,  which is more
 or lefs dangerous, according to the part where it  is
 fituated.  When this happens in the pleura, it feme-
 times breaks outwardly, and the matter is difcharged
 by the wound.
  When  the fuppuration  happens within  the fub-
ftance or body of the lungs, the  matter may be dif-
charged by expectoration; but if the matter floats in
the cavity of the breaft, between the pleura and the
lungs, it  can only be  difcharged by an incifion made
betwixt the ribs.
  If the  patient's ftrength does not return, after the
inflammation is,  to all appearance,  removed ;  if his
pulfe continues quick,  though  foft,  his breathing
difficult and oppreffed ;  if he has cold fhiverings at
times,  his cheeks flufhed, his lips  dry ;  and if he
complains of thirft, and want of appetite, there is
                        N                 reafon 
178            OF CONSUMPTIONS.
reafon to fear a fuppuration, and that a phthifis,  or
confumption of the lungs  will enfue.    We fliall,
therefore, next proceed to  confider the proper treat-
ment of that difeafe.
CHAP.    XVIII.
                Of Confumptions*


          A CONSUMPTION is  a wafting or
decay of the whole body,  from an ulcer, tubercles,
or concretions of the lungs, or an. empyema.
   Dr.  Arbuthnot  obferves that, in his  time, con-
fumptions made up  above one-tenth   part  of the
bills of mortality, in and about London.  There is
reafon  to believe they have rather  increafed fince;
and we  know  from experience,  that  they  are not
lefs fatal in fome other towns of England,  than in
London.
   Young perfons, between the age of fifteen and
thirty, of a flender make, long neck, high fhoulders,
and flat breafts, are  moft liable to this  difeafe.
   Confumptions prevail  more  in  England  than in
any other part of the world,  owing, perhaps, to the
great ufe of animal food, and the general application
to fedentary employments.   To which  we may add,
the perpetual changes in  the atmofphere, or  varia-
blenefs of the weather.
   CAUSES.—It  has already  been obferved, that
an inflammation of  the breaft often ends in an im-
pofthume : confequently,  whatever difpofes  to this
                                          difeafe, 
               OF CONSUMPTIONS.            i7^
 difeafe, muft likewife  be confidered  as*a  caufe of
 confumption.
   Other difeafes, by  vitiating the habit, may like-
 wife occafion confumptions; as the fcurvy, the fcro-
 phula, or king's evil, the venereal difeafe, the afthma,
 fmall-pox, mealies, &c.
   As this  difeafe is too  feldom cured, we  fhail en-
deavour the more particularly to point out its caufes,
in order that  people may be enabled  to avoid it.
 Thefe are :
   -----Confined or unwholefome  air.   When this
 fluid  is impregnated with the fumes of metals, or
 minerals,  it proves  extremely hurtful to the lungs,
 and often corrodes  the tender veffels of that necef-
 fary organ.
   -----Violent paflions, exertions or affections of the
mind^  as  grief,  difappointment, anxiety,  or clofe
application to the ftudy of abftrufe arts or fciences.
   -----Great evacuations;  as fweating, diarrhoeas,
diabetes, exceffive venery, the fluor albus,  an over-
difcharge  of the  mcnftrual flux,  giving fuck too
 long, &c.
   -----The fudden  floppage  of cuftomary evacua-
tions ; as  the  bleeding piles,  fweating  of the feet,
bleeding at  the nofe, the menfes, iffues, ulcers,  or
eruptions of any kind.
   -----Injuries done to the lungs, calculi, &c.   I
lately faw  the  fymptoms of  a   phthifis occafioned
by a  fmall bone  fticking in the bronchia.   It was
afterwards vomited along  with a confiderable quan-
tity of  purulent matter, and the patient, by a pro-
per regimen, and" the   ufe  of the Peruvian bark,
recovered.
   -----Making a fudden  tranfition from a  hot to a
 very cold  climate, change of apparel,  or whatever
 greatly leffens the perfpiration.
N 2
---Fre- 
 i8o            OF CONSUMPTIONS.
   -----Frequent and exceffive  debaucheries.   Late
 watching, and drinking ftrong  liquors, which gene-
 rally go together, can hardly fail to deftroy the lungs.,
 Hence the bon compagnon generally falls a facrifice to
 this difeafe.
   -----Infection.  Confumptions are likewife caught
 by fleeping with  the difeafed ; for which reafon, this
 fliould be carefully avoided.   It cannot be of great
 benefit to the fick, and muft  hurt  thofe in  health.
   -----Occupations in life.    Thofe artificers who
 fit much, and are conftantly leaning forward, or pref-
 ling upon the ftomach and breaft, as  cutlers, taylors,
 flioe-makers, feamftreffes, &c. often die of confump-
 tions.  They likewife prove  fatal  to fingers,  and all
 who have occafion  to make frequent and  violent
 exertions of the.lungs. *
   -----Cold.  More  eonfumptive patients date the
 beginning of their diforders from wet feet,  damp
 beds, night air,  wet clothes, or catching cold after
 the body had been heated, than  from all other caufes.
   Sharp, faline, and  aromatic  aliments,  which heat
 and  inflame  the  blood, are  likewife  frequently the
 caufe of confumptions.
   We fhail only add, that this difeafe is often owing
 to an hereditary  taint, or a fcrophulous habit.
   SYMPTOMS.—This   difeafe   generally  begins
 with a  dry  cough,  which often  continues for fome
 months.   If a  difpofition  to vomit  after  eating be
 excited  by it, there is ftill greater reafon  to fear an
 approaching  confumption.   The  patient  complains  ,
of a more than ufual degree  of heat, a pain and op-
 preffion  of the breaft, efpecially' after motion; his

  * An eminent phyfician of our country (Dr. Rufli) is,
however, of a different opinion, and recommends finging as a
 cure ior this dife ife.  See his Medical Inquiries and Obferva-
rjons.
fpittle 
OF CONSUMPTIONS.
181
fpittle is of a faltifh tafte, and fometimes mixed  with
blood.   He is apt  to  be fad ; his appetite is  bad,
and his thfrft great.  There is  often a quick,  foft,
fmall pulfe ; though fometimes the  pulfe is pretty
full,  and rather  hard.   Sometimes  it is  fmall and
hard.   Thefe are the common fymptoms of a begin-
ning confumption.
  Afterwards,  the  cough  increafes,  the  patient
begins  to fpit a greenifh,  white,  or bloody matter.
His body is extenuated by the  hectic fever,  and
colliquative fweats, which mutually fucceed  one an-
other,  viz.  the one towards night, and the other in
the morning.  A loofenefs, and an exceffive difcharge
of urine, are often  troublefome  fymptoms at this
time, and greatly weaken the patient.  There  is  a
burning heat m the palms of the hands, and the face
generally flufhes  after eating;  the  fingers  become
remarkably fmall, the  nails  are bent inwards,  and
the hairs fall off.
  At laft a diarrhoea,  the fwelling of the feet .and
legs, the total lofs of ftrength, the finking  of the
eyes,  the difficulty of fwallowing, and the coldngfc
of the extremities,  fhew the immediate approach of
death,  which, however, the patient feldom believes
to be fo near.   Such is the ufual progrefs of this
fatal difeafe, which, if not early checked,  commonly
fets all medicine at defiance.
  REGIMEN.—On the firft appearance  of a con-
fumption, if the patient lives in a large town, or any
place where the air is confined, he ought immediately
to quit it, and to make choice of a  fituation in  the
country,  where the air is pure and free.  Here he
muft not  remain inactive, but take every day as much
exercife as he can bear.
  The beft method of taking  exercife is to  ride on
horfeback,  as this gives the body a great  deal  of
motion without much fatigue'.   Such as cannot  bear
                       N  3                  this 
 i$2            OF CONSUMPTIONS.
 this kind of exercife,  muft make ufe of a  carriage.
 A long journey, as it amufes the mind by a continual
 change of obje&s, is  greatly preferable to riding the
 fame ground over and over.   Care, however,  mufl
 be taken to avoid catching cold  from wet clothes,
 damp beds, or  the like.   The patient ought always
 to finifh his ride in the morning, or at leaft before  .
 dinner ;  otherwife it will oftener do harm than good. *
   It is a pity that thofe who attend  the fick feldom
recommend riding in this  difeafe, till the patient is
 either unable to bear  it,  of the  malady has become
 incurable,  Patients  are likewife  apt to trifle  with
every thing that is in their own power.  They can-
 not fee how one of the common actions of life fhould
 prove a  remedy in an obflinate difeafe, and therefore
 they reject  it, while  they greedily hunt  after relief
from medicine, merely becaufe they do  not under-
ftand it.
   Thofe who have  ftrength  and  courage to under-
take a pretty long voyage, may expect great advan-
 tage from- it.    This,  to my knowledge, has fre-
quently  cured a confumption after the patient  was,
 to  all appearance, far advanced in that difeafe, and
where medicine had proved ineffectual.   Hence it is
reafonable to conclude, that if a voyage were under-
 taken in due time,  it would feldom fail  to perform a
cure. *
   Such  as try this method of cure,  ought to carry
as much frefh provifions along with them as will ferve

  * Two things chiefly operate to prevent the benefits which
would strife from failing.   The one is, that phyficians feldom
order it till the difeafe is too far advanced ; arid the other is,
that they feldom order a voyage of fufficient length. A patient
may receive no benefit by eroding the channel, who, fhould
he crofs  the Atlantic, might be completely cured.  Indeed,
we have reafon to  believe, that a voyage of this kind, if taken
in due time, would feldom 'fail to cure a confumption.
                                                for 
               OF CONSUMPTIONS.            183
for the whole time  they are at fea.  When milk is
nol eafily to be obtained in this fituation, they ought
to live upon fruits, and the broth of chickens or other
young animals which can be kept alive on board.  It
is fcarcely neceffary to add, that fuch voyages fhould
be undertaken, if poffible, in the mildeft feafon, and
that  they ought to be towards a warmer climate. *
   Thofe who  have not courage for a long voyage,
may  travel  into  a  more fouthern  climate,  as  the
fouth of France, Spain, or  Portugal;  and if they
find  the air  of thefe countries agree with them, they
fhould continue  there,  at leaft till their health  be
confirmed, f
   Next to  proper air  and exercife, we would  re-
commend a due  attention  to diet.   The patient
fliould eat nothing that  is either heating or hard of
digeftion, and his drink muft be  of a foft and cool-
ing nature.   All  the  diet ought to be  calculated to
leffen the inflammatory ftate of the fyftem,  and to
nourifh and fupport the patient.   For this  purpofe
he muft keep  chiefly to the ufe of vegetables  and
milk.  Milk alone is of more  value in  this difeafe,
than the whole materia medica.
   Affes  milk  is  commonly reckoned preferable "to
any  other ;  but it cannot always  be obtained ;  be-
fides, it is generally taken in a very fmall quantity  ;
wnereas, to produce*any effects,  it ought to make a
confiderable part  of the  patient's diet.   It  is hardly
to be expected, that a gill or two of affes milk, drank
 •
   *  Though  I did not  remember to have feen one inftance
of a  genuine  confumption of the lungs cured  by medicine,
yet I have known  a Weft India voyage work wonders in
that  dreadful diforder.
   f  For Americans, we may recommend the fame voyage, if
practicable.  If not,  they may go to* the fouthern ftates in win-
ter, and to the eaftern ftates in fummer.   If a journey by land
is preferred, the back parts of our country are the beft.
                        N 4                      in 
184           OF CONSUMPTIONS.
in the fpace of twenty-four hours,  fhould. be able to
produce any confiderable  change in an  adult;  and
when people  do not perceive its effects  foon, they
lofe hope,  and fo leave  it  off.   Hence  it happens,
that this remedy, however valuable, very feldemr. per-
forms a cure.   The reafon  is  obvious; it  is com.
monly ufed too late, is taken in too fmall quantities,  ,
and is not  duly perfifted in.
   I  have  known  extraordinary effects:  from  affes
milk  in obflinate coughs,  which  threatened a  con-
fumption of the lungs ; and do verily believe, if ufed
at this period, that it would feldom fail; but if it be
delayed till an ulcer is formed, which is generally the
 cafe, how can it be expected to fucceed ?
   Affes milk ought to be drank,, if poffible, in its na-
 tural warmth, and, by a grown perfon,.  in the quan-
 tity of half a pint at a time;  Inftead of taking this.
quantity night and morning: only,, the patient ought
 to ta<ke it four times;, or at leaft thrice a^day, and to.
 eat a little light bread along with it, fo  as: to make it
 a kind of meal.
   If the  milk fliould happen to purge, it: may be
 mixed with old conferve- of rofes. ^ When that caiiK
 not- be obtained, the powder of  crabs claws may be
 ufed in its ftead.  Affes  milk  is  ufually ordered to.
 be drank warm -in bed;  but  as it  generally rhrcogs.
 the-patient into  a fweat when: taken  in this way,  it'
 would perhaps be  better to give it after he  rifes.
   Some extraordinary cures  in  confumptive  cafes
 have been performed by women's milk.   Could this
 be obtained in fufficient quantity, we would, recom-
 mend it in preference to any other.   It  is  better  if
 the patient can. fuck it from the breaft, than to  drink
 it afterwards.   I knew a man who was reduced  to
 fuch a degree of weakn^efs in  a  confumption, as not
 to be able to turn himfelf in bed.   Plis wife was  at
 that time  giving fuck,  and; the child happening  to
                                               die, 
              OF CONSUMPTIONS.      v     i&5
die, he fucked her breaft, not  with a view to reap
any advantage from  the milk, but to make her eafy.
Finding himfelf, however, greatly benefited by it, he
continued to  fuck her  till he became perfectly well'
and is at  prefent a ftrong and healthy man.
  Some prefer butter-milk to any other, and it is in-
deed a very valuable medicine, if the ftomach be able
to bear it.  It docs  not agree; with  every perfon at
firft ; and is therefore often laidi afide without a fuffi*
cient triah  It fhould at firft be taken fparingly, and
the quantity  gradually increafed, until it comes to
be almoft the fole food.  I never knew it fucceed un-
lefs where the patient almoft lived upon it.
   Cows milk is  moft  readily  obtained of any, and
though it be not fo eafily digefted  as  that of affes
or mares, it may: be rendered lighter by adding to
it an equal quantity of water, or allowing it to ftand
for feme hoursj, and afterwards taking off the cream.
If it fhould,  notwithftanding^,   prove heavy On  the
ftomach, a fmall quantity of  brandy,  with  a little
fugar, may be added, which will render it both more
light and notirifhing.
   It is not to be wondered at, that milk  fhould for
fome time difagree with a ftomach that has not been
accuftomed to digeft any thing but fiefe. and  ftrong
liquors,  which is the cafe with many of thofe who
fell into  confumptions.   We do not, however, advife
thofe who. have  been accuftomed to  animal  food?
and ftrong liquors, to leave them  off  all at once.
This might be dangerous.  It will  be  neceffary for
fuch  to  eat a little once  a-day of  the flefh of fome
young animal, or rather  to ufe the broth made of
chickens, veal,   lamb, or fuch like.  They  ought
likew^e  to drink a little wine made into  negus, or
diluted with twice  or  thrice  its quantity of water,
 and to make it gradually weaker till they can leave
 it off altogether.
                                            Thefe 
 *86      .      OF CONSUMPTIONS.
   Thefe muft be ufed only as preparatives to a diet
confifling chiefly of milk. and vegetables^ which the
fooner the patient can be brought to bear, the better.
Rice and milk, or  barley and  milk,  boiled  with a
little fugar, is very proper food.  Ripe fruits roafted,
baked, or boiled, * are likewife proper, as goofeberry
or currant tarts,  apples  roafted, or boiled  in milk,  ¥
&c.    The jellies, conferves  and preferves,  &c.  of
ripe  fubacid fruits, ought to  be eaten  plentifully,  as
the jelly of currants, conferve of rofes,  preferved
plums, cherries, &c.
   Wholefome air, proper exercife,  and a diet con-
lifting  chiefly of thefe  and other vegetables,  with
milk, is the only courfe that  can be depended on  in  ,
a beginning confumption.
   In a populous town  in  England, *  where con-
fumptions are very common, I have frequently feen
confumptive  patients, who  had  been  fent to the
country with orders to ride, and live upon-milk and
vegetables, return in  a few months quite plump, and
free  from any complaint.  This indeed was not  al-
ways the cafe, efpecially when the difeafe was here-
ditary, or far advanced ; but it was the only method
in which fuccefs was  to be expected : where it failed,
I never knew medicine fucceed.
   If the patient's ftrength and fpirits  flag, he mufl
be fupported  by ftrong broths, jellies,  and fuch
like.   Some  recommend  fhell-fifh in this diforder,
and  with fome reafon,  as they are nourifhing and
reftorative. f   All the food and drink ought, how-
ever, to be  taken in fmall quantities, left an over-
charge of frefh  chyle   fliould  opprefs the lungs,

  *  Sheffield.                                 j
  •f I have often known perfons of a confumptive habit, where
fhe fymptoms were not violent, reap great benefit from the ufe
cf oyfters.  They generally ate them raw, and drank the juice
along with them.
                                              and 
              OF CONSUMPTIONS.            187
and  too  much  accelerate  the  circulation of  the
blood.
   The patient's  mind ought to be kept as eafy  and
cheerful as poffible.  Confumptions are often occa-
fioned, and always aggravated, by a melancholy  caft
of mind ; for which reafon mufic, cheerful company,
and every  thing  that infpires  innocent mirth,  are
highly beneficial.   The patient  ought feldom  to be
left alone, as brooding  over his calamities  is fure to
render them worfe.
   MEDICINE.—Though  the cure of this  difeafe
depends, in a great meafure, upon regimen and  the
patient's own endeavours,  yet  we fhail mention  a
few things which may be of fervice in relieving fome
of the more violent fymptoms.
   In  the frit ftage of a  confumption, the cough
may often be appeafed by  bleeding,  to be ufed in
fmall  quantities, and  repeated,  occafionally,  while
the pulfe requires it:  at the fame time the patient
fhould live on a  milk and vegetable diet, take gen-
tle exercife,  ufe country air,  and apply  a  blifter
to any part of the breaft where there is moft pain,
take cooling laxatives; in  fhort, ufe all the means
to leffen inflammation.
   It is too common in this ftage of the difeafe to load
the patient's  ftomach  with oily  and balfamic medi-
cines.   Thefe, inftead of removing the caufe of  the
difeafe,  tend rather to  increafe  it, by  heating  the
blood, while they pall the appetite, relax the folids,
and prove every  way hurtful to the patient.  What-
ever is ufed for removing the cough, befides riding,
and other proper regimen, ought to be medicines of
a calming nature, as,   for  example,  the paregoric
mixture.   (Vide Appendix.) { &f
   Acids feem to have peculiarly good effects in  this
difeafe;  they both  tend to quench  the patient's
thirft, and to cool  the blood.  The vegetable acids,
                                               as 
 r88           OF CONSUMPTIONS.
 as apples, oranges, lemons, &c.  appear  to  be the
 moft proper.   I  have known patients fuck the juice
 of feveral lemons and oranges every day with mani-
 feft advantage, and would for this reafon recommend
 acid vegetables to  be taken in  as  great quantity as
 the ftomach will bear them.
   For the patient's drink we  fhould  recommend  »
barley-water,  rennet-whey,  toaft  and water,  &c.
Thefe may be drunk at pleafure.   They at the fame
 time anfwer all the purpofes of dilution, and quench
thirft: much better  than thing3 that are lufcious and
fweet.   If the patient fpits blood, the feme  are pro*
per for his ordinary drink.
   There  are  many  other mucilaginous  plants and
feeds, of an healing and  agglutinating nature,, from
which  decoctions  or  infufions  may  be  prepared
with the fame intentions;  as the orchies, the quince-
feed, coltsfoot, lintfeed, farfapariila, &c.  It is not
neceffary to mention the different ways  in which
 thefe  may be  prepared.   Simple infufion or boiling
 is all that is neceffary, and the dofe may be at di£
cretion.
   The conferve of rofes is  here  peculiarly  proper.
 It may either be  put into the decoction above de-
fcribed, or eaten by itfelf.  No benefit is to be ex<
pected from trifling dofes of this medicine.   I never
knew it of any fervice, unlefs where three  or four
ounces  at  leaft  were  ufed daily for a confiderable
time.  In this way I have feen it produce very happy
effects, and would  recommend it wherever there is a
difcharge of blood  from the lungs.
   When the fpitting up of  grofs mutter, oppreffion
of the breaft, and the hectic fymptoms, fhew that an
impofthume is ^JfeTtd in the  lungs, fix grains of
ipecacuanha taken  every other morning before rifing,
and continued for  about  a week,  will  be of  great
fervice;  it will vomit gently.   The vitriolic  mucila-
                                            ginous 
          .    OF CONSUMPTIONS.           189
gimus mixture (fee  Appendix) is alfo  now of great
fervice, and the paregoric mixture is to be continued,
and Peruvian bark.
   An ounce of the bark m powder may be divided
into eighteen or twenty dofes, of which one may be
taken every three hours through the day, in a little
fyrup, or a- cup of horehound tea.
   If the bark  fhould happen to  purge, it may be
made into an electuary,  with the conferve of rofes,
thus, Take old conferve of rofes a quarter of a
pbund, Peruvian bark in powder an ounce, fyrup of
orange  or lemon,  as much  as  will make it of  the
confidence of  honey.  This  quantity will ferve  the
patient  four or five days, and may be repeated as
there is occafion.             •
   Such as cannot take the bark in fubftance,  may
infufe  it in cold water.  Half an  ounce of bark in
powder may be infufed for twenty-four hours in half
a pint of water.  Afterwards  let an ordinary tea-
cupful of it be taken three or four times a-day.
   We would  not  recommend the bark while  there
are any fymptoms of an inflammation of the breaft ;
but  when it is certainly  known that matter is collect-
ed there, it is one of the beft medicines  which can
be ufed.   Few patients indeed  have  refolution
enough to give the bark a'fair trial at this period of
the difeafe, otherwife we have reafon  to believe that
fome benefit might be  reaped from it.  As long as
the bark occafions no difficulty  of breathing it may
be taken to advantage.  The tar water and tar pills
(fee AppendixJ are very ufeful medicines.  If the
patient has a fixed pain about the fternum very con-
fiderable benefit will be derived by a cauftic to the
part.   After the matter is formed, and the expecto-
 ration has come on, the- vitriolic  and paregoric mix-
 tures and bark are to be continued to  the clofe of the
 difeafe.
Whrv 
 *9°            OF CONSUMPTIONS.
   When it is evident that there is an impofthume iri
 the breaft, and the matter can neither be fpit up
 nor carried off by abforption,  the  patient may draw
 in the fleams of warm water or vinegar with his
 breath,  &c.   When  it happens to burft within the
 lungs, the  matter may be difcharged by  the mouth.
 Sometimes indeed  the  burfting of  the .vomica oc-
 cafions immediate death, by fuffocating the patient.
 When the quantity of matter is great, and the pa.
 tient's ftrength exhaufted, this is commonly the cafe.
 At any rate the patient is ready to fall into a fwoon,
 and fhould have volatile falts or  fpirits  held to his
 npfe.
   If the  matter difcharged be thick,  and the  cough
 and breathing  become  eafier,  there  may be  fome
 hopes of a cure.  The diet at this time ought to be
 light, but reftorative, as  chicken-broths, fago-gruel,
 rice-milk, &c.  the  drink, butter-milk,  or  whey,
 fweetened  with honey.  This is  likewife a proper
 time for ufing the Peruvian  bark,  which may be
 taken as  directed above.
   If the  vomica or impofthume fliould difcharge it-
 felf into  the cavity  of the breaft, betwixt the  pleura
 and the lungs,  there is no way of getting the matter
 out but by an incifion, as has already been obferved.
 As this  operation muft always  be performed by  a
 furgeon,  it is not neceffary here to defcribe it.  We
 fhail only add,  that it is  not  fo  dreadful as people
 are apt to  imagine, and that it is the only chance
 the patient in this cafe has for his  life.

   A NERVOUS  CONSUMPTION is a wafting
 or decay  of the whole body,  without any confider-
able degree of fever, cough, or difficulty of breathing.
It  is attended with indigeftion, weaknefs, and want
 of appetite, &c.
Thofe 
              OF CONSUMPTIONS.            t9i
   Thofe who are of a fretful temper, who indulge
in fpirituous liquors, or who breathe an unwholefome
air, are moft liable to this difeafe.
   We would  chiefly recommend,  for  the cure of a
nervous  confumption, a  light and nourifhing diet,
plenty of exercife in a free open air, and the ufe of
fuch  bitters as brace  and ftrengthen  the  ftomach;
as the Peruvian bark, gentian root, camomile, hore-
hound, &c.  Thefe may be infufed in water or wine,
•and a glafs of it drank frequently.
   It will greatly  affift the digeftion, and promote the
cure  of this difeafe, to take twice a-day twenty or
 thirty drops of the elixir of vitriol in a glafs of wine
 or water.  The chalybeate wine is likewife an ex-
 cellent medicine in this cafe.   It ftrengthens the fo-
 lids,  and powerfully  affifts nature  in the preparation
 of good blood. *
   Agreeable  amufements,  cheerful  company,  and
 ridirig about,  are,  however,  preferable to all medi-«
 cines in this difeafe.   For  which reafon,  when the
 patient  can afford it, we would  recommend a long
journey of pleafure,  as the moft likely means to re-
 flore his health.
   What is called a fymptomatic  confumption  cannot
 be cured without firft removing the difeafe by which
 it is occafioned.  Thus, when  a confumption proceeds
 from  the  fcrophula or king's evil, from the fcurvy,
 the afthma, the venereal difeafe, &c. a due attention
 muft be paid  to the malady from whence it arifes,
 and  the regimen and medicines directed accordingly.
   When exceffive evacuations of any kind occafion a
 confumption,* they muft not  only be  reftrained, but
 the patient's ftrength muft be reftored by  gentle ex-
 ercife, nourifhing diet, and generous cordials.  Noting
 and delicate mothers often fall into confumptions  by

           * See Appendix,  Chalybeate wine.
                                            giving 
 i$2        OF THE NERVOUS FEVER.
 giving fuck too long.  As foon  as they perceive their
 ftrength and appetite begin to fail, and are troubled
 with chills and fevers, or a pain or  weaknefs of. the
 breaft, they ought immediately  to wean the child, or
 provide another nurfe, otherwife they cannot expeft
 a cure.
   Before we quit  this fubject, we would  earneflty
 recommend it to all, as they wifh to avoid confump-
 tions, to take  as much  exercife  without  doors as
 they can, to avoid unwholefome air, and*to fludy fo;-
briety.   Confumptions owe their prefent increafe not
a little to the fafhion of fitting up  late,  eating hot
fuppers,  and fpending every  evening over a bowl of
hot punch  or other ftrong  liquors.  Thefe liquors,
when too  freely ufed, not only hurt the digeftion,
and fpoil the  appetite,  but heat  and inflame the
blood,  and fet  the whole conftitution on fire.
                  CHAP.  XIX

           Of the Slow or Nervous Fever.


       JNeRVOUS fevers have increafed greatly
of late years amongft tis, owing doubtlefs»to our dif-
ferent manner of living, and the increafe of fedentary
employments; as they commonly attack perfons of a
weak relaxed habit, who neglect exercife, eat little fo-
lid food, fludy hard, or indulge in fpirituous liquors.
  OiAUSES.—Nervous fevers may be  occafioned
by  whatever  depreffes the fpirits^or  impoverifhes
the blood; as grief,  fear, anxiety, want of  fleep, in-
tenfe thought,  living  on poor watery  diet, unripe
                          4                 fruits, 
           OF THE NERVOUS  FEVER.        193
fruits,  cucumbers, melons, &c.   They may likewife
be occafioned  by  damp, confined,  or unwholefome
air.  Hence they prove moft fatal to thofe who live
in dirty low houfes, crowded ftreets, hofpitals, jails,
or fuch-like places.
  Perfons whofe conftitutions have  been broken by
exceffive venery, frequent falivations, too free an
ufe of purgative medicines, or by any other exceffive
evacuations, are moft liable to this difeafe.
  Keeping on wet clothes, lying on the damp ground,
expofure  to  the  night  air, exceffive fatigue, and
whatever obftructs the  perfpiration,  may likewife
occafion nervous fevers.  We  fhail only add, fre-
quent  and great irregularities  in diet.  Too great
abftinence as  well as  excefs, is hurtful.  Nothing
tends fo much to preferve the body  in a found  ftate
as a regular diet;  nor can any thing contribute more
to occafion fevers  of  the worft kind than its oppo-
fite.
   SYMPTOMS.—Low  fpirits, want of appetite,
weaknefs, wearinefs after motion, watchfulnefs, deep
fighing, and dejection  of mind, are generally the
forerunners of this difeafe.  Thefe  are fucceeded by
a quick low pulfe,  a dry tongue without any confi-
derable thirft, chillinefs, and flufhing in turns, &c.
   After fome time the patient complains  of a giddi-
nefs and pain of the head, has a naufea,  with retch-
ings and vomiting; the pulfe is quick, and fometin.es
intermitting ;  the urine  pale, refembling dead  fmall
beer, and the breathing is difficult, with oppreffion
of the breaft,  and flight alienations  of mind.
   If towards the ninth,  tenth, or  twelfth day, the
tongue becomes more moift, with a  plentiful fpitting,
a gentle purging, or a moifture upon the fkin ; or if a
fuppuration happens in one or both ears, or  large
puftules break out about  the lips and  nofe, there is
reafon to hope for a favourable crifis.
                         O                    But 
 fQ4        OF THE NERVOUS FEVER.
   But  if there is an exceffive loofenefs, or  wafting
 fweats, with frequent fainting  fits ;  if the  tongue,
 when put out  trembles  exceffively, and  the extre-
 mities feel cold, with  a  fluttering  or flow creeping
 pulfe ;  if there is a ftarting of the tendons, an almoft
 total lofs of fight and hearing, and  an involuntary
 difcharge by ftool and urine, there  is reafon to ap-
 prehend confiderable danger.
   REGIMEN.—It is very neceffary in  this difeafe
 to keep the patient cool and  quiet.   The leaft mo-
 tion would fatigue him,  and will be  apt  to occafion
 wearinefs, and even faintings.   His mind ought not
 only to be kept eafy, but foothed and  comforted.
 Nothing is more  hurtful in low fevers of this kind
 than prefenting to the patient's  imagination  gloomy
 or frightful ideas.  Thefe of themfelves often occa-
 fion  nervous fevers,  and it is not to be doubted but
 they will likewife aggravate them.
   The patient muft not be kept too low. His ftrength
 and fpirits ought  to be fupported by nourifhing diet,
 and generous cordials.  For this purpofe  his gruel,
 panada, or whatever food he takes, muft be mixed with
 wine according as the fymptoms may require. Pretty
 ftrong  wine-whey, or fmall  negus, fharpened with
 the juice of orange or  lemon, will be proper for his
 ordinary drink.  Muftard-whey  is  likewife  a very
 proper  drink in this fever,  and may be rendered an
 excellent cordial medicine by the addition of a proper
 quantity of white-wine*.
  Wine in  this difeafe,  when genuine, is often al-
moft the only medicine that  is neceffary.   Good
 wine poffeffes all the virtues of the cordial  medicines,
while it is free from many of their bad qualities.  I
fay good wine, for however common this article of
luxury is now become, it is too feldom  to be ob-

            * See Appendix, MufarJ-whey.
                                           tained 
           OF THE NERVOUS FEVER.        195
 tained genuine, efpecially by the poor,  who are ob-
 liged to purchafe  it in fmall quantities.
   I have often feen patients  in  low nervous fevers
 where the pulfe could hardly be felt, with a conftant
 delirium, coldnefs of  the extremities,  and  almoft
 every  other  mortal  fymptom,  recover  by ufing in
 whey, gruel,  and negus, a bottle or two  of ftrong
 wine  every  day.  Good old  found Madeira, or
 Sherry, are the beft,  and may  be made into negus,
 or given alone, as circumftances require.
   In  a word,  the great aim in this difeafe is to fup-
 port the patient's ftrength, by giving him frequently
 fmall quantities of the  above, or other  drinks of a
 warm and  cordial nature.   He is not,  however,
 to be over-heated, either with  liquor  or  clothes ;
 and his food ought to  be light, and given in fmall
 quantities.
   MEDICINE.—Where a naufea, load,  and fick-
 nefs at ftomach, prevail at the beginning of the fever,
 it will be neceffary to give the patient a gentle vomit.
 Fifteen or twenty grains of ipecacuanha  in fine pow-
 der, or a few fpoonfuls of the vomiting julep *, will
 generally anfwer this purpofe very well.  This  may
 be repeated any time before the third or fourth day,
 if the above  fymptoms continue.   Vomits  not only
clean  the ftomach, but, by the general fliock which
they give, promote the perfpiration,  and have many
other excellent effects in flow fevers, where there are
no figns of inflammation.
  Such as dare not venture upon a vomit, may clean
the bowels by a fmall dofe of Turkey rhubarb, or an
infufion of fenna and manna.
  In  all  fevers, the great point is to  regulate  the
fymptoms, fo as to prevent them from  going to ei-
ther extreme.   Thus,  in  fevers  of the inflammatory

           *  See  Appendix, Vomiting Julep.
                      Q 2                  kind, 
196        OF THE NERVOUS FEVER.
kind, where the force of the circulation is too great,
and the fibres too rigid,  bleeding  and other evacua-
tions are neceffary.   But in nervous fevers, where
nature flags,  where the folids are relaxed, the lancet
muft be fpared, and wine, with other cordials, plenti-
fully adminiftered.
   Though bleeding  is  often  improper in  this  dif-
eafe, yet bliftering is highly  neceffary.  Bliftering-
plafters  may be applied at  all times  of the  fever
with great  advantage.  If the patient is delirious,
he ought to be bliftered on  the neck or head,  and
it will be  the  fafeft  courfe, when  the infenfibility
continues,  as foon as the difcharge  occafioned by
one bliftering-plafter  abates,   to  apply  another to
fome  other  part of  the body, and by that means
keep up a continual fucceffion of them, till he be
out of danger.
   I  have  been more fenfible of the  advantage of
bliftering in  this than in any other  difeafe.   Blifter-
ing-plafters not only flimulate  the  folids to action,
but likewife occafion a continual difcharge, which
may,  in fome meafure, fupply the  want of critical
evacuations,  which feldom  happen  in this  kind of
fever.   They are moft  proper, however, either to-
wards the beginning,  or after feme  degree of ffupor
has come  on, in which  laft  cafe  it   will always be
proper to blifter the head.
   If the patient is coftive through the courfe of the
difeafe,  it  will be  neceffary to procure a ftool, by
giving him every  other day  a clyfter of milk  and
water, with a little fugar; to which may be added,
a fpoonful of common  fait, if the  above does  not
operate.
   Should  a  violent loofenefs  come on, it  may be
checked by fmall quantities of laudanum, or giving the
patient for his ordinary drink the white decoction*.
           * See Appendix, White doecilion.
                                           A mili- 
           OF THE NERVOUS FEVER,         i9j
   A miliary  eruption  fometimes  breaks out  about
the ninth or tenth day.   As eruptions are often cri-
tical,  great care fhould be taken not to retard Na-
ture's  operation 'in  this particular.   The eruption
ought  neither  to be checked  by evacuations, nor
pufhed  out by  a  hot  regimen; but  the p:t:ient
fhould be ftipported  by gentle cordials,  as  vine-
whey,  fmall negus,  fago-gruel with a little wine in
it, and fuch like.  H^  ought not to be  keot too
warm ; yet a  kindly breathing fweat fliould  by no
means  be checked.
   Though bliftering and the ufe of cordial liquors
are the chief things to  be depended on  in  this kind
of fever;  yet,  for thofe who may chufe to ufe  thjm,
we fhail mention one or two of the forms of med;-
cine which are commonly prefcribed in it;  centaury
and fnake-root tea,  volatile boluffes.
  In defperate cafes, where the hiccup  and ftarting
of  the tendons have  already  come  on,  we have
fometisies  feen  extraordinary effects  from  Urge
dofes of mufk frequently repeated.  Mufk is doubt-
lefs an antifpafmodic,  and  may  be  given to' the
quantity of a fcruple three or four  times  a-day,  or
oftener, if neceffary.   Sometimes it may  be pro; er
to add to the mufk a  few grains  of camphire, and
fait of hartfliorn, as thefe  tend to  promote perfpi-
ration  and  the difcharge  of urine.   Thus  fifteen
grains  of mufk, with three grains of camphire, and
fix grains of fait of hartfliorn, may be  made  into a
bolus with a little fyrup, and given as above.
   If the fever  fhould  happen to intermit, which  it
frequently  does towards the decline, or  if the pa-
tient's ftrength fliould  be  wafted with colliquative
fweats, &c. it  will be  neceffary to give him the Pe-
ruvian bark.   Half a drachm, or a  whole drachm,
if the  ftomach  will bear  it,  of the ljark  in fine
powder, may be given four or frve times  a-day in a
                      O 3                   glafs 
198        OF THE NERVOUS FEVER.
 glafs of  red Port or  claret.   Should the bark in
 fubftance not fit eafily on the ftomach, an ounce of
 it in  powder may be infufed in a bottle of Lifbon or
 Rhenifh wine for two or three  days, afterwards it
 may be ftrained, and a glafs of it taken frequently.*
   Some give the bark in this and other fevers, where
 there  are no fymptonr, of  inflammation, without
 any regard  to  the remiffion  or intermiffion of the
 fever.  How far  future obfervations may  tend to
 eftablifh this practice, We will not pretend  to fay;
 but we have reafon to believe that the bark is a very
 univerfal  febrifuge, and that it may be adminiftered
 with advantage  in moft fevers where  bleeding  is not
 neceffary, or where there are no fymptoms of topical
 inflammation.

  * The bark may likewife be very properly adminiftered,
 along with  other cordials, in the following manner:  Take an
ounce of Peruvian bark, orange-peel half an ounce, Virginian
fnake-root two drachms.  Let all  of them be powdered, and
infufed in a pint of the beft brandy for three or four days.
Afterwards the liquor may be ftrained, and  two tea-fpoonfuls
of it given three or four times a-day in a glafs of a fmall wine
or wine and water.
CHAP, 
C  *99  3
CHAP.   XX.
    Of the Malignant, Putrid, or Spotted Fever.


           1 HIS may be called the peflilentialfever
 of Europe,  as  in many of its  fymptions  it bears a
 great refemblance to that dreadful difeafe, the plague.
 Perfons of a lax habit, a melancholy difpofition, and
 thofe whofe vigour has been wafted by long fafting,
 watching,  hard  labour, exceffive venery,  frequent
 falivations, &c. are moft liable to it.
   CAUSES.—This fever is occafioned by foul air,
 from a  number of people being confined in a narrow
 place,  not properly ventilated ;  from putrid animal
 and  vegetable  effluvia, &c.  Hence it  prevails in
 camps,  jails, hofpitals, and  infirmaries,   efpecially
 where fuch places are too much crowded,  and clean-
 linefs is neglected.
   Thefe fevers often fucceed great inundations in low
 and marfliy countries, efpecially when thefe are pre-
 ceded or followed by a hot andfultry feafon.
   Living too much upon animal  food, without a
 proper mixture of vegetables,  or eating fifli or flefh
 that  has been kept too long, are likewife apt to oc-
cafion  this  kind  of fever.  Hence failors  on long
 voyages, and the inhabitants of  befieged cities, are
 very often vifited with putrid fevers.
   Corn that has been greatly  damaged by rainy fea-
 fons, or long keeping, and water which has become
 putrid by  ftagnation, &c. may likewife occafion this
 fever.
O4
Dea 
2o©     PUTRID OR SPOTTED FEVER.
   Dead carcafes tainting  the  air, efpecially  in  hot
feafons, are very apt to  occafion  putrid difeafes.
Hence this kind of fever  often prevails in countries
which are the fcenes of war and  bloodfhed.  This
fliews  the  propriety of removing burying-grounds,
flaughter-houfes, &c. to a proper diftance from great
towns.
   Want of cleanlinefs is  a very general caufe of pu-
trid fevers.   Hence they  prevail amongft  the poor
inhabitants of large towns, who breathe a confined
unwholefome  air,  and  neglect  cleanlinefs.   Such
mechanics as carry on dirty employments, and are
conftantly  confined within doors, are likewife very
liable to this difeafed
   We fhail  only  add,  that  putrid, malignant, or
fpotted fevers, are highly infectious, and are there-
fore often communicated by contagion.
   SYMPTOMS.—The malignant fever is generally
preceded  by  a  remarkable  weaknefs, or  lofs of
ftrength, without any apparent caufe.  This is fome-
times fo great, that the patient can fcarcely walk, of
even fit upright,  without being in danger of fainting
away.  His mind  too is  greatly  dejected ; he fighs,
and  is full of dreadful apprehenfions.
   There is a  naufea, and fometimes a vomiting of
bile  ;  a violent pain of the head, with a ftrong pul-
fation or  throbbing  of  the temporal arteries; the
eyes often appear red  and inflamed, with a pain at
the bottom of the orbit;  there is a noife in the ears,
the  breathing is  laborious,  and  often interrupted
with a figh ;  the patient complains of a  pain about
the  region of the ftomach,  and in his back  and
loins; his tongue is at firft  white, but  afterwards it
appears black and chapped ; and his teeth are covered
with a black cruft.  He fometimes paffes worms both
upwards and downwards, is affected with tremors or
fliaking, and often becomes delirious.
                                               If 
PUTRID OR SPOTTED FEVER.
201
   If blood is let,  it appears diffolved, or'with a very
fmall degree of cohefion, and foon becomes putrid;
the ftools fmell extremely foetid,  and are fometimes
of agreenifh, black, or reddifh caft.   Spots of a pale
purple,  dun, or black colour, often appear upon the
/kin, and  fometimes there are violent haemorrhages,
or difcharges of blood from the  mouth, eyes, nofe,
&c.
   It fometimes   happens,  that  the inflammatory,
nervous, and  putrid  fymptoms  are  fo  blended to-
gether, as to  render it very difficult to  determine
to which  clafs the fever belongs.  In this cafe the
greateft caution  and  /kill  are requifite.   Attention
muft be paid to thofe fymptoms which are moft pre-
valent,  and both  the regimen and medicines muft be
adapted to them*.
   Inflammatory and nervous fevers may be converted
into malignant and putrid,  by too hot a regimen, or
improper medicines.
   The duration of putrid fevers is extremely uncer-
tain ; fometimes they terminate between the feventh
and fourteenth day, and at other times they are pro-
longed  for  five  or fix weeks.   Their duration de-
pends greatly  upon the conftitution of the patient,
and the manner of treating the difeafe.
   The moft favourable fymptoms  are, a gentle loofe-
nefs after the fourth or fifth day, with a warm mild
fweat.   Thefe, when continued  for a  confiderable
time, often carry  off the fever,  and  fhould never be
imprudently  flopped.  Small  miliary puftules  ap-
pearing between  the petechia?, or purple fpots, are
likewife favourable, as alfo  hot  fcabby eruptions
about the mouth  and nofe.  It is a good  fign  when

  * After all that has been faid upon this fubjefl, it is hot at
all probable, that any fever can with propriety be called pu-
trid.  They are always inflammatory at firft.
the 
 202      PUTRID OR SPOTTED FEVER.
 the pulfe rifes  upon  the  ufe  of wine, or other cor-
 dials,  and the nervous  fymptoms  abate ;  deafhefs
 coming on towards  the  decline  of  the  fever, is
 likewife often  a favourable fymptom *, as are  ab-
 fceffes in  the groin or parotid glands.
   Among the  unfavourable fymptoms may be reck-
 oned  an   exceffive  loofenefs,  with a hard fwelled
 belly;  large black  or  livid blotches breaking  out
 upon the fkin ; aphthae in the mouth ;  cold clammy
 fweats; blindnefs; change of the voice ; a wild flar-
 ing of the eyes;  difficulty of fwallowing;  inability
 to put out the tongue ; and a conftant inclination to
 uncover  the  breaft.   When  the  fweat and  faliva
 are tinged with blood,  and the  urine  is black, or
 depofites  a black footy fediment, the patient is in
 great  danger.   Starting of the tendons, and  foetid,
 ichorous,  involuntary ftools, attended with  coldnefs
 of the extremities, are moft generally the  forerun-w • j
 Hers of death.                                     :i
   REGIMEN.—In  the  treatment of this difeafe,;-  v
 we ought  to endeavour,  as far as poffible,  to  coun-'
 teract  the putrid tendency  of the humors,f to fup-
 port the patient's ftrength  and fpirits ;  and to affifl    ,'
 nature  in expelling  the  caufe of  this difeafe,  by
 gently  promoting perfpiration and the other evacu-
 ations.
   It has been obferved, that putrid  fevers are often   *
 occafioned by unwholefome air, and of  courfe they
 muft be aggravated by it.   Care fhould therefore be
 taken  to  prevent the  air from flagnating in the  pa-
 tient's chamber,  to keep it cool,  and renew it fre-

  * Deafnefs is not always a favourable fymptom in this  dif-
 eafe. Perhaps it is only fo when occafioned by abfceftes formed
 within the ears.
  f It is wordi  remarking here, that although much  is faid
by medical writers of a putridity of the humors, yet fuch a ftate
 qf thgra feldom or never exifts, unlefs indeed in the excretions.    |
                                           quently. 
         PUTRID OR SPOTTED FEVER.      203
quently, by opening the doors or windows of fome
adjacent apartment.   The breath and perfpiration of
perfons in perfect health, foon render the air of a
fmall apartment noxious ; but  this will fooner happen
from the perfpiration and breath of a perfon whofe
whole mafs of humors are in a difeafed ftate. *
   Befides the  frequent admiffion  of frefh air, we
would recommend the ufe of vinegar, verjuice, juice
of lemon, Seville orange, or any kind of vegetable
acid that can be moft readily obtained.   Thefe ought
frequently to be fprinkled upon  the floor, the bed,
and every part  of the  room.  They may alfo be
evaporated by pouring them on an hot iron,  or by
boiling,  &c.  The frefh fkins of lemons or oranges,
ought  likewife to be laid in  different parts of the
room,  and they  fhould be  frequently  held to the
patient's  nofe.   The  ufe of  acids in this manner,
would not only prove very refrefhing to the patient,
but would likewife tend to prevent the infection from
fpreading among thofe who  attend him.  Strong
fcented  herbs, as rue,  tanfy, rofemary, wormwood,
Sec. may  likewife be laid in  different parts of the
houfe,  and  fmelled to  by  thofe who  go near the
patient.
   The patient muft not only be kept cool, but like-
wife quiet and eafy.   The leaft  noife will affect his
head, and the fmalleft fatigue will  be apt to  make
him faint.
   Few things are of greater importance in this dif-
eafe than acids,  which ought  to be  mixed with all
the patient's food as well as  drink.   Orange, lemon,
or vinegar-whey, are all very proper, and may be
drank by turns,  according  to the  patient's inclina-

  * It is of the utmoft importance to change the patient's
linen, bed-clothes, and bed daily, and, when practicable, to
remove him into another room.  A matrafs is far preferable
to a bed.
tiOH. 
204      PUTRID OR SPOTTED  FEVER.
tion.   They may be rendered cordial, by the addi-'
tion of wine in fuch quantity as the patient's ftrength   i
feems to require.   When he is  very low, he may
drink negus, with only  one half  water,  and fharp.
ened with the juice  of orange or lemon.  In fome   '
cafes, a glafs of wine may now and then be allowed.
The  moft proper  wine is good Madeira, or Sherry;
but if the body be open, red Port or claret is to be
preferred.
   When the body is bound, a  tea-fpoonful  of the
cream  of tartar may be put into a cup of the patient's
drink, as  there is occafion ;  or  he may drink a
decoction of tamarinds, which will both  quench his
thirft,  and promote a difcharge by ftool.
   If camomile-tea will fit upon his ftomach,  it  is a
very proper drink in this difeafe.  It may be fharp-
ened by adding to every cup of the tei ten or fifteen
drops of the elixir of vitriol.
   The food muft be  light, as  panada or oatmeal
gruel, to which wine  may be added, if  the patient -1
be weak and low; and  they ought all to be fharp-
ened with the juice  of orange, the jelly of currants,  |
or the like.  The patient ought likewife to eat freely   ;
of ripe fruits, as roafted apples,  currant or  gobfe-  'j
berry tarts, preferved cherries, or plums, &c.
   Taking a little food or drink  frequently, not only
fupports the  fpirits,  but counteracts the  putrid ten-   v
dency of the humors;  for which reafon,  the  patient
ought frequently  to be fipping fmall  quantities of
fome of the acid liquors  mentioned above,  or any
that may be more agreeable to  his  palate, Or more
readily obtained.
   If he is delirious, his feet and  hands ought to be
frequently fomented with a ftrong infufion of camo-
mile flowers.  This, or an infufion of the bark^ to
fuch  as can  afford  it, cannot fail  to have a good .,,<
effect.  Fomentations  of this kind not only relieve  *
                                               the 
         PUTRID OR SPOTTED FEVER.      205
the head, by relaxing the veffels in the extremities,
but as their contents  are abforbed, and taken  into
the  fyftem, they may affift in preventing the pu-
trefcency of the humors.
   MEDICINE.—If a vomit be given at the begin-
ning of this fever, it will hardly fail to have a good
effect; but if the fever has gone on  for fome days,
and the fymptoms are violent, vomits  are  not  quite
fo fafe.  The body, however, is always to be kept
open by  clyfters, or laxative medicines.
   Bleeding is neceffary in putrid fevers to be regu-
lated by the figns of  inflammation.
   Bliftering plafters  are to be ufed, according  to
circumftances.   If the petechias or fpots fliould fud-
denly difappear,  the  patient's pulfe fink remarkably,
and a delirium, with other bad fymptoms  come on,
bliftering may be permitted.  In this cafe, the blifter-
ing plafters are to be applied to the head,  and infide
of the legs or thighs.
   It is common, in the beginning  of this fever,  to
give the emetic tartar in fmall dofes, repeated every
fecond or third hour,  till it fliall either vomit,  purge,
or throw the patient into a fweat.   This  practice is
very proper, provided it be not pufhed fo far as to
weaken the patient.
   A very  ridiculous notion  has long prevailed,  of
expelling the poifonous matter of malignant difeafes,
by trifling  dofes of cordial or alexipharmic  medicines.
In confequence of this notion, the  contrayerva-root,
the  cordial confection, the mithridate, &c. have been
extolled as infallible remedies.   There  is  reafon,
however, to believe that thefe feldom do much good.
Where cordials  are neceffary, we know none  that u
fuperior  to good wine, and therefore again recommend
it, both as the fafefi and befi.   Wine, with acids and
antifeptics, are the only cordials  to be relied on, in the
cure of malignant fevers. 
 206      PUTRID OR SPOTTED FEVER.
   In the  moft dangerous fpecies of this difeafe, when   ;
 it is attended with purple, livid or black fpots,  the
 Peruvian  bark muft  be adminiftered.   1  have feen   !
 it, when joined with acids, prove fuccefsful, even in
 cafes where the petechiae had the moft threatening
 afpect.   But, to anfwer  this purpofe, it muft not
 only be given in large dofes, but duly perfifted in.
   The beft method of admyiiftering  the bark is cer-
 tainly in fubftance.   An ounce of it in powder, may
 be mixed with  half  a  pint  of water, and the fame
 quantity of red wine, and fharpened with the elixir or
 the fpirit  of vitriol,  which will both make it fit eafier
 on the ftomach, and render it more benefical.   Two
 or three ounces of the fyrup of lemons may be added,
 and  two table-fpoonfuls of the mixture  taken every
 two hours, or oftener, if the ftomach is able to  bear it.
   Thofe who cannot take the bark in fubftance, may
 infufe it in wine, as recommended in the preceding1 '^1
 difeafe.                                          '*"■
   If there be a violent loofenefs, the bark muft be
 boiled in red wine with a little cinnamon,  and fharp-   •
 ened with the elixir of vitriol, as above.   Nothing
 can  be more beneficial, in  this kind ©f loofenefs,   /
 than plenty of acids, and fuch things  as  promote a
 gentle perfpiration.
   If the patient be troubled with  vomiting,  a dram
 of the fait of wormwood, diffolved in an  ounce and
 a half of frefh lemon juice," and made into a draught  , \
 with an ounce of fimple cinnamon water, and a bit of
 fugar, may be  given and repeated as  often  as it is
 neceffary.  A table-fpoonful of milk every half hour
 will often flop the vomiting.
   If fwellings of the glands  appear, their fuppura-
 tion  is  to be promoted by the application of poulti-
ces,  ripening cataplafms, &c.  And as foon as there
is any appearance of matter in them, they ought to
be opened, and the poultices continued.
                                           I have 
PUTRID OR  SPOTTED FEVER.      207
   I have known large ulcerous  fores  break out in
 various  parts  of the  body, in  the decline of  this
 fever, of a livid gangrenous appearance,  and a moft
 putrid cadaverous fmell.   Thefe gradually healed,
 and the  patient  recovered, by  the plentiful ufe of
 Peruvian bark and wine, fharpened with  the fpirits
 of vitriol.
   For preventing putrid fevers we would recommend
 a ftrict regard to cleanlinefs; a dry fituation; fufficient
 exercife in the open air; wholefome food, and a mo-
 derate  ufe  of generous  liquors.  Infection  ought
 above all things to be avoided.  No conftitution is
 proof againft it.  I have known perfons feized with
 a  putrid fever, by only making a fingle vifit to a pa-
 tient in it; others have caught it by lodging for  one
 night  in a town where  it prevailed;  and fome by
 attending the funerals of fuch as died of it.*
   When a putrid fever feizes any perfon in a family,
 the greateft attention is neceffary  to prevent the  dif-
 eafe from  fpreading.   The fick  ought to be  placed
 in a large apartment,  as remote from the  reft of  the
 family as poffible ; he ought likewife to be kept ex-
 tremely  clean, and fhould have frefh air conflantly
 let into  his chamber;  whatever comes  from  him
 fliould be immediately removed, his linen fhould be

   * The late Sir John Pringle exprefled  a concern left thefe
 eautions fhould prevent people from attending their friends or
 relations when afflicted with putrid fevers.  I told him I meant
 only to difcourage  unneceflary attendance, and  mentioned a
 number of inftances where putrid fevers  had proved fatal to
 perfon*, who were rather hurtful than beneficial to the fick.
This fagacious phyfician agreed with me, in thinking that a
good doctor and a careful nurfe were the only neceffary attend-
ants ; and that all others,  by  their folicitude and ill-directed
 care, hurt the fick.
   If perfons  attendant on the fick wmild  pay fufficient atten-
 tion to cleanlinefs, and not fit near the patisnt unneccifarily,
 they would fcldou) be infected.
                                          frequently 
208      PUTRID  OR SPOTTED FEVER.
frequently changed,  and thofe in health ought to
avoid all unneceffary communication with him.
   Any one who is apprehenfive of having caught
the  infection,  ought immediately to take a vomit,
and to work it off by drinking plentifully of chamo-
mile tea.  This may be  repeated in a day or two, if
the apprehenfions ftill continue, or any unfavourable
fymptoms appear.
   The perfon  ought likewife to take an infufion of
the bark and chamomile flowers for his ordinary drink;
and  before he goes to bed, he may drink a pint of
pretty ftrong  negus, or a few  glaffes of generous
wine.   I have been frequently obliged to follow this
courfe,  when  malignant fevers prevailed, and have
likewife  recommended  it  to  others  with conftant
fuccefs.
   People generally fly to bleeding and purging as
antidotes againft infection ;  but thefe are fo far from
fecuring them, that  by  debilitating the body they
increafe the danger*.
   Thofe who wait upon the  fick in  putrid fevers,
ought always  to have a piece of  fpunge or a hand-
kerchief dipt in vinegar, or juice of lemon,  to fmell
to while near the patient.  They ought  likewife to
wafh] their hands, and,  if poffible, to change their
clothes,  before they go into company.

   * This may be true in many cafes, but where fymptoms of
inflammation occur, bleeding and purging are conftantly the
chief and only remedies.
ghap. 
t  209  3
                CHAP.  XXI,


              Of the Miliary Fever.

           1 HIS  fever takes its  name  from  the
fmall puftules or bladders which appear on the fkin,
refembling, in fhape and fize, the feeds of millet  The
puftules are either red or white, and fometimes both
are mixed together.
   The whole  body is  fometimes  covered with puf-
tules ; but they are generally more  numerous where
the fweat is moft  abundant, as  on the breaft,  the
back, &c.   A gentle fweat or moifture on the fkin,
greatly promotes the eruption;  but, When the  fkin
i§ dry, the eruption is both more painful and  dan-
gerous.
   Sometimes this  is a  primary  difeafe ',  but  it is
much oftener only a fymptom of fome other malady,
as the fmall-pox, meafles, ardent or nervous fever,
&c.   In all thefe  cafes it  is generally the effect of
too hot a regimen  or medicines.
   The young and the aged are more liable to it than
thofe  in the vigour and prime of life.   It  is likewife
more incident to women than men, efpecially the de-
licate and the indolent, who, neglecting exercife, keep
continually within doors, and live upon weak watery
diet.   Such females are extremely liable to be feized
with this difeafe in child-bed.
   CAUSES.—The miliary fever is fometimes occa-
fioned by violent paflions or affections  of  the mind ;
as exceffive grief,  anxiety,  thoughtfulnefs, &c.  It
may likewife  be occafioned by exceffive watching.
great evacuations,  a weak watery  diet, eating too
freely of cold, crude,  unripe fruits, as plumbs,  cher-
                        P                    . ries, 
210
OF THE MILIARY FEVER.
ries, cucumbers,  melons,  &c.  Impure waters, or
provifions which have been fpoiled by rainy feafons,
long keeping, &c.  may likewife caufe miliary fevers.
  This  difeafe  in childbed-women is  fometimes the
effect of great coftivenefs during pregnancy ; it  may
likewife be occafioned by their exceffive ufe of green
trafli, and other unwholefome things, in which preg-
nant women are too apt to indulge.   But its  moft
general  caufe is indolence.   Such women as lead a
fedentary life,  efpecially during pregnancy, and at
the fame time  live grofsly, can hardly efcape this
difeafe in childbed.  Hence it proves extremely  fatal
to women  of fafhon, and likewife  to thofe women
in manufacturing towns, who, in order to  affift their
hufbands, fit clofe within doors for almoft  the whole
of their time.  But amongft women who  are active
and laborious,  who live  in the country,  and  take
fufficient exercife without doors,  this difeafe is  very
little known.
  SYMPTOMS.—-When this is a  primary difeafe,
it makes its attack,  like moft other  eruptive  fevers,
with a  flight fhivering, which is fucceeded by heat,
lofs of ftrength, faintnefs,  fighing, a low quick pulfe,
difficulty of  breathing, with great  anxiety and op-
preffion of the  breaft.   The patient is reftlefs, and
fometimes delirious; the tongue appears white, and
the hands  fhake, with  often a burning heat in the
palms;  and  in childbed-women the milk generally
goes away, and the other difcharges flop.
  The  patient  feels an  itching or pricking pain un-
der the  fkin, after which innumerable fmall puftules
of a red or white colour begin to appear.   Upon this
the fymptoms generally abate, the pulfe becomes more
full and foft, the fkin grows moifter,  and  the fweat,
as the diicifc advances, begins to have a peculiar foetid
fmell;   the great load on the breaft and oppreflion of
the fpirits, generally go oil", and  the cuftomary eva-
                                         cuations 
OF THE MILIARY FEVER.
2ir
 tuations gradually  return.   About  the  fixth  or
 feventh day from the eruption, the puftules begin to
 dry and fall off, which  occafions a very difagreeable
 itching in the fkin.
   It is impoffible to afcertain the exact time when
 the puftules will either appear or go off. They gene-
 rally come out on the third or fourth day, when the
 eruption is critical;  but, when fymptomatical,  they
 may appear at  any time of the difeafe.
   Sometimes the puftules appear and  vanifh by turns.
 When that is the cafe,  there is always danger ; but
 when they go in all of a fudden, and. do not  appear
 again, the danger is great.
   In child-bed women the puftules are commonly at
 firft filled  with  clear water, afterwards they grow
 yellowifli.  Sometimes they are interfperfed with puf-
 tules of a red colour.  When thefe only appear the
 difeafe goes by the name of a rajh.
   REGIMEN.—In all  eruptive fevers, of whatever
 kind, the chief point is  to  prevent the  fudden difap-
 pearing of the puftules,  and to promote their matu-
 ration.  For this  purpofe the patient  muft be  kept
 in fuch a  temperature, as neither to  pufh out the
 eruption too fail, nor to  caufe it to retreat prema-
 turely.  The diet and drink ought  therefore to be
in a moderate degree nourifhing and  cordial; but
neither ftrong nor heating.   The patient's  chamber
ought  neither to be kept too hot nor too cold ; and
he  fhould  not be too much covered  with clothes.
Above all,  the mind is to be kept eafy  and cheerful.
Nothing fo certainly makes an eruption go in as fear,
or the apprehenfion of danger.
   The food muft be weak chicken-broth with bread,
panada,  fago,  or oatmeal-gruel, &c.  to a  gill  of
which  may be added a fpoonful or two of wine,  as
the patient's ftrength requires, with a few grains  of
 fait and a little fugar.  Good apples roafted or boiled,
                       P  2                  with 
m         ©F THE MILIARY  FEVER.
with other ripe fruits of an opening cooling nature,
may be eaten.
 ' Tfhe drink may be fuited to the ftate of the patient's
ftrength and fpirits.   If  thefe be  pretty  high,  the
c^ink ought to be  weak ; as water-grud, or balm
tea.
   When the patient's fpirits are low,  and the erup-
tion does  not rife fufficiently, his drink muft  be a
little more generous ;  as  wine-whey, or fmall negus,
fharpened with the juice of orange or lemon,  and
macje ftrqnger or weaker as cireumftances may re-
quire.
   Sometimes the miliary fever approaches towards a
putrid nature, in which  cafe the  patient's ftrength
mull be fupported with generous cordials, joined with
acids ; and,  if the degree  of putrefeence be great, the
Eeruvian bark muft be adminiftered.  If the head be
much affected, the body muft be kept open by emol-
lient clyfters.
   MEDICINE.—If the  food and  drink be properly
regulated,  there will  be little occafion for medicine
in this difeafe.  Should  the eruption, however, not
rife, or the fpirits flag, it will not only be neceffary
to fupport  the patient with  cordials, but  likewife to
apply  bliftering-plafters.   The  moft proper cordial,
in this cafe, is good wine, which may either be taken
in the patient's food or drink ;  and if there be figns
of putrefcency, the bark and acids may be mixed with
wine,  as directed in the putrid fever.
   Some  recommend  bliftering  through  the  whole
courfe'of this difeafe ; and  where nature flags, and
the  eruption comes and goes, it  may  be neceffary to
keep up a ftimulus, by a continual fucceffion of fmall
bliftering-plafters ;  but  we  would  not recommend
above one at a time.   If, however, the pulfe fliould
fink remarkably, the puftules fall in, and the head be
affected, it will he necr/Tary to apply feveral bliftering-
                                           plafters; 
           OF THE MILIARY  FEVER.        213
 plafters to the moft fenfible parts, as the infide of the
 legs and thighs, &c.
   Bleeding is  feldom  neceffary in this difeafe, and
 fometimes it does much hurt,  as it weakens the pa-
 tient, and depreffes his fpirits.   It is therefore never
 to be attempted, unlefs by the advice of a phyfician.
 We mention this, becaufe it has been cuftomary to
treat this  difeafe in  childbed-women  by  plentiful
bleeding j and otlier evacuations, as if it were highly
inflammatory*.
   If the difeafe proves tedious; or the recovery flow,
 we would recommend the Peruvian bark, which may
 either be taken in fubftance;  or infufed in wine or
 water, as the patient inclines.
   The miliary fever, like other  eruptive difeafes, re-
 quires gentle purging when the fever is gotte off; and
 the patient's ftrength will permit.
   To prevent this  difeafe, a pure dry air, fufficient
exercife, and wholefome  food, are neceflary.  Preg-
nant  women fliould guard  againft coftivenefs,  and
 take daily as much exercife as they can bear, avoid-
 ing all green fruits, and other unwholefome things;
 and When in childbed they ought ftrictly to obferve a
cool regimen.

  * The only rule to go by here is the Mate of the pulfe and
violence of the fymptoms.  If thefe require bleeding, it cannot
be improper.
P 3                  CHAP. 
C  *M  ]
                 CHAP.  XXII.


              Of the Remitting Fever.


           1 HIS fever takes  its name from a re-
 miffion of the fymptoms,  which happens fometimes
 fooner, and fometimes later.  The remiffion is com-
 monly preceded by a gentle fweat, after which  the
 patient feems greatly relieved, but  in a few hours
 the  fever  returns.   Thefe remiflions  return at very
 irregular periods, and are fometimes of longer, fome-
,times of fhorter duration :  the nearer, however, that
 the  fever  approaches to a regular intermittent,  the
 danger is the lefs.
   CAUSES.----Remitting fevers prevail in low
 marfhy countries, abounding with wood  and flagnat-
 ing water; but they prove moft fatal  in places where
 great  heat and moifture are combined, as in fome
 parts  of Africa, the province of Bengal in the Eaft
 Indies, &c. where remitting fevers are generally very
 fatal.   They  are  moft frequent  in clofe calm wea-
 ther, efpecially after rainy feafons, great  inundations,
 or the  like*.  ' No age, fex, or  conftitution, is  ex-
 empted from the attack of this fever; but it  chiefly
 feizes perfons of a relaxed habit, who live in low dirty
 habitations, breathe  an impure flagnating air,  take
 little exercife, and ufe unwholefome diet.
   SYMPTOMS.—The firft fymptoms of this fever
 are generally yawning, ftretching, pain and giddinefs
 of the head and limbs, with alternate fits of heat and

   *  In America, they are often moft prevalent after dry
 fummers.
cold. 
          OF THE  REMITTING FEVER.       215
*old.   Sometimes the patient is affected with a de-
lirium at the very firft attack.  There is a pain, and
fometimes a fwelling, about the region of the fto-
mach, the tongue is white, the eyes and fkin frequent-
ly appear yellow, and  the  patient is often  afflicted
with bilious vomitings.  The  pulfe is fometimes a
little hard, but feldom full, and the blood, when let,
rarely fhews any figns  of inflammation.  Some pa-
tients are exceedingly coftive, and others are afflicted
with a very troublefome loofenefs.
   It is  impoffible to defcribe all  the fymptoms  of
this  difeafe, as they vary according to the fituation,
the  feafon of the year, and the conftitution of the
patient.   They may likewife be greatly changed by
the method of treatment, and by many  other cir-
cumftances too tedious to mention.   Sometimes the
bilious fymptoms predominate,  fometimes the ner-
vous, and at other times the  putrid.   Nor is it at all
uncommon to  find a fucceffion of  each of thefe,  or
even a complication of them at the fame time, in the
fame perfon.   This fever in its common appearance,
approaches neareft to an intermittent with protracted
paroxyfms.
   REGIMEN.—The  regimen  muft be adapted to
the prevailing fymptoms.  When there are a»ny figns
of inflammation, the diet muft  be flender,  and the
drink weak and diluting.  But when nervous fymp-
toms occur, it will be neceffary to fupport the patienr
with food  and liquors of a  more generous nature,
fuch as are recommended in the immediately pre-
ceding fevers.   We muft, however, be very cautious
in the ufe of things of a heating quality, as this fever
is frequently changed into a continual  one by an hot
regimen, and improper medicines.
   Whatever the fymptoms are, the patient ought to
be kept  cool,  quiet, and clean.   His  apartment, if
poffible, fhould  be large, and frequently ventilated
                      P 4                   by 
US       OF THE. REMITTING FEVER.
by letting in frefh air at the  doors or windows.  It
ought likewife to  be fprinkled  with  vinegar, juice
of lemon, or the like.  His linen,  bed clothes;  &c.
fliould be frequently  changed, and all his excrements
immediately removed.  Though thefe  things  have
been recommended before, we think neceffary  to re-
peat them here, as they are of more importance to the
fick than practitioners are apt to imagine*.
   MEDICINE.—In order to  cure this  fever, we
muft endeavour to bring it to a regular intermiffion.
This intention may   be  promoted  by bleeding, if
there be figns of inflammation ; but, when that is
not the cafe, bleeding ought not to be attempted; as
it will weaken the patient,  and prolong the difeafe.
A vomit, however,  will feldom be improper, and is
generally of great fervice.  Fifteen or twenty grains
of ipecacuanha will  anfwer this purpofe very well;
but,  where it  can be obtained, we would  rather re-
commend a grain or two of tartar emetic, with five or
fix grains of ipecacuanha, to be made into a draught,
and given for a vomit.  This may be  repeated once
or twice, at proper intervals, if the ficknefs or naufea
continues,  Sometimes the naufea and vomiting are
very troublefome,  To remove this we bleed,  if the
pulfe will bear it; if not, we apply blifters to the
wrifts or ancles.

  * The ingenious Dr.  Lind, of Edinburgh, in his inaugural
diflertatioh concerning the putrid remitting fever of Bengal,
has the following obfervation  :  " The patient's  fhirt,  bed-
" clothes, and bedding,  ought frequently to be changed, and
" expofed to the air, and all his excrements immediately re-
(i moved ;  the bed-chamber fliould be made pure  and whole-
fc fome, and frequently fprinkled with vinegar ;  in fhort every
f* attention fhonld be paid to the patient.  I can affirm, that a
fi phyfician who  puts thefe in praftice^ will much oftener fuc-
" ceed than one who is even more fkilful, but has not oppor-
w tunity of ufing  thefe means,"
The 
          OF THE REMITTING  FEVER.       217
   The body ought  to be kept open either by laxa-
 tives, as infufions of fenna and manna, fmall dofes of
 cream of tartar, tamarinds, ftewed prunes, or the like.
 The ftronger  purgatives,  as  calomel  with jalap  or
 rhubarb, are often neceffary.
   By this courfe the fever, in a few days, may gene-
 rally be brought to a pretty regular or diftinct inter-
 miffion ; and if the  intermiffion is not complete,  the
 faline julep, and blifters to the wrifts, will moft com-
 monly prodhce one; in which cafe the Peruvian bark
 may be adminiftered, and, if the  ftomach will bear
 it, it will feldom fail to perfect the cure.  Wherever
 the bark is proper in  fevers,  the  beft method is  to
 give as much as the ftomach will bear, and continue
 it for one or two days in thefe dofes.  It is needlefs
 here to repeat the methods of giving the  bark, as we
 have  already  had  occafion frequently  to mention
 them*.
  The moft likely way to avoid this fever, is to ufe
 a wholefome and  nourifhing diet, to  pay the moft
 fcrttpulbus attention  to cleanlinefs,  to keep the body
 warm, to take fufficient  exercife,  and, in hot coun-
 tries to avoid damp fituations, night air, evening dews,
 and the like.   In countries where  it is endemical, the
 Beft preventive medicine  which we can  recommend,
is the Peruvian bark, which may either be chewed, or
 infufed in wine.   Some recommend fmoking tobacco,
 as very beneficial in  marfhy countries, both for the
 prevention of this and  intermitting fevers.

  * It often happens that  the ftomach will not  bear the bark,
or perhaps the intermiffion, is not fufficiently evident to give it.
 In fuch cafes, a ftrong tea, made of three fourths centuary and
 one fourth Virginia fnake root, may be  drank cold, a tea-cup
 full every hour.
CHAP. 
[  2*8  ]
                CHAP.   XXIII.


               Of the  Yellow Fever.


          X1 EVERS have already been divided and
fubdivided into too  many fpecies;  and, it is by no
means from a wifh to add to the number, that I in-
fert  this chapter on,  what  is commonly called, the
Yellow Fever.   But, as there are fome particulars in
it, which feem  to diftinguifh it from other fevers, al-
though the difcriminating fhades betv/een fevers are
difficult to mark, and as the practice does certainly
vary from that  which is proper in others, to which
it has a confiderable refemblance, I thought it might
be ufeful to give a general account of it; more efpe-
cially, as  there are  but few, even of  the phyficians
in the United States,  who have had an opportunity
of feeing this difeafe.  To thefe I would particularly
recommend a careful perufal of Dr. Rufh's book on
the fubject.  I  need  hardly remark,  that a more full
account, than  that which is here given, would  be
improper in the prefent work.
  This fever is fo called from a yellownefs of the
whole furface, which takes place, generally, from the
fecond and third to the  fixth and feventh days: it does
not, however,  occur in every inftance.
  It  would feem,  from  the defcriptions  given  by
▼arious authors, that this  difeafe appears in  different
forms:  fome tell us of  its appearance with fuch fymp-
toms as indicate great debility ; others place it among
the moft violent inflammatory fevers;  and it is cer-
tain,  that this laft was  the form it generally affumed
at Philadelphia, in the fummer and autumn of 1793;
                                         although 
OF THE YELLOW FEVER.
219
although it fuffered all the varieties produced by age,
conftitution, the ftate of  the atmofphere, feafon of
the year,  together with a number  of other caufes,
fuch as fear, grief,  and defpondency, which power-
fully operated on the mind.
  The young and  plethoric  were  moft fubject to
this difeafe, efpecially at the beginning ; but, during
its progrefs,  no age nor  conftitution  were  exempt
from its attacks.
  The danger was, in general, to  be eftimated by
the violence of the attack,  and age  of the  patient.
It ofteneft proved mortal from the third to the feventh
day.: a yellownefs on the  fixth day, was not an un-
favourable fymptom.
   CAUSES.—It remains a matter of difpute, whe-
ther this difeafe is always imported,  or  whether it
ever originates in this country.  But, as  it is agreed
that it may be imported, the ftricteft vigilance fhould
be  exercifed  at every  port  of the  United States
during,  at leaft, the months of July, Auguft,  and
September, when this difeafe is known to prevail in
the  Weft  Indies  and  South America, and  more
efpecially in a time of war there.   Perhaps it would
not be too ftrict to fubject every veffel, coming from
a fickly  or fufpected place,  to a delay of at  leaft
thirty days, in  fome port, at a convenient  diftance
from any town.
  Though it may not be an eafy matter to determine
the queftion concerning  the origin of the difeafe, it
is by no means difficult to trace the caufes of its
fpreading,  when once amongft us.  Thefe are,  dry,
or moift and hot weather,  dirty ftreets or houfes,
want of  cleanlinefs in general, fcarcity of good  ripe
fruit, intemperance, expofure to the fun or night air,
fatigue,  and fear.
   And,  as thofe who fuppofe the difeafe to be always
imported,  regard the caufes juft mentioned to be the
                                             moft 
22o        OF THE YELLOW FEVER.
moft probable  ones of fpreading the  difeafe,  and
thofe who fuppofe it to be an original  diforder, be-
lieve thefe to be the caufes of the difeafe :  it is, in
either cafe,  ftrictly incumbent on the magiftrates and
citizens of every city  to  have the ftreets kept per-
fectly clean, as well as to have them properly watered
in dry  feafons.
   SYMPTOMS.—Thefe are various ;   generally
however, after a previous laffitude, the fever attacks
with a chill more or lefs violent, followed by heat,
fevere  pains in the head,  back,  and hips,  oppreffion
at the  breaft, naufea and  vomiting, delirium, arid
watchfulnefs.  The eyes are muddy, fometimes fpark-
ling, fometimes dull, the pupil dilated, the tofigue
is moift,  the  ikin  dry, the  bowels  generally very
coftive, the pulfe  fometimes oppreffed, and fmall, ge-
nerally  hard,  the fever has irregular exacerbatiOBs,
but  moftly one in the evening or during the nipt;
thefe are not followed by fweat  as  in  the rem'itfHit
fever.   The  urine is in fmall quantity and higfi co-
loured ; eruptions fometimes appear, particularly about
the breaft.  In  the moft  fatal  cafes thefe fymptoms
continue with violence till the third or fourth day,
when the pulfe  fails, the fkin turns yellow;  hfeifidr-
rhagies from  different  parts come on,  the vomiting
increafes, and, inftead of bile and the contents of the
ftomach, a dark coloured liquor is  thrown  ur>j ex-
actly refembling coffee grounds diflblved  in water;
this  vomiting  is often accompanied with a diftrelfiflg
noife and exceffive reftleffnefs,  the  extremities be-
come cold, the  debility increafes, and  the patient is
foon relieved by death  from all his agonies;
   When the difeafe terminates favourably, the fymp-
toms of attack are much the fame at firft, and of dif-
ferent degrees of violence ; by proper remedies they
often abate on  the firft or fecond  day,  and when '
they  continue  longer, the  exacerbations'  are lefs
                                           violent, 
OF THE YELLOW FEVER.
221
violent, there is lefs vomiting, pain, &c.  If the pa-
tient lives over the eighth or ninth day, there is more
reafop  to hope a favourable iffue.
   REGIlVfEN.—The fame regimen is proper here
as in moft fevers ; but we muft be particularly care-
ful to place the fick in as large and airy a room as
poffible,  to change his linen and  bed clothes  every
day, and to carry the cooling plan to its greateft ex-
tent ; the bed clothes fliould be very light, the win-
dows   and doors fhould be  kept open  conftantly,
linen cloths dipt in cold water fhould be applied often
to the  forehead and hands, efpecially where the pain
in the head is violent.   Every attention fliould be
paid to leffen  the exertions of the fick ; the  feces
fhould be removed immediately, and fugar and falt-
petre burnt  in the chamber on coals—the floor may
be often fprinkled with vinegar.
   The diet muft be very light,  and confifting chiefly
of vegetables,  indeed moftly of drinks,  fuch as thin
fago-gruel,  lemonade, toaft  and  water,  tamarind-
water, molaffes and water : a fmall quantity of thefe
muft be taken at a time to prevent vomiting.   This
is a moft troublefome and dangerous fymptom, and
will  often  yield  to a few table-fpoonfuls  of  milk
every  hour, or  a table-fpoonful  of good olive oil
occafionally.
   The fick perfon fliould drink very freely of any of
the mild diluents above mentioned if his ftomach will
bear it, and the drink muft be offered to him.
   MEDICINES.—The  chief remedies in this dif-
eafe are bleeding and purging : and were thefe  timely
adminiftered and repeated in fufficient quantity, with
proper nurfing  and accommodations there is no cafe
of fever that would become lefs fatal than this terri-
ble one.
   The bleeding fliould be performed on the firft at-
tack,  and repeated two,  three, or four times  a-day,
                                        according 
 222         OF THE YELLOW FEVER.             <
 according to the  violence of the fymptoms, in the
 quantity of from eight and ten to fourteen and twenty
 ounces, until the  fymptoms are fubdued, or in com-
 mon language, until the fever is broken.  Every new
 exacerbation of fever calls for another bleeding, and
this  may  be repeated  commonly until  the feventh  j
and eighth day if neceffary, or  longer if there is any
local determination  to the head,  breaft, or bowels.
The pulfe will direct us greatly  here ; we are not
always to look for the ftrong,  hard pulfe, it is often
a fmall, tenfe, or, as it may be ftiled, chorded pulfe,
which requires bleeding ; where there is fuch a pulfe
we are  not  to be reftrained by hremorrhagies from
the ufe of the lancet.  The blood drawn firft appears
of a fcarlet colour,  without much feparation ;  it will
afterwards generally put on the appearance of blood
in other inflammatory diforders, or what is commonly
called buffy  blood.
  Purging is alfo abfolutely neceffary.   As the cof-
tivenefs is  obflinate we  are  obliged to  ufe fuch
cathartics as will overcome it.  Nothing  has been
found  more effectual for  this  purpofe than  calo-
mel, and  as it is flow,  though  fure in its  effects,
we add fome jalap or rhubirb  to quicken  its opera-
tion.   From eight to twelve grains of calomel with
the fame, or rather a larger,  quantity  of jalap or
rhubarb may be given every four or fix hours until
they operate.   It is, however, often neceffary alfo
to give  feveral purgative glyfters  before  the  bowels
can be opened.
  After fix  or eight large dark coloured  or black
ftools have been procured, we may give, perhaps, a
fmgle dofe  of this  medicine daily,  and when the
fymptoms abate,  any other purgative may be ufed,
as caftor-oil, Glauber falts,  &c. and fometimes it is
neceffary, efpecially after the difeafe has continued
for fome day;-, aii.l  the coftivenefs remains obflinate*
                                               to 
          OF THE YELLOW  FEVER.         223
to combine the calomel with aloes or gamboge, in the
form of pills, two of which, containing equal parts of
each,  may be  given every three or four hours until
they operate.
  Confiderable advantages arife from giving a few
grains of calomel daily  until the difeafe is fubdued.
It will often vomit as well as purge when  firft admi-
niftered.   It will bring  on perfpiration, and it feems
to increafe the fecretion and excretion of  the bile,
which appears to be deficient in this difeafe.
  The  fears which  fome entertain  reflecting  the
rough and inflammatory nature of this mercurial purge
are totally groundlefs.   Indeed, when we confider
that it is the cathartic almoft univerfally employed in
the difeafes of children, we furely cannot fuppofe it
to be too heating in thofe of adults.
  The difeafe has fometimes been  fuddenly refolved
by a general perfpiration.   It will not, however,  be
fafe to lofe time  by attempting to procure this eva-
cuation, more  efpecially as the means made ufe of to
bring it on, would increafe the  inflammatory ftate of
the fyftem,  if they failed of producing their defired
effect.
   Having faid thus much of bleeding and purging,
little need be added concerning any other  remedies,
as the whole cure depends on the ufe of thefe and of
a proper regimen.   It fometimes happens, in the  ad-
vanced  ftage  of this difeafe,  when bleeding is no
longer proper, that pain of any particular part, coma5
vomiting, or a continuance of fever, require the ap-
plication of blifters.  In  this  ftate only,  laudanum
may be of fervice, efpecially if there is any delirium.
Sinapifms to the ancles may be  ufed if there is much
ftupor,  as well as wine and other cordials ;  but thefe
are only admiffible in that ftage of the difeafe when
the pulfe is too weak to bear bleeding, and there is
no appearance of fever. 
224         OF THE YELLOW FEVER.
   The efficacy of the above remedies depends uppg
their being early applied.
   To prevent infection,  the bowels fhould be kept
open by gentle laxatives ; a temperate diet, confuting
of broths, milk,  vegetables, and  ripe  fruits  of all
kinds fhould be ufed,  and the  exciting caufes of un.,
ufual heat,  cold, and  fatigue, fhould  be  carefully
avoided.
   During the convalefcence,  light food, rjpe fruit,
beer and water, wine and water, the elixir of vitdol,
and centaury-tea, may be ufed ; and, when  able, the
patient fhould ufe exercife in a carriage.  But there
is great danger of a relapfe, and much caution is ne-
ceffary not to be expofed to fatigue, the rays of the
fun, or night air.
   It does not* appear that this difeafe is communicable
in the country, and we  are told  by Dr. fining of
Charlefton,  where it  has  often prevailed,  that no
perfon  can have  it twice, though this is  doubted.
The black people, and perfons from the  Weft Indies,
are lefs fubject to it than others.
   The treatment above recommended applies to the
yellow fever as it appeared here in 1793 and  1794.
If it fhould hereafter  appear  in a different form,  a
different mode of practice may be requifite.  This,
however, can eafily be afeertained by the fymptoms.
If they are inflammatory, they will undoubtedly re-
quire the fame treatment, and at any rate cathartics
cannot be improper.
CHAP. 
[  425  ]
                 CHAP. XXIV.

                Of  the  Small-Pox.

           I HIS  difeafe,  which  originally  came
 from Arabia, is now become fo general,  that very
 few efcape it at  one time of life or another.  It is a
 moft contagious malady,  and has for many years
 proved the fcourge of Europe and America.
   The  fmall-pox  generally  appear  towards the
 fpring.  They are very frequent  in fummer, lefs  fo
 in autumn,  and leaft of all in winter.   Children are
 moft liable to this difeafe ; and thofe  whofe food is
 unwholefome, who want proper exercife,  or  who
 ufe too much exercife,  or drink diftilled fpirits, run
 the greateft hazard from it.
   The difeafe is diftinguifhed into the diftinct and
 confluent  kind ;   the latter of which  is always at-
 tended with danger.  There  are  likewife  other dis-
 tinctions of the  fmall-pox ;  as the  cryftalline, the
 bloody, &c.
   CAUSES.—The fmall-pox is commonly caught
 by  infection.    Since the difeafe was firft brought
 into Europe,  the  infection has never been wholly
 extinguifhed, nor have any proper methods, as far
 as I  know, been  taken for that purpofe ; fo that now
 it has become in a manner conltitutional.   Children
 who have over-heated themfelves by running, wreft-
 ling, &c. or adults after a debauch, are moft apt  to
 be feized with the fmall-pox.
  SYMPTOMS.----This  difeafe is fo generally
 known, that a minute defcription of it is unnecef-
 fary.   Children commonly look  a little dull, feem
Jjftlefs  and drowfy for a  few days before  the  more
                        Q                 violent 
226          OF THE SMALL-POX.
violent fymptoms of  the  fmall-pox  appea*.   They  -9
are likewife more inclined to drink than ufual, have   J
little appetite for folid food, complain of wearinefs,
and, upon taking exercife, are apt to fweat.  Thefe   '
are fucceeded by flight fits of cold and heat in turns,   "
which, as the time of  the eruption  approaches,  be-   i
come more violent,  and are accompanied with pains   <
of the head and loins, vomiting, &c.  The pulfe is  J
quick, with a great  heat of the fkin, and reftleffnefs.   a
When the patient drops afleep,  he wakes  in a kind  \M
of horror, with a fudden flart, which is a very com-  ■
mon fymptom of the  approaching eruption; as  are
alfo convulfion-fits  in  young  children.    We may  .'■
remark, however, that all the feverifh fymptoms of   i
fmall-pox are greatly  relieved  by walking  about in
the cool air, and  often intermit.
   About the third or fourth  day from the time of
iickening, the fmall-pox generally begin to appear;   4
fometimes indeed they appear fooner.  At  firft they   jl
very nearly referable  flea-bites,  and are fooneft dif-   A
covered on the face, arms, and breaft.               ' i
   The moft  favourable fymptoms are  a flow erup-   J
tion, and an  abatement of the fever as foon  as the   1
puftules  appear.   In  a mild  diftinct kind of fmall-   ^
pox the puftules  feldom  appear before the third or   j
fourth day from the time of fickening,   and they   1
generally keep coming out gradually for feveral days  *1
after.  Puftules which are diftinct, with a  florid red   j
bafis, and which fill with thick purulent matter, are   *■>
the beft.
   A livid brown colour of the puftules is an unfa-   &
vourable fymptom; as alfo when they are  fmall  and   J
flat, with black fpecks in the middle. Puftules which   -TJ
contain a thin watery ichor are very bad.   A great   j
number of pock on the face is always attended with   '*
danger.   It is likewife a bad fign when they run into   ■;
one another.                                        "
i' 
              OF THE SMALL-POX.           227
   It is a moft unfavourable fymptom when petechia?,
 or  purple,  brown, or black fpots are  interfperfed
 among the puftules. #    Bloody ftools or urine, with
 a fwelled belly, are bad fymptoms; as is alfo a con-
 tinual ftrangury.   Pale urine, and a  violent throb-
 bing of the arteries of  the neck, are figns  of an  ap-
 proaching  delirium,  or of  convulfion-fits.  When
 the face does not fwell, or falls before the pock come
 to maturity, it is very unfavourable.    If the face
 begins to fall about the eleventh or twelfth day, and
 at the fame time the hands and feet begin to fwell,
 the patient generally does well; but  when thefe do
 not fucceed to  each other,  there is reafon to appre-
 hend danger.   A  continual  fpitting is now very  fa-
 vourable.    When the tongue  is covered with a
 brown cruft, it is an unfavourable fymptom.  Grind-
 ing of the  teeth, when  it proceeds from an affection
 of jhe nervous fyftem,  is a bad fign ;  but fometimes
 it is occafioned  by worms, or  a difordered ftomach.
  REGIMEN.—When convulfions  appear,  they
 give a dreadful  alarm  ;  immediately fome noftrum
 is applied, as if this were a primary difeafe  ; whereas
 it is only a fymptom, and far from being an unfa-
 vourable one, of the approaching eruption.  As  the
fits  generally go off before  the actual appearance of
the fmall-pox, it is  attributed  to the medicine, which,
by  this means,  acquires a'reputation without  any
merit, f

  * And yet we often fee a few purple pock fcattered amongft
a very good  diftinct kind ; her§ there is no danger.
  f Convulfion-nts are no doubt very alarming, but their effects
are often falutary.   They feem to be one of the means made
ufe of by Nature for breaking the force of a fever.   I have al-
ways obferved the fever abated, and fometimes quite removed,
 after one or moie convulfion-fits.  This readily accounts for
convulfions being a favourable fymptom in the fever which pre-
cedes the eruption of  the froall-pox, as every tiling that miti-
 gates this fever Icifeni the eruption.
                        Q_2                  I have 
  228           OF THE SMALL-POX.
    All that is, generally fpeaking, neceffary during
  the eruptive fever, is to keep  the patient cool and
  eafy, allowing him  to  drink freely of fome  weak
  diluting liquors ;  as  balm-tea, barley-water,  rennet-
  whey,  gruels, &c.   He fliould not be confined  to
  bed,  but fliould  fit up,  and go into the cool air,  as
  much as he is able.  His food ought to be very light;
  and he fhould be as  little difturbed with company as
  poffible.
    Much mifchief is done at this period by confining
  the patient too foon  to his  bed, and plying him with
  warm cordials or fudorific medicines.   Every thing
  that heats and inflames  the blood, increafes the fe-
j  ver, and puflies out the puftules prematurely.  This
  lias  numberlefs ill effects.  It not  only  increafes the
  number of puftules, but likewife tends to make them
  run into one another;   and when they have been
  pufhed out  with too great violence, they generally
  fall  in  before  they come to maturity.
    The good women, as foon as  they fee the fmall-
  pox begin to  appear,   commonly  ply  their  tender
  charge with  cordials,   faffron,  and marigold-teas,
  wine, punch, and even brandy itfelf.  All thefe are
  given with a view, as they term it, to throw out the
  eruption from  the heart.   This,  like moft other po-
  pular miftakes, is the abufe of a very juft obferva-
  tion, that when  there- rs a moifture on the fkin, the
  pock rife better, and the patient is  eafier, than when it
  continues dry and parched.   But that is  no reafon for
  forcing  the patient  into a  fweat.   Sweating  never
  relieves unlefs where it conjes on  fpontaneoufly, or is
  the effect of drinking weak diluting liquors.

    I have never feen a cafe in which convulfions, preceding the
  eruption, were fatal. If the fever is high, expofure to cool air;
  if the feet are very  cold, the warm bath ; if the pulfe requires
  it, bleeding ; alfo emetics and anodynes are amongft the moft
  siefel remedies.
                                           Children 
OF THE SMALL-POX.,          229
   Children are often fo peevifh, that they will not
lie a-bed without a  nurfe  conftantly  by them.  In-
dulging them in this, we have reafon  to believe, has
many bad  effects, both upon the nurfe and child.
Even the natural heat of the nurfe cannot fail to aug-
ment the fever of the child ; but if fhe alfo proves
feverifh, which is often the cafe, the danger muft be
increafed.
   Laying  feveral  children who have the fmall-pox
in the fame bed has  many ill confequences.   They
ought, if poffible,  never to be in the  fame  chamber,
as the perfpiration, the heat, the fmell, &c. all tend
to augment the fever,  and to heighten the difeafe.^
It is common among the poor to  fee two  or three
children lying in the fame bed,  with  fuch  a load  of
puftules  that even their fkins flick together.  One
can hardly view a fcene of this  kind  without being
fickened by the fight.   But how muft the effluvia
affect the poor  patients, many  of whom perifh by
this  ufage. *
   A very dirty cuftom prevails among  the lower
clafs of people, of allowing children in the fmall-pox
to keep on the fame  linen during the whole  period
of that loathfome  difeafe.   This is  done left they
fliould catch cold ;  but it  has many ill confequences.
The  linen  becomes  hard  by the moifture  which it
abforbs, and frets the tender fkin.   It likewife occa-

  * This obfervation is likewife applicable to hofpitals, work-
houfes, &c.  where numbers of children happen to have the
fmall-pox at the fame  time.  I  have feen  above'forty chil-
dren cooped up in one apartment all the  while  they had
this difeafe,  without any of them being admitted to breathe
the trefh air.  No one can be  at a lofs to fee the impro-
priety of fuch conduit.  It ought to be a  rule,  not only in
hofpitals for the  fmall-pox, but likewife for  other difi.tfc:,
that no patient fliould  be within fight or hearing < f another.
This is a matter to which too little regard is paid.
                        0^3                  fiom 
23°           OF THE SMALL-POX.
jions a bad fmell, which is very pernicious,  both to^
the patient and to thofe about him ; befides, the filth
which adheres to the linen being refojrbed,  or taken
up again into the body, greatly augments the difeafe.
   A patient fliould not be fuffered to be dirty in an
internal difeafe, far lefs in the fmall-pox.  Cutaneous
diforders are often occafioned by naftinefs alone, and
are always increafed by it.   Were the patient's linen
to be changed every day, it would  greatly refrefh
him.   Care indeed is to be taken that the linen be
thoroughly dry.    It  ought likewife to be put on
when the  patient is  mofl cool, and fhofcld be old
and foft, without any flarch in it.
   So ftrong is the vulgar prejudice in this  country,"*"
notwithftanding all that has been faid againft the hot
regimen in the fmall-pox, that numbers ftill fall a
facrifice to that error.   I  have feen poor women tra-
velling in the  depth  of winter, and carrying their
children along with them  in the fmall-pox, and have  -
frequently obferved others begging by the way-fide,r-
with infants in their arms covered  with the puftules;
yet I could never learn that one of thefe children
died by this fort of treatment.  This is certainly a
fufficient proof of the fafety  at leaft, of expofing pa-
tients in the fmall-pox to the  open air.  There can
be no reafon  however for expofing them  to public
view.  It is  now  very common  in the environs of
great towns to meet patients in the fmall-pox on the
public walks.   This practice, however well it  may
fuit the purpofes of boafting  inoculators, is danger-
ous to the citizens, and contrary to the laws of hu-
manity and found policy.
   The food  in this difeafe ought to be very light,
and of a cooling nature, as panada, or bread boiled
with equal quantities of milk and water, good apples
roafted or boiled with milk, and  fweetened with a
little fugar, or fuch like.
                                              The 
              OF THE SMALL-POX.           231
   The drink may be  toaft and water, clear fweet ,
whey,  barley-water, or thin gruel, &c.   After the
pock is full, butter-milk, being  of an  opening and
cleanfing nature, is  a  very proper drink, or wine
whey if the patient  is low.
   MEDICINE.—This difeafe is  generally divided
into  four different  periods,  viz.   the fever which
precedes the  eruption, the eruption itfelf, the fup-
puration, or  maturation  of the puftules, and  the
fecondary fever.
   It has already been  obferved, that little more is
neceffary during the primary fever than to keep the
patient cool and quiet, and allowing him to drink
diluting  liquors.   Though  this  be generally  the
fafeft courfe  that can  be taken with  infants,  yet
adults  of a  ftrong  conftitution and plethoric habit
generally require bleeding.   When a full pulfe,  a
dry fkin, and other  fymptoms of inflammation render
this operation neceffary,  it. ought  to be performed ;
if the body is bound, purges muft be given of Glau-
ber's falts,  or calomel  joined with jalap or rhubarb.
Many have fuppofed that the contagion of the fmall-.
pox could be entirely deftroyed by mercury. Though
this is not proved,  yet much good will arife from  a
free  ufe of  the mercurial powder, (fee Appendix,)
when a patient is fuppofed either to have received or
to be liable to the contagion.
   If there is a  great naufea or inclination to vomit,
weak camomile-tea or lukewarm water may be drank,
or fifteen  grains of ipecacuanha may be  given, in
order to clean the ftomach.
   Though  every method  is to be taken during the
primary fever, by a cool regimen, &c.  to prevent
too great an  eruption; yet after  the puftules have
made their appearance, our bufmefs  is to promote
the fuppuration, by diluting drink, light food,  and
if Nature feems to flag,  by generous cordials.  When
                       Q^4                 a low, 
^l^          OF THE SMALL-POX.
a  low,  creeping  pulfe,  faintnefs,  and great lofs of
ftrength, render cordials neceffary, we would recom-
mend good wine, which may be  made  into negus,
with an equal quantity of water, and fharpened with
the juice of orange, the jelly of currants, or the like.
Wine-whey,  fliarpened as  above, is likewife a proper
drink in this cafe ; great care however muft be taken '
not to overheat the patient  by any - of thefe things.
This, inftead of promoting, would retard the eruption..'
   The rifmg of the fmall-pox is often prevented by
the violence of the fever ; in this cafe the cool regi-
men is ftrictly to  be obferved.   The patient's cham-
ber muft not only be kept  cool, but he ought like- ,
wife frequently to be taken out of  bed, and to be
lightly covered with clothes while in it.
   Exceffive reftleffnefs  often prevents the  rifing and r
filling of the fmall-pox.   When this happens, gentle
opiates are neceffary. Thefe, however, ought always^ -t
to be adminiftered with a fparing hand.   To an in-
fant,  a tea-fpoonful of the anodyne mixture * may be (
given every  five or fix hours  till it has the defired
effect.  An adult will require a table-fpoonful in or-
der to anfwer the fame  purpofe.
   If the patient  be  troubled with  a ftrangury, or
fuppreffion of the urine, which  often happens in the
fmall-pox, he fhould be frequently taken out of bed,
and, if he be able, fliould walk  acrofs the room with
his feet bare.   When he  cannot do  this,  he may be
frequently fet on his knees in  bed,  and fliould en-
deavour to pafs his urine as often as he can.  When
thefe do not  fucceed,  a  tea-fpoonful of  the fweet
fpirits of nitre may be occafionally mixed with his
drink.  Nothing more certainly relieves  the patient,
or is more beneficial in the  fmall-pox, than a plenti-
ful difcharge of urine.
* See Appendix, Anodyne Mixture.
If 
             OF THE  SMALL-POX.          233
   If the mouth be foul,  and the tongue  dry and
chapped, it ought to be frequently waflied, and the
throat gargled with water and honey, fliarpened with
a little vinegar or currant-jelly.
   During the rifmg of  the  fmall-pox, it frequently  ''
happens  that the patient  is feveral days without a
ftool.   This not only tends to heat and inflame the
blood, but the feces, by lodging fo long in the body,
become acrid,  and  even putrid ;  from whence bad
confequences muft enfue.  It will therefore be pro-
per, when the body is bound, to  throw in an  emol-
lient clyfter every day, through the whole courfe  of
the difeafe.   This will  greatly cool and relieve the
patient.
   When petechia?, or purple, black,  or livid fpots
appear among the fmall-pox, the Peruvian bark muft
immediately be adminiftered in as large dofes as the
patient's ftomach can bear.  For a  child, two drachms
of the bark in powder may be mixed in three ounces
of common water, and one ounce  of fimple cinnamon
water.   This may be fliarpened  with the  fpirits of
vitriol, and a table-fpoonful of it  given every hour.
If it be given to an adult in the  fame form, he mav
take at  leaft three or four table-fpoons full  every
hour.   This  medicine ought not to be trifled with,
but muft be adminiftered as frequently as  the fto-
mach can bear it; in which cafe it will often produce
very happy  effects.   I have frequently feen the pe-
techias  difappear, and the fmall-pox, which  had a
very threatening afpect, rife and fill with laudable
matter, by  the  ufe of the bark and acids.
   The patient's* drink ought likewife in this cafe to
be generous, as wine or ftrong negus acidulated with
fpirits of vitriol, vinegar, the juice of lemons, jel^r
of currants,  or  fuch like.   His  food muft con fill cf
roafted apples,  preferved cherries, plums,  and other
fruits of an acid nature.
                                             Th? 
234          OF THE SMALL-POX.                M
   The bark and acids are not only neceffary when   W
the petechias or putrid fymptoms appear, but likewife
in the lymphatic or cryftalline fmall-pox, where the .  M
matter is thin,  and not duly  prepared.   The  Peru-
vian bark feems to poffefs a lingular power of aflifting   _§
Nature in preparing laudable pus,  or what is  called,1JI
good matter ; confequently it  muft be beneficial both   M
in this and other  difeafes, where the crifis depends J||
on a fuppuration.   I have often  obferved where the   Jl
fmall-pox were flat, and the matter contained in them    j
quite clear and  tranfparent,   and where at firft they
had the appearance of  running into  one  another,
that the Peruvian bark, acidulated as above, changed ,\  3§
the colour and confiftence of the matter, and pro-    j
duced the moft  happy effects.                         *'•
   When the eruption fubfides fuddenly, or as it is
termed, when  the  fmall-pox filrike in, before they
have arrived at maturity, the danger is very  great,   M
In this cafe bliftering-plafters muft  be immediately   J
applied to the  wrifts  and ancles,  and  the patient , ™
fupported with  cordials.                            Wm
   Sometimes bleeding has a furprifing effect in railing <?M
the puftules after they have fubfided ; but it requires -jh$m
fkill to know when this is proper, or to what length   4g
the patient can bear it. *   Sharp cataplafms however   Jj
if the pulfe is weak may be  applied to the feet  and    $1
hands, as they  tend to promote the fwelling of thefe   '^
parts.                                               /:
   The moft dangerous period of this difeafe is what    *
we call the fecondary fever.   This  generally  comes    v
on when  the fmall-pox begin to blacken, or turn on
the face ; and moft of thofe who die of the fmall-pox
are carried off by this fever.

  * It is proper when the pulfe is tenfa, whether high or low,
but never when the pulfe is weak or foft.
Nature 
             OF THE SMALL-POX.          235
   Nature often attempts, at the turn of the fmall-
pox, to relieve the patient by loofe ftools,  efpecially
in children.  Her endeavours  this way are by no
means to be counteracted, but promoted, and the
patient  at  the  fame time  fupported by food  and
drink of a nourifhing and cordial nature.
   If, at the approach  of the fecondary fever, the
pulfe be very  quick, hard,  and ftrong,  the  heat
intenfe, and the  breath'.ig laborious,  with other
fymptoms of an inflammation of the breaft, the pa-
tient muft  immediately be bled.   The  quantity of
blood to be let muft be  regulated by the patient's
ftrength, age, and the urgency of the fymptoms.
   But, in  the  fecondary  fever, if  the patient be
faintifh, the puftules become fuddenly pale, and if
there be great coldnefs of the extremities,  bliftering
plafters muft be applied,  and the patient  muft be
fupported with generous cordials.    Wine is often
given, in fuch cafes, with amazing fuccefs.
   As the fecondary fever is in great meafure, if not
wholly, owing  to the puftules, it would feem highly
confonant to reafon  that thefe, as foon as they come
to maturity, fliould  be opened.   This is every day
practifed in other phlegmons, which  tend  to fuppu-
ration ;  and there feems to  be no caufe why it fhould
be lefs  proper  here.   On the  contrary, we have
reafon to believe, that by this means the fecondary
fever might always be leffened,  and often wholly
prevented.
   The puftules fliould be opened when they begin to
turn of a yellow colour.   Very little  art is neceffary
for this operation.   They may either be opened  with
a lancet or  a needle, and the matter  abforbcd by  a
little drv lint.   As the puftules are generally firft
ripe  on the face, it will be proper to begin  with
opening thefe,  and  the  others  in  courfe as  they
become ripe.  The puftules  generally fill again,  a
                                           fecond 
 236           OF THE SMALL-POX.
 fecond or even a third time;  for which caufe, the
 operation muft be repeated, or  rather continued, as
 long as there is any  confiderable appearance of mat-
 ter in the puftules.
   We have reafon  to  believe  that this operation,
 rational as  it is, has been neglected from a piece of
 miftaken tendernefs  in parent:.  They believe that
 it muft give great pain to the poor child ; and, there-
 fore, would rather  fee it dH:, than  have it thus tor-
 tured.   This  notion, however,' is   entirely  without
 foundation.   I have frequently  opened  the  puftules
 "when the patient did not fee me, without his  being
 in the  leaft fenfible of it; but, fuppofe it were at-
 tended with a little  pain,  that is nothing in compa-
 rifon to the advantages which arife  from it.
   Opening the  puftules not  only  prevents  the re-
 forption of the matter into the blood,  but  likewife
 takes off the tenfion of the fkin, and by that means
 greatly  relieves the patient.    It likewife  tends to
 prevent the pitting  which is a  matter of no  fmall
 importance.  Acrid  matter, by lodging long in the
 puftules, cannot fail to corrode  the  tender fkin ; by
 which many an handfome face becomes fo deformed
 as hardly to bear a refemblance to the human figure, *
   It is generally neceffary,  after the  fmall-pox are
 gone off, to purge  the patient.  If, however, the
 body has been open through the   whole courfe of
 die difeafe, or if butter-milk and other things of an
 opening nature, have been  drank  freely after the
 height  of the fmall-pox, purging becomes lefs necef-
 fary ; but it ought never wholly  to be neglected. -

   *  Though this operation can never do  harm, yet  it is only
 neceiury when the patient has a great load of fmall pox, or
 when the matter which they contain is of fo thin and acrid a
 nature, that there is reafon to apprehend bad confequences
from its being too quickly reforbed,  or taken up again into
 the maii of circv.kt;r.g  humors.
                                               For 
              OF THE SMALL-POX.          237
   For very young children, an infufion of fenna and
prunes, with a little rhubarb,  may be fweetened with
coarfe fugar,  and  given  in  fmall quantities  till it
operates.    Thofe  who are  farther  advanced muft
take  medicines of a fharper nature.   For example,
a child of five  or fix years of  age, may take eight or
ten grains of  fine rhubarb in powder, or the fame
quantity of jalap in powder.   This may be wrought
off with frefh broth or water gruel.  For children
further advanced, and adults, the dofe muft be in-
creafed in proportion to the age and conftitution.
   When  impofthumes  happen  after  the fmall-pox,
which is not feldom the cafe, they muft be brought
to fuppuration as foon as poffible, by  means of ripen-
ing poultices,  and opened, if they have not broke of
their  own  accord.  The  Peruvian bark and a milk
diet,  will  likewife be ufeful in this cafe.
   When a cough, a difficulty of breathing, or  other
fymptoms of a confumption,  fucceed to the fmall-
pox,  the patient muft be  fent to a place where the
air is  good, and put upon a courfe of affes or cow's
milk,  with fuch exercife as he can bear.  For fur-
ther directions in this cafe, fee the article Confump-
tions.

               OF INOCULATION.

   Though, perhaps, no difeafe, after it is formed,
baffles the powers of medicine more  effectually than
the fmall-pox,  yet  more may be done before-hand,
to render  this  difeafe favourable, than any one  wc
know, as almoft  all Jvj danger from  it may  be pre-
vented by  inoculation.   This falutary invention has
been knev/n in Ev.rope above half a century ; but,
like moft other ufeful difcoveries, it has, till of late,
made  but  flow  prourefs.   It  muft, however,  be ac-
knowledged* to the honour  of this   country,  that
                                       inoculation
f 
238          OF THE  SMALL-POX.
inoculation has met with a more  favourable  recep-
tion that among any of our neighbours.   It is ftill,
however,  far from being general, which we have
reafon to fear will  be the cafe, as long as the practice
continues in the hands of the faculty.
  No  difcovery can be  of general utility,  while the
practice of it is kept in   the  hands of  a few.   Had
the inoculation  of the fmall-pox been introduced as
a fafhion,  and not as a  medical  difcovery,  or had it
been practifed by the fame kind of operators here,
as it is in thofe  countries from whence we learned it,
it had long ago been univerfal.   Hence  it is, that
the practice of inoculation never became in any mea-
fure general, till taken  up by men not bred to phy-
fic.   Thefe have not only rendered the practice more
extenfive,  but likewife more fafe,  and by  acting un-
der lefs reftraint than the regular practitioners, have
taught them that the patient's greateft danger arofe,
not from the want of care, but from the excefs of
it.
  They know very little of the  matter, who impute
the fuccefs  of  modern  inoculators to any fuperior
fkill,  either in  preparing  the patient or  communi-
cating the difeafe.  Some of them, indeed, from a
fordid defire of  engroffing  the  whole practice to
themfelves,  pretend to have extraordinary fecrets or
noftrums for preparing perfons for  inoculation, which
never fail  of fuccefs.   But this is only a pretence
calculated to blind the  ignorant and inattentive.
Common  fenfe  and prudence  alone  are fufficient,
both in the choice of the fubject and management of
the operatipn.  Whoever  is poffeffed of thefe, may
perform this office for his children  whenever he finds
it convenient, provided they be in a good ftate of
health.
  This fentiment is not the refult  of theory,  but of
obfervation.  Though few phyficians have had more
                         1            opportunities, 
              OF THE SMALL-POX.           239

opportunities of trying inoculation in all its different
forms, fo little  appears  to me  to depend on thofe,
generally reckoned important circumflances  of pre-
paring the  body,  communicating  the infection  by
this or the other method,  &c. that for feveral years
paft,  I have perfuaded the parents  or nurfes to per-
form  the whole  themfelves, and  have found that
method followed with equal fuccefs,  while it is free
from  many  inconveniences that attend the other. ■*
   The  fmall-pox may be  communicated in  a great
variety of ways, with nearly the fame degree  of fafety
and fuccefs.  In Turkey,  from  whence we learned
the practice,  the women communicate the difeafe to
children, by opening a bit of the fkin with a needle,
and  putting  into the wound a  little  matter taken
from a ripe puftule.  On  the coaft of Barbary they
pafs a thread, wet with  the matter, through the fkin
between  the thumb  and fore-finger: and in  fome of
the ftates of Barbary,  inoculation is  performed  by

   * A critical fituation, too  often to be met with, firft. put me
upon  trying this method. A gentleman  who had loft all his
children, except one fon, by  the natural fmall pox, was deter-
mined to have him inoculated.  He told me his intention, and
delired I would perfuade the mother and grand-mother, &c. of
its propriety.  But that was impoffible.  They were not to be
perfuaded, and either could not get the better of their fears,
or were determined againft convidtion.   It was always a point
with me not  to perform the  operation without the confent of
the parties concerned.   I therefore  advifed die father, after
giving his fon  a  dofe  or two of rhubarb, to go to a patient
who had the fmall pox of a good kind, to open two or three
of the puftules, taking up the matter with a little cotton,  and
as foon as he came home, to take his fon apart,  and give his
arm a flight fcratch with a pin, afterwards to rub the place well
with the cotton, and take no further notice of it.  All this he
 punctually performed ; and, at the ufual period, the fmall-pox
 made their appearance, which were of an exceeding  good kind,
 and fo mild as not to  conrine the  boy an hour to his  bed.
 None of the  other relati«ns knew but the difeafe had come m
 the natural way,  till the boy was well.
                                              rubbing 
 =4»           OF THE SMALL-POX.
 rubbing in the variolous matter between the thumb    ]
 and fore-finger, or on other parts of the body.  The
 practice of communicating the fmall-pox, by  rubbing
 the  variolous matter  upon the  fkin, has been  long    \
 known in many parts of Afia and Europe, as well as
 in Barbary, and has  generally gone by the  name of    \
 buying the fmall-pox.
   The  prefent method of inoculating in Britain  is,
 to make two or three flanting incifions in the arm, fo
 fuperficial  as not to  pierce quite through the fkin,
 with a  lancet  wet  with frefh matter  taken from a
 ripe puftule; afterwards the wounds are. clofed up,
 and  left without  any dreffmg. *                        ,
   We do not find that inoculation is at  all confidered  .  J
 as a medical operation in thofe countries from whence
 we learned  it.   In Turkey it  is  performed by the
 women, and in the Eaft Indies by the Brachmans  or
 priefts.   In this country, the cuftom is ftill too much
 in its infancy; we  make no doubt,  however, but it
 will foon become fo familiar, that parents will think
 no more of inoculating their children,  than at  pre-
 fent they do of giving them a purge.
   No fet of men have it fo much in their power to
 render  the  practice of  inoculation general  as the
 clergy,  the greateft oppofition to  it ftill arifing from
 fome fcruples of confeience.  I would recommend it
 to them not only to endeavour to remove the religi-
 ous objections  which weak minds may have to  this
 falutary practice, but to enjoin  it as  a duty, and  to
 point out the danger of neglecting to make  ufe of a
 mean which Providence has put  in our power for

  * The American method is, to open the ripe puftules with
 a lancet,  put the matter on a bit of glafs or ivory,  and when
 it is to be ufed, render ic moift with  a little cold water, wet
the point of a lancet with it, and introduce it under the  fkin,
fo as juft to fee the blood: one puncture is  as certain as a
dozen.
                        2 ■                  faving 
                OF THE SMALL-POX.            241

 Giving the lives of our offspring.  Surely fuch parents
 as wilfully neglect the means of faring their children's
 lives, are as guilty as thofe  who  put them  to death.
 I  wifh this matter were duly weighed.   No one is
 more ready to make allowance for human weaknefs
 and  religious prejudices, yet I cannot help  recom-
 mending it, in  the warmeft manner,  to parents, to
 confider how great an injury they  do their  children,
 by neglecting to give them  this difeafe in the  early
 period of life.
   The numerous advantages arifing from the inocu-
 lation of the fmall-pox have been pretty fully pointed
 out by the learned Dr. M'Kenzie, in his hiftory of
 Health. *   To thofe mentioned  by the Doctor we


   * " Many and gvea*.," fays this him.ine author, " are the
 "  dangers attending the natural infection, from all which the
 " inocul.i'i  n is quite fecure.  The natural infection  may in-
 " vade weak or  diftempered bodies by no means  difpofed
 •' for its kindly reception.   It may attack them at  a feafon
 " of the year either violently hot, or intenfely cold.  It may
 " lay hold  upon people, unexpectedly.    It may furprife u?
 " foon after exceiies committed  in luxury, intemperance, or
 " lewdnefs.  It may likewife feize on the innocent after in-
 " difpcnfable watchings,  hard  labour,  or neceffary journies.
 " And is it a trivial  advantage, that all thefe unhappy cir-
 " cumftances can be prevented by inoculation i By morula-
 " tion  numbers  are  Javed  from deformity as well as from
 " death.  In the  natural  fmall pox, how  often are the  fineft
 '* features,  and the moft beautiful complexions, miferably dif-
 " figured ? Whereas inoculation rarely leaves any ugly marks
 " r>f fears, even where the number of puftules on the face has
*' been very confiderable,  and the  fymptoms by no means fa-
" \ourable.   And many  other grievous complaints, that are
" frequently fubfequent to the natural fort, feldom "follow the
" artitici.il.   Does not injculation alfo prevent thofe inexpref-
" fible terrors that perpetually harafs perfons who never had
" this difeafe, infomuch that when the fmall-pox is epidemical,
" entire villages are depopulated, markets ruined, and the face
" of diflrefs is fpread over the whole country r From this terror
" it arilos, that juflice is frequently p^ftponed, or difcouraged,
 " ;:t fcihons or affiles where the  fmall-pox rages.  Witneifes
                          R                      " and 
3^2           OF THE SMALL-POX.
fliall only add, that fuch as have not had the fmall-
pox in the early period of life, are not only rendered
unhappy, but likewife in  a great  meafure unfit for
fuftaining many of the moft  ufeful and important
offices.   Few people would chufe even to hire a fer-
vant who had not had the fmall-pox.  I low could a
phyfician or a furgeon, who had  never had the fmall-
pox himfelf,  attend others under that malady ? How
deplorable is  the fituation of females, who arrive at
mature age without having  had the fmall-pox !  If an
infant happen to be feized with the fmall-pox  upon
the mother's breaft, who has not had the difeafe her-
felf, the fcene muft be diftreffing ! If fhe continue to
fuckle  the child, it is at the  peril of her own life;
and if  flie wean it, in all probability it will perifli.
I low often is the  affectionate mother forced to leave
her  houfe, and abandon her children,  at the very
time  when her care  is moft neceffary ? Yet fhould
maternal affection  get the better of her fears, the
confequences would  often   prove  fatal.    I  have
known  the  tender mother  and her fuckling infant
laid  in  the  fame  grave,  both  untimely victims  to
this  dreadful malady.   But  thefe are fcenes too
fhocking even  to  mention.   Let parents who run
away with their children to avoid the fmall-pox,  or
who refufe to inoculate them in infancy,  confidcr to

,:  and juries dare not appear.  Does not inoculation, in like
 " manner,  prevent   our failors from being feized  with this
 *' diftemper on fhipboard,  where they mull  quickly  fpread
 •« the infection among fuch of the  crew  who never  had it
 «* before, and where they have  fcarce  any chance to efcape,
 " being half ftifled with the clofenefs  of their cabins, and
 " but very indifferently nurfed ? Laftly, with regard to  the
 " foldiery,  the miferies attending thefe pocr  creatures vhen
 " attacked by the fmall-pox on  a march, ;ne inconceivable,
 " without attendance, without lodgines, w"thout any accom-
 " modation ; fo that one cf three  commonly perifh:;:."
what 
              OF THE SMALL-IOX.          243
what deplorable fituations they may be reduced by
this miftaken tendernefs!
   As the  fmall-pox has now become  an epidemical
difeafe in moft parts of the known  world,  no other
choice remains but to render the malady as mild  as
poffible.    This is  the  only  manner  of extirpation
now left in our power ;  the artificial method of com-
municating the difeafe, could it be rendered univer-
fal, would amount to nearly the fame  thing as root-
ing it out.   It is a matter of fmall confequence, whe-
ther a difeafe be entirely extirpated, or  rendered  fo
mild as  neither to deftroy life nor hurt  the conftitu-
tion ; but  that this may be done by inoculation, does
not now admit of a doubt.   The numbers who die
under inoculation hardly deferve to be  named.   In
the natural way, one in four or five generally dies :
but  by inoculation not one  of a thoufand.    Nay,
fome can boaft of having  inoculated ten thoufand-
without the lofs of a fingle patient.
   I  have  often wifhed to fee fome plan eftablifhed
for rendering this falutary practice univerfal; but am
afraid I fliall  never  be fo  happy.   The difficulties
indeed are many ; yet the thing is by no means im-
practicable.   The aim is great ;  no lefs than faving
the lives of one-fourth part  of  mankind.    Wiiat
ought not to be attempted in order to accomplifh  fo
defirable an  end ?
   The firft ftep towards rendering the practice uni-
verfal, muft be to remove  the religious prejudices
againft it.   This, as already  obferved, can be done
by the clergy.  They muft not only  recommend  it
as a duty to others,  but  likewife practice it on their
own  children.   Example will ever have more influ-
ence than precept.
   The next thing requifite is  to put it in the power
of all.  For this purpofe we would recommend it  to
the Faculty to inoculate the children  of the poor
                       R  2                gratis. 
244          OF THE SMALL-POX.
gratis.  It is hard that fo  ufeful a part of mankind
fliould by their poverty be excluded from fuch a be-
nefit.
   Should this fail, it is furely in the power of any
State to render the practice general, at leaft as far
as their dominion extends.   We do not mean that
it ought to be enforced by  a law.   The beft way to
promote it would be to employ a fufficient mimber
of operators  at the  pubiic  expence to inoculate the
children of  the poor.    This  would  only  be ne-
ceffary till the practice became general ; afterwards
cuftom, the  ilrongeft of all Ihws, would oblige every
individual to inoculate  his children to prevent reflec-
tions.
   It may be objected  to this  fcheme,  that the poor
would refufe to  employ the inoculators ;  this diffi-
culty is eafily  removed.  A fmall  premium to en-
able  mothers to attend their children  while under
the difeafe,  would be  a fufficient inducement  ; be-
fides, the fuccefs attending  the operation would foon
banifh all objections to it.   Even  confiderations of
profit would induce the poor to embrace this  plan.
They often bring up their children to the age of ten
or twelve, and when they come to be ufeful, they are
fnatched away by this  malady, to  the great lofs of
their parents, and detriment of the  public.
   The Britifh legiflature  has of  late years fliewn
great attention to the prefervation of  infant-lives,
by fupporting  the foundling hofpital, &c.   But we
will venture to fey, if one-tenth part of the fums
laid out in  fupporting that  inftitution, had  been
bellowed towards promoting the practice of inocu-
lation of the fmall-pox among the poor,  that not
only more ufeful lives had been faved, but the prac-
tice ere now rendered quite univerfal in this ifland.
It is  not to  be imagined what effect example  and  a
little money will have upon the poor ;  yet, if left to
                                       themfelves, 
              OF THE SMALL-POX.           245
 themfelves, they would go on for ever in the old way,
 without  thinking of any  improvement.    We only
 mean this as a hint to the humane and public-fpirited.
 Should fuch a fcheme  be approved,  a proper plan
 might eafily be laid down for the  execution of it.
   Bur as public plans  are  very difficult  to bring
 about, and often, by  the felfifh  views and mifcon-
 duct of thofe entrufted with the execution  of them,
 fail of anfwering the noble purpofes for which they
 were defigned ; we fliall therefore point  out fome
 other  method by which the benefits of inoculation
 may be extended to the poor.
   There is no doubt but inoculators will  daily be-
 come more  numerous.  We would  therefore have
 every parifh in Britain to allow them a fmall  annual
 falary for inoculating all the children of the parifh at
 a proper age.   This might be done at a very trifling
 expence, and it would enable every one to  enjoy the
 benefit of this falutary invention.
   Two things chiefly operate to prevent the progrefs
 of inoculation.   The one is  a wifh to put the evil
 day as far off as poffible.  This  is a principle  in our
 nature;  and  as  inoculation feems  rather to be anti-
 cipating  a future  evil,  mankind  are  therefore fo
 averfe  to it.   But this objection is  fufficiently an-
fwered by the fuccefs.  Who in his fenfes would not
prefer  a  leffer evil to-day to a greater to-morrow,
provided they were equally certain ?
  The other obftacle is the fear of reflections.   This
has very great weight with  the bulk of  mankind.
Should the child  die, they think the world  would
blame them.   This they cannot bear.  Here lies the
 diiiiculty ; and till that be removed, inoculation will
make but fmall progrefs.   Nothing, however, can
 remove it but cuftom.  Make  the practice fafhion-
 able, and all objections will foon  vanifli. It  is fafhion
 that has, in a great degree,  led the multitude fince
                       Pv 3                    the 
24&          OF THE SMALL-POX.
the beginning of the world, and will lead them to
the end.  We  muft therefore  call upon the more
enlightened part of mankind  to fet a pattern to  the
reft.  Their  example, though it may for fome  time
meet with oppofition, will at length prevail.
   I am aware of the objection to this practice from
the expence with which it may be attended:  this is
eafily obviated.   We do not mean that  every parifli
ought to employ a Sutton or a Dimfdale  as inocu-
lators.  Thefe have, by their fuccefs, already recom-
mended  themfelves,  and are  beyond   the  vulgar
reach ;  but  have not others an equal chance to  fuc-
ceed ?  They certainly have.  Let them make the
fa rue  trial,  and  the  difficulties  will  foon  vanifh,
There is not a parifh, and hardly a village in Britain,
deflitute of fome perfon who can bleed.   But this is
a far more   difficult  operation, and requires both
more fkill and dexterity than inoculation.
   The  perfons  to  whom we would chiefly  recom-
mend the performance of  this operation,  are the
clergy.   Moft of them know fomething of medicine,
Almoft all of  them bleed,  and can order  a purge,
which are  all the  qualifications  neceffary for  the
practice of inoculation.  The priefts among  the lefs
enlightened Indians  perform this office,  and why
fliould a  Chrftian teacher think himfelf above it ?
Surely the bodies of men, as well as their fouls, me-
rit a part of the paftor's care ; at leaft the greateft
Teacher who ever  appeared among men thought fo.
   Should all other methods fail, we would  recom-
mend it to parents to perform the operation them-
felves.   Let them take any method of communi-
cating the difeafe they pleafe ;  provided the  fubjects
be healthy,  and of a  proper age, they will feldom
fail to fucceed to their wifh.   I  have known many
inftances even of mothers performing the operation,
and never fo much  as heard of one bad confequence.
                                         A planter 
             OF THE  .SMALL-POX.           247
A planter in one of the  Weft India iflando is faid to
have inoculated, with his own hand,  in  one year,
three hundred  of  his flaves, who, notwithftanding
the warmth of  the climate, and  other  unfavourable
circumftances,   all   did  well.   Common  mechanics
have often, to  my knowledge, performed  the opera-
tion with as good fuccefs as phyficians.   We do not,
however,  mean to difcourage thofe who  have it in
their power, from employing people of fkill to inocu-
late their children,  and  attend them while under the
difeafe, but only to fliew, that where fuch cannot be
had, the operation ought not, upon that account, to
be neglected.
   We have been the more full upon this  fubject be-
caufe the benefits of inoculation cannot be extended
to  fociety by  any other means than by making the
practice  general.  While it  is confined to a few, it
muft prove hurtful  to  the  whole.  By means of it
the contagion  is  fpread, (and is  communicated to
many who might otherwife never  have had the dif-
eafe.   Accordingly  it is found that more die of the
fmall-pox  now than before  inoculation  was intro-
duced ; and this important difcovery, by which alone
more lives might be faved than by  all the  endeavours
of the  Faculty, is in great meafure loft by its benefits
not being extended to the whole community. *
   The fpring and autumn are ufually reckoned the
moft proper  feafons for inoculation,  on  account of
the weather being then moft temperate.
   The moft proper age for inoculation  is between
 two and five.   Many approve of  inoculating on  the
 breaft, and where no circumftances forbid this prac-
 tice, 1 have no objection to it.  Children,  however,

   * Bv a well-laid plan for extending inoculation, more lives
 might be faved at a fmall expence, thin are at pre'tnr preferved
 by all the hofpitals in E.'g'and,  which coll the public .uch an
 amazing fum.
                        R  4                   are 
248          OF THE  SMALL-POX.
are more liable to convulfions at this time than after.
wards ; befides, the anxiety of  the mother or nurfe,
fliould the child be  in danger,  would  not  fail  to
heighten it by  fpoiling the milk.
   Children who have  conltitutional   difeafes muft
neverthelefs be inoculated.   It will often  mend the
habit of body ; but oudii:  to be performed at a time
when they  are moft healthy.    Accidental  difeafes
fliould always, if poffible,  be removed before inocu.
lation.
   It  is generally thought neceffary to regulate the
diet for fome time  before the  difeafe be communi-
cated.  In children, however, great alteration in diet
is feldom neceffary, their  food being commonly  of
the moft fimple and wholefome kind, as milk, water-
pap, weak broths, bread, light pudding,  mild roots,
and white meats.
   But children who have  been accuftomed to a
hotter diet,  who are of a grofs habit,  or  abound
with bad humors, ought to be  put upon a fpare diet
when they are inoculated.   Their food fhould be  of
a light cooling nature, and their drink  whey, butter*
milk, and fuch like.
   We would recommend no  other medicinal pre-
paration but two or three mild purges, which ought
to be fuited to  the age and ftrength of the patient. *
The fuccefs  of inoculators  does  not depend  on the
preparation of their patients, but on  their manage-
ment of them while under the  difeafe.  Their con-
ftant care  is to  keep  them  cool, and their bodies
gently open, by which means the fever is kept low,
and the eruption greatly leffened.  The  danger  is
feldom or never  great when the puftules  are  few ;
and their  number is  generally  in  proportion to the

  * Many phyficians, however, are in fhe praclice of giving one
of the mercurial powders (fee Appendix) every r.ioinisig after
the inoculation, until the eruption.
                                             fever 
              OF THE MEASLES.            249
fever which precedes  and  attends  the  eruption.
Hence the chief fecret of inoculation confifts  in  re-
gulating the eruptive fever, which generally may be
ktpt fuiheiently low  by  the  methods mentioned
above.
  The  regimen during the difeafe  is in all refpects
the fame as under the natural fmall-pox.  The pa-
tient muft  be  kept  cool,  his diet  fhould  be light,
and Lis drink weak  and diluting, &c.   Should any
bad fymptoms  appear, which is feldom the cafe, they
muft be treated  in filename way as  directed in the
natural fmall-pox.
               CHAP.   XXV.

                 Of the Meafles.


           1 HE meafles appeared in Europe about
the fame time with the fmall-pox, and  have a great
affinity to that difeafe.  They both came from the
fame quarter of the world, are both contagious, and
d > not attack the fame perfon more than once. The
meafles  are  moft  common in the fpring feafon, and
generally difappear in fummer.   The difeafe itfelf,
when properly managed, feldom proves  fatal; but
its confequences are often very troublefome.
  CAUSE.—This difeafe,  like the fmall-pox, pro-
ceeds from infection, and is  more  or lefs dangerous
according to the conftitution  of  the patient,  the fea-
fon of the year, the climate,  &c.
   SYMPTOMS.—The meafles, like  other feverifh
complaints, are preceded by alternate fits of heat and
cold, with ficknefs, and lofs of appetite. The tongue,
                                               is 
270
OF  THE MEASLES.
is  white,  but generally moift.    There  is a fliort
cough, a heavinefs of the head and eyes, drowfinefs,
and a running at  the nofe.   Sometimes indeed the
cough  does  not  come before the eruption has ap-
peared.  There  is an  inflammation and heat in the
eyes, accompanied with a defluxion of fharp rheum,
and great acutenefs of fenfation, fo that they cannot
bear the light without pain.   The eye-lids frequently
fwell fo as to occafion blindnefs.   The patient gene-
rally complains of his throat ;  and  a  vomiting or
loofenefs often precedes thq| eruption.   The ftools
in  children  are commonly greenifh ;  they complain
of an itching of the fkin, and are remarkably peevifh.
Bleeding at  the nofe is common,  both before and in
the progrefs of the difeafe.
   About  the fourth day,  fmall  fpots, refembling
flea-bites, appear,  firft upon the face, then upon
the breaft,  and afterwards on the extremities : thefe
may be diftinguiflied from  the  fmall-pox  by  their
fcarcely rifing above the ikin.  The fever,  cough,
and difficulty of breathing, inftead of being removed
by the eruption  as in the fmall-pox, are rather in-
creafed ; but the vomiting generally ceafes.
   About the fixth or feventh day from the time of
fickening, the meafles begin to turn pale on the face,
and afterwards upon the body;  fo that  by the ninth
day they entirely  difappear, leaving furfuraceous or
branny  appearances of the  fkin.   The fever, how-
ever,  and  difficulty of breathing,  often  continue,
efpecially if  the patient has  been kept upon too hot
a regimen.   Petechiae, or purple fpots,  may likewife
be occafioned by this error.
   A violent loofenefs fometimes fucceeds the  mea-
fles ; in which cafe  the patient's life is in imminent
danger.
   Such as die of the meafles generally  expire about
the ninth day from the infection, and are commonly
                                           carried 
              OF THE MEASLES.            251
carried off by the peripneumony, or inflammation  of
the lungs.
   The moft favourable fymptoms  are  a moderate
loofenefs, a moift fkin, and  a  plentiful difcharge  of
urine.
   When the  eruption fuddenly ftrikes  in, and the
patient is feized with a delirium, he is in the greateft
danger.  If the meafles turn too foon of a pale  co-
lour,  it is  an unfavourable  fymptom,   as  are alfo
great weaknefs,  vomiting,  reftleffnefs, and difficulty
of fwallowing.   Purple  or black fpots appearing
among the meafles are very unfavourable.   When a
continual cough, with hoarfenefs,  fucceeds the  dif-
eafe, there is reafon to fufpect an approaching con-
fumption of the lungs.
   Our bufmefs in this difeafe  is to aflift Nature,  by
proper cordials, in throwing out the eruption, if her
efforts be too languid ;  this, however, is feldom  the
cafe : but  when they are  too violent they muft be
reftrained by evacuations,  and cool diluting liquors,
Bzc.  We ought likewife  to  endeavour to appeafe
the moft urgent fymptoms, as the cough, reftleffnefs,
.uid difficulty of breathing.
   REGIMEN.—The cool regimen is neceffary here
as well as in the fmall-pox.   The food  too muft  be
light,  and the drink diluting.   Small-beer  likewife,
though a good drink in the fmall-pox, is here impro-
per.    The  moft fuitable  liquors are decoctions  of
liquorice with marflimallow roots,  infufions of flax-
feed, or the flowers of elder, balm-tea, whey, barley-
water,  bran-tea, and fuch like.   Thefe, if the  pa-
 tient be coftive, may be fweetened with honey ;  or,
 if that fliould difagree  with  the  ftomach, a little
 brown-fugar may occafionally be added to them.
   MEDICINE.—The mealies being an inflammatory
 difeafe, without any critical difcharge of matter, as
 in the fmall-pox,   bleeding is commonly neceffary,
                                         efpecially 
^*           OF THE  MEASLES.
efpecially when the fever runs high, with difficulty of
breathing, and great oppreffion of the breaft.  But if
the difeafe be of a mild kind, bleeding may be omitted.
   The patient is often greatly relieved by vomiting.
When there  is a  tendency this way, it ought to be
promoted  by drinking lukewarm water, or weak ca-
momile-tea.
   When the cough  is very troublefome, with dry-
nefs of  the throat, and difficulty of breathing, the
patient may hold  his  head over the fleam of warm
water, and draw the fleam into his  lungs.
   He may likewife lick a litde fpermaceti and fugar-
candy pounded together; or take now and then a
fpoonful of the  oil of fweet almonds, with  fugari
candy diffolved in  it.   Thefe will foften the  throat-,
and relieve the tickling cough.
   If at the turn of the difeafe the fever affumes new
vigour, and there appears great danger of fuffoca-
tion, the patient muft'be bled according to his pulfe,
and bliftering-plafters applied, with  a view to prevent
the load from being  thrown on  the lungs, where if
an inflammation  fliould  fix  itfelf,  the patient's life
will be in danger.
   In cafe the meafles fliould fuddenly  difappear, it
will be neceffary  to  purfue the  fame method which
we have recommended when the  fmall-pox recede.
The patient muft be fupported with wine and cordials.
Bliftering-plafters  muft be applied to the legs and
arms,  and the body rubbed all  over  with warm
flannels.  Warm  poultices may be likewife applied
to the feet and palms of the hands.
   When  purple or black fpots appear, the patient's
drink fliould be fliarpened with fpirits of vitriol; and
if thefe fymptoms  increafe, the  Peruvian bark muft
be adminiftered in the fame manner as directed in the
fmall-pox.
Opiates 
              OF THE MEASLES.           253
   Opiates are fometimes neceffary, but fliould never
be given except in cafes of extreme reftleffnefs, a
violent loofenefs, or when the cough is very trouble-
fome.   For  children,  a  tea-fpoonful  of afthmatic
elixir may  be occafionally  given,  according  to the
patient's age, or  the  violence, of  the  fymptoms.
Whenever opiates are given in this difeafe, antimonial
wine fhould be added.   One or two tea-fpoonsful  of
the paregoric mixture (fee Apvendix) may be given
every two or three hours, if neceffary.
   After the  meafles are gone off,  the patient ought
to be purged.  This may be conducted in the fame
manner as  directed in the fmali-pox.
   If a violent loofenefs fucceeds  the meafles,  it may
be checked by taking for fome days a gentle  dofe of
rhubarb in the morning,  and an opiate over night;
but if thefe do not remove it, and  the pulfe is hard,
bleeding will feldom fail to have that effect.
   Patients  recovering  after the  meafles  fliould  be
careful  what  they eat or drink.   Their food for
fome  time ought to be light, and in fmall quantities,
and  their drink diluting, and rather of an opening
nature, as  butter-milk, whey, and fuch like.   They
ought alfo  to beware of expofing themfelves too foon
to the cold air, leaft a fuftbcating catarrh, an afthma,
or a confumption of the lungs, mould enfue.
   Should a cough, with difficulty of breathing, and
other fymptoms of a confumption,  remain  after the
meafles, fmall quantities of blood may be frequently let
at proper intervals, as the patient's ftrength and confti-
tution will permit. He ought likewife to drink milk, to
remove to a free air, if in a large  town, and to ride
daily  on horfeback.   He muft keep clofe to a diet con-
lifting of milk and vegetables ; and  laftly, if thefe do
not fucceed,  let him remove to a warmer climate. *

   *  Attempts have been made to communicate the meafles,
as well as the fmall-pox, by inoculation, and we make no doubt
                                               but 
r  254   ]
            OF THE SCARLET FEVER.

   The fcarlet fever is fo called from the colour of the
patient's fkin,  which appears, as if it  were, tinged
with red wine. It happens at any feafon of the year,
but  is moft common towards the end  of fummer  ; at
which time it often feizes whole families; children
and  young perfons are moft fubject to it.
   It begins,  like other  fevers,  with  coldnefs  and
fhivering,  without any violent ficknefs.   Afterwards
the fkin is covered with red fpot% which are broader,
more florid, and lefs uniform than the meafles.   They
continue two or  three  days,  and  then  difappear ;
after which  the cuticle or fcarf-fkin falls off.
   There is  feldom any  occafion  for medicine in  this
difeafe.   The patient ought, however, to keep with-
in doors, to abftain  from  flefh,  ftrong liquors,  and
cordials, and to drink freely of cool diluting liquors.
If the fever  runs  high, the body  muft  be kept gently
open by emollient clyiters,  or fmall dofes of flowers
of fulphur and cream of tartar.

but in time the practice may fucceed.  Dr. Home of Edin-
burgh fays, he communicated the difeafe by the blood.  Others
have tried this method, and have not found it fucceed.  Some
think the difeafe would be more certainly communicated, by
rubbing the fkin of a patient who has the meafles with cotton,
and afterwards applying the cotton to a wound, as in the fmall-
pox ; while others rccemmend a bit of flannel, which had  been
applied to the patient's fkin  all the time of the difeafe, to be
afterwards laid upen the arm or leg  of the perfon, to whom
the infection is to be communicated.  There is no doubt but
this difeafe, as well  as the fmall-pox,  may be communicated
various  ways ;  the moft probable, however,  is either from
cotton rubbed upon the fkin, as mentioned above, or by intro-
ducing a little of the fharp humor, which diftils from the eyes
of the patient into the blood.  It is agreed on  all hands,  that
fuch patients  as have  been inoculated had the difeafe  very
mildly; we therefore wifh the praflice were more general, as
the meafles are often fatal.
                                             Children 
           OF THE BILIOUS FEVER.         255
  Children and young perfons  are  fometimes feized
at the beginning of this difeafe, with a kind of flu-
por and epileptic fits.   In this cafe,  the feet and legs
fhould be bathed in warm water, a large bliftering-
plalter applied to the  neck,  and the patient bled, if
the pulfe is ftrong and hard.
  The fearlet fever,  however, is  not always of fo
mild a nature.   It is fometimes attended with putrid
or malignant fymptoms, in which  cafe  it is always
dangerous.  In the malignant fearlet fever, the pa-
tient is not only affected with coldnefs and fhivering,
but with languor, ficknefs,  and great oppreflion ;  to
thefe fucceed exceffive  heat,  naufea  and vomiting,
with a forenefs of the throat;  the pulfe  is extremely
quick, but fmall and depreffed; the  breathing fre-
quent  and laborious ;  the  ikin  hot,  but  not quite
dry ; the tongue moift,  and covered with a whitifh
mucus;  the tonfils inflamed and ulcerated.   When
the eruption appears,  it brings no relief:  on  the
contrary, the fymptoms generally  grow worfe, and
frefh ones come on, as purging, delirium, &c, *

            OF THE  BILIOUS FEVER.

  When a continual,  remitting, or  intermitting fever
is accompanied with  a frequent  or copious evacua-
tion of bile, either by  vomit or ftool,  the fever is
denominated bilious.    The bilious fever generally
makes its appearance  about the end of fummer, and
ceafes  towards the approach of  winter.   It is moft
frequent and fatal in warm countries, efpecially where
the foil is marfliy, and when great rains are fucceeded
by fultry heats.   Perfons who work without doors,

  * For the treatment of this mr.lignant  fearlet fever, as it is
here called, fee putrid ulcerous fore-throat, as  there is every
reafon to believe they are the fame difeafes,  differing only in
the  violence of the fymptoms.
                                               lie 
256*        OF THE BILIOUS FEVER.
 lie in camps,  or who are expofed to the night air,
 are moft liable to this kind of fever.
   If there  are  fymptoms  of  inflammation  at the
 beginning of this fever, it will be neceffary to bleed,
 and to put the patient upon the cool diluting regimen
 recommended in the inflammatory  fever.   The fa-
 line draught may likewife be frequently adminiftered,
 and the patient's body kept open by clyfters or mild
 purgatives.   But if the fever fliould remit or  inter-
 mit, bleeding will feldom be neceffary.   In this cafe,
 a vomit  may be adminiftered, and, if the body be
 bound, a gentle purge ; after  which  the Peruvian
 bark will generally complete  the cure.
   In cafe of a violent loofenefs, the patient muft be
 fupported  with chicken-broth,  jellies  of  hartfliorn,
 and the like ;  and he may ufe the white decoclion for
 his ordinary drink. *   If a bloody flux fhould accom-
 pany this fever, it muft  be  treated in the manner
 recommended under the article Dyfentery.
   When  there  is a  burning  heat,  and the patient
 does  not  fweat, that evacuation  may  be  promoted
 by giving him,  three or  four times a-day, a table-
 fpoonful of Mindererus's fpirit, f mixed in a cup of
 his ordinary drink.
   If the bilious fever be  attended with the nervous,
 malignant, or putrid fymptoms,  which  is  fometimes
 the cafe,  the  patient muft  be treated  in  the fame
 manner as directed under  thefe difeafes.
   After  this fever, proper care is neceflary to pre-
vent a relapfe.   For this purpofe, the patient, efpe-
cially towards the end of autumn, ought to continue
the ufe of the Peruvian bark,  for fome  time after he
is  well.   He fliould likewife  abftain from all trafliy
fruits, new  liquors,  and  every  kind  of  flatulent
aliment.
          *  See Appendix,  White DecaRion.
          f See  Appendix,  Spirit of Mindererus.
                       i                    CHAP- 
C  ?J7  ]
                 CHAP.  XXVI.

      Of the Eryfipelas,  or St. Anthony's Fire.


           1 HIS  difeafe, which  in  fome  parts of
Britain is called the rofe, attacks perfons  at  any
period of life,  but is moft  common between the age
of thirty  and  forty.  Perfons of a fanguine or  ple-
thoric habit are moft liable  to it.   It often attacks
young  people, and pregnant women  ;  and fuch as
have once  been  afflicted  with it are very liable to
have it again.   Sometimes it is a primary  difeafe,
and at other times only a fymptom  of fome other
malady.   Every part  of the body is liable to  be at-
tacked by an eryfipelas, but it moft frequently feizes
the legs or face, efpecially the  latter.  It  is moft com-
mon in autumn, or when hot weather is fucceeded by
cold and wet.
  CAUSES.—The eryfipelas may be occafioned by-
violent  paflions or affections of the mind;  as fear,
anger, &c.   When  the body has been  heated to a
great degree, and is immediately expofed to the cold
air,  fo that  the perfpiration is fuddenly  checked,  an
eryfipelas will often enfue*.  It may alfo be occafioned
by  drinking to excefs, by continuing too long in a
warm bath, by vegetable and mineral  poifons, or by

    The country people in many p:irts of Bi itain c ill this dif-
eafe a bla/i, and imagine it proceeds from foul air, or ill wind,
as they term it.  The truth  is, they often lie down to reft
ihem, when warm and fatigued, upon the damp  ground, where
they fall afleep, and lie fo long  as  to catch cold, which occa-
li ns the eryfipelas.  This difeafe  may indeed  proceed from
other caufes, but  we may venture to fay, that  nine times out
of ten it is occafioned by cold caught after the body has been
greatly heated or fatigued.
                          S                     any 
258          OF THE ERYSIPELAS,
any thing that overheats the blood.   If any of the
natural evacuations be obftructed, or  in too  fmall
quantity, it may caufe an eryfipelas.  The fame  effect
will follow from the ftoppage of artificial evacuations ;
as iffues, fetons, or the like.
   SYMPTOMS.—The eryfipelas attacks with fliiver-
ing, thirft,  lofs  of ftrength; pain in the head and
back, heat,  reftleffnefs, and a quick pulfe ; to which
may be added vomiting, and  fometimes a delirium.
On the fecond, third,  or fourth day, the part fwells,
becomes red, and fmall puftules appear ; at which
time the fever generally  abates.
   When the eryfipelas feizes the foot, the parts con-
tiguous fwell, the fkin fhines ; and, if the pain be vio-
lent,  it will  afcend to  the leg,  and will not  bear  to
be touched.
   When it  attacks the face, it fwells,  appears red,
and the Jkin is often covered with fmall puftules, filled
with  clear water.   One or both eyes  are generally
clofed  with  the fwelhng ; and there is a difficulty  of
breathing.
   If the eryfipelas affects  the  breaft,  it fwells and
becomes exceedingly hard, with great pain, and may
fuppurate.   There is fometimes. a violent pain in the
arm-pit on the fide affected, where an abfeefs  is often
formed.
   If in a day or two  the fwelling fubfides, the heat
and pain abate, the colour of the.  part turns  yellow,
and the cuticle breaks  and falls off in fcales, the dan-
ger is  over.
   When the eryfipelas is large, deep,  and affects a
yery fenfible part  of the body, the. danger is great.
If the  red colour  changes into a livid or black,  it
may end in a mortification.   Sometimes the inflam-
mation cannot be difcuffed,  but comes to a fuppura-
tion ;  in which cafe, fiftulas, a-gangrene, or  mcrtiii-
cation,  often enfue. 
           OR ST. ANTHONY'S FfRE.         259
   Such as die of  this difeafe are commonly carried
off by the fever, which is  attended  with difficulty
of breathing,  and fometimes with a delirium and great
drowfinefs.   They generally die about the feventh
or eighth day.
   REGIMEN.—In  the eryfipelas the patient muft
neither  be kept too hot nor too cold, as either of
thefe extremes will tend to make it retreat, which is
always to be  guarded againft.   When the difeafe is
mild,  it will  be fufficient to keep the patient within
doors, without confining him to his bed, and to pro-
mote  the perfpiration by diluting liquors, &c.
   The diet ought to be flender, and of a moderately
cooling and moiftening quality,  as oatmeal-gruel, pa-
nada, chicken or barley-broth,  with  cooling herbs
and fruits,   &c.  avoiding  flefh, fifh, ftrong drink,
fpices, pickles, and  all  other things  that may heat
and inflame  the blood ;  the drink  may  be  barley-
water, an infufion of elder  flowers,  common whey,
and fuch like.
   But if the  pulfe be low, and the fpirits funk,  the
patient  muft  be fupported  with negus,  and other
things of a cordial nature.   His food may  be fago
gruel, with a  little wine, and nourifhing broths taken
in fmall quantities, and often repeated.   Great care
however muft be taken not to overheat him.
  MEDICINE.—In this difeafe much  mifchief is
often  done by  medicine, efpecially  by  external ap-
plications.  People,  when they fee an inflammation,
immediately think that fomething ought to be applied
to it.   This indeed is neceffary  in large phlegmons;
but in an eryfipelas  the fafer courfe is to apply  no-
thing.   All  ointments,  falves,   and  plafters,  being
of a greafy nature, tend rather to obftruct and repel,
than promote any difcharge  from the  part.  At  the
beginning of  this difeafe it is neither fafe to  promote
a fuppuration, nor to repel the matter too  quickly.
                     S 2                     The 
26s          OF THE ERYSIPELAS,
The eryfipelas  in many refpects refembles the gout,
and is to be treated with the greateft caution.  The
inflamed parts fliould be kept  conftantly powdered
with rye-meal.
   It is common to bleed in the eryfipelas ; but this
likewife requires caution.   If, however, the fever be
high, the pulfe hard  and ftrong,  and  the  patient
vigorous,  it will be proper to bleed ; but the quan-
tity muft  be regulated by thefe circumftances, and
the operations repeated as the fymptoms may require.
If the patient has been accuftomed to ftrong liquors,
and the difeafe  attacks his head, bleeding is abfolute-
ly neceffary.
   Bathing the  feet and legs frequently in lukewarm
water, when the difeafe attacks  the face or brain,
has an excellent effect.  It tends to make a  deriva-
tion from the head, and feldom  fails  to relieve the
patient.   When bathing proves ineffectual poultices,
or fharp finapifms, may be applied to the feles of the
feet, for the fame  purpofe.
   In cafes where bleeding is requifite, it is likewife
neceffary  to  keep the body open.  This may be ef-
fected by  emollient clyfters, or fmall dofes  of nitre
and rhubarb.  Some indeed recommend very large
dofes of nitre in the eryfipelas ;  but nitre feldom fits
eafy on the ftomach when taken in large dofes.  It
is, however, one of the beft medicines when the fever
and inflammation run high.  Half a drachm of it, with
four or five grains of rhubarb,  may be taken in the
patient's ordinary drink four times a-day.
   When  the eryfipelas  leaves the  extremities, and
feizes the head, fo as to occafion a delirium or ftupor,
it is abfolutely neceffary to open the body. If clyfters
and mild purgatives fail to have this effect, ftronger
ones muft be given.  Bliftering plafters muft likewife
be applied to the neck, or behind the ears, and fharp
cataplafms laid on the feles of the feet.
                                           When 
            OR ST. ANTHONY'S FIRE.         261
   When  the inflammation cannot be  difcuffed, and
■the part has a tendency to ulcerate, it will then be
proper to promote fuppuration.
   When  the black, livid, or blue colour of the part
fliews  a  tendency  to  mortification,  the  Peruvian
bark muft be adminiftered.  It may be taken along
with acids, as recommended' in the  fmall-pox, or
in any other form more agreeable to the  patient.
It muft not, however, be trifled with, as the patient's
life is at  flake.  A drachm may be given every two
hours, if the fymptoms be threatening, and cloths
dipped in warm camphorated fpirits of wine, or the
tincture of myrrh and aloes, may be applied to the
part, and frequently  renewed.   It may likewife be
proper  in  this cafe to  apply poultices  of the bark,
or  to  foment  the part  affected with  a ftrong de-
coction of it.
   In what is commonly called the fcorbutic eryfipelas,
which continues for a confiderable time,  it will only
be neceffary to give gentle laxatives,  and fuch things
as purify the blood, and promote the perfpiration.
Thus,  after the inflammation has been checked by
opening medicines, the decoction of farfaparilla*  may
be drank ; after which a courfe of bitters  would be
proper.
   Such as are  liable to frequent attacks of the  ery-
fipelas  ought carefully  to  guard againft all violent
paflions ;  to  abftain from ftroiag liquors,  and all fat,
vifcid,  and highly nourifhing food.   They fliould
likewife take 'fufficient exercife, carefully avoiding
the extremes of heat  or cold.   Their food fliould
confift  chiefly of milk,  and fuch fruits,  herbs, and
roots, as  are of a cooling quality, and their drink
ought to be fmall-beer, whey, butter-milk, and  fuch
like.   They fliould never fuffer  themfelves to be

        * See Appendix, Decof'.'-on of Sarfaparilla*
                       S 3                    long 
26z
OF THE PHRENITIS, OR
long coftive.  If that cannot be prevented by fuitable
diet, it wiJl he proper to take frequently a gentle dofe
of rhubarb, cream of tartar, the lenitive electuary, or
fome otlier mild purgative.
               CHAP.  XXVII.

   Of the Pbrenitis, or Inflammation of the Brain.


          i HIS is fometimes a primary difeafe, but
oftener only a fymptom of fome other malady ; as the
inflammatory, eruptive, or fpotted fever,  &c.  It is
very common, however, as a primary difeafe in warm
climates, and is moft  incident  to perfons about the
prime or vigour of life.  The paffionate, the ftudious,
and thofe whofe nervous fyftem is irritable in a high
degree, are moft liable to it.
   CAUSES.—This difeafe is often  occafioned by
night-watching, efpecially  when joined  with hard
ftudy: it may  likewife  proceed from hard drinking,
anger, grief, or anxiety.  It is often occafioned by
the ftoppage of ufual evacuations; as the bleeding
piles in men,  the  cuflomary  difcharges  of  women,
&c.   Such as imprudently  expofe themfelves to the
heat of the fun, efpecially by fleeping without doors
in a hot feafon,  with their heads uncovered, are often
fuddenly feized  with  an inflammation of the brain,
fo as to awake quite delirious.   When repellents are
imprudently ufed in an eryfipelas, an inflammation
of the brain is fometimes the  confequence.  It may
Jikewife be occafioned by external injuries,  as blows
or bruifes upon the head, &c.
SYMP- 
       INFLAMMATION OF THE BRAIN.     263
   SYMPTOMS.----The fymptoms which  ufually
precede a true inflammation of  the brain, are,  pain
of the head, rednefs of the eyes, a dilated pupil,  a
violent Unfiling of the face, difturbed fleep, or a total
want of it, great drynefs of the fkin, coftivenefs,  a
retention  of urine,  fometimes  a fmall dropping  of
blood from the nofe, finging of the ears, and extreme
fenfibility of the  nervous fyftem.
   When the inflammation is formed, the fymptoms
in general are fimilar to thofe  of  the inflammatory
fever.  The pulfe indeed is often weak, irregular,
and  trembling ;  but fometimes it  is  hard  and con-
tracted.   When the brain itfelf  is  inflamed,  the
pulfe is always low ; but when the  inflammation only
affects the integuments  of the brain,  viz. the dura
and pia matter, it is hard.  A remarkable quicknefs
of hearing is a common fymptom of this difeafe ; but
that feldom continues long.  Another ufual fymptom
is a great throbbing or pulfation in  the  arteries of
the neck  and temples.   The patient feldom complains
of thirft, and even refufes drink. The mind chiefly runs
upon fuch objects as have before made a deep impref-
fion on it; and fometimes, from a fullen filence, the
patient becomes all of a fudden  quite outrageous.
   A conftant trembling and ftarting of  the tendons
is an unfavourable fymptom, as are alfo a fuppreffion
of urine ; a total want of fleep ; a conftant fpitting
and a grinding of the teeth.  When a phrenitis fuc-
ceeds an  inflammation of the lungs, of the inteftines,
or of the throat, Szc. it is owing to a tranflation of
the difeafe from thofe parts to the brain, and often
proves fatal.  This fliews  the neceflity of  proper
evacuations, and the danger of repellents in all in-
flammatory difeafes.
   The favourable fymptoms are, a free perfpiration,
a copious  difcharge  of blood from the nofe,  the
bleeding piles, a plentiful difcharge of urine, which
                       S 4 
 26*4         OF THE PHRENITIS, OR
 lets  fall a copious fediment.   Sometimes the difeafe
 is carried off by a loofenefs, and in women  by an
 exceffive flow of the menfes.
   As this difeafe often proves fatal in a few days, it
 requires the moft fpeedy  applications.  When it is
 prolonged,  or improperly treated, it fometimes ends
 in madnefs, or a kind of ftupidity,  which may con-
 tinue for life.
   In the cure, two things are chiefly to be attended
 to, viz.  to leffen the quantity of blood in the brain,
 and  to  retard the circulation towards the head.
   REGIMEN.—The patient ought to be kept very
 quiet.   Company, noife, and every thing that  affe&s
 the fenfes,  or difturbs the imagination, increafes the
 difeafe.  Even too much light is hurtful ; for which
 reafon  the  patient's  chamber ought to be a little
 darkened, and he fliould neither be kept too hot nor
 too cold.  It is not however neceffary to exclude the
 company of an agreeable friend, as this has a tendency
 to foothe and quiet the mind.  Neither ought the pa-
 tient to be kept too much  in the dark, left it fhould
 occafion a gloomy melancholy, which is too often the
 confequence of this difeafe.
   The  patient muft, as far as poffible, be foothed
 and  humoured in every thing.   Contradiction will
 ruffle his mind, and increafe his malady.  Even when
 he calls for  things which are not to be obtained, or
 which might prove hurtful, he is not to be pofitively
 denied them, but rather put off with the promife of
 having them as foon as  they can be obtained,  or by
 fome other  excufe.   A little  of any  thing  that the
 mind is fet upon, though not quite proper,  will hurt
 the patient  lefs than a pofitive refufal.  In a  word,
 whatever he was fond of,  or ufed to be  delighted
with when  in health, may here be tried, as pleafing
{lories,  foft  mufic,  or whatever has  a tendency to
foothe the paffions and compofe the mind.  Boerhaave
                                         propofe? 
       INFLAMMATION OF THE  BRAIN.     265
propofes feveral mechanical experiments for this pur-
pofes ; as the foft noife of water diftilling by drops
into a bafon, and the patient trying to reckon them,
ccc.  Any uniform found, if low and continued, has
a tendency to procure fleep, and confequently may be
of fervice.
  The aliment ought to  be light,  confuting  chiefly
of farinaceous  fubftances ;  as panada,  and  water-
gruel fharpened  with jelly  of currants,  or juice of
lemons,  ripe fruits roafted  or boiled,  jellies,  pre-
ferves, &c.   The drink fmall, diluting, and cooling;
as whey,  barley-water, or decoctions of barley and
tamarinds, which latter not only  render the liquor
more palatable, but likewife  more beneficial, as they
are of an opening nature.
  MEDICINE.—In  an inflammation of the brain,
nothing more certainly relieves the patient than a free
difcharge of blood from the nofe.   When this comes
of its own accord,  it is  by no means to be  flopped,
but rather promoted, by applying  cloths dipped in
warm water to the part.  The chief remedy is frequent
and copious bleeding.
  Bleeding in  the temporal  arteries alfo greatly re-
lieves the head :  but as this operation cannot always
be performed, we would recommend  in its  ftead bleed-
ing in the jugular veins.  When the patient's pulfe
and fpirits are fo low, that he cannot bear bleeding
with the lancet, leeches may be applied to the temples.
Thefe  not only draw  off  the blood more gradually,
but by being applied nearer to the  part affected, ge-
nerally give more immediate relief.   Cupping is alfo
of effential fervice in this cafe.
  A difcharge of blood from the hamiorrhoidal veins
is likewife of great fervice, and ought by all means
to be promoted.   If the patient has been fubject to
the bleeding piles, and the difcharge  has been flopped,
jevery method mull be tried to reflore it; as the ap-
                                         plication 
a66       OF THE OPHTHALMIA, OR
plication of leeches to the parts, fitting over the fleams
of warm water, fharp clyfters, or fuppofitories made
of honey,  aloes, and rock-falt.
   If the inflammation of the brain  be occafioned bv
the ftoppage of evacuations either natural or artificial,
as the menfes, iffues, fetons, or  fuch like,  all means
muft be ufed to reftore them as foon as poffible, or to
fubftitute others in their flead.
   The patient's body muft be  kept open by ftimu-
lating clyfters or fmart purges ;  and fmall quantities
of nitre ought frequently to be mixed with his drink.
Two or three drachms, or more, if the cafe be danger-
ous, may be ufed  in the fpace of twenty-four hours.
   The head  fliould be fliaved and cloths dipped in
cold water frequently applied to it.
   If the difeafe proves  obflinate and does not  yield
to thefe medicines,  it will  be neceffary to apply a
bliftering-plafter to the whole head.   Blifters to the
ancles are alfo very ufeful.
               CHAP.   XXVIII.

   Of the Ophthalmia, or Inflammation of the Eyes.


              IS  difeafe  may be occafioned by ex-
ternal  injuries ;  as blows, burns, bruifes, and the
like.   It may likewife proceed from duft, quick-lime,
or other fubftances,  getting  into  the eyes.  It is
often caufed by the ftoppage of cuftomary  evacua-
tions ; a§ the healing of old fores, drying up of
iffues,  the  fuppreffing  of gentle morning fweats, or
of the fweating of the feet, &c.   Long expofure to
the night air,  efpecially in cold northerly winds, or
                                         whatever
Th 
        INFLAMMATION OF THE EYES.     zC:
whatever fuddenly checks the perfpiration, efpecially
after the body has been much heated, is very apt to
caufe an inflammation of the eyes.  Viewing fnow
or other white bodies for a  long  time, or looking
fleadfaftly at the fun, a  clear fire, or any bright ob-
ject, will likewife  occafion this malady.   A fudden
tranfition from darkncfs to very bright light will often
have the fame effect.
   Nothing more  certainly occafions an  inflammation
of the eyes than night-watching, efpecially reading or
writing by candle-light.   Drinking fpirituous liquors,
and excels of venery are likewife very hurtful to the
eyes. The acrid fumes of metals, and of feveral kinds
of fuel, are alfo pernicious.  Sometimes  an inflamma-
tion of die eyes proceeds from a venereal taint, and
often from a fcrophulous  or gouty habit.  It may liker
wife be occafioned by hairs in the eye-lids turning in-
wards, and hurting the eyes.   Sometimes the difeafe
is epidemic, efpecially after wet feafons, and often in
dry feafons ; and I have frequently known it to prove
infectious, particularly to thofe who lived in the fame
houfe with the patient.  It may be occafioned by moift
air, or living in low damp houfes,  efpecially in per-
fons who are not  accuftomed to fuch fituations.  In
children it often proceeds from imprudently drying up
of fcabbed heads,  a running  behind the ears, or any
other difcharge of that kind.  Inflammations of the
eyes often fucceed the fmall-pox or meafles, efpecially
in children of a fcrophulous habit.
   SYMPTOMS.—An   inflammation of the eyes is
attended with acute  pain, heat, rednefs, and fwel-
hng.  The  patient is not able to bear the light, and
fometimes he feels a pricking pain, as if his eyes
were pierced with a thorn.    Sometimes he imagines
his  eyes are full of motes,  or  thinks  he fees flies
dancing before him.    The  eyes  are filled with  a
fealding rheum, which ruflies  forth in great quantities,
                                         whenever 
268       OF THE OPHTHALMIA, OR
whenever the  patient attempts to  look  up.  TIic
pulfe is generally quick and hard, with fome degree
of fever.   When the difeafe is violent,  the neigh-
bouring parts fwell, and there is a throbbing or pul-
fation in  the temporal arteries, &c.
   A flight inflammation of the eyes, efpecially from
an external caufe, is eafily cured ;  but when the dif-
eafe  is  violent, and continues long,  it often leaves
fpecks  upon the eyes, or dimnefs of fight, and fome-
times total blindnefs.
   If the  patient  be feized with a loofenefs,  it has a
good effect;  and when the inflammation paffes from
one  eye to another, as it were by infection, it is no
unfavourable fymptom.  But when the difeafe is ac-
companied with a violent pain of the head,  and con-
tinues  long, the patient is in danger of lofing his fight.
   REGIMEN.----The diet,  unlefs in fcrophulous
cafes,  can hardly be too fpare,  efpecially at the be-
ginning.   The patient muft abftain from every thing
of a  heating nature.   His food fhould confift chiefly
of mild vegetables, weak broths, and gruels.   His
drink may be barley-water, balm-tea, common whey,
and  fuch like.
   The patient's  chamber muft  be darkened, or his
eyes fliaded by a cover,  fo  as  to  exclude the light,
but not to prefs upon the eyes.  He  fhould not look
at a candle, the fire,  or any luminous object; and
ought  to avoid all fmoke, as the fumes of tobacco,
or any thing that may caufe  coughing, fneezing, or
vomiting.  He fliould be kept quiet, avoiding all vio-
lent  efforts, either of body or mind, and encouraging
fleep as much as  poffible.
   MEDICINE.----This  is  one of thofe difeafes
wherein great hurt is often done  by external appli-
cations.   Almoft every perfon pretends  to  be pof-
feffed of a remedy for the cure of fore eyes.  Thefe
remedies generally confift  of eye-waters and oint-
                                           ments, 
         INFLAMMATION OF THE EYES.     269
 ments, with other external  applications, which do
 mifchief twenty times for once they do good.  People
 ought therefore to be  very  cautious how they ufe
 fuch things, as even the preffure upon the eyes often
 increafes the malady.
   Bleeding, in a violent inflammation of the eyes,
 is always neceffary.  This  fliould be performed as
 near the part affected  as  poffible.   An  adult may
 lofe ten  or  twelve ounces of blood from the jugular
 vein,  and  the operation may be repeated according
 to the urgency of the fymptoms.  If it fliould not be
 convenient  to bleed in the neck, the fame quantity
 may be  let from the arm,  or any other part  of the
 body, efpecially from  the  temples  and  behind the
 ears by  cupping.
   Leeches are often applied  to the  temples,  or un-
 der the  eyes,  with good effect.  The wounds muft
 be  fuffered  to  bleed  for  fome  hours,  and  if the
 bleeding flop foon, it  may be promoted  by  the ap-
 plication of cloths dipt in warm water.   In obflinate
 cafes, it will be neceffary to repeat this operation fe-
 veral times.
   Opening and diluting medicines are, by no means,
 to be neglected.   The patient  may take a fmall  dofe
 of Glauber's falts, and  cream of tartar, every fecond
 or third day, or a decoction of tamarinds with fenna.
 If thefe be  not agreeable,  gentle dofes of rhubarb
 and  nitre, a  little lenitive  electuary, or any other
 mild  purgative will anfwer the fame end.  The pa-
 tient, at the fame time, muft drink freely of water-
 gruel, tea, whey,  or any other weak diluting  liquor.
 The Collyrium of lead,  (fee Appendix,;  fhould be
 dropped into the eyes,  often in a day.
   If the inflammation does not yield  to thefe evacua-
 tions, bliftering-plafters muft be applied to the temples,
 behind the ears, or upon the neck, and kept open for
 fome time,  by the mild bliftering ointment.   I have
                                            feldom
U 
270       OF THE  OPHTHALMIA, OR
feldom known thefe, long enough kept open,  fail t0
remove the moft obflinate inflammation of the eyes;
but, for this purpofe, it is often neceffary to continue
the difcharge for feveral  weeks.
   When the difeafe has been of long ftanding,  I have
feen very extraordinary  effects from a feton  in the
neck, or between the fhoulders, efpecially the  latter.
It fhould be put upwards and downwards, or in the
direction of the fpine, and in the  middle between the
flioulder-blades.   It may  be dreffed twice a-day with
yellow bafilicon.  I have known patients, who had been
blind for a confiderable time, recover fight by  means
of a feton placed as above.  When the feton is  put a-
crofs the neck, it foon wears out, and is both more pain-
ful and troublefome than  be?ween the fhoulders; be-
fides, it leaves a difagreeable mark, and does not dif-
charge fo freely.   An  iffue in each arm made by a
cauftic is alfo very beneficial.
   When the heat and pain  of the  eyes are very great,
a poultice of bread  and milk, foftened with fweet
oil or frefh butter, may be applied to  them,  at leaft
all  night;  and they may be bathed with milk and
water in the morning.
   If  the  patient cannot  fleep, which is fometimes
the cafe, he may take twenty or thirty  drops of lau-
danum, or two tea-fpoonfuls of the paregoric elixir,
over night, more or lefs,  according to his age,  or the
violence of the fymptoms.
   After the inflammation is gone off, if the eyes ftill
remain weak and tender they may be  bathed every
night and morning with cold water and a little brandy,
fix parts of the former to one of the latter.  A method
fliould be contrived by which the eye can be quite im-
merfed in the brandy and water,  where it fliould be
kept for fome time.  I have generally found this, or
cold water and vinegar, as good a ftrengthener of the
eyes,  as many of the moft celebrated collyriurns.
                                            When 
        INFLAMMATION OF THE EYES.     271
  When an inflammation of the eyes proceeds from
a fcrophulous habit, it generally proves very obfli-
nate.  The moft proper medicine is the Peruvian bark,
which may either be given in fubftance, or prepared
in the following manner :
  Take an ounce of the bark in powder,  with two
drachms of Winter's bark, and boil them in a quart
of water to  a pint; when it has boiled  nearly long
enough, add half an  ounce of liquorice-root  fliced.
Let the liquor be  ftrained.   Two, three, or four
table fpoonfuls, according to the age of  the patient,
may be taken three or four times a-day.  It  is im-
poffible to fay how  long this medicine fliould be con-
tinued, as the cure  is  fooner performed in fome than
in others ; but, in general, it requires  a confiderable
time to produce any lafting effects.
  Dr. Cheyne fays, " That iEthiops  mineral never
" fails in obflinate  inflammations of the eyes, even
" fcrophulous  ones, if given in a fufficient  dofe, and
" duly perfifted in."  There is  no  doubt but this,
and other preparations of mercury, may  be of Angu-
lar  fervice in ophthalmias of long continuance, but
they  ought always to be adminiftered  with the
greateft caution, or by perfons of ikill in phyfic.  In
obflinate ophthalmias, a grain of calomel every night,
for  one or  two  weeks,  is of  great  fervice; and,
when fpecks or films are formed on the fight, this
medicine,  with a  blifter or iffue, is of the- greateft
fervice.
  It will be proper frequently to look  into the eyes,
to fee if any hairs be turned inwards, or preffing upon
them*.  Thefe ought to  be  removed by plucking
them  out  with a pair of fmall pincers.

  * Any foreign body lodged in the eye, may be expeditionfly
removed, by pafling a fmall hair pencil between the eye-lid and
the ball of the eye.  In fome places, the pe.ii'ants  do this very
effectually,  by ufing their toigue in the fr.nae manner.
                                            Thofe 
272          OF THE QUINSEY, OR
   Thofe who  are liable to frequent returns of this
difeafe, ought conftantly to have an iffue on one or
both arms.  Bleeding or purging, in the fpring and
autumn, will  be very  beneficial  to  fuch  perfons.
They ought likewife to  live with the greateft regu-
larity, avoiding ftrong liquor, and every thing of a
heating quality.  Above all let them avoid the night-
air and late fludies.
               CHAP.  XXIX.

    Of the Quinfey, or Inflammation of the Throat.


          I HIS  difeafe is very common, and is
frequently attended  with great danger.   It prevails
in the winter and fpring, and is moft fatal to young
people of a fanguine temperament.
   CAUSES.—In general it proceeds from the fame
caufes  as other inflammatory diforders, viz. an ob-
ftructed  perfpiration, or whatever heats or  inflames
the blood.   An inflammation  of the throat is  often
occafioned  by  omitting  fome part of the  covering
ufually worn about the neck, by drinking cold liquor
when the body is warm, by riding or walking againft
a cold northerly wind, or any thing that greatly  cools
the throat, and parts adjacent.   It may likewife pro-
ceed from  the  neglect of bleeding, purging, or any
cuftomary evacuation.
   Singing,  fpeaking loud  and long, or whatever
ftrains  the  throat, may likewife  caufe an inflamma-
tion of that  organ.   I have  often known the quinfey
prove fatal  to jovial companions, who, after fitting
long in a warm  room,  drinking hot liquor:.,  and
                    £                       j,prr!por 
       INFLAMMATION  OF THE THROAT.    273
 finging with Vehemence,  were fo imprudent as to go
 abroad in the cold  night-air.   Wearing thin fhoes,
 fitting with Wet feet, or keeping on wet clothes, are
 very apt  to occafion this  malady.   It is likewife fre-
 quently  occafioned  by  continuing long m a  moift
 place, fitting near an  open window, fleeping in a
 damp bed,  fitting in a room that has  been  newly
 plaftered, &c.  I know  people  who  never fail  to
 have a fore throat if they fit even but a fllOrt time
 in a room that has been lately waflied.
   Acrid or irritating food  may likewife inflame the
 throat, and ocCafion a quinfey.  It may alfo proceed
 from bones, pins, or other  fharp fubftances, fticking
 in the throat, Or from the cauftic fumes of metals or
 minerals, as arfehic,  antimony,  &c. taken in by the
 breath.
   SYMPTOMS.—The inflammation  of the throat
 is evident from  inflection, the parts  appearing red
 and fwelled; befides, the patient  complains of pain
 in fwallowing.   His pulfe is quick a<nd hard,  with
 other fymptoms of a fever.   If blood be let, it is
 generally covered with a tough  coat of a whitifli
 colour, and the patient fpits  a  tough phlegm.  As
 the fwelling and inflammation increafe, the breath-
 ing and fwallowing become  more difficult; the pain
 affects the ears ; the eyes generally appear red ; and
 the face fwells.  The patient is often obliged to keep
 himfelf in an erect pofture,- being lit danger of fuffo-
 cation ; there is a conftant naufea, or  inclination to
 vomit, and  the drink,  inftead of pafling  into the
 ftomach, is often returned by the nofe.   The patient
 is fometimes ftarved at laft,  merfely from an inability
 to fwallow any kind of food.
  When the breathing is laborious, with ftraitnefs of
 the breaft, and anxiety, the danger is gtfeat. Though
the pain in fwallowing be very great,  yet while the
 patient breathes eafy, there is net fo mi&fcf danger,
                        T                    An 
274          OF THE QUINSEY, OR
An external  fwelling is no unfavourable fymptom ;
but if it fuddenly  falls, and the difeafe affects the
breaft,  the  danger is very great.  When  a quinfey
is the confequence of fome  other difeafe, which has
already  weakened the  patient,  his fituation is dan-
gerous.   A frothing at the mouth, with a fwelled
tongue, a pale ghaftly countenance,  and coldnefs of
the extremities, are  fatal fymptoms.
   REGIMEN.—The  regimen  in this  difeafe is in
all refpects the fame as in the pleurify, or peripneu-
mony.  The food muft be light, and in fmall quan-
tity, and the  drink plentiful,  weak, and diluting,
mixed with acids.
   It is  highly neceffary that the  patient be kept eafy
and quiet.   Violent affections of the mind, or great
efforts  of the body, may  prove fatal.   He fhould
not even attempt to fpeak but in a low voice.   Such
a degree of warmth as to promote a conftant, gentle
fweat,  is proper.   When the patient is in bed,  his
head ought to be raifed a little higher than ufual.
   It is  peculiarly  neceffary that  the neck be kept
warm ; for which purpofe feveral folds of foft flannel
may  be  wrapt  round  it.  That alone  will often
remove a flight complaint of the throat, efpecially
 if applied in due time.  We cannot  here omit  ob-
 ferving the propriety of a cuftom  which prevails
 among the peafants of Scotland.  When they feel
 any uneafinefs of the throat, they  wrap  a flocking
 about it all night.   So effectual is this remedy,  that in
 many places it paffes for a charm, and  the flocking
 is  applied with  particular ceremonies: the cuftom,
 however,  is  undoubtedly  a good one, and  fliould
 never  be  neglected.  When the throat  has been
 thus wrapped up all night, it muft not l?e expofed to
 the cold air through the day,  but a handkerchief or
 a piece of flannel kept abq#t it,  till the inflammation
 ke removed.
        4                                     Th^ 
      INFLAMMATION  OF THE THROAT.   '275
   The jelly  of black currants  is a medicine  very
much in efteem for  complaints of the throat; and
indeed it is of fome  ufe.   It fhould be  almoft  con-
ftantly kept  in the  mouth, and fwallowed down
leifurely.   It may  likewife be mixed in the patient's
drink, or taken any other way.   When  it cannot
be obtained,  the jelly of red currants,  or of  mul-
berries, may be ufed in its flead.
   Gargles for the throat are very beneficial.  They
may be made of fage-tea, with  a little vinegar  or
alum and honey, or by  adding  to half an Englifh
pint of the pectoral decoction two or three fpoonfuls
of honey, and  the fame quantity  of currant-jelly.
This may be ufed three or four times a-day ; and if
the patient be troubled  with tough vifcid phlegm,
the gargle may be rendered more fharp and clean-
fing, by adding to it a tea-fpoonful of the fpirit  of
fal ammoniac.   Some recommend gargles made of a
decoction of the leaves or bark of the black currant-
bufh ; but where the jelly can be had, thefe are un-
neceffary.  Two tea-fpoonfuls of the crude fal am-
moniac powdered, in a full pint  of water,  makes  an
excellent gargle.
   There is no difeafe wherein the benefit of bathing
the feet and  legs in lukewarm  water is more appa-
rent :  that practice ought therefore never to be neg-
lected.  If people were careful  to keep warm,  to
wrap up  their  throats with flannel, to bathe  their
feet and  legs in warm water, and to ufe a fpare diet,
with diluting  liquors,  at  the  beginning of this dif-
eafe, it would feldom proceed to a great  height,  or
be attended with any danger; but  when thefe pre-
cautions  are neglected, and the difeafe becomes vio-
lent, more powerful medicines are neceffary.
   MEDICINE.----An  inflammation of the throat
 being a moft acute and dangerous diftemper, which
 fometimes tikes  off the patient very  fuddenly, it
                       T 2                  will 
27#          OF THE QUINSEY, OR
will be proper,  as foon as the fymptolns  appear,  to
feleed in the arm, and to repeat the Operation if cir-
ctihiftances require.
 < The body  fhould  likewife be kept  gently open.
This may either be done by giving the  patient for
lils ordinary drink a decoction of figs and tamarinds,
or finall dofes of rhiibarb and nitre, as1 recommended
in the eryfipelas, or of Glauber's fait.  Thefe maybe
increafed according to the age of the patient,  ana re-
peated till they have  the defired effect.
   1 have often known  very good effects from a bit
offalprunel,  or purified nitre,  held in the mouth,
arid fwallowed down  as it  melted.   This promoted
the difcharge  of faliva, hy  which  means it  anfwefs
the  end of a gargle, while  at  the fame  time  it
abates  the fever, by  promoting  the difcharge of
urine, &c.
   The throat ought likewife to be rubbed twice or
thrice a-day  with a little  of the  volatile liniment.
This feldom  fails to  produce  fome  good  effects.
At  the  fame  time the  neck ought to be carefully
covered with  wool or  flannel, to  prevent the cola
from penetrating the fkin,  as this application ren-
ders it very tender.
   Bliftering upon  the neck or  behind the  ears in
violent  inflammations of the throat is very  benefi-
cial ; and  in  bad cafes  it will  be  neceffary  to lay
a bliftering-plafter quite acrofs  the throat,  fo as to
reach from ear to ear.   After the plafters are  taken
off,  the parts  ought to be kept  running by the ap-
plication of iffue ointment,  till  the  inflammation is
gone.
   When the patient  has been treated  as above, a
fuppuration feldom  happens.   This,  however,  is
fometimes  the  cafe,  in  fpite of all endeavours to
prevent it.  When  the inflammation and  fwelling
continue, and  it is evident  that  a  fuppuration wifl
                                            enfue. 
       INFLAMMATION OF THE THROAT.   277
 enfue,  it ought to be  promoted by  drawing  the
 fleam of warm water into the throat through a fun-
 nel,  or  the like.  Soft poultices ought likewife to
 be applied  outwardly,  and  the patient may keep a
 roafted fig conftantly in his mouth.
   It fometimes  happens, before the tpmpr breaks.
 that  the fwelling is fo greaf, as entirely  to  prevent
 any thing  from  getting into the ftomach.   In this
 cafe the patient muft inevitably perifli,  unlefs he can
 be fupported in feme other way.   This can only he
 done fry nourifiVing clyfters  of brot)}, or gruel with
 milk, &c.   Parents  have often been  fupported fry
 tfiefe for feveral days, till the tumor l?tas broke ;  and
 afterwards tliey Jiave recovered.
   Not  only the fwallowing, but the breathing,  is
 often prevented by  the tumor,.  Ip. tjiis  cafe no-
 thing can  fave the  patient's life but  opening the
 trachea or  wind-pipe.   As that has been  often done
 with  fuccefs, no perfon,  in  fuch defperate  circum-
 ftances,  ought to hefitate a moment  about the ope-
 ration ; but  as it can  only be performed by  a fur-
 gepn, it is not neceffary here to  give any directions
 about it.
   When a difficulty  of fwallowing ;s not attended
 with  an  acute pain  or inflammation, jt is generally
 owing to an obftructio.n of  the glands  about  the
 throat,  and  only requires that  tjhe part be Jce.pt
 warm, and the throat frequently gargled with fome-
 thing tjhat may gently  ftimujate  th^e glands, as  a
 decoction of figs with vinegar and honey; -to which
 may be  added a jittle muftard, or  p. fmall quantity
 of fpirits.   But this gargle is never to be ufed where
 there are  figns of au  inflammation.   This fpecies
 of  angina  has  various names among  the common
 people,  as the falling down of the almonds of the ears,
 &c.  Accordingly, to remove it, they lift  the patient
:up by the hair oJF the head,  and  thru ft  their fmgers
                       T ^                  under 
 278          OF THE QUINSEY,  Sec.
 under his jaws, &c. all which practices arc at beft
 ufelefs, and often hurtful.
   Thofe  who are fubject to  inflammations of  the
 throat, in order to avoid that difeafe, ought to live
 temperately.  Such as do not chufe to obferve this
 rule, muft have frequent recourfe to purging and
 other evacuations,  to difcharge the fuperfluous hu-
 mors.   They ought likewife to beware of catching
 cold, and fliould abftain from aliment and medicines
 of an aftringent or itimulating nature.
   Violent exercife, by increafing  the motion  and
 force of the blood, is apt to  occafion an inflamma-
 tion  of  the  throat,  efpecially  if cold  liquor  be
 drank  immediately after  it,  or the body fuffered
 fuddenly  to  cool.  Thofe  who would  avoid this
 difeafe, ought therefore,  after fpeaking aloud, fing-
 ing, running, drinking warm liquor,  or  doing  any
 thing that may ftrain the throat, or increafe the cir-
 culation of the blood towards it,  to take care to
 cool gradually,  and to wrap fome  additional cover-
 ings about their necks.
   I have often known perfons  who had been fub-
ject to fore  throats, entirely freed from  that com-
 plaint by only wearing a ribband, or a bit of flannel,
 conftantly about their necks, or by wearing thicker
 fhoes, a flannel waiftcoat, or the like.  Thefe may
 feem trifling,  but  they have  great effects.   There is
 danger indeed  in  leaving  them off  after perfons
have been accuftomed  to them;  but furely the in-
■conveniency of ufing fuch things  for life,  is not to
 be compared with  the danger which may attend
 the neglect of them.
   Sometimes, after an inflammation, the  glands of
 the  throat continue fwelled, and become hard and
callous.   This  complaint  is  not  eafily  removed,
and is often  rendered  dangerous  by the too  fre-
quent  application  of ftrong  /Emulating and ftyptic
                                        medicines. 
      OF THE MALIGNANT QTJINSEY, &c.   279
medicines.  The beft method is  to keep it warm,
and  to  gargle  it twice a-day with a decoction of
figs fliarpened a little with the elixir or fpirit of
ritrioL

  OF THE MALIGN \NT QTJINSEY, OR  PUTRID
          ULCEROUS SORE THROAT.

   This kind of quinfey is but  little known in the
northern parts of Britain, though, for  fome  time
paft,  it has been fatal in the  more fouthern coun-
ties.   Children  are  more  liable  to it than adults,
females than  males, and the delicate than thofe  who
are hardy and robuft.  It prevails chiefly  in autumn,
and is moft frequent after a long courfe of damp or
fultry weather.
   CAUSES.—This  is evidently a contagious dif-
temper,  and  is generally communicated by infection.
Whole families, and  even  entire villages,  often re-
ceive the infection  from   one  perfon.   Whatever
tends to produce  putrid or  malignant fevers,  may
likewife occafion the putrid ulcerous fore throat,  as
unwholefome air,  damaged provifions,  neglect  of
cleanlinefs, &c.
   SYMPTOMS.—It begins  with alternate fits  of
fliivering and heat.   The pulfe  is  quick, but low
and  unequal, and  generally continues fo  through
the whole courfe of the difeafe.   The patient  com-
plains greatly  of  weaknefs  and oppreffion of the
breaft;  his  fpirits are  low,  and he is apt to faint
away when fet upright; he is troubled with a nau-
fea, and often with a vomiting or purging.   The
two latter are moft common in children.   The eyes
appear red  and watery, and the face fwells.   The
 urine is at firft pale and crude ; but, as the difeafe
 advances, it turns more of a yellowim colour.  The
 tongue is white, and generally  moift, which  diftin-
                        T 4                guifh.es 
z$V    OF THE MALIGNANT FEVER, OR
guifhei this difeafe.   Upon looking into the throat
it  appears fwc'led,  and  of  a  florid  red  o'our.
Pale or  aih-ccbured fpots, however,  arc  hire and
there intcrfperfed, and  fometimes one  broadcatch
or fpot,  of an  irregular figure,  a^d pale white co-
lour,  furrounded  with florid red,  only  appears.
Thefe whitifli fpots or floras cover lb many ulcers.
   An  efllorefcence,  or crup-.ion  uvjoii  the neck,
arms, breaft, and fingers,  about the fecond or third
day, is a common fymptom of this difeafe.  When
it appears, the  purging  and vomiting generally ccafe.
   There is often a flight degree of delirium, and the
face frequently appears  bloated,  and theinfide of the
noftrils red and inflamed.   The  patient complains of
a difagreeable  putrid fmclj, angl his  breath is very
offenfive.
;  The  putrid, ulcerous fore  throat may be  cfiftin-
guifhed from the inflammatory by the vomiting and
3oof§nefs, with which it  is  generally ufliered in ; the
foul ujcers in  the   throat covered with a white or
livii coat;  an4 hy &? exceflive weaknefs of the
patient.
   Unfavourable fymptoms are, an obftuiate purging,
extreme  weaknefs,  dimnefs of  the fight,  a livid or
black colour of the  fpots, and  frequent fhiverings,
v. ith a weak fluttering pulfe.  If fhe eruption upon
•the (kin fuddenly difappears,  or becomes  of a livid
• olour,  with a difcharge of blopd from the  nofe or
mouth,  the  danger  is very great.
   If a  gentfe  fweat break out  about the third or
.fourth  day,  and continue with  a  flow,  firm, and
equal  pnlfe ; »f the  Houghs caft off in a kindly man-
ner, and appear clean and florid at the bottom ; and
if >!'.' breathing is foft and free,  with a lively colour
of ilio eyes, there is reafon to ]icpe for a falutary crifis.
   REGIiVIEN.-----The patient muft be kept quiet,
.gnd  for  the  moft part  in bed, or on the bed.  His
                                              food 
     PUTRID ULCEROUS SORE THROAT.   281
food muft be  nourifhing and reftorative; as  fago-
gruel with red wine, jellies, ftrong broths, &c.   His
drink ought to be  generous, and of an antifeptic
quality; as red-wine negus, white-wine whey, an$
fuch like.
  MEPICINE.-----The medicine in tjiis kind of
quinfey  is rather different from that which is pro^
per in the inflammatory.  However,  if the pulfe re-
quires it, bloeding muft be performed and repeated,
but if the pulfe is very weak, all evacuations, as bleed-
ing, purging, &c. which weaken the patient, muft be
avoided.   Cooling medicines, as nitre and cream of
tartar, arc then likewife hurtful.  Strengthening cor-
dials alone can be ufed with fafety ; and thefe plight
never to be neglected.
  If at the beginning there is a  great naufea,  pr in-
clination to vomit, the patient muft drink ,$n infufion
of green tea,  camomile flowers, or carduus benedkf
ins,  in order  to  cleanfe the  ftomach.   If Jtljefe arc
not fufficient,  he may take a few grains  of the  pow-
der of ipecacuanha, or any other gentle vomit.
  If the  difeafe js mild, the  throat may be gargled
with an infufion  of fage and  rofe leaves, to  a gill of
which may be added  a fpoonfuj or  two of honey,
and as much vinegar as will make it agreeably  acid;
but  when  the fymptoms are urgent, -the fjoughs
large and thick,  and the breath very offenfiyc, the
following gargle may be ufed :
  To fix or feven ounces of  the pectoral .decoction,
when boiling, add  half  an  ounce of contrayerva-
»oot; Jet it boil for fome time, and afterwards  ftrain
t'ie  liquor; to which add two ounces of white-wine
vinegar, an ounce of fine honey, and  an ounce of
1 he  tincture of myrrh.   This ought  not only  to be
ufed 4* a garglo,  but  a  little of it fliould frequently
be injected with a fyringc to clean the tjirpajt, before
#h : patient takes any  meat or drink.  This method
is 
2"82   OF THE MALIGNANT QTJINSEY, &c.
is peculiarly neceffary  for  children  who cannot ufe
a gargle.
  It will be of great benefit if the patient frequently
receives into his mouth, through an  inverted funnel,
the fleams of warm vinegar,  myrrh, and honey.
  But when the putrid fymptoms run high, and the
difeafe is attended with danger,  the  only medicine
that can be  depended upon  is the Peruvian bark.
It may be taken in fubftance, if the patient's ftomach
will bear it.   If not, an ounce of bark grofsly pow.
dered, with two drachms of Virginian fnake-root,
may be boiled in a pint and  a half  of water to half
a pint; to which a tea-fpoonful of  the  elixir of vi-
triol may be added, and an ordinary tea-cupfull of it
taken  every three or four  hours.  Bliftering-plafters
are very beneficial  in  this difeafe,  efpecially when
the patient's pulfe and fpirits are low.   They may
be applied to  the throat,  behind the ears, or upon
the back part of  the neck.
  Should  the vomiting prove  troublefome,  it will
be proper to give the patient two table-fpoonfuls of
the faline julep every hour.  Tea made of mint and
a little cinnamon  will be very proper for his ordinary
drink, efpecially  if an  equal quantity of red-wine be
mixed with it.
   In cafe of a violent loofenefs, the fize cf a nut-
meg of diafcordium,  or the japonic  confection,  may
be  taken* two or three times a-day,  or oftener  if
neceffary.
   If a difcharge  cf blood from the nofe happens,
the fleams of warm vinegar  may be received  up the
noftrils frequently ; and the drink muft be fliarpened
with fpirits of vitriol, or tincture of rofes.
   In cafes of a ftrangury, the belly muft  be fomented
with warm water, and emollient clyfters given three
8r four times a-day.
After 
           OF COLDS AND COUGHS.        2S3
   After the violence of the difeafe is over,  the body
fliould be kept open with mild purgatives; as manna,
fenna, rhubarb, or the like.
   If  great  weaknefs  and dejection  of fpirits, or
night-fweats, with other fymptoms  of a  confump-
tion,  fliould enfue, we would  advife the patient to
continue the  ufe  of  the  Peruvian bark,  with the
elixir of vitriol, and  to take frequently a  glafs of
generous wine.  Thefe, together with a  milk-diet,
and riding on horfeback,  are the moft  likely means
for recovering his  ftrength*.
                CHAP.   XXX.

               Of Colds and Coughs.

          1T has already been obferved, that colds
are the effect of an obftructed perfpiration ; the com-
mon caufes of which we have likewife endeavoured
to point  out,  and fliall not here repeat them.  Nei-
ther fliall we  fpend time  in enumerating all the va-
rious fymptoms of colds, as they  are pretty gene-
rally known.   It may  not however be amifs to  ob-
ferve,  that almoft  every cold  is  a kind  of fever,
which only differs  in  degree  from  fome of  thofe
which have been already treated of.

  * This  difeafe, in reality, fliould be treated, according to
the fymptoms—if highly inflammatory we bleed,  purge, &c.
and it is always more or lefs fo at its firft onfet.  The inge-
nious author feems to have regarded it as a difeafe of debility,
or, as he ftiles it, putridity.  In America, the moft fuccefsful
mode of treatment is, to  ufe the cooling or cordial regimen ac-
cording to the fymptoms ; and with this generally to give, firft
an emetic  of ipecacuanha, and afterwards a few grains of calo-
mel twice  every  dav until the Houghs come off.
                                                No 
284        QF COLDS AND COUGHS.
   No age,  fex,  or  conftitution, is  exempted  from
fhis difeafe; neither is it in the power of any medi.
cine or regimen to prevent it.   The inhabitants  of
every climate  are liable to catch cold, nor can even
the greateft circumfpection defend them  at all times
from its attacks.   Indeed,  if the human body could
be kept cpnftantly in an uniform degree  of warmth,
fuch a thing as catching cold would  be  impoffible:
hut as that  cannot be  effected by any  means, the
perfpiration muft be liable to many changes.  Such
changes, however, when  fmal], do  not  affect the
health ; but, when great,  they muft prove hurtful.
   When oppreflion of the breaft, a  fluffing of the
nofe,  unufual  wearinefs, pain of the head, &c. give
ground to believe that  the perfpiration is obftrucled,
or, in other words, that the perfon has caught cold,
he ought immediately  to leffen his diet,  at leaft the
ufual  quantity of his folid food,  and to abftain from
all ftrong liquors.   Inftead of flefh, fifh,  eggs, milk,
and other nourifhing diet,  he may eat light bread-
pudding,  veal or chicken broth, panada,  gruels,
and fuch like.   His drink may be water-gruel fweet-
ened with a  little honey; an infufion of balm, or
flaxfeed fliarpened with the juice of limes  or lemon ;
a decoction of barley and  liquorice,  with  tamarinds,
or any other cool, diluting, acid liquor.
   Above all,  his fupper fliould  be  light ; as fmall
poffet, or water-gruel fweetened with honey, and a
little toafted bread in it.   If honey  fliould difagree
with the ftomach, the gruel may be  fweetened  with
mobiles or coarfe fugar, and fliarpened with the jelly
of currants.   Thofe  who  have been accuftomed to
generous  liquors may  take  wine-whey  inftead of
gruel, which may be fweetened as above.
   The patient ought to bathe his feet, to lie longer
than ufual a-bed, and  to  encourage  a gentle fweat,
which is  eafily  brought  on towards  morning, by
                                         drinking 
OF COLDS AND COUGHS.        285
drinking tea, Or any kind of warm dilating liqnor.
I have often known this practice carry off a cold ift
one day, which in all probability, had  it been neg-
lected, would have coft the patient his life, or hav£
confined him for fome months.  Would people facri-
fice a little time  to eafe and warmth, and  praetife a
hidderate degree of abftinence  when the firft fymp-
toms of a Cold appear, We  have reafon to believe,
that tndft of the bad effects which flow from an ob-
ftructed perfpiration might be prevented.  But, after
the difeafe has gathered ftrength by delay, all attempts
to remove  it often prove Vain.  A pleurify, a perip-
heumoriy, or a fatal confumption of the lungs, are
the common effects of colds which have  either beedt
totally neglected or treated improperly.
   Many attempt to cure a cold, by getting drunk.
But this, to fay no worfe of it,  is a very hazardous
experiment.  No doubt it may fometimes fucceed,
by fuddenly reftoririg the perfpiration ;  but when
there is any degree  of inflammation, tfchich is  fre-
quently the cafe, ftrong liquors, inftead of removing
the malady will increafe it.   By this means a com-
mon cold may be converted into  an inflammatory-
fever.
   When thofe who labour for their daily bread have
the misfortune to catch cold,  they cannot afford to
lofe a day or two,  in order to keep themfelves warm
and take a little medicine ; by which means the dif-
order is often fo  aggravated as to confine them for a
long time, or even tO render them ever  after un-
able to fuftain  hard labour.   But even fuch of the
labouring poor as can afford  to  take care of  them-
felves,  are  often too hardy to do it; they affect to
defpife colds, and as long as they can crawl about,
fcom to be confined by what they call a common cold.
Hence it is, that colds deftroy fuch  numbers of man-
kind.   Like an enemy defpifed,  they gather ftrength
                                           from 
286        OF COLDS AND COUGHS.
from delay ; till at length they  become invincible.
We often fee this verified in travellers, who, rather
than lofe  a day in the profecution of their bufmefs,
throw away  their lives by purfuing their journey,
even in the fevereft weather, with this difeafe upon
them.
   It  is  certain, however, that  colds may  be too
much indulged.   When a perfon, for every  flight
cold,  fhuts himfelf up in a warm room, and drinks
great quantities  of  warm liquor,  it  may occafion
fuch a general relaxation of the folids as will not be
eafily removed.   It will therefore be proper,  when
the difeafe will permit, and the weather  is mild, to
join to the regimen  mentioned above, gentle exer-
cife ;  as walking, riding  on horfeback,  or in a car-
riage, &c.  An obflinate  cold, which no medicine
can remove,  will yield to  gentle  exercife and a pro-
per regimen of the diet.
   Bathing the feet and legs  in  warm water has a
great tendency to reftore the perfpiration.  But care
muft  be  taken  that  the  water be  not too  warm,
otherwife it will  do hurt.  It fliould never be warmer
than  is agreeable to the hand of a perfon in health,
and the patient fhould go immediately to bed after
ufing it.  Bathing the feet in warm water, lying in
bed, and  drinking warm water-gruel, or other weak
liquors, will-feoner take off a fpafm, and reftore the
perfpiration, than all the hot fudorific medicines in
the world.  This is all that is neceffary for removing
a  common cold; and if this courfe be taken at the
beginning, it will feldom fail.
   But  when the fymptoms  do  not yield  to abfti-
nence,  warmth, and diluting liquors, there  is reafon
to  fear the  approach of  fome other  difeafe,  as an
inflammation of the  breaft, an ardent fever, or the
like.   If the pulfe, therefore, be hard and frequent,
the  flvin  hot  and dry, and the patient complains of
                                               hi. 
OF COLDS AND COUGHS.
287
his head or breaft, it will be neceffary to bleed,  and
to give the  cooling  powders  recommended  in  the
fearlet fever every three or four hours, till they give
a flool.
   It  will likewife be proper to give two table-fpoon-
fuls of the faline mixture every two hours, and in
fliort  to  treat the patient in all refpects as for a flight
fever.  1 have often feen this courfe, when obferved
at the beginning, remove the complaint in two or
three days, when the patient had all the fymptoms
of an approaching ardent fever,  or an inflammation
of the breaft.
   The chief fecret of preventing colds lies in avoiding,
as far as poffible, all extremes either of heat  or cold,
and in taking care, when the body is heated, to let
it cool gradually.   Thefe,  and other circumftances
relating to this important fubject, are fo fully treated
of under the article Obflrucled Perfpiration, that it is
needlefs here to refume the confideration of them.


             OF A COMMON COUGH.

    A cough  is generally the effect of a cold, which
 has cither been improperly treated, or entirely  neg-
 lected.  When it proves obflinate, there is always
 reafon  to fear the confequences,  as this fliews a weak
 ftate of the lungs, and  is often  the forerunner of a
 confumption.
    If the cough be violent, and  the  patient young
 and  ftrong,  with a hard quick pulfe,  bleeding will
 be proper.  When the patient fpits freely, and the
 pulfe i; not hard, bleeding  is unnecefiury, and fome-
 times hurtful, as it tends to leffen that difcharge.
    When the cough h not attended with any degree
 ef fever, and the fpittle  is vifcid and tough,  fharp
 pectoral medicines are to be adminiftered ; as gum
 arnnjoniac, fan ills, &c.   Two t^ble-fpcenf ih of the
      \                                    felatiou 
 *8S          OF A COMMON COUGH.
 foliition of gum ammoniac may  be taken  three cr
 four times a-day, more or lefs,  according to the age
 and conftitution of the  patient.   Squills may  be
 given  various ways :  two ounces  of the vinegar, the
 oxymel, or the fyrup, may be mixed with  the fame
 quantity of fimple  cinnamon-water,  to which may be
 be added ail ounce of common water,  and an ounce
 of fyrup.  Two table-fpoonfuls of  this mixture may
 be takeh three or  four times a-day.
   A  fyriip  made  of  equal  parts  of lemon-juice,
 honey, and  fugar-candy, is likewife very proper in
 this  kind of cough.  A table-fpoonful of it may be
 taken  at pleafure.
   But when the defluction  is  fharp  and thin, thefe
 medicines rather do hurt.   In this cafe gentle opiates,
 oils, and mucilages are more proper.  A  cup of an
 infufion of wild poppy leaves, and marfli-mallow roots,
 or the flowers of colts-foot, may be taken frequently;
 or a tea-fpoonful of the paregoric elixir may be put
 into the patient's drink twice a-day.
   When a cough is occafioned by acrid humors tick-
 ling  the throat and fauces,  the patient  fliould keep
 fome foft pectoral   lozenges almoft  conftantly in his
 mouth ; as the liquorice cakes, barley-fugar, the com-
mon balfamic lozenges, &c.  Thefe blunt the acri-
mony of the humors, and by taking  off their ftimula-
ting  quality, help  to appeafe the  cough*.

  *  In a former edition of this book  1 recommended, for an
obftinate tickling cough, an oily emulfion, made with the pare-
 goric elixir of the Edinburgh Dilpenfatory, inftead of the com-
mon  alkaline fpirit.  1 have fince been  told by leveral pr.icli-
lioners, that they found it to be an excellent medicine in this
di.brder, and every way d.feiving of the cluraSter which I had
given of it.  Where this elixir is not kept, its phce may  be
lupphed by adding to  the common oily  cmulfion aft adequate
proportion of the Thelai: tir.Uure^ or liquid kudu::i:m.

        t                                         In 
             OF A COMMON COUGH.         289
   In  obftinate  coughs, proceeding  from a flux of
humors upon the  lungs, it will often be neceffary,
befides expectorating medicines, to have recourfe to
iffues,  fetons, or  fome other drain.   In this cafe I
have often obferved the moft happy effects from a
Burgundy-pitch plafter applied between the fhoul-
ders.   I have ordered this fimple remedy in the moft
obftinate coughs, in a great number of cafes, and
in many different  conftitutions, without ever know-
ing it  fail  to give  relief,  unlefs  where there were
evident figns of an ulcer in the lungs.
   About the bulk of a nutmeg  of Burgundy pitch
may be fpread thin upon a  piece of foft leather, about
the fize of the hand, and laid between the fhoulder-
blades.  It may be taken off and wiped every three
or four days, and ought to  be renewed once a fort-
night or three weeks.  This is indeed a cheap and
fimple  medicine,  and confequently  apt  to  be  de-
fpifed ;  but we will venture  to affirm,  that it is effir
cacious in  almoft every kind of cough.  It  has  not
indeed always an  immediate  effect;  but,  if kept on
for fome time, it will fucceed where many other me-
dicines fail.
   The only inconveniency attending this plafter  is
the itching which it occafions ; but furely this  may
be difpenfed with, confidering the advantage which
the patient may expect to  reap from the application ;
befides, when  the  itching   becomes  very  uneafy,
the plafter may be  taken  off, and the part rubbed
with a dry cloth, or wafhed   with a little warm milk
and water.  Some caution indeed is  neceffary in dif-
continuing the ufe of fuch a plafter ; this, however,
may be  fafely  done by making it fmaller by de-
grees, and at length quitting it altogether in a warm
feafon. *

   * Some complain that the pitch plafter adheres too faft,
while  others find difficulty in keeping it on.  This proceed-
                        U                    from 
290         OF A COMMON  COUGH.
   But coughs proceed from, many other caufes be-
 fides defludions upon the lungs.  In thefe  cafes the
 cure  is not to be  attempted by pectoral medicines.
 Thus, in a cough proceeding  from a foul nefs and
 debility  of  the  ftomach,  fyrups,  oils,  mucilages,
 and all kinds of balfamic medicines do hurt.    The
fiomach cough may be known from one that is owing
 to  a fault in the  lungs by this, that in the latter
 the patient  coughs whenever he  infpires,  or draws
 in his breath fully ; but in the former that does not
 happen.
   The  cure of this cough  depends  chiefly  upon
 cleanfing and ftrengthening the ftomach ; for which
 purpofe gentle vomits and bitter purgatives are moft
 proper.   Thus, after a vomit or two, the tincture of
 aloes * may be taken for a confiderable time in the
 dofe of  one or two tea-fpoonfuls  twice a-day,  or as
 often  as  it is  found  neceffary,  to keep  the  body
 gently open.
   In coughs which proceed from a debility of the
 ftomach, the Peruvian  bark  is likewife of confider-
 able fervice.   It may  either be  chewed,  taken in
 powder,  or  made  into  a tincture along  with other
 ftomachic bitters.
   A nervous cough can only be removed by change
 of air and proper  exercife ; to which may be added
 the ufe  of gentle  opiates.    Inftead of  the fapona-
 ceous pill, the  paregoric elixir, &c. which are only
 opium difguifed, ten, fifteen,  twenty,  or twenty-
 five drops of liquid  laudanum, more or lefs, as cir-
 cumftances  require,  may be  taken at bed-time, or
 when.the cough is  moft troublefome.    Immerfing

 from the different kinds of pitch mad* ufe of, and likewife from
 the manner of making it. 1 generally find it anfwer beft when
 mixed with a little bees-wax, and fpread  as cool as  poffible.
 The cleat, hard, tranfparent pitch anfwers the purpofe beft.
   * Sec Appendix, TinRure of siloes..
                                               the 
         OF THE WHOOPING-COUGH, &c.     291
 the feet  and hands in warm water will often appeafe
 the violence of a nervous cough.
   When a cough is only the fymptom of fome other
 malady,  it is  in vain to attempt to remove it with-
 out firft curing the difeafe from which  it proceeds.
 Thus when a cough  is occafioned by teething,  keep-
 ing the body open, fcarifying the gums,  or whatever
 facilitates the cutting of the teeth, likewife appeafes
 the cough.  In like manner,  when  worms occafion
 a cough, fuch medicines  as  remove thefe vermin,
 will generally cure the cough ; as bitter purgatives,
 oily clyfters, and fuch like.
  Women, during the laft months of pregnancy, are
 often greatly afflicted with a cough, which is gene-
 rally  relieved  by bleeding, and keeping the body
 gently open.   They ought to avoid all flatulent food,
 and to wear a loofe eafy drefs.
  A cough is not only a fymptom, but is often like-
wife the  forerunner of difeafes.  Thus,  the gout is
frequently ufhered in  by a very troublefome cough,
which affects  the  patient for  fome days before  the
coming on of  the fit.   This cough is generally  re-
 moved by a  paroxyfm  of  the  gout,  which  fhould
therefore be promoted,  by keeping  the  extremities
warm, drinking warm liquors,   and bathing the feet
and legs  frequently in lukewarm water.

OF  THE WHOOPING COUGH, OR  CHIN-COUGH.

  This cough feldom affects adults, but proves often
fatal to children.  Such children as  live upon thin
watery diet,  who breathe  unwholefome air,  and
have too  little exercife, are moft liable to this difeafe,
and generally fuffer moft from it.
  The chin-cough is fo well Joiown,  even to nurfes,
that a defcription of it is  unneceffary.   Whatever
hurts  the digeftion,  obftructs   the perfpiration,  or
                       U  2                relaxes 
%r-       OF THE WHOOPING-COUGH,
relaxes the folkls, difpofes  to  this  difeafe:  confe-
quently  its cure muft depend  upon  cleanfing and
ftrengthening the  ftomach,  bracing the folids, and
at the fame time promoting  perfpiration and the dif-
ferent fecretions.
   The diet muft be light, and  of eafy digeftion ;  for
children^ good  bread made into  pap or  pudding,
chicken-broth,   with other  light  fpoon-meats, are
proper ; but thofe who are  farther advanced may be
afiowed  fkgfe-grael,  and if  the fever be  not high, a
little boiled chicken,  or other white meats.  The
drink may be hyffop, or penny-royal tea, fweetened
with honey or fugar-eandy, fmall  wine-whey;  or,
if the patient be weak, he may fometimefc be allowed
a little ftegus*
   One of tfee moA  effectual  remedies in  the chin-
eough is change of air.    This often removes the
malady,  even when the change feems to be from a
purer  to a lefs wholefome  air.   This may in fome
ifteafure  depend on the  patient's  being  removed
from the place  where the  infection prevails.  Mofl
&f the difeafes of  children  are  infectious ;  nor is  it
at all uncommon to find  the chin-cough prevailing
in one town or  village, when another, at a very
fmall diftance, is quite free  from it.  But  whatever
be the caufe,  we are fure of the  fact.    No time
ought  therefore to be loft in removing the patient at
fome diftance from the place  where he caught the
difeafe, and, if poffible, into a more pure and  warm
air. *
   When the difeafe proves  violent,  and the patient
is in danger of being fuffbeated  by the  cough, he

  * Some think the air ought not to be changed till the difeafe
is on the decline ;  but there feems to be no fufficient reafon for
this opiniojlr^s patients have been known to reap benefit from
a ch'atfgfc of air at all periods of the difeafe.  It is not fufficient
i>u taMi th« £s«!i**rto« 4aily in a  carriage.
                                            ought 
                OR CHINXTOUGH.            log
ought to be bled, efpecially if there be a fever with
a hard full  pulfe.    But a6  the  chief intention of
bleeding is to prevent an inflammation of the lungs,
and to render it more fiife to give vomits, it will fek
dom be nece&ry  to repeat the  operation; yet if
there are fymptoms of an inflammation of the lungs,
a fecond, or even a third* bleeding may be requifite.
  It is generally reckoned a favourabje fymptom
when a fit  of  coughing makes the  patient vomit.
This cleanfes the ftomach,  and greatly relieves  the
cough.   It will therefore be .proper to promote £«*$
difcharge,  either by fmall  dofes of ipecacuanha, or
the vomiting julep, recommended in-dse AppesdiM. *
  It is very difficult to  make children drink after a
vomit.  I  have often feen them  happily deceived,
by ipfufing a ferupie or  half aichachiisiiaf tfoe powdgr
of ipecacuanha in  a tea-pot, wkh half an  jEng}ife
$'mt  of boiling water.   If this  be diignifed with $
few drops of milk, and  a ditde fugar,  they will iwa*
gine it tea, and drink  it very .greedily.   A fmajj
tea-cupful of this may be given esrery quarter of an
hour, or rather every ten minutes, till it operates.
When the  child begins to puke, there yri$ be >ni>
occafion for drinking any more, as the water already
on the ftomach will be fufficient.
  Vomits not only  cleanfe the ftomach, which in
this difeafe is generally  loaded  with  vjfcid phlegrj^,
but they  likewife promote the perfpiration and pjt&er
fecretions,  and  ought therefore to be repeated ac-
cording to the obftinacy  of the difeafe.   They fhould
not however be ftrong ; gentle vomits frequently re-
peated, are both lefs dangerous, and more beneficial,
than ftrong  ones.
  The body ought  to  be  kept gently open.   The
beft  medicines for this purpofe are rhubarb and  ijts

           * See Appendix,  Vomiting Julep.
                       U  3               prepara 
294       OF THE WHOOPING-COUGH,
preparations, as the fyrup, tincture,  &c.  . Of thefe
zl tea-fpoonful or two may be given to an infant twice
or  thrice a-day, as  there  is  occafion.   To fuch as
are farther  advanced,  the  dofe muft be   propor-
tionally increafed,  and  repeated till it has  the de-
fired effect.   Thofe who cannot be brought to take
the bitter tincture,  may have  an  infufion  of fenna
and  prunes, fweetened  with manna,  coarfe fugar,
or  honey ;  or a few grains  of  rhubarb mixed with
a  tea-fpoonful  or  two  of fyrup,  or  currant-jelly,
fo as to difguife the  tafte.  Moft children  are fond
of fyrups and jellies, and feldom refufe  even a dif-
agreeable medicine when mixed with it.
   Many  people believe that oily,  pectoral,  and bal-
famic medicines poffefs wonderful virtues for the cure
of fhe chin-cough, and accordingly exhibit them plen-
tifully to patients of every age and conftitution, with-
out confidering that every thing of  this nature muft
load the  ftomach, hurt the  digeftion,  and  of courfe
aggravate the diforder. *
    Opiates are  fometimes  neceffary to  allay the vio-
lence of the cough.   For  this  purpofe five,  fix, or
feven drops of laudanum, according  to the age of
the patient,  may be taken in a little fugar or water,
and repeated occafionally.  f

   * Pr. Duplanil fays he has feen many good effects from
the kermes mineral in  this complaint, the cough  being fre-
quently alleviated even by the firft dofe.   The dofe for a child
of one year old, is a quarter of a grain difTolved in a cup t>f any
liquid, repeated two or three times a-day.  For a child of two
years the dofe is half a grain ;  and the quantity muft be thus
increafed in proportion to the age of the patient.
   f Some recommend the extract of hemlock  as an extraordi-
nary remedy in the whoeping-cough ; but fo far as I have been
able to obferve, it is no way fuperior to opium, which, when pro-
perly adminiftered, will often relieve  fome of the rood trouble-
fome fymptoms of this diforder ;  but opium fhould be given
very  cautioufly, if there is any difficulty of  breathing from
phlegm.
                                                The 
                OR CHIN-COUGH.            295
   The  garlic-ointment is a well known remedy in
 North-Britain for  the chin-cough.   It is  made by
 beating in a mortar garhc with an equal quantity oj*
 hog's lard.   With this the foles of the feet may; be..
 rubbed  twice or thrice a-day;  but the  beft method
 is to fpread it upon a rag, and apply it in  the fornv
 of plafter.   It  fhould be renewed  every night and
 morning at leaft, as  the garlic foon lofes its  virtue.
 This is  an exceeding good medicine,  both  in the
 chin-cough, and in moft other  coughs of an obftinate
 nature.   It  ought  not,  however, to be ufed when
 the patient is very hot or feverifh, left  it fhould in*
 creafe thefe fymptoms.
   The  feet  fliould  be bathed  once every two or
 three days in lukewarm water; and  a Burgundy-
 pitch plafter  kept  conftantly between the flu ulders.
 But when the difeafe proves very violent, it will be
 neceffary, inftead of it, to apply a bliftering-plafter,
 and to keep the part  open for fome time with iffue-
 ointment.
  When the difeafe  is prolonged, and  the patient is
 free from a fever,  the Peruvian bark, and other bit-
 ters, are the moft proper medicines.   The bark may
 either be taken in  fubftance, or in a decoction or in-
 fufion, as is moft agreeable. For a child, ten,  fifteen,
 or twenty grains, according to the age of the patient,
 may  be  given three or four  times  a-day.   For an
an adult, half a drachm or two feruples will be pro-
per.  Some give the extract of the bark with cantha-
rides; but to  manage this requires a confiderable at-
 tention.  It is  more fafe to give a few grains of caftor
 along with the bark.  A child  of fix or feven years
of age may take feven or eight grains of caftor, with
fifteen grains  of powdered bark, for a dofe.  This
 may  be  made into  a mixture,  w ith  two  or three
 ounces of a fimple diftilled water, and a little fyrup,
 and taken three or four times a-dav.
                      U 4                  CHAP. 
[  zc>6 ]
 ■>*  v-           CHAP.  XXXI.


  feflammation of the  Stomach,  and other Vifcera.


          ALL  inflammations of the bowels are
dangerous, and require the moft fpeedy affiftance;  as
they frequently end in a fuppuration, and  fometimes
in a mortification, which is certain death.
  CAUSES.—An inflammation of the ftomach may
proceed from  any of the caufes  which produce  an
inflammatory fever ;  as cold liquor drank while the
body is warm, obftructed perfpiration, or the fudden
ftriking in of any eruption.   It may likewife proceed
from the  acrimony of the bile, or from  acrid and
ftimulating fubftances  taken  into  the ftomach ;  as
ftrong  vomits or purges,  corrofive poifons, and fuch
like.   When  the  gout has been  repelled from the
extremities, either by cold or improper applications,
it often occafions  an inflammation of the ftomach.
Hard  or indigeftible  fubftances taken into  the fto-
mach,  as bones, the ftones of fruit, &c. may likewife
have that effect.
   SYMPTOMS.—It is attended with a fixed pain
and burning heat  in  the ftomach ; great reftleffnefs
and anxiety; a fmall, quick, and hard pulfe ; vomit-
ing, or, at leaft,  a naufea and ficknefs; exceffive
thirft; coldnefs of  the  extremities;  difficulty  of
breathing ; cold clammy fweats ;  and  fometimes con-
vulfions and fainting fits.   The ftomach  is  fwelled,
and often feels hard to the  touch.   One of the moft
certain figns of this difeafe is the fenfe of pain, which
the patient feels  upon  taking any kind of food or
drink,  efpecially if it be either too hot or too cold.
                                           When 
  INFLAMMATION OF THE STOMACH,  &c.   297
  When the patient vomits every thing he eats or
drinks, is extremely reftlefs, has a hiccup, with an
intermitting pulfe, and frequent fainting  fits,  the
danger is very great.
  REGIMEN.-^-All acrimonious, heating, and irri-
tating food  and drink  are carefully to  be  avoided.
The weaknefs  of the patient may deceive the  by-
ftanders, and induce them to give him wines,  fpi-
rits, or other cordials; but thefe  never fail  to in-
creafe the difeafe, and  often occafion fudden  death.
The inclination to  vomit  may likewife impofe  on
the attendants,  and make  them think a vomit necef-
fary ; but that  too is almoft certain death.
  The  food muft be light, thin,  cool, and eafy of
digeftion.    It  muft be  given in fmall quantities,
and fliould neither be quite cold nor too hot.   Thin
gruel made of barley or  oatmeal,  light  toafted
bread diffolved   in  boiling  water, or  very  weak
chicken-broth,  are the moft  proper.   The   drink
fliould be clear  whey, barley-water,  water in which
toafted bread has been boiled, or decoctions of emol-
lient vegetables ; as liquorice and marfhmallow roots,
&c.
  MEDICINE.—Bleeding in  this  difeafe is abfo-
lutely  neceffary, and  is almoft  the only thing that
can be depended on.  When the difeafe proves ob-
ftinate,  it will  often be proper  to repeat this opera-
tion feveral times, nor muft the  low  ftate  of the
pulfe deter  us  from  doing fo.   The  pulfe  indeed
generally rifes upon  bleeding,  and as long as that
is the cafe, the  operation is fafe.
  Frequent fomentations with  lukewarm water, or
a decoction of emollient   vegetables,  are likewife
beneficial.   Flannel cloths  dipped  in thefe  muft  be
applied to the  region of the ftomach, and removed
as they grow cool.  They  muft neither be applied
too warm, nor be fuffered   to continue  till  they be-
                                            come 
298  INFLAMMATION OF THE  INTESTINES.
come quite cold, as either of thefe extremities would
aggravate the difeafe.
  The feet and legs ought likewife to be frequently
bathed in lukewarm water, and warm bricks or poul-
rices may be applied to the foles  of the feet.   The
warm bath, if it can be conveniently ufed, will be of
great fervice.
  In this, and all other inflammations of the bowels,
an epifpaftic,  or bliftering-plafter, applied over  the
part affected, is one of the beft remedies I know.  I
have often ufed it, and do not recollect one inftance
wherein it did not give relief to the patient.
  The  only internal  medicines which we fhail ven-
ture to recommend in this  difeafe, are mild clyfters.
Thefe may be made of warm water, or thin  water-
gruel ; and if the patient is coftive, a little fweet  oil,
honey, or manna, may be  added.  Clyfters  anfwer
the purpofe of  an internal  fomentation,  while they
keep the body  open,  and at the  fame time nourifh
the patient, who is often in this difeafe  unable to
retain any  food upon  his ftomach.  For thefe rea-
fcns they muft not be neglected,  as the patient's life
may depend on them.

     INFLAMMATION OF THE  INTESTINES.

  This is  one  of the moft painful  and dangerous
difeafes that mankind is liable  to.   It generally pro-
ceeds from the fame caufes as the inflammation of the
ftomach ; to which may be added coftivenefs, worms,
eating unripe  fruits,  or great   quantities of nuts,
drinking hard windy  malt liquors, as ftale bottled
beer or ale, four wine, cyder,  &c.  It may likewife
be  occafioned  by a rupture,  by fcirrhous  tumors
of the inteftines, or by  their oppofite fides growing
together.
The 
    INFLAMMATION OF THE INTESTINES.  299
   The inflammation of the inteftines is denominated
Iliac paffion, Enteritis, bfc.  according  to the names
of the parts  affected.   The treatment,  however, is
nearly the fame whatever part of the inteftinal canal
be the feat of the  difeafe ;  we fhail  therefore omit
thefe diftinctions left they fhould perplex the reader.
  The fymptoms here  are nearly the fame as in the
foregoing difeafe ;  only the pain, if poffible,  is more
acute, and is  fimated  lower.   The vomiting is like-
wife  more violent, and  fometimes even  the excre-
ments, together with  the clyfters,  are difcharged  by
the mouth.   The patient is continually belching up
wind, and has often an obftruction of  his urine.
  While the pain  fhifts, and the  vomiting only re-
turns at certain intervals, and while the clyfters pafs
downwards, there  is  ground for  hope;  but when
the clyfters and faces are vomited, and the patient
is exceedingly weak, with a  low fluttering pulfe,  a
pale  countenance,   and a  difagreeable or  ftinking
breath,  there is  great reafon to fear that the confe-
quences  will  prove fatal.    Clammy fweats, black
foetid ftools, with  a fmall intermitting  pulfe, and a
total  ceffation of pain, are figns  of a  mortification
already begun, and of approaching death.
  REGIMEN.—The regimen in  this  difeafe is in
general the fame as in an inflammation of the ftomach.
The  patient muft be kept quiet, avoiding cold, and
all violent paffions  of the mind.  His food ought to
be very  light, and given  in fmall  quantities; his
drink weak and diluting; as  clear  whey, barley-wa-
ter, arid fuch  like. *
  MEDICINE.—Bleeding in this, as well as in the
inflammation of the ftomach, is of the greateft im-

  * Indeed we  can give very little food, ether liquid or fo-
lid, in this difeafe, until  the moft dangerous  fymptoms,  ef-
pecially vomiting, are fubdueJ.
portance. 
300  INFLAMMATION OF THE INTESTINES.
portance.   It fhould be  performed as foon as the
fymptoms appear, and muft be repeated according
to the ftrength of the patient,  and the violence of
the difeafe.
  A bliftering-plafter is here  likewife to  be applied
immediately over  the part where fhe moft violent
pain is.    This not only relieves  the pain of the
bowels, but  even clyfters and  purgative medicines,
which  before had no effect, will operate when the
blifter begins to rife.
  Fomentations  and  laxative  clyfters   are by  no
means to be  omitted.   The patient's feet and legs
fliould frequently be bathed  in warm water; and
cloths  dipped in it  applied to  his belly.   Bladders
filled with warm  water may likewife be applied to
the region of the navel, and warm  bricks, or bottles
filled with warm  water,   to the foles of the feet.
The clyfters  may be made of  barley-water or thin
gruel with fait,  and foftened with  fweet  oil or frefh
butter.  Thefe  may be  adminiftered every two or
three  hours,  or oftener, if the  patient  continues
coftive.
   If the difeafe does not  yield to clyfters and fomen-
tations,  recourfe muft  be had to pretty  ftrong pur-
gatives ; but as thefe, by irritating the bowels, often
increafe their contraction, and by that means fruflrate
their own intention, it will be neceffary to join them
with opiates,  which, oy  allaying the pain, and re-
laxing the fpafmodic contractions of the guts, greatly
aflift the operation of purgatives m this cafe.
   What  anfwers the purpofe of opening  the body
 very well, is a folution of the  bitter purging falts.
 Two  ounces of thefe  may be  diffolved  in a pint of
warm water,  or thin  gruel, and a tea-cupful of it
 taken every  half hour till it operates.   At the fame
time fifteen, twenty, or twenty-five drops  of  lauda-
 num may be given in a glafs of  peppermint or  fimple
                                         cinnamon- 
    INFLAMMATION O* THE  INTESTINES.  301
cinnamon-water, to appeafe the  irritation, and  pre-
vent the vomiting, &c.
   Acids have often a  very happy effect  in  flaying
the vomiting, and appeafing the  other violent fymp-
toms of this difeafe.  It will therefore be of ufe  to
fharpen the patient's  drink  with cream  of tartar,
juice of lemon, or, when thefe cannot be obtained,
with vinegar.
   But it often happens that  nov liquid whatever will
flay on the ftomach.  In this  cafe the patient muft
take purging pills.  I have generally found the fol-
lowing anfwer very well: Take jalap in powder, and
vitriolated tartar, of each half a drachm, opium one
grain, Caftile foap as much as  will make the mafs fit
for pills.  Thefe  muft be taken  at one dofe, and if
they do not operate in a few hours, the dofe may be
repeated.
   If a ftool cannot be procured by any of the above
means, it  will be neceffary  to immerfe the patient
in warm water up to the breaft.   I have often feen
this fucceed when other means  had  been tried  in
vain.   The patient muft continue in the water  as
long as he can eafily bear it  without fainting, and if
one immerfion has not the defired effect,  it may be
repeated as foon as the patient's ftrength and fpirits
are recruited.   It is more fafe  for him to go fre-
quently into the bath, than to continue too  long  at
a time, and it is often neceffary  to  repeat it feveral
times before it has the defired effect.
  It has fometimes  happened, after all other means
of procuring a  ftool has been tried to  no purpofe,
that this was brought about by immerfing  the pa-
tient's  lower extremities in  cold water,  or  making
him walk  upon  a wet pavement,  and dafhing his
legs, thighs,  and body, with the cold water.  This
method, when others fail, at leaft merits a trial.
If 
 302             OF THE COLIC.
   If the difeafe proceed from a  rupture, the patient
 muft be laid with his head very low, and  the intef-
 tines returned by gentle preffuVe with the hand.  If
 this, with fomentations and clyfters,  fliould not fee-
 ceed, recourfe muft be had to a furgical operation,
 which may give the patient relief.
   Such as would avoid this excruciating and danger.
 ous difeafe,  muft take care never  to  be too long
 without a ftool.   Some  who have died of it have
 had feveral pounds  of hard dry faces  taken out of
 their guts.   They fhould  likewife beware of  eating
 too freely of four or unripe  fruits,  or drinking flale
 windy liquors,  &c.   It likewife proceeds  frequently
 from cold caught by wet clothes, &c. but efpecially
 from wet feet.

                 OF THE COLIC.

   The colic  has a great refemblance to  the two pre-
 ceding difeafes, both in its fymptoms  and  method of
 cure.  It is generally attended  with  coftivenefs  and
 acute pain of the bowels ; and requires  diluting diet,
 evacuations,  fomentations, &c.
   Colics  are  varioufly  denominated  according to
 their caufes,  as  the flatulent, the bilious, the hyjieric,
 the nervous,  &c.  As  each of  thefe requires a par-
ticular method of treatment, we fliall  point out their
 moft general  fymptoms, and  the means to be ufed
 for their relief.
   The flatulent,  or  wind-colic, is  generally occa-
fioned  by the indifcreet ufe of  unripe fruits,  meats
of  hard   digeftion,  windy  vegetables,  fermenting
liquors, and  fuch like.    It  may likewife proceed
from an  obftructed  perfpiration,  or  catching cold.
Delicate  people, whofe digeftive powers are weak,
are moft liable to this kind of colic.
The 
OF THE COLIC.
3«3
  The flatulent colic may either affect  the  ftomach
or inteftmes.   It is attended with a painful  ftretch-
inp- of the affected part.   The patient feels  a rum-
bling in his bowels,  and is  generally relieved  by a
difcharge of  wind, either upwards  or downwards.
The pain is feldom  confined to any particular part,
as  the  vapour  wanders  from one  divifion  of the
bowels to another till it finds a vent.
  When the  difeafe  proceeds  from  windy liquor,
green fruit, four herbs, or the like,  the beft medi-
cine on the firft appearance of the  fymptoms  is a
dram of brandy, gin, or any good fpirits.   The pa-
tient fliould likewife fit  with his feet upon  a warm
hearth-ftone,  or apply  warm  bricks  to  them ;  and
warm  cloths  may be  applied to  his ftomach  and
bowels.
   This is the only colic wherein  ardent fpirits, fpi-
ceries, or any thing of a hot nature, may be ven-
tured upon. *  Nor indeed are they to be ufed  here
unlefs  at the  very beginning, before any fymptoms
of inflammation appear.   We have reafon to believe,
that a  colic occafioned by wind  or  flatulent  food
might always be cured by fpirits or warm liquors,
if they were taken immediately upon perceiving the
firft uneafinefs ; but when the pain has continued for
a confiderable time,  and there is reafon to fear  an
inflammation  of the bowels is already begun, all hot
things  are to be avoided as poifon,  and the patient
is to be treated in the fame manner as for the inflam-
mation of the inteftines.
   Several kinds of food,  as honey,  eggs, Szc.  occa-
 fion colics in fome  particular conftitutions.   I  have


   * I believe there is never a neceffity of ufing fyirits in thii
 cafe—A glafs of mint-water, or mint,  ginger, or penny-royal
 tu, would always anfwer the purpofe.
generally 
304             OF THE COLIC.
generally found  the  beft  method  of cure for theft
was to drink plentifully of fmall diluting liquors, as
water-grutl, fmall poffet, water with toafted bread
foaked in it,  &c.
   Colics which  proceed from excefs and indigeftion
generally cure  themfelves  by  occafioning vomiting
or purging.   Thefe  difcharges are by no means to
be ftopped,  but promoted  by drinking plentifully of
warm water, or weak  poffet.  When their violence
is over, the  patient may take a dofe of rhubarb, or
any other gentle  purge, to  carry  off the dregs of
his debauch.
   Colics which are occafioned by wet feet, or catch-
ing cold, may generally be removed at the beginning,
by bathing  the feet and  legs in  warm  water,  and
drinking fuch warm diluting liquors as will promote
the perfpiration, as weak wine-whey, or water-gruel,
with a fmall quantity of wine in it.
   Thofe flatulent  colics,  which  prevail  fo much
among country people,  might generally be prevented
were they careful  to change their clothes when they
get wet.  They ought likewife, after eating any kind
of green trafh,  to take a glafs of good  peppermint
water,  which will have nearly the fame effect as a
glafs of brandy, and is to be preferred.
   The bilibus colic is attended with very acute pains
about  the  region of the navel.   The  patient com-
plains of great  thirft,  and is generally coftive.  He
vomits  a  hot, bitter,  yellow-coloured  bile, which
being difcharged,  feems to afford fome relief, but is
quickly followed by  the fame violent pain as before.
As the diftemper  advances,  the propenfity to vomit
fometimes increafes fo as to become almoft continual,
and the proper motion of the inteftines is fo  far per-
verted, that there are all  the fymptoms  of an im-
pending iliac paffion.
                           4                    If 
                OF THE COLIC.              305
   If the patient be young and  ftrong, and the pulfe
full  and frequent,  it will be proper to bleed, after
which glifters may  be adminiftered.   Clear whey or
gruel, fliarpened with the juice of lemon, or cream
of tartar, muft be drank freely.  Small chicken-broth,
with a little manna diffolved  in it, or a flight decoction
of tamarinds, are likewife very proper, or any other
thin, acid, opening liquor.
  Befides  bleeding and plentiful dilution, it will be
neceffary to foment the belly with cloths dipped in
warm water, and if this fliould not fucceed,  the pa-
tient muft be immerfed  up  to the  breaft in warm
water.
   In the bilious colic the vomiting is often very dif-
ficult  to  reftrain.   When  this happens  the patient
may  drink a decoction  of toafted bread,  or  toafted
oats, or an infufion of mint in boiling water.   Should
thefe not have the defired effect,  the faline draught,
with a few drops of laudanum in it, may be  given, and
repeated according to the urgency of the  fymptoms^
A fmall quantity of Venice  treacle may be fpread in
form of a cataplafm, and applied to the  pit  of the
ftomach.   Clyfters with a proper quantity of Venice
treacle  or liquid laudanum in them, may likewife be
frequently adminiftered.
  .Such as are liable to  frequent returns  of  the bi-
lious colic fliould ufe flefh fparingly, and  live chiefly
upon a light vegetable diet.   They  fhould likewife
take frequently a dofe of cream of tartar with tama-
rinds,  or any other cool acid purge.
  The hy/ieric colic bears a  great refemblance to the
bilious.  It is attended with acute  pains about the
region of  the  ftomach, vomiting, &c.   But what
the  patient vomits  in  this  cafe is  commonly of a
greenifh colour.   There is  a  great  finking of the
fpirits,  with  a dejection of mind and  difficulty cf
breathing, which are the characteriftic fymptoms of
                        X                     this 
3o6              OF THE COLIC.
this diforder.   Sometimes it is accompanied with the
jaundice,  but this generally goes off of its own ac-
cord in a  few days.
   In this  colic, all evacuations, as bleeding, purging,
vomiting, &c. do hurt.   Every thing that weakens
the patient,  or finks his fpirits, is to  be avoided.
If,  however,  the vomiting  fhould prove  violent,
lukewarm water, or fmall poffet,  may  be drank to
cleanfe the ftomach.  Afterwards  the  patient may
take fifteen,  twenty, or  twenty-five drops of liquid
laudanum in  a glafs  of  cinnamon-water.  This may
be repeated every ten or twelve hours till the fymp-
toms abate.
   The patient may likewife take four or five of the
fcetid  pills every fix hours, and drink a cup of penny-
royal  tea after them.  If afafcetida fliould prove dif-
agreeable, which is fometimes the cafe, a tea-fpoonful
of the tincture of caftor in a cup of penny-royal tea,
or thirty  or forty drops of the balfam of Peru dropped
upon  a bit of loaf-fugar, may be taken in its flead.
The anti-hyfteric plafter may alfo be ufed, which has
often  a good effect.*
   The nervous colic prevails among miners,  fmelters
of lead,  plumbers,  the  manufacturers of white-lead,
&c.   It  is very common in the cyder countries of
England, and is fuppofed to be occafioned  by the
leaden veffels ufed in preparing  that liquor.  It is
likewife a frequent difeafe in  the Weft Indies, where
it is termed the dry belly-ache.
   No difeafe of the bowels is attended with more ex-
cruciating pain than this.  Nor is it foon at an end.
I have known it  continue eight or ten  days with
very little intermiffion, the body all the while continu-
ing bound in fpite of medicine, yet at length yield,

         Se-* Appendix, Anii-hyflency orfiomach-plaflor.
and 
                 OF THE COLIC.              367
and the patient, recover*. It generally however leaves
the patient weak, and often ends in a palfy.
   The general treatment of this difeafe is fo nearly
the fame with that of the iliac paffion, or inflamma-
tion of the guts,  that we fliall not infift upon it.  The
body is to be opened by mild purgatives given  in fmall
dofes,  and frequently repeated,  and their  operation
muft be aflifted by foft oily clyfters, fomentations, &c.
The caftor oil is  reckoned peculiarly proper  in this
difeafe.   It may both be mixed with the clyfters and
given by the mouth.   The warm bath generally gives
great  relief.
   The Barbadoes tar is faid to be an efficacious me-
dicine in this complaint.  It may  be taken  to the
quantity  of two drachms   three  times  a day,  or
oftener if the ftomach will bear it.   This tar, mixed
with an  equal quantity of ftrong rum,  is likewife
proper for  rubbing the fpine, in cafe any tingling,
or other  fymptoms of a palfy, are felt.  When the
tar cannot be  obtained,  the back may  be  rubbed
with  ftrong fpirits,  or a little oil of nutmegs or  of
rofemary.
   If the patient remains weak and languid after this
difeafe, he muft take exercife on horfeback, and ufe
an infufion of the Peruvian  bark in wine.  When
the difeafe ends in a palfy, the warm-fprings are found
to be  extremely proper.
   To avoid this  kind  of colic, people muft fhun all
four fruits, acids, and auftere liquors, &c.  Thofe

  * As the fmoke of tobacco thrown into the bowels will often
procure a ftool when all other means have failed, an apparatus
for this purpofe ought to be kept by every furgeon.  It may
be purchafed at a fmall expence,  and will be of fervice in feve-
ral other cafes, as the recovciy  of drowned perfons,  &c.—A
table-fpoonful of muftard-feed a  little bruifed and given every
two or three hours, will fometimes open the bowels when every
thing elfe has failed.
                       X :                    wh© 
3©8             OF THE COLIC.
who work in lead ought never to go to their bufmefs
fafting, and their food fhould be oily or fat.   They
may take a glafs of falad oil every morning.   Liquid
aliment is beft for them ; as fat broths, &c. but low
living  is bad.  They  fliould  frequently go  a little
out of the tainted air ; and fhould never fuffer them-
felves to be  coftive.   In the  Weft  Indies, and  on
the coaft of Guinea, it has been found of great ufe,
for preventing this colic, to wear  a piece of flannel
round the waift,rand to drink an infufion of ginger by
way of tea.
   Sundry other kinds of this difeafe might be men-
tioned, but too many diffractions would tend only to
perplex the reader.   Thofe  already mentioned are
the moft material, and fhould indeed be attended to,
as their treatment is very different.  But even per-
fons who are not in a condition to diftinguifh very
accurately  in  thefe matters,  may neverthelefs be of
great fervice to patients in colics of every kind, by
only obferving the  following general rules, viz.  To
bathe the feet and legs in  warm water ;  to apply
bladders filled with warm water, or cloths dipped in
it, to the ftomach and bowels : to make the patient
drink freely of diluting mucilaginous liquors ; and to
give him  an emollient clyfter every two or three
hours.  Should thefe not fucceed,  the patient ought
to be immerfed in warm water ;  and in almoft every
cafe of colic, except where  inflammation is prefent,
the  chief remedy, in  the firft inftance,  where the
pain is violent, is laudanum—from twenty to twenty-
five drops may be  given every hour in a little fugar
and water, until the pain abates—when we fufpedt
inflammation the laudanum in dofes  of ten drops in
the camphor mixture*—and when there are fymptoms

          *  See Appendix, Caviphor Mixture.
of 
       INFLAMMATION OF THE KIDNEYS.    309
of hyfteria,  the  fame quantity in a tea-fpccnfuj of
fetid tincture.

      INFLAMMATION OF THE KIDNEYS.

  CAUSES.----This difeafe may proceed from any
of thofe caufes which produce an inflammatory fever.
It may likewife be occafioned by  wounds or bruifes
of the kidneys; fmall ftones or gravel lodging within
them ; by ftrong  diuretic medicines ;  as  fpirits of
turpentine,  tincture of cantharides,  &c.  Violent
motion, as hard  riding or walking, efpecially  in hot
weather, or whatever  drives the  blood too forcibly
into the kidneys, may occafion  this malady.  It may
likewife proceed  from lying too  foft,  too much on
fhe back, involuntary contractions,  or fpafms, in
fhe urinary veffels, 8cc.  alfo  from  the  mifplaced
gout.
  SYMPTOMS.—There  is a fharp  pain about the
region  of the kidneys, with fome degree of fever,
and a ftnpor or dull pain in the thigh of the affected
fide.  The urine is at firft  clear, and afterwards of a
reddifh colour ;  but in the worft kind of the difeafe
it generally continues  pale, is  paffed with difficulty,
and commonly in fmall quantities at a time.   The
patient feels  great uneafinefs when he endeavours to
walk or fit upright.  He lies with moft eafe on the
affected fide, and has generally  a naufea or vomiting,
refembling that which happens  in  the colic.
  This difeafe, however, may  be diftinguifhed from
fhe  colic by the pain being feated  farther  back,  and
by the difficulty of pafling urine with which it  is con-
ftantly attended.
  REGIMEN.—Every thing  of a heating or flimu-
lating nature  is  to be avoided.   The food muft be-
thin and light  ; as panada, fmall  broths, with mild
vegetables and the like.   Emollient and thin lirpior:
                      X  3                   Jluift 
3io    INFLAMMATION OF THE KIDNEYS.
niuft  be plentifully drank ;  as clear whey, or balm-
tea fweetened with honey, decoctions of  marfh-mal-
low roots,  with barley and liquorice, &c.  The pa-
tient, notwithftanding the vomiting, muft conftantly
keep fipping fmall quantities of thefe or other  dilut-
ing liquors.  Nothing fo  fafely and certainly abates
the inflammation, and expels the  obftructing caufe,
as copious dilution.   The patient muft hi kept eafy,
quiet, and free from cold, as lon-j as any fymptoms
of inflammation remain.
   MEDICINE.—Bleeding  is  generally  neceffary,
efpecially at the  beginning.  Ten  or  twelve  ounces
may be let from the arm  or foot with  a  lancet,  and
if tile pain and inflammation continue,  the operation
may  be .q^ated in twenty-four hours, or fooner,
efpecially if the  patient be of a full habit.   Indeed
there are few cafes which  require more copious bleed-
ing.  Leeches may likewife be applied to  the haemor-
rhoidal veins,  as a difcharge from thefe will greatly
relieve the patient.
   Cloths dipped in warm-water,  or  bladders filled
with it, muft be applied as near as poffible to the part
affected, and renewed as "they grow cool.
   Emollient clyfters ought frequently to be admi-
niftered ; and if thefe do not open the body,  a little
fait and honey, or manna, may be added to them.
   The fame courfe is to be followed where gravel or
a ftone is lodged in the kidney, but when the gravel
or ftone is feparated from the  kidney, and lodges in
the Ureter*,  it will be proper, befides the fomenta-
tions, to rub the fmall  of the back with fweet oil,
 and to give  gentle diuretics;  a tea-fpoonful  of the
fweet fpirits of nitre, with a few drops of laudanum,

   v The Ureters n*e two long and fmall canals, one on each
 fide*, which carry the urine from the bafon of the kidneys to
the bladder.  They are fometimes obtruded by fmall ftones of
 |;av<-l .'Vding down from the kidneys, and lodging in them.
                                              in iV 
      INELAMMATION OF THE BLADDER.   311
may now and then be put into a cup of the patient's
drink : the warm bath and opium are here of great
fervice.
   When the difeafe is protracted beyond the feventh
or eighth day, and the patient complains of a ftupor
and  heavincfs  of the part,  has  frequent returns of
cliillinefs,  fliivering,  &c. there is reafon to fufpect
that  matter is forming in  the kidney, and that an
abfcefs will enfue.
  When matter in  the urine fliews that an  ulcer is
already formed in the kidney, the patient muft be
careful to abftain from all acrid, four, and faked pro-
vifions, and to live  chiefly  upon mild mucilaginous
herbs and fruits, together with the broth of animals,
made with barley and common pot herbs, &c.   His
drink may be whey, and butter-milk that is not four.
The latter is by fome reckoned a fpecific remedy in
ulcers  of the  kidneys.  To  anfwer  this character,
however, it  muft be  drank  for a confiderable time.
Chalybeate  waters have likewife been found bene-
ficial in this  difeafe.  They muft likewife be ufed for
a confiderable  time, in order to produce any falutary
effects.
   Thofe who are liable to frequent returns of inflam-
mation, or obftructions of the kidneys, muft abftain
from  wines, and  their  food ought to be light, and
of eafy digeftion.  They fliould ufe moderate exeiv
cife,  and fliould not lie too hot, nor too much  on
their back.

      INFLAMMATION OF  THE BLADDER.

  The inflammation  of the bladder proceeds, in a
great meafure, from  the fiune caufes  as that of the
kidneys.   It ]■:, known  by  an  acute pain towards
the bottom  of the belly, and  difficulty of paffing
urine,  with  fome  degree of  fever,  a conftant inch-
                       X 4                nation 
3.12   INFLAMMATION OF THE BLADDER.
nation to go to ftool, and a perpetual defire to make
water.
   This difeafe  muft be treated on the fame  princi-
ples as the one  immediately preceding.  The diet
muft  be light  and thin, and the drink of a cooling
nature.  Bleeding  is very proper at the beginning,
and in robuft conftitutions  it  will often be neceffary
to repeat it.  The  lower part of the belly fhould be
fomented  with  warm water, or a decoction of mild
vegetables; and  emollient clyfters ought frequently
to be adminiftered,  &c.
   The patient fhould abftain from every thing that
is  of  a hot, acrid,  and ftimulating  quality,  and
fhould live entirely upon fmall broths, gruels, or mild
vegetables.
   A ftoppage of urine may proceed from other caufes
befides an inflammation of the bladder ; as a fwelling
of the haemorrhoidal veins,  hard faces lodged in the
reclum ; a ftone in the bladder  ;  excrefcences in
the urinary paffages, a palfy of the bladder, hyfteric
affections,  &c.   Each of thefe requires a particular
treatment, which does  not fall under our prefent con-
fideration.   We  fhail only  obferve, that in all of
them mild  and gentle applications are the fafeft, as
ftrong diuretic  medicines, or things of aa irritating
nature, generally increafe the danger.   I have known
fome perfons  kill themfelves by introducing probes
into the urinary paffages, to remove, as they thought,
fomewhat that obftructed the difcharge of urine, and
others bring on a violent inflammation of the bladder,
by ufing ftrong heating medicines, as oil of turpentine,
&c. for that purpofe.
LXFLAM- 
[  3*3   ]
       INFLAMMATION OF TEE LIVLtc.

  The liver is lefs fubject to inflammation than moft
of the other vifcera, as in it the circulation is flower;
but when  an inflammation does  happen, it is with
difficulty removed, and often ends m a fuppuration
or fcirrhus.
  CAUSES.—-Befides  the common  caufes of  in-
flammation, we may here reckon fhe following, viz.
exceffive fatnefs, a fcirrhus of the liver itfelf, vio-
lent fhocks from  ftrong vomits when the liver was
before unfound,  any thing that  fuddenly cools the
liver after  it  has been greatly heated, flones obftruct-
ing the courfe of the bile, drinking ftrong wines and
fpirituous liquors,  ufing hot fpicy aliment, obftinate
hypochondriacal affections, &c.
  SYMPTOMS.—This difeafe is known by a pain-
ful  tenfion of the right fide under the falfe  ribs, at-
tended with more or lefs fever, a fenfe of weight, or
fulnefs of the part, difficulty of breathing,  loathing
of food,  great thirft, with a pale or yellowifli  colour
of the fkin and eyes.
  The fymptoms here are various, according  to the
degree  of inflammation,  and likewife according to
the particular part of the liver where the inflammation
happens.   Sometimes the pain is  fo  inconfiderable,
that an inflammation is not fo much as fufpected ;  but
when it happens  in fhe upper or convex part  of the
liver, the pain is more acute,  the pulfe quicker,  and
the patient is often troubled with a dry cough, a hic-
cup, and a pain extending to the flioulder,  with dif-
ficulty of lying on the left fide, &c.
  This difeafe may  be diftinguiflied  from the pleu-
rify by the pain being lefs viofeni, feated under the
falfe ribs,  and by the difficulty of lying on the left
fide.   It  may he  diftirjuifhr.i fy^r-i  ihe hyftcric and
                                        hypochon- 
   3i4     INFLAMMATION OF THE LIVER.
   hypochondriac diforders by the degree of fever with
   which  it is. always attended.
     This difeafe,  if properly treated,  is feldom mor-
   tal.  A  conftant hiccuping, violent  fever, and ex-
   ceffive  thirft, are bad fymptoms.'  If it ends in a fup-
   puration, and the matter cannot be difcharged out-
   wardly,  the danger is great.   When the fcirrhus
   of the liver crifues, the  patient, if  he  obferves a
   proper regimen, may  neverthelefs  live a number of
   years tolerably  eafy ;  but if he indulge  in animal
   food and ftrong liquors, or  take  medicines  of  an
   acrid or irritating nature, the fcirrhus will be con-
   verted  into  a cancer, which muft  infallibly prove
   fatal.
     REGIMEN.—The fame regimen  is  to  be ob-
   ferved  in this as  in  other inflammatory  diforders.
   All hot things are to be  carefully avoided, and cool
   diluting liquors,  as whey, barley-water,  &c.  drank
   freely.   The food muft be light  and thin, and the
   body, as well as the mind, kept  eafy and quiet.
     MEDICINE.—Bleeding  is proper at the begin-
   ning of this  difeafe, and  it  will be neceffary, if the
   pulfe fliould  feel hard,  to repeat it.  All violent pur-
   gatives are to be avoided ; the body,  however, mufl
   be kept  gently  open.   A decoction  of  tamarinds,
   with a little honey or  manna,  will anfwer this pur-
   pofe  very well.   The fide affected muft be fomented
   in  the  manner   directed  in  the foregoing difeafes.
   Mild laxative clyfters fhould be frequently adminif-
   iered ;  and,  if the pain fliould, notwithftanding, con-
   tinue violent, a b'iftering-plafter may be applied over
   the part affected.
     When there   is  an inclination  to fweat, it ought
^fo be promoted, but not  by warm  fudorifies.   The
   only  thing to be  ufed for that purpofe  is  plenty of
   diluting liquors drank about  the warmth  of the hu-
   r.an blood.  Indeed the patient in this cafe, as well
                                                  as 
        INFLAMMATION OF THE LIVER.      31 $
as in all other topical inflammations, ought to drink
nothing that is colder than the blood*.
   If the ftools fliould be loofe, and even ftreaked
with blood,  no means muft  be ufed to flop  them,
unlefs they be fo frequent as to weaken the patient.
Loofe ftools  often prove critical, and  carry off the
difeafe.
   If an abfcefs or impofthume is formed in the liver,
all methods fliould be tried to make  it  break  and
difcharge  itfelf outwardly, as  fomentations, the  ap-
plication  of  poultices,  ripening  cataplafms,  Sec.
Sometimes  indeed the  matter of an  abfcefs  comes
away  in  the  urine, and fometimes it is difcharged
by ftool ; but thefe are effects of nature which no
means can  promote.  When  the abfcefs burfts  into
the cavity of the abdomen at  large, death enfues ;
nor will the event be  more favourable when the ab-
fcefs is opened by an incifion, unlefs in cafes where
the liver  adheres to the pcritonaum, fo as to form a
bag for the matter,  and prevent  it from  falling  into
the cavity of the abdomen ; in which cafe opening the
abfcefs  by  a fufficiently large  incifion will probably
fave the patient's life f.
   If the  diforder, in  fpite of  all  endeavours to the
contrary,  fhould end in a fcirrhus,  the patient muft
be careful to regulate his diet, &c. in fuch a manner
as  not  to  aggravate  the difeafe.   He muft  not in-

   * The American practice is, after bleeding and purging, to
 give two or three grains 01  calomel twice a-day, until the dif-
 eafe is fubdued ; if this purges much, a quarter of a grain of
 powdered opium may be added to each dofe ; if the fymptoms
 are violent, from half? drachm to a drachm of mercurial oint-
 ment fliould be rubbed into the fide twice a-day.  There are
 few cafes that will not yield to this treatment.
   f I know  a gentleman who has had feveral abfeefles of the
 liver opened,  and is now a ilr. ny and healthy man, though
 vbove ehhty  years cf ;:£«?.
dufee 
 316     OF THE CHOLERA MORBUS, &c.
 du%e in flefh,  fifh, ftrong liquors or any highly fea.
 foned or falted provifions ; but fhould, for the moft
 part, live  on mild vegetables, as fruits and roots;
 taking gentle exercife, and  drinking  whey, barley-
 water, or butter-milk.
   We fliall  take no notice  of inflammations of the
 other vifcera.  They muft in  general be treated upon
 the fame principles as thofe already mentioned.  The
chief rule with refpect to all  of them, is to let blood,
to avoid every thing that is  ftrong,  or of a heatin^
nature, to apply warm fomentations to the part affect-
ed, and to caufe the patient to drink a fufficient quan-
 tity of warm diluting liquors.
                CHAP.  XXXII.

Of the Cholera Morbus, and other exceffive Difcharges
           from the Stomach and  Bowels.


           JL EfE cholera morbus is a violent purging
and  vomiting,  attended  with gripes, ficknefs, and a
conftant defire  to go to ftool.   It  comes on fuddenly,
and  is moft common in fummer and autumn.
   CAUSES.—It is occafioned by a redundancy and
acrimony of the  bile; cold ; food that eafily turns
rancid  or  four on  the  ftomach ; as butter, bacon,
fweet-meats, cucumbers, melons,  cherries, and other
cold fruits*.   It is  fometimes the  effect of ftrong
acrid purges or  vomits, or of  poifonous fubftances
taken  into the ftomach.   It  may likewife  proceed

  *'  I have been  twice brought to the gates of death by this
difeafe, and  both times  it was occafioned by eating rancid
kacon.
                                             from 
        OF THE CHOLERA MORBUS, tsV.     317
from violent paflions or affections of the mind; as
fear, anger, &c.
  SYMPTOMS.—It is  generally  preceded by  a
cardialgia,  or  heart-burn, four belchings,  and fla-
tulencies, with pain  of the  ftomach and inteftines.
To  thefe fucceed exceffive vomiting, and purging of
green, yellow, or blackifh coloured bile, with a dif-
tenfion of  the ftomacli,  and violent griping pains-
There is likewife a great thirft, with a very quick
unequal pulfe, and often a  fixed acute pain about
the  region  of the  navel.   As the difeafe advances,
the  pulfe  often finks fo  low as to become quite im-
perceptible, the extremities  grow cold, or cramped,
and arc often covered with a clammy fweat, the urine
is obftructed,  and there is a palpitation of the heart.
Violent hiccupping, fainting, and convulfions, are the
figns of approaching  death.
  MEDICINE.—At the beginning of this difeafe
the  efforts  of nature to  expel the  offending caufe
fhould  be  affifted, by  promoting the  purging  and
vomiting.   For this purpofe the patient muft drink
freely of diluting  liquors ;  as whey,  butter-milk,
warm water,  thin water-gruel,  fmall  poffet, or, what
is perhaps  preferable  to any  of  them, v^ry weak
chicken broth.
  After thefe evacuations have been continued for
fome time,  a  decoction  of toafted oats may be drank
to flop  the vomiting.  The oats  fhould be toafted
'till  of a brown colour, and afterwards made into a
tea.  If oats  cannot be had,  wheat bread,  or  oat-
meal well toafted, may be ufed in their ftead.  if
this does not put a flop to the  vomiting, two tafcle-
fpoonfuls of  the faline julep,  made without lemou-
iuice, with ten drops of laudanum, may be taken every
half hour,  'till it ceafes.
  The vomiting and purging however, ought never
to be ftopped too foon.   As long as thefe difcharges
                                              do 
 318     OF THE CHOLERA MORBUS, fjc.
do  not weaken  the patient, they are falutary, and
may be allowed to go  on, or  rather, ought  to be
promoted.   But, when the patient is weakened by
the evacuations, which may be  known from the fink-
ing of his  pulfe, &c. recourfe muft immediately be
had to  opiates, as recommended above ;  to  which
may be added ftrong wines, with fpirituous cinnamon-
waters, and other generous cordials.   Warm negus,
or  ftrong wine-whey, will likewife  be neceffary to
fupport the patient's  fpirits and promote the perfpi-
ration.   His legs fhould be bathed in warm water,
and afterwards rubbed  with flannel cloths, or wrap-
ped in warm blankets,  and warm bricks  applied to
the foles of his feet.   Flannels, wrung out of warm
fpirituous fomentations, fhould likewife be applied to
the region of the ftomach.
   The patient's  food ought to be nourifhing, but
taken in fmall quantities, and  he fhould ufe  mode-
rate exercife,  when able to go  abroad.  As the fto-
mach and  inteftines are generally much weakened,
an  infufion of the  bark, or other bitters, in fmall
wine, fliarpened with  the  elixir of vitriol, may be
drank for feme time.
   Though phyficians are fometimes not called  in due
time in this difeafe, they ought not to defpair of re-
lieving the patient even  in the moft defperate circum-
ftances.   Of this I lately  faw a moft  ftriking proof
in an old man and his fon, who  had been both feized
with it about the middle of the  night.  I did  not fee
them till next morning,  when they had much more
the  appearance of dead than  of living men.  No
pulfe could be felt; the extremities  were cold and
rigid ; the countenance was ghaftly, and the ftrength
almoft  quite  exhaufted.   Yet  from  this deplorable
condition they were both  recovered  by the ufe of
opiates and cordial medicines.   Indeed, opium feems
here to be a fovereign  remedy.
                       i                      OF 
C  3J9  ]
      OF A DIARRHCEA, OR LOOSENESS.

  A loofenefs, in many cafes, is not to be confidered
as a  difeafe, but rather as a falutary evacuation.   It
ought, therefore, never to be ftopped, unlefs  when
it continues too long, or evidently weakens the pa-
tient.  As this, however, fometimes happens, we fhail
point out the moft common caufes of a loofenefs, with
the  proper method of treatment.
  When a loofenefs  is occafioned by catching cold,
or an obftructed perfpiration, the  patient ought to
keep warm, to drink freely of weak diluting liquors,
to bathe his feet and legs frequently  in  lukewarm
water, to wear flannel next his fkin, and to take every
other method to reftore the perfpiration.
  In a loofenefs which proceeds from excefs  or re-
pletion, a vomit is the proper medicine.   Vomits
not  only cleanfe  the ftomach  but promote all die
fecretions,  which renders them of great importance
in carrying o'f a debauch.   Fifteen grains of  ipeca-
cuanha in powder,  will  anfwer this  purpofe very
well.  A day or two after the vomit, the fame quan-
tity  of rhubarb may be taken,  and repeated two or
three times, if the loofenefs continues.   The patient
ought to live upon light vegetable food  of eafy di-
geftion, and to drink whey, thin gruel, or barley-
water.
  A loofenefs, occafioned by  the obftruction of any
cuftomary  evacuation, generally requires  bleeding.
If that does  not fucceed, other evacuations may be
fubftituted in the room of thofe which are obftructed.
At  the fame time, every  method  is to be  taken to
reftore the ufual difcharges,  as not only the cure of
the  difeafe, but  the patient's life may depend on
this.
A peri- 
  320    OF A DIARRHCEA, OR LOOSENESS.
    A periodical  loofenefs ought never to be flooped.
  It is always an  effort of nature  to carry off fome
 • offending matter, which,  if retained in the  body
  might have fatal effects.   Children are  very liable
  to this kind of  loofenefs, efpecially while teething.
  It is, howeyer,  fo far from being  hurtful to  them,
  that fuch children generally  get  their teeth  with
  leaft  trouble.   If thefe  loofe ftools  fhould at  any
  time prove four or griping, a tea-fpoonful of  mag.
 neiia alba, with  four or five grains  of rhubarb, may
 be given to  the child.   This,  if repeated three or
 four times,  will generally  correct  the  acidity,  and
 carry off the griping ftools.
    A  diarrhoea,  or loofenefs,  which proceeds  from
 violent paflions or affections of the mind, muft be
 treated with the greateft caution.  Vomits, in this
 cafe,  are highly improper.  Nor  are  purges  fafe,
 unlefs they be very mild,  and  given  in fmall quan-
 tities.  Ophites, and other antifpafmodk  medicines,
 are moft proper.  Ten  or twelve drops  o^ liquid
 laudanum, may be taken in a cup of valerian or penny-
 royal tea every eight or ten hours, till the fymptoms
 abate.  Eafe,  cheerfulnefs  and  tranquillity of mind,
 are here  of the greateft importance.
   When  a loofenefs  proceeds  from  acrid  or  poi-
 fonous fubftances taken into the fiomach, tlie patient
 muft drink large quantities  of diluting liquors, with
 oil or fat broths to promote vomiting and purging.
 Afterwards,  if there be  reafon to fufpect  that the
 bowels arehifiamed, bleeding will be neceffary.  Small
 dofes of laudanum  may likewife be taken to remove
 their  irritation.
   When  the gout, repelled from  the  extremities,
occafions a loofenefs, it ought to be  promoted by
gentle dofes  of rhubarb,  or odier mild purgatives.
The gouty matter is likewife to be folicited towards
the extremities by warm  fomentations,  cataplafms,
                                              &c. 
       OF A DIARRHCEA, OR LOOSENESS.    321
 Sec.   The perfpiration ought, at the fame time,  to
 br promoted by warm diluting liquors ; as wine-whey,
 With fpirits of hartfliorn,  or a few  drops of liquid
 laudanum, in it.
   When  a loofenefs proceeds from worms, which
 may be  known  from  the fliminefs of the ftools,
 mixed  with pieces of decayed worms, &c.  medicines
 muft be given to  kill and carry off thefe vermin, as
 die green vitriol, with purges of rhubarb and calomel.
 Afterwards lime-water, either alone, or with a fmall
 quantity of  rhubarb  infufed,  will be  proper  to
 flrengtlien the bowels,  and prevent the new genera-
 tion of worms.
   A loofenefs  is  often occafioned by drinking bad
 water.   When this  is the cafe, the difeafe generally
 proves endemical.   When  there is reafon to be-
 lieve that this,  or any other difeafe, proceeds from
 the ufe of unwholefome water, it ought immediately
 to be changed, or,  if that cannot be done, it may
 be corrected by mixing  it with quick-lime, chalk, or
 the  like.
   In people whofe flomachs are weak, violent exer-
 cife  immediately  after eating will occafion a loofe-
 nefs.   Though the cure of this is obvious, yet it will
 be  proper, befides avoiding violent exercife, to  ufe
 fuch medicines as tend to  brace and ftrengthen the
 ftomach,  as infufions of the bark with  other bitter
 and aftringent ingredients, in white-wine.   Such per-
fons ought likewife frequently to take a  glafs or two
of old  red port, or good claret.
  From whatever caufe a  loofenefs proceeds, when
it is found neceffary  to  check it, the diet  ought to
confift  of rice boiled with  milk,  and feafoned with
cinnamon ; rice-jelly ;  fago, with red port ;  and
the lighter forts   of flefh-meat.   The drink  may
be thin water-gruel, rice-water, beef,  or chicken-
broth.
                       Y                Perfons 
322            OF VOMITING.
   Perfons who, from a peculiar weaknefs, or too great
an irritability of the bowels, are liable to frequent
returns of this difeafe, fliould live temperately, avoid-
ing crude fummer fruits, all unwholefome food,  and
meats of hard digeftion.  They ought likewife to be-
ware of cold, moifture, or whatever may obftruct the
perfpiration, and fliould wear flannel next their fkin.
All violent paffions,  as fear, anger, &e. are likewife
carefully to be guarded againft.

               OF  VOMITING.
   Vomiting may proceed from various caufes, as ex-
cefs  in eating and drinking ; foulnefs of the ftomach;
the  acrimony of the aliment;  a  tranflation of the
morbific matter of ulcers, of the gout^the eryfipelas,
or other difeafes, to  the ftomach.  It may likewife
proceed from a loofenefs having been too fuddenly
flopped ; from the ftoppage of any cuftomary evacu-
ation,  as the bleeding piles, the menfes, &c. from a
weaknefs of the ftomach,  the  colic, the iliac paffion,
a rupture,  a fit of the gravel, worms ; or from any
kind of poifon taken into the ftomach.  It is an ufual
fymptom of injuries done to the brain ; as contufions,
compreflions,  &c. It is likewife a fymptom of wounds
or inflammations of the diaphragm, inteftines, fpleen,
liver, kidneys,  &c.
   Vomiting may be occafioned by unufual motions;
as failing, being drawn backwards in a cart or coach,
&c.   It may likewife be excited by violent paffions,
or by the idea of naufeous and  difagreeable objects,
efpecially of fuch  things as have formerly produced
vomiting.  Sometimes it proceeds from a regurgita-
tion of the bile into the ftomach :  In  this cafe, what
the patient vomits is generally of a yellow or greenifh
colour, and has a bitter tafte.  Perfons who are fub-
ject to nervous affections are  often fuddenly feized
with violent fits of vomiting.  Laftly, vomiting is a
                                          common 
               OF VOMITING.            323
common fymptom of pregnancy.  In this cafe, it gene-
rally comes on about two weeks  after the ftoppage
of the menfes, and continues during the firft three or
four months.
   When vomiting  proceeds from  a foul  ftomach or
indigeftion, it is not to be confidered as a difeafe, but
as the cure of a  difeafe.   It ought, therefore, to be
promoted by drinking lukewarm water, or thin gruel.
If this does not put a ftop to the vomiting, a dofe
of ipecacuanha may be taken, and worked  off with
weak camomile-tea.
   When the retroceffion of the gout, or the obftruc-
tion of cuftomary evacuations,  occafion vomiting, all
means  muft bg ufed to reftore thefe difcharges ; or,
if that cannot be  effected,  their place muft be fup-
plied by others, as bleeding, purging, bathing the ex-
tremities  in warm water, opening iffues, fetons, per-
petual blifters, &c.
   When vomiting  is the effect of pregnancy, it may
generally be mitigated by bleeding, and keeping the
body gently open.  The bleeding, however, ought
to be in fmall quantities at a time,  and the purgatives
fliould be of the mildeft kind, as figs, flewed prunes,
magnefia, manna,  or fenna.   Pregnant  women are
moft apt to vomit in the morning,  immediately af-
ter getting out of bed, which is owing partly to the
change of pofture,  but more to the emptinefs of the
ftomach.   It may generally be prevented by taking
a difh of coffee,  tea,  or fome light breakfaft in bed*
Pregnant women who are  afflicted  with vomiting,
ought to  be kept eafy, both  in body  and mind.
They fliould neither allow their  flomachs to be quite
empty, nor fliould they eat much at once.  If the fpi-
rits are low, and the perfon apt to faint, a fpoonful of
cinnamon water, with a little marmalade of quinces
or oranges,  may be taken.   Vomiting, in this cafe,
fo often proceeds from irritability, that a few drops
                       Y  %.                    *£ 
 324            OF  VOMITING.
 of laudanum in mint-water, after bleeding, will ge-
 nerally ftop it.
    If vomiting proceeds  from weaknefs of the  fto-
 mach, bitters will be of fervice.   Peruvian bark, or
 Columbo root, infufed in wine  or brandy,  with 3s
 much rhubarb as will keep the body  gently  open,
 is an excellent medicine in this  cafe.   The elixir of
 vitriol is alfo a good medicine.   It may be taken in
 die dofe of fifteen or twenty drops,  twice or thrice
 a-day, in a glafs of water.  Habitual  vomitings are
 fometimes alleviated  by  making  oyfters a principal
 part of diet.
    A vomiting, which proceeds from acidities  in the
 ftomach, is relieved  by  alkaline purges.  The belt
 medicine of this kind is the magnefia alba, a tea-fpoon-
 ful of which may be  taken in a difli of tea or a little
 milk, three or four times a-day, or oftener if neceffary,
 to keep  the body open.
    When vomiting  proceeds from violent paflions,
 or affections of the  mind, all  evacuations muft be
 carefully avoided, efpecially vomits.   Thefe are ex-
 ceedingly dangerous.  The patient in this cafe ought
  to be kept  perfectly eafy and quiet,  to have the
 mind  foothed,  and  to take fome gentle  cordial, as
  negus, to which a few drops of laudanum may occa-
  fionally  be added.
    When vomiting  proceeds from fpafmodic affec-
  tions of the ftomach, mufic, caftor, and other anti-
  fpafmodic medicines, are of ufe.   Warm and  aro-
  matic plafters have  likewife  a  good   effect.    The
  ftomach-plafter  of the  London or Edinburgh  Dif-
  penfatory may be applied to the pit of the ftomach,
  or a plafter of theriaca, which will anfwer  rather
•  better.   Aromatic medicines may likewife be taken
  inwardly, as cinnamon or mint-tea, wine with fpice-
  ries boiled in it, Sec.  The region of the  ftomach
r may be rubbed with aedier,  or,  if that cannot be
                                                had, 
OF THE VOMITING, &c.
5~' 3
 had, with ftrong brandy or other fpirits.   The belly
 fhould be fomented with warm water, or the patient
 immcrfed up to the breaft in a warm bath.
   I have always found the faline draughts taken in
 the act of effervefcence, of Angular ufe in flopping
 a  vomiting,  from  whatever caufe  it  proceeded.
 Thefe  may  be  prepared  by diffolving a  drachm of
 the felt of tartar in an ounce and a half of frefh lemon
juice, and adding to it an ounce of peppermint-water,
 the fame quantity  of fimple  cinnamon-water,  and a
 little white fugar.   This draught muft be fwallowed
 before the effervefcence is quite over, and may be
 repeated every two hours, or oftener, if the vomit-
 ing be violent.   A violent vomiting has fometimes
 been ftopped by cupping on the region of the ftomach
 after all other means had  failed.
   As the leaft motion will often bring on  the vomit-
 ing again, even after it has been ftopped, the patient
muft avoid all manner of action.   The diet muft b&
fo regulated as to fit eafy upon the ftomach, and no-
thing fhould be taken that is hard of digeftion.  We
 do not however mean that  the patient fhould live en-
 tirely upon flops.   Solid food, in this cafe, often fits
 eafier on the ftomach than liquids.

    OF THE VOMITING AND  PURGING OF
                  CHILDREN.
   This fatal difeafe feems peculiar to our cities*.  It
occurs,  moft commonly,   in  the months  of  June,
July, and Auguft,  and is  always moft frequent and
moft violent in  the hotteft weather, and in children
under two years of age.   It feldom occurs violently
after this age, or in the cool feafons ;  although den-
tition,  worms or  any thing which irritates the fto-
mach  and inteftines  may  bring  it on at any  time.
   * In the United States of America.—This feci ion, as well
 as the chapter on the yellow fever, being iuU.ed by the Ame-
 rican cditi r.
                       Y 3                  The 
326         OF THE VOMITING AND
The patient is either feized with a violent or more
moderate cholera, which is to be treated as the cho-
lera  in  grown  people.   When the  violence of  it
abates,  diarrhoea, with an almoft conftant tendency
to vomit, enfues ; a fever, in many refpects refembling
the remittent, comes on ; the patient becomes ema-
ciated.   The fymptoms  are often very flattering,
but the appetite fails,  the emaciation encreafes, the
food often paffes unchanged, great thirft enfues, the
belly fwells  and grows hard, the feet are cedematous,
the child becomes very drowfy,  a fore mouth  comes
on, petechias often appear, and death, fooner or later,
clofes the feene.
   This difeafe is often much encreafed by the whoop-
ing-cough.   It is very often attributed  to teething and
to worms, and there is no doubt that thefe greatly ag-
gravate it.
   To prevent,  or at leaft to mitigate,  this deftructive
diforder, experience teaches us to remove  children
at  this age into  the country  during the fummer
months. If they are about cutting their teeth, which
is generally the cafe, to give the proper medicines,
efpecially  to have their gums lanced  ; if worms are
fufpected,  to ufe  the  remedies recommended for
them,  particularly calomel  and fteel  ; to avoid all
the  caufes which produce remittents, or tend to de-
bilitate the ftomach, as expofure to the fun or night
air,  unripe fruit, &c. to  ufe the cold bath daily, and
in weakly children,  a flannel fhirt—the feet fhould
be kept warm.
   When  the  difeafe  exifts, the  firft thing to be
given  is a fmall dofe of rhubarb, or  rhubarb  and
calomel, then  give the  anodyne  laxative  mixture
(fee Appendix).  If this does not anfwer, ufe the
infufion of  Colombo, with a little tincture of cinna-
mon and laudanum ; or, if the diarhoea is violent, a
fmall quantity of alum with laudanum may be given, or
of the tincture or infufion of kino in the fame manner.
                                                It 
            PURGING OF CHILDREN.         327
 It  is fuppofed that a plafter made of Venice treacle,
 and a few drops of the oil of mint, applied directly to
 the region of the ftomach, is of great fervice.  The
 Peruvian bark given in the form of mixture, decoction,
 or  infufion, is often a very ufeful medicine, when the
 ftomach will bear it.
   For diet, ufe  thin fago-gruel, wine-whey,  clear
 broth, rice-water, and fait meat, fait fifh, and  good
 cheefe, when the patient will take them.
   Baths of warm wine and brandy have been  often
 found to  be very beneficial when  the patient was
 much reduced.   When  the child drinks it fwallows
 greedily, and of courfe foon throws it up : this might
 be prevented by reftricting it to a fmall quantity at
 a  time.    Cold water  is generally craved, but it
 fhould always have a toaft in it.   At night  children
 will drink any thing, though they will not in  the day.
 if lime or lemon-juice is  mixed  with a little  boiling
 water, and more  water is added,  and the whole
 fweetened  with  loaf-fugar,  a moft  agreeable and
 ufeful drink is made.   Port wine or claret and water
 are alfo very proper.   The abfurd practice of giving
 brandy or rum and water is as improper here  as in
 all other cafes.
  But the chief remedy is yet to be mentioned—this
is a change  of air; and, were children  removed in-
 to the country, in  any reafonable time after die at-
tack, we may venture to affert, that this difeafe would
feldom prove fatal,   It is almoft impoffible to fay
when it is too late  to remove them ;  it would be bet-
ter to lay it down as a rule, that it is never  too late
to attempt  it.
  Thofe who cannot  be removed into  the •country
 fliould be taken out a riding once or twice a-day,
 and  even  when in the country this exercife is  very
neceffary.    Thofe who  cannot  take their children
a riding,  fhould carry them out of town daily in the
                      Y 4             afternoon. 
328           OF A DIABETES, &c.
afternoon.   A compliance with thefe directions is fo
abfolutely  neceffary,  that  without it medicines  arc
feldom of any fervice.
               CHAP.  XXXIII.

Of the Diabetes,  and other Diforders of the  Kidneys
                   and Bladder.


           J HE diabetes is a frequent and exceffive
difcharge of urine.  It  is feldom to  be  met with
among young  people;  but often attacks perfons in
the decline of life, efpecially thofe who follow the more
violent employments, or  have been hard drinkers in
their youth.
   CAUSES.—A  diabetes is often the confequencc
of acute  difeafes, as fevers, fluxes, &c. where  the
patient has fuffered by exceffive evacuations;  it may
Afo be occafioned  by  great fatigue, as riding long
journies  upon a hard-trotting  horfe, carrying heavy
burdens,  running,  &c.    It may be brought on by
hard drinking, or the ufe of ftrong ftimulating diu-
retic medicines, as  tincture of cantharides,  fpirits of
turpentine, and fuch like.  It  is fometimes brought
on by  long expofure to cold and damp.  It is often
the effect of drinking too great  quantities of mineral
waters.   Many imagine that thefe will do them no
fervice unlefs they be drank in great quantities,  by
which  miftake it often happens that  they occafion
worfe  difeafes than thofe they were intended to cure.
In a word, this difeafe may either proceed from  too
great a laxity of  the organs which fecrete the urine,
from fomething that ftimulates thekindeys too much,
                                               or 
             OF A DIABETES,  &c.           329
or from a  thin diffolved ftate  of the  blood, which
makes too great a quantity of it run off by  the uri-
nary paffages.
   SYMPTOMS.----In a diabetes  the urine gene-
rally exceeds in quantity all the liquid  food which
the patient takes.  It is  thin  and pale, moft com-
monly of a fweetifh tafte,  and an agreeable fmell.
The patient has a continual thirft, with fome degree
of fever ;  his mouth is dry,  and he fpits frequently
a  frothy fpittle.   The  ftrength  fails,  the appetite
decays, and the flefli  waftes  away till the patient is
reduced to lh in  and bone.    There  is a heat of the
bowels ;  and frequently the loins, tefticles, and feet
are fwelled.
   This difeafe may be often cured at the beginning ;
but after it has continued long, the cure  becomes
very difficult.  In drunkards, and very old people, a
perfect cure is hardly to be expected.
   REGIMEN.----Every  thing  that ftimulates the
urinary paffages, or tends to relax  the habit, muft
be  avoided.  For this reafon the patient fliould live
chiefly on  folid food.   His thirft may  be  quenched
with  acids ;  as  forrel, juice of lemon,  or vinegar.
The mucilaginous vegetables, as rice, fago, tapioca,
and falep, with  milk, are the moft proper food.  Of
animal fubftances, fliell-fifli  are to be preferred;  as
oyfters, crabs,  &c.
   The drink may be Briftol-water.  When that can-
not be obtained, lime-water, in which a due propor-
tion of oak-bark has been  macerated, may be  ufed.
The white  decoction*, with  ifmglafs diffolved  in it,
is likewife a very proper drink.
   The patient ought daily  to take exercife, but  it
fhould be fo gentle as not to fatigue him.   He fhould
lie upon a hard  bed or mattrefs.  Nothing hurts the

           * See  Appendix,  White De;rcVon.
                                          kidnevs 
33*
OF A DIABETES, &c.
 kidneys more than lying too foft.   A warm dry air,
 the ufe of the flefh-bruih,  and every thing that pro-
 motes perfpiration,  is of  fervice.   For this reafon
 the patient ought to wear flannel next his fkin.   A
 large  ftrengthening  plafter may  be applied to  the
 back.
   MEDICINE.—Gentle  purges,  if the patient be
 not too much weakened  by the difeafe, have a good
 effect.  They may confift of rhubarb, with cardamom
 feeds,  or any other fpiceries, infufed in wine,  and
 may be taken in fuch quantities as  to keep the body
 gently open.
   The patient muft next have recourfe to aftringents
 and corroborants.   One feruple of powder  of alum
 may be taken four times a-day, or oftener, if the  fto-
 mach will bear it.
   If the patient's ftomach cannot  bear the alum in
 fubftance,  whey may  be made of it, and taken in
 the  dofe of a tea-cupful three or four times a-day.
 The alum-whey is prepared by boiling two quarts
 of milk over a flow fire, with three drachms of alum,
 till the curd feparates.
   Opiates  are of fervice  in this difeafe, even though
 the patient refts well.  They take off fpafm  and irri-
 tation and  at  the  fame time leffen  the force of  the
 circulation.  Ten or twelve drops of liquid laudanum
 may be taken in a  cup of the patient's drink three or
 four times a-day.
   The  beft corroborants which  we know,  are  the
 Peruvian bark and wine.  A drachm  of bark may
 be taken in a glafs of red port or claret three times
 a-day.  ■ The medicine  will be both more efficacious
 and  lefs  difagreeable, if  fifteen or  twenty drops  of
 the acid elixir of vitriol be added to each dofe.  Such
 as cannot take the bark in fubftance may ufe the  de-
coction, mixed with  an equal quantity of red wine,
 and fharpened as above.
                                           There 
         OF A SUPPRESSION  OF URINE.      351
   There  is a  difeafe  incident to many  peorle  in
 the  decline of life, called an INCONTINENCT
 of urine.   But this is very different from a diabetes,
 as the water paffes off involuntarily by drops,  and
 does not exceed the ufual  quantity.   This difeafe is
 rather troublefome than dangerous.   It is owing  to
 a relaxation of the fpincter of the  bladder, and  is
 often the  effect of a palfy.  Sometimes it proceeds
 from hurts, or injuries occafioned by blows, bruifes,
 preternatural labours, &c.   Sometimes it is the effect
 of a fever.  It may likewife be occafioned by a long
 ufe  of ftrong diuretics.
   This difeafe may be mitigated by the ufe of aftrin-
 gent and corroborating medicines, fuch as have been
 mentioned above,  and  by a blifter to the ioweft part
 of the back bone.
   In an incontinency of urine,  from whatever caufe,
 a piece of fponge ought  to be worn, or a bladder
 applied in fuch a manner as to prevent the urine from
 galling and excoriating the parts.

         OF A SUPPRESSION  OF URINE.
   It has already  been obferved,  that a fuppreflion
 of urine may proceed from various caufes ; as an in-
 flammation of the  kidneys,  or bladder ;  fmall ftones
 or gravel lodging in  the  urinary  paffages,  hard
faces lying in  the reclutn,  pregnancy,  a fpafm or
 contraction of the  neck of the bladder, clotted blood
 in the bladder itfelf, a fwelling of the hemorrhoidal
 veins,  &c.
   Some of thefe cafes require the catheter, both  to
 remove the obftructing matter, and  to draw off the
 urine ; but as this inftrument can only be managed
 with fafety by  perfons fkilled in forgery,  we fliall
 fay  nothing farther of its ufe.   A  bougie may be
 tiled by any cautious hand, and will  often fucceed
 better than the catheter,
                                              Wc 
 332      OF A SUPPRESSION OF URINE.
   We would chiefly  recommend, in all obftructions
 of urine, fomentations  and evacuations.  Bleeding,
 as far as the patient's ftrength will  permit,  is necef-
 fary, efpecially where there  are  fymptoms  of topi-
 cal inflammation.   Bleeding in this cafe not only
 abates the fever, by  leifening  the  force of the cir-
 culation,  but, by relaxing the folids, it  takes off
 the fpafm or ftricture upon the veffels which occa-
 fioned  the obftruction.   Opiates fliould be ufed if
 there is any  pain.
   After bleeding, fomentations muft be ufed.   Thefe
 may either confift of warm water alone, or of decoclions
 of mild vegetables ;  as mallows, camomile-flowers &c.
 Cloths dipped in thefe may either be  applied  to the
 part affected, or a large bladder filled with the decoc-
 tion,  may be kept continually upon it.  Some put
 the herbs themfelves into a flannel-bag, and  apply
 them to the part, which is far from being a bad me-
 thod.   Thefe continue  longer warm than cloths dip-
 ped in the decoction, and at the fame  time keep the
 part equally moift.   Sitting in warm water is  alfo a
 very important remedy.
  Jn all obftructions of urine,  the body ought to
 be kept open.  This is not, however, to be attempted
 by  ftrong purgatives, but by emollient clyfters, or
gentle  infufions of fenna and manna.   Clyfters in
this cafe not only open the body, but  anfwer the
purpofe of an internal fomentation,  and greatly af-
fift in removing tlie fpafms of the bladder and parts
 adjacent.
  The food muft be light, and taken in fmall  quan-
tities.   The  drink may  be weak broth, or decoc-
 tions and infufions  of  mucilaginous  vegetables, as
marfh-mallow roots,  lime-tree  buds,  &c.   A tea-
fpoonful of  the fweet fpiiits  of nire,  or a  drachm
 oc Caftile feap, may be frequently put into the pa-
tient's drink.
                                          Perfon. 
        OF'^TilE GRAVEL AND  STONE.      333
  Perfons fubject to  a  fuppreflion of urine ought
to live very temperately.   Their diet fliould be light,
and  their liquor  diluting.   They fliould avoid all
acids and auflere  wines,  fliould take fufficient exer-
cife, lie hard,  and avoid fludy and fedentary  occu-
pations.

         OF THE GRAVEL AND STONE.

  When fmall flones are lodged  in the kidneys, or
difcharged  along with the urine, the patient is faid
to be  afflicted with  the gravel.   If one  of thefe
flones   happens to  make a lodgment in the bladder
for fome time, it accumulates frefh matter, and at
length  becomes too large to pafs off with the urine.
In this cafe the patient is faid to have the ftone.
   CAUSES.—The  ftone and gravel may be occa-
fioned  by high living;  the  ufe of ftrong aftringent
wines ; a fedentary life  ; lying too hot, foft, or too
much  on the back ; the conftant ufe  of water im-
pregnated  with earthy  or  ftony particles ;  aliments
of an  aftringent or windy nature,  &c.   It may like-
wife proceed  from  an hereditary  difpofition.   Per-
 fons in the decline of life,  and thofe who have been
 much  afflicted with the gout or rheumatifcp, are moft
 liable  to it.
   SYMPTOMS.—Small  flones  or  gravel in the
 kidneys occafion pain in the loins ;   ficknefs ; vo-
 miting,  and fometimes  bloody  urine.    When the
 ftone defcends into the  ureter, and is  too large  to
 pafs along with eafe,  all  the above  fymptoms arc
 increafed ; the pain  extends  towards  the bladder ;
 the thigh and leg of  the affected fide are benumbed ;
 the tcfticles are drawn upwards, and the urine is ob-
 ftructed.
    A  ftone in the  bladder is  known from  a pain at
 the time, as well as before and after making water ;
                                              from 
33+      OF THE GRAVEL AND Sf ONE.
from the  urine coming away by drops,  or flopping
fuddenly when it was running in a full ftream ; by a
violent  pain  in the  neck of the bladder upon mo-
tion, efpecially on horfeback, or in a  carriage on
a rough road ; from a  white,  thick, copious,  ftink-
ing, mucous fediment  in the urine ;  from an itch-
ing  in  the  top of  the  penis;  from bloody urine;
from an  inclination  to go  to  ftool  during the dif-
charge of urine ;  from the patient's  paffing his urine
more eafily when lying than  in an erect  pofture;
from a  kind of convulfive motion occafioned by. the
fharp pain in difcharging the laft drops of the urine;
and laftly, from founding or fearching with the ca-
theter.
   REGIMEN.—Perfons  afflicted with  the gravel
or  ftone fhould avoid  aliments  of a windy or heat-
ing  nature, as fait  meats,  four fruits,  &c.   Their
diet ought chiefly to confift of fuch things as tend to
promote the fecretion  of  urine, and to  keep the
body open.   Artichokes,  afparagus,  fpinnage, let-
tuce, parfley, fuccory, purflane, turnips,  potatoes,
and  carrots, may be fafely eaten.   Onions, leeks,
and  cellery are,  in this cafe,  reckoned medicinal.
The molt prope  drinks are whey, butter-milk, milk
and  water,  Darley-water, decoctions or  infufions of
the roots  of marfh-mallows, parfley,  liquorice,  or of
other mild mucilaginous vegetables, as flax-feed, lime-
tree buds or leaves,  &c.
   Gentle exercife is proper; but violent motion is
apt to occafion bloody urine.   We would  therefore
advife that it fliould be taken  in moderation.   Per-
fons afflicted with gravel often  pafs a great number
of flones after riding on horfeback, or in a carriage;
but  thofe who have  a  ftone in  the  bladder are fel-
dom able to bear thefe kinds  of exercife.   Where
there is "an hereditary  tendency to this difeafe, a fe-
dentary life  ought  never  to  be indulged.   Were
people  careful, upon the firft  fymptoms  of gravel,
                      %                        to 
        OF THE GRAVEL AND STONE.      335
to obferve  a proper regimen  of diet, and  to take
fufficient exercife, it might often be carried off, or
at leaft  prevented from increafing;  but if the fame
courfe which occafioned the difeafe is perfifted in,  it
muft be aggravated.
   MEDICINE.—In what is called a fit  of the gra-
vel, which is commonly occafioned by a ftone ftick-
ing in the ureter, or fome part of  the urinary paf-
fages, the patient muft be  bled, warm fomentations
fliould  likewife be  applied to the part affected, the
warm bath ufed, emollient clyfters adminiftered, and
diluting mucilaginous liquors drank, &c.  The treat-
ment of this cafe has been fully pointed out under the
articles  inflammation of the kidneys  and bladder, to
which we refer.
   Dr Whyte advifes patients  who are fubject to fre-
quent fits of gravel  in the kidneys, but have no ftone
in the bladder,  to drink every morning, two or three
hours before breakfaft, a pint of oyfter or cockle-fliell
lime-water.  The Doctor very juftly obferves, that
though  this quantity might be too fmall to have any
fenfible  effect in diffolving a ftone in the bladder, yet
it may very probably prevent its growth.
   When a ftone is  formed in the bladder, the Doc-
tor recommends Alicant foap,  and oyfter or cockle-
fliell lime-water *,  to  be  taken in the  following
manner: The patient muft fwallow every day, in
any form that  is leaft difagreeable, an ounce of the
internal  part  of Alicant  foap, and  drink three or
four  Englifh  pints  of oyfter or cockle-fliell lime-
water.   The foap is to be divided into three dofes ;
the largeft to be taken fafting in the morning early ;
the fecond at noon  ; and the  third at feven in the
evening ; drinking above each  dofe a large draught
»f the lime-water ;  the remainder of which he may

            *  S;e Appendix, Lin;-sealer.
                                             take 
 336      OF THE GRAVEL AND STONE.
 take any time betwixt dinner and fupper, inftead of
 other liquors.
   The patient fliould begin with  a fmaller quantity
 of the  lime-water and foap  than that mentioned
 above ;  at  firft an Englifh pint of  the  former, and
 three drachms of  the  latter  may  be taken  daily.
 This quantity, however,  he  may  increafe by de-
 grees,  and ought to perfevere in the ufe of thefe
 medicines,  efpecially  if he finds  any abatement  of
 his complaints, for feveral months;  nay, if the ftone
 be very  large, for years.
   The  cauftic  alkali, or foap-lees, is the medicine
 chiefly in vogue at prefent for the ftone.  It is of a
 very acrid nature, and  ought  therefore to be given
 in fome  gelatinous or mucilaginous  liquor ;  as veal-
 broth,  new milk, flaxfeed-tea, a folution  of gum-
 arabic, or a decoction of marfhmallow roots.   The
 patient muft begin with  fmall  dofes  of  the  lees,  as
 thirty or forty drops, and increafe  by degrees, as far
 as the ftomach can bear it*.
   Though  the  foap-lees and lime-water are power-
 ful medicines for the ftone, yet there are fome things
 of a  more fimple nature,  which in certain  cafes are
 found to be beneficial, and therefore deferve a trial.
An infufion of the feeds  of daucus fylvcdris ; or wild
carrot,  fweetened  with  honey, has been found to
give  confiderable  eafe in cafes where  the ftomach
could not bear  any thing  of an  acrid  nature.  A
decoction of raw  coffee-berries taken  morning and
evening, to the  quantity of  eight or ten  ounces,
with ten drops of fweet  fpirit of nitre, has likewife
been  found very efficacious in bringing away large

  * The  cauftic alkali may be prepared by mixing two parts
cf quick-lime with  one of  pot-afhes and fullering them  to
ft and  till the lixivium be formed, which  muft be carefully fil-
trated before  it be ufed.  If the folution does not happen rea-
dilv,  a fmall quantity of water may be added to them ixtuie.
                      4                 quantities. 
      INVOLUNTARY DISCHARGES, &c.     337
quantities of earthy matter in flakes.   Honey  is
likewife  found to  be of confiderable fervice,  and
may be taken in gruel, or in any other form that is
more agreeable.
   The other medicine which we fhail mention is the
uva urfi.   It has been  greatly  extolled of  late both
for the gravel and ftone.   It feems,  however, to be
in all  refpects  inferior to the foap and lime-water ;
but it is lefs difagreeable,  and has frequently,  to my
knowledge, relieved gravelly complaints^  It is ge-
nerally taken  in  powder from half a drachm to a
whole drachm, two or three times a-day.   It may,
however, be taken  to the quantity of feven or eight
drachms  a-day,  with  great fafety and good effect.
Five drops of the fpirit of vitriol in  a tea-cupful of
cold  water, two or  three times a-day, is, perhaps,
one of the beft remedies  for thefe complaints; wa-
ter impregnated with fixed air, procured by  mixing
the vitriolic acid with marble or chalk, has  alfo been
found very ufeful.
                CHAP.  XXXIV.

       Of Involuntary  Difcharges of Blood.


          Spontaneous or  involuntary  dif.
charges of blood, often happen from various parts
of the body.  Thefe, however, are fo far from being
always dangerous,  that they  often  prove falutary.
When fuch  difcharges  are  critical, which  is  fre-
quently  the cafe in fevers, they  ought not to be
ftopped.   Nor  indeed  is it  proper at any  time to
ftop them, unlefs they be fo  great  as  to endanger
                      Z                       the 
;S'S         INVOLUNTARY DISCHARGES
the patient's life. Moft people, afraid of the fmalleft
difcharge  of blood  from any part of the body, fly
immediately to the ufe of ftyptic and aftringent me-
dicines, by which means an inflammation of the brain,
or fome other fatal difeafe, is occafioned, which, had
the difcharge been  allowed to go  on, might have
been prevented.
   Periodical  difcharges  of blood,  from whatever
part of the body they  proceed, moft not be ftopped.
 They  are always the efforts  of. Nature to relieve
herfelf ; and fatal difeafes have often been the con-
fequence  of obftructing  them.   It  may  indeed be
 fometimes neceffary  to  check the violence of fuch
difcharges,  but even  this requires  the  greateft
caution.
   In the  early period of life,  bleeding at  the nofe
is very common.   Thofe who are  farther advanced
in  years are more liable to haemoptoe,  or difcharge
of Dfeod from the lungs.  After the middle period
of life  hemorrhoidal fluxes are moft common ;  and
 in the decline of  life, difcharges of blood from the
 urinary paffages.
   Involuntary fluxes  of blood  may proceed  from
 very different, and often from quite oppofite caufes.
 Sometimes they are owing to a  particular conftruc-
 tion of the body,  as  a  fanguine  temperament, a
 laxity  of  the veffels,  a plethoric  habit, &c.  At
 other  times  they proceed from  a  determination of
 the blood towards one particular part, as the head,
 the hcemorrhoidal  veins,  &c.  They  may likewife
 proceed from an inflammatory  difpofition  of the
 blood-veffels, in which cafe  there is generally  fome
 degree of fever : this likewife happens when the flux
 is  occafioned by  an  obftructed  perfpiration,  or a
 ftricture upon the fkin, the bowels, or any particular
 part of the fyftem.
                                           Violent 
               0 F B L O OD.               339
   Violent paffions  or  agitations of the  mind will
likewife have this effect.  Thefe often caufe bleed-
ing at the nofe, and 1 have known them fometimes
occafion an hemorrhage in  the brain.   Violent  ef-
forts of  the  body, by  overftraining or hurting  the
veffels, may  have the fame  effect, efpecially when
the body is long  kept in an  unnatural pofture,  as
hanging  die head very low, &c.
  The cure of an haemorrhage muft be adapted to
its caufe.  When it proceeds from too much blood,
or a tendency to inflammation, bleeding, with gentle
purges,  and other evacuations, will be  neceffary.
It will  likewife be proper for  the patient  in this
cafe to  live chiefly upon a vegetable diet, to avoid
all ftrong liquors, and  food that is of an acrid, hot,
or ftimulating quality.   The body  fhould  be kept
cool, and the mind  eafy.
  When  an hemorrhage is  owing to debility,  the
patient ought to live  chiefly  upon acid fruits, with
milk and vegetables of a nourifhing nature, as fago,
falop, Sec. His drink may be wine diluted with wa-
ter, and fliarpened  with the juice of lemon, vinegar,
or fpirits of vitriol.   The beft medicine in this  cafe
is the Peruvian bark,  which may be taken accord-
ing to the urgency of the fymtoms.
  When a flux of blood is the effect of acrid food,
or of ftrong ftimulating medicines, the cure is to be
effected by foft and mucilaginous diet.
  When  an  obftructed perfpiration, or a ftricture
upon  any part of  the  fyftem,  is  the caufe of an
hcemorrhage, it may be removed by drinking warm
diluting  liquors, lying a-bed,  bathing  the  extremi-
ties in warm water,  &c.
Z 2                     OF 
[  340  ]
         OF BLEEDING AT THE NOSE.

  Bleeding at  the nofe is  commonly preceded by
feme degree of quicknefs  of the pulfe,  flufhing in
the face, pulfation.of the  temporal arteries, heavi-
nefs in the head, dimnefs of the fight, heat and itch-
ing of the noftrils, &c.
  To perfons who abound with blood this difcharge
is very falutary.   It often cures a vertigo, the head-
ach, a phrenzy, and even  an epilepfy.   In fevers,
where there is a  great determination of blood to-
wards the head, it is of the utmoft  fervice.   It is
likewife beneficial  in inflammations of the liver and
fpleen,  and often  in the gout and rheumatifm.  In
all  difeafes  where bleeding is  neceffary,  a  fponta-
neous difcharge of blood from the nofe is of much
more fervice than the fame quantity let with a lancet.
  In a difcharge of blood from the nofe,  the greater
point is to determine whether it ought to be ftopped
or  not.   It is  a common practice to  ftop the bleed-
ing, without confidering whether it be a  difeafe, or
the cure of a difeafe.  This conduct  proceeds  from
fear; but it has often bad,  and fometimes fatal con-
fequences.
  When a difcharge of blood  from the nofe hap-
pens in an inflammatory difeafe, there is always rea-
fon to believe that it may prove falutary ;  and there-
fore it fliould be fuffered to go on, at leaft as long as
the patient is not weakened by it.
  When  it happens to perfons  in  perfect  health,
who are full of blood, it ought not to  be fuddenly
ftopped,  efpecially  if  the fymptoms of plethora,
mentioned  above,  have preceded it.   In  this cafe it
cannot be ftopped  without  rifking the patient's life.
  In  fine, whenever bleeding at the nofe  relieves
any bad fymptom, and does not proceed fo far as to
                                        endanger 
         OF BLEEDING AT THE NOSE.       341
 endanger the patient's life, it  ought not to be ftop-
 ped.   But when it returns frequently, or continues
 till the pulfe becomes low, the extremities begin to
 grow cold, the lips pale, or the patient complains of
 being fick or faint, it muft immediately be ftopped.
    For this purpofe,  the patient fhould be fet nearly
 upright,  with  his head  reclining a little,  and his
 legs immerfed in water about  the warmth of  new
 milk.  His hands ought likewife to be put into luke-
 warm  water, and  his  garters  may be tied a little
 tighter  than ufual.  Ligatures may be  applied to
 the arms,  about the place where they are ufually
 made for bleeding,  and with nearly the fame degree
 of tightnefs.  Thefe  muft be gradually flackened as
 the  blood begins to  ftop,  and removed entirely as
 foon as it gives over.
   Sometimes dry lint fluffed up in the noftrils will ftop
 the bleeding.   Blue vitriol diffolved in water, may
 likewife be ufed for this purpofe, or a tent dipped
 in the white of  an egg well beat up, may be  rolled
 in  a powder made  of equal parts of white fugar,
 burnt alum, and white vitriol, and  put up the nof-
 tril from whence the blood iffues.   A blifter applied
 to the back of the neck is often of effential fervice.
   Internal medicines  can hardly be of ufe here, as
 they have  feldom time  to  operate.   It  may not,
 however,  be amifs to  give the patient half an ounce
 of Glauber's  fait, and the fame quantity  of manna,
diffolved in four or  five ounces  of barley-water.
 This may be taken at  a draught, and repeated, if it
 does not operate, in a few hours.   Ten or  twelve
grains of nitre may be  taken in a glafs of cold water
and vinegar every hour,  or  oftener, if the ftomach
will bear it.  If a ftronger medicine be neceffary, a
tea-cupful of the tincture of rofes, with twenty or
thirty  drops  of  the weak fpirit of vitriol, may be 
34^       OF BLEEDING AT THE NOSE.
taken every hour.   When  thefe things cannot  be
had,  the patient may drink water, with a little com-
mon fait in it, or equal parts of water and  vinegar.
   If the genitals  be  immerfed for fome time in cold
water,  it will generally ftop a bleeding at the nofe.
I have not known this fail.
   Sometimes,  when  the  bleeding  is ftopped out-
wardly, it continues inwardly. This is very trouble-
fome, and requires  particular  attention, as the  pa-
tient is apt to be  fuffocated with the blood, efpecially
if he falls afleep,  which he is  very ready to do after
lofing a great quantity of blood.
   When the patient is in danger of fuffocation from
the blood getting into his throat, the paffages may
be ftopped by drawing threads up  the noftrils, and
bringing them out  of the mouth,  then  faftening
pieces of fponge,  or  fmall rolls of linen cloth to their
extremities;  ^.afterwards  drawing  them back, and
tying them on the outfide with a fufficient degree of
tighcnefs.
   After the bleeding is ftopped, the patient ought
to be kept as eafy and quiet as poffible.  He fljould
not pick his nofe, nor take away  the tents or clotted
blood,  till they fall  off of their own  accord, and
fhould not lie with his head low.
   Thofe who are affected with frequent bleeding at
the nofe ought to  bathe  their  feet  often  in  warm
water, and  to  keep  them warm and dry.   They
ought to wear nothing tight about  their necks,  to
keep their body as much  in an erect pofture  as pof-
fible, and never to view any  object  obliquely.   If
they have too much  blood,  a  vegetable  diet, with
now and then a cooling purge, is the  fafefi way to
leffen it.
   But when the  difeafe proceeds from debility, the
diet fhould be rich and nourifhing ;  as ftrong broths- 
    OF THE BLEEDING AND BLIND PILES.   345
  and jellies, fago-gruel with wine and fugar, &c. Infu-
  fions of the Peruvian bark in wine,  ought likewife
  to be taken and perfifted in for a confiderable time.
      OF THE BLEEDING  AND BLIND PILES.
    A difcharge  of  blood  from  the  hemorrhoidal
  veffels is called the bleeding piles.   When the veffels
  only fwell, and difcharge no blood, but are exceed-
  ingly painful, the difeafe is called the blind piles.
   Perfons  of a loofe fpungy fibre, of a  bulky fize,
  who live high, and lead a fedentary inactive life, are
  moft fubject to this difeafe.   It is often owing  to an
  hereditary  difpofition.  Where this  is the cafe, k
  attacks perfons more early  in life than when it is ac-
 cidental.  Men  are more  liable to it than women,
 efpecially thofe of a fanguine, plethoric,  or a feor-
 butic habit, or of a melancholy difpofition.
   The  piles  may be  occafioned  by  an  excefs  of
 blood, by ftrong aloetic purges, high feafoned  food,
 drinking great quantities of fweet, or other wines,
 the neglect  of cuftomary evacuations, much riding,
 great coftivenefs, or any thing that occafions hard
 or difficult  ftools.  Anger, grief,  or  other violent
 paffions,  will  likewife  occafion the piles.  I  have
 often  known  them  brought  on by  fitting on the
 damp ground.   A pair of thin breeches will excite
 the diforder in a perfon  who is  fubject to it,  and
 fometimes even in thofe who never had it before.
 Pregnant women are often afflicted with  the piles.
   A flux of blood from the anus,  is not always to
 be treated  as  a difeafe.  It is even more falutary
 than  bleeding at the nofe,  and often prevents  or
 carries off difeafes.   It  is  peculiarly  beneficial in
 the gout, rheumatifm, afthnia, and hypochondriacal
 complaints,  and often proves  critical in colics, and
inflammatory fevers.
                     Z 4                      In 
34+  OF THE BLEEDING AND BLIND PILES.
   In the  management of the patient, regard mu"
be had  to his habit of body,  his age, ftrength,  an^
manner of  living.   A difcharge  which  might bc
exceffive  and  prove  hurtful to one, may be very
moderate, and even falutary to another.   That only
is to be  efteemed  dangerous which continues  too
long, and is in fuch quantity as to wafle the patient's
ftrength,  hurt the  digeftion,  nutrition,  and other
functions neceffary to  life.
   When this is the cafe, the difcharge muft be check-
ed by  a  proper  regimen, and aftringent medicines.
The DIET  muft  be cool but nourifhing, confifting
chiefly of bread, milk, cooling vegetables and broths.
The drink may be chalybeate water,  orange-whey,
decoctions or infufions of the aftringent and  mucila.
ginous  plants,  as the  tormentil root, biftort,  the
marfhmallow-roots, &c.
   Old  conferve  of red rofes is a very good medi-
cine in  this cafe.   It may be mixed with  new milk,
and taken in the quantity of an ounce, three or four
times a-day.  This medicine  is in no great  repute,
owing to its being feldom taken in fuch quantity as
to produce any  effects ; but  when taken as here
directed,  and duly perfifted in,  I have known it
perform very extraordinary cures in violent hemor-
rhages, efpecially when  affifted by  the  tincture of
rofes ;  a tea-cupful of which may be taken about an
hour after every  dofe of the conferve.
   The Peruvian bark is likewife proper in this cafe,
both as a ftrengthener and aftringent. Half a drachm
of it may be taken  in a glafs of red-wine, fliarpened
with a few  drops of the elixir of vitriol, three or
four times a-day.
   The bleeding  piles are fometimes periodical,  and
return  regularly once a-month,  or once in three
weeks.   In this cafe,  they  are always to be confi-
dered  as a falutary difcharge, and bv no means to
                                               be 
  OF  THE BLEEDING AND BLIND  PILES.   345
be ftopped.  Some have entirely ruined their health,
by flopping a periodical difcharge of blood from  the
hemorrhoidal veins.
  In  the  blind piles bleeding is generally of ufe.
The diet muft be light and thin,  and the drink cool
and diluting.   It is likewife neceffary that the body
be kept gently open.  This  may be done by fmall
dofes of the flowers of brimftone and cream of tartar.
Thefe may be mixed in  equal quantities, and a tea-
fpoonful taken two or three times a-day, in molaffes,
or oftener if neceffary.   Or an ounce of the flowers
of  brimftone and half an ounce of purified  nitre,
may be mixed with three or four ounces of the leni-
tive electuary,  and a tea-fpoonful of it taken three
or four times a-day*.
  Emollient clyfters are  here  likewife  beneficial;
but there is fometimes fuch an aftriction of the anus,
that they cannot be thrown up.
  When the piles are exceedingly painful and fwelled,
but difcharge nothing,  the patient muft fit over  the
fleams of warm water.   He may  likewife apply a
linen cloth,  dipped in warm  fpirits of wine to  the
part,  or poultices made of bread  and milk,  or of
leeks fried with butter.  If thefe do not produce a
difcharge, and  the piles appear large,  leeches muft
be applied as near them as poffible,  or, if they will
fix  upon the piles themfelves, fo much the better.
When leeches will  not fix, the piles may be opened
with a lancet.   The operation is very eafy, and is
attended with no danger.
  Various ointments  and other external applications,
are recommended in the piles; but 1 do not remem-
ber to have feen any effects from thefe worth mention-
ing, except the aftringent  ointment (fee Appendix.)
  * There is no better, nor more certain, laxative ia thefe
cafes, than  a tab!c-f;>oo;.f;.i  of. call • r-t-il, iu;xed with  a little
wine,
                                            The 
34<5           SPITTING  OF BLOOD.
 The piles, when  ulcerated,  may  be anointed with
 this ointment twice a day.  Their  principal ufe is to
 keep the part moift, which may be done as well by
 a foft poultice, or an emollient cataplafm.  When the
 pain, however, is very great, a liniment made of two
 ounces  of emollient ointment, and half an ounce  of
 liquid laudanum, beat up with the yolk of an egg,
 may be applied.

              SPITTING OF  BLOOD.
   We mean here to treat of that difcharge of blood
 from the lungs only,  which is called an hamoptoe or
fpitting of blood.   Perfons of a flender make,  and a
 lax fibre, who have long  necks and ftrait breafls,
 are  moft liable to this difeafe.   It is moft common  in
 the  fpring, and generally attacks people before they
 arrive at  the prime or middle period of life.   It  is
 a common obfervation,  that  thofe who  have been
 fubject to bleeding at the nofe when young, are af-
 terwards moft liable to an hemoptoe.
   CAUSES.—An hemoptoe may proceed from ex-
 cefs  of blood, from a peculiar weaknefs of the lungs,
 or bad conformation of the breaft.   It is often occa-
 fioned by exceffive drinking, running, wreftling, fing-
 ing, or fpeaking aloud.  Such as have weak lungs,
 ought to avoid all violent exertions of that organ, as
 they value life.  They fhould likewife guard againft
 violent paffions, exceffive drinking, and every thing
 that occafions a rapid circulation of the blood.
   This  difeafe  may likewife  proceed from wounds
 of the lungs.  Thefe may  either  be received  from
 without,  or they may be occafioned by  hard bodies
 getting  into the wind-pipe,  and fo falling down upon
 the  lungs,  and hurting  that tender organ.   The
 obftruction of any cuftomary evacuation, may  occa-
fion  a fpitting of blood ; as  neglect of bleeding or
 purging at  the  ufual feafons, the ftoppage of the
                     4                  bleeding 
            SPITTING OF BLOOD.            347
 bleeding piles in men, or the menfes in women,  8ec.
 It may likewife proceed from a  polypus, fchirrous
 concretions,  or any thing that obftructs  the circu-
 lation of the blood in the lungs.  It is often the ef-
 fect of a long and violent cough.   A violent degree
 of cold fuddenly applied to the external parts of the
 body will occafion an  hemoptoe.   It may  likewife
 be occafioned by  breathing air  which  is too much
 rarified to be  able  properly to expand  the lungs.
 This is often the cafe  with  thofe who work in  hot
 places, as furnaces,  glafs-houfes, or the like.  It is
 likewife faid to happen to fuch as afcend  to the top of
 very high mountains, as the  Peak of Teneriffe, &c.
   Spitting of blood is not always to be confidered as a
 primary difeafe. It is often only a fymptom, and in feme
 cafes not an unfavourable one.  This is the cafe in
 pleurifies, peripneumonies, and fundry other fevers. In
 a dropfy, fcurvy, or confumption, it is a bad fymptom.
   SYMPTOMS.—Spitting of blood  is  generally
 preceded by a fenfe of weight,  and oppreflion of
 rhe breaft, a dry tickling cough, hoarfenefs, and a
 difficulty of breathing.   Sometimes it is ufliered in
 with fliivering, coldnefs of the  extremities,  coftive-
 nefs, great  laflitude, flatulence,  pain of  the back
 and  loins, 8ec.   As  thefe fliew  a  general ftricture
 upon the veffels,  and  a  tendency of the blood to
 inflammation, they are commonly  the  forerunners
 of a  very copious difcharge.   The above  fymptoms
 do not attend a difcharge of  blood  from  the gums
 or fauces, by which means  thefe  may always  be
 diftinguiflied  from an  hemoptoe.   Sometimes the
 blood that is fpit up is thin, and  of a florid  red co-
 lour  ; and at other times it is thick, and  of a dark
or blackifli colour ; nothing, however,' can be infer-
red from thefe circumftances,  but that the  blood has
 lain a longer or fhorter time in the breaft before it
 v as difcharged.
          o
                                        Spitting 
 34-8            SPITTING OF BLOOD.
    Spitting of blood,'in a ftrong, healthy perfon, of a
 found conftitution, is not very dangerous ;  but when
 it attacks the tender and delicate, or perfons of a weak
 lax fibre,  it is with difficulty removed. When it pro-
 ceeds from a fchirrus  or polypus of the lungs, it is bad.
 The danger is greater when the difcharge proceeds
 from  the rupture of a large veffel than of a  fmall one.
 When  the  extravafated blood  is not fpit up,  but
 lodges in the breaft,  it corrupts, and greatly increafes
 the danger.   When the  blood proceeds  from an
 ulcer  in the lungs, it generally proves fatal.
   REGIMEN.—The patient ought  to be  kept cool
 and  eafy.   Every thing that heats  the  body, or
 quickens the circulation, increafes the danger.  The
 mind  ought  likewife  to be foothed, and every occa-
 fion  of exciting the paflions  avoided.   The  diet
 fhould be foft,  cooling, and flender  ; as rice boiled
 with milk, fmall broths, barley-water, panada, &c.
 The diet,  in this cafe, can fearcely be too low. Even
 water-gruel  is fufficient  to fupport the patient for
 fome  days.   All ftrong liquors  muft be  avoided.
 The patient may drink milk and water, barley-water,
 whey, butter-milk,   and fuch  like.   Every  thing,
 however,  fliould be drank  cold, and  in fmall quan-
 tities  at  a time.  He fhould obferve the ftrictefl
 filence, or at leaft fpeak with a very low voice.
   MEDICINE.—This,  like the other involuntary
 difcharges of blood,  ought not to be fuddenly ftop-
 ped  by aftringent medicines.  More mifchief is often
 done by thefe than if it were fuffered to go on.  It
 may, however, proceed fo far as to weaken the pa-
 tient,  and even  endanger  his  life ;  in which cafe
 proper means muft be ufed for reftraining it.   Much
 benefit has been experienced from the ufe of a table
fpoonful  of common  fait every  hour in thefe cafes
until the hemorrhage is ftopt; the fame quantity of
brown fugar  has likewife. been ufed to advantage.
                                             The 
            SPITTING OF BLOOD.'            34j
   The  body  fhould be kept  gently open by laxa-
tive diet;  as  roafted apples, flewed prunes, and
fuch like.   If  thefe fhould not  have  the defired
effect,  a tea-fpoonful of the lenitive electuary  may
be taken twice or thrice a-day, as is found neceffary.
If the bleeding proves violent, ligatures may be ap-
plied to the extremities,  as directed for a bleeding at
the nofe.
   If the patient be hot or feverifh, bleeding and
fmall dofes  of nitre will  be  of ufe;  a fcruple or
half a  drachm of  nitre may be taken in a cup of
his ordinary drink twice or thrice a-day.   His  drink
may likewife  be fliarpened with acids, as juice of
lemon,  or a few drops of the fpirit of vitriol;  or he
may take frequently a cup of the tincture of rofes.
   Bathing the feet  and legs in lukewarm water  has
likewife  a  very good effect in this difeafe.  Opi-
ates too are fometimes  beneficial;  but thefe muft
be adminiftered with caution.   Ten or twelve drops
of laudanum may be given  in a cup of  barley-water
twice a-day, and  continued for fome time,  provided
they be found beneficial.
   The  conferve of rofes  is  likewife  a very  good
medicine in this cafe, provided it be taken in fuffi-
cient quantity, and long  enough perfifted in.   It
may be  taken to  the quantity  of three or four
ounces a-day; and,  if the patient be troubled with
a  cough, it fliould  be made into an electuary  with
balfamic fyrup, and a little  of the fyrup of poppies.
  If ftronger aftringents be neceffary, fifteen or twen-..
ty drops of the elixir of vitriol may be given in a glafs
of water fix or eight times a-day, or from  two  to fix
grains of powdered  alum with  half a drachm of Pe-
ruvian bark, three times a  day.
   Thofe who are fubject to frequent returns of this
difeafe fliould  avoid all  excefs.   Their diet fliould
be light and-cool, confuting chiefly  of milk and  ve-
                                        getables- 
 3cc          VOMITING OF BLOOD.
 getables.   Above all, let them beware of vigorous
 efforts  of the body, and violent agitations of the
 mind*.
             VOMITING OF BLOOD.

   This is not fo common as the  other  difcharges
 of blood which have already been mentioned ;  but
 it is very dangerous, and requires  particular atten-
 tion.
   Vomiting of blood is generally preceded  by pain
 of the ftomach, ficknefs,  and naufea ; and is accom-
 panied  with great anxiety and frequent fainting fits.
   This difeafe is fometimes periodical;  in which
 cafe it is lefs dangerous.  It often proceeds  from
 an obftruction of the menfes in  women;  and fome-
 times from  the flopping of the hemorrhoidal flux
 in men.   It may be occafioned  by  any thing that
 greatly ftimulates or wounds the ftomach, as ftrong
 vomits or purges,  acrid  poifons,  fharp or hard fub-
 ftances  taken into the ftomach, &c.   It is often the
 effect of obftructions in the liver,   the fpleen, or
 fome  of the other vifcera.   It  may likewife  proceed
 from external violence, as blows or  bruifes,  or  from
 any of the caufes which produce inflammation.  In
 hyfteric women,  vomiting of blood is  a  very  com-
 mon,  but by no means a dangerous fymptom.
   A great part of the danger in this  difeafe arifes
 from the extravafated bloooVlodging in the  bowels,
 and becoming putrid.  The beft way of preventing
 this is to keep the body gently open, by frequently
 exhibiting emollient clyfters.  Purges  muft not be
given till  the difcharge is ftopt,  otherwife they will
irritate  the ftomach,  and increafe the diforder.   AH
the food and drink muft be of a mild cooling nature,

   * The moft beneficial effects have been experienced from tra-
velling in this, and ev-ry other preternatural difcharge of blood.
                                             aud 
            OF BLOODY URINE.             55T
and taken in fmall quantities.  Even drinking cold
water has fometimes  proved a remedy, but it will
fucceed better  when fliarpened with the weak fpirits
of vitriol.  When there are figns of an inflammation,
bleeding is neceffary.   Opiates may be of ufe ; but
they muft be given in  very fmall dofes, as four or five
drops of liquid laudanum twice or thrice a-day.
  After the difcharge is over, as the patient is ge-
nerally troubled with gripes,  occafioned by the acri-
mony of the blood lodged  in the inteftines, gende
purgtts will be  neceffary.
              OF BLOODY  URINE.
   This is a difcharge  of blood  from the  veffels of
the  kidneys or bladder, occafioned by their being
either enlarged or  eroded.   It is more or lefs dan-
gerous according to the different circumftances which
attend it.
   When pure blood  is voided fuddenly without in-
terruption and  without  pain, it proceeds from the
kidneys ; but if the  blood be in fmall quantity, of
a dark colour, and emitted with heat and pain about
the  bottom of the belly, it proceeds from the blad-
der.  When  bloody urine  is occafioned by  a rough
ftone defcending from the  kidneys to the bladder,
which wounds  the ureters,  it is attended with  a
fharp pain  in the back,  and difficulty of making
water.   If the coats  of the  bladder are hurt by  a
ftone, and the  bloody urine follows,  it is attended
with the utmoft acute pain,  and a previous ftoppage
of urine.
   Bloody urine may likewife be occafioned by falls,
blows,  the lifting or carrying of heavy burdens,
hard riding,  or  any   violent motion.   It may alfo
proceed  from ulcers  of the bladder,  from  a  ftone
lodged in the  kidneys,  or from  violent purges, or
fharp medicines, efpecially cantharides.
                                           Bloody 
3*2
OF BLOODY URINE.
   Bloody urine is always  attended  with fome  dc-
 gree of danger :  but it is peculiarly fo when mixed
 with purulent matter, as this fliews an ulcer fome-
 where in the urinary paffages.   Sometimes this  dif-
 charge  proceeds  from  excefs  of blood,  in  which
 cafe it is  rather to be confidered  as a falutary eva-
 cuation than a difeafe. If the difcharge, however, be
 very great, it may wafle the patient's ftrength, and
 occafion  an ill habit of  body,  a dropfy,  or a con-
 fumption.
   The  treatment of this  diforder  muft be  varied  ac-
 cording to the different caufes from which it proceeds.
   When it is owing to a ftone  in the bladder,  the
 cure depends  upon an operation; a defcription of
 which would be foreign to our purpofe.
   If it be attended with a plethora, and fymptoms
 of  inflammation, bleeding  will be neceffary.  The
 body muft likewife be kept open  by  emollient clyf-
 ters, or cooling  purgative medicines ; as cream of
 tartar,  rhubarb,  manna,  or fmall  dofes of lenitive
 electuary.
   When bloody urine  proceeds from the  fmall-pox,
 a fever, or the like, the patient's life depends on  the
 liberal ufe of the Peruvian bark  and  acids, as has*
 already been fliewn.
   When  there is reafon  to fufpect an ulcer in  the
 kidneys or bladder, the patient's diet muft be cool,
 and his  drink  of a foft,  healing, balfamic quality,
 as decoctions of marfh-mallow roots with  liquorice,
 folutions  of gum-arabic,  &c.   Three  ounces  of
 marfh-mallow roots, and half an ounce of  liquorice,
 may be boiled in two quarts of water to one ; two
ounces of gum-arabic,  and half an ounce of purified
nitre, may be diffolved in  the ftrained liquor, and
a tea-cupful of it taken four or five times  a-day, and
a continued courfe of mercurial medicines will be  of-
ten found of fervice.
                             i                The 
             OF THE DYSENTERY, &c.        353
   The early ufe of aftringents  in  this difeafe has
 often  bad confequences.   When the flux is ftopped
 too foon, the grumous blood,  by being confined in
 the veffels, may produce inflammations, abfcefs,  and
 ulcers.  If, however, the cafe be urgent, or the patient
 feems  to fuffer from the lofs of blood, gentle aftrin-
 gents may be neceffary.  In this cafe the patient may
 take three or four ounces of lime-water, with half an
 ounce  of the tincture of Peruvian bark, three times
 a-day, or  twenty drops of elixir of vitriol in a tea-cup-
 ful of  water four or five times a-day.

    OF THE DYSENTERY, OR BLOODY FLUX.

   This difeafe prevails chiefly in the fpring, fummer,
 and autumn.  It is moft common in marfhy countries,   ^
 where, after hot and dry  fummers, it is apt to  be-
 come epidemic.  Perfons are moft liable to it who  are
 much expofed to the night air, or who live in places
 where  the air is confined or unwholefome.  Hence it
 often proves fatal in camps, on fhipboard, in jails, hof-
 pitals,  and fuch like places.
   CAUSES.—The dyfentery may be occafioned by
 anything that obftructs the perfpiration, as damp beds*
 wet clothes, unwholefome air, &c.  But it is moft fre-
 quently communicated by infection.
 A  SYMPTOMS.—It is known by a  flux of the   ,V-
belly, attended with violent pain of the bowels, a con-
ftant inclinadon to go to ftool, and generally more or
lefs blood  in the ftools.   It begins, like other fevers,
with chillinefs, lofs of ftrength,  a quick pulfe, great
thirft, and an  inclination  to vomit.  The ftools are at
firft greafy and frothy,  afterwards they  are ftreaked
with blood, and at laft have frequently the appearance
of pure blood, mixed with fmall filaments refembling
bits of fkin.  Worms are fometimes paffed both up-
rwrls  —.1  dov.-.v.vards  through the whole courfe of
                       A a                    the 
 354          OF THE DYSENTERY,
 the difeafe.  When the patient goes to ftool, he feefs
 a bearing down, as if the whole bowels  were falling
 out, and fometimes a part of the inteftine is  actually
 protruded,  which proves  exceedingly troublefome,
 efpecially in children.  Flatulency is likewife a troubles
 fome fymptom, efpecially towards the end of the difeafe.
   This difeafe may be diftinguifhed from a diarrhoea
 or loofenefs, by the acute pain of the bowels, by the
 bearing down, and the blood which generally appears
 in the ftools.  It may be diftinguifhed from the cholera
 morbus by its not being attended with fuch violent and
 frequent fits of vomiting, &c.
   When the dyfentery attacks the old,  die delicate,
 or fuch as have been wafted by the gout, the fcurvy,
 or other lingering difeafes, it often proves fatal.  Vo-
 miting and hiccuping are bad figns,  as they  {hew an
 inflammation of the fiomach.   When  th~  ftools are
 green, black,or have an exceedingly difagreeable cada-
 verous fmell, the danger is very great. It is an unfa-
 vourable fymptom when clyfters are immediately re-
 turned ;  but ftill more fo, when the paffage is fo oh-
.ftinately fliut that they cannot be injected.   A feeble
 pulfe, coldnefs of the extremities,  with  difficulty of
 fwallowing, and convulfions, are figns of approaching
 death.
   REGIMEN.—Nothing is of more  importance in
 this difeafe than cleanlinefs.   It contributes greatly to
 the recovery of the patient, and no lefs to  the fafety
 of fuch as attend him.  In all contagious difeafes the
 danger is increafed, and the infection fpread, by the
 neglect of cleanlinefs ; but in no one more  than this.
 Every thing about the patient fhould be frequently
 changed. The excrements fhould never be fuffered to
 rontinue in his chamber,but removed immediately,and
 buried under ground.   A conftant ftream of frefh air
 fhould be  admitted i.iro the chamber : and it ought
frequently to be (rrirJ  led with vinegar, juice of lemon,
                                               er 
               OR BLOODY FLUX,.           $$j
 t»r fene other ftrong acid.  It is often of great impor-
 tance in the cure of this difeafe, for the fick to change
 Roi only their bed, but alfo their bed-chamber.
   The patient muft  not be difcouraged.   Nothing
 tends more to  render  any difeafe mortal, than  the
 fens and apprehenfions of the fick.   All difeaies of
 this nature have a tendency to fink and deprefs  the
 fpirits, and when that is increafed by fears and alarms
 from thofe whom the patient believes to be perfons of
. fkill, it cannot fail to  have the worft effects.
   A flannel waiftcoat worn next  the ikin has often a
 very good effect in the dyfentery.  This promotes the
 perfpiration without over-heating the  body.   Great
 caution, however, is neceffary in leaving it off. I have
 often known a dyfentery brought on by imprudently
 throwing off a flannel waiftcoat before the feafon was
 furficiently warm.  For whatever purpofe this piece of
 drefs is worn, it fliould never be left off but in a warm
 feafon.
   In this difeafe the greateft attention muft be paid to
 the patient's diet.  Flefh, fifli, and every thing that has
 a tendency to turn putrid or rancid on the ftomach,
 muft be abftained from. Apples boiled in milk, water-
 pap,  and plain light pudding, with broth made of the
 gelatinous parts of animals, fago-gruej, may conftitute
 the principal part of the patient's food.
   Another kind of food very proper in the dyfentery,
 which may be ufed by fuch as cannot take the broth
 mentioned above, is made by boiling a few handfuls
 of fine flour, tied in a cloth, for fix  or feven hours,
 till it becomes as hard as ftarch.  Two  or three table-
 fpoonfuls of this  may be grated down, and boiled in
 fuch a quantity of new milk and water as to be of the
 thicknefs of pap.   This may be fweetened to the pa*
 tient's tafte, and taken for his  ordinary food*.
   * The learned and humane Dr Rutherford, late profeflbr of
 medicine iu the univerfuy of Edinburgh, ufed to memieu this
                      A a a                     food 
ftS            OF THFJ DYSENTERY,

   In a dyfentery the patient may  be  allowed  to rail
freely  of moft kinds of  good ripe fruit; as  grapes,
ftrawberries,  rafpberrres, blackberries,  &c.   Thefc
may either be eaten raw or boiled,  with or without
milk, as  the patient chufes.   The  prejudice againft
fruit in this difeafe is fo great,  that many believe it
to be the common caufe Of dyfenteries.   This, how-
ever, is  an egregious miftake.   Both reafon and ex-
perience fhew,  that good fruit is one of the beft me-
dicines, both for the prevention and cure of the dyfen-
tery.  Good fruit is  in every refpect calculated to
 counteract that tendency to putrefaction, from whence
 the moft dangerous kind of dyfentery proceeds.  The
 patient in fuch  a cafe ought therefore to be allowed
"to eat as much fruit  as he pleafes, provided  it be
 ripe'*.

 food in his public lectures with great encomiums.  He directed
 it to be made by  tying a pound or two of the fineft flour, as
 t'ght as p'fTible, in a linen rag, afterwards to dip it frequently
 in water, and to  dredge the outfide with flour,  till a cake or
 cruft was formed around it, which prevents the water fr^m
 foaking into it while boiling. -It is then to be boiled till it be-
 comes a hard dry  mafs, as directed above.   This, when mixed
 wiriVmilk arid water, will" not only anfwer the purpofe of food,
 but may likewife be :given in clyfters.
   *  I lately law a young man who had been feised with a dy-
 fentery in North-America.  Many things had been tried there
 for his relief,  but to no purpofe.  At length, tired out with
 difappcintmcnts from medicine, and reduced to fkin and bone,
 he came over to Britain, rather'with a view to die among his
 relations, than with any hopes of a cure.   After taking fundry
 medicines here with no better fuccefs than abroad, I zdvifed
 him to leave off the ufe of drugs, and to truft entirely to a diet
 of milk and fruits, with gentle exercife.  Strawberries was the
 only truit'he ceufd procure  at that feafon.  Thefe he ate with
 milk twice,'and  fbmetrmes thrice  a-day.   The confequence
vas, thatinafhort rime'his "ftools were reduced from upwards
 of twenty in a-day, to three or four, and fometimes not fo many*
 He ufed the other fruits as they came in, and was in a few weeks
 fo well as to leave that part of the cotmtry where I was, with
avir.v co return to America*
                         ---                     The 
               OR BLOODY FLUX.            357
   The moft proper drink in  this difordey is whey.
 The dyfentery has often been  cured by the ufe  of
 clear whey  alone.  It may be taken both for  drink
 and in form of clyfter.  When whey cannot  be had,
 barley-water, fliarpened with cream of  tartar, may
 be drank, or a decoction  of barley and  tamarinds;
 two ounces  of the former and one of the latter, may
 be boiled in two quarts of water to  one.  Warm
 water,  water-gruel,  or water wherein  hot iron has
 been frequently quenched, are all very proper, and
 may be drank in. turns.  Camomile-tea, if  the fto-
 mach will bear it, is a very proper drink.   It both
 ftrengthens  the ftomach, and tends to prevent a mor-
 tification of the bowels.
   MEDICINE.—At the beginning of this difeafe it
 is always neceffary to cleanfe the firft paffages.   For
 this  purpofe, if there is any fever or ficknefs at fto-
 mach, a vomit of ipecacuanha muft be given, and
 wrought off with weak camomile-tea.    Strong vo-
 mits are feldom neceffary here.   A fcruple, or fifteen
 grains of ipecacuanha,  is generally fufficient for an
 adult, and fometimes a very few  grains  will fuffice.
 The day after the vomit, an ounce or  an ounce and
 a half of Glauber's falts or a table-fpoonful of caftor
oil.   This dofe may be repeated eyery other day, for
two  or three times.  Afterwards fmall dofes of ipeca-
cuanha may be taken for feme time.  Two or tliree
grains of the powder may be mixed in a table-fpoon-
ful of the fyrup of poppies, and taken three times a-
day.  This difeafe generally yields to the following
plan : A dofe of Glauber's falts or caftor-oil in the
morning, and one  or two grains of  opium at night,
to be repeated until  the  difeafe  is  conquered.  In
children, from five to feven grains of calomel, with a
 little magnefia or rhubarb,  anfwer much better than
 any other purgative.   Fever is  fo very  common  an
 attendant on dyfentery that the judicious Sydenham 
$$$  .        OF THE DYSENTERY,
calls it fever of the bcwcls.  It is always neceffary t*
treat it as  fever, and according to the ftate of the
pulfe, to bleed, purge, blifter, &c. until the fever is
removed.~The truth is, that here,  as  in all  other
cafes, we muft  direct our practice according to the
difeafes of the feafon, or reigning epidemic.
   Thefe evacuations, and  the  regimen  prefcribed
above, will often be fufficient to effect a cure. Should
it, however, happen otherwife, the  following addi-
tional aftringent medicines may be ufed.
   A clyfter of flarch, or fat mutton-broth, with thirty
or forty drops of liquid laudanum in it, may be ad-
miniftered twice a-day. At the fame time on  ounce of
gum-arabic, and half an ounce of gum-fragacanth,
may be diffolved in a pint of barley-water, over a flow
iire, and a table-fpoonful of it taken every hour.
   If thefe have not the defired effect, the patient may
take, four times a-day, about the bulk of a nutmeg of
the faponic confeclion, drinking after it a tea-cupful of
the  decoction of logwood* ; or,  the Columbo  root
may be given in infufion or decoction. Two  drachms
of the root fliced may be put to a pint of boiling-water,
half a drachm  of cinnamon bark may be added ;  a
wine glafs full for a dofe four or five times a-day.
   Perfons who have  been cured of this  difeafe arc
very liable  to  fuffer a  relapfe;  to  prevent which,
great circumfpection with refpect to diet is neceffary.
The patient muft abftain from all fermented liquors,
except now and then a glafs of good wine; but he
muft drink no kind of malt-liquor.  He fhould  liker
wife abftain from ftrong animal food, and live prin-
cipally on milk and vegetables.
   Gentle  exercife  and wholefome air are  likewife of
importance.   The  patient fliould  go to the country
'as foon as his ftrength will permit, and fhould take ex-

         * See Appendix, Decoflion of Logwood.
                                            erci^g 
               OR BLOODY FLUX.            359
erclfe daily on horfeback, or in a carriage.   He may
likewife ufe bitters, and may drink twice a-day a gill of
lime-water mixed with an equal quantity of new milk.
   When dyfenteries prevail, we would recommend a
ftrict attention to cleanlinefs, a fpare ufe of animal food,
and a free ufe of found ripe fruits,  and other vege-
tables. The night air is to be carefully avoided, and
all communication with the fick.  Bad fmells are like-
wife to be fliunned,  efpecially thofe which arife from
putrid animal fubftances.   The neceffaries where the
fick go, are carefully to be avoided.
   There are fundry  other fluxes of the belly, as the
LIENTERY and  CCELIAC PASSION, which,
though  lefs dangerous than the dyfentery, yet merit
conlideration.   Thefe difeafes generally proceed from
a relaxed ftate of the ftomach and inteftines, which is
fometimes fo great that the  food paffes through them
without almoft any fenfible alteration ; and the patient
dies merely from the want of nourifhment.
   When the lientery or cceliac paffion fucceeds to a
dyfentery, the cafe is bad. They are always dangerous
in old age, efpecially when  the conftitution has been
broken by excefs or acute  difeafes.   If the ftools be
very frequent, and quite crude, the thirft great, with
little urine, the mouth ulcerated, and the face marked
with fpots of different colours, the  danger is very
great.
  The treatment of the patient, is in general the fame
^s in the dyfentery. In all obftinate fluxes of the belly,
and efpecially in the diarrhoea Vvhich often  follows dy-
fentery, the cure muft be attempted, firft by cleanfing
the ftomach and bowels with gentle vomits and purr
ges; afterwards, fuch a diet as has a tendency to heal
and ftrengthen the bowels, with opiates and aftringent
jr. 'dichi.s. will generally "perfeci the cure.
A a 4
CHAP- 
C  J&>  J
                CHAP.  XXXV.


                 Of the Head-ach.


          xTlCHES  and  pains proceed from  very
jiifferent caufes, and  may affect any part  of the
body ; but we fhail point out thofe only which occur
moft frequently, and are attended with the greateft
danger.
   When the  head-ach is  flight, and affects a parti-
cular part of  the head only, it is called cephalalgia \
when the whole head is affected, cephaltea ; and when
pn one fide only, hemicrania. A fixed pain in the fore-
head, which may be covered with the end  of the
thumb, is called the clavis hy/lericus.
   There are alfo other diftinctions.   Sometimes the
pain is internal, fometimes external ; fometimes it is
an original defeafe, and at other times only fympto*.
matic.   When the head-ache  proceeds from a hot
bilious habit,  the pain is very acute and throbbing,
with a confiderable heat of the part affected.   When
from a cold phlegmatic habit,  the patient complains
of a dull heavy pain,  and  has a fenfe of coldnefs in
the part.
   Whatever  obftructs the free circulation  of the
blood through the veffels of the head, may  occafion
a head-ach.   In perfons of a full habit, who abound
with blood, or other humorsr-the  head-ach often
proceeds from the fuppreffion of cuftomary evacua-
tions ; as bleeding at the nofe, fweating of the feet,
&c.   It may  likewife proceed  from  any  caufe that
determines  a  great flux of blood towards the head;
as coldnefs pf the extremities, or hanging down the
                                             hV-d 
            OF THE HEAD-ACH.             tft
head for a  long time.  Whatever prevents the re-
turn of the blood from the head will likewife occa-
fion a head-ach;  as  looking  long obliquely at  any
object, wearing any thing tight  about the neck, or
the like.
   When a head-ach proceeds from  a ftoppage of
a running  at  the nofe, there is a heavy,  obtufe,
preffing pain in the  fore part  of the  head,  in which
there feems to be  fuch a weight, that  the patient
can fcarcely hold it up. When it is occafioned by the
venereal difeafe,  it generally affects the fkull,. and
often produces a caries of the bones.
   Sometimes  the head-ach proceeds  from the repul-
fion or  retroceflion  of the gout, the eryfipelas, the
fmall-pox,  meafles,  itch, or other  eruptive difeafes.
What is called hemicrania generally proceeds from
crudities or indigeftion.   Inanition,  or emptinefs,
will often alfo  occafion head-achs.  I  have often feen
inftances of this in  nurfes who  gave fuck too long,
or who  did not  take a fufficient  quantity  of folid
food.
   There is likewife  a moft violent,  fixed,  conftant,
and almoft intolerable  head-ach,  which  occafions
great debility both of body and mind, prevents fleep,
deftroys the appetite, caufes a  vertigo,  dimnefs of
fight, a noife  in the ears, convulfions, epileptic fits,
and fometimes vomiting, coftivenefs,  coldnefs of the
extremities, Sec.
   The  head-ach, is often fymptomatic in continual
and intermitting  fevers, efpecially quartans.   It is
likewife  a  very common fymptom in hyfteric  an4
hypochondriac complaints.
   When a head-ach attends an acute  fever, with
pale urine,  it  is an unfavourable fymptom.  In ex-
ceffive head-achs, coldnefs of the extremities is a bad
 $£n.
                                           When 
S^            OF THE HEAD-ACH.
   When the difeafe continues long, and is very y1«k
lent,  it may terminate in  blindnefs, an apoplexy,
rieafnefs, a  vertigo, the palfy, epilepfy, &c.
   In this difeafe the cool regimen in general is to. be
obferved.   The diet ought to confift of fuch emol-
lient fubftances as will correct the  acrimony of the
humors, and keep the body  open ; as apples boiled
in milk, fpinage,  turnips, and fuch like.   The drink
ought to be diluting;  as  barley-water, infufions of
mild  mucilaginous vegetables,  decoctions of  the
fodorific woods,  Sec.   The  feet and legs  ought to
be kept warm, and frequently  bathed  in lukewarm
water;  the head fhould be  fhaved,  and  bathed with
water and vinegar.  The  patient ought as much as
poffible to keep in an erect  pofture, and not to  lie
with his head too low.
   When  the head-ach is owing to  excefs of blood,
or an hot bilious  conftitution, bleeding  is neceffary.
Cupping alfo,  or the  application of leeches  to the
temples, and behind  the ears, will be of fervice.
Afterwards,  a  bliftering-plafter may be applied to
the neck, behind  the  cars,  or  to  any  part  of the
head  that is moft affected.    In fome cafes it will  be
proper  to blifter the whole  head.   In perfons of a
grofs habit,  iffues or perpetual blifters will be offer-
vice.   The body  ought likewife to  be kept open  by
gentle laxatives.
   But  when the  head-ach continues with a  dull,
heavy,  continual  pain, which will  neither yield  to
bleeding nor gentle laxatives, then more  powerful
purgatives are  neceffary, as pills made of aloes, refin
of jalap, or  the like.  It will  alfo be neceffary in this
cafe to blifter the  whole head, and to keep on  the
back  part of the  neck,  for  a confiderable time, a
perpetual blifter.
When, 
            OF THE HEAD-ACH.             363
  When the head-ach is occafioned by the ftoppage
of a running at the nofe, the patient fhould frequently
fmell to a  bottle of volatile falts; he may likewife
take fnuff, or any thing that  will irritate the nofe,
fo as to.promote a difcharge  from it; as the frerb
maftich, ground-ivy, &c.
  A hemicrania, efpecially a periodical one, is gene-
rally owing to a foulnefs of the  ftomach,  for which
gentle vomits muft be  adminiftered,  as alfo  purges
of rhubarb.  After the bowels have been fufficiently
cleared,  chalybeate waters,  and fuch  bitters as
flrengthen the ftomach, will be neceffary.  A peri-
odical head-ach has been  cured by wearing a piece
of flannel over the forehead during the night.
   When  the  head-ach arifes from a vitiated ftate of
the humors, as in the fcurvy and venereal difeafe,
the patient,  after, proper evacuations, muft  drink
freely of the decoction of woods, or the decoction of
farfaparilla, with raifins and liquorice*.  Thefe pro-
mote perfpiration, fweeten the humors, and,  if duly
perfifted in, will produce very happy effects.  When
a collection of matter is felt under the fkin,  it muft
be difcharged by an incifion,  otherwife it will render
the bone carious.
   When  the head-ach is fo intolerable as  to endan-
ger the patient's life, or is attended with continual
watching, delirium, &c.  recourfe muft  be had to
opiates.   Thefe, after proper evacuations by  clyfters
or mild purgatives, may be  applied both externally
and internally.   The affected part may  be rubbed
with Bate's anodyne balfam,  or a cloth dipped  in it
may be applied to the part.   The patient may,  at
the fame time, take twenty drops of laudanum,  in a
cap of valerian or penny-royal tea,  twice or thrice
^-»1:y.  This is only to be done in cafe of extreme

        * Set Appendix, Dtcofltonof Sarfaparilla.
*,m                                           pais. 
 364            OF THE TOOTH-ACH.
 pain.   Proper  evacuations  ought always  to accom-
 pany and follow the ufe of opiates*.
   When  the patient cannot bear  the lofs of blood,
 his feet ought frequently to be bathed in lukewarm  '
 water, and well rubbed with a coarfe cloth.  Cata.
 plafms with muftard or horferadifh ought likewife to
 be applied to them.  This courfe is peculiarly necef.  '
 fary when the  pain  proceeds  from a  gouty humor
 affecting the head.
   When  the  head-ach is occafioned  by great heat,
 hard labour, or violent exercife of any kind, it may
 be  allayed  by cooling  medicines;   as  the falinc
 draughts withmitre,  and the like.
   A  little of Ward's  effence, dropt  into  the pain
 of the hand, and applied to the forehead,  will fome.
 times  remove a violent head-ach ; and fb will aether,
 when  applied in the fame manner.

              OF THE TOOTH-ACH.

   This difeafe is  fo  well known that it needs no de-
 fcription.   It has great affinity with the rheumatifm,
 and often fucceeds pains of the fhoulders  and other
 parts of the body.
   It may  proceed from obftructed perfpiration, or
 any of  the  other caufes  of inflammation.  I have
 often known the  tooth-ach  occafioned by neglecting
 fome part of the ufual covering of  the head, by fitr

   *  When the pain is very violent, and does not yield to fnull
 dofes of laudanum,  the  quantity may be increafed.  I have
 known  a patient in extreme pain take three hundred drops in
 twenty-four hours; but fuch dofes ought only to be adminif*
 tered by a perfon of fkill.
   What is called the nervous head-ach, which comes on perio-
dically, beginning with a dimnefs of fight, followed by violent
pain, may be very effectually relieved for the time, by giving
from twenty to thirty drops of laudanum.-
ting 
           OF THE TOOTH-ACH.            36c
ting with the head  bare near an open  window, or
expofing it any how  to a draught of cold air.  Food
or drink taken either too hot  or  too  cold  is very
hurtful to the teeth.   Great quantities of fugar, or
other fweet-meats,  are likewife hurtful.  Nothing
is more deftructive to the teeth  than  cracking nuts,
or chewing any kind of hard  fubftances.   Picking
the teeth with pins, needles, or any thing that may
hurt the  enamel with which they are covered,  does
great mifchief, as the  tooth is fure to be fpoiled
whenever the air gets into it.   Breeding women are
very  fubject to the  tooth-ach,  efpecially during the
firft three or four months of pregnancy.  The tooth-
Hch  often proceeds  from fcorbutic humors affecting
the  gums.   In this cafe  the  teeth  are fometimes
wafted, and fall out without any confiderable degree
of pain.  The more immediate caufe of the tooth-
ach is a rotten or carious tooth.
   In order to relieve the tooth-ach, we muft firft
•tndeavour to leffen  the flux of humors to the  part
affected.   This may be  done  by  mild purgatives,
fcarifying the  gums,  or  applying  leeches to them»
and bathing  the feet frequently with warm water.
The perfpiration ought likewife to be promoted, by
drinking freely of diluting liquors, with fmall  dofes
of nitre.
   If'•this fails, and the pain and  inflammation ftill
increafes, a fuppuration may be expected ; to promote
which a toafted fig  fhould be held  between the gum
and the cheeks;  bags filled with  boiled camomile-
flowers,  flowers of elder, or the like, may be applied
•near  the part affected, with as great -a  degree of
warmthas the patient can bear,  and renewed as they
•grow cool:  the  patient  may  likewife receive the
fteame of. warm water into  his mouth, through an
inverted funnel,  or by holding his  head over the
mouth of a porringer filled with warm water, &c.
                                            Such 
tffifc
OF THE TOOTH-ACH*
   Such tilings as promote the difcharge of faliva, or
 caufe the patient to fpit, are fometimes  of  fervice*
 For this purpofe, bitter, hot, or pungent vegetables
 may be chewed ; as gentian, calamus aromaticus.
   Many other herbs, roots,  and feeds, are recom-
 mended for curing  the tooth-ach; as the leaves or
 roots  of  millefoil   or   yarrow  chewed,   tobacco
 fmoaked or  chewed, ftaves-acre, or the feeds of
 muftard chewed, &c.  Thefe bitter, hot, and pun-
 gent things,  by occafioning a greater flow of faliva,
 frequently give eafe in the tooth-ach.
   Opiates often relieve  the tooth-ach.   For  this
 purpofe  a little  cotton wet with laudanum  may be
 held  between the  teeth ;  or a  piece of   fticking
 plafter, about the bignefs of a fhilling, with a bit
 of opium in  the middle of it,  of a fize not to  pre-
 vent  the  fticking of the other, may be laid on the
 temporal artery, where the pulfation is  moft fenfi-
 ble*.  De la Motte affirms, that there are few cafes
 wherein this will  not  give relief.   If there be a  hol-
 low tooth, a fmall pill made of equal parts  of cam-
 phire and opium, put into the hollow, is often bene-
 ficial.  When this cannot be had, the hollow tooth
 may be filled  with gum maftich, wax, lead, or any
 fubftance that will flick in it, and keep out  the ex-
 ternal air.
  Few applications give more relief in the tooth-ach
 than bliftering-plafters.   Thefe may  be applied be*
 tween the fhoulders;  but they have the  beft effect
 when put behind the  ears, and made fo large as to
 cover a great part of the lower jaw.
  After all,  when a tooth is carious, it is often im-
poffible to  remove  the pain without extracting it;
 *nd, as a  fpoilt  tooth never becomes found again,
 it is  prudent  to  draw it fooo, left it fhould affect
  * Or vi-hat is much better, a plalter made of laudanum ani
Gammon wheat flour.
                                              tJlCr 
            OF THE TOOTH-ACH.            367
 the reft. Tooth-drawing, like bleeding, is very much
 practikd  by mechanics, as well as perfons of the
 medical profeffion. The operation, however, is not
 without danger, and  ought always to be performed
 with care.  A perfon unacquainted with the ftructurc
 of the parts will be in danger of hurting thejaw-bone,
 or of drawing  a  found tooth  inftead  of a rotten
 one*.
   When the tooth-ach returns periodically, and the
 pain chiefly affects the gums, it may be cured by the
 bark.
   Some pretend to have found great benefit in the
 tooth-ach,  from the application  of an artificial  mag-
 net to the affected tooth.  We  fhail not attempt to
 ■ account for its mode of operation;  but, if it be found
 to anfwer,  though only in  particular  cafes, it  cer-
 tainly deferves a trial,  as it is attended  with no ex-
 pence, and cannot do any harm. Electricity has like-
 wife been recommended,  and particular  inftruments
 have been invented for fending a fhock through the
 affected tooth.   The  tooth-ach may very often be
 prevented by the ufe of a flannel night cap.
   Perfons who have returns of the tooth-ach at cer-
 tain feafons, as fpring and autumn, might often pre-
. vent it by taking a purge at thefe times.
   Keeping  the teeth  clean has no doubt a tendency
 to prevent  the  tooth-ach.  The beft method of do-
 ing this is to rub the gums daily  with the bark,  and
 to have  the tartar taken off when  it collects in any
 quantity..   And inftead of a tooth, pick  to clean the
 teeth by pafling a bit of thread between them.
   * This may always be prevented by the operator ftrikfrg
.upon the teeth with any piece of metal, as this never fails to
 excite the pain in the carious, tooth.
OF 
t  3<s*  3
                   OF THE EAR-ACH.

       This diforder chiefly affects  the membrane which
     lines the inner cavity  of the ear, called the  meatus
     -mtditorius.  It is often fo violent as to  occafion great
     reftleffnefs, anxiety,  and even delirium.
       The ear-ach may proceed from any of the caufes
     which  produce  inflammation.   It  often  proceeds
     from  a fudden fuppreflion of perfpiration, or from
     the head being expofed to cold when covered with
     fweat.  It may alfo be occafioned by worms,  or
     other infects getting into the ear, or being bred
     there; or from  any hard  body fticking in the ear.
     Sometimes it proceeds from the tranflation of matter
     to  the ear.   This often  happens  in the decline of
     malignant fevers, and occafions deafnefs.
       When  the ear-ach proceeds from infects,  or any*1
     hard body fticking in the ear, every  method mull
     he  taken  to remove them as foon as poffible.  The
     membranes may be  relaxed by  dropping into  the
     car oil of fweet almonds, or olive oil.   If this fhould
     not force out the body, it muft be extracted by art.
     I have feen infects, which had got into the ear, come
     out of their own accord upon pouring in oil, which
     is a thing  they cannot bear.  The pain in the ear is
     fometimes fo violent, as to make it  abfolutely necef-
     fary to give twenty-five drops of liquid laudanum  in
     a little water every hour,  until the pain abates.
        When  the  pain of the ear proceeds from inflam-
     mation, it muft.be treated  like other topical inflam-
%   nations? by a cooling regimen,  and opening medi-
     cines.  Bleeding at the beginning, either in the arm
     or jugular vein,  or cupping in die neck, will be pro-
     per.  The ear may likewife be fomented with fleam i
     of  warm  water; or  flannel bags filled with boiled
     mallows and camomile flowers may be applied to  it
                          1                     warm; 
          PAIN OF THE STOMACH, &c.        369
warm; or bladders filled  with warm milk and water.
A very good method of  fomenting the ear is to ap-
ply it clofe to the mouth  of  a jug filled  with warm
water, on a ftrong decoction of camomile-flowers.
   The patient's feet  fliould be  frequently bathed in
lukewarm water, and he ought to take fmall dofes
of nitre and rhubarb, viz. a fcruple of the former,
and ten grains of the latter, three times a-day.   His
drink may be whey, or  a  decoction of .barley  and
liquorice, with figs or raifins.   The parts behind the
ear ought frequently to be rubbed with campho-
rated oil, or  a  little of the volatile liniment ; or
what perhaps is  far preferable,  a blifter applied be-
hind the ear.
   When the inflammation cannot be difcuffed, a poul-
ricc of bread and milk, or roafted onions, may be ap-
plied to the  ear,  and  frequently  renewed,  till the ab-
fcefs breaks, or can be opened.   Afterwards the hu-
mors may be diverted by  gentle  laxatives, blifters, or
iffues;  but the difcharge  muft not be fuddenly dried
up by any external application.

          PAIN OF THE STOMACH, &c.

   This may proceed from various caufes; as indi-
geftion, wind, the acrimony of the bile, fharp, acrid,
or poifonous fubftances taken into the ftomach,  &c.
It may likewife  be occafioned by  worms, the ftop-
page of cuftomary evacuations, a tranflation of gouty
matter to the ftomach, the bowels, Sec.
   Women in the decline of life are very liable to
pains in the ftomach and bowels,  efpecially fuch as
are afflicted  with hyfteric  complaints.   It is like-
wile very common  to hypochondriac men  of a feden-
rary and luxurious life.   In fuch  perfons it fometimes
proves fo extremely obftinate as to baffle all the pow-
ers of medicine.
B  b
When 
370       PAIN OF THE STOMACH, &c.
   When the  pain  of the ftomach is moft  violent
 after eating,  there  is reafon to fufpect  that it pro-
 ceeds from fome fault either in the digeftion or the
 food.  In this cafe  the patient ought to change his
 diet, till he finds what kind of food agrees'beft with
 his ftomach,  and fhould  continue chiefly to ufe it.
 If a change of diet does not remove the complaint,
 the  patient may take  a gentle vomit,  and  after-
 wards a dofe  or  two  of  rhubarb.   He ought like-
 wife to take an infufion of camomile-flowers, or fome
 other ftomachic bitter, either in wine or water.  I have
 often known exercife remove this complaint, efpecially
 failing, or a long journey on horfeback, or in a carriage.
    When a pain of the ftomach proceeds from flatu-
 lency, die patient is conftantly belching up wind, and'
 feels an  uneafy diftention of the ftomach after meals.
 In general, the patient ought to avoid all  windy diet,
 and every thing that fours on the ftomach, as greens,
 roots, &c.  This rule, however, admits of fome ex-
 ceptions.   There are many inftances  of perions very
 much troubled with wind, who have received great
 benefit from eating parched peafe, though that grain
 is generally fuppofed to be of a windy nature*.
    this complaint  may be likewife greatly relieved
 by labour, efpecially digging, reaping,  mowing,  or
 any kind of active employment by which the bowels
 are  alternately  compreffed and dilated.   The mofl
 obftinate cafe of this kind I  ever met with was in a
 perfon  of a  fedentary occupation, whom 1  advifed,
 after he had tried  every  kind of medicine in vain,
 to turn gardener ;  which he did,  and has ever fince
 enjoyed  good health.
    When a  pain of the ftomach  is  occafioned by
 the  fwallowing  of  acrid  or  poifonous  fubftances,

    *  Thefe are prepared by fleeping or flaking  peafe in water,
 and afterwards drying them in a pot rr kiln till they be quite
 hard. They may be ufed at plcafure.  Ti is preparation moll
 probably expels the wind.
                                               they 
           PAIN OF THE STOMACH, Sec       371
 they muft be  difcharged  by vomit ;  this  may be
 excited by butter,  oils,  or other foft things, which
 fheath and defend the ftomach from the acrimony of
 its contents.
   When pain of the  ftomach proceeds from  a tranf-
 lation of gouty matter, warm cordials are neceffary,
 as generous wines,  French brandy, Sec.   Some have
 drank a whole bottle of brandy or rum, in this cafe,
 in a few  hours, without being  in the  leaft intoxi-
 cated, or even feeling the ftomach warmed by it.  Tt
 is impoffible to afcertain the quantities neceffary upon
 thefe occafions.   This muft be left to the feelings and
 difcretion of the patient.   The fafer way however is,
 not to go too  far*.
   If a pain of the ftomach proceed from the ftoppage
 of cuftomary evacuations, bleeding will be neceffary,
 efpecially  in fanguine and very full habits.  It will
 likewife be of ufe to  keep the body gently open  by
mild purgatives ; as rhubarb or fenna, &c.   When
 this difeafe affects women, in the decline of life, after
 the ftoppage of the menfes, making an iffue in the leg
 or arm will be of peculiar fervice.
   When the difeafe is occafioned by worms, they muft
 be deftroyed, or expelled by fuch means as are recom-
mended in the following fection.
   When the ftomach is greatly relaxed, and the di-
geflion bad, which often occafions flatulencies, the
elixir of vitriol will be of Angular fervice.   Fifteen
or twenty  drops of it may be taken in a glafs of wine
or water twice or thrice  a-day,  or a glafs of the de-
coction of Columbo, as recommended in  the dyfentery,
may be taken three  or four times  a-day.
  Perfons afflicted with flatulency are  generally un-
happy  unlefs  they  be, taking fome purgative medi-

  * A. tea-fpoonful of ether, with ten drops of laudanum, in
.1 little water, repeated every half hour if needfary, will do
 more good in thefe cafes th v\ a gallon of bran J y. '  "
                      f> b .:. t              cines; 
372            O  F W O P. M S.,
cines ; thefe, though they  may give immediate oil-
tend to weaken and relax  the ftomach and bowels
and confequently increafe  the diforder.   Their beft
method is to mix purgatives and ftomachics together.
Equal parts of Peruvian bark and rhubarb may he
ufed in wine, and taken in fuch quantity as to keep the
body gently open.
                CHAP.  XXXVI.

                   Of Worms.


           1 HESE  are chffefly of three kinds, viz.
the* tania, or tape-worm ;  the teres, or round  and
long worm ;  and the  afcarides, or round and fhort
worms.   There  are  many other kinds  of worms
found in  the human body ; but as they proceed, in
a great meafure, from fimilar caufes, have nearly the
fame fymptoms, and require almoft the fame method
of treatment as thefe already mentioned, we fliall not
fpend time in enumerating them.
   The tape-worm is white, very long, and full of
joints.  It is generally bred either in the ftomach or
fmall inteftines.   The  round and long  worm is like-
wife bred in the fmall  guts, and fometimes in the
ftomach.   The round  and fhort  worms  commonly
lodge in the rcclum, or what is called the end gut, and
occafion a difagreeable itching about the feat.
   The long round worms occafion fqueamiflinefs,
vomiting,  a  difagreeable breath, gripes,  loofenefs,
fwellings of the belly, fwooning, loathing  of food,
and at other times a voracious appetite,  a dry cough,
convulfions, epileptic fits, and  fometimes a privation 
OF  WORMS.            373
of fpcech.  The effects of the tape-worm  are nearly
the fame with thofe  of  the long and round, but ra-
ther more violent.
   Andry  fays, the following fymptoms particularly
attend fhe folium, which is a fpecies of the tape-worm,
viz.  fwoonings, privation of fpeech, and a voracious
appetite.  The round worms  called afcaridcs, befides
an itching of the anus, caufe fwoonings, and tenefmus,
or an inclination to go to ftool.
   CAUSES.—Worms   may proceed  from various
caufes; but they are feldom found to be  trouble-
fome,  except in weak and  relaxed flomachs, where
the  digeftion  is bad.  Sedentary perfons are more
liable to them than the  active and laborious.  Thofe
who cat great  quantities of unripe fruit, or who live
much on raw herbs and  roots,  are* generally fubject
to worms.  There feems to be an hereditary difpofi-
tion  in fome perfons to this difeafe.  I have often feen
all the  children of a family fubject to worms of a par-
ticular kind.
   SYMPTOMS.—The common fymptoms of worms
are, palenefs of the countenance, and at other times,
an  univerfal  flufhing of the  face ; itching of the
nofe ;  this, however, is doubtful,  as  children  pick
their nofes in  many difeafes; ftarting, and grinding
of the teeth in fleep ;  fwelling of the upper lip ; the
appetite  fometimes  bad, at  other times quite vora-
cious ; loofenefs ; a four or ftinking breath ; a  hard
fwelled belly ; great thirft ; the urine frothy, and
fometimes of a whitifli colour ; griping, or colic pains ;
an involuntary difcharge of faliva, efpecially when
afleep, frequent pains of the fide, with a dry cough,
and  unequal pulfe ;  palpitations of the heart; fwoon-
ings ;  drowfinefs ; cold fweats ; palfy ; epileptic fits,
with many other unaccountable nervous  fymptoms,
which  were formerly  attributed to witchcraft, cr the
influence of evil  fpirits.   Small bodies in the excre-
                     B b 3                 menu. 
J74             OF  WORM S.
ments, refembling melon or cucumber feeds, are fymp-
toms of the tape-worm.
   I lately faw fome very furprifing effects of worms
in a girl about five years of age, who  ufed to  lie for
whofe hours as if dead.   She  at laft expired, and,
upon opening  her body,  a number  of the teres, or
long round worm,  were  found in her guts,  which
were confiderably inflamed ;  and what anatomifts call
an intus fufecptio, or involving of one part of the gut
within  another, had taken place in no lefs than four
different parts of the  inteftinal canal*.
   MEDICINE.—Though numberlefs medicines are
extolled for expelling  and killing wormsf, yet no dif-
eafe more frequently baffles the phyfician's fkill.   In
general, the moft proper medicines for their expulfion
are ftrong purgatives; and to prevent their breeding,
ilomachic bitters.      v
   The beft purge is  jalap  and calomel.   Five  and
twenty or thirty grains of the former with fix or feven
of the latter, for an adult, mixed in fyrup, may be
taken early in  the morning, for a dofe.   It will be
proper  that the patient keep the houfe all day,  and
drink nothing cold.   The dofe may be repeated once
or  twice  a week, for a  fortnight or  three  weeks.
On  the intermediate  days, die patient may take a

  * That worms exift in the human body, there can be no
doubt; and that they mnft fometimes be confidered as a difeaff,
is equally certain: but "this is not the cafe Co often as people
imagine.  The idea that worms occafion many difeafes, gives
an opportunity to the profefled worm doctors of impofmgon
the credulity of mankind, and doing much mifchief.  They
rind worms in every cafe, and liberally throw in their antidotes,
which generally confift of ftrong, draftic purges.  I have known
thefe given,  in delicate conftitutions, to the deftrudtion of the
patient, where there was not the leaft fymptom of worms.
  ■f A medical writer of the prefent age, has enumerated up-
wards of fifty Britifh plants^ all celebrated for killing and ex-
pelling worms.
drachm 
                0 F  W Q R M S.             375
drachm of the powder of tin,  twice or thrice a-day,
mixed with fyrup,  honey or molaffes.
  Thofe who do no chufe to take calomel, may make
ufe of the bitter purgatives; as aloes, hiera picra, tinc-
ture of fenna, rhubarb,  &c.
  Oily medicines are  fometimes  found-beneficial for
expelling worms.  An  ounce of fallad  oil,  and a
table-fpoonful of common fait may be taken in a glafs
of red port wine thrice a-day,  or oftener, if the fto-,
mach  will bear  it.   But the more common  form of
ufing oil is in clyfters.  Oily clyfters, fweetened with
fugar or honey, are very efficacious in  bringing away
the fhort round worms called afcarides, and  likewilc
the teres,
   The Harrowgate water is an excellent medicine for
expelling worms, efpecially the  afcarides.   As  thk
water is impregnated with Tulphur, we  may hence
infer, faat  iulphun alone muft be a  good medicine
in this cafe'; which  is  found to be a fact.   Many
practitioiers give flour of fulphur in very large dofes, .
and with great fuccefs.  It fhould be made into an
electuary with honey  or molaffes, and taken in  fuch
 quantity ;s to purge the patient.
   Where Harrowgate  water cannot be obtained,
 fea-water may be ufed,  which  is far from  being a
 contemptble medicine  in  this  cafe.   If fea-water
 cannot be had, common  fait diffolved in water may
 be dijink   I have often feen this ufed by  country
 nurfej, viith very good effect.   Some flour of fulphur
 may  le taken  over night, and the falt-water in the
 mornpg.
   Bif worms,  though  expelled, will foon breed
 ag;i:i, if the ftomach remains" weak and relaxed ; to
 prevtit which, we would  recommend the Peruvian
 barl^  Half a drachm of bark in powder may be
 take in a glafs of red port wine three or four times:
 a-da, after  the above  medicines'have  been ufed.
 lim^vater  is  likewife good  for  this  purpofe,  or a
                      B b 4                 table- 
 3?6             O F W O R M S.
 table-fpoonful of the chalybeate wine taken twice or
 thrice a-day.  Infufions or decoctions of bitter herbs,
 may likewife be  drank ;  as the infufion of tanfy,
 water trefoil, camomile-flowers, tops of wormwood,
 centaury, &c.
   For a child of four or five years old, fix grains of
 rhubarb, five of jalap, and  fix of calomel,  may be
 mixed in a fpoonful of fyrup or honey, and given in
 the  morning.  The child  fhould keep  the houfe all
 day, and take  nothing  cold.   This  dofe  may be
 repeated twice a-week for three or four weeks.  On
 the  intermediate days the child may take a fcruple
 of powdered tin and ten grains of ccthiops mineral in
 a fpoonful of molaffes twice a-day.   This dofe mufl
 be increafed or diminifhed according to the age of the
 patient.                                  ;
   Biffet fays, the great baftard black heileWe,  or
 bear's foot,  is  a moft powerful vermifuge Jfor the
 long round  worms.   He orders the  decoftion of
 about a drachm  of the green leaves,  or  aboyt fifteen
 grains of the dried leaves in powder for a /(ofe to a
 child between four and feven  years of afe.   This
 dofe is to be repeated two or three times.  He adds,
 that the green leaves made into a fyrup wth coarfe
 fugar, is almoft the only  medicine he hi ufed for
 round worms for  three years paft.   Befoie preffing
 out  the  juice, he moiftens  the bruifed lerves  with
 vinegar, which  corrects the  medicine.   Tie dofe is
 a tea-fpoonful at  bed-time,  and one or  \.va  next
 morning.                                I
  1  have frequently known thofe big bellies, which
 in children are commonly reckoned a fign of \orms,
 quite removed by giving them white foap ir their
 pottage, or  other  food.   Tanfy, garlic,  anc rue,
 are all good againft worms, and  may  be ufed vrious
ways.   We might here mention many other  pints,
both for external and internal ufe, as the  cabage-
hark, &c. but think the powder of tin with o?u'ops
                                         mbral,, 
                 € F  WORMS.              577
 mineral, and the purges of rhubarb and calomel, t;?c
 more to be  depended on.   Perhaps there is no me-
 dicine more  powerful, in thefe cafes, and at the feme
 time more fafe,  than from two to eight grains of fal
 martis, with five grains of iron filings, twice a-day, for
 feveral days, in a little fyrup or molaffes.
   Ball^5 purging vermifuge powder is a very power-
 ful medicine.   It is  made of equal parts of rhubarb,
 fcammony, and calomel, with as much double refined
 fugar as is equal to the weight of all the other ingre-
 dients.  Thefe muft be well mixed together, and re-
 duced to a fine powder.  The dofe for a child is from
 ten grains to twenty, once or twice a-week. An adult
 may  take  a  drachm  for a dofe*.
   Parents who would preferve  their children  from
 worms, ought to allow them plenty of exercife in the
 open air;  to take care that their food be wholefome
 and fufficiently  folid  ; and, as far as poffible, to pre-
 vent  their  eating raw  herbs, roots,  or green trafliy
 fruits.  It will not be amifs,  fometimes,  to allow a
 child who  is fubject  to worms, a glafs of  red  wine
 after meals ; as every thing that braces and ftrength-
 ens the ftomach is good both for preventing and ex-
 pelling thefe verminf.

  * A powder for the tape-worm, was long kept a fecret on
 the  Continent; it was lately purchafed by the French king,
 and will be found  under the article Powder, in the Appendix.
  •j- We think i: neceffary here to warn people of their danger
 who buy cakes, powder?,  and other worm medicines, at ran-
 dom  from quacks, and  give them  to their children without
 proper care.  The principal ingredients in moft of thefe medi-
 cines rs mercury,  which  is never to  be tiifled with.  I lately
faw a fhockin<>  inftance of the danger of this conduct.  A girl
 who had taken a dofe of worm powder, bought of a travelling
 quack, went out, and peihaps was fo imprudent as to drink
cold water, during its operation. She immediately fwelled, and
 died on the following day, with a'l  the fymptoms of having
b-.er poifoned-
CHAP- 
[  37§   ]
           -   CHAP.  XXXVI [.


                 Of the Jaundice.


             i HIS  difeafe is firft obfervablc in the
white of the eye, which appears yellow.  Afterwards
the whole fkin puts on  a yellow appearance.   The
urine, too, is of a faffron hue, and dies a white cloth
of the fame colour.   There  is likewife a fpecies oi
this difeafe called the Black Jaundice.
   CAUSES.—The  immediate caufe of the jaundice
is an  obftruction of the bile.   The remote or occa-
fional caufes  are, the bites of poifonous animals, as'
the viper,  the mad dog, &c.  the bilious or hyfteric
colic ;  violent paflions, as grief, anger, &c.  Strong
purges or vomits will likewife occafion the jaundice.
Sometimes it proceeds from obftinate agues, or from
that difeafe being prematurely ftopped by aftringent
medicines ; alfo from affections of the liver and biliary
ducts.  In  infants it is often occafioned by the meconium
not being fufficiently purged off.  Pregnant women
are very fubject to it.   It is likewife a fymptom in feve-
ral kinds of fever.   Catching cold, or the ftoppage
of cuftomary  evacuations, as the mcnfes,  the bleed-
ing piles,  iffues,  &c. will occafion the jaundice.
   SYMPTOMS.—-The patient at firft complains of
exceffive wearinefs, and has  great averfion to every
kind of motion.  His fkin is  dry, and he generally
feels a  kind  of itching or pricking pain  over the
whole body.   The ftools are of a whitifli or clay co-
lour,  am'  the urine,  as was  obferved above, is yel-
low.  The breathing  is difficult, and the patient com-
plains of an unufual load or oppreffion on  his breaft,
often attended with  great defpondency.  There is a
           i                                  heat 
              OF THE JAUNDICE.            r9
is a heat in the noftrils,  a bitter tafte in  the mouth,
loathing of food,  ficknefs at the ftomach,  vomiting,
flatulency, and other fymptoms of indigeftion.
  Jf the patient  be young, and  the difeafe compli-
cated with no other malady, it is feldom dangerous ;
but in old people, where it continues long, returns
frequently, or is complicated with the dropfy or  hy-
pochondriac fymptoms,  it often  proves  fatal.  The
black jaundice, or vomiting of a dark coloured fluid,
h more  dangerous than  the yellow.
  REGIMEN.—The diet fhould be cool, light, and
diluting, confiding chiefly of ripe  fruits  and mild
vegetables ; as apples boiled or roafted, ftewed prunes,
preferred plums, boiled fpinage, &c. Veal  or chick-
en-broth, with light bread, are likewife very proper.
.Many have been  cured  by living almoft wholly  for
fome days on raw eggs.   The drink fliould be butter-
milk, whey fweetened with honey,  or decoctions of
cool opening, vegetables; or marfh-mallow roots, with
liquorice, Sec.
  The patient fliould take as much exercife as he  can
bear, either on horfeback or in a carriage ; .walking,
running, and even jumping, are likewife proper, pro-
vided he can bear them without pain, and there be
no fymptoms of inflammation.  Patients have been
often cured of this  difeafe  by a long journey, after
medicines had  proved ineffectual.
  Amufements are likewife of great ufe  in the jaun-
dice.  The difeafe is often occafioned by a fedentary
life,  joined to  a dull melancholy difpofition.   What-
ever therefore tends to promote jhe circulation, and
to cheer the fpirits, muft have a good effect, as danc-
ing, laughing, finging,  Sec.
  MEDICINE.—If the patient be young,  qf a  full
fanguine habit, and complains of pain in the right iide
about the region of the liver, bleeding will  be necef-   \
far v.  If bleeding does not relieve, a blifter  fliould
                                              be 
 3«o            OF THE JAUNDICE.
be applied directly  to the painful part.   The body
muft likewife be kept open by taking a fufficient quan-
tity of Caftile foap, or the pills for the jaundice re-
commended in the Appendix.
  Fomenting the parts about the  region of the  flo-,
mach and liver,  and rubbing them with  a warm
hand or flefh-brufh, are likewife beneficial ;  but  it is
ftill more  fo for the patient to fit  in a bath of warm
water up  to the breaft.   He ought  to do this  fre-
quently, and fliould  continue in  it  as long as his
ftrength will permit; but if the pain continues  vio-
lent, it will be neceffary to have recourfe to the liquid
laudanum.
  Many dirty things  are  recommended for  the cure
of the jaundice ;  as lice, millepedes, Sec.  But thefe
do more harm  than good,  as people truft to them,
and  neglect more valuable medicines ; befides, they
are  feldom  taken in fufficient quantity  to  produce
any  effects.  People always expect that  fuch things
fliould act as charms, and  confequently feldom  per-
fift in the ufe  of them.   Bleeding, purges, fomen-
tations, and exercife, will  feldom fail to cure the
jaundice when it is a fimple difeafe,  and when com-
plicated with the dropfy,  a fchirrous liver, or other
chronic complaints,  it requires  a  more particular
treatment.
   Numberlefs Britifh herbs are extolled for the  cur*
of this difeafe.   The author of the Medicina Britan-
 nica mentions near  an hundred, all famous for  cur-
 ing  the jaundice.   The fact is,   the difeafe often
goes off of its own  accord ; in which cafe  the laft
medicine is  always faid to have performed  the cure.
I have fometimes however feen  confiderable benefit,
in a very obftinate jaundice, from  a decoction of
hempfeed.  Four ounces of the feed may  be boiled
in two  Englifh  quarts of ale, and fweetened with
coarfe fugar.   The  dofe is  half an Englifli  pint
                                            every 
               OF THE DROPSY.             38i
every morning.  It may be continued for eight or
nine days.
   I have likewife known Harrowgate fulphur-water
cure a jaundice of very long ftanding.  It fhould be
ufed for fome weeks,  and  the patient  muft both
drink and bathe.
   The foluble tartar is a very proper  medicine in
the jaundice.   A drachm  of it may be taken every
night and morning in a cup of tea or water-gruel.
If it does not  open the body,  the dofe may be in-
creafed.
   Perfons fubject  to the jaundice  ought  to take as
much exercife as poffible, and to  avoid  all heating
and aftringent aliments.
            CHAP.   XXXVIII

                  Of the  Dropfy.  .


          1 HE dropfy is  a  preternatural fwelling
of the whole body, or fome  part of it, occafioned by
a collection of watery humor.   It is diftinguifhed by
different names, according  to the part affected,  as
the anafarca, or a collection  of water under the fkin ;
the afcites or a collection of  water in  the  belly ; the
hydrops  pecloris,  or dropfy of the breaft ; the hydro-
cephalus, or dropfy of the brain, &c.
   CAUSES.—The dropfy is often owing to  an he-
reditary difpofition.  It may likewife proceed from
drinking ardent  fpirits, or other ftrong liquors.  It
is  true almoft to a  proverb, that great drinkers die
of a dropfy.   The want of exercife is alfo a  very
common caufe of the  dropfy.   Hence  it is  juftly
                                        reckoned 
  3S;             OF THE DROIY>\\
  reckoned among the difeafes of the-fedentary.  It
  fometimes proceeds from exceffive evacuations, as fre-
  quent and copious bleedings, ftrong purges often re-.
  peated, frequent falivations,  &c. t The fudden flop-
  page of cuftomary or neceffary evacuations,  as the
  menfes, the haemorrhoids, fluxes of the belly, &c. may
  likewife caufe a 4ropfy.
    I  have known the dropfy occafioned by drinking
  large quantities of cold, weak, watery liquor, when
  the body was  heated by violent exercife.  A low,
  damp, or marfhy fituation is likewife a frequent caufe.
  of it.   Hence it is a common difeafe in moift, flat,
  fenny countries-  It may alfo be brought on by a long
  ufe of poor watery diet,  or of vifcous aliment that is
  hard of digeftion.  It is very often the effect of other
  difeaies, as the jaundice, a  fchirrus of the liver, a
  violent  ague of long  continuance, a diarrhoea, a dy-
  fentery, an empyema, or a confumption of the  lungs.
  In fhort, whatever obftructs  the  perfpiration, or pre-
  vents the blood from being duly prepared, may occa-
  fion  a dropfy.
    SYMPTOMS.—The  anafarca generally  begins
  with a fweliing of the feet and ancles towards  night,
  which   for fome time difappears  in the  morning.
  In the evening,  the parts, if preffed  with  the finger,
  will  pit.  The fwelling gradually afcends, and occu-
  pies  the trunk of the  body,  the  arms, and the head.
  Afterwards the breathing becomes difficult, the urine
  is in fmall quantity, and the thirft great; the body is
  bound, and the  perfpiration is greatly obftructed.
  To  thefe fucceed  torpor, heaviness, a flow wafting
*  fever,  and a troublefome cough.  This laft is gene-
  rally a bad fymptom, as it fhows that the lungs are
  affected.
    In an afcites, befides  the  above fymptoms, there
  is a  fweliing of the  belly, and  often a  fluctuation,
  which   may  be  perceived by ftriking  the belly  on
                        4                      one 
               OF THE DROPSY.             383
one fide,  and laying the palm of the hand on the op-
pofite.  This may be  diftinguifhed frqm a tympany
by  the weight of the fwelling, as well as by the
fluctuation.  When the a?iafarca and afcites are com-
bined, the cafe is more  dangerous.  Even a  fimple
afcites too feldom admits of a radical cure.
  When the difeafe comes fuddenly on,  and the pa-
tient is young and ftrong,  there is reafon, however,
to hope for a cure, efpecially if medicine be given (
early.  But if the patient be old, has led  an irregular
or a fedentary life, or if there  be reafon to fufpect
that the liver, lungs, or any of the vifcera are un-
found, there is great  reafon to  fear that the confe-
quences will prove fatal.
   REGIMEN.—The patient muft abftain as much
as poffible from all  drink, efpecially weak and watery
liquors, and muft quench his  thirft with muftard-
whey, or acids,  as juice of lemons, oranges,  forrel,
or  fuch  like.  His aliment  ought to  be  dry,  of a
ftimulating  and   diuretic quality,  as  toafted  bread,
the  flefli  of birds, or other wild animals, roafted;
pungent and aromatic  vegetables, as garlic, muftard,
onions, creffes,  horfe-radiuh, rocambole,  flialot, &c.
He may alfo eat  fea-bifcuit,  dipped in wine.   This
is not only nourifhing, but  tends  to quench thirft.
Some have been actually cured of a dropfy from a total
abftinence from  all liquids, and living entirely upon
fuch  things as are mentioned above.   If the  patient
muft have drink, the  Spa-water, or Rhenifli wine,
with diuretic medicines infufed in it,  are the beft.
There are,  however, many diuretic medicines which
require a large quantity  of drink to make them ope-
rate.
   Exercife  is of  the greateft importance in  a dropfy.
If the patient be able to walk, dig,  or the like, he
ought to continue thefe exercifes as long as he can.
 If he is not able to walk or  labour, he  muft rick on
                                        horfeback, 
tfi             OF THE DROTSY.
horfeback, or in a carriage ;  and the more violent
the motion fo much the better,  provided he can bear
it.  His  bed ought  to be hard  and the air of his
apartments warm and  dry.   If he lives in a damp
country,  he ought  to  be removed into a dry one,
and, if poffible,  into a  warmer climate.  In a word,
every method fliould be taken  to promote the per-
fpiration,  and to brace  the folids.  For this purpofe
k will likewife be proper to  rub the patient's body,
two or three times a-day,  with a hard cloth, or  the
fiefh-brufh ; and he ought conftantly to  wear flannel
next his fkin.  Thefe obfervations apply to the cure
of dropfy,  attended  with  the common fymptoms of
weaknefs.  For  there  are many cafes of dropfy in
which die pulfe  evidently indicates bleeding and  the
remedies proper  for inflammatory difeafes.
   MEDICINE.—If the patient be young, his confti-
tution good, and the difeafe has come on fuddenly,
it may generally be removed by bleeding,bri]k purges,
aud fuch medicines as  promote a difcharge by fweat
and urine.
   The parient may take the following purge : Jalap
in powder half a drachm, cream of tartar, two drachms,
calomel fix grains.   Thefe may be made into a bolus
with a little fyrup of pale  rofes, and taken early in
the morning.
   The patient may likewife take every night at bed-
time the following bolus:  To four or five grains of
camphor add one grain of opium, and as much fyrup
of orange-peel as is  fufficient to  make  them into a
bolus.   This will generally promote a gentle fweat,
which fliould be encouraged by drinking now and then
a fmall cup of wine-wh-y,  with  a tea-fpoonful of  the
fpirits of hartfliorn in it. A tea-cupful of the follow-
ingdiuretic infufion may likewife be taken every four
<*r five hours through the day:
Take 
              OF TUZ DRCI'SY.             3^
   t'Vve juniper  berries, muftard-feed,  and  horll>-
rdifh, of each half an  or.nee, allies of broom half
a pound;  infufethem in a quart of Rhenifli wine or
ftrong ale,  for a few days,  and afterwards ftrain off
the liquor.   Such as cannot take this  infufion,  may
ufe the docoction of feneka-root, which is both  diu-
retic and fudorific. I have known an obftinate anafarca.
cured by an infufion of the afhes of broom  in wine.
  The above courfe will  often cure an incidental
dropfy,  if  the conftitution be good ;  but when the
difeafe  proceeds from a bad  habit, or an  unfound
ftate of the vifcera,  ftrong purges are not  to be  ven-
tured upon.  In this cafe, the fafer courfe is to pal-
liate the fymptoms, by the ufe of fuch medicines as
promote the fecretions,  and to fupport the patient's
ftrength by warm and nourifhing cordials*
  The fecretion of urine may be greatly promoted
by nitre.   Brookes fays, he knew a young woman
who was cured of a dropfy by taking a drachm of
nitre every morning in  a draught  of ale, after fhe
had  been given over as  incurable.   The powder of
fquills"  is  likewife  a good diuretic.  Six or eight
grains of it, with a fcruple of nhre, may be  given
twice a-day  in  a  glafs of ftrong cinnamon-water.
Ball fays,  a large fpoonful  of unbruifed muftard-
feed taken every night  and morning, and drinking
half a  pint of the  decoction of the tops  of  green
broom after it,  has performed  a cure after other
powerful medicines had proved ineffectual.
  I  have  often  feen  good  effects  from cream of
tartar in this  difeafe.   It  promotes the difcharges
by ftool and urine, it will at leaft palliate, and often
perform a cure.  The patient  may begin by taking
an  ounce  every fecond or third day, and may in-
creafe the quantity to two,  or even  to three ounces,
if  the ftomach will  bear it.   This quantity is  not,
however,  robe taken at once,  but divided into three
                     C c                     or 
3SS               OF THi: DROPSY.
or four dofes, and drink freely of camomile tea,  c?
any diluiimp liquor.  The fox-g!ove, taken in dofes of
two or three grain;,,  ni.dit and morning, for  five or
fix days, will prove more diuretic than moft other re-
medies.  It will be neceffary to drink  xery  freely  of
camomile-Lea, weak  wine and water, or any other
drink of this kind, to promote its operation. Indeed,
this is neceffary, when we ufe any kind of  diuretic:.-.
if the fox-^iove either does not prove diuretic in a few
days,  or if it produces a flownefs in the pulfe, its ufe
muft be diicontinued. In pure afcites diuretics do no
good.
   To  promote perfpiration,  the patient may ufe the
deco'tioi!  of  feneka-root, as directed above;  or he
may take two table-fpoonfuls of Mindererus's fpirit,
in a cup  of wine-whey,  three or lour times a-day.
To nro'wote a difcharge of urine, the following infu-
lion of the London hoiptals will likewife be beneficial:
   Take ofzedoary root  two drnchms; dried fquills,
rhubarb, and juniper-berries braked, of each a drachm;
eff nam on in powder, three drachms;  fait  of worm-
wood, a drachm and a half; infufe hi a pint and a half
ef old hock wine, and when fit for ufe, filter the liquor.
A wine-glafs of it may be taken three or four times
a-day.
   In an cfcites,  when the difeafe does not  evidently
and fpeedily give way to pnagativeand diuretic medi-
cines,  the water ought to be let off by tapping. This
is a very fimple and fafe operation, and would often
fucceed, if it were performed  in  due time; hut if
it be delayed  till  the humors are vitiated, or  the
bowels  fpoiled,  by  long  leaking  in  water,  it can
b .rely be expected that K\y permanent relief will be
procured*.   Aicites is often  relieved,  and fometimes
aired, by  ri.hbing the belly with iv/ect-oil.
  * T;-e v<-ry n.mi:  of an open ion 'm dread ul ro mo:l peo-
f\', and tJicy wifh to try eve; y thing bo! t.: mcy h;ive recciin^
\» it-. T!,!.; is the rcLa v.hy Mpj.rr.ij i'cidora iuccfeJs to our
                                             \vi!hv 
                OF THE  GOUT.                3S7
    After the evacuation of the water, the patient is <o
 be put on a courfe cf ftrengthenin^ medicines; as the
- Peruvian bark; the elixir of vitriol;  preparations  of
 iron;  warm  aromatics,  with a  due  proportion  of
 rhubarb,  infufed  in wine, and fuch  like.  His cli-t
 ought  to  be dry and  nourifhing, fuch as is rec em-
 mended in the  beginning of the  Chap a r ;  and ;-.c
 fhould  take as much exercife as  he  can bear  with-
 out fatigue.   He  fhould  wear flannel next his fkin3
 and make daily ufe of the flefh-brufh.
                 CHAP.  XXXIX

                   Gf the 'Gout.


           1  HERE is no  difeafe which fets  die
(advantages of temperance  and exercife in a ftronger
light, than the gout.  Excefs and idlenefs are the true
fources from whence it originally fprung,  and all
who would avoid it muft be aclive and temperate
   Though idlenefs and intemperance are the  princi-
pal caufes  of the gout, yet many other things may
contribute to bring on the  diforder in  thofe who are
not, and to induce a paroxyfm in thofe who are fub-
ject to it; as intenfe fludy ; too free an ufe o£ acidu-
lated  liquors ; night-watching; grief or  uneafjnefs
of the mind ;  an obftruction or defect of any of the
cuftomary difcharges, as the menfes, fweating of the
feet, perfpiration,  &c.

wifh.  I have had a pa.lent who was regularly tapped, once
a month, for feveral years, and who ufed to eat her. dinner ;:s
wt.ll after the operation, as if nothing  had happened.  She
*li;d ;>t lall,  rather worn out by age than by the dif.J'fe.
                       C c 2-            SYMP-* 
tfz               or Tin:  GOUT'.
   STMrTOTvIG.—A  fit  cf the-gout is  general .'y
preceded  by  indigeftion,  drowfincfs,  belching of
wind, a flight head-ach, fickncf:, and fometimes vo-
mking.   'phe patient  complains  of wearinefs and
dejection of  fpirits,  and has  often  a pain  in the
limbs, with a fenfation  as  if wind  or  cold water
Were palling down die  thigh.  The appetite is often
remarkably keen a day or  two before the fit, and
there is a flight nain in paffing urine,  and  fometimes
an involuntary fhedding of  tears.   Sometimes thefe
fymptoms  are much more violent, efpecially upon
the near  approach of the  fit;  and  tome obferve,
that as is  the fever which ufliers in the gout,  fo will
the fit be ; if the fever be fhort and fharp, the fit
will be fo likewife; if it be  feeble,  long, and lin-
gering,  the fit will be fuch alio. But this obfervation
can only hold with refpect to very regular fits of the
gout.
   The  regular  gout generally makes its  attack in
the  fpring, or beginning of  winter, in the follow-
ing manner :  About two cr three in the morning-
the patient is feized  with  a  pain  in his  great toe
fometimes  in the heel,  and at other times  in the an-
kle or calf of the leg.   This pain is accompanied
with a fenfation  as if cold water were poured upon
the par1-,  which  is fucceeded by  a fliivering, with
fome  degree  of fever.  Afterwards  the   pain  in-
creafes,- and fixing among the fevill bones of the foot,
the patient feels  a'l  the different kinds of torture,
as if the pam were ftretched, burnt, fqueczed, gnaw-
ed, cr lorn in pieces,  &c.  The part at  length be-
comes fo exquifitely fenfiblc, that the  patient cannot
hear to have it touched, or even fuffer any perfon to
walk  acrofs the room.
   The patient h  generally  in  exquifite torture fbr
twenty-four hours, from the time of the coming on
'sf the fit: he then become: ca::t:-,  the part begins
                                               t* 
                OF THE COUT.                s&;
 to fwcU,  appears  red,  and is covered  with a  little
 moifture.  Towards  morning he  drops afiecp, and
 generally falls into a  gentle breathing fweat.   h his
 terminates the firft paroxyfm,  a  number of which
 conftitute  a  fit of the  gout;  which  is longer or
 fhorter according to the patient's age, ftrength, the
 feafon of the year, and the difpofition of the body to
 diis difeafe.
   The patient  is  always worfe  towards night,  and
 eafier in the morning.  The paroxyhns however ge-
 nerally grow milder every day, till at length the dif-
 eafe is carried olf by  perfpiration, urine,  ana the
 other evacuations.  In fome patients this happens in
 a  few days;  in  others, it  requires weeks, and in
 fome,  months, to finifh  the fit.   Thofe whom age
 and frequent fits  of  the  gout have greatly debili-
 tated,  feldom get free from it before the approach
of fummer, and fometimes not till it be pretty far ad-
 vanced.
   REGIMEN.—As  there  are  no  medicines  yet
 known that will certainly cure the gout, we fhail con-
 fine our obfervations chiefly to regimen,  both in and
 out of the fit.
   In  the fit,  if the  patient be young and  ftrong,
his diet ought to be thin and cooling, and his drink
of a diluting nature ;  but where the conftitution is
 weak,  and the patient has  been  accuftomed  to  live
high,   this is not  a  proper time  to retrench.   In
this cafe he muft keep nearly to his ufual diet,  and
fliould take frequently  a cup of ftrong negus, or a
glafs  of  generous wine.    Wine-whey is  a very
proper drink  in  tins  c.;fe, as it promotes  the per-
fpiration  without  greatly  heating the  patient.   It
v. ill anfwer this purpofe better  if a tea-fpo. nful ef
(Id volatile olefum, or fpirits of hartfliorn, be  put
into a cup of it twice a-day.   It v.ill likwvife he
proper to give at bed-time two or three teiL-fpoonfuls
                     C c  3                    pi; 
39®              OF THE  GOUT.
of the volatile tincture cf guaiacum in a large draughf
of  warm wine-whey.   This will greatly  promote
perfpiration through the night.
   As the moft fafe and efficacious method of  dif,
charging the gouty  matter  is by perfpiration,  this
ought to be kept up by all  means, efpecially  in the
affected  part.  For this purpofe  the  leg  and foot
fliould be wrapt in foft flannel, fur, or wool.   The
laft is moft readily obtained,  and feems to anfwer
the purpofe better  than any thing elfe.  The peo-
ple of  Lancafhire  look  upon wool as a  kind of
fpecific in  the  gout.  They wrap a  great quantity
 of it about the  leg and foot affected,  and cover it
 with a Jkin of foft dreffed leather.  This they fuffer
to continue for eight or ten  days, and fometimes for
a fortnight  or  three  weeks, or  longer, if the pain
does not ceafe.  I never knew any external applica-
tion anfwer fo well in  the gout.   1 have often, feen
 it applied when the fwelling and  inflammation were
very great, with violent  pain, and have  found all
 thefe fymptoms relieved by it in a few days.   The
 wool which they ufe is generally greafed, and carded
 or combed.  They chufe the  fofteft which can be
had, and feldom or never remove it till  the fit  be en-
 tirely gone off.  It is, however, neceffary to obferve,
 that too much heat is always hurtful.  When flannel
or wool produce perfpiration and give eafe they are
 ufeful ;  but when  they have not this effect, and in-
creafe the heat, they are improper.
    The patient ought likewife to  be kept  quiet and
 eafy during the fit.  Every thing that affects the
 mind dillurbs the paroxyfm, and tends to throw the
 gout upon the nobler  parts.   All external applica-
 tions that  repel the matter, are  to be avoided  as
 death.   They do not cure the difeafe, but remove it
 from a fafer to a more dangerous part cf the  body,
5-vhers it often proves fatal.  A fit of the gout is to be 
                OF THE GOUT.               59i
 Confidered as Nature's method of removing feme-
 thing that might prove deftructive to the body,  and
 all that we can do, with fafety, is to promote  her
 intentions, and  to am ft  her in expelling the enemy
 in her own  way.   Evacuations by bleeding, iiooi,
 c:c. are likewife to be ufed  with caution ;  the)  do
 not remove the  caufe of  the  difeafe,  and  fometimes
 by weakening the patient, prolong the fit: but w here
 ike conftitution is able to bear it, it wiii be of ufe to
 keep the body gently open by diet, or very mild lax-
 ative medicines.   It may, however, be laid down as
 a general rule,  that, where the pulfe. is  ftrong or
 tenfe, bleeding  is abfolutely neceffary, as  well as
 purging,  in thofe cafes where the gout  affarnes  the
 form of apolepxy, pleurify, ftrangury, <fec.
   f-Ir.ny things  wiii indeed fliorten a fit cf the gout,
 and fome will drive  it off altogether :  but  nothing
 has yet been found which will do this with fafety to
 the patient.   In pain v. e eagerly grahp at any thing
 that promifes immediate cafe, and even hazard  life
 itfelf for  a temporary relief.   This is the  true rea-
 fon why fo many infallible remedies hare been pro-
 pofed  for the gout, and why  fuch  numbers have
 loft their lives by the  ufe  of them,   it would  be
 as  orudent  to ftop  die  fmall-pox from rifing, and
 t> drive  them into the blood,  as to attempt to  re-
 pel the gouty  matter after it  has been thrown upon
 the extremities.  The hitter  is as much an effort cf
 Nature to free herfclf from au offending caufe, as the
former, and ought equally to be promoted.
   When the  pain, however,  is very greaf, and the
pa?fent isreftlefs, thirty or forry drops el laudanum,
more or lefs,  according to the violence of the fympr
toms, may be taken at  bed-timr.  This will eafe the
pain, procure reft, promote perfpiration, and forward
ihe crifis  of the diftafe.
   After the fit is over, the patient,  if he is in  a weak
jgate, ought lo take a gentle dofe pr two pf the bitter
                  C e 4                  tincture 
392               OF THE GOUT.
tincture of rhubarb,  or fome other v. arm  ftomachic
puv^e.   He  fliould  alio  drink a weak  infufion of
ftomachic bkters in 'mail wine, as the Peruvian bark,
with cinnamon,  Virginian  lnake-rooi,  and orange-
peel.   The  diet  at  this  time feamld be light, but
nourifhing, and gentle exercife ought to be taken on
horfeback, or in a carriage.
    Oi-L of the fit, it is in the patient's power to do
many things  towards preventing a return of the dif-
order, or rendering the fit, if it fliould return, lefs
fevcre.   This, however,  is  not to be attempted by
medicine.  I  have  frequently known the gout kept
off for feveral years by the Peruvian bark and other
aftringent medicines; but in all the cafes where I had
occafion  to fee this  tried,  the perfons died fuddenly,
and,  to all appearance, for want of a regular fit of
the  gout.  One would  be  apt,  from  hence,  to
conclude, that a fit of the gout, to fome conftitutions,
 in the decline of life, is rather falutary than hurtful.
    Though it may be dangerous to fop a fit of the gout
by medicine, yet  if  the  conflitution can be fo changed
by diet and exercife, as to leffen or totally  prevent its
 return, there  certainly can be no danger in following
fuch a courfe.   It is well known that the whole  habit
may be fo altered  by  a proper  regimen,  as quite to
eradicate  this difeafe ;  and thofe only who have  fuffi-
cient rcfolution to perfi.fl in fuch a courfe,  have reafon
to expeel a cure.
    The courfe which we would recommend for pre-
 venting the gout,  is as  follows:  In the firft place,
 univerfal temperance.   In the next placefufficient ex-
ercife*.   By this we do not mean  launtering  abouj:

   * Some make a fecret of curing the gout by mufmlar exer-
cife.  This fecre', howcvei, i* as old as Cthus, who Itroi g!y
K'C'■ mmen-Jv'J '.hat mode of cure;  and whoever will "uhmif
 t  't, in th>- fuILft t.Owatj may crpcifi :c reap foed and ntrma-
|i;ntuiva::t.:v;t^
                                                 m 
               OF THE COUT.               393
in an indolent manner, hut labour,  fweat,  and toil.
Thefe only ca 1 render the  humors wholefome, and
keep them lo.  Going early to bed, and rifing be-
times, are alfo  of great importance.   It is likewife
proper to  avoid night ftudies, and all intenfe  thought.
The fupper fhould be light, and  taken  early.  All
ftrong liquors, efpecially generous  wines  and  four
punch, are to be avoided.
   Wc would likewife recommend fome dofes of mag-
nefia alba and rhubarb to be taken every fpring and
autumn ;  and afterwards, if the ftomach is  weak, a
courfe of ftomachic bitters, as tanfey cr water-tre-
foil tea, an infufion of gentian  and camomile flowers,
or a decoction of burdock root, Sec.  Any of thefe,
or an infufion of any wholefome bitter that is more
agreeable to the rati- nt, may be drank for two or
three weeks in March and October twice a-day.  An
iflue or perpetual  blifter has a  great  tendency to
prevent  the  gout.   If  thefe were  more  generally
ufed in the decline of life, they would not only often
prevent  the gout,  but alfo other  chronic  maladies.
Such as can  afford  to go to Bath, will find great
benefit  from bathing and  drinking the water.  It
both promotes digeftion, and invigorates the habit.
   Though there is little room for medicine during a
regular  fit of the gout, yet when it leaves the extre-
mities and falls on fome of the  internal parts, proper
applications to recal  and fix  it, become abfolutely
neceffary.  When the gout affects  the head,  the pain
of the joints ceafes, and the fwelling difappears, while
cither fevere head-ach, drowiinefs, tremblin^,  gid-
dinefs, convulfions,  or delirium come on.   When it
hazes the  lungg great oppreffion,  with cough and
difficulty of b:e alhing, enfue.   If it attacks the fto-
mach, extreme ficknefs,  vomiting,  anxiety, pain in
the epigaftric region, and total lofs cf ftrength, will
^iiccecu. 
 394               CF THE GOUT.
    When the-gout attacks the head or lung?, every
 method muft be taken  to fix it  in the feet.  They
 muft be frequently bathed in warm water,  and acrid
 cataplafms made of equal parts of the flour of muftard
 and rye-meal, mixed with hot vinegar, applied to the
 folcs.   Bliftering-plafters may likewife be applied to
 the ankles or calves of the legs.   Bleeding is alfo ne-
 ceffary, and purges.  The patient ought to keep in
 bed for the moft part, if there be any figns of inflam-
 mation, and fhould be very careful not to catch cold.
   If it attacks the ftomach with a fenfe of cold,  the
 rnoft warm  cordials are neceffary ;  as  ftrong wine
 boiled up with cinnamon or other fpices ; cinnamon.
 water; peppermint-water, or a tea-fpoonful  of ether
 every  hour  in a little  water, with the addition of fif-
 teen or twenty drops of laudanum  to every dofe if
 there  is much pain.   The patient  fliould keep his
 bed, and endeavour to promote a fweat by drinking
 Twarm liquors.
   When the gout attacks the kidneys,  and imitates
 gravel pains, the patient ought to drink  freely of a
 decoction of marfli-mallows, and to have the parti
 fomented with warm water.   An  emollient clyfter
 ought  likewife to be given, and afterwards an opiate.
 If the  pain be very violent, twenty  or thirty  drops
 of laudanum maybe taken in a cup of the decoction.
   Perfons who have had the gout fliould be very at-
 tentive to any complaints that may happen  to them
 about the time when  they have reafon to expect a
 return  of the fit.   The  gout  imitates many  other
 diforders, and by being  miftaken  for  them,  and
 treated improperly,  is often diverted from its regular
■courfe,  to the great danger of the patient's life.
   Thofe who never  had  the gout, but who, from
 their conftitution or  manner of  living, have reafon
to expect it, ought  likewife to be very  circumfpect
 r.irh regard  to its firft  approach.   If the difeafe, by
                                          vvrong 
          OF THE RHEUMATISM.           sof
Kvrong conduct or improper  medicines, be diverted
from its proper courfe, the  miferable  patient has a
chance  to be ever  after  tormented with head-achs,
coutihs, pains of the ftomach and inteftines ;  and to
fall at laft a victim to its attack upon  fome  of the
more noble yarts.   When the gout attacks any part
befides the feet, without fymptoms  of  inflammation,
ualefs indeed  it is  in the ftomach, the tincture of
guaiacum will be found of great fervice.

            OF THE RHEUMATISM.

   This  difeafe has often a refemblance to the gout.
It generally attacks the mufcles  and large joints with
exquilite pain, and is fometimes attended with inflam-
mation and fwelling.  It is moft common in the fpring,
and towards the end of autumn.  It is  ufually diftin-
guifhed into acute and chronic ; or the rheumatifm
with and without a fever.
   CAUSES.—The caufes of a rheumatifm are fre-
quently the fame as thofe of an inflammatory fever,
viz. an obftructed  perfpiration,  the immoderate ufe
of ftrong liquors, and the like.   Sudden changes of
the weather, and all quick tranfitions from heat to
cold,  are very apt to occafion the rheumatifm.  The
moft extraordinary cafe of a  rheumatifm that  I ever
faw, where almoft every joint of the body was dif-
torted,  was that of a man who ufed to work one part
of the day by the fire, and the other part of it in the
water. Very obftinate rheumatisms have likewife been
brought on by perfons not accuftomed to it, allowing
their feet to continue long  wet.  The fame effects
are often produced  by wet clothes, damp beds,  fit-
ting or  lying on the damp ground, travelling in the
night, &c.
   The  rheumatifm  may  likewife be  occafioned by
jpxeciiive  evacuations, er the ftoppage of cuftomary
                                      d.ichargcj, 
 V$           OF THE RHEUMATISM
 difcharge,.   It is often the effect of chronic difeafes,
 which vitiate the humors;  as  the fcurvy,  the lues
 venerea,  obftinate autumnal agues, Sec.
   The rheumatifm  prevails in  cold, damp,  marfliy
 countries.  It  is moft  common  among  the poorer
 fort of peafants, who are ill cloathed, live  in low damp
 honfes,  and eat  coarfe  unwholejome food, which
 contains but little nourishment,  and is not eafily di-
 gefted.
   S \feMPTOMS.—-The acute rheumatifm commonly
 begins with wearinefs,  fliivering, a quick pulfe, reft-
 leffnefs,  thirft, and other fymptoms of fever. After-
 wards the patient complains of  flying pains, which
 are increafed by the leaft motion.  Thefe  at length
 fix in the joints,  which are often affected with fvvel-
 ling and  inflammation.  If blood be let in this dif-
 eafe, it has generally the fame appearance as in the
 pleurify.
   In this kind of rheumatifm the  treatment of the
 patient is nearly  the fame as  in an acute or  inflam-
 matory fever.  If he be young and ftrong, bleeding
 is neceffary,  which may be repeated according to the
 exigencies of the cafe.   The body ought likewife to
 be kept open by emollient  clyfters, or cool opening
 liquors ; as  decoctions  of tamarinds, cream of tartar
 whey, fenna-tea,  and the like.  The diet fhould be
 light and in  fmall  quantity,   confift ing chiefly of
 roafted apples, oatmeal-gruel, or weak chicken-broth.
 After the feverifh fymptoms have abated, if the pain
 ftill continues the patient muft keep his bed, anal take
 fuch things as promote  perfpiration ; as  wine-whey
 with fpiriius Mindereri, Sec.   He may likewife take,
for a few nights, at bed-time, in a cup of weak wine-
whey, a drachm of the cream of tartar,  and half  a
drachm of gum guaiacum in powder*.
  * Smart purlin*; in iheurnahfm  is  ^nciully of very effen-
tfel feivice.
                                           Wa.rjQ 
          OF THE RHEUMATISM.           397
  Warm bathing,  after proper  evacuations,  has
rften an exceeding good effect.   The patient may
cither be put into a bath of warm water, or have
cloths wrung out of it applied to the parts affected.
Great care muft be taken that he do not catch cold
after bathing.
  The chronic rheumatifm  is feldom attended with
any confiderable degree of  fever, and  is generally
confined, to fome particular part of the body,  as the
fhoulders, the back, or the loins.   There is feldom
any inflammation  or fwelling in this cafe.  Perfons
in the decline of life are moft fubject to the chronic
rheumatifm.   In  fuch patients it  often proves  ex-
tremely obftinate.
   In this kind of rheumatifm the  regimen fliould be
nearly the fame as in  the acute.   Cool  and diluting
diet,  confifting chiefly  of  vegetable  fubftances,  as
ftevd prunes, coddled apples,   currants or goofe-
berrics boiled in  milk, is  moft proper.   Arbuthnot
fays, " If there be a fpecific in aliment for the rheu-
matifm,  it  is certainly whey ;" and adds, " That he
knew  a  perfon fubject to  this  difeafe, who  could
never  be cured by any other method but a diet of
whey  and bread."  He likewife fays,  " That cream
of tartar in water-gruel, taken for feveral days,  will
cafe rheumatic pains  confiderably."   This I have
often experienced, but found it  always more effica-
cious when  joined with gum guaiacum, as  already
directed.   In this cafe the patient may take the dofe
formerly  mentioned  twice a-day, and  likewife two
tea-fpoons full of the volatile tincture of gum guaia-
cum, at bed-time, in wine-whey.
   This  courfe may  be continued for a week, or
longer, if the cafe proves obftinate,  and the patient's
 ftrength will permit.  It  ought  then to be omitted
 for a few days,  and  repeated again.   At the  fame
 time leeches or a-bliftering-phfter may  be applied to
                                              ti-3 
 398           OF the rheumatism.
 the part affected.  What I have generally found a»,
 fwer better than  either of thefe, in obftinate fixed
 rheumatic pains, is the warm plafter*.  I have like-
 wife known a plafter of Burgundy  pitch worn  for
 fome time on  the part affected give great relief in
 rheumatic pains. My ingenious friend,  Dr. Alexan-
 der of  Edinburgh, fays,  he  has frequently  cured
 very  obftinate rheumatic pains  by rubbing the part
 affected  with tincture of  cantharides.   When  the
 common  tincture  did  not  fucceed, he  ufed it of a
 double or treble ftrength.   Cupping upon the part
 affected,  is likewife  often  very beneficial, and is
 greatly preferable to the application of leeches.
   Though this  difeafe may not feem to yield to me-
 dicines for fome time, yet they ought ftill to be per-
 fifted in.   Perfons who are fubject  to  frequent re-
 turns of the rheumatifm, will often find their account
 in  ufing  medicines,  whether  they be  immediately
 affected with the difeafe or not.   The chronic  rheu-
 matifm is fmilar to the gout in this refpect, that  the
 moft proper time for ufing medicines to extirpate it,
 is when the patient is moft free from the  diforder.
   To  thofe who can  afford  the  expence, I would
 recommend the warm baths of Buxton  or Matlock
 in Derbyfliire.  Thefe have often, to my knowledge,
 cured  very obftinate  rheumatifm?, and are always
 fafe either in or out of the fit.   When the rheuma-
 tifm is complicated with fcorbutic complaints, which
 is not feldom the cafe, the Harrowgate waters, and
 thofe of Moffat,  are proper.  They, fhould both be
 drank and ufed as a warm bath.
  There are feveral of our own domeftic plants which
 may be  ufed  with advantage in the  rheumatifm.
 One of the beft is the white  mufiard.   A table-
fpoonful of the feed of this plant may be  taken twice
* See Appendix, Warn P.'rJJrr. 
           OF THE RHEUMATISM.           Z$J
«r thrice  a-day,  in a glafs  of water or fmall wine*
The water trefoil is likew ife of great ufe in this com-
plaint.   It may  be  infufed  in wine,  cr  drank in
form of tea.   The ground-ivy, camomile,  and feve-
ral other bitters, are alfo  beneficial, and may be,
ufed in  the fame  manner.   No benefit however is to
be expected from thefe unlefs they be taken for a
confiderable  time.   Excellent  medicines  are often
defpifed in this difeafe, becaufe they do not perform
an immediate cure ;  whereas nothing would be more
certain  than  their effect,  were  they duly perfifted in.
Want of perfeverance  in the ufe of medicines is one
reafon why chronic difeafes are fo feldom cured.
   Cold bathing,  efpecially in fait water, often cures
the rheumatifm.   We would alfo recommend riding;
or horfeback,  and wearing  flannel next  the fkin.
J fines are likewife very proper, efpecially in chrome
cafes. If the  pain affects the fhoulders, an iffue may
be - made  in  the arm;  but  if it affects the loins, it
fliould be put into the leg or thigh.
   Perfons  afflicted with the fcurvy are very fubject
to rheumatic complaints.   The beft  medicines in this
cafe are bitters and mild purgatives.  Thefe may ei-
ther be taken feparately or together, as the patient
inclines.  An ounce of Peruvian bark, and half an
ounce of  rhubarb in powder, may  be infufed in a
•bottle of wine ; and one, two,  or three wine glaffes
of it taken  daily, as fliall be  found neceffary, for
keeping the body gently open.  In  cafes where the
bark itfelf proves fufficiently purgative, the rhubarb
may be  omitted.
   Such as are fubject to frequent attacks of the rheu-
matifm  ought to  make choice of a dry, warm filia-
tion, to avoid the night-air, wet  clothes, and wet
feet,  as much as poffible.   Their clothing  fliould be
warm,  and they fliould wear flannel next  their fkin,.
and make frequent ufe of the flefh brufli.
                                          Chronic 
4=0              OF THE SCURVY.
   Chronic rheumatic affections often appear in the"
form of ipafms of different parts, with  violent pam.
This kind is moft certainly relieved  by the balfam of
Peru, balfam copaivi, or fpirits of turpentine, from
thirty to fixty drops for a dofe, dropped on fugar and
mixed with wine or water, twice or three times a-day.
                 CHAP.   XL.

                  Of the Scurvy.


        IHIS  difeafe  prevails  chiefly * in  cold
northern countries, efpecially in low damp fituation?,
near large marfhes, or great quantities of  ftagnatmg
water.  Sedentary people of  a dull melancholy dil-
pofition, are moft fubject to it. It proves often fatal
to failors on long voyages, particularly in fliips that
are not  properly ventilated,  have many  people  on
board, or where cleanlinefs is neglected.
   It is not neceffary to mention the different fpecies
into which this  difeafe has been divided,  as they
ditfer from one another chiefly in degree.   What'is
called the land fcurvy,  however, is feldom attended
with thofe highly putrid  fymptoms which appear in
patients who have been long at fea,  and which, we
prefume,  are rather owing to  confined air,  want of
exercife, and the unwholefome food  eaten by failors
on long voyages,  than to any fpecific difference in the
difeafe.
   CAUSES.—The fcurvy is occafioned by cold
moift air;  by the long ufe of  faked  or  fmoke-dried
provifions, or any kind of food that is hard of di- 
                OF THE SCURVY.              4ai
 geilion, and affords little nourifliment.  It may alfo
 proceed  from the  fuppreflion of cuftomary evacua-
 tions ;  as the menfes,  the  haemorrhoidal flux,  c-:c.
 It  is  fometimes owing to  an hereditary  taint, in
 which  cafe a very  fmall caufe will  excite the latent
 diforder.  Grief, fear,  and other depreffing paffions,
 have a great tendency both to excite  and aggravate
 this difeafe.   The fame obfervation holds,  with re-
 gard to neglect of  cleanlinefs; bad cloathing ;  the
 want of  proper exercife;  confined air; unwhole-
 fome food;  or any difeafe which greatly  weakens
 the body, or vitiates the humors.
   SYMPTOMS—This difeafe may  be known by
 unufual wearinefs, heavinefs, and difficulty of breath-
 ing, efpecially after motion ; rottennefs of the gums*
 which are apt to bleed  on the flighteft touch ; a
 ftinking breath;  frequent  bleeding  at  the nofe;
 crackling  of the joints ; difficulty of walking ; fome-
 times a fwelling and fometimes a falling away of the1
 legs,  on which there  are livid, yellow, or violet-
 coloured  fpots;  the face is generally  of a  pale or
 leaden colour. As the difeafe advances, other fymp-
 toms come on ; as rottennefs of the teeth,  hemor-
 rhages, or difcharges of blood from different  parts
 of the body,  foul obftinate  ulcers,  pains in  various
 parts, efpecially about  the breaft, dry fcaly erup-
 tions all over the  body, &c.  At laft  a wafting or
 hectic fever comes on,  and  the miferable patient is
 often carried off by a dyfentery, a diarrhoea, a dropfy,
 the palfy,  fainting fits,  or a mortification of fome of
 the bowels.
  CURE.—We know no way of curing this difeafe,,
but by purfuing a plan directly oppofite to that which
brings it on.   It proceeds from a vitiated ftate of the
humors occafioned by errors in diet, air,  or exercife ;
 and this cannot be removed,  but by  a  proper atten-
 tion to thefe important articles*
                      Dd                     If 
402
OF  THE SCURVY
    If the patient has been obliged to breathe a cold",
 damp, or confined  air, he fliould  be  removed,  as
 foon  as  poffible, to  a dry, open, and moderately
 warm one.   If  there is reafon  to believe that the
 difeafe proceeds from a fedentary life,  or deprefling
 paffions, as grief,  fear, Sec. the patient  muft  take
 daily as much  exercife in the  open air as he can
 bear,  and  his mind  fliould be diverted by cheerful
 company and other amufements.   Nothing has a
 greater tendency,  either to prevent or remove this
- difeafe,  than conftant cheerfulnefs and  good humor.
 But this, alas ! is feldom the lot of perfons afflicted
 with the fcurvy ; they are generally furly,  peeviih,
 and morofe.
    When the fcurvy has been  brought on by a long
 ufe  of  faked provifions,  the  proper medicine is a
 diet confuting chiefly  of frefh vegetables ;  as oranges,
  apples,  lemons, limes, tamarinds, water-creffes, fcur-
  vy-grafs, brook-lime, Sec.   The ufe of thefe,  with
 milk, pot-herbs, new bread, and frefh i>eer or cyder,
 will feldom fail to remove a fcurvy of  this  kind, if
  taken before it be  too far advanced  ; but to have
  this effect,  they muft  be perfifted in for a confider-
  able time.    When  frefh  vegetables cannot be ob-
  tained,  pickled or preferved ones may  be ufed ; and
 where thefe  are wanting,  recourfe mull be had  to
 the  chymical acids.   All the patient's food and drink
 fliould,  in this cafe, be fliarpened with cream of tar-
 tar,  elixir of vitriol,  vinegar, or the fpirit of fea-falt.
    Thefe things, however,  will more certainly pre-
 vent than  cure the  fcurvy; for which reafon, fea-
 faring people, efpecially on long voyages, ought  to
 lay  in plenty of them.   Cabbages, onions, goofe-
 berries,  and  many other vegetables, may be kept a
 long time by pickling, preferving, Sec.  potatoes will
 keep for a long time  with  little  trouble ;  and when
 thefe fail,  the chymkal acids,  recommended above, 
OF THE SCURVY
403
 which will keep for any length of time, may be ufed.
 We have reafon to believe, if fhips were  well venti-
 lated, had good ftore  of  fruits, greens, cyder,  Sec.
 laid in, and if proper regard were paid to cleai iinefs
 and warmth,  that  failors would be the moft healthy
 people  in the world, and would feldom fuffer eirher
 from the fcurvy or putrid fevers, which are fo fatal
 to  that uferul fet  of men, but it is  too  much  the
 temper of fuch people to defpife all precaution ;  they
 will not think of any calamity  'till it overtakes them,
 when it is too late to ward off  the blow.
   It muft, indeed, be owned, that many of them have
 it not in their power to make  the provifion we are
 fpeaking of;  but, in this cafe, it is  the duty of their
 employers to do it for them;  and no man ought to
 engage in a long voyage, without having thefe arti-
 cles fecured.
   I have often feen very extraordinary effects in the
 land-fcurvy from a  milk diet.  This  preparation  of
 Nature, is a mixture of animal and vegetable proper-
 ties, which, of all others,  is  the moft fit  for reftor-
 ing a decayed conftitution.  But, people defpife this
 wholefome and nourifhing food,  becaufe it is cheap,
 and devour with greedinefs, flefh,  and fermented li-
 quors, while milk is only deemed fit for their hogs.
  The moft proper drink in the fcurvy is  whey,  or
 butter-milk.   When  thefe  cannot  be had, found
 cyder, perry,  or fpruce-beer,  may be umd.  Wort
 has likewife been found to be  a proper drink in, the
 fcurvy,  and may be ufed at fea, as  malt will keep
 during the longed voyage.   A decoction oi he tops
 of the fprucefir, is likewife proper. It may be drank
in the quantity of  a pint, twice a-day.   Tar-water
 may be ufed for the fame  purpofe,  or decoctions  of
 any of the mild mucilaginous vegetables;  as farfapa-
 rilla,  marfh-mallow  roots,  Sec.  Infufions  of the
 bitter plants,  as ground  ivy,   the  leffer  centaury,
                   D d 2                  marfh- 
fo4              OF THE SCURVY.
marfh-trefoil,  Sec. are  likewife beneficial.   I  have
feen the peafants, in fome parts of Britain, exprefs the
juice of the laft-mentioned plant,  and drink it with
good effect in thofe foul fcorbutic eruptions with
which they are often troubled in the fpring feafon.
   Harrowgate-water is certainly an excellent medi-
cine in the land  fcurvy.  I have often feen patients
who had been reduced to the moft deplorable  con-
dition   by this difeafe,  greatly relieved  by drinking
the fulphur-water, and bathing in it.  The chaly.
beate-water may alfo be ufed with advantage, efpe-
cially with a view to brace the ftomach after drinking
the fulphur-water,  which, though it fharpens the
 appetite, never  fails to  weaken  the powers of di-
geftion.
   A flight degree  of fcurvy may be carried off, by
frequently fucking a little of the  juice of a bitter
 orange, or a lemon.   When the  difeafe  affects the
 gums  only, this  practice, if continued for fome time,
 ■will generally carry it off. We would, however, re-
commend the bitter orange as  greatly preferable to
 lemon  ; it feems to be as  good a medicine, and is
 not near  fo hurtful to the  ftomach.   Perhaps  our
 own forrel may be little inferior to either of them.
    All  kinds  of fallad are good in the  fcurvy, and
 ©ught to  be eaten very plentifully, as fpinnage, let-
 tuce,  parfley, cellery, endive, radifb, dandelion, Sec.
 It is amazing to  fee how foon frefii vegetables in the
fpring, cure  the brute animals of any fcab or  foul-
 fiefs which is  upon their fkins.   It is reafonable to
fuppofe,  that their effects would  be as great  upon
 the human fpecies, were they  ufed in proper quan-
tity, for  a fufficient length of time.
    I have fometimes feen  good effects  in  fcorbutic
complaints of very long ftanding,  from the ufe of a
 decoction of  the roots of water dock.   It is ufually
made  by boiling a pound  of the frefii root in fix
                                             pint* 
           OF THE SCROPHULA, kc.          4*5
 pints of water, 'till about one-third of it be confumed.
 The dofe is from half a pint to a whole pint of the
 decoction  every day.   But  in all the cafes where I
 have feen it  prove beneficial, it was  made  much
 ftronger,  and drank in larger quantities.   The fafeft
 way, however, is for the patient to begin with fmall
 dofes, and increafe them both in ftrength and quan-
 tity as he finds his ftomach will bear it.   It muft be
 ufed for a confiderable time.  I have known fome
 take it for many  months, and have been told of
 others who had ufed it for feveral years, before they
 were fenfible of any benefit, but who neverthelefs
 were cured by it at length.
   The leprofy, which was fo common in this coun-
 try long ago, feems  to have been near  a-kin to the
 fcurvy. Perhaps its appearing fo feldom now, may be
 owing to the inhabitants of Britain eating more vege-
 table food than formerly,  living more upon tea and
 other diluting diet, ufing lefs falted meat, being more
 cleanly, better lodged and  cloathed,  Sec.—For the
 cure of this difeafe  we would recommend the famfc
 courfe of diet and medicines as in the fcurvy.

    OF THE SCROPHULA,  OR KING's EVIL.

  This difeafe chiefly affects the  glands,  efpecially
thofe of the neck.   Children and young perfons of
a fedentary life are very fubject to it.  It is one of
thofe difeafes which may be removed by proper regi-
men, but too feldoin yields to medicine. The inhabi-
tants of cold,  damp,  marfhy countries are moft liable
to the fcrophula.
  CAUSES.—This  difeafe may  proceed  from  an
hereditary taint.   Children who have the misfortune
to be born of fickly parents, whofe conftitution j.ave
been greatly injured  by the pox,  or other chronic
 difeafes, are apt to be  affected  with the fcrophula,
                     Dd3                    \z 
4°6            OF THE SCROPHULA,
It may likewife proceed from fuch difeafes as weaken
the habit  or vitiate the humors, as the  fmall-pox,
mealies, &c.  External  injuries, as blows, bruifes,
and the like, fometimes produce fcrophulous ulcers;
but we have reafon to believe,  when  this happens,
that there has been a  predifpofition in the habit to
this difeafe.   In fhort, whatever tends to vitiate the
humors or  relax the  folids, paves  the way  to the
fcrophula ;  as the want of proper exercife,  too much
heat  or cold, confined air, unwholefome food,  bad
water, the long ufe of poor, weak, watery aliments,
the neglect  of cleanlinefs, Sec.   Nothing tends more
to induce this difeafe in children, than  allowing them
to continue  long wet*.
   SYMPTOMS.—At firft fmall knots appear under
the chin or behind the ears, which gradually increafe
in number and  fize,  till they  form one large hard
tumor. This often continues for a long time without
breaking, and when it does break, it only difcharges
a thin fanies, or watery humor.   Other parts of the
body are likewife liable to to its attack, as the arm-pits,
groins, feet, hands,  eyes, breafts, &c. Nor are the
internal  parts  exempt  from it.   It  often affects the
lungs, liver, or fpleen ; and I  have frequently  feen
the glands of the mefentery greatly enlarged by it.
   Thofe obftinate ulcers which break out  upon the
legs,  feet, and hands, and indeed  every part  of the
body, with fwelling and  little or  no rednefs, arc
of the fcrophulous  kind.   They  feldom  difcharge
good matter,  and are exceedingly  difficult  to cure.
The white fwelUngs of the joints feem  likewife to be
of this kind.  They are with difficulty brought  to  a
fuppuration, and when opened they only difcharge  a
        c
   * 'i he fcrophula, as well as the rickets, is found to prevail
in large manufacturing towns, where people live  grofs, and
Isjiii iedentary lives.
                                              thin 
               OF KING'S EVIL.              407
'dun ichor.   There  is not a more general fymptom
of the fcrophula,  than a  fwelling of the upper lip
and nofe, and, often, a dilated pupil.
   REGIMEN.—As this difeafe proceeds, in a great
meafure, from relaxation, the diet ought to be gene-
rous and nourifhing,  but, at the fame time, light and
of eafy digeftion ;  as  well fermented bread, made of
found grain, the flefli and  broth of young animals,
with now  and then a glafs of generous wine, or good
porter.   The air ought to be open, dry, and not too
cold, and the patient fhould take  as much exercife
as he can  bear.   This is of the  utmoft  importance.
Children  who  have  fufficient  exercife are  feldom
troubled with the fcrophula.
   MEDICINE.—The vulgar  are  remarkably  cre-
dulous with  regard  to  the cure of the fcrophula ;
many of them believing in the virtue  of the royal
touch, that  of  the feventh fon,  &c.   The truth is,
where  reafon or medicines fail, fuperftition always
comes  in  their  place.   Hence it is, that in difeafes
which are the  moft difficult to underftand, we gene-
rally hear  of the greateft number of miraculous cures
being performed.   Here, however,, the deception is
eafily accounted  for.  The fcrophuhi, at a certain
period of life, is often cured of itfelf;  and, if the
patient  happens to be touched about this time,  the
cure is  imputed to the tench,  and not to Nature,
who is really the phyfician.  In the fame way the
infignificant noftrums of quacks  and old wom«n often
gain applaufe when they deferve  none.
   There is nothing more pernicious than the cuftom
of plying  children in the fcrophula with  ftrong  pur-
gative medicines.  People imagine  it proceeds from
humors  which  muft  be purged  off, without  conii-
dering that thefe purgatives increafe the debility  and
aggravate the difeafe.   It has,  indeed,  been  found,
tkat keeping the  body gently  open for feme time,
                  D d 4               efpecially 
4o«r           OF THE SCROPHULA,
efpecially with fea-water,  has  a good  effect;  but
this fliould only be given in  grofs habits,  and in fuch
quantity as to procure one, or at moft two ftools
every day.
   Bathing in the fait water has  likewife a very good
effect,  efpecially in the warm feafon.  I have often
known a courfe of bathing in fait water, and drink-
ing it in fuch quantities as  to keep the body gently
open,  cure a fcrophula, after many other medicines
had been tried in vain.  When falt-water cannot be
obtained,  the patient may  be bathed in frefh water,
and his body kept open by fmall  quantities of fait
and water, or fome other mild  purgative.
   Next to cold bathing, and drinking the falt-water,
we would  recommend the Peruvian bark.  The cold
bath may be ufed in fummer, and the  bark in winter.
To an adult half  a  drachm of the bark in powder
may  be given in a glafs  of red wine  four or five
times a-day.   Children and fuch as cannot take it in
fubftance, may ufe the decoction made in the follow-
ing manner:
   Boil an ounce of Peruvian bark  and  a drachm of
 Winter's  bark, bothgrofsly powdered, in  a quart
of water  to a pint;  towards the end half an ounce
 of fliced liquorice-root, and a handful of raifins may
 be added, which will both render the decoction lefs
 difagreeable, and make it take up more  of the bark.
The liquor muft be ftrained,  and two, three, or four
table-fpoonfuls, according  to the age of the patient,
given  three times a-day,
   The Moffat and Harrowgate waters,  efpecially
the latter, are likewife very proper  medicines in the
fcrophula.  They ought not, however,  to be drank
in large quantities, but fhould  be taken fo as to keep
the body gently open,  and  muft be ufed for a con-
fiderable time.
                                             Tk<3 
              OR KING'S EVIL.              4of
   The hemlock may fometimes be ufed with advan-
tage in the fcrophula.   Some lay it down as a gene-
ral rule,  that the fea-water  is moft  proper before
there are any  fuppuration or fymptoms of tabes;
the Peruvian bark,  when  there are running  fores
and a degree of hectic fever ; and the hemlock in old
inveterate cafes,  approaching to the  fchirrous or
cancerous ftate.  Either  the extract  or the  frefii
juice of this plant may be  ufed.  The dofe muft be
fmall at firft, and increafed gradually  as far  as the
ftomach is able to bear it*.
   External  applications are of little ufe. Before the
tumour breaks,  nothing ought  to be  applied  to it
unlefs a piece of flannel,  or  fomething to keep it
warm. After it breaks, the fore may bedreffed  with
feme digeftive ointment.  What I have always found
to anfwer beft, was the yellow bafilicon mixed  with
about a fixth or  eighth part of its weight of red
precipitate  of mercury.   The fore  may be dreffed
with this twice a-day ; and if it be very fungous, and
does not  digeft well,  a larger proportion of the pre-
cipitate may be added.
   Medicines which mitigate this difeafe, though they
do not cure it, are not to  be defpifed. If the patient
can  be kept alive by any means till he arrives at the
age  of puberty, he  has a great  chance to get  well.
   There is  no "malady which parents are  fo apt to
communicate to their offspring as the fcrophula, for
which reafon  people ought to beware of  marrying
into families affected with  this difeafe.

   *  We often find fcrophula,  efpecially when it firft appears,
attended with a confiderable degree of fever:   Here repeated
fmall bleedings, gentle purging, and  low diet, will do moft
good ; after this fmall dofes of corrofive fublimate and bark,
with wort for drink, will  be found of the greateft ervicc.
For' 
.17 0
OF  THE ITCH.
   For the means of preventing the fcrophula,  we
muft refer the reader to the obfervations on nurfing,
at the beginning of the book.

                 OF THE ITCH.

   Though this difeafe is  commonly communicated
by infection,  yet it feldom prevails where due regard
is  paid to cleanlinefs, frefh air,  and wholefome diet.
It  generally appears in form of fmall watery puftules,
firft about the wrifts or between the fingers; after-
wards  it affects the arms,  legs, thighs, &c.   Thefe
puftules are  attended with  an intolerable  itching,
efpecially when the patient  is warm a-bed, or  fits
by the fire.   Sometimes indeed  the fkin is  covered
with  large blotches  or  fcabs,  and at other times
with  a white fcurf, or fcaly eruption.   This laft is
called the dry itch,  and is the moft difficult  to cure.
   The itch  is feldom a dangerous difeafe, unlefs
when it is rendered fo by neglect, or improper treat-
ment.  If it be fuffered to continue  too long, it may
vitiate the whole mafs of humors ; and,  if it be fud-
denly drove  in,  without proper evacuations, it may
occafion fevers,  inflammations of the vifcera, or other
internal diforders.
   The beft medicine yet known for the itch is ful-
phur, which  ought to  be ufed both externally and
internally.  The parts moft  affected may be  rubbed
with an ointment made of the flower of fulphur,  two
ounces ; crude fal ammoniac, finely powdered,  two
drachms ;  hog's lard,  or  butter, four onces.  If a
icruple or  half a drachm of the effence of lemon  be
added it will entirely take away the difagreeable fmell.
About the bulk of a nutmeg of this  may be  rubbed
upon the extremities every night at bed time.  It is fel-
dom neceffary to rub the whole body  ; but when it is
it ought not to be done all at once, but by turns, as
                                               it 
               OF THE ITCH.                411
it  is dangerous to ftop too many pores  at the fame
lime.
   Before the patient begins to ufe the ointment,  he
ought, if he be of  a full habit, to bleed or take a
purge  or two.   It  will  likewife be proper, during
the ufe of it,  to take every  night and morning as
much of the flower of brimftone and cream of tartar,
in a litle molaffes,  as  will  keep  the  body  gently
open.   He  fliould beware of catching cold,  fliould
wear more clothes  than  ufual,  and  take  every-
thing juft warm.   It will alfo  be proper daily to
■wafh oft' the ointment with warm water and a  little
Caftile foap,  fome  hours before anointing  afrefh.
The fame clothes, the  linen excepted,  ought to be
worn  all the  time of ufing the ointment; and fuch
clothes as  have  been worn while the  patient  was
under the difeafe, are not to be ufed again,  unlefs
they have been fumigated with brimftone,  and tho-
roughly cleaned,  otherwife  they  will communicate
the infection anew*.
   I never knew brirrftone, when ufed as directed
above, fail to cure the itch ;  and  I  have reafon to
believe, that, if duly periifr J in,  it never will fail;
but if it be only ufed once or  twice,  and cleanlinefs
neglected,  it  is no  wonde; i(  the diferder returns.
The  quantity of  ointment  mentioned above  will
generally be  fufficient for the cure of one  perfon;
but,  if any fymptoms of die difeafe fliould appear
again, the  medicine may be repeated.   It is  both

   *  Sir John Pringle obferves, that though this difeafe may
feem trilling, there is no one in the army that is moretrouble-
ibme to cure, as the infection often lurks in clothes,  &c.  and
breaks out a fecond, or even a third time. The fame inconve-
niency occurs in private families,  unlefs particular regard is
paid to the changing or cleaning cf their clothes, which laft is
by no means an eafy operation.
more 
V*               OF THE ITCH.
more fafe and efficacious when perfifted in for a con-
fiderable time, than when a large quantity is applied
at once*  As moft  people  diflike  the  fmell of ful-
phur,  they may ufe in its  place  the powder  of
white  hellebore root  made  up into an  ointment,
in the fame manner, which will  feldom fail to cure
the itch.
   People ought to be  extremely  cautious left they
miftake other eruptions  for the itch ;  as the ftoppage
of thefe  may be attended  with fatal confequences.
Many  of the eruptive diforders to  which children
are liable, have a near  refemblance to this difeafe ;
and I have often known  infants killed by being rub-
bed with greafy ointments that made thefe eruptions
ftrike fuddenly  in, which Nature had thrown out to
preferve the patient's life,  or prevent fome other
malady.
   Much mifchief is likewife  done by the ufe of mer-
cury in this difeafe.   Some perfons are fo fool-hardy
as to wafh the parts affected with a ftrong folution
of the corrofive fublimate.   Others ufe the mercu-
rial ointment, without taking the leaft care either to
avoid cold,  keep the body open, or obferve a pro-
per  regimen.   The confequences  of fuch  conduct
may. be eafily gueffed.   I have known even the mer-
curial girdles produce bad effects, and would advife
every  perfon, as he  values  his health,  to beware
how he ufes  them.   Mercury ought never to be ufed
as a  medicine without the greateft care.   Ignorant
people look upon thefe  girdles as  a kind of charm,
without  confidering  that the  mercury  enters the
body.
   It is not to be told what mifchief is done by ufing
mercurial ointment for curing the' itch and killing
vermin ; yet it  is unneceffary for either : the former
inay be always  more certainly cured by fulphur, and
                                             die 
              OF THE ASTHMA.               413

*he latter will never  be found where due  regard is
paid to cleanlinefs*.
   Thofe who  would avoid the  deteftable  difeafe
ought to beware  of infected perfons,  to  ufe whole-
fome food,  and to fludy univerfal cleanlinefsf.
                CHAP.    XLI.


                  Of the Afihma.



         1 HE  afthma  is a  difeafe  of the  lungs,
*hich rarely  admits of a perfect cure.  Perfons in
the decline of life are moft liable to it.  It is diftin-
guifhed into the moift and dry, or  the humoral and
nervous.  The former is attended with expectoration
©r fpitting;  but in the latter the patient feldom fpits,
unlefs fometimes a  little tough phlegm by the mere
force of coughing.

  *  If Mercury is ufed, the ungucntum citrinum is the moft
powerful  form of it.  The moft inveterate itches are cured by
an ointment made by mixing from fifty to one hundred drops
©f fpirits of vitriol with  an ounce of hog's lard.
  f The itch is now, by cleanlinefs, banifhed from every genteel
family in  Britain. It ftill, however, prevails among the poorer
fort of peafants in Scotland,  and among the manufacturers in
England. Thefe are not only fufficient to keep the feeds of the
difeafe alive, but to  fpread  the infection among others. It
were to be wifhed that fome effectual method could be devifed
for extirpating it altogether. Several country clergymen have
told  me,  that by getting fuch as were infeclcd cured, and
ftrongly recommending an attention to cleanlinefs, they have
banifhed the itch entirely out of  their parifhcs.  Why might
lot others do the fame I
                                         CAUSES. 
 4*4             OF THE ASTHMA.
   CAUSES.—The afthma is fometimes hereditary.
 It may likewife proceed from a bad formation of the
 breaft ; the fumes of metals or minerals taken  into
 the lungs ; violent exercife, efpecially running ; the
 obftruction of cuftomary evacuations, as the menfes,
 haemorrhoids, &c. the fudden  retroceflion of the
 gOut, and ftriking in of eruptions, as the fmall-pox,
 meafles, Sec. violent paffions of the mind, as fudden
 fear or furprife.  In a word, the  difeafe may proceed
 from any  caufe  that  either impedes the circulation
 of the blood  through the lungs, or prevents their
 being dulv expanded by the air.
   SYMPTOMS.—An afthma is known by a quick
 laborious  breathing, which is generally performed
 with a kind of wheezing noife.   Sometimes the diffi-
 culty of breathing is fo great,  that the patient is ob-
 liged to keep in  an erect pofture, otherwife he  is in
 danger of  being fuffocated.  A  fit  or  paroxyfm of
 the afthma generally happens after a perfon has been
 expofed to cold eafterly winds,  or has been abroad
 in thick foggy weather, or has got wet, or continued
 long in a damp place,  or  has taken food which the
 ftomach could not digeft, as paftries, toafted cheefe,
 or the like.
  , The paroxyfm  is commonly ufliered in with  lift-
Ieflhefs, want of  fleep, hoarfenefs,  a cough, belch-
 ing of wind, a fenfe of heavinefs about the breaft,
and difficulty of breathing.  To thefe fucceed heat,
 fever, pain of the head, ficknefs and naufea, great
 oppreffion of the breaft, palpitation of the heart,  a
 weak,  and fometimes intermitting pulfe,  an involun-
 tary flow of tears, bilious vomitings, &c.   All the
fymptoms grow worfe towards  night; the  patient is
eafier when up than in  bed, and  is very defirous of
cool air.
   REGIMEN.----The food ought to be light, and
•f eafy digeftion.   Boiled meats  are to be preferred
                                              to 
             OF THE ASTHMA.              41^
to roafted, and the flefh of animals come to their full
growth, to that of old.  All windy food, and what-
ever is apt to fwell in the ftomach,  is to be avoided.
Light puddings, broths, and ripe fruits baked, boiled,
or roafted, are  proper.  Strong liquors of all  kinds,
efpecially  malt-liquors,  are hurtful.   The patient
fliould eat a very light fupper,  or rather none at all,
and  fliould  never fuffer himfelf to be long coftive.
His cloathing fliould be warm, efpecially in the win-
ter-feafon.   As- all diforders of  the  breaft are much
relieved by  keeping the feet warm,' and promoting
the perfpiration, a flannel fhirt or waiftcoat,  and
thick fhoes will be of Angular fervice.
   But nothing  is of fo great importance in the afth-
ma as pure and moderately warm  air.  Afthmatk
people can feldom bear either  the clofe heavy air of
a large  town, or the fharp, keen atmofphere of a
bleak hilly country;  a medium therefore between
thefe is to be chofen.   The air near a large town is
often better than at a diftance,  provided the patient
be removed  fo  far as not be affected by the fmoke.
Some afthmatic  patients  indeed breathe eafier in
town than in  the country; but this  is feldom  the
cafe, efpecially in towns where much  coal is  burnt.
Afthmatic perfons who are obliged to be in town all
day,  ought at leaft to fleep out of it.  Even this will
often prove  of  great fervice.  Thofe who can afford
it ought to  travel  into a  warmer  climate.   Many
afthmatic  perfons who cannot  live in Britain, enjoy
very good health in the fouth of France, Portugal,
Spain, or Italy.
   Exercife is likewife of very great importance in  the
afthma,  as  it  promotes the digeftion, preparation
of the blood, Sec  The blood of afthmatic perfons
is feldom duly prepared,  owing to the  proper action
of the lungs being impeded.  For this reafon fuch
people ought daily  to t ke  as much exercife, either
                                              on 
4i€
OF THE ASTHMA.
 on foot,  horfeback, or  in a carriage,  as  they Caa
 bear.
   MEDICINE.----Almoft all that can be done by
 medicine  in  this  difeafe, is to relieve the  patient
 "when feized with a violent fit. This indeed requires the
 greateft expedition,  as  the difeafe fometimes proves
 fuddenly fatal.  In the paroxyfm or fit,  the body is
 generally bound ;  a purging clyfter, with a folution
 of afafcetida, ought therefore  to be adminiftered ;
 and, if there be occafion, it may be repeated two or
 three times.   The patient's feet and legs  ought to
 be immerfed in warm water,  and afterwards rubbed
 with a warm hand, or dry cloth.  Bleeding, unlefs
 weaknefs or old age, fliould forbid it,  is highly pro-
 per.   If there be a violent fpafm about the breaft or
 ftomach,  warm fomentations, or bladders filled with
 warm  milk and water, may be applied  to the part
 affected, and warm  cataplafms  to  the  foles of the
 feet.   The  patient  muft  drink freely  of  diluting
 liquors, and  may take a tea-fpoonful of the tincture
 of caftor, in  a cup of  valerian-tea, twice  or thrice
 a-day.  Sometimes a vomit  has a very good effect,
 and fnatches the patient, as  it were,  from  the jaws
 •f death.  This however will be more fafe after other
 evacuations have been premifed.  A very ftrong in-
 fufion of roafted coffee is faid  to give eafe in an afth-
 matic paroxyfm.
   In the moift afthma, fuch things as promote expec-
 toration or fpitting ought to be ufed; as the fyrup
 «f fquills,  gum ammoniac, and fuch like.   A com-
 mon fpoonful of the fyrup, or oxymel of fquills,
 mixed with an equal quantity of cinnamon-water, may
 be taken three or  four times  through the day, and
 four or five pills made of equal parts of afafcetida
and gum-ammoniac,  at bed-time*.
  * After copious evacuations, large dofes of sether have been
ftmad very efficacious hi removing a fit of  the aUhmw I have
                        *                  'itewiis 
                OF THE ASTHMA.            417
   For the convulfive  or nervous afthma,  antifpaf-
modics and bracers are  the moft- proper medicines.
The patient may take a tea-fpoonful of the parego-
ric elixir twice a-day.   The Peruvian bark is fome-
times found to be of  ufe in this cafe.  It may be
taken in fubftance, or infufed in wine.   In fhort,
every thing that braces the nerves, or takes off fpafm,
may be of ufe in a nervous  afthma.  It is often  re-
lieved by the ufe of affes inilk ; I have likewife known
cows miik, drawn warm  in the morning, have a very
good effect in this cafe.
   In every fpecies of afthma,  fetons and iffues have
a good effect;  they may either be fet in the back or
file, and  fliould never be allowed to dry up.   We
fliall here, once for all, obferve, that not  only in
the  afthma, but in moft chronic difeafes, iffues are
extremely proper.   They are  both a fafe and effica-
cious remedy ; and though they  do not always cure
the difeafe, yet they will often prolong the patient's
life.  Blifters to the breaft are often highly neceffary,
and fometimes a very  large warm plafter, conftantly
worn on the  breaft,  has been found of effential fer-
vice.


likewife known the following mixture produce very happy ef-
fects : To four or iivs ounces of the folution of gum-ammoniac
add two ounces of fimple cinnamon-water, and half an ounce
of paregoric elixir. Of this two table-fpoonfuls may be taken
every three  hours.
E c
CHAP. 
C  4tS  1
                  CHAP.   XLII.

                  Of the Apoplexy.


           1 HE apoplexy is a fudden lofs  of fenfe
 and motion,  wherein the patient is to all appearance
 dead ;  the heart and  lungs,  however, ftill  continue
 to  move.  Though  this  difeafe proves  often, fatal,
 yet it may fometimes be removed by proper care.   It
 chiefly  attacks  fedentary perfons  of a  grofs habit,
 who ufe  a  rich and  plentiful diet, and indulge in
 ftrong liquors.   People in the decline of life  are moft
 fubjc&to  the apoplexy.  It prevails  moft in winter,
 efpecially  in rainy feafons, and very low ftates of the
 barometer.
   CAUSES.—The immediate caufe of an apoplexy
 is a compreffion  of the brain, occafioned by an excels
 of  blood, or a  collection of watery humors.   The
 former is called a fanguine, and  the latter a ferous
 apoplexy.   It may be  occafioned by any thing that
 increafes  the circulation towards  the brain, or pre-
 vents the  return of the blood from the head ;  as in-
 tenfe fludy ;  violent paffions*; viewing objects for a
 long time  obliquely ;. or much Hooping ; wearing any
 thing too tight about the neck ; a rich and luxurious
 diet; fuppreffion of urine ; fuffering the body to cool

  *  I knew a woman who in a violent fit of anger was feized
 with a fanguine apoplexy.   She at firft complained of extreme
 pain, ai if daggers had been thrtft through her bead, as (he expref-
#ed it.  Afterwards Ike became comatofe,  her pulfe  funk very
 low, and it  was exceeding flow.   I>y bleeding, bliftering, and
 other evacuations,  ilie was kept alive for about a  fortnight.
When her head was opened, a large quantity of extravafated
blood w^s found in the left ventricle of the brain.
fuddenly 
              OF THE APOPLEXY.           4Tfi
fuddenly after having been greatly heated ; continuing
too long in a warm or a cold bath ;  the exceffive ufe
of fpiceries, or high feafoned-food ; excefs of venery;
the fudden ftriking in of any eruption ; fuffering iffues,
fetons, Sec. fuddenly to dry up, or the ftoppage of any
euftomary evacuation ; a mercurial falivation puflied
too far, or fuddenly checked by cold ; wounds or
bruifes on the head ; long expofure to exceffive cold ;
poifonous exhalations, &c.
   SYMPTOMS, and method of cure.  The ufual
forerunners of ail apoplexy are giddinefs,  pain and
fwimming of the head ; lofs of memory ; drowfinefs ;
noife  in the  ears ; the  night  mare ;  a fpontaneous-
flux of tears, and laborious refpiration.  When per-
fons of an  apoplectic  make obferve thefe fymptoms,
they have  reafon to fear the approach of a fit, and
fhould endeavour to prevent it by bleeding, a flender
diet, and opening medicines.
   In the fanguine apoplexy,  if the patient does not
die fuddenly,  the countenance appears florid, the
face is fwelled or  puffed up,  and the blood-veffek,
efpecially about the  neck and temples, are turgid ;
the pulfe beats ftrong ; the eyes are prominent and
fixed,  and the breathing is difficult, and performed
with a fnorting noife.  The excrements and urine are
often  voided  fpontancoufly,  and the patient is fome-
times  feized with vomiting.
   In this fpecies of apoplexy every  method muft be
taken to leffen the force of the circulation towards
the head.  The patient  fliould be kept perfectly eafy
and cool.  His head fliould be raifed pretty high,
and his  feet fuffered to  hang  down.  His  clothes
ought  to be loofened, efpecially  about the neck, and
frefii  air  admitted into  his chamber.  His  garters
lhould be tied pretty  tight, by which means the mo-
tion of the blood from the lower extremities will be
..  rarded.  As fcon as the patient is placed in a proper
                     E e 2                pofture, 
42£T           OF THE APOPLEXY.
pofture, he fliould be bled freely in the neck or arm,
and,  if there be occafion, the operation may be re-
peated in two or three hours. A laxative clyfter, with
plenty of fweet oil, or frefh butter, and a fpoonful or
two of common fait in  it,  may be adminiftered every
two hours ; and  bliftering-plafters applied between
the fhoulders, and to the calves of the legs.
   As foon as  the fymptoms are a little abated, and
the patient is able to fwallow,he ought to drink freely
of fome diluting opening liquor, as a decoction of ta-
marinds and liquorice, cream of tartar-whey, or com-
mon whey with cream of tartar diffolved in it.  Or he
may take any cooling purge, as Glauber's fait, manna
diffolved in an infufion of fenna, or the like. All fpirits,
and other  ftrong  liquors are to be avoided.   Even
volatile falts held  to the  nofe do mifchief.   Vomits,
for the fame reafon, ought  not to  be given, nor any
thing that may increafe the motion of  the blood to-
 wards the head.
   In the ferous apoplexy,  the fymptoms are nearly
the fame, only the pulfe is not fo ftrong,  the coun-
 tenance is lefs florid, and the breathing lefs difficult.
 Bleeding is not fo neceffary here as in the former
 cafe.  It may, however, generally be performed once
 with fafety and advantage, but fliould not be repeated.
 The patient fliould be placed in the fame  pofture as
 directed above, and fliould have bliftering-plafters ap-
 plied, and receive opening clyfters in the fame manner.
Purges here  are  likewife neceffary, and the patient
 may drink  ftrong balm-tea.   If  he be inclined  to
fweat,  it ought to be promoted  by drinking fmall
wine-whey, or an  infufion of carduus benedidtus.  A
 plentiful  fweat kept  up  for a confiderable time has
often carried off a ferous apoplexy.
   When apoplectic fymptoms proceed from opium,
or other narcotic fubftances taken into the ftomach,
 vomits  are neceffary.  The patient is generally re-
                                            lieved 
OF COSTIVENESS, &c.
421
iicved as foon as he has difcharged the poifon in this
way.
  Perfons of an apoplectic make,  or thofe who have
been attacked by it,  ought to ufe a very fpare and
flender diet, avoiding all ftrong liquors, fpiceries, and
high feafoned food.  They ought  likewife to guard
againft all violent paflions, and to avoid the extremes
of heat and  cold.  The head fliould  be  fhaved, and
daily waflied with cold water.  The feet ought to be
kept warm,  and never fuffered to continue long wet.
The body muft be kept open either by food or medi-
cine, and a little blood may be let every fpring and
fall.  Exercife fhould by no means be neglected ; but
it outfit to be taken in moderation.  Nothing has a
more happy effect, in preventing an apoplexy than per-
petual iffues or fetons ;  great care, however, muft be
taken not to fuffer  them to dry up, without opening
others in their ftead.  Apoplectic perfons ought never
to go to reft with a full ftomach, or to lie with their
heads low, or wear  any thing tight about their necks.
                CHAP.  XLIII.

Of Cofiivenefs, and other Affeclions of the Stomach and
                     Bowels.


          W E  do not mean here to treat of thofe
aftrictions of the  bowels which are the fymptoms of
difeafes, as of the colic, the iliac paffion, Sec. but only
to take notice of that infrequency of ftools which fome-
times happens, and  which, in fome particular confti-
tutions may occafion difeafes.
   Coftivenefs may proceed from drinking rough red
wines, or other  aftringent  liquors;  too  mu:h exer-
                       E e 3                 cife? 
422           OF COSTIVENESS, &c.
cife, efpecially on horfeback.   It may likewife pre-
ceed from a long ufe of cold infipid food,  which does
not fufficiently ftimulate the inteftines.  Sometimes it
is owing to the bile not defcending  to the inteftines,
as in the jaundice ; and at other times it proceeds from
difeafes of the inteftines themfelves, as a palfy, fpafms,.
torpor, tumors, a cold dry ftate of the inteftines, Sec.
   E.-celiive coftivenefs is apt to occafion pains of the
head,  vomiting, colics, and other complaints of the
bowels.  It is peculiarly hurtful to hypochondriac and
hyfteric  perfons,  as  it  generates  wind  and other
grievous fymptoms.  Some people, however, can bear
coftivenefs  to a great degree.  I know perfons who
enjoy pretty good health, yet do not go to ftool above
once a-week,  and others not above once a-fortnight.
Indeed I have heard of fome who do not  go  above
once a-month.
   P nffons who are generally coftive fliould live upon
a moiftening and  laxative diet, as roafted or boiled,
apples, pears, flewed prunes, raifins, gruels with cur-
rants,  butter, honey, fugar, and fuch like.  Broths
with  fpinage, leeks,  and other foft pot-herbs,  are
likewife proper.   Rye-bread, or that which is made
of a mixture of wheat and rye together, ought to be
eaten.  No perfon, troubled with coftivenefs, fhould
eat white bread alone, efpecially that which is made
of fine flour.   The beft bread for keeping the body
foluble is what, in fome parts of England,  they cat
mefiin.  It is made of a mixture of wheat and rye, and
is very agreeable to thofe who are accuftomed to it.
   Coftivenefs is  increafed  by keeping the body too
warm,  and by every thing that promotes the perfpi-
raticn ; as wearing flannel, laying too long a-bed, Sec.
Intenfe thought, and a  fedentary life, are likewife
hurtful.  All the fecretions and excretions are pro-
moted by moderate exercife without doors, and by  a
   v, cheerful, and fprMnly  temper  of mind, 
               OF COSTIVENESS, &c.           42$

   The drink fliould be of an opening quality.   All
ardent fpirits, auftere and aftringent wines, as port,
claret, Sec.  ought to  be avoided.   Malt-liquor that
is fine, and  of a moderate ftrength,  is very proper.
Butter-milk,  whey,  and other  watery  liquors,  are
likewife proper,  and may be drank in turns,  as  the
patient's  inclination directs.
   Thofe  who are  troubled with coftivenefs, ought,
if poffible, to remedy it by diet,  as the conftant  ufe
of medicines for that purpofe, is attended with many
inconveniences, and often  with  bad confequences*.
I never knew any one  get  into a habit  of  taking
medicine  for  keeping  the body  open, who  could
leave it off.   In time, the cuftom becomes neceffary,
and generally ends in  a total relaxation of the bowels,
indigeftion,  lofs of appetite, wafting of the ftrength,
and death.
   When the body  cannot  be  kept open  without
medicine, we would recommend gentle dofes of rhu-

   *  The learned Dr Arbuthnot advifes thofe who are troubled
with coftivenefs to ufe animal oils, as frefii butter, cream, mar-
row, fat broths, &c.  He likewife recommends the exprcffed
oils of mild vegetables, as olives, almonds,  piftaches, and the
fruits themfelves ; all oily and mild fruits, as figs ; decoctions
of mealy vegetables; thefe lubricate the inteftines ; fome fa-
ponaceous  fubftances which flimulate gently, as honey, hydro-
mel, or boiled honey and water, unrefined fugar, &c.
  The Dollar obferves, that fuch lenitive fubftances are proper
for perfons of dry atrabilarian conftitutions, who are fubject to
aftrL'tion of the belly, and the piles, and will operate when
ftronger medicinal fubftances are f. metimes ineffectual; but that
fuch lenitive diet hurts thofe whofe bowels are weak and  lax.
He likewife obferves, that all watery  fubftances are lenitive,
and that even common water, whey,  four milk, and butter-
milk, kive that effect;—That new milk, efpecially affes milk,
ftimulates ftiU more  when it fours on the ftomach ; and that
whey turned four will purge ftrongly;—That moft garden fruits
are likewife laxative ; and that fome of them, as grapes,  will
throw f.ich as take them immoderately into a cholera morbus,
cr incurable diarrhea.
                        E e  4                   bark 
 424          WANT OF APPETITE.
 barb to be taken twice or thrice a-week.  A very good
 practice in thefe cafes is to chew a piece of the root
 of rhubarb, about the fize of an hazel-nut every morn-
 ing.   This is not near  fo injurious to the ftomach as
 aloes, jalap, or the other  draftic purgatives fo much
 in ufe.  Infufions of fenna and manna may likewife
 be taken,  or half  an ounce of foluble tartar diffolved
 in water-gruel.  About the fize of a nutmeg of lenitive
 electuary taken twice or thrice a-day generally anfwcrs
 the purpofe very  well.   Perhaps there is no purga-
 tive fo fafe for thofe who are troubled with habitual
 coftivenefs as caftor oil.   A  table-fpoonful may be
 taken for  a dofe,  and the  quantity need not be in-
 creafed.  Eight or twelve grains of the extract of the
 butter nut, is an excellent cathartic in thefe  cafes.  A
 large  lump of brown fugar eaten at bed-time, will
 generally prove laxative.

              WANT OF APPETITE.

   This  may proceed from a foul ftomach ; indigef-
 tion ;  the want of free air and exercife ; grief; fear;
 anxiety ; or any of the deprefling paflions ; exceffive
 heat; the ufe of ftrong  broths, fat meats, or any
 thing that  palls  the appetite,  or is hard of digeftion,
 the immoderate ufe of  ftrong liquors, tea, tebacco,
 opium. Sec.
   The patient ought, if poffible, to make choice  of
 an open  dry air  ; to take exercife daily on horfeback
 or in a carriage ; to rife betimes ; and to avoid all in-.
 tenfe thought. He fliould take a diet of eafy digeftion;
 and fliould avoid exceffive heat and great fatigue.
   If want  of appetite proceeds from errors in diet,
 or any other part of the patient's regimen,  it ought
 to be changed.  If naufea and retchings fhew  that
 the ftomach is loaded with  crudities, a vomit will be
nf fervice.   /v.ter  this a gentle purge or two of rhu- 
            OF THE HEART-BURN.         42;
barb, may be taken.  The patient ought nent to ufe
fome of the ftomachic bitters infufed in wine. Though
gentle evacuations be neceffary, yet ftrong purges and
vomits are to he avoided, as they weaken the ftomach
and hurt digeftion.
   Elixir of vitriol  is an excellent medicine in moft
cafes  of indigeftion, weaknefs of the ftomach, or
want  of appetite.   From twenty to thirty drops of it
may be taken twice or thrice a-day in a glafs of wine,
or water.  It may likewife be mixed with the tincture
of the bark, one drachm of the former to an ounce
of the latter, and two tea-fpoonfuls of it taken in wine
or wa;er as above.
   The  chalybeate waters, if drank in  moderation,
are generally  of confiderable fervice in  this  cafe.
The fait water has' likewife good effects; but it muft
not be ufed too freely.   The waters of Harrowgate,
Scarborough, Moffat, and  moft  other Spas  in Bri-
tain, may be ufed  with  advantage.   We would ad-
vife all wdio  are afflicted with indigeftion and want of
appetite, to repair to thofe places of public rendez-
vous.  The very change of air, and the cheerful corn-
pan}-, will be of fervice ; not to mention the exercife,
amufements, Sec.

            OF THE HE ART-BURN.

  What is commonly called the heart-burn, is not a
difeafe of that organ, but an uneaiy fenfation  of heat
or acrimonv about die pit of the itormmi).. wnieh is
fometimes attended wliii anxiety, naufea, : ad vo-
miting.
  It may proceed from debilhy of t;ie uomncn, indi-
geftion, bile, the abounding of an acid in the ffemach,
&c.   Perfons who arc iafele to this complaint ought:
tp avoid  llale liquort",  ati.e,  v.may gy  grmuY aiir
                                          n....;;;^ 
426          OF THE HEART-BURN.
ments, and fhould never ufe violent exercife foon af-
ter a plentiful meal.   I know many perfons who ne-
ver fail to have the heart-burn if they ride foon after
dinner, provided they have drank ale, wine, or any
fermented liquor.
   When the  heart-burn proceeds from debility of
the  ftomach,  or  indigeftion,  the patient  ought to
rake a dofe or two of rhubarb ; afterwards he  may
ufe infufions of the Peruvian bark,  or any other of
the ftomrxhic bitters.   Exercife in the open air will
likewife be of ufe, and every thing that promotes
digeftion.
   When bilious  humors occafion the heart-burn, a
tea-fpoonful of the fweet fpirit of nitre in a glafs of
water, or a cup of tea, will generally give eale.  In
this  cafe the elixir of vitriol or columbo-root are of
peculiar fervice.   If it proceeds from the ufe of
greafy aliments, a tea-cupful of mint water may be
taken.
   If acidity or fournefs of the  ftomach  occafions the
heart-burn, abforbents  are  the proper  med'  "nes.
In this cafe an ounce of powdered chalk, and a  quar-
ter of an  ounce of gum-arabic, may be mined in a
quart of water, and a tea-cupful  of it taken as often
as is neceffary.  But  the fafefi and beft abforbent is
magnefiia alba.   This not only acts as an  abforbent,
but  likewife  as a purgative ;  whereas chalk, and
other abforbents of  that kind, are apt to lie in the
inteftines, and  occafion obftructions.   This powder is
not difagreeable, and may be taken in water or a cup
of tea, or a glafs of mint-water.   A large tea-fpoonful
is the ufual dofe ; but it may be taken in a  much
greater quantity when there is occafion.  Thefe things
are now generally made up into lozenges for the con-
veniency of being carried in the pocket, and taken at
pkafere.
If 
OF NERVOUS DISEASES.
427
  If wind be the caufe  of this complaint, the moft
proper medicines  are  thofe called  carminatives; as
anifecds,  juniper-berries, ginger, canella alba, car-
damom feeds, Sec.  Thefe may either be chewed, or
i-ifufed in wine.   One of the fafefi medicines of this
kind is the tincture made by infufing an ounce of rhu-
barb, and a quarter of an ounce of the ieffer carda-
mom feeds, in a pint of brandy.  After this ha.s di-
gefted for fix or eight  days, it ought to be ftrained.
A table-fpoonful of it may be  taken occafionally  for
a dofe.
  I have  frequently known  the heart-burn cured,
particularly  in pregnant women, by chewing green-
tea.   Two tabie-fpoonfuls of what  is called the milk
of gum-ammoniac, taken  once or twice a-day, will
fometimes cure the heart-burn.  The  fame effeft is
produced by drinking  cow's milk.   The heart-burn
is a  fymptom of  indigeftion,  and of courfe  can be
cured only by thofe means which promote digeftion ;
die chief of thefe, as have  been already mentioned,
are air, exercife,  and proper diet.
               CHAP.  XLIV.

              Of  Nervous Difeafes.


         vJF all difeafes incident to mankind, thofe
©f the nervous  kind  arc  the moft complicated  and
difficult to cure.  A volume would not be fufficient
to point out their various appearances.  They  imi-
tate  almoft  every  difeafe ; and are feldom alike in
two different perfons, or even  in the fame perfon at
different  times.  lnroteusdike, they are continually 
 428         OF NERVOUS  DISEASES.
 changing fhape ; and upon every frefh attack, the
 patient thinks he feels fymptoms which he never ex-
 perienced before.  Nor do they only affect the body ;
 the mind likewife fuffers, and is often thereby render-
 ed  extremely  weak  and peevifli.   The low  fpirits,
 timoroufnefs, melancholy, and ficklenefs of temper,
 which generally attend nervous diforders, induce many
 to believe that they are entirely difeafes of the mind ;
 but  this change of temper  is rather a confequence,
 than the caufe of nervous difeafes.
   CxAUSES.-----Every thing that  tends to relax or
 weaken the body, difpofes it  to nervous difeafes, as
 indolence,  exceffive  venery, drinking too much tea,
 or other weak watery  liquors warm,  too  frequent
 bleeding, purging, vomiting,  Sec.   Whatever hurts
 the digeftion,  or prevents the proper aflimiiation of
 the food, has likewife  this  effect;  as  long fafting,
 excefs in eating or drinking, the ufe  of windy, crude,
 or unwholefome aliments, an unfavourable pofture of
 the body, Sec.
   Nervous diforders often proceed  from intenfe ap-
 plication to fludy.  Indeed  few  ftudious perfons are
 entirely  free from them.   Nor is  this at  all to be
 wondered at; intenfe thinking not only preys upon
 the fpirits but prevents the porfon from taking  proper
 exercife, by which means  the digeftion is impaired,
 the nourifliment prevented, the folids  relaxed, and
 the whole mafs of humors vitiated.   Grief and dif-
 appointment likewife  produce the fame effects.  I have
 known more  nervous patients, who dated  the com-
 mencement of their diforders from the lofs of a huf-
 band, a favourite child, or from fome difappointment
 in life, than from any other caufe.  In a word, what-
ever weakens the body,  or depreffes the fpirits, may
occafion nervous diforders, as unwholefome air, want
 of fleep, great fatigue,  difagreeable apprehenfions,
 anxiety, vexation, the.
                                   SYMPTOMS. 
            OF MERVOUS  DISEASES.         429
   SY vIPTOMS.—We fliall only mention fome of
the moft general  fymptoms  of  thefe diforders, as it
would be  both an ufelefs and an endlefs talk to enu-
merate the whole.   They  generally begin  with in-
flations or diftentions of  the ftomach and inteftines ;
the appetite and  digeftion are ufually bad ; yet fome-
times there is an uncommon craving for food and a
quick digeftion.  The  food often  turns four on the
ftomach ;  and the patient is troubled with vomiting
of clear  water, or  tough  phlegm.   Excruciating
pains are often felt about the navel, attended with a
rumbling or murmuring noife  in  the bowels.  The
body is fometimes loofe, but more commonly bound,
which  occafions  a  retention of wind and  great un-
eafmefs.
   The urine is fometimes in fmall quantity, at other
times very copious and quite clear.  There is a great
ftraitnefs of-the breaft,  with difficulty of breathing ;
violent palpitations of the heart;  fudden flufhings of
heat in various parts of the body ;  at other times a
fenfe of cold, as if water  were  poured on diem ; fly-
ing  pains in the arms and limbs ;  pains in  the back
and belly,  refembling  thofe occafioned by gravel;
the pulfe very variable, fometimes  uncommonly flow,
and  at other times very quick ;  yawning, the hiccup,
frequent fighing, and a  fenfe of fuffocation, as if from
a ball or lump in the throat ; alternate fits of crying
and  convulfive laughing ; the fleep is  unfound and
feldom refrefhing ; and the patient is often troubled
with the night-mare.
   As the difeafe increafes, the patient is  molefted
with head-aches, cramps, and  fixed pains in various
parts of the body ; cold feet ;  the eyes are clouded,
and often affected with pain and dry nefs;  there is a
noife in the ears, and often  a duilnefs of heariay • in
fhort, the whole animal  functions are impaired. The
mind is difturbed on the moft trivial occafions,  ana
is 
43d          OF NERVOUS DISEASES.
is hurried into the moft perverfc commotions, inquie-
tudes, terror, fadnefs, anger, diffidence, &.c. The pa-
tient is apt to entertain  v. ild imaginations and extra-
vagant fancies ;  the memory becomes weak, and
the judgment fails.
  Nothing is more charadteriftic of this difeafe than a
conftant dread of death.  This  renders thofe unhappy
perfons who labour under it peevifli, fickle, impatient,
and apt to run from one phyfician to another ; which
is one  reafon why they feldom reap any benefit from
■medicine, as they have not fufficient refolution toper-
lift in any one courfe till it has time to produce its
proper effects. They are likewife apt to imagine fimt
they labour under difeafes from which they are quite
free ;  and are angry  if any one attempts to fet them
right, or fo laugh them out of their ridiculous notions.
  REGIMEN.—Perfons afflicted with nervous  dif-
eafes ought never to faft long.  Their food  fliould
be folid and nourifhing, but of  eafy digeh ;on.   Fat
meats  and heavy fauces are hurtful.   All  excefs
fliould be carefully  avoided.   They ought never to
eat more at a time than they can eaiily digeft ;  but if
rhey feel themfelves weak  and faint  between  meals,
they ought to eat a bit of bread  and drink  a glafs of
wine.   Heavy fuppers are to- be avoided.  Though
v/ine  in excefs enfeebles the  body, and impairs the
faculties of the  mind,  yet taken  in  moderation it
ftrengthens  the  ftomach,  and  promotes  digeftion.
Wine  and water is a very proper drink at meals ; but
if wine fours on the ftomach, or the patient is much
trembled with wind,  the ftronger bodied  wines as
Madeira and Sherry  mixed with water,  or porter,
trill anfwer better.  Every thing that is  windy  or
hard  of digeftion rnuft  be avoided.   All weak  and
v. arm liquors are hurtful, as tea, coffee, punch, &c.
People may find a temporary relief in the ufe of thefe,
but timv always  increafe the malady,  as they weaken
                        i                     the 
          OF NERVOUS DISEASES.          45i
the ftomach  and hurt digeftion.  Above  all things,
drams ought to be avoided. Whatever immediate eafe
the patient may feel  from the ufe of  ardent fpirits,
they are fure to aggravate the malady,  and prove
certain poifons at laft.  Thefe  cautions are the more
neceffary, as molt nervous people are peculiarly fond
of tea  and ardent fpirits ; to the ufe of which many
of them fall victims.
  Exercife,  in  nervous diforders, is fuperior to stii
medicines.    Riding  on  horfeback  is generally  ef-
teemed the beft, as  it gives  motion to  the whole
body,, without fatiguing it.   I have known fome pa-
tients, however, with whom walking agreed better,
and others  .who  were moft  benefited by  riding ia
a carriage.   Every one ought  to ufe that  kind of ex-
ercife which he finds moft beneficial.   Long fea-voy-
ages have an excellent effect;  and to thofe who have
fufficient refolution, we would by all  means recom-
mend this courfe.  Even change of place, and  the
fight of new objects,  by  diverting the mind, have a
great tendency to remove thefe complaints.  For this
reafon a  long journey,  or. a voyage,  is  of  much
more  advantage  than riding  fhort journeys  near
home.
   A cool and dry air is proper, as  it braces, and
invigorates the whole bod v.  Few things tend more
to relax  and  enervate than hot,air, efpecially that
whfeh is  rendered  fo by  great fires, or  ftoves ia
fmall apartments.  But when  the ftomach or bowels
a.  weak, the body ought to he well guarded againft
cold, efpecially in winter, by wearing a flannel fhirt.
1 he fhoes fhould be fuch  as will keep the feet warm
and dry-   This will  keep up  an equal perfpiration,
and defend  the alimentary canal from many hnpief-
lions to which it would otherwife  be fubject, upon
every  fudden change  from warm  to cold  weather.
 Rublnm.  the body frequently  whh  a flefh-brufh, cr
                                         a ecmh: 
 43-J          OF NERVOUS DISEASES:
 a coarfe linen cloth, is likewife beneficial, as it pro-
 motes the circulation,  perfpiration,  Sec.   Perions
 who have weak nerves ought to  rife early,  and take
 exercife  before breakfaft,  as lying too long in bed
 cannot fail to relax the folids.  They ought  likewife
 to be diverted, and to be kept as c^Xy and  cheerful
 as poffible.   There is not any thing whicm hurts the
 nervous  fyftem, or weakens the  digeftive  powers,
 mere than  fear, grief, or anxiety.
  MEDICINES.—Though nervous difeafes are too
 feldom radically cured, yet their fymptoms may fome-
 times be alleviated,  and the patient's  life rendered,
 at leaft more comfortable, by proper medicines.
  When the  patient is coftive,  he ought to take  a
 little  rhubarb, or fome other mild purgative,  ,m.J
 fhould never fuffer his body to be  long bound.   All
 ftrong and violent  purgatives are, however,  to be
 avoided.   I have generally feen  an infufion  of fenna
 net rhubarb anfwer very well.   This may  be made
 of  any ftrength, and taken  in fuch quantity as the
 patient finds neceffary.  When  digeftion is bad, or
 tie ftomach relaxed  and weak,  the Peruvian bark,
 sad other bitters,  may be  ufed  with  advantage.
 Centaury or  gentian tea  anfwer very well; or an
 ounce of powdered columho  root, and as much fteel
 filings,  may  be  infufed  in «a quart of  Madeira or
 Sherrv wine, and a  wine-glafs  full cf it taken two
 or three  times a-day.  Many perfons have  received
 co-eat advantage from taking two or three times a-day,
 a whir gia's full of an infufion of four table fpoons full
 of the.juice of green fage in a quart  of port wine.
  lew  tilings tend  more to ftrengthen the  nervous
 fvilcm than  cold bathing.   This practice,  if duly
pmfeh'd  in, will produce very extraordinary  effects ;
but when the liver or otlier vifecra are obftructed,
or  otherwife  unionnd, the  cold  bath  is improper.
It h therefore to be  ufed  with  very great  cauitir-n.
                                             The 
               OF  MELANCHOLY.           433
The moft  proper  feafons for  it are fummer and au-
tumn.   It will be fufficient, efpecially for perfons of
a fpare habit, to go into the cold bath three or four
times a-week.   If the patient be weakened by it, or
feels chilly for a long time after coming out, it is im-
proper.
  In patients afflicted with wind, I have  always  ob-
ferved the greateft  benefit from the elixir of vitriol.
It may be taken in the quantity of fifteen, twenty, or
thirty drops, twice or thrice a-day in a glafs of water.
This both  expels wind, ftrengthens  the  ftomach,
and promotes digeftion.   Opiates have been  recom-
mended in thefe maladies; but as they only palliate
the fymptoms, and generally afterwards increafe the
difeafe,  we would advife people to be extremely fpar-
ing in the ufe of them, left habit render them at laft
abfolutely neceffary.   Much  good  has been experi-
enced from pills of myrrh and afafcetida, made into
a mafs with Caftile foap, and  taking two or three of
a moderate fize  three or four times a-day.
   It would be an  eafy matter to enumerate many
medicines which have been extolled for relieving ner-
vous diforders ;  but, whoever wifhes for a thorough
cure, muft expect it from regimen alone; we fhail
therefore omit mentioning more medicines, and again
recommend  the ftricteft attention to diet,  air,
exercise, and amusements.

               OF  MELANCHOLY.

  Melancholy is that ftate of alienation or weaknefs
of mind which renders people incapable of enjoying
the pleafures, or performing  the duties of life.   It is
a degree of infanity, and often terminates in abfoiute
madnefs.
Ff
CAUSES. 
434            OF MELANCHOLY.
   CAUSES.—It may proceed  from an hereditary
difpofition ; intenfe thinking, efpecially where the
mind is  long  occupied about  one  object ;  violent
paffions or affections of the mind, as love, fear, joy,
grief, over-weening pride, and fuch like.   It may
alfo be  occafioned by  exceffive  venery ; narcotic or
ftupefactive poifons ; a fedentary life ; folitude ; the
fuppreffion of cuftomary evacuations; acute fevers, or
other difeafes.   Violent anger will fometimes change
melancholy into madnefs ; and  exceffive cold, efpe-
cially of the lower extremities,  will produce  all the
fymptoms of madnefs.   It may likewife proceed from
the ufe  of aliment that is hard of digeftion, or which
cannot  be  eafily aflimilated ;  from a callous  ftate of
the integuments of the brain, or a drynefs of the brain
itfelf.   To all which we may add gloomy or miftaken
notions of religion.
   SYMPTOMS.—When perfons begin to be me-
lancholy, they  are timorous; watchful; fond of fplj-
tude ; fretful; fickle ; captious and  inquifitive ; feli-
citous about trifles ;   fometimes niggardly,  and at
other times prodigal.  The body is generally  bound ;
the urine thin, and in fmall quantity ;  the  ftomach
and bowels inflated with wind ; the complexion pale;
the pulfe flow  and weak.  The functions of the mind
are alfo greatly perverted, in fo much that the patient
often imagines himfelf dead, or changed  into Tome
other animal.   Some  have imagined  their  bodies
were made of  glafs, or other brittle fubftances, and
were afraid to move, left they fliould  be broken to
pieces.   The  unhappy patient,  in  this cafe,  unlefe
carefully watched,  is apt to put an end to his own
miferable life.   '
    When the   difeafe is owing  to an obftruction of
cuftomary  evacuations, or to any bodily diforder,  ic
is eafier cured than when it proceeds from affections
of the  mind,  or an hereditary taint.  A difcharge
                                                of 
                 OF  MELANCHOLY.            435
  of blood from  the nofe,  loofenefs,  fcabby eruptions,
  the bleeding piles, or the menfes, fometimes carry off
  this difeafe:
    REGIMEN.—Tim diet fliould confift chiefly of
  vegetables of a cooling and opening quality,  with a
  due proportion of the lightell animal food.   Salted
  or finoke-dried  fifli  or flefli,  ought to  be avoided.
  All kinds of fruits that are wholefome may be eaten
 with advantage.  Boerhaave gives  an inftance of a
  patient who recovered by a long ufe of whey, water,
  and garden-fruit.
    Strong liquors of every kind ought to be avoided
 as poifon.   The moft proper drink is water,  whey,
 or fmall beer.   Tea  and coffee are improper.   If
 honey agrees with the patient, it may be eaten freely,
 or his drink  may be fweetened with  it.   Infufions of
 balm-leaves, penny-royal, the roots of wild valerian,
 or the flowers of the lime-tree, may be drank freely,
 either by themfelves,  or  fweetened  with honey, as
 the patient fhail  chufe.
   The patient ought to take as much exercife in the
 open air as he can bear.   This is  a  very important
 remedy.  It is,  indeed, more fo than any otlier that
 has ever been thought of.  It  helps to remove ob-
 ftructions, promote the perfpiration, and  all  other
 fecretions.   Every kind of madnefs is attended with
 a diminifhed perfpiration ;  all means  ought therefore
 to be ufed to promote that neceffary and falutary dis-
 charge.  Nothing can have a more  direct tendency
 to increafe the difeafe than confining  the  patient to a
 clofe apartment.   Were he forced to ride or walk a
 certain number  of miles  every day,  it would tend
greatly  to alleviate his diforder ; but it would have
ftill a better effect, if  he  were obliged to labour a
 piece of ground.   By digging, hoeing, planting, fow-
 ing, Sec. both the body and mind would be exercifed.
 A long journev, or a voyage, efpecially towards a
        (           l  f 2                  warmer, 
43*            OF MELANCHOLY.
warmer climate, with agreeable companions, has often
very happy effects.  A plan of this kind, with a ftrict
attention to diet, is a much more rational method of
cure, than confining the patient within doors, and ply-
ing him with medicines.
   MEDICINE.—In the cure of this difeafe, parti-
cular attention muft be paid to the mind.  When the
patient is in a low ftate, his mind ought to be foothed
and diverted with variety of amufements, as enter-
taining flories, paftimes, mufic,  &c.  This feems to
have been the method of curing  melancholy among
the Jews,  as we learn from the ftory of king Saul;
and, indeed, it is a very rational one.   Nothing can
remove difeafes of the mind fo effectually as applica-
tions to the  mind itfelf, the moft efficacious of which
is mufic.   The patient's company ought, likewife, to
confift of fuch perfons as are agreeable to him. People
in this ftate are apt  to conceive unaccountable  aver-
fions againft particular perfons ; and the very fight of
fuch perfons is  fufEcicnt to diffract their minds, and
throw them into the utmoft perturbation.
   When the patient's ftrength is high, or the ftate of
the pulfe  admits of it, evacuations are neceffary.  In
this cafe,  he muft be  bled, and  have his body kept
open by purging medicines, as manna, rhubarb, cream
of tartar, or the foluble tartar.   I have feen the laft
have very happy effects.   It may be  taken in the dofe
 of half an ounce, diffolved in water-gruel, every day,
for fundry weeks, or  even for months, if neceffary.
 More  or lefs may be given according as  it operates.
 Vomits have likewife a good effect; but they muft be
pretty ftrong, otherwife they will not operate.
   Whatever increafes the evacuation  of  urine or
promotes perfpiration, has a tendency to remove this
difeafe.   Both thefe fecretions may  be  promoted by
the ufe of nitre and vinegar.  Half a drachm of pu-
 rified nitre may be given three or  four times a-day,
                                                in 
               OF MELANCHOLY.            457
in any manner that is moft agreeable to the patient;
and an ounce and a half of diftilled vinegar may be
daily  mixed with  his drink.  Dr Locker feems to
think vinegar the beft medicine that can  be given in
this difeafe.
   Camphire and mufk have likewife been ufed in this
cafe  with  advantage.   Fifteen or twenty grains of
camphire  may be  rubbed  in a  mortar with half a
drachm of nitre, and taken twice a-day, or oftener,
if the ftomach will bear it.   If it will not fit upon the
ftomach in this form, it may be  made into pills with
gum afafoetida and  Ruffian caftor, and taken in the
quantity above  directed.   If mufk is  to be adminif-
tered, a fcruple or twenty-five grains  of it may be
made into a bolus with a little honey or  common
fyrup, and taken twice or thrice a-day.  We do not
mean, that all thefe medicines  fhould be  adminif-
tered at once; but which ever of them  is given, muft
be duly perfifted in, and where one fails another may
be tried.
   As it is very difficult to induce patients in this dif-
eafe to take medicines,  we fhail mention a few out-
ward applications, which  fometimes do good; the
principal  of thefe  are iffues,  fetons, blifters, and
warm-bathing.  Iffues may be made in any part of the
body, but they generally  have the beft effect near
the fpine.  The difcharge from thefe may be greatly
promoted  by  dreffing them with the mild bliftering
ointment, and keeping what are commonly called the
orrice peafe in them.   The moft proper place for a
feton is between the flioulder-blades; and it ought to
be placed upwards and downwards, or in the direction
of the fpine.   Blifters to the ankles have been found
to be peculiarly  ferviceable in this difeafe*.

   * There are two cafes of melancholy in which the fymp-
toms are very diftreffing, and in which, however, we may pro-
mise our patients a recovery, from time, exercife, and change
                        F f 3                   of 
C  438  1
                 OF THE PALSY.

   The palfy is a lofs or diminution  of fenfe or mo-
tion, or of both, in one or more parts of the body.
Of all the affections called nervous,  this is the moft
fuddenly fatal.  It is more or lefs dangerous according
to to the importance of the part affected.  A palfy of
the heart, lungs, or any part neceffary to life, is gene-
rally mortal.   When it affects the ftomach,  the intef-
tines, or the bladder, it is highly dangerous.  If the
face be affected, the cafe  is bad, as it fliews that  the
difeafe  proceeds from the brain.   When the part af-
fected feels  cold,  is infenfible, or waftes  away,  or
when the judgment or memory begin to fail, there is
leaft hope of cure.
   CAUSES.—The immediate caufe of the palfy  is,
any thing that  prevents the regular  exertion of the
nervous power, upon any particular mufcle or part
of the body.   The occafional  and predifpofing caufes
are  various,  as drunkenefs;  wounds  of the brain,
or fpinal marrow;  preffure upon the brain or nerves;
very cold or damp air ; the fuppreffion of cuftomary
evacuations ;  fudden fear ; want of exercife ; or what*
ever greatly  relaxes the  fyftem, as drinking  much
tea*, or coffee, &c.  The palfy may likewife proceed

of air and objects.  I mean thofe cafes which occur after fevers,
and to women after lying in.   In  thefe, it is the duty of the
phyfician constantly to  endeavour  to infpire his patients with
hope, as there are few or no cafes  of the kind, which do not
terminate favourably.
   *  Many people imagine, that tea has no tendency to hurt
the nerves, and  that drinking  the fame quantity of warm  wa-
ter would be equally pernicious.  This, however, feems to be
a miflake. Many  perfons drink three or four cups of warm
milk and water daily, without feeling any bad confequences;
yet the fame quantity of tea  wi'.l make their hands /hake for
twenty-four bouts.  That tea affects  the nerves,  is likewise
evident from  its preventing fleep, occasioning giddincf-, dim-
pefsof the fight, ficknefs., %c.
                                               r 
                 OF THE PALSY.              439
from wounds of the nerves themfelves, from the poi-
fonous fumes of metals or minerals, as mercury, lead,
arfenic.
  In young perfons of a full habit the palfy muft be
treated in the fame manner as the fanguine apoplexy.
The patient muft  be bled,  bliftered, and have his
body opened by fharp clyfters or purgative medicines.
But. in old age, or when the  difeafe proceeds from
relaxation or debility', which is  generally the cafe, a
quite  contrary courfe muft be  purfued*.   The diet
muft be warm and  invigorating,  feafoned with fpicy
and aromatic  vegetables, as muftard,  horfe-radifh,
&c.  The drink may be generous wine  and muftard-
whey.   Friction  with the flefh-brufh or  a warm
hand,  is extremely proper, efpecially on  the  parts
affected.   Bliftering-plafters may likewife be applied
to the affected parts with advantage, and particularly
to the head in cafes  of coma  or delirium.  When
this cannot be done, they may be rubbed with the
volatile liniment, or the nerve ointment of the Edin-
burgh difpenfatory.   One of the beft  external ap-
plications is electricity.  The fliocks fliould be received
on  the part affected ;  and they ought daily to be re-
peated for feveral weeks.
   Cephalic fnuff, or any thing that makes the patient
fneeze, is  likewife  of ufe.  Some  pretend to have
found great benefit from rubbing the parts  affected
with nettles ; but this does not  feem to be  any way
preferable  to bliftering.  If the  tongue is  affected,
the patient may gargle his  mouth frequently with
brandy and muftard; or he may hold a bit of fugar
in his  mouth  wet  with  the compound fpirits of la-
vender.   The wild  valerian root is a very proper

  * It often happens, however, that the fame treatment db
redt-d for the young is neceffary in old perfons, at leaft in a
decree, if the pulfe is  vigorous, an J. there are fymptoms of
fulnefi.
                     E f 4                  medicine 
 440.           OF THE EPILEPSY,
 medicine in this cafe.  It  may either  be taken in an
 infufion with fage-leaves, or half a drachm of  it in
 powder may be given in a glafs of wine three times
 a-day.  If  the  patient  cannot ufe  the valerian, he
 may take of fal volatile oleofum,  compound fpirits of
 lavender,  and tincture of caftor, each  half an ounce;
 mix thefe together,  and take forty or fifty drops in
 a glafs of wine three or four times a-day.  A table-
 fpoonful of muftard-feed  taken daily about eleven
 o'clock, is a very good medicine.  The patient ought
 likewife to  chew cinnamon  bark, ginger, or other
 warm fpiceries.
   Exercife is of the utmoft importance in the palfy;
 but the patient muft beware of cold, damp, and moift
 air.  He  ought to wear  flannel next his fkin ;  and,
 if poffible, fliould remove into a warmer climate.

  OF THE  EPILEPSY,  OR FALLING .SICKNESS.

  The  epilepfy is  a fudden deprivation  of all the
 fenfes, wherein the patient falls fuddenly down,  and
 is affected with violent convulfive motions.   Children,
 efpecially  thofe  who are delicately brought up, arc
 moft fubject to it. It more frequently attacks men than
 women, and is often very difficult to cure.  When the
 epilepfy attacks children,  there is reafon to hope it
 may go off about the time  of puberty.
  When it  attacks any perfon after twenty years of
 age, the cure is difficult; but when after forty, a
 cure is hardly  to be expected.   If the fit continues
 only for a fhort fpace,  and returns feldom, there is
 reafon to hope; but if it continues long, and  returns
 frequently,  the  profpect is bad.  It is^ an unfavour-
able fymptom when the  patient is  feized with the fits
 in his fleep.
  CAUSES.—The epilepfy is fometimes hereditary.
ft may likewife proceed from blows, bruifcs, or wounds 
            OR FALLING SICKNESS.         441
on  the head ;  a collection of water, blood, or ferous
humors in the brain ;  a polypus; tumors  or concre-
tions  within the fkull; exceffive drinking;  intenfe
fludy; much bodily fatigue; excefs of venery; worms;
teething ; fuppreffion  of cuftomary evacuations ;  too
great emptinefs or repletion ; violent paffions or affec-
tions of the mind, as fear, joy, &c.; hyfteric affections;
contagion received into the body, as the infection of
the fmall-pox, meafles, Sec.
  SYMPTOMS.—An epileptic fit is generally pre-
ceded by unufual wearinefs ; pain of the head ; dul-
nefs ; giddinefs ; noife in the ears ; dimnefs of fight;
palpitation of  the heart; diflurbed fleep ; difficult
breathing; the  bowels are inflated with wind ;  the
urine is in great quantity, but thin ; the complexion
is pale ; the extremities are cold ; and the  patient
often feels, as it were, a ftream of cold air afcending
towards  his head, and it often comes on fuddenly
without any previous  notice.
  In the fit, the patient generally makes an unufual
noife; his thumbs are drawn  in towards the palms
of his hands ;  his eyes are diftorted ;  he  ftarts, and
foams at the mouth ;  his extremities are bent  or
twilled various ways; he often difcharges his urine and
fasces involuntarily ; and is quite deftitute of all fenfe
and reafon.  After the fit is over, his fenfes gradually
return, and he complains of a kind of ftupor, wearinefs,
and pain of his  head  ; but has no remembrance of
what  happened to him during the fit.
  The fits are fometimes excited by violent affections
of the mind, a debauch of liquor, exceffive  heat, cold,
or the like.
  This  difeafe, from the difficulty of inveftigating
its  caufes, and  its  ftrange fymptoms, was formerly
attributed to the wrath of the  gods,  or the  agency
of  evil  fpiiits.   In  modern times it  has  often,  by
die vulgar,  betn imputed to  witchcraft,  or ihfeina-
                                             tior.. 
 44*            OF THE EPILEPSY,
 tion.  It depends, however, as  much  upon natural
 caufes as any other malady ; and  its cure may of-
 ten  be affected by perflating in the ufe of proper
 means.
    REGIMEN.—Epileptic patients ought, if poffi-
 ble, to breathe a  pure and  free  air.    Their diet
 fhould be light  but  nourifhing.   They  ought  to
 drink  nothing  ftrong, to avoid fwine's flefli,  water-
 fowl,  and likewife all  windy  and  oily vegetables,
 as cabbage,  nuts,  Sec.   They ought to endeavour
 to keep themfelves cheerful, carefully guarding againft
 all violent paffions, as anger, fear, exceffive joy, and
 the  like.
    Exercife is likewife of great ufe ; but  the patient
 muft be careful to avoid all extremities either of heat
 or cold, all dangerous fituations, as ftanding upon pre-
 cipices, riding through deep waters, and fuch like.
    MEDICINE.—The  intentions of cure muft vary
 according to the  caufe of the difeafe.  If the patient
 be of a fanguine  temperament, and there be reafon
 to  fear  an obftruction in the brain, bleeding and
 other  evacuations will be neceffary.  When the dif-
 eafe is occafioned by the ftoppage of cuftomary eva-
 cuations, thefe, if poffible, muft be reftored ; if this
 cannot be done,  others may be fubftituted in their
 place.    Iffues  or fetons in  this cafe have  often a
 very good effect.   When there  is reafon to believe
 that die difeafe proceeds from worms, proper  medi-
 cines muft be ufed to kill, or carry off thefe vermin.
 When the difeafe proceeds from teething, the body
" fliould be kept open  by emollient  clyfters, the feet
 frequently bathed in warm  water, and, if the fits
 prove  obflinate, a bliftering-plafter  may be  put be-
 tween  the fhoulders.   When  epileptic  fits precede
 the  eruption of the fmall-pox or meafles, the method
 pointed out in the chapter on the fmall-pox is to  be
 followed.
                                             When 
            OR FALLING SICKNESS.         443
   When the difeafe is hereditary, or proceeds from
a wrong formation of the brain, a cure is fearcely to
be expected.   When it is owing to a debility, or too
great an irritibility of the nervous fyftem, fuch me-
dicines as tend to brace and ftrengthen the nerves may
be ufed, as the Peruvian bark, and fleel.
   The flowers of zinc have been highly extolled, for
the cure of the epilepfy.  Though this medicine will
not be found to  anfwer the expectations which have
been  raifed  concerning it,  yet in obftinate epileptic
cafes it  well deferves a trial.   The dofe is from one
to three or four grains, which may be taken either in
pills or a  bolus, as the patient inclines.  The beft
method is to  begin with a fingle grain four or five
times a-day, and gradually to increafe the dofe as far
as the patient can bear it.   I  have known  this medi-
cine,  when duly perfifted in,  prove beneficial.   The
cuprum ammoniacum in the form of pills, two grains
two or three  times a-day, and the blue vitriol in the
fame form, in a dofe of one fourth of  a grain twice
a-day, are of great fervice in thofe cafes of epilepfy
which are evidently connected with hyfteria ; and it
is  in thefe cafes the zinc does good.       ,
   Mufk has fometimes been found to fucceed in the
epilepfy.  Ten or twelve grains of it, with the fame
quntity of factitious cinnabar,  may be made up into
a bolus, and taken every night and morning.
   Sometimes the epilepfy has been cured by electri-
city.  Change of air will often produce the moft hap-
py effects.
   Many kind of convulfion-fits proceed from the fame
caufes, and muft be treated in  the fame manner as the
epilepfy.
  There is one  particular  fpecics of convulfion-fits
which  commonly goes by  the  name of St Vitus's
dance, wherein the patient  is  agitated with ftrange
motions and  gefticulations, which by  the common
                                           people 
 44+            OF THE HICCUP.
 people are generally believed  to be the effects of
 witchcraft.   This  difeafe may be cured by repeated
 bleedings and purges ; and afterwards ufing the me-
 dicines prefcribed above for the epilepfy, viz. the
 Peruvian  bark,  cuprum  ammoniacum, and  blue vi-
 triol.   Chalybeate waters are found to be beneficial
 in this  cafe.   The  cold  bath is likewife of fingular
 fervice, and  ought never to be neglected when the
 patient can bear it.  Change of climate and fea voy.
 ages are remedies  of the utmoft  importance  in  this
 difeafe.

                OF THE HICCUP.

   The hiccup is a fpafinqdic or convulfive affe&ion
 of the  ftomach  and midriff,  arifing  from any caufe
 that irritates  their  nervous fibres.
   It may  proceed from excefs in eating or drinking;
 from a hurt of the ftomach ; poifons  ; inflammations
 or fchirrous tumors of the ftomach, inteftines, bladder,
 midriff, or the reft of the vifcera.  In gangrenes, acute
 and malignant fevers, a hiccup is often the forerunner
 of death.
   When the hiccup proceeds from the ufe of aliment
 that is flatulent, or hard of  digeftion, a draught of
 generous wine, or a tea-cupful of mint-water will ge-
 nerally remove it.   If poifon be the  caufe, plenty of
 milk and oil muft be drank, as has been formerly re-
 commended.   When it proceeds  from an inflamma-
 tion of the ftomach, &c. it is very dangerous.   In  this
 cafe the cooling regimen ought to be ftrictly obferved.
 The patient muft be bled, and a blifter applied to the
 region of  the ftomach.
   When  the hiccup proceeds from  a gangrene or
mortification,  the Peruvian bark, with  other anti-
feptics,  are the only  medicines which have a chance
 \q fucceed,.   When it is a primary difeafe, and pro-
                                            ceeds 
                OF THE  HICCUP.            44;
ceeds from a foul ftomach, loaded  either with a pi-
tuitous or a bilious humor, a gentle vomit and purge,
if the patient be able to bear them, will be of fervice.
If it arifes from  flatulencies, the carminative medi-
cines muft be ufed.
   When the hiccup proves very obftinate, recourfe
muft be  had to the moft powerful aromatic and an-
tifpafmodic  medicines.  The principal  of thefe  is
mulk; fifteen or  twenty  grains  of which may be
made into a bolus and  repeated occafionally.  Opi-
ates are likewife of fervice.   A bit of fugar dipped
in compound fpirits of lavender, or the  volatile aro-
matic tincture, may be taken frequently.   Externa!
applications are fometimes alfo beneficial;  as the fto-
mach plafter, or a cataplafm of  the Venice treacle  of
theEdinburgh or London Difpenfatory, applied to the
region of the ftomach.
   I lately attended a patient  who  had almoft a con-
ftant hiccup for above nine weeks.  It was frequent-
ly ftopped by the ufe of mufic, opium, wine, and other
cordial and  antifpafmodic medicines,  but always re-
turned.  Nothing, however, gave the patient fo much
eafe as brifk fmall-beer.   By drinking freely of this,
the hiccup was often kept off for feveral days, which
was more than could be done  by the  moft power-
ful medicines.  The patient was at length feized with
a vomiting of blood, which foon put  an end to his
life.   Upon opening the body, a  large fchirrous tu-
mor was found near the  pylorus  or  right orifice of
the ftomach.
   The hiccup may be removed  by taking vinegar, or
a few  drops of the oil of vitriol taken in water.  Wc
know the hiccup may fometimes  be removed by fright,
and by  holding  the  mouth  full  of water; fluffing
the mouth with brown fugar has  iuceeeded in very
bad cafes.
CRAMP 
L  44<5  J
           CRAMP OF THE STOMACH.

   This difeafe  often  frizes  people fuddenly, is very
 dangerous,  and requires immediate affiftance.  It is
 moft  incident to perfons in the decline of life, efpeci-
 ally the nervous, gouty, hyfteric, and hypochondriac.
   If  the patient has great inclination to vomit,  he
 ought to take fome  draughts  of warm-water,  or
 weak camomile-tea, to cleanfe his  ftomach.  After
 this,  if he has been coftive, a laxative clyfter may be
 given.  He  ought then to take laudanum.  The beft
 way  of adminiftering  it is in a clyfter.  Sixty or  fe-
 venty drops of liquid laudanum may be given in a
 clyfter of warm-water.  This is much more certain
 than laudanum given by the mouth, which is often
 vomited, and in fome cafes,  though rarely, increafes
 the pain and fpafms in the ftomach*.
   If the pain and cramps return with  great violence,
 after  the effects of the anodyne  clyfter are over, an-
 other, with  an  equal or a larger  quantity of opium,
 may be given ;  and every four or five hours a bolus,
 with ten or  twelve grains of mufk, and half a drachm
 of the Venice treacle.
   In  the mean  time, the  ftomach ought  to be fo-
 mented with cloths dipped in warm water, or blad-
 ders filled with warm milk and water  fliould be con-
 ftantly applied to it.  I have often feen thefe produce
 the moft happy effects.  The  anodyne balfam may alfo
 be rubbed on the part affected ;  and an anti-hyfteric
 plafter worn upon it for fome time after the cramps
 are removed, to prevent their return.
   In very violent and  lafting pains  of the  ftomach,
 fome blood ought to be let, unlefs the weaknefs of
 the patient forbids it.   When the  pain  or cramps

  * If, however, the pain of the ftomach is violent, laudanum
 muft always be given internally, either alone, or mixed with
ether, mufk, &c.
                       4                 proceed 
             OF THE  NIGHT-MARE.         447
proceed from a fuppreffion of the menfes,  with ple-
thora,  bleeding is of ufe.   If they be owing to the
gout, recourfe muft  be had to ether,  or fome of the
warm cordial waters.   Bhitering-plafters ought like-
wife in this cafe to be applied to the ankles.   I have
often feen violent cramps and  pains of the ftomach
removed by covering  it with a large plafter of Ve-
nice treacle.

             OF THE NIGHT-MARE.

   In tins difeafe, the patient, in time of fleep, imagines
he feels  an uncommon  oppreffion or weight about his
breaft  or ftomach,  which he can by no means fliake
off.  He groans, and  fometimes  cries out, though
oftener he attempts  to fpeak in vain.   Sometimes he
imagines himfelf engaged with an enemy, and in dan-
ger of being killed, attempts to run away,  but finds
he cannot.  Sometimes he fancies  himfelf in an houfe
that is  on fire, or that he is in danger of being drown-
ed in a river.  He  often thinks he is falling  over" a
precipice, and the  dread  of being dallied  to pieces
fuddenly awakes him.
   This diforder has been fuppofed to proceed from
too  much blood ; from a ftagnation of blood in the
brain,  lungs, &c.  But it  is rather a nervous af-
fection,  and arifes chiefly from indigeftion.   Hence
we find that perfons of weak nerves,  who  lead a fe-
dentary life, and live  full, are moft  commonly af-
flicted  with the night-mare.  Nothing tends more
to produce  it than heavy fuppers,  efpecially when
eaten  late,  or the  patient goes to bed foon after.
Wind  is likewife a  very frequent caufe of this  dif-
eafe ;  for which reafon thofe who are afflicted with
it ought to  avoid all flatulent food.  Deep thought,
anxiety, or  any thing that opprelfes the mind, ought
alfo to be avoided.
As 
44*            OF SWOONINGS.
  As perfons afflicted with the night-mare generally
moan, or make fome noife in the fit, they fliould be
waked, or fpoken to by fuch as hear them, as the un-
eafinefs generally goes off as  foon  as  the  patient is
awake.   We would have the patient depend upon
the ufe of food of eafy digeftion, cheerfulnefs, exer-
cife through the day, and a light fupper taken early.
A glafs of pepper-mint-water will  promote digeftion
when any thing of this kind is neceffary.
  Perfons who are young, and full of blood, if trou-
bled with the night-marc, ought to take a purge fre-
quently,  and ufe a fpare diet.

                OF SWOONINGS.

  People of weak nerves or delicate conftitutions arc
liable to fwoonings or fainting-fits.   Thefe indeed arc
feldom dangerous when duly attended to; but when
wholly neglected,  or improperly treated,  they often
prove hurtful, and fometimes fatal.
  The general caufes of fwoonings are, fudden tran-
fition from cold to heat  ; breathing air that is de-
prived of  its  proper fpring  or  elafticity  ; great fa-
tigue ; exceffive weaknefs;  lofs of blood ; long faft-
ing ;  fear, grief, and other violent paffions or affec-
tions  of the mind.
  It is well known, that perfons who have been long
expofed  to  cold, often faint or  fall  into a  fwoon,
upon coming into the houfe, efpecially if they drink
hot liquor, or fit near a large fire.   This might eafily
be prevented by taking care not  to go into  a warm
room immediately after having been  expofed to the
cold air, to approach the fire gradually,  and not to
cat or drink any thing hot,  till the  body has  been
gradually brought into a warm temperature.
  When any one, in confequence  of neglecting thefe
precautions, falls into a fwoon, he ought immediately
                                                to 
                OF SWOONIFrGS.             4^9
 to be removed to  a  cooler apartment, to have liga-
 tures applied  above his  knees and elbows, and to
 have his  hands and face fprinkled with  vinegar or
 cold water.   He fhould likewife be made to fmell to
 vinegar, and fliould have a fpoonful or two of water,
 if he can fwallow, with about a third part oft vinegar
 mixed with  it, poured into his mouth.  If thefe fliould
 not remove  the complaint, it will be neceffary to bleed
 the patient  if the pulfe will  bear it,  and afterwards
 to give  hurt a clyfter.
   As air that is  breathed  frequently  lofes  its  elaf-
 ticity or fpring, it is no  wonder if perfons who re-
 fpire in  it often fall into a fwoon or fainting fie.  They
 arc in this cafe deprived of the very principle of life.
 Hence  it is  that ftdn'ing  fits are fo  frequent in all
 crowded affemblies, efpecially in hot feafons.  Such.
 fit:;, however, muft be confidered as a kind  of  tem-
 porary death ;  and,  to the weak and  delicate,  they
 fometimes prove fatal.   They ought, therefore, with
 the  utmoft  care  to  be guarded  againft.   The me-
 thod of doing this is obvious.  Let all places of pub-
 lic refort, be large and  well  ventilated ;  and let the
 weak and delicate avoid fuch places,  particularly in
 warm feafons.
  A perfon v. ho faints,  in  fuch a fituation, ought
 immediately  to be carried into the  open  air ; his
 temples fliould be rubbed  with ftrong  vinegar or
 brandy, and volatile fpirits or falts held to his nofe.
 fie  fliould  be laid  upon  his  back,  with his head
 low,  and have a little  wine or  fome  other  cor-
 dial, as foon as  he is  able to fwallow  it,, poured
into  his mouth.   If the  perfon   has  been fubject
to hyfteric  fits, caftor  or afafcetida fliould be  ap-
plied to the  nofe, or burnt  feathers, horn, or lea-
 ther, &c.
Rg
When 
45©            OF SW00N1NGS.
   When fainting  fits  proceed from mere  weaknefs
or exhauftion,  which is often the cafe after great fa-
tigue, long fafting, lofs of  blood,  or the  like, the
patient muft be fupported with generous cordials, as
jellies, wines,  &c.  Thefe,  however, muft be given
at firft in  very fmall  quantities, and increafed gra-
dually as  the patient is able to  bear them.   He
ought to be allowed to lie quite ftill and eafy  upon
his back, with his head low, and fhould have  frefii
air admitted into his chamber.  His food fliould con-
fift of nourifhing broths, fago-gruel with wine, new
milk, and other things of a  light and cordial nature.
Thefe things are to be given out of the fit.   All that
can be done in the fit is, to let him fmell  to a bot-
 tle of Hungary water, eau de luce,  or fpirits of hartf-
 horn, and to rub his temples  with warm brandy, or to
 lay a comprefs dipped in it to the pit of the ftomach.
   In fainting fits  that proceed from fear, grief, or
 other violent paflions or affections of the mind, the
 patient muft be very cautioufly managed.  He fliould
 be fuffered to remain  at reft, and only made to fmell
 to fome vinegar.   After he is  come to himfelf, he
 may drink freely of warm lemonade,  or  balm-tea,
 with fome orange or lemon-peel in  it.  It will likewife
 be proper, if the fainting fits have been long and fe-
 vere, to cleanfe the bowels  by throwing in an  emol-
 lient clyfter.
    It is common in fainting fits, from whatever caufe
 they proceed,  to bleed the patient. , This practice
 may be  very proper in ftrong perfons of a full habit;
 but in thofe who are  weak  and delicate, or fubject
 to nervous diforders, it  is  dangerous.   The proper
 method with fuch people is, to expofe them to the
 free air, and to ufe cordial and ftimulating medicines,
 as volatile falts, Hungary-water,  fpirits of lavender,.
 tincture of caftor  and the like.
OF 
C  451  ]
         OF FLATULENCIES,  OR WIND.

   All  nervous patients, without exception, are af-
flicted  with wind or flatulencies in the ftomach and
bowels, which arife chiefly from  the want  of tone
or vigour in thefe organs.   Crude  flatulent aliment,
as green peas, beans, coleworts, cabbages,  and fuch
like, may  increafe this complaint; but  ftrong and
healthy people are feldom troubled  with wind,  unlefs
they either overload their flomachs, or drink liquors
that are in a fermenting ftate, and confequently full
of elaftic air.   While,  therefore,  the matter  of fla-
tulence proceeds from our aliments, the caufe  which
makes  air feparate from them in fuch quantity as to
occafion "complaints, is almoft always a fault of the
bowels themfelves, which are too weak either to pre-
vent the production of elaftic  air, or to expel it after
it is produced.
   To  relieve this  complaint,  fuch medicines  ought
to be ufed as have a tendency to expel wind, and by
ftrengthening the alimentary canal, to prevent its being
produced there*.
   The lift of medicines for expelling wind is very nu-
merous; they often, however, difappoint the expecta-
tions of  both the phyfician  and his patient.   The
moft celebrated among this clafs of carminatives are
juniper-berries;  the  roots  of ginger and  zedoary ;
the feeds of anife, caraw;iy, and coriander ; gum afa-
fcetida and opium ; the warm waters, tinctures, and
fpirits, as the aromatic water, the tincture of wood-
foot, the volatile aromatic fpirit, ether, Sec.

   '  Many nervous people find great benefit from eating a
dry  bifcuit, efpecially when the  ftomach is empty.   I look
upon this as one of the beft carminative medicines : and would
recommend it in all  complaints of the  ftomach, ariGng from
 flatulence, indigeftion, &c.
                        G  g  2                  Dr 
452      OF FLATULENCIES, OR WIND.
   Dr  Whytt fays,  he  found  no  medicines  more
efficacious in expelling wind,  thrm aether and lauda-
num.  He generally gave the laudanum in a mixture
with peppermint  water and  tincture  of caftor,  or
ftveet fpirits of nitre.   Sometimes,  in place of this,
he gave opium in pills with afafcetida.  He obferves,
that the good  effects  of opiates are equally confpi-
cuous, whether the  flatulence  be contained in the
ftomach or inteftines;  whereas thofe warm medicines,
commonly  called  carminatives,  do not  often  give
immediate  relief,  except when the  wind'  is in the
ftomach.
   With regard to arther,  the  Doctor fays, he has
often feen very good effects ffrom  it in  flatulent com-
plaints, where other medicines failed.   The dofe is a
tea-fpoonful mixed with two table-fpoonfuls of water*.
   When  the  cafe  of flatulent patients is fuch as
makes it improper  to give them warm medicines in-
wardly,  the Doctor recommends  external applica-
tions,  which are fometimes  of  advantage.  Equal
 parts of the anti-hyfteric and ftomach plafter may be
 fpread upon a piece of foft leather, of fuch fize as to
cover  the greater part of the belly.   This fhould be
 kept on for a confiderable time, provided the patient
 be able to  bear it;  if it fliould  give great- lineafmefs,
 it may be taken off,  and the following liniment ufed
 in its ftead :
   Take of Bates's anodyne balfam an ounce ; of the
 expreffed oil of mace half an ounce ; oil of mint, two
 drachms.   Let thefe ingredients  be mixed together,
 and about  a table-fpoonful well rubbed 0:1 the parts
 at bed-time.

   * Though the p-.tient may begin with this quantity, it will
 be nec,eiT,iry  to increafe the dofe gradually, as the ftomach can
 bear it. ^ ./Ether is now given in confiderably greater dofes than
 h was  in Dr Whytt'a time.
                                                For 
          OF FLATULENCIES, OR WIND.      453
   For ftrengthening the ftomach and bowels,  and
 confequently for leffening the  production  of flatu-
 lence, the Doctor  recommends the Peruvian  bark,
 bitters, chalybeates, and exercife.   In flatulent cafes,
 he thinks  fome nutmeg or ginger lhould be added
 to  the tincture of the  bark  and bitters, and that
 the aromatic powder fliould be joined with the filings
 of iron.
   When windy complaints are attended with coftive-
 nefs, Vvhich is often the cafe, few things will be found
 to anfwer  better than  four or  five of the following
 pills, taken every night  at bed time :
   Take of afafcetida two drachms; focotorine aloes,
 fait  of  iron,  and  powdered  ginger,  of each one
 drachm; as  much of the elixir proprietatis as will be
 fufficient to form them into pill-:.
   On the other hand,  when  the body is too open,
 twelve or  fifteen  grains of rhubarb,  with half a
 drachm or two fcruples of the japonic  confection,
 given  every  other evening,  will  have  very  good
 effects.
   In thofe flatulent complaints which come on about
 the time the menfes ceafe, repeated fmall bleedings
 often give more relief than any other remedy.
   With, regard to diet, the  Doctor obferves,  that
 tea,  and likewife  all flatulent aliments  are  to be.
 avoided.
  As Dr Whytt has paid great attention to this fub-
ject,  and as his fentiments upon it in a great  mea-
fure  agree  with mine,  I have taken the liberty to
adopt  diem ; and  fliall  only  add to   his obferva-
tions, that  exercife is,  in my opinion, fuperior to
ail medicine,  both for preventing the production and
likewife for expelling  of  flatulencies.  Thefe  effects,
however, are not  to be expected from  fauntering
ji.jout, or- lolling in  a  carriage;  but  from labour,
                      & g 3                    or 
454            OF LOW  SPIRIT'.
cr fuch active amufements as give exercife to every
part of the body.

               OF LOW SPIRITS.

   All who have weak nerves are fubject to low fph
rits, in a greater or lefs degree.  Generous diet, the
cold bath, exercife, and amufements,  are  the moft
likely means to remove this complaint.   It is greatly
increafed  by folitude and indulging gloomy ideas ;
but  may often be relieved by cheerful company and
fprightly amufements.
   When  low fpirits  are owing to a weak  relaxed
fhite of the ftomach and  bowels, an infufion of the
Peruvian  bark,  with cinnamon, or nutmeg,  will be
proper.   Steel  joined with  aromatics  may  likewife
in this cafe be ufed with advantage ; but riding, and
a proper diet, are moft to be depended on.
   When  they arife from a foulnefs of  the  ftomach
and  inteftines, or obftru6tion  in the hypochondriac
vifcera, aloetic purges will be proper.   I have fome-
times known the Harrowgate fulphur-water of fervice
in this cafe.
   When  low  fpirits  proceed  from a fuppreffion of
the  menftrual or  of the hemorrhoidal flux,  thefe
evacuations may  either be reftored, or fome others
fubftituted in  their  place, as iffues, fetons, or the
like.   Dr  Whytt obferves, that  nothing  has fuch
fudden good effects  in this  cafe as bleeding.  The
propriety of this evacuation, however,  muft depend
on the ftate of the pujfe and general habit.
   When  low fpirits have been brought on   by long-
continued grief, anxiety,  or  other dillrefs  of mind,
agreeable company, variety of amufements, and change
of place,  efpecially travelling into foreign countries,
vill  afford the mofl certain relief.
Perfon^ 
          OF HYSTERIC AFFECTIONS.       455
   Perfons  afflicted  with low fpirits fhould avoid atf
hinds of excefs, efpecially of venery and ftrong li-
quors.  The moderate ufe of wine is by no means
hurtful; but when  taken to excefs, it weakens the
ftomach, vitiates the humors, and depreffes  the  fpi-
rits.   This caution  is the more neceffary, as the un-
fortunate  and melancholy often fly to ftrong liquors
for relief, by which means they never fail to precipi-
tate  their own deftruction.

          OF HYSTERIC AFFECTIONS.

   Thefe alfo belong to  the  numerous tribe of ner-
vous difeafes, which may be reckoned the reproach
of medicine.  Women  of a delicate habit, whofe
ftomach and inteftines are relaxed, and  whofe ner-
vous fyftem is extremely fenfible, are moft fubject
to hyfteric complaints.  In fuch perfons an  hyfteric
fit, as it is called, may be brought on by  an irritation
of the nerves of the ftomach or inteftines, by wind,
acrid humor,  or the like.  A fudden fuppreffion of
the menfes often gives rife to hyfteric fits.  They may
likewife be excited by  violent  paffions  or affections
of the mind, as fear, grief,  anger, or  great disap-
pointments.
   Sometimes  the hyfteric fit refembles  a fwoon or
fainting fit, during which the patient  lies  as  in  a
fleep, only the breathing is fo  low as  fcarce to be
perceived.   At other times  the  patient is  affected
with catchings  and  ftrong convulfions.   The fymp-
toms which precede hyfteric fits are likewife  vari-
ous  in different perfons.  Sometimes the fits come
on with coldnefs of  the extremities, yawning  and
ftretching, lownefs  of fpirits, oppreflion and anxi-
ety.   At  other times  the  approach of the fit  is
foretold by a  feeling, as  if there were  a ball at the
fower part  of the  belly, which gradually  rifes to-
                     G  g 4                wards 
 456       OF HYSTERIC AFFECTIONS.
 wards the ftomach, where it occafions inflation, fick.
 nefs,  and fometimes vomiting ; afterwards it rifes
 into  the  gullet,  and occafions a degree  of fufioca-
 tion, to which  quick breathing,  palpitation of the
 heart, giddinefs  of the head, dimnefs  of  the  fight,
 lofs- of hearing, with convulfive motions of the ex-
 tremities and other parts of the body, fucceed.   The
 hyfteric  paroxyfm is  often introduced  by an immo-
 derate fit  of laughter,  and fometimes it goes off by
 crying.   Indeed there is  not  much  difference be-
 tween the laughing and crying of an highly hyfteric
 lady.
   Our aim in  the treatment of this difeafe muft be
 to fliorten the'fit or paroxyfm when prefent, and to
 prevent  its return.   The longer the  fits  continue,
 and the more frequently they return,  the difeafe
 becomes  the  more obftinate.   Their  ftrength is in-
 creafed by habit, and they induce fo great a relax-
 ation of  the  fyftem,  that it' is with  difficulty re-
 moved.
   It  is cuftomary, during  the  hyfteric fit  or parox-
 yfm,' to bleed the  patient.  In ftrong perfons of  a
 plethoric  habit,  and where the pulfe is  full, this
 is often  proper ; but in  weak and delicate conftitu-
 tions,  or  where  the  difeafe has been  of long ftand-
 ing, or arifes from inanition, it is not fo fafe.   The
 beft courfe in fuch  cafes  is to  roufe the patient by
 ftrong fmells, as burnt feathers, afafcetida, or fpi-
 rits  of hartfliorn-,  held   to the nofe.   Hot bricks
 may alfo be applied to the foles of the feet, and the
 legs,  arms, and belly may be  ftrongly rubbed -with
 a warm  cloth.  But  the  beft  application is to put
 the feet and legs into warm water.  This is pecu-
 liarly proper when the fits precede  the flow of the
menfes.  In cafe of coftivenefs, a  laxative clyfter,
with afafcetida, will, be proper ; and as foon as the
patient can fwallow,  two  table-fpoonfuls  of a folu-
                                              tion 
           OF HYSERIC  AFFECTIONS         457
tion of afafcetida,  or of fome cordial julep, may be
given*.
   The rueical cure of this diforder will be beft at-
tempted  at a  time when  the patient  is  moft free
from the fits.   It  will  be  greatly  promoted by  a
proper attention  to diet.   A milk and  vegetable
diet, when duly  perfifted  in, will often  perform  a
cure.  If,  however, the patient has been accuftomed
to a more generous diet, it will not be fafe to leave
it off all  at once, but by degrees.   The belt general
rule in thefe cafes is to ufe a low diet, when ,ihe pa-
tient is apt to be feverifh, but not to perfift in it,  if
the  ftomach is weakened  by  it.   The moft  proper
drink  is  water with a fmall  quantity of  wine.   A
cool dry air is the  beft.   Cold bathing, and every
thing  that braces  the nerves, and invigorates  the
fyftem, is  beneficial ;  but  lying  too long  in  bed,
or whatever relaxes the body, is hurtful.   It  is of
the  greateft importance to have the mind kept con-
ftantly eafy and cheerful;  and, if poffible, to have
it  always engaged  in fome agreeable a-id irttercilhig
purfuit.
   The proper medicines are thofe which ftrengthen
the  alimentary canal and the  whole nervous  ft Item,
as die preparations of iron,  the Peruvian  bark, and
other  bitters.   Twenty  drops of the  elixir of vi-
triol, in  a cup of the  infufion of the bark,  may
be  taken  twice  or  thrice  a-day.    The  bark and

  * When hyfteric fits are occafioned by fympathy, th-y m-'v
be cured by  exciting an oppofite paflion.  Tin's is {Yd t. haw
been the cafe with a whole fchoel of young ladies in Holf-md,
who were  all cure! by being told, that the ii:ft who wasfei./?d
fhould be  burnt to  death.   But this  method of cure, to rnv
knowledge,  will not always fucc.jd.  I  v. idd therefore ad-
vife,  that young luiieswho are fubjecl  to hylteric fits fin.id.!
not be fern to boarding fchnols, as the difeafe m.iy be caught
by imitation.. I have known  mad.icfs  hf.if brought out,,
fympathy.
                                               iron 
45s        OF HYSTERIC AFFECTIONS,
iron may  likewife  be taken  in  fubftance, provided
the ftomach  can bear them ;  but they are generally
given in too fmall  dofes  to have  any effect.  The
chalybeate waters generally prove beneficial  in this
diforder.
   If the ftomach is loaded with phlegm,  vomits will
be of ufe ; but  they fliould  not be too ftrong, nor
frequently repeated,  as   they  tend  to  relax  and
weaken  the  ftomach.  If there be a  tendency to
coftivenefs, it muft be removed either by diet, or
by taking an opening pill as  often  as  it fhail  be
found  neceffary.
   To  leffen  the irritability of the fyftem, antifpaf-
modic  medicines  will be  of ufe.   The beft antifpaf-
modic  medicines are afafcetida, rrufk, opium, and
caftor.   When opium disagrees with the ftomach,  it
may either be applied externally, or given in clyfters.
It is often fuccefsful in  removing thofe periodical
head-aches to which hyfteric and hypochondriac pa-
tients  are fubject.   Caftor has in  fome cafes been
foue.d  to procure fleep where opium failed ; for which
reafon  Dr Whytt advifes, that they fliould be joined
together.  He likewife recommends the anti-hyfteric
plafter to be  applied  to the abdomen*.
   Hyfteric women  are often  afflicted with  cramps
in various parts of the  body, which  are moft apt
i; ieize them in bed, or  when afleep.   The moft
eflic.icious medicines in  this  cafe are  opium, blif-
tering-plafters, and  warm bathing or  fomentations.
When the cramp or fpafm is  very  violent,  opium  is

  * Though anrifpafmndics and anodynes are univerfally re-
c:-.mnjcnd«d in this difeafe, }et all the extraordinary cures that
I evci knew in  hyfteric cafes, were  performed by means of to-
nic and  corroborating medicines ; and though it may  often be
neceflary to ufe opium,  yet it  is by no means  a f„fe medicine
to be m the conftant ufe cf: afafcetida is, generally, equally
• :• int.ae powerful,  and perfectly fafe.
                                               the 
      OF HYPOCHONDRIAC AFFECTIONS.   45-,
fhe remedy moft to  be depended on.  In  milder
cafes, immerfing  the  feet and legs in warm  water,
or applying a bliftering plafter to the part affected,
will often be fufficient to remove the comphe: :.  In
patients whofe nerves are uncommonly delicate and
feniible,  it will he better to omit the bhftcring-plaf-
ler, and to attempt the cure by opiates, mulk, cam-
phire,  and the warm bath.
   Cramps are often prevented cr cured by  com pre f-
fion.   Thus, cramps in the legs are prevented, and
fometimes  removed,  by tight bandages; and when
convulfions arife  from a flatulent diftention  cf the
inteftines,  or from fpafins beginning in them, they
may be often leffened or cured by making a pretty
ftrong compreflion upon the abdomen, by means cf a
broad belt.   A roll of brimftone, held  in die hand,
is  frequently ufed as a remedy for cramp-:.   Though
this feems to  owe its  effects chiefly to  imagination ;
yet,  as  it fometimes fucceeds,  it  merits  a  trial".
When fpafins or convulfive motions arife from fharp
humors  in the  ftomach and  inteftines, no  lafting
relief  can'be procured  till thefe are either corrected
or expelled.    The  Peruvian  bark has fometimes
cured periodic convulfions, after other medicines had
tailed.   The  great  remedy, however, is  air and
exercife.

      OF HYPOCHONDRIAC AFFECTIONS.

   This  difeafe generally  attacks the indolent,  the
luxurious, the unfortunate,  and  the  ftudioui.   It
becomes daily more common  in this country,  owing,
no doubt, to the increafe of luxury and iedentary

   * Some perfons afflicted v.i:h cramps pretend to reap great
benefit from fmall bundles  of roiemary tl:i a 1 night about
fheir feet, ankles, and knees.
                                    employmentj. 
 460   OF HYPOCHONDRIAC AFFECTIONS.
 empio /ments.   It has fo near a refemblance  to that
 immediately preceding,  that man}'  authors  conftder
 them, as the feme  difeafe,  and  treat  them  accord-
 ingly.   They  require,  however,  a  very different
 regimen :  and  the  fymptoms of the hitter,  though
 lei's violent, are move permanent than thefe of the
 former.
   Men of a melancholy temperament, whofe minds
 are capable  of great  attention,  and whofe paffions
 are not  eafily  moved, arc, in the, advanced  periods
 or  life,  moil liable to  this  difeafe.   It  is  ufually
 brought on by long and ferious attention to abdruie
 fubjects, grief,  the fuppreffion of cuhmmary evacua-
 tions;, excefs  of venery,  the repulfion  of  cutaneous
 eruptions,  long-continued evacuations,' obftructions
 in fome of the viicara, as the liver,  fpleen, &c.
   TL/nochondriac perfons, ought never to faft long,
 and their food fhould be  folid and nourhhing.  All
 afceicent and wind/ vegetables  are to be avoided.
 Fie'li meats agree oet  whh  them,  and their drink
 fhould be old claret, or good Madeira.
   Clieerfulnefs and  ferenity of  mend, are  by all
 means to be  cultivated.   Exercife  of every  kind is
 ufeful.   The cold  bath is likewife  beneficial ;* and,
 where it does not  agree with the patient, frictions
 with the fiefh-brufh, or a coarfe cloth, may be tried.
 If the patient has it in his power, he ought to travel
 either  by  fea  or -and.   A voyage or a long journey,
 cfacially towards a warmer  Ciivdale,  will be of more
jlrvice than any medicine.
   The general intentions of cure, in this difeafe, are
 to ftrengthen the alimentary  canal,  and to  promote
 the  fecretions.   Thefe  intentions will be  beft an-
 fwered by  the different preparations  of iron and the
 Peruvian bark, which, after proper evacuations, may
 be  taVe-.i in the fame manner as directed in the pre-
 pedim' difeafe.
                                                If 
      OF HYeF'CHONDRIAC AFFECTIONS.   40;
  if the patient be coftive, it will be  neceffary  to
make ufe of fome gentle opening medicine, as pills
compofed of equal parts of aloes, rhubarb, and afa-
fcetida,  with as much of the elixir proprietatis as is
neceffary  to  form the ingredients into pills.   Two,
three, or four of thefe may taken as often as it iha'l
be found necdfnl, to keep the body gently open.  Such
as cannot bear  the  afafcetida may iubititute Spanh'h
foap in  its place.
  Though a cheerful glafs may have good effects in
this difeafe, yet all manner of excefs is hurtful.  In-
tenfe llady, and every thing that depreffes the fpirits,
are likewife pernicious.
   Though the  general fymptoms  and treatment  of
nervous diforders, were pointed out in the beginning
of this chanter ; yet, for the benefit of thofe unhappy
perfons  afilht:d wihi thefe obftinate and complicated
ina'a.iie.-, I havs treated feveral of their capital  fymp-
toms  under diftinct Or feparate he ids.  Thefe, how-
ever, are not to be  confidered as different difeafes,
but  as  various  modifications  of the fame difeafe.
They all  arife from the fame general caufes, and re-
quire nearly the fame method  of treatment.   There
are many other fymptoms that merit particular  atten-
tion, which the nature of my plan will not permit me
to treat of at full length.  I fliall therefore omit them
altogether, and conclude this chapter with a few gene-
ral remarks, on the moft obvious means of preventing
or avoiding nervous diforders.
   In all perfons  afflicted with nervous diforders,
there is a great delicacy and fenfibility of the  whofe
nervous fyftem,  and an uncommon degree  of  weak-
nefs of  the organs of digeftion.   Thefe  may  be
either  natural or  acquired.    When  owing to  a
defect in the conftitution, they are difficult  to  be
removed ;  bait may  be mitigated by  proper care.
When  induced  by difeafes, as  long  cr  repented fe- 
$62   OF HYPOCHONDRIAC AFFECTIONS.
vers,  profufe hamiorrh.ages, or the like, they  prove
alfo very obftinate, but will yield to a courfe of regi-
men and exercife calculated to reftore and invigorate"
the habit.
   But nervous affections arife more frequently front
caufes, which it is in a great .meafure in our own pow-
er to' avoid, than from difeafes, or an original fault in
the conftitution, Sec.   Exceffive grief, intenfe  ftudy,
improper  diet, and neglect of exercife,  are  the  great
fources  of this extenfive clafs  of difeafes.
   It has  been already  obferved that  grief indulged
deftroys the appetite  and digeftion,  depreffes  the
fpirits,  and induces  an univerfal relaxation and de-
bility of the whole fyftem.  Inftances of  this are daily
to be feen.  The lofs of a near relation,  or any other
misfortune in  life, is often fufficient to  occafion  the
moft complicated feries of nervous fymptoms.  Such
misfortunes, indeed,  are not to be avoided, but furely
their effects, by a vigorous and proper exertion  of the
mind, might be rendered lefs hurtful.   For directions
in this matter, we muft refer the reader to the  article
Grief, in die  chapter on the paffions.
   The  effects of intenfe ftudy are pretty fimilar to
thofe occafioned by grief.  It preys upon the animal
fpirits,  and deftroys the appetite and digeftion.  To
prevent thefe effects, ftudious  perfons ought, accord-
ing to  the Poet, to toy with their  books*.   They
fliould  never  ftudy too long at a time ; nor  attend
long  to one particular  fubject,  efpecially if it be of
a  ferious  nature.  They ought  likewife  to be atten-
tive to  their pofture,  and fliould take  care  frequent-
ly to unbend their minds by mulic, diverfions, or going
into agreeable company.
   With regard  to  diet, I fliall only obferve, that
nervous difeafes may be induced either  by excefs or

               * Arrr.ftrr.ng on Health.
manition.- 
      OF HYPOCHONDRIAC AFFECTIONS.    4.65
inanition.   Both of  thefe extremes  hurt digeftion,
and vitiate the humors.   When  Nature is oppreffed
with frefii loads of food,  before  file has had time, to
digeft and aflimilate the former meal, her powers are
weakened, and the veffels are filled with crude hu-
mors.  On  the other hand, when the food is not
fufficiently nourifhing, or is taken  too  feldom,  the
bowels are inflated with wind, and the humors, for
want  of  regular frefii  fupplies of wholefome chyle,
are vitiated.  Thefe extremes  are,  therefore,  with
equal care, to be avoided.  They both tend to induce
a relaxation, and debility of the nervous fyftem, with
all its dreadful train of confequences.
   But the moft general caufe of nervous diforders is
indolcnc:.   The active and laborious are feldom trou-
bled with them.   They are  referved for the children
of eafe and affluence, who generally feel their keen-
eft  force.   All we fliall fay to fuch perfons is, that
the  means  of prevention and cure are both in  their
own power.   If the  conftitution of human nature be
fuch, that man muft either  labour or fuffer difeafes,
furely no individual has any right to expect an exemp-
tion from the general rule.
   Thofe, however, who are willing to take exercife,
but whofe  occupations  confine  them to the houfe,
and perhaps to an unfavourable pofture, really de-
ferve our pity.  We have,  in a former part of the
book, endeavoured to lay down rules for their con-
duct ; and fliall  only add, that  where  thefe cannot
be  complied with, their place may, in fome meafure,
be  fupplied by the ufe of bracing and ftrengthening
medicines, as the Peruvian bark, with other bitters ;
the preparations of fleel; the elixir of vitriol, &c.
CHAP. 
[  4<5+  ]
                  C II  A P.  XLV.

              Diforders of the  Senfes.


           V \ E ao not mean to treat of the nature
 of our fenfations, or to give a minute  defcription of
 the various organs by which they are performed ; but
 to point out fome of the difeafes to which thefe organs
 are moft liable,  and to fliew how they may be pre-
 vented or remedied.

                   OF THE EYE.

   No organ of  the body is fubject to more difeafe*
 than  the eye;  nor is  there any one  of which the
 difeafes  are more  difficult  to cure.  Though more
 ignorant perfons pretend to cure thefe than any other
 clafs of difeafes ; yet a very fuperficial acquaintance
 with  the ftructure of the  eye,  and  the nature of
 vifioii, will be fufficient  to  convince any one of the
 danger of trufting to them.   Thefe difeafes often ex-
 ceed the Jkill of the moft learned phyfician ; hence we
 mayr eafily infer  the danger  of trufting them  to igno-
 rant quacks,  who, without doubt, put out more eyes
 than they cure.   But,  though many difeafes of  the
 eye can  feldom be cured, they might often, by due
 care, be  prevented ; and,  even where the fight is to-
 tally loft, many things might be done, which are gene-
 rally negleffed,  to render the unhappy perfon both
 more ufeful to himfelf and to fociety*.

  * Tt is a pity  thofe  who  have the  misfortune  to be born
blind, or vgio lcie their fight when young, fhould be fuffered
to remain  in ignorance, or to beg.  This is both cruelty  and
 van:- of economy.   There are many employments of which 
OF THE  EYE.
455
   The eyes are hurt by viewing bright or luminous
 objects;  keeping the head  too long in an hanging
 pofture ;  violent  head-aches ;  exceffive venery ;  the
 effluvia from  acrid  or volatile fubftances;  various
 difeafes;  as the fmall-pox, meafles, &c. but, above
 all,  from  night-watching, and candle-light  ftudies.
 Long-fafting is likewife hurtful to  the eyes, and fre-
 quent heats and colds  are no  lefs  pernicious.  The
 eyes are often hurt by the ftoppage of cuftomary eva-
 cuations ;  as morning  fweats ;  fweating of the feet ;
 the menfes in women ; and the bleeding piles in men.
 All kinds of excefs are likewife hurtful to the fight,
 particularly the immoderate  ufe of ardent fpirits and
 other  ftrong liquors.
   In afl difeafes of the eyes, efpecially thofe attend-
 ed with inflammation,  the cool regimen ought to be
 obferved.   The patient muft abftain from all fpiritu-
 ous liquors.  The fmoke of tobacco, fmoky  rooms,
 the vapours of onions and garlic, and all vivid lights
 and glaring colours, are carefully to be avoided.  The
 drink may be water,  whey,  or fmall beer ;  and the
 aliment muft be light and of  eafy digeftion.
   For preventing diforders of the eyes, iffues and
 fetons are of prime ufe.   It will likewife be of ufe to
 keep the body gently open, and  either to  bleed  or
 purge  every fpring and fall.   All  excefs and night

 blind perfons are very capable, as  knitting, carding, turning a
 wheel, teaching languages, &c.  Nor are inftances wanting r.f
 perfons who have arrived at the higheft pitch of learning, with-
 out having the leaft idea of light.  Witnefs the late famous
 Nicholas Saunderfon cf Cambridge, and rhy worthy friend Dr.
Thomas Blacklock of Edinburgh.  The former was erne of
 the firft mathematicians of his age, and the latter, befides  be-
 ing a good  poet and  philofcpher, is matter of all the learned
languages, and a very confiderable adept in the liberal arts.
 To thefe we may add the juftly celebrated natural pl.ilofopher
 and chymid,  Doctor Henry Moyes.
                       H  h                  ftudies 
±66              OF THE EVE
ftudies arc to be  avoided.   Such  ar.  do not chufe
a feton or an  iffue, will  find benefit from  wear-
ing a  fmall  Burgundy-pitch plafter between  their
fhoulders.
  A gutta ferena,  or amaurofis, is an abolition of
the fight without any apparent caufe or  fault in the
eyes.   When it is  owing to a decay or wafting of
the optic nerve, it  does  not  admit of a cure ; but
when it proceeds from a compreflion of the nerves
by redundant humors, thefe may in fome meafure be
drained off, and the patient relieved.   For this pur-
pofe,  the body muft be  kept open with the mercu-
rial purging pills*.   If the patient be young, and of
a fanguine habit, he  may be bled.  Cupping, with
fearifications on the back part of the head, will like-
wife be of ufe.   But the moft likely means of re-
lieving the patient are iffues or blifters  kept open for
a long time on the  bach part  of the  head,  behind
the ears, or on "the neck.  I have  known  thefe re-
ftore  fight, even after  it had been  loft for a con-
fiderable time.
  Should thefe fail, recourfe may  be  had  to a mer-
curial  falivation.   After thefe remedies have been
tried,  or where they are not neceffary,  great relief
may be expected  from electricity.  This fliould  be
ufed daily ; firft fparks, and afterwards flight fliocks,
to the affected part.
  A cataracl is  an  ohftruction of the  pupil, by the
interpoiition  of fome opaque fubftance which either
diminiflies or totally extinguifhes the fight.   It is ge-
nerally an opacity  of the  cryftalline humor.  In a
recent or  beginning cataract,  the  fame  medicines
are to be ufed  as  in the gutta  ferena ;  and they
will  fometimes  fucceed.   But when this  does not
happen,  and the cataract becomes firm, it muft be

         ■'  See .Append:::,  Mercurial purging pill.
                                         couched. 
                  OF THE EYE.               4^7
couched,  or rather extracted.   I have refelved a
recent cataract by giving the patient frequent purges
with  calomel, keeping a poultice of  frefii hemlock
conftantly upon the eye, and a perpetual blifter on
the neck.
   The myopia, or fnort fightednefs; and the prefbyopia,
or feeing only at too great a  diftance,  are  diforders
which depend on the original ftructure or figure of
the eye, therefore  admit of no cure.  The incon-
veniences arifmg from  them may,  however, be in
fome  meafure remedied by the help of proper glaffes.
The former requires  the aid  of a concave,  and the
latter a convex glafs.
   Afirabifmus, or fquintingi depends upon an irre*
gular contraction of the mufcles of  the eye  from a
fpafm, palfy, epilepfy, or an ill habit.   Children often
contract this diforder by having their  eyes unequally
expofed to the  light.  They may likewife acquire it
by imitation from a fquinting nurfe or play-fellow,
Sec.   As this diforder  can  with difficulty be cured,
parents ought  to be careful  to prevent ir.   Almoft
the only  thing which can be done for it is,  to con-
trive  a maik for the child to wear,  which will only
permit him  to fee in a ftraight direction.
   Spots or fpecks on the eyes are generally the effect
of inflammation, and  often  appear  after the fmall-
pox,  the meafles,  or violent  ophthalmias.   They
are very difficult to cure, and often  occafion  total
blindnefs*.
   The blood-jhot  eye may be occafioned by a ftroke,
a fall, retching, vomiting, violent coughing,  Sec.  I
have  frequently known it happen to children in the
whooping-cough.   It appears at firft like a bit q£ fear-
let, and is  afterwards of a livid or blackifli colour.

   * Thefe difeafes may, no doubt, often be cured by firft ufing
the general means for leifening inflammation, if neceffary; then
giving a grain or two of calomel, or a dofe of the mercurial
                       H h z                 powjev 
  46S               OF THE  EAR.
  This diforder  generally goes  off without medicine.
   Should it prove obftinate, the patient may be  Died,
   and have his eyes  frequently waflied with the  vitri-
   olic collyrium ; and the body fliould be kept  open
   by  gentle purgatives.
     The watery or weeping eye, is  generally occafioned
   by a relaxation or weaknefs of the glandular parts of
   that organ.   Thefe  may be braced and ftrengthened
   by bathing the eye with brandy and water, Hungary
   water, rofe-water with white vitriol diffolved in it,
v   &c.   Medicines which make a revulfion  are likewife
   proper ;  as mild purgatives, perpetual blifters on the
   neck, bathing the feet frequently  in lukewarm wa-
   ter, &c.
      When this  difeafe proceeds from an obftruction of
   the lachrymal duct,  or natural paffage of the tears, it
   is called Tififlula lachrymalis,  and can only be  cured
   by  a  furgical  operation : though k may be greatly
   relieved  by continual blifters or  iffues, and avoiding
   the caufes  of irritation and inflammation.

                     OF THE EAR.

      The  functions  of  the  ear  may be  injured by
   wounds, ulcers,  or any thing  that  hurts its fabric
   The hearing may likewife be  hurt by exceffive noife ;
   violent  colds  in   the head ;  fevers; hard wax, or
   other fubftances  fticking in the cavity of the car ;
   too great a degree of moifture or drynefs of the ear.
   Deafnefs is very often  the  effect of old age,  and is
   incident  to moft people in the decline of life.   Some-
   times it is  owing  to an original fault in the ftructure

   powder daily, for fome we,eks,  or months, difcontinuing it  if
   the mouth fhould become fore;  blifters muft at the fame time
   be kept to the back of  the neck, to  the arms, or behind the
   ears ;  and the Peruvian bark ufed in the latter part  of the
   treatment.  The idea of cutting off  ©r deftroying thefpeck
   is a very dangerous one.-
                                                   or 
                     OF THE  EAR.                469

 or  formation ..of the car itfelf.   When  this  is  the
 cafe, in admits of no  cure ;  and the  unhappy  per-
 fon not  only continues deaf, but generally  likewife
 dumb,  for life*.
    When deafnefs is  the effect of wounds or ulcers of
 the  ears,  or of old  age, it  is  not  eafily removed.
 When it  proceeds  from  cold  of the head,  the pa-
 tient muft be careful to keep his  head warm, efpe-
 cially in  the night; he  fhould likewife  take fome
 gentle purges  and  keep  his  feet warm,  and  bathe
 them frequently  in  lukewarm  water  at  bed-time.
 When deafnefs is  the effect of  a fever, it generally

   * Though  thofe who have  the  misfortune  to be born deaf
 are generally fuffered to continue dumb, and confequently are
 in a great meafure loft to fociety, yet nothing is more certain
 than that fuch perfons may be taught not only to read and write,
 but alfo to fpeak and t >  underftand what others fay to them.
 Teaching the dumb to fpeak will appear paradoxical to thofe
 who do not conftder that the formation of founds is  merely
 mechanical, and may be taught  uhhout the affiftance cf the
 ear.  This is not only capable of demonftration, but is actually
 reduced to practice by the ingenious Mr Thomas Braidwood of
 Edinburgh. This gentleman'has, by  the mere force of genius
 and application, brought the teaching of dumb perfons to fuch
 a degree of perfection, that his fcholars are generally more for-
 ward in their education than thofe of the fame  age who enjoy
 all dieir faculties.   The) not only read and write with the ut-
 moft  readinefs, but likewife fpeak, and are c.tpable of holding
 converfation with any perfon in the light.  What a pity that
 any of the human  fpecies fhould remain in a ftate of idiotifm,
 who are capable of being rendered as ufeful and intelligent as
 others! We mention this not only from humanity to thofe who
 have the misfortune to be born  deaf, but alfo in juftice to  Mr
 Braidwood, whofe fuccefs has far exceeded all former attempts
 in this way ; and indeed it exceeds imagination itfelf fo far, that
 no perfon who  has not feen and examined his pupils, can be-
lieve what they are capable of.  As this gentleman, however
 willing;,  is only able to teach a few,  and as the far greater
 part of thole who are born deaf cannot afford to attend him,
 it would be an act of gre.U humanity, as well as of public utility,
 10 erect an academy for their b n. fit.
                          H h  3                   goe-s 
4?o              OF THE EAR.
goes off after the patient recovers.  If it ^roeeeds ti* >m
dry  wax fticking in the ears, it may be foftened by-
dropping oil into them ;  afterwards they muft be fy-
ringed with warm milk and water.
   If  deafnefs  proceeds  from drynefs  of  the cars,
which may be known  by looking into them, half
an ounce of the oil of fweet almonds,  and the fame
quantity of liquid opodcldoch,  or tincture of afafce-
tida,  may be mixed together, and a few drops of it
put  into the ear every  night at bed-time, flopping
them afterwards with a little wool or cotton.  Some,
inftead of oil, put a fmall flice  of the fat  of bacon
into each  ear, which is faid to anfwer the purpofe
very well.   When the ears abound with moifture, it
may be drained off by an iffue or feton, which fliould
be made as near the affected  parts as poffible.
   Some, for the cure of deafnefs, recommend to be
dropped into the ear equal parts of Hungary-water
and  fpirits of  lavender.   Etmuller extols amber and
mufic; and Brookes fays, he has often known hard-
nefs of hearing cured by putting a grain  or two of
mufic into  the ear with  cotton-wool.  But thefe  and
other applications muft be varied according to  the
caufe of the diforder.
   Though fuch applications may fometimes be of
fervice, yet they much oftener fail, and  frequently
they  do hurt.   Neither  the eyes nor ears ought
to be tampered with ;  they are tender organs, and
require a  very  delicate touch.   For this reafon
what we would chiefly recommend in deafnefs, is, to
keep the head warm.  From whatever caufe the  dif-
order proceeds,  this is  always  proper ; and I have
known  more benefit from it alone, in the moft  ob-
ftinate cafes of deafnefs, than from all the medicines
I  ever ufed.
OF 
                     [  471  j           ,

         OF THE TASTE AND SMEL-L.

  Though thefe fenfes are not of fo great importance
to man in a ftate of fociety, as the fight and hearing ;
yet, as  the lofs of them israttended wiih inconveci-
ency, they deferve our  notice.   They are feldom to
be reftored when loft ; which ought to make us very
attentive to their prefervation, by carefully avoiding
whatever may  in the leaft  prove injurious to them.
As  there is a very great  affinity between the organs
of tailing and fmelling, whatever hurts the one gene-
rally affects the other.
  Luxury is highly injurious to thefe organs.  When
the  nofe  and palate  are frequently flimulated by
fragrant  and poignant  difhes,   they foon  lofe  the
power of diftinguifhing  taftes and odours  with any
degree of nicety.  Man, in  a ftate of nature, may
perhaps  have thefe faculties as acute as any other
animal.
  The fenfe of fmelling may be diminiflied or de-
ftroyed  by difeafes ; as, the moifture,  dry nefs, in-
flammation or fuppuration of that membrane which
lines the infide of the nofe,  commonly called the ol-
factory  membrane ;  the  compreffion of the nerves
which  fupply this membrane,  or fome  fault in the
brain itfelf at their  origin.  A  defect or too great a
degree of folidity, of the fmall fpungy bones of the
upper jaw,  the caverns  of the forehead,  &c. may
likewife impair the fenfe of fmelling.   It may alfo be
injured by a collection of foetid matter  in thofe ca-
verns,  which keeps conftantly exhaling frdm  there.
Few things are more hurtful to  the fenfe of fmelling
than taking great quantities of fnuff.
  When the nofe abounds with  moifture, after gentle
evacuations,  fuch things  as tend  to take off irritation,
and coagulate the thin fharp ferum, may be applied ;
:«s the oil of anife mixed with  fine flour ;  camrhire
       ,              H h 4               diffolved 
472       OF THE TASE AND SMELL.
diffolved in oil of almonds^ &c.  The vapours of am-
ber, frankincenfe,  gum-maftic,  and  benjamin, may
likewife be received into the nofe and mouth.
   For moiftening the mucus when it is too dry, feme
recommend fnuff made of the leaves  of marjoram,
mixed with the ,oil of amber, marjoram and anifeed;
or  a  flernutatory  of calcined  white vitriol;  twelve
grains of which may be mixed with two ounces of
marjoram-water, and filtrated.   The fleam or vapor
of vinegar upon hot iron received up  the noftrils is
likewife of ufe for foftening the mucus, opening ob^
ftructions, &c.
   If there is an ulcer in the nofe it ought to be dreffed
with  fome emollient ointment,  to which, if the pain
be very great, a little laudanum may be added.  If it
be a  venereal ulcer, it is not to be cured without mer-
cury.   In that cafe the folution of the corrofive fub-
limate in water may be taken.   The ulcer  ought
likewife  to  be  waflied  with  it ; and  the  fumes of
cinnabar  may be received up the noftrils.
   If  there be reafon to fufpect that the nerves which
fupply the organs  of fmelling are inert,  or want fti-
mulating  volatile falts,  ftrong fnuffs,  and other things
which occafion fneezing, may be applied  to the nofe.
The  forehead may likewife  be anointed with bal-
fam of Peru, to which may be added a little of the
oil of amber.
   The tafte may be diminifhed by crufts, filth, mu-
cus, aphtha?, pellicles, warts, &c. covering the tongue:
k may be depraved by a fault of the faliva,  which,
being difcharged into the mouth, gives the fame fen,
fation as if the food which the perfon takes had really
a bad tafte ; or it may be entirely  deftroyed by in-
juries done to the nerves of the tongue and palate.
Few  things prove  more hurtful either to  the fenfe of
tafting or fmelling than obftinate colds, efpecially thofir
V'h'xh affect the head.
When 
                OF THE TOUCH.             473
  When the tafte is diminifhed by filth, mucus, Sec.
the tongue ought to be fcraped and frequently waflied
with a mixture of water, vinegar, and honey, or fome
other detergent.  When the faliva is vitiated, which
feldom happens unlefs in fevers or other difeafes, the
curing of the diforder is the cure of this fymptom.
To relieve it however in the mean time, the following
things may be of ufe ; if there be a bitter tafte, it may
be taken away by vomits, purges, and other things
which evacuate bile.  What is called a nidorous tafte,
arifing from putrid humors, is corrected by the juice
of citrons, oranges, and other acids.   A fait tafle is
cured by plentiful dilution with watery liquors.  An
acid tafte is deftroyed by abforbents, and alkaline falts,
as powder of oyfter-fhells, fait of wormwood, Sec.
   When the fenfibility of the nerves  which  fupply
the organs of tafte is diminifhed, the chewing of horfe-
radifli, or other ftimulating fubftances, will help to re-
cover it.

                OF THE TOUCH.

   The fenfe of touching may be  hurt  by any thing
that obftructs the nervous influence, or prevents its
being regularly conveyed to the organs of touch-
ing ; as preffure,  extreme cold,  &c.  It may  like-
wife  be hurt by too  great  a degree  of fenfibility,
when the  nerve is not fufficiently  covered by the
cuticle  or fcarf-ikin, or  where  there is too great
a  tenfion  of it or it  is too delicate.   Whatever
diforders the functions  of  the  brain  and  nerves,
hurts the  fenfe of touching.  Hence  it appears  to
proceed from the fame general caufes as palfy and
apoplexy,  and requires  nearly the fame method of
treatment.
   In -dftupor, or defect of touching, which arifes from.
an obftruction of  the cutaneous nerves, the patient
muft firft be purged ; afterwards fuch medicines as
                                             excite 
474     OF A SCHIRRUS AND CANCER.
excite the action of the nerves, or ftimuiate the fyficiw.
may be ufed.   For this purpofe, the fpirit of harts-
horn, horfe-radifli,  chc.  may be taken inwardly ; the
difordered parts, at  the fame time, may be frequently
rubbed  with frefii nettles, or fpirit  of fal ammoniac.
Bliftering-plafters and finapifms applied to the parts
will likewife be of  ufe, as alfo warm bathing,  efpe-
cially in the natural hot baths.
                 CHAP.  XLVI.

            Of a Schirrus and Cancer.


          J\ SCHIRRUS  is an hard  indolent tu-
mor feated in fome of the glands ; as  the  breafts,
the arm-pits, Sec.  If the tumor becomes large,  un-
equal, of a livid, blackifh, or  leaden  colour, and is
attended with violent  pain, it  gets the  name of an
occult cancer.   When  die ikin  is broken, and 3.fi;?;ies
or ichorous matter of an abominable  foetid  fmell is
difcharged from the fore, it is  called an  open or ul-
cerated cancer.   Perfons  after the age of forty-five,
particularly women, and thofe  who lead  an indolent
fedentary life, are moft fubject  to this difeafe.
   CAUSES.—This  difeafe  is often  owing to fup-
preffed  evacuations ;  hence it  proves fo frequently
fatal to women of a grefs habit, about  the time when
die menftrual  fmx  ceafes.   It may likewife be occa-
sioned by exceffive  fear,  grief,  anger, religious me-
ranchol/,  or any of the deprefling paffions.   Hence
J he unfortunate, the choleric, and thofe perfons who
devote themfelves to a religious life in  convents or
monafteries, are often afflicted with jt.  It may alfo
                                               be 
        OF A SCHIRRU3 AND CANCER.      475
be occafioned by the  long continued ufe of  food
that is. too hard of digeftion, or of an acrid nature :
indolence ; cold ; blows ; friction ; preffure ;  or the
like.   Women  often  fuffer from  the' laft  of thefe
by  means of their  flays, which fquceze and com-
prefs  their breaft fo as  to occafion  great mifchief.
.Sometimes the  difeafe is owing to an hereditary dif-
pofition.
  SYMPTOMS.—This diforder  feems  often  very
trifling at the beginning.   A hard tumor about the
fize of a hazle-nut, or perhaps fmaller, is generally
the firft fymptom.   This  will often continue for a
long time without feeming to increafe,  or giving the
patient great uneafinefs ;  but  if the conftitution be
hurt,  or the tumor irritated by preffure, or improper
treatment  of any kind, it begins to extend itfelf to-
wards the neighbouring parts by pufhing out  a kind
of  roots  or limbs.  It  then gets the name of cancer,
from a fancied refemblance between thefe limbs and
the claws  of a crab.   The colour of the fkin begins
to change, which is  firft red, afterwards purple, then
bluifli, livid, and at laft black.  The patient complains
• if heat, with a burning, gnawing, fliooting pain.  The
tumor is very hard, rough, and unequal, with a pro-
tuberance, or rifing in the middle  ; its fize increafes
daily, and the neighbouring veins become thick, knot-
ty, and of a blackifh colour.
   The fkin at  length  gives way, and a thin fiiarp
ichor  begins to flow, which corrodes the neighbour-
ing parts till it forms a large unfightly ulcer.   More
occult cancers   arife,  anci communicate with  the
neighbouring glands.   The pain and flench become
intolerable; the  appetite fails ; the ftrength  is ex-
haufted by a continual hectic  fever;  at  laft, a vio-
lent haemorrhage, or difcharge of blood, from fome
part of the  body,  with  faintings,  or convulfion fit ■.,
generally put an end to the miferable patient's life.
                                     REGIMEN 
 476      OF A SCHIRRUo AND CANCER.
   REGIMEN.—-The diet  ought to be  light,  but
 nour'fhng.   All  ftrong  liquors,  and  high-feafoned
 or fait provifions, are to be avoided.   The  patient
 may take as  much  exercife as he can eafily bear.
 All kinds of external injury are carefully to be guard-
 ed againft, particularly  of the  affected part, which
 ought to be defended from all preffure, and even from
 the external air, by covering it with fur, or foft flannel.
   MEDICINE.—This  is one  of thofe difeafes  for
 which no certain remedy is yet  known.   Its progrcfs
 however may fometimes be retarded, and fome of its
 moft difagreeable fymptoms mitigated, by proper ap-
 plications.   One  misfortune attending  the difeafe is9
 that the unhappy patient often conceals it  too long.
 Were proper means ufed in due time, a cancer might
 often be cured ; but after the diforder  has arrived at
 a certain height, it  too generally  fets all medicine at
 defiance.
   When a  fchirrous tumor is firft  difcovered,  the
 patient ought to obferve a proper regimen, and to
 take t ice or thrice a-week  a dofe of  the common
 purging  mercurial pill.    Some blood  may alfo be
 let, and leeches daily applied  to  the part for one or
 two weeks ; or a few ounces  of blood taken every
 day or  two for fome time by cupping as near  the
 tumor as poffible; and the part  affected may be kept
 warm with fur or flannel.   The food muft be light,
 and a pint  of the decoction  of  woods or farfaparilla
 may be drank daily.
  Should the tumor, however, not yield to this treat-
 ment,  but, on  the contrary,  become larger  and
 harder, it will  be proper to  extirpate  it, either by
die knife or cauftic.   Indeed, whenever this can be
done with  fafety, the fooner it is done the better.
It can anfwer no purpofe to extirpate a cancer after
the conftitution is ruined, or the whole mafs of hu-
mors corrupted by it.  This, however,  is the com-
                                            mon 
        OF A SCIIIRRUS  AND CANCER.     47/
mon wav, vvhich makes the operation fo feldom fuc-
ceed.  Few people will fubmit to the extirpation till
death flares them in  the face;  whereas, if it were
done early, the patient's life would not be endan-
gered by the operation, and it would generally prove
a radical cure.
  When the cancer  is  fo fituated that  it cannot be
cut  off,  or if the patient will not fubmit to the ope-
ration, fuch medicines as will mitigate or relieve the
moft urgent fymptoms may be ufed.
  The medicine moft  in repute at prefent  for this
difeafe is hemlock.  Dr. Stork, phyfician at Vienna,
has recommended the extract of this plant as very
efficacious in cancers  of every  kind.    The, Doctor
fays, he has given fome hundred weights pi" it with-
out ever hurting any body, and  often with manifeft
advantage.  He advifes the patient, however,  to
begin with very fmall dofes, as two or  three grains,
and  to  increafe the  dofe gradually tijl fome good
effect be  perceived,  and there  to  reft  without fur-
ther increafe.  From two  or  three grains  at firft,
the  Doctor  fays he has increafed the  dofe to two,
three, or four  drachms a-day,  and finds that fuch
dofes may be continued for feveral weeks without any
bad  confequences.
  The regimen which the Doctor recommends during
the  ufe of the medicine, is to avoid farinaceous fub-
ftances not fermented,  and too acrid aromatics.  lie
fays,  good wine will not be hurtful to thofe who are
accuftomed to it,  nor a moderate ufe of acids ;  and
adds, that the  patient  fliould live in a pure free air,
and keep his mind as quiet and cheerful  as poffible.
  The Doctor  does not pretend  to fix the time in
which a cancer  may be refolved  by the ufe  of hem-
lock, but fays  he has  given it for above two years
in large dofes without  any  apparent benefit; never-
                                           thelefs 
4.7S     OF A SCHIRRUS AND CANCER.
thelcfs the patient has been cured by perfifting in the
ufe of it for half a year longer.  This is at leaft en-
couragement to give  it a fair triai.   Though we are
far from thinking the hemlock merits thofe extrava-
gant encomiums which the  Doctor has beftowed up-
on it, yet,  in a difeafe which has fo long baffled the
boafted powers of medicine, we think it ought always
to be tried.
   The powder of hemlock is  by feme  preferred to
the extract.  They are both made of the ft e.di leaves,
aid may be ufed nearly in the  fame manner.  Dr.
Nicholfon  of Berwick fays, he  gradually increafed
the dofe of the powder from a few  grains to half a
drachm^,and gave near four  drachms  of it  in the
day  with  remarkable good effects.   The hemlock
may alfo be  ufed  externally  either  as a poultice or
fomentation.   The fore may likewife be kept clean
by injecting daily a ftrong decoction of the tops and
leaves into it.
   Few things contribute more to the healing of foul
fordid ulcers of any  kind,  than  keeping them  tho-
roughly clean.   This ought never to be neglected.
The beft application  for this purpofe, feems to be the
carrot poultice.    The root of  the  common carrot
may be grated, and moiftened  with as much water as
will bring it to the confidence of a poultice or  cata-
plafm.  This muft be applied to the fore, and renewed
twice a-day.   It generally cleans the fore, eafes the
pain, and takes away the difagreeable fmell, which
are objects of no fmall importance in  fuch a dreadful
diforder*.
   Wort; or an infufion of malt,  has  been recom-
mended not only as a proper drink, but as a power-
ful medicine in this  difeafe.   It muft be frequently
made frefh,  and the  patient may take it at pleafure.
              * London Medical Effays.
                                             Two 
          OV A SCHIRRU3  AND CANCER.      479
 Tuo, three, or even four pints of it may be drank
 every diy for a confiderable time.   No  benefit can
 be expected from any medicine in this difeafe,  unlefi;
 it be perfifted in for a long  time.   It  is of too obfti-
 nate a nature  to be foon  removed ;  and, when  it
 admits of a cure at  all,  k muft be brought about by
 inducing an almoft  total change  of the habit,  which
 muft always be  a work of time.   Setons or  iffues,
 applied   near  the cancer, have  fometimes good  ef-
 fects*.
   When all other  medicines  fail, recourfe muft be
 had to opium, as a kind of folace.    This will not,
 indeed, cure the difeafe, but it will eafe the patient's
 agony, and render  life  more tolerable while  it con-
 tinues.
   To avoid this  dreadful diforder,  people ought to
 ufe  wholefome food ;  to take  fufficient  exercife in
 the open air ;  to be as eafy  and cheerful as poffible;
 and carefully  to  guard  againft  all  blows, bruifes,
 and every kind  of preffure upon the breafts. or other
 glandular partsf.

   *  In a cancer which had fet 11 medicines,  and even fur^er?*
 at defiance, I lately faw rm:likable effects from an obftinate
 pcrieverance in a courfe of antifeptics.  I  ordered  the deep
 ulc.\-s to be wailwi to the bottom by mean? of a fyringe, twice
 or thrice a day, either with  an  in.'ufion of the bark,  or a de-
 coction of canot, and  that the  patient fhould  take four or
 rive times a-day, a ^lafs of good wine, with  half a drachm of
 the bed powdered bark in it. The fores, after being warned,
 were likewife ipr hikled w th the fame powder.  When the patient
 began this courfe, her de.-iih was daily expected.  She conti-
nued it for above  two  years, with manifeft advantage; but,
being told by an eminent furgeon, that the bark would not cure
a cancer,  and that the fores  ou^h: not to be  wafhed,  fhe dis-
continued the practice, and died in a few weeks,  This* courfe
 was not expected to cure the c.ineer, but to prolong the patient's
life, which it evidently  did almoft to a miracle.
  f As hemlock is the principal medicine »ecommended in this
 dife.ikr, we would have given fome directions  for the gathering
 tv..\ preparing cf th.-a plant; but as its different preparations
                                                  are 
r  480  3
                 CHAP.  XLVII.

                    Of Poifons.


          il<VERY perfon ought,  in fome meafure,
 to be acquainted with the nature and cure of poifons.
 They are generally taken unawares, and their effects
 are often fo fudden and violent, as not to admit ^of
 delay, or allow time to procure the affiftance of phy-
 ficians.  Happily, indeed, no great degree  of medical
 knowledge is here neceffary ;  the remedies for mofl
 poifons* being generally at hand,  or eafily obtained,
 and nothing  but  common prudence needful in the ap-
 plication of them.
   The vulgar notion, that  every poifon is cured by
 fome  counter-poifon,  as a  fpecific,  has done much
 hurt.   People believe they can do  nothing  for the
 patient,  unlefs they know the particular antidote to
 that kind of  poifon which he has  taken.   Whereas,
 the cure of all poifons taken into the ftomach, with-
 out exception, depends chiefly on difcharging them
 as foon  as poffible.
   There is no cafe,  wherein the indications  of cure
are more obvious.   Poifon is feldom long  in  the
ftomach  before it occafions ficknefs, with an incli-
nation to vomit.  This fliews plainly what ought to
be done.  Indeed, common fenfe dictates to every
one, that, if any thing has  been  taken into the  fto-
mach  which endangers life, it ought immediately to
be difcharged, if poffible.  Were this duly  regarded,
the danger arifing from poifons might generally be

are now kept in fhops, we think it much  fafer for people to
^et them there, with proper directions for ufing them.
2
avoided. 
                  OF POISONS.            48i
 avoided.   The method of prevention is obvious,  and
 the means are in the hands of every one.
   We  fliall  not  take up the  reader's time with  a
 detail of the ridiculous notions which have prevailed
 among  ignorant people, in different ages, with regard
 to  poifons ;  neither  fliall we mention the  boafted
 antidotes, which have been recommended either  for
 preventing or obviating their effects; but fhail con-
 tent ourfelves with pointing out  the poifons moft com-
 mon in  this country,  and  the means of avoiding their
 dangerous confequences.
   Poifons either belong to the mineral, the vegetable,
 or the animal kingdom.
   Mineral poifons are commonly of an acrid or cor-
 rofive quality ; as arfenic, cobalt, the corrofive fub-
 Jimate of mercury, &c.
   Thofe of the vegetable kind, are generally of a nar-
 cotic or ftupefactive quality ; as poppy, hemlock, hen-
 bane, berries of the deadly night-fliade, ftramonium,
 palma chrifti,  &c.
  Poifonous animals communicate their infection either
 by the  bite or fling.  This  poifon is very different
 from the former, and only produces its effects when
 received into the body by a wound.
   MINERAL POISONS.----Arfenic is the  moft
common of this clafs ; and, as the whole of them are
 pretty fimilar, both  in their  effects  and method  of
 cure,  what is faid with refpect to it will be applica-
 ble to every other fpecies of corrofive poifon.
   When  a perfon  has taken arfenic,  he  foon per-
ceives a burning heat, and a violent pricking pain in
his  ftomach and bowels,  with an intolerable thirft,
and an inclination to vomit.   The tongue and throat
feel rough and dry ;  and, if proper means  be not
foon adminiftered, the patient  is feized with great
anxiety,  hiccupping,  faintings, and  coldnefs  of the
extremities.   To thefe fucceed black vomitings, foetid
                         I i                  ftools, 
482             OF  POISONS.
ftools, with a mortification of the ftomach and intef-
tines, which are the immediate forerunners of death.
   On the firft  appearance  of thefe fymptoms, the
patient fliould drink large quantities of new milk and
fallad  oil,  till he vomits ;  or, he  may  drink warm
water mixed with oil.   Fat broths are likewife pro-
per, provided they can be got ready in time.  Where
no oil is  to be had, frefh butter may be melted and
mixed with the milk  or water.  Thefe things are tq
be drank as  long  as  the inclination to vomit conti-
nues.  Some have drank  eight or ten  quarts before
the vomiting ceafed ;  and it is never fafe to leave off
drinking, while one particle of the poifon remains in
the ftomach.
   Thefe  oily  or  fat fubftances not only  provoke
vomiting, but likewife blunt the acrimony of the poi-
fon, and prevent its wounding the bowels; but if they
fhould not make the  perfon vomit,  half a drachm or
two fcruples of the powder of ipecacuanha muft be
given, or a few fpoonfuls of the oxymel or vinegar of
fquills, may be mixed  with the water which he drinks.
Vomiting may likewife be  excited by tickling the in-
fide of the throat with a feather.  Should thefe me-
thods, however, fail, half a drachm of white vitriol,
or five or fix grains of emetic tartar, or two fcruples
of powdered ipecacuanha, muft be adminiftered.
   If tormenting pains are felt in  the  lower belly,
and there is reafon  to fear that the poifon has got
down to the inteftines, clyfters of milk  and oil muft
be very frequently thrown up ; and the patient muft
drink emollient decoctions of barley, oat-meal, marfh-
mallows, and fuch like.  He  muft  likewife take an
infufion of fenna and  manna, a folution of Glauber's
falts, or fome  other  purgative.  If corrofive fubli-
mate or fugar of lead have been taken, the  patient
fhould drink frequently of a folution of fait  of tar*
tar in water.
                                            After 
                 OF POISONS.              4Sj
  After the poifon  has been evacuated, the patient
ought, for fome time, to live  upon  fuch  things as
are of a healing and cooling quality ;  to abftain from
flefh and all ftrong liquors, and to live  upon  milk,
broth, gruel,  light puddings, and other fpoon meats
of eafy digeftion.  His drinks fliould be barley-water,
flax-feed-tea,  or infufions of any of the mild mucila-
ginous vegetables.
  VEGETABLE POISONS, befides heat and pain
of the ftomach, commonly occafion fome degree of gid-
dinefs, and often a kind of ftupidity or folly.  Perfons
who have taken thefe poifons muft be treated in the
fame manner  as for the mineral  or corrofive.
  Though the vegetable  poifons, when allowed to
remain in the ftomach, often prove  fatal; yet the dan-
ger is generally over as foon as  they are difcharged.
Not being of fuch a cauftic or corrofive nature, they
are lefs  apt to wound or inflame the bowels  than
mineral fubftances:  no time, however, ought  to  be
loft in having them difcharged.
   Opium, being frequently taken  by miftake, merits
particular attention.   It is ufed as a  medicine,  both
in a folid and  liquid form,  which latter commonly
goes by  the  name  of laudanum.   It is, indeed, a
valuable  medicine, when taken in proper quantity ;
but, as an over-dofe proves a ftrong poifon, we fliall
point out its common effects, together with the me-
thod of cure*
  An over-dofe of opium generally  occafions  great
drowfinefs, .with ftupor and other apoplectic  fymp-
tons.  Sometimes the perfon has fo  great  an  incli-
nation to' fleep,  that  it is almoft  impoffible to keep
him awake.   Every method muft, however, be tried
for this purpofe.  He fhould be toffed, fliaked, and
moved about.   Sharp bliftering-plafters fhould  be
applied  to his  legs or arms, and ftimulating  medi-
cines  as falts of hartfliorn,   Sec. held under  his
                       1 i  2                 uofc*. 
4?4    BITES OF POISONOUS ANIMALS.
nofe.   It will alfo be proper to let blood if the pulfe
requires it.  At the fame time every method muft be
taken to make him difcharge the poifon.   This may
be done in the  manner  directed above,  viz. by the
ufe of ftrong vomits, drinking plenty of warm water
with oil, large draughts of vinegar, or lime-juice and
water.
   Mead, befides vomits, in this cafe, recommends acid
medicines with lixivial falts.   He fays,  that  he has
often given fait of wormwood mixed  with juice of le-
mon in repeated dofes with great fuccefs.
   If the body fliould remain weak and languid after
the poifon has been difcharged, nourifhing diet and
cordials will be proper ; but when there is reafon to
fear  that the ftomach  or  bowels are inflamed,  the
greateft circumfpection is neceffary, both with regard
to food and medicine.

    OF THE BITES OF POISONOUS ANIMALS.
   We fhail begin with the bite of a mad dog, as it
 is both the moft  common and dangerous animal-poi-
 fon in this country.
    The creatures naturally liable to contract this dif-
 eafe are,  as far as we yet know, all of the dog kind,
 viz. foxes,  wolves, and dogs.   Hence it is called the
 rabies canina, or dog madnefs.   It fo feldom happens
 that any  perfon is bit by the two firft, that they fcarce
 deferve to be taken notice oft   If fuch a thing fliould
 happen, the method of treatment is precifely the fame
 as for die bite  of a mad dog.
    The fymptoms of madnefs  in  a  dog are as  fol-
 low : At firft he  looks  dull, fhews an averfion to food
 and company : he does not bark as ufual, but feems
 to murmur, is peevifh, and  apt  to bite  ftrangers:
 his ears and tail droop more than ufual, and he ap-
 pears  drowfy : afterv.ards he begins to loll out his.
 ^ngue, and froth at  the mouth, his eyes  feeming
                                            heavy 
         BITES OF POISONOUS ANIMALS.    485
 heavy and  watery: he  now, if not confne.!,  takes
 off, runs panting along  with a kind of dejected air,
 and endeavours to bite every one he meets.  Other
 dogs are faid to fly from him.   Some think  this a
 certain fign of madnefs, fuppofmg that they  know
 him by  the fmell; but it is not to be  depended on.
 If he efcapes being killed, he feldom runs above two
 or three days, till  he dies exhaufted with heat,  hun-
 ger, and fatigue.
   This difeafe is moft frequent after long,  drv, hot
 feafons; and fuch dogs as live upon putrid, flinking
 carrion,  without having enough of  frefii water, are
 moft liable to it.
   When any perfon has been bit by a dog, the ftrict-
 eft inquiry ought to be made whether the animal was
 really  mad.  Many difagreeable confequences  arife
 from neglecting to afcertain this point.  Some people
 have lived in continual anxiety 'or many  years, be-
 caufe they had been bit by a dog which they believed
 to be mad ; but, as he had been killed on the fpot,
 it was  impoffible to afcertain the  fact.   This fhould
 induce us,  inftead of killing the dog the moment he
 has bit any perfon,  to do all in our power to  kejp
 him alive, at leaft  till we can be certain whether he
 be mad or not.
  Many circumftances may contribute to make peo-
ple imagine a dog  mad.   He lofes his  mafter,  runs
about in queft of him, is fet upon  by other dogs,
and perhaps by men.  The creature, thus fright-
ened, beat,  and  abufed,  looks wild, and lolls out his
tongue as he runs along.   Imhiediately a croud is
after him ;  while  he, finding himfelf clofely  pur-
fued, and taking every one he meets for an enemy,
naturally attempts to bite in felf-defence.  He foon
gets knocked on the head, and it  paffes currently
that he was  mad, as it  is then impoffible to Lrove
 he contrary.
                      I  i 7                   This 
4S5     BITES OF POISONOUS ANIMALS.
   This being the true hiftory of, by far, the greater
part of thofe  dogs which  pafs for mad,  is it  any
wonder that numberlefs  whimfical  medicines  have
been extolled for preventing the effects of their bite ?
This readily accounts for the  great variety of infalli-
ble remedies for  the bite' of  a mad dog, which are
to be met with in almoft every family.  Though not
one in a thoufand has any  claim to merit, yet  they
are all fupported by numberlefs vouchers.  No won-
der that imaginary difeafes  fliould be cured by  ima-.
ginary remedies.  In this way, credulous people firft
impofe  upon themfelves, and then  deceive others.
The fame medicine which was fuppofed to prevent the
effects of  the bite, when the dog was not mad, is re-
commended to a perfon who has had the misfortune to
be bit by a dog that was really  mad.   He takes  it,
trufts to it, and is undone.
   To thefe miflakes we muft impute the frequent ill
fuccefs of the medicines ufed for preventing the effects
of the bite of a mad dog.   It is  not  owing fo much
to a defect in medicine, as  to wrong applications.   I
am perfuaded, if proper medicines were  adminiftered
immediately after the bite is  received, and continued
for a fufficient length of lime, we fliould not lofe one
in a thoufand of thofe who have die misfortune to  be
bit by a mad dog.
   This poifon is generally communicated  by a wound,
 which, neverthelefs,  heals  as  foon  as a common
wound :  but afterwards it  begins to feel  painful,
:--nd as the pain  fpreads towards the neighbouring
parts,  the perfon  becomes heavy  and liillefs.  His
fleep  is unquiet, with frightful  dreams; he fighs,
looks dull,  and  loves folitude.  Thefe are  the  fore-
runners, or r:wher the firft  fymptoms of that dread-
ful difeafe  occafioned by  the bite  of a  mad  do <\
But as we do  not propofe to  treat fully of the
difeafe  i.ftff, hu! to point  out the  method  of pre-
                                          venting 
         bites of Poisonous animals.    487
Tenting it, we fliall not take up time in fliewing its
progrefs from the firft invafion to its commonly fatal
end.
   The common notion, that this poifon may lie in
the body for many years, and afterwards prove fatal,
is  both  hurtful and ridiculous.   It muft  render fuch
perfons as have had  the misfortune to be  bit very un-
happy, and can have no good effects.  If the perfon
takes proper medicines for forty days after the time
of his being bit, and feels no fymptoms of the difeafe,
there is reafon to believe him out of danger.
   The  medicines recommended for preventing the
effects of the bite of a mad dog, are chiefly fuch as
promote the different fecretions, and antifpafmodics.
   Dr Mead  recommends  a preventative medicine,
which,  he fays, he  never  knew fail, though in the
/"pace of thirty years he had ufed it a thoufand times.
   The Doctor's prefcription is as follows:
   " Take afli-coloured ground liver-wort, cleaned,
dried, and powdered, half an ounce ;  of black pep-
per powdered,  a  quarter  of an ounce.   Mix thefe
well together, and divide the powder into four dofes ;
one of which muft be taken every morning, fafting,
for four mornings fuccelfively, in half a pint of cows
milk warm.
   " After thefe four dofes are taken, the  patient muft
go into  the cold bath, or a cold fpring or river, every
morning fafting, for a month ; he muft be dipped all
over, but not flay in (with his head above  water)
longer than half a minute, if the water be very cold.
After this he muft go in  three times a-week for  a
fortnight longer.
   " The perfon muft be bled before he begins to ufe
the medicine*/'

   * Though  we give  this prefcription on the credit of Dr,
Mead, yet we  would not advife any perfon, who has reaihn to
believe that he has been bit by a deg which was really mad,
                        I i 4                     to 
458     BITES OF POISONOUS  ANIMALS.
   We  fliall next mention the famous Eaft India fpe-
 cific, as it  is called.   This medicine  is  compofed
 of cinnabar and mulk.  It is efteemed  a  great an-
 tifpafmodic ; and, by many, extolled as an infallible
 remedy for preventing the effects of the  bite  of a
 mad dog.
    " Take native and fa&itious  cinnabar,  of  each
 twenty-four grains,  mufk fixteen grains.  Let  thefe
 be  made into a fine powder, and taken in a glafs of
 arrack or brandy."
    This hngle dofe is faid  to fecure the perfon for
 thirty  days, at the end of which it muft be repeated;
 but if he has any fymptoms of the difeafe, it muft be
 repeated in three hours.
    The following is  likewife reckoned  a good anti-
 fpafmodic medicine:
    " Take  of Virginian fnake-root in powder, half a
 drachm, gum afafcetida twelve grains, gum cannphire
 feven  grains; make thefe into a bolus  with a little
 fyrup  of faffron."
    Camphire may  alfo be given in the  following
 manner :
    " Take purified  nitre  half an  ounce,  Virginian
 fnake-root  in powder  two drachms, camphire one
 drachm ; rub them together in a mortar,  and divide
 the whole into ten dofes."
    Mercury is likewife recommended as  of great effi-
 cacy, both in the prevention and cure of this kind of
 madnefs.   When ufed as a preventative,  it will be
 fufficient to rub daily a drachm of the ointment into
 the parts about the wound.
    Vinegar is likewife  of confiderable  fervice, and
 fnould be taken freely,  either in the patient's  food
 or drink.

 to trufl to it alone.  Mead was an able phyfician, but he feems
 to have been no great philofophyr, and was fometimes the dupe
 of his own credulity,
                                             Thefe 
       BITES OF POISONOUS ANIMALS.      485,
  Thefe are the principal medicines recommended
for  preventing the effects  of the bite of a mad dog.
We wouid not, however, advife people to truft to any
one of them ; but from a proper combination of their
different powers,  there is the  greateft reafon to hope
for  fuccefs.
  The great error in the  ufe of thefe medicines lies
in not taking them  for a fufficient length of time.
They are ufed more  like charms, than medicines in-
tended to produce any change in  the body.   To this,
and not to the infufficiency of the medicines, we muft
impute their frequent want of fuccefs.
  Dr Mead fays, that the  virtue of his medicine con-
fifts in promoting urine.   But how a poifon fhould be
expelled  by urine, with only three or four dofes of
any medicine, however powerful, it  is not eafy to
conceive.   More  time  is certainly neceffary,  even
though the medicine were more  powerful than that
which  the Doctor prefcribes.
  The Eaft India fpecific is ftill more exceptionable on
this account.
  As thefe and moft  other medicines, taken fingly,
have  frequently been found to fail, we fhail recom-
mend the following courfe:
  If a perfon be  bit  on  a  flefliy part,  where there is
no hazard of hurting any large blood-veffcl, the  parts
adjacent  to the wound may be cut away, or apply a
cauftic directly on the part.
  The wound may be dreffed with fait and water, or
a pickle made of vinegar and fait, and afterv.ards dref-
fed  twice a-day, with red precipitate of mercury*.
  The patient fliould begin to ufe either Dr Mead's
medicine, or fome of the others mentioned above. If
he takes Mead's medicine,  he may ufe it as the Doctor

  * In every cafe  of wound from the bite of a doc;-, there •>  •
no application equal to  ted precipitate, in  order to prodr.ee
good matter,
                                          tilt •.._'_., 
4re>    BITES OF POISONOUS ANIMALS.
directs, for four days fucceflively.  Let him then omit
it for two or three  days, and again repeat the fame
number of dofes as before.
  During this  courfe he muft rub into the  parti
about the wound,  daily,  one drachm of the mercu.
rial ointment.   This may be done for ten or twelve
days at leaft.
  When  this courfe is over, he may  take a purge
or two, and  wait a few day days till the effeft of the
mercury  be gone  off.  He  muft then begin to ufe
the cold  bath?  into which he  may go every morn-
ing for five or fix weeks.   If he fliould feel cold and
chilly for a long time after coming out of the cold bath,
it will be better to ufe a tepid one, or to have the wa-
ter a little warmed.
   In the mean time, we would  advife him not to
leave off all  internal medicines, but  to take either one
<$ the bolufes of fnake-root, afafcetida, and camphire;
or one of the powders of nitre, camphire, and fnake-
root, twice  a-day.  Thefe may be  ufed during the
whole time he is bathing.
   During the  ufe of the mercurial  ointment, the
patient muft keep  within doors,  and  take  nothing
cold.
   A proper regimen muft be  obferved throughout
the whole courfe.  The  patient fliould abftain fiom
flefh, and all failed and high  feafoned provifions. He
muft avoid ftrong liquors, and live moflly upon a light
and rather fpare  diet.   His mind  fliould be kept as
eafy and  cheerful as poffible,  and all exceffive heat
and violent  paflions avoided  with the utmoft care.
   I have never feen this courfe of medicine, with pro-
per regimen, fail to prevent the hydrophobia, and
cannot help again obferving, that the want of fuccefs
muft generally  be owing either to  the  application of
improper medicines, or  not ufing  proper ones for a
fufficient  length of time.
                                        Ma,nkin4 
       BITES OF POISONOUS ANIMALS.     491
  .Mankind are extremely fond of every thing that
proniifcs a fudden or miraculous cure.   By trufting
to thefe they often lofe their lives, when a regular
courfe of medicine would  have rendered diem abso-
lutely fafe.   This  holds remarkably  in  the prefent
cafe. Numbers of people, for example, believe if they
or their cattle were once dipped in the fea, it is fuffi-
cient ;  as if  the fait water were a charm againff the
effects of the bite.   This,  and fuch like whims, have
proved fatal to many.
  It is a common notion, if a perfon be bit by a
dog  which is not mad, that,  if he  fliould go mad
afterwards,  the perfon would  be affected with the
diforder  at the fame  time ; but  this notion  is too
ridiculous to deferve  a ferious ccnfaleraticn.  It is
a good rule, however, to avoid dogs as much as
poffible.
  Though we do not mean to treat fully of the cure
of the hydrophobia, yet we are far  from reckoning
it incurable.  The notion  that this difeafe could not
be cured, has been productive of the moft horrid con-
fequences.   It was ufual either  to  abandon the im-
frappy perfons, -as foon as  they  were  feized with the
difeafe, to  then- fate,  to bleed  them  to death, or to
fuffocate  them between matreffes or feather beds Sec.
This conduct certainly deferved the fevered  puniiu-
ment!  We feme,  for  the  honor of human nature, it
will never azgtin be heard  of.
   I have never had an  opportunity of treating this dh-
iafe, and therefore can lay nodhng of it from my own
experience; but the IcvvneuDr. Tiflbt fays,  i: may
he cured  in the following manner:
   1. The patient muft be bicd to a conf derahie u-mm-
fi'y ;  and this may be repeated twice, or  thrice, or
even a fourth time, if ciraunfiances remme it.
   z.  The  patient fliould  be put,  ific'ff'fufe, into  a
warm ba'h;  mig dm  (Louid be ufed  twice a-duy.
                                           Z-  He 
 4>2     BITES OF POISONOUS ANIMALS.
    3. He fliould every day receive two, or even three
 emollient clyfters.                                  '
    4.  The  wound, and the  parts  adjoining  td  it,  l
 fhould be rubbed with  the mercurial ointment twice  J
 a-day.                                              J
    5. The  whole  limb which contains the  wound  1
 fliould be rubbed with oil, and be wrapped up in an
 oily flannel.
    6. Every three  hours a  dofe of Cob's powder
 fliould be taken in a  cup of the infufion of lime tree
 and elder flowers.   This powder is made, by rubbing  1
 together in a mortar, to a  very fine powder, of native
 and factitious cinnabar, each  twenty-four grains; of  j
 mulk, fixteen grains*.
   7. The following bolus is to be given every night,  <
 and to be repeated  in the morning,  if the patient  is
 not eafy, warning it down with the infufion mention-
 ed above :   Take  one drachm of Virginian  fnake-
 root  in  powder ;  of camphire and  afafcetida, ten
 grains each;  of opium, one  grain ; and with a fuf-
 ficient quantity of conferve, or rob of elder, make a
 bolus.
   8. If there be a great naufea at the ftomach, with
 a bitternefs in the mouth, thirty-five or forty grains
 of ipecacuanha,  in powder,  may be taken for a vo-
 mit.
   9. The patient's food, if he takes any, muft be
 light; as panada, foups made of farinaceous or mealy
vegetables,  &c.

  ■* The Ormfkiik medicine, as it is called, feems to me to
confift chiefly of cinnabar.  Though it is faid to be infallible, as
a preventative; yet I would not advife any one to trufl to it
alone. Indeed it is ordered to be taken in a manner which gives
it more the appearance of a charm than of a medicine.  Surely
if a medicine is to produce any change in the body, it muft be
taken for fome confiderable time and in fufficient quantity.
JO. If 
        BITES OF POISONOUS  ANIMALS.      493
   10.  If the patient fhould long  continue weak, and
fubject to terrors, he may  take half a drachm of the
Peruvian bark thrice a-day*.

   The next poifonous animal which we fliall mention
is  the VIPER.  The greafe of  this  animal  rubbed
into the  wound is faid to  cure  the bite.   Though
that is all the  viper-catchers generally do when bit,
we fliould not think it  fufficient for the  bite of an
enraged  viper.  It would furely be more fafe to have
the  wound well  fuckedf,  and  afterwards  rubbed
with warm  falad-oil.  A poultice of bread and milk,
foftened with  falad-oil,  fliould likewife be applied to
the wound ; and  the patient ought to drink  freely of
vinegar-whey, or water-gruel with vinegar  in it,  to
make him fweat.   Vinegar is one of the belt medi-
cines which can be ufed in any  kind of  poifon, and
ought to be taken very liberally.  If the patient be
fick, he may take a vomit.  This  courfe  will be fuf-
ficient to cure the bite of any of the poifonous animals
of this country.
   With regard to poifonous infects, as the  bee, the
wafp, the hornet, Sec. their flings  are feldom attend-
ed with danger, unlefs when a perfon  happens to

   * It is to be lamented that the cure of this difeafe is fo little
underflood.  The ufe of the cauftic at the beginning is of the
greateft importance, afterwards  we  fhould treat it as we do
1 -.ther difeafes according to the general habit, either by evacu-
ations or tonics.
   f The practice of fucking out poifon is very ancient. There
can be no danger in performing this office, as the poifon does
no harm unlets it be taken into the body by a wound.  The
perfon who fucks the wound ought, however, to walh his mouth
frequently with falad-oil, which will fecure him from even the
leaft inconveniency.   The Pfylli in Africa, and the Marfi in
Italy, were famed for curing the bites of poifonous animals by
fucking the wound ; and we are told, that the Indians in North-
Ameiic.i p-aclif; the fume at this d/>y.
                                                  U~ 
4'.'f        OF VEGETABLE POISON".
be  flung  by a great  number  of them at the fame  i
lime; in  which cafe fomething fhould be  done to  =]
abate the  inflammation and fwelling.   Some, for this
purpofe, apply honey, others lay pounded parfley to
the part.   A mixture of vinegar and Venice treacle
is likewife recommended :  but I have always found  •'
rubbing the part with  warm  falad oil fucceed very
well.  Indeed when the flings are fo numerous as to
endanger  the  patient's  life, which is fometimes the
cafe,  he muft be bled,  and take fome cooling medi-
cines, as nitre or cream of tartar,  and fliould drink  *
plentifully of diluting liquors.
  It is the happinefs of Great-Britain to have very
few poifonous animals, and thofe which we have are
by no means of the moft virulent kind.   Nine-tenths
of the effects attributed to poifon  or  venom  in  this
country, are really other difeafes,  and proceed from
quite  different caufes.

           OF VEGETABLE POISONS.

  We cannot, however, make the fame obfervation
with regard to poifonous vegetables.   Thefe  abound
every where,  and  prove often fatal  to the ignorant
and unwary.   This, indeed, is chiefly owing  to care-
{eflheft. Children ought early to be cautioned againft
eating any kind of fruit, roots, or berries which they
do not know, and all  poifonous plants to vvliieh they
can have accefs,  ought,  as far as poiabie, to be de-
ftroyed.   This would  not be fo difficult a tafk as fome
people imagine.
  Poifonous plants have  no doubt  their ufe,  and
they ought to be propagated in proper places; but,
as they prove often deftructive to cattle, they fhould
be rooted out of ail pafture-grounds.   They ought
likewife, for the fafety of the  human fpeeies, to be
deftroyed  in the neighbourhood of  all towns and vil-
                  1                         iages ; 
           OF VEGETABLE POISONS.        49;
lagcs; which, by the by, are the places where they
moft commonly abound.  I have feen the poifonous
hemlock,  henbane, wolfsbane,  and deadly  night-
fliade, all growing within  the environs  of a fmall
town, where, though feveral perfons within the me-
mory of thofe living in it, had loft their lives by one
or other of thefe plants ;  yet no method, that I could
hear  of, had ever been taken to  root  them out;
though this might be done at a very trifling expence*
   Seldom a year  paffes  but  we have accounts  of
feveral perfons poifoned by  eating hemlock roots in-
ftead of parfnips, or fome kind of fungus  which they
had gathered for mufhrooms.  Thefe examples ought
to put people upon their guard  with refpedt to the
former, and to put the latter entirely out of ufe.
Mufhrooms may be a delicate difli, but  they are a
dangerous one, as they are  generally gathered by
perfons who do not know one kind of fungus from
another, and take every thing for a  mufliroom which
has that appearance.
   We might here mention many other  plants  and
 animals of a poifonous nature which are found in fo-
 reign countries ; but, as our obfervations are chiefly
 intended  for Great-Britain,  we fliall pafs thefe over.
 It  may not  however  be amifs to  obferve, for the
 benefit of fuch of our countrymen as go to America,
 that  an effectual remedy is now faid to be found for
 the bite of the rattle-fnake.   The  prescription is as
 follows:  Take  of the roots of plantain and hore-
 hound, in fummer, roots and branches  together, r
 fufficient   quantity ; bruife  them  in a mortar, and
 fqueeze out  the juice, of which give, as  foon as pof-
 fible, one large fpoonful;  if the patient be fwelled
 you muft force it down  his throat.  This  generally
 will cure ; but, if he finds no relief in  an hour after,
 you  may give another fpoonful, which never fails.—
 If the roots  are dried, they  muft be moiftened  with
                                            a little 
 496      OF THE VENEREAL DISEASE.
 a little water.  To the wound may be applied a leaf
 of good tobacco moiftened with rum.
   We give this upon the faith of Dr Brookes, who
 fays it was the invention of a negro ; for the diicovery
 of which he had his freedom purchafed, and  a hun-
 dred pounds per annum fettled upon him during life,.
 by the General Affembly of Carolina.
  It is poffible there may be in nature fpecific  reme-
 dies for every kind of poifon ; but as we  have very
 little faith in  any of thofe which have  yet  been pre-
 tended to be  difcovered, we fliall again recommend
 the moft ftrict attention to the following rules, viz.
 That  when  any poifonous fubftance has been taken
into the ftomach it ought,  as foon as poffible,  to be
 difcharged by vomits, clyfters, and purges ; and, when
 poifon has beenVeceived into the body by a wound,
 that  it be expelled by medicines  which  promote the
 different  fecretions, efpecially  thofe of fweat, urine,
and infenfible perfpiration  ; to which  may be joined
antifpafinodics, or  fuch medicines as take off tenfion
and irritation ; the chief of which are opium, mufk,
 samphire, and afafcetida.
               CHAP.  XLVIII.


             Of the Venereal Difeafe.


          IN the firft edition of this book tie veil--
teal  difeafe  was omitted.  The reafons,  however,
which at that time induced me to leave it out, have
upon more mature confideration vaniflied.   Bad con-
fequences, no doubt, may arife from ignorant perfons
               a                       tampering 
          OF THE VENEREAL DISEASE.      497
 tampering  with medicine in this diforder ; but  the
 danger from that quarter feems to be more than  ba-
 lanced by the great and folid advantages,  which muft
 arife to the patient from an early  knowledge of  his
 cafe,  and an attention to a plan of regimen, which,
 if it does not cure the difeafe,  will be fure to render
 it more mild, and lefs hurtful to the conftitution.
   It is peculiarly unfortunate for the unhappy per-
 fons who contract this difeafe,  that  it  lies  under a
 fort  of  difgrace.   This renders  difguife neceffary,
 and  makes the patient either conceal his diforder al-
 together,  or apply to thofe who promife a fudden and
 fecret cure ; but who in fact only remove the fymp-
 toms for  a time,  while they fix the  difeafe deeper in
 the habit.  By this means a flight  infection, which
 might have been eafily removed, is  often converted
 into an obftinate,  and fometimes incurable malady.
   Another unfavourable circumftance attending this
 difeafe is, that it affumes a variety of different fhapes,
 and  may with more propriety be called an affemblage
 of difeafes,  than a fingle one.   No  two difeafes can
 require a more different method  of treatment than
 this does in its different flages.  Hence the folly and
 danger of trufting to  any particular noftrum for the
 cure  of it.   Such  noftrums are  however generally
 adminiftered in the fame manner to all who apply for
 them, without the leaft regard to . the ftate of the
 difeafe, the conftitution of the patient, the degree  of
 infection,  and a thoufand other circumftances  of the
 utmoft importance.
   Though the venereal difeafe  is generally the  fruit
 of unlawful  embraces,  yet it may be communicated
 to the innocent as  well as the guilty.  Infants,  nur-
 fes, mid wives, and married women,  whofe hufbands
 lead  diffolute lives, are  often affected with  it, and
frequently  lofe their  lives by  not  being aware  of
 their danger  in due time.  The unhappy condition 
49$   OF THE VIRULENT GONORRHOEA.
of  fiich perfons  will  certainly  plead our excufe, 'ff
any excufe  be neccffilry, for endeavouring to point
out the fymptoms and cure of this  too common dif-
eafe.
   To enumerate all its different fymptoms, however,
and to trace the difeafe minutely through its various
ilages, would require a much larger fpace than falls
to this part of  my fubject;  I fhail,therefore confine
my obfervations chiefly to circumftances  of import-
ance, omitting fuch as  are either trifling, or which
occur but feldom.  I fliall likewife  pafs over the hif-
tory  of the  difeafe, with  the  different  methods of
 treatment which it has undergone   fince  it was firfl
 introduced  into Europe,  and many  other circumftan-
 ces of a fimilar nature ;  all  of which, though they
 might tend  to amufe the reader, yet could afford him
 little or no ufeful knowledge.

       OF THE VIRULENT GONORRHOEA.

    The virulent gonorrhoea  is  an involuntary dif-
 charge of  infectious  matter  from  the parts cf ge-
 neration  in either fex.  It generally makes its ap-
 pearance within eight or ten days  after the infec-
 tion  has been received :  fometimes  indeed it appears-
 in two or three days,  and at other times not before
 the  end of four or five weeks.   Previous to the dif-
 charge, the  patient feels an itching with a fmall de-
 gree of pain in the genitals.  Afterwards a thin glai-
 ry matter begins to diftil from  the urinary 'paffage,
 which ftain-s  the linen, and  occafions a fmall degree
of titiilation,  particularly in the  time of  making wa-
 ter ;  this gradually increafing, arifes at  length to a
degree of heat  and pain, which are chiefly  perceiv-
ed about the extremity of the urinary paffage, where
a flight degree  of  rednefs and inflammation likewife
 begin to appear.
                                               As 
      OF THE VIRULENT GONORRHOEA.    409
   As the diforder advances, the pain, heat of urine,
and running, increafe,  while frefli  fymptoms  daily
enfue.   In  men the erections  become painful  and
involuntary, and are more frequent and lafting than
when natural.  This fymptom is moft troublefome
when the patient is warm in  bed.  The pain which
was  at firft  only perceived towards  the  extremity,
now begins to reach all up the urinary paffage,  and
is moft intenfe juft after the patient has done making
water.   The running  gradually grows yellow,  and
at  length puts on the appearance of matter.
   When the  diforder  has arrived at  its height, all
the fymptoms are more intenfe;  the  heat of urine
is fo great,  that the patient dreads the making  wa-
ter ; and though he feels a conftant inclination  this
way, yet it is rendered with  the greateft difficulty,
and  often only by drops : the involuntary erections
now become extremely  painful and frequent; there
is alfo a pain, heat,  and  fenfe of fulnefs  about the
feat, and the running is  plentiful and fharp, of a
brown,  greenifh,  and fometimes of  a  bloody co-
lour.
   By a proper  treatment the  violence  of  the fymp-
toms gradually  abates;  the. heat of urine goes  off;
the involuntary and painful  erections, and the heat
and pain about the feat, become eafier ; the running
alfo gradually decreafes,  grows whiter and  thicker,
till at laft it entirely difappears.
   By attending to  thefe fymptoms, the gonorrhoea
maybe  generally diftinguifhed  ft >m any other dif-
eafe.  There are however fome  few diforders  for
which  it may  be  millaken, as  an ulcer in the  kid-
nics or bladder, the fluor alb us or whites in  women,
the.  But in  the former of thefe, the matter comes
away only w ith \\c urine, or when the fphincter of the
bladder is open ; whereas in  a  gonorrhoea,  the dif-
charge is contain:.  From the latter it is more difficult:
                      K k 2                   to 
500    OF THE VIRULENT  GONORRHOEA.
to be diflinguifhcd,  and muft be known chiefly from
its effects, as pain, communicating the infection, &c.
   REGIMEN.----When a perfon  has reafon to
fufpect that he has caught the venereal infection, he
ought moft ftrictly to  obferve  a cooling regimen,
to avoid every thing of an heating nature, as wines,
fpirituous liquors, rich fauces, fpiced, falted,  high-
feafoned and  fmoke-dried  provifions,  &c. as alfo
all aromatic and ftimulating vegetables,  as onions,
garlic, fliallot,  nutmeg, muftard, cinnamon,  mace,
ginger, and fuch like.  His  food ought chiefly to
confift of mild vegetables, milk,  broths, light pud-
dings,  panada,  gruels,  &c.   His drink  may be
barley-water,  milk  and water, decoctions of marfli-
mallows and liquorice, flaxfeed-tca, or clear  whey.
Of  thefe he  ought  to drink plentifully.  Violent
exercife of all kinds, efpecially riding on horfeback,
and  venereal  pleafures,  are to  be avoided.   The
patient muft beware of cold, and when the inflam-
mation is violent, he  ought to keep his bed.
   MEDICINE.----A  virulent  gonorrhoea cannot
always be cured fpeedily  and effectually  at the fame
time.   The patient  ought therefore  not to expect,
nor the phyfician to  promife it.   It will  often con-
tinue  for two or  three weeks,  and fometimes for
five or fix, even where the treatment has been  very
proper.
   Sometimes  indeed a flight infection may be car-
ried off in a few days, by bathing the parts  in warm
mill: and water, and injecting frequently  up the ure-
thra a little fweet oil or linfeed-tea about  the warmth
of new milk.   Should thefe not fucceed  in  carrying
off the infection,  they will at leaft have  a tendency
to leffen its virulence.
   To effect  a erne,  however,  aftringent injections
will  generally be found neceffary.   Thefe may be
various ways prepared, but I think thofe made with
                                              the 
    "  OF THE VIRULENT  GONORRHOEA.     cot
the white vitriol are both moft  fafe  and efficacious.
They can be made  ftronger  or  weaker as circum-
ftances may require ; but it is beft to begin with the
more gentle, and  increafe  their power if neceffary.
1 generally  order a  drachm  of  white vitriol to be
diffolved in eight or nine ounces of common or rofe-
water,  and an  ordinary fyringe  full  of  it  to be
thrown up three or four  times  a-day.  If this quan-
tity does  not  perform a cure, it may be repeated,
and  the dofe increafed*.
   Whether injections be ufed or not, cooling purges
are always  proper in the gonorrhoea.   They ought
not  however  to be of the ftrong  or draftic  kind.
Whatever raifes a violent commotion in the  body
increafes  the danger, and tends to drive the difeafe
deeper into the habit.   Procuring   two  or  three
ftools  every fecond  or  third day  for the  firft fort-
night, and the  fame number every fourth  or fifth
day for  the fecond, will generally  be fufficient to
remove the inflammatory fymptoms,  to diminifli  the
running,  and  to change its colour  and confiftence.
It gradually becomes  more white and ropy  as the
virulence abatesf.

   * Although it is now very common to cure the gonorrhoea
by afh intern injections, there are ftill many practitioners who
do nut approve this mode of practice.  1 can, however, from
much experience, affert, that it is both the  moft eafy, elegant,
and efficacious merhod of cure ; and that any bad confluences
ariling from it muft be owing to the ignorance or mifconduct
of the practitioner himfelf, and not to the remedy.  Many,
for example,  ufe  ftrong preparations of lead, all of which are
dangerous when  applied to the internal furfices of the body ;
ethers uf: efcharotics,  which inflame and injure the parts.  I
have known a gonorrhoea actually cured by an injection made
of green-tea, and wou-ld always  recommend gentle methods
where they wiii  fucceed.
   f  If the patient can fwallow a folution of fdts and manna,
he may take  fix drachms, or, if his conftitution requires it, an
ounce of the  former,  with half an ounce  of the latter.  Thefe
                        h k ?,                   may 
*02     OF THE VIRULENT GONORRHOEA.

   When  the  inflammatory   fymptoms  run   high,
bleeding is always neceffary at the beginning.  This
openfion,  as in other topical  inflammations, muft
be r.peated  according  to  the ftrength and  conftitu-
tion of  the patient, and the vehemence and urgency
of the fymptoms.
   Medicines which promote  the fecretion of urine,
are  likewife  proper  in this  ftage of  the diforder.
For this purpofe,  an ounce of nitre and two ounces
of gum-arabic,  pounded  together,   may  be divided
into twenty-four dofes,  one of which may be taken
frequently in a  cup of the patient's drink.   If thefe
fliould  make him pafs  his urine fo  often  as to  be-
come troublefome to him, he may either take them
lefs  frequently, or  leave out the  nitre altogether,
and take equal parts of gum arable and  cream  of
tartar.   Thefe  may be pounded  together,  and a
tea-fpoonful  taken  in  a cup  of the  patient's  drink


may be  diffolved in "an Englifh pint "of boiling water, whey,
or thin water-gruel, and taken early in the morning.
   If an infufion of fenna and tamarinds  be more agreeable,
two drachms <f the former, r. d an ounce of the latter, may
be infufed ad night in an Engliih pint of boiling water.  The
infufion  may be (trained next morning, and half an ounce of
Glauber's  fiks  diffolved in it.  A tea -cupful of this infufi' n
iruv be taken every half hour till it operates.
   Should the  patient prefer an  electuary,  the following  will
he found to anfwer very v\  11.  Take  of the lenitive electuary
four ounces, cream of tartar two ounces, jalap in powder two
drachm;, rhubarh one drachm, and as much of the fyrup of
pale rofes ar will ferve to make up  the whole into a foft elec-
tuary. Two or three tea fpoonfuls of this may be taken,over-
nighr, and about the fame quantity rcxt morning,  every day
that  the  patient chufes to take a  purge.
   The dofes of the above medicines may he increafed or-dimi-
l.ifhed according as the parent finds  it neceffary.  We have
rrdered  the fdrr. to be diffolved  in a large qantity of water,
et'_..!.'!"£  it readers their ope: ah n mcr? mild.


                                                 fop 
      OF THE VIRULENT GONORRHOEA.    5c^
four or five times a-day.  I have generally  foun^
this anfwer extremely well  both as a diuretic, and
for keeping the body gently open.
   When the pain and  inflammation arc feated high
towards the neck of the bladder,  it will be proper
frequently  to throw up an emollient clyfter, which,
befides the benefit of procuring ftools,  will ferve as
a fomentation to the inflamed parts.
   Soft  poultices, when  they  can conveniently  be
applied  to the parts, are  of  great fervice.  They
may be made of the  flour of linfeed,  or of wheat-
bread and milk,  foftened with  frefii butter or fweet
oil.  When poultices  cannot be  conveniently ufed,
cloths wrung out of warm  water, or bladders filled
with warm milk and water, may be applied.  I have
often known the moft excruciating pains, during the
inflammatory ftate of  the  gonorrhoea, relieved  by
one or other of thefe applications.
   Few  things tend more  to  keep off inflammation
in the fpermatic veffels,  than a proper trufs for the
fcrotum.  It ought to be fo contrived as to fupport
the  tefticles,   and fliould  be  worn  from  the  firft
appearance of  the  difeafe  till it  has  ceafed  fome
weeks.
   The above  treatment  will fometimes remove the
gonorrhoea fo quickly, that the  perfon  will  be in
doubt whether he really laboured under that difeafe.
This, however, is too favourable a turn to be  often
.expected.
   When the above treatment has removed the heat
of urine,  and  forenefs  of the genital  parts; when
the  quantity  of running is conliderably  leffened,
without any pain or fwelling in the groin or tefticle
fuperw ning ; when the patient is  free from involun-
tary' erections ; and laftly? when the running becomes
pale, whitifli,  thick, veld of ill fmell, and tenacious
•or ropy ;  when all or moft of thefe lymptoms appear,
                     K k a                   the 
$o\              OF  GLEET S.
the gonorrhea is arrived at its laft ftage, and we may
gradually proceed to treat it as a  gleet, with aftrin-
gent and agglutinating medicines.

                 OF GLEETS.

   A gonorrhoea frequently  repeated, or improperly
treated, often ends in a gleet, which may either pro-
ceed horn relaxation, or from fome  remains of the
difeafe.   It is, however, of the greateft importance,
in the cure of the gleet,  to know from which of thefe
caufes it proceeds. When the difcharge proves very
obftinate, and receives little or no check from aftrin-
gent  remedies,  there is ground to fufpect that  it is
owing to the latter ; but,  if the  drain is inconftant,
and is chiefly obfervable when the patient is flimulated
by lafcivious ideas,  or upon ftraining to go  to ftool,
we may reafonably conclude,  that it is chiefly  owing
to the former.
   In the cure of a gleet proceeding from relaxation,
the principal defign is to brace, and reftore a proper
degree of tenfion to the debilitated and relaxed veffels.
For this purpofe, befides the medicines  recommended
in the gonorrhea,  the  patient may have recourfe to
ftronger and more powerful aftringents,  as the Peru*
vian bark*,  alum, vitriol, galls, tincture of gum kino,
Sec.  The injections may be rendered more aftringent
by the addition of a  few grains of alum, or increafing
the quantity of vitriol as far as the parts are able to

   * The Peruvian bark may be  combined with other aftrin-
 gents, and prepared in the following manner:
   Take of Peruvian bark  bruifed fix drachm?, of frefh  galls
bruifed two drachm? ; boil them  in  a pound and a half of
 v.atcr to a pound : to the ftrained liquor add three ounces of
the fimple tincture of the  bark.  A fmall tea-cupful of this
 ;oay be t:d.\en  three times a-day, adding to each cup fifteen or
twenty  drovs  of the ac;d eiixir of vitriol.
                                                bcac 
               OF  GLEETS.             505
bear it.  From twenty to fixty drops of the balfam
capaivi, or oil of turpentine, taken two or three times
a-day,  in a little fugar and water, will  be found to
be  one of  the  moft powerful -medicines  in  thefe
cafes.
  The laft remedy which  we fliall mention in this
cafe is  the cold bath, dian which  there is not per-
haps a more powerful bracer in the whole compafs
of  medicine.  It  ought never to be  omitted  in this
fpecies of gleet, unlefs  there be fomething  in  the
conftitution  of the patient which renders the ufe of
it unfafe.   The  chief objections to  the ufe  of  the
cold bath  are, a full  habit, and  an unfound ftate
of the vifcera.  The  danger from the  former may
always be leffened,  if not removed, by  purging and
bleeding ; but the latter  is an unfathomable obftacle,
as the preffure of" the water, and the  fudden con-
traction  of  the  external  veffels, by throwing  the
blood with too much force upon the  internal  parts,
are apt to  occafion ruptures of the veffels, or a flux
of humors upon the  difeafed organs.   But where no
objection of  this kind prevails,  the patient ought to
plunge over head in water every  morning fafting,
for three  or four weeks  together.   He fhould not,
however, flay long in  the water, and fliould take
care to have his fkin dried as foon  as he comes out.
   The regimen proper in this cafe,  is  the fame as
was mentioned in the laft ftage of the  gonorrhea :
the diet muft be drying and aftringent, and the drink
Spa, Pyrmont, or Briftol waters, with which a little
claret  or red wine may fometimes  be mixed.  Any
perfon may now afford to drink thefe waters,  as they
can be every where  prepared at aimed  no expence,
"by a mixture of common chalk and oil cf vitriol.
   When the gleet does not in the  fmalleft degree
 yield  to thefe medicines,  there is reafc   to fufpect
 ;b.a: it proceeds fVe.u  ulcere,   In this cafe, recourfe
                                             mufl 
 5-6             O F  G L E E T S.
 muft be had to mercury, and the decoction of China,
 farfaparilla,  faffafras,  or the like.
   Mr. Fordyce fays, he has feen many obftinate gleets
 of two,  three,  or .four  years  ftanding,  effectually
 cured by  a mercurial unction,  when  almoft every
 other medicine has been tried in  vain. Dr. Chapman
 feems to be of the fame opinion ;  but  fays, he has
 always found the mercury fucceed beft,  in this  cafe,
 when  joined with terebinthinate and other  aggluti-
 nating medicines.  For which  reafon, the  Doctor
 recommends pills made of calomel and  Venice tur-
 pentine* ;  and delires that their  ufe may  be accom-
 panied with a decoction of guaiacum or farfaparilla.
   The laft kind of remedy which we fliall  mention
 for the cure of ulcers in the urinary paffage,  are the
 fuppurating  candles or bougies : as  thefe  are pre-
 pared various ways, and are generally to be bought
 ready made, it is needlefs to  fpend time in enume-
 rating the  different  ingredients  of which they are
 compofed, or teaching the manner of preparing them.
 Before  a bougie be  introduced into the urethra,
 however, it fhould be fmeared all over with fweet
 oil,  to prevent it from ftimulating too fuddenly ;  it
 may be fuffered  to continue  in from one to feven or
 eight" hours,  according  as  the  patient  can  bear it.
 Obftinate ulcers are not only  often healed, but tu-
 mors and excreffences in the urinary  paffages taken
 away, and an obftruction of urine removed, by means
 of bougies.  Obftinate gleets may be removed by the
 ufe of bougies.

  * Take Venice turpentine,  boiled to a fufficiera degree  of
 harJiuf:., half an ounce, calomd half a drachm. Let thefe he
irf'xed into fixty pilh, of which five or  fix may be taken nh'ht
 ?.:id ni'iriilii;;.  if,  dming the v.i'c of thefe  pills, the mouth
jhoald grow for., or the breath become ofFeolive, they muft
bt J:foo:i.;:i..;;c ed theie f.mpm.ns dif:  rp< -::.
OF 
C  5°7  3
        OF THE SWELLED TESTICLE.

  The  fwelled tefticle  may either proceed from in-
fection lately contracted, or from the venereal poifon
lurking in the blood : the latter, indeed, is not very
common, but the  former frequently happens,  both
in the firft and fecond flages  of a  gonorrhea; par-
ticularly when the running is unfeafonably checked,
by cold, hard drinking, ftrong  draftic purges,  vio-
lent  exercife,  the too early ufe  of aftringent  medi-
cines,  or the like.
  In  the inflammatory   ftage bleeding 'is neceffary,
which muft  be repeated  according to the urgency of
the fymptoms*.   The food muft be light, and the
drink diluting.   High-feafoned  food,  flefh,  wines,
and every thing of an heating nature, are to be avoid-
ed.   Fomentations are   of'lingular fervice.   Poul-
tices of bread  and milk,  foftened with  frefh butter
or oil are likewife very  proper,  and ought to be ap-
plied  when the patient is in bed, where he ought to
be conftantly : when he gets  up, the tefticles mould
be kept warm, and fupported by a bag or trufs.
  If  it fhould be found  impracticable to cure  the
tefticle  by  the cooling  regimen now  pointed out,
and  extended according  to circumftances, it will be
neceffary  to lead the  patient through fuch a com-
plete  anti-venereal courfe as fliall enfure him againft
any  future  uneafmefs.   For  this  purpofe,  befides
rubbing the mercurial ointment  on the part, if free
from  pain, or on the thighs, the patient  muft be
confined to bed, if neceffary,  for  five  or  fix weeks,

  * I have been accuftomed, for fome time paft, to apply
leec! es to inlhimrd tefticles,  which practice has always been
/ellowtd with the me ft happy effects.
fufp ending 
5o3             OF  BUBOES,
fufpending the tefticle all the while  with a bag or
trufs, and plying him inwardly with ftrong decoctions
of farfaparilla.
   When thefe means do not fucceed, and there is
reafon to fufpedt a fcrophulous  or cancerous habit,
either of which may fupport a fchirrous  induration,
after  the  venereal  poifon  is corrected, the parts
fhould be fomented daily with a decoction of hem-
lock,  the bruifed  leaves of which may  likewife be
added to the  poultice, and  the  extract at the fame
time taken inwardly*.   This practice is  ftrongly re-
commended by Dr Stork in fchirrous and cancerous
cafes ;  and Mr Fordyce affures  us, that  by this  me-
thod he has cured difeafed  tefticles of two or three
years ftanding, even when  ulcerated, and when the
fchirrus had begun  to be affected with pricking and
lancing  pains.

                OF  BUBOES.

   Venereal  buboes  are hard tumors feated in  the
groin, occafioned by the venereal poifon lodged in
this  » art.
   The cure of recent buboes, that is, fuch as appear
foon after impure coition, may be firft attempted by
difperfion, and, if that fliould not fucceed, by fuppu-
ration.  To promote the difperfion  of a bubo,  the
fame regimen muft be obferved as was  directed in
the firft  ftage of a gonorrhea.   The patient  muft
likewife be  bled, and take  fome cooling  purges, as
the decoction of tamarinds  and fenna,  Glauber's
falts,  and the like.   If,  by  this  courfe,  the fwelling
and  other inflammatory fymptoms  abate, we  may

  * The extract of hemlock may be made into pills, and taken
in the manner directed under the  article Cancer.
fafely 
                 OF CHANCRES.              5oo.
fafely proceed to the ufe of mercury, which muft be
continued till the venereal virus is quite fubdued*.
   But if the bubo fliould,  from  the beginning, be
attended with great heat, pain, and pulfation, and it
cannot be difperfed, it will  be proper to promote its
fuppuration.   For this purpofe the patient may be al-
lowed to ufe emollient cataplafms, confuting of bread
and milk, foftened with oil or  frefli butter, applied to
the part; and, in cold conftitutions, where the tumor
advances flowly, white lily-roots boiled, or fliced onions
raw, and a fufficient quantity of yellow bafilicon, may
be added to the poultice.
   When the  tumor is ripe,  which may be known
by its conical figure, the foftnefs of the  fkin, and
a  fluctuation  of matter plainly to be felt under the
finger, it may be opened  either  by a  cauftic  or  a
lancet,  and afterwards dreffed with digeflive oint-
mentf.
   It  fometimes  however happens, that buboes  can
neither be  difperfed nor brought to a fuppuration,
but remain hard,  indolent tumors.   In this cafe,
the indurated  glands muft be  confumed by cauftic ;
if they  fliould become fchirrous, they muft  be dif-
folved by  the application of hemlock,  both exter-
nally  and  internally,  as directed  in  the   fchirrous
tefticles.

                 OF CHANCRES.

   Chancres  are - fuperficial,  callous, eating  ulcers,
which may happen either with or without a gonor-
rhea.  They are commonly feated  about the glans,

   * For the difperfion of a bubo, a number of leeches applied
to the  part affected will be found equally efficacious as in the
inflamed teilicle.
   f The cauItic is preferable to the lancet, but it is better  if
they will open of themfelves.
                                               or
\ 
 5T°              OF CHANCRES.
 or prepuce, and make their appearance in the follow-
 ing manner.  Firft a little red pimple arifes, which foon
 becomes pointed at  top,  and is filled with a whitifh
 matter inclining to yellow.  This  pimple is hot, and
 itches generally before it breaks :  afterwards it dege-
 nerates  into an obflinate ulcer, the bottom of which is
 ufually  covered with a vifcid mucus, whofe edges
 gradually become hard  and callous.   Sometimes the
 firft appearance refembles a fimple excoriation of the
 cuticle ;  which,  however, if the caufe be venereal,
 foon becomes a true chancre.
    A chancre  is  fometimes a primary affection, but
 it is  much oftener fymptomatic,  and  is the mark of
 a confirmed lues.  Primary chancres  difcover them-
 felves foon after impure  coition, and are generally
 feated in parts covered  with a thin cuticle, as the lips,
 the nipples of women, the glans penis of men, &c*.
    When a  chancre  appears foon after  impure coi-
 tion, its treatment is nearly  fimilar to  that of the
 virulent  gonorrhea,  if there  is much inflammation.
 The patient muft obferve the cooling regimen, lofe
 a little blood, and take  fome gentle  dofes of falts and
 manna.   The parts affected  ought  frequently to be
 bathed,  or rather foaked, in warm milk and water,
 and, if the inflammation be great, an emollient poul-
 tice  or  cataplafm may  be applied  to them.   This
 courfe  will, in moft cafes, be fufficient to  abate the
 inflammation, aiad prepare the patient for the ufe of
 mercury.

   * When venereal ulcers  are feated in the lips, the infection
 may be communicated by kiffing.  I have feen very obftin.ite
 venereal  ulcers in the lips, which I had all  the reafon in the
 woild to believe were communicated in this  manner.
   Nurfes  ought to beware  of fuckling infected children, or
 having their breads drawn by perfon.s tainted  with the venereal
 difeafe.   This caution is peculiarly neceffary fhr  nurfes who
, telide in the neighbourhood  of great towns.
Symp- 
                 OF CHANCRES.               511
  Symptomatic chancres are commonly accompanied
with ulcers in the throat, nocturnal pains, fcurvy erup-
tions about the  roots of the hair,  and other fymp-
toms of a  confirmed lues.   Though  they may be
feated  in  any of the  parts  mentioned above,  they
commonly  appear upon the  private  parts, or  the
infide of the  thigh.  They are alfo lefs painful, but
frequently much larger and harder than primary chan-
cres.   As  their cure muft depend upon that of the
pox, of which they are only a fymptom, we fliall take
no further notice of them, till we come to treat of a
confirmed lues*.
  Thus we have related moft of the fymptoms which
accompany or fucceed  a virulent gonorrhea, or lues,
and have alfo given a fhort view of their proper treat-
ment ; there are, however, feveral others which  fome-
timc- attend this difeafe, as a flrangury, or obftruction
of urine, a phymofis, paraphymofis, Sec.
  A flrangury  may be  occafioned either  by a fpaft
modic  conftriction,  or  an inflammation of the ure-
thra and parts about the  neck of the bladder.  In
the former cafe,  the patient begins to void his urine
with tolerable eafe ; but, as foon  as  it touches the
galled  or  inflamed  urethra,  a  fudden  conftriction
takes place,  and the urine is voided by fpurts, and
fometimes  by drops only.  When the ftranguary Is
owing to an  inflammation  about the neck of the
bladder, there  is a  conftant heat and uneafinefs of
the part, a  perpetual defire to  make water,  while
the patient  can only  render a  few  drops,  and  a

  * I have found it anfwer extremely well to fprinkle chancres
twice a-day with calomel.  This will often perform a cure with-
out any other application whatever.  If the chancres are upon
the giant, they  may be waflied with milk and water,  a little
warm, and afterwards the calomel may be applied as above, or
they may be touched with the lunar cauftic  for two or three
days, and then  dreffed with red precipitate finely pgwderf d.
                                          trouble- 
 S\z              OF CHANCRES.
 troublefome tenefmus, or conftant inclination to go to
 ftool.
    When  the  flrangury is owing to fpafm, fuch me-
 dicines as tend to dilute  and blunt the falts of the
 urine will be proper.   For this purpofe, befides the
 common  diluting liquors,  foft and  cooling  emul-
 fions, fweetened  with  the fyrup  of  poppies,  may
 be ufed.   Should thefe not have the  defired effect,
 bleeding,  and emollient fomentations,  will be  ne-
 ceffary.
   When  the  complaint is evidently owing to an in-
 flammation about the neck of  the bladder, bleeding
 muft be more  liberally performed,  and repeated ac-
 cording to the urgency  of  the fymptoms.  After
 bleeding,  if  the flrangury  ftill continues, foft clyf-
 ters, with a proper quantity of laudanum in them,
 may be adminiftered, and emollient fomentations ap-
 plied to the region of the bladder.  At the fame
 time, the  patient may take, every four hours, a tea-
 cupful of barley-water, to a pint of  which half an
 ounce cf  nitre may be  added.  If thefe remedies
 fhould not relieve the  complaint,  and a  total  fup-
 preffion of urine fliould come on, bleeding muft be
 repeated,  and  the patient fet in a warm bath up to
 the middle.  It will be proper in  this  cafe to dis-
 continue  the  diuretics, and  to draw  off the water
 with the catheter ; but  as the patient  is  feldom able
 to bear its being introduced, we would rather recom-
 mend the  ufe of mild bougies.   Thefe often lubricate
 the paffage, and greatly facilitate  the difcharge of
 urine.  Whenever they begin to ftimuiate or give any
 uneafinefs, they may be withdrawn.
   The phymofis is fuch  a conftriction of the prepuce
 over the glans, as hinders it from being drawn back-
wards ;  the paraphymofis,  on  the contrary, is fuch"a
conftriction of the prepuce behind the glans, as hinders
it from being brought forward..
       i                                     The 
            OF  A CONFIRMED LUES.        515
   .1 fie  treatment of thefe fymptoms is fo nearly the
fame with that of  the virulent  gonorrhea,  that we
have no occafion  to enlarge upon it.  In general,
bleeding,  purging, poultices, and emollient  fomen-
tations are fufficient.  Cold  water dropt on the part
has fometimes relieved the moft violent cafes, efpe-
cially if it be applied for a confiderable time.
  It fometimes happens,  that,  in fpite of all endea-
vours to the  contrary,  the inflammation goes  on,
and fvmptoms of  a* beginning  mortification  appear.
When this is the cafe the prepuce muft be fcarified
with a  lancet,  and, if neceffary, divided,  in order.
to prevent a ftrangulation,  and  fet the imprifoned
glans a: liberty.    We fliall  not defcribe the manner
of performing this operation, as it ought  always to
be done by a furgeon.   When a mortification  has
actually taken place, it  will be neceffary,   befides
performing the  above  operations,  to  foment  the
parts frequently  with cloths wrung out of a ftrong
decoction of camomile-flowers and bark, and  to give
the patient a drachm of the bark in powder every
two or three hours.
   With regard to the priapifm, chordee, and other
diftortions  of the  penis, their treatment is no way
different from that of the gonorrhea.  When they
prove  very  troublefome, the  patient may  take  a
dofe of laudanum at night, efpecially after the opera-
tion of a purgative through  the day*

            OF A  CONFIRMED  LUES.

   We have  hitherto treated cf thofe  affections hi
which the venereal poifon is fuppofed to be confined
chiefly  to the particular  part  by which it  was re-
ceived, and fliall next take a view of the lues  in its
confirmed {fate ; that is, when the poifon is  actually
received into the blood,  and,  circulating  with  it
                        L  1               through 
5h        OF A CONFIRMED LUES.
through  every  part of  the body,  mixes  with the
feveral  fecretions,  and  renders  the  whole  habit
tainted.
   The fymptoms of confirmed lues are,  chancres,
buboes in the groin, pains of the head and joints,
which  are  peculiarly  troublefome in the  night, or
when the patient is warm in bed ;  fcabs and  fcurfs
in various parts of the body,  efpecially  on  the head,
of  a yellowifli colour, refembling  a  honey-comb;
corroding ulcers in various parts of the body,  which
generally begin about the throaty from whence they
creep gradually, by the palate,  towards  the carti-
lage of  the nofe,  which they deftroy;  eruptions in
different parts, excrefeences or exoftofes arife  in die
middle of the bones, and their fpongy  ends become
brittle ;  and break upon the leaft accident; at other
times they are foft, and bend like wax ; the conglo-
bate glands become hard and callous,  and form, in
the  neck,  armpits,  groin, and mefentery,  hard
moveable tumours, like the king's evil; tumours of
different kinds  are likewife formed in  the  lymphatic
veffels, tendons, ligaments,  and  nerves, as the gum-
mata, ganglia,  nodes, tophs,  Sec.  ;  the eyes are af-
fected with  itching,  pain, rednefs, and  fometimes
with total blindnefs,  and the ears with  a flnging
noife,  pain,  and deafnefs, whilft their internal fub-
ftance is exulcerated and rendered carious; at  length
all the animal,  vital,  and natural functions are de-
praved ; the face becomes  pale and livid ;  the body
emaciated  and unfit for motion, and  the  miferable
patient falls into an atrophy or wafting  confumption.
   Women have fymptoms peculiar to the fex ; as
cancers of the  Ireaft ;  a fuppreffion or overflowing
of the menfes ;  the  whites; hyfteric affections; an
inflammation, abfcefs,  fchirrhus,  gangrene, cancer,
or ulcer of the womb ;  they are  generally  either
barren or  fubject to abortion  j  or,  if they bring
                                          children 
             OF A CONFIRMED LUES.        515
 children into the world,  they have an univerfal cry*
 fipelas, are half rotten,  and covered with ulcers.
    Such is the catalogue of fymptoms  attending this
 dreadful difeafe in its confirmed ftate.   Indeed they
 are feldom all to be met with in the fame  perfon,
 or at  the  fame  time; fo  many  of them,  however,
 are generally prefent  as  are fufficient  to alarm the
 patient; and if he has reafon to fufpect the infection
 is lurking  in his body, he ou^lit immediately to  fet
 about the  expulfon of it,  otherwife the moft  tragical
 confequences may enfue.
   The only certain  remedy hitherto known for the
 cure of this  difeafe, is mercury,  which may be ufed
 in  a great variety of forms, with nearly  the fame
 fuccefs.  Some time ag6  it was reckoned impoffible
 to  cure a confirmed lues without a falivation.   This
 method is  now  however pretty generally laid afide,
 and mercury is. found to be  by far moft efficacious
 in  expelling the  venereal  poifon,  when adminiftered
 in fuch a manner as not. to run  off by the falivary
 glands.
   The moft certain mode of curing this difeafe is to
 introduce mercury into the fyftem until we obferve
 the  fymptoms  to give way, then continue  its  ufe
 until the fymptoms entirely difappear  and  for fome
 time afterwards.  If we ufe the mercurial ointment,
 half a drachm may be rubbed into the infide  of the
 thighs, or legs, or arms, twice a day,  taking care,
 daily to wafli thefe parts with warm water and  Caftile
 foap.  If we ufe mercury internally, the mercurial
 pill, fee Appendix, may be given  in  common  cafes,
 from one to three every day.   If the fymptoms are
 violent or  the fkin affected, the folution or  pill of
 fublimate,  fee Appendix.   This  laft in  fmall dofes
 agrees  beft with  children.   The  main point is to
charge the  body  with mercury,  and this  may be
effected, by not  letting it  run  off by the bowels,
                       L 1 2               which 
yitf        OF A CONFIRMED LUES.
which a little opium will prevent;  and not getting
cold,  which would bring on a falivation.
   It is impoffible to afcertain either the exact quan-
tity of medicines that  muft be taken, or  the time
they ought to be continued, in order to perform a
cure.   Thefe will ever vary according to the confti-
tution of  the patient,  the feafon  of the year,  the
degree of infection, the time it has lodged in the  bo-
dy, &c.   But though  it is difficult, as  Aftruc  ob-
ferves, to determine a  priori, what quantity of mer-
cury  will, in the whole,  be neceffary to  cure  this
diftemper completely ; yet  it may be judged of a
pofieriori,  from the abatement and ceafing of  the
fymptoms.   The fame author adds, that commonly
not  lefs  than two  ounces of the  ftrong  mercurial
ointment  is  fufficient,  and not more than  three or
four  ounces neceffary.
r Several roots, woods,  and barks, have been re-
'COimiended  for curing the  venereal  difeafe;  but
none of them have been found, upon experience, to
anfwer the high encomiums, which had been  be-
llowed upon them.  Though no one  of thefe is to
be depended upon  alone,  yet,  when joined with
mercury, fome of them are found to be very bene-
ficial in  promoting  a  cure.   One of  the beft we
know yet is  farfaparilla,  which  may be prepared
and  taken according to the directions in the Appen-
dix *.
   The mezereon-root  is likewife found to be a pow-
erful afliftant to  the fublimate, or any other mercu-
rial.   It may either be ufed along with  the farfapa-
rilla, as directed in the Appendix, or by itfelf.  Thofe
who  chufe to ufe the mezereon by itfelf,  may boil
an ounce  of the frefii bark, taken from the root, in
twelve pints  of water  to eight, adding towards the

        * See Appendix, Deccfl. of Sa-faparilla.
                                             end 
             OF A  CONFIRMED LUES.         517

end an ounce of liquorice.  The dofe of this is the
fame  as of the decoction of farfaparilla.
   We have been  told that the natives of America
cure  the venereal difeafe,  in every  ftage, by a decoc-
tion of the root of  a plant called the Lobelia.   It is
ufed  either frefh or dried;  but we have no certain
accounts with regard to the proportion.   Sometimes
they  mix oilier roots with it,  as thofe of the ranun-
culus,  the  ceanothus,  &c.;  but whether thefe are
defigned to difguife or aflift it, is doubtful.   The pa-
tient takes a large  draught of the decoction early  in
the morning, and continues to ufe  it for his ordinary
drink through the  day *.    It  has  of late years been
afferted that opium alone, in large dofes, would entire-
ly cure this difeafe.   It is certain  that  opium  is  of
great fervice by leffening  the  irritability of the bow-
els, and by the relief it gives in thofe cafes of violent
pain  which fo often accompany this difeafe, and there

   *  Though we are ftill  very much in the dark with regard to
the method of curing  this difeafe among the natives of Ame-
rica, yet it is generally affirmed, that they do cure it with fpeed,
fafety, and fuccefs, and  that without the leaft knowledge of
mercury.  Hence it becomes an object of confiderable import-
ance to difcover their  method  of cure.   This  might furely be
done  by making trials of the various plants which are found in
thofe  parts, and particularly of fuch as the natives are known
to make ufe of.   All people in a rude ltate take their medicines
chiefly from the vegetable kingdom, and are often poffeffed of
valuable fecrets with regard to the virtues cf plants, of which
more enlightened nations are  ignorant.   Indeed  we make no
doubt but fome plants of our  own growth, were proper pains
taken to difcover them, would  be found as efficacious in curing
the venereal  difeafe as thofe of America.   It muft, however, be
remembered, that what will cure the  venereal difeafe in one
country, will not always be found to have equal'fuccefs is ano-
ther; and it is moft probable that no medicine but mercury will
cure this difeafe ; and although many diftrefting fyro$:oms, fuch
as ulcers, nodes, Sec. remain after the proper ufe of mercury,
yet thefe are not  venereal, and are to be cured by fome of ths
many remedies here recommended.                :
                        L 1 3                      is 
£t8         OF A CONFIRMED LUES.
is no doubt that many fores, originally of this nature,
have been cured by it, but it does not certainly ap-
pear that opium will do any thing more.
   Many other roots  and foods might be mentioned
which have been extolled for curing the  venereal
difeafe, as the china-root, the roots of foap-wort,
burdock, &c. as alfo  the wood of guaiacum and faf-
fafras ;  but as none of thefe have been found to pof-
fefs virtues fuperior to thofe already  mentioned, we
fliall, for the  fake of brevity, pafs  them over, and
fhail conclude our obfervations on this difeafe with a
few general remarks  concerning the  proper  manage-
ment of the patient, and the nature  of the infection,

           GENERAL OBSERVATIONS.

   The  condition of the patient ought  always  to  be
confidered previoufly to  his entering upon  a courfe
of mercury in any form.  It might be  rafh and dan-
gerous  to adminifter mercury to a perfon labouring
under any violent acute difeafe, as a fever,  pleurify,
peripneumony, or the like.    It would likewife  be
dangerous in  fome chronic cafes; as  a flow  hectic
fever, or the laft ftage of a confumption.  Sometimes,
however,  thefe difeafes  proceed from  a confirmed
lues j in which cafe it v/ill be neceffary to give mer-
cury. In chronic difeafes of a lefs dangerous nature,
astheafhmi,  the gravel,  and fuch like, mercury,
if neceffaiy, may be fafely adminiftered.   If the pa-r
dent's ftrength has been greatly  exhaufted  by fick-
nefs,  labour, abftinence, or any other caufe, the ufe
of mercury muft be poftponed, till by time, reft, and
a  nourifhing diet,  it can be fufficiently reftored.
   If in  pregnancy circumftances render it neceffary,
mercury may be given, but in fmaller dofes, and at
greater  intervals than ufual; with thefe precautions,
both the mother and child may be cured at the fame
                                           time j 
           OF A CONFIRMED LUES.         5i9
time ; if not, the diforder  will at leaft be kept from
growing wrorfe, till the woman be brought to bed and
fufficiently recovered,  when a more effectual method
may be purfued, which, if fhe fuckles her child, will
in all probability be fufficient for the cure of both.
   Mercury ought  always  to be adminiftered to in-
fants with  caution.   A  fimilar conduct  is recom-
mended  in  the treatment of old perfons,  who have
the misfortune to labour under a confirmed lues.
   Hyfteric perfons, and fuch as are fubject to an ha-
bitual diarrhea, or  who are  afflicted with the fcurvy,
ought to be cautious in the ufe of mercury.  Where
any one of  thefe  diforders prevails,  it  ought,  if
poffible,  to be cured, or at leaft palliated, before
the patient enters upon a courfe of mercury. When
this cannot be done, the mercury muft  be adminif-
tered in fmaller dofes, and at longer intervals than
ufual.
   The moft proper  feafons for entering upon a courfe
of mercury,  are the  fpring, fummer, and autumn,
when the air  is of  a moderate warmth.   If  the cir-
cumftances of the cafe, however, will not admit of
delay, we muft not  defer the cure on account of the
feafon, but muft adminifter the mercury ; taking care
at the  fame  time  to keep  the patient's chamber
warmer or cooler according as the feafon of the year
requires.
   The next thing to be  confidered is the preparation
neceffary to be ©bferved before we proceed to  ad-
minifter a courfe of mercury.  Some lay great ftrefs
upon this circumftance, obferving, that by previoufly
relaxing  the  veffels, and correcting  any diforder
which may happen  to prevail in the blood, not only
the mercury will be difpofed to act more kindly, but
many other inconveniences will be prevented.
   We  have  already recommended  bleeding and
gentle purges,  previoufly to the adminiftration of
                      L  1  4             mercury. 
520        OF A  CONFIRMED LUES.
mercury, and fliall only now add, that thefe are a!,
ways to  be repeated according to the age, ftrength,
conftitution,  and other circumftances of the patient.
Afterwards,  if it  can be conveniently done,  the pa-
tient  ought to bathe once or twice a-day, for a few
days, in  lukewrarm water.  His diet in the mean  time
muft be  light, moift, and  cooling.   Wine,  and all
heating liquors, alfo violent bodily exercife, and all
great exertions  of the  mind,  are carefully to be
avoided,
   A  proper regimen  is likewife  to be obferved by
fuch as are under  a courfe  of mercury.  Inattention
to this not only endangers the patient's life,  but oft
ten alfo  difappoints him of a cure.  A much fmaller
quantity of mercury will be fufficient for the cure of
a perfon who lives low,  keeps  warm, and avoids all
manner of excefs, than of  one who cannot endure
to put the fmalleft reftraint upon  his  appetites: in-
deed  it but rarely happens  that fuch are thoroughly
cured.   If,   for want of proper  attention to  thefe
cautions, the mouth fliould become fore,  and faliva-
tion come on, the  patient may firft of all be bled,  if
ihe pulfe and conftitution require  it.   He muft keep
in his chamber,  take a tea-fpoonful  of the flowers
of fulphur twice a-day, in  a little milk or molaffes,
wafli  his mouth with an aftringent gargle, and dift
continue the mercury ; thus will  generally fet all to
rights in a few days.
   There is  hardly any thing  of  more importance,
either for preventing or  removing venereal infection
than cleanlinefs.   By an early  attention to this, the
infection might often be prevented from entering the
body  j and,  where it  has  already taken  place, its
effects may be greatly mitigated.  The moment any
perfon has reafon to fufpect that he has received the
Infection, he  ought to wafli the parts with water and
fpirits, fweet oil, cr milk and water 3 a fmall quantity
                                               of 
             CF A CONFIRMEC LUES.         32;

of the laft may likewife be injected up the urethra, if
it  can be conveniently done.   Whether this difeafe
at firft took its rife from dirtinefs is  hard to fay ; but
wherever that prevails, the infection is found in its
greateft  degree of virulence, which gives ground to
believe that a ftrict attention to cleanlinefs would go
far towards extirpating it altogether  *.
   When the  venereal  difeafe has been neglected or
improperly treated,  it often becomes a diforder of
the habit.   In  this cafe the cure  muft be attempted
by reftoratives, as a milk  diet, the decoction  of far-
faparilla, and fuch like, to  which  mercury may be
occafionally added. It is a common  practice in North

   * I have not only feen a recent infection carried offina few
days by means of cleanlinefs, viz. bathing, fomentations, injec-
tions, Sec. but have likewife found it of the greateft advantage
in the more advanced ftages of the difeafe.  Of this I had lately
a very remarkable inftance in a man whofe penis was  almoft
wholly confu-ned  by venereal ulcers ; the matter had been al-
lowed to  continue on the fores, without any care having been
Jaken to clean them, till,  notwithftanding the ufe of mercury
and other medicines, it had produced the effects above men-
tioned.  I ordered warm milk and water to be injected three
cr tour limes a day into all the finuous ulcers, in order to waih
out the matter ; after which they were  fluffed with dry lint to
abforb the frelh matter as it was generated.  The patient at the
fame  time took every day half a  gr.-iin  of the corrofive fubli-
mate  of mercury, diffolved in an ounce of brandy,  and drank
a quart of the decocti.n of farfaparilla.   By this treatment, in
about lix weeks, he was perfectly cured  ; and,  what was very
remarkable, a part of the penis was  actually regenerated.
   Doctor Gilchrift has given an account of a fpecies of the lues
venerea which prevails in the weft of Scotland, to which the
natives gave the name of Sibbins or  Si-wbis.   The Doctor cl>-
ferves, that the  fpreading of this difeafe is chiefly owing to a
neglect of cleanlinefs, and feems to  think, that by a due atten-
tion to that virtue, it might be extirpated.  The treatment of
this difeafe is fimilar to that of a confirmed lues cr pox. The
yaws, a difeafe which is now very common both in America
and the  W.ft India, iil.md', may  alio be cured in the i\nne
 mae:i.r.
                                                 Britain 
522        OF A CONFIRMED LUES.
Britain  to fend  fuch patients  to  drink  goat-whey.
This  is  a very proper plan, provided the infection
has been totally  eradicated before-hand ;  but when
that is not the cafe, and the patient  trufts to the whey
for finifhing his cure, he will often be difappointed.
I have frequently known  the difeafe return with all
its virulence after a courfe of goat-whey, even when
that courfe had been thought quite fufficient for
completing the cure.
   One of the moft unfortunate  circumftances attend-
ing patients in this difeafe,  is the neceffity  they are
often laid under of  being foon well.   This  induces
them  to take medicine too faft,  and to leave it off too
foon.    A  few grains  more of medicine, or a few
days longer confinement, would often be fufficient
to perfect the cure ; whereas,  by neglect of thefe,
a fmall degree of virulence is ftill left in the humors,
which gradually vitiates,  and  at length contami-
nates  the whole mafs.    To aviod this,  v.re would
advife, that the patient fhould never leave off taking
medicine immediately upon  the difappearing of the
fymptoms, but continue it for  fome time after, gra-
dually leffening  the quantity,  till there is fufficient
ground  to believe that the difeafe is  entirely eradi-
cated.
   It is  not only difficult, but  abfolutely impoffible,
to afcertain the  exact degree of virulence that may
attend the difeafe ; for which reafon it will always be
a much fafer rule to continue the ufe of medicine too
long, than to leave it off too foon.   This feems to be
the leading maxim of a modern practitioner  of fome
note for the venereal difeafe, who always orders his
patient  to perform a quarantine  of  at  leaft  forty
days, during which  time he takes forty bottles  of,
I fuppofe,  a ftrong decoction of farfaparilla, or fome
other anti-venereal fimple.   Whoever  takes this me-
thod, and adds  a  fufficient  quantity of  corrofive
                                        fublimate, 
            OF A  CONFIRMED LUES.         523
 fublimatc, or fome  other active preparation of mer-
 cury  to the decoction,  will generally cure a con-
 firmed lues.
   It  is peculiarly unfortunate for the cure of this
 difeafe, that not one in ten of thofe who contract  it,
 are either able or willing to fubmit to a proper plan
 of regimen.  The  patient  is  willing to take medi-
 cine ; but he muft follow his bufmefs,  and, to prevent
 fufpicions, muft eat and drink like the reft of the fa-
 mily.   This is the true fource of  nine-tenths of all
 the mifchief arifing from the venereal difeafe.   I  ne-
 ner knew the cure  attended with any great difficulty
 or danger where the patient ftrictly followed the phy-
 fician's advice : but a volume would not be fufficient
 to point out the dreadful confequences which proceed
 from  an  oppofite conduct.  Schirrous tefticles,  ul-
 cerous fore throats, madnefs, confumptions,  carious
 bones,  and a rotten progeny, are a few of the blef-
fings derived from this fource.
   There  is a fpecies  of falfe reafoning, with regard
 to this difeafe, which proves fatal to many.  A per-
 fon of a found conftitution contracts a flight degree of
 the diforder.   He gets well without taking any great
 care, or ufing much medicine, and hence concludes,
 that this  will always be the cafe.   The next time  the
 difeafe  occurs, though ten times  more virulent, he
 purfues the fame courfe, and his conftitution is ruined.
 Indeed, the different degrees of virulence in the fmall-
 pox are not greater than in this difeafe, though,  as
 the learned Sydenham obferves,  in fome cafes  the
 moft fkilful phyficians  cannot cure, and in others  the
 moft ignorant old woman  cannot kill the patient  in
 that diforder.   Though a good conilitudon is always
 in favour of the patient, yet too great ftrefs may be
 laid upon it.  It does not appear from obfervation,
 that the  moft  robuft  conftitution  is able to over-
 come the  virulence  of the venereal contagion, after
                                                it 
5H  ♦        DISEASES OF WOMEN.
it has  got into  the  habit.   In this  cafe a  proper
courfe  of medicine is always indifpenfably neceffary.
   Although it is impoffible, on account  of the  dif-
ferent  degrees of virulence, &c.  to lay down fixed
and  certain rules for the cure of  this difeafe,  yet
the following general plan will always be found fafe,
and  often  fuccefsful,  viz.  to bleed and  adminifter
gentle  purges with diuretics, during  the inflammatory
ftate, and  as foon as  the  fymptoms  of inflammation
are abated, to adminifter mercury in the form that is
beft fuited to the fymptoms/  The fame medicine,
afljfted by  the decoction of farfaparilla, and a proper
regimen, will not only fecure the conftitution againft
the further progrefs of  a confirmed pox, but  will
generally perform a  complete cure ; and  if the  pa-
tient is weakened  by the courfe,  or  by the difeafe,
the  bark,  reftorative diet, and above all,  country
air, will be neceffary to reftore his health.
                 CHAP.  XLIX.

                Difeafes  of Women.


          W OMEN, in.all civilized nations, have
the management of domeftic  affairs, and it is very
proper they fhould, as Nature has made  them lefs
fit for the more active and laborious employments.
This indulgence,  however, is  generally  carried too
far j and females, inftead of being benefited  by it,
are greatly injured, from  the  want of exercife  and
free air.   To be fatisfied  of  this, one need only
compare  the frefh and ruddy looks of a  milk-maid,
with the pale complexion  of  thofe  females whofe
                                           whole 
     QF THE MENSTRUAL DISCHARGE.    52$
whole time is fpent  within doors.  Though Nature
has made an evident diftinction between  the male
and female with  regard  to  bodily ftrength and  vi-
gour, yet flie certainly never meant, either that the
one fhould be always without, or the other always
within doors.
   The confinement  of females, befides hurting their
figure and complexion, relaxes their folids, weakens
their  minds,  and diforders all  the functions  of the
body.   Hence proceed obftructions, indigeftions, fla-
tulencies, abortions, and the whole train of nervous
diforders.  Thefe not only unfit women  for being
mothers and  uurfes,  but often render them whimfi-
cal and ridiculous.   A found mind depends fo much
upon a healthy body, that where the latter is want-
ing, the former is rarely to be found.        „
   I have always obferved, that women  who were:
chiefly employed without doors,  in  the  different
branches of hufbandry,  gardening,   and the  like,
were almoft as hardy as their hufbands, and that their
 children likewife  were ftrong and healthy.  But as the
 bad  effefts of confinement and inactivity  upon both
 fexes  have  been already fliewn, we fhail proceed to
 point out thofe circumftances in the ftructure and de-
 fign of females,  which fubject  them to peculiar dif-
 eafes j the chief of which are, their monthly evacua-
 tions, pregnancy, and  child-bearing.   Thele indeed
 cannot properly  be called difeafes, but from the de-
 licacy of the fex, and  their being often  improperly
 managed in fuch fituations,  they become the fcurce
 of numerous calamities.

        OF THE  MENSTRUAL DISCHARGE.

    Females  generally begin to menftruate about the
  age of fifteen,  and leave  it off about fifty, which
  renders thefe two periods the moft  critical cf their
                                             livp--.. 
  -:.G    OF TFIE  MENSTRUAL DISCHARGE.
  lives-*.   About the firft appearance of this difcharge,
  the  conftitution   undergoes   a   very   confiderable
  change, generally indeed  for the  better,  though
  fometimes for  the worfe.   The greateft care is now
  neceffary, as the future health and happinefs of the
  female'depends in a great meafure upon  her conduct
  at this period f.
    If  a girl about this time of life be confined to the
 houfe,  kept conftantly fitting, and neither allowed to
 run about, nor employed  in any active  bufmefs,
 which gives exercife to the whole body,  flie becomes
 weak, relaxed, and puny;  her blood not being duly
 prepared,  file looks pale and wan ; her  health, fpi-
 rits, and  vigor decline, and  file finks into a valetu-
 dinarian for life.   Such is  the fate of  numbers  of
 thofe  unhappy females, who, either from  too much
 indulgence, or  their own narrow circumftances, are,
 at this critical period,  denied the  benefit of exercife
 and free air.
   A  lazy  indolent difpofition proves likewife very
 hurtful to. girls at this  period.   One feldom meets
 with complaints from obftructious  amongft  the more
 active  and induftrious part  of the  fex; whereas the
 indolent and lazy are feldom free from them.   Thefe
 are in a manner eaten up by the chlorofis,  or green-

   * This period, however, varies in different countries.   It
 occurs earlieft in fouthern climates.
   -j- It is the duty of mothers, and thofe who are entrufted with
 the education of girls, to inftruct them early in the conduct and
 management of themfelves at this critical period of their live;;,
 Falfe modefty, inattention, and ignorance of what is beneficial
 cr hurtful at this  time, are the fources  of many difeafes and
 misfortunes  in life, with a few fenfible leffons from an experi-
 enced matron might have pevented.  Nor is care  lefs neceffary
 in the fubfequant returns of this difcharge.  Taking improper
food, violent affections of the mind, or catching cold at this pe-
 riled, is  often fufficient to ruin the health, or to render the fe-
male ever after incapable of procreation.
                                            fickneft, 
      OF THE MENSTRUAL DISCHARGE.    527
ficknefs, and other difeafes of this nature.  We would
therefore  recommend  it to all who wifh to  efcape
thefe  calamities,  to  avoid  indolence and inactivity,
as their greateft enemies, and to be as much abroad
in the open air as poffible.
   Another thing which proves very hurtful to girls
about this period of life, is unwholefome food.  Fond
of all manner  of trafli,  they often indulge in it,  till
their whole humors are quite vitiated.   Hence enfue
indigeflions, want of appetite, and a numerous train
of evils.   If the fluids be not duly prepared, it is
utterly impoffible  that the fecretions fhould go pro-
perly on.   Accordingly we find, that  fuch  girls as
lead an indolent  life,  and  eat  great quantities of
trafli,  are not  only fubject to  obftructions of the
menfes, but  likewife to glandular obftructions;  as
fhe fcrophula or king's evil, &c.
   A dull- difpofition is alfo very hurtful  to girls at
this period.   It is a rare thing to fee a fprightly girl
who does  not enjoy good health, while the moping,
melancholy creature, proves the very prey of vapours
and  hyfterics.   Youth is the feafon for mirth  and
cheerfulnefs.  Let it therefore  be indulged.  It is
an abfoiute duty.  To lay in a ftock  of health in
time of youth, is as neceffary a  piece  of prudence,
as to make provifion againft the decays  of old age.
While, therefore, wife Nature  prompts the  happy
youth to join in  fprightly amufements,  let not  the
fevere dictates of hoary age forbid the ufeful impulfe,
nor damp, with ferious gloom, the feafon deftined to
mirth and innocent feftivity.
   Another thing very hurtful to females about this
period  of  life is ftrait clothes.   They are fond of
a fine fhape, and fooliihly  imagine that  this can be
acquired  by  lacing themfelves   tight.    Hence, by
fqueezing the ftomach and bowels,  they hurt  the
digeftion,  and  occafion  manv  incurable maladies.
                                             This 
5^S    OF THE MENSTRUAL DISCHARGE.
This error is not indeed fo common as it has beer, i
but, as fafliions change, it may come about again :
we therefore think it not improper to mention it.   I
know many  females who, to this day, feel the dire-
ful effects of that wretched  cuftom wdiich prevailed
fome years ago, of fqueezing every girl into as fmall
a fize in the middle as poffible.   Human invention
could not poffibl'y have devifed a practice more  de-
ftructive to health.
   After a female has arrived at that period of life
when the nienfcs ufually begin to flow, and they do
not appear,  but, on the contrary, her health and
fpirits begin  to decline, we would advife,  inftead of
ihutting the poor girl up in  the houfe, and dofing
her with fteel, afafcetida, and other  naufeous  dru£3,
to place her. in a fituation where fhe  can enjoy  the
benefit  of free air and agreeable company.   There
let her  eat wholefome food,  take fufficient  exer-
cife,  and amufe herfelf in  the moft agreeable man-
ner ;  and we have  little  reafon to  fear,  but Na-
ture, thus affifted,  will do  her  proper work.  In-
deed  flie feldom fails, unlefs where the fault is on
our fide *.
   The difcharge in  the beginning is feldom fo  in-
stantaneous  as to furprife  females  unawares.   It  is
generally preceded by fymptoms which foretel its ap-
proach ; as  a fenfe  of heat,  weight,  and dull pain
in the loins; diftention and hardnefs of the brcafts;
head-ach \ lofs of appetite ; laffitude ;  palencfs of
the countenance, and fometimes a  flight  degree of
fever.   When thefe fymptoms appear about the age
at which  the  menftrual flux ufually  begins,  every

   * This advice is well worth attending to.   Inftead of truft-
ing to medicine, we fhould attend to the general health, which
b beft procured by country air, exercife, and the  cold  bath.
 When this is eftahlilhed, we may life the preparations of fteel
 with the greateft  advantage.
                        4                     thing 
      OF THE MENSTRUAL DISCHARGE.    529
thing fliould be carefully avoided which may obftruct
that neceffary and falutary evacuation*.
   After the menfes have once begun to flow, the
greateft care fhould be taken  to avoid every thing
that may tend to obftruct  them.  Females ought
to be exceeding  cautious of what  they eat or drink
at the time  they are out  of order.   Every thing
that is cold,  or apt  to  four on the ftomach, ought
to be avoided ;  as fruit, butter-milk,  and fuch like.
Fifli, and all kinds of food that are hard of digeftion,
are alfo to be avoided.   As it is impoffible to mention
every thing  that may difagree with individuals at this
time, we would recommend it to every female to be
very attentive to what  difagrees with herfelf, and
carefully to avoid it.
   Cold is extremely hurtful  at this particular period*
More of the fex date their diforders from colds,
caught while they are out of  order,  than  from all
other caufes.   This ought furely to  put them upon
their guard,  and to make  them  very circumfpect
in their conduct  at fuch times.  A degree  of cold
that will not in  the leaft hurt them at another time,
will  at this period be fufficient entirely to ruin their
health and conftitution.
   The greateft attention  ought likewife  to  be paid
to the  mind,  which fliould  be kept as eafy and
cheerful as poffible.   Every part of the animal ceco-
nomy is  influenced by  the  paflions, but  none more
fo than this.   Anger,  fear, grief, and other  affec-
tions of the  mind, often  occafion obftructions of
the  menftrual  flux,  which prove  abfolutely incura-
ble.

  * Complaints of the breaft, coftivenefc, and violent pain in
different parts, now alfo occun  Thefe are co be treated ac-
cordingly.  For the pain, nothing anfvvers better than the cam-
phor mixture with fome laudanum.  See Appendix*
                       M m                  From 
$$0   OF THE MENSTRUAL DISCHARGE.
  From whatever caufe this flux is obftructed, exccp?
in the ftate of pregnancy, proper means fliould be
ufed to reftore it.   For this purpofe we would recom-
mend fuflicient exercife,  in a dry, open,  and rather
cool air ;  wholefome diet, and, if the body be weak
and languid, generous liquors ; alfo cheerful company
and proper active amufements.  If thefe fail, recourfe
muft be had to medicine.
  When obftructions  proceed  from a weak relaxed
ftate of the folids, fuch medicines as tend to promote
digeftion, to brace the folids, and affift the body in
preparing good blood, ought to be ufed. The principal
of thefe are iron and  the Peruvian bark, with other
bitter and aftringent medicines. Prepared fteel may be
taken in the dofe of half a drachm, mixed with a little
honey or treacle, three or four times a-day.  Or what
is much better, and by far niQre powerful, from four
to eight grains of the fait of fteel or green  vitriol,
made into a powder with  twenty or  thirty grains of
prepared  fteel twice a-day ; or the fame quantity of
fait of fteel may be taken in the form of  pills, made
up  with the foft extract of gentian.   The bark and
other bitters may either be  taken in fubftance or in-
fufion, as is moft agreeable to the patient.
   When  obftructions proceed from an inflammatory
ftate of the fyftem ; or for women of a grofs or full
habit, evacuations, and fuch medicines as attenuate
the humors, are neceffary.  The patient in this cafe
ought to be bled, to bathe her feet frequently in warm
water, to take now and then a cooling purge, and to
live upon a fpare thin diet.  Her drink mould be whey,
water, or fmall beer,  and fhe ought to take fufficient
exercife.  A tea-fpoonful of the  tincture of black
hellebore  may alfo be taken twice a-day  in a cup of
warm water.
  When  obftructions  proceed from affections of the
mind, as grief, fear, anger, Sec. every method fliould
                                              l>c 
        OF THE MENSTRUAL DISCHARGE.   S$i
  be taken to amufe and divert the patient.   And that
  fhe may the more readily forget the caufe of her af-
  fliction,  flie ought, if poffible  to be removed from
  the place where it happened.  A change  of place,
  by prefenting the mind with a variety of new objects,
  has often a very happy influence in relieving it from
  the deepefl diftrefs.   A foothing, kind, and affable
  behaviour to females in this fituation is alfo of the laft
  importance.
    An obftruction of the  menfes is often the effect of
  other maladies. When this is the cafe, inftead of giving
  medicines to force  that difcharge,  which might be
  dangerous, we ought by all means to endeavour to re-
<  ftore the patient's health and ftrength.   When  that
  is effected, the other will return of courfe.
    But the menftrual flux may be too great as well
  as too fmall.  When this  happens, the patient be-
  comes weak, the colour  pale,  the  appetite and di-
  geftion are  bad, and cedematous  fwellings  of the
  feet, dropfies, and confumptions often enfue.   This
  frequently happens to women about  the age of forty-
  five or fifty,  and is  very difficult to cure.   It may
  proceed from a fedentary life ; a full diet, confifting
  chiefly of fal ted, high-feafoned,  or  acrid food;  the
  ufe  of fpirituous liquors;  exceffive fatigue; relaxa-
  tion ; a  ftate of debility ; violent  paffions  of the
  mind, Sec.
    The treatment of this difeafe muft  be varied ac-
  cording to its caufe.   When it is  occafioned by  any
  error in  the patient's regimen,  an oppofite  courfe to
  that which induced the diforder muft be purfued,  and
  fuch medicines taken as have a tendency to reflrain
  the flux, and counteract the morbid affections of the
  fyftem from whence it proceeds.
    To reflrain  the flux, the patient fliould be  kept
  quiet  and eafy both  in body and mind.   If it be
  very vioknt,  and the pulfe will bear it, flie muft be
                      M m  2                 b!ex£ 
 $r-    OF THE" MENSTRUAL DISCHARGE.
 bled, and ought to lie in bed with her head low ;  to
 live upon a cool and flender diet, as veal or chicken
 broths with bread; and to drink decoctions of nettle-
 roots,  or the greater comfrey.  If thefe be not fuf-
 ficient  to ftop  the flux,  ftronger aftringents may be
 ufed, as Japan earth, Gum kino, ialum, elixir of vitriol,
 the Peruvian bark*, Sec.
   The uterine flux  may offend in quality as well  as
 in quantity.  What is ufually called the fiuor albus,
 or whites, is a very common difeafe, and proves ex-
 tremely hurtful to delicate women.   This difcharge,
 however, is not  always white, but fometimes  pale,
' yellow, green, or of a  blackifh colour ;  fometimes it
 is fharp and corrofive, fometimes foul and foetid, &c.
 It is attended  with a pale complexion,  pain in the
 back, lofs of appetite, fwelling of the feet, and other
 figns of debility.   It proceeds  from a relaxed ftate of
 the body, arifing from indolence, the exceffive ufe of
 tea,  coffee, or other weak  and watery  diet, and a
 variety of other caufes.
   To remove  this  difeafe,  the patient muft take as-
 much exercife as fhe can bear without fatigue.   Her
 food fhould be folid and nourifhing, but of eafy
 digeftion ; and her drink  rather generous, as red port
 or claret, mixed with Pyrmont, Briftol, or lime-water.
 Tea  and  coffee are to be  avoided.   I have often
 known ftrong broths have an exceeding  good effect,

   *  Two drachms of alum and one of Japan earth may be
 pounded together, and divided into eight or nine dofes, one
 of which may be taken three times a>day.
   Perfons  whofe flomachs cannot bear the  alum,  may take
 two table-fpconftils of the tincture of rofes three or four  times
 a-day, to each dofe of which ten drops cf laudanum may be
 added.
   If thefe fliould fail, half a drachm of the Peruvian bark, in
powder, with ten drops of the elixir of vitriol, may be taken, in
a glafs of red wine, four times a-day.

                                               and 
       OF THE MENSTRUAL DISCHARGE.   533
 and fometimes a milk diet alone will perform a cure.
 The patient ought- not to lie too long a-bed.  When
 medicine  is neceffary,  we know none preferable to
 the Peruvian bark, which in this  cafe ought always
 to be taken in fubftance.  In warm weather, the cold
 bath will  be of confiderable fervice.  This is a very
 diftreffing complaint, and is owing to a variety of
 caufes, which muft feverally be attended to.  Where
 i| is owing to mere debility, the preparations of iron
 and balfam capaivi are  the beft medicines.
   That period of life  at which the menfes ceafe to
 flow, is likewife very critical to the fex.  The flop-
 page of any cuftomary  evacuation, however  fmall,
 is fufficient to diforder the whole frame, and often
 to deftroy life itfelf.   Hence it  comes to pafs, that
 fo many  women  fall into chronic diforders,  about
 this  time.  Such  of them, however, as  furvive  it,
 without contracting  any chronic difeafes, often be-
 come more healthy and hardy than they were before,
 and enjoy ftrength and vigour to a very great age.
   If the  menfes ceafe all  of a fudden,  in women of a
 full habit, they ought  to abate  fomewhat  of  their
 ufual quantity of food, efpecially of the more nourifh-
 ing kind,  as  flefli, eggs, &c.   They ought likewife
 to take fufficient exercife, and to keep the body open.
This may be done by taking, once or twice a-week,
 a little rhubarb, or tincture  of aloes j and fmall but
 repeated bleedings are of great fervice.
   It often happens that women of a grofs habit,  at
 this  period of life, have ulcerous  fores break out
 about their ankles, or in other  parts of  the body.
 Such  ulcers ought to be confidered  as critical, and
fliould cither be fuffered to continue open,  or have
artificial drains fubftituted in their ftead.  Women
who will have fuch fores dried up, are often foon after
carried off by acute  difeafes, or fall into thofe of a
chronic nature.
                    M  m 3                   OF 
C  5te  }
               OF PREGNANCY.

  Though pregnancy is not a difeafe, yet that ftate
is often attended with a variety of complaints which
merit attention, and which  fometimes require the af-
fiftance of medicine.  Some women indeed are more
healthy during  their pregnancy  than at  any other
time ; but this is by no means the general cafe : mqff
of them breed  in farrow,  and  are frequently indif-
pofed during the whole  time of pregnancy.  Few fatal
difeafes, however,  happen  during  that period ; and
hardly  any,  except abortion, that can be  called dan-
gerous.  We fliall therefore pay particular attention
to them, as it proves generally fatal to the child, and
fometimes fo to the mother.
  Pregnant women are often afflicted with the heart-
burn.   The  method of  treating this complaint has
been already pointed  out.   They are likewife,  in
the more early periods of   pregnancy, often haraff-
ed with ficknefs and vomiting, efpecially in the morn-
ing.  The method of relieving thefe complaints has
alfo been fhewn.   Both the head-ach and tooth-ach
are very troublefome fymptoms of pregnancy.  The
former may be generally removed by keeping  the
body gently open, by the ufe of prunes, figs, roafted
apples, and fuch like.   When  the pain is very vio-
lent, bleeding may be neceffary.  For the treatment
of the  latter, we muft refer to that  article.   Several
other complaints incident to pregnant women might
be mentioned, as a cough and difficulty of breathing,
fuppreffion and incontinency of urine, &c.; but  as
all of thefe have been  taken notice of before, it is
needlefs to repeat  them.
  Every pregnant  woman is more or lefs in danger of
abortion.  This fliould be guarded againft with  the
greateft care, as it  not only  weakens the conftitution,
                                             but 
                 OF PREGNANCY.              535
but renders the woman liable to the fame misfortune
afterwards*.   Abortion may happen at any period
of pregnancy,  but it  is moft common in the fecond
or third month.   Sometimes, however, it happens in
the  fourth or  fifth.   If  it happens within  the firft
month, it is ufually called  a falfe conception ; if after
the feventh month, the child may often be kept alive
by proper care.
   The common caufes of  abortion are,  the death of
the  child ; weaknefs  or relaxation  of the mother ;
great  evacuations ;  violent exercife ; railing great
weights ;  reaching too  high; jumping,  or ftepping
from an eminence ; vomiting ; coughing ; convulfion
fits ;  blows  on  the belly ;  falls ; fevers ; difagree-
able fmells; excefs of blood; indolence ;  high living,
or the contrary ;  violent paffions or affections of the
mind, as fear, grief,  Sec.
   The figns of approaching abortion are, pain in the
loins, or about the bottom of the belly ; a dull heavy
pain  in the infide  of  the  thighs ; a flight degree of
coldnefs,  or fliivering ; ficknefs,  palpitation of  the
heart; the  breafts become flat and foft; the belly
falls ; and there is a difcharge of blood or watery hu-
mours from the womb.
   To prevent  abortion,  we would advife  women
of a weak or relaxed habit to ufe folid food, avoid-
ing  great quantities  of  tea, and  other weak  and
watery liquors ; to rife early and go foon  to bed;

   *  Every mother  who  procures an abortion does it at the
hazard of  her life ;  yet there  are not a few who run this rifk
merely to prevent the' trouble of bearing and bringing up chil-
dren.  It is furely a moft unnatural crime, and cannot, even
in the moft abandoned be viewed without horror ; but in the
decent matron, it is  ftill more unpardonable.—Thofe wretches
who daily  advertife  their affiftance to women in this bufmefs,
d?fc*-ve, in my opinion, the moft fevere of all  human punilh-
wents.
M m 4
to 
536             OF PREGNANCY.
to fhun damp houfes ; to take frequent exercife in
the open  air, but to avoid fatigue ; and  never to
go abroad  in  damp  foggy weather,  if they  can
avoid it.
   Women of a full habit ought to ufe a fpare diet,
avoiding ftrong liquors,  and every thing that may
tend  to heat the  body, or increafe the quantity of
blood.  Their diet fhould be of an opening nature,
confuting  principally of vegetable  fubftances.  Eve-
ry woman with child ought to be kept  cheerful  and
eafy in her  mind.   Her  appetite,  even though  de-    /
praved, ought to be indulged as far as prudence  will
permit.
   When  any figns of  abortion appear, the woman
ought to  be laid oil a bed or mattrefs, with her head
low.   She fhould  be kept quiet, and her mind  footh-
ed and comforted.  She  ought not to be  kept  too
hot, nor to take any thing of a heating nature.  Her
food fhould confift of broths,  rice and milk, Jellies,
gruels made of oat-meal, and the like,  all of which
ought to be taken cold.
   If fhe be able to bear it,  fhe  fliould lofe at leaft
half a#pound of blood from the  arm.   Her  drink
ought to  be barley-water, fliarpened with juice of
lemon ; or fhe  may take fifteen grains of powdered
nitre,  in  a  cup of water-gruel, every two or three
hours.  If feized with a  violent loofenefs, fhe  ought
to drink the  decoction of calcined hartfliorn prepared.
If fhe be affected with vomiting, let her take frequent-
ly two table-fpoonfuls of the faline mixture.  In gene-
ral, opiates are  of fervice j but they fhould always be
given with caution.
   Sanguine robuft women, who are liably to mifcarry
at a certain time of pregnancy, ought always to be
bled a few days before that period arrives.   By this
msans, and obferving the regimen  above prefcribed,
they might often efcape that misfortune.
                                         Though 
               OF CHILD-BIRTH.             537
  Though we recommend due care for preventing
abortion,  we would not  be underftood as reftraining
pregnant  women  from their  ulual exercifes.   This
would generally  operate  the  quite contrary  way.
Want of exercife »ot only relaxes the body, but in-
duces a plethora, or too great a fulnefs of the vaffels,
which are the  two principal  caufes  of  abortion.
There are,  however, fome women of fo delicate  a
texture,  that it is neceffary for them to avoid almoft
every kind of  exercife during  the whole period of
pregnancy.

                OF CHILD BIRTH.

   Many difeafes  proceed from the want of due care
in child-bed ;  and the more hardy part of the fex
are moft  apt to defpife the neceffary precautions in
this  ftate.   This is peculiarly  the  cafe with young
wives.   They think,  when  the  labour-pains are
ended, the  danger is over ;  but  in  truth it  may
only then be faid to be  begun.  Nature, if left to
herfelf, will feldom fail to expel the fixtus ; but pro-
per care and management  are certainly neceffary for
the recovery of the mother.  No doubt mifchief may
be done  by  too  much as well  as by too little  care.
Hence, females wdio have the  greateft number of
attendants in child-bed, generally recover worft. But
this is not peculiar  to the ftate of child-bed.  Excef-
five  care  always  defeats  its  own intention, and  is
generally more dangerous than none at all*.

  * Though the management of women in child-bed has been
praclifed as an employment fince the earlieft accounts of time ;
yet it is ftill, in moft countries, on a  very bad footing.  Few
women think of following this employment till they are reduced
to the neceffity of dning it for bread.  Hence, not one hi an hun-
dred of them have any education, or proper knowledge of their
Uufinif--,  It is true, thai Nature, if left to herfelf, will gene-
                                              :ul)v 
53^
OF CHILD-BIRTH.
   During actual labour, nothing of a heating nature
ought to be given.   The woman may now and then
take a little panada, and her drink ought to be toaft
and water, or thin oatmeal-gruel. Spirits, wines, cor-
dial-waters, and  other  things which are given with
a vi^tv to ftrengthen  the mother,  and promote the
birth, for the moft part, tend only to  increafe the
fever, inflame - the womb, and  retard the  labour.
Befides,  they  endanger the  woman afterwards,  as
they  often  occafion violent  and mortal haemorrha-
ges,  or  difpofe her to eruptive and  other fevers.
   When the labour proves tedious  and difficult,  to
prevent  inflammations,  it  will  be  proper to bleed.
An emollient clyfter  ought likewife to  be adminif-
tered.   The paffage ought  to be gently rubbed with
a little  lard or frefh  butter.   Thefe  directions are
fuflicierit in natural  labours ; and in all  preternatural
cafes, a fkilful furgeon, or  man-midwife, ought  to
be called as foon as poffible.
   After  delivery,  the woman  ought to be  kept  as
quiet and  eafy  as  poffible*.   Her food fliould be

rally expel the fetus ; but  it is equally true, that moft women
in child-bed require to be managed with fkill and attention, and
that they  are clten hurt by the fuperftiti-ai. prejudices of igno-
rant and officious midwives. The mifchief done in this way is
much greater than is generally imagined ; muft of which might
be prevented, by allowing no woman to practice midwifeiy but
fuch as are properly qualified. Were due attention paid to this,
it  would not only be the means of faving many lives, but would
prevent the neceffity of employing men in this indelicate and
difagreeable branch of medicine,  which is, on many  accounts,
more proper  tor the  other  fex.
   * We  cannot help taking notice of that ridiculous cuftom
which ftill prevails,  in fome parts cf the country, of collecting
:>. number of women together upon fuch occafions.  Thefe,  in-
ftead of being ufeful, ferve only to crowd the houfe, and'ob-
ftruct  the  neceffary attendants.  Befides, they hurt the patient
r.ivh their noife; and often, by their untimely and impertinent
advice, do much mihhief.
light 
               OF CHILD-BIRTH.              53sJ
light and thin,  as gruel, panada,  &c. and her drink
weak and diluting.   To this  rule,  however, there
may be exceptions.
  Sometimes  an  exceffive  haemorrhage  or flooding
happens after  delivery.   In this cafe  the   patient
fliould belaid with her head low, kept cool,  anc^be
in all refpects treated as for an exceffive flux of the
menfes.   If the flooding proves violent,  linen  cloth?,
which have been  wrung out of  a mixture of equal
parts of vinegar  and water, or red  wine, fliould be
applied to the belly, the loins, and the  thighs : thefe
muft be  changed as they grow dry ; and may be dif-
continuedas  foon as the flooding  abates*.
   If there be violent pains after delivery, the patient
ought to take one or two opium piiisf.
   An inflammation of the  womb is a dangerous  dif-
eafe, after delivery.  It is known  by pains  in the
lower part of the belly,  which are greatly increafed
upon touching it; by the  tenfion or tightnefs of the
parts ; great weaknefs ; change  of  countenance ; a
conftant fever, with a weak and  hard pulfe ;  a flight
delirium or raving ; fometimes inceffant vomiting ; a!n
hiccup ;  a difcharge of reddifli, ftinking, fharp water
from  the womb ;  an inclination to go frequently to
ftool;  a heat, and fometimes  total  fuppreffion  of
 urine.
    This muft be treated like other inflammatory dif-
 orders, by bleeding and plentiful dilution. The drink

   * In a violent flooding after  delivery, T have feen vory gcod
 effects from the following mixture : Take of pennyroyal water,
 fimple cinnamon-water, and fyrup of poppies,  ea, h tvvo ounces
 elixir of vitriol a drachm.  Mix, and take two tabiefpoor.tuh
 every two hours, or oftener, if neceffary.
   When the patient is low-fpirited,  ortrouM.-d with liyilerical
 complaints, (lie ought to take frequently twelve or ii  teen diop^     «
 of the tincture of afafcetida, in a cup  of penny-royal tea.
    j-  See Appendix, Opi:i;;i Pills,
                                                mav 
  54o             OF CHILD-BIRTH.
  may be thin gruel or barley-water ;  in a cup of which
  half a drachm of nitre may be diffolved, and taken
  three or four times a-day.   Clyfters  of  warm milk
  and water muft be frequently adminiftered ; and the
  belly fhould be fomented  by cloths wrung out of
  warm water;  or apply bladders filled with milk and
  water to it.
    A fuppreffion  of  the lochia,  or  ufual difcharges
  after delivery, and  the milk-fever, muft be treated
 nearly in the fame manner as an inflammation of the
 womb.  In all thefe cafes, the fafefi courfe is plenti-
 ful dilution, gentle evacuations,  and fomentations  of
 the parts affected. In the milk-fever, the breafts may
 be embrocated with  a little  warm linfeed-oil,  or the
 leaves  of  cabbage  may be  applied to them.   The
 child fliould be  often put to the  breaft, or it fhould
 be drawn by fome other perfon.
   Nothing would tend more to prevent the milk-fe-
 ver than putting the child early to the breaft.   The
 cuftom of  not  allowing children to  fuck  for the firft
 two or three days, is  contrary to Nature and com-
 mon fenfe, and is very hurtful both to  the mother
 and child*.
   Every mother who has milk in her breafts,  ought
 either to fuckle her own child, or  to have  her breafls
 frequently  drawn, at leaft for the firft month.  This
 would prevent many of the difeafes which  prove fatal
 to women in child-bed.
   When an inflammation happens in the  breaft, at-
 tended with rednefs,  hardnefs,  and  other fymptoms
of fuppuration, the  fafefi application  is  a  poultice
of bread and milk, foftened  with  oil  or frefli butter.
This may be renewed twice a day, till  the tumor be
either difcuffed or brought to fuppuration.   The ufe

  * The child fliould be put to the breaft within twenty-four
hours after delivery. 
               OF CHILD-BIRTH.           . 541
of repellents,  in  this cafe, is very dangerous ; they
often occafion  fevers,  and fometimes cancers*.
   When the nipples are fretted and chapt, they may
be anointed with a mixture of oil and bees-wax, or
a little powdered  gum-arabic  may  be fprinkled on
them.   I  have feen Hungary water applied to the
nipples have a very  good effect.   Should the com-
plaint prove obftinate, a cooling purge may be given,
which generally removes it f.
   The miliary fever is a difeafe incident to women in
child-bed ; but as it has been  treated of already, we
fhail take no further  notice of  it.   The celebrated
Hoffmann obferves, That this fever of child-bed wo-
men might generally  be  prevented,  if during their
pregnancy,  they  were regular in their diet, ufed mo-
derate exercife, took now and then a gentle laxative
of manna, rhubarb,  or cream of  tartar ; not forget-
ting to bleed in the firft months, and  avoid all  fliarp
air.  When the labour is coming on, it is not  to be
haftened with  forcing medicines,  which inflame the
blood and humors,  or put them into unnatural com-
motions.  Care fliould be taken,  after  the birth,
that the natural excretions proceed regularly ; and if
the pulfe be quick, a  little nitrous powder, or fome
other cooling medicines, fhould be adminiftered.
   The moft fatal  diforder confequent upon delivery
is  the puerperal,  or  child-bed fever.  It generallyN
makes  its attack upon the fecond or  third day after
delivery.  Somedmes indeed it comes on fooner, and
at other times,  though rarely, it does not  appear be-
fore the fifth or fixth day.

  * As it is better  to prevent than to cure a difeafe,  much
good may be done  by bleeding in thefe c^fes when the pulfe
will bear it.
  f To prevent fore nipples, they fhould be wafhed twice a-day
with brandy for  a month or fix weeks,  previous to the lying-
in.
It 
542            OF CHILD-BIRTH.
    It begins,  like moft other  fevers, with a cold or
  fliivering fit, which is fucceeded by reftleffnefs, pain
  of the head, great ficknefs at ftomach,  and bilious
  vomiting.  The pulfe  is generally quick,  the tongue
  dry, and there is a remarkable  depreffion of fpirits
  and lofs  of ftrength.   A great pain is ufually felt in
  the back, hips, and region of the womb ;  a fudden
  change in the quantity or quality of the lochia alfo
  takes place ;  and the patient is  frequently  troubled
  with a tenefmus, or conftant inclination to go to ftool.
  The urine, which is very high coloured, is  difchar-
  ged in fmall quantity,  and  generally with pain.  The
  belly fometimes  fwells to  a confiderable bulk, and
 becomes  fufceptible of pain  from  the flighteft touch.
  When the  fever has  continued for  a few days, the
 fymptoms of inflammation  ufually fubfide, and the
. difeafe acquires a more putrid form.  At this period,
 if not foonet, a bilious or putrid loofenefs, of an ob-
 ftinate and dangerous nature,  comes on, and accom-
 panies the difeafe through all its future progrefs.
   There  is not any difeafe that requires to be treated
 with more fkill and attention than this;  confequently
 fhe beft  affiftance ought always  to be  obtained as
 foon as poffible.  In women of plethoric conftitutions,
 bleeding  will generally be proper at the beginning;
 it ought  however to be ufed with caution, and not
 to be repeated unlefs  where the  figns of inflamma-
 tion rife high  ; in which cafe it wall alfo be neceffary
 to apply a bliftering plafter to the region of the womb.
   During the rigor,  or  cold fit,  proper  means
fhould be  ufed to abate  its violence, and fliorten its
 duration.   For  this purpofe the patient may drink
freely of warm diluting liquors, and if low, may take
now and  then a  cup of wine-whey ; warm applica-
tions to the extremities, as  heated bricks,  bottles or
bladders filled  with warm  water, may  alfo be  ufed
with advantage.
              2                          Emollient' 
               OF CHILD-BIRTH.            54J
  Emollient clyfters of milk and water, or of chicken
water, ought to be frequently adminiftered through
the courfe of the difeafe.   Thefe prove beneficial by
promoting  a difcharge from the inteftines, and alfo
by acting as a fomentation to the womb and parts ad-
jacent.  Great care,  however, is requifite in giving
them, on  account of  the tendernefs  of the parts  in
the pelvis at this time.
   To evacuate the offending bile from the  ftomach,
a vomit  is  generally given.
   The medicine which I have always found  to fuc-
ceed beft in this difeafe is the faline draught.   This,
if frequently repeated, will often put a ftop to  the
vomiting,  and at the fame time leffen the violence of
the fever.    If it runs off by ftool,  or if the  patient
he reflkfs, a few drops of laudanum may occafionally
be added.
   If the ftools fliould prove" fo  frequent as to weaken
and exhauft the patient, a ftarch clyfter, with thirty
or forty drops of laudanum in it, may be adminiftered
as occafion fliall require ; and the drink may be rice-
water, in every pint of which half an ounce of gum
arable has been diffolved. Should thefe fail, recourfe
muft be had  to Columbo-root, or fome other ftrong
aftringent.
   Though in general the  food ought  to  be light,
and the drink diluting, yet  when  the  difeafe has
been long protracted, and  the patient is greatly fpent
by evacuations,  it  will be neceffary to fupport  her
with nourifiling diet and generous cordials.
   It was obferved that this fever,  after continuing
for fome time, often acquires a putrid form.   In this
cafe the Peruvian bark muft be given, either by itfelf,
or joined with cordials, as  circumftances may require.
 As the bark in  fubftance will be apt  to purge, it-may
be  given  in cfecoclion  or kffufion mixed  with  the
                                          tincture 
 544            OF CHILD-BIRTFL
 tincture of rofes, or other gentle aftringents ; or, a
 fcruple of  the extract of bark with half an ounce of
 fpirituous  cinnamon-water,  two  ounces of common
 water, and ten drops of laudanum, may be made into
 a draught, and given every fecond, third, or fourth
 hour,  as mail be found neceffary.
   When the ftomach will not bear  any kind of nou-
 rifliment,  the patient may be fupported for fome time
 bv clyfters of beef-tea, or chicken-water.
  ' To  avoid this fever, every woman in child-bed
 ought to to kept perfectly eafy ; her food  fliould be
 light and fimple, and her bed-chamber  cool, and pro-
 perly ventilated.  There is  not any thing more hurt-
ful to  a woman in this fituation than  being kept  too
 warm.  She ought not to have her body bound too
 tight,  nor to rife too  foon from bed, after  delivery ;
 catching cold is alfo to be avoided ; and a proper at-
 tention fliould be paid  to cleanlinefs.
   To prevent the milk fever, the  breafts  ought to
 be frequently drawn ;  and if they are filled previous
 to  the onfet  of a fever,  they fhould,  upon  its firft
 appearance,  be drawn, to prevent the  milk from be-
 coming acrid, and its being abforbed in this ftate.
 Coftivenefs is likewife to be avoided.   This will be
 beft effected  by the ufe of mild clyfters  and a laxative
 diet.
   We fliall conclude  our obfervations on child-bed
 women by recommending it to them above all things
 to beware of  cold. Poor women, whofe circumftan-
 ces oblige them to quic their bed too foon, often con-
 tract difeafes from cold, of which they never recover.
 It js a pity the poor are not better  taken care of L?
 this fituation.
   But women in more affluent circumftances run the
 greateft hazard from too much heat.   They  are ge-
 nerally kept  in a fort of bath for the  firft eight or
                  1                            ten 
               OF BARRENNESS.            54;
teii days and then dreffed out to fee company.   The
danger  of this conduct muft be  obvious  to  every
one*.
  The fuperftitious cuftom of  obliging women  to
keep the houfe  till they go to church, is  likewife a
very common caufe of catching  cold.  All churches
are damp and moft of them cold ; confequently  they
are the very worft places to which a woman can go
to make her firft vifit, after having been confined in
a warm room for a month.

               OF  BARRENNESS.

   Barrennefs may be very properly reckoned airlong
the difeafes of females, as few married  women who
have not children enjoy a  good ftate of health.  It
may proceed  from various caufes,  as  high living,
grief, relaxation, &c. but it  is chiefly owing to an
obftruction or irregularity of the menftrual flux.
   It is very certain  that high living vitiates  the hu-
mors  and prevents  fecundity.  We feldom find  a
barren woman among the labouring poor,  while
nothing is more common among the rich and affluent.
The inhabitants of every country are  prolific in pro*
portion  to their poverty ; and  it  would be an eafy
matter to adduce many inftances of woman,  who, by
being reduced to live entirely upon  a milk and vege-
table diet, have conceived and  brought forth chil-
dren, though they never had any  before.  Would
the rich ufe the fame fort of food and exercife as the
better fort of peafants, they would feldom have caufe
to envy the poor the bleffing; of  a numerous and
healthy offspring,  while they pine  in forrow for want
of even a fingle heir to their extenfive domains.

  * And it were much to be wifhed that this cuftom was en-
tirely fet afide.
                     N n              fAfffoence 
546        DISEASES OF CHILDREN.
   Affluence  begets  indolence,  which not only  vi-
 tiates  the humors,  but induces a  general  relaxa-
 tion of the  folids;  a  ftate highly  unfavourable to
 fruitfulnefs.  To  remove  this,  we would  recom-
 mend  the following courfe:  Firft, fufficient  exer-
 cife in the open air ;  fecondly, a diet confifting chiefly
 of milk and* vegetables; thirdly, the ufe of aftringent
 medicines, as fteel,  alum, elixir of vitriol, the Cha-
 lybeate waters, Peruvian bark, &c. ; and laftly, above
 all, the cold bath.
   Barrennefs is often the confequence of grief, hid-
 den fear, anxiety, or any of the paffions  which tend
 So obftruct the menftrual flux.  When  barrennefs
 is fufpected to proceed from affections of  the mind,
 the perfon ought to be kept  as  eafy and cheerful as
 poffible.
                G H A P.  XLIX.

               Difeafes of Children.


          MISERABLE indeed is the lot of man
in the ftate of infancy!  He comes  into the  worH
more helplefs than any other animal, and ftands much
longer in need of the protection and care of his pa-
rents ; but, alas! this care is not always  bellowed
upon him ; and when it is, he often fuffers as much
from improper management as  he would have done,
from neglect.  Hence  the officious care of parents,
mirfes, and midwives, becomes one the  moft fruitful
fources of the diforders of infants*.

  '* Of the officious and iil judged care of mid wives, we fhail
adduce only one inftance,  viz. the common practice of tortu-
                                             ring 
            DISEASES OF  CHILDREN.        547
   ft  muft  be  obvious to  every  attentive  perfon*
that  the firft difeafes  of infants  arife chiefly  from
their bowels.   Nor is this in the leaft, to be  won-
dered  at,  as they are in  a manner poifoned  with
indigeftible drugs  and improper diet as foon  as they
come into the world.   Every thing that the ftomach
cannot  digeft may be confidered  as a poifon ; and
Unlefs it can  be thrown  up, or voided by ftool, it
muft occafion ficknefs, gripes,  fpafmodic  affections
of the bowels,  or  wdiat the good women call  inward
fits, and at laft convulfions  and death.
   As thefe  fymptoms evidently  arife from fome-
what  that  irritates  the  inteftines,   doubtlefs  the
proper method of cure muft  be to expel it  as foon
as poffible.  The moft fafe and effectual method  of
doing this, if the  child  be coftive,  is by a gentle
purge ;  for  this  purpofe, fome manna may  be  dif-
folved in boiling  water,  and given  in fmall quan-
tities till it  operates ;  or,  what will  anfwer rather
better,  a  few grains of magnelia  alba and rhubarb
may be mixed in any kind of food that is  given
to the child, and  continued  till it has  the  defired
effect.   If thefe medicines be properly adminiftered,
 and  the child's  belly and  limbs  frequently rubbed
 with a warm hand before  the fire, they will feldom

 ring infants by fqueezing their breafts, to draw off  the milk,
 as they call it.  Though a fmall quantity of moifture is gene-
 rally found in the breafts of infants, yet,  as they a?e  certainly
 not intended  to give fuck, this ought never to be drawn off.
 I have feen thi* cruel operation bring onhardnefs, inflammation,
 and fuppuration of the breafts ;  but never knew any ill confe-
 quences fr.im its being omitted.  When the breafts  are hard,
 the only application that we would recommend is a  foft poul-
 tice, or a little of the diachylon plafter, fpread thin upon  a bit
 of foft leather, ab'iit the fize  of half a crown, and applied
 over each r.ipple.  Thefe may be fuffered to ccniinue  till the
 hard nefs difippears.
N H 3-
fail 
54S           OF THE MECONIUM.
fail to  relieve thofe affections  of the ftomach  and
bowels from which infants fuffer fo much.
   Thefe  general  directions  include  moft of what
can be don- for  relieving the  internal diforders of
infants.  They will likewife  go a confiderable way
in alleviating thofe which appear externally, as the
rifli, gum, Sec.   Thefe, as was formerly obferved,
are principally owing  to too  hot  a regimen,  and
confequently will be  moft  effectually relieved   by
gentle   evacuations.   Indeed,  evacuations   of  one
kind or  other confiitute  a principal part  of the me-
dicine  of  infants,  and will  feldom,  if adminiftered
with prudence, in any of their difeafes, fail to  give
relief.

              OF THE MECONIUM.

   The ftomach  and  bowels of  a  new born  infant
are filled with a blackifli-coloured matter of the con-
fiftence  of  fyrup, commonly  called  the meconium.
This is generally paffed foon after the birth, by the
mere effort of Nature ; in which cafe it is not necef-
fary to give  the infant any kind of medicine.   But
if it  fliould be  retained, or not fufficiently carried
off, a  little  manna magnefiia alba  or rhubarb  may
be given, as mentioned  above;  or, if  thefe fhould
not be  at  hand, a table fpoonful of whey, fweet-
ened with a little  honey,  or brown fugar,  will anfwer
the purpofe.
   The moft proper medicine for expelling the meco-
nium is the  mother's milk, which is always at firft of
a purgative quality.  Were  children allowed to fuck
as foon as they fliew an inclination for the breaft, they
 would feldom have  occafion  for  medicines  to dif-
charge the meconium.
THE 
C  549  ]
           THE APHTHiE OR THRUSH.

   The  aphtha? are little whitifli ulcers affecting the
 whole  infide  of the mouth, tongue,  throat,  and
 .ftomach of infants.  Sometimes  they reach through
 the whole inteftinal canal;  in  which cafe they are
 very  dangerous.
   If  the aphthce are of a pale colour, pellucid, few
 in number, foft,  fuperficial,  and fall eafily  off,  they
 are not  dangerous ; but  if opake, yellow, brown,
 black, thick, or running together,  they ought to be
 dreaded.
   It  is thought that the  aphthre  owe their origin
 to acid humors ; we have  reafon however to be-
 lieve, they are generally owing  to too  hot a regi-
 men both of the mother and child.  We too often
 find the  child  dofed with wine,  punch, cinnamon-
 waters, or fome  ocher  hot  and  inflaming liquors,
 almoft as foon as it is born.   It is  well known  that
 thefe  will occafion inflammatory  diforders even in
 adults ; is it any wonder then they fliould heat  and
 inflame the tender bodies  of infants,  and  fet  as it
 were  the whole conftitution in a blaze?
   The  moft  proper medicines for  the  aphtha? are
 vomits,  fuch  as have been  already  recommended,
 and gentle laxative.  Five grains  of rhubarb  and
 half a drachm of magnefia alba may be rubbed toge*
 ther,  and divided into fix  dofes, one  of which may
 be given to the infant .every four or five hours till
 they operate.   Thefe powders may either be given
i:i the child's food,  or a little of the  fyrup  of pale
rofes,  and may be  repeated as often as is found ne-
ceffary to keep the  body open.   It is common in
this cafe to adminifter calomel, which is  more effec-
tual than any other medicine,
                    N n 3                Many 
S.S9              OF ACIDITIES.
  Many things have been recommended for gargling
the mouth and throat  in this difeafe ;  but it  is not
eafy to apply thefe in very young infants ;  we would
therefore recommend it to the nurfe to rub the child's
mouth frequently with a little borax and honey ; or
with  the following mixture:   Take  fine honey an
ounce, borax a drachm, burnt  alum half a drachm,
rofe-water  t*/o drachms ;  mix  them  together.   A
very proper application in  this  cafe, is a folution of
ten or twelve grains of white vitriol in eight ounces
of barley-water.   Thefe may be applied with the
finger, or by means of a  bit of foft rag wrapped
round the finger.

                 OF  ACIDITIES.

   The food of children being for the moft part of an
acefcent nature,  it readily  turns four upon the fto-
mach, efpecially if the body be any way  difordered.
Hence molt difeafes  of  children are accompanied
with evident figns of acidity, as green ftools, gripes,
&c.  Thefe appearances ha^ induced many  to be-
lieve, that  all the  difeafes of children were owing to
an  acid abounding in  the  ftomach and bowels ; but
whoever confiders the matter  attentively, will  find
that thefe fymptoms of acidity are oftener the effect
than the caufe of their difeafes.
   Nature evidently intended, that the food of  chil-
dren  fliould be acefcent ; and  unlefs fhe body be
difordered,  or the  digeftion hurt,  from fome other
caufe, we  will  venture to fay,  that the acefcent
quality  of  their  food is  feldom injurious to them*
Acidity, however, is  often a fymptom of diforders
in cliildren, and, as it is  fometimes  a  troublefome
one,  we fliall point out the method of relieving it.
When 
       GALLING AND EXCORIATION.       551
  When green ftools, gripes, purghigs, four fmells,
Sec. fliew that the bowels abound with an acid, die
child  fhould have  a little  clear broth, with  light
white bread in it;  and fliould have  fufficient exer-
cife in order to promote the digeftion.  It has  been
cuftomary in this cafe to give the pearl-julep, chalk,
crabs  eyes, and other  teftaceous powders.  Thefe,
indeed, by their abforbent quality, may correct the
acidity ;  but they  are attended with  this inconveni-
ence,  that they are apt to lodge in the bowels, and
occafion coftivenefs,  which may prove hurtful to the
infant.  For this reafon diey fhould never be  given
unlefs mixed with  purgative medicines j  as rhubarb,
manna, or fuch like.
  The beft medicine which we know,  in all cafes of
acidity, is  that  fine infipid powder  called magnefiia
alba.   It purges, and at the fame time corrects the
acidity :  by which  means it not only removes the
difeafe, but carries off its caufe.   It maybe given in
any kind of food, or in a mixture, as  recommemded
in the Appendix*.
  When an infant is troubled  with gripes, it ought
never to be dofed  with brandy,  fpiceries, and other
hot things-,  but fliould have its body opened  with  an
emollient clyfter, or the medicine mentioned above;
and at the  fame time a little brandy may be  rubbed
on its belly with a warm hand before  the fire.   I
have  feldom feen this  fail  to  eafe the gripes  of in-
fants.   Strong fennel-feed tea,  fweetened with mo-
laffes,  is a very ufeful medicine here.

         GALLING AND EXCORIATION.

  Thefe are very troublefome  to children.   They
happen chiefly  about the groin and wrinkles of the

  * See Appendix, Laxative Alforient Mixture
                       N n 4                neck. 
 552        STOPPAGE OF THE NOSE.
 neck,  under the arms,  behind the ears,  and  in
 other  parts  that  are moiftened  by the fweat  or
 urine.
   As thefe complaints are,  in a great meafure, ow-
 ing to want of cleanlinefs, the moft effectual means of
 preventing them are, to  wafh the parts  frequently
 with cold water, to change the  linen often, and, in
 a word, to keep the child in all  refpects thoroughly
 clean.  When this  is not  fufficient, the excoriated
 parts may be fprinkled  with abforbent or drying
 powders ;  as prepared chalk, flarch-powder,  and the
 like.   When the parts affected  are very fore, and
 tend to a real ulceration,  it will be proper to anoint
 the  place  with Goulard's cerate.   If the parts be
 waflied with fpring-water, in which a little white vi-
 triol  has been diffolved,  it will  dry and heal them
 very  powerfully.   One  of the beft applications for
 this  purpofe, is to  diffolve fome fuller's  earth in a
iiifficient quantity of hot water;  and after it has
 flood till it is cold, to rub it gently upon  the galled
 parts once or twice a-day.

           STOPPAGE OF THE NOSE.

   The noftrils of infants are often plugged up with
 a grofs  mucus, which prevents their breathing freely,
 and likewife renders  it difficult for them to fuck or
 fwallow.
   Some in this cafe order, after a fuitable  purp-e,
 two or three  grains of white vitriol diffolved  in  half
 an ounce of water,  and filtered,  to be applied now
 and then to  the noftrils with a linen rag.  Wedelius
fays,  if two grains of white vitriol,  and  the  fame
quantity of elaterium, be diffolved in half an ounce
of marjoram-water, and applied to the nofe, as above
directed, that it brings   away the mucus without
fneezing.
                                               In 
                 OF VOMITING.              553
  In  obftinate  cafes thefe medicines  may be tried;
but I have never  found any thing neceffary, befides
rubbing and introducing into the nofe  at bed-time  a
little fweet-oil,  or frefh butter.   This refolves  the
filth,  and renders the breathing more free.

                OF VOMITING.

  From the delicate ftate of children, and the great
fenfibility cf their organs, a vomiting or loofenefs
may be induced   by any  thing that irritates  the
nerves  of  the ftomach  or inteftines.   Hence thefe
diforders are much more common in childhood than
in the more advanced  periods  of  life.  They  are
feldom, however, dangerous, and ought never to be
confidered as difeafes, unlefs when  they are violent,
or continue fo long as to exhauft the ftrength of  the
patient.
  Vomiting may  be  excited by an over-quantity of
food ;  by food that is of fuch a nature as to irritate
the nerves of the ftomach too  much ;  or by  the fen-
fibility of the nerves being fo much increafed as to
render them unable to bear the ftimulus of even the
mildeft  element.
  When vomiting is occafioned  by too  much food,
it ought to be promoted,  as  the cure will  depend
upon cleanfing the ftomach.   This may be  done ei-.
ther by a few grains  of ipecacuanha,"  or a weak fo-
lution of emetic tartar,  as mentioned before.  Whert
it is owing to food of an acrid or irritating  quality,
the diet ought to be changed, and aliment of a milder
nature fubftituted in its ftead.
  When vomiting proceeds from an  increafed degree
of fenfibility,  or  too great an  irritability of  the
nerves of the ftomach, fuch medicines  as have a ten-
dency to brace and  ftrengthen  that  organ, and to
abate its fenfibility, muft be ufed. The firft  of thefe
                                       intentions 
J54            OF A LOOSENESS.
intentions may be anfwered by a flight infufion of the
Peruvian  bark, with the addition  of a little  rhu-
barb and orange-peel ;  and the fecond  by the faline
draughts, to which a few drops of liquid laudanum
may be occafionally added.
   In obftina,te vomitingTthe operation of internal me-
dicines may  be affifted  by  aromatic  fomentations
made with wine, applied warm to the pit of the. fto-
mach ; or the ufe of the ftomach-plafter, with the
addition of a little  Theriaca.

               OF A LOOSENESS.

   A loofenefs  may generally be reckoned falutary
when the ftools are four, flimy, green, or cruddled.
It is not  the  difcharge,  but  the caufe of  fueh
ftools,  which ought to  be remedied.   Even where
the purging is thin and- watery, it ought not to be
checked  too fuddenly,  as it  often  proves critical,
efpecially when the child has caught  cold, or an
eruption on  the  fkin  has difappeared.  Sometimes
an evacuation of this kind fucceeds an humid ftate
of the atmofphere, in which cafe it may alfo prove
of advantage, by carrying off a quantity of  watery
humors which  would  otherwife  tend to  relax the
habit.
   As the principal intention  of the cure of a loofe-
nefs is  to  evacuate tke  offending matter,  it  is cuf-
tomary to give  the  patient  a gentle vomit of ipe-
cacuanha,  and afterwards to exhibit fmall and fre-
quent dofes of rhubarb ; interpofing abforbent me-
dicines to mitigate the acrimony cf the humors.  The
beft purge, however, in this cafe, is magnefia alba.
It is at  the fame  time  abforbent and  laxative, and
operates without exciting gripes.
   The antimonial wine, which acts both as an eme-
iic and purge,  is  alfo  an excellent medicine in this
                                            cafe, 
               OF ERUPTIONS.              55s
cafe.   By being diluted with water, it may be pro-
portioned to the weakeft  conftitution;  and, not be-
ing difagreeable to the palate, it may be repeated as
often as occafion requires.  Even one  dofe will fre-
quently mitigate the difeafe, and pave  the way for
the  ufe  of abforbents.   If,  however,  the patient's
ftrength will permit, the medicine ought to be re-
peated every fix or eight  hours, 'till the ftools begin
to affume a more  natural appearance; afterwards  a
longer fpace may be allowed to intervene  between
the dofes.   When it is neceffary to repeat  the me-
dicine frequently, the dofe ought  always  to be  a
litde increafed, as its efficacy is generally diminifhed
by ufe.
  Some, upon the firft  appearance cf a loofenefs,
fly immediately to  the ufe  of  abforbent medicines
and  aftringents.   If  thefe  be  adminiftered  before
the offending  humors  are difcharged, though the
difeafe may appear to be  mitigated for  a little time>
it foon afterwards breaks forth with  greater violence,
and often proves fatal.  After proper evacuations,
however,  thefe medicines may  be adminiftered with
confiderable advantage.
  Should any gripings or reftleffnefs remain after the
fiomach and bowels have been cleanfed, a tea-fpoon-
ful of the fyrup of poppies may be given in a little
fimple cinnamon-water, three cr four times a-day till
thefe fymptoms have ceafed.

                 OF ERUPTIONS.

   Children,   while on the breaft, are feldom free
from eruptions of one kind or other.    Thefe, how-
ever, are not often dangerous, and ought never  to
be  dried  up but with the  greateft caution.   They
tend to free the bodies of infants from hurtful humors^
which,  if retained, might rrodu.ee fatal diforders.
                                             The 
  Ss6              OF ERUPTIONS.
     The eruptions of children are chiefly owing to im.
  proper food and neglect of cleanlinefs.  If a child be
  fluffed at all hours with food that its ftomach  is not
  able to digeft, fuch food,  not being properly affirm'-
  lated, inftead of nourifhing the body, fills it with grofs
  humors. Thefe muft either break out in form of erup.
  tions upon the fkin, or remain in the body, and occa-
  fion fevers and other internal diforders.  That neglect
  of cleanlinefs is a very general caufe of eruptive dif-
  orders, muft be obvious to every one.  The children
  of the poor, and of  all who defpife cleanlinefs, are
  almoft conftantly found  to fwarm with vermin, and
  are generally covered with the fcab, itchr and other
  eruptions.
    When eruptions are the effect of improper food, or
 want of cleanlinefs, a  proper attention to thefe alone
 will generally be fufficient to remove them.  If this
 fliould not be the cafe, fome drying medicines will be
 neceffary. When they are applied, the body ought at
 the fame time to be kept open, and cold is carefully to
 be avoided.  We know no medicine that is more fafe
 for drying up cutaneous eruptions than fulphur, pro-
 vided it be prudently ufed.  A little of the flour of ful-
 phur may be mixed with frefli butter,oil,or hog's lard,
 and the parts affected frequently touched with it.
   The moft obftinate of all the eruptions incident to
 children are, the tinea capitis,  or fcabbed head, and
 chilblains.   The fcabbed  head is  often exceedingly
 difficult  to cure, and fometimes  indeed  the  cure
 proves  worfe than  the  difeafe.   I have frequently
 known  children  feized with  internal diforders,  of
 which they died foon  after their fcabbed heads had
 been healed by the application of drying medicines*,

  '■* I fome time ago faw a very ftriking inftance of the danger
of fuSitiruting drying medicines in the place of cleanlinefs and
wholef .me ford, in the Fnui-id'ing Hofpital at Ackwonf, where
Jh.c .-delhs'.i we-e  c/cvk ufly afflicted v i'th  fcabbed heads and
                                               other 
             OF EkUPTIONS.                  557
The cure ought always firft to be attempted by keep-
ing the head very clean, cutting off the hair, combing
and brufliing away the feabs, Sec.  If this is not fuffi-
cient, let  the head  be fhaved once  a-week,  waflied
daily  with foap-fuds, and  gently anointed with the
citrine ointmentf.   While thefe things are  doing, the
natient muft  be confined to a regular light diet, the
body fliould be kept gently  open ;  and cold, as far
as poffible, ought to be avoided.  To prevent any bad
confequences from  flopping this difcharge, it will be
proper, efpecially in children ofa grofs habit, to make
an iffue in the neck or arm, which may be kept open
till the patient becomes more ftrong, and the conftitu-
tion be fomewhat mended.
   Chilblains commonly attack children in cold wea-
ther.   They are generally occafioned by  the feet or
hands being  kept  long wet or cold, and  afterwards
fuddenly heated.   When children are cold, inftead of
taking exercife to  warm themfelves gradually,  they
run to the fire.
   To prevent it, violent cold and  fudden heat muft be
equally avoided.    When the  parts begin  to look red
and fwell, the patient ought to be purged and to have
the affected  parts  frequently  rubbed with Goulard's

 other cutaneous  diforders.  Upon inquiry it was found, that
 very little  attention was paid either to the propriety or found-
 nefsof their provifions, and that cleanlinefs was totally neglecl-
 td; accordingly it  was advifed (that they fhould have more
 wholefome food, and be kept thoroughly  clean.  This advice,
 however was not followed.  It was too troublefome to the fer-
 vants, fuperintendants, Sec.  The bufmefs uras to be done by
 medicine; which was accordingly attempted, but had nearly-
 proved fatal to the whole houfe.  Fevers and other internal
 diforders immediately appeared, and  at length a putrid  dyfen-
 tery, which proved fo infectious, that it carried off a great many
 of the children, and fpread over a confiderable part of the
 neighbouring  country.
   f  See Appendix,  Citrine Ointtnent.
cerate. 
  55*       OF THE CROUT OR HIVES.
  cerate.   They ought likewife to  be covered with
  flannel, and kept warm and dry.  Some apply warm
  afhes between cloths  to the  fwelled parts,  which
  frequently help to reduce them.   When there is a
  fore,  it muft be dreffed with Goulard's cerate,  Tur-
  ner's cerate, the ointment of  tutty, or the tar oint-
  ment, which  is made by melting one table-fpoonful
  of  tar with four table-fpoonfuls of tallow.  Thefe
  fores  are  indeed troublefome, but feldom dangerous
  They generally heal as  foon  as the warm weather
  fets in.

            OF TFIE CROUP OR HIVES.

   This difeafe is called  the Croup in many parts of
  Scotland,  and it is thus ftiled by moft of the Britifli
 medical writers.  In America  it is moft  generally
 known by the name of the Hives,  although feveral
 eruptive difeafes, particularly the nettle rafli are im-
 properly fo called;  moreover,  fo great is  the dread
 of this difeafe,  that almoft every catarrh  in youn-
 cliildren has been fufpected for it.   As it is of>rca1
 coniequence to be able to diftinguifli this compfaint,
 we mail be more full in our account of it.
   The difeafe more ftri&ly called the hives or croup
 generally attacks children under fix years of age but
 it may occur at any time  of life.  The child is' firft
 drooping for a few  days,  neither fick nor well, per.
 haps feme  flight fymptoms of a cold, when the dif-
 eafe fuddenly increafes, the  voice  particularly,  and
 breathing  are  changed.    This  laft  becomes  quick,
and  during refpiration  the air  paffes  through  the

bfe noife faid to refemble the crowing of a cock, but
with more  propriety ,t  raay be  likened to the noife
produced  by  air forced   through  a  narrow  tub
uhofe  fides are very hard;  this noife continual to the
                                             Ian :• 
          OF THE CROUP  OR KIVES.        559
hut: fometimes the phlegm will appear to rattle, as
if loofe ;  the face is generally fluflied, the countenance
diftrefled, the noftrils expanded,  the  head thrown
back :  indeed the patient  cannot  lie down, and is
very reftlefs  ;  continually feeking for eafe from a
change of pofture.   More or lefs  cough, and fever
attend ;  the pulfe varying, but generally quick ; the
bowels moftly coftive ;  the face and hands now be-
come livid ; the fkin often  moift, from  the agonyr the
patient is in.
   Thefe fymptoms continue to the laft, when the pa-
tient appears to fink under fuffocation and debility. A
little momentary eafe, however, will often produce fuch
an alleviation of the fymptoms, as to give rife to the
moft flattering hopes; but thefe fliould never induce
us to  remit our exertions,  for it is fo  common  to be
called to this difeafe, after it has made a confiderable
progrefs, that there is not a moment to be loft.
   Some other difeafes appear to  terminate fatally in
 this, more efpecially  the rheumatifm, pleurify, fmall-
 pox,  meafles, and fearlet fever, or  putrid fore throat,
 as it is called.   It is  worthy of remark, that the mo/i
 dangerous fpecies  of hives is that which fucceeds to
 other difeafes,  and  therefore it  requires the moil
 fpeedy application of powerful remedies.
   This I would denominate the true hives.  But there
 is another difeafe highly dangerous, which has  gene-
 rally been called by the $tme name—its fymptoms are
 as follows:
   It attacks children of the fame age as before-men-
 tioned, more efpecially fuch as are of a grofs, plump
 habit of body,  after expofure to  cold or  wet, the
 ftriking in of eruptions, eating indigeftible food, Sec.
 They are generally feized when in the higheft health,
 moftly in the night;  it begins  with very laborious
 refpiration,  fluflied face, and fomething  of a croak-
 ing noife, but  more refembling a fit of the afthma,
                                              thao 
  5Gc*       OF THE CROUP OR HIVES.
  than the  true hives; a confiderable degree of fever
  comes on: If neglected, or not checked, thefe fymp-
  toms  will increafe until the patient dies, fuffocated,
  as  in  the other cafe.   This fpafmodic alihma as it
  has been called, is  often  produced by worms  and
  teething.
    The treatment of thefe two difeafes is  in fome re-
  fpects  fimilar.
    In  the true  hives,  the  firft thing to be done, if
  called  early in the difeafe, is to be bled, if the  pulfe is
  hard,  or inflammatory difeafes prevail.   Directly af-
  terwards, to  give from fix  to twelve or fifteen grains
  of ipecacuanha, or  repeated  dofes of the vomiting
„ julep,  until the child is well puked ; then give from
  "four to twenty grains of calomel, at firft,  with eight
  or ten grains of jalap to open the bowels, and then
  continue  the calomel with a few grains of magnefia
  two or three times  a-day, fo  as to keep the bowels
  conftantly loofe.  This is peculiarly to be attended to,
  as  it is the chief remedy, and no time muft be loft;
  and even if the fymptoms appear to be alleviated we
  muft not  defift until the patient  is fairly out  of dan-
  ger.   A blifter  fhould be applied to the  throat and
 "breaft if the  fymptoms are violent; bathing the feet
  in  warm water may be tried.  It is almoft incredible,
  to thofe who have not feen this difeafe, how much
  calomel very young children will bear, and how dif-
  ficult it is to move their bowels.
     In the fpafmodic afthma, a moft important  remedy
  is* the  warm-bath  and a glyfter, efpecially if ufed at
  the firft attack.  If the fymptoms do not yield to  this,
  bleeding will be neceffary, and fhould be repeated ac-
  cording to their violence.  An emetic  will often do
  good  ; ipecacuanha,  tartar emetic,  or  vinegar of
  fquilfs may be ufed; the bowels fhould be kept  tho-
  roughly opened by pretty large dofes of jalap and ca'o-
  mch as moft  of the difeafes of children require a drain
                                                 in 
                  OF TEETHING.             561
in the bowels, and there is no medicine that promotes
this fo well as calomel.  A Burgundy-pitch plafter
fliould be put between the ftioulders, or if the violence
of the fymptoms demand it, a blifter fhould be ap-
plied  there.
  If  worms  or  teething occafion  the  diforder, the
medicines  recommended in thefe cafes are to be ufed.
Many children are troubled with this complaint for
a few years,  and then feem to  outgrow it.  What-
ever ftrengthens the body  will prevent, or at leaft
leffen the  violence  of the attack ; fuch as light food,
a flannel  fhirt, cold bath, country air, and gentle
exercife.
  It often happens that  children who  are troubled
with this difeafe, are much  relieved by a tea-fpoonful
or two  of the juice of a raw  onion.   This may be
tried, but  if it does not foon give relief, recourfe muft
be had  to the other more powerful remedies.


                 OF TEETHING.

  Dr Arbuthnot obferves,  that above  a tenth part
of infants die in teething, by fymptoms proceeding
from  the  irritation  of the tender nervous parts of
the jaws,  occafionirig inflammations,  fevers, convul-
fions,  gangrenes,  &c.   Thefe fymptoms  are  in  a
great meafure owing to the great delicacy and ex-
quiiite fenfibility of the nervous fyftem at this time
of life, which  is too often  increafed by  an effemi-
nate  education.   Hence it  comes to pafs,  that chil-
dren,, who are  delicately brought up,  always fuf-
fer moft in teething, and often die in convulfive dif-
orders.
   About  the fixth or feventh month the teeth gene-
rally  begin to make their appearance ;   firft, die incU
fores, or fore-teeth ;  next,  the canini, or  dog-teeth;
                       O  o                  and, 
5C2             OF TEETHING.
and,laftly, the molares, or grinders. About the feventh
3rear, there comes a new fet; and about the twentieth,
the two inner grinders, called denies fapientia, the
teeth of wifdom.
   Children, about the time of cutting their  teeth,.
fiaver much, and have generally a loofenefs.  When
the teething is difficult, efpecially when the dog-teeth
begin  to make their  way through the gums, many
children have flartings in their fleep, tumors of the
gums, watchings, gripes, green ftools, the thrufh, fever,
difficult breathing, and convulfions.
   Difficult teething requires nearly  the  fame treat-
ment  as an inflammatory difeafe.   If the body be
bound, it  muft be opened either by emollient clyfters
or gentle purgatives ; as manna, tnagnefia alba, rhu-
barb, fenna, or the like.  The food fliould be light,
and in fmall quantity; the drink plentiful, but weak
and diluting, as  infufions of balm,  or of elder flow-
ers ; to which about a third or fourth part of milk
may be added.
   If the fever be very high,  bleeding will be necef-
fary ;  but if it is not, purging,  vomiting,  or fweat-
ing, agree much better with them, and are generally
more beneficial.  After copious purging, if the pulfe
be fufficiently reduced, a tea-fpoonful of the anodyne
mixture (fee Appendix) every two hours will be of
great fervice.  Harris, however, obferves, that when
an inflammation appears, the phyfician will labour in
vain, if the cure be not begun with applying a leech
under  each ear.  If the child be feized with convul-
fion.-fits, a bliftering-plafter may be applied between
the flioulders, or one  behind each ear, or the warm
bath may be ufed and frequently repeated.
   Sydenham fays, that m fevers occafioned by teeth-
ing, he never found any remedy fo effectual as two,
three,  or four drops of fpirits of hartfhorn in a fpoon-
ful of  fimpls water,  or other conrenient vehicle,
                                            given 
OF TEETHING*.  '            5^
given every four hours.  The number of dofes may
be four,  five,  or  fix.  I have often  prefcribed this
medicine with fuccefs, but always found a larger dofe
neceffary.  It  may be given from five drops to fifteen
or twenty, according to  the age of the  child, and,
when cofiivenefs does not forbid it, three or four drops
of laudanum mav be added to each dofe.
   In  Scotland it is very common, when children are
cutting their teeth,  to put a  fmall Burgundy-pitch-
plafter between their flioulders.  This generally eafes
the tickling cough which attends teething, and is by
no means an ufelefs application.  When the teeth are
cut with difficulty, it ought  to be kept on during the
whole time of teething.  It  may be enlarged as occa-
fion requires,  and ought to be renewed at leaft once a
fortnight.
   Several things have been recommended for rid>
bing the gums,  as  oils, mucilages, &c. ;  but from
thefe much  is not to be expected.  If any thing of
this kind is to be ufed, we would recommend a little
fine honey, which may be rubbed on with the finger
three or four  times a-day.   Children are  generally at
 this time difpofed to chew whatever they get in their
 hands.   For this reafon they ought never to be with-
 out fomewhat that will yield  a little to  the preffure
 of their gums, as a cruft of bread, a wax-candle, a bit
 of liquorice-root, or fuch like.
    Cutting or lancing the gums maybe performed by
 the finger-nail,  the  edge of a fixpenny  piece that is
 worn thin, or any  fharp body, which  can be with
 fafety introduced  into the mouth ;  but the lancet in a
 ikilful hand is certainly the moft proper.
    in order to render the teething lefs  difficult, pa-
 rents ought  to  take care  that their children's food
 be light and wholefome, and that their  nerves be
 braced  by fufficient exercife  without doors,  the ufe
                       O o 2                   of 
5&f            OF  THE RICKETS.
of the cold bath, &c.   Were thefe  things  duly re-
garded, they would have a much better effect than
teething necklaces, or other nonfenfical amulets worn
for that purpofe.

               OF THE RICKETS.
   This difeafe generally attacks children between the
age of nine months  and  two years.  It appeared firft
in England about the time when manufactures began
to flourifh, and ftill prevails moft in towns where the
inhabitants follow fedentary employments ; by which
means they neglect either to take proper  excercife
themfelves, or to give it to their children.
   CAUSES.—One caufe of the rickets is difeafed
parents.   Mothers of a weak  relaxed habit,  who
neglect exercife,  and live upon weak diet, can nei-
ther  be expected to bring forth ftrong and healthy
children,  or to  be able to nurfe them, after  they
are  brought forth. Accordingly we find,  that the
children of fuch  women generally die of the rickets^
the  fcrophula, confumptions, or  fuch  like  difeafes.
The  children of men  in the decline of life,  who are
fubject to the gout, the gravel, or other chronic dif-
eafes, or who have been often affected with the ve-
nereal difeafe in their youth, are likewife very liable
to the rickets.
   Any diforder that weakens the  conftitution, or re-
laxes the habit of children, as the  fmall-pox, meafles,
teething, the whooping-cough, &c. difpofes them  to
this difeafe.   It  may likewife be occafioned  by im-
 proper diet,  as food that is either too weak and wa-
tery, cr fo vifcid  that the ftomach cannot digeft  it.
   Bad nurfing is  the  chief caufe  of  this difeafe.
When the nurfe is  either difeafed, or has not enough
of mi]k to nourifh  the  child, it cannot thrive.  But
children fuffer oftener  by want of care in nurfes  thaa
                                            ' want 
               OF THE  RICKETS.            565
want of food.  Allowing an infant to lie or fit too
much,or not keeping it thoroughly clean in its clothe?,
has the moft pernicious effects.
   The want  of free  air is  likewife very hurtful to
children in this refpect.  When a nurfe  lives  in a
clofe fmall houfe, where the air is damp and con-
fined,  and is too indolent to carry  her child abroad
into the open air, it will hardly efcape this difeafe.
A healthy child  fhould always be  in motion, unlefs
when  afleep ; if it  be  fuffered to  lie, or fit,  in-
ftead of being toffed and dandled about, it will not
thrive.
   SYMPTOMS.—At the beginning  of  this difeafe
the child's flefli  grows foft and flabby ; its ftrength
is diminifhed;  it lofes its  wonted cheerfulnefs, looks
more grave and compofed than is natural  for its age,
and does  not chufe to be moved.   The head  and
belly become  too  large in  proportion  to the other
parts ;  the  face  appears  full, and the complexion
florid.  Afterwards the bones begin to be affected,
efpecially in  the more foft and fpongy parts.  Hence
the wrifts and ankles become thicker than ufual; the
fpine or back-bone puts on an unnatural fhape ; the
breaft is  likewife often  deformed  ; and the bones
of the arms and legs grow crooked.  All thefe fymp-
toms vary according to the violence of the difeafe.
The pulfe is generally quick, but feeble ; the appe-
tite and digeftion for  the moft  part bad; the teeth
come flowly  and with difficulty ; and  they often  rot
and fall out afterwards.   Rickety children generally
have great acutenefs -of mind, and an underftanding
above their years.   Whether this  is owing to their
being  more in the company of adults than other chil-
dren, or to the preternatural enlargement of the brain,
is not  material.
   REGIMEN.—As  this difeafe is always attended
with evident  figns of weaknefs  and relaxation, our
                       O o 3                 chi-ef 
566"            OF THE  RICKETS.
chief aim in the cure muft be to brace and ftrength-
en the folids, and, to promote digeftion and the due
preparation of the fluids.   Thefe important ends will
be beft anfwered by wholefome  nourifhing diet,
fuited to the'age  and ftrength of  the  patient, open
dry air, and fufficient exercife.   If the child has a
bad nurfe,  who either neglects her duty, or does not
underftand it, fiie fhould be changed.   If the feafon
be cold, the child ought to be kept warm ; and when
the weather is hot, it ought  to be kept cool; as
fweating is apt to weaken it, and too great a degree
of cold has the fame effect.   A flannel fhirt  fhould
be worn conftantly.   The  limbs  fhould be rubbed
frequently  with a warm hand, and the child kept as
cheerful as poffible.
   The diet ought to be dry and nourifhing, as good
bread, roafted flefli, Sec.  Bifcuit  is the beft bread ;
and pigeons, pullets, beef, rabbits, or mutton roafted
or minced, are the moft proper flefli.  If the child be
too young for fleih-meats, he may have rice,  millet,
or pearl-barley boiled with raifins, to which  may be
added  a little wine «>nd fpice.  His  drink may be good
claret, mixed v/ith an equal quantity of water.  Thofe
who cannot afford claret, may give the child now and
then a wine-glafs full of good porter.
   MEDICINE.—Medicines are here of little avail.
The difeafe may often be  cured  by the nurfe, but
feldom by the phyfician.   In children of a grofs ha-
bit, gentle vomits and repeated purges of rhubarb
may fometimes be of ufe,  but they will fekiom carry
off the difeafe ; that muft depend chiefly  upon fuch
things as brace and ftrengthen the fyftem : for which
purpofe, befides the regimen mentioned above, we
would  recommend the cold  bath,  efpecially in the
warm feafon.  It muft, however, be ufed with uru-
iience,  as fome rickety children cannot bear it.  The
Leu: time for uiiWj the  cold  bath  is  in the mo:::ing,
                                             and 
               OF  CONVULSIONS.             567
and the child fliould be well rubbed with a dry cloth
immediately after he comes  out  of it.   If he  fliould
be weakened by the cold bath,  it muft be difcon-
tinued.
  Sometimes  iffues have been found beneficial in
this  difeafe.  They are peculiarly neceffary for chil-
dren who abound with  grofs humors.   An infufion
of the Peruvian bark in wine would be of fervice.
We  might here mention many other medicines which
have been recommended for the rickets ; but as there
is far more danger in trufting to thefe than in  ne-
glecting them  altogether, we choofe rather to pafs
them over,  and  to  recommend  a proper regimen as
she tiling chiefly to  be depended on.

               OF  CONVULSIONS.

  Though more children are faid to  die  of convul-
fions than of any other difeafe,  yet they are for  the
moft part only  a fymptom of  feme other malady.
Whatever greatly irritates or ftimulates  the nerves,
may occafion  convulfions.   Hence  infants,  whofe
nerves are eafily affected,  are  often  thrown into
convulfions by any  thing that  irritates  the alimen-
tary canal; likewife  by teething;  ftrait  clothes;
the approach  of the  fmall-pox, meafles,  or other*
eruptive  difeafes.
  When  convulfions  proceed from  an  irritation of
the ftomach or  bowels, whatever clears  them  of
their acrid contents, or renders thefe mild and  in-
offenfive, will generally perform a cure :  wherefore,
if the child be coftive, the beft way will  be  to begin
with a clyfter, and afterwards to give a gentle vomit,
which may be repeated occafionally, and the body
in the mean time kept open by  gentle dofes of mag-
nefui alba alone, or mixed  with fmall quantities of
rhubarb,
                       O 0 4          ConvulhoRtj 
568            OF CONVULSIONS.
   Convulfions which precede the eruption  of the
fmall-pox  or  meafles generally  go off upon  thefe
making their appearance.   The principal danger
in this cafe arifes from the fears  and apprehenfions
of thofe who have the  care  of the  patient.   Con-
vulfions are  very  alarming,  and fomething  muft
be done to  appeafe  the  affrighted parents, nurfes,
&c.
   When  convulfion  fits arife  from  the  cutting of
teeth,  befides lancing the gums and  gentle evacua-
tions,  we would recommend bliftering,  and the ufe,
of a few drops of laudanum,  mixed in a little water,
and  given occafionally.
   When  convulfions  proceed from any  external
caufe,  as the  preffure occafioned by ftrait clothes
or bandages, &c. thefe  ought immediately  to be
removed;  though   in  this  cafe taking away the
caufe will not always remove the  effect,  yet it ought
to be done.  It is not likely  that the patient will re-
cover, as  long as  the caufe which firft  gave rife to
the diforder continues to act.
   When  a child is feized  with convulfions,  without
having any complaint  in  the bowels, or fymptoms
of teething ;  or any  rafh or other difcharge which
has  been fuddenly dried up ; we  have reafon tu con-
clude  that it is a primary difeafe, and proceeds im-
mediately  from  the brain.    Cafes of this  kind,
however, happen  but feldom, which is  very for-
tunate, as it is difficult  to relieve the  unhappy
patient.  When a  difeafe proceeds  from an  origi-
nal fault in the formation or ftructure of the brain
itfelf, we cannot expect that it fliould yield to me-
dicine.  But as  this is not always  the caufe,  even
of convulfions which proceed immediately  from the
brain,  fome  attempts  fliould be  made  to remove
them.  The chief intention ,to be purfued  for  this
purpofe,  is by bleeding,  or to  make feme derivation
                                            from 
           OF WATER IN THE HEAD, &c.      5fy
   from the head,  by bliftering, purging, and the like.
   Should thefe fail,  iffues  or fetons may be put in the
   neck, or between the flioulders.  Bathing the feet
   in warm water is  proper in almoft every cafe of con-
   vulfions in children.


     OF WATER  IN THE HEAD,  OR, DROPSY OF
                     THE BRAIN.

     Though  water  in  the head, or a dropfy of the
   brain,  may  affect adults  as well  as children, yet, as
   the latter are more peculiarly liable to it, we thought
   it would be moft proper to place it among the dif-
   eafes of infants.
      CAUSES.---A dropfy of  the brain  may pro-
'  ceed from  injuries done to the braia itfelf by falls,
   blows, or  the  like ;  it may  likewife proceed from
   an original1  laxity  or  weaknefs  of  the brain;  from
   fchirrous  tumors or excrefcences within  the fkull.
   It often occurs  in  the latter ftage of fevers  and fe-
   verifh difeafes,  by a determination  of fluids  to the
   brain and  congeftion and confe.que.nt  inflammation
   t(jere.
      SYMPTOMS.----This difeafe  has at firft the
   appearance  of  a flow fever ;  the patient complains
   heavily of a pain in the hen.d, where he moftly places
   his hands,  or over his eyes ; he fhuns the light,  is
   fick, and fometimes vomits; his pulfe  is irregular,
   fometimes full,  fometimes low,  often preternaturally
   flow, and  generally hard; the pupils are dilated ;
   the  body  very coftive ;  urine  in  fmall  quantities.
   This difeafe is  often  attributed  to  worms, and,  in-
   deed,  before it was  well underftood, was  generally
   called the Worm-Fever.  Though the patient feems
   heavy and dull, yet he does not fleep :  he is feme-
                                                times 
57©      OF WATER IN THE HEAD, &c.
times delirious, and frequently  fees objects double;
towards the end of the  difeafe, the  pulfe becomes
more frequent, the pupils continue dilated, a fquint-
ing comes on,  the cheeks are fluflied, the patient
becomes  comatofe, and a palfy or convulfions clofe
the fcene.
  MEDICINE.----The cure of this difeafe is, by
repeated  bleedings, as long as the hard pulfe, fever,
pain and dilated pupils continue.   Or even while  a
contracted pupil continues ; for it is  the infenfibility
of the pupil, to the light, whether  it remains  con-
tracted or dilated,  that conftitutes the  danger.   No
time muft be loft in ufing this neceffary evacuation ;
and were it ufed foon enough and in fufficient quan-
tity, this hitherto formidable  difeafe  would yield as
foon as moft others. It is, in fact, an  inflammation of
the brain, ending in effufion or dropfy ; and by curing
the inflammation, we prevent  the dropfy.  For this
purpofe,  along with the bleeding,  the cooling regi-
men fhould be ufed in its  utmoft extent, as in other
inflammatory difeafes, particularly cold applications
to the head.   The bowels fhould be  kept  conftantly
loofe  with  calomel mixed  with jalap, rhubarb or
nitre ; blifters  fhould be kept  running at the back
of the neck or behind the ears ; or to the crown of
the head, after it has been fhaved ; the diet fliould be
light.  If there is reafon to fuppofe the effufion has
taken place, which is known by the  continuance of
die difeafe and the fymptoms above-mentioned, we
muft bleed, if the pulfe will bear it;  ufe the purga-
tives and blifters very freely ;  and endeavour, to ex-
cite a falivation, by rubbing  in mercurial ointment
on the throat and  neck.   Towards  the clofe of the
difeafe, if the patient is weak, ftrengthening  medi-
cines and regimen,  particularly exercife are  proper.
The chief caution  to be attended to  in the  cure of 
                 OF SURGERY.               571
this  difeafe, is to apply our remedies fpeedily and
freely*.
                  CHAP.  LI.

                   Of Surgery.


           I O defcribe  all the  operations of for-
gery, and to point out the different difeafes in which
thefe operations  are neceffary,  would  extend this
article far beyond  the limits allotted to it:  we muft
therefore  confine  our obfervations to fuch cafes as
moft  generally  occur, and in  which proper  affift-
ance  is either not afked, or  not always to be  ob-
tained.
   Though  an acquaintance with the  ftructure  of
the human  body  is indifpenfably neceffary to qua-
lify a man for being an expert furgeon ; yet many
things may be done to fave the  lives of  their fellow-
men in emergencies by thofe who are no adepts in
anatomy.   It is  amazing  with  what  facility  the
peafants daily perform operations upon brute ani-
mals, which are not  of a lefs  difficult  nature than
many of thofe performed on the human  fpecies j  yet
diey often meet with fuccels.
   indeed  every man is in fome meafure a furgeon
whether hsf will or not.   lie feels an inclination to

   11  Lars;e and continued dofes cf calomel have been much
recommenced for the cure of this difeafe. They may fomerimes
fucceed before the effufion takes jlace, and are certainly of
treat fervice' afterwards ;  but the more active  practice ab.>v<;
recomjner.dcd i; ciiiciiy to be trufted  to.
                                              affift 
    Si-             OF BLEEDING.
    affift his fellow-men in diftrefs, and accidents very of.
    ten  happen which give occafion  to  exerciie this
    feeling.  The feelings of the heart, however,  when
    not directed by  the judgment, are apt to miflead.
    Thus  one,  by  a'rafti  attempt  to fave  life,  may
    fometimes deftroy it;  while  another,  for fear  of
    doing  amifs, ftands ftill and  fees  his  bofom-friend
    expire  without  fo  much as  attempting to relieve
    him, even when  the means are in his  power.  As
    every good man  would wifh  to  fleer  a courfe dif-
    ferent  from cither of thefe, it will no doubt be agree-
    able to him to know what ought  to  be done upon
    fuch emergencies.

                     OF BLEEDING.

      No  operation  of forgery  is fo frequently necef-
    fary as bleeding -,  it ought therefore to be very ge-
    nerally underftood.   But though  practifed by mid-
    wives,  gardeners,  blackfmiths, &c. we  have reafon
    to believe that very few know when it is proper.
S*  It is however an operation of great importance, and
    muft, when feafonably  and properly performed, be
    of fingular fervice to thofe in diftrefs.
      Bleeding is proper at the beginning of all inflam-
    matory fevers, as pleurifies,   peripneumonies,  &c.
    It  is  likewife  proper  hi  all   topical  inflamma-
    tions,,  as thofe of the  inteftines,  womb,  bladder,
    ftomach,  kidneys,  throats, eyes,  Sec. as alfo in the
    afthma, fciatic pains,   coughs,   head-achs,   rheu-
    matifms,  the apoplexy,  epilepfy,   and  bloody flux.
    After falls,  blows, bruifes,  or any violent hurt re-
    ceived  either externally or  internally,  bleeding  is
    neceffary.   But  in ail  diforders proceeding from a
    relaxation of the folids,  and an impoveriflied ftate of
    the  blood,  as feme kind of dropfies,  cacochymies,
    Bee. bleeding is improper.
                                            Bleeding, 
OF BLEEDING.
573
  Bleeding, for topical inflammations, ought always
to be performed as near the part affected  as poff.ble.
When this can be done w ith a lancet, it is to be pre-
ferred to any other method ; but  where  a vein can-
not be  found, recourfe muft  be had to leeches  or
cupping.   .
  The quantity  of blood  to be let muft always  be
regulated by the ftrength^ age, conftitution, manner
pf life, and other circumftances relating to the patient.
   From whatever part of the body blood is to be
let, a bandage muft  be  applied  between that part
and the heart.   A.3 it is often  neceffary,  in order to
raife the vein, to make the bandage pretty tight, it
will be proper,  in fuch cafes,  as  foon as the blood
begins  to flow, to flacken it a little.  The  bandage
ought  to  be applied at  leaft two or three inches
from  the place where the wound is intended to be
 made.
   Perfons  not fkilled in anatomy, ought never to
 bleed in a vein that lies over an artery- or a tendon,
 if they can avoid it.   The  former may eafily be
 known from  its pulfation or beating,  and the latter
 from its feeling hard or tight,  like a whipcord, under
 the finger.
   It was formerly a rule,  even among thofe who had
 the character of being regular practitioners,  to bleed
 their patients, in certain difeafes, till they fainted.
 Surely a more ridiculous rule  could not be propofed.
 One perfon will faint at the  fight of a lancet,  while
 another will lofe almoft the whole blood of his body
 before he faints. Swooning often depends more upon
 the ftate of the mind, than of the body ; befides, it
 may often  be occafioned or prevented,  by the man-
 ner in which the operation is performed.
    Though children are generally  bled with difficulty,
  yet would thofe  who practice bleeding take  a little
  more pains, and accuftom themfelves to bleed  chil-
                                             dren,. 
?74
OF BLEEDING.
dren, they would not find it fuch a difficult opera-
tion as they imagine.
   Certain hurtful prejudices, with regard to bleeding,
ftill prevail.   There is a talk,  for inftance, of head-
veins, heart-veins, breaft-veins,   &c.  and  it is  be-
lieved that bleeding in thefe,  will certainly cure  all
difeafes of the parts from  whence they are luppofed
to  come, without  confidering that all  the blood-
veffels arife from the heart,  and return to it again ;
for which reafon, unlefs in topical inflammations, it
ftgnifies very little from what part of the body blood
is taken.  But this, though a foolifli prejudice, is not
near  fo hurtful as  the vulgar notion, that the firft
bleeding will perform wonders.   This belief makes
them often poftpone the operation,  when neceffary,
in order toreferve it for fome  more  important occa-
fion,  and,  when they think  themfelves in  extreme
danger,  they fly to it for relief, whether it be proper
or not.   Bleeding at  certain ftated  periods  or  fea-
fons, has lik-wife often bad effects.
   It is  a common  notion, that bleeding in the feet
draws  the  humors downwards,  and  confequently
cures difeafes of the  head and other fuperior parts:
but we have already obferved,  that, in all topical
affections,  the blood  ought  to be drawn as  near  the
part as poffible.  When it is neceffary, however, to
bleed in the foot or hand, as the  veins are fmall, and
the bleeding is apt  to ftop too foon, the  part ought
to be immerfed in warm water, and kept  there till a
fufficient quantity of blood be let.
   We  fhail not fpend time in  defcribing  the manner
of performing this operation : that will be  better
learned by example than  precept.  Twenty pages of
defcription would not convey  fo  juft an  idea of the
operation, as feeing it once performed by an expert
hand.  Neither is it neceffary to  point  out the dif-
ferent parts of the  body from whence blood may be
               1                             taken, 
    OF INFLAMMATIONS  AND ABSCESSES. .57;
taken, as the arm, foot,  forehead,  temples,  neck,
Sec.   Thefe will  readily occur to every intelligent
perfon, and the foregoing obfervations will be fuf-
ficient  for determining which of them is  moft pro-
per upon any particular occafion.  In all cafes, unlefs
where topical bleeding is neceffary,  the arm is the
moft commodious  part of the  body, in which the
operation can be performed.

    OF INFLAMMATIONS  AND ABSCESSES.

   From whatever caufe an  inflammation  proceeds,
it  muft terminate  either by difperfion, fuppuration,
or  gangrene.   Though it  is impoffible to  foretel,
with certainty, in which of thefe ways any particular
inflammation will terminate, yet a probable conjec-
ture may be formed, with regard to the event, from
a knowledge of the patient's age and conftitution.
Inflammations happening  in a  flight degree upon
colds,  and without any previous indifpofition, will
moft probably be difperfed ;  thofe which follow clofe
upon a fever,  or happen  to  perfons of a grofs habit
of body, will  generally fuppurate ;  and thofe which
attack very  old people, or perfons of a dropfical ha-
bit, will have a ftrong tendency to gangrene.
   If the inflammation be flight, and the conftitution
found, the difperfion ought always to be  attempted.
This will be beft promoted by a flender diluting diet,
plentiful bleeding, and repeated purges.   The part
itfelf muft be fomented,  and,  if the ikin be very
tenfe,  it may be embrocated with a mixture of three-
fourths of fweet oil, and one-fourth of vinegar, and
afterwards covered with a piece of wax-plafter.
   If, notwithftanding thefe  applications, the  fymp-
tomatic  fever  increafes,  and  the  tumor  becomes
larger,  with  violent pain  and  pulfation, it will be
proper to promote the fuppuration.   The beft appli-
                                           cation 
5l6 OF INFLAMMATIONS AND ABSCESSES.
cation for this purpofe,  is a foft poultice of bread and
milk, which fliould always be renewed  fix or leven
times a-day.  If the fuppuration proceeds but flowly,
a raw  onion, cut  fmall or bruifed,  may be  fpread
upon the poultice.  When the abfcefs  is ripe or  fit
for opening, which may eafily be  known from the
thinnefs of the fkin in the moft prominent part of  it,
a fluctuation of matter which may be felt under the
finger, and, generally fpeaking,  an abatement of the
pain, it may be opened either with  a  lancet or  by
means of cauftic*.
   The laft way in which an inflammation terminates,
is in  a  gangrene or mortification,  the approach  of
which  may be known by the following fymptoms:
the inflammation lofes its rednefs, and becomes dufk-
ifli or  livid ; the tenfion of the fkin goes off, and
it feels flabby ;  little bladders filled with ichor of dif-
ferent colours fpread all over it ;  the  tumor fubfides,
and  from a  dufkifh complexion becomes black; a
quick  low pulfe with  cold clammy  fweats, are the
immediate fore-runners of death.
   When thefe fymptoms firft appear, the part ought
to be  dreffed with a cataplafin made  of lye and bran.
Should the fymptoms become  worfe, the part muft
be fcarified and  afterwards dreffed with bafilicum
foftened  with oil of turpentine.   All  the dreflings
muft be applied warm.   With regard to internal me-
dicines, the patient muft be fupported with generous
cordials,  and the Peruvian bark exhibited in as large
dofes as the ftomach  will bear it.   If the mortified
parts fliould feparate,  the wound will become a com-
mon ulcer,  and muft be treated accordingly.
   This article includes the  treatment of all thofe dif-
eafes,  which in different  parts  of the  country,  go

   *  It  fonvtin es happens that, from the fituation  of an in-
flammation, we do not wifh it  to fuppurate.  In tlvs caf; it
W<iy  be refolved by fcarifying.
       4                                      by 
                  OF WOUNDS.               577
by  the names of biles,  impofihumes, whitloes, Sec*
Tfiey are  all abfceffes in  confequence of a previous
inflammation, which, if poffible, ought to be difcuf-
fed ; but when this cannot be done, the fuppuration
fhould be  promoted, and the matter difcharged  by
an incifion, if neceffary ;  afterwards the fore may be
dreffed with yellow bafilicum, or  fome other digef-
tive ointment.

                  OF WOUNDS.

   No part of medicine has been more miftaken than
the treatment or cure of wounds.   Mankind  in ge-
neral  believe  that   certain herbs, ointments, and
plafters are poffeffed  of  wonderful  healing powers,
and  imagine that no  wound  can be cured without
the application of them.  It is however a well eftab-
lifhed  fact,  that  no   external application  whatever
contributes  towards the  cure of a wound, any other
way than by keeping  the  parts foft, clean, and de-
fending them from the external  air, which may be
as effectually done by dry lint, as by the moft  pom-
pous applications, while it is exempt from many of
the bad confequences attending  them f.
   The fame obfervation holds with refpect to inter-
nal applications.   Thefe only promote the cure of
wounds as far as they tend  to prevent a  fever, or to
remove any caufe that might obftruct or impede the
operations of Nature.   It is  Nature alone that  cures
wounds.  All that art can do is to remove  obftacles,

  * The paronychia or whitlow is cured with moft certainty by
thrufting a lancet into the moft  painful part, fo as to  feel the
bone.
  f It may be faid that frefh wounds are  healed by the appli-
cation of Turlington's balfam,  and fimilar medicines.  The
truth is, that thefe fubftances do good only by  excluding the
external air, which dry lint would do much better.
                       P p                    and- 
578
OF WOUNDS.
 and to put the parts in fuch a condition  as  is the
 moft favourable to Nature's efforts.
   With this fimple view we  fliall  confider the treat-
 ment of wqunds,  and endeavour  to point  out fuch
 fteps as ought to be taken to facilitate their cure.
   The firft thing to be done when a perfon  has re-
 ceived a wound,  is to examine whether any  foreign
 body be lodged  in  it,  as wood,  ftone,  iron,  lead,
 glafs,  dirt,  bits   of cloth,  or the like.   Thefe,  if
 poffible, ought   to  be  extracted,  and  the  wound
 cleaned before any dreffings  be applied.   When that
 cannot be effected with fafety, on  account  of the
 patient's weaknefs,  or  lofs  of blood, they muft be
 fuffered to remain in the wound, and afterwards ex-
 tracted when he is more able to bear it *.
   When a wound penetrates into any of the  cavities
 of the  body, as the breaft, the bowels, Sec. or where
 any confiderable blood-veffel is cut, a fkilful furgeon
 ought  immediately to be called, otherwife the patient
 may lofe his life.   But  fometimes the difcharge of
 blood  is fo great, that if it be not ftopt, the patient
 may die even before a furgeon, though at no great
 diftance, can arrive.   In this cafe fomething muft
 be done by thofe who are  prefent.  If the  wound
 be in any  of the  limbs, the  bleeding may  generally
 be ftopt by  applying  a tight ligature  or bandage
 round  the  member  a little  above the wound.   The
 beft method of doing this is to put  a ftrong  broad
 garter  round the part, with a comprefs  of linen di-
 rectly on it, but. fo  flack, as  eafily to admit  a fmall
 piece of ftick to  be put under it,  which muft be
 twifted, in  the fame manner  as a  countryman does
a  cart-rope to  fecure his loading, till the bleeding
flops.  Whenever this is the cafe, he muft take care

  * The lips of a fimple wound fhould always be brought
rgaher either by bandage, fticking plafter, or future.
                                               t© 
                   OF WOUNDS.                5-9

to twift  it no longer, as ftraining it too much might
occafion an inflammation of the parts, and  endanger
a gangrene.
   In  parts where this bandage cannot be  applied,
various other  methods  may   be   tried to  ftop  the
bleeding, as  the  application  of ftyptics, aftringents,
&c.   Cloths dipped in  a  folution of blue vitriol in
water,  or the ftyptic water  of  the Difpenfatories,
may be applied to the wound.  When thefe cannot
be obtained,  ftrong fpirits  of wine  may  be ufed.
Some recommend the agaric* of the oak  as prefer-
able to any of the other  ftyptics ;  and indeed it  de-
ferves confiderable encomiums. It  is eafily obtained,
and ought to be kept in every family,  in cafe of ac-
cidents.   A piece of it muft be laid upon the wound,
and covered with  a good deal of lint, above which a
bandage may be  applied fo tight  as to  keep it firmly
on f.
   Though fpirits, tinctures, and hot balfams may be
ufed, in order to ftop the bleeding when it is excef-

   * Dr..Tiffot, in his Advice to the People, gives the following
directions for gathering, preparing, and applying the agaric :
"  Gather in autumn," fays he,  "while-the fine weather lafts,
the agaric of the oak, which  is a kind of fungus or excrefcence
iffuing from the  wood of that tree.  It confifts at firft of four1
parts, which prefent themfelves fucceffively :  1. The outward
rind or fkin, which  may be thrown away.  2. The part im-
mediately under this rind, which is the  beft of all.   This is to
be beat well with a hammer, till it becomes foft and very plia-
ble.  This is the only preparation  it requires, and a flice of it
of a proper fize is to be applied directly over the open blood-vef-
fels.   It conftringes and brings them clofe together, ftops the
bleeding, and generally falls off at the end of two days. 3. The
third part adhering to the fecond may ferve to ftop the bleeding
from the fm-iller veffels ; and the fourth and laft part may be
reduced to powder as conducing to the fame purpofe." Where
agaric cannot be had.Tponge may  be ufed in its ftead.  It muft
be applied in the lame manner, and has nearly the fame effects.
   f Lint alone,  or lint  dipped in flour, will often ftop a bleed-
ing, fo will fcraped  hat and cob-webs.
                       P p 2                   five. 
S««.              ©F WOUNDS-
five, they arc improper at other times,   They  do
not promote but retard the cure, and often change
a fimple wound  into  an ulcer.  People imagine be-
caufe hot balfams congeal the blood, and  feem, as
it were, to folder up  the wound, that they therefore
heal it;  but  this is only a  deception.  They may
indeed ftop the flowing blood, by fearing the mouths
of the veffels ; but, by rendering the part  callous,
they obftruct the cure.
  In flight wounds,  which do  not. penetrate much
deeper than the fkin, the beft application is a bit of
the common black fticking-plafter.   This  keeps the
fides  of  the wound  together, and prevents the  air
from hurting it, which is all that is neceffary. When
a wound penetrates deep, its lips fliould  be drawn
together by futures.
   We fhail not fpend time in defcribing the different
bandages that may be proper for wounds in different
parts.of the body ; common fenfe will generally fug-
geft the  moft commodious method of applying a
bandage  ; befides, defcriptions  of this  kind are not
eafily underftood or remembered.
   The firft dreffing ought to continue on for at leaft
two days;  after which it may be removed, and frefli
lint applied as before.  If any part of the  firft dref-
fing fticks fo clofe as not to be "removed  with eafe
t>r fafety to the patient, it may be allowed to con-
tinue, and frefh lint dipped in fweet oil laid over it.
This will foften it, fo as  to  make it come off eafily
at the next dreffing.  Afterwards the wound may be
dreffed twice a-day in the fame manner till it be quite
healed.   Thofe who are fond of falves or  ointments,
may5  after the wound is become very fuperficial,
drefs it with the  yellow bafilicum* ;  and  if fungous,
fir what  is called  proud flefh,  fhould  rife  in  the

          * See Appendix, Telloiu Bafjcum.
                                          wound
i 
                  OF  BURNS.              581
"wound,  it may be  checked  by  fprinkling on  it
a little burnt alum or red precipitate of mercury.
   When a wound is greatly inflamed, the moft pro-
per application is a poultice of bread and  milk, juft
warm, foftened with a little fweet oil, frefli butter or
lard.  This muft be applied inftead of a plafter, and
fhould be changed feveral times a-day.
   If the wound be large, and there is reafon to fear
an inflammation, the patient  fliould be kept on  a
Very low diet.  He muft abftain from  flefh, ftrong
liquors, and every thing that is of an heating nature.
If he be of a full habit, and has not loft  much blood
from the wound, he muft be bled ; and, if the fymp-
toms  be- urgent, the operation  muft be repeated.
But  when the patient has been greatly weakened by
lofs of  blood from the wound, it will be needlefs to
bleed him, unlefs  a  fever fliould enfue.'  Nature
fliould never be too far exhaufted.
   Wounded   perfons  ought   to be kept perfectly
quiet and eafy.  Every  thing that ruffles the mind
or moves the  paffions, as love, anger, fear, exceffive
joy, &c.  are very  hurtful.  They ought  above all
things to abftain from  venery.  The body  fliould
be kept  gently open, either by laxative clyfters, or
by a cool vegetable diet, as  roafted apples,  ftewed
prunes, boiled fpinage, and fuch like.

                   OF BURNS.

  In flight burns which do not break the  fkin, it  is
cuftomary to hold the part near the fire for a com-
petent time, to rub it with fait, or to lay a comprefs
upon it dipped  in fpirits  of wine or brandy.   But
the proper way of treating burns is to  apply linen
cloths dipped in cold  water, conftantly to the  part,
until the pain is relieved.   This is the moft effectual
remedy to prevent pain, inflammation and ulceration.
                       P p 3                 But 
5*2             OF  BURNS.
But when the burn has penetrated fo deep  as  to
blifter or break  the fkin, it muft  be  dreffed with
fome of the liniment  for burns mentioned  in the
Appendix, or with the ointment, commonly called
Goulard's  cerate *.   This  may be mixed with  an
equal quantity of Turner's cerate f,  and fpread upon
a  foft rag, and applied to the part affected, if the
part is  very  irritable.  If it is not,  the Goulard's
cerate alone  is the  beft application.   When  this
ointment  cannot be had, an egg may be beat  up
with about an equal quantity of the fweetefl falad oil.
This will ferve very well till a proper ointment can  be
prepared.  When the burning is very deep, after the
firft two or three days, it fliould be dreffed with equal
parts of Goulard's and Turner's cerate mixed together,
   When the burn  is violent,  or has  occafioned a
high degree of inflammation, and there is reafon  to
fear a  gangrene or mortification,  the fame means
muft be ufed  to prevent it  as  are recommended  in
other violent inflammations.  The  patient, in this
cafe, muft  live  low,  and drink  freely of weak  di-
luting liquors.   He muft  likewife  be  bled, and
have his body kept open.   But if the pulfe falls and
the burnt parts fliould become livid or black,  with
other fymptoms of mortification, it will be neceffary to
bathe them frequently with warm camphorated fpirits
of wine, tincture of myrrh, or other antifeptics, mixed
with a decoction  of the bark.  In this  cafe the bark
muft likewife be taken internally, and  the  patient's
diet muft be more generous *,

    * See Appendix, Goulard's cerate.
    f See Appendix,  Turner's cerate
  * The fore remaining after a burn  is generally filled with
fungous  or as it is commonly called, proud flefh ; this fhould
be kept down by the daily applic.-.ticn  of the lunar cauftic, blue
vitriol, cr bjir.it alum.
                                                As 
                OF BRUISES.           583
   As example teaches better  than  precept, I fliall
 relate the treatment of the  moft dreadful cafe of
 this kind that  has occurred  in my practice.  A
 middle-aged  man,  of  a good conftitution, fell  into
 a large veffel  full  of  boiling-water, and miferably
 fcalded about one half of his body.   As his clothes
 were on,  the burning  in fome  parts  was very deep
 before they could be  got  off.   For the  firft  two
 days the fcalded parts  had  been frequently anointed
 with a mixture of lime-water and  oil,  which is  a
 very proper  application for recent burns.  On the
 third day when I firft faw him, his fever was high,
 and his body coftive,  for  which  he was bled,  and
 had an emollient clyfter adminiftered.   Poultices of
 bread  and  milk, foftened with  frefh butter, were
 likewife applied to  the  affected parts, to abate the
 heat and  inflammation.  His  fever  ftill  continuing
 high, he  was bled a fecond time, was  kept ftrictly
 on  the cooling regimen,  took  the faline mixture
 with fmall dofes of  nitre, and had an emollient clyf-
 ter adminiftered once a-day.   When the inflamma-
 tion began to abate, the parts were dreffed with a
 digeflive compofed of brown cerate and yellow bafi-
 licum    Where any  black  fpots appeared,  they
 were flightly fcarified,  and  touched with  the tinc-
 ture of myrrh ; and, to prevent their fpreading, the
 Peruvian  bark was  adminiftered.   By  this courfe,
 the man was fo well in three weeks as to be able to
 attend to  his bufmefs.


                OF BRUISES.

  Bruifes  are generally productive of  worfe confe.
 quences than  wounds.    The  danger  from them
does not appear immediately,  by which means it
often happens that they are neglected.   It  is  need-
                     Pp4                    left 
5?+            OF  BRUISES.
lefs to give any definition of a difeafe fo  univerfally
known ;  we fliall therefore proceed to point out the
method of treating it.
   In  flight bruifes it will be fuflicient to bathe the
part with warm vinegar, to which a little brandy or
rum  may occafionally be added, and to keep cloths
wet with this mixture conftantly applied to it.   This
is more proper than rubbing it with  brandy, fpirits
of wine, or other ardent fpirits, which are commonly
ufed  in fuch cafes *.
   When a hruife is very violent, the patient ought
immediately to be bled, and put upon  a proper re-
gimen.  His food fhould be light and cool,  and his
drink weak, and of an opening nature ;  as  whey
fweetened with honey, decoctions of tamarinds, bar-
ley,  cream of  tartar-whey, and  fuch  like.   The
bruifed  part muft be bathed with  vinegar, as  di-
rected above ; and a poultice made by boiling crumb
of bread,  and camomile-flowers, in equal quantities
of vinegar and water, applied to it.  This  poultice
is peculiarly proper when  a wound  is joined to the
bruife.   It  may be  renewed two  or three  times
a-day.
    As the ftructure of the veffels is totally  deftroyed
by a violent bruife, there often enfues a great lofs of
fubftance, which  produces an ulcerous  fore difficult
 to cure.   If the bone be affected,  the  fore will not
 heal before an exfoliation  takes place;  that is, be*
 fore the difeafed  part  of the bone feparates, and
 comes out through the wound.    This is often a
 very flow operation,  and  may even require feveral
 years to be  completed.    Hence it happens, that

    *  In every cafe of recent bruife, if the fkin is not broke, and
 fhe part is immediately immerfed in cold vinegar or cold water
 and  kept there for fome time,  moft of the difagreeable confe*-
 quences may be prevented.
                                               Ihefe 
                O F  U L C E R S              58-
thefe  fores arc frequently  miftaken for the king's
evil, and treated as fuch, though in fact  they pro-
ceed folely from the injury which the folid parts re-
ceived from the blow.
  Patients in this  fituation  are peftered with  dif-
ferent advices.   Every one who fees them propofes
a new remedy, till the fore is fo much irritated with
various and  oppofite applications,  that it  is often
at  length- rendered abfolutely incurable.   The beft
method  of  managing fuch  fores is,  to  take  care
that  the  patient's  conftitution  doest not  fuffer by
 confinement, or improper medicine,  and to apply
nothing  to   them  befides  fimple  ointment  fpread
 upon foft lint, over which  a poultice of bread and
milk, with   boiled  camomile-flowers,   or the  like,
 may be put, to nourifli the  part, and  keep  it foft
 and  warm.  " Nature,  thus affifted, will generally
 in  time operate a cure, by throwing off the difeafed
 parts of the bone,  after which the fore foon heals,

                 OF  ULCERS,

    Ulcers may be the confequence of wounds, bruifcs,
 or impofthumes  improperly  treated ; they may like-
 wife proceed from an ill ftate of the humors, or what
 is  called  a bad habit of body.
    In the latter cafe,  they ought  not  to  be haftilv
 dried up,  otherwife it may prove fatal  to the pa-
 tient.  Ulcers happen moft commonly  in the de-
 cline of life ; and  perfons  who  neglect exercife, and
 live grofsly, are moft liable to  them.   They might
 often be prevented by retrenching  fome part of the
 folid food,  or by opening artificial  drains, as iffacs.
  fetons or the like.
    An ulcer may be diftinguifhed  from a wound by
  its difcharging a thin watery humor,  wlfch  is often
  fo acrid as  to inflame and corrode  the fkin ;  by the
                                           hardiiels 
 5*6             OF  ULCE RS.
 hardnefs and perpendicular fituation of its  fides  or
 edges, by the time of its duration, &c.
   It requires confiderable  fkill to be able to judge
 whether or not an  ulcer ought to be dried  up.   In
 general, all ulcers  which  proceed from a  bad  ha-
 bit of body, fliould  be fuffered  to continue open,
 at leaft till the conftitution has  been fo  far  changed
 by proper regimen, or the  ufe   of medicine, that
 they feem difpofed  to heal  of their  own  accord.
 Ulcers  which are the effect of malignant fevers, or
 other acute  difeafes,  may  generally be healed with
 fafety  after the health has been  reftored for fome
 time.  The cure ought not however to be  attempt-
 ed too  foon, nor at  any  time without the ufe of
 purging medicines  and a  proper regimen.   When
 wounds or bruifes  have,  by wrong treatment,  de-
 generated into ulcers, if the conftitution be good,
 they may generally be healed with fafety.   When
 ulcers either accompany chronic difeafes, or  come in
 their ftead, they mui'l be cautioufly healed. If an ulcer
 conduces to the patient's health, from whatever caufe
 it proceeds, it ought not to be healed ; but if, on the
 contrary,  it waftes  the ftrength,  and confumes the
 patient by a flow fever, it fliould be healed as foon as
 poffible.
   We would earneftly recommend a ftrict attention
 to thefe particulars, to all who have the misfortune
 to labour under  this diforder,  particularly  perfons
 in the decline of life ; as we have frequently known
 people throw away their  lives by the  want  of it,
 while  they were extolling and generoufly  reward-
ing thofe whom they ought to have looked  upon as
 their executioners.
   The moft proper regimen for promoting the cure
of ulcers, is  to  avoid all  fpices, falted and high-
feafoned food, all ftrong liquors,  and to leffen  the
 ufual quantity of flefh meat.   The body ought to
                                              be 
                 O F  U L C E R S.             587
be kept gently open by  a diet  confifting  chiefly of
cooling laxative vegetables,  and by drinking  but-
ter-milk,  whey fweetened with honey, or the like.
The patient ought to be  kept  cheerful, and  fhould
take as much exercife as he can  eafily bear.
   When the bottom and  fides of an ulcer feem hard
and callous, they may be fprinkled twice a-day with
a little red precipitate  of mercury, and  afterwards
dreffed with  the yellow bafilicum ointment.   Some-
times it will be neceffary to have  the edges  of the
ulcer fcarified with the lancet.
   Lime-water  has  frequently been known to have
very  happy effects  in  the cure of obftinate  ulcers.
It  may be ufed, made in the fame manner as directed
for the ftohe and gravel.
   My late learned and ingenious friend, Dr. Whytt,
ftrongly recommends the ufe  of  the folution of cor-
rofive fublimatc of mercury in brandy, for the cure
of obftinate ill-conditioned ulcers.   I have frequent-
ly found  this   medicine,  when given  according to
the Doctor's directions, prove very  fuccefsful.   The
dofe is a table-fpoonful night and  morning ;  at  the
fame time wafhing the  fore twice or thrice a-day
with  it.   In a letter which I  had from the Doctor a
little  before his death, he informed me,  ' That he
' obferved wafhing  the fore thrice a-day with  the
4 folution  of a triple ftrength was very beneficial *.'
   A fiftulous ulcer can feldom be cured without  an
operation.   It  muft either fte laid open fo as to have
its callous parts deftroyed by fome  corrofive applica-
tion  or they muft be entirely  cut away by the  knife :
but as this operation requires the hand of an  expert
furgeon, there  is no occafion  to  defcribe it.   Ulcers.

  * In ulcers of the lower limbs great  benefit is often received
from tight rollers, or wearing a laced flocking, as this prevent
tfcj fluv of humors to the fores, and Jifpofes them to heal.
                                          . about 
 5'SS             ©F ULCERS.
 about tile anus are moft apt to become fiftulous, and
 are very difficult to cure.  Some  indeed pretend  to
 have found Ward's Fiftula pafte  very  fuccefsful  in
 this complaint.   It is not a dangerous medicine, and
 being eafily procured,  it may  deferve a trial; but
 as  thefe  ulcers  generally ' proceed from an ill habit
 of body,  they will feldom yield to any  thing  except
 a  long courfe  of regimen, affifted by medicines,
 which are calculated to correct that particular habit,
 and to induce an almoft total change  in the conftitu-
 tion. «*■
   The beft general rule,  for the  cure  of ulcers,  is
 to reduce the callous edges,  procure good pus, and
 ftrengthen the part affected ; and  to do this we muft
 treat our patients as in other  cafes.  If the fymptoms
 of  inflammation  prevail,  ufe fuch remedies as will
 leffen it; bleeding, purging, and a vegetable diet.
 Half a drachm of  nitre twice  or  three times  a-day
 fliould  be  given.   If debility prevails in the  fyftem
 give bark, wine, and generous  diet.  In either cafe
 abfoiute reft is neceffary.  To  relieve  violent pain
 we ufe opium internally, and the  lead water to the
 part;  to reduce the edges, lunar cauftic or the knife.
 If thefe dp  not  produce good  pus, we fill the fore
 with red precipitate, or arfenic powder,fee Appendix,
 or powdered  columbo  root, or rhubarb, according
 to the nature of it.   If the fore fmells bad, the  carrot
 poultice or lime juice.  If thefe do not produce good
 pus,  one  of the calomel pills night and morning
 undl it change the  nature of the  difcharge.   In all
 old ulcers, an iffue  fliould be made;  and when the
 fore has become  healthy, the tight roller of  coarfe
muflin will be found of the greateft fervice.
CHAP. 
[  5*9   ]
                 CHAP.  LII.

                 Of Difiocations.


          VV HEN a  bone is  moved out  of its
place or articulation, fo as to impede its proper func-
tions, it is  faid to be luxated or difiooated.   As this
often happens to perfons in fituations where no me-
dical affiftance  can be  obtained,  by  which  means
limbs, and  even lives, are frequently  loft, we fliall
endeavour  to point  out  the  method of reducing
the moft common  luxations, and thofe  which  re-
quire immediate  affiftance.   Any  perfon  of com-
mon fenfe  and refolution, who is prefent when a
diflocation  happens, may often  be of  more fervice
to the patient, than  the  moft  expert  furgeon can
after the fwelling  and inflammation have  come on.
When thefe are prefent, it is difficult to  know the
flate of  the joint, and dangerous  to attempt  a re-
duction ; and by waiting till they are  gone off, the
mufcles may become fo relaxed, and the cavity filled
up,  that the bone can never afterwards be retained
in its place.
   A  recent  diflocation may generally be s reduced
by extenfion  alone, which  muft always be  greater
or lefs according  to  the  ftrength  of the  mufcles
which  move  the  joint,  the   age, robuftnefs, and
other  circumftances  of  the   patient.  When the
bone has been  out  of its place for any confiderable
time, and a fwelling or inflammation has come on,
it will be neceffary  to  bleed the  patient, and, after
fomenting the part,  to apply  foft  poultices with
vinegar to  it for fome time  before the reduction is
attempted,  and indeed  bleeding is generally proper
                                               i» 
590       DISLOCATION OF THE  JAW.
in all cafes of diflocation.   Bleeding, even to faint-
ing, produces fuch a  relaxation  of  the mufcles  and
ligaments, that  obftinate  cafes of fome  weeks ftand-
ing have yielded to this method.
   All that is  neceffary  after the  reduction, is to
apply cloths dipt in  vinegar  or camphorated fpirits
of wine  to the part, and  to keep it perfectly eafy.
Many bad confequences  proceed  from  the  neglect
of this rule.  A diflocation feldom  happens with-
out the tendons and  ligaments of  the joints being
ftretched  and  fometimes  torn.   When  thefe are
kept eafy till they  recover their ftrength and tone,
all goes on very well; but if the injury be increafed
by too frequent an exertion of the parts, no wonder
if they be found weak and difeafed ever after.
          DISLOCATION OF THE JAW.

   The  lower  jaw  may  be  luxated by  yawning,
blows, falls, chewing  hard fubftances, or  the like.
It is eafily known from  the  patient's being unable
to fliut his mouth, or to eat any thing, as the  teeth
of the under jaw do not correfpond with thofe of the
upper;  befides, the  chin  either hangs down, or  is
thrown  toward  one  fide, and the  patient is neither
able to fpeak diftinctly, nor to fwallow without confi-
derable difficulty.
   The ufual method  of  reducing a diflocated jaw,
is to fet the patient upon  a low ftool,  fo  as  an af-
fiftant may hold the head  firm by preffing  it againft
his breaft.   The operator is then  to thruft his two
thumbs,  being firft wrapped up with linen  cloths
that they may  not flip, as far  back into the pa-
tient's mouth as he can,  while  his fingers are ap-
plied  to the jaw externally.   After he has got firm
hold of the jaw, he is to prefs  it ftrongly  down-
                                           wards 
         DISLOCATION OF THE NECK.      59l
wards and backwards,  by which means  the  elapfed
heads of the jaw may be  eafily puflied into their
former cavities.
   The peafants in fome parts of the  country have
a  peculiar way of performing this operation.   One
of them  puts  a  handkerchief under the  patient's
chin, then turning his  back to that of  the  patient,
pulls him up by the chin  fo as to fufpcnd him from
the ground.  This  method  often fucceeds,  but we
think it  a  dangerous one, and therefore recommend
 the  former.

         DISLOCATION OF THE NECK.

   The neck may be di(located by falls, violent blows,
 or the like.   In  this cafe, if the patient receives no
 affiftance, he foon dies, which makes  people imagine
 the  neck was  broken ; it is, however, for  the moft
 part only partially diflocated, and may be reduced by
 almoft  any perfon who has  refolution enough to at-
 tempt it.   A complete  diflocation of the neck is in-
 ftantaneous death.
   When the neck  is diflocated, the patient is  im-
 mediately  deprived  of all fenfe and  motion ;  his
 neck fwells,  his countenance  appears  bloated;  his
 chin lies upon his  breaft,  and his  face is generally
 turned towards one fide.
    To  reduce this  diflocation, the  unhappy  .perfon
 fliould  immediately  be  laid upon  his back on the
 ground, and  the operator  muft place himfelf behind
 him, fo as to be able to lay  hold  of his  head  with
 both hands, while he  makes a refiftanee  by  placing
 his knees  againft  the patient's flioulders.   In this
  pofture  he muft  pull* the head with confiderable
  force, gently twilling  it at  the fame time, if the  face
  be turned to one fide, till he perceives that the joint
                                                is
4 
592      DISLOCATION OF THE  RIBS.
is  replaced, which may be  known  from the  noife
which the bones generally make when going in, the-
patient's beginning to breathe, and the  head conti-
nuing in its natural pofture.
   This is one of thofe operations which  it  is  more
eafy to perform than defcribe.  I have  known in-'
fiances  of  its being happily  performed  even  by
women, and  often by men of  no medical educa-
tion.  After the neck  is reduced, the patient ought
to be  bled, and fhould be fuffered to reft  for fome
days, till the parts recover their  proper tone.


         DISLOCATION OF  THE RIBS.

   As the  articulation  of the  ribs  with the back-
bone  is very ftrong, they are not  often diflocated.-
It  does however fometimes happen,  which is  a fuf-
ficient reafon for our taking notice-of it.   When a
rib is diflocated either upwards  or downwards, in
order to replace it, the patient fliould be laid upon
his belly on a table, and the operator muft endeavour
to pufh the head  of the bone into  its proper place.
Should this method not fucceed, the arm of the dif-
ordered fide may be fufpended over a gate or ladder,.
and, while  the ribs are thus" ftrctehed afunder, the
heads of fuch as are out of place may be thruft into
their  former fituation.
   ThoTe diflocations wherein  the  head's of the ribs
are forced  inwards,  are  both more dangerous and
the moft difficult  to reduce,  as  neither the  hand
nor any inftrument  can be applied  internally to di-
rect the luxated heads of the ribs.   Almoft  the only
thing that can be  done is,  to* lay the patient upon
his belly over a cafk, or fome gibbous  body, and to
move the fore-part of the  rib inward towards the
      2                                    back,- 
      DISLOCATION OF THE SHOULDER.   J5j
back, fometimes fhaling it; by this means the heads
of the luxated ribs may flip into their former place.

      DISLOCATION OF THE SHOULDER.

   The humerus or upper bone of the arm may be
diflocated in various directions: it happens, however,
moft frequently downwards, but very feldom directly
upwards.   From the nature of its articulation, as well
as from its  expofure to external injuries, this bone is
th^ moft fubject to diflocation  of any in the body.
A diflocation of the humerus may  be  known by a
depreffion  or cavity on  the top of  the flioulder, and
an inability to move the  arm.   When the diflocation
is downward or forward,  the arm is elongated,  and
a ball or lump is  perceived under the arm-pit;  but
when it is backward,  there appears a protuberance
behind the  flioulder, and the arm is thrown forwards
towards the breaft.
   The ufual method of  reducing diflocations  of the
flioulder is  to  feat the  patient upon  a low ftool,
and to caufe an affiftant  to hold his body fo that it
may not give way to the extenfion, while another.
lavs hold of the arm a  little  above the elbow,  and
gradually extends  it.    The  operator  then puts a
napkin under the  patient's arm, and caufes it to be
tied behind his own neck: by this, while a fufficient
extenfion is made,  he  lifts up the head of the bone,
and with his hands directs it into  its proper place.
There are  various machines invented for facilitating
this operation, but the  hand  of an expert furgeon
is always more fafe.  In young and delicate patients,
I have generally found it a very eafy matter to reduce
the flioulder, by extending the arm  with one hand!*
and thruft ing in the head of the bone with the ©then
In making the extenfion, the arm ought always to ^e
& httle bent.
                      <^q                 £13* 
t  594  3
        DISLOCATION OF THE ELBOW.

  The bones of the fore-arm may be diflocated in
any direction.  When this is the cafe, a protuberance
may be obferved on that fide of the arm towards which
the bone is puflied, from which, and the patient's in-
ability  to bend his arm, a diflocation of this joint may
eafily be known.
  Two afliftants are generally neceffary for reducing
a diflocation of the elbow ; one of them muft lay hold
of the  arm above, and the other below the joint, ;»nd
make a pretty ftrong extenfion, while the operator re-
turns the bones into their proper place.   Afterwards
the arm muft be bent, and fufpended for fome tune
with a fling about the neck.
   Luxations of the wrift and fingers are to be removed
in the fame manner as  thofe of  the elbow, viz. by
making an extenfion in different directions, and thruft-
ing the head of the bone into its place.

         DISLOCATION OF THE THIGH.

   When the thigh-bone is  diflocated  forward  and
downward, the knee and foot are turned out, and the
leg is longer than the other ; but when it is difplaced
backward, it is ufually pufhed  upward at the fame
time, by which means the  limb is fliortened, and the
foot is turned inwards.
   When the thigh-bone  is difplaced  forward  and
downward, the patient, in order to have  it reduced,
muft be  laid upon his back,  and  made faft  by ban-
dages, or held by afliftants, while by others an exten-
fion is made by means of flings fixed about the bottom
of the thigh a little above  the knee.  While the ex-
tenfion is made, the operator muft pufli the head of
the bone outward, till it gets into the focket.  If the
                                       diflocation 
             OF BROKEN BONES, kc.         59$
diflocation be outward, the patient muft be laid u^on
hi-face, and, during the extenfion, the head of the
bone mull he pufhed inward.
   Diflocations  of  the  knees, ankles,  and  toes,  are
reduced much  in  the fame manner as  thofe of the
upper extremities,  viz.  by making  an  extenfion in
oppofite directions, while the operator replaces the
bones.   In many cafes, however, the extenfion alone
is  fufficient,  and  the bone will flip into its place
merely  by pulling the  limb with fufficient force.  It
is  not  hereby  meant,  that force alone is fufficient
ft.r the  reduction  of diflocations.   Skill and addrefs
will often fucceed  better than force.  I have known
a diflocation of the thigh reduced by one man, after
all the force that could be  ufed by fix had proved
ineffectual.
   CHAP.  LIII.

Of Broken  Bones,  Ss»V.
           1 HERE  is,  in  riloft country villages,
fome  perfon  who  pretends to the art  of  reducing
fractures.   Though in general fuch perfons are very
ignorant, yet fome of them are very fuccefsful; which
evidently proves, that a fmall degree of learning, with
a fufficient  (hare of common fenfe and a mechanical
head, will enable a man to be ufeful in this way.  We
would, however, advife  people never to  employ fuch
operators, when an expert and fkilful furgeon can  be
had,  but when that is  impracticable, they muft  be
employed :  we fhail therefore recommend the follow-
ing hints to their confideration :
                     (^qi                When 
5$ 6         OF BROKEN BONES, Stc.
   When a large bone  is broken,  the  patient's  diet
ought in all refpects to be the fame as  in an  inflam-
matory  fever.   He  fliould  likewife be kept quiet
and cod, and his body open  by emollient clyfters '7
or, if thefe cannot be  conveniently adminiftered, by
food that is of an opening quality ; as flewed prunes*
apples  boiled in milk, boiled fpinage, and the like.
It ought however to be here remarked, that perfons
who have been accuftomed  to live high,  are not all
of a fudden to be reduced ta a very low diet.   This
might have fatal effects.   There is often a neceffity
for indulging even  fuch habits,  in fome meafure*,
where  the# nature of the difeafe  might require a dif-
ferent treatment.
   It will generally be  neceffary  to bleed the  patient
immediately after a fracture, efpecially if he be young,
of a full habit, or has  at the fame time received any
bruife or contufion.  This operation fhould not oniy
be performed foon after the accident happens, but
if the patient be very feverifli,  it may bo. repeated
next day.  When feveral of the ribs are broken, bleed-
ing is peculiarly neceffary.
   If any of the large bones which fupport the body
are broken, the patient  muft  keep his bed for feve-
ral weeks.  It  is by  no means  neceffary, however,
that he fhould  lie all that time,, as  is cuftomary,
upon his back.  This  fituation finks the fpirits, galls
and frets  the patient's fkin,  and renders him very un-
eafy. After the fecond week he may be gently raifed
up, and may fit feveral hours,  fupported by a bed-
chair,  or the like, which will greatly relieve him.
Great care, however, muft be taken in railing him up,.
and laying him down,  that he make no exertions him-
felf, otherwife.the action of  the mufcles may pull the
bone out  of its place*.

   * Various  pieces of machinery have been contrived for
counteracting the force, of :h: mulch3, and rc'.a'r.'ng the frag.- 
              OF  BROKEN  BONES, &c.          597
   It is of great importance to keep the patient  dry
and  clean  while  in this fituation.   Jfy neglecting
this, he is  often  fo galled and excoriated, that he is
forced to keep fhifting places for eafe.   I have known
a fractured thigh-bone, after it had been kept ftraight
for  above a fortnight, difplaced  by this means, and
continue bent for life, in fpite of all that could be
done.
   It has been cuftomary when a  bone was broken,
to  keep the  limb for five  or fix  weeks continually
upon the  ftretch.  But  this is a bad pofture.  It is
both uneafy to the patient,  and unfavourable to  the
cure.   The beft  fituation is to keep the limb a little
bent.   This  is the pofture  into which every animal
puts its limbs when it goes  to  reft, and in  which
feweft  mufcles  are upon the ftretch.   It  is eafily
effected, by either laying the  patient upon  his. fide,
or  making the bed fo as to favour this pofition of
the  limb.
   Bone-fetters ought  carefully to examine  whether
the  bone be  not fhattered or broken into feveral
pieces.   In this cafe it may  fometimes be neceffary
to have the limb  immediately taken off,  otherwife a
gangrene or  mortification may enfue.   But  it is un-
neceffary to give further directions on this head, as
foch an operation will never be attempted without die
advice of a Jkilfol furgeon,

ments of broken bones ; but as defcriptions of thefe without
drawings would be of little ufe,  I  fhail refer the reader to a
cheap and ufeful performance on the  nature and cure of fraflures,
lately published by my -ingenious lnend Mr Aitkin,furgeon in
Edinburgh ; wherein that gentleman has not oniy given an ac-
count of the  machines recommended in fra,£*iures by former
suthors, but has likewife added feveral  improvements of his
own, which are peculiarly ufeful in compound fraclmes, and in
.cafes where patients with broken bones are obliged to be tranf-
j>o:ted i'viin one place to another.
Q q 3                 When 
 598         OF BROKEN BONES, &,-.
   When a fracture is accompanied with a wound, it
 muft be dreffed in all refpects as a common wound.
   All that art can do towards the cure of a broken
 bone, is to lay it perfectly ftraight,  and to keep it
 quite eafy.  All tight bandages do hurt.   They had
 much better be wanting altogether.   A  great many
 of the bad confequences which fucceed to fractured
 bones are  owin<? to tight bandages.  This  is one of
 the ways in which the  excefs of art, or rather the
 abufe of it,  does more  mifchief than would be occa-
 fioned by  the want of it.  Some of the moft fudden
 cures of broken bones which were ever known, hap-
 pened where no bandages were applied at all.  Some
 method however muft be taken to keep the member
 fteady; but this may  be done many ways without
 bracing it  with a tight bandage.
   The beft method of retention is by two or more
 fplints made of leather or ftrong pafteboard.  Thefe,
 if moiftened before they be applied, foon affume the
 fhape of the included member, and are fufficient by
 the affiftance of a very flight bandage, for all the
 ourgofes of retention.  The bandage which we would
 recommend is that made with feveral diftinct pieces
 cf broad tape or ferret.   It is much eafier applied and
 taken off  than rollers,  and anfwers all the purpofes
 of retention equally well.  The fplints fhould always
 be as long as the limb,  with  holes cut for the ankles
 when the  fracture is in the leg.
   In fractures of the ribs, where a bandage cannot
 be properly ufed, an adhefive plafter may be applied
 over the part.  The patient in this cafe ought to keep
 himfelf quite eafy, avoiding every thing that may oc-
 cafion freezing, laughing, coughing, or the like.  He
 ought to keep his body in a ftraight pofture, and fhould
take care that his ftomach be  conftantly  diftended,
by taking  frequently fome light food, and drink free-
ly of weak watery liquors.
                                            The 
               O F  S T R A I N S.            599
   The  moft proper  external application for a frac-
ture is oxytrate, or a mixture of vinegar and water.
The bandages fhould be wet with this at every dref-
fing.

               OF  STRAINS.

   Strains are often attended with worfe confequences
than broken bones.  The reafon is obvious; they
aTe generally neglected.   When  a  bone is  broken,
the patient  is obliged to keep the member eafy, be-
caufe he cannot make ufe of it;  but when a joint is
only ftrained, the perfon, finding he can ftill make a
ihift to move it, is forry  to lofe his time for fo trifling
an ailment.  In  this way he  deceives himfelf, and
converts into an incurable malady, what might have
been  removed  by only  keeping the part eafy for a
few days.
   Country  people generally immerfe a ftrained limb
in cold  water.   This is  very proper, provided it be
done immediately, and not kept in too long.
   Wrapping a garter, or fome other bandage, pretty
tight about the ftrained part,  is likewife of  ufe.   It
helps to reftore the proper tone of  the veffels, and
prevents the action of the parts from increafing the
difeafe.  It fliould not, however, be applied too tight.
1 have frequently known bleeding near the  affected
part have a very good effect: but what we would
recommend above all is  eafe.   It is more to be  de-
pended upon than any medicine, and feldom fails to
remove the complaint.   The parts affected generally
remain  weak after diflocations, fractures, and ftrains.
There is no  application  equal to cold water, poured
once  or twice a-day on  the part from a tea-pot, and
afterwards rubbing fmartly with flannel or the flefli-
brufh*.

   * A great many external applications are recommended for
ft-rains, fome of which do good, and others hurt. The follow-
ing are fuch as may b: ufed with the greateft fafety, viz. poul-
                       O^q 4.                  tices 
[  6q0  3
                 OF  RUPTURES.

   Children and old  people are moft  liable to rup-
tures.  In the former,  it is generally occafioned by
exceffive. crying,  coughing, vomiting, or  the like.
In the latter, it is commonly  the effect of blows or
violent exertions of the ftrength, as leaping, carrying
great weights, Sec.  In both, a relaxed habit, indo-
lence, and very moift.  $et, difpofe  the body to this,
difeafe,
   A rupture fometimes  proves fatal before it is dif-
covered.   Whenever ficknefs, vomiting,  and obfti-
nate coftiveneis..  give reafon to fufpect an obftruction
of the bowels ail thofe places  where ruptures ufually
happen ought  carefully to be examined.    The pro-
■tru.fion of a very (mall part of the  gut will occafion
all  thefe fympotms; and, if not reduced in due time,
may prove mortal.
   On the firft appearance  of  a rupture in an infant,
it ought to be lajd upon its back, with its head very
low.  While  in  this  pofture, if  the gut does not
return  of itfelf, it may eafily be  put up  by gentle
preffure.   After  it is  returned, a piece of fticking-
plafter may be applied over the part, and a proper trufs
or bandage muff be conftantly worn for g, confiderable
time.   The method  of making and applying thefe
rupture-bandages for children is pretty well known.
The child muft, as far as poflihle, be kept  from  cry%
ing,. and from all  violent exertions, till the rupture is
quite healed*.

tices made of ffale beer or vinegar  and oat-meal, camphorated
fpit its r.f wine, Mindererus's fpirit, volatile liniment, volatile
aromatic fpirir, diluted with a double quantity of  water, and
fhe common fomentation, with the addition of brandy r-i fpirit
of vv i ne.
  *  The cold bath,  ufed daily, and for  a confiderable time,
U a capfaj remedy foi this complaint in children.
                                                 IP 
OF RUPTURES.
601
  In adults, when the gut has  been forced down
with grc.it violence,  or  happens from any  caufe to
be  inflamed, there is often  great difficulty  in re-
turning it,  and fometimes the thing is quite imprac-
ticable without an operation ;  a defcription of which
is foreign  to our  purpofe.  As I  have been fortunate
enough, however, always to fucceed  in my  attempts
to return  the  gut, without  having recourfe to any
other means than what are in the power  of every
man,  I fliall briefly mention the method which I ge-
nerally purfue.
   After  the patient ha? been bled, he muft be laid
upon  his back,  with his head  very low,  and his
breech raifed  high with pillows.  In  this  fituation
flannel-cloths wrung out of a decoction  of  mallows
and camomile-flowers, or, if thefe are not  at hand,
of warm water,  muft be applied  for  a  confiderable
time.   A  clyfter made  of this  decoction,   with a
table fpoonful of butter and an ounce or two of fait,
may be afterwards thrown up.   If thefe fliould not
prove  fuccefsful,  recourfe muft  be  had to  preffure.
If  the tumor he  very hard, this muft be continued
for a confiderable time,  for it is not force which fuc-
ceeds here.  The operator, at  the  fame time that
fie makes a preffure with the palms of his hand, muft
with  his  fingers artfully conduct the gut in by the
fame aperture through which it came out. The man-
ner of doing this can be much eafier conceived than
defcribed.   Should thefe  endeavours prove ineffec-
tual,  clyfters of the fmoke of tobacco may be tried.
Thefe have been often known to  fucceed where every
other  method failed.
   There  is reafon  to  believe that,  by perfifting in
the ufe of thefe, and fuch other means as the cir-
cumftances of the cafe  may  fuggeft, moft hernias
might be  reduced without an operation.   Cutting
for the hernia is ?. nire and difficult matter.   I would
                         ,               therefore 
 6c*              OF RUPTURES.
 therefore  advife furgeons  to try every  method of
 returning  the gut before they have  recourfe  to the
 knife.  I have once  and again fucceed by perfever-
 ing in my endeavours,  after  eminent  furgeons had
 declared the reduction of the  gut impracticable with-
 out an operation*.
   An adult, after  the gut has been returned, muft
 wear a fteel bandage.  It is needlefs  to defcribe this,
 as it may always be had ready-made from the  artifts.
 Such bandages  are generally uneafy to  the  wearer
 for fome time,  but  by  cuftom  they  become quite
 eafy-   No perfon  who has had  a rupture  after  he
 arrived at man's eftate  fliould ever be  without one
 of thefe bandages.
   Perfons who  have  a  rupture  ought carefully  to
 avoid all violent  exercife,  carrying great weights
 leaping,  running, and the like.   They fhould like-
 wife  avoid windy aliment and ftrong liquors; and
 Ihould carefully guard agaimt catching cold.


  * I would here  beg leave to recommend it to every prac-
 titioner, when his patient complains of pain in the belly with
 obllin.ite coftivenefs, to  examine the  groins and every place
vrhvre a* rupture may happen,  m order that ii may be immedi-
ately reduced.  By neglecting this, many perifk who were not
£»fpet>ed to have had ruptures till alter they  were dead.  I
have known  this happen where half  a dozen of the  faculty
 were in attendance.
CHAP. 
C  *>3   3
                CHAP  LIV.

                  Of Cafualties.


         IT is  certain that life,  when to all ap-
pearance loft,  may often,  by due care,  be reftored.
Accidents frequently  prove fatal,  merely becaufe
proper means are not ufed  to counteract their effects.
No perfon ought to be  looked upon as killed by
any accident, unlefs where the ftructureof the heart,
brain,  or fome organ  neceffary to life,  is evidently
deftroyed.   The action of thefe organs  may be fo
far impaired as even to be for fome  time impercep-
tible, when  life is by no means  gone.  In this cafe,
however,  if the fluids be  fuffered  to grow cold,  it
may be impoffible to  put them  again  in motion,
even though the folids fhould  recover  their power
of acting.   Thus,  when the motion of the lungs has
been  ftopt  by  unwholefome  vapour,   the  action
of the  heart by a ftroke on the  breaft, or the func-
tions  of the brain by a blow on  the head, if the
perfon be fuffered  to grow cold, he  will in all pro-
bability continue fo;   but,  if  the  body be kept
warm, as foon as the  injured part has recovered its
power of acting, the fluids will again begin to move,
and all the vital functions will be reftored.
   It is a horrid cuftom immediately to confign over
to death every perfon who has the  misfortune, by a
fall, a blow, or the like,  to be deprived of the ap-
pearance of life.  The unhappy perfon, inftead of
being carried into a warm houfe, and  laid by the fire,
or put to a warm bed, is generally hurried away to
fome damp  houfe, where,  after a  fruidefs attempt
has  been made  to bleed him,  perhaps by  one who
                                            knew 
8of    SUBSTANCES STOPT BETWEEN
Jcaew nothing of the matter, he is given over for
 'dead, and no further notice  taken  of him.   This
 conduct feems  to be the refult  of ignorance, fup-
 ported by an ancient fuperftitious notion, which for-
 bids the body of any perfon killed by accident to be
 laid in an houfe that is inhabited.  What the ground
 of this fuperftition may be, we fhail not pretend to
 inquire; but furely  the conduct  founded upon it is
 contrary to all the principles of reafon,  humanity,
 and common fenfe.
   When a perfon feems to be fuddenly deprived  of
 life,,  our firft bufmefs is  to  inquire  into  the  caufe.
 We  ought carefully to obferve whether  any fub-
 ftance be lodged  in the wind-pipe or gullet; and, if
 diat is the cafe, attempts muft be made to remove it.
 When unwholefome  air  is  the  caufe, the patient
 ought immediately *o be removod out of it.  When
 the caufe cannot  be fuddenly removed,  our  great
 aim muft be to keep up the vital  warmth by rubbing
 die patient with hot cloths,  or fait,  and covering his
 body with warm fand, afhes, or the like.
   I  fliould now proceed to treat  more fully of thofe
 accidents, which without immediate affiftance, would
 often  prove fatal, and to point  out the moft likely
 means for relieving the unhappy fufferers; but as I
 have been happily  anticipated  in this part  of my
 fubject  by the learned and  humane  Dr Tiffot, I
 feall  content myfelf with felecting fuch of his  obfer-
 vations  as feem to  be the moft important, and add-
 ing  fuch of my own as have  occurred in the courfe
 of practice.

    OF  SUBSTANCES STOPT BETWEEN THE
            MOUTH ANJ3 STOMACH.

   Though accidents of this  kind are very  common,
 and extremely dangerous, yet they are generally the
                                            effect 
         THE MOUTH AND STOMACH.       605
effect of carekffnefs.   Children fliould be taught to
chew their food well, and to  put  nothing into their
mouths which it  would be  dangerous for  them to
fwallow.   But children ire  not  the only  perfons
guilty of  this piece of imprudence.   I  know  many
adults who put pins,  nails, and other fharp-pointed
fubftances in their mouths upon every occafion, and
fome who even fleep with the former  there all  night.
This  conduct is  exceedingly injudicious, as a fit of
coughing, or twenty other accidents, may force over
the fubftance before the perfon is  aware*.
   When  any fubftance is  detained  in the gullet,
there are two Ways of removing  it, viz. either by
extracting it, or  pufliing  it  down.   The fafeft and
moft  certain way is  to extract it;  but this  is .hot
always  the eafieft; it  may  therefore be more eli-
gible fometimes  to thruft it  down, efpecially  when
the obftructing body  is of fuch a nature, that  there
is no  danger from its reception  into the  ftomach.
The fubftances which may be puflied down without
danger are,  all common nourifhing  ones, as breads
flefli, fruits, and the like.   All  indigeftible bodies,
as cork, Wood,  bones, pieces of metal, and  fuch
like, ought  if poffible to  be extracted, efpecially if
thefe bodies be fharp pointed, as pins, needles, Sili-
bones,  bits of glafs, Sec.
   When  fuch  fubftances have  not  faffed  in to*
deep,  we  fhould  endeavour to extract them  with
our fingers, which method often  fucceeds.   When
they are lower, we muft make ufe of nippers, or .a
fmall pair  of forceps, fuch as  furgeons ufe.  But
this  attempt to extract rarely fucceeds, if the fub-
 ftance bt of a flexible nature, and has defcefcded far
 into the gullet.
   * A woman in one of  the  hofpitals of this city lately dif-
 charged a great number of pins,  which fhe had fwallowed m
the courfe of her bufmefs, tl;:ru>?h an ukc:r ia her  fide.
                                                $2 
 6oi>     SUBSTANCES STOPT BETWEEN
    If the fingers and nippeis fail, or  cannot be duly
 applied, crotchets, a  kind  of hooks, muft be em-
 ployed.  Thefe may be made  at once,  by bending
 a piece of pretty ftrong iron wire at one end.   It
 muft be introduced in the flat way ;  and for the
 better  conducting it, there fliould likewife be a curve
 or bending at  the  end it  is  held by, to  ferve as a
 kind of handle  to it ; which has this  further ufe,
 that it  may be fecured  by a  firing  tied to it,  a cir-
 cumftance not to be omitted in any  inftrument em-
 ployed on  fuch  occafions,  to avoid fuch ill  acci-
 dents as have  fometimes  enfued from thefe inftru-
 ments  flipping out of the operator's  hand.   After
 the crotchet has paffed below the fubftance that ob-
 ftructs the paffage,  it is drawn up  again, and  hooks
 up the  body along with it.  The crotchet is alfo
 very convenient, when a fubftance fomewhat flexible,
 as a pin or fifh-bone,  fticks  acrofs the  gullet, the
 hook,  in fuch cafes, feizing them about their middle
 part, crooks and thus difengages them ;  or, if they
 are very brittle fubftances, ferves to break them.
   When the obftrucling bodies are fmall,  and only
 ftop up a part of the paffage,  and which  may either
 eafily elude  the hook, or ftraighten  it by their refift-
 ance, a kind of rings,  made either of wire, wool,
 or filk,  may be ufed.   A  piece of fine wire  of  a
 proper  length may  be  bent into a circle, about the
 middle, of  about an inch diameter, and the long
 unbent fides brought parallel,  and  near each otlier :
 thefe are to be held in the hand,  and the circular
part or ring introduced into the gullet, in  order to
be  conducted  about the obftructing  body, and fo
 to extract it.  More flexible rings may be  made of
 wool,  thread,  filk, or  fmall  pack-thread, which
may be  waxed for their greater ftrength and confift-
ence.   One of thefe is to  be tied  faff, to a handle
of iron  wire,  whale-bone,  or any  kind  of flexible
                                          wood, 
         THE MOUTH AND STOMACH.      607
wood, and by  this means  introduced,  in order to
furround  the obftructing fubftance, and to draw it
out.  Several  of  thefe rings  paffed  through  one
another may be ufed,  the more certainly to lay hold
of the obftructing body,  which  may be involved
by  one,   if another  fhould mifs  it.   Thefe rings
have  one advantage,  which is,  that when the  fub-
ftance to be extracted  is once laid hold of, it may
then, by turning the handle, be retained fo ftrongly
in  the ring thus  twifted,  as  to be  moved  every
way, which muft  in   many cafes  be a confiderable
advantage.
   Another material employed on thefe unhappy oc-
cafions is the fponge.   Its property of fwelling con-
fiderably on being wet is  the principal foundation
of its ufefulnefs here.  If any fubftance is ftopt la
the gullet, but without filling up the whole paflage,
a bit of fponge may be introduced into  that part
which is unftopt,  and beyond the fubftance.  The
fponge  foon dilates,  and grows larger in  this moifl
fituation ;  and indeed the enlargement of it may be
forwarded by  making  the  patient fwallow a  few
drops of water.   Afterwards it is to be drawn back
by  the handle  to which it is  faftened;  and as  k is
now too large to return through the fmall  cavity by
which it was conveyed in, it draws out the obftruct-
ing body along with it.
   The compreffibility of fponge is another founda-
tion of its  ufefulnefs  in fuch cafes.  A pretty large
piece  of  fponge  may be  compreffed or fqueezei
into a fmall fize, by winding a firing of tape clofely
about it, which may  be eafily  unwound, and with-
drawn,  after  the fponge  has been introduced.  A
bit of fponge may likewife be compreffed by  a piece
of whale-bone fpiit at one end ; but this can  hardly
be introduced in  fuch a manner  as not to hurt the
patient.
I hare 
6o3     SUBSTANCES STOPT BETWEEN
   I have  often known pins  and other fharp bodies,
which had fluckin the throat,  brought  up by cauf-
ing the perfon to fwallow a bit of tough meat tied td
a thread,  and drawing it quickly up again.  This is
fafer than  fwallowing fponge, and will often anfwer
the purpofe equally well.
   When all thefe methods prove unfuccefsful, there
remains one more, which  is, to make the patient
vomit: but  this can fearcely be of any fervice,  un-
lefs when  fuch obftructing bodies are fimply engaged
in, and not hooked or ftuck  into the fides of the
gullet,  as in this cafe vomiting  might fometimes
occafion further  mifchief.   If the patient  can fwal-
low, vortiiting may be excited by  taking  half  a
drachm or two fcruples of ipecacuanha in  powder
made into a draught.   If he is not able to fwallow,
an attempt  may  be  made to  excite vomiting, by
tickling his throat with a feather ; and,  if  that
fliould not fucceed, a  clyfter of tobacco may be  ad-
miniftered.  It is  made by  boiling  an ounce of to-
bacco in a fuflicient quantity of water :  this has of-
ten been found to fucceed, when other attempts to
excite vomiting had failed.
   When the obftructing body is of fuch a nature that
it may with  fafety  be  pufhed downwards, this may
be attempted by means of a fmall wax-candle  oiled,
and a little heated, fo as to make  it flexible;  or a
piece of whale-bone, wire,  or flexible wood, with a
fponge faft ened to one end.
  Should  it be impoffible to extract even thofe bodies
which it is dangerous to admit into  the ftomach, we
muft then  prefer the leaft  of two  evils, and rather
run the hazard of pufliing them down than fuffer the
patient to perifh in  a few minutes ; and we ought to
fcruple this refolution  the lefs,  as a great many  in-
ftances have happened,  where the fwallowing of fuch
hurtful and indigeftible fubftances has been followed
by no diforder.
                   x                  Whenever 
         THE MOUTH AND STOMACH.      609
  Whenever it  is manifeft  that all  endeavours ei-
ther to extract  or pufh  down  the  fubftance muft
prove ineffectual, they  fhould be difcontinued ; be-
caufe the inflammation  occafioned  by perfifting in
them  might be  as  dangerous as  the obftruction
itfelf.  Some have died in  confequence  of the in-
flammation,  even after the body which  caufed the
obftruction had been entirely removed.
  While the means recommended above are making
ufe of, the patient  fliould often fwallow, or, if he
cannot, he  fliould frequently receive by  injection
through   a  crooked tube or pipe that may reach
down to  the gullet, fome emollient liquor,  as warm
milk and water,  barley-water,  or   a  decoction of
mallows.  Injections of this kind not  only foft en and
foothe the irritated parts, but, when  thrown in with
force, are often  more fuccefsful in  loofening the ob-
ftruction  than all attempts with inftruments.
   When, after all our endeavours, we are obliged
to  leave  the  obftructing  body in  the part, the pa-
tient muft be  treated  as  if he had an inflammatory
difeafe.   He fliould be  bled, kept upon a  low diet,
and have his  whole neck furrounded with  emollient
poultices.  The like treatment muft  alfo be ufed, if
there be any occafion to expect an inflammation of
the  paffages,  though  the  obftructing body be  re-
moved.
   A proper degree of  agitation has fometimes  loof-
ened the  inhering body more effectually than inftru-
ments.   Thus, a blow  on the back has often forced
up a fubftance which fluck in the gullet; but this is
ftill more proper and efficacious when the  fubftance
gets into  the Wind-pipe.   In this cafe, vomiting and
freezing  are likewife  to  be excited.   Pins, which
fluck in the gullet, have been frequently difcharged
by riding on horfeback, or in a carriage.
R  r
When 
6xo         OF DROWNED PERSONS.
   When any indigeftible fubftance  has been forced
down into the ftomach, the patient fliould ufe a very
mild and fmooth diet, confifting chiefly of fruits and
farinaceous  fubftances,  as  puddings,  pottage, and
foups.   He  fliould avoid all heating and  irritating
things, as wine, punch, pepper, and fuch like; and.
his drink fhould be milk and water,  barley-water,
or whey.
   When the gullet  is  fo ftrongly  and fully clofed,
'hat the patient can  receive no food by the mouth,
he muft be nouriflied by clyfters  of foup, jelly, and
the like.
   When  the patient is in danger of being imme-
diately fuffocated, and all hope of freeing the paffage
is vaniflied,  fo that death feems at  hand,  if refpira:
tion be  not  reftored; the  operation of bronchotomy,
or opening  of  the  wind-pipe, muft be directly per-
formed.   As this operation is neither difficult  to  an
expert furgeon, nor  very painful to the patient, and
is often the  only method which can be taken to pre-
ferve life in  thefe emergencies, we thought proper to
mention  it,  though  it fhould only be  attempted  by
perfons fkilled  in forgery.

            OF DROWNED PERSONS.

   When a perfon has remained above a quarter of
an hour under  water, there can be no confiderable
hopes of his recovery.   But as feveral  circumftances
may happen to have continued life, in fuch an unfor-
tunate  fituation,  beyond   the  ordinary term, we
fliould never too foon refign the unhappy  object  to
his fate, but try every method for his relief, as there
are many well  attefted  proofs  of the recovery  of
perfons to life and health, who had been taken out
of the water apparently dead, and  who remained a
confiderable time without exhibiting any figns of life.
                                             The 
            OF DROWNED PERSONS.         6li
  The firft thing to be done, after the body is taken
out of the water, is to convey it as foon as poffible
to fome convenient place, where the neceffary ope-
rations for. its recovery may be performed.  In do-
ing  this, care muft  be taken not to bruife or injure
the  body by  carrying  k in any unnatural pofture,
with the head downwards, or the like.  If an adult
body, it ought  to  be laid on  a bed, or  on ftraw,
with the head a little raifed, and carried  on a cart or
on men's flioulders, and kept in as natural and eafy
a pofition as poffible.   A fmall  body may  be  carried
in the arms.
  In  attempting  to  recover   perfons  apparently
drowned, the principal intention to  be  purfued  is,
to reftore  the natural warmth,  upon  which  all  the
vital  functions  depend ; and to excite thefe func-
tions by the  application of ftimulants,  not only  to
the fkin, but likewife to the lungs, inteftines, &c.
  Though cold was by no  means the caufe of the
perfon's death,  yet it will  prove an effectual  ob-
ftacle to his recovery.   For this reafon, after ftrip-
ping him  of his wet  clothes, his   body muft  be
ftrongly rubbed for a confiderable time  with coarfe
linen cloths,  as  warm  as  they  can  be  made ;  and,
as foon as  a well-heated  bed can be got ready,  he
may be laid into it, and the rubbing fliould be conti-
nued.  Warm   cloths ought   likewife  to  be fre-
quently applied to the ftomach  and bowels, and hot
bricks, or bottles of warm water, to  the foles  of
his  feet, and  to the palms of his hands.
  Strong  volatile fpirits  fhould be frequently ap-
plied  to the  nofe;  and die fpine of the  back and
pit  of the  ftomach  may  be  rubbed  with warm
brandy or fpirit  of wine.   The temples  ought  al-
fo  to be  chafed with  volatile  fpirits;  and' ftimu-
lating powders may be blown up the noftrils.
R r  z
To 
6iz         OF DROWNED PERSONS.
   To  renew the breathing,  the  lungs  may be in-
flated by  blowing through one of the  noftrils, and
at the  fame  time  keeping   the  other clofe.   Dr
Monro for this purpofe recommends a wooden  pipe,
fitted at one end for filling the noftril, and at  the
other for receiving the pipe of a pair  of bellows, to
be employed for the fame purpofe, if neceffary.
   When air cannot be  forced into the cheft by  the
mouth or nofe,  it may be neceffary  to  make an
opening into the  wind-pipe for this purpofe.  It is
needlefs,  however,  to  fpend  time in  defcribing this
operation, as it fhould not be attempted  unlefs by
perfons fkilled in forgery.
   While  thefe  things  are doing, fome of the at-
tendants ought to be  preparing  a warm bath, into
which the perfon fliould  be put, if the above  en-
deavours  prove  ineffectual.  Where  there are no-
conveniences  for  ufing the warm bath,  the  body
may be covered with warm fait, fand, aflies, grains,
or fvich like.   Tiffot mentions aia  inftance of a girl
who was reftored to life, after flie had been  taken
out  of the  water, fwelled, bloated,  and to all  ap-
pearance dead, by laying  her naked body upon  hot
afhes,  covering  her with  others equally  hot, put-
ting a bonnet round her head, and a flocking round
her  neck fluffed with the fame, and  heaping  co-
verings over all.  After flie had  remained  half an
hour in  this fituation,  her pulfe  returned, flie re-
covered fpeech, and cried  out, / freeze,  I freeze ;
a little cherry-brandy was given  her,  and  flie  re-
mained buried as it were under the afhes for eight
hours ;  afterwards flie  was taken out, without any
other complaint  except  that  of laffitude  or weari-
nefs, which went  off in a few days.   The Doctor
mentions likewife an inftance  of a man who was re-
ftored to life after he had remained fix hours under
water, by the heat of a  dunghill.
                                             Till 
            OF DROWNED PERSONS.         613
   Till the patient fliews feme figns of life, and is
able to fwallow, it would be ufelefs and even  dan-
gerous  to  pour liquors into his mouth.   His  lips
however, and  tongue may be frequently wet with a
feather dipt in warm brandy or other ftrong fpirits;
and, as foon as he has recovered the power of fwal-
lowing,  a  little warm  wine,  or  fome other cordial,
ought every now and then to be adminiftered.
   We are by  no means to difcontinue our  affiftance
as foon  as the patients  difcover  fome  tokens of
life, fince  they fometimes expire  after  thefe  firft
appearances of recovering.   The warm  and ftimu-
lating  applications  are ftill  to be  continued,  and
fmall  quantities of fome cordial liquor  ought  fre-
quently  to be adminiftered.   Laftly,  though  the
perfon fliould  be manifeftly re-animated, there fome-
times remain, an oppreffion,  a cough, and afeverifh-
uefs, which effectually conftitute a  difeafe.   In this
cafe it  will be  neceffary to bleed the patient in the
arm, and to caufe him to  drink plentifully of barley-
water, elder-flower-tea, or any other foft pectoral in-
fufions.                                         \
   Such  perfons as have the misfortune to be  de-
prived of the appearances of life, by a fall, a blow,
fuffocation, or the  like,  muft be treated nearly in
the fame manner  as thofe who have been for fome
time under water.    I once  attended  a patient  who
was fo flunned by a fall from a horfe, that for above
fix hours he fcarcely exhibited any figns of life.; yet
this man, by being bled, and proper methods taken
to keep up the vital warmth, recovered, and in a
few days was  perfectly well.   Dr  Alexander gives
an inftance to  the  fame purpofe, in the Edinburgh
Phyfical and Literary Effays, of a man who was to
all. appearance killed  by  a blow on the breaft, but
recovered upon being immerfed for  fome  time in
warm water.   Thefe,  and  other inftances of a fimi-
                   R r  3                      lar 
614         OF NOXIOUS VAPOURS.
lar nature,  which might be adduced, amount to a
full proof of this  fact, that many of thofe unhappy
perfons who lofe their lives by falls, blows, and other
accidents, might be faved by the ufe  ef proper means
duly perfifted in.

          OF  NOXIOUS VAPOURS.

  Air may be many ways rendered noxious, or even
deftructive  to  animals.    This may  either happen
from its vivifying principle being deftroyed, or from
fubtle exhalations  with  which it  is impregnated.
Thus air that has  paffed through burning fuel is
neither  capable of fupporting fire nor the life of ani-
mals.  Hence the danger of fleeping in clofe cham-
bers with charcoal fires.   Some indeed  fuppofe  the
danger here proceeds from the fulphureous oil con-
tained in the charcoal,  which  is  fet  at liberty and
diffufed all over the chamber ; while others imagine
it is owing to the air of the room being charged with
phlogifton.  Be this as it may, it is a fituation care-
fully to be avoided.   Indeed, it is dangerous to fleep
in a fmall  apartment, with a fire of any  kind.   I
lately faw  four perfons  who had been fuffocated by
fleeping in  an apartment where a fmall  fire of coal
had been left burning.
   The  vapour  which  exhales from wine,  cyder,
beer, or other liquors,  in  the ftate of fermentation,
contains fomething  poifonous, which kills in  the
fame manner as  the vapour of coal.  Hence  there
is always danger in going into cellars where a large
quantity of thefe  liquors  is in a ftate of fermenta-
tion, efpecially if they  have been clofe  fliut  up for
fome time.   There  have been many inftances of per-
fons ftruck dead  on entering fuch places, and  of
others who have with difficulty efcaped.
When 
            OF NOXIOUS  VAPOURS.         615
  When fubterraneous  caves, that have been very
long fliut,  are opened,  or when  deep  wells are
cleaned, which have  not been emptied for feveral
years,  the  vapours arifing  from them produce the
fame  effects  as  thofe mentioned  above.   For this
reafon, no perfon ought to  venture into a well, pit,
cellar,  or  any place  that  is damp,  and  has been
long fliut up,  till the air   has been fufficiently pu-
rified,  by burning  gunpowder in  it.  It  is eafy  to
know, as  has been obferved  in'  a former part  of
this work, when the air of fuch places is unwhole-
fome, by  letting down  a   lighted  candle,  throwing
in burning fuel,  or the like.   If  thefe continue  to
burn, people may fafely venture in  ; but where they
are fuddenly extinguiflied, no one ought to enter till
the air has been firft purified by fire.
   The offeafive fmell of lamps and of candles, efpe-
cially when their flames are  extinguiflied, operate
like other vapours, though with lefs violence, and
lefs fuddenly. / There have, however, been inftances
of people   killed  by the fumes of  lamps which had
been  extinguiflied  in a clofe  chamber, and perfons
of  weak delicate breafts generally  find  themfelves
quickly oppreffed  in apartments  illuminated with
 many candles.
   Such as are fenfible,of their danger in  thefe fitua-
 tions, and  retreat feafonably from   it, are  generally
 relieved as foon as  they get into the open air, or, if
 they have any remaining uneafinefs, a little water and
 vinegar, or lemonade,  drank hot, affords them re-
 lief.   But when  they are fo far poifoned, as to haye
 loft their  feeling and underftanding, the  following
 means muft be ufed for their recovery :
   The patient fhould be  expofed  to a  very pure,
 frefli, and open air ;  and volatile falts, or other fti-
 mulating  fubftances, held   to  his  nofe.   His legs
 ou"ht to  be put into warm water, and well rubbed.
             *        Rr4                    As 
G\6      EFFECTS OF EXTREME COLD.
As foon as he can fwallow, fome lemonade, or water
and vinegar, with the addition of a little nitre,  may
be given him.
  Nor are fharp clyfters by  any  means  to  be ne-
glected ;  thefe may be made,  by adding to  the
common clyfter, fyrup of buckthorn and tincture of
fenna,  of each two ounces ;  or, in their ftead, half
an ounce of Venice  turpentine diffolved in the  yolk
of an ejg.   Should thefe things not be at hand, two
or three large fpoonfuls of common fait may be  put
into  the  clyfter.    The fame  moans, if neceffary,
which were recommended in  the former part  of this
chapter,  may be ufed to reftore the circulation,
warmth,  &c.
  Dr Frewen, of Suffex, mentions the  cafe  of a
young man who  was ftupefied  by  the fmoke of fea-
coal but was recovered by being plunged  into cold
water, and afterwards laid in a warm  bed.
  The practice of plunging perfons  fuffocated by
noxious vapours  in  cold  water, would feem to be
fupported by the  common experiment of fuffocating
dogs in the grotto del cani, and  afterwards recover-
ing them, by throwing them into  the neighbouring
lake.

        EFFECTS OF EXTREME COLD.

  When cold  is  extremely fevere, and a perfon is
expofed to it  for a long time, it  proves  mortal, in
confequence of  its flopping  the  circulation  in the
extremities,  and forcing too great a  proportion of
blood  towards the  brain ; fo that the patient dies
of a kind of apoplexy,  preceded   by great  fleepi-
nefs.   The  traveller, in this  fituation,  who  finds
himfelf begin to  grow drowfy,  fliould redouble his
efforts to extricate himfelf from the  imminent  dan-
ger he is expofed to.  This"  fleep,  which he might
       v                                 confider 
         EFFECTS OF EXTREME COLD.      617
confider as fome alleviation of his fufferiiiTs, would,
if indulged, prove his laft.
  Such violent effects of cold are happily  not very
common  in  this  country ; it  frequently happens, /
however, that the hands  or feet of travellers  are fo
benumbed or frozen, as  to be  in danger of a mor-
tification,  if  proper  means are not ufed to prevent
it.  The chief danger in this  fituation arifes from
the fudden application of heat.  It is very  com-
mon, when the hands or feet are pinched with cold,
to hold them to the fire ;  yet reafon and obfervation
fliew  that  this is  a  moft dangerous and imprudent
practice.
  Every peafant knows, if frozen  meat,  fruits, or
roots  of any kind,  be brought near  the fire,  or put
into warm water, they will be deftroyed, by rotten-
nefs or a kind of mortification ; and that the only
way to recover them, is  to immerfe them for fome
time in very cold water.   The fame obfervation holds
with regard to animals in this condition.
  When the hands or  feet are greatly benumbed
with cold,  they ought either   to   be  immerfed in
cold water, or rubbed with fhow,  till they recover
their  natural warmth and fenfibility ;  after  which
the perfon may be .removed into   an  apartment a
little warmer, and may drink fome cups of tea, or an
infufion of elder-flowers, fweetened  with  honey.
Every perfon muft have  obferved,  when his  hands
were  even but  flightly affected with cold, that the
beft way to warm them was by wafhing them in cold
water, and continuing to  rub  them well  for feme
time.
  When a perfon has been fo  long expofed  to the
cold, that all  appearances  of life are gone,  it will
be neceffary to rub him all over with fhow or cold
water ; or,  what  will anfwer  better,  if  it  can be
obtained,  to  immerfe  him  in  a bath  of the vera 
 6x8      EFFECTS OF EXTREME HEAT.
 coldeft water.  There is the greateft encouragement
 to perfill in the ufe of thefe means, as we are affured
 that perfons who had  remained  in the fnow, or had
 been expofed to the freezing air during five or fix
 fucceffive days, and who had difcovered  no marks
 of life for feveral hours, have  neverthelefs been  re-
 vived.
   I have always thought,  that  the whitloes, kibes,
 chilblains, and other inflammations  of  the extremi-
 ties,  which are fo common among the peafants in
 the cold feafon, were chiefly occafioned  by their fud-
 den tranfitions from cold to heat.  After  they have
 been expofed to  an extreme degree of cold, they
 immediately apply their hands and feet to the  fire,
 or, if they have occafion, plunge  them into warm
 water, by which means, if a  mortification  does not
 happen, an inflammation feldom fails to enfue.  Moft
 of the ill confequences from this quarter  might be
 eafily  avoided, by  only obferving  the precautions
 mentioned  above.

        EFFECTS OF EXTREME HEAT.

   The effects of extreme heat, though not  fo com-
 mon  in this country, are  no lefs  fatal,  and much
 more fudden than  thofe of cold.  In  hot countries
 people frequently drop down dead in the ftreets, ex-
 haufted with heat  and fatigue.   In this cafe, if any
 warm cordial can be poured into the mouth, it ought
 to be done.   If this cannot  be effected,  they  may be
 thrown up in form of a clyfter.   Volatile fpirits, and
 other things of a ftimulating nature, may be applied
 to the fkin, which fliould be well rubbed with coarfe
cloths, or other ftimulating things.
CHAP, 
[  6i9  ]
                 CHAP.   LV.

  Of Fainting Fits, and other  Cafes which require
               immediate Affiftance.


          oTRONG  and  healthy  perfons, who
abound with blood,  are often feized with  fudden
fainting fits, after violent exercife,  drinking freely of
warm or ftrong liquors, expofure  to great heat, in-
tenfe application to ftudy, or the like.
  In fuch cafes the patient  fliould be made to fmell
to feme vinegar.   His temples, forehead, and wrifts
ought  at the fame time to be bathed with vinegar
mixed  with  an  equal quantity of warm water; and
two or three table-fpoonfuls of vinegar, with four or
five times as much water, may, if he can fwallow, be
poured into  his mouth.
  If the fainting proves  obftinate, or degenerates
into  a fyncope,  that  is, an abolition  of feeling and
underftanding,  the  patient muft be bled.   After
the bleeding, a clyfter will be proper, and then he
fhould be kept eafy and quiet, only giving him every
half hour a  cup or two of an infufion  of any mild
vegetable, with the  addition of a little fugar and vi-
negar.
  When fwoonings, which arife from  this  caufe,
occur  frequently  in the fame perfon,  he  fliould,  in
order to efcape them, confine  himfelf to a light diet,
confifting chiefly  of bread, fruits, and other vegeta-
bles.   His drink  ought to be  waterpr fmall liquors,
and he fhould fleep but moderately, and  take  much
exercife.
   But fainting fits proceed often \from a defect  of
blood.   Hence they are very ready to happen after
                                             great 
 $20  FAINTING FITS, &c. WHICH REQUIRE
 great evacuations of any kind, obftinate watching,
 Want of appetite, or fuch like.   In thefe an almoft
 directly oppofite courfe to that mentioned above muft
 be purfued, if a weak pulfe, palenefs and coldnefs
 attend.
   The patient fliould be laid in bed, with his  head
 low  and  being  covered,  fliould  have  his  legs,
 thighs, arms, and his whole  body rubbed ftrongly
 with  hot flannels.   Hungary  water,  volatile  falts,
 cr ftrong-fmelling herbs, as rue, mint, or rofemary,
 may  be held to his nofe.   His mouth may be wet
 with  a little  hartfliorn in water ; and, if he can fwal-
 low,  fome hot wine, mixed with fugar and cinnamon,
 which is an  excellent  cordial,  may be poured  into
 his mouth.   A comprefs of flannel, dipt in hot wine
 cr brandy, muft be applied to the pit of the ftomach,
 and warm bricks, or  bottles filled with hot water,
 laid to  the feet.
   As foon as  the patient is recovered a  little, he
 fliould take fome ftrong foup or  broth, or  a little
 bread or  bifcuit foaked  in  hot-fpiced  wine.  To
 prevent the return of the fits, he ought to take often,
 but in fmall quantities, fome light,  yet ftrengthening,
 nourifhment, as panada made  with foup inftead of
 water, new  laid  eggs lightly poached,  chocolate,
light  roaft meats, jellies, and  fuch  like.
   Thofe fainting fits, which are the effect of bleed-
 ing, or of the violent  operation of purges,  belong
 to this clafs.   Such as happen after artificial  bleed-
 ing are feldom dangerous, generally terminating as
foon as the patient is laid upon the bed ;  indeed,  per-
fons fubject to this kind fliould always be bled  lying,
in order to prevent it.  Should the fainting, however,
continue  longer than ufual,  volatile fpirits may  be
held to the nofe, and rubbed on the temples, &c.
   When fainting is  the effect of too ftrong or acrid
purges or vomits, the patient  muft  be treated in all
                                          refpects 
           IMMEDIATE ASSISTANCE.        6zi
refpects as if he  had taken poifon.   He fhould be
made  to drink plentifully of milk, warm  water and
oil, barley-water, or fuch like ; emollient clyfters will
likewife be proper, and  the patient's ftrength fliould
be recruited, by giving  him generous cordials, and
anodyne medicines.
  Faintings are  often  occafioned  by  indigeftion.
This may  either proceed from the quantity or qua-
lity of the food.  When the former  of thefe is the
caufe, the cure  will be beft performed by vomiting,
which may be  promoted by caufing the  patient  to
drink a weak   infufion of camomile-flowers, carduus
benediclus, or the  like.   When the diforder proceeds
from  the nature  of the food, the patient, as in the
cafe of weaknefs, muft  be  revived  by ftrong fmells,
&c. after which  he fliould be made to fwallow  a
large  quantity of  light warm fluid, which may ferve
to drown, as it  were, the offending matter, to fofteu
its acrimony, and  either to effect a difcharge of it by
vomiting,  or force it down into the inteftines.
   Even difagreeable fmells will  fometimes  occafion
fwoonings,  efpecially  in  people  of weak  nerves..
When this  happens, the  patient  fliould be carried
into the  open  air,  have ftimulating  things held  to
his nofe,  and  thofe fubftances which are difagree-
able   to  him  ought  immediately to be  removed.
But  we  have already taken notice of fwoonings
which arife from nervous diforders, and  fliall there-
fore fay no more  upon that head.
   Fainting  fits  often  happen   m the  progrefs  of
difeafes.   In the beginning of putrid difeafes they
generally denote  an  oppreflion at ftomach, or a maft
of corrupted humors, and they  ceafe after evacua-
tions  either by vomit or  ftool.   When  they occur
at the beginning  of malignant fevers, they indicate
great danger.   In  each of thefe cafes, vinegar ufed
both  externally and internally is the beft  remedy du-
ring 
 622  FAINTING  FITS, Sec. WHICH REQUIRE
 ring the paroxyfm, and  plenty  of lemon-juice  and
 water after it.  Swoonings which happen in difeafes
 accompanied with great evacuations, muft be treated
 like  thofe which  are  owing  to  weaknefs, and  the
 evacuations  ought  to be reftrained.   When they
 happen  towards the end  of a violent fit of an inter-
 mitting fever, or at  that  of each  exacerbation  of a
 continual fever, the patient  muft  be  fupported  by
 fmalh draughts of wine and water*.
   Delicate and hyfteric  women  are very liable to
 fwooning  or  fainting fits  after  delivery.  Thefe
 might be often prevented  by  generous  cordials,  and
 the   admiffion  of frefii air.   When  they are occafi-
 oned by exceffive flooding, it ought by  all  means
 to be reftrained.   They are generally  the effect  of
 mere weaknefs or  exhauftion.   Dr Engleman  re-
 lates the cafe of a woman " in childbed, who, after
 " being  happily  delivered,  fuddenly  fainted, and
•" lay  upwards of a quarter ■  of  an hour apparently
 " dead.   A phyfician was fent for ; her own maid,
 " in the mean while, being out  of patience  at  his
 " delay, attempted to  affift her herfelf, and extend-
 " ing herfelf upon her miftrefs, applied her mouth
 " to her's, blew in as much breath as  flie poffibly
 " could, and in  a  very   fhort time the  exhaufted
 " woman awaked  as out of a  profound  fleep; when
 " proper  things being given her, flie foon  reco-
 " vered.
   " The maid  being afked how flie came to think
 "  of this expedient, faid  fhe  had feen  it practifed
" at  Altenburgh, by midwives, upon  children  with
"  the happieft effect."

  * It fometimes happens that this weaknefs occurs in  the
exacerbation of fevers from too much fullnefs and oppreffion.
In this cafe bleeding is the remedy.  The propriety of ufing
it may be known by the pulfe.
                                              We 
           IMMEDIATE  ASSISTANCE.        62J
  We  mention  this  cafe chiefly that other mid-
wives may be induced to  follow fo laudable  an ex-
ample.   Many children are  born without any figns
of life, and  others expire foon after the birth, who
might, without - all doubt, by proper  care, be re-
ftored to life.
   From  whatever caufe fainting fits proceed, frefii
air is always of the greateft importance to the pa-
tient.  By  not attending to  this  circumftance, peo-
ple  often kill  their friends  while they are endea-
vouring  to  fave  them.   Alarmed at  the  patient's
fituation, they call in  a  crowd of people  to  his af-
fiftance,  or  perhaps   to  witnefs   his  exit,  whofe
breathing exhaufts the air,  and  increafes the dan-
ger.  There is not the  leaft doubt  but this prac-
tice, which  is  very common among  the lower fort
of people, often  proves  fatal, efpecially to  the deli-
cate, and fuch  perfons   as  fall   into  fainting fits
from mere exhauftion,  or  the violence  of fome dif-
eafe.   No more  perfons  ought ever to be admitted
into the  room where a patient lies  in a fwoon than
are abfolutely  neceffary  for  his  affiftance,  and the
windows of the apartment fliould always be opened,
at leaft as far as to admit  a ftream of frefii air.
   Perfons fubject to  frequent fwoonings, or faint-
ing  fits, fliould  neglect  no  means to remove the
caufe of them, as  their  confequences  are  always
injurious  to  the conftitution.  Every fainting fit
leaves the perfon in  dejection and weaknefs ; the
fecretions are thereby fufpended,  the  humors dif-
pofed  to ftagnation,  coagulations and obftructions
are formed, and,  if the  motion of the blood  be to-
tally intercepted,  or very confiderably  checked, po-
lypufes are fometimes formed in the heart or  larger
veffels.   The   only  kind of  fwoonings  not  to be
dreaded  are thofe which  fometimes marl: the crilis
            4                                  m 
 624            OF INTOXICATION.
 in fevers; yet even thefe ought, as foon as poffible,
 to be removed.

               OF INTOXICATION.

   The effects of intoxication  are  often fatal.  No
kind  of  poifon  kills more certainly than art over-
dofe  of ardent fpirits.  Sometimes,  by deftroying the
nervous energy, they put an end to life at once ; .but
in general their effects are more flow, and in many
refpects  fimilar  to  thofe of opium.   Other kinds
of intoxicating liquors may prove fatal when taken
to excefs, as  well as ardent fpirits; but they may
generally be  difcharged  by vomiting,  which ought
always to be excited  when  the  ftomach is over-
charged with liquor.
  ■More of thofe unhappy perfons,  who die intoxi-
cated, lofe their lives from an inability to conduct
themfelves than from the deftructive quality of the
liquor.   Unable to walk,  they  tumble down, and
lie in fome awkward pofture,  which obftructs  the
circulation or breathing, and often  continue  in this
fituation  till they die.  No drunken perfon fhould be
left by himfelf,  till  his  clothes have been  loofened ^
and his body  laid in fuch a pofture  as  is moft  fa-
vourable for  continuing the vital motions, difcharging
the contents  of the  ftomach, &c.  The  beft  po-
fture for  difcharging the  contents   of  the ftomach,
is to lay the perfon  upon  his belly; when afleep he
may  be laid on his fide, with his head a little raifed,
and particular care muft be taken that  his neck  be
no way bent, twifted,  or have any thing  too tight
about it.
   The  exceffive degree  of  thirft  occafioned   by
drinking   ftrong liquors,  often  induces  people to
quench it by taking  what is hurtful.  I have known
                                            fatal
       i 
               OF INTOXICATION.,            6i$
fatal confequences  even  from  drinking  freely of
milk after a debauch of wine or four punch ;  thefe
acid liquors, together with the heat of the ftomachj
having coagulated the milk in fuch a  manner that it
could nerer be digefted.  The fafeft  drink  after a
debauch  is water  with  a foaft,  tea,  infufions of
balm,  fage,  barley-water, and   fuch like.   If  the
perfon wants to vomit, he may  drink a weak infu-
fion of camomile-flowers, or lukewarm  water and
oil; but  in  this condition vomiting  may  generally
be excited by only tickling the throat with the  fin-
ger or a  feather.
  Inftead of giving a detail of all the different fymp-
toms   of intoxication  which indicate  danger, and
propofing a general plan of treatment for perfons in
this fituation, I fliall  briefly relate the hiftory of a
cafe which lately  fell  under my  own  obfervation,
wherein  moft  of  thofe fymptoms ufually reckoned
dangerous occurred, and where the  treatment was
fuccefsful.
  A  young man, about  fifteen years of  age, had,
for a hire, drank ten glaffes of ftrong brandy.   He
foon after fell  faft afleep, and continued in that fitu-
ation for  near twelve hours, till at length his uneafy
manner of breathing, the coldnefs of the extremities,
and other threatening fymptoms alarmed his friends,
and made them fend for me.  I found him ftill fleep-
ing,  his  countenance ghaftly, and his ikin  covered
with a cold clammy fweat.   Almoft the  only figns
of life  remaining were, a  deep laborious breathing,
and a convulfive motion or agitation  of his  bowels.
  I tried to roufe  him, but  in  vain, by pinching,
fhaking,  applying volatile fpirits, and otlier ftimu-
lating things to his nofe, &c.  A few ounces of blood
were'  likewife   taken  from  his arm, and  a  mixture
of vinegar and water was poured into  his  mouth ;-
but, as "he could not fwallow, very little of this  got
                        $. f                   into- 
6z6    SUFFOCATION AND  STRANGLING.
into  the ftomach.   None of thefe things having the
leaft effect, and  the danger feeming to increafe, I
ordered his legs to  be  put  into warm water, and a
fharp clyfter to be immediately adminiftered.   This
gave him a ftool, and was the firft thing that relieved
him.  It  was  afterwards  repeated  with  the  fame
happy  effect, and feemed to be the chief caufe of his
recovery.  He then began to fhow fome figns of life,
took drink when it was offered him, and came gra-
dually  to  his  fenfes.  He  continued, however, for
feveral days weak and feverifh, and complained much
of a forenefs in his  bowels, which  gradually  went
off,  by means  of  a  flender diet,  and cool mucilagi-
nous liquors.
   This young man  would probably have been fuf-
fered  to  die, without  any affiftance being called,
had not a neighbour, a few days before,  who had
been advifed to drink a bottle of fpirits to  cure him
of  an  ague,   expired  under  very  fimilar circum-
ftances.

     OF  SUFFOCATION AND  STRANGLING.

   Thefe may fometimes proceed from an infraction
of the lungs,  produced by vifcid clammy humors,
or a fpafdomic  affection of the nerves of that organ.
Perfons who feed grofsly and abound in  rich  blood,
are  very  liable to fuffocating fits  from the former,
of thefe caufes.   Such  ought,  as foon as they are
attacked, to be bled, to receive an emollient clyfter,
and  to take frequently a cup of diluting  liquor with
a little nitre in it   They fhould likewife receive the
fteams of hot vinegar into their lungs by breathing.
   Nervous and afthmatic perfons  are moft fubject  to
fpafmodic affections of the lungs.   In this cafe the
patient's legs  fhould  be immerfed  in warm  water,
and the fteams of vinegar applied  as above.  Warm
                                          diluting 
      SUFFOCATION AND STRANGLING.     62?
diluting  liquors fhould likewife be drank ;  to a cup
of which a tea-fpoonful  of the  paregoric  elixir may
occafionally be  added.    Burnt paper, feathers, or
leather, may be held to the patient's nofe, and frefh
air fliould be freely admitted to him.
  Infants are often  fuffocated by  the careleffnefs or
inattention  of their  nurfes*.  An infant when in
bed fhould always be laid fo, that it cannot  tumble
down with its head under the bed-clothes; and when
in a cradle, its face ought  never to be covered.  A
fmall degree of attention to thefe two fimple  rules
would fave  the lives of many infants, and prevent
others from being rendered weak and fickly all  their
days by the injuries done to their lungs.
  Inftead of laying down a plan for the recovery of
infants  who are fuffocated, or   overpaid  as  it is
termed by  their nurfes, I fliall give the hiftory of a
cafe related by Monfieur fanin, of the Royal  Col-
lege of Surgery at  Paris,  as  it was  attended with
fuccefs, and contains almoft every  thing that can be
done on  fuch occafions.
  A nurfe having had the misfortune  to  over-lay a
child, he was called  in,  and found the infant with-
out any  figns of life; no pulfation in the  arteries,
no refpiration, the  face  livid, the eyes' open,  dull,
and  tarnifhed,  the  nofe full  of fnivel,  the mouth
gaping;  in fhort it  was almoft cold.   Whilft  fome
linen clothes and a  parcel  of afhes were warming,
he had the boy unfwathed, and laid  him in a warm
bed, and on  the right  fide.   He then was rubbed
all over with  fine linen,  for fear of fretting his ten-

  * Thefe accidents are not always the effe&s of careleffnefs.
I have known an infant over-laid by its mother being feized in
the night with an hyfteric fit.  This ought to fei ve as a caution
againft employing hyfbric womea as nurfes •, and fhould like-
wife teach  fuch women never to lay an infant in the fame btd
with themfelves, but in H fmall adjacent one.
                         S f %                 der 
6zt    SUFFOCATION AND STRANGLING.
der and delicate fkin.   As foon as the afhes had re-
ceived their due degree of heat, Mr Janin buried
him in them except the face, placed him on the fide
oppofite to that on which he  had been  at firft laid,
and covered him with a blanket.   He had  a  bottle
of eau de luce in his pocket, which he  prefented to
his nofe from  time to  time ; and  between  whiles
fome puffs of tobacco were blown up his noftrils : to
thefe  fucceeded the blowing into his  mouth,  and
fqueezing  tight his nofe.  Animal heat  began thus
to be excited gradually ;  the pulfations of the tem-
poral artery were foon felt,  the breathing became
more frequent  and free, and the eyes clofed  and
opened alternately.  At length the child fetched fome
cries  expreifive of his want of the  breaft,  which
being applied  to  his  mouth, he catched at it with
avidity, and fucked  as  if nothing had happened to
him.   Though the pulfations of the arteries were by
this  time  very well re-eftablifhed, and it  was hot
weather,  yet   Mr  Janin thought  it  advifable to
leave his  little patient  three  quarters  of  an  hour
longer under the  aflies.  He was afterwards  taken
out, cleaned and dreffed as ufual; to which a gentle
fleep fucceeded, and he continued perfectly well.
   Mr Janin  mentions   likewife  an  example  of a
young man who had hanged himfelf through defpairr
to whom he adminiftered help as effectually  as in the
preceding  cafe.
   Mr Glover,  furgeon in Doctors' Commons, Lon-
don, relates the cafe of  a perfon who  was reftored
to life after twenty-nine minutes hanging,  and  con-
tinued in good health for many years after.
   The principal means ufed  to  reftore  this man to
life were,  opening the temporal artery  and the  ex-
ternal jugular ; rubbing the back, mouth, and neck,
with a quantity of volatile fpirits and oil;  adminif-
tering the tobacco clyfter by  means of lighted pipes,
                                             and 
           PERSONS WHO EXPIRE, &c.       629
and  ftrong frictions  of the  legs and  arms.   This
courfe had been continued  for  about  four  hours,
when an incifion was  made  into the wind-pipe, and
air  blown ftrongly through a canula into  the lungs.
About twenty minutes  after this,  the  blood at  the
artery began  to run down the face, and a flow pulfe
was juft perceptible at the wrift.   The frictions were
continued for  fome time  longer ;  his pulfe  became
more frequent, and his mouth and nofe  being irri-
tated with fpirit of fal ammoniac, he opened his eyes.
Warm cordials were  then  adminiftered  to him, and
in two days he was  fo well  as  to be able to walk
eight miles.
  Thefe cafes are fufficient to fliew what may be done
for the recovery of thofe unhappy perfons who ftrangle
themfelves in a fit of defpair.

    OF  PERSONS  WHO EXPIRE IN CONVUL-
                  SION  FITS.

  Convulfion fits often conftitute the laft fcene of
acute or chronic diforders.   When this is the cafe,
there can  remain  but fmall  hopes of the patient's
recovery after expiring in  a  fit.  But when a per-
fon,  who appears to be in perfect health,  is fuddenly
feized with  a convulfion  fit,  and  feems  to  expire,
fome attempts ought always be made  to  reftore
him  to life.   Infants are moft liable to convulfions,
and  are often carried  off  very fuddenly  by one or
more fits  about the  time of  teething.   There  are
many well-authenticated occounts of  infants having
been reftored to life,  after they had, to  all  appear-
ance, expired  in convulfions ;  but we fliall only re-
late  the following inftance mentioned by Dr John-
fon  in his pamphlet on the practicability of recovering
perfovs vifibly dead.
S f 3                      fo 
6$o         PERSONS WHO EXPIRE
   In the parifh of St. Clemens in Colchefier, a child
of fix months old,  lying  upon  its mother's  lap,
having had the breaft,  was feized with  a ftrong
convulfion  fit, which lafted fo long, and ended with
fo total a privation of motion in the body, lungs, and
pulfe, that it  was deemed  abfolutely dead.  It  was
accordingly ftripped,  laid out,  the pafling-bell or-
dered to be tolled, and a coffin to  be made ; but a
neighbouring  gentlewoman who ufed to admire  the
child, hearing of its  fudden death, haftened to  the
houfe, and upon examining the  child  found it  not
cold,  its ioi its limber, and fancied that a glafs fhe
held to its  mauth and nofe was a little damped  with
the breath ; upon which fhe took the child in  her
lap, fat down before the  fire, rubbed it,  and kept it
in  gen le  agitation.   In a quarter of an hour fhe
felt the heart  begin to beat faintly ; flie then put a
little of the mother's milk  into its mouth, continued
to rub its palms and foles, found the child begin to
move, and the milk was fwallowed ; and in another
quarter of an hour  fhe  had  the  fatisfaction of re-
ftoring, to its difconfolate mother, the babe quite
recovered, eager to lay hold of  the breaft, and  able
to fuck again.   The child  throve, had no more  fits,
js grown up, and at  prefent alive.
   Thefe means, which are certainly in the  power of
every perfon, were fufficient to reftore  to life an in-
fant to all  appearance dead, and  who,  in all proba-
bility, but for the ufe of  thefe  fimple endeavours,
would have remained fo.    There are, however,  ma-
ny other things  which  might be done  in cafe the
above fliould not fucceed;  as rubbing the body with
ftrong fpirits,  covering it  with warm  afhes or  fait,
putting it up to the neck  in pretty hot water, blow-
ing air into the lungs, throwing up warm ftimulating
clyfters, or the fmoke of tobacco, into the inteftines,
and fuch like,
                                          When 
              IN COxNVULSION FITS.          631
   When  children  are dead  born,  or expire foon
after the birth, the fame means ought to be ufed for
their recovery, as if  they had  expired  in  circum-
ftances fimilar to thofe mentioned above.
   Thefe  directions  may  likewife be extended to
adults, attention being always paid to the age  and
other circumftances of the patient.
   The  foregoing cafes  and obfervations afford  fuf-
ficient  proof of  the  fuccefs which may attend the
endeavours of perfons totally ignorant of medicine,
in affifting thofe who  are fuddenly deprived  of  life
by any  accident or difeafe.  Many facts of a fimilar
nature  might  be adduced, were it neceffary ;  but
thefe, it is hoped, will be fufficient to call up the at-
tention of the public,  and to excite the humane  and
benevolent to exert their  utmoft endeavours for the
prefervation of their fellow-men.
   The fociety for the recovery of drowned perfons, in-
ftituted  at Amllerdam in  the year  1767, had  the,
fatisfaction to find that not  fewer  than 150 perfons,
in the  fpace of four years, had been faved by the
means  pointed out by them, many of whom owed
their prefervation to peafants and  people of no  me-
dical knowledge.    But the means ufed with fo much
efficacy  in  recovering  drowned  perfons  are, with
equal fuccefs, applicable to a number of cafes where
the powers  of life  feem in reality to be only  fuf-
pended, and to remain capable of renewing all their
functions,  on  being  put into motion  again.  It is
fliocking to  reflect,  that  for want of this confidera-
tion  many perfons have been committed to the grave,
in whom the principles of life  might have been re-
vived.
   The cafes wherein  fuch endeavours are moft likely
to be  attended  with fuccefs, are all  thofe  called
fudden deaths from an invifible caufe,  as apoplexies,
hyfterics, huntings, and many other diforders where-
                       S f 4                    in 
632         PERSONS WHO EXPIRE
in perfons in a moment fink down and expire.   The
various cafualties in  which  they may  be tried are,
fuffocations  from the  fulphureous  damps of mines,
coal-pits,  Sec. ;  the unwholefome  air  of long un-
 opened wells  or caverns; the  noxious vapours ari-
fing from fermenting liquors ;  the fteams of burning
charcoal; fulphureous mineral acids ; arfenical efflu-
via, &c.
   The various  accidents  of drowning,  ftrangling
and apparent  deaths, by blows, falls, hunger, cold,
 Sec. likewife  furnifli  opportunities of trying fuch
 endeavours,   Thofe perhaps who to appearance are
 killed by  lightning, or by any violent agitation of
 the paffions,  as fear, joy, furprife, and fuch like,
 might alfo  be  frequently recovered by  the  ufe of
 proper means, as blowing ftrongly into  their lungs,
 Sec*.
    The means to be ufed for the recovery  of perfons
 fuddenly depriyed of life are  nearly the fame in all
 cafes ; they are practicable by  every  one who hap*
 pens  to be prefent at the accident, and  require no
 gr^at expence,  and  lefs  fkill.  The great aim is to
 reftore the warmth and vital motions.  This  may in
 ge ieral be attempted by means  of  heat,  frictions,
 bleeding, blowing air into the  lungs,  adminiftering
 clyfters and generous cordials,   Thefe muft be varied
 according to circumftances.    Common  fenfe, and
 the fituation  of the patient, will fuggeft the  proper
 manner of conducting them.  Above  all we would
 recommend perfeverance.  People ought  never to
 defpair on account of difcouraging circumftances, or
 to leave off their endeavours as long as there is the
 leaft hope of fuccefs.  Where much good and no
 hurt  can be done, no one ought to grudge his la-
 bour.
    It  were greatly to be wifhed, that an inftitution,
 fimihy; to that of Amfterdam, was eftabliflied,  upon
                                            a more 
             IN CONVULSION  FITS.          Cy.
a more extenfive plan, in Great Britain ;  and that a
reward was allowed to  every one who fhould  be in-
ftrumental in  reftoring to  life a perfon feemingly
dead*.   Men will  do much for fame, but ftill more
for money.   Should no profit, however, be annexed
to thofe benevolent offices,  the  heart-felt pleafure
which a good man  muft enjoy, on reflecting that he
has  been the happy inftrument of faving one of  his
fellow-creatures from an untimely grave, is  itfelf a
fufficient reward.
   The many focieties formed in  different parts  of
Europe and America for the recovery of perfons appa-
rently dead from  drowning, &c.  &c. have  clearly
proved the benefits produced by fuch inftitutions. The
following directions publifhed fome years fince by  the
Humane Society of Philadelphia are fo intelligible as
well as  comprehenfive, that we have fubjoined them
here in order to give  a general view  of the fubject.
The fociety,  in order to render  them more exten-
fively ufeful, have had  them printed in large charac-
 ters, and hung up in moft of  the public  places and
 compting houfes of this  city ;  more  particularly in
 the neighbourhood of the river, and on pumps which
 are much frequented in hot weather.

   * The Author is happy to obferve, that fince the firft pub-
 lication of this work, feveral focieties  have been inftituted in
 Britain with the  fame benevolent intention as that of Amfter-
 dam, and that their endeavours have proved no lefs fuccefsfui.
 He is likewife  happy to  obferve, that premiums have been
 awarded to thofe who have been active in their endeavours U>
 reftore to life perfons who had been drowned, or fuddenly de-
 prived of life by  any accident.  How much  is this fuperior u;
 the fuperftitious inftitution, which allows any man a premium
 who brings a dead perfon out of the  water, fo that he  may
  receive Chriftian  burial; but allows nothing to the perfon who
  brings him out  alive, or whe recovers him  after he has  been
  to a}l appearance dead.
                                          Directions, 
634       PERSONS  SUPPOSED  DEAD
 Direclions, for recovering Perfons, who  are fuppofed
             to be Dead from drowning.

   I.  As foon as the body is taken out of the water,
 it muft be conveyed  to a houfe, or any other place,
 where  it can  be laid dry  and  warm, avoiding the
 ufual deftructive methods of hanging  it  by the heels,
 rolling  it on  a barrel, or placing it acrofs a  log on
 its belly.
   II. The clothes muft  be immediately  ftripped  off,
 and the body wrapped up in blankets, well warmed.
 It fhould be laid  on its back, with the head a little
 raifed.   If the weather be cold, it fhould be placed
 near  a fire ; but if the weather fliould be warm, it
 will be fufficient  to  place it between two blankets
 well heated;  taking care to  prevent the room from
 being crowded, with any perfons who are not necef-
 farily employed about the body.
   III. As foon as it can poflibly be done, a bellows
 fhould  be applied  to one  noftril, while the other
 noftril and the  mouth are kept  clofed, and the lower
 end of the prominent part of the wind-pipe (or that
 part which is called by the anatomifts, Pomum Ada-
 mi) is  preffed backward.   The bellows is  to  be
 worked in this fituation; and when the breaft is
 fwelled by it, the bellows fhould ftop, and an aflif-
 tant fliould prefs the belly upwards, to force the air
out.  The bellows fhould then be applied as before,
 and the belly fliould again be preffed ; and this pro-
cefs fhould be  repeated from twenty to thirty times
 in a minute, fo as  to imitate natural breathing as
nearly as poffible.   Some volatile fpirits, heated,
fhould be held under the valve of the bellows,  while
it works.   If a bellows  cannot  be procured,  fome
perfon fhould blow into  one of the noftrils, through
                                           a pipe 
           FROM DROWNING, &c. &c.         6$$
a pipe  or  quill, while the other noftril  and mouth
are clofed as before ;  or  if a pipe or quill be not at
hand, he fhould blow into the  mouth, while both
noftrils are clofed; but whenever a bellows can be
procured, it fhould be  preferred, as  air forced  in
by  this means, will be much  more ferviceable than
air which has already been breathed.
  IV. At the  fame time, the whole body  fliould be
rubbed  with the hand, or  with hot woollen  cloths.
The  rubbing fhould be  moderate, but continued
with induftry a long time, and particularly about  the
breaft.
   V. During  this time, a  large  quantity of aflies,
or  fait, or fand, fliould  be heated ; and  as  foon as
it is milk-warm,  the  body  fliould be placed in it;
the blowing and rubbing are then to  be continued
as before; and when the afhes,  or fait, are cooled,
fome warmer muft be  added, fo that the  whole may
be kept milk-warm.
  Thefe methods fhould be continued  three or four
hours, as in feveral inftances they have proved fuc-
cefsful,  although no figns of life appeared until that
time.   When  the patient is  able  to  fwallow,  he
fliould take fome  wine, or rum and water; bleed-
ing or purging ought not to be ufed,  without con-
fulting a phyfician, who fliould be called  in  as foon
as poffible.
To prevent the fatal effecls of drinking cold  Water,  or
     cold Liquors of any  kind in warm Weather.

   iff, Avoid drinking while you are warm, or,
  2d, Drink only a fmall  quantity at once, and let
jt remain  a  fhort  time  in your mouth before you
fwallow it;  or,
3<*, 
<5j5        PERSONS SUPPOSED DEAD
   3d, Wafli  your hands and  face, and rinfe your
mouth with cold water before you drink.  If thefe
precautions have been neglected, and  the diforder
incident to drinking cold water hath been produced,
the firft, and in moft  inftances, the only remedy to
foe  adminiftered, is  fixty drops of liquid laudanum
in fpirit  and water, or warm drink of any kind.
  If this fliould fail of giving relief, the fame quan-
tity may be given twenty minutes afterwards.
  When laudanum  cannot  be  obtained, rum and
water, or  warm  water fhould  be given.   Vomits
and bleeding fhould not be ufed without confulting
a phyfician.


The dangerous  Effecls of  noxious  Vapours,  from
  " Wells, Cellars, fermenting Liquors,  &c.  may be
  prevented,

   3y procuring a  free circulation of air, either by
ventilators, or opening the doors or windows, where
it is confined, or by  changing  the air, by keeping
fires in  the infected place, or by throwing in water,
in which flone-lime has been diffolved.
   Thefe precautions  fhould  be taken, before enter-
ing into fuchj fufpected places, or a lighted  candle
fhould be  firft introduced, which will go out,  if the
air is bad.  When a perfon is let down into a well,
he fhould be carefully watched, and drawn up again
on  the  leaft  change.  But when a perfon is  appa-
rently  dead, from the  above-mentioned caufe,  the
firft thing to  be done is  to remove the body  to  a
cool place in  a wholefome air;  then let the body
be  flripped,  and  let cold  water be thrown from
buckets over it for fome time.   This is particularly
ufeful in cafes of apparent death from  drunkennefs,
,^-Let the treatment now  be the fame as that for
                                         drowned 
            FROM DROWNING, &c. kc.         Cy
drowned perfons.  The head Jliould be raifed a lit-
tle ;  and  continued frictions, with blowing into the
noftril with.a bellows, fliould be practifed for feveral-
hours.


In Cafes  of Suffocation, from the  Fumes  of Burning
                    Charcoal.

   The  general treatment recommended for curing
the diforders brought on  by noxious vapours, is to
be applied ; but the dangerous effects of this may
be prevented, by taking care not to  fit near it when
burning ; to burn it in a chimney ; and where there
is no chimney, to keep the door open, and to place
a large tub  of water in the room.
   In all thefe, as well as in cafes of drowned per-
fons, moderate purges and bleeding are only  to  be
ufed, with the advice of a phyfician.
      To prevent the fatal Mffecls of Lightning.

  Let your houfe be provided with an iron conduc-
tor ; but when this cannot be had, avoid fitting,  or
ftanding,  near the window, door, or walls  of  an
houfe,  during the time  of a  thunder guft.   The
nearer you are placed to the middle of a room, the
better.   When you are  not in an houfe, avoid fly-
ing to the cover  of the  woods, or a folitary  tree,
for fafety.
   When a perfon is ftruck by lightning, let  conti-
nued frictions and inflations of the lungs be practifed:
Let  gentle fliocks  of electricity be  made to pafs
through the cheft, when  a fkilful  perfon can be pro-
cured to apply it ; and let  blifters be applied to the
breaft.
                                               ■n 
638         PERSONS SUPPOSED DEAD
  To prevent Danger from Expofure to  the Exceffive
                  Heat of the Sun.

    Diforders from this caufe,  or (as they  are vul-
 garly termed)  ftrokes  of the fun, may be expected,
 when a  perfon  who is expofed  to his rays, is affec-
 ted with a violent head-ach, attended with throb-
 bing  or  with  giddinefs; where the diforder takes
 place, thefe fymptoms are followed by faintnefs and
 great infenfibility, with violent heat  and drynefs  of
 the fkin, rednefs  and drynefs of the  eyes,  difficulty
 of breathing, and, according as the  difeafe  is more
 or lefs violent, with a  difficulty, or entire inability
 of fpeaking or moving.
   To guard againft thefe dangerous  effects of heat,
 it will be proper,
    i ft, To avoid  labour,  or violent  exercife, or ex-
 pofing yourfelf to the rays of the fun, immediately
 after eating a hearty meal:
   2d, To avoid  drinking fpirits  of any kind, when
 you are thus expofed.   Thefe add  an  internal fire
 to the heat of the fun, and are  particularly hurtful
 in  harveft.  Vinegar  and water, fweetened  with
 molaffes  or brown fugar,  butter-milk  and water,
 fmall beer, whey, or milk and  water, are the moft
 proper drinks for  people,  who are expofed to excef-
five  heat.   But the lefs  a perfon drinks of liquors
of any kind in the forenoon, the better  will he  endure
 the heat of a warm day.   It will alfo be proper,
   3d, To  wear a white  hat,  or to  cover a black
one with white paper, when you are neceffarily ex-
pofed to  the  hot  fun,  and to  avoid  ftanding ftill
when in fuch a fituation.
  4th, To retire into the  fhade as foon as you begin
to be affected with pain or throbbing  in  the  head,
with giddinefs or with faintinefs.
                                                If 
            FROM DROWNING, &c.&c.         6yj
  If thefe precautions have been neglected, and the
fymptoms above defcribed have come  on, it will be
proper,
   i ft, To remove the perfon fo affected into a cool
dry place, and  to  loofen  all his  garments,  particu-
larly thofe around his neck and breaft.
   2d, To examine whether the pulfe at the  wrift or
temples beats forcibly, and if  it  does, to bleed im-
mediately ;  but if the pulfe be weak,  or cannot be
perceived, bleeding muft not be performed.
   3d,  To place his  feet  and  legs (or if it can be
done)  the lower half of  his body, in  warm water.
But  if this remedy fails,
   4th, Dr Tiffot advifes  to apply linen cloths  wet
with cold water, or with  cold water and vinegar, to
the temples and all over the head.
   5th, To  adminifter plentiful draughts of vinegar
and water fweetened.
   In all  cafes of this  kind, a phyfician fliould be
fent  for, unlefs the patient recovers fpeedily.
     To  prevent the  Effecls  of exceffive Cold.

  Perfons are In danger of being deftroyed  by it,
when they become very  drowfy, or  are affected
with general numbnefs or  infenfibility of the body.
As the cold which proves fatal, generally affects the
feet firft, great care fliould be taken to keep them
as warm as poffible.
   1 ft, By protecting them when you are expofed  to
cold  with wool, or woollen  focks within the fhoes
or boots, or  with  large v.oollen ftockings  drawn
over them,  or when you ride, with hay or ftraw
wrapped round  them.
  2d, By -keeping  up  a brifk circulation  in the
blood veffels of the feet, by  moving  them  ccnfiantly;
        s                                      or 
 <V     PERSONS SUPPOSED DEAD, &c.
 or when this is impracticable, from  a confined fitu--
 ation, arid two or more perfons  are expofed toge-
 ther.
   3d, By placing  their  feet, without fhoes,  againft
 each other's breafts.
  If  notwithftanding  thefe  precautions, a perfon
 fliould be rendered  fleepy or infenfible by cold,  he
 muft exert himfelf and move  about  quickly, for if
 he fhould fleep in the cold, he will inevitably  perifli.
 When a perfon who  is travelling in company? begins
 to be affected in this manner, his companions fhould
 force him to walk brifkly or to run.
  When  cold  has produced apparent  death,  the
 body fhould be placed in a room  without fire, and
 rubbed fleadily with  fnow, or cloths wet with cold
 water, at  the fame time that  the bellows  is  applied
 to the nofe, and  ufed as in  the  cafe of drowning.
 This  treatment fliould be continued  a long time,  al-
 though no  figns  of life  appear,  for fome   perfons
 have recovered, who were  to  appearance lifelefs for
 feveral  hours.
  When the limbs only are affected by cold, they
 fliould be  rubbed gently with fnow, or  bathed  in
 cold  water with ice in it, until  their feeling and
 power of motion returns ; after  which, the  bathing
 or rubbing wi:h fnow is  to be repeated once every
 hour, and continued a   longer or fhorter time, as
 the pains are more or lefs violent.
  The perfon thus affected fliould be kept from the
 fire, for warmth and  acrid   applications  of every
kind are very injurious.
*
CHAP. 
C  641   J
>
              CHAP.   LVI.

Cautions  concerning Cold Bathing, and drinking
             the Mineral Waters.
          J\S it is now fafliionable  for perfons  of
all ranks to plunge  into  the fea, and drink dro mi-
neral waters, I  was defirous of rendering  this work
ftill more extenfively ufeful, by the addition of fome
practical remarks on thefe active and ufeful reme-
dies.   Finding  it impoffible to bring  thefe obferva-
tions within  fo  narrow a compafs as  not to fwell
the book, already too large, into an enormous fize,
I refolved to confine myfelf to a few hints or cau-
tions ;  which  may   be of  fervice  to perfons who
bathe, or drink  the mineral waters,  without being
able to put themfelves under the care of a phyfician.
   No part of the practice of medicine is  of greater
importance,  or  merits more  the  attendon  of the
phyfician, as many lives are  loft, and. numbers ruin
their health, by cold bathing, and  an  imprudent ufe
of the  mineral  waters.   On fome future  occafion
may probably  refume this fubject, as I  know not
any work that  contains a fufficient number of prac-
tical obfervations to regulate the patient's conduct-
in the ufe of thefe active and important remedies.
   We  have indeed many  books on the mineral
waters, and fome of them are written with  much
ingenuity ; but  they are chiefly employed in  afcer-
taining the contents of the waters by chymical ana-
lyfis.   This, no  doubt, has its ufe,  but it is  by  no
means  of fuch   importance  as fome  may imagine.
A man may know  the chymical analyfis of all the
                        T t               articles 
 042        ON COLD  BATHING, AND
 articles in the  materia medica, without being able
 properly to apply any one of them in the cure of
 difeafes.   One  page  of practical  obfervations is
 worth a whole volume of  chymical analyfis.   But
 where  are fuch obfervations to be  met with ? Few
 phyficians  are  in  a  fituation to make them,  and
 fewer ftill are  qualified for fuch a tafk.  It can only
 be accomplifhed by practitioners who refide  at  the
 fountains,  and  who, poffeffing  minds fuperior to
 local prejudices, are capable of diftinguifliing difeafesr
 with accuracy,  and of forming  a found judgment
 refpecting the  genuine effects of medicines.
   Without a proper  difcrimination with regard to
 the  difeafe and  the conftitution of the patient,  the
 moft powerful medicine is  more  likely to  do harm
 than good.  Every one knows- that  the fame phy-
 fician who, by cold bathing, cured Auguftus, by an
 imprudent ufe of the fame medicine,  killed  his heir.
 This induced  the  Roman  fenate to make  laws  for
 regulating the baths, and  preventing the numerous
 evils which arofe from an  imprudent and  promifcu-
 ous  ufe of thofe elegant and fafhionable pieces of
 luxury.  But  as no fuch laws exift in  this  country,
 every one does that which is right in his  own eyes,
 and of courfe many muft do wrong.
   People are  apt to imagine that  the fimple element
 6f water can do no hurt, and that they may plunge
 into it at any time with impunity.   In this, however,
 they are much miftaken.  I have  known apoplexies
 occafioned  by  going into the cold bath, fevers  ex-
 cited by flaying too long in it, and  other  maladies
 fo much aggravated by its continued  ufe, that they
could never be wholly eradicated.   Nor are  exam-
ples  wanting,  either  in ancient  or modern times, of
the  baneful  confequences  which have arifen  alfo
from an injudicious application of the warm bath ;
but as warm baths  are  not fo common in this coun-
                                            try, 
         DRINKING MINERAL WATERS.      6tf
 try, and are feldom ufed but under the direction  of
 a phyfician, I  fliall  not enlarge on that part of the
 fubject.
   Immerfion  in  cold  water is a cuflom which lays
 claim to the moft remote antiquity :  indeed it muft
 have been coeval with man himfelf.   The neceffity
 of water  for  the purpofe of cleanlinefs,  and the
 pleafure  arifing  from  its application to the body  in
 hot countries,  muft very early have recommended
 it  to the human fpecies.    Even  the  example  of
 other  animals  was  fuflicient to give  the hint  to
 man.  By inftinct many of them are led  to apply
 cold  water in  this manner;  and fome, when de-
 prived  of its ufe,  have been known to  languifh,
 and even die.    But whether the practice of cold
 bathing  arofe  from neceffity, reafoning,  or  imita-
 tion, is an inquiry of no  importance; our bufmefs
 is to point ought the advantages  which  may be de-
 rived from  it,  and  to guard people  againft an im-
 proper ufe of it.
   The cold bath recommends itfelf ih a variety  of
 cafes, and is peculiarly beneficial  to  the inhabitants
 of populous cities,  who indulge  in idlenefs, and
 lead fedentary  lives.    In  perfons  of this  defcrip-
 tion the action  of the folids is always  too weak,
 which induces a  languid circulation,  a  crude  indi-
 gefted  mafs  of  humors,  and obftructions in the
 capillary  veffels and glandular fyftem.   Cold water,
 from its gravity as well  as its  tonic power, is well
 calculated either to obviate or remove thefe fymp-
 toms.  It accelerates the motion of the  blood, pro-
 motes the different fecretions, and gives permanent
 vigour to the folids.   But  all thefe important pur-
 pofes will be more effentially anfwered  by the ap-
 plication  of fait water.    This ought  not only to be
preferred on account of its fuperior gravity, but like-
 wife for  its greater power  of ftimulating the  fkin,
                    Tt a                 which 
644        ON COLD BATHING,  AND
which promotes the  perfpiration,  and prevents th«
patient from catching cold.
   It  is neceffary, however,  to obferve, that cold
bathing is more likely to prevent,, than  to remove
obftructions of the  glandular  or lymphatic  fyftem.
In this cafe the cold  bath will only aggravate  the
fymptoms, and hurry the unhappy patient into an
untimely grave.  It is therefore of the  utmoft im-
portance, previous to the  patient's entering upon
die ufe of  the cold bath, to determine whether or
not he labours  under any  obftinate obftructions of
the lungs or other vifcera; and where  this  is the
eafe,  cold bathing ought ftrictly to be prohibited *.
   In  what is called a plethoric  ftate,  or too great
a fulnefs of the body, it  is  likewife dangerous to life
the cold bath, without due preparation.  In this cafe
there is great danger of burfting a blood-veffel, or
occafioning  an inflammation of the brain, or fome of
the vifcera.  This precaution is the more  neceffary
to citizens,  as  moft of them live full,  and are of  a
grofs habit.   Yet, what is very  remarkable, thefe
people refort in crowds every feafon to the fea-fide,
and plunge in  die water without the leaft  confidera-
tion.   No  doubt they  often  efcape with  impunity,
but does this give a fanction  to the  practice ?  Per-
fons of this defcription ought by no means to bathe,
unlefs the  body has been  previoufly prepared by
fuitable evacuations.

   * The celebrated Dr. Smollet has  indeed faid, that if he
were perfuaded he had an ulcer in the lungs, he would jump
into the cold bath : but here the doclor  evidently  fhews raore
courage than difcretion ;  ar.d that he was more a man  of wit
than a phyfician, every own will allow.  A nervous afthma, or
 an atrophy, may be miftaken for a pulmonary confumption ;
 yet, in the two former, the cold bath proves often beneficial,
 though I never knew it fo in the latter.  Indeed, all the phthi-
 fical  patients I ever faw, who had tried the cokLbath, were
 evidently hurt by it.
                                           Another 
         DRINKING MINERAL WATERS.     645
Another clafs of patients, who fland  peculiarly in
need of the  bracing qualities of cold  water, is the
nervous.  This includes a great number of the male,
and almoft all the female inhabitants of great  cities.
Yet even thofe perfons ought to be cautious in  ufing
the cold bath.    Nervous people have often weak
bowels, and may, as well as others, be  fubject to
congeftions  and  obftructions of the vifcera; and in
this cafe they will not be able to bear the  effects of
the cold  water.   For  them,  therefore, and indeed
for all  delicate people,  the beft  plan would be to
accuftom themfelves to  it by the  moft pleafing  and
gentle  degrees.   They ought to begin  with the tem-
perate  bath, and gradually ufe  it cooler, till at
length the coldeft proves quite agreeable.  Nature
revolts againft all great  tranfitions ; and  thofe who
do violence to her dictates, have often caufe to repent
of their temerity.
   Wherever cold bathing  is practifed, there  ought
likewife to be tepid baths for the  purpofe mentioned
above.   Indeed  it is the practice  of feme countries
to throw cold water over the patient  as  foon as he
comes  out of the warm  bath ;  b.ut though this may
not injure a Ruffian peafant, we dare not recommend
it to the inhabitants  of this country.   The ancient
Greeks and Romans,   we are told,  when covered
with  fweat and duft, ufed to plunge  into rivers,
without receiving the fmalleft injury.  Though  they
might often efcape danger from this imprudent con-
duct, yet it was certainly contrary to found reafon.
I  have known many  robuft men  throw away  their
lives by fuch an  attempt.   We would not, however,
advife patients to go  into the cold water when the
body is cliilly ;  as much exercife, at leaft, ought to
be taken,  as may excite a gentle  glow  all over the
body, but by no means fo as to overheat  it.
Tt3
To 
646        ON COLD BATHING, AND
   To  young  people,  and particularly to children,
cold bathing  is of the laft importance.  Their lax
fibres render its tonic powers peculiarly  proper.   It
promotes their  growth,  increafes  their  ftrength*,
and prevents a variety of difeafes incident  to child-
hood.   Were infants  early accuftomed  to  the  cold
bath, it would feldom difagree with  them;  and we
fliould fee fewer inftances of the fcrophula,  rickets,
and other difeafes,  which prove fatal to  many, and
make others miferable for life.   Sometimes indeed,
thefe diforders  render infants  incapable of bearing
the fhock of cold water ;  but this is owing to their
not having been early and  regularly accuftomed  to
it.   There is  no practice equal to cold-bathing  for
fortifying the body againft the heats of fummer.   It
is however neceffary  here to caution  young  men
againft too frequent bathing; as  I have known many
fatal confequences  refult from the  daily  practice  of
plunging into rivers, and continuing  there too long.
It is feldom that fwimming can be regarded as a re-
medy.    It is right for every boy  to learn to fwim ;
and  it is a cleanly practice ; but  much mifchief is
done by going  into the water at improper times  of
the day, and flaying in too long.
   The  moft  proper time of  the  day for ufing the
cold bath is, no doubt, the morning, or at leaft be-
fore dinner;  and the beft  mode, that of quick im-
merfion.  As cold  bathing  has  a conftant tendency
to propel the  blood and other humors towards the
head it ought to be a rule  always  to  wet that  part
as foon as poffible.  By due attention to this circum-

  * The celebrated Galen fays,  that immerfion in cold wafer
is fit only for the young of lions and bears ; and recommends
warm bathing as conducive to the growth and ftrength of  in-
fants. How cgregioufly do the greateft men err whenever they
lofe fight of fads, and fubftitute rcafoning in phyfic in place of
obfervation and experience !
                                           fiance, 
        DRINKING MINERAL WATERS.     64;
fiance, there is reafon to believe, that violent head-
achs, and other complaints, which frequently proceed
from cold bathing, might be often prevented.
  The cold bath, when too long continued  in, not
only occafions  an exceffive  flux of  humors towards
the head, but chills the blood, cramps the mufcles,
relaxes the nerves,  and wholly defeats the intention
of bathing.  Hence, by not  adverting to this cir-
cumftance, expert •fwimmers are often injured, and
fometimes even lofe their lives.  All the beneficial
purpofes of cold bathing are anfwered by one, two,
or three immerfions at  a time; and the patient ought
to be rubbed dry the moment he comes out  of the
water, and fhould continue to  take exercife for fome
time after.  When the cold bathing  is fucceeded by
aglow, it is ufeful.   When this does not follow the
patient fhould  be  well rubbed, and put between
blankets.
   When cold bathing  occafions chillnefs,  lofs of ap-
petite, liftleffnefs, pain of  the breaft or bowels,  a
proftration of ftrength, or violent head-achs, it ought
to be difcontinued.
   Though thefe hints  are by no means' intended  to
point out all the cafes where  cold bathing  may be
hurtful,  nor to illuftrate its  extenfive  utility as  a
medicine ; yet it is hoped they may  ferve to guard
people againft fome of thofe errors into which from
mere inattention, they are  apt to fall, and thereby
not only to endanger their own lives, but bring an ex-
cellent medicine into difrepute.

    OF DRINKING THE MINERAL WATERS.

   The internal  ufe of water, as a  medicine, is  np
lefs an object of the  phyfician's attention than the
external.   Pure elementary water is indeed the moft
inoffenfive of all  liquors,  and conftitutes a princi-
                       T t 4                   pal 
           ON COLD BATHING, AND
 pal part of the food of every animal.   But  this ele-
 ment is often impregnated with  fubftances of a very
 active and penetrating nature; and of fuch an infidious
 quality, that, while they promote certain fecretions,
 and even alleviate fome difagreeable fymptoms, they
 weaken the powers of life,  undermine  the  conftitu-
 tion,  and  lay the foundation of worfe  difeafes than
 thofe which they  were  employed  to  remove.  Of
 this every practitioner muft  have feen inftances; and
 phyficians of eminence have more than one  declared
 that they have known more difeafes occafioned than
 removed by the ufe of mineral waters.'  This doubt-
 lefs has proceeded from  the abufe of  thefe powerful
 medicines,  which evinces the neceffity of ufing them
 with caution.
   By examining the  contents of the mineral waters
 which are  moft ufed in this country, we fliall be
 enabled  to form an  idea of the danger which may
 arife  from an improper  application  of them  either
 externally or internally,  though it is  to the latter of
 (hefe that the prefent obfervations are chiefly confined.
   The waters moft in ufe  for  medical purpofes in
 Bdtain* are thofe impregnated  with falts,  fulphur,
 iron, and mephitic air, either feparately,  or varioufly
 combined.   Of thefe  the moft powerful is the faline
 fulphureous water of  Harrowgate, of which I have
 had more occafion  to obferve the pernicious confe-
 quences, when improperly ufed, than of any other.
 To this, therefore, the following remarks  will more
immediately relate,  though they  will be found appli-
cable to all the purging waters in the kingdom which
are ftrong enough to merit attention *.

  * The greateft clafs  of mineral waters in this country is the
chalybeate.  In many parts of Briruin  thefe are to be found in
almoft every held ; but thofe clvefly in. ufe, for medical pur-
 pofes are the purging chalybeate?, as the waters ofScaibo-
 rougf, Cl:eheiih..m, Thorp Arch, Nevil licit, <xc.  Of thefe
                                            whkh 
        DRINKING MINERAL WATERS.     649
  The  errors which fo often defeat the intention of
drinking the purgative mineral waters, and  which
fo frequently prove injurious to the patient, proceed
from the manner of ufing them, the quantity  taken,
the regimen  purfued,  or ufing them in cafes where
they are not  proper.
  A  very  hurtful prejudice ftill  prevails in this
country, that all difeafes muft be cured by medicines
taken into the ftomach, and that the more violently
thefe medicines operate, they are  the more likely to
have  the  defired effect.  This opinion has proved
fatal  to thoufands, and  will,  in  all probality, de-
ftroy many more before it can  be  wholly  eradicated.
Purging is often ufeful  in  acute  difeafes, and in
chronical cafes may pave the way for the operation
Of other medicines; but it will   feldom  perform  a
cure ;  and by exhaufting  the ftrength of the patient,
will  often leave him in a worfe  condition than   it
found him.   That  this is frequently the cafe with
regard to the more active mineral  waters, every per-
fon converfant in thefe matters will  readily allow.
  Strong ftimulants  applied  to   the  ftomach and
bowels for a length of time,  muft  tend  to weaken
and deftroy their energy; and what ftimulants are
more active than fait and fulphur,  efpecially  when
thefe fubftances are intimately  combined, and carried
through the  fyftem by the penetrating medium of
water ?  Thofe bowels muft be ftrong indeed, which
can withftand the daily operation of fuch active prin-
ciples  for months  together, and  not to  be injured.
This however is the plan purlued  by  moft of thofe

which do not  purge,  the  waters of Tunbridge  ftand in the
higheft repute. The faliive purging  waters, as thofe of Aclon,
Epfom, Kilburn, &c. are alfo  in very general efteem ; but the
fountains moft  frequented  by  the fick in  this country, are thofe
to which the minerals impart a certain degree of heat, as Bath,
Biiftoh Buxton, &c.
                                              wbc 
650        ON COLD BATHING, AND
who drink the purging mineral waters, and whofe
circumftances  will  permit  them to continue  long
enough at thofe fafhionable places of refort.
   Many people imagine that every thing depends on
the quantity of water taken, and that the more they
drink they will the fooner  get  well.   This is an
egregious error;  for,  while   the  unhappy patient
thinks he is by this means eradicating  his  diforder,
he is often, in fact, undermining the powers of life,
and ruining his conftitution.   Indeed nothing can do
this fo  effectually as weakening the powers of digef-
tion by  the improper application of ftrong ftimulants.
The very effence of health depends on the digeftive
organs performing their due functions, and the moft
tedious maladies are all connected with indigeftion.
   Drinking the water in too great quantity, not only
injures  the  bowels and  occafions indigeftion, but
generally defeats the intention for which  it  is taken.
The difeafes for the cure  of which  mineral  waters
are chiefly celebrated, are  moftly  of the chronic
kind; and it is well known that  fuch  difeafes can
only be cured  by the flow operation  of alteratives,
or fuch medicines  as  act by  inducing a gradual
change  in the  habit.  This requires length of time,
and never can   be  effected by  medicines which run
off by ftool, and operate chiefly on the firft paffages.
   Thofe who wifh for the cure of  any obftinate ma-
lady from the   mineral  waters, ought to take  them
m fuch  a manner as hardly  to produce any effect
whatever on the bowels.  With this view a  half-
pint glafs may be drank at bed-time*, and the fame
quantity an hour before breakfaft, dinner, and fup-
per.  The dofe, however, muft vary  according to

   :i> When I fpe\k of drinking a glafs of the water over-night,
I muft beg leave to caution diofe who follow this plan  againft
eating kcavy fuppers.
                                    circumftances. 
        DRINKING MINERAL WATERS.     65l
circumftances.   Even  the quantity mentioned above
will purge fome perfons, while  others  will drink
twice  as much without being in the leaft moved  by
it.  Its operation on the  bowels is the only ftandard
for ufing the water as an alterative.  No more ought
to be  taken than barely to move the body ; nor is it
always neceffary to carry it this length, provided the
water goes off by  the other emunctories, and does
not occafion a chillnefs, or flatulency in the ftomach
or bowels.  When the water is intended to purge,
the quantity mentioned above may be  all taken be-
fore breakfaft.
   I would not only caution patients who drink the
purging mineral waters over night to avoid  heavy
fuppers, but alfo from eating heavy meals at any
time.   The ftimulus of water impregnated with falts,
feems  to create a falfe appetite.  I have feen a deli-
cate perfon, after drinking  the Harrowgate waters
of a morning, eat a breakfaft fufficient to have ferved
two ploughmen, devour  a plentiful dinner of flefh
and fifli, and, to crown all, eat fuch a fupper as might
have fatisfied a hungry porter.
   All  this, indeed, the ftomach feemed to crave;
but this craving had better remain not quite fatisfied,
than that the ftomach  fliould be loaded with what
exceeds its powers.  To ftarve patients was never
my plan ;  but I am clearly of opinion,  that, in the
ufe of  all  the  purging mineral waters,  a light and
rather  diluting diet is the moft proper ;  and that no
perfon, during fuch a courfe, ought to eat  to the
full ex:ent of what his appetite craves.
   To promote the operation  of mineral waters, and
to carry  them through the  fyftem, exercife is indif-
penfably neceffary.   This may be taken in any man-
ner that is moft agreeable to the patient;  but he ought
never  to carry  it to excefs.   The beft kinds of exer-
cife are thofe  connected  with  amufement.   Every
              4                            thing 
 t>*        ON COLD  BATHING, AND
 filing that  tends to exhilarate the fpirits, not only
 promotes the operation of the waters, but  acts as a
 medicine.   All who  refort  to the mineral  waters
 Ought therefore to leave every care behind, to mix
 with the companyr and to make themfelves as cheer-
 ful  and happy as  poffible.   From this  conduct, af-
 filed by the free and wholefome air of thofe fttfhion-
 abfe places of refort, and alfo the  regular  and early
 hours which are ufually kept, the*patient often re-
 ceives more benefit than from ufing the waters.
   But  the greateft errors in drinking the purging
 mineral waters arife from their being ufed in cafes
 where they are abfolutely improper, and adverfe to
 the nature of the difeafe.  When  people hear of a
 wonderful cure  having  been performed by fome
 mineral water, they  immediately  conclude  that it
 will cure every thing, and   accordingly fwallow it
 down, when they might as  well take  poifon.  Pa-
 tients ought  to be  well informed, before  they be-
 gin to drink the more active kinds  of mineral wa-
 ters,  of the propriety of the courfe, and  fliould
 never perfift  in ufing them  when  they are found to
 aggravate the diforder.
   In all cafes where purging  is indicated,  the faline'
 mineral waters will be found to fulfil  this  intention
 better than any other medicine.  Their operation, if
 taken in proper quantity, is generally mild ; and they
 are neither found to irritate the nerves, nor  debilitate
 the patient fo much as  the other purgatives.
   As a purgative, thefe  waters are chiefly  recom-
 mended in difeafes of  the firft paffages, accompanied
 with, or proceeding from, inactivity  of the ftomach
and bowels, acidity, indigeftion, vitiated bile, worms,
 putrid fordes, the piles, and jaundice.  In moft cafes
of this kind they are the beft  medicines that can  be
adminiftered.   But when  ufed with  this view, it is
fufficient to take them twice, or at moft three times
        1                                  a-week,
               % 
        DRINKING MINERAL WATERS.      6S$
a-week, fo as to move the body three or four times ;
and it will be proper to continue this courfe for fome
weeks.
   But the operation of the more active mineral  wa-
ters  is not confined to the bowels.   They often pro-
mote  the  difcharge  of urine, and not unfrequently
increafe the perfpiration.   This fliews that they are
capable of penetrating into every part of the  body,
and  of ftimulating the whole fyftem.  Hence arifes
their efficacy in removing the  moft obftinate of alt
diforders, obfiruclions of the glandular and lymphatic
fyftem.  TTnder this clafs is comprehended the fcro-
phula  or  king's evil, indolent tumors,  obftructions
of the liver, fpleen, kidneys, and mefenteric glands-
When thefe great purpofes are to  be  effected, the
waters muft be ufed in the gradual manner mentioned
above, and perfifted in for a length of time.   It will
be proper, however, now  and then to difeontinuc
 their ufe for a few days.
   The next great  clafs  of difeafes where mineral
 waters are found to be beneficial, are thofe of the fkin,
 as the itch, fcab, tetters  or ringworms, fcaly erup-
 tions,  leprofies, blotches, foul ulcers, &c.  Though:
 thefe may Teem fuperficial,  yet  they are often  the
 moft obftinate which the  phyfician has to encounter,
 and not unfrequently  fet his  fkill at  defiance: but
 they will fometimes yield to the application of mine-
 ral waters for a fufficient length of time, and in  moll
 cafes of this kind thefe waters deferve a trial.  The
 faline fulphureous waters, fuch as  thofe of Moffat in
 Scotland, and Harrowgate in England, are the molt
 likely to  fucceed in  difeafes of the  Jkin ; but for -this
 purpofe  it will be neceffary  not  only  to drink the
 waters, but likewife to ufe theni externally.
    To enumerate more  particularly the qualidcs of
 the different  mineral  waters, to fpecify thofe dif-
 eafes in  which they are refpectively  indicated, and
                                                to 
 654          ON COLD  BATHING, &c.

 to  point  out  their  proper modes  of application,
 would  be an ufeful, and by  no means a difagree-
 able employment;  but  as the limits  prefcribed  to
 thefe remarks will not allow me to treat the fubject
 at more length, I  fliall  conclude  by obferving, that
 whenever the mineral waters are found  to exhauft
 the ftrength, deprefs the fpirits,  take away the ap-
 petite,  excite fevers, diftend the bowels, or occafion
 a  cough, they ought to be  difcontinued.

   *#* Thefe Cautions having been printed and fold feparately
 for the accommodation of thofe who had purchafed the former
 editions of this book, has induced fome perfons to confider them
 as a Treatife onfea-bathing and drinking the mineral waters;
 whereas the author's fole intention was to furnifh a few general
 hints to perfons who frequent thofe fafhionable places of refort,
without  putting themfelves under the care of a phyfician.
As he looks upon this fubjecl, however, to be of the greateft
importance to the fick, he pledges himfelf to treat it at  more
length on a future occafion. 
       APPENDIX:
                                     i
                 CONTAINING

A lift of Simples and of fuch Medicinal Prepa-
   rations  as  ought to   be  kept  in  readinefs
   for private  Practice:

The method  of preparing and compounding
   fuch Medicines as are recommended in the
   former Part of the Book, with the Addition
   of feveral others  of a fimilar Nature :

Remarks on  the Dofes, Ufes,  and Manner of
    applying  the  different Preparations. 
 
INTRODUCTION.
        AGNORANCE and  fuperflition  have attributed
extraordinary medical virtues to almoft every production of
nature.   That fuch virtues were often imaginary, time and
experience have  fufficiently  fliewn.   Phyficians, however,
from a veneration for antiquity, ftill  retain  in their lifts of
medicine  many things which owe their reputation entirely '
to the fuperflition and credulity of our anceftors.
   The inftruments of medicine will always  be multiplied, in
proportion to men's ignorance of the nature and caufe of
difeafes ; when thefe are fufficiently underftood, the method
of cure will be fimple and obvious.
   Ignorance of the real nature and permanent properties of
thofe fubftances employed in the cure of difeafes, is another
reafon why they have been fo greatly multiplied. Phyficians
thought they could effect by a  number of ingredients, what
could not be done by any one of them.  Hence arofe thofe
amazing farragos which have fo long difgraced the medical
art, and which wea*efteemed powerful in proportion to the
number of fimples- mat entered their compofition.
   The great variety of forms into which almoft every article
of medicine has been manufactured, affords another proof of
the imperfection of the medical art. A drug which is perhaps
moft efficacious in the fimpleft form in which it can be admi-
niftered, has been  neverthelefs ferved up in fo many diffe-
rent fhapes, that one would be induced to  think the whole
art of phyfic lay in exhibiting  medicine under as many dif-
ferent modes as poffible.
   Different forms of medicine,  no doubt, have thur ufe; but
they ought never to be wantonly increafed.   i hey are by no
means fo neceffary as is generally imagined. A few grains
of powdered rhubarb, jalap, or ipecacuanha,  will actually
perforin all that can be done by the different preparations of
                       IT  U                       'belt 
6 5S
APPENDIX.
 thefe roots, and may alfo be exhibited in as fife and agree-
 able a  manner.  The fame obfervation hold.,  with regard
 to the Peruvian bark, and many other fimples, of which
 the  preparations are very numerous.
   Multiplying the ingredients of a medicine, not only renders
 it more expenfive,  but alfo lefs certain, both in its dcfleand
 operation. Nor is this all.  the compound, when kept, is
 apt  to i'poil, or acquire qualites of a different nature. When
 a medicine is  rendered more fafe, efficacious, or agreeable,
 by the  addition of another, they ought, no doubt,  to be
 joined ; in all other cafes,  they  are better kept  afunder.
 The combination of medicines embarraffes the phyfician, and
 retard.-" the progrefs of medical knpwledge.  It is impoffible
 to afcertain the precife effect of  any one medicine, as long as
 it is  combined with others, either of a fimilar or diffimilar
 nature.
   In the exhibition of medicine, regard fhould not only he
 had  to fimpiicity, but likewife.to  elegance. Patients feldom
 reap much bcncfir from things  that are highly difagreeable
 to their fenfes.  To tafte or fmell like a drug, is become a
 proverbj  and  to fay truth, there is too much ground for it.
 Indeed no art  can take away the difagreeable tafte and fla-
 vour of fome drugs, without entirely deftroying  their effica-
 cy;  it is poffible, however, to  render  many  medicines lefs
 difguftful, and others even agreeable •,  an object highly de-
 ferving the attention of all who adminifter  medicine.
   The clefign  of the following pages is, to exhibit fuch a lift
 of drugs and medicines as may be neceffary for private prac-
 tice.   They are confiderably more  numerous indeed than
 thofe recommended in the former part of the Bool^, but are
 ftiil  greatly  within  the number contained  in the moft re-
 formed difpenfatories.  The fame medicine is feldom exhi-
 bited under different forms ;  and where different medicines
 anfwer  nearly  the fiimc intention, there is  commonly  no
more than one of  them ietainec.  Multiplying forms  of
medicine for the fame iiKcLihou tends rather to bewilder than
affile, the young practitioner,  and the experienced phyfician
can never be at a lofs to  vary his prefcriptions as occafion
requites.
   The chemical and other difficult preparations  are  for the
moft part omited. All of them that are ufed  by any private
practitioner are not worth  preparing.   He  wiii buy them
                                                 much 
                 APPENDIX.                 C59

mnch cheaper than he can make thein.  Great care however
is neceffary to obtain them genuine.   They are often adul-
terated, and ought never to be purchafed unlefs from perfons
of known veracity.   Such of them as  are in common  ufe,
are inferted in the lift of drugs  and medicines.   Lhcir pro-
per dofes  and manner of application, are mentioned in the
practical part of the Bock, wherever they are prefcribed.
  Such articles of medicine as are to be found in the houfe or
garden of almoft every peafant, as  barley, eggs, onions, &c.
arc likewife, for the moft part, omitted.  It is needlefs to fwell
a lift of medicines with fuch things as can  Ix obtained when-
ever they are wanted, and which fpoil by being kept.
  The preparations made and fold by diftillers and confec-
tioners are alfo generally left out.   Thefe people,  by ope-
rating upon  a  larger plan, generally make things better,
while it is in their power to  afford them  much cheaper,
than they can be prepared by any private hand.
  The quantity ordered of every medicine is as fmall as
could well be prepared, both to prevent unneceffary expence,
and that the  medicine might not fpoil by keeping.   Almjft
every medicine fuffers by being kept, and fhould be ufed as
foon after  it has been  prepared as poffible.   Even fimple
drugs are apt to fpoil, and fhould therefore be laid in in
fmall quantities;  they either rot, are confumed by infects,
or  evaporate fo  as to lofe their peculiar tafte  or  flavour,
and often become quite  infignificant.
  In the preparation of medicine, I have generally followed
the moft improved difpenfatories }  but  have  taken  the li-
berty to differ from them wherever my  own obfervations,
or thofe of other practical writers, on whofe  judgment I
could depend, fuggefted an improvement.
  In feveral compolitions, the ingredient on which the  effi-
cacy of  the medicine principally depends  is increafed, while
the auxiliaries, which are generally otdered in fuch trifling
quantities as  to be of no importance, are left out, or only
fuch of  them retained as are neceffary to give the medicine
a proper confiftencc, or the like.
  The colouring ingredients are likewife for the moft  part
omitted.  They increafe the bulk and price of the medicine,-
without adding any thing to its value.  It would be well if
they were never ufed at all.  Medicines are often adulterated
for the  ink- ot a colour.   Acrid,  and even po'ffonous  lab 
66o
APPENDIX.
 fiances are, for this purpofe, fometimes introduced into thofe
 medicines  which  ought to be moft bland and  emollient.
 Ointment of elder, for example, is often mixed with verde-
 grife to give it a fine green colour, which entirely fruftrates
 the intention of that  mild ointment. Thofe who wifh to ob-
 tain genuine medicines thou Id pay no regard to their colour.
   Some regard is likewife paid to expence.  Such  ingredi-
 ents as greatly increafe the price of any compofition,  with-
 out adding confiderably  to its virtue,  are generally  either
 omitted, or fomewhat lefs expenfive fubftituted in their place.
 Medicines are by no means powerful in proportion to their
 price.  The cheapeft are often the beft; befides,  they are
 the leaft apt to be adulterated, and are always moft readily
 obtained.
   With regard to the method of compounding medicines, I
 have generally followed that which feemed to be the moft
 fimple and natural, mentioning the different fteps  of the pro-
 cefs  in the fame  order  in  which they ought to be taken,
 without paying an implicit regard to the  method of  other
 difpenfatories.
   For many of the remarks concerning the preparation, &c.
 of medicines,  I have been obliged to the author of the New
 Difpenfatory.   The  other  obfervations are either fuch as
 have occurred to myfelf in practice, or have been fuggefted
 in the courfe  of reading, by authors whofe names I am not
 able diftinctly to recollect.
   I have followed the alphabetical order, both with regard
 to the fimples and preparations.   A more fcientific method
 would have been agreeable to fome perfons, but lefs  ufeful
 to the generality of readers.   The different  claffes of  me-
 dicine have no great dependence  upon one  another; and,
 where they have, it is hard to fay which fhould (land firft or
 laft ; no doubt the fimple preparations ought to precede the
 more compound.  But all  the advantages arifing from this
 method of arrangement do not appear  equal to  that fingle
 one,  of being able, on the firft opening of the book, to find
 out any article, which, by the alphabetical  order, is  ren-
 dered quite eafy.
   The dofe of every medicine is mentioned whenever it ap-
 peared neceffary.   When this is omitted, it is to be under-
.flood that the medicine may be ufed at difcretion.  The dofe
 mentioned ;r chcayrfor an adult, unlefs %vhen the contrary is ex-
                                                prefftd. 
APPENDIX.
ftj'i
prejftd. It is not an  eafy matter to proportion the dofes of
medicine exactly to  the  different  ages,  conftitutions, &c
of patients;  but, happily  for  mankind, mathematical ex-
actnefs here is by no means neceffary.
  Several attempts have been made to afcertain the proporti-
onal dofes for the different ages and conftitutions of patients 5
but, after all that can be faid upon this fubjeel, a great deal
muft be left to the judgment and fkill of the perfon who admi-
nifters the medicine. The  following general proportions may
be obferved ; but they are by  no means intended for exact
rules. A patient between twenty and fourteen may take two-
thirds of the  dofe ordered for an adult;  from fourteen to
nine, one half; from nine to fix, one-third;  from fix to
four, one-fourth ; from four to two, one fixth ;  from two
to one, a tenth ; and below one,  a twelfth.
  NB.  The Apothecary's weights, and the Englifh wine
ineafures, are ufed throughout the whole book, the diffe-
rent denominations of which will appear from the following
Table:
          A pound contains twelve ounces.
          An ounce   -  - eight drachms.
          A drachm -  -  three fcruples.
          A fcruple   -  -  twenty grains.

          A gallon contains eight pints.
          A pint  -  -  - fixteen ounces.
          An ounce  -  -  eight  drachms.
     A  table-fpoonful is the meafure  of half an ounce.
     A tea-fpoonful is one-fourth of a table-fpoonful.
     Sixty drops make one  tea-fpoonful.
A LIST 
66z
APPENDIX.
A LIST of SIMPLES, and cf fuch MEDICINAL PRE.
  PORTIONS,  as  ought to be kept in readinefs for  private
  Practice.
      AGARIC
       Alum
 Antimony, crude
 Arfenic, white
 Balfam of Capivi
 ------of Peru
 Bark, caffia
 ---- cinnamon
 ---- Mezerion
 ----• Peruvian
 Borax
 Calamine ftone, levi-
     gated
 Caftor,  Ruffian
 Cauftic,  common
 ------- lunar
 Chalk prepared
 Earth, Japan
 ---- Armenian bole
 Extracts of Gentian
 ------- cf Hellebore, black
 ------- of hemlock
 ■       of liquorice
 ------- of Peruvian bark
 Flowers of camomile
 -----— colt's foot
 ------- elder
 ------- red rofes
 Fox-glnve
 Fruits, caflia fiftularis
 ----  Curaffao oranges
 ----  hgs,  dried
----  French prunes
----  Jamaica pepper
----juniper berries
■----  nutmegs
----  tamarinds
Galls
Gums, aloes
 ----  ammoniac
 Gums, arabic
 ---- afafcetida
 ---- camphor
 ---- galbanum
 ---- gamboge
 <---- guaiacum
 ---- kino
 ---- myrrh
 ---- opium
 Herbs, leffer centaury
 -------peppermint
-------penny-royal
 -------favin
 -------trefoil
-------'iva urfi
-------wnrmwcod
Lead, Litharge
---- extract  of
      fugar of
Lemcn-peel
Mace
Magnefia alba
Manna
Mercury,  crude
■         calcined
— calomel
— corrofive fublimatc
— red precipitate
— white ditto
Mufk
Oil, efTential, of amber
 .-----------of anife
 -----------of cinnamon
-----------■ of lemon-peel
---------;—  of peppermint
— ex pre/Ted, of linfeed
Oil  of olives,  or Florence oil
   caftor oil
—  of turpentine
Ora:;ge-ped
                       Refins 
APPENDIX.
663
Refins, benzoin
       flowers of
Burgundy pitch
white,  or rofin
fcammony
Roots, calamus aromaticus
----- Carolina pink
----- Colombo
----- garlic
----- gentian
---- ginger
---- hellebore, black, white
-----jalap
---— ipecacuanha
----- lily,  white
----- liquorice
----- marfhmallow
---- mezerion
<---•- rhubarb
----- farfaparilla
----- feneka
----- fquills
---- tormentil
.■ . 1   Virginia fnake
.---- wild valerian
---- zedoary
Saffron
Sal ammoniac, crude
--------------volatile
Salt, Epl">m
    ■ nf Glauber
---- i:i'r-j. :<uriBed
---- Rochelle
——- fo da,  phofphorata
----- of tartar
Seeds, anife
---- caraway
----- cardamom
—:— coriander
«---- cummin
Seeds, muftard
---- fweet fennel
Senna
Spanilh flies
Sperma ceti
Spiiits, asthertal, or xther
-------of hartlhorn
-------of lavender,compound
-------of nitre
-------ditto dulcified
-------of fal ammoniac
-------of fea fait
-------of vinegar
-------of vitriol
..       of wine rectified
-------volatile  aromatic
Steel, tilings of
---- rull of,  prepared
Sulphur
-------flowers of
Tar
— Barbadoes
Tartar, cream of
----1--- emetic
-------foluble
------- vitriolated
Tin prepared
Tutty, levigated
Turpentine, Venice
Verdegrife
Vitriol, green
-------  blue
-------white
Wax,  white
----- yellow
Woods,  guaiacum
-    — logwood
------- falfafras
,------ faunders, red
Zinc,  flowers of
MEDI; 
L*  664   ]
MEDICINAL  PREPARATIONS.
                   BALSAMS.

     THE fubject of this fection is not the natural balfams, but
      certain compofttinns, which, from their being fuppofed
to poffefs bdfarnic qualities, generally go by that name.
   This clafs of medicines was formerly very numerous, and
held in great  efteem : modern practice, however, has juftly
reduced it to a very narrow compafs.

                   Anodyne  Balfam.

  Take of white Spanifh foap,  one ounce ; opium, unprepared,
two drachms ; brandy, nine ounces.  Digeft them together in
a gentle heat for three days;  then drain off the liquor, and
add to it three drachms of camphor.
  This balfam, as its title expreffes, is intended to eafe pain.
It is of fervice in violent  ftrains and  rheumatic complaints,
when  not attended with  inflammation.  It  muft  be lubbed
with a warm hand on  the part affected; or  a linen rag moif-
tened  with it may be applied to the part, and renewed every
third or fourth hour, till the pain abates.  If the opium is left
out, this will be  the faponaceous balfam.

                   BOLUSES.

  AS bolufes are  intended for immediate  ufe, volatile falts
and other ingredients improper for being kept, are  admitted
into their compofition.  They  are generally compofed of pow-
ders,  with a proper quantity of fyrup, conferve, or mucilage.
The lighter powders are commonly made up with fyrup, and
the more ponderous, as mercuiy, &c.  with conferve ; but thefe
of the lighter kind would  be more conveniently made up with
mucilage, as it increafes  their bulk lefs than the other  addi-
tions, and likewife occafions the medicine to pafs down  more
ealily.
                   Aftringent  Bolus.

  Take of alum  in  powder, five  grains;  fyiup, a fuflicient
quantity to make a bolu^.
                                 4                   In 
                   BOLUSES.                 Us
   In an exceffive flow of the menfes, and other violent difchar-
 ges of bio. >d,  proceeding from  relaxation, this  bnlus  may be
 given every four or five hours till the difcharge abates.

                    Diaphoretic Bolus.

   Take of gum guaiacum,  in powder, ten grains; flowers of
 fulphur and cream of tartar, of each one fcruple, fimple fyrup,
 a fufficient quantity.
   In rheum uic complaints, and diforders  of the fkin, this
 bolus may be taken twice, a-diy.

                    Mercurial Bolus.

   Take of  calomel,   fix grains;  conferve  of rofes,  half a
 drachm.  Make a bolus.
   Where mercury is  neceffary, this bolus may be taken twice
 or thrice a week.  It  may be taken over night; and if it does
 not operate, a few grains of jalap will be  proper next day to
 carry it off.

           Bolus of  Rhubarb and  Mercury.

   Take of the  beft  rhubarb, in powder, from a fcruple to
 half a drachm ; of calomel, from four to fix grains j  fimple
 fyrup, a fufficient quantity  to make a bolus.
   This  is a proper purge in hypochondriac conftitutions ; but
 its principal intention  is to expel worms.   Where a  ftronger
 purge is neceffary, jalap may be ufed inftead of the rhubarb.

                     Pecloral Bolus.

   Take of fperrna ceti, a fcruple ; gum ammoniac, ten grains \
 fait  of  hartfliorn, fix grains; fimple fyrup as much  as will
 make them into  a bolus.
   This  bolus is  given in colds and coughs of long ftanding,
 afthmas, and  beginning confumptions of the lungs.   It is ge-
 nerally proper to bleed the patient before  he begins to ufe it.

                     Purging Bolus*

   Take of jalap, in powder, a fcruple; cream of tartar, two
fcruples.  Let them be rubbed together, and formed into a
bol is, with fimple fyrup.
   Where a mild purge is wanted, this will anfwer the  purpofe
very well.  If a ftronger dofe is neceffary, the  jalap may be
increafed to half a drachm or upwards.
                        X X                        yjatil* 
66$
APPENDIX',
                     Volatile  Bolus.

   Take of volatile fal ammoniac,  fix grains; conferve of rofcr,
enough to make it into a bolus-.   To be taken every two cr
 three hours in low nervous fevers.

          CATAPLASMS  AND SINAPISMS.

   CATAPLASMS  poffefs  few or no  virtues fuperior  to a
poultice, which may be fo made as, in moft cafes, to fupply
their place.   They are chiefly  intended either to act as dilcu-
tients, or to  promote fuppuration.

                         Sinapifms.

   Sinapifms-are employed to recal the blood and fpirits  to a
weak part, as in  the  palfy and atrophy.   They aie alfo of
fervice in deep feated pains,  as the fciatica, &c.   When the
gout feiz s the he-id or the ftomach, they are applied to the feet
to  ring the diforder to thefe paits. They.are likewife applied
to the patient's fole* in the low ftate of fevers.   They ihonld
not be fuffered to lie on,  however, till they have raifed  blif-
ter-.,  but till the parts become red, and will continue fo when
preffed with the finger.
   The finapifm is only a poultice made with vinegar inftead of
milk, and rendered warm and ftimulating by the addition of
muftard, horfe-radifh, or  garlic.
   The common finapifm  is  made by taking crumb of bread
or flour, and  flour of muftard, of each  equal quantities ; ftrcng
vinegar as  much  as  is fufficient,  and mixing them  fo as to
make a poultice.

                  CLYSTERS.

   THIS clafs of medicines  is of more  importance  than  is
generally imagined.   Clyfters fcrve, not only to evacuate the
contents of the belly, but alfo to convey very  active medicines
into the fyftem.  Opium, for example, may be adminifteied in
ibis way  when  it will not fit   upon the. ftomach, and alfo in
larger dofes than at any time  it can be  taken by the  mouth.
The Peruvian bark may likewife be with good effect, admini-
ftered in form of clyfter to jpeifonswho cannot take it by the
><"outh.
                                                 A fimple . 
                 CLYSTERS.                667
   A fimple clyfter can feldom do hurt, and  there are many
cafes where it may do much good.  A clyfter even of warm
water, by ferving as  a  fomentation to the parts, may be of
confiderable fervice  in inflammations of the bladder, and the
lower inteftines, &c.
   Some fubftances,  as the fmoke of tobacco,  maybe thrown
into the bowels  in  this way,  which  cannot by  any other
means whatever.  This may be eafily effected by means of a
pair of hand-bellows,  with  an apparatus fitted to them for
thar purpefe.
   Nor is the ufe of clyfters confined to medicines.   Aliment
may alfo be conveyed in this way.   Perfons  unable to fwal-
low,  have  been,  for a  confiderable  time,   fupported  by
clyfters.

                    Emollient  Clyfter.

   Take  of flaxfeed tea  and new milk,  each fix ounces.   Mifc
them.
   If fifty or fixty drops  of laudanum be added to this,  it will
fupply the place of the Anodyne Clyfler.

                    Laxative Clyfter.

   Take of warm water,  half a pint; fweet oil  or frefli butter,
and brown fugar, of each two ounces.  Mix them.
   If an ounce  of Glauber's fait, or a  table-fpoonful of com-
mon fait,  be added to this,  it will be the Purging Clyjler.

                 Carminative  Clyfter.

   Take of camomile  flowers, an  ounce ; anife-feeds, half an
ounce.   Boil in a pint and a half of water to one pint.
   In hyfteric and hypochondriac complaints this may be ad-
miniftered inftead of the Fetid C'yjler,  the fmell of which is fo
difagreeable to mot patients.

                      Oily  Clyfter.

   To four ounces of the infufion of camomile flowers, add
an equal quantity of fweet oil.
   This clyfter is  beneficial in bringing  off die fmall worm?
lodged in' the lower parts  of the  alimentary  canal.  Y/hen
given  to children the  quantity muft  be proportionally lef- 
66$                APPENDIX.

                     Starch  Clyfter.
   Take  jelly of ftarch,  tour ounces ;  linfeed  oil, half aa
ounce.   Liquify the jelly over a gentle fire, and then mix in
the oil.
   In the dyfentery or bloody flux, this clyfter may be admi-
niftered after every loofe ftool, to heal the ulcerated inteftines
and  blunt  the fharpnefs  of corroding humours.  Forty or
fifty drops  of laudanum may be occaiionally added ; in which
cafe,  it  will  generally fupply  the  place of the Aftringent
Clyjier,
                   Turpentine  Clyfter.

   Take of  common decoction, ten ounces; Venice turpentine,
diffo ved with the yolk of an egg, half an ounce;  fweet oil,
one ounce.   Mix them.
   This diuretic clyfter is proper in obftructions of the urinary
paffages, and in colicky complaints,  proceeding from gravel,
or coftivenefs.
                    Vinegar Clyfter.

   1 his clyfter is made by mixing  three ounces of vinegar with
five of water-gruel.
   It avfwers all the purp-fes of a common  clyfter, with the
peculiar advantages of being proper either in inflammatory or
putrid diforders, efpecially in the latter.
   (r*j* We  think it unneceffary to give  m^re examples of this
clals  of medicines, as ingredients adapted  to any particular
intention may be occafionally added to  one  or other of the
ibove forms.

            COLLYRIA, or EYE-WATERS.
   EYE-WATERS have  been  multiplied  without number,
almoft every perfon pretending to be poffeffed  of  fome ferret
preparation for the cure of fore eyes.   I have examined many
of them, and find  that they are  pretty much  alike, the  bafrs
of moft  r.f them being either alum, vitriol or lead.  Their
effects evidently are, to brace and  reftore the tone of the parts;
hence they are principally of fervice  in flight inflammations ;
and in that relaxed ftate of the parts which  is induced by ob-
ftinate _011cS.
   Camphor is commonly  added  to  thefe compofitions; but
as it feldom incorporates properly with  the water, it  can be
of little u!e.   Boles and other earthy fubftances, as they do
sot diffolye in water,  are likewife unfit for this purpofe.
                                                 Collyrfafn 
            CONFECTIONS.            669

                  Colly Hum of Alum.

  Take of alum, half a drachm ; agitate it well together with
the white of one egg.
  This  is the Collyrium of Riverius.   It is ufed  in inflamma-
tion of the  eyes,  to allay heat,  and reflrain the flux of hu-
mor*.   It muft be put in a fine  linen bag, and applied to the
eyes at bed-time.

                   Vitriolic Collvrium.

  Take of  white  vitriol,   half  a drachm;  rofe-water,  fix
ounces.  DifLlve  the   vitriol in the water, and  filter the
liquor.
  This, though fimple, is perhaps equal in  virtue to moft of
the celebrated coll) ria.  Ii is an ufeful application in weak,
watery, and inflamed eyes.  Though the flighter inflamma-
tions will generally )ield to it,  yet in thofe of  a more obfti-
nate nature, the affiftance of bleeding and bliftering will often
be neceffary.
  When a  ftrong  aftringent  is  judged  proper,  a  double or
triple quantity of the vitriol may be ufed.   I have  feen a fo-
lution  of four times the ftrength  of  the above ufed with ma-
nifeft advantage.

                  Collyrium of Lead.

   Take fugar of lead, and crude fal  ammoniac,  of each four
grains.  Diffolve them in eight  ounces of common water.
   F« rty or fifty drops of laudanum may be occafionally added
to this collyrium.
   Thofe who choofe may fubftitute inftead  of this  the colly-
rium  of lead rccommenJed by  Goulard ;  which is mads by
putting twenty-five drops  of his  Extract of Lead to eight oun-
ces of water, and adding a tea-fpoonful of brandy.
   Indeed,  common water  anJ brandy, without  any other ad-
dition,  will in many cafes  anfwer very  well as a collyrium,
An ounce of the latter may be added to five  or  fix ounces of
the forme-; and  the eyes, if weak, bathed with it  night and
morning.

                    CONFECTIONS.
   CONFECTIONS containing above  fixty ingredients are
ftill to be found in fome of the moft  reformed difpenfatories.
As moft of their intentions, however, may  be more certainly,
*nd as effectually anfwered by a few glaff-s of wine or grains
                                                       of 
 670                APPENDIX.

 of  opium, we fliall pafs over this clafs of medicines very
 flightly.

                   Japonic  Confections.

   Take of Japan  earth,  three ounces ;  tormentil root, nut-
 meg,  olibauum, of each  two ounces ; opium diffolved in a
-fufficient quantity of Lifbon wine,  a drachm and a half; fim-
 ple  fyrup and conferve of rofes, of each fourteen ounces. Mix
 and make  them into an electuary.
   This fupplies the place of the Diafccrdium.
   The dofe of this electuary is from a fcruple to a drachm.


           CONSERVES AND PRESERVES.
   EVERY Apothecary's fhop was formerly fo full of thefe
 preparations,  that it might have paffed  for a  conicctioner's
 warehoufe.  They  poffefs very few  medicinal properties, and
 may rather  be claffed  among  fwectmeais  than medicines.
 They are f>metimes, however, of ulc, for reducing inf bo-
 ivfis or pills fome of the  more ponderous powders, as the pre-
 parations of iron, mercury, and tin.
   Conferves are compofitions of frefh vegetables and fugar,
 beaten together into an uniform mafs.  In making thefe pre-
 parations,  the leaves of vegetables  muft  be  freed from their
 ftalks,  the  flowers from their  cups, and  the yellow  part  of
 orange peel taken off with a ra'p. They are then to be pound-
 ed in a marble mortar, with a wooden peftle, into a imooth
 mafs;  after which,  thrice their weight of fine  fugar  is com-
monly added by degrees, and the  beating continued till they
are uniformly mixed; but the  conferve will be better if only
twice its weight of  fugar be added.
  Thofe who prepare large quantities of conferve generally
reduce the  vegetables  to a pulp by  the means of a mill, and
afterwards  beat them up with the fugar.

                Conferve of Red Rofes.

  Take a pound of red rofe buds, cleared of their heels  ; beat
them well in a  mortar, and, adding by  degrees two pounds
of double-refined fugar, in powder, make a conferve.
  After the fame manner are prepared the ennferves of orange
peel, rofemary flowers, fea wormwood, cf the leaves of wood-
forrel,  &c.
  The conferve of rofes is one of the moft agreeable and ufe-
ful preparations belonging to this chfc.   A drachm or two
                                                       of 
             DECOCTIONS.              671
of it,  diffolved in warm milk, is ordered to be p-iven as a gen-
tle reftringent in weaknefs of the ftomach, and likewife in phthi-
fical coughs, and fpitting of blood.  To have any confiderable
effects, however,  it muft be taken in larger quantities.

                   Conferve  of Sloes.

   This may be made by boiling the floes  gently in water,  be-
ing careful to take them out before they burft; afterwards ex-
preffing the juice, and beating it up with three times its weight
of fine fugar.
   In  relaxations  of the uvula and  glands of the  throat, this
makes an excellant gargle,  and may be ufed at difcretion.
   Prefrmes are  made by fleeping  or boiling frefh vegetables
firft in water, and afterwards in fyrup,  or a folution of fugar.
The fubject is either preferved moift  in the fyrup,  or taken  out
anddiieJ, that the fugar may candy upon it.  Thelaftis  the
moft uieful method.
                  Candied Orange-peel.
   Soak Seville orange-peel in feveral waters, till it lofes its bit-
ternefs ;  then boil it in a  folution  of double-refined fugar in
water, till it becomes tender and tranfparent.
   Candied lemon-peel is prepared in the fame manner.
   It  is reedlefs to add  more of thefe preparations, as  they
belong rather to  the art  of the confectioner  than  that of the
apothecary.
                     DECOCTIONS.

   WATER readily extracts the gummy and faline parts of
vegetables; and  though  its action is chiefly, confined to thefe,
yet the refinous  and oily  being  intimately blended with the
gummy and faline, are in great part taken up along with them.
Hence watery decoctions and infufions of vegetables, conflitute
a lar^e,  and not unufeful, clafs of medicines. Although moft
vegetables yield  their virtues to water, as well by infufion as
decoction, yet the latter is often neceffary,  as itfavcs time, and
does  in a few minutes what the other would require hours, and
fometimes days,  to effect.
   The medicines of this clafs are  all intended for immediate
ufe.
                  Decoclion of Althaa.

   Take  of the  roots  of marfh-mallows,  moderately  dried,
•hree  ounces;  raifins cf the fun, one ounce;  water, three
pints.
                                                       Boil 
672
APPENDIX.
   Boil the ingredients in the water till one-third of it is  eon-
fumed ; afterwards ftrain  the  decoction,  and let it  ftand for
fome time to fettle.   If  the  roots be thoroughly dried,  they
muft be boiled till one half the water be confumed.
   In coughs, and fharp  defluctions upon  the lungs, this de-
coction may be ufed for ordinary drink.

                The Common Decoclion.

   Take of camomile flowers,  one ounce; elder flowers,  and
fweet fennel feeds, of each half an ounce;  water, two quarts.
Boil them a little while,  and then ftrain the decoction.
   A medicine equally good may be prepared by infufing the
ingredients for fome hours in boiling water.
   This decoction is  chiefly intended as the bafis of clyfters,
to which  other  ingredients may be  occafionally added.  It
will  likewife ferve as a  common fomentation, fpirit  of wine
or other things being added in fuch quantity as the cafe  may
require.

                Decoclion  of Logwood.

   Boil three ounces of the ftiavings, or chips, of logwood, in
four pints of water,  till one half of the liquor is wafted. Two
or three ounces of fimple cinnamon-water jnay be  added to
this decoction.
   In fluxes of the belly, where the ftronger aftringents are im-
proper, a tea-cupful of this decoction may be taken with ad-
vantage three or four times a-day.

                Decoclion  of the Bark.

   Boil two ounces of the Peruvian bark,  grofsly powdered, in
a  pint and a half of water to one  pint; then ftrain the de-
coction.  If a tea-fpoonful of  the weak fpirit of vitriol be ad-
ded to this medicine, it will render it both more agreeable and
efficacious.

           Compound Decoclion of the Bark.

   Take of Peruvian bark  and Virginian  fnake ro»t, grofsly
powdered,  each  three drachms.  Boil them in a pint of wa-
ter to one half.
   This is a proper medicine towards the decline  of malignant
fevers, when the pulfe is  low,  the voice weak, and the head
affected with ftupor, but with little delirium.
   The dofe is four table-fpoonfuls every fecond or third hour*
                           i                     Decoclion 
                  DECOCTIONS.              673

               Decoclion of Sarfaparilla.
   Take of frefh farfaparil'a r< of, fliced and bruifed, two ounces;
fhavings ' f guaiacum wood, one ounce.   Boil over a flow fire,
in three quart-, of wa'.e-, to one ;  adding towards the end half
an ounce of liquorice-root.  Str tin th- decoction.
   This may eiih.r be employed as an affift mt to a courfe  of
mercurial alteratives,  or taken  after the mercury has been
ufed for fome time.   I< ftrengthens  the ftomach and  reftores
fleih and vigour to habits emaciated by the venereal difeafe.
It may alfo  be taken in  the rheumitifm, and cutaneous dif-
orders proceeding from foulnefs  of the bl od and juices.
   This decoction maybe taken, from a pint .nd a half, to two
quarts in the day.
   The following decoction is faid to  be  fimilar to that ufed by
Kennedy, in the cure  of the venereal difeafe, and may fupply
the place of Lifbon diet drink :
   Take of farfaparilla, three ounces; liquorice and mezereon
root, of each half an  ounce ;  fhavings of guaiacum and fa.la-
fras wood, of each one ounce ;  crude  antimony, powdered,
an ounce and a half.   Infufe  thefe ingredients in eight pints
of boiling  water for  twenty-four  hours, then boil them till
one half of the water is tonfumed ; afterwards ftrain  the de-
coction.
   This decoction may be ufed in the fame manner as the pre-
ceding.

                  Decoclion of Seneka.

   Take of feneka rattle fnake root, one ounce ; water, a pint
and a  half.   Boil to one  pint, and ftrain.
   This decoction is recommended in the  pleurify, dropfv, rheu-
matifm, and'fome obftinate dif >rders  f the fkin.  The dofe is
two ounces, three  or  four times a-day,  or oftener, it  the fto-
mach will bear it.

                     White Decoclion.

   Take of the pureft chalk,  in  pow.ler, two ounces ; gum
arabic, half an ounce  ; water, three pints.  Boil to one quart,
and ftrain  the decoction.
   This h a proper drink in acute difeah■% attended with, or
inclining to,  a loofenefs,  and where acidities abound in the
ftomach or bowels.   It is peculiar y proper for children when
afflicted with'fournefs  of the ftomach, and for perfi>ns who are
fubject to  the heartburn.  It may have two or three ounces
if fimple cinnamon-water added to  it.
       *   ~                 Y  y                      An 
?74               A  P P E N D I X.
  An  ounce of powdered  chalk,  mixed with  two pints of
water,  will occafion dly fupply the place of this decoction, and
alfo of the chalk julep.

                  DRAUGHTS.

  THIS is a proper form for exhibiting fuch medicines as are
intended to operate immediately, and which do not need to be
fcqiently  repeated ;  as purges, vomits, and a  few  others,
which are to be taken at one dofe.  Where a medicine requires
to be ufed  for any length of time, it is  better to  make up a
larger  quantity of it at once, which faves  both trouble and
expence.

                  Anodyne  Draught.

  Take cf liquid laudanum, twenty-five drops; mint-water, an
ounce.   Mix them with a little fuear.
  In exceffive pain, where bleeding  is not neceffary,  and in
great reftleffnefs  this compofing draught may  be taken and
repeated occafi . r.ally.

                   Diuretic Draught.

  Take of nitre, half a drachm ;  common water, an ounce.
  This draught'is of fervice in an obftruction or deficiency of
aria.1.

                  Purging Draughts.

  Take of manna, an  ounce ; foluble tartar, or  Rochelle fi.Iu
from three to four drachms.   Diffolve in three ounces of boil-
ing water ; to which add peppermint-water, half an ounce.
  As manna  fomeiimes will  not fit upon the ftomach,  an
ounce  or ten dracl.ms of the bitter purging falts,  diffolved in
four ounces cf warer,  may be taken inftead of the  above.
  To make Glauber or £,>fom falts agreeable, we add cream
of tartar or lime-juice, and fweeten with fugar.
  Thofe who cannot take falts, may ufe the following draught:
  Take r.f jalap  in powder, a fcruple ; common water, an
ounce ;  mint-'vwater, fix  drachms.  Rub the jalap  with twice
its weight of fugar, and add to it the other  ingredients.

                 sSzueating  Draught.

  Take fpirit of Mindererus, two ounces ;  liquid laudanum,
antimonial wine, each  twenty-five drops; mint-water, half an
•tmcc.   Make 'h-.-.v into a draught.
                                                       I- 
               ELECTUARIES.              C-]S
   In recent colds and rheumatic comp'ai' ts, rKs draught is of
fervice.   To promote its effects, h-.wever, the patient ought
to drink freely of warm watei-gruel,  or of fome other weak
diluting liquor.
                   Vomiting Draughts.
   Take of  ipecacuanha,  in  powder,  a fcruple ;  water, an
©unce ; fugar,  a drachm.   Mix them.
   Perfons who require a ftr-ng r  vomit, may add to the
above half a grain,- or a grain, of erne ic tartar.
   Thofe who do not choofe the powder, may take ten drachms.
of the ipecacuanha wine; or  half an ounce of the wine, and
an equal quantity of the  fyrup  of fquiiis.

                 ELECTUARIES.

   Electuaries are generally compofed of  the lighter pow-
ders, mixed with fyrup, honey, conferve, or  muciiage, into
fuch  a  confiftence, that the powders may neither feparate by
keeping,  nor the mafs prove too ftiff for fwallowing. ' They
receive chiefly the milder alterative medicines, and fuch as
are  not ungrateful  to the  palate.
   Aftringent electuaries, and fuch as have pulps  of fruit in
them, fliould be  prepared only  in fmall quan ities ; as aftrin-
gent medicines lofe their virtues by being kept in this form,
and the pulps  of ;rnits are apt to ferment.
   F< r  rhe extraction of pulps it will  be neceffary  to boil un-
ripe  fruits, and  ripe ones it  they are dried, in a fmall quan-
tity of water,  till they become foft.  The i ul i  is then ro be
preffed out through a ftrong hair fieve, or tliin cloth, and after-
wards boiled to  a due confidence, in an earthen veifel, over a
gentle fire, taking care to prevent the matter from burning by
continually ftirring  it.  The pulps of fruits that are both ripe
and frefii, may be preffed out without  any previous boilir >j.

               '    Lenitive Elecluary.              i

   Take  of fenna, in fine  powder, eight ounces ; coriander
 feeds, alfo in  powder, four ounces ;  pulp  of tamarinds and
 of French  prunes, each a pound.  Mix the pulos and pow-
 ders toge'her, and  with a  fufficient quantity of ample fyrt;p,
 reduce the whole into  an  electuary.
   .A tea-fpoonful of this electuary, taken two or three tini.s
 a-dav, generally proves an  agreeable  laxative.   It  likewii^
 ferves  as a convenient vehicle  for exhibit'] g more active me-
 dicines,  as jalap, fcamm ny, and fuch like.
    This may fupply  the place of the  electuary of Cafla-
                         Y  y 2                     EL Hilary 
676               APPENDIX.

                Elecluary of the  Bark.

   Take of Peruvian bark, in powder, three ources ; cafcariila,
half an ounce ; fyrup of ginger, enough to make an electuary.
   In 'he cure  of obftinate intermitting levers, the bark  is af-
fifted by  the cafcariila.  In hectic habits,  however, it will be
beter t- leave out the cafo.ri'.la, and put three drachms of
crude fal ammoniac in its ftead.

                ELcluary for  the Piles.

   Take flowers of fulphur, cream of tartar  powdered, each
one  ounce ; molaffes a fufficient quantity to form an electuary.
   A tea-ipooi.ful  of  this may be taken three or four  times
a-day.
                Elecluary for the Palfiey.

   Take of powdered -nuftard-feed, and conferve of rofes, each
an ounce ; fyrup of ginger, enough to make an electuary.
   A tea-fpoonful of this  may be  taken.three or four  times
 n-day.

             Elecluary for  the Rheumatifm,

   Take  of conferve of  rofes, two ounces; gum guaiacum, in
 powder, an ounce ; fyrup  of  ginger, a fufficient quantity to
 makv/ a  electu iry.
   In obftinate rheumatifm^, which are not accompanied with
 a fever, a tea fpoonful of this electuary  may be taken twice
 a-day with c^nfiderabie advantage.

                  EMULSIONS.

   Emulsions, befides their ufe as medicines, are alfo proper
 vehicles for certain fubftances, which  cou'd  not otherv ife be
 converi-nt'.y  taken in a liquid form.  Thus  camphor,  tritur-
 ated wi  h  aim nds readily unues with water  into an emulfion.
 P.ire r{\.,  ba'fams,  . e'.i.s. and other fimilar fubftances, are
 likewife rendered mifcible  with water  by the intervention of
 mucilages.

                    Common Emulfion.

   Take of fweet almonds, an ounce ;  Water, two pints.
   Let the almonds be blanched, and beat up in a marble mor-
 tal  ; adding  the  water by little and little, fo as  to make an
 emulfion j afterwards let it be ftrained.

                                                  Arabic 
                EXTRACTS.                677

                   Arabic Emulfion.

  This  is made in the fame manner as the  above,  adding to
the almonds, while  beating, two ounces aid  a half of the
mucilage of  gum arabic.
  Where foft cooling medicine^ are neceffary, thefe emulficns
may be ufed as ordinary drink.

                 Camphorated Emulfion.

  Take of camphor, half a drachm ; fweet ajmonds, half a
dozen ; white  fugar, half an ounce; mint water, eight ounces.
Grind the camphor and almonds well together in a ftone mor-
tar,  and  add by degrees  the m:nt-water ;  then ftrain the
liquor,  and diffolve  in  it the fugar.
   In fevers, and other diforders which require the ufe of cam-
phor, a table -fpoonful of this  emulfion may be taken every
two or  three  hours.

               Emulfion of Gum Ammoniac.

   Take of gum ammoniac, two drachms; water, eight ounces.
 Grind  the gum  with the water poured upon it by little and
 little, till it be  diffolved.
   This emulfion is ufed for attenuating tough,  vifcid phlegm,
 and  promoting expectoration.   In  obftinate   coughs,  two
 01 nee > of the fyrup of poppies may be added to it.   The dole
 Is two table-fpooufuls three or  four times a-day.

                      Oily Emulfion.

   Take of foft water, fix ounces ; volatile fpirit, two dr ichrns ;
• fweet oil,  an ounce; fhake  them well together, and add, of
 fimple fyrup, half an ounce.
   In recent  colds and coughs, this emulfion  is generally of
 fervice ; but if the cough proves obftinate, it will fucceed bet-
 ter when made with the paregoric elixir, hi ftead of the volatile
 fpirit.  A table-fpoonful of it may be taken every two" or three
 hours.
                   EXTRACTS.

    Extracts are prepared by boiling the fubjeet in water, and
 evaporating  the ftrained  decoction, to a due confidence.   By
 this procefs fome of the more  active parts of plants are freed
 from the  ufelefs, indiffoluble earthy matter, which  mates the
 larger {hare  of their bulk.  Waver, however,  is not the only
  jnenftrum ufed in the preparation cf exacts;  Ibm-jtimes it is 
C7S                APPENDIX.
j: ;ned with fpirits, and at other times rectified  fpirits alone is
empl'-yed for that purpofe.
   Extracts are prepared from a variety of different drugs, as
the b .k, gentian,'jalap, &c, ; nut as they require a trouble-
fome and tedious o.eraiii n,  it will be more convenient f< r a
priva*' practitioner to punhafe what he needs of them from a
profHfec druugift than to p- c.oart ti.crn himfelf.   Such of them
as ai^'generally  ufed are mil-ru-d in our lift of fuch drugs an.*
medicines a, aie  to be kept for private practice.

              FOMENTATIONS.

   Fomekt/.tions are generally  intended either to eafe pain,
by taking off tenfion and  fpafm ; or to brace ai d  re ft < re the
tone aid \igorof thofe p^rts to which  they are  applied.  The
firft  of  hefe ;mentions may gen  rally  be anfwered by warm
water, and the fecor.d by  cold.   Certain fubftances, however,
are ufually added to water, wth a view to heighten its effects,
as anodynes, ar< matics, afti indents Sec.   We  fh .11 therefore
fubjoin  a few of  the moft ufeful medicated fomentations, that
people may have it in their power to make ufe of them if they
choofe.

                  Anodyne  Fomentation.

   Take of white poppy heads, two ounces ; elder-flowers, half
an cin.ee ; water, three pints.  Boil till one pint is evaporated,
and  ftrain out the liquor.
   This fomentation, as its title expreffes, is ufed for relieving
acute pain.

                 Aromatic  Fomentation.

   Take  of Jamaica  pepper,  half an ounce ; red wine, a pint.
Boil them a little, aid then  ftrain the liquor.
   This is intended, not only as a topical application for exter-
nal complaints, but alfo for relieving the intemal parts.  Pains
of the b iwels, which accompany dyfenteries  and diarrhoeas,
flatulent colics,  uneafinefs or the ftomach, and retchings to
vomit, are frequently abated by fomenting the abdomen and
region of the ftomach with the warm  liquor.

               Comr'on Bitter  Fomentation.

   Take tops of  wormwood  and camomile flowers, dried,  of
each two ounces, water,  two quarts.  • After a flight boiling,
pour off the liquor.
          ,                                          Brandy 
GARGLES.
<79
  Brandy or fpirit of wine may be added to this fomentation,
in fuch  quantity  as  the  particular  circumftances of the cafe
fhail require; but thefe are not always neceffary.

                 Emollient Fomentation.
  This is the fame  s the common  decoction.

               Strengthening Fomentation.
  Take of oak baik, one ounce ;  a'um, two drachms;  water,
three pints.  Boil the" water with t  e bark to the ccnfumptior^
of one third ; then ftrain the remaining decoction, and diffolve
the alum in it.
  This  aftringent liquor is employed  as an external fomenta-
tion to weak parts;  it may alfo be ufed internally.

                    GARGLES.

  HOWEVER  Rifling this clafs  of  medicines may appear,
they "are by no  means without their ufe.  They feldom indeed
cure difeaies, but they o ten alleviate very difagreeable fymp-
toms ; as parchednefs of  the mouth, foulnefs or the  tongue
and fauces, &c.  they  are peculiarly ufeful in  fevers and fore
throats.  In the  latter, a garble  will  fometimes  remove the
diforder ; and  in the form.r,  few things are more refiefhing
«r agreeable to the patient, than to have his mouth frequently
wa'.hed with fome foft detergent gargle.
   One  advantage of thefe medicines  is, that they are eafily
prepared.   A  little  barley-water or fage tea and honey  may
be had  any where ;  and if to thefe  be  added as much vinegar
or  alum as will  give them an agreeable fharpnefs, they will
 make a very  ufeful gargle for  foftening and cleanfing the
 mouth.
   Gargles have the  beft effect when injected with a fyringe.

                   Attenuating Gargle.

   Take of water, fix ounces ;  honey, one  ounce ; nitre, a
 drachm and a half.   Mix  them.
   This cooling gargle may be ufed  either in the inflamma-
 tory quinfey, or in fevers, for cleanfing the tongue and fauces.

                      Common Gargle.

   Take of water, fix ounces ; fugar,  half an  ounce ; fpirit of
 vitriol,  a fufficient quantity to give it an agreeable iharpnefsP
 Mix them.
                                                      This 
  63o         .       APPENDIX.
                       Jb
   This gargle, befides  cleanfing the tongue and fauces, acts
 as a genie repellent,  and  will  fometimes remove a  flight
 quinfe..   A very good  gargh may be  made by pouring boil-
 ing water on  Sumach berries.

                    Detergent Gargle.

   Take of the  emollient gargle, a pint; tincture of myrrh,
 an ounce ; honey, two ounces.   Mix them.
   When exulcerations require to be cbjanfed, or the  excre- ,
 tion of tough  vifcid faliva promoted,  this gargle will  be of
 fervice.

                    Emollient Gargle.

   Take an ounce of mp-fhmallow roots, and two or  three
 figs ; boil them in a quart of water till near one  half of it be
 confumed ; then ftrain out the  liquor.
   If an ounce  of honey, and half an  oun^e of fj. hit of fd-
 ammcniac,  be added to the above, it will then be a good atte-
 nuating gargle.
   This gargle is benefieial in fevers, where the  tongue and
 fauces are  rou^h and parched, to foften thefe parts,  and pro-
 mote the difcharge  of faliva.
   The  learned and accurate Sir John Pringle obferves, that
 in the  inflammatory qunffcy, or ftrangulatien of the fauces,
 little benefit arifes from the common  gargles ; that fuch as
 are of  an acid nature do more harm than good,  by contract-
 ing the emuridtones of the faliva and mucus, and thickening
 thofe humors ;  that a decoction  of figs  in  milk and  water
 has a contrary effect, efpecially if fome  fal-ammoniac  be ad-
 ded;  by which  the  faliva is made  thinnei,  and  the glands
 brought to fecrete more freely ; a circumftance always con-
 ducive to the cure.

                 INFUSIONS.

  VEGETABLES yield nearly the fame properties to  water
by iniulion as by decoction;  and  though they may require a
longer time to give out their vhtues in  this  way, yet  it has
fe.eral  advantages over the  other;  fince boiling  is found to
ill hi pate the finer parts of many bitter and aromatic fubftances,
without more fully extracting  their medicinal pr rciples.
  TJ&e author of the  New Difpenfatory oblerves,  that  even
from thofe vegetables  whuh are weak  in virtue,  rich infu-
fions may  be  obtained,  \y returning  the liquor  upon frefli
quantities  of the fnhject,  the water loading  itftlf more and
                       ?-                             more, 
INFUSIONS.
681
 more with the active parts;  and that thefe loaded infufions
 are applicable to valuable purpafes in medicine, as they con-
 tain in a  fmall compafs the finer, mere fubtile, and active
 principles of vegetables,  in a form readily  mifcible with the
 fluids of the human body.  A very good  and expeditious
 mode of making infufions, is to  reduce the fubfta»:e to a fine
 powder, add the water gradually  to  it in a mortar, rubbing
 them well  together.  Then let it ftand to fettle; in a few
 hours it will be fit for ufe.

                     Bitter Infufion.

   Take tops of centaury  and camomile flowers, of each half
 an ounce;  orange peel, carefully freed from the inner white
 part,  two drachms.   Cut them  in fmall pieces,  and infufe
 them in a quart of boiling water.
   For indigeftion, weaknefs of the ftomach,  or want of appe-
 tite, a tea-cupful of this infufion  may  be taken twice or thrice
 a-day.
                 Infufion  of the Bark.

   To an ounce of the bark,  in powder, add one or two table-
 fpoonfuls of brandy, and a pint  of boiling water.  Let them
 infufe for two or three days.
   This  is a good preparation of  the bark for weak ftomachs.
 In diforders where the corroborating virtues of that medicine
 are required, a  tea-cupful of it may be taken two or three
 times a-day.
                  Infufion  of  Carduus.

   Infufe an ounce of the dried leaves of carduus benedidtus,
 or bleffed thiftle, in a pint of common  water, for i'm hours,
 without heat; then  filter the liquor through paper.
   This light infufion  may be given, with  great  benefit, in
 weaknefs of the ftomach, where the  common bitters do not
 agree.  It  may be  flavoured at pleafure with cinnamon,  or
 other aromatic materials.

                  Infufion  of  Flaxfced

   Take of flaxfeed, two fpoonfuls ;  liquorice  root, fliced,
 half an ouncei  boiling water, three pints.  Let them ftand
 to infufe by the fire for  fome hours,  and then ftrain  off the
liquor.
   If an  ounce of the leaves of colt's  foot be added to thefe
ingredients, it will  then  be  the  perioral  infufion.   Both thefe
 are emollient mucilaginous liquors, and may  be taken with
                       Z z                      advantage 
6*2
APPENDIX.
 advantage as  ordinary drink in difficulty of making water ;
 and in coughs and other complaints of the breaft.


                    Infufion of Rofes.

   Take of red rofes, dried,  half an ounce; boiling water,  a
 quart;  vitriolic acid, commonly called oil of vitriol, half a
 drachm;  loaf fugar  an  ounce.
   Infufe the rofes in the water for four hours, in an unglazed
 earthen  veffel; afterwards  pour  in  the acid,  and having
 ftrained the liquor, add to it the fugar.
   In an exceffive flow of the menfe>, vomiting  of blood, and
 other hemorrhages,  a tea-cupful of this gently aftringent in-
 fufion may be taken every  three or four hours.  It likewife
 makes an exceeding good gargle.
   As the quantity of rofes ufed  here can have little or no
 effect, an  equally valuable medicine may be prepared by mix-
 ing the acid and water without infufion.


           Infufion  of Tamarinds and Senna.

   Take of tamarinds, one ounce ; fenna, and cryftals of tart
 tar, each two drachms.  Let thefe ingredients be infufed four
 or five hours in a pint of boiling water;  afterwards let the
 liquor he ftrained, and an ounce or two of the aromatic tincture
 added to it.   Perfons who  are  eafily  purged may leave out
 either the tamarinds or ihe cryftals of tartar.
   This is  an agreeable cooling purge.  A tea-cupful may be
 given every half hour till it operates.
   This fupplies the  place  of the decoclion  of tamarinds and
fenna.

                 Infufion for the Palfey.

   Take of hojfe-radifh roou fhaved, muftard  feed bruifed, each
 four ounces.  Infufe them in two quartsof boiling water, in a
 clofe veffel, for twenty-four hours.
   In paralytic complaints, a tea-cupful of  this warm ftimu-
 lating medicine may be taken three or four times a-day.  It
 excites the  action of the folids, proves diuretic, and,  if the
 patient be kept warm, promotes perfpiration.
   If two  or three ounces of the dried leaves of marfh-trefoil
 be "ufed inftead of the muftard,  it  will make  the antlfcorbutic
 hftfon.
                                                JULEPS. 
C  683  ]
                      JULEPS.

   THE  bafis of juleps is generally common water, or fome
 fimple diftilled water, with one-third or one fourth its quantity
 of diftilled fpirituous water, and as much fugar or fyrup as is
 fufficient to render the mixture agreeable.  This is fliarpened
 with vegetable or mineral  acids, or impregnated with other
 medicines fuitable to the intention.

                  Expeclorating  yulep.

   Take of the emulfion of gum ammoniac, fix ounces; fyrup
 of fquills, two ounces.   Mix them.
   In  coughs, afthmas,  and obftructions of  the breaft, two
 table-fpoonfuls of this julep may be taken every three or four
 hours.
             Mucilaginous Vitriolic Julep.

   Take of powdered gum arabic, two ounces ; water,  eight
 ounces ;  elixir of vitriol and fugar, each half an ounce.  Mix
 tbem together. A table-fpoonful may be taken for a dofe four
 or five times a-day, in catarrh and  cough, with much expec-
 toration.
                      Mufk Julep.

   Rub half a drachm of mufk well together, with  half an
 ounce of fugar and gum arabic ; and add to it, gradually, of
 fimple cinnamon or peppermint-water, four ounces.
   In the low ftate of nervous fevers, hiccupping,  gout in the
 ftomach, convulfions, and other  fpafmodic affections, two ta-
 ble-fpoonfuls of this julep may be taken every two or three
 hours.
                      Saline Julep.

   Diffolve two drachms of fait  of tartar in three ounces of
frefh  lemon-juice, ftrained; when the effervefcence  is over,
add, of mint-water, and common water,  each two ounces.
   This removes  ficknefs at the  ftomach, relieves  vomiting,
promotes perfpiration, and may be of fome fervice  in fevers,
efpecially in ttiofe of the inflammatory kind.

                    Vomiting  Julep.

   Diffolve four  grains of emetic  tartar in eight  ounces  of
water.
                         7 z 2                         In 
684
APPENDIX.
   In the beginning of fevers,  where there is  no  topical in-
 flammation,  thi? julep may be given in the dofe of one table-
 fpoonful every quarter of an hour till it operates.  Antimonial
 vomits ferve  not only to evacuate the contents of the ftomach,
 but likewife to  promote the different excretions.  Hence they
 are found  in fevers to have nearly the fame  effects as Dr.
 James's Powder.

                      MIXTURES.

   A mixture differs from a julep in this refpect, that it re-
 ceives imo its compofition not only falts,  extracts, and other
 fubftances diffoluble in water, but alfo  earths, powders, and
 fuch fubftances as cannot be diffolved.   A mixture is feldom
 either an elegant or agreeable medicine.   It is neverthelefs ne-
 ceffary.  Many perfons can take a mixture, who are not able
 to fwallow a bolus or an electuary : befides, there are medicines
 which act better in this than in any other form.

                   Anodyne Mixture.

   Take of liquid laudanum, thirty drops;  water, one ounce j
 fugar, half a drachm.   Mix them together.

                  Aftringent  Mixture.

   Take fimple cinnamon-water and common water, of each
 three ounces; Japonic confection, half an ounce.  Mix them.
   In dyfenteries  which  are not of long ftanding,  after the
 neceffary evacuations, a fpoonful or two of  this  mixture may
be  taken every  four hours, interpofing every fecond or third
 day a dofe of rhubarb.

                   Camphor  Mixture.

   Take of camphor reduced to a powder by rubbing with a
 few drops of brandy,  one drachm ;  powdered myrrh, ten
 grains; rub them well together, and add gradually four oun-
 ces of water.
   The dofe is a table-fpoonful, to be repeated every two hours
in cafes of delirium in fever, or violent colics.

                   Diuretic  Mixture.

  Take of mint-water, five ounces; vinegar of fquills, fix
drachms ; fweet fpirit of nitre, half an ounce.  Mix them.
  In  obftructions of  the urinary paffages, two fpoonfuls of
this mixture may be taken twice or thrice a-day
                                               Guaiacum 
MIXTURES.             685
                  Guaiacum  Mixture.
  Take of gum guaiacum, finely powdered,  two drachms;
gum arabic, loaf fugar,  powdered, each two drachms ; pow-
dered liquorice-ball, half a drachm.   Mix them well together,
and add gradually tour  ounces of water.
  The dofe is  a table fpoonful two or three times a-day,  in
thofe cafes of rhumatifrri where  moft  inflammation prevails.

            Laxative Abforbent  Mixture.
  Rub one drachm of magnefia alba  in a mortar with ten or
twelve grains of the beft Turkey rhubarb,  and add to them
three ounces of common water ; fimple mint-water, one ounce ;
fugar,  two drachms.
  As moft difeafes of infants are accompanied with acidities,
this mixture may either  be given with a view to correct thefe,
or to  open  the body.   A table-fpoonful may be taken for a
dofe,  and repeated three times a-day.  Where the pain is very
fevere, from twenty  to  thirty drops of laudanum may be ad-
ded to the mixture.  To a very young child, half a fpoonful
will be fufficient.
  When the mixture is intended to purge, the dofe may either
be increafed, or the quantity of rhubarb doubled.
  This is one of the moft generally ufeful medicines for chil-
dren with which I am acquainted.
                  Paregoric  Mixture.
  Take of paregoric elixir,  one ounce ; antimonial wine, half
an ounce; mucilage of i;um arabic, liquorice-ball, each half an
ounce ; water,  eight ounces.  Mix them together.
  The dofe is a table-fpoonful, to be repeated every three  or
four hours  if neceffary,  in cafes of ctarrh and pleurify,  where
the cough is troublefome.
                    Saline Mixture.
  Diffolve  a drachm of the fait of tartar in four ounces of
boiling water;  and, when  cold,  drop into it fpirit of  vitriol
till the effervefcence  ceafes; then add, of peppermint-water,
two ounces, fimple fyrup, one ounce.
  Where frefli lemons cannot be had, this mixture  may occa-
fionally fupply the place of the faline julep.

                    Squill Mixture.
  Take  of  fimple cinnnmon-wa'er,  five ounces; vinegar  of
fquills, one ounce; fyrup  of marfhmallows, an ounce and  a
half.   Mix  them.
                                                     This 
686
APPENDIX.
    Tills mixture, by promoting expectoration, and the fecretion
 of urine, proves fervieeable in afthmatic and dropfical habits.
 A table-fpoonful of it may be taken frequently.

     OINTMENTS, LINIMENTS, AND CERATES.
   Notwithstanding the extravagant encomiums which have
 been bellowed on different preparations of this kind,  with re-
 gard to their efficacy in the cure of wounds, fores, &c. it is
 beyond a doubt, that  the moft proper application to a frefh
 Wound is dry lint.  But though ointments do not heal wounds
 and fores, yet they ferve  to defend  them from the external
 air, and to retain fuch fubftances as may be neceffary for dry-
 ing, deterging,  deftroying proud flefh, and fuch like.  For
 thefe purpofes, however, it will be fufficient to infert  only a
 few of the moft fimple forms, as ingredients of a more  active
 nature can occafionally be added to them.

              Yellow  Bafilicwn Ointment.
   Take of yellow wax,  four ounces ; white refin, ten ounces ;
 melt them together over a gentle fire ;  then add, of hog's lard,
 prepared, one pound.   Strain the ointment while warm.
   This  ointment  is  employed  for  cleanfing and  healing
 wounds and ulcers.
                Ointment of Calamine.
   Take of olive oil, a pint and a half; white wax, and cala-
 mine ftone,  levigated,  of each half a pound. Let the calamine
 ftone,  reduced into a fine powder, be rubbed with fome part
 of  the oil, and  afterwards  added to  the reft of die oil and
 wax, previoufly  melted together, continually ftirring them till
 quite cold.
   This ointment, which  is commonly known by the name of
 Turner's Cerate,  is an exceeding good application  in burns
 and excoriations from whatever caufe.

                    Citrine Ointment.
  Take of purified  quickfilver, one ounce ;  fpirit of nitre, two
 ounces ; hog's lard, one pound.   Diffolve the quickfilver in
 the acid, in a gentle heat, and while  it is warm, ftir into it, gra-
 dually, the hog's lard which has been  melted, and cooled fo
 much as juft to be growing  thick.

                    Eye  Ointment.
  Take of hog's lard, prepared, four ounces ; white wax, two
drachms; tutty,  prepared,  one  ounce ; melt the wax  with
                                                     the 
            OINTMENTS,   &c.            687
the lard over a gentle fire, and then fprinkle in the tutty, con-
tinually ftirring them till the ointment is cold.
   This ointment will be more efficacious, and of a better con-
fidence,  if two or  three drachms of camphor be rubbed up
with a little oil, and intimately mixed with  it.

                        Another.
   Take of camphor, and calamine  ftone, levigated, each  fix
drachms ;  verdegrife well prepared, two drachms; hog's lard,
and mutton fuet, prepared, of each two ounces.  Rub the cam-
phor  well  with the powder;  afterwards mix in the lard and
fuet,  continuing the triture till they be perfectly united.
   This ointment has been  long  in  efteem  for difeafes cf the
eyes.   It ought, however,  to be ufed  with  caution, when the
eyes ate much inflamed or very tender.   It is indeed, as well
as rhe preceding one, more proper to anoint the edges of the
eye-lids with when they are fore.
                    Iffue Ointment.
   Mix half an ounce of  Spanifh flies, finely powdered, infix
ounces of yellow bafilioum ointment.
   This ointment is chiefly intended for dreffing blifters, in or-
der to keep them open during pleafure.
                   Ointment of Lead.
   Take of olive oil, half a pint;  white wax, two ounces ; fu-
gar of lead, three  drachms. Let  the  fugar of lead, reduced
into a fine  powder, be rubbed up with fome  part of the  oil,
and  afterwards  added  to  the  other ingredients,  previoufly
melted together, continually ftirring them till quite cold.
   This cooling and gently aftringent  ointment may be ufed
in all  c :fes where the intention is to dry and fkin over the part,
as in fcalding, &c.
            Go uLara's Ointment  or Cerate.
   Take of yellow  wax, four ounces ;  olive oil, one  pound.
Melt  thsm together,  and  when  cooling, gradually mix,  by
beating with a wooden  fpatula, four ounces of extract of lead
diffolved in half a pint of rain water.
   This cerate is  yery ufeful for burns, or any kind of ulcers
attended with much heat and pain.

                  Mercurial  Ointment.
   Take of quickfilver, two  ounces ;  hog's lard,  three ounces;
mutton fuet, one ounce.   Rub the quickfilver with an  ounce
of the hoff's lard in a warm mortar, till  the globules be per,
        ■                                            fectly 
6oS
APPENDIX.
fectly extingniflied; then rub  it up with the reft of  the lard
and fuet, previoufly melted together.
   The principal intention of this ointment is to convey mer-
cury into the body by being rubbed  upon the fkin.
                  Aftringent  Ointment.
   Take of hog's lard two ounces,powdered galls, three drahms;
mix them together. This ointment is moft ufed  in the piles.
                 Ointment of Sulphur.
   Take of hog"s lard, prepared, four ounces;  flowers of ful-
phur, an ounce and a half; crude fal ammoniac, two drachms ;
effence of lemon,  ten or twelve drops.   Make them into an
ointment.
   This ointment, rubbed upon the parts affected, will gene*
rally cure the itch.   It is both the fafeft and beft. application
for that purpofe,  and, when  made  in this way, has no dif-
agreeable fmell.

                    White  Ointment.
   Take of olive  oil, one pint, white wax and fpermaceti,  of
each three ounces.   Melt them with a gentle heat, and keep
them conftantly and brifkly ftirring together, till quite cold.
   If two drachms of camphor, previoufly rubbed with a fmall
quantity  of oil, be added to the above, it will make the  White
Camphorated Ointment.

                  Liniment for Burns.
   Take equal parts of Florence oil,  or frefh drawn linfeed oil,
and lime-water ;  fhake them well together in a wide mouthed
bottle,  fo as to form a liniment.
   This  is found to be a  very  proper application for recent
fcalds or burns.  It may either be fpread upon a cloth, or the
parts affected may be anointed with it twice or thrice a-day.

                    White Liniment.

   This is  made  in  the  fame manner as the white ointment,
two-thirds of the wax being left out.
   This liniment may be applied in cafes of excoriation, where,
on account of the largenefs of the furface, the ointments with
lead or calamine might be improper.

                Liniment for  the Piles.
  Take of white ointment, two < unces ; liquid laudanum,
half an ounce.  Mix trufe ingredients with the yolk of an egg,
and work them well together.
                                4                 Volatile 
PILLS.
1CS9
                    Volatile Liniment.

   Take of olive oil, an ounce;  fpirit o£ hartfliorn,  half an
ounce.   Shake them together.
   This liniment,  made with  equal parts of the fpirit and oil,
vvill be more  efficacious, where the patient's fkin is able to
bear it.
   Sir John Pringle obferves, that in the inflammatory quinfey,
a piece of flannel, moiftened with this liniment, and applied to
the throat, to be renewed every four or five hours, is one of the
moft efficacious remedies; and that it feldom fails, after bleed-
ing, cither to leffen or carry off the complaint.   The truth ot
■this obfervation I have often  experienced.

                    Camphorated Oil.

   Rub an ounce of camphor,  with two ounces of olive oil, in
a moi tar, till the camphor be entirely diffolved.
   This  antifpafmodic liniment may be ufed  in obftinate rheu-
matiims., and in fome  other caies accompanied with extreme
pain and tenfion of the parts.

                      PILLS.
   MEDICINES which  operate in a fmall  dofe, and whofe
difagreeable tafte, or fmell, makes it neceffaryth.it they fhould
be concealed from the palate,  are moft commodioiifly exhibited
in tl.isform.  No medicine, however,  that is intended to ope-
rate very quickly, ought to be made into pills, as they often
lie for a confiderable time on  the ftomach before  they are dif-
folved,  fo as to produce any effect.
   As the ingredients which enter the compofition of pills are
generally  fo  contrived, that  one pill of an ordinary fize may
contain  about five grains of the compound,  in mentioning the
dofe we fhail only fpecify the  number of pills to  be taken ; as
one, two, three, &c.

                     Compofing Pill.

   Take of purified  opium, tengrains; Caftile  foap, half a
drachm. Beat them together, and form  the whole into twenty
pills.
   When a quieting draught will  not fit upon  the ftomach,
one, two, or three of thefe pills may be  takea, as occafion re- 
6:>?
A PPENDIX
                       Fcetid Pill.
  Take of afaccethla, an ounce ;  Caftile foap, half an ounce ;
add as much w.iter as  is neceffary to fc-rm it into pills.
  In h\fte:ie complaints, four or  five pills, oi an ordinary fize,
m ly be taken twice or thrice a-day.  They are  likewife often
of iervice to persons, afflicted with  the afthnia.
  When it is. nec-.ffay to keep the body open, a proper quan»
tity of rhubarb, aioes,  or jalap, may occalionally be added to
the above mats.

                      Hemlock  Pill.
  Take any quantity of the extract of hemlock, and adding to
it about a fifth part its weight  of the powder of the  dried
lea  es, form it into pills of the odinary Cne.
  The extract of hemlock may be taken from one grain to fe-
veral  drachms  in  the day.   The  beft method, however, of
ufing thefe pilh, is to  begin with one or two, and to increafe
the  loie, gr.(dually, as far  as the patient can bear them, with-.
cut any reuurkabie degree offtupor or giddinefs.

                    Mercurial Pill.
  Take of purified quickfilver and honey, ench half an ounce.
Rub them tog ther in a morar,  till the gl bules of mercury
are perfectly extinguiflied ;  then add, of Caftile foap, two
drachms;  powdered liquorice or crumb of bread, a fufficient
quantity to give the mats a proper conliftence for pills.
  When ftronger mercurial pills  are wanted,  the quantity of
quickfilver may be doubled.
  The dofe of  thefe pills is different, according to the  inten-
tion with which they are given.   As an alterant, two or three
may be  taken daily.   To  raife a falivation, four or five  will
be neceffary.
  Equal parts of the above pill and powdered rhubarb made
into a mafs, with  a fuflicient quantity oi fimple fyrup,  wi.l
make a Mercurial purging Pill.

               Mercurial Sublimate Pill.
  Diffolve fifteen grains cfthe corrofive fublimate of mercury
in two drachms c f the fat mated folution oi crude fal ammo-
i.'.ac, and make it into a pafte, in a glafs mortar, with a fuffi-
cient quantity of the  crumb  of  bread.   This  mafs muft be
iomed into one hundred and twenty pills.
   This pill, which is the  moft  agreeable form of exhibiting
sh; fublimate,  has been found ilhcaeious, not onlv in turino- 
                     PILLS.                    69,

the venereal difeafe, but alio in killing and expelling worms,
after  other powerful medicines had failed*.
   For  tiie  venereal difeafe,  four  of thefe pills may  be taken
twice a-day,  as an alterant three,  and for worm, two.

                       Opium Pill.
   Take of  opium, Caftile foap, each one fcruple; beat them
together in  an iron mortar, and make them  into twenty pills.

                     Plummer's Pill.
   Take of calomel, or fweet  mercury, and  precipitated ful-
phur  of antimony,  each three drachms; extract of liquorice,
two drachms.   Rub the fulphur  and mercury well together ;
afterwards add  the extract, and, with a fufficient quantity of
the mucilage of  gum arabic,  make them im.o pills.
   This pill has been found  a powerful, yet fafe,  alterative
in obftinate cutaneous diforders ;  and  has  completed  a cure
after  falivation  had failed.  In  venereal cafes it has likewife
produced excellent eff its.   Two or three pills of an ordinary
fize may be taken night and morninj, the patient keeping mo-
derately warm,  and drinking after each dofe a draught of de-
coction of the woods, or of farfaparilla.

                       Calomel  Pill.
   Take of calomel, one drachm;  powdered opium fix grains;
Caftile  foap, two fcruples ; add a fufficient quantity of water
lo make lixty pills.   The dofe is one pill night and morning.

                     Purging Pills.
   Take  of focotorine aloes, and Caftile  foap,  each two
drachms; of fimple fyrup, a fufficient quantity to make them
into pills.
   Four or five of thefe pills  will generally  prove a  fufficient
purge.   For keeping the body gently open,  one may be taken
night and morning.  They are reckoned both deobffuent and
ftomachic, and  will be  found to anfwer all the purpofes of Dr.
Andetf n's pill's, the principle ingredient of which is aloes.
   Where aloctic purges are improper, the following pills may
be  ufed :
   Take extract of jalap, and vitn^l ited tartar, of  each two
drachms; fyrup of ginger, as much as will make them of  a
proper  conliftence for pills.
   Thefe pills may be taken in the fame quantity as the above.

  * Sec a paper on this fnbject in the Edinburgh Fhrfu~l and Literary
Eflays, b" the ingenious Dr. John Gardener.
                         3 A 2                         Pul 
0£2
APPENDIX.
                 Pill for  the Jaundice.
   Take of  Caftile  foap, focotorine  aloes, and  rhubarb,- of
 each one drachm.   Make them into pills with a  fufficLnt
 quantity of fyrup or mucilage.
   Thefe pills, as their title expreffes, are chiefly intended for
 the jaundice, which, with the affiftance of proper diet,  they
 will often cure.  live or fix of them may be taken twice a day.
 more or lefs, as is neceffary to keep the body open.
                     Stomachic  Pill.
   Take extract  of gentian, two drachms :  powdererf rhubarb
 and vitriolated tartar, of each one drachm;  oil of mint, thirty
 drops;  hmple  fyrup, a fufficient quantity.
   1'h  e or four of thefe pills may be taken twice a-day, for
 invigorating the ftomach, and keeping the body gently open.

                       Squill  Pills.
   Take powder of dried fquills, a drachm and a half; gum
 ammoniac, and cardamom feeds,  in powder, of each three
 drachms; fimple fyrup, a fufficient quantity.
   In dropfical and afthmatic complaints, two or three of thefe
 pills may betaken twice a-day,  or oftener, if the ftomach will
 bear them.
                   Strengthening Pill.
   Take foft extract of the bark, and fait of fteel, each a drachm.
 Make into pills.
   Tn diforders arifing from exceffive debility, or relaxation of
 >he folids, as the chlorofis,  or green fickqpfs, two of thefe pills
 may be taken three times a-day.

                        Tar Pills.
   Thefe are made by mixing a fufficient quantity of powdered'
 liquorice, or wheat flour, with common tar, fo as to make it of
 a proper confiftence to be  formed into pills. Three or four of
 which may be taken  three times a day.

                 {PLASTERS.
   Plasters  ought to be of a different confiftence, according to
 :he purpofes for which they are intended.  Such as are  to be^ap-
plied to the breaft or ftomach ought to be  foft and yielding;
while thofe defigned for the limbs fhould be firm ana adhefive*
   It has been fuppofed,  that plafters  might be impregnated
with the virtues of different vegetables, by  boiling the  recenS
 re|seti\ble with the oil employed for the compofuion  of the
                                                  Fhfi>r> 
                PLASTERS.                69i

plafter ; but this treatment does not communicate  to the oils
any valuable  qualities.
   The calces of lead boiled with oils unite with them into a
plafter of  a proper confiftence, which make the bafis of feveral
other plafters.  In  boiling thefe compolitions, a quantity of
hot water  muft be added  from  time to time to prevent the
plafter from burning or growing black. This, however, fliould
be done with care, left it caufe the matter to explode.

                    Common Plafter.
  Take of common olive oil,  fix pints; litharge reduced to a
fine powder, two pounds and a half.  B >il the litharge and oil
together over a gentle fire, continually ftirring them, and keep-
ing always about half a gallon of water in the veffel: after they
have b >iled  about three hours,  a  little of the plafter may be
taken out  and put into cold water, to try if it be of a proper
confiftence:  when that is the  cafe,  the whole may be fuffered
to cool, and the water well preffed out of it with the hands.
   This  plafter  is generally applied in flight wounds and ex-
coriations of the fkin.   It keeps the part foft and warm, and
defends it  from the air, which is all that is  neceffary in fuch
cafes.   Its principal ufe, however, is  to ferve as a bafis for
other plafters.

                    Adhefive  Plafter.
   Take of common plafter, half a pound ; of Burgundy pitch,
a quarter  of a pound. M-lt them together.
   This plafter is principally  ufed  for  keeping on  other
dreffings.

                    Anodyne Plafter.
   Melt an ounce  of adhefive plafter, and, when it is cooling,
mix with it a drachm of powdered opium, and the fame quan-
tity of camphor, previoufly rubbed up with a little oil.
   This plafter generally gives eafe in acute pains, efpecially
of the nervous kind.

                   Bliftering  Plafter.
   Take of  Venice turpentine, fix ounces;  yellow wax, two
ounces } Spaniih flies in fine powder, three ounces ; powdered
muftard,  one ounce.  Melt  the wax, and while it is warm,
add to it the turpentine, taking care not to evaporate it by too
much heat.   After the turpentine and wax are fufficiently in-
corporated,  fprinkle in the powders,  continually ftirring the
mafs till it be cold.
                                                 Though 
694               APPEND!!
  Though this plafter is made in a variety of ways,  one fel-
dom meets with it of a proper confiftence.   When compound-
ed with oils and other greafy fubftances, its efftdrs are blunted,
and  it is apt to run ; while pitch and refin render  it too hard
and very inconvenient.
  When the bliftering plafter is not at hand, its place may be
fupplied by mixing with any fhft ointment  a fufficient quantity
cf powdered flies ; or by forming them into a pafte with flour
aod vinegar, or what  is  ftill better by  firft fpreading yellow
bafilicon ointment on leather, and then  covering  it entirely
with Spanifh flies,  finely powdered.

                     Gum  Plafter.
  Take of  the common plafter, four pounds ;  gum ammo-
niac and galbanum, ftrained, of each  half  a pound.  Melt
them together,  and add, of Venice turpentine, fix  ounces.
  This plafter is  ufed as a digeftive, and likewife  for difcuf-
fing indolent tumours.

                  Mercurial Plafter.
  Take of common plafter, one pound ;  of gum ammoniac,
ftrained,  half a  pound.  Melt  them together,  and, when
cooling, add  eight ounces of quickfilver, previoufly extin-
guiflied by triture, with three ounces cf hog's lard.
  This plafter is recommended  in pains of the limbs arifing
from a venereal caufe.   Indurations of the glands, and  other
violent tumours, are likewife found  fometimes to yield to it.

                   Stomach  Plafter.
  Take of gum plafter,  half a pound ; camphorated oil, an
ounce and  a half; black pepper, or capficum, where it can
be had, one  ounce.  Melt the plafter, and mix  with it the
oil; then fprinkle  in the  pepper, previoufly redi*ccd to a fine
powder.
  An ounce or two of this plafter, fpread upon foft leather,
and applied to the region of the ftomach, will be  of  fervice
in flatulencies arifing from hyfteiic and hypochondriac affec-
tions.  A little of the expreffed oil of raace, or a few drops
of the effential oil of mint,  may be. rubbed,  upon it  before it is
applied.
  This may fupply the place of the Antihyfleric Plafter.

                    Warm Plalier.
  Take  of  gum  plafter, one ounce; bliftering plafter, two
dhachms.   Melt them together over a gentle fire.
                                                    This 
                 P O  W D E  R S.                  C9i

  This plafter is ufeful  in the fciatica and other fixed pains
of the rheumatic kind : it ought, however, to be worn for fome
time, and  to be renewed,  at leaft, once a-week.   If this is
found to blifter the part, which is  fometimes the cafe, it muft
be made with a imaller proportion of the bliftering plafter.

                       Wax  Plafter.

  Take  of yellow wax, one pound ;  white refin,  half a
pound ; mutton faet, three  quarters of  a pound.   Melt them
together.
  This  is genera^y ufed inftead of the Melilot Plajler.  It is
a proper application after blifters, and in  other cafes where a
gentle digeftive is neceffary.


                   POWDERS.
   THIS is one  of the moft fimple  forms in which medicine
can lie adminiftered.  Man)  medicinal fubftances, however,
cannot  be reduced into powder, and  others are too difagree-
able to be taken in this  form.
   The lighter powders may  be mixed in  any agreeable thin
liquor, as tea or water  gruel.  The heavier ones will  require
a nil re confident vehicle,' as fyrup, conferve,  jelly, or honey.
   Gum^,  and other fubftances which are difficult to powder,
fhould  be pounded along  with  the  drier ones;  but thofe
which are too dry, efpecially aromatics, ought to be fprinkled
 during their pulverization with a few drops of-aay  proper
 water.
   Aromatic powders are to be prepared only in fmall quan-
 tities at a time,  and kept in glafs veffels clofely ftopped.  In-
 deed, no powders ought  to be expofed  to  the air or kept
 too long,  otherwife their virtues will  be in great meafure de-
 ftroyed.

                    Arfenic Powder.
   T^ke of white arfenic powdered, five grains; Peruvian bark,
 powdered, one diachm and an half.  Mix them well together.
 This is to be tiled externally to obftinate ill conditioned ulcers,
 more efpecially to cancerous ones.

                   Aftringent  Powder.

    Take of alum and Japan earth,  each two drachms. Pound
 them together, and divide the whole into, ten or twelve dofes. 
696
APPENDIX.
    In an immoderate flow ©f  the menfes, and  other  haemor-
  rhages, one of thefe powders  may be taken every hour, or
  every half-hour, if the difcharge be violent.

                     Powder  of Bole.

    Take of Armenian bole, or French bole, two ounces;  cin-
  namon, one ounce ; tormentil root  and gum arabic,  of each
  fix drachms ;  long  pepper, one drachm.  Let all thefe in-
  "■reaients be reduced into a powder.
    This warm, glutinous aftringent powder, is given in fluxes,
  and other diforders where medicines of that clafs are neceffary,
  in the dofe of a fcruple,  or half a drachm.
    If a drachm of opium be added, it will make the Pcivder of
 Bole with Opium, which is a medicine of confiderable efficacy.
 It may be taken in the fame quantity  as the former, but  not
 above twice or thrice a-day.

                 Carminative Powder.

   Take of coriander-feed, half an ounce; ginger, one drachm *
 nutmegs, half a  drachm; fine fugar, a  drachm and a half-
 Reduce them into powder for twelve dofes.
   This powder  is employed for expelling flatulencies arifing
 from indigeftion, particularly thofe to which hyfteric and hy-
 pochondriac perfons are fo liable.  It may likewife be given
 *in fmall quantities to children in their fi_od, when troubled
 with gripes.

                   Diuretic  Powder.

   Take of gum arabic, four ounces ; purified nitre, one ounce.
 Pound them together, and divide the whole into twenty-four
 dofes.
   During the  firft ftage of the virulent gonorrhoea, one of
 thefe cooling powders may be taken three times a-day, with
 confiderable advantage.

              Aromatic Opening Powder.
  Take of the beft Turkey rhubarb, cinnamon, and fine fugar,
each two drachms.   Let the ingredients be pounded, and  af-
terwards mixed well together.
  Where flatulency is accompanied with  coftivenefs,  a tea-
fpoonful  of this  powder may  be taken once  or  twice  a day,
according to circumftances.
                             I                 Mercurial 
POWDERS.
*97
                  Mercurial Powder.

  Take of magnefia alba, one fcruple ; calomel eight grains;
powdered ipecacuanha,  fix grains.   Make them into eight
powders.
  To take a powder every morning, in inoculation for  the
fmall-pox, eruptions, and fore eyes.

                   Nitrous  Powders.

  Take of nitre, one fcruple ; emetic tartar, one fixth of a
grain.   Make a powder.
  To be ufed in moft feverifh complaints.

               Saline  Laxative Powder.

  Take of foluble  tartar,  and cream  of tartar,  eacli  one
drachm ;  purified nitre, half a drachm,  Make them into a
powder.
  In fevers, and other  inflammatory diforders, where  it is
neceffary to keep the body gently open,  one of thefe cooling
laxative powders may be taken in  a little gruel, and repeated
occafionally.
                    Steel  Powder.

  Take filings of fteel,  and loaf fugar,  of each two ounces ;
ginger, two drachms.  Pound them together.
  In obftructions of the menfes, and other cafes  where fteel
is proper, a tea-fpoonrul of  this powder may be taken twice
a-day, and waflied down with a little wine or water.

                   Sudorific  Powder.
   Take purified nitre and vitriolateu tartar, of each half an  .
ounce;  opium and ipecacuanha, of  each one drachm.  Mix
the ingredients, aad reduce them to a fine powder.
  This is generally  known by the name of Dover's  Poivder.
It is  a powerful fudorific.   In  obftinate rheumatifms,  and
other cafes where it is neceffary to excite a copious fweat,  this
powder may  be adminiftered in the dofe of a fcruple or  half
a drachm. Some patients will require two fcruples.  It ought
to be accompanied with  the plentiful ufe of fome warm dilu-
ting liquor.
                    Worm  Powders.
  Take  of fait of  fteel reduced  into a fine powder', half a
drachm ; prepared fteel, two drachms.   Mix them well toge-
ther, and divide the whole into fix dofes.
                            <5 B                     One; 
69S                APPENDIX.

   One of thefe powders may be taken in a little fyrup, her-
 ney,  or treacle, twice a-day.   After they have been all  ufed,
 the following anthelmintic purge may be proper.

                 Purging  Worm-Powder.

   Take  of powdered rhubarb, a fcruple; fcammony  and ca-
 lomel, of each five  grains.  Rub them together in a mortar
 for one dofe.
   For children the above dofes muft be leffened according to
 their age.

              Powder for the  Tape-Worm.

    Early in the morning the patient is to take in any liquid,
 two  or  three drachms, according to his age and conftitution,
 of the root of  the male  fern reduced into  a  fine powder.
 About  two hours  afterwards, he is to take  of calomel and
 refin of  fcammony,  each ten grains,  gum  gamboge, fix
 grains.   Thefe ingredients muft be finely powdered andgiven
 in a little fyrup, honey, treacle, or any thing that is moft agree-
 able to  the patient.  He is then to walk gently about, now and
 then drinking a difh of weak green tea, till the worm is paffed.
 If the powder of the fern produces naufea, or ficknefs,  it may
 be removed by fucking the juice of an orange or lemon.
    This medicine, which  had  been  long kept a fecret abroad
 for the cure of  the tape worm, was fome  time ago purchafed
 by the French King,  and  made public  for the benefit of man-'
 kind.   Not having had an opportunity  of trying it, I can fay
  nothing  from experience  concerning its efficacy.   It  feems,
  however, from  its ingredients, to be an active medicine, and
  ought to lie taken  with care.   The  dofe here prefcribed is luf-
  ficient for the ftrongeft patient;  it muft, therefore, be reduced
  according to the age and conftitution.


                       SYRUPS.

    SYRUPS  were fome time ago  looked upon  as  medicines
  of confiderable  value.  They are at prefent, however, regard-
  ed chiefly as vehicles for medicines of greater efficacy, and are
  ufed for fweetening  draughts, juleps,  or mixtures ; and for
  reducing the  lighter powders into bolufes, pills, and electuaries.
  As  all- thefe  purpofes may be anfwered by  the fimple fyrup
  alone, thete is little occafion for any other; efpecially as thev
arc 
              TINCTURES,  ELIXIRS, &c.          699
 are  feldom found but in a ftate of fermentation ; and as the
 dofe of any medicine given  in  this form  is very uncertain.
 Perfons who ferve the public muft keep whatever their cuftom-
 «rs call for ; but to the private practitioner nine-tenths of the
 fyrups ufually kept in the fhops are unneceffary.

                      Simple  Syrup.

   Is made by diffolving in water, either with or without heat,
 about double its weight of fine fugar.
   If twenty-five drops of laudanum be added to an ounce of
 the fimple  fyrup,  it will fupply the place of diacodium, or
 the fyrup of poppies, and will be found a more fafe and cer-
 tain medicine.
   The lubricating virtues  of the fyrup of marfhmallows may
 likewife be fupplied, by adding to the common  fyrup  a  fuffi-
 cient quantity of mucilage of gum arabic.
   Thofe who choofe  to preferve the juice of lemons in  form
 of fyrup, may diffolve in it, by the heat of a warm bath,  near-
 ly double its  weight  of fine  fugar.   The juice ought to be
 previoufly  ftrained, and fuffered to ftand till it fettles.
   The fyrup of ginger is  fometimes of ufe as a warm  vehicle
for giving medicines  to perfons  afflicted with flatulency.  It
 may be ufed by infufihg two ounces of bruifed  ginger in two
pints of boiling water for twenty-four hours.  After the liquor
has been ftrained, and has  ftood to fettle for fome time, it may
be poured  off, and a little more than double its  weight of fine
powdered fugar diffolved in it.

              TINCTURES, ELIXIRS,  Sec.

   RECTIFIED fpirit is  the direct menftrum  of the refins
and  effential oils of vegetables, and totally extracts thefe active
principles from fundry fubftances, which yield them to water,
either not at all, or only in part.
   It diffolves likewife thofe  parts of animal  fubftances in
vvhich their peculiar  fmells  and taftes refide.   Hence the
tinctures prepared with rectified fpirits form an  ufeful and
elegant clafs of medicines, poffeffing many  of the moft effen-
tial virtues of fimples, without being clogged with their  inert
or ufelefs parts.
  Water, however, being  the proper menftruum of the gum-
my,  faline, and faccharine parts of medicinal  fubftances, it
will  b; neceffary, ia the preparation  of ftreral tincmres, to
                          3  B  2                     make 
7^o               APPENDIX.
make ufe of weak fpirit, or a compofition of rectified fpirit
a. 1 water, and, of courfe, good  brandy will be  found fuf-
ficiently  ftrong  for every purpofe.

                  Aromatic Tinclure.

   Infufe two  ounces  of Jamaica  pepper in two  pints of
brandy for a  few days; then ftrain  off the tincture.
   This fimple  tincture will fufficicndy anfwer all the inten-
tions  of the more coftly preparations of this kind.  It is ra-
ther too  hot to be taken by itfelf; but it is very proper for
m xiig with fuch medicines as might  otherwife prove too
cold for die ftomach.

                 Tinclure of the Bark.

   Take of Peruvian bark, two  ounces-.   Let the  bark be
grofsly powdere ', and infufed in a pint of brandy, for eight
or ten days, in a clofe veffel; afterwaids ftrain off the  tincture.
   This tincture is not  only  beneficial in intermitting  fevers,
but alfo  in the flow,  nervous,  and putrid kinds, efpecially
towards their decline.
   The dofe is from one d. achm  to three or four, every fifth
or fixth hour.   It may be  given in any fuitable liquor, and
occafionally iharpened  with a  few  drops of the  fpirit of
vitriol.

                 Tinclure of Cinnamon.

   Take of cinnamon  or caffia bark  grofsly powdered, two
ounces; brandy,  one pint.  E^eu for eight or ten days.
   This is  an  elegant  tincture, and very proper to mix with
ftomachic  medicines.

                    Foetid Tinclure.

   Infufe two  ounces  of afafcetida in one pint  of brandy,
for eight days, in a dole bottle, frequently ihaking  it; then
ftrain the  tincture.
   Th's medicine  is beneficial in hyfteric  diforders, efpecially
when attended with lownefs of fpirits, and faintings.   A tea-
fpooniul  of it may be taken in a  glafs of water every two or
thiee hours.

              Tinclure of Gum  Guaiacum.

  Take of gum guaiacum, two ounces; brandy, a pint.  In-
fufe in a veffel well ftopped, for eight or ten days;  then ftrain
off the ti?;dure.
                                                       In 
                 TINCTURES.              7ci

  In rheumatic complaints, two tea-fpoonfuls of this tincture
may be taken in a cup of water twice or thrice a-day.  It may
be made volatile, by adding four ounces of volatile fpirit.

              Tinclure of Black Hellebore.

  Infufe two ounces of the  roots of black hellebore, bruifed,
in a pint of brandy, f>r feven  or eight days; then filter the
tincture through paper.   A fcruple of cochineal may be infufed
along  with  the roots, to give the tincture a  colour.
  In obftructions of the fnenfes, a tea-fpoonful of this tincture
may be taken in a cup of camomile or  penny-royal tea twice
a-day.
                  Aftringent Tinclure.

  Digeft two ounces of gum  kino,  in  a  pint and  a  half of
brandy, for eight days ; afterwards ftrain  it  for vife.
  This tincture isa good aftringent medicine.   With this view
two tea-fpoonfuls, or more of it may  be taken three or four
times a-day,

             Tinclure  of Myrrh and Aloes.

  Take of gum myrrh, an  ounce and  a half; hepatic aloes,
one ounce.  Let them be reduced to a powder, and infufed in
two pints of brandy, for fix days, in a gentle heat; and ftrain
the tinclure.
  This is principally ufed by furgeons for cleanfing foul ulcers,
and reftraining the progrefs of gang! enes.  It is alfo, by fome,
though improperly, recommended as  a  proper application to
frefh wounds.

       Tinclure of Opium, or Liquid Laudanum.

  Take of crude opium, two ounces; brandy, a pint.  Dif-
folve  the opium fliced, in the brandy, with a gentle  heat, fre-
quently fhaking it;  and ftrain off the tincture.
  The common dofe may be from twenty to thirty drops.

                    Tinclure  of Aloes.

   Take  of focotorine aloes in powder,  ore ounce ;  Virginian
fnake-root and ginger, of each two drachms.   Infufe in a pint
of brandy,  for  a week, frequently fhaking tire bottle, then
ftrai^  off the tincture.
  This is a fafe  and ufeful purge for perfons cf a languid and
phel&matic  habit;  but  U thought to have better  effects, taken
in fmal^dofes as a laxative. 
702               APPENDIX.
    The dofe, as a purge, is from two drachms to half an ounce.

              Compound Tinclure  of Senna.

    Take of fenna, one ounce ; jalap, coriander feeds, and cream
 ©f tartar,  of each half an cunce.   Infufe  them in a pint  and
 a half of French brandy for a week ; then ftrain the tincture,
 and add to it four ounces of fine fugar.
    This is  an agreeable purge, and anfwers all the purpofes of
 the Elixir falutis, and of Daffy's Elixir.
    The dofe is from one to two or  three ounces.

                Tinclure of Spanifh Flies.

   Take of Spanifh flies, reduced to a fine powder, two ounces t
 brandy, one pint.  Infuie for two  or  three days ; then ftrain
 off the tincture.
   This is intended as an acrid ftimulant for external ule. Parts
 affected with the palfy or chronic rheumatifm may be frequent-
 ly rubbed  with it.

                 Tinclure of Rhubarb.

   Take of rhubarb,  two ounces and a half;  leffer cardamom
 fee^s, half an ounce ; brandy, two pints.   Digeft for a week,
 and ftrain  the tincture.
   Thofe who chufe to have a vinous tincture  of rhubarb, may
 infufe the above ingredients in a bottle «f Lifbon wine, adding
 to it about two ounces of brandy.
   If half an ounce of gentian root, and a drachm of Virginian
 fnake-root be added to the above ingredients,  it will  make the
 bitter tincture of rhubarb.
   All thefe tinctures are defigned as ftomaehics  and corrobo-
 rants as well as  purgatives.   In weaknefs of the ftomach,  in-
 digeftion, laxity of the inteftines, fluxes, colicky and fuch like
 complaints, they are frequently of great fervice.   The dofe is
 from  half a table-fpoonful to three or four table-fpoonfuls or
 more,  according to the circumftances of the patient, and the
 purpofes it is intended to anfwer.

                   Paregoric Elixir.

  Take of flowers of benzoin,  half an ounce ;  camphor and
 opium,  each two drachms.  Infufe in one pint of brandy, for
eight  or ten  days, frequently fhaking the bottle; afterwards
ftrain the elixir.
  This  is an agreeable and fafe way of adminiftering opium.
It eafes pain, allays tickling  coughs,  relieves  difficult  breath-
                                                     ing, 
              TINCTURES,   &c.           703

iag,  and is ufeful in many diforders of children, particularly
the whooping cough.
   The dofe to an adult is from fifty to an hundred drops.

          1            Sacred Elixir.

   Take of rhubarb cut fmall, ten drachms ; focotorine aloes,
in powder, fix drachms ; leffer cardamom feeds, half an ounce ;
French brandy, two pints.   Infufe for two or three days, and
then ftrain the elixir.
   This ufeful ftomachic  purge may be taken  from one ounce
to an ounce and a half.
                     Stomachic  Elixir.
   Take of gentian root,  two ounces ; Curaffao oranges, one
 ounce ; Virginian fnake-root, half an  ounce.   Let the ingre-
 dients be bruifed, and infufed tor three or  four  days in  two
 pints of French brandy ;  afterwards ftrain out the  elixir.
   This  is an elega: t ftomachic  bitter.  In flatulencies, indi-
 geftion, want of appetite, and fuch like complaints, a fmall
 glafs of it may be taken  twice a-day.   It likewife relieves ths
 gout in the  ftomach,  when  taken in a large dofe.

                  Acid  Elixir  of Vitriol.

    Take of brandy, one pint; oil of vitriol, three ounces.   Mis
  them gradually,  and after the faeces  have fubfided, filter tho
  elixir through paper, in  a glafs  funnel.
     Thib is one of the beft  medicines which I know of for hyfteric
  and hypochondriac patients, afflicted  with  flatulencies arifing
  from relaxation or debility of the  ftomach and inteftines.  It
  will fucceed where the moft celebrated ftomachic bitters have
  no effect.  The dofe is from ten to forty drops, in a glafs of
  water, fweetened with a little fugar fo as to make it palatable,
   twice or  thrice a-day.   It  fhould be  taken  when the ftomach
   is  moft empty.
                Camphorated Spirit  of Wine.
     Diffolve an ounce of camphor in a pint of fpirits or brandy. ^
     This  folution  is  chiefly employed as  an embrocation in
   bruifes, palfies, the chronic rheumatifm, and for preventing
   gangrenes.
     The above quantity  of camphor,  diffolved in half a pound
   •f the volatile aromatic  fpirit,  makes Ward's Effence.

                    Spirit of Mindererus.
     Take  of volatile fill  ammoniac, any quantity.  Pour en it.
   gradually  ftrcng vinegar, till -h: effervescence cc-.fes.
                                                         i 'hie 
 704              APPENDIX.

   This medicine  is ufeful in promoting a difcharge both by
 the fkin and urinary patTages.  It is alio a good external appli-
 cation in  (trains and bruifes.
   When intended to raife a fwear, half an ounce  of it in a cup
 of warm gruel, may be given to the patient in bed every hour
 till it has the defired effect.

                   VINEGARS.

   VINEGAR is  an acid produced from vinous liquors by a
 fecond fermentation.   It is an ufeful medicine bodi in inflam-
 matory and putrid diforders.  Its effects are, to cool the blood,
 quench thirft, counteract a tendency to putrefaction, and allay
 inordinate motions of  the  fyftem.   It likewife promotes the
 natural fecretions, and in fome cafes excites a copious fweat,
 where the  u arm  medicines,  called alexipharmic, tend rather
 to prevent that falutary evacuation.
   Weaknefs, faintings, vomitings,  and  other hyfteric  affec-
 tions, are often relieved by vinegar applied  to the mouth and
 nofe, or received into  the ftomach.  It is of excellent ufe alfo
 in correcting many poifonous fubftances,  when taken into the
 ftomach;  and in  promoting their expulfion, by  the different
 emunctcries, when received into the blood.
   Vinegar  is not only an ufeful medicine, but  ferves likewife
 to extract,  in tolerable perfection, the virtues of  feveral other
 medicinal fubftances.   Moft of the odoriferous flowers impart
 to it their fragrance, togecher with a beautiful purplifh or red
 colour.  It alfo aflifts or coincides with the intention of fquills,
 garlic, gum ammoniac, and  feveral ether valuable medicines.
   Thefe effects, however,  are  not to  be  expected from every
 thing that  is fold under the name of vinegar, but  from fuch as
 is found and well  prepared.
   The beft vinegars are thofe prepared from French  wines.
   It is neceffary for fome purpofes th.it the vinegar be  diftilled ;
 but as this operation re .pares a particular chemical apparatus,
 we fliall not infert it.
                  Vinegar of Litharge.

   Take of litharge, half a  pound ;  ftrong vinegar, two  pints.
 Infufe them together in a moderate  heat  for  three days,  fre-
 quently fhaking the veffel ; then filter  the liquor  for ufe.
  This medicine  is little ufed, from  a  general  notion of its
being dangerous.   There is no doubt, IfWever,  that the pre-
parations of lead  with vineg-ir are poffeffed of  valuable pro-
perties, and  that  they  may be  nCcd in many cafes  with fafety
 and  fuccefs.
                            ■:                        A pre- 
             WATERS BY  lNFUSION; &c.          70j
  A. preparation of a imilar nature with the above has of late
been extolled by Goulard,  a French  lurgeon, as a fafe  and
extenfively ufeful  medicine, which he calls the Extract of Sa-
turn, and orders to be made in the following manner :
  Take  of litharge, one pound ; llrong  vinegar, two  pints.
Put them together into a glazed earthen pipkin,  and let them
boil, or rather fimmer, for  an hour, or an hour and a quarter,
taking care to ftir them all the while with a wooden fp-itula.
Alter the whole his ftood to fettle,  pour off the  liquor which
is upon the top i  to bottles for ufe.
  W'th this extract Goulard makes his  vegelo-mineral nvaterH',
which  he recommends in a great variety of external diforders,
as inflammations, burns, bruifcs, f .rains,  ulcers, &c.
   He likewife prepares with it a number of other forms of me-
dicine,  as poultices, plafters, ointments, powders, &c.

                    Vinegar  of Squills.

   Take  of dried  {quills, two  ounces ;  diftilled  vinegar, two
pints.   Infufe lor ten days or a fortnight in a  gentle degree
of heat;  afterwards ftrain  off the liquor,  and add to it about
a twelfth part of its quantity of proof fpiris.
   This medicine has good  eff ts in difordeTs of  the breaft, oc-
cafioned by a load of vifcid phlegm.   It is alfo of ufe in hy-
dropic cafes  for promoting a difcharge  of urine.
   The dofe is from two drachms to two ounces, according to
the  intention for  which it is given.  When intended to act
as a vomit,  the dofe  ought to be large.   In other cafes,  it
muft not only be exhibited in  fmall dofes, but alfo mixed  with
cinnamon-water, or fome  other agreeable  aromatic liquor, to
prevent the naufea it might otherwife occafion.

             WATERS  BY INFUSION, &c.

                       Lime  Water.

   POUR two gallons of water gradually uprm a pound of
 frefh  burnt  quicklime ; and when  the ebullition  ceafes, ftir
 them well together; then  fuffer the whole to ftand at reft, that
 the lime may fettle, and afterwards decant the liquor which 1,
 to be kept in veffels clofely ftopt.
   The lime-water  from calcined oyfter-iheih, is preparer  m
 the fame manner.

                      Sec Collyrium of I.eaJ.
                           3C                       Lime* 
7®r>               APPENDIX.
   Lime-water is principally ufed for the gravel; in which cafe,
 from a pint to two or more of it may be drank daily.  Exter-
 nally  it is ufed for  wafhing foul  ulcers, and removing the
 itch, and other difeafes of :h  fkin.

              Sublimate  Water,  or  Solution.

   Diffolve eight grains of the corrofive fublimate,  and half a
 drachm of crude fal ammoniac, in  a pint of water.
   It a uruiue.  fidution is warned,  a double or triple quantity
 of fublimate umj  be  ufed.
   The weaker folution is ufed in the dofe of a table fpoonful,
 morning and  evening in lues, for adults ; and from twenty to
 thnty, or  fi-rty drops in a little  water for children.
   T:,e ftronger folution  is ufed for a wafh in fome obftinate
 eruptions  and ulcers.

                      Styptic Water.

   Take of blue vitriol and alum, each an ounce  and a half;'
 water, one pint.    Boil  them  until  the falts are diff-lved,
 then fiher the liquor,  and add to it a drachm  of the oil of
 vitriol.
   This  water is ufed for flopping a bleeding at the nofe, and
 other  haemorrhages ; for  which purpofe cloths or doffils  dipt
 in it muft  be  applied to the part.

                       Tar Water.

   Pour a gallon of water on two pounds  of tar, and ftir them
 ftrongly together  with a  wooden rod  : after they  have  flood
 to fettle for two days, pour off the water for ufe.
   Though tar-water  falls greatly fhort of the character which
 has been given of it, yet it  poffeffes  fome medicinal virtues.
 It fenfibly raifes the pulfe,  increafes the fecretions, and fome-
 times  opens the body,  or occafions vomiting.
   A pint  of  it may be drank daily,  or more, if the ftomack
 can bear it.   It is generally ordered to be taken on an empty
 ftomach, viz. four ounces morning  and evening, and the fame
 quantity about two hours after breakfaft and dinner.

           SIMPLE  DISTILLED  WATERS.

   A  great  number of diftilled waters were formerly kept in
 the  fhops, and are ftill retained in  fome Difpenfatories.   But
 we  confider them chiefly  in the light of grateful diluents, fuit-
 able vel w-les  for medicines of gvtrattr  efficacy, or for render
                                                        ing 
SIMPLE DISTILLED  WATERS.
7-7
hig difguftful ones more agreeable to the palate and ftomach.
We fhail therefore infert only a few of thofe  which are beft
adapted to thefe intentions.
   The management of a ftill being now generally underftood,
it is needlefs to fpend time  in giving directions for  that pur-
pofe.
   All thefe waters may be imitated fufficiently well by dif-
folving  the effentiwl oils in a little rectified fpirits; then adding
a fmall quantity of loaf fugar, and a larger or fmaller pro-
portion of water, according to the ftrength we wilh the pre-
paration to be.

                    Cinnamon Water.

   Steep one pound of cinnamon bark, bruifed, in a gallon and
a half of water, and  one pint of brandy, for two days ; and
then  diftil  off one gallon.
   This is an ^reeable aromatic water, poffefling in a high de-
gree the fragrance and cordial virtues of the fpice.

                   Pennyroyal Water.

   Take of pennyroyal leaves, dried, a pound and a half; wa-
ter, from a gallon and a half to two gallons.  Draw off by
diftillation  one gallon.
   This water poffeffes, in a confiderable degree, the fmell, tafte,
and virtues of the plant.  It is given in mixtures and juleps to
hyfteric patients.
   An infufion of the  herb  in boiling water anfwers nearly the
fame  purpofes.

                   Peppermint Water.

   This is made in the fame manner as the preceding.

                   Spearmint Water.

   This may alfo be prepared in the fame way  as the penny-
royal water.
   Both thefe  are ufeful ftomachic  waters, and will fometimes
relieve vomiting, efpecially when it proceeds from indigeftion,
or cold vifcid phlegm.  They are  likewife ufeful in fome co
licky  complaints, the gout in the ftomach, &c. particularly
the peppermint water.
   An infufion of the  frefli  plant is frequently found to have
the fame effects as the diftilled water.
                          3 C  2                      Rofe 
70$               APPENDIX.

                      Rofe Water.

   Take of rofes frefh gathered,  fix pounds ;  water, two gal-
 lons.  Diftd off v,ne gallon.
   This water is principally valued on account of its fine fla-
 vour.

                Jamaica Pepper Water.

   Take of Jamaica pepper, half a pound ; water, a gallon and
 a half.   Diftil  off one gallon.
   This is a very elegant diftilled  water, and may in moft cafes
 fupply the place of the more coftly fpice waters.

        SPIRITUOUS  DISTILLED WATERS.

               Spirituous Cinnamon Water.

   TAKE of cinnamon  bark, one pound ; proof fp'rit, and
 coni.i.on  water, of each  one gallon.   Steep the cinnamon in
 the liquor for two days ; then diftil off one gall n.

           Spirituous  Jamaica Pepper Water.

   Take of Jamaica pepper, half a pound ;  proof fpirit, three
 gallons;  water two gallons.  Diftil off three gall*.ns.
   This is a fufficiently a  -leeable  cordial, and may fupply the
 place of the Aromatic  Water.

                      WHEY S.

                      Alum  Whey.

   BOIL two drachms of powdered alum in a pint of milk till
it is crudled ; then ftrain out the whey.
   This whey is beneficial in an immoderate flow of the menfes,
and in a diabetes, or exceffive difcharge of urine.
   The dofe is  two, three,  or  four ounces,  according as  the
ftomach wdl  bear it, three times a-day.  If  it  fhould occafion
vomiting, it may be diluted.

                    Muftard Whey.

   Take milk and  water, of each  a pint ;  bruifed  muftard-
feed, an ounce  and a half.  Boil them together till  the curd
is perfectly feparated ; afterwards  ftrain the whey through a
•cloth.
This 
                       W  I  N  E S.                   Tcj

  ^ This is the moft elegant, and by no mears the lead effica-
 cious method of exhibiting muftard.   It warms  and invigo-
 rates the habit, and promotes the different lecre ;o....   Hence,
 in a low ftate of nervous fevers, it will often lupply the place
 of wine,   It  is alio of ufe in the chronic rheumatiim, paliy,
■dropfy, &c.  The addition of a little fugar will ve\>di? it more
 agreeable.
   The dofe is an ordinary tea-cupful four or five times a-day.

                Cream  of Tartar  Whey.

   This is  made  by ftining  two tea-fpoonfuls of powdered
 Cream of Tartar  into a  pint of boning milk, to be fweetened
 to the tafte.  It affords a cooling laxative dunk in fevers.

                     Scorbutic  Whey.

   This whey is made by boiling half a pint of the  'corbutic
juices in a quart  of cow's  milk.  More benefit,  h -ucver, is
 to be expected from eating the plants, than  from  their ex-
 preffed juices.
   The fcorbutic plants are, bitter oranges,  brooklime, srarccn
 fcurvy-grafs, and water  creffes.
   A number of other wheys mav be prepared nearly in the f \ ■■■"<•
 manner, as orange whey, e<c. Thef • are cooling pleafimt drinks
 in fevers, and may be rendered  cordial,  when  ne„efhiry, by
 the addition of wine.

                       W  I  N  E S.

   THE effects of wine are to raife the pulfe, promote per-
fpiration, warm  the habit,  and exhilarate the fpirit-..   Tue
 red wines, befides thefe effects, have  an aftringent quality, by
 which they ftrengthen the tone of the ftomach  and inte'tines,
 and by  this means prove ferviceable in reftraining izm: oderate
 fecretions.
   The thin fharp wines have a different tendency.  They pafs
 off freely by the different  emuncrories, and gently  open the
 body.  The effects of the full  bodied wines are, however, much
 more durable than thofe of the thinner.
   All fweet wines contain  a glutinous fubftance, and do not
 pafs off freely.  Hence  they will heat the body m-ire than an
 equal quantity of any other  wine, though it fliould contain fully
 as much fpirit.
   From the  obvious qualities of wine, it muft appear  to he
 an excellent cordial medicine^   Indeed,  to  fay the truth, it i;
 .worth all the reft put toguher.
J 
 yio              APPENDIX.
   But to anfwer this charader, it muft  be found and good.
 No  benefit is  to  be  expected from  the common trafh that is
 often fold by  the name of wine, without poffeffing one drop
 of the juice of the grape.   Perhaps no medicine is more rarely
 obtained genuine than wine.
   Wine is not only  ufed as a medicine, but is alfo employed
 as a menfiruum for extracting the virtues of other medicinal
 fubftances ;  for which it is not ill adapted, being a compound
 of water, inflammable fpirit, and acid; by which means it is
 enabled to act upcn vegetable and animal fubftances, and alfo
to diffolve fome bodies of the metallic kind, fo as to impregnate
 itfelf with their virtues,  as fteel, antimony,  &c.

                    Antimonial Wine.

   Take glafs of antimony, reduced  to  a fine powder, half an
 ©unce;  Lifbon wine, fixteen ounces.   Digeft, without  heat,
 for three or  icur days, now and then fhaking the bottle; af-
 terwards filter the wine through paper.
  The dofe of this  wine  varies  according to the intention.
 As an alterative and diaphoretic, it may be taken from  ten to
fifty or fixty drops.  In a larger  dofe  it generally proves ca-
thartic, or excites vomiting.

                      Bitter Wine.

  Take of  gentian root,  yellow rind of lemon-peel,  frefh,
each one ounce ; long pepper, two drachms ;  Lifbon or Sher-
 ry wine, two  pints.  Infufe without heat for  a week,  and
ftrain out  the  wine  for ufe.
  In complaints  arifing from weaknefs  of the  ftomach, or
indiv eftion,  a  glafs of this wine may be taken an hour before
dinner and fupper.

                   Ipecacuanha Wine.

  Take of ipecacuanha, in powder, one ounce; Lifbon wine,
a pint.  Infufe for three or four days ;  then filter the  tincture.
  This is a fafe vomit, and  anfwers extremely well for fuch
perfons as cannot fwallow the powder,  or whofe ftomachs arc
too irritable to bear it.
  The dofe is from one ounce to an ounce and a half.

               Chalybeate or Steel Wine.

  Take of filings of iron, two ounces ; cinnamon, two drachms ;
Lifbon wine, two pints.   Infufe for  three or  four weeks, fre-
                                                  quently 
                      WINES.                   711

quently fliaking the bottle ; then pafs  the  wine through a
filter.
  In obftructions of the menfes, this preparation of iron may
be taken, in the dofe of half a wine-glafs twice or thrice a-day.
  The medicine would  probably be  better if Iharpened with
half an ounce of the cream of tartar, or a fmall quantity of
the vitriolic acid.

                     Stomach Wine.

  Take of Peruvian bark, grofsly powdered,  an ounce ; car-
damom feeds, and orange peel, bruifed, of each two drachms.
Infufe in a bottle of Sherry or Lifbon wine for five or fix days ;
then ftrain off the wine.
  This wine is not only of fervice in debility of the ftomach
and inteftines, but may alfo be  taken  as a preventative, by
perfons liable to the intermittent  fever, or who refide in places
where this difeafe  prevails.   It will be of ufe likewife to thofe
who recover  flowly after fevers of any kind,  as it affifts di-
geftion,  and  helps  to reftore the  tone and  vigour  of the
fyftem.
   A glafs of it may be taken two or three times a-day.
A GLOS. 
[  7"  3
A
GLOSSARY.
            _/\LTHOUGH  teims of art have  been feda-
Iov.fly avoided in the compoiition of this treatife, it is impoffible
entirely to bar.iih technical phrafes when writing on medicine,
a fcience that has been lefs generally attended to by mankind,
and continues  therefore  to be  more  infected with  the  jargon
of the fchools, than  perhaps any other. ' Several perfons have
expreiLd their  opinion that a Gloflary would make this work
more generally intelligible,  the following concife explanation
of the few terms of art that occur, has been added in compli-
ance with their fennments, and to.fulfil the original  intention
of this treatife, by rendering it hneiligible and  ufeful  to  all
ranks and claffes of mankind.

                            A.

Abdomen.   The belly.
Abforbents.  Veffels  that convey the nourifliment from the in-
   teftines, and the fecreted fluids from the  various cavities into
   the mafs of blood.
A.rimonv.   Corrofive fharpnefs.
Acute.   A difeafe, the fymptoms of which are violent, and tend
   to a fpeedy termination, is called acute.
Adult.  Of mature age.
Adujl.  Dry,  warm.
Antifpafmodic.   Whatever tends to prevent or remove fpafm.
Abhtha.  Small whitifli ulcers appearing in the mouth.
Ajlrii'lkn.   A  tightening or leffening.
Atrabilariaju  An epithet cmmonly applied to people of a cer-
   tain temperament, marked by a dark complexion, black hair,
   fpare habit, which the ancients  fuppofed to  arife from the
   air a litis, or the  black bile.
                                                          B.. 
A  GLOSSARY.
713
                            B.
Bile or Gall.   A fluid which is fecreted by the liver into the
     gallbladder,  and from thence  paffes into  the inteftines,
     in order to promote digeftion.

                            C.
Cacochymia.  An unhealthy ftate of the body.
Caries.   A rottennefs of a bone.
Chyle.  A milky fluid feparated from  the  aliment rin the in-
     teftines, and  conveyed by the abforbents into the  blood
     to fupply the wafte  of the animal body.
Chronic.   A difeafe whofe progrefs is  flow, in oppofition to
     acute.
Circulation.  The motion  of the blood,  which  is  driven by
     the heart through the arteries, and returns  by the veins.
Comatofe.   Sleepy.
Conglobate  Gland.   A fimple gland.
Conglomerate.   A compound gland.
Contagion.   Infectious matter.
 Cutis.   The fkin.
 Cutaneous.   Of or belonging to the fkin.
 Crifs.   A certain period  in the progrefs of a difeafe, from
      whence  a decided  alteration either for the better or the
      worfe takes  place.
 Critical.   Decifive or important.
 Critical Days.  The fourth,  fifth,  feventh,  ninth,  eleventh,
      thirteenth,  fourteenth,  feventeenth,   and twenty-firft,
      are by fome authors denominated critical days, becaufe
      febrile complaints have  been obferved to take a decifive
      change  at thefe periods.

                              D.

 Debility.   Weaknefs.
 Delirium.  A temporary diforder of the mental faculties.
 Diaphragm.   A  membrane feparating the  cavity cf the cheft
      frum that of the belly.
 Diuretic.   A medicine  that promotes the  fecretjon  of unne.
 Drajlic.  Ts applied to fuch purgative medicines as are violent
       or harfh in  their operation.

                            E.
  Empyema.  A colleaion of  purulent matter in the  cavity of
       the  breaft.
                             „  j)                      Endemic 
7i4              A  GLOSSARY.
Endemic.  A difeafe peculiar to a certain  diftrict of country.
Epidemic.   A difeafe generally  infectious.
Exacerbation.   The increafe of any difeafe, or  rather the com-
     ing on of the paroxyfm or fit,  as in an  intermittent.
                            F.
Faeces.  Excrement.
Foetid.  Emitting an offenfive  fmell.
Foetus   The child before birth, or when born  before the pro-
     per period, is thus termed.
Flatulent.   Producing wind.
Fungus.  Proud flefh.
                            G.
Gangrene.   Mortification.
Gummata, 1  Venereal excrefCences.
(juinglia.  j
Gymnajlic-   Exercife taken with a view to preferve or  reftore
     health.—The  ancient phyficians reckoned this an impor-
     tant branch of medicine.

                            H.
Heflic Fever.  A flow confirming fever, generally attending
     a bad habit of body,  or fome incurable  and deep rooted
     difeafe.
Hemorrhoids.   The piles.
Hemorrhage.   Difcharge of blood.
Hypochondriacijm.   Low fpirits.
Hypochondriac vifcera.   The liver, fpleen, &c.  fo termed from
     their fituation in the  hypochondriac or upper and lateral
     parts of the belly.

                              I.
Ichor.  Thin bad matter.
Impojlhume.  A collection of purulent matter.
Inflammation.  A furcharge of blood, and an increafed action
     of the veffels, in any particular part of the body.

                             L.
Ligature.  Bandage.
Lixivium.   Ley.

                             M.
 Mefentery.   A double membrane which connects the inteftines
     to the back bone.
Miliary 
                   A   GLOSS A  RY.               715

Miliary Eruption.  Eruption of  fmall puftules refembling the
     feeds of millet.
Morbifc.   Caufing difeafe, or difeafed.
Mucus.  The matter difcharged from the nofe, lungs, &c.

                            N.
Nervous.   Irritable.
Naufea.  An  inclination to vomit.
Nodes.  Enlargements of the bones produced by the venereal
     difeafe.

                            P.

Pectoral.  Medicines adapted to  cure difeafes of the breaft.
Pdvis.  The  bones fituated at the lower  part of the  trunk ;
     thus named  from their refembling in  fome meafure a
     bafon.
 Peritoneum.   A membrane lining  the cavity of the belly and
     covering the-' iteftines.
 Pericardium.  Membrane containing  the heart.
 Perfpiration.   The matter difcharged from the pores  of the
     fkin in form  of vapor or fweat.
 Phlogifton.  Is here ufed to fignify fomewhat rendering the air
   unfit for the purpofes of refpiration.
 Phelgmaiic.   Watery,  relaxed.
 Plethoric.  Replete with blood.
 Polypus.  A  difeafed  excrefcence,  or a  fubftance formed ot
     coagulable lymph, frequently found in the large blood
     veffels.
 Pus.  Matter contained in a boil.

                             R.
 Regimen.  Regulation of diet.
 Redum.  The ftraight gut,  in  which the  faeces are contained.
 Refpiration.   The aft of breathing.

                             S.
 Saliva.   The fluid fecreted by the glands of the mouth.  #
 Sanies.   A  thin bad matter, difcharged from an ill conditioned
       fore.
 Schirrous.   A  ftate of difeafed  hardnefs.
 Slough.   A part feparated and  thrown off by  fuppuration.
 Spafm.   A  difeafed contraction.
  Spine.  The back bone.
  Styptic.  A medicine for flopping  the difcharge of blood.
                          3 D 2                     Syncope 
7t6               A  GLOSSARY.

Syncope.  A fainting fit attended with a complete abolition of
     fenfation and thought.
                            T.
 Tabes.   A fpecies of confumption.
 Temperament.  A peculiar habit of body,  of which there are
     generally  reckoned four, viz. the  fanguine,  the  bilious,
     the melancholic, and the phlegmatic.

                            U.
 Vertigo.   Giddinefs.
 Ular.   An ill conditioned fore.
 Ureters.  Two long and fmall canals  which convey the urire
     from the kidneys to the bladder.
 Urethra. The canal which conveys the urine from the  blad-
     der out of the body.
INDEX. 
INDEX.
                            A.

 j^BLUTIONS, Jewifti, and  Mahometan,  well calculated
     for the prefervation of health, 105.
.Abortion, caufes and fymptoms of, 534. Means of prevention,
   5 $5.   Proper treatment in the cafe of, 536.
 Abfcffes, how to be treated, 315-575.
 Accidents.  See Cafualties.
 Acids,  of peculiar fervice in confumptions, 187.  In  putrid
   fevers, 203.                               N
 Acidities in the bowels of infants,  the origin of, ^o. Method
   of cure, 551.
 Ackivorth, Foundling Hofpital at, caufe of the children there
   being afllicted with fcabbed heads, and fatal confequences of
   their ill-treatment, 556,, note.
 Addifon,  his remark on the luxury of the table,  97.
 JEther, very ferviceable in gout in the ftomach, 371, 394.  In
   removing fits of the afthma, 416, note.   Is excellent ior fla-
   tulencies, 452.
 JEthiopt, mineral, ftrongly  recommended  by Dr. Cheyne in
   inflammations  of the eyes, 271.
 Africans, their treatment of children,  11,  note.
 Agaric of the oak, its merit ar. a ftyptic, 579.   Method of ga-
   thering,  preparing,  and applying it, ibid. note.
 Agriculture, a healthful, conftant, and profitable employment,
   49.   Is too much neglected in  favour of manufactures, ibid.
   Gardening  the moft wholefome amufement for fedentary
   perfons.  54.
 Ague, a fpecies of fever no perfon can miftake, and the proper
   medicine  for,  generally  known, 152.   Caufes  oi,  ibid.
   Symptoms, 153.  Regimen  for, ibid.   Medical  treatment
   of, 154. Often degenerates into obftinate chronical difeafes,
   if not radically cured, 158.  Peruvian bark the only medh 
718                   INDEX.
  cine to be relied on in, 160. Children how tn be treated in,
  ibid.  Preventative medicine for thofe who live  in  marfliy
  countries.  161.
Airy confined, poifonous to children, 32. A free open air will
  fometimes cure the moft obftinate diforders in children, 34.
  Occupations which injure the health by unwholefome air, 39,
  50.  The qualities of, act more fenfibly  on the body, than
  is generally imagined, 76.  The  feveral noxious qualities
  of, fpecified, 77.   In  large cities, polluted by various cir-
  cumftances, ibid.  The air in  churches,  how  rendered un-
  wholefome, 78.  Houfes ought to be ventilated daily, 79.
  The danger attending fmall apartments, ibid.  Perfons whofe
  bufmefs confines them to town ought to fleep in the country,
  ibid. High walls obftruct the free current of air, 80. Trees
  fliould not be planted  too near to houfes,  81.   Frefh air
  peculiarly neceffary for the fick, ibid.  The fick in hofpitals in
  more danger from the want of frefh  air, than from their
  diforders, 82.   Wholefomenefs  of the  morning air,  86.
  The changeablenefs of, one great caufe of  catching  cold,
  129. Thofe who keep  moft within doors, the moft  fenfible
  of  thefe changes,  13,0.   Of  the night, to  be carefully
  guarded againft,  131.  Frefh  air often  of  more  efficacy
  in  difeafes than  medicine, 143.   Its importance in fevers.
  149,  164.  Muft be kept cool and  frefh in  fick chambers
  under thefe diforders, 202. Change of, one of the moft effec-
  tual remedies for the whooping-cough, 292.   The qualities
  of, a material confideration for  afthmatic  patients, 415.
  The various ways by which it may be rendered noxious, 614.
  Confined, how to try,  and purify,  615. Method of recover-
  ing perfons p"ifoned by foul air, ibid. Frefh,  of the greateft
  importance in fainting fits, 623.
Aitken, Mr.  his  treatife on the nature and cure of fractures,
  recommended, 597, no.e.
Alkali, cauftic, recommended in the ftone, 336.  How to pre-
  pare it, ibid- note.
Aliment is capable  of changing the whole conftitution of the
  body,  63. Will in many cafes anfwer every intention in the
  cure ef difeafes, ibid.  The calls of hunger and thirft, fuf-
  ficient for regulating the due quantity of,  64.  The quality
  of,Ph)Winjured  ibid. A due mixture  of vegetables neceffary
  with our animal food, 66.   To what the bad  effects of tea
  are principally owing, 67.  Water, good and bad, diftin-
  guifhed, 68  Inquiry into the qualities of fermented liquors,
  with  inftructions for the due making of them,  69.   The
  qualities of good bread, and why adulterated by bakers, 71.
                                                    Unfer- 
                       INDEX.                  719
  Unfermented  bread not  f > unwholefome as  is generally
  imagined,  ibid.  General rules  for  the  choice of food, 72.
  Ought not to be too uniform, 73.  Meals ought to be taken
  at regular times,  74.   Long  fafting injurious both to ©Id
  and young, ibid.  Breafcfafts md flippers, 75.  Changes of
  diet ought to be gradually made, ibid.
Amaurofts.   See Gutta ferena.
American Indians,  their method of curing the venereal difeafe,
  517.
Amufements,  fedentary, improper  for  fedentary perfons, 52.
  Ought always to be of an active kind, 87.
Anafarca.   See Dropfy
Anger, violent fits  of, injurious to the conftitution,  114.  Tran-
  quility of mind effential  to health,  115.
Animal food, cautions in giving it to children,  19.   Animals
  that die  of themfelves, unfit for food, 65. Over-driven cattle
  rendered unwholefome,  ibid.   The artifices of butchers ex-
  pofed, 66.  Too great a quantity of animal food, generates
  the fcurvy, ibid.
Animals and  plants,  the  analogy*in the nourifhment of, ftated,
  96.
Anthony's fire, St.  See Eryfipelas.
Aphtha:. See Thrufh.
Apoplexy, who moft liable to this  diforder, 418.  Caufes, ibid.
   Symptoms and method  of cure, 419.  Cautions to perfon-s
   of an apoplectic make, 421.
Apothecaries weights,  a table of,  661.
Apparel.  See Clothing.
Appetite, want of, caufes and remedies for, 424.
Arbuthnot,  Dr. his advice  in  the inflammation of the  lungs,
   176.  His advice for perfons troubled with coftivenefs, 423,
   note.
Arfenic, the  effects of, on  the ftomach, 481.  Medical treat-
   ment when the fymptoms appear, 482.
Arts.   See Manufactures.
Afcites.  See Dropfy.
Affes milk, why it feldom does any  good, 183.   Inftructions
   for taking it, 184.
 Ajlhma, the different kinds of  this difarder diftinguifhed, 413.
   its caufes, 414.  Symptoms,  ibid. Regimen, ibid. Medical
   treatment, 416.  Remedies proper in the moift afthma, ibid.
 Atmofphere.   See Air.
BaW* 
7iO
INDEX.
                           B.
Ball's purging vermifuge powder,  preparation of, 377.
Balfarr.s, how  to  prepare.  Anodyne  balfam,  664.  Balfam
  capaivi, in rheumatifm, 400. In Gleets, 505.
Bandages,  tight, produce moft of the bad  confequences at-
  tending fractured bones, 598.
Bark, Peruvian, the beft antidote  for failors againft diforders
  on a foreign  coaft,  48.  How  to be adminiftered in the
  a^ue, 15 5.  Diftinction between the red and pale bark,  ibid.
  note. A  Decoction or infufion of, may be taken by thofe who
  cannot fwallow  it in fubftance,  157.   Is often adulterated,
  ibid.  note.  Is the  only medicine to be depended on in agues,
  160.  How it maybe rendered  more palatable, ibid.  May
  be adminiftered  by clyfter,  ibid.  May be infufed  in  cold
  water, 189.  How to  be adminiftered in the putrid fever,
  206; and in the eryfipelas,  261.  In an  inflammation of
  the eyes,  271.  Its efficacy in a  malignant quinfey, 282. In
  the whooping-couc;h, 295.  A good medicine in vomiting,
  when it proceeds from weaknefs  of the ftomach,  324.   Its
  efficacy in a diabetes, and  how to take it,  530.  Is good
  againft the piles, 344 ;  and worms, 375. Its  ufe dangerous
  for preventing a fit of the gout,  392.  A good remedy in
  the King's evil,  408 ; and in ihcfuor albus, 533.
ifar/ey-water, how made,  169.
Ear> cnnefs in women,  the general  caufes of, 545.  Courfe  of
  relief, 546.
Bath waters, good in the gout, 393.
Bath, cold, the good effects of, on children, 31. Recommended
  to the ftudious, 62.  Is peculiarly excellent for ftrengthen-
  ing the nervous  fyftem, 432.   Should never be omitted in
  pleets, 505.  Is good for rickety children, 566.  Cautions
  concerning the improper ufe  of in adults, 641. 647.
Balh, v.-.irm, ci great fervice in an inflammation  of  the fto-
  mach.  298.
Bathing, a religious duty under the Judaic  and Mahometan
  laws, 105.   Is conducive to health,  106.
Bears-ioot, recommended as a powerful remedy againft worms,
  376.      .
Beds,  inftead of beirg made up again as foon  as perfons rife
  from them, ought to be turned down and expofed  to the
  air, 78. Bad effects of too  great indulgence in bed,   85.
  Damp, the danger of, 131.   Soft, are injurious to  the kid-
  neys, 329.330.
4
Beer 
                      INDEX.                   724
Seer, the ill confequences of making Jt too weak, 70.  Per-
  nicious artifices of the dealers in, ibid.
Bells, parifh, the tolling  of them for  the  dead a dangerous
  cuftom,  116.
Biles, 577.
Bilious colic, fymptoms and treatment of,  305.
Bilious fever.   See Fever.
Bite of a mad dog.  See Dog.
Bitters,  v/arm and aftringent, antidotes to agues,  157.  Are
  ferviceable in vomiting when it proceeds from weaknefs in
  the ftomach, 324.
Bladder, inflammation of, its  general  caufes, 311.  Medical
  treatment of, 312.
Bladder, ftone in.  See Stone.
Blajl.   See Eryfipelas.
Bleeding, cautions for  the operation of,  in  fevers,  150.  In the
  ague.  155.   Its importance in  the  acute continual fever,
  165.   In the pleurify, 170.  When  neceffary in an inflam-
  mation of the  lungs,  177.   Caution againft,  in a nervous
  fever, 196.  In the putrid fever, 205. In the miliary  fever,
  213.   When neceffary in the fmall-pox,  231.   When ufeful
  in  the meafles,  252.  When neceffary  in the bilious fever,
  255.   Under what circumftances  proper in the eryfipelas-;
  260.   Mode cf, proper  in  an  inflammation  of the  brain,
  265.   Is always neceffary in an inflammation of the eyes,
  269.  When proper, and improper, in a cough, 287.  When
  proper in the  whooping-cough, 293.   Is almoft the only
  thing to be depended on in an inflammation of the ftomach,
  297.   And in an inflammation  of the  inteftines, 299.  Is
  neceffary in an inflammation of the  kidneys, 31.0.   Its ufe
  in a fuppreffion of  urine, 332.   In dropfy, 384. Is proper
  in an afthma, 416.  Is dangerous in fainting fits,  without
  due caution, 450. Cautions proper in the puerperal fever,
  542.   Is an operation generally performed by perfons who
  do not underftand when it is proper,  572.   In what cafes it
  ought to be had recourfe  to, ibid.  The quantity taken
  away, how to  be  regulated, 573.  General  rules for the
  operation," z'£/V,   Prevailing prejudices relating to bleeding,
  574.   The arm the moft commodious  part to  take blood
  from, 575.                                   _
B'eeding at the nofe, fpontaneous, is of more fervice, where
  bleeding is neceffary, than the operation with the lancet, 340.
  Ought not to be ftopped  without due  confideration, ibid.
  How to ftop it  when  neceffary, 341.   Cautions to prevent
  frequent returns of, 342.
                            q  E                      Blind 
722                   I  N D  E X.
Blind perfons, when born  fo, might  be educated  to employ-
   ments fuited to their capacity, 464,  note.
Blifers, peculiarly  advantageous  in  the nervous fever, 196.
   When only to be applied in the putrid fever, 205.   When
   proper in the miliary  fever,  212.   Seldom fail to remove
   the mofl obftinate inflammation of the eyes, 269.   A good
   remedy in the quinfey,  276.   Proper  for a  violent whoop-
   ing-cough,  295.   The beft  remedies  for  an inflammation
   of the ftomach,  298.   Are  efficacious in the tooth ach,
   366.
Blood, involuntary difcharges of, often falutary, and  ought not
   to be raflily ftopped, 338   The feveral kinds of thefe dif-
   charges, with their ufual caufes, ibid. Methods  of cure, 339.
 Blood, fpitting of,  who moft fubject to,  and at what feafons,
   346.  Its  caufes, ibid.  Symptoms, 347.   Proper regimen
   in, 348.   Medical treatment,  Hid. Cautions, to perfons lub-
   ject to it, 349.
 Blood, vomiting of,  its caufes  and fymptoms,  350.   Medical
   treatment, ibid.
 Blood-ihot eye, how to cure, 468.
 Blcody-f\\ix.   See Dyfentery.
 Boerhaave, his obfervation on  drefs,  95, note. H;s mechanical
   expedients to relieve an inflammation of the brain, 264.
 Bolufes,  general rules for the preparing of, 664. The aftringent
   bolus, ibid.  Diaphoretic bolus, 665.  Mercurial bolus, ibid.
   Bolus  of rhubarb and mercury, ibid.   Pectoral bolus, ibid.
   Purging bolus, ibid.   Volatile bolus, 666.
 Bones, the exfoliation of,  a very flow operation, 584.   Bones,
   broken, often fuccefsfully undertakenby ignorant  operators,
   C95.  Regimen to be adopted  after the accident, 596.  Hints
   ot conduct if the patient  be confined to his bed, ibid.  Clean-
   linefs to be  regarded during  this confinement, 597. The
   limb not to be kept continually on the  ftretch, ibid-  Cautions
   to be obferved in'fetting a bone, ibid.   Tight bandages con-
   demned, 598.   How  to  keep the limb  fteady by an eafy
   method, ibid.   Fractures of the ribs,  ibid-
 Bowels, inflammation of.  See Stomach.
 Braid-vood, Mr. his fkill  in teaching the dumb to fpeak, 469,
   note.
 Brain, inflammation of,  who moft liable t>  it,  with its caufes
   and fymptoms,  262.   Regimen,  264.  Medical  treatment,
  ■ 265.
 Bread, proper food for children, as foon as they  can chew ir,
   18.   Acruftof, the  beft g.irn ftick,  i'id.  The beft mode*
   ot preparing >t in food for children,  19.  Good, the qualities 
t
                       INDEX.                  723
   or,  and for what purpofe  adulterated by  the bakers, 714
   Toafted, a decoction of, good to check the  vomiting in a
   cholera morbus, 317.
Brimflone.   See Suphur.
Bruifcs, why of worih confequence than wounds,  584.  Proper
   trea.mentof, ibid.   The exfoliation of injured  bones a very
   flow operation, 585.   How to cure fores occafioned by, ibid.
Buboes, ciftirgu.fhed,  with their proper treatment, 508.
Burdens, heavy, injurious to the lungs, 42.
Burgundy pitch, a plafter of, between the fhoulders, an excellent
   remedy in a cough, 289. In a whooping-cough, 295.  And
   for  children in teething, 563.
Burials, the dangers attending their being allowed in the midft
   ot populous towns,  77.
Burns, flight,  how to cure, 582.  Proper treatment of recent
   ones, ibid. Treatment of, when violent, ibid. Extraordinary
-  cafe of, 583. Liniment for,  688.
Butchers,  their profeffional artifices explained, and condemned,
   66.
Butter ought to be very fparingly given to children,  22.
                            C.
Cabbage leaves, topical application of, in a pleurify, 171.
Camphor,  why of little  ufe in eye-waters, 668.
Camphoratea'o'A, preparation of, 689.
 Camphorated fpirit of wine, 703.
Camps, the greateft neceffity oi confulting cleanlinefs  in, 105*
Cancer, its different ftages defcribed, with the producing cau-
   fes, 474.   Symptoms, 475.   Regimen, and medical  treat-
   ment, 476.  Dr. Storck's method of treating  this diforder,
   477. Cautions for avoiding it, 479.
Carriages, the indulgence of, a facririce of health to vanity, 83.
 Carrot, wild,  recommended in the  ftone, 336.
 Carrot poultice for cancels, how to prepare, 478.
 Cafualties,- which apparently put an end to  life, neceffary cau-
   tions refpecYmy;, 603. 610. 614. 632.
 ---------fubftances ftopped in the gullet, 604.
 ---------drowning,  610.
 ---------noxious vapours, 614.
 ■      ---extremfty of cold, 6x6.
 ----■-----extreme heat, 618.
 Cataplafms, their general intentions, 666.
 CataraSl, the di "order and  hs proper treatment defcribed, 406.
 Cattle, ftail fed, are unwholefome food, 65.   Over driven are
   killed in a  high fever, ibid.   The artifices of butchers ex-
   pofed, -66.
                            3  E 2.                   CclLrs 
7H                   I- N D  E X.
Cellars, long fhut, ought to be  cautioufly opened, 79.  And
  iunk (lories of houfes unhealthy to live in, 1^3. Of liquors
  in a ftate of  fermentation, dangerous to enter, 614.  How
  to purify the air in,  615.
Celfus, his  rules for the prefervation of health, 137.
Chancres,.defcribed, 509. Primary, how to treat, 510. Symp-
  tomatic,  511.
Charcoal fire.,  the danger of fleeping in the fume of, 614.
Charity, the proper exercife of, 45.
Cheyne, Dr. his perfuafive  to  the   ufe  of exercife,  85.   His
  judgment of the due quantity of urine,  not to be  relied on,
  127  Strongly recommends iEthicps mineral in inflamma-
  tions cf the eyes, 271.
Chilblains,  caufe of, 557.  How to cure,  ibid.
Child-bed women,  how to be treated under a miliary fever,  212.
Child-bed fever.   See Fever.
Child-birth,  the  feafon of, requires  due care after the labour
  pains are over, 537,   Medical advice to women in labour,
  538.  Ill effects of collecting a number of women on fuch
  occafions,  ibid, no.'e.   How to guard  againft the  miliary
  fever, 541. Symptoms of the puerperal fever, ibid.  Proper
  treatment of this fever, 542.  General cautions for  women
  at this feafon,  544.545.
Children, their difeafes generally acute, and delay dangerous, 6.
  Their diforders lefs complicated, and eafier cured, than thofe
  of adults, ibid.  Are often the heirs  of the difeafes of their
  parents,  7.  Thofe born of difeafed parents require peculiar
  care in the  nurfing, 9.   Are often killed or deformed by in-
  judicious clothing;, 10.  How treated in Africa and America,.
  11, no.'e.  The ufual caufes of  deformity in, explained, ibid.
  Their clothes ought to be faftened on with filings, 14.   Ge-
  neral rules for  clothing them, 15.   Cleanlinefs an  import-
  ant artitle  in  their drefs, ibid.  The milk  of the mother the
  moft natural  food for,  16. Abfurdity of giving them drugs
  as their firft fuod,  ibid.   The beft method of expelling the
  meconium, 17.  How they  ought to be weaned from the
  breaft, 18.   A cruft of bread the beft gum-ftick  for them,
  'ibid-  How to prepare bread in their food, 19. Cautions as
  to giving them animal food, ibid.  Cautions  as to the quan-
  tity  of their food, ibid.   Errors in the quality of the^ food
  more frequent than in the quantity, 20. The food of adults
  improper for  children, ibid.   Strong  liquors  expofe  them to
  inflammatory diforders, ibid.  Ill effects of urn ipe fruit, 21.
  Butter, ^22.  Honey, a wholefome article of food for them',
  ivul.  I lie. importance of exercife to'promote their growth
                                                      and. 
INDEX.
725
 -and ftrength,  ibid.   Rules for  their exercife, 24.  Poverty
 of parents occafions their neglect of children, 25.  The  uti-
 lity of exercife demonftrated from the organical ftructure of
 children, ibid.  Philofophical arguments fliewing the neceffity
 of exercife, ibid.  Ought not to  be lent to fchool  too foon,
 26.  Nor be put too foon to labour,  29.  Weakly children
 fliould be employed out  of doors, ibid.   Dancing  an excel-
 lent exercife for them, 30.  The cold bath, ibid.  Want of
 wholefome air deftructive to children, 32.   To wrap them
 up clofe in cradles,  pernicious, 33.  Are treated like plants
 in  a hot-houfe, 34. The ufual faulty  conduct  of nurfes
 pointed  out, 35.  Are crammed with  cordials by indolent
 nurfes,  36.   Eruptions  ignorantly treated by nurfes,  37.
  Loofe .ftools,  the proper treatment of, ibid.  Every  method
  ouj'ht  to be taken  to make them ftrong and hardy,  38.  In-
  dications of the fmall-pox in,  225.  Vomiting and purging
  of, 325.
Chincohgh.   See Cough.
Cholera  morbus, the  diforder  defined, with  its  caufes,  316.
  Symptoms and Medical treatment,  317.
Churches,  the feveral circumftances that render the air in,  un-
  wholefome, 77.
Churching of women after lying-in,  a dangerous cuftom, 545.
Churchyards, the bad confequences of having  them  in large
  towns,  77.
Cities, large, the air  in, contaminated by  various means, 77.
  The bad effects of  burying the dead in,  ibid.  Houfes ought
  to be ventilated  daily, 78.   The danger attending fmall
  apartments,  79.  All who can ought to fleep in the  country,
  ibid.   Diforders that large towns are peculiarly hurtful to,
   80.  Cleanlinefs not fufficiently attended to in, 103. Should
   be fupplied with plenty of water,  108, note. The  beft means
   to guard againft infection in,  hi.
 Cleanlinefs,  an  important < article of attention in the drefs of
   children,  15; and to fedentary artifts,  53.  Ts neceffary to
   health, 102.   Diforders originating from the want of, ibid.
   Is not fufficiently attended to in large towns, .103.  Nor by
   country peafants,  104.   Great attention paid  to, by the
   ancient Romans, ibid.  note.  Neceffity of confulting cleanli-
   nefs in camps, 105. Was the  principal object of the, whole
   fyftem of the Jewilh laws, ibid.   Is a great part  of the reli-
   gion of  the Eaitern countries,  ibid.  Bathing and wafhing
   greatly conducive  to  health,  106.  Cleanlinefs peculiarly
   neceffary on board of fliips, ibid.   And to  the fick, 107.
   General remarks on,  108.   Many diforders  may  be cured
                                                         by 
-S                  I N D E X.
  by  cleanlinefs  alone,  144.  The  want of,  a very general
  caufe of putrid  fevers,  200.  Is a great preferv'ative aga nit
  venereal infection, 520 ; and againft galling in infants, 552.
Clergy,  exhorted to remove popular prejudices againft inocula-
  tion,  240.  Minht do great good by undertaking the prac-
  tice of it themfelves,  246.
Clothing,'the only natural ufe of,  10. That of children, lias be-
  come a  fecret  art, ibid.   Ought  to be  faftened on infants
  with  firings  inftead of pins, 14.  Pernicious confequences
  of ftays,  15.  The due quantir. of,  dictated by the climate,
  91. Should be increafed in the  decline of life, 92. and adap-
  ted to the'feafons,  ibid. Is often hurtful by being made  fub-
  fervient  to the purpofes  of vanity, 93.  Pernicious confe-
  quences  of attempting  to mend  the  fhape by drefs, ibid.
  Stays, ibid.  Shoes, Hid,   Garters, buckles, and  other  ban-
  dages, 94. The perfection of, to be eafy and clean, 95.   Ge-
  neral remaks on,  ibid.   Wet,  the danger of, and how to
  guard againft it,  130.
Clyjlers, a proper  form of, for an inflammation of the ftomach,
  298.  And for an inflammation of the  inteftines,  300.  Of
  tobacco lmoke, its efficacy in procuring a ftool, 307,  note.
  Their ufe in a fuppreffion  of urine,  332. Ought to be fre-
  quently adminiftered in the puerperal fever, 543. Of tobacco
  to  excite vomiting, 6c8.  The genera) intention of.  666.
  Preparation of the emollient clyfter, 667. Laxative clyfter,
  ibid.  Carminative clyfter, ibi:l. Oily clyfter, ibid.  Starch
  clyfter,   663. Turpentine clyfter.   ibid.  Vinegar clyfter,
  ibid.
Cxliac paffion, proper treatment for, 359.
Co fee berries recommended in the  ftone, 336.
Cold,  extreme,  its effects on the human  frame,  616.   The
  fudden application  of heat dangerous in fuch cafes, 617.
  Hcr.v to  recover frozen or  benumbed limbs, ibid.
Cold. Bath.   See Bath.
Colds, frequently  occafioned by imprudent changes of clothes
  at the firft approaches  of fummer, 93, note.  Various caufes
  of, fpecified,  129.   Their general caufes,  284.   Proper re-
  gimen on the fymptoms of, appearing, ibid.  Danger of ne-
  glecting the diforder, 285.  The chief fecret for  avoiding,
  287.
Cdie, different  fpecies  of, 302. Medical treatment of. accord-
  ing to  their fpecies and  caufes, 304.   Bilious colic,  ibid.
  Hyfteric colic,  305.   Nervous  colic, 306.  Cautions necef-
  fary to guard againft the  nervous  colic,  307.  General ad*
  vice in colics, 308.
                                                   Co 'lyria> 
                      INDEX.                   727
Collyia.   See Eyewaters.
Commerce often mipe-rs infectious diforders,  no.  Means  fa<r-
  gefted t>> g-:ard againft uiis dam er,  11 i, note.
Collections .tt:n very needlefsly compounded, 669.   Prepara-
  tion of the J iponie confection, 670.
Gon;erves ev.v. j>ref.rvcs, general  remarks on, and their compw-
  fit.on, 670.  Of red rofes, ibid. Or floes,  671.  Candied
  orange-peel, Hid.
Confhwion, good or bad,  the foundation of, generally laid dur-
  ing infancy, 1.
Co»/ options,  the increafe of this diforder, may be  attributed
  tc hard drinking, 100. Who moft liable to, and  the caufes,
   17S. Symptoms, 180.  Regimen, j8i.  Riding, ibid. Much
  benefit to be expected from s;oing a long voyage,  182. Tra-
  velling,  183. DLt, Hid. Great efficacy  of  the  milk, ibid.
  Medical treatment, 187.
------------Nervous, defined, 190. The petfons moft liable to,
  191. Proper treatment of, ibid.
-----------Symptomatic, the treatment of, muft be direcled
  to the producing caufe  191.
Conv.lfons,  why new-born infants are fo liable  to,  13.  Thofe
  precedingthe eruption in the fmall-pox favourablefymptoms,
  227. The  general caufes of, 567.  'Proper  treatment of,
  ibid.  Extraordinary recovery of an  infant feemingly killed
  by, 629.  Further inftructnns in like cafes, 630.
Co.ih, Captain, the circumnavigator, his means of  preferving
  the  health ol his men,  47, note.
Cookery, the arts of, render many things unwholefome that are
  not naturally fo, 68.
Cordials, ought not to be given to infants, 17.  Are the com-
  mon refuge of nurfes who neglect their duty to children., 36.
  Are often  fatal in an infiammarion of the  ftoma"h,  297,
   When good in the  colic, 303.   Ought not to be  given to a
  pregnant woman during 1 .bour, 538.
Corn, damaged, will produce the putrid fever, 199.
Ccrns  in the  feet are occafioned by wearing tight fhoes, 94.
Cortex.  See Bark.
Cofiivenefs, a frequent recourfe to medicines for  the  preventr-n
   of,  injurious  to the c  nftituti. n, 125.  Is rather to be re-
   moved by diet than by drugs, ibid.  Its general caufes  and
   ill effects, 422.  Regimen, ibid.   Remedies for, 423.
Co'/gh, the proper remedies for, 287.  A  plafter of Burgundy
   pitch  laid  between the flioulders'an excellent remedy fo ,
   289. The ftomach-cough, and  cough <.f the  ln\?s, difti-n-
   gnfthed. 290.  Treatment for the r.ervous cough, ibid.
                                                    Couf.% 
  ?28                   INDEX.
■  Cough,  whooping, who moft liable to, with its difpofing can-
    fes, 291.  Remedies,  292.  Is  infectious,  ibid.  Vomits,
    their  ufe, and  how  to adminifter them  to  children, 293.
    Garlic ointment a good remedy for,  295.
  Cough,  phthificdl, incident to fedentary artificers, from their
    breathing confined air. 50.
  Cradles, on many accounts hurtful to children, 33.
  Cramp,  proper remedies for, 459.
  Cramp ofthejlomach, who moft fubjeft to,  446.  Medical treat-
    ment of, ibid.
  Crotchets, how to ufe  for extracting fubftances  detained in the
    gullet, 606.
  Croup or hives in children, defcribed, and its fymptoms, 558.
    Proper treatment, 560.
  Cuprum ammoniacum,  its ufe in epilepfy, 443.
  Cyder,  the ill confequences of making it too weak, 70.

                              D.
  Dancing, an excellent kind of exercife for young  perfons, 30.
  Daucus fylvejlris.  See Carrot.
  Deafnefs, when  a favourable fymptom  in the putrid fever, 202,
     note.  Methods of cure according to its caufes, 469.
  Death,  the evidences of, fometimes fallacious  and ought not
     to be too foon credited, 603. 610. 612.632.  The  means
     to be ufed for the  recovery of perfons from, nearly the fame
     in all cafes, 632.
  Decotlions,  general remarks on, 671.   Preparation of the de-
     coction of althaea, ibid.  Common decoction, 672.  Of log-
     wood, ibid.   Of  bark, ibid.  Compound decoction of bark,
     ibid.   Of  farfaparilla,  673.  Of fimeka, ibid.  White  de-
     coction, ibid.
  Deformiy,  often occafioned by the injudicious method of dref-
     fing  cliildren, 10.  Is feldom  found among favage nations,
     11.  The ufual caufes of, explained, ibid.
  Dews,  night, dangerous to health,  131.
  Diabetes,  who moft  liable to this diforder, and its caufes, 328.
     Symptoms,  and regimen, 329.   Medical  treatment,  330.
     Diftinguifhed from incontinency of urine,  331.
   Diarrhcc.:.  See Loofenefs.
   Diet,  will often anlwer moft of the indications of cure in dif-
     eafes, 142.   I.luftrations,  143. See Aliment.
   Digeftion, the powers of,  equally impaired by repletion or ina-
     nition, 74.
   Difeafes,  hereditary, cautions to perfons afflicted with,  8.   Pe-
     culiar diforders amending particular occupations, 39. Many
            1                                               of 
                       INDEX.                  729

  -of them infectious,  108. The knowledge of, depends more
  upon experience and obfervation than upon fcientifical prin-
  ciples, 139.  Are to be diftinguifhed by  the moft obvious
  and  permanent fymptoms,  ibid.  The differences of fex, age,
  and  conftitution,  to-be  confidered, 140.  Of the mind,  to
  be diftinguifhed from thofe  of the body,  141.   Climate,
  fituation,  and occupation to be  attended to, ibid.  Oilier
  collateral  circumftances, ibid. Many indications of cure,  to
  be anfwered by diet alone, 142. Cures often effected by frefh
  air,  143,  by exercife, or  by cleanlinefs, 144. Nervous dif-
  eafes, of a complicated nature,  and difficult to cure, 427.
Diflocations,  fhould be reduced  before the fwelling and inflam-
  mation come on, andhow, 589.   Of the jaw, 520. Of the
  neck, 591.  Of the ribs, 592.  Of the fnoulder, 593.  Of
  the elbow, 594.  Of the thigh,  ibid.  Of the knees, ankles,
  and  toes,  595.
Diuretic infufion for the Dropfy, how to prepare, 384, 385.
Dog, fymptoms  of  madnefs  in, 484.  Ought to be carefully
  preferved  after biting any perfon,  to afcertain whether he is
  mad or not, 485.  Is often reputed mad when he is not  fo,
  ibid.  Symptoms of the bite  of a mad dog,  486.  The poi-
  fon  cannot lie  many years  dormant in the body,  as is lup-
  pofed, 487.   Dr.  Mead's receipt for the  bite, ibid.  The
  famous Eaft India fpecific for, 4S8.  Other recipes^ ibid.
 ,. Vinegar of confiderable fervice in this diforder, ibid.  Medi-
 . cal courfe of treatment  recommended, ibid.  Regimen, 490.
  Dipping in the fea  not to be  relied on, 491.   Dr. Tiifct's
  medical courfe for  the  cure  of the hydrophobia, ibid.  Re-
  marks on the Ormfkirk  medicine,  492,  note.
Dofes of medicines, the relative proportions of, for different
  ages, 660.
Dramt ought to be avoided by perfons afflicted with nervous
  diforders, 431.
Drawht, is the proper form far fuch medicines as are intended
  forrimmed:ate  operation, 674. How to prepare the anodyne
  draught,  ibid.  Diuretic draught,  ibid.  Purging  draughty
  ibid. Sweating draught, ibid.  Vomiting draught, 675.
Drefs.  See Clothing.
Drinking,  perfons who are feldom intoxicated may neverthelefs
  injure their confbtutions by,  99. The habit of drinking, fre-
  quently originates from misfortunes, 100.   Frequently  de-
  ftroys the powers of the mind,  101.  Perfon^. often forced
  to it by  miftaken  hofpitality, ibid. note.  Leads  to  other
   -ices, IQ2.
3 F
Proffy, 
730                   I N D E X."
Dropfy, the feveral diftinctions of, with its caufes, 381. Symp»
   toms, 382. Regime:;, 383.  Medical treatment,  384.  Tap-
   ping, a fafe a.'d fimple operation, 386.
Dr ply  of the brain.  See Water in the head.
Drowned perfons. ourht not to be rafhly given up for dead, 610.
   Proper  trials for the recovery of,  611.  Endeavours ought
   rot to be fufpended upon the firft returns of life, 613.  Suc-
   cefs of the Amfterdam fociety for the recovery of, 631.
Drunlcnnef.   See Intoxication.
huvd perfons may be taught to read, write, and difcourfe, 469.
   vote                               *
Dyfentery,  where and when  moft prevalent,  353.   Its caufes
   and  fymptoms, ibid.  Rer.imen,  354. Fruit, one of the beft
   remedie- for, 356.   Proper drink for, 357.  Medical treat-
   ment, ibid.  Cautions to prevent arelapfe, 358.

                            E.
Ear, ^he feveral injuries it  is liable to, 468. Deafnefs, medical
   treatment of,  according to its caufes, 469.  Ought not to
   be tampered with,  470.
Earach,  its  caufes,  and proper  treatment for,  368.  How to
   drive infect? out of, ibid.
Education of children,  fliould be begun at home by the parents,
   27, note.  That of girls hurtful to the conftitution, 28.
Effluvia,  putrid, will occafion the fpotted fever, 199.
Eleffricity beneficial in the palfy, 439.   In gutta ferena, 466.
Electuaries, gc-eral  rules  for -making,  675.  Preparation of
   lenitive electuary, ibid.   Of the bark, 676.  For the  piles,
   ibid.  For the palfy,  ibid.   For the rheumatifm, ibid.
Elixir, paregoric, how to prepare, 702.  Sacred elixir, 703.
   Stomachic elixir, ibid. Acid elixir of vitriol,  ibid.
Emulfions, their  ufes,  676.   Preparation  of  the common
   emullion, ibid  Arabic  emulfion,  677.  Camphorated emul-
   fion, ibid.  Emulfion of  gum ammoniac, ibid. Oily emulfion,
   ibid.
Engleman, Dr. his account of the German method of recover-
   ing perfons fr'<rh fainting fits, 622.
 Entrails.   See Inteflines.
Epilepfy,  the diforder defined, 440.  Its caufes, ibid.  Symp-
   toms, 441.  Due regimen, 442.  Medical  treatment, ibid.
Eruptions in  children often free them from bad humors, but are
   miftaken and ill treated by nurfes, 37.   Ought never to be
   ftopped without proper  advice, ibid.   In fevers, how  to be
   treated, 197. 205. 211.  212.  In the fmalhpox, 227, 231.
   in children, the caufes  of, 556.   How to cure, ibid.
                                                   Eryfipelas 
                        INDEX.                  73-t
 Eryfipelas, a diforder incident to the laborious, 43.  Its caufes
   explained, and who moft fubject to it, 257.  Its fymptoms,
   258.   Regimen, 259.   Medical treatment, ibid.  The fcor-
   butic  eryfipelas, 261.   Inftructions for  thofe who are fub-
 y ject to this diforder, ibid.
 Evacuations of the human body, the principal, fpecified, 124.
   By ftool, ibid.  Urine. 126. Perfpiration, 128.
 Exercife, the importance of, to promote the growth and ftrength
   of children,  23.  All young  animals exert their organs of
   motion as foon as they are able, ibid. The utility of, proved
   from anatomical confiderations,  25.  And from philofophi-
   cal deductions, 26.   Benefits of dancing,  30.  Is better for
   fedentary perfons under lownefs of fpirits  than the tavern, 53.
   Gardening the beft exercife for the fedentary,  ibid. Violent,
   ought not to be taken immediately after  a full meal, 6^. Is
   as neceffary as food for the prefervation of health,  82.   Our
   love of activity an evidence of  its utility, 83.  Indolence
   relaxes the folids, ibid. The indulgence  of carriages as ab-
   furd as pernicious,  ibid.  Is almoft the only cure for glandu-
   lar obftructions,  84.   Will prevent and remove  thofe dif-
   orders that medicine cannot  cure,  85. .  Is the beft cure for
   complaints in the  ftomach,  86.   How  to be  taken within
   doors, when not to be done in the open air,  ibid.   Active
   fports better than fedentary amufements, 87.   The golf a
   better exercife  than cricket,  ibid. note. Exercife fhould not
   be extended to fatigue, ibid.  Is as neceffary  for the mind
   as  for the body,  120.   Is often of more  efficacy  than
   any medicine whatever,  144.  The beft mode of taking it
   iu a confumption,  181.  Is of the greateft importance in a
   dropfy, 383.   Mufcular, for the gout,  392.   Is neceffary
   for the afthmatic, 415.  Is fuperior to all medicine  in ner-
   vous diforders, 431.  And in the palfy,  440.  Is proper for
   pregnant women, unlefs they are of a very delicate texture,
   537-  Want of, the occafion of rickets in children, ^6<j.
Extracts, general rules for making ; but are more conveniently
   purchafed ready made, 677, 678.
Eyes, inflammation of, its  general  caufes,  266.   Symptoms,
   267.   Regimen,  268.   Medical treatment, ibid.   How to
   be treated  when it proceeds from a fcrophulous habit,  271.
   Advice to thofe who  are fubject to this complaint,  272.
   Are fubject to many difeafes which are  difficult to  cure,
   464.   The means by ;which  they  are frequently  injured,
   465.   General  means  of prevention, ibid. The feveral dif-
   orders cf,  with their medical treatment, 466.
3 F 2
Eye- 
732                 INDEX.
Eye-waters, general remarks on, and their principal intention^,
  666.  Collyrium of alum, 669.   Vitriolic collyrium,  ibid.
  Collyrium of lead, ibid.

                            1*.
Fainting ft j, how to cure,  449. 619.  Cautions to perfons fub-
  ject to them,  623.
Fal'ingficknefs.  See Epilepfy.
Fajlinq, long, injurious  to thofe who labour hard, 44. Is hurt-
   ful both to old and young,  74.
Fathers, culpably inattentive to the management of their  chil-
  dren, 5.   Their irregular lives  often injure the conftitution
  of their  children,  8.
Fear, the influence of,  very great, in occafioning and aggra-
  vating difeafes,  115. Its various operations,  ibid.
Feet, injured by wearing tight fhoes, 93.  The wafliing of, an
  agreeable article of  cleanlinefs, 106.  Wet, the danger of,
   130.  Bathing them  in  warm  water, a good remedy in a
  cold, 286.  And in  the whooping-cough, 295.           ,
Fermentation, the vapour of liquors in a ftate of,  noxious,  614.
Fevers, of a bad kind, often occafioned among labourers by  poor
  living, 45. Frequently  attack fedentary perfons after  haid
  drinking,  53.   Nervous,  often  the confequence  of in-
  tenfe ftudy, 58.  Malignant, often occafioned by want of
  cleanlinefs, 103. The moft general caufes of, enumerated,
   145. The dittinguifhing  fymptoms of, Hid.  The feveral
  fpecies of, 146.  Is  an effort of nature,  which ought to be
  affilled,  ibid. How this  is to be done, 147.   Cordials and
  fweetmeats improper in, 149. Frefli air of great importance
   in, ibid.  The mind of the patient  ought  not to be alarmed
   with religious terrors, 150. Cautions as to bleeding, ibid, and
   fweating in,  151. Longings, the calls  of nature, and de-
   ferve attention,  ibid.  Cautions to prevent a relapfe, ibid.
 Fever, acute, continual, who moft liable tor 162. Caufes, ibid.
   Symptoms, ibid. Regimen, 163.  Medical treatment,'  165.
   Symptoms favourable  and unfavourable, 166.  Regimen
   to be obferved during recovery, 167.
 Fever, bilious,  general time of its  appearance 255.  Proper
   treatment of, according to its fymptoms, 256.
 Fever, intermitting. Sec-Ague.
 Fever, miliary,  from what the name derived,  and its general
   appearances,  209. Who moft liable  to it, ibid. Caufes, ibid.
   Symptoms, 210.   Regimen,  211.  Proper   medical  treat-
   ment,  212.   Cautions  for avoiding  this  diforder,  213.
   How to prevent, in childbed-women, 541.
                                                    Fever, 
                      INDEX.                  733
Pever, milk, hew to prevent, 540.  1
Fever, nervous,  why more common now than formerly, and
  who moft liable to it, 192. Its caufes, ibid. Symptoms, 193.
  Regimen,  194.  Medical treatment of, 195.
Fever, puerperal, or child-bed, the  time of its  attack, 541.
  and fymptoms, 542.  Medical treatment of, 543. Cautions
  for the prevention of this fever, 544.
Fever, putrid, is of a peftilential nature, and who moft liable
  to it, 199. Its general caufes, ibid.  Symptoms of, 200. Other
  fevers may be converted  to this, by improper treatment,
  201.   Favourable and unfavourable fymptoms of, ibid. 202.
  Regimen,  ibid. Medical treatment, 205. Cautions  for the
  prevention of this diforder, 207.
Fever, remitting, derivation'of its name, 214. Its caufes and
  fymptoms, ibid. Proper regimen, 215.  Medical treatment,
  216.  Cautions for avoiding this fever, 217.
Fever, fearlet, why  fo named,  and  its ufual feafon of attack,
   254.  Proper treatment of, ibid. Is fometimes attended with
  putrid and malignant fymptoms,  255.
Fever, fecondary in the fmall-pox, 234. Proper treatment 0^235.
Fever, yellow, why fo called, 218. Its caufes, 219. Symptoms,
   220.   Regimen neceffary,  221. Medical treatment ibid.
Flatulencies in the ftomach,  remedies againft, 370.  The feve-
   ral caufes of,  451. Medical treatment of, ibid.
Flatulent colic, its caufes, and feat of the diforder, 302. Reme-
   dies for, 303.
Fluor albus defcribed, with its proper treatment, 532.
 Fomentations, how to make and apply, 678. General intentions
   of, ibid.  Anodyne fomentation, ibid   Aromatic fomenta-
   tion,  ibid.  Common  bitter fomentation,  ibid.  Emollient
   fomentation, 679.  Strengthening fomentation, ibid.
 Food.   See Aliment.
 Forgivenefi of injuries, ought to be practifed from  a regard to
   our own health, 114.
 Fox-glove, its ufe in dropfy, 386.
 Fradures.  See Bones, broken.
 Frozen  limbs, how to recover, 617.
 Fruit,  unripe, very hurtful to children, 21.  One of the beft
   medicines both for the prevention and cure of a dyfentery,
   356.                      m
 Funerals, the great number of  vifitors  attending them, dange-
   rous  Co their health, 109.
Gulfing, 
734
INDEX.
                            G.
 Galling, in infants, the caufe and cure of, 551.
 Gangrene, proper treatment  of, 576.
 Gardening, a wholefome amufement for fedentary perfons, 53.
 Gargles for the throat,  how to make, 275.  277.  General  in-
   intentions of, 679. Method of making the attenuating gargle,
   ibid.  Common gargle, ibid. Detergent gargle, 680.  Emol-
   lient gargle, ibid.  For the mouth of  infants in the thrufh,
   550.
 Garlic ointment, a North Britifh remedy for the whooping-cough,
   how to apply it, 295.
 Gilders.  See Miners.
 Ginger, fyrup of,  how to prepare, 699.
 Girls, the common mode of education prejudicial to their con-
   ftitution, 28.  Means  of rectifying it recommended, ibid.
 Gleet, how occafioned,  and  its  fymptoms, 504.  Method of
   cure, ibid.   Regimen, 505.  Obftinate gleets cured by mer-
   curial unctions, 506.  How to apply  bougies, ibid.
 Glover,  Mr. his courfe of treatment for the recovery of a hang-
   ed man, 628.
 Gonorrhoea, virulent,  the nature of, and its fymptoms, 498.
   Regimen,  500. Medical treatment, ibid.   Is often cured
   by aftringent injections,, ibid. Cooling purges always proper
   in, 501.
 Goulard, M. preparation  of  his celebrated extract of Saturn,
   705.  His various applications of it, ibid.  Cerate, 687.
 Gout, the general caufes  of, 56.  How to treat a loofenefs oc-
   cafioned by the repelling it from the extremities,  320.  The
   fources  of this diforder, and its fymptoms, 387, 388.  Re-
   gimen for, 389.  Wool the beft external application in, 390.
   Why there are fo many noftrums for,  391.  Proper medi-
   cines  after the  fit,  ibid.  Proper regimen in the intervals
   between fits to keep  off their return, 392.  How to remove
   it from  the nobler parts to the extremities,  393.  General
   cautions to prevent danger by miftaking  it for other difor-
   ders,  394.
Gravel, how formed in the bladder, 127.  How  diftinguiflied
   from  the ftone,  333. Caufes and fymptoms, ibid. Regimen,
   334.  Medical treatment, 335.
Green fcknefs  originates in indolence, 526.
Grief, its effects permanent, and often  ia'al, 119.  Danger  cf
  the mind dwelling  long upon 01c  u j;ct, efpecially if of a
   difagreeable nature, ibid.  The mind requires exercife as well
                                                        as 
                      INDEX.                   735
  as the body, 120. Innocent amufements not to be neglected,
  121. Is productive of nervous difeafes, 428.
G>i es in infant'., pioper treatment of, 551.
Guaiacum, gum, a good remedy for the rheumatifm, 396.
Gulut, how to remove  fubftances detained in,  605.  Cautions
  for the ufe of crotchets with this intention, 606.  Other me-
  chanical expedients,  ibid.  Treatment if the obftruction can-
  not be removed, 609.
Gums of children,  applications to,  during teething, and how  to
  cut them, 563.
Gut 1 a ferena, proper treatment of, 466.

                            H.
Hatmoptoe, fpitting  of blood.  See Blood.
Hemorrhage.  See Blood.
Harrowgate water, an excellent medicine for expelling wormst
  375. And for the jaundice, 381.  In the fcurvy, 398.
Head ach, the fpecies  of,  diftinguiflied,  360.   Caufes of, ibid.
  Regimen,  362.  Medical treatment, ibid.
Health of the people in general, a  proper  objeft of attention for
  the magiftrates, vii.  Ought to be attended to in  matrimo-
  nial contracts, 8.  Is often laboured for after it is deftroyed,
  62.  Rules given by Celfus for the prefervation  of, 137.
Heart-burn, the nature of this diforder, with its caufes, and re-
   medies for, 425.
Heat, extreme, how to recover perfons overcome by,  618.
Hemlock, a good remedy in the king's  evil,  409.  Is  recom-
   mended by Dr. Storck foi  the cure of cancers, 477.
Hemp feed, a decoction of, good in the jaundice, and  how to
   prepare it, 380.
 Hiccup, its caufes, and method of treatment, 444.
 Hives.  See Croup.
 Hoffman, his rules for guarding child-bed  women againft the
   miliary fever, 541.
 Honey, a wholefome article of food for children,  22.  Is recom-
   mended in the ft  ne, 337.
 Hofpitals, the want of frefh air in, more dangerous to the  pa-
   tients than their diforders,  82.  Cleanlinefs peculiarly ne-
   ceffary in, 107.  Often fpread infection by being fituated in
   the middle of populous towns,  in. How  they might be
   rendered proper receptacles for the  fick, ibid.  Particularly
   in infectious  diforders, 113.  The fick in, ought not to be
   crowded together,  229,  note.
 jlorfe radijh,  the chewing of, will reftore fenfibility  to the or-
    gans of tafte when injured, 473. 
73°"
INDEX.
 Houfes, inftead of contrivances to make them clofe and  warm,
   ought to be regularly ventilated,  78.  In marfhy fituations
   unwholefome,  81.  Ought to be built in a dry fituation, 133.
   Danger of inhabiting new-built houfes before thoroughly dry,
   ibid.   Are often rendered damp by unfeafonable cleanlinefs,
   134.  Are dangerous when kept too clofe and hot, i^C.
 Hujbandmen, the peculiar diforders they are expofed to, from the
   viciffitudes of the weather, 42.
 Huxham, Dr. recommends the ftudy^of the dietetic part of me-
   dicine,  ix.
 Hydrocephalus.  See Dropfy.
 Hydrophobia, Dr. Tiffot's method of curing, 491.
 Hydrops peBoris.   See Dropfy.
 Hypochondriac cffeclions, frequently produced by intenfe ftudy,
   58.   Their caufes, and who moft fubject to  them, 459. The
   general intentions of cure, 460. Regimen, 462.
 Hyfterics, a diforder produced by  the habitual ufe of tea, 67,
   General canfes, 455.  Symptoms,  ibid.  Proper treatment
   of, 456.  Regimen, 457.   Medicines  adapted to, ibid.
Hyfierie colic,  fymptoms and treatment of, 305.

                            I.
Jails, why malignant fevers  are often generated in them, 78.
   Often fpread infection by being fituated in the middle of po-
   pulous towns, in.  Ought to be removed, ibid.
janin, M. his relation of  the recovery of an overlaid infant,
   627.   And of a man who had hanged  himfelf,  628.
Jaundice,  the different ftages of its appearance, with the caufes
   of this  diforder,  and its fymptoms, 378.  Regimen,  and
   medical treatment, 379.
Jefuits  Bark.   See Bark.
Jews, the whole fyftem of their laws tending to promote clean-
   linefs, 105. 1 ro.
Iliac paffion, a particular kind of inflammation of the inteftines,
   299.
Impojlhume in thelreafl, in confumptions, how to be treated, 189.
   Impofthumes after the fmall-pox, proper treatment of,  237.
 Incontinency of urine, diftinguifhed from a diabetes, 331.  Expe-
   dient for relief, ibid.
 Indigefiion, is one confequence of intenfe  ftudy,  57.  General
   caufes, and remedies for, 423.
Indo?ence, its bad effects on the conftitution, 83. Occafions glan-
   dular obftructions, 84. Ill confequences of too much .indul-
   gence in bed, 85. Is the parent of vice, 88.   Is the general
|  caufe of moft nervous diforders, 463.
          r                                        Infancv, 
                     INDEX.                     7j7

Infancy, the foundation of a good or bad conftitution, generally
   laid in this feafon of life, i.
Infants, nearly one half of thofe born in Great Britain die un-
   der twelve years of age, i.  Perifli moftly by art, 2.  Ought
   not to be fuckled  by delicate women, 3.   Importance of
   their being  nurfed  by their  mothers,  5.   Often  lofe their
   lives, or become deformed, by errors in clothing them, 10.
   How the a't of bandaging them became the province cf the
   midwife,  ibid.   How treated in Africa, n, note.   Philofo-
   phical obfervations on  their original ftructure,  and on the
   caufes of deformity,  12.  Why they  fo  frequently  die of
   convulfions,  23.  Why expofed to fevers, 14.   And colds,
   ibid.  Rules for their drefs, 15.  Their food, 16.  Reflections
   on  the many evils  they are expofed to,  546.   Why their
   firft diforders  are in their  bowels,  547.   Ho-v to cleanfe
   their bowels, ibid.   The meconium,  548.  Thrulli, 549.
   Acidities, 550.  Gripes, 551.  Galling  and  excoriations,
   ibid.  Stoppage of the nofe, 552.  Vomiting, 5^.  Loofe-
   nefs,  554.  Eruptions, 555.   Scabbed heads  556.  Chil-
   blains, 557.   The croup, 558.   Teething,  561.  Rickets,
   564.  Convulfions, 567.   Water in the head, 569.  How
   to recover infants feemimjly  dead,  623.  * Ought  never to
   fleep in  the fame bed with  their mothers or  nurfes 627,
   note.  Cafe of the recovery of an overlaid infant,  627. Cale
   of an infant feemingly killed by a ftrong convulfion fit, and
   recovered, 630,  See Children.
Irfeclion, the danger of, incurred by injudicious or unneceffary
   attendance on the fick,  108.   And on funerals,  109.   Is
   often communicated by clothes, no.  Is frequently imrort-
   ed, ibid.   Is fpread by hofpitals and jails being fituatcd in
   the middle of populous towns, in.   How to  prevent in-
   fection in fick chambers, 112.   In what refpects the fpread-
   ing  of infedion might  be checked  by the magiftrate, Hid.
   Small-pox, 225.
Infidmmaiiom, how the laborious part of mankind expofe them*
   felves to, 44.   Proper treatment of, 575,
Inflammation of the bladder.   See Bladder,
_J---------of the brain.   See Brain.
-----------of the eyes.   See Eyes.
___________of the inteftines.  See  Inieflines,
_____-------of the kidneys.   See  Kidneys.
.____-------.of the liver.   See Liver.
_________.— of the lungs.  See Peripneumony,
___________of the ftomach.   See Stomach.
___________of the throat.   See Quinfey.
______,----, of the womb.  See Womb.
                          3  G                 '  Infufions 
738                   INDEX.
Infufions, advantages  of, over decoctions, 680.   How  to ob-
   tain rich infufioi.s from weak vegetables, ibid.   E.vpedi ious
   mode of preparing them, 681.   Preparation  of the bitter
   infufion,  ibid.   Infufion of the bark, ibid.   Infufion of car-
   duus, ibid.  Of flaxfeed, Hid.   Of rofes, 682.  Ofumarir.ds
   and fenna, ibid.   For the paliy,  ibid.
Inns.  The great danger of meeting with damp  beds in them,
   131.  The fheets in, how treated to fave waifim;:, 132.
Inoculation  of the  fmall-pox, more  favourably  received here
   than in neighbouring countries, 237.   Cannot prove  of ge-
   neral utility while kept in the hands of a few, 238.  No my-
   ftery in the procefs, ibid.   May  falely be performed by pa-
   rents or  nurfes,  239.  Various  methods  of doing it, ibid.
   The clergy exhorted to remove the  prejudices againft the
   operation, 240.   Moft fimple method of performing the ope-
   ration, ibid. note.   Arguments cited from Dr Mackenzie in
   favour of inoculation,  241, note.   Otght  to be rendered
   univerfal,  243.   Means  of extending the practice of, ibid.
   Two obftacles to the progrefs of, ftated,  245.  Might  be
   performed by clergymen, or  by  patents themfelves, 246*.
   The proper feafons  and age for performing it, 247.   Will
   often mend the habit of body, 248.   Neceffary preparation
   and regimen for, ibid.
Infeffi,  when they  creep into the ear, how to  force them out,
   368.  Poif mous, the bites of, how to be treated, 493.
Intemperance, one great caufe of the difeaies of feamen, 46. The
   danger of,  ajgued  from the conftruction of the human bo-
   dy, 96.  The analogy in the nourifhment of plants and ani-
   mals, ibid.  Is the  abufe of natural paflions, ibid.  In diet,
   97.   In  liquor and carnal pieafures,  (hid.   The  bad confe-
   quences  of, involve whole families,  98.   Effects of drunk-
   ennefs upon the conftitution, 99.   Perfons  who feldom get
   drunk, may neverthelefs injure their conftitutions by  drink,
   ibid.  The habit of drinking, frequently acquired  under mif-
   fortunes, 100.   Is peculiarly hurtful to young perfons, 101.
   Leads to all other vices, IC2.
Intermitting fever.   See Ague.
In'efiines, inflammation of, general caufes from whence it pro-
   ceeds, 298.  The fymptoms,  regimen, and medical treat-
   ment, 299.  Cautions to guard againft it,  302.
Intoxication produces  a fever, 99.    Fatal confequences of a
   daily repetition of this vice, ibid.  Perfons  who ieldom get
   drunky may neverthelefs  injure  their conftitution by  drink.
   ing, ibid.  Getting drunk, a hazardous remedy  for a cold,
   285.  Often produces fatal effect,, 624.  Proper cautions far
   treating  perfons in liquor, ibid.   The fafeft drink after a de-
   bauch, 6.1'.  Remarkable cafe, ibid.
                                                   Jchnforr 
                       INDEX.                   739
Johnfom, Dr,  extraordinary  recovery of an infant feemingly
  kifted by a ftrong convulfion fit,  related by, 629.
Iffues,  how to make tnevn take the beft effeft, 437.
Itch, the nature and fymptoms of this difeafe defcribed, 410.
  Sulphur, the beft remedy againft,  ibid.  Great danger of the
  injudicious ufe of mercurial preparations for, 412.   Clean-
  linefs the beft prefervative againft, 413.   note.
Juleps, the f,,rm of, explained,  683.  Preparation of the ex-
  pectorating julep,  ibid.   Mucilaginous vitriolic julep, ibid:
  Mufk julep, ibid.  Saline julep, ibid.  Vomiting julep, ibid.

                             K.
Kermes mineral, recommended by Dr Duplanil for the whoop-
   ing cough, 294,  note.
Kidneys, inflammation of, its general caufes, 309.  Its fymp-
   toms and  proper regimen, ibid.   Medical treatment, 310.
   Where it  proceeds from the ftone and gravel, ibid.   Cau-
   tions for thofe fubject to this diforder, 312.  See Gravel.
 King's Evil.  See Scrophula.

                             L.
 Laborious  employments,  the  peculiar diforders incident  to, 42.
   The folly of men emulating each other in trials of ftrength,
   ibid.  Difadvantages attending their diet, 43.  How they
   expofe  themfelves to inflammations, 44.   Danger of fleep-
   in"- in  the  fun, ibid.  Long  fafting hurtful to them,  ibid.
   Injuries arifing fiom  poor living, 45.   Many of the d f-
   eafes of labourers, not only occafioned, but aggravated, by
   poverty, ibid.
 Labour fliould not be impofed too early on children, 29.
 Labotr, in child-bed,  medical advice  for,  538.  Inconveni-
   ences of collecting a number of women at, ibid. note.
 Laudanum, its efficacy in  fits of an ague,  153,  note.  In a
   loofenefs,  320.   In a  diabetes, 330.  When proper for the
   head-ach, 363.   How to  apply for the tooth-ach,  366.
   Will eafe  pain  in the gout,  391.  How to  adminifter tor
    the cramp'in the  ftonucb,  446.   Is good for flatulencies,
    452.   Ei ets of an over-dofe of,  483.   Medical treatment
    in this cafir, ibid..
  Leading firings, injurious to young  children, 24.
  Lee*h*s may'be fuccefsfullv applied to inflamed  tefticle?, 507,
    note.  And to difperfe buboes, 509,  note.  Are proper to
    apply  to clvldrca vhere inflamma ions appear in  teething,
    562.
  Levies.  See Oranges.
                            7, G 3                     Lcprcj, 
 740                  I N D E  X.

 Leprofy,  why  lefs frequent  in  this country  now than  for-
   merly, 405.   Requires  the fame treatment as the fcurvy,
   ibid.
 Liev.icry, proper treatment for,  359.
 Life may frequently be reftored, when the appearances of it are
   fu.pended by fudden cafualties, 601, 610, 614, 63 r.
 Light ring, perfons apparently killed by,  might poffibly  be re-
   covered by  the ufe of proper  means,  632.
 Lime-water recommended fo prevent gravel in the kidneys from
   degenerating  to the ftone in  the bladder, 335.  Is a good
   remedy  for worms, 375.  Happy effects cf, in the cure of
   obftinate uleert.  587.
 Lind, Dr his prefeription  to abate fits of an ague,  153, note.
   His diiect'otis for the  treatment of patients under putrid
   remitting fevers, 216, note.
 Linimei.t for burns, preparation of, 688.  White liniment, ibid
   For the piles, ibid.  Volatile liniment,  689.
 Liquors, ftrong, expofe children to inflammatory diforders, 20.
   Fermented, the qualities of, examined, 69.   The bad  confe-
   quences  of making them  too  weak,  70.   Why  all families
   ought to prepare their own liquors, ibid.  Cold, the danger
   of drinking, when a perfon is hot, 134.
 lioer,  fchirrous, produced by fedentary employments, 57.
 Liver,  inflamma ion of, its caufes and fymptoms, 313.   Re-
   gimen and  medical treatment, 314.  Abfcefs in, how to
   be treated,  315.  Cautions in the event of a fchirrus being
   formed,  ibid.
 L.belia, an American plant, ufed by the natives in the venereal
   difeafe, 517.
 Lochia, a fuppreffion cf, how to be treated, 40.
 Longings, in dieires,  are the calls of nature, and often point
   out what may be of real ufe, 151.
 Lcofcnefs, habitua1, general directions for perfons fubject to,
   1 26. Its general caufes,  319.  A periodical loofenefs, ought
   never to be  ftopped, 320.   Medical treatment of, according
   to its  vai i  us caufes, ibid.  Means of checking it when ne-
   ceffary, 321.   In children, proper treatment of, 554.
 Love, why perhaps the ftrongeft of all the paffions,  121.   Is
   not  rapid in its progrefs,  and may therefore  be guarded
   againft at its  commencement, ibid.  To pretend  to  it for
   amufement,  cruelty to the object, 122.   Children often real
   martyrs between inclination and duty,  ibid. note.
Lues, confirmed, fymptoms of, 513.  Mercury the only certain
   remedy known in Europe for  this difeafe, 515.  American
   method of curing this difeafe,  517*
                                                   Lungs* 
                      INDEX.                  74t
Lungs, ininred-hy-^irtifts working in bending pcftures, 51. Stu-
  dious per fens liable  to confumptions of,  57.
Luxury, highly injurious to the organs of tafte and fmell, 471.

                           M.
Mackenzie, Dr his arguments in favour of inoculating in the
  fmall pox,  241, note.
Mad-dr.g.   See Dog.
Magnej'.a alba, a remedy for the heart-burn, 426.  Is the beft
  medicine in all cafes of acidity, 551.
Magnets, artificial, their reputed virtue in the tooth-ach, 367.
Matt liquors  hurtful in the afthma, 415.  See Beer.
Man, why inferior to brutes in the management of his young,
   1. Was never intended to be idle, 88.
Manufactures, the growth of, produce the rickets in children,
   23.  More favourable to riches than to health, 29.  Some,
  injurious to health, by confining artifts in unwholefome air,
   39.   Camions to  the workmen,  Hid.    Compared  with
   agriculture,  49.    Are injurious  to  health from artifts
   being crowded together, ^o.   And from their working in
   confined poftures,   ibid.   Cautions  offered  to  fedentary
   artifts,  52.  Sedentary arts better fuited to women than to
   men, 85, note.
Mr.trimony ought not to be contracted without a due attention
   to health arid form, 9.
Mead, Dr his famous  recipe for the bite of a mad dog, 487.
   His character as a phyfician,  ibid. note.
Meals  ought  to be taken at regular times, 74.  Reafons for
   this uniformity, ibid.
Mofles, have great affinity to the fmall-pox, 249.   Caufe and
   fymptoms, ibid.  Proper regimen and medicine, 251.   Ino-
   culation of, might prove very falutary, 253,  note.
Mechanics ought to employ their leifure hours in gardening, 54.
Meconium, the befi mode cf expelling it,  17. 54$.
Medicine,  the origin of the art of, ix. The operation of, doubt-
   ful at beft, x.   Is made a myftery of, by its profeffors, xvii.
   The ftudy of, neglected by gentlemen, xviii.  This ignorance
   lays men  open to pretenders, xx.   Ought to be generally
   underftood, xxi.  A diffufion of the knowledge of, would
   deftroy quackery, ibid.   Objections to the cultivation of me-
   dical knowledge anfwered, ibid.   The fneory of, can never
   fupply  the want of experience and obfervation, 139.
Medicines have more virtue attributed to them than they deferve,
   142.   Ought  not to be adminiftered by the ignorant, ncr
   without caution, 144.   Want of perfeverance in the ufe of,
                                                       one 
74*                   INDEX.
  one reafon why chronic difeaies are  fo feldom cured, 390.
  Many retained, which owe their reputation to credulity, 657.
  Are multiplied and compounded in pr portion to ignorance
  cf the caufes and natrr. ol dilate-., ib'm.   Difadvantages < i
  compounded medicines, ibid.  Are aten adulter:-. Led mi ihe
  fake of colour, 659.   The roapve pi opoirit-n cf c oles of, b:r
  different ages, 661.   A lift of fuch me.hcal preparations as
  ought to be kept for private practice, Lid.
Melancholy, religious, its effects,  122.   Leads to filicide, 123.
  Defined, 433.   Its caufes and f\ mpcorn^. 434.   Regimen,
  435.  Medical treatment, 436.
Metdtiual difcharge in women, the commencement and decline
  of, the moft critical periods of their lives, 525.  Confinement
  injurious to growing young women, 526  ;  ar.d tight lacing
  for a fine fhape, 527.  Symptoms of the  firft appearance of
  this difcharge, 528.  Objects of attention  in regimen at this
  time, ibid.   Ought   to be reftored whenever unnaturally
  obftructed,  and how, 530.  When an obftruction proceeds
  from another malady, the firft caufe is to be removed, 53 r.
  Treatment under a redundancy of the difcharge, ibid. Regi-
  men and medicine  proper at the final decline of the men-
  fes, 533-
Mercury, ufe of fublimate in fcrophula, 409, note.  Great cau-
  tion neceffary  in ufing mercurial preparations for the itch,
  412.  Is the only certain remedy known  in Em ope for the
  cure of a confirmed  lues, 515.  Neceffary cautions  in the
  ufe cf  mercury,  518.  Proper feafons  for entering  on a
  courfe of, 519-  Preparations for, ibid.   Regimen urder a
  courfe of, 520.
M'.zerecn root, a powerful affiftant in venereal cafes,  516.
Midwifery, ought net to be  allowed to  be practifed by any wo-
  man not properly qualified, 538, note.
Midwives,  hiftorical view of the profeffion,  10.  How they
  became intruded  with the care of bandaging infants, with
  the ill effects of their attempts at dexterity in this office, ibid.
  Inftances of their rafhnefs and officious ignorance, 546, note.
Miliary fever.  See  Fever.
Milk, that cf the mother, the moft natural food for an infant,
  16.  Cows milk, better  unboiled than boded,  19.  Is a
  good antidote avjamft  the fcurvy, 67.   Of more  value  in
  confumptions  tl.'ti  the whole  Materia  /ifedica,  183.   Its
  great efficacy in  the fcutvy,  403.  A milk diet {roper  in
  cafes cf bancr.nc-f*,  546.
Milk teve:-.  See Fever.
Mind, 
                       INDEX.                  7^3
Mind,  difeafes of,  to be.^liftinguifhed from thofe of the body,
   141.   See Paffions.
Miners, expofed to injuries from unwholefome air, and mineral
   particle.^, 40.   Cautions to, ibid.
Mineral waters, the danger of drinking tnem in too lar<?e quan-
   tities, 328   Ate of confiderable fervice in weakneffes of the
   ftoma'-h,  425.  Caution^ concerning the drinking of,  647,
   —648.
Mixture.., general  remarks on this  form of medicine,  684.
   Cjmpofiti'ai of  the anodyne mixture, ibid.  Aftringent mix-
   ture,  ibid.  Diuretic  mixture, ibid.   Camphor mixture,
   ibid. Guaiaum mixture, 685.  Laxative abforbenr mixture,
   ibid.  Pne^oric  mixture, ibid.  SalL.e mixture, ibid.  Squill
   mixture, ib'd.
Molaffes,  an intoxicating fpirit much  ufed by the common peo-
   ple at Edinburgh, 100, note.
Mo.hers,  prepoilerous, when they think it below them to nurfe
   their own children, 2.   Under  what circumftances they may
   be  really unfit  to perform this tafk.  ibid.   Importance oi
   their fuckling  their own children, 3,  note.  Delicate mothers
   produce unhealthy fhort lived children, 7.  Their milk, the
   beft food for  children,  16.   Ought to give  their  children
   proper exercife,  25 ; and air,  32.
Mouth, cautions  againft putting pins or other dangerous arti-
   cles into, 605.
Mufcular exercife a cure  for the gout,  392.
Mufhrooms,  a dangerous  article of food,  as other fungufes are
   often gathered inftead of them, 495.
Mufic, the performance of, recommended as a proper amufe-
   ment for ftudious perfons, 61.
Mufy, extraordinary effects produced by, under particular cir-
   cumftances, in  the nervous fever,  197.  Is a good  remedy
   in the epilepfy,  443.   And for the hiccup, 445.  Deafnefs
   cured  by, 470.
M'fflard, white, a good remedy in the lheumatifm,  398.

                            N.
Natural hiftory, the ftudy of, neceffary  to the improvement
   of agriculture,  xvi.
Nervour  difeafes, the moft complicated and difficult to cure of
   all others 427.  General  caufes of, 428.   Symptoms of,
   429.   Regimen,  430.  Medical  treatment, 432.   A cure
   only to be expected from regimen, 4.3.  The feveral fymp-
   toms of, though differently named, all modifications of the 
  744                   INDEX.
 Nervous colic, its caufes and fymptoms, 306.   Medical treat-
   ment of, 307.
 Nervous fever.   See Fever.
 Night-mare, its caufes and fymptoms defcribed, 447.  Proper
   treatment of, 448.
 Nipples, fore,  how to prevent, 541, note.
 Nitre, purified, its good effects in a quinfey, 276.   Is an effi-
   cacious remedy for the  dropfy,  ^^.  Promotes .urine and
   perfpiration, 436.
 Nofe, ulcer in, how to cure, 472.   Stoppage  of, in children,
   how to cure, 552.  See Bleeding at.
 Nurfes, their fuperftitious prejudices in bathing of children, 31.
   The omy certain evidences of a good one, 35.  Their ufual
   faults pointed out, ibid. Adminifter cordials  to remedy their
   neglect of duty towards children, ibid.  Their miftaken treat-
   ment of eruptions, 37.  And loofe  ftools, ibid.  Are apt  to
   conceal the diforders of children that arife from  their own
   negligence, ibid.  Ou>.dit to be punifhed for the misfortunes
   they thus occafion, 38.  Senfible, often able to difcover dif-
   eafes fooner than'perfons bred to phyfic, 139.
 Nurfery, ought  to  be the largeft and beft aired room in  a
   houfe,  33.

                            O.
 Oil,  an antidote to the injuries  arifing from working in mines
   or metals, 40.  Oil, caftor, a good purgative, 424.  Salad
   oil. the beft application  to the fling of a wafp or bee, 494.
   Camphorated,  how to prepare,  689.
 Oils, effential, of vegetables, the proper menftruum for, 699.
 Ointment for the itch, 410.   Ufe of ointments when applied to
   wounds and fores, 686.  Preparation of yellow bafilicum,
   ibid.  Ointment of calamine, ibid.  Citrine  ointment,  ibid.
   Eye ointments, ibid.-  Iffue ointment, 687.  Goulard's oint-
   ment, or cerate, ibid.  Ointment of lead, ibid.  Mercurial
   ointment, ibid. Aftringent ointment, ibid-  Ointment of ful-
   phur, 688.  White ointment, ibid.  See Liniment.
 Ophthalmia.  See Eye,
Opiates, efficacious, in a cholera morbus, 318.  -In a diabetes, 330.
 ' When proper for the head-ach, 363.   Recommended for the
   tooth-ach,  364.  Are delofive remedies  in nervous difeafes,
   433,  How far ufeful in lues, 517.  See Laudanum.
Orange and lemon peel, how to candy,  671.   How to preferve
   orange  and lemon juice in the form of fyrup, 699.
Orrfkirk medicine for the bite of a mad dog, lemarks on, 492,
   note.
Oxycrate, the moft proper external application in a fracture, 599.
                      1                               Cyflers 
INDEX.
745
Oyflers, of great fervice in confumptions, 186, note.

                            P.

Painters.  See Miners.
Palfy,  the  nature of this diforder explained,  with its caufes,
  438.   Medical treatment, 439.
Paraphrenias, its fymptoms and treatment,  174.
Parents,  their interefted views in the  difpoial of'their children
  in marriage, often a fource of bitter repentance, 122,  note.
  See  Fathers and Mothers.
Paffions,  intemperance the abufe of, 96. Have great influence,
  both in the caufe and cure of difeafes,  114.   Anger,  ibid.
  Fear, 115. Grief,  119.   Love  121.  Religious melancholy,
  122.  The beft method of counteracting the violence of any
  of the paffions,  123.
Peas, parched, good in cafes of flatulency,  370.
Peruvian bark.   See  Bark.
Penis,  ulcerated, cured, and partly  regenerated, by a careful
  attention to cleanlinefs, 521, note.
Peripneumony, who moft fubject to 175. Its caufes, fymptoms,
  and proper regimen,  ibid. 176.
Perfpiration, infenfible,  the obrtrutfion of, diforders the whole
  frame,  128.   The various caufes  of its being checked,  1 29.
  Changes in the  atmofphere, ibid.   Wet clothes, 130.  Wet
  feet, ibid. Night air 131.  Damp beds, ibid.  Damp houfes,
  133.  Sudden tranfitions from heat to cold,  134.
Philadelphia, humane fociety of, their directions for recovering
  perfons fuppofed to be dead, from drowning and other ac-
  cidents,  634.
Philofophy, advantages refulting from the ftudy of, xvi.
Phrenitis.  See Brain.
Phymofs defcribed, 512.   How to treat,  513.
Phyficians,  ill confequences of their inattention to the manage-
  ment of children, 6.   Their cuftom of prognofticating the
  fate of their patients, a bad  practice, 117.  Are too feldom
  called in, until medicine can give no relief,  163.
Pickles, provocatives injurious to the ftomach, 68.
Piles, bleeding and blind,  the diftinction between, 343.  Who
  moft fubject to  the  diforder, ibid.  General  caufes,  ibid.
  Medical treatment of, 344-  Periodical difcharges of, ought
  not  to be ftopped, ibid.  Proper treatment of the blind piles,
   34c.  External ointments of little ufe, ibid.             <
 Pills,  purging, proper  form of, for  an inflammation of the ,n-
   teilines%oi.   The  general intention of this cUfs  cf meu<-
                            *  H                      clQes» 
746*                   I N D E  X.
  cines, 689. Preparation of the  compofmg pill, ibid. Foetid
  pill,  690.  Hemlock pill,  ibid. Mercurial pill, ibid.  Mer-
  curial fublimate pills, ibid.   Opium pills,  691.   Calomel
  pill,  ibid.  Plummer's pill,  ibid.  Purging  pill, ibid.  Pill
  for  the jaundice,  692.  Stomachic pill, ibid.   Squill pills,
  ibid. Strengthening pills, ibid.  Tar pills, ibid.
 Pins ought never to be ufed in the dreffing of children,  14.
   Swallowed, difcharged from an ulcer in the fide, 605,  note.
 Plaflers  the general intentions of, and their ufual bafis, 692.
   Preparation of the common plafter,  693. Adhefive plafter,
   ibid.  Anodyne plafter, ibid.  Bliftering ptafter, ibid.  Gum
   plafter,  694.   Mercurial plafter, ibid. Stomach plafter, ibid.
   Warm plafter, ibid. Wax  plafter,  695.
 Plevrify, the nature of the diforder explained, with its  caufes,
   168.  Symptoms, 169.  Regimen, ibid.  Medical treatment,
   170.  A decoction  of  Seneka reckoned a fpecific in,  172.
   Ballard pleurify,  173.
 Plumbers.   See Miners.
 Poifons, the nature and cure of, a general concern, and eafily
   acquired, 480. Mineral poifons,  481.   Vegetable  poifons,
   483.  Bites of poifonous animals,  484. Bite of a mad dog,
   ibid.   Bite of a viper, 493.  The practice  of fucking the
   poifon out of wounds recommended, ibid. note.  Poifonous
   plants ought to be deftroyed in  the neighbourhood of towns,
   494.  Negro remedy to cure the bite of a rattle-fnake, 495.
   General rules  for fecurity againft poifons, 496.
 Poor living, the  dangers of,  45.
 Porters fubject to diforders of  the lungs, 42.
 Poflures, confined, injurious to the health of fedentary  artifts,
   S1'
 Poverty occafions parents to neglect giving their children proper
   exercife, 25.   Deftroys parental affection,  ibid. note.  Not
   only occafions, but aggravates, many of the difeafes of la-
   bourers, 45.   The poor great  fufferers by the fale  of  bad
   provifions, 64, note.  And by bad air in large cities, 78.
 Poultices proper for inflamed wounds,  581.
 Powders,  general inftructions for making and adminiftering,
   695.   Arfenic  powder,   ibid,   Aftringent powder,  ibid.
   Powder of bole, 696.   Carminative powder, ibid. Diuretic
   powder, ibid.   Aromatic purging powder,  ibid.  Mercurial
   powder, 697.  Nitrous powder, ibid.  Saline laxative pow-
   der,  ibid. Steel powder,  ibid.   Sudorific powder,  ibid.
   Worm powder, ibid.  Purging worm powder,  698.  Pow-
   der for  the tape-worm,  ibid.
Pot, 
                       INDE X.                  747
 Pox, fmall,  who moft liable to, and at what feafons, 225.  Its
   caufes and fymptoms, ibid.   Favourable and unfavourable
   fymptoms in, 226, 227.  Regimen, ibid. How the patient
   ought to be  treated during the eruptive fever, 228.   Chil-
   dren in this diforder ought not to  lie together in the fame
   bed,  229.   Should be  allowed clean linen,  ibid.   Parients
   under this  diforder ought not to appear  in public view, 230.
   Medical treatment, 231. The fecondary fever, 234. "vXfchen
   and how to open the puftules, 235.  Of inoculation, 237.
Pregnancy, how to treat vomiting when the effect of, 323. Rules
   of conduct for women under the  diforders incident  to,  534.
   Caufes  and fymptoms of abortion,  ^25'  How to guard
   againft abortion, ibid. Treatment in cafes of abortion, 536.
   Child birth,  537.
Prov'fwns, unfound,  the fale of,  a public injury, 64.
Puerperal fever.   See Fever.
Purges,  the frequent  taking of them renders  the habitual ufe
   of them neceffary,  125.  Their efficacy in agues, 155.  Pro-
   per form for an inflammation of the inteftines, 300.   Ufe-
   ful in rheumatifm,  396, note.  Form of  a gentle purge for
   infant? difordered in the bowels, 547. For the Thrufli, 549.
Puftules in the fmall pox, favourable and unfavourable appear-
   ances of, 226,  227.   The fuppuration of, to be promoted,
   231.   When and  how  to open,  235.
Putrid fever.   See Fever.

                           0^
Quacks put out  more eyes  than they cure, 464.
Quackery,  how to deftroy,  xxi.
Quakers, their mode of dreffing  recommended, 95.
Quinfey, a common and dangerous diforder, and to whom moft
   fatal, 272.   Its caufes,  ibid.   Symptoms, 273.  Regimen,
   274.  Medical applications, 275. How to promote fuppu-
   ration, 277.  How to nourifh the patient when he cannot
   fwallow, ibid.   Advice to perfons fubject to this diforder,
   278.
-------, malignant, who moft fubject tn, and its caufes, 279.
   Its fymptoms, ibid.  Regimen, 280.  Medical treatment,
   281.

                           R.
Ratllefnake, Negro remedy for the cure of its bite, 495.
Reoimen ought to co-operate with medicine to  accomplifli the
   cure of difeafes,  ix.   Will often cure difeafes without medi-
   cine,  144.   See Aliment.
                         3 H 2                   Religicn, 
748                  INDEX.

 Religion, true, calculated to  fupport  the  mind  under  ever
   affliction, 123.   The  inftructors in, ought not to dwell too
   much on gloomy fubjects, ibid.
 Remitting fever.   See Fever.
 Repletion, impairs the digeftive power, 74. Difeafes occasioned
   by,  75.  How to treat a loofenefs produced b\, 319.
 Refentment, the indulgence of, injurious tQthe conftitution, 114.
 Refins, andeffential oils, the  proper menftruum  f r, 699.
 Refpiration, how to reftore in  a drowned perfon,  611.
 Rheumatifm, acute  and  chronic  diftinguiflied, 395.   Caufes
   ibid.   Symptoms,  396.  Medical treatment, ibid. Cautions
   to perfons fubject to this diforder, 398.
 Rickets, the appearance of, in Britain, dated from the growth
   of  manufactures  and  fedentary employments, 23.   The
   caufes of, 564.   Symptoms  and  regimen, 565.  Medical
   treatment, 566.
 Rollers, pernicious tendency of applying them round the bodies
   of  infants,  13.
 Romans, ancient, their great attention to the cleanlinefs of their
   towns, 104, note.
 Rofes, conferve of, its great virtue againft haemorrhages, 344.
   349-
 Rofemary, the  external application of, a  popular remedy for
   the cramp, 459, note.
 Ruptures, are chiefly incident to children and very old perfons,
   600.  The caufes reflectively,  ibid.  Method  of treatment,
   ibid.  Cutting fhould be avoided if poffible, 602.   Cautions
   for perfons  afflicted with a rupture, ibid.   Often prove fatal'
   before difcovered, ibid.  note.
 Rutherford, Dr, his preparation for the cure of  a dyfentery,
   355, note.

                             S.
 Sailors, their health injured by change of climate, hard weather,
   and bad provifions, 46.  Many of their difeafes fpring from
   intemperance, ibid.   Ought  to guard againft  wet clothes,
   ibid. How the ill effects cf fait provifions might be corrected,
   ibid   Peruvian bark the beft antidote to faibrs on a foreign
   coaft, 48.  Cleanlinefs greatly conducive to their health, 106.
 Sal prunella, its, good effects in a quinfey, 276.
 Saline draughts, of good  ufe for flopping a vomiting, 325.
   Preparation of,  for this purpofe, ibid.   Peculiarly good in
   the puerperal fever, 543.
 Salivation not  neceffary in the cure of the venereal difeafe, 515.
 Salt and Sugar, their ufe in fpitting of blood, 348.
                                               Sarfxparilla, 
                      INDEX.         '          749
Sarfaparilla, a powerful affiftant in venereal cafes, ei6.
Scabbedhead in children, difficult to cure, 556.  Medical treat-
  ment, 557.
Scarlet fe ve r.  See Fever.
School, fending children there too  young, its bad confequences,
  26. Ought to  be feated in a dry air, and not to be too much
  crowded, 34.
Schirrus in the liver, proper regimen in the cafe of, 315.  See
  Cancer.
Scrophula, nature of this difeafe, and its caufes, 405.   Symp-
  toms, 406. Regimen, and medical treatment, 407.
Scurvy, why  pi evalent among the Englifh, 66.  Where moft
  prevalent, and the two diftinitions of, 400.  Caufes of, ibid,
  Symptoms and cure,  401.  Inftructions to fea-faring men
  402.   Extraordinary effects of'milk, 403.   Proper liquors,
  ibid.
Sedentary life, includes the greater part of the human fpecies, 48.
  Few  perfons  follow agriculture  who are capable of other
  bufmefs,  49.   Sedentary and active employments ought to
  be intermixed, for the fake  of health, ibid.   Artifts fuffer
  from unwholefome air, by being crowded together, ibid. The
  poftures artifts are confined to  injurious to health, 50. Dif-
  orders produced by, ibid.  Sedentary amufements improper
  for fedentary perfons, 52.  Cautions offered to the fedentary,
  53.  Hints relating to improper food, ibid.  Exercife  a finer
  relief for low fpirits than drinking, ibid.   Gardening a whole-
  feme amufement  for the  fedentary, ibid.   Diforders occa-
  fioned by intenfe ftudy, 56.  Dietetical advice to the feden-
  tary, 73.  Sedentary occupations better adapted ip women
  than men, 85, note,
Sea water a good remedy in the king's evil, 407.
Senfes, diforders  of, 464.
Seton, fometimes  has extraoidinary  effects in  inflammation
   of die eyes, 270.   Is of fervice  for preventing apoplexies,
   421.   The beft method of making it,  437.
Shoe, tight,  the bad  confequences  refulting fom, 93.   The
  high  heels cf  women's fhoes,  94.
Sibbins,  a venereal diforder fo termed in the weft of Sc-.tl-.-.d,
   how  to cure,  521, note.
Sick, the mutual  danger incurred  by unneceffary vlfito-;  :\\
   109,  Perfons in health to be kept at a diftance from the ih '.:,
   110.  Proper nurfes ought to be employed ab-'Utth m, 11 = .
   Inftructions for avoiding infection, 112.   Tolling  of be..;
   for the dead very dangerous to, \  16.  Their fears ought no:
   to be alarmed,  1 18.
                                                      SigL 
 750                   INDEX.
 Sight injured by ftudying by candle-light, 58.
 Simples, a lift of thofe proper to be kept for private practice, 662.
 Sinapifms, the general intentions of, 666. Directions for making
   of, ibid.
 Sleep, the due proportion of not eafy to fix, 89.  Hew to make
   it refrefhing, 90.  Complaints of the want of, chiefly made
   by the indolent, ibid.   Heavy fuppers caufe  uneafy nights,
   ibid.   Anxiety diftruclive  of fleep,  91.   That  in the fore-
   part of the night moft refrefhing,  ibid.  Early  rifers  the
   longetl livers, ibid. note.
 Sleeping in the  fun, the danger of, 44.
 Small pox.  See Pox.
 Smell, injuries to which the fenfe of, is liable, with  the reme-
   dies applicable to, 4.71.
 Soap, Alicant, recommended in the  ftone, 335.  Soap lees,
   how to take, 336.
 Solanum.  See Night fhade.
 Specks in the eye, how cured, 467.
 Spine often bent by artifts working in unfavourable poftures, 51.
 Spirit, rectified, the direct  menftruum for  refins and effential
   oils of vegetables, 699.   Of wine,  comphorated, how to
   prepare, 703.   Spirit of Mindererus, ibidi
 Spirits, lownefs of, the general forerunner of a nervous fever,
   193.   The proper remedies for, 454.  Cautions to perfons
   under this complaint, 455.
 Spirituous liquors, when good in the colic, 303..  And for gouty
   complaints in the ftomach, 371.   Should be avoided by  all
   perfons afflicted with nervous diforders,  431.   The ufe of,
   often fatal, 624.
 Spitting of blood.  See Blood.
 Sponge, may be ufed to fupply the want of agaric as  a ftyptic,
   579, note.  Its ufe in extracting fubftances ftopped in the gul-
   let, 607.
 Sports, active, far more wholefome than fedentary amufements,
   87.  Golf, a better exercife than cricket, ibid. note.
 Spots in the eye how to treat, 467.
 Squinting, hew to correct the habit of, 467.
 Stays, a ridiculous  and  pernicious article of female drefs, 15.
  '93.  The  wearing of, tends  to  produce cancers  in the
   breafts, 475.
 Sternutatories, preparations of, recommended for  reftoring loft
   fmell, 472.
Sticking Plaflerh the beft application for  flight wounds, 580.
Stomach, exercife the beft cure for diforders of, 86.   Inflamma-
   tion of, a diforder that calls for fpeedy affiftance, 296.  Its
                                                     caufes 
                      INDEX.                   751
  caufes,  ibid.  Symptoms,  ibid.   Regimen, 297.  Medical
  treatment, ibid.   Pain in,  its caufes, 369.  Remedies for,
  370.   Inftructions for perfons fubject to, 371.
Stone, the formation of, in the bladder,  explained, 127.   This
  diforder how diftinguiflied from  the gravel, 333.   Caufes
  and fymptoms, ibid.   Regimen,  334,  Medical treatment,
   335.   Alicant foap and lime water, how to  take for this
  diforder,  ibid.   The uva urfi, a remedy in prefent requeft
  for. 337-
Stool. loole, the benefit of, to children,  37.  Proper treatment
   of, when exceffive, ibid.   The difcharge by, cannot be regu-
   lar, if the mode of living be irregular,  124.  One in a day
   generally fufficient for an  adult, 125.  How to produce a
   regularity of, ibid.   Frequent recourfe  to medicines for cof-
   tivenefs,  injurious  to the conftitution, ibid.
 Storck, Dr,  his method of treating cancers, 477.
 Strabif/ius.   See Squinting.
 Straits, proper method, of treating, 599.   The fafeft external
   appl cations, ibid. note.
 Strangury, from a bliftering plafter, how to guard againft, 171.
   In the fmall-pox,  how to  relieve,  232.   From a venereal
   caufe, defcribed, with its proper treatment, 511, 512.
 Strangulation, courfe  of treatment for  the recovery of perfons
   from, 628.
 Strength, the folly of trials of, from emulation, 40, 44.
 Study, intenfe, injurious todiealth, 55. The diforders occafioned
   by, 56.  Character of a mere ftudent,  59.  Hints of advice
   to ftudious perfons, 60.  Danger of their having recourfe to
   cordials, 61.  Health often neglected while in poffeflion, and
   laboured for after  it is deftroyed, 62. No perfon ought to ftu.
   dy immediately after a full meal, 63.   Dietetical advice to
   the ftudious, 73.  The general  effects of, on  the conflitu-
   tion, 428.
 Siffocation, by the fumes of charcoal, liable to happen  i-i clofe
   chambers, 614.  General carries of fuffocation, 626.   Over-
   laying of infants, 627.
 Sugar, an improper article in the food of children. 19.
 Sulphur, a good remedy for expelling worms, 375.  And for the
    itch, 410.
  Suppers, ought not to deftroy the appetite for  breakfaft, 75.
    Heavy fuppers fure to cccafion uneafy nights,  90.
  Surgery, many of the operations of, fuccefsfully performed by
    perfons  unfkilled in anatomy, 571.   Hum-inity induces every-
    one more or lefs to be a furgeon. ibid.

                                                   S-r.'.'at'wfr, 
 752                   INDEX.
 Sweating, generally excited in an improper manner, in fevers*
   151. 164.
 Swoonings the feveral caufes of, defcribed, 440.   Proper treat-
   ment of this diforder, 442. 618.  Cautions to pcrfcns fubject
   to them,  623.
 Sydenham, Dr, his method of treating fevers in children from
   teething,  562.
 Symptoms, difeafes better diftinguiflied by, than by  the fyftemati-
   cal arrangement of,  139.   The differences of  fex, age, and
   conftitution, to be confidered,  140.   Difeafes of the mind to
   be diftinguifhed from thofe of the body, 141.
 Syncope, proper treatment in,  619.
 Syrups, the general intention of,  698.   How to  make  fimple
   fyrup, and to modify it for  particular purpofes, 699

                            T.
 Tacitus, his  remark on the degeneracy  of the  Roman iadies>
   4, note.
 Tallow chandlers- and others working on putrid animal fubftan-
   ces, cautions to, 41.
 Tapping for  the dropfy, a fafe and fimple operation, 386.
 Tar, Barbadoes, its efficacy in the nervous colic,  307.
 Tartar, foluble, a good remedy for the jaundice, 381.   Cream
   of, a good remedy in a dropfy, 385.   And rheumatifm,
   396.
 Tafie, how to reftore the fenfe of, when injured, 473.
 Tailors, are  expofed to injuries from breathing confined air, 50.
   Are fubject to confumptions, ibid. note. Often lofe the ufe of
   their legs, 51.  Hints of inftiuction  offered to them in re-
   gard to their health, 52.
Tea, the cuftomary ufe of,  injurious, to female conftitutions, 7.
   Deftroys their digeftive powers, and produces hyfterics, 67.
   The bad qualities of, principally owing to imprudence in the
   ufe of it, ibid.  Green, chewing of, a  remedy for the  heart-
   burn, 427. Has a powerful effect upon the nerves, 438, note.
   Is bad for perfons troubled with flatulencies, 453.
Teething, the  diforders attending,  561.   Regimen, and  medi-
   cal treatment in,.562.   Applications to the gums,  and how
   to cutthem, 563.
Temperance,  the parent of health, 96.
Teficles, fwelled,  the  caufe of, 507.  Regimen and medicine
  in, ibid.  Treatment under a cancerous or fcrophulous ha-
  bit, 508.
Thirfl, hew it may le quenched when a perfon is hot, without
  danger, 135.
       4                                         Thoight, 
                       INDEX.                    753'
Thought, intenfe, deftruct * e of health,  55.
Tkrnfjj in infants, the  diforder and its caufes defcribed, 549.
  Me  ical trea1-- entof, ibid.
Tinclura and elixirs, the proper medicines to exhibit in the form
  of, 699.  Preparations of the aromatic tincture, 700.  Tinc-
  tu 1 e of the bark, ibid.  Tincture of cinnamon, Hid.  Foetid
  tincture.  Hid.  Tincture of gum guaiacum,  ibid.   Timftuie
  of black hellebore, 701. Aftringent tincture, ibid.  T net re
  of myrrh and aloes, ibid. Tincture of opium, or liquid lauda-
  num",  ibid.   Tincture of  aloes, ibid.  Compound tintfure o£
  fenna, 702.  Tincture of SpanilE'flies, ibid. Tincture of rhu-
  barb,  ibid.
Tiff J, Dr, character  of his Avis au Peupl;  xi.  His medial
  courfe for the cure of the  hydrophobia,  491. His" dir-ftions
  for gathering, preparing, and applying agaric of the oak as
  a ftyptic, 579, \nte.   Inftances  froni,  of the recovery of
  drowned perfons,  612.
Tobacco, a clyfter of  a decoction of,  ufeful to excire vomftmg,
  608.  A clyfter of  the fumes of, will  ilimulate  the intef-
  tines, and produce a ftool, 30^, note.
Toes,\hi free motion of, deftroyed by wearing tight  fhoes, 94.
Tooth-ach,  the  general caufes of,  364.  Medical treatment of,
  365.  When recourfe  muft be had to extraction, 366.  Di-
  rections for  cleaning the teeth, 367.
 Touch, injuries to which the fenfe of, is liable, with the reme-
   dies applicable to,  473.
 Towns, great, the air of, deftructive to the  children of the poor,
   32.  Children bred in the country ought  not  to be fent too
   early into towns, 34.  Cleanlinefs not  futhciently attended
   to in, 103.  Ought to be fupplied with plenty  of water for
   wafhing the  ftreets, 108, note.  The beft  means to guard
   atrainft  infection in,  112.
 Trades, fome injurious to health  by making artifts, breathe un-
   wholefome  air, 39. S°'                    .,, rr o.
 Tranftions, fudden,  from  heat  to cold,  the  ill effects of, to
   the conftitution, 134.
 Travellers, the ufe of vinegar recommended to, 47.^ Ought to
    be very careful not to fleep in damp beds, 131.  1'evet* why
   retell fatal t  , 148.
 Trees fhould not be planted too near to houfes,  81.
 Trefoil'water,  a goCd remedy in the rheumatifm, 399.
 Tumours,  pr> per treatment of,  576.
 Ti'n.eSs err.:!:. -rer:;r;:rion cf, 686.
?J
Vjtpour 
754
INDEX.
                           V.
Vapour of fermenting liquors, noxious nature of, 614.
Vegetables, wholefome correctors of the bad qualities of animal
  food, 66.  Their extraordinary effects in the fcurvy,  404.
Venereal difeafe, why omitted in the firft  edition of this work,
  496.   Unfavourable circumftances attending this diforder,
  497.   The virulent gonorrhoea, 498.  Gleets, 504. Swell-
  ed tefticles, 507.   Buboes, 508.  Chancres, 509.   Stran-
  gury,  511.  Phymofis, ,512.   A confirmed  lues,   513.
  American method of curing this difeafe,  517.  General ob-
  fervations, 518.   Cleanlinefs  a great prefervative againft,
  520. The ufe of medicines ought not to  behaftily dropped,
  522. Is often too much difregarded, 523.
Ventilators, the moft ufeful of all  modern  medical  improve-
  ments, 79.
Vertigo often produced by intenfe ftudy, 58.
Vinegar,  a great  antidote againft difeafes,  and ought to be
  ufed by all travellers, 47.  Should be fprinkled in ficlccham-
  ber?, 112.  165. 203.  Is of confiderable fervice in the bite
  of a mad dog,  488; and in any kind of  poifon, 493.   Its
  medical properties, 704. Is of ufe to  extract the virtues of
  feveral medical fubftances, ibid.  How  to prepare vinegar of
  litharge, ibid. Vinegar of Squills,  705.
Viper, the bite of, the fufficiency of the, greafe for the cure of,
  doubted, 493.  Method of  treatment recommended, ibid.
Vitriol, blue, its ufe in epilepfy, 443.
Vitriol, elixir of,  an excellent medicine in weaknefs of the fto-
  mach, 425.  Spirit of, in  gravel, 337.  And for windy
  complaints, 433.
Vitus, St, his dance, method of cure of,  443.
Vomiting and purging,  of  children. Caufes,  fymptoms,  re-
  gimen, and method of cure, 325.
Vomits, their ufe in agues, 154 ;  and in the nervous fever, 195.
  Caution for adminiftering in the putrid fever, 205.  Ought
  by no  means to be adminiftered in an  inflammation of the
  ftomach, 297.  Are ufeful in cafes of repletion, 319. Are
  the firft object to be purfued when poifon  has been received
  into the ftomach, 482.  Their ufe in whooping cough, and
  how to adminifter them to children, 293.  Form of a gentle
  one for infants  difordered in the bowels, 547.
Vomiting,  the  feveral  caufes of, 322. Medical treatment
  of, 323.  Saline draught for flopping of, 325.  Caufes of, in
  children,  553.   EJow to be treated,  ibid.  Of blood.  See
   Bhod.
 /                                                 Voyage, 
                      INDEX-                   755
Voyage,  a long one  frequently cures  a  confumption,  182.
  Voyages have an excellent effect on perfons afflicted  with
  nervous  diforders, 431.

                              U.
Ulcers, proper treatment of, according to their differentnatures,
  585.   Lime  water, a good  remedy, 587.  Dr Whytt's
  method of treating  them,  Hid. Fiftulous ulcers,  ibid.
Ureters,  and their ufe, defcribed, 310,  note.
Urine, the appearances and quantity of, too uncertain to form
  any determined judgment from,  126.  Dr Cheyne's judg-
  ment as to the due quantity  of, not  to  be relied on, 127.
  The fecretion and difcharge of, how obftructed, ibid.  Bad
  confequences of  retaining  it too  long, ibid.  Too great a
  quantity of,  tends to a confumption,  128. Stoppage of, its
  general caufes, 312.   Caution as to the treatment of, Hid.
  Diabetes,  328.  Incontinency of,  331.  Snppreffion  of,
  medical treatment in,  ibid.  Caution to perfons fubject to this
  diforder,  333.  Bloody, caufes of, ibid.   Medical  treatment
  of, 352«
Ur'me doctors,  their impudence, and great fuccefs from the
  credulity of the populace,   126, note.
Uva urfi, a remedy in prefent requeftfor the ftone,  337.

                           W.
Walls, high, unwholefome, by obftruaing the free current of
  air, 80.
Ward's effence, preparation .of,  703.   His fiftula pafte,  a p -
  pular remedy that  may deferve trial, 588.
Wars occafion  putrid fevers, by  tainting  the air  with  the
  effluvia  of dead  carcafes,  200.
V/afps,  hornets, or bees, how the fting of ought to be treated,
  493.
Water,  frequently unwholefome  by mineral impregnations, 68.
  Cautions for  the  choice of, 69.  Cold, the danger of drink-
  ing when a perfon is hot,  134.
P/ater in the head,  is a  diforder chiefly incident to children,
   -69.   Its caufes, fymptoms,  and proper treatment, ibid.
Waters by infufion, how to prepare :  Lime water,  705. Sub-
   limate water, or folution, 706.  Styptic water, ibid.   Tar
   water, Hid.
Waters, fimple diftilled, their medical ufes, 706.  Preparation
  of cinnamon water, 707.  Pennyroyal water, ibid.  Pepper-
   mint water,  ibid. Spearmint water. Hid,  Rofe water, 708.
   Jamaica pepper water, ibid.
                           3 I 2                    Item. 
75S                   I N D E X.
Waters, fpirituous diftilled : Spirituous cinnamon water, ycH
  Spirituous Jamaica pepper water, ibid.
Watery eye, how to cure, 468.
Weaning of children from ihe breaft the proper mode of, j 8, 19.
Weather,  ftates of,  which produce the  putrid fever,  199.
IV.Ih,  cautions to  perfons  going down  into them,  70,  r.ote.
  Deep, ought not to be entered until the air in, is purihed,

  6l$               -                         ..          '
Whey,  m excellent drink in ft dyfentery, 357 ; and in the rheu-
  matifm, 397.   Orange whey, how  to make, 163.  Alum
  whey,  330. 708.  Muftard whey, ibid.  Scorbutic whey^ 709.
  cream  or tartar whey, ibid.
Whitlow, 575.   How to cure,  577.
I'/t.'opintr-cough.  See Cough.
Whytt,  Dr, his remedies for flatulencies, 452.
Wind.   See Flatulencies.
Windows, the danger of throwing them open on  account of
  heat, and filing near them,  136.
Wine,  good,  the beft medicine in a nervous fever,  194.
Wines,  the medical properties of,  709. Their ufe in extracting
  the  virtues of medical  fubftances, 710.  Preparation of
  Antimonial wine,  ibid Bitter wftne,  ibid. Ipecacuanha wine,
  ibid. Chalybeate cr fteel wine, 710. Stomachic wine, 711.
Womb,  inflammation of,  its fymptoms, 539.  Medical treat-
  ment of,  ibid.
Women, errors in their education pointed out, 4.  Why fubject
  to hyftertcs,  67.   Are better adapted  to follow fedentary
  occupations than  men,  -5, note.   In childbed,  often  die
  from their apprehenfions of death,  116.  Their diforders
  rendered  epidemical  by the force of imagination,  ibid.
  Every thing  that  can alarm them  to be carefully guarded
  againft, Hid.   Evil tendency of tolling bells for the dead,
  ibid.  How expofed to a miliary fever during  pregnancy,
   209.  Their confiVtutffehs injured by living too much within
  doors, 524.   Thofe who work in  the open air almoft as
  hardy as men,  S25-  Advice to, with reference to the men-
  llrual  difcharge, ibid.  At the commencement, 526. Fluor
  alb us,  with its proper  treatment, defcribed, 532.  Advice
   to,  at the ceafing of  the menfes, 53-.   Rules of conduct
   during pregnancy, 534. Caufes and iymptoms of abortion,
   535.  How  to  guard  againft abortion,  ibid.  Treatment
  m cafes of abortion, 536. Inftructions at the times of child-
  birth,  537.  Caufe of the milk fever,  540. How to guard
  againft the miliary fever, 541.  The puerperal fever,  ibid.
  General cautions for women in child bed, 544.  Caufes of
  barreimef:, -..»c.
             _■ . <
                                                    IV00L 
                     INDEX.                   757

Wool, the beft external application in the gout, 390.
Workhoufes,  poifonous  to infants, 32.
Worms, how to treat  a loofenefs produced by, 321.  Three
  principal kinds of, diftinguifhed, 372.  Symptoms of,  373.
  Caufes, ili  .  Medical  treatment for,  374.  General cau-
  tions for preferving children from them, 377.   Danger of
  taking quack medicines for them, ibid,  r.ote.
Wort, recommended for the fcurvy, and proper to drink  at
  fea, 403.  Is a powerful remedy in cancerous cafes, 478.
Wounds, are not cured by external applications, 577.  Are cured
  by nature, ibid.  Proper courfe of treatment, 578.  How to
  ftop the bleeding, ibid.  Caution  againft improper ftyptics.
  579.   Method of dreffing them, 580. Poultices for inflamed
  wounds, 581.   Regimen  in,  ibid.
Writing,  hints of advice to thofe who are much employed in,
  57,  6c.

                           Y.
Taws, general hint for the cure of, 521, note.
Toung animals, all exert their organs of motion as foon as they
  are able,  23.

                           Z.
7dnc, the flowers of, a popular remedy for  the epilepfy, 443.
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