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  A Liniment.—A recipe for a liniment which  I
have used for fifteen years.   When all patented
liniments proved  as nostrums, this liniment was
applied, and proved highly efficacious in all cases
of sprains,  bruises, wounds, external or internal,
on man or beast.  I have used it with great success
in severe cases of rheumatism.  No farmer should
be without it, for there is none as good that I have
tried, and I have tried the Arabian, Mustang, and
half a  dozen others, and to no  effect.  In  cuts,
fresh wounds, scrape lint  and put  on  it  sugar:
then saturate the sugar  and the lint with the lini-
ment.   After well  shaking, apply to the wound,
and keep it in that  condition for two or three days:
then leave off the sugar.  In other cases, rub well
with  the liniment:  apply, after rubbing, a  thick
flannel to  the parts.  One-half ounce of spirits  of
hartshorn, two ounces of camphor-gum, one gill  of
 spirits  turpentine,  one-half pint of sweet-oil, one
 pint  of alcohol, well shaken in  all cases  before,
 using.—So. Rec.
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                   ADVERTISEMENT             *    ^*

                      BY DR. BtfCHAN.

  THE Author, having been in constant practice since the first appear-
ance of this Book,  has taken  occasion in the later Editions  through
which it has passed, to improve many articles which were inserted with
less accuracy in the more early impressions.   To the preceding Edition
was added a Chapter on Diet,  recommending a method of living less
expensive, and more conducive to  health, than the present.   Several
other improvements have been also made in the form of notes to illus-
trate the text, pr put people on their guard in dangerous situations, and
prevent fatal mistakes in the practice of medicine, which, it is to be re-
gretted, are but too common.
  Although the Domestic Medicine was never intended to supersede
the use of a Physician, but to supply his  place in situations where me-
dical assistance could not easily be obtained; the Author is sorry to ob-
serve, that the jealousies and fears of some of the Faculty have prompt-
ed them to treat the Work in a mauner very unbecoming the Professors
of a liberal science: notwithstanding this injurious treatment, convinced
of the utility of his plan, he shall spare no pains to make it more useful;
determined that%either interest nor prejudice shall ever deter him from
exerting his best endeavours to  render the Msdical Art more exten-
sively beneficial to Maxkixd.    *'•••-
            * ■      .  •
   New-Store Street; Bedford Square, l
           June 4, 1798.           $

     J^tS^J^__-             (7 '        . 

#La+ it  imr   CONTENTS. ^/*»r ^^
*, L/Ir-^^AyCUj,
            PART I.
  ^ the general causes of diseases.
             chap. i.
  Of Children   -  -  -  Page 33
  — Diseased Parents  -  -   -  36
  — Clothing of Children -   -  37
  — Food of ditto  -  ---  40
  — Exercise of  ditto -  -   -  44
  — Bad effects of  unwholesome
    Air upoa ditto  -  - -  - 49
  — Nurses*......50
               «APII.
               s&c.  -  -  - 52
  — the Sedentary  -  -  -  - 58
  — the Studious.....bl
             chap in.
  Of Aliment......66
             CHAP IV.
  Of Air.......78
             CHAP V.
  Of Exercise -  -  -   -    82
             CHAP VI.
  Of Sleep.......85
  — Clothing.....86
             CHAP. VII.
  Of Intemperance  -  -  -  -  89
            CHAP. VIII.
  Of Cleanliness.....92
             CHAP IX.
  Of Infection......95
              CHAP X.
  Of the Passions   -  - -  - ^98
  — Anger    ......ib.
  — Fear.......99
  — Grief......101
  — Love......lt)2
* — Religious Melancholy  -  103
             CHAP. XI.
  Of the Common  Evacuations  ib.
  — Stool  -  -.....ib.
  — Urine......105
  — Perspiration   -  -  -  -   106
  — being affected by Changes
     in the Atmosphere  -  -   - ib.
  — Wet Clothes  -   -  -  -   107
  — Wet feet  ------    ib.
Of Night Air  -  -  -  Page 107
— Damp Beds    -  -  -   -   j'6,
— Damp Houses -   -  -  - 108
— Sudden Transitions from
   Heat to Cold  -  -  -   -  109

          PART II.
          Of Diseases.
           CHAP. XII.
Of the Knowledge and Cure of
   Diseases  -   -  -  -  -  -111
        .   CHAP. XIII.
Fevers in general  -  -  -   -   114
           CHAP. XIV.
Of intermitting Fevers or Agues
                            117
           CHAP. XV.
Of an acute continual fever    123
           CHAP. XVI.
Of the  Pleurisy  -  -  -   -   126
------Bastard ditto   -   -   129
------ Paraphrenitis   *  -   ib.
           CHAP. XVII.
Inflammation of the Lungs    13d
           CHAP. XVIII.
 Of Consumptions  -   -  -   132
           CHAP. XIX,
 Of the Slow or Nervous Fever 139
            CHAP xx.
 Malignant, Putrid or Spotted
   Fever......143
           CHAP. XXI.
 Miliary Fever    -  -  -   -   148
           CHAP. XXII.
 Remitting Fever  -   -  -   -   151
          CHAP.  XXIII.
 Of the Yellow Fever  -  -   153
          CHAP.  XXIV.
 The Small Pox   -  -  .♦ -   159
 Inoculation.....166
           CHAP xxv.
 Of the Cow-pox, and its Inocu-
   lation  .......173
           CHAP XXVI.
 The Measles.....179
 ----Scarlet Fever  -  -   -   18? 
>^r-
^^^SZ^HR1^,
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CONTENTS. .

 ThTe#Bilious.Fefe|  »  &gcj83<
         xchap. XXVII.
^ Anthony VFift  -  -   -   )83
          CHAP. XXVIII. f.  .#,.. .
Inflammation of the Brain  -  186
          chap. xxix.
Inflammation of the Eyes   -   189
          chap. XXX.
TheQuiusey.....192
 ----Malignant ditto    -  -  196
           chap, xxxi,
 Colds and Coughs    -   -  -  198
 A Common Cough   -   -  -  20o
 Hooping Cough  -  -   -  -  202
          chap, xxxii.
 Inflammation of the Stomach  205
 -----------of the Intestines 206
 Of the Colic.....209
 Inflammation of the Kiddies   212
 ------------of the Bladder  213
 ------------of the. Liver    21 -1
          chap, xxxiii.
 Of  the  Cholera  Morbus  and
  other  excessive  dischatgcs
  from the Stomach and Bow-
   els  ......-  -216
 — a Diarrhoea, or Loosenets   217
 —• Vomiting.....219
          CHAP xxxiv.
Disorders of the kidnies and
  Bladder......221
Of the Diabetes, or excessive
             .  m
% \      "CHAP. XXXIX..
OT tne* Dropsy* -n*- •'-' *Tage €50-
CHAP. XL.
.Of the Gout -  - —.i
  '-----■'RtfeumfctiSm"-*'
           CHAP XLI.
Of the Scurvy   -  -
-----— Scrophula
-------Itch    -  -  -
          CHAP. XLII.
,-'  2*54
--»268

-  260
-  263
-  265
267
  Discharge of Urine
— Suppression of ditto  -
— the Gravel and Stone
          CHAP. XXXV.
iuvoluntary  Discharges of

Bleeding at the Nose  -  •
Bleeding and Blind Piles  ■
Spitting of Blood    -  -  •
Vomiting of ditto    -  -
Bloody Urine    -   -  -  ■
-------Fluv  -  -  -  -
Cceliac Passion   -  -  -
          CHAP. XXXVI.
Of the Head-ach  -  -
-------Tooth-ach
—-----Ear-ach   -  -
Pain of the Stomach, <fcc.
         CHAP.  XXXVII.
Of Worms   -  -  -  -
         CHAP. XXXVI1I.
Of J&e Jaundice    -  -
 -  ib
  223
  224

Blood
  226
  227
  229
  231
  233
  234
  235
•  238

- 239
- 241
- 243
  244

•  245

  248
 Of the Asthma      -   -
           CHAP.  XL1II.
 Of the Apoplexy    -   -  -  269
           CHAP.  XLIV.
 Of Costiveness   -   -   -  -   271
 — Want of Appetite   -  -   273
 — Heart-burn   -  •( -  -   ib.
           CHAP  KV.
 Of Nervous DiseaSI   -  -  274
 — Melancholy   -   -   -  -   277
 — the Palsy.....280
 — the  Epilepsy,  or  falling
    Sickness.....281
 — the Hickup   -   -   -  -   283
 — Cramp  of the Stomach  .-   284
 — The Night  Mare     -  -    ib.
 — Swoonings    ....   285
— Flatulencies or Wind  -   286
—- Low Spirits  -   -   -  -   288
— Hysteric affections   -  -   289
— Hypochondriac arteclions   291
The  Tetanus,  or  the Locked
  Jaw.......293
          CHAP. XLVI.
Disorders of the Senses
         of the Eye
 295
  ib.
 296
  ib.
297
A Gutta Serena
A Cataract    -  -  -
Slftrt Sightedness
Seeing only at too great  a dis-
  tance  - " -  -   -   -   -  -  ib.
                             ib.
                             ib.
                             ib.
                             ib.
                             ib.
                            299
                            300
Squinting   -  -  -  -  -
Spots or Specks  -  -  -
Bloodshot  l£ye   -   -   -   ■
Watery or Weeping Eye
Of the Ear    ....
------Taste and Smell
—----Touch   -  -  -
          CHAP. XLVII.
Of a Scirrhous and Cancer
          CHAP. XLVIII.
Of Poisons   -  -   -   -   ■
— Mineral Poisons   -   -   ■
— Vegetable  ditto  -   -  •
301

304
305
 ib 
CONTENTS'.
vii
Bites of poisonous animals P.  306
_--- of the Mad Dog  -  -   ib.
—— of the viper   -  -  -  311
.---- of Poisonous Insects  -   ib.
---- of the Rattle-Snake  -  312
Kettering's Specific for the Hydro-
phobia......	313
CHAP. XLIX.	
Of the Venereal Disease	ib.
	314
OfGleets......	319
— Swelled Testicles - -	321
	ib.
— Chancres - - -	322
— A confirmed Lues or Pox	324
General observations - - -	327
CHAP. L.	
Diseases of Women - - -	330
Of the Menstrual Discharge -	331
— Pregnancy.....	335
— Child-birth - - - -	337
— Barrenness -	341
CHAP. LI.	
Diseases of Children - -	342
Of the Meconium - - -	,3^3
— The Apthae or Thrush -	344
	ib.
— Galling and Excoriation	3*5
— Stoppage of the nose - -	345
	ib.
— A Looseness - - - -	347
— Eruptions -----	ib.
— The Croup or Hives -	319
— Teething - - -	350
— The Rickets - - - -	352
—■. Convulsions - - -• -	353
— Water in the head - -	354
CHAP. LII.	
Of Surgery . -.,--»<-	355
	356
—.\nflammations and Abscess-	
	358
	3*59
—- Burns and Scalds ' - -	-361
	363
	364
CHAP. mi.	
Of Dislocations - - - -	366
Dislocation of the Jaw - -	ib.
_________of the neck - -	367
......of the Ribs	ib.
., ___ of the Shoulder	368
of the Elbow -	ib.
Dislocation of the Wrist and
  Fingers  -  -    -  Page 363
---------of the Thigh  -   -  ib.
-      — of the Knees  -   • 369
------•— of the  Ancles  -    ib-
---------of the Toes  -  -   ib.
           CHAP. LIV.
Of  Broken Bones, &c.     -   ib.
—  Strains......371
—  Ruptures.....372
            CHAP. LV.
Of Casualties   .   -  -  -    373
—  Substances stopt between the
  Mouth and the  Stomach   - 374
—  Drowned Persons - -  - 377
—  Noxious Vapours  -  -   380
Effects of extreme Cold  -   - .381
•*---------,_^_vKe^t :-   - 382
           CHAP. LVII.
Of Fainting Fits, and other Ca-
  ses which require immediate
  Assistance  -----     2  }%t~
—  Intoxication   -  -  -   -    )5
—  Suffocation and Strangling 086
—  Persons who expire in Con-
'  'vUls'fcn'Fits   -  -   -  -    388
           CHAP. Lyn.
Cautions concerning  Gold Bath-
  ing* and (Jrinking the Mineral
  Waters   -----. 390
           CHAP. LVIIi.    *\
Observations  concerning Diet,
  recommending  a method 4of
  living Jets -expensive,; and
  more  conducive  to health
  than the present  -  -  -   39?
General observations' on Aliment398
Of Bread......  399
,—  Boiled Grain  -  -  -    402,
— Butter  -   -  -  -  -'  - 405
k—  Fruits and  Roots   -  -   -  407
— Broths and Soups  -  -   41]
 Conclusion -  -  -   -  -   -413
■  ■   ..' .APPENDIX.
 Introduction  -----   413
 List of,Simples  -   -  -  -   421
  *.% MEDICAL .PREPARATIONS.
 Balsams....... 423
Boluses.....-      ib.
Cataplasmsfnd Sinapisms  -  424
 Clysters......    425
 Collyria, or Eye-waters  -   -  42fi 
 VI11
Confections  -  - -  Page
Conserves and Preserves -
Decoctions.....
Draughts  ----- -
Electuaries -  -  -  -  -
Emulsions.....
Extracts.....
Fomentations  -  -  - -
Gargles  ------
Infusions  ------
Juleps  - - -  - -
Mixtures  ------
CONTENTS.
426
 ib
427
428
429
430
431
 ib.
432
433
434
435
Ointments, Liniments and  Ce-
  rates  - - -  -  Page   135
Pills.......137
Plasters......   439
Powders.....      ib.
Syrups......    442
Tinctures, Elixirs, &c. -  -   ib.
Vinegars  -----  -  445
Waters by infusion, &c.  - - 446
Simple distilled Waters  - -  ib.
Spirituous distilled Waters- - 447
Wheys -  -  -  - -  -  -   ib.
Wines  -------   ib.
GLOSSARY
449 I INDEX
451
TZteu  ^uA^ Sj/i*-**^/-**&£■ f

<jC Lt,Z**t- l><*U*+>  L*-4&~  «-<— _^ 
PREFACE.
      WHEN  I  first signified my intention of publishing the fol-
lowing sheets, I was  told by my friends  it would draw  on me the re-
sentment of  the  Faculty.  As  I never could entertain such  an unfa-
vourahle idea, I was resolved to make the experiment,  which indeed
came out pretty much  as might have been  expected.  Many  whose
learning and  liberality of sentiments  do  honour to medicine, received
the book in a manner which at once showed their indulgence, and the
falsity of the opinion that every physician wishes to conceal his art; while
the more selfish  and narrow-minded, generally the most numerous in
every profession,  have  not  failed to  persecute both the book and its
author.
   The reception,  however, which this work has met with  from the Pub-
lic, merits my most grateful acknowledgments.   As the best way of ex-
pressing these, I have endeavoured to render it more generally useful,
by enlarging  the prophylaxis, or that part which treats of preventing di-
seases ;  and by adding many articles which had been entirely omitted in
the former impressions.   It is needless to  enumerate these additions;  I
shall only say, that I hope they will be found real improvements.
   The observations relative to  Nursing and the Management of chil-
dren, w ere chiefly suggested by an extensive practice among infants, in
a large branch of the Foundling Hospital, where I had an opportunity not
only of  treating the diseases incident to childhood,  but likewise of try-
ing different plans of nursing, and observing their effects.  Whenever
1 had it in  my power to place the children under the  care of proper
nurses, to instruct these nurses  in their duty, and to be  satisfied that
they performed it, very few of them died; but when,  from distance of
place, and other unavoidable circumstances, the children  were  left to
the sole care of mercenary nurses, without any person to instruct and
superintend them, scarce any of them lived.
   This  was so apparent, as with me to amount to a proof of the follow-
ing melancholy fact: That almost one half of the human species perish
in infancy, by improper management or neglect:  This reflection has made
me oftWwish to be  the happy instrument of alleviating the miseries of
those suffering innocents,  or of rescuing them from an  untimely grave.
No one, who has  not had an opportunity of observing them, can ima-
gine what ab.-uvd  and ridiculous practices still prevail in  tlie nursing
a:i<l management of infants,  and what numbers of lives  are by that
means lost to society.   As tliese practices are chiefly owing to igno-
rance it M to be hoped, that wheu nurses are better  informed, their
conduct  w^be more proper.
  The apjBcation of medicine to the various occupations  of  life has
been in  general the  result  of  observation.  An extensive  practice for 
X
PREFACE.
 several years, in one of the largest manufacturing towns in England af
 forded me sufficient opportunities of observing the injuries which those
 useful people sustain from their particular employments, and likewise  of
 trying various methods of obviating such injuries.   The  success which
 attended these trials Mas sufficient to encourage this attempt,  which  I
 hope will be of use to those who are under the necessity of eating their
 bread by such employments as are unfavourable to health.
   I do not mean  to intimidate  men, far less to insinuate that even
 those arts, the  practice of which is attended with some degree of dan-
 ger, should not  be carried on; but to guard the less  cautious and un-
 wary against those dangers which they have it in their power to avoid,
 and which the} often, through mere ignorance, incur.  As every occu-
 pation in  life disposes those who follow it to  some particular diseases
 more than to others, it is certainly of importance to know these,  in or-
 der that people may be upon their guard against them.   It is  always
 better to be warned of the approach,  of an enemy, than to be surprised
 by him, especially when there is a possibility of avoiding  the danger.
   The observations concerning Diet, Air, Exercise, &c.  are of  a more
 general nature, and have not escaped the attention of physicians in any
 age.   They  are subjects of too great importance, however, to be passed
 over in an attempt of this kind, and can never be sufficiently recom-
 mended.   The man who pays a proper attention to these, will seldom
 need the physiciau;  and he who does not, will seldom enjoy health, let
 him employ  as many physicians as he pleases.
   Though Ave have endeavoured to point  out the causes of diseases,
 and to put people upon their guard .against them, yet it  must  be ac-
 knowledged that they are often of such a nature as to admit of being re-
 moved only by the diligence and activity of the public magistrate. We
 are  sorry, indeed, to observe, that the  power of the magistrate  is sel-
 dom exerted in this country for  the preservation of health.  The  im-
 portance of a proper medical police is either not understood, or little
 regarded.  Many things highly injurious to the public health are daily
 practised with impunity, while others, absolutely necessary for its pre-
 servation, are entirely neglected.
   Some of the public means  of preserving health are mentioned in the
 general  prophylaxis, as  the inspection  of  provisions,  widening  the
 streets of great  towns, keeping  them clean, supplying the inhabitants
 with Avholesome water, &c.;  but they are passed over in a very cursory
 manner.   A  proper attention to  these would have swelled this volume
 to too large a size; I have therefore reserved  them for the subject of  a
 future publication.
   In the treatment of diseases, I have been peculiarly attentive to
 regimen.   The  generality  of people lay too much  stress upon Medi-
 cine, and trust too little to  their  own endeavours.   It  is  always in the
 poiver of the patient, or of those about him,  to do as much towards
 his recovery  as can be effected by the physician.  By not attending to
 this, the designs  of medicine are often frustrated; and the patient, by
 pursuing a wrong plan of regimen, not only  defeats  the Doctor's en-
 deavours, but renders  them dangerous.   I have often knoAv'h patients
 killed by an  error  in regimen, Avhen they Avere using venflteropcr me-
 dicines.  It  will be  said,  the  physician always  orders me regimen
when he  prescribes a  medicine.  I  wish it  were so, both for the ho 
PREFACE.                         XI
uour of the faculty and the safety of their patients: but physicians, as
well as other people, are too little attentive to this matter.
  Though many  reckon it doubtful whether  physic is beneficial or
hurtful to mankind, yet all allow the necessity and  importance of a
proper regimen in diseases.  Indeed the very appetites  of the sick
prove its propriety.  No  man  in his senses,  ever  imagined that a
person in a fever, for example,(<y)uld eat, drink, or conduct himself in
the same  manner as one in perfect  health.   This  part  of  medicine,
therefore, is evidently founded in Nature, and is every Avay consistent
with reason and common sense.  Had men  been more attentive to it,
and less solicitous in hunting after secret remedies, Medicine had never
become au object  of ridicule.
  This seems to have  been the  first idea of Medicine.   The ancient
physicians acted  chiefly in the capacity of nurses.   They Avent very
little beyond aliment in their prescriptions; and even this they gene-
rally administered  themselves,  attending the  sick  for that purpose
through the Avhole course of the disease; which gave  them an opportu-
nity not only of marking the changes of diseases with great accuracy,
but likewise of observing the effects of their different applications, and
adapting them to  the symptoms.
   The  learned  Dr. Arbuthnot  asserts, that by a proper attention to
those things which are almost within the reach of every body, more good
and less mischief will be done in acute diseases, than by medicines im-
properly and unseasonably administered; and that great cures may be
effected in chronic  distempers, by a proper  regimen  of the diet  only.
So intirely do the Doctor's sentiments  and mine agree,  that 1  Avould
advise every person, ignorant of physic, to  confine his practice solely
to diet, and the other parts of regimen; by which means he may often
do much good, and  can seldom do any hurt.
   This seems also  to have been the opinion of the  ingenious Doctor
Huxham, who observes, that we often seek from Art  what all-bountiful
Nature most readily, and as effectually, offers us, had Ave diligence and
sagacity enough to  observe and make use of them; that the dietetic part
of Medicine is not so much studied as it ought to be; and that though
less pompous, yet it is the most natural method  of curing diseases.
   To render this book more generally useful, however, as well as
more acceptable  to the intelligent part of mankind, I have in most
diseases, besides regimen,  recommended some  of the most simple and
approved forms of  medicine, and added such  cautions and  directions
as seemed necessary for their sui'e administration.  It Avould no doubt
have been more  acceptable to many, had it abounded with pompous
prescriptions, and  promised great cures in consequence of  their use;
but  this Avas not m\ plan :  I think the administration of medicines
always doubtful,  and  often dangerous  and Avould much rather teach
men how to avoid the necessity of using them,  than how they should be
used.
   Several medicines, and those of considerable efficacy, may be admi-
nistered with great freedom and safety.  Physicians generally trifle  a
long  time with medicines  before they  learn thtir proper  use.  Many
peasants at present  know better how to use some of the most  important
articles in the materia medica, than physicians did a  century ago; and
doubtless the same observations  Avill hold  with regard to  others some 
XH                       PREFACE.
 time hence.  Wherever I was convinced that  medicine  might be used
 with  safety,  or  where the cure depended chiefly upon it, I have taken
 care to recommend it;  but Avhere it A\as either  highly dangerous, or not
 very necessary, it is omitted.
   I have not troubled the reader with an useless parade of quotations
 from  different authors, but have in general adopted their observations
 Avhere my  own  Mere  either defecti\% or totally wanting.   Those  to
 whom I am most obliged are, Ramizffii, Arbuthnot, and Tissot; the las!
 of which, in his  Jris du Pcnplc, comes the nearest to my views of any
 author Avhich I  have seen.   Had the Doctor's plan been as complete
 as the execution is masterly, we should have had no occasion for any
 new treatise  of  this kind soon;  but  by confining himsell to the acute
 diseases, he has  in my opinion omitted the most useful part of his sub-
ject.  People in  acute diseases may sometimes be their own physicians;
 but in  chronic cases, the cure must ever depend chiefly upon the pa-
 tient's own endeavours.  The Doctor has also  passed over the Prophy-
 laxis, or preventive part of medicine very slightly, though it is certain-
 ly of the greatest  importance in such a work.   He had no  doubt his
 reasons for ; o doing, and I am so far from finding fault Avith him, that
 I think his performance does great honour both  to  his head  and his
heart.
  Several other  foreign physicians of eminence have written on nearly
 the same plan with Tissot, as the Baron Van  Swienten, physician  to
 their Imperial Majesties,  M. Rosen, first physician of the kingdom  of
 Sweden, &c; but these gentlemen's productions have never  come  to
my hand.  I cannot help wishing,  hoAvever, that some  of  cur distin-
guished countrymen Avould folkvw their example.   There still remains
much to be dme  on this subject,  and it does not appear to me how any
man could better employ his time or talents, than in eradicating hurtful
prejudices,  and diffusing useful knowledge among the people.
  I  know  some of the Faculty disapprove of every attempt of this
nature,  imagining  that it must  totally destroy their influence.   But
this notion appears to me  to  be as absurd as it is illiberal.  People
in distress  will  always apply for relief to men of superior abilities,
A^hen they have it in their power; and they Avill do this with far greater
confidence and readiness when they believe that medicine is a rational
science,  than when they take it to be only a  matter of mere conjec-
ture.
  Though I have endeavoured to render this Treatise plain and useful,
yet I  found it impossible to avoid some terms of art, but those are  in
general  either explained,  or are such as most  people understand.  In
short, I have endeavoured to conform my style to the capacities of man-
kind in general;  and, if my Readers do not flatter either  themselves  or
me, with some degree of success.  On a medical subject,  this is not  so
easy a matter as some may imagine.  To make a shew  of learning  is
easier than to Avrite plain sense, especially in a science which has been
kept at such a distance from common observation.  It would however
be no difficult matter to prove, that every thing  valuable  in the practi-
cable part of medicine is Avithin the reach of common abilities.
  It would be ungenerous not to express  my warmest acknowledg-
ments to those gentlemen who  have endeavoured to extend the use-
fulness of this performance; by translating it into  the l.uiguage of
their  respective  countries   Most of them  have not only giveu ele 
PREFACE.
xni
gant translations  of  the Book, but have  also enriched it  Avith many
useful  observations,  by Avhich it is rendered more complete, and better
adapted to the climate and the constitutions of their countrymen.  To
the learned Dr. Duplanil of Paris, physician to the Count d'Artois, I
lie under particular obligations; as this gentleman has  not  only consi-
derably enlarged  my  treatise, but, by his very ingenious and useful
notes, has rendered it so popular on the Continent,  as to occasion its
being translated into all the languages of modern Europe.
  1 have only to add, that the book has not more exceeded my expecta-
tions in its success, than in  the effects it has  produced.  Some  of the
most pernicious practices, with regard to the treatment of the sick, have
already given place to a more rational conduct;  and many of the most
huitlul prejudices, which seemed to be quite insurmountable, have in a
great measure yielded to better information.   Of this a stronger in-
stance  cannot be  given  than  the  inoculation of the  small  pox.  Few
mothers, some years ago, Avould submit to have their children inoculated
even by the hand of  a physician ;  yet nothing is more certain, than that
of late  many of them  have  performed this  operation with their own
hands; and as their success has been equal to that of the  most dignified
inoculators, there is little reason to doubt  that the practice will become
general.   Whenever this shall be the case, more lives will be saved by
inoculation alone, than are at present by all the endeavours of the Fa-
culty. 
INTRODUCTION.
         THE improvements in Medicine, since the revival of learn-
ing,  have by no means kept pace with those of the other arts.  'UN-
reason is obvious.  Medicine has been studied by few, except those who
intended to live by it as a business.   Such either from a mistaken zeal
for the honour of Medicine, or to raise their owu importance,  have en-
deavoured to disguise and conceal the art.  Medical authors have gener-
ally written  in  a foreign language; and those who were uuequal to this
task,  have even valued themselves upon couching, at least, their pre-
scriptions, in terms and characters unintelligible to the rest of mankind.
   The contentions of the clergy, which soon happened after  the re-
storation of  learning, engaged  the attention of mankind, and paved the
way for that freedom of  thought and enquiry, which has since prevailed
in most parts of Europe  with  regard to religious matters.   Eveiy man
took a side in those bloody disputes; and eveiy gentleman, that he might
distinguish himself on  one side or  other  was instructed in Divinity.
This taught people to think and reason for themselves in  matters of reli-
  ion, and at last totally destroyed that complete and absolute dominion
which the clergy had obtained over the minds of men.
   The study of Law has likewise in most civilized nations, been justly
deemed a necessary part of  the education of a gentleman.   Eveiy gen-
tleman ought certainly to know at least the laws of  his own country; and,
if he were also acquainted with those of others, it might be more than
barely an ornament to him.
   The different branches of  Philosophy  have also of late been very
universally studied by all who pretended to a liberal education.   The ad-
vantages of this are manifest.   It frees the mind from prejudice  and  su-
perstition, fits  it for the investigation  of truth;  induces habits  of  rea-
soning and judging  properly; opens an inexhaustible  source of enter-
tainment;  paves the  way to  the improvement of arts and agriculture;
and qualifies men for acting Avith propriety in the  most importaut sta-
tions of  life.
   Natural History is likewise become an object of general attention; and
 it well deserves to be so.  It leads to discoveries of the greatest import-
 ance.   Indeed agriculture, the most useful of all arts, is only a branch of
 Natural History, and can never arrive at a high degree of improvement
 where the study of that science is neglected.
   Medicine however, has  not, as far as I know,  in  any country, been
 reckoned a necessaiy part of the education of a gentleman.   But surely
 no sufficient reason  can be assigned for  this omission.   No science
 lays open  a  more  extensive field  of  useful  knowledge,  or affords
 more ample entertainment  to an inquisitive mind.  Anatomy,  Botany,
 Chymistry, and the Materia Medica, are all branches of Natural Histo-
 ry, and are fraught with such amusement and utility, that  the man who
 entirely neglects them has but a sorry claim either to taste or learning.
 If a gentleman has a turn for  observation, says an excellent aad  sensible 
INTRODUCTION.
XV
writer*, surely the natural history of  his own species is a more interest-
ing subject, and presents a more ample field for the exertion of genius,
than the natural history of spiders and cockle-shells.
   We do not mean that every man should become a physician.  This
would  be au attempt as ridiculous as it is impossible.  All we plead for
is, that  men of sense and learning should be so far acquainted Avith the ge-
neral principles of Medicine, as to be in a condition to derive from it some
of those advantages with which it is  fraught;  and at  the same time to
guard themselves against the destructive influences of ignorance, supersti-
tion and quackery.
   As matters stand at present, it is easier to cheat a man out of his life
than of a shilling, and almost impossible either to dectect or punish  the
offender.  Notwithstanding this, people still shut their eyes, and take every
thing upon trust that is administered by any Pretender to medicine, Aviih-
out daring to ask  him a reason for any   part of his conduct.   Implicit
faith, every where: else the object of ridicule, is still sacred  here.  Many
of the faculty are  no doubt worthy of all the confidence  that can be re-
posed in them, but as this can never be the character of every individual
in any profession, it would certainly be for the  safety, as m ell as the hon-
our, of  ,i'Miikind, to have some clieck upon the conduct of  those to whom
the} emrust so valuable a treasure as health.
   The veil of mystery, which still hangs over  Medicine,  renders it  not
only a conjectural, but even a suspicious art.   This has  been long ago re-
moved from the other sciences, which induces many to bel^-ve that  me-
dicine is a mere trick, and that it will not bear a  fair and candid exami-
nation.  Medicine, however, needs only to be better knoAvn, in order to'
secure the general esteem of mankind.  Its  precepts are such as eveiy
Avise man would chuse to observe, aud it forbids nothing but Avhat is in-
compatible wi'.h true happiness.
   Disguising  Medicine not  only retards its improvement as a science,
but exposes the profession to ridicule, and is injurious to the true interests
of society.   An art founded  on observation never can arrive at any high
degree of improvement, while it is confined to a few who make a trade of
it.  The united observations of all  the ingenious and sensible part of
mankind, Avould do more in a few years towards the improvement of  Me-
dicine,  than  those of the  Faculty alone in a great many.   Any  man
can tell Avhen a medicine gives him  ease as well  as a physician; and if
he only knows the name and dose of  the medicine, and the name of the
disease, it is sufficient to perpetuate   the fact.  Yet the  man who adds
one single fact to the stock of medical observations, does  more  real  ser-
vice to the art, than he who  writes a  volume in support of some favour-
ite hypothesis.
   Very few of ihe valuable discoveries in medicine   have been made
by physicians.    They have in general  either been the effect of chance
or of necessity, and have been usually  opposed by the Faculty; till eveiy
one else avos convinced of their  importance.   An implicit faith in the
opinions of  teachers, an attachment to systems and  established forms, and
the dread of reflections, will always   operate upon those  who folloAV me-
decine as a trade.   FeAV   improvements  are  to be expected  from

          * Observations on the Duties  and Offices of a Physician. 
XVI                    INTRODUCTION.
 a man Avho might ruin his. character and family by the smallest deviat'on
 from an established rule.
   It men of letters,  says the author of the performance quoted aliove,
 were to claim their right of inquiry  into a matter that so near)}  con-
 cerns them, the good effects on medicine Avould  soon appear.  Such
 men would have no separate interest from that of the art.   They would
 detect and expose assuming Iguorancc under the mask  of Gravity and
 Importance, and would be the judges and patrons of modest merit.  Not
 having their understandings perverted in their youth by false theories,
 unawed by authority, and  unbiassed  by interest,  they Avould canvass
 with freedom the most universally received principles in medicine, and
 expose the uncertainty of many of those doctrines, of which a physician
 dares not so much as seem to doubt.
   No argument, continues  he, can be brought against laying open me-
 dicine, which does not apply with equal, if not greater, force to religion;
 yet experience has shown, that since the laity have asserted their right
 of inquiry into these subjects,.Theology, considered as  a scieuce, has
 been improved, the interests of real religion have been promoted, and
 the  clergy have  become a  more learned,  a more  useful,  and a more
 respectable body of men, than  they ever were in the days of their great-
 est power and splendour.
   Had other medical Arriters been as honest as this gentleman,  the art
 had  been upon a very different looting at this day.  Most of them extol
 the merit of those men who brought Philosophy out of the schools,  and
 subjected it  to the rules of common sense.   But they never consider
'that  medicine, at present, is in nearly the same situation as philosophy
 was  at that  time, and  that it  might be as much  improved by being
 treated in the same manner.  Indeed no science can either be render-
 ed rational or useful, without being submitted to the common  sense and
 reason of mankind.   These alone stamp  a value upon  science;  and
 what will not bear the test of these ought to be rejected.
   I know it  will be said, that  diffusing medical knowledge among the
 people might induce them to tamper with medicine, and to trust to their
 own skill instead of calling a physician.  The reverse of this however
 is true.  Persons who have  the most knowledge in these matters, are
 commonly most ready both  to ask and to follow advice, when it is ne-
 cessary.  The  ignorant are always  mo»t apt to tamper with medicine,
 and have the least confidence in Physicians.   Instances of this are daily
 to be met with  among the ignorant peasants,  who,  while they absolute-
 ly refuse to take a medicine which has been prescribed by a physician,
will sAvallow Aviii greediness any thing that i recommended to them by
 their credulous  neighbours.   Where men  will act even  without hnow-
ledge, it is certainly more rational to afford them all the light Ave can,
 than  to leave them entirely  in  the dark.
   It may abo  be  alleged,  that  laying medicine more  open to man-
 kind would lessen th if faith in it.  This Avould indeed  be the case
 with  regard to s ome ; but it would have a quite contrary effect upon
others.  I know man*  p"ople who have the utmost dread and horror
of every thing  prescribed by  a  physician, but who will nevertheless
very readily t;ike a medicine which they know,  and whose qualities
tJiey  are in  so tic measure acquainted with.   Heme it is evident, that
the dread arises iio.a the doctor, not licm the drug.  J\'othLig catt 
INTRODUCTION.
XVll
can or will inspire mankind with an absolute confidence in physicians,
but an open, frank, and undisguised behaviour.  While the least shadow
of mystery remains in the conduct of the Faculty, doubts, jealousies and
suspicions, will arise in the minds of men.
  No doubt cases will sometimes occur, Avhere a prudent physician may
find it expedient to disguise  a medicine.  Tlie whims and humours of
men must be regarded  by those avIio mean to do them service ; but this
can never affect the general argument in favour of candour and openness.
A man might as well allege, because there are knaves and fools  in  the
world, that he ought to take every one he meets for  such, and to treat
him accordingly.   A sensible physician will always know Avhere disguise
is necessary; but it ought never to appear on the face of his general conduct.
   The appearance of mystery  in the conduct of  physicians not only
renders their art suspicious, but lays the foundations of Quackery, which
is the disgrace of Medicine.  No tAvo  characters can be more differeflfc
than that of the honest physician and the quack; yet they have general-
ly been veiy much confounded.   The line between them is not sufficient-
ly apparent;  at least is too  fine for the  general eye.   Few persons are
able to distinguish sufficiently between the conduct of that man Avho ad-
ministers a secret medicine, and him who writes a prescription in mystical
characters  and  an unknown tongue.   Thus the conduct of  the honest
physician, which needs no disguise, gives a sanction to that of  the villian>
whose sole consequence depends  upon secrecy.
  No laws will ever be able to  prevent quackery, while people believe
that the quack is as honest a man, and as well qualified, as the  physician.
A very small degree of medical knoAvledge, however, would be sufficient
to break this spell; and nothing else can effectually undeceive them.  It
is i\m ignorance and credulity of the multitude, with regard to medicine,
Avhich renders them such an easy prey to every one who has the hardiness
u#attack them on this quarter.  Nor can the evil be remedied by any
other  means but by making  them Aviser.
  The most effectual way to destroy quackery in any art or science, is to
diffuse the knoM ledge of it among mankind.   Did physicians write their
prescriptions in the common language of the country, and explain their
intentions to the patient, as far as he could  understand  them, it would
enable him to know when the medicine had  the desired effect; would
inspire him with absolute  confidence in the physician; and would make
him dread and detest every  man who pretended to cram a secret  medi-
cine doAvn his throat.
  Men in the different states of society, have very different view's of the
same  object.  Some time ago  it was the practice of this country for
every person to say his prayers  in Latin, whether he kneAV any thing of
that language or not.   This conduct, though sacred in the eyes of our
ancestors, appears ridiculous enough to us; and doubtless some parts of
ours will seem as strange to posterity.   Among these we may reckon the
present mode of medical prescription, which, we venture to affirm, will
some time hence appear to have been completely ridiculous, and a very
high burlcfque upon the common sense of mankind.
  But this practice  is  not only  ridiculous, it is  likeAvise dangerous.
However capable  physicians may be of writing  Latin, I am certain
apothecaries are not ahvays in a condition to read it, and that  dangerous
mtstake?, in consequence of  this, often happen.   Bnt suppose the apothc- 
XVlii                     INTRODUCTION.
cary ever so able  to read the physician's  prescription, he  is generally
otherwise employed, and the business of making up prescriptions is left
entirely to the apprentice.  By this means the greatest man in the king-
dom, even when he employs a first-rate physician, in reality trusts his
life in  the hands of an  idle boy, who  has not only the chance of being
very ignorant, but. likewise giddy and careless.   Mistakes will sometimes
happen in spite of the greatest care ; but,  where human  lives are con-
cerned, all possible methods ought certainly to be taken to prevent them.
For this reason, the prescriptions of physicians, instead of being couclied
in mystical characters and a dead language, ought, in my humble opinion,
to be conceived in the most plain and obvious terms imaginable.
  Diffusing medical knowledge among the people Avould not only tend to
improve the art and to banish quackeiy, but likewise to render Medicine
more universally useful, by extending its benefits  to society.  However
ling Medicine may have been known as a science, Ave will  venture to
say, that many of its most important purposes to society have either been
overlooked, or very little attended to.   The cure of diseases is doubtless
a matter of  great importance; b$  the   preservation of health is of still
greater.   Tlus is the concern of every  man, and surely what relates to it
ought to be  rendered as plain and obvious to all as possible-  It is not to
be supposed, that men can be sufficiently upon  their guard against  di-
seases, who are totally ignorant of their causes.  Neither can the Legisla-
ture, in whose power it is to do much more for preserving the public health
than can ever be done by the Faculty, exert that power with propriety,
and to the greatest advantage, Avithout some degree of medical knowledge.
  Men of every occupation and condition in life might avail themselves
of a degree of medical  knowledge; as it would teach  them to  avoid
the dangers peculiar to  their respective stations; Avhich is always easier
than to remove their effects.    Medical knowledge,  instead of being a
check upon the enjoyments of life, only teaches men how to make tbjp
most of them.  It has indeed been said, that to live  medically, is to live
miserably ; but it might with  equal propriety be said, that to live ra-
tionally is to live miserably.   If physicians obtrude their own ridiculous
whims upon mankind,  or lay  down  rules inconsistent  with reason or
common sense, no doubt they will be despised.  But  this is not the fault
of medicine.   It proposes no rules that I know, but such as are perfect-
ly  consistent with  the true enjoyment of life, and every way coudu-.
cive to the real happiness of mankind.
  We  are sorry indeed  to observe, that Medicine  has  hitherto  hardly
been considered as a popular science, but as a branch of knowledge sole-
ly confined  to a particular set of men, while ah the rest have been taught
not only to neglect, but even to dread  and despise it.  It will however
appear, upon a more strict examination, that no  science better deserves1
the attention, or is more capable of being rendered generally useful.
  People are told, that if they dip the least into medical knowledge, it
will render them fanciful, and make them believe they have every disease
ef which they read.   This I am satisfied  will seldom %>. the case with
sensible people; and suppose it were, they must soon  be»Uideceived.
A short time will shew them their  error, and a little  more reading will
infallibly correct it.  A single instance will shew the absurdity of this
notion.  A sensible  lady, rather  than read a medical performance,
which   would  instruct  her  ia   the   management  of  her  children. 
"T"? ">   mum
                       INTRODUCTION.                   XIX

generally leaves them entirely to the care and conduct of the most igno-
rant, credulous, and superstitious part of the human species.
  No part of medicine is of  more general importance than that which
relates to the nursing and management of children.  Yet feAV parents pay
a proper attention to it.  They leave the sole care ©f their tender off-
spring, at the very time Avhen care and attention are most necessary, to
hirelings, who are  either too  negligent to do their duty, or too ignorant
to know it.  We will venture to affirm,  that more human  lives are lost
by the carelessness and inattention of parents and nurses, than are saved
by the Faculty ; and that the joint and well-conducted endeavours, both
of private persons and tlie public,  for the preservation of infant lives,
would be of more advantage  to society than the whole art of medicine,
upon its present footing.
  The benefits of medicine, as  a  trade, will eAer be confined to those
who are able to pay for them; and of course, the far greater part of man-
kind  Avill be every where deprived of  them.   Physicians, like other
people, must live by their employment, and the poor must either Avant
advice altogether,  or take up  Avith that which is worse than none.
There are not hoMrever any where wanting Avell-disposed people, of bet-
ter sense, who are willing to supply the defect of medical advice to the
poor,  did not their fear of doing  ill often suppress  their inclination to
do  good.  Such people  are  often deterred from  the most noble and
praise-worthy actions,  by the foolish alarms sounded in their ears by a
set of men, avIio, to raise  their own importance, magnify the difficulties
of doing good, find fault Avith what is truly commendable, and fleer at
eveiy attempt to relieve  the sick which  is not conducted by the  precise
rules of medicine.   These gentlemen must however excuse me for say-
ing, that I  have often known such well-disposed persons  to  do much
good; and that their  practice, which is generally the result of good
sense and observation,  assisted by a little medical reading, is frequently
more rational than that of the ignorant retainer of physic, who despises
both  reason and  observation, that he may be wrong by rule;  and who
while he is dosing his patient  with medicines, often neglects other things
of far greater importance.
  Many things are necessary for the sick besides medicine. Nor is the
person who takes care to  procure these  for them, of les9 importance than
a physician.   The poor oftener perish in diseases for want of proper
nursing than of medicine.  They are frequently in want of even the
necessaries of lite, and still  more  so of what is proper for a sick-bed.
No one can imagine, who has not been a witness  of these situations,
how much good a well-disposed person  may do, by only takiug care to
have such Avants supplied.  There certainly cannot be a more necessa-
rv,  a more noble, or a more god-like action,  than to administer to the
Avants of our felloAV-creatures  in distress.—While virtue or religion are
knoAvn  among mankind, this conduct will be approved; and while Hea-
ven is just it must be rewarded!
  Persons who do not choose to administer medicine to the sick, may
nevertheless direct  their regimen.  An eminent medical  author has
said,  That by diet alone all the intentions of medicine may be ansAver-
ed.*   No doubt a great  many of them may; but there are other things
*  Arbuthnot. 
XX
INTRODUCTION.
besides diet, which ought by no means to be neglected.  Many hurtful
and destructive prejudices, Avith regard to the treatment of the sick, still
prevail among the people, Avhich persons of better sense and learning alone
can eradicate.   To guard the poor against the influence of these preju-
dices, and to instil into their minds some just ideas of the importance of
proper food, fresh air, cleanliness, and other pieces of regimen necessary
in diseases, would be a work of great merit, and productive  of many
happy consequences.   A proper regimen, in most diseases, is at least
equal to medicine, and iu many of them  it is greatly superior.
   To assist the Avell-meant endeavours of the humane and benevolent
in relieving distress;  to  eradicate dangerous and hurtful prejudices; to
guard the ignorant and credulous against the frauds and impositions of
quacks and impostors; and to show men  what is in their owu power,
both with regard to the prevention and cure of diseases,  are certainly
objects worthy of the physician's attention.—These were the leading
views in composing and publishing the  following  sheets.  They Avere
suggested by an  attention to the conduct of mankind with regard to me-
dicine, in the course of a pretty long practice in different parts of this
island, during which the  author has often had occasion to  wish that his
patients, or those about them, had been possessed of some such  plain di-
rectory for regulating their conduct.  How far he has succeeded in his
endeavours to supply this deficiency, must be left to others to determine:
but if they be found to contribute in any measure towards alleviating the
calamities of mankind, he Avill think his labour very well bestoAved.
   § " Before we enter upon the prevention or cure of diseases, it may
 not be improper to take a cursory view of  the human body, respecting
 the functions immediately connected  with life.   So wonderful is the
 structure of our frame, as displayed by anatomy, that atheistical per-
 sons, obdurate to every other evidence of the existence of a God, who
 created the universe,  have, on witnessing a dissection, been  instantly
 convinced of their mistake, and have acknoAvledged with equal astonish-
 ment and shame, that nothing less than a Being of infinite M'isdom  and
 power could have contrived and executed such a wonderfnl  piece of
 mechanism as that of the human body.
   " The primary agent  in the circulation  of the blood is the heart, a
 large muscle situated in the left side of  the  breast (thorax, or chest) and
 endoAved  Avith great irritability.  In the first rudiments of animal life,
 even before the brain is formed, the punctum saliens, as it is called, points
 out the embryo heart in miniature, and  marks its primaeval irritability as
 a sure presage of its future importance in supporting the vital motions.
 As this  singular  organ  exhibits irritability  the first,  so it never relin-
 quishes it till the la6t; Avhence it has been called the primum mobile, and
 ultimum moriens, that is,  " the first part that moves, and the  last  that
 dies," of the animal machine.   It is observable, that  the  motion of  the
 heart not only survives that of the organs of voluntary motion, but con-
 tinues a considerable time even after it is  separated from the body of
many animals.  Hence, in drowning, or suffocation,  though the pulse
be imperceptible, and apparently extinguished,  yet the heart still pre-
serves this latent power or susceptibility of motion, and  wants only to
be gently excited by suitable means to  renew its action.
   This  organ is surrounded by the pericardium, or  heart-purse,  an 
INTRODUCTION.                   XXI
 exceeding strong membrane,  which  covers  the heart,  even to its basis.
 Its uses are to  keep the heart from  having any friction with  the lungs,
 and to contain a fluid to lubricate or moisten its surface.
    " From the  right ventricle or cavity of the heart, the irritability  of
 which is excited into action by the circulating fluid,  the blood is  pro-
 pelled Jhrough  the lungs, Avliich are situated on the right and left side  of
 the heart, from  which they differ on appearing to  be  void of irritability.
 They are divided into two lobes, and these into more divisions, three
 on the right side, and tAvo on the  left.  The trachae, or wind-pipe, de-
 scends into the lungs,  and forms innumerable cells, which have a  com-
 munication with each other,  and give  the Avhole the appearance of a
 honey-comb or sponge.
    " The blood, after passing through the lungs, arrives again  at the
 heart, and from the left ventricle is expelled  into the aorta,  or great ar-
 tery ; which dividing into two branches, one upwards, and the other
 downwards, distributes the blood through  the whole body; from the ex-
 tremities of  which it  returns, by various veins,  through the ascending
 and descending cava,* and is transmitted  again to the heart.
    " The heart  is the grand organ which actuates  the vital functions, and
 to this purpose  it is admirably fitted  by its own irritability;  but it is ne-
 cessarily supported in its action by the powerful influence of the nerves,
 which are the ultimate instruments  both  of motion and sensation, and
 have their origin in the brain.
   " The diaphragm or midriff is a  large broad  muscle which divides
 the thorax from the abdomenf or belly.   In its natural state,  it is  con-
 cave or vaulted towards the abdomen, and convex towards the thorax.f;
 Haller calls it " the most noble boAvel next to the heart;" and, like the
 latter, it is in constant action.   At the time of inspiration it approaches
 toAvards a plane.   Besides being a  muscle of inspiration, it  assists in
 vomiting, and the expulsion of the faeces.§   From the exertion of  this
 muscle likewise proceed sighing, yawning, CMighing,  and laughing.   It
 is  effected by spasms, as in the hickup, &c.^It is both a muscle of vo-
 luntary and involuntary action.  We may observe in this muscle strong
 characters of admirable contrivance.  It separates posteriorly into  two
 slips, between which the descending aorta passes. A little above this, and
 towards the left side, in the most fleshy part of the midriff, there is a di-
 rect opening for the passage of the oesophagus or gullet.  There  is also on
 the right side a large triangular hole for the  passage of the ascending
 cava.
  " The gullet is composed both of  longitudinal and  circular fibres, but
 chiefly circular, much more so than the  intestines; because this has no
 foreign power to assist,  and because it is necessary that the food should
 make a shorter  stay in the throat than in the bowels.   The inner sur-
face is a smooth membrane,  Avell  supplied  with mucilage, to sheath
the organ, and render the passage of  the aliment or food easy.
  " The stomach lies across the upper part of the abdomen, and is co-
vered by the liver; when distended it presses on the spleen.   It nearly

  *  Cava is the large vein which conveys the refluent blood  to the heart.
  f Abdomen, from abdo, to hide, as its contents lie hidden.
  *  Derived from the Greek, signifying the breast
  §  This word with chymists is used to express the ingredients and settling af-
ter distillation and infusion :  here it metms excrement. 
xn
INTRODUCTION.
resembles in figure the  pouch of a bag-pipe,  its upper side being au>
cave, and the lower convex.   Its It ft end is the most capacious.   On
the leftside is the entrance from the gullet; on the right is the opening.
called pylorus, by which the chyle passes into the intestines.   Here is.
a circular valve, or spincter muscle, which prevents  a regurgitation  ol
the aliment.   The stomach has circular and longitudinal  fibres, and its
inner membrane is covered Avith a strong viscid mucus.
  " The liver, the largest gland in the  body, is situated immediately
ander the vaulted cavity of  the midriff, chiefly  on the right side, and
someAvhat on the left over the stomach.  Exteriorly, or anteriorly, it is
convex, inwardly it is concave;  very think in its superior part,  and thin
in its inferior.   The upper 6ide adheres  to the midriff; and it is  fixed
to this, and the sternum, or breast-bone, by a broad ligament.  It is also
tied to the navel by a ligamentous band, Avhich is the umbilical vein of
the unborn infant, degenerated into a ligament.  Both these bands serve
to suspend it,  Avhile lying on the back, from bearing  too much on tin
subjacent cava ; othenvise it might press on this important returning ves-
sel, stop the circulation, and put a period to life.  Dogs  and  cats, and
other animals who are designed for leaping, have their liver divided into
many distinct lobules, to prevent too great a concussion of the organ.
The liver is the viscus orboAvel which performs the secretion of the bile.
  " The gall-bladder is situated under the great lobe of the liver, a little
to the right.  In a standing posture it lies fonvards and downwards.  Its
bottom is raised by a fulness, and depressed by the emptying of the sto-
mach.  The use of the gall-bladder is to serve as a receptacle for the bile.
  "• The intestines  are destined to receive the food from  the stomach,
and after exposing the useful part of it to  the lactcals, a set  of extreme-
ly small vessels, to convey the remainder  out of the body.  The intes-
tinal canal is usually five times the length of the individual: it is  curi-
ously convoluted in the abdomen,  and is extremely irritable.  Anato-
mists have divided this  ^nal, although  one continued  pipe, into six
portions, three of which  are termed the small intestines,* and the  three
last, the great.  In the  small intestines there are numerous plaits to de-
tain the food, and alloAV a  larger surface for its  absorption.  These
are larger, and far more numerous near the  stomach, where  the  food
is thinner, than they are towards the other extremity.  At the  entrance
©f the ilium into the colon, there are tAvo very large  valve3, M'hich pre-
vent  the regress  of the faeces  into the ilium.   The eweum and colon,
tAvo of the intestines toAvards the lower  extremity,  besides  having
stronger muscular coats than  the  small intestines,  are furnished with "
three ligamentous bands, running lengthwise oh their outside,  dividing
their surfaces  into  three portious nearly equal.  Though appearing
extremely like ligaments, they are  composed in their inner structure,
of true muscular fibres.   The ligament-like bands, which  in the caecum
and colon are collected into three portions, are spread equally over the
surface of the  rectum, or lower extremity of the intestines.   This is a
  * The three smaller are, the duodenum, (from  its length being about that of
the breadth of twelve fingers,) jejunum, and ilium, from the Greek, signifying
to turn about, because it makes many convolutions.
  The three larger are, the aecum, or blind gut (so called from its being perfo-
rated  at one  end only ;) the colon, signifying hollow, a word from the Greek
and the rectum, or straight gut. 
INTRODUCTION.                  XXIII
vise precaution of Nature, that no part of it may be weaker than ano-
ther, lest it should give way iu the efforts for expelling the feces.   The
plaits are considerably fewer in the great intestines.    They have all an
inner membrane, covered with an infinite number of arteries  or glands,
which discharge a lubricating fluid.  They are furnished with muscular*
.fibres, both circular and longitudinal.
  " The spleen, or milt, is situated  immediately under the edge of the
midriff, above the  left kidney, and between  the stomach and ribs.   In
figure, it resembles a depressed oval, near twice as long as broad, and al-
most twice as broad as thick.  Cheselden informs us, that it  has  been
taken from dogs without any  observable  inconvenience  to them.   Its
use is still  problematical.
   " The pancreas, or sweet-bread, is situated transversely under the sto-
mach.  Its shape resembles a dog's tongue.   Along the Avhole length of
it there is  a duct, which terminates in the upper part of  the  intestines
near the stomach.  The pancreatic juice resembles the saliva, but is lesp
viscid or slimy, and contains a larger proportion of the 6alts of the blood.
It is probably intended for the solution of our aliment.
   The kidneys are  two oval bodies, situated in the loins, contiguous to
the two last short ribs; the right under  the liver, and the  left under the
spleen.  The structure of the kidneys is curiously fitted for securing the
urine, which is carried from each of them by canals termed the ureters,
into the bladder, the  reservoir of that fluid, situated in the  lower part of
the belly.   They enter the bladder near its  neck, running for the space
of  an inch obliquely between its coats, and forming, as it Avere, to them-
selves, tAvo valves; so that, upon the contradiction of the  bladder, the
urine is directed along the urethra, which is its proper passage out of the
body.
   Over the upper part of  the abdomen is spread the omentum, or  caul
consisting  of  two broad,  thin,  and  transparent membranes,  joined to-
gether by celVilar texture, in the cells of Avhich a quantity of fat is depo-
sited.  The uses of it are to interpose betAveen the peritonorum,* or lining,
the intestines, and the stomach, to  keep all these parts moist, warm, slip-
pery, and to prevent their adhesion.
   Last of all comes the  peritonaeum, a strong membrane, which confines,
as iu an inclosure, the intestines and contents  of the abdomen.
   Such, in a general  vieAV, are the contents of the cavities of the  breast
and belly, which perform, respectively, the vital motions, and those natu-
ral functions that are subservient to the support of our frame.   But there
remains to be mentioned another essential cavity, with its dependent sys-
tem,  to the primary influence of which all the other parts of the body art
indebted  for their action and energy.   The  cavity to which  I allude is,
the skull, the receptacle of the brain.  The brain is divided into two por-.
tions; namely, the cerebrum and cerebellum ;f the former situated in the
upper part of the skull, and the  latter under it, in the hind part.  The
brain is a soft pulpy  substance, surrounded by two membranes; one calr
led dura, aud the other/a'a, matter.  It has also a third, called arachnoid,
  • Signifying near to, stretching round, or about, as periosteum, /wricarpium;
near to the bone, heart, &c.
  f Cerebellum, the little brain as it were: botfc are often called thus, wktti
the. brain is spoken of in small animals". 
XXIV                  INTRODUCTION.
from its fineness, as being similar to  a spider's  wed.  It contains some
sinuses, which are nothing more than large veins or receptacles for blood,
and four cavities called ventricles, moistened, in a healthful state, with a
fine vapour, which increasing gives rise to diseases.  Like other parts of
the body, it has a variety of arterial  branches from the heart, which dif-
fuses through its substance, and on the membranes.   The brain is the great
claboratory, where the animal spirits, or nervous influences Avliich actuate
our frame, are supposed to receive their  existence.  The nature of this
fluid,  if really a fluid, has not yet been  sufficiently investigated.  It is
certain, however, that from this source  the nerves derive their origin.
These are white, firm, solid cords, wlrich arise from the  brain and spinal
marrow, which is only an elongation of the brain, and are spread over ever)
part of  the  body  endoAved  with  sensibility, by  innumerable filaments.
Ten pair  of nerves issue from the brain itself, and thirty from the spinal
marrow.  Those that go to the organs of sense  are  considerably larger
than the rest, and are in part divested of their  outer covering.
  Whether an immaterial and invisible Being  can positively be said to
exist in any place, it might appear presumptuous to determine; but it is a
prevailing opinion in physiology, that the  brain is the seat of the soul; and
the pineal gland, hi the penetralia of the brain, has been assigned as the sa-
cred mansion of this immortal inhabitant.   Human vision can discover no
signs to confirm this  opinion;  but  the  man Avould be blind,  and utterly
void of  understanding,  who  could not trace  through  the Avhole of the
animal system the most evident  marks of divine intelligence  and wis-
dom;  of intelligence which  excites admiration,  and of wisdom  beyond
conception.
  The  wonderful contrivance exhibited in the  human frame is, if pos-
sible,  still more manifest from the curious formation of the eye and ear;
of Avhich  only a very imperfect idea could be conveyed by verbal de-
scription.   1 shall therefore not attempt to delineate  those admirable or-
gans: nor need I mention the construction of the limbs;  of the arms and
legs;  of the hands and feet;  so nicely united  Avith joints, and so happily
supplied Avith muscles and tendons, with  ligaments and nerves, that they
are adapted to all the various  purposes of convenience and utility in mo-
tion.
  I shall conclude this imperfect sketch of the human body with a brief
account of digestion, that important  process in the animal economy, by
means of Avhich  the continual  and unavoidable waste of the constitution
is regularly supplied.
  The aliment being received into the mouth, the first operation it un-
dergoes is to be masticated by  the action of the teeth and several  muscles.
This mastication is of a greater moment than is generally  imagined; and
the good  effects of  it  are further promoted  by  mixing with the food
a quantity of saliva,  discharged from  the  glands  of the mouth, and
which is  greatly conducive  to  digestion.    When  the food is  carried
doAvn the  gullet  into  the  stomach, it there   meets  Avith an addi-
tional supply of juices, called the gastric juices, of a nature yet  more
efficacious  than  the former, besides a  small portion  of bile.    Dur-
ing its  continuance  in  the  stomach,  it  experiences  the  effects of
heat  and muscular  action,  from the coats of that  organ, and  the mo-
tion and  Avarmth  of the surrounding parts.   It thence passes  out gra-
dually by the  right orifice of the  stomach, and there  meets  with an 
INTRODUCTION.
XXV
 additional quantity of bile from  the gall-bladder and liver; besides the
 pancreatic juice, or that of the  sweet-bread, of a nature similar to the
 saliva, but rather more thick, and the fluids separated by the intestines.
 It now receives the action of the bowels, or the peristaltic motion,  by
 which they churn, as it were, the Avhole mass, minutely mixing together
 the food, and the  different  juices,  collected in the  passage from the
 mouth.   A fluid is noAV produced called chyle, which is separated from
 the grosser materials, and taken up by a set of extremely, small absor-
 bent vessels, called lacteals.   These have their origin in the inner coat
 of the intestines, and, passing thence,  discharge themselves  into a  duct
 named the receptacle of the  chyle, Avhence this fluid proceeds along the
 thoracic* duct,  Avhich terminates in the left subclavian! vein.  In the
 passage from the intestines to the receptacle, there is a number of glands,
 which separate a watery liquid,  for the purpose of giving the chyle  a
 thinner consistence.   To prevent the  chyle from falling back in its pro-
 gress through the lacteals, the construction of these  vessels is admirably
 contrived.  They are  furnished with a number of valves,  which open
 only fonvards, and are shut by any fluid  pressing backwards.  From the
 subclavian vein, the chyle is poured into the blood, and thence imme-
 diately thrown into the right auricle  and ventricle! of the heart;  from
 which, now mixed Avith the  blood, it  passes into the lungs.  It under-
 goes in that organ a considerable change from  the act of respiration.
 From the lungs it proceeds through the pulmonary vein to the left auri-
 cle of the heart, and then into the left ventricle:  Avhence, at last endow-
 ed with all the qualities of blood, it passes into the aorta, and is diffused
 universally through the frame; the wants of which it is fitted to supply
 by the addition of nourishing particles.   Is it possible to contemplate
 this admirable mechanism Avithout breaking forth in the exclamation of
 the  Psalmist,  that  " we are  wonderfully made?"   I  may  justly add,
 that, considering the great variety of  Avays in which  the human  body
 may be affected, both from without  and Avithin, with the necessity for
 the perpetual motion of the vital powers,  and  the  millions of vessels, in-
 visible to the naked eye, through which  the fluids ought to pass, it is a
 matter of real astonishment  that we should subsist a single day.   And
doubtless  it Avould be impossible, were not the machine constantly sus-
tained by  the same Almighty and Beneficent Being who formed it.
  * From thorax, the breast.
  f A term applied to any thing under the arm-pit or shoulder.
  * Two muscular bags, one on each side, are termed its auricles, from the
Latin signifying ears.
.1 
XXVI
        MEDICINES USED  IN  PRACTICE.

  MANY  Avho peruse the Domestic Medicine, have expressed a Avish
that the catalogue of medicines contained in that book should be more
extensive, and likeAvise that the dose of each article should be ascer-
tained, as they are often at a loss to knoAV how to administer even those
medicines, the names of Avhich they meet with in almost every medical
author.   To obviate this objection, and furnish a greater scope to those
who may wish to employ more articles than are contained in the Dis-
pensatory annexed to the above work, the  folloAving List  of Simples
and Compounds, taken from the most improved Dispensatories, is now
inserted.
  To prevent mistakes, the English name of every medicine is not only
used, but the different articles are arranged according to the order of
the English alphabet, and the smallest and largest dose placed opposite
to each article.   The doses indeed refer to adults, but may be  adapted
to different ages by attending to the rules laid down in the Introduction
to the Appendix, (page 420.)  Short cautions are occasionally inserted
under such articles as require to be used Avith care.
  Though  a greater variety of medicines is contained in this than in
any former  edition of the  Domestic Medicine, yet  the author Avould
advise those Avho peruse it, as far as possible, to adhere to simplicity in
practice.  Diseases are not cured by the multiplicity of medicines, but
by their proper application.   A feAV simples, judiciously administered,
and accompanied with  a proper regimen, will do more good, than a
farrago of medicines employed at random.
A LIST OF THE MEDICINES COMMONLY USED IN  PRACTICE, WITH

                     •THEIR PROPER  DOSES.
Acacia,  the  expressed juice,
Acid, the acetous
-----, muriatic
-----, nitrous, diluted
-----, vitriolic,  diluted
/Ether, vitriolic
jEthiops mineral
Aloes    -
Alum    ...     -
-----, burned
Amber, prepared
Ammoniac, gum
■---------,  milk of
Angelica, the root powdered
Anise, the seeds
Antimony
---------, calcined
          glass of
from
Asafoetida
-, milkf f
Asarum, to provoke sneezing
 1  scruple to
 1  scruple
10  drops
15  drops
15  drops
30  drops
10  grains
 5  grains
 6  grains
 3  grains
 \  drachm
 5  grains
 h  oz.
 \  drachm
10  grains
10  grains
  1  scruple
 \  grain
 6  grains
 half oz.
 3  grains
 1 drachm
 1 drachm
40 drops
40 drops
40 drops
 2 drachms
30 grains
30 grains
20 grains
12 grains
 1 drachm
30 grains
 1 ounce
\\ drachm
 1 drachm
 1 drachm
 1 drachm
 2 grains
 half a dra.
 1 ounce
 5 grains 
MEDICINES  USED  IN  PRACTICE.
XXVU
Balsam of capivi
------, Canadian
------, of Peru    ...
------, ofTolu
Bark, Peruvian, powder
Bears foot, poAvder
Benzoin, resin of
Benzoin, flowers of
Bistort, powder of the root
Blessed thistle     ...
----------■■—, expressed juice of
Bole Armenian    ...
----, French    -
Borax    -
Broom, ashes of the tops
Burdock, powder of the root
Caiomel      -
Camphor                •
Canella alba, powder of
Cautharides    -    .     -    -
Cardamoms    -
CaraAvay seed    -
Cascarilla bark   -
Cassia, the pulp    #
Castor.....
Catechu     -
Camomile, in powder
Chalk    .....
Cinnamon     -
Colocynth     -
Columbo     -
Confection, aromatic
-------—, opiate
Crabs claAvs, prepared
Conserve of roses
—------, of squills
---------, of arum
Contrayerva
Coriander seed
Cowhage, the spiculae of one pod
   mixed with honey or molasses.
 Dandelion, expressed juice
Decoction of hartshorn, half a pint
   repeated as often as necessary.
______, of broom, 1 oz. to a pint of
   water, to be taken by tea-cupsful.
------of Peruvian bark
------of the inner bark of the elm
------of sarsaparilla
                    compound
from 20 drops   to   60 drops
	
	
2 scruples	2 drachms
10 grains	20 grains
4 grains	20 grains
10 grains	20 grains
1 scruple	1 drachm
10 grains	1 drachm
2 dra.	2 ounces
10 grains	40 grains
10 grains	40 grains
1 scruple	1 drachm
10 grains	1 drachm
1 gr. to 3 gr	alterative
3 do. to 12 do. purgative	
2 grains to half a drachm	
1 scruple	2 drachms
\ grain	4 grains
5 grains	20 grains
10 grains	40 grains
10 grains	40 grains
2 dra.	1 oz.
8 grains	1 drachm
15 grains	30 grains
20 grains	1 drachm
20 grains	2 scruples
5 grains	1 drachm
10 grains	1 drachm
10 grains	1 drachm
10 grains	2 scruples
10 grains	2 scruples
10 grains	1 drachm
1 dra.	1 oz.
20 grains	30 grains
20 grains	1 flrachm
20 grains	2 scruples
15 grains	1 drachm
1 oz.
1 oz.
4 oz.
4 oz.
3 oz.
 4 oz.
16 oz. daily
16 oz. daily
— of guiacum, 3 drachms to
a pint ofVatcr.   A pint daily. 
XXVlli      MEDICINES  USED  IN  PRACTICE.
Electuary of cassia        -     -     from 1 dra.
----    ' of scammony                   20 grains
--------lenitive, or of senna     -      30 grains
Elixir of vitriol      ....    15 drops
Elecampane, poAfder of the root     -     20 grains
Extract of broom tops                     \ dra.
------of Peruvian bark    -    -       10 grains
------carcarilla    ....    10 grains
------camomile                        20 grains
------colocynth
------gentian       ...
■     — liquorice
—---— logwood
——— black hellebore
------jalap
———— guaiacum      -      -     -
----■— white poppies
------rue
------savin       ...
------senna        ...
Fern, powder of the root
Fennel seed
Fox glove, poAvder of the leaves
   or a drachm infused in a p'nt of
   boiling water, of which a dose is
     Should be administered with caution.
Galbanum         ...
Galls.....
Garlic, cloves  of
Gentian        -       -
Germander
Ginger      .....
Ginseng      ....
Guaiacum, gum-resin
Gum arabic       -      ...
----gamboge       ...
Hartshorn, prepared
--------, spirits of       -       -
--------, caustic in some mucila-
          ginous vehicle
--------, salt of
Hellebore, Avhite
-----:---, black     ...
Hemlock, should always be begun
   in very small doses, of one grain
   or less, and gradually increased
   as the constitution will bear.
Hiera picra
Honey of squills
---r— of roses      ...
to
   ft*
 5 grains
10 grains
 1 dra.
10 grains
 3 grains
10 grains
10 grains
 1 grain
10 grains
10 grains
10 grains
 \ dra.
20 grains
 i graiu

 1 oz.

10 grains
10 grains
No. 1.
10 grains
15 grains
 5 grains
20 grains
10 grains
15 grains
 2 grains
20 grains
10 drops

 5 drops

 2 grains
 1 grain
 5 grains
Hoffman's anodyne liquor
Jalap, powder
10 grains
10 grains
 1 drachm
20 drops
10 grains
  1  oz.
 1  drachm
 6  drachms
50  drops
 1  drachm
 1  drachm
 ^  drachm
 \  drachm
 1  drachm
25  grains
 £  drachm
 I  oz.
 &  drachm
10  grains
20  grains
20  grains
 5  grains
20  grains
30  grains
30  grains
  h.  oz.
  1  drachm
 3  grains
30 grains
20 grains
No. 6.
40 grains
 1 drachm
20 grains
30 grains
30 grains
 1 drachm
12 grains
 1 drachm
40 drops

25 drops

12 grains
 5 grains
10 grains
20 grains
40 grains
 2 drachms
60 drops
40 grains 
MEDICINES  USED  IN  PRACTICE.
XXIX
Infusion of Gentian, poAvder       -    from
-------of roses      ...     -
----■—of senna     -
Ipecacuanha       -
Iron, rust of
Iron ammoniated       -
Iron tartarised      -
—— salt of
Juniper, powder of the berries
Kino,  gum       -
Kermes, juice of
Lichen,  ash-coloured
------Icelandic, a strong decoction of
Lime-water
Lixivium, of tartar
 Linseed, an infusion of 1 ounce to a
   quart  of  water; may be  used at
   pleasure.
 Madder poAvder
 Mace       -
 Magnesia       -
 -------- calcined
 Manna       -
 Mastich, gum      -       -
 Mercury, crude
 ------ calcined
 ------ Avith chalk
 ------ corrosive sublimate
 ------ cinnabar of       -       -
 ------  yelloAV emetic, as sternutory
 Mezereon, decoct, to a pint of water
 Millepedes
 Musk       -
 Mustard seed      -
 Myrrh, gum      -
 Nitre, purified,
 Nutmeg       -      -       -     -
 Oil of Almons
 .---- Linseed       -
  ----  Castor
Olibanum
Onion, expressed juice of a pow-
  erful diuretic
Opium
Opopanax
Oxymel of colchicum
------ of  squills
Petoleum
Pills, aloetic
----of the gums
----mercurial
Pomegranate, powder of
1
  1  ounce  to
  2 ounces
  £  ounce
10 grains
 5 grains
 2 grains
 2 grains
 5  grain
20  grains
10  grains
 1  drachm
 3  grains
 1  ounce
 4  ounces
 15 drops
 \ drachm
10 grains
 \ drachm
%	ounce
10	grains
I	ounce
1 5 10 I 8 10	grain grains grain grains
]	grain
20	grains
1	grains drachm
10	grains
10	grains
6 i	grams ounce
 2 drachms
 5 grains

 | ounce

 \ grain  '
10 grains
 | drachm
 \ drachm
10 drops
10 gi'ains
10 grains
10 grains
20 grains
 3 ounces
 8 ounces
 2 ounces
30 grains
20 grains
10 grains
10 grains
 5 grains
 1 drachm
30 grains
  3 drachms
40 grains
  4  ounces
  8  ounces
 40 drops
 1 drachm
20 grains
 2 drachms
 2 ounces
30 grains
 4 ounces
 2 grains
30 grains
 \ grain
30 grains
 3 grains
 2  drachms
 2  drachms
40 grains
  1  ounce
  1  drachm
30 -grains
  \  drachm
 1  ounce
 1 ounce
30 grains

 2 ounces
 2 ounces
30 grains
 1 ounce
 2 drachms
 30 drops
30 grains
30 grains
20 grains
 1 drachm 
XXX        MEDICINES  USED  IN  I'RACTICE.
Powder antimonial      -      -     from
   May be taken according to the direc-
     tions for James' powder, with which
     it nearly coincides.
Powder of Contrayerva, compound
------of Chalk compound
------of Chalk compound, with opium
------of Ipecacuanha, compound, )
   or Dover's powder              )
Quassia        -        -        -
   Two drachms to a pint of water for
     a decoction.
Quince seeds, mucilage of, at pleasure,
   to obtund acrimony.
Rhubarb, poAvder     -     -      -
Resin, yellow
Rue powder
St. John's-Avort
Saffron      -
Sagapenum       -
Sal ammoniac
Salt, Epsom
■      Glauber
----Polychrest
----of Tartar
Sarsaparilla, powder of
Scammony
Seneca      -
Senna      ...
Soap
----  lees      .       .        -
Scurvy-grass, expressed juice
Snake root       -       -
Sorrel, juice of, depurated
Spirit of Mindererus
----  sweet, of vitriol
---------of nitre
----  of  sal ammoniac
.----■  ----  compound
---------foetid
Spirits, distilled
Spermaceti
Sponge, burned
Sulphur, flowers of
.     — precipitated, of antimony
Squill, dried poAvder
-----fresh
Syrup of poppies
-----of buckthorn
-----of ginger
Syrups in general
Tar water.  A pint daily.
3 grains   to   6 grains
15 grains
20  grains
10 grains
10  grains
  5  grains
 10  grains
  3  grains
 20  -grains
 20  grains
  5  grains
 10  grains
 10  grains
  2  drachms
  4  drachms
20  grains
 10  grains
20  grains
  5  grains
20  grains
20  grains
20  grains
 10  drops
  1  ounce
 20  grains
  4 ounces
  1  drachm
 15 drops
 15 drops
 15 drops
 | drachm
20 grains
20 grains
20 grains
 1 grain
 1 grain
 5 grains
 \ drachm
 1  drachm
 1  drachm
 1  drachm
30 grains
40 grains
40 grains
30 grains

30 grains
40 grains
20 grains
40 grains
 1 drachm
20 grains
30 grains
30 grains
l£ ounces
 2 ounces
 | ounce
30 grains
40 grains
10 graius
40 grains
40 grains
 \ ounce
30 drops
 4 ounces
40 grains
 8 ounces
  1 ounce
40 drops
40 drops
40 drops
 \ ounce
 1 drachm
 1 drachm
 1 drachm
 4 grains
 3 gi-ains
\b grains
 \ ounce
 2 drachms
 \ ounce
 2 drachms 
MEDICINES  USED  IN  PRACTICE.
Tartar, cream of    -
---—regenerated       -  -
-■       soluble
------emetic, alterative
-------------as emetic
Terra japonica
Tobaco, an infusion of, 1 drachm to
  a pint of Avater; should be admin-
  istered by table spoonfuls: strong-
  ly diuretic.
Tin, powder of     -
Tumeric      -    -
Turpentine, spirits of
Tincture of aloes
---------compound
---- of asafcetida
---- Benzoin, compound
——- of cantharides
---- of cardamoms
----  of castor
——•  of catechu
---- of Peruvian bark
----  of iron,  muriated
---- of Columbo
---- of Gentian, compound
---- guaiacum volatile
——  of black hellebore
----  of jalap
---- of lavander, compound
---- of myrrh
---- of opium
-              camphorated,
   or paregoric elixir
----  of rhubarb
----  of sena
----  of snake-root
----  of valerian
               volatile
from
 2  drachms
20  grains
 2  drachms
 |  grain
 1 grain
20 gi-ains
to
from
TormentiL poAvder of
Valerian powder of
Vinegar, distilled
------of squills
--------------as emetic
Vcrdigrease, violent emetic
Vitrol, Avhite, as a tonic
------------as a quickly  )
  operating emetic          $
        blue emetic
IIva ursi, in powder
Water-cress, expressed juice of
Water, the simple distilled, }
  may generally be given   S
 20 grains  to
 20 grains
 10 drops
  \ nunce
  \ drachm
  | drachm
 10 drops
 10 drops
  1 drachm
  1 drachm
  1 drachm
  1 drachm
 10 drops
  1 drachm
  1 drachm
  1 drachm
  1 scruple
  1 drachm
 20 drops
   1 scruple
 10 drops

   1 drachm

  £ ounce
  2 drachms
  1 drachm
  1 drachm
  1 drachm
 10 gi-ains
 20 grains
 2 drachms #
 10 drops
 \ ounce
 1 grain
 2 grains

20 grains

 1 grain
20 grains
 £  ounce

 \  ounce.
     XXXI

 1 ounce
 1 drachm
 1 ounce
 | grain
 3 grains
40 grains
 1 drachm
 1 drachm
30 drops
  1  ounce
  2 drachms
  2 drachms
 40 drops
 40 drops
  \ draclims
 1 g drachms
  2 draclims
  £ ounce
 60 drops
  3 drachms
  3 drachms
  3 drachms
  1  drachm
  § ounce
  2  drachms
  1  drachm
 40 drops

  3 drachms

  2  ounces
  1  ounce
  2 drachms
  3 drachms
  2 drachms
  1 drachm
  2 drachms
  1 ounce.
 50 drops
  1 ounce
  2 grains
  5 grains

  1  drachm

  3  grains
  1  drachm
  2 ounces

  3 or 4 oz. 
XXXU      MEDICINES  USED  IN  PRACTICE.
W7ormAvood, expressed juice           from jounce   to    2 ounces
White lead                              1 grain        3 grains
Wine, aloetic       ...       J ounce        1 ounce
----antimonial                         20 drops        2 drachms
----Ipecacuanha                        1 drachm     1 \ ounce
----Rhubard                           \ ounce        2 oinices 
                    PART  I.
                           ♦—
OF  THE  GENERAL CAUSES OF DISEASES.
                            CHAP.  I.

                         OF CHILDREN.

           THE better to trace diseases from their original causes, Ave
 shall take a view of the common treatment  of mankind in the state of
 infancy.  Iu this period of our lives, the foundations of a good or bad
 constitution are laid; it is therefore of importance, that parents be
 well acquainted with the various causes which may injure the health
 of their offspring.
    It appears from the annual registers of the dead, that almost 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 exami-
 nation, it will be found to be one of our own creating.  Were the death
 of infants a natural evil, other animals would be as liable to die young
 as man; but this we find is by no means the case.
    It may seem strange that  man, notwithstanding his superior reason,
 should fall so far short of other animals in the management of his young:
 Bat our surprise will soon cease, if we consider  that brutes,  guided by
 instinct, never err in this respect; while man, trusting solely to art,  is
 seldom right.   Were a catalogue of those infants who perish annually
 by art alone  exhibited to public view, it would astonish most people.
    If  parents are  above taking care of their children, others must be
 employed for that purpose:  these will always endeavour to recommend
 themselves by the appearance of extraordinary  skill and  address.  By
 this means such a number of unnecessary and destructive articles have
 been introduced into the diet, clothing, &c. of infants, that it is no won-
  der so many of them perish.
    Nothing can be more preposterous than a mother who thinks it below
 her to take care of her own child, or who is so ignorant as not to know
 what is proper to be done for it.   If we search Nature throughout, Aye
 cannot find a parallel to this.   Every other animal is the nurse of its
 own offspring, and they thrive accordingly.  Were the brutes to bring
  up their young by proxy, they would share the same fate  with those of
  the human species.
    AVe mean not, however, to impose it as a task upon every mother  to
  suckle her own child.   This, whatever  speculative writers may allege,
  is in  some cases impracticable,  and would inevitably prove destructive
  both to the mother and  child.   Women of delicate constitutions, sub-
 ject to hysteric fits, or other nervous affections, make very bad nurses:*
'^nd these complaints are now so common, that it is rare to find a woman
  of fashion free from them; such women, therefore, supposing them will-
  liu«',  are often unable to suckle  their own children.
    Almost every mother would be iu a condition to give suck, did man-

    * I have known an hysteric  woman kill her child, by being seized with a fit
  in the night. 
34
OF CHILDREN*
kind live agreeably to Nature;  but whoever considers how far many
mothers deviate from her dictates, will not be surprised to find some of.
them unable to perform that necessary office.  Mothers who do not eat
a sufficient quantity of solid food, nor enjoy the benefit of fresh air and
exercise, can neither have wholesome juices themselves, nor afford pro-
per nourishment to an infant.  Hence children who are suckled by deli-
cate women, either die young, or continue weak aud sickly all their lives.
  WThen Ave  say that mothers are not ahvays in a condition to suckle
their own children, we Avould not be understood as discouraging  that
practice.  Every mother who can, ought certainly to perform so tender'
and agreeable an office.*   But suppose it to be out of her power,  she
may, nevertheless,  be  of great service to her  child.   The business of
nursing is by no means confined to giving suck.  To a woman  who
abounds with milk, this is the easiest part of it.  Numberless other offices
are necessary for a child, which the mother ought at least to see done.
   A mother who abandons the fruit of her womb, as soon as it is born,
to the sole care of an hireling, hardly deserves that name.  A child by
being brought up under the mother's eye, not only secures her affection;
but may reap all the advantages of a parent's care, though  it be suckled
by another.   Hoav can a mother be better  employed  than in superin-
tending the nursery?   This is at once the most delightful and impor-
tant office; yet the most trivial business  or  insipid  amusements  are
often preferred to it!   A strong proof both of the bad  taste and wrong
education of modern females.
   It is indeed to be regretted,  that more care is not bestowed in teach-
ing the proper management of children to those whom Nature has de-
signed  for  mothers.    This, instead of being made the principal,  is
seldom considered as any part of female education.   Is it any wonder*
when females so educated come  to be mothers, that they should be quite
ignorant of the duties belonging to that character ? However strange it
may appear, it is certainly true, that many mothers, and those of fashion
too, are as ignorant, when they have brought a child into the world, of
Avhat is to be done for it, as the infant itself.  Indeed, the  most ignorant
of  the sex are generally reckoned most knowing  in the business of nur-
sing.  Hence sensible people become the dupes of ignorance and super-
stition ;  and the nursing of children, instead of being conducted by rea-
son, is the result of whim and caprice.f
  * Many advantages would arise to society, as well as to individuals, from
mothers suckling their own children.  It would prevent the temptation which
poor women are laid under of abandoning their children to suckle those of the
rich for the sake of gain ;  by which means society loses many of its most use-
ful members, and mothers become in some sense the murderers  of their own
offspring.  I am sure I speak within the truth when 1 say,  that not one in
twenty of those children live, who are thus abandoned by their mothers.   For
this reason no mother should be allowed to suckle another's child, till her own
is either dead, or fit to be weaned.  A regulation of this kind would save many-
lives among the poorer sort, and could do no hurt to the rich,  as most women
who make good nurses are able to suckle two children in succession upon the
same milk.
  f Tacitus, the celebrated Roman historian, complains greatly of the degen-
eracy of the Roman ladies  in his time,with regard to the care of their offspring.
lie sa\s that, in former times, the greatest women in Rome used to account it
tlieir chief glory to keep the house and attend their children ; but that now the
young infant was committed to the sole care of some poor Crecian vvench, or 
OF CHILDREN.
35
  Were the time that is generally spent by female3 in the acquisition of
trifling accomplishments,  employed  in  learning  hoAV to bring up their
children; Iioav to dress them so as not to hurt, cramp, or confine their
motions; how to feed them with wholesome and nourishing food; how
10 exercise tneir tender bodies so as best to promote  their growth and
strength: Avere these made the  objects  of female instniction, mankind
would derive the greatest advantages from it.  But Avhile the education
of females implies little more than Avhat relates to dress and public shoAv,
we have nothing to expect from them but iguorance even in the most
important concerns.
  Did mothers reflect on their  own importance, and lay it to heart, they
would embrace every opportunity of informing themselves of the duties
which they OAve to their infant offspring.  It is their province,  not only
to form the body, but also to give the mind its most early bias.  They
have it very much  iu their poAver to make men healthy, or valetudina-
ry, useful in life, or the pests of society.
   But the mother is not the only person concerned in the management
of children.  The father has an equal interest in their welfare, and ought
to assist  in every thing that respects either the improvement of the body
or mind.
   It is pity that the men should be so inattentive to this matter.  Their
negligence is one reason Avhy females know so little of it.  Women will
ever be  desirous to excel in such accomplishments as recommend them
to the other sex.  But men generally keep at such a distance from even
the smallest acquaintance with the  affairs  of the nursery,  that many
would reckon it an affront, were they  supposed to  know a ;r thing  of
them.  Not so, hoAvever, Avith the kennel or the  stables: a gentleman of
the first  rank is  not ashamed  to give directions concerning the manage-
ment of his dogs or horses, yet would blush Avere he surprised in perform-
ing  the same office for that being who derived its existence from him-
self, Avho is the heir of his fortunes, and the future hope of his country.
   Nor have physicians themselves been sufficiently attentive to the ma-
nagement of children:  this has been generally considered as the sole
province of old women, while  men of the first character in physic, have
refused to visit infants  even when sick.  Such  conduct in  the faculty
has not only caused this branch of medicine to be neglected, but has also
encouraged  the other sex to  assume an absolute title to prescribe for
children5 in  the most dangerous diseases.   The consequence  is,  that a
physician is  seldom called till the good  women have exhausted all their
skill; when his attendance can  only serve to divide the blame, and ap-
pease the disconsolate parents.
   Nurses should do all in their power to prevent diseases; but when a
 child is taken ill, some person of skill ought immediately to be consult-
 ed.   The diseases of children are generally acute,  and the least delay
is dangerous.                                    .
   Were physicians more attentive to the diseases ol infants, they would
 not only be better qualified to treat them properly when sick, but like-
 wise to  «ive useful directions  for their  management when  well.   The
 diseases'of children are by no means so difficult  to be understood as ma-
other menial servant—We are afraid, wherever luxury and effeminacy prevail,
there will be too much ground for this complaint. 
36                      OF  CHILDREN.
ny imagine.  It is true, children cannot tell their complaints;  but the
causes of them may be pretty certainly discovered by observing the symp-
toms, and putting proper questions to the uurses.   Besides, the diseases
of infants being less complicated, are easier cured than those of adults.*
  It is  really astonishing, that  so llxtle aneutlun should iu general be
paid to the preservation of infants.  What labour and expense are daily
bestowed  to prop an old tottering carcase for a  few years, Afhile thou-
sands of those who might be useful in life, perish without being  regard-
ed! Mankind are too apt to value things according to their present, not
their future usefulness.  Though this is of all others the most erroneous
method of estimation;  yet upon no other principle is it possible to ac-
count for the general indifference Avith respect to the death of infants.

                      Of Diseased Parents.
  One great source of  the diseases of children is, the unheai.thiness of
parents.   It Avould be as reasonable to expect a rich crop from a  bar-
ren soil, as that strong and healthy children should be born of parents
Avhose constitutions have been Avorn out w ith intemperance  and disease.
  An ingenious writerf observes, that  on the constitution of mothers de-
pends originally that of their offspring.  No one who believes this, will
be surprised, on a view  of the female  Avorld, to find diseases and death
so frequent among  children.   A delicate  female,  brought up Avithin
doors, an utter stranger  to exercise and open air, Avho lives on tea and
other slops, may bring a child into the Avorld but it will hardly be  fit to
live.  The first blast of disease will nip the tender plant in the bud :  or
should  it struggle through  a few years  existence,  its feeble  frame,
shaken with convulsions from every trivial cause, will be unable to per-
form the  common functions of life, and prove a burden to society.
   If to the delicacy of mothers, Ave add the irregular lives of fathers, we
shall see  further cause to believe that children are often hurt by the
constitution of their parent-.  A sickly frame may be originally induced
by hardships aud intemperance, but chiefly by the latter.  It is impossi-
ble that a course of vice should not spoil the best constitution:  and, did
the evil terminate here, it Avould be a just punishment  for the  folly of
the sulTerers; but when  once a  disease is contracted and rivetted in the
habit, it  is entailed on  posterity.  What  a dreadful inheritance is the
gout, the scurvy, or thp kind's  evil, to transmit to our offspring.!  how
happy  had it been for the heir  of many a great estate, had he been born
 a beggar, rather than to inherit  his father's fortunes at the expense  of in-
 heriting his  diseases!
   A person labouring under any incurable malady, ought not to marry.
 He  thereby not  only shortens his own  life,  but  transmits misery to
 others; but  when both parties  are deeply tainted with the scrophula,
 the scurvy, or the like,  the effects must still be worse.  If such  have
 any issue, they must be miserable indeed.   Want of attention  to these
  * The common opinion, that the diseases of infants are hard to discover and
difficult to cure,  has deterred many physicians from paying that attention to
them which they deserve.   1 can, however, from experience declare, that this
opinion is without foundation; and  that the diseases of infants are neither so
difficult to discover, nor so ill to cure, as those of adults.
  \ Rousseau.




                                                            >' 
OF  CHILDREN.
37
things, in forming connections for life, has rooted out more families than
plague, famine, or the sword; and as long as these connections are
formed from mercenary views, the evil will be continued.*
  In our matrimonial contracts, it is amazing so little regard is  had to
the health and form of the object.   Our sportsmen knoAv that the gene-
rous courser cannot be bred out of the foundered jade, nor the sagacious
spaniel out of  the snarling cur.   This is settled upon immutable laws.
The man Avho marries a woman of a sickly constitution, and descended
of unhealthy parents, Avhatever his vieAvs may be, cannot be said to act a
prudent part.   A  diseased Avoman may prove fertile; should this be the
case, the family must become an infirmary : Avhat prospect of happiness
the father of such a family has, we shall leave auy one to judge.f
  Such children as have the misfortune to be borne of diseased parents,
will require to  be nursed with greater care than others.   This is the only
Avay to make amends for the defects of constitution; and it will often go
a great length.  A healthy nurse,  wholesome air,  and sufficient  exer-
cise, will do wonders.   But when these are neglected, little is to be ex-
pected from any other quarter.  The defects of constitution cannot be
supplied by medicine.
   Those who inherit any family disease, ought to  be very circumspect
in their manner of living.   They  should consider Avell the nature  of
such diseases,  and guard against it by a proper regimen.   It is certain,
that family diseases have often, by proper care, been kept off for one
generation;  and there is reason to believe, that,  by  persisting  in the
same course, such diseases might at length be avholly eradicated.   This
is a  subject very little regarded, though of the  greatest importance.
Family constitutions are as capable of  improvement as family estates;
and the libertine who  impairs the one,  does greater injury to his poste-
rity, than the prodigal who squanders aAvay the other.

                 Of  the  Clothing  of Children.
   The clothing of  an infant is so simple a matter, that it is surprising
how any person should err in it; yet many children lose their lh'es, and
others are deformed, by inattention to this article.
   Nature knows  no use of clothes to an infant,  but to keep it  Avarm.
 All that is necessary for this purpose, is to Avrap it in a soft loose cover-
 ing.   Were a mother left to the dictates of Nature alone, she would
certainly pursue this course.  But the business of dressing an infant has
 long been out  of the hands of mothers, and has at  last become a secret
 which none but adepts pretend to understand.
   From the most early ages it has been thought necessary, that a woman
 in labour  should  have some person to attend her.  This intime became
 a business; and, as  in all others, those Avho Avere employed in it strove
 to  outdo one another in the different branches of their profession.  The
 dressing of a child came of course to be considered as the  midwifes

   * The Lacedemonians condemned their king Archidamus for having married
 a weak, puny woman; because, said they, instead of  propagating  a  race of
 heroes, you will fill the  throne with a progeny of changelings.
   | The Jews, by their laws, were, in certain cases, forbid to have any manner
 of commerce with the diseased; and indeed to this all wise legislators ought to
 have a special regard.  In some countries diseased persons have actually been
 forbid to marry.  This is an evil of a complicated kind, a natural deformity,
 and political mischief; and therefore requires a public consideration. 
38                     OF  CHILDREN.
 province,  who no doubt imagined, that the more  dexterity she could
 shew in this article, the more her skill would be admired.   Her attempts
 Avere seconded by the vanity of parents, who, too often desirous of
 mak'ng a shewr of the infant as soon as it was born,  were ambitious to
 have as much finery heaped upon it as possible.   Thus it came to  be
 thought as necessary for a midwife to excel in bracing and dressing  an
 infant,  as for a surgeon to be expert in applying bandages to  a broken
 limb; and the poor child, as soon as it came into the world, had as many
 rollers  and wrappers applied to  its body, as  if every bone  had  been
 fractured in the birth;  Avhile these were often so tight, as not only to
 gall and Around its tender frame, but even to obstruct the motion of the
 heart, lungs, and other organs necessary for life.
   In most parts of Britain, the practice of rolling children with so many
 bandages is now, in  some measure, laid aside; but it would  still  be a
 difficult task  to  persuade the generality of mankind, that the shape of
 an infant does not entirely depend on the care of the midAvife.  So far,
 however, are all her endeavours to mend the shape from being success-
 ful, that they constantly operate the contrary Avay,  and mankind become
 deformed in proportion to the means used to prevent it.  Hoav little de-
 formity of body is to be found among uncivilized nations ?  So little in-
 deed, that it is vulgarly believed they put all their deformed children to
 death.   The  truth is,  they hardly knoAv such a thing  as a  deformed
 child.   Neither should Ave,  if we followed their example.  Savage na-
 tions never think of manacling their children.  They alloAV  them the
 full use of eveiy organ, carry them abroad in the open air, wash  their
 bodies daily in cold Avater, &c.  By this management, their  children
 become so strong and hardy, that  by the time our puny infants get out
 of the nurse's arms, theirs are able to shift for themselves.*
   Among  brute animals,  no art is necessary to procure a fine shape.
 Though many of them are extremely delicate Avhen they come into the
 world, yet wc never find them grow crooked for want of sAvaddling bands.
 Is Nature less generous to the human kind ?  No:  but Ave take the bu-
 siness 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 easy and free from all pressure.   They
 cannot  indeed tell their complaints; but they can shew signs of paiu:
 and this they never fail to  do, by crying when hurt by their clothes.
 No sooner  are they freed from their bracings, than they seem pleased
 and happy: yet, strange infatuation! the moment they hold their peace,.
 they are again committed  to their chains.
   If we consider the body of an infant as a bundle of soft pipes, replen-
 ished with fluids in continual motion, the danger of pressure Avill appear
 iu the strongest light.   Nature, iu  order to make way for the growth of
 children, has formed their bodies soft and flexible; and lest they should
 receive any injury from pressure in the womb, has surrounded the foetus
 every where Avith  fluids.  This shews the care which Nature takes to
 prevent all unequal pressure on the bodies of infants, and to defend them
 against every thing that might in the least cramp or confine their motions.

  * A friend of mine, who was several years on the coast of Africa, tells me,
that the natives neither put any clothes upon their children, nor apply to their
bodies bandages of any kind, but lay them on a pallet, and suffer them to tum-
ble about at pleasure ; \ <:t they ru'e cdj straight, and seldom have any disease. 
6f children'.
39
  Even the bones of an infant are so soft and cartilaginous, that they
readily yield to the slightest pressure, and easily assume a bad shape
Avhich can never after be remedied.  Hence it  is, that so  many people
appear Avith high shoulders, crooked spines, and flat breasts, Avho were
as Avell proportioned at their births as  others, but had the misfortune to
be squeezed out of shape by the application of stays and bandages.
  Pressure, by obstructing the circulation, likewise prevents the equal
distribution of nourishment to the different parts of the body, by Avhich
means the  growth becomes unequal.   One  part grows too large, while
another remains too small;  and thus hi time the ivhole frame becomes dis-
proportionate and misshapen.   To this av e must add, that when a child is
cramped in its clothes, it naturally shrinks from the part that is hurt; and
by putting its body into unnatural postures, it becomes deformed by habit.
  Deformity of body may indeed proceed from weakness or disease; but
in general, it is the effect of improper clothing.  Nine -tenths, at  least, of
the deformity among mankind, must be imputed to this cause. A deform-
ed body is not only disagreeable to the eye, but by a bad figure both the
animal and vital functions must be impeded, and of course health impair-
ed.  Hence few people remarkably misshapen are strong or healthy.
  The neAV motions which commence at the birth, as the circulation of
the whole mass of blood through the lungs, respiration, the peristalic mo-
tion, &c.  afford another strong argument for keeping the body of an  in-
fant free from all pressure.   These organs, not having been accustomed
to move, are easily stopped;  but  Avhen this happens, death must ensue.
Hardly any method could  be devised more effectually  to stop these
motions, than bracing the body too tight with  rollers* and bandages.
Were these to be applied in the same  manner to the body of an adult
for an equal length of time, they would hardly fail to hurt the digestion
and make  him sick.  Hoav much more hurtful they must prove to  the
tender bodies of infants, Ave shall leave  anyone to judge.
  Whoever considers these things will  not be surprised,  that so many
children die of convulsions soon after the birth.   These fits are gene-
rally attributed to some inward cause; but in fact they oftener proceed
from our own imprudent conduct.  I have known a child seized with
convulsion-fits soon after the midwife had done swaddling it, Avho, upon
taking offthe  rollers and bandages, was immediately relieved, and never
had the disease afterwards.  Numerous examples of this might be given,
were they  necessary.
  It would be safer to fasten the clothes of  an infant  with strings than
pins, as these often gall and irritate their tender skins,  and occasion dis-
orders.  Pins have been found sticking above half an inch into the body
of a child, after it had died of convulsion fits, which in all probability
proceeded from that cause.
   Children are not only hurt by the tightness of their clothes,  but also
by  the quantity.   Every child has some degree of fever after the birth;
and if it lie loaded  with too many clothes, the fever must be increased.
But this is not all; the child is generally laid  in bed with the  mother,
who is often likewise  feverish; to which we may add the heat of the bed-
  * This is by no means inveighing against a thing that does not happen.  Iu
many parts of Britain at this day, a roller eight or ten feet in length, is applied
tightly round the child's body as soon as it is born. 
40
OF  CHILDREN.
chamber, the wines, and other heating things, too frequently given to
children immediately after the birth.   When all these are combined,
which does not seldom happen, they must increase the fever to such a
degree as av;11 endanger the life of the infant.
   The danger of keeping infants too hot will further appear, if we con-
sider that, after they have been for some time in the situation mentioned
above, they are often sent into the country to be nursed in a cold house.
Is it any wonder, if a child, from such a transision,  catches a mortal cold,
or contracts some other fatal disease ?  When an  infant is kept too hot,
its lungs, not being siifficiently expanded, are apt to remain weak and
flaccid for life; hence proceed coughs, consumptions, and other diseases
of the breast.
   It Avould answer little purpose to specify the particular species of dress
proper for an infant.   These will always vary in different countries, ac-
cording to custom and the humour of parents.   The great rule to be
observed is,  That a child have no more clothes than are necessary to keep
it warm, and that thei/ be quite easy for its body.
   Stays are the very bane of  infants.  A volume would not suffice to
point out all the bad effects of this ridiculous piece of dress both on
children and adults.   The madness in favour of stays seems however,
to be someAvhat abated; and it is to be hoped the world will, in time, be-
come wise enough to knoAv, that the human shape does not solely depend
upon Avhale-bone and bend leather.*
   I shall only add with  respect  to the clothes of children, that they
ought to be kept thoroughly clean.  Children perspire more than adults;
and if their clothes  be not frequently changed, they become very hurt-
ful.   Dirty clothes not only gall and fret the tender skins of infants, but
likewise occasion ill smells; and  Avhat is worse, tend to produce vermin
and cutaneous diseases.
   Cleanliness is not only agreeable to the eye, but tends greatly to pre-
serve the health of children.   It promotes the perspiration, and, by that
means, frees the body from superfluous humours, which, if retained, could
not fail to occasion diseases.   No mother or nurse can have any excuse
for allowing a child to be dirty.  Poverty may oblige her to give it coarse
clothes; but if she does not keep them clean, it must 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 sufficient to prevent some who
think themselves Aviser than Nature,  from attempting to bring up their
children Avithout her provision.  Nothing  can  show  the disposition
which  mankind  have to depart  from Nature  more than their endea-
vouring to bring up children without the breast.  The mother's milk,
or that of a healthy nurse, is unquestionably the best food for an infant.
Neither art nor nature can afford a proper substitute for  it.  Children
  * Stays made of bend leather are worn by all the women of lower  station in
many parts of England.
  I am sorry to understand, that there are still mothers mad enough to lace
their daughters very tight in order to improve their shape.  As reasoning would
be totally lost upon such people, I  shall*»eg leave just to ask them, Why there
are ten deformed women for one man ? and likewise to recommend to their pe-
rusal a short moral precept, which forbids us to deform the human body. 
OF CHILDREN.
41
may 6eem to  thrive for a few  months without the breast; but when
teething, the small-pox, and other diseases incident to childhood, come
on, they generally perish.
   A child, soon after the birth, shows an inclination to suck; and there
is  no reason why it should 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: besides, the first  milk that the child can squeeze out
of the breast answers the purpose of cleansing, better than all the drugs
in the apothecary's shop, and at the same time prevents inflammations
of the breast, fevers, and other diseases incident to mothers.
   It is strange how people came to think that the first thing given to a
child should  be drugs.   This is beginning  with medicine by times, and
no wonder if they generally end with it.   It sometimes happens, indeed,
that a child does not discharge the meconium so soon as could be Avish-
ed;  this has  induced physicians, in such cases, to give something  of  an
opening nature to cleanse the first passages.   Midwives have improved
upon this hint, and never fail to give syrups, oils, &c.% whether they be
necessary or not.  Cramming an infant  with such indigestible stuff as
soon as it is born, can hardly fail to make  it sick,  and is more likely to
occasion diseases than to prevent them.  Children a e sel ;om long after
the  birth without having a  passage both  by stool and  urine; though
these evacuations may be wanting for  some time without any danger.
But if children must have something before they be allowed the breast,
let it be a little thin water pap,  to which may be added an equal quan-
tity  of new milk; or rather water  alone,  with the addition of a  little
raw  sugar.  If this be given without any wines or spiceries, it will nei-
ther heat the blood, load the stomach, nor occasion gripes.
   Upon  the first sight of an infant, almost every person is  struck with
the idea of its being weak, feeble, and wanting support.   This naturally
suggests the need of cordials.  Accordingly wines are universally mixed
with the first food of children.   Nothing  cau be  more fallacious than
this  way of reasoning, or more hurtful to infants than the conduct found-
ed upon it.  Children require veiy little  food for some time after the
birth;  and what they receive should be  thin, weak, light, and of a cool-
ing quality.  A very small quantity of  wine is sufficient to heat and
inflame the blood of an infant; but every person conversant in these
matters must know, that most of the diseases of infants proceed from the
heat of their humours.
   If the mother or nurse has enough of milk, the child will need little
or no food before the third or fourth month.  It will  then be proper to
give it, once or twice a day,  a little of some food that is  easy of diges-
tion, as water pap, milk-pottage, weak broth with bread in it, and such
like.  This will ease the mother, will accustom the child by degrees to
take food, and will render the weaning  both less difficult and less dan-
gerous.  All great and  sudden  transitions are to be avoided in nursing.
For this purpose, the food of children ought not only to be simple, but
to resemble, as nearly as possible, the properties of milk.   Indeed milk
itself should make a principal part of their food,  not only before  they
are weaned, but for some time after.
   Next to milk, we would recommend good light bread.   Bread may
be given to a child as soon as it shews an inclination to chew; and it may
at Jill times  be allowed as much plain bread  as it will eat.  The very 
42'                     OF  CHILDREN*
chewing of bread will promote the cutting of the teeth, and the dischar&e
of saliva,  while  by mixing Avith the nurse's milk in the stomach, it will
afford  an  excellent  nourishment.   Children discover  an early inclina-
tion to chew whatever is put into their hands.   Parents observe the in-
clination,  but generally mistake the object.  Instead of giving the child
something which may at once  exercise its gums and afford it  nourish-
ment, they commonly put into its hands a piece of hard metal, or im-
penetrable coral.  A crust of bread is the best gum-stick.   It not only
ansAvers the purpose better than any thing else, but has the additional
properties of nourishing the child and carrying the saliva doAvn to the
stomach, which is too valuable a liquor to be lost.
   Bread, besides being used dry,  may be  many Avays prepared into
food for children.   One of the best methods is to boil it in Avater, after-
wards pouring the Avater off, and mixing with the bread a proper quan-
tity of neAv milk unboiled.   Milk is both more wholesome and nourish-
ing this way than boiled, and is less apt to occasion costiveness. For a
child farther advanced, bread may be mixed  in veal or chickeu broth,
made  into puddings, or the like.   Bread is a proper  food for children
at all times, provided it be plain, made of Avholesome grain, and well
fermented;  but  when enriched with fruits, sugars, or such things, it be-
comes very unwholesome.
   It is soon enough to allow children animal  food Avhen they have got
teeth to eat it.   They should never taste it till after they are Aveaned,
and even  then they ought to use it sparingly.   Indeed,  when  children
live wholly on vegetable  food, it is apt to sour on their stomachs; but,
on the other hand, too much flesh heats the body,  and occasions fevers
and other inflammatory diseases.  This plainly points out a  due  mix-
ture of animal and vegetable food as most proper for children.
   Few things prove more hurtful to infants than the common method of
sweetening  tlieir food.  It  entices them  to take  more than they ought
to do, which makes them groAv fat and bloated.   It is pretty certain, if
the food of children were quite plain, that they would never take  more
than enough.   Their excesses are entirely owing to nurses.   If a  child
be gorged with  food at all hours, and enticed  to take  it, by making it
sAveet and agreeable to the palate, is it any wTonder that  such a child
should in time be induced to crave more food  than it ought to have ?
   Children may be hurt by  too little a.s well as too much food.  After a
child is Aveaned, it ought  to be fed four or five times a day;  but should
never be  accustomed to eat in the night;  neither should  it have too
much at a time.   Children thrive best with small  quantities of food fre-
quently given.   This neither overloads the stomach nor hurts the diges-
tion, and  is certainly most agreeable to nature.
   Writers on nursing have inveighed with such vehemence against giv-
ing children too much food, that many parents, by endeavouring to shun
that error, have ruu into the opposite extreme, and ruined the constitu-
tions of their children.  But the error of pinching children in their food
is more hurtful than the other extreme.  Nature  has many Avaysof  re-
lieving herself when overcharged; but a child,  who is pinched  with
hunger, will never become  a strong or healthy man.  That errors' are
frequently committed on both sides, Ave are  ready to acknowledge; but
where one child is hurt by the quantity of its food, ten suffer from the
quality.   This is the principal evil, and claims our strictest  attention. 
OF CHILDREN.
43
   Many people imagine, that the food  which  they themselves  love,
cannot be bad for their children: but this notion  is very absurd.  In the
more advanced  periods of life  Ave often acquire an inclination for food,
which  when children we could not  endure.  Besides, there  are many
things that by habit may agree  very well with the stomach of a groAvu
person, which would be hurtful to  a child: as high-seasoned, salt, and
smoke-dried provisions, &c.   It would  also be improper to feed children
with fat  meat, strong broths, rich soups, or the  like.
   All strong liquors are hurtful to children.  Some  parents teach their
ehildren to guzzle ale, and other fermented liquors, at every  meal.  Such
a practice cannot fail to do mischief.  These children seldom escape the
violence of the  small-pox, measles, hooping-cough, or some  inflammatory
disorder.  Milk, water,  butter-milk, or whey, are the most proper for
children to  drink.   If they have any thing stronger, it may be fine small
beer, or a little  wine  mixed with  water.   The  stomach of  children can
digest well enough without the assistance of warm stimulants: besides, being
naturally hot, they are easily hurt by every thing  of a heating quality.
   Few  things  are more  hurtful to children than unripe fruits.   They
weaken  the powers of digestion, and sour and relax the stomach, by which
means it becomes a proper nest for insects.  Children indeed shew a great
inclination for fruit, and I am apt to believe, that if good ripe fruit were*
allowed  them in proper quantity, it Avould have no bad effects.  We never
find a natural inclination Avrong, if properly regulated.   Fruits are gen-
erally of a  cooling nature, and correct  the heat  and  acrimony of the hu-
mours.   This is what most children require;  only care should be taken
lest they exceed.   Indeed the best Avay to prevent children  from going to
excess in the use of  fruit, or eating that which  is bad, is to allow them a
proper quantity of Avhat i6 good.*
   Roots which contain a crude viscid juice should be sparingly given to
children.   They fill the body with gross  humours, and  tend  to produce
eruptive diseases.  This caution is peculiarly necessary for the poor ^ glad
to obtain at a small price what will fill the bellies of  their children, they
stuff them two or three times a  day with crude'vegetabies.  Children had
better eat a smaller quantity of food which yields a wholesome nourishment,
than be  crammed with what their digestive powers are unable properly to

   Butter ought likeAvise to be sparingly given to children. It both relaxes
the stomach, and  produces gross humours.  Indeed,  most things that are
fat or oily have this effect.  Butter when salted becomes still more hurtful.
Instead  of butter, so liberally given to  children in most parts of Britain,
we would recommend honey.  Honey is not only wholesome, but cooling,
cleansing, and tends to sweeten the humours.   Children who eat honey
are seldom troubled  with worms: they are also less subject  to cutaneous
diseases, as itch, scabbed head, &c.
   Many persons err in thinking that the diet of children ought to be al-
together moist.  When children live entirely upon slops, it  relaxes their
ed for:
Children are always sickly in the fruit season, which may be thus account-
>r : Two-thirds of the fruit which comes to market in this country is really
nnriDe • and children not being in a condition to judge for themselves, eat what-
ever thev can lay their hands upon, which of.tn proves little better than poison
to their tender bowels.  Servants, and others who have the care of children,
should be strictly forbid to give them any fruit without the knowledge of then-
par cots. 
44
OF CHILDREN.
solids, renders them weak, and disuses them to thc'rickcls, scrophula, and
other glandular disorders.   Relaxation is one of the most general  causes
of the diseases c  children.  Every thing therefore  which tends to un-
brace their soiids, ought to be carefully avoided.
  We v ould uot be  understood by these observations as confining chil-
dren to  any particular kind of food.  Their diet may be frequently va-
ried, provided always that sufficient regaru be had to simplicity.

                 Of the Exercise of Children.
  Of all the  causes which cons,are to render the life of nnn short and
miserable,  none have greater  influence  thau the want of  proper Exer-
cise: healthy parents, Avholesome food, and  proper  clothing, will avail
little, where exercise is neglected.  Sufficient exercise will make up for
several defects in nursing;  but nothing can supply the want of it.  It is
absolutely necessaiy to the health, the growth, and the strength of children.
  The desire of exercise is coeval Avith life itself.   Were this principle
attended to, many diseases might be  prevented.   But, while indolence
and  sedentary employments prevent two-thirds of mankind from either
taking sufficient exercise themselves, or giving it to their children, what
have we to expect but diseases and  deformity among their  offspring ?
The rickets,  so destructive to children, never appeared in  Britain till
manufactures began to flourish, and people, attracted by the  love of gain,
left the  country to folloAv sedentary employments in great  towns.  It is
amongst these people that this disease  chiefly prevails, and  not only de-
forms but kills many of tlieir offspring.
  The conduct of other young animals shews the propriety of giving ex-
ercise to children.  Every other animal makes use of its organs of motion
as sotm as it can, aud many of  them, even when under no necessity  of
moving  in quest of food,  cannot be restrained  without force.  This is
evidently the  case Avith the calf, the lamb, and most other young animals.
If these creatures were not permitted to frisk about and take exercise,
they Avould soon die  or become diseased.  The same inclination  appears
very earl)  in the human species; but as they are not able to take exercise
themselves, it is the business of their parents and nurses to assist them.
  Children may be exercised various Avays.  The  best method, Avhile
they are light, is to carry them about in the nurse's arms.*   This gives
the nurse an opportunity of talking to the child, and of pointing out every
thing that may please and delight its  fancy.  Besides, it is  much safer
thau  sAvinging an infant in a  machine, or leaving it to the care of such
as are not fit to take care of themselves.   Nothing can be more absurd
than to set one child to keep another; this conduct  has proved fatal to
many infants, and has rendered others miserable for life.
  When children  begin to walk, the safest and best method of  leading
them about is  by the hands.   The common Avay^of sAvinging them  in
leading strings, fixed to their backs, has several bad consequences.   It
makes them throw their  bodies forward,  and press  Avith their Avhole
weight upon the  stomach  and breast;  by this  means the breathing ia
obstructed, the breast flattened, and the bowels compressed; Avhichnmst

  * The nurse ought to be careful to keep the child in a proper position ; as de-
formity is often the consequence of inattention to this circumstance.  Its situa-
tion ought also to be frequently changed  I have known a child's leg  bent all
on one side, by the nurse carrying it constanly on one arm. 
OF  CHILDREN.
45
hurt the digestion,  and occasion consumptions  of the lungs, and other
diseases.
  It is a common notion, that if children are set  upon their feet too soon,
their legs will become crooked. There is reason to believe, that the very
reverse of this is true.   Every member acquires strength  in proportion
as it is exercised.   The limbs of children are weak indeed, but their bo-
dies are proportionably light;  and had they  skill to  direct themselves,
they would soon be able to support their  own  weight.  Who ever beard
of any other animal that became crooked by using its legs too soon ?  In-
deed, if a child is not  permitted to make any use of its  legs till a con-
siderable time after the birth, and be then set upon them with its whole
Aveight at  once,  there may be some danger; but this proceeds entirely
from the child's not having been accustomed to  use its legs from the be-
ginning.
  Mothers of the poorer sort think they are great gainers by making
their children lie or sit while they themselves work.  In  this  they  are
greatly mistaken.  By neglecting to give their children exercise, they
are obliged to keep them a long time before they can do any thing for
themselves,  and to spend  more on  medicine than would  have paid for
proper care.
  To take care of their children, is the most useful business in which
even the poor can be employed: but alas! it is not always in their poAver.
Poverty often obliges them to neglect their offspring in order to procure
the necessaries of life. Whenthisis the case, it becomes the interest as Avel I
as the duty of the public to assist them. Ten thousand times more benefit
would accrue to the state, by enabling the poor to bring  up  their oavo
children, than from all the hospitals* that ever can  be erected for  that
purpose.
  Whoever considers the structure of the human body will soon be con-
vinced of the necessity of exercise for the health of children.  The bo-
dy is composed of an infinite  number of tubes,Avhose fluids  cannot  be
pushed on Avithout the action and pressure of the muscles.   But, if  the
fluids remain inactive, obstructions must happen, and the humours will
of course be vitiated, which cannot fail to occasion diseases.  Nature
has furnished both the vessels which carry the blood and lymph with nu-
merous valves, in order that the action of every muscle might push  for-
ward their contents; but without action, this admirable contrivance can
have no effect.    This part  of  the animal economy proves to a demon-
stration the necessity of exercise for the preservation of health.
  Arguments to shew  the importance of exercise might be drawn from
every part of the animal economy;  Avithout  exercise, the circulation of
the blood cannot be properly carried on, nor the different secretions duly
performed; without exercise, the fluids cannot be properly prepared, nor
the solids rendered strong or firm.  The action  of the heart, the motion
of the lungs, and all the vital functions are greatly assisted by exercise.
  »"lf it were made the interest of the poor to keep their children alive, we
should lose very  few of them. A small premium given annually to each poor
family, for every child they had alive at the year's end, would save more infant
lives than if the whole revenue of the nation were expended on hospitals for this
purpose.  This would make the poor esteem fertility a blessing; whereas maiw
of them think it the greatest curse Uiat can befal them; and in place of wisli^
intr their children to live, so far does poverty get the  better of natural affection,
that they are often very happy when they die. 
46
OF  CHILDREN.
 But to point out the manner in which  these  effects are produced, would
 lead us further into the economy of the human body, than most of those
 for Avhom this treatise is intended Avould be able  to  follow.  We shall
 therefore only add, that, when exercise is neglected, none of the animal
 functions can be duly performed; and when that is the  case, the whole
 constitution must go to Avreck.
   A good constitution ought certainly to be our first object in the man-
 agement of children.  It lays a foundation for their being useful and hap*
 py in life: and whoever neglects it, not only fails in his duty to his off-
 spring, but to society.
   One  very common  error of parents, by Avhioh they hurt the constitu-
 tions of their children, is the sending them too young to school.   This is
 often done solely to prevent trouble.   When the child  is at school  he
 needs no keeper.   Thus the schoolmaster is  made the nurse; and the
 poor child is fixed to a seat seven or eight hours a-day, which time ought
 to be spent  in exercise and diversions.   Sitting so long cannot fail to
 produce the Avorst effects upon the body:  nor is the  mind less injured.
   Early application weakens the faculties, and often  fixes in the mind
 an aversion to books, Avhich continues for life.*
   But suppose this Avere the Avay to make children scholars, it certainly
 ought uot to be done at the expense of their constitutions.   Our  ances-
 tors, Avho seldom went to school very young, Avere not  less learned than
 Ave.   But we  imagine the boys education will be quite marred,  unless he
 be carried to school in his nurse's amis.  No Avonder if such hot-bed
 plants seldom become either scholars or men!
  Notonly the confinement of children in public schools, but their num-
 ber, often proves hurtful.    Children are much injured by being kept in
 crowds Avithin doors; their  breathing not only renders the place unwhole-
 some, but if any one of them happens to be diseased, the rest catch the
 infection. A single child has been often knoAvn to communicate the bloody
 flux, the hooping cough, the itch, or other disease, to almost every indivi-
 vidual iu a numerous school.
   But, if fashion must prevail,  and  infants are to be sent to school, Ave
 would recommend it to teachers, as they value the  interests of  society,
 not to confine them tAvo long at  a time, but alloAV them to run about and
 play at such active diversions as may promote their groAvth, and strengthen
 their constitutions.   Were boys, instead of being whipped for stealing an
 hour to  run, ride, swim, or  the like, encouraged to employ a proper part
 of their time in these manly and useful exercises, it Avould have many ex-
 cellent effects.
   It would be  of great service to boys, if, at a proper age,  they  were
 taught the military exercise.  This Avould increase their strength, inspire
 them with courage, and Avhen their country called  for  their assistance,
 would enable them to act in her defence, without being obliged to under-
 go a tedious and troublesome course of instructions, at a time when they
 are less fit to learn new motions, gestures, &c.f
  * It is undoubtedly the duty of parents to instruct their children, at least till
 they are of an age proper to take some care of themselves.  This would tend
 much to confirm the ties of parental tenderness  and filial affection, of the want
 of which there  are at present so many deplorable instances.  Though few fa-
thers have time to instruct their children,  yet most mothers have ; and  surely
 they cannot be better employed.
  ■\ I am happy to find that the masters of academies now begin to put in prac-
 tice this advice.  E^ch of them ought to keep a drill sergeant for teaching the 
OF  CHILDREN.
47
  An effeminate education will infallibly spoil the best natural constitu-
tion ;  and if boys are brought up in a more delicate manner thau even
girls ought to be, they will never be men.
  Nor is the common education of girls less hurtful to the constitution
than that of boys.   Miss is set down to her frame before she can put on
her clothes;  and is taught to believe, that to excel at the needle is the
only thing that can entitle her to general esteem.   It is  unnecessary
here to insist upon the dangerous consequences of obliging girls to sit
too much.   They are pretty well knowu,  and  are  too often  felt  at a
certain time of life.  But supposing this critical period to be got over,
greater dangers still aAvait them Avhen they come to be mothers.  Wo-
men who have been early accustomed to a sedentary life, generally run
great  hazard in  child-bed;  Avhile  those who have  been used to romp
about, and take sufficient exercise,  are seldom in any danger.
   One hardly meets Avith a girl Avho can at the same time boast of early
performances by the needle, and a good constitution.   Close and early
confinement generally occasions indigestions, head-achs, pale complec-
tions, pain of the stomach, loss of appetite, coughs, consumptions of the
lungs, and deformity of body.   The last  of these  indeed is not to be
Avondered at, considering the awkward postures in Avhich girls sit at
many kinds of aeedle-work,  and  the  delicate flexible state of their
bodies in the early periods of life.
   Would mothers, instead of having their daughters instructed in many
trifling accomplishments, employ them in plain work and house-vifery,
and allow them sufficient exercise in the open air, they w ould both make.
them more healthy mothers, and more useful members of society.   I am
no enemy to genteel accomplishment, but Avould have them only consi-
dered as secondary, and always disregarded when they impair the 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 Avere so employed as not to hurt tlieu- health or growth: but, Avhen
these suffer, society, instead of being benefitted, is a real loser by  their
 labour.  There are few  employments, except sedentary ones, by Avhich
children can earn a livelihood; and if they be set to these  too soon,  it
ruins their constitutions.  Thus, by gaining a few years from childhood,
 Ave generally lose twice as many in the latter period of life, and  even
 render the person less useful while  he does live.
   In order to  be satisfied of the truth of this observation, we need only
look into the great manufacturing towns,  where avc shall find a  puny
 degenerate race of people, weak and sickly all their lives, seldom ex-
 ceeding the middle period of life ; or if  they do, being  unfit for  busi-
 ness,  they  become a burden to society.   Thus arts and manufactures,
 though they may increase the riches of  a country, are  by no means
 favourable to the health of its inhabitants.  Good   policy would there-
 fore require, that such people as labour during life, should not be set
 too early to work.  Every person conversant  in the breed of horses,
 or other working animals, knows,  that if they be set to hard labour too
 soon, they never  will  turn  out to  advantage.  This is  equally true
 with respect to the human species.   Weakly children should always be
 put apprentices to trades which require their being mostly out  of doors.

 boys the military ewrcise.  This, besides contributing to their health and
 vigour of body, would have many other happy effects. 
48
OF CHILDREN.
        There  are nevertheless various Avays of cmplo)ing young people
 ,    without hurting their  health.   The easier parts  of  gardening,  hits
A   baudry, or any business carried on without doors, are  most proper.
     These are employments which most young people are  fond of, and
     some parts of them may ahvays  be adapted to their age, taste, aud
     strength.*
        Such parents, hoAvever, as are under the necessity of employing their
     children within doors,  ought to allow them sufficient time for active di-
     versions without.  This  iould both encourage  them to do more work,
     and prevent their constitutions from  being hurt.
        Some imagine, that exercise withiu doors is sufficient;  but  they are
     gre>tly mistaken.   One hour spent  in running, or any other exercise
     without doors, is worth ten within.  When children cannot go abroad,
     they may iudeed.be exercised at home.  The best method  of doing this,
     is to make them run about in a large room, or dance.  This last kind of
     exercise, if not carried to excess, is of excellent service to  young peo-
     ple.   It cheers the spirits, promotes perspiration, strengthens the limbs,
     &c.   I knoAV an eminent physician Avho used to say, that  he made his
     ch ldren dance, instead of giving them physic.   It were  Avell if more
     people followed his example.
        (The cold bath may be considered as an aid to exercise.   By it the
     body is braced and strengthened, the circulation and secretions promo-
     ted, and, were it conducted with prudence, many diseases, as the rickets,
     scrophula, &c. might thereby be prevented.  The  ancients, Avho took
     every method to render children hardy and robust,  were no strangers  to
     the use of the cold bath; and, if we may credit report, the practice  of
     immersing children daily in cold water must have been very common
     among our ancestors.
        The greatest objection to the use  of  the cold bath arises  from the
     superstitious  prejudices of nurses.  These are often so strong,  that it is
     impossible to bring them to make a proper use of it.   I  have known
     some  of them who would not dry a child's skin after bathing it, lest  it
     should destroy the effects of the water.   Others Avill even put clothes
     dipt in water upon the  child, and either put it to bed, or suffer it to go
     about in that condition.  Some believe,  that the Avhole virtue of the
     Avater depends upon its  being dedicated  to a  particular  saint; while
     others place their confidence in a certain number of dips, as three, seven,
     nine, or the like; and the world could not persuade them, if  these do
     uot succeed, to try it a  little longer.   Thus, by the whims  of nurses,
     children lose the benefit of the cold bath,  and the hopes  of the physician
     from that  medicine are often frustrated.
        We ought not, hoAvever, entirely to set aside the cold bath, because
     some  nurses  make  a wrong  use of it.   Every child when in health,
     should at least have its extremeties daily  washed in cold water.   This
     is a partial use of the cold bath, aud is better  than none.  In winter
     this may suffice; but,  in the warm season, if a child  be relaxed, or
     seem  to have a tendency to  the rickets or scrophula,  its  Avhole body
     ought to be  frequently  immersed in cold  water.  Care however must
     be taken not to do this when the body is hot, or the  stomach full.  The
  * I have been told that in China, where the police is the best in the world,
all the children are employed in the easier part of gardening and husbandry ;
as weeding, gathering stones off the land, and such like. 
OF CHILDREN.
49
child should be dipped only once  at  a time, should be taken out  im-
mediately, and have its skin well  rubbed with a dry cloth.

    The  bad Effects  of unwholesome Air upon Children.
  FeAv things prove more destructive to children than  confined  or un-
Avholesome air.   This is one  reason why so few of those infants, who are
put into hospitals, or parish  workhouses, live.   These  places are gene-
rally crowded with old, sickly, and infirm people; by Avhich means the air
is rendered so extremely pernicious, that it becomes a poison to infants.
   Want of Avholesome air is likewise destructive  to many of the children
born  in great toAvns.  There the poorer sort of inhabitants live in low,
dirty, confined houses,  to which the fresh air has hardly any  access.
Though grown people, who are hardy and robust, may  live in such situ-
ations, yet they generally prove fatal to their offspring,  few of whom ar-
rive  at maturity, and those who do are weak and deformed.  As such
people are  not  in a condition to carry their children abroad into the
open  air, we must  lay our account  Avith  losing the  greater part of
them.  But the rich have not this excuse.   It is their business to see
that their children be daily carried abroad, and that they be kept in the
open air for a sufficient time.  This will always succeed better if the mo-
ther goes along Avith them.   Servants are often negligent in these matters,
and allow a child to sit or lie on the damp ground, instead of leading or
carrying  it about.  The mother  surely needs  air  as well as her chil-
dren ; and hoAV can she  be better employed than in attending them ?
   A veiy bad custom prevails of making children sleep in small apart-
ments, or crowding tAvo or three beds  in one chamber.   Instead  of this,
the  nursery ought always to be the  largest and best aired room in the
house. When  children are  confined in small  apartments, the air not
only becomes unAvholesome,  but  the  heat relaxes their solids, renders
them delicate, and disposes them to  colds and many other disorders.
Nor is the custom of wrapping them up too close in cradles less perni-
cious.  One would think that nurses were afraid lest children should suf-
fer by breathing free air, as many of them actually cover the child's face
while asleep, and others Avrap a covering over the Avhole cradle, by which
means the child is forced to breathe the same air over and over all the
time it sleeps.   Cradles indeed are on many accounts hurtful to children,
and it would be better if the use of them were  totally laid aside.*
   A child is generally laid to sleep Avith all its clothes on;  anct if a num-
ber of others are heaped above them, it must be over-heated; by which
means it cannot fail to catch cold  on  being taken out of the cradle,  and
  * It is amazing how children escape suffocation, considering the manner in
which they are often 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 be.' ged for a little free air to the poor babe ; but
though this indulgence was granted during my stay, I found it always on my
return in the same situation.  Death, as might be expected, s .on freed the in-
fant from all its miseries : but it was not in my power to free the minds of its
parents from those prejudices which proved fatal to their child
  I was very lately called to see an infant which was said to be expiring in con-
vulsion fits   1 desired the modier to strip the child, nndAVrap it in a loose co-
vering.  It had no more convulsion fits. 
50                      OF  CHILDREN.
exposed  to the open air Avith only its usual clothing, which  is too fre-
quently the case.
   Children who are kept within doors all day, aud sleep all night in
warm close apartments, may, Avith great propriety, be compared to plants,
nursed in a hot-house, instead of  the  open air.   Though  such  plants
may by this means be kept alive for some time, they will never arrive at
that degree  of strength, vigour, and magnitude, which they would have
acquired in the open air, nor  would they be able to bear it afterward?,
should they be exposed to it.
   Children brought up iu the country, who have been accustomed to open
air, should not be too early sent to great towns, where it is confined and
umvholesome.  This is frequently done Avith a  vieAV to forward their
education,  but  proves  very hurtful to  their health.   All schools and
seminaries of learning ought, if possible, to be so situated as to have fresh,
dry, wholesome air, aud should never  be too much crowded.
   Without entering into a detail of the particular advantages of whole-v
some air to cliildren, or of the bad consequences Avhich proceed from the
want of it,  I shall only observe,  that  of several thousands of children
which  have been under my care, 1 do not remember one instance of a
single child who contmued healthy in a close confined station; but have
often knoAvu the most obstinate diseases cured by removing  them from
such a situation to an open free air.

                           Of Nurses.
   It is not here  intended to lay down rules for the choice  of  nurses.
This Avould be  wasting  time.  Common sense will direct every one to
chuse a woman Avho is healthy, and has plenty of milk.*   If she be at
the same time cleanly, careful, and good natured, she can hardly fail to
make a proper nurse.f  After all,  hoAvever, the only certain proof of a
good nurse, is a healthy child upon her breast.  But, as the misconduct
of nurses often proves fatal to  children, it will be of importance to point
out a few of their most  baneful errors, in order to rouse the attention of
parents, and to  make them look more strictly into the conduct of those to
whom  they commit the care of their infant offspring.
   Though it admits of some  exceptions, yet Ave may lay it doAvn  as a
general rule, That every woman who nurses for hire should be carefully
looked after, otherwise she will not do her duty.  For this reason parents
ought always to have their children nursed under their OAvn eye, if pos-
ble; and Avhere this cannot  be done, they should  be extremely cir-

   * I have often known people, so imposed upon, as to give an infant to a nurse
to be suckled who had not one drop of milk in her breast.
   t Next of importance to a healthy, cleanly, and good-natured nurse, is her
diet—On this subject after a close  and lengtlw investigation, Dr. Cullen, con-
cludes.  " I allege it to be a matter of experience, that nurses living entirely,
or for the most part, upon vegetable aliment, afford a greater quantity of milk,
and of a more proper quality, than nurses livingupon much animal food.   This,
I venture to assert, from the observation of fifty years; during which time, I
have known innumerable  instances of the healthiest  children reared upon the
milk of nurses living entirely upon vegetable aliments; and I have known many
instances of children becoming diseased, by their being fed by the milk of nurses
who had changed their diet from entirely vegetaMe, to their taking in a quan-
tity of animal food.  Nay, I have known  instances of children's becoming dis-
ordered from a nurse's making a single meal, of an unusually large portion of
animal food.''                                                  a. c. 
                          OF  CHILDREN.                     51

cumspect in the choice  of those persons to Avhom they intrust them.  It
is folly to imagine that any woman, who abandons her oAvn child to suckle
another for the sake of gain, should feel all the affections of a parent to-
wards her nursling; yet so necessary are the affections in a nurse, that,
but for them, the human race Avould soon be extinct.
   One of  the most common faults of those Avho nurse for hire, is dosi  g
children  Avith stupefactives, or such things  as  lull them  asleep.  An in-
dolent nurse, Avho does not give  a child sufficient exercise in the open air
to make  it sleep,  and does not chuse to be disturbed by it hi the night, will
seldom fail to procure for it a dose of laudanum, diacodium, saffron, or
what answers the same  purpose, a dose of spirits, or other strong liquors.
These, though  they be certain poison  to infants,  are every  day adminis*
tered by many who bear the character of very good nurses.*
   A nurse who has not milk  enough is apt  to imagine that this defect
may be  supplied by giving the child Avines, cordial waters, or other strong
liquors.   This is an egregious mistake.  The  only  thing that has any
chance to supply the place of the nurse's milk, must be  somewhat nearly
of the same quality, as coav's milk, ass's milk, or beef-tea, with a little bread.
It never can be done by the help of strong liquors.   These,  instead of
nourishing an infant, never fail to produce the contrary effect.
   Children are  often  hurt by  nurses suffering them to  cry long and ve-
hemently.  This strains their tender bodies, and frequently occasions rup-
tures, inflammations of the throat, lungs, &c.   A child never continues to
cry long  without  some  cause,  which might  always be discovered by
proper attention; and  the  nurse w ho cau  hear an infant  cry till  it has
almost spent itself,  without endeavouring to please it,  must be  cruel in-
deed,  and is unworthy to  be intrusted with the care of an human crea-
ture.                                                      \
   Nurses who deal much in medicine are always to be suspected-  They
trust to it, and  neglect their duty.   I never knew a good nurse aMio had
her Godfrey's cordial, Daffy's elixirs, Oalby's carminative, &c. at hand.
Such generally imagine, that a  dose of medicine will make up for all de-
fects in food, air, exercise, and  cleanliness.   By errors of this kind, 1 will
venture to say, that one half of the children who die  annually in London
lose their livos.
   Allowing cliildren tocontiune long Avet, is another very pernicious cus-
tom of indolent nurses. * Thi§ re not only disagreeable, but galls and frets
the infant, aud, by relaxing the  solids, occasions scrophulas, rickets,  and
other diseases.   A dirty nurse is always to be Suspected.
   Natuie often attempts to free  the bodies of children from bad humours,
by throAviug them upon the skin:  by this means fevers and  other diseases
are prevented.   Nurses are apt to mistake such critical eruptions for an
itch, or  some  other infectious  disorder.   Accordingly they take  every
method to drive  them in.   In this Avay many children lose  their lives;
and no Avonder, as nature is opposed in the very method she takes to re-
lieve them.  It ought to be a rule, which every nurse  should observe,
never to stop any emption without proper advice, or being Avell assured that
it is not  of a critical natuie.  At any  rate, it is never to be done without
previous evacuations.

   *  If a mother on visiting her child at nurse finds it always asleep, I would ad-
vise her to remove it immediately  ; otherwise it will soon sleep its last. 
52      OF  THE  LABORIOUS,  THE  SEDENTARY,

   Loose stools is another method by which nature often prevents or carries
off the diseases of inf.nts.   If these proceed too far, no doubt they ought
to be checked;  but  this is never to be done Avithout the greatest caution.
Nurses, upon the first appearance of loose stools, frequently fly to the use
of astringents, or such things as  bind the body.  Hence inflammatory
fevers, and other fatal diseases,  are occasioned.   A dose of rhubarb, a
gentle vomit, or  some other evacuations, should always precede the use of
astringent medicines.
   One of the greatest faults of  nurses is, concealing the diseases of chil-
dren from their parents.   This they are extremely rer.dy to do, especially
Avhen the disease is the effect of their own  negligence.   Many instances
might be given of persons Avho have been rendered lame for life by a fall
from the nurse's arms, which, she through fear, concealed till the misfor-
tune was past cure.   Every parent who intrusts a nurse Avith the care of
a child, ought to give her the  strictest charge  not to conceal the most tri-
fling disorder or misfortune that may befal it.
   We can see no reason why a nurse, who conceals any  misfortune Avhich
happens to  a child under her care, till it loses its life, or limbs, should not
be punished.  A feAV examples of this Avould  save the  lives of many in-
fants; but as there is little reason to expect that it ever will be the case, Ave
Avould earnestly recommend it to all parents to look carefully after their
children, and not to trust so valuable a treasure entirely in  the hands of an
hireling.
'   No person ought to imagine these things unworthy of his attention.  On
the proper management of children depend not only their  health and use-
fulness  in life, but likewise the safety and prosperity of the state to which
they belong.   Effeminacy  ever  will prove the ruin of any state where it
prevails; and, Avhen its foundations are laid  in infancy, it can never after-
Avards be wholly eradicated.   Parents who love their offspring, and Avish
well to  their country, ought therefore, in the  management of their children,
to avoid every thing that may have a tendency to make them weak or ef-
feminate, and to take eveiy method in their power to render their constitu-
tions strong and hardy.

                            " By arts like these
            " Laconia nurs'd of old her hardy sons ;
            " And Rome's unconquer'd legions urff'd their way,
            " Unhurt, through every toil m«very  clime."   Armstrong.

                      •         »

                           CHAP. II.

  OF  THE LABORIOUS,  THE  SEDENTARY, AND THE
                           STUDIOUS.

          1 HAT men are exposed to particular diseases from the oc-
cupations which they follow,  is  a  fact well known;  but to remedy this
evil is a matter  of some difficulty.   Most people are under  the necessity
of following those employments to which they  have been  bred, whether
they be favourable to health or not.   For this reason, instead of inveigh-
ing, in a general way, as some authors have done, against  those  occu-
pations  wliich  are  hurtful  to  health,  Ave  shall endeavour to  point, 
AND  THE STUDIOUS.                 53
out the circumstances in each of them  from which the danger chiefly
arises, and to propose the most rational methods of preventing it.
   Chymists, founders, forgers, glass-makers and several other artists, are
hurt by the uiiAvholesome air which they are obliged to breathe.   This
air is not only loaded with the  noxious exhalations arising from metals
and minerals, but is so charged  with phlogiston as to be rendered  unfit
for expanding the lungs sufficiently, and answering the other important
purposes of respiration.   Hence proceed asthmas, coughs, and consump-
tions of the lungs, so incident to persons who follow these employments.
   To prevent such consequences, as far as possible, the places where
 these  occupations are carried  on, ought  to be  constructed in such a
 manner as to discharge the smoke and other exhalations, and admit a
 free current of fresh air.  Such artists ought never to continue too long
 at work;  and when they give over, they should suffer themselves 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 Avateiy
 liquors, while tlieir bodies are hot, nor to  indulge in raw fruits, sallads,
 or any thing that is cold^u the stomach.*
    Miners, and all Avho wOTk under ground, are likeAvise hurt by unwhole-
 some air.  The air, by its stagnation in  deep mines, not only loses  its
 proper spring and other qualities necessaiy for respiration, but is often
 loaded with such noxious exhalations as to become a most deadly poison.
    The tAvo kinds of air which prove most destructive  to miiiers, are
 what they call the fire damp, and the choice damp.  In both cases the air
Jjccomes  a poison  by  its  being  loaded  with phlogiston.  The danger
Wrom the former may be obviated by making it  explode before it accu-
 mulates 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 unwholesome air, but likeAvise by the
 particles of metal which adhere to their  skin, clothes, &c.   These are
 absorbed, or taken up into the body,  and  occasion palsies, vertigoes, and
 other nervous affections, which often prove fatal.  Fallopius observes,
  that those who work iu mines of mercury, seldom live  above three or
  four years.  Lead, and several other metals, are likewise very perni-
  cious to the health.                           t
    Miners ought never to go to work  fasting, nor to continue too long at
  work.   Their  food ought to be  nourishing,  and their liquor generous:
  nothing more certainly hurts  them  than  living too Ioav.  They  should
  by all means avoid costiveness.  This may either be done by chewing
  a little rhubarb, or taking a sufficient quantity  of sallad oil.  Oil  not
  only opens the body, but  sheathes and defends the intestines from  the
  ill effects of the metals.  All who work in mines or metals ought to wash
  carefully, and to  change  their clothes as soon as they give over work-
  ing.  Nothing would tend more to preserve  the health of such  people
  than a strict, and almost religious regard to cleanliness.
    Plumbers, painters, gilders,  smelters, makers  of white lead, and many
  others who work in metals,  are liable  to the  same diseases as miners;
  and ought to observe the same directions for avoiding them.
    TalloAV-chaudlers, boilers of oil, aud  all who work in putrid  animal
  • When persons heated with labour have drank cold water, they ought to
continue at work for some time after. 
54
OF THE  LABORIOUS,  THE  SEDENTARY,
 substances, are likeAvise liable to suffer from the unwholesome smells  or-
 effluvia of these bodies.  They ought to pay the same regard to clean-
 liness as miners; and when they are affected with nausea, sickness,  or
 indigestion, we would advise them  to take a \omit or gentle purge.
 Such substances ought always  to be manufactured as soon a9 possible.
 When long kept, they not only  become unwholesome to those who manu-
 facture them, but likewise to people who live in the  neighbourhood.
   It Avould greatly exceed the  limits of this part of our subject, to speci-
 fy the diseases peculiar to persons of every occupation; we shall there-
 fore consider mankind under the general classes of Laborious, Sedentary,
 and Studious.

                         The Laborious.

   Though those who follow laborious employments are in general the
 most healthy of mankind, yet  the nature of their occupations, and the
 places Avhere they  are  carried on,  expose  them more particularly  to
 some diseases.  Husbandmen, for example, are exposed to all the vicis-
 situdes of the Aveather,  Avhich,  in this country are often very great and
 sudden, and occasion colds, coughs,  quinsies, rheumatisms, fevers,  and
 other acute disorders.  They are  likewise forced  to  work hard,  and
 often to carry burdens above their strength, which, by overstraining the
 vessels, occasion asthmas, ruptures, pleurisies, etc.
   Those Avho labour Avithout doors are often afflicted with intermitting
 fevers or agues, occasioned by the frequent vicissitudes of heat and cold,
 poor living, bad water, sitting  or lying  on  the damp groujad, eveninm
 deAVs, night air, &c. to wrhich they are frequently exposed.            ^
   Such as bear heavy burdens, as porters, labourers,  &c. are obliged  to
 draAV in the air with much greater force, and also to keep their lungs
. distended with more violence  than  necessary for common respiration;
 by this means the tender vessels of  the  lungs  are overstretched, and
 often burst, insomuch that a spitting of blood or  fever ensues.  Hippo-
 crates mentions an instance to this purpose, of a man, who, upon a wager,
 carried an ass; but was soon after seized with a fever, a vomiting  of
 blood, and a rupture.
   Carrying heavy burdens is generally the effect of mere laziness, which
 prompts people to do at once what should be done at tAvice.   Sometimes
 it proceeds from vanity or emulation.  Hence it  is.  that the  strongest
 men are roost commonly hurt by heavy burdens, hard labour, or feats  of
 activity.  It is rare to find one who boasts of strength without a rupture,
 a spitting of blood, or some other disease, which he reaps as the fruit of
 his folly.  One would imagine  the daily instances we have of the fata!
 effects of carrying great weights, running, wrestling, and the like, would
be sufficient to prevent such practices.
   There are indeed some  employments which  necessarily  require  a
 great exertion of strength; as  porters, blacksmiths, carpenters, &c.
 None ought to follow these but men of strong body;  and they should
 never exert tlieir strength to the utmost, nor Avork too long.   When the
 muscles are violently strained, frequent rest is necessary, in order  that
 they may recover their tone; Avithout this, the strength and constitution
soon Avill be worn out, and a premature old age be induced.
   The  erysipelas,  or St. Anthony's fire, is a disease very incident to
 the laborious.  It is occasiooed by whatever gives a  sudden check to 
AND  THE  STUDIOUS.
55
<he perspiration, as drinking cold water when the body is Avarm, wet feet,
keeping on Avet clothes, sitting or lying on the damp ground, &c.   It is
impossible for those who labor without doors always to guard against these
inconveniences; but it is known from experience, that their ill consequen-
ces might often be  prevented by  proper care.
   The iliac passion, the cholic,  and other complaints of the bowels,  are
often occasioned by the same causes as the erysipelas; but they may like-
wise proceed  from flatulent and indigestible food.   Labourers generally
eat unfermeuted bread, made of  peas, beans, rye, and other Avindy ingre-
dients.   They also devour great quantities of unripe fruits, baked, stewed,
or raw, Avith various kinds of roots and herbs, upon which they often drink
sour milk, stale small beer, or the like.   Such a mixture cannot fail to  fill
the boAvels with wind, and occasion diseases of those parts.
   Inflammation, Avhitloes, and other diseases of the  extremities, are like'.
wise common among those Avho labour without  doors.   These diseases
are often attributed to venom, or some kind of poison: but they generally
proceed either from sudden heat after cold, or the contrary.  When labour-
ers, milk-m;>ids, &e. come from  the field, cold or wet, they run to the fire,
and often plunge their hands in warm Avater, by Avhich  means  the blood
aud other humours in those parts are suddenly expanded, and, the  vessels
not yielding so quickly, a strangulation happens, and an inflammation  or a
mortification ensues.
   When such persons come home cold, they ought  to keep at a distance
from the fire for some time, to Avash their hands in cold Avater, and  nib
them well auUi a dry cloth.   It sometimes happens, that  people are so be-
numbed with  cold, as to be quite deprived of the use of their limbs.  In
this case the only  remedy is to rub the  parts affected Avith snoAv, or Avhere
it cannot be had, Avith cold water.  If they be held near the fire, or plung-
ed into warm water, a mortification will generally ensue.
   Labourers in  the  hot season are apt to lie down and sleep in the sun.
 This practice is so dangerous, that they often aAvake in  a burning fever.
 These ardent fevers Avhich prove so fatal about the end of the summer
 and beginning of autumn, are frequently occasioned by this means.  When
 labourers leave off work, which  they ought always to do  duringthe heat of
 the day, they should go  home, or at least get under some cover where they
may repose themselves in safety.
   Many people follow  their employment in the fields from morning  till
 night, Avithout eating any thing.  This cannot fail to hurt  their  health.
 However homely their fare be, they ought to have it at regular times;  and
 the harder they Avork, the more frequently they should  eaL  If the  hu-
 mours be not  frequently replenished Avith fresh nourishment, they soon be-
 come  putrid, and produce fevers of the veiy worst kind.
   Many peasants are extremely careless with respect to what they eat or
 drink, and often,  through mere  indolence, use unwholesome food, when
 they might, for the same expense, have that Avhich is wholesome.  In some
 parts of "Britain, the peasants are two careless even to take the  trouble of
 dressing their own victuals.   Such people would live upon one meal a-
 day, inlndolence, rather than labour, though it Avere to  procure them the
greatest affluence.
   Fevers of a very bad kindareoften occasioned among labourers by poor
 Uvino-.  When  the body is not sufficiently nourished, the humours become
 vitiated, and the  solids  weak; from whence the most fatal consequences 
  56      6F  THE  LABORIOUS,  THE  SEDENTARY,

 ensue.  Poor  living is likewise productive of many of those cutaneous
 diseases so frequent among the  lower class of people.   It is remarkable
 that cattle, Avhen pinched in their food, are generally affected Avith diseases
 ol the skin, which seldom fail to disappear when they are put upon a good
 pasture.   This sIioavs how much a good state of the humours depends upon
. a sufficient quantity of proper nourishment.
    Poverty not only occasions, but aggravates, many of the diseases of the
 laborious.  Few of them have much foresight; and, if they had,  it is sel-
 dom in their power to save any thing.   They arc glad to make a shift  to
 live from day to day; and when any disease  overtakes  them, they arc
 miserable indeed.  Here the godlike virtue of charity ought always  to
 exert itself.  To relieve the  industrious poor in distress,  is  surely the
 most exalted act of religion and humanity.   They alone who are witnesses
 of those scenes of calamity, can form a notion of what numbers perish  in
 diseases, for want of proper assistance, and even for Avant of the neces-
 saries of life.
    Labourers are often hurt by a foolish emulation, Avhich prompts them to
 vie with one another, till they overheat themselves  to such a degree as  to
 occasion a fever, or even  to drop down dead.  Such as Avantonly throw
 aAvay their lives in this manner,  deserve  to be  looked upon iu no better
 light than self-murderers.
    The office of a soldier, in  time of Avar, may be ranked among the la-
 borious employments.  Soldiers suffer many hardships from the inclemen-
 cy of seasons, long marches, bad  provisions,  hunger, watching, unwhole-
 some climates, bad water, &c.  These occasion  fevers, fluxes, rheumatisms,
 and other fatal diseases, Avhich generally do  greater execution than the
 sword, especially when campaigns are continued too late iu the season.  A
 fcAv Aveeks of  cold rainy weather Avill often prove more fatal than an en-
 gagement.
    Those who have the command of armies should take care that their sol-
 diers be Avell clothed and well fed.  They  ought also to finish tlieir cam-
 paigns in due  season, and to provide their men  with dry and Avell-aired
 Avinter quarters.   These rules, taking care, at the same time,  to keep the
 sick at a proper distance from those in health, Avould tend greatly to pre-
 serve the lives of the soldiery.*
    Sailors may also be numbered among the laborious.   They  under-
 go great hardships  from  the  change of  climate, the violence of the

   * It is indeed to be regretted, that soldiers suffer not  less from indolence and
 intemperance in the time of peace, th.-n from hardships in time of war.  If men
 are idle they will be vicious.  It would therefore  be of great importance, could
 a scheme be formed for rendering the military, in times of peace, both more
 healthy and more useful.  These desirable objects might, in our opinion, be ob-
 tained, by employing them for some hours every  day, and advancing their pay
 accordingly.  By this means, idleness, the mother of vice, might be prevented,
 the price of labour lowered, public works,as harbours, canals, turnpike roads, &c.
 might be made  without hurting manufactures ; and soldiers might be enabled
 to  marry and bring up children.    A scheme of this kind might easily be con-
 ducted, so as not to depress the martial spirit, provided the men were only  to
 work four or five hours every day, and always to work without doors : no sol-
 diers should be suffered to work too long, or to follow any sedentarv employment.
 Sedentary employments render men weak and  effeminate, quite unfit for the
 hardships of war : whereas working for a few hours every day without  doors,
 would inure them to the weather, brace their nerves, and increase their strength
 and courage. 
                      AND THE STUDIOUS.                  57

weather, hard  labour,  bad provisions, &c.  SailorAk of so great im-
portance, that too much pains can never be bestoAvexHn pointing out the
means of preserving their lives.
   One great source of the diseases of sea-faring people is excess. When
they get on shore, after having  been long at sea, Avithout  regard to the
climate, or their oavu constitutions, they plunge headlong into all maimer
of riot, and often persist till a fever puts an end to their lives.  Thus
intemperance,  and not the  climate, is often the cause why so  many of
our brave sailors die on foreign coasts.  Such  people ought not to live
too low;  but they will find moderation  the best defence against fevers
and many other maladies.
   Sailors, when on duty,  cannot avoid sometimes getting Avet.  Wrheu
this happens, they should  change  their clothes as soon as they are re-
lieved, and take every method to restore the perspiration.   They should
not, in this case, make too free Avith spirits  or other strong liquors, but
should rather drink them diluted with warm Avater, and go immediately
to bed, where a sound sleep and gentle sweat would set all to rights.
   But the health  of sailors suffers most from unwholesome food.   The
constant use of salted provisions vitiates their  humours, and occasions
the scurvy, and other obstinate maladies.   It  is no  easy  matter to pre-
vent this disease in  long voyages; yet we cannot  help  thinking, that
much  might be done towards effecting so desirable  an end, were due
pains  bestowed for that purpose.  For example, various roots, greens,
and fruits, might be kept a long time at sea, as onions, potatoes, cabbages,
lemons, oranges,  tamarinds, apples, &c.   When  fruits cannot  be  kept,
the juices of them, either  fresh or fermented, may.   With these all the
drink, and  even the food of the ship's company, ought to be acidulated
in long voyages.
   Stale bread and beer likewise contribute to vitiate the humours. Flour jm
will keep for a long time on board, of which fresh bread might frequ§nt- ^^
ly be  made.  Malt too might be kept, and infused w ith boiling  water at**
any time.   This liquor, when drank even in  form of wort, is ATery whole-
some,  and is found to be an antidote against the  scurvy.   Small Avines
and cyder might  likeAvise  be plentifully laid in ; and should they turn
sour, they would still be useful as vinegar.  Vinegar is a great antidote
against diseases, and  should be used by all travellers, especially at sea.
It may either be mixed Avith the Avater they drink, or taken in their  food.
   Such animals as can be  kept alive, ought likewise to be carried on
board, as hens, ducks, pigs, &c.   Fresh broths made of portable soup,
and puddings made of peas or other vegetables, ought to be used plen-
tifully.  Many other things  will readily occur to people  conversant in
these matters,  which would tend to preserve the health of that brave
and useful set of men.'*
  • The celebrated Captain Cook, has shown how far, by proper care and atten-
tion, the diseases formerly so fatal to seamen may be prevented.  In a voyage
of three years and eighteen days, during which he was exposed to every cli-
mate, from the 52c north to the 71° of south latitude, of one hundred and
eighteen men, composing the ships company, he lost only one, who died of a
Phthisis Pulmonalis.  The principal means he used were, to preserve a strict at-
tention to  cleanliness, to procure abundance of vegetable and fresh provisions,
especially good water, and to allow his people sufficient time for rest. 
    58       OF THjpLABORIOTS,  THE SEDENTARV,

      We have reaso^^believe, if due attention were paid to the diet,  air,
    clothing, and above  all things to the cleanliness*  of sea-faring people,
    they Avould be the most healthy set of men in the world; but when these
    are  neglected, the very reverse will happen.
      The best  medical antidote that we can recommend to sailors or  sol-
    diers on foreign coasts, especially where dampness prevails, is the Peru-
    vian burk.   This  will often prevent fevers, and other fatal diseases.
    About a drachm of it may be chewred every day;  or if this should prove
    disagreeable, an  ounce of bark, with half an  ounce of  orange peel,  and
    two drachms of snake-root coarsely poAvdered, may be infused for two or
    three  days in an English quart of brandy, and half a wine-glass of  it
    taken tAvice or thrice a day, when the stomach is empty.  This has been
    found to  be an excellent antidote against fluxes, putrid, iutemiitting, and
    other fevers, in unhealthy climates.  It is uot material in what form this
    medicine is taken.   It may either be infused in  water, wine, or spirits, as
    recommended above,  or made into an elcctury with syrups  of lemons,
    oranges, or the like.

                             The Sedentary.
      Though nothing can be more contrary to the nature of man than a se-
    dentary life,  yet this class comprehends by far the greater part of the
    species.   Almost the whole female world,  and in manfacturing countries,
    the major part of the males, may be reckoned sedentary.f
      Agriculture, the first and most healthful of all employments, is now fol-
    loAvcd by few who are able to carry on any other business.   But those
    Avho imagine that the culture of the earth is not sufficient to employ all
    its  inhabitants, are greatly mistaken.   An ancient Roman, we are  told,
    could maintain his family from the produce of one acre of ground.   So
^k might a  modern Briton if he would be contented to live like a Roman.
    Ij^'s shows  what an immense increase of inhabitants Briton might admit
    of,  and all of them live by the culture of the ground.
      Agriculture is the great source of domestic riches.   Where it is  neg-
    lected, whatever wealth may be imported from  abroad, poverty and mi-
    sery will abound at home.   Such is,  and ever will be, the fluctuating
    state of trade and manufactures, that thousands of people may be in full
    employment to-day and in beggaiy to-morrow.   This  can never happen
    to those Avho cultivate the ground.  They can eat the fruit  of their  la-
    bour, and always by industry obtain, at least, the necessaries of life.
       Though sedentary employments are necessary, yet  there seems to be
    no  reason why any person should be  confined  for life to these alone.
    Were such employments intermixed with the more active  and laborious,
    they would never do hurt.   It is constant  confinement that  ruins the
    health.   A man may not be hurt by sitting five or six hours a-day; but
    if he is obliged to sit ten or tAvelve, he Avill toon become diseased.
  * A regulation on board the United States' Navy, requiring every individual,
at lean once a weei to wash their feet clean, is worthy of general attention, as a
means of preserving health.                                      a. e.
  f The appellation of sedentary has generally been given only to the studious;
wc can see no reason, however, for restricting it to them alone.  Many artificers
may, with as much propriety, be denominated sedentary as the studious, with
this particulur disadvantage, that they are often obliged to  sit in very awkward
postures, which the studious, need not do, Unless they please. 
AND  THE STUDIOUS.
59
   But it is not Avant of exercise alone Avhich hurts sedentary people;
they likewise  suffer from  the confined air which they breathe.   It  is
very common  to see ten or a dozeu tailors,* or stay-makers, for exam-
ple, croAvded into one small  apartment, where there is hardly room for
one person to  breathe  freely.  In this situation they generally continue
for many hours at a time, often with the addition of several candles,
which tend likewise to waste the air, and render it less  fit  for respira-
tion.   Air that is breathed repeatedly becomes unfit  for expanding the
lungs.  This  is one cause of the phthisical coughs, and other complaints
of the breast,  so incident  to sedentary artificers.
   Even the perspiration  from a great number of persons pent up  toge-
ther,  renders the air unwholesome.   The danger from this quarter will
be greatly increased, if any one of them happens to have bad lungs, or
to be otherwise  diseased.  Those  Avho sit near him, being forced  to
breathe the same air, can hardly fail to be infected.   It Avould be a rare
thing, however, to find a dozen of sedentary people all in good health.
The  danger  of  crowding them together must therefore be  evident  to
every one.
   Many of those Avho folloAV sedentary employments are constantly  in
a bending posture, as shoemakers,  tailors, cutlers, &c.   Such a situa-
tion is extremely hurtful.  A bending posture obstructs all the  vital
motions, and  of course must destroy the  health.   Accordingly  we  find
such artificers generally complaining of indigestions, flatulencies, head-
achs, pains of the breast,  &c.
   The aliment in sedentary people, instead of being pushed forwards by
an erect posture, and the  action of the muscles, is in  a manner confined
in the bowels.  Hence indigestion,  costiveness, w ind, and other hypo-
chondrical  affections,  the constant companions of the sedentary.  In-
deed none of the excretions can be duly performed  Avhere exercise  is
Avanting; and when the matter Avhich ought  to  be  discharged in this
way is retained too long in the  body, it must have bad effects, as it  is
again taken up into the mass of humours.
   A bending posture is likewise hurtful to the lungs.   When this organ
is compressed, the air  cannot have free access in all its parts, so as to ex-
pand  them properly.   Hence tubercles,  adhesions,  <fcc. are  formed,
which often end in consumptions.  Besides, the  proper  action of the
lungs being absolutely necessary for making good blood, when the organ
fails, the humours soon become universally  depraved, and the whole
constitution goes to wreck.
   Sedentary artificers are not only hurt by pressure on the  boAvels, but
also on the inferior extremities, which obstructs the circulation in  these.
parts, and renders them weak and feeble. Thus tailors, shoemakers, &c.
frequently lose the use of their legs altogether : besides,  the  blood and
humours are,  by  stagnation,  vitiated, and the perspiration is obstructed;
from  whence  proceed the scab,  ulcerous sores, foul blotches, and other
cutaneous diseases so common among sedentary artificers.
   A  bad figure of body is a very  common consequence of close appli-

   * A person of observation in  that line of life told  me, that most tailors  die of
consumptions ; which he attributed chiefly to the unfavourable  postures  in
which they sit, and the unwholesomencss gkthose  places where tlieir business
is carried on.  If more attention was not p!B to profit than to the preservation
of human lives, this evil might be 3m\\y remedied; but while masters only
mind their own interest, nothingwill be done for the safety  of ifeeir servants. 
60      OF  THE  LABORIOUS, THE  SEDENTARY,

cation to sedentary employments.   The spine, for example, by being
continually bent, puts on a crooked shape,  and generally remains so
ever after.   But a bad figure of body has already been observed to be
hurtful to health, as the vital  functions are thereby impeded.
  A sedentary life seldom fails to  occasion  an  universal relaxation of
the solids.  This is the great  source from Avhence most of the diseases
of sedentary people Aoav.  The scrophula, consumption,  hysterics,  and
nervous diseases, ooav so common, were very  little known iu this country
before sedentary artificers became so numerous; and they are very little
known still among such of our people as follow active employments w ith-
out doors, though in  great towns at least two thirds of the inhabitants
are afflicted with them.
  It is very difficult  to remedy those evils, because many Avho have been
accustomed to a  sedentary life, like ricketty children, lose all  inclina-
tion for exercise ;  Ave shall, however, throw out a few hints with respect
to the  most likely means for preserving the  health of this useful set of
people, which some of them, we hope, will be Avise enough to take.
  It has been already observed, that sedentary artificers are often  hurt
by their  bending posture.  They ought therefore to stand or sit as erect
as the  nature of their employments will permit.   They should likewise
change their posture frequently, and should never sit too long at a time,
but leave off work, and  Avalk, ride, run, or do any thing  that will  pro-
mote the vital functions.
  Sedentary artificers are generally allowed too little time for exercise j
yet short as it is, they seldom employ it  properly.  A journeyman tai-
lor or weaver, for example, instead of walking abroad for exercise  and
fresh air, at his hours of leisure, chuses often to spend inem in a public-
house, or  in playing at some sedentary game, by which he generally
loses both his time and his money.
   The awkward  postures in which  many  sedentary  artificers work*
seem rather to be the effect of custom than necessity.   For example, a
table might surely be contrived for ten  or a dozen tailors to sit round
Avith liberty for their legs either to hang down, or rest upon a foot-board,
as they should chuse.   A place might likewise be  cut out  for each per-
son, in such a  manner that he might sit as conveniently for Avorking as
in the  present mode  of sitting cross-legged.
  All sedentary artificers ought to pay the most religious regard to clean-
liness.   Both their situation  and occupations render this highly neces-
sary.  Nothing would contribute more to preserve their health, than a
strict attention to it: and such  of  them as neglect it, not only  run the
hazard of losing health, but of becoming a nuisance to their neighbours.
  Sedentary people  ought to  avoid food that is Avindy or hard of diges-
tion, and should pay the strictest regard to sobriety.   A person  Avho
w orks  hard without  doors will soon throw off a debauch; but one  who
sits has by no means an equal chance.   Hence  it often happens,  that
selentary people  are seized  with  fevers after hard drinking.   When
such persons feel their spirits low,  instead of running to the tavern for
relief,  they should ride or walk in the field. This would remove the
complaint  more effectually than strong liquor,  and would never hurt
the constitution.             ^
  Instead  of multiplying ruWforDreserving the  health of  the seden-
tary, we shall recommend  to  theln the following general  plan,  viz* 
                    AND  THE  STUDIOUS.                   61

 That every  person Avho folloAvs a sedentary employment should cultivate
 a peice of ground Avith his own hands.   This he might dig, plant, soav,
 and Aveed at leisure  hours, so as to make it both an exercise aud amuse-
 ment, while it produced many of the necessaries of life.   After working
 an  hour in a  garden,  a man will return with more keenness to his em-
 ployment within doors,  than if he had been all the while idle.
  ^ Labouring the ground is every Avay conducive to health.  It not only
 gives exercise to every part of the body, but the veiy smell of the earth
 and fresh herbs revives and cheers the spirits, whilst the perpetual  pros-
 pect of something coming to maturity, delights and entertains the mind.
 We are so formed as to be always pleased with someAvhatin prospect, how-
 ever distant or however trivial.  Hence the happiness that most men feel
 in  planting,  sowing, building, &c.   These seem to have  been the chief
 employments of the more early  ages: and, when kings and conquerors
 cultivated the  ground, there is reason to believe that they knew as Avell
 wherein true happiness consisted as we do.
•* *W^y  seem romantic  to recommend gardening to  manufacturers in
 g^eat towns; but observation proves  that the plan is veiy practicable.
 In  the town of Sheffield, in Yorkshire, where the great iron manufacture
 is carried on, there is hardly a journeyman cutler who does not possess a
 piece  of ground,  which he  cultivates as  a garden.  This  practice has
 mauy salutary effects.   It not only induces these people to take exercise
 Avithout doors, but also  to eat may greens, roots, &c. of their own growth,
 which they would never think of  purchasing.  There can be no reason
 why manufacturers in any other town in Great-Britain should not folloAV the
 same plan.   It is  indeed to be regretted, that in such  a place as LondoD
 a plan of this kind is not practicable: yet even there, sedentary artificers
 may find opportunities (^taking air and exercise, if they chuse to embrace
 them.                     ^
   Mechanics are two much inclined to croAvd into great towns.   The situ-
 ation may have some advantages: but it has likeAvise many disadvanta-
 ges. All mechanics who live in the country have it in their poAver to culti-
 vate a piece of  ground; which indeed most of them  do.  This not only
 gives them exercise, but enables them to live more comfortably   So far
 at least as my observation  extends, mechanics who live in the country are
 far more happy than those in great toAvns.   They  enjoy  better health,
 live in greater affluence, and seldom fail to rear a healthy  and numerous
 offspring.
  In a Avord, exercise Avithout doors, in one shape or another, is absolute-
 ly  necessary to health.  Those  Avho neglect it, though they may for
 awhile drag out life, can hardly be said  to enjoy it.   Weak and effenii-
 uate, they languish for a few years, and soon drop into an untimely grave.

                          The  Studious.

  Intense thinking is so destructive to health, that few instances can be
 produced of  studious persons who  are strong and  healthy.   Hard study
 ahvays implies a sendentary life;  and Avhen intense thinking is joined to
 the want of exercise, the consequences must be bad.   We have frequent-
 ly  knoAvn even a few months of close application  to study  ruin an excel-
 lent constitution  by  inducing a train of nervous complaints, which  could
 never be removed.  Man is evidently uot  formed for continual thought 
 62       OF  THE  LABORIOUS,  THE SEDENTARY.

 more than for perpetual  action, and Avould  be as soon worn out by the'
 one as the other.
   So great is the power of the mind over the body, that by its influence,
 the  Avhole vital motions may be accelerated or retarded, to almost any
 degree.  Thus cheerfulness and mirth quicken the circulation, and pro-
 mote all the secretions; Avhereas sadness and profound thought never fail
 to retard them.   Hence it Avould appear, that even a degree of thought-
 lessness is necessary to health.   Indeed the perpetual thinker seldom en-
 joys either health or spirits; while the person Avho can  hardly  be said  to
 think at all, generally enjoys both.
   Perpetual  thinkers, as  they are called, seldom  think long.   In a few
 years they generally become quite stupid, and exhibit a melancholy proof
 hoav readily the greatest blessings may be abused.   Thinking,  like every
 thing else, when carried to extreme, becomes a vice;  nor can any thing
 afford a greater proof of Avisdom, than for a man frequently and seasona-
 bly to unbend Ms mind.   This may generally  be done  by  mixing  in
 cheerful company, active  diversions, or the  like.
   Instead  of  attempting  to investigate  the nature of that   connection
 which subsist between the mind and  body, or  to inquire into the manner
 in which  they mutually  affect each other, Ave shall only mention  those
 diseases to which the learned  are more peculiarly liable, and  endeavour
 to point out the means of avoiding them.
   Studious persons are a ery subject to the gout.   This painful disease  in
 a great measure proceeds from indigestion, and an obstructed perspiration.
 It is impossible that the man who sits from morning till night should either
 digest his food, or have any of the secretions in due quantity.  But Avhen
 that  matter Avhich should  be thrown off by the skin, is  retained in the bo-
 dy, and the humours are not duly prepared, diseases must ensue.
   The studious are likewise veiy liable  to#|e sxone and gravel.   Exer-
 cise  greatly promotes both  the secretion and discharge of urine;  conse-
 quently a sedentary life must have the contrary effect.  Any one may
 be satisfied of this by observing, that he passes much more urine by day
 than in the night, and also when he walks or rides, than when he sits.
   The circulation in the liver being slow, obstructions in that organ can
hardly fail to be the consequence of inactivity.   Hence sedentary people
 are frequently afflicted Avith schirrous livers.   But the proper secretion
 and discharge of the bile is so necessary a part of the   animal economy,
that Avhere these are not duly performed, the health must soon be impaired.
Jaundice, indigestion, loss of appetite, and a Avasting of the Avhole body,
 seldom fail to be  the consequences of a vitiated state of the liver or ob-
structions  of  the bile.
   FeAv diseases prove more  fatal to the studious than consumptions of the
 lungs.   It  has already been  observed,  that this organ cannot be duly
expanded in those Avho  do not take  proper exercise; and where this  is
the case, obstructions and adhesions will ensue.   Not only want of ex-
 ercise, but the posture in which  studious persons generally  sit,  is  very
hurtful to the lungs.   Those who read or write much are  ready to con-
tract a habit of bending forwards, and often press with  their breast  upon
a table or bench.   This posture cannot fail to hurt the  lungs.
   The functions of the  heart may likewise  by  this means be injured.
1  remember to have seeu a man opened, whose  pericardium adhered 
AND  THE  STUDIOUS.                  63
to the  breast-bor.e in such  a manner  as to obstruct the motion of the
heart, and occasion his death.   The only probable cause that could be
assigned for this singular symptom was, that the  man, whose business
was Avritiug, used constantly to sit in a bending posture, with his breast
pressing upon the edge of a  plain table.
  No person can enjoy health Avho does  not  properly digest his food.
But intense thinking and inactivity never fail to w eaken the powers of
digestion.  Hence the humours become crude  and  vitiated, the solids
weak and relaxed, and the  whole constitution goes to ruin.
   Long and intense  thinking often accasions grievous head-achs, which
bring oa vertigoes,  apoplexies, palsies, and other fatal disorders.   The
best Avay to prevent these  is, never to study too long at one time, and
to keep  the body regular, either by proper food, or taking frequently a
little of some opening medicine.
   Those who read  or  write much are often afflicted with sore eyes.
Studying by candle-light is peculiarly hurtful to the sight.   This ought
to be practised  as seldom  as possible.  When  it is unavoidable, the
eyes should be shaded, and the head should not be held too low.  When
the eyes are weak  or painful, they should be bathed eveiy night  and
morning in cool Avater, to w bich a little brandy may be added.
   It has already been observed, that  the excretions are very defective
in the studious.  The  dropsy is often  occasioned  by the retention of
those humours which ought to be carried off iu this Avay.   Any person
may observe, that sitting makes his legs swell, and that this goes off by
exercise; which clearly points out the  method of prevention.
   Fevers, especially of the nervous kind, are often  the effect of study.
Nothing effects the nerves so much as intense thought.   It in a manner
unhinges the Avhole  human frame, and not only hurts the vital motions,
but disorders the mind itself.  Hence a delirium,  melancholy, and even
madness, are often  the  effects of  close application to study.  In fine,
there is no disease which can proceed either from a bad state of the hu-
mours, a defect of the usual secretions, or a debility of the nervous sys-
tem, which may not be induced by intense thinking.
   But the most afflicting of all  the diseases which attack the studious is
the hypochondriac   This  disease seldom fails to be the companion of
 deep thought.   It may rather be called a complication of maladies thau
a single one.   To what a wretched condition are the best of men often
reduced by it!   Their strength and appetite fail;  a perpetual gloom hangs
over their minds; they live in the constant dread of  death, and are con-
 tinually in search of relief from medicine; where, alas! it is not to be found.
 Those who labour under this disorder, though they  are often made the
 subject of ridicule, justly claim our highest sympathy and compassion.
   Hardly any thing can  be more  preposterous  than for a person to
 make study his sole business.   A mere student is seldom an useful mem-
 ber of society.   He often neglects the most important duties of life, iu or-
 der to pursue studies of a  very trifling nature.  Indeed it rarely hap-
 pens, that any useful  invention is the effect of mere  study.  The far-
 ther men dive into profound researches, they generally deviate the more
 from common sense, and tooioften lose sight of it altogether.  Profound
 speculations, instead  of making men Aviser or better, generally render
 them absolute  sceptics, and overwhelm them with doubt and uncertain-
 ty.   All that is necessary  for a man to know, in order to  be  happy i- 
64       OF  1HE  LABORIOUS, THE SEDENTARY,

easily obtained; and the rest, like the forbidden  fruit, serves only to
increase his misery.
  Studious persons, in order to relieve their minds, must uot only discon-
tinue to read  and Avrite, but engage in some employment or diversion
that will not so far occupy the thought as to make them forget the bu-
siness of the closet.  A solitary ride or walk are so far from relaxing the
miud, that they rather encourage thought.  Nothing can divert the mind
when it gets into a train of serious thinking, but attention to subjects of a
more trivial nature.   These prove a kind of play to the mind, and con-
sequently relieve it.
  Learned men often contract a contempt for what they call trifling com-
pany.  They are ashamed to be seen with any but philosophers.   This
however is no proof of their being philosophers themselves.  No man de-
serves the name who is ashamed to unbend his miud, by associating with
the cheerful and gay.  Even the society of children will relieve the mind,
and expel the gloom Avhich application to study is too apt to occasion.
  As studious people are necessarily  much within  doors,  they should
make choice of a large and well aired place for study.   This would not
only prevent the bad effects which attend  confined air, but would cheer
the spirits and have a most happy influence both on the body and mind.
It is said of Euripides the  tragedkin, that he  used to retire to a dark
cave to compose  his tragedies, and of Demosthenes the Grecian orator,
that he chose a place for study  where nothing could be either heard  or
seen.  With all deference to such venerable names, we  cannot help
condemning their taste.  A man may surely think to as good purpose in
an elegant apartment as in a cave; and may have as happy conceptions
where the all-cheering rays  of  the sun render the air wholesome, as  in
places  where they never enter.
   Those who read or write much should be very attentive to their pos-
ture.  They ought to sit and stand by turns, always keeping as nearly
in an erect posture as possible.   Those who dictate, may do it walking.
It has an excellent effect frequently to read or speak aloud.  This not
only exercises the lungs, but almost the Avhole  body.  Hence studious
people are greatly benefitted by delivering discourses in public.  Public
speakers,  indeed, sometimes hurt themselves, by overacting their part;
but this is their own fault.  The martyr to mere vociferation merits not
©ur sympathy.
   The morning has, by all medical Avriters, been reckoned the best time
for study.  It is so.  But it is also the most proper season  for exercise,
while the stomach is empty, and  the spirits refreshed with sleep.   Stu-
dious people should therefore sometimes spend the morning in walking,
riding, or some manly diversions without doors.  This would  make them
return  to study with greater alacrity, and Avould be of more service than
twice the time after their spiritsare worn out with fatigue.   It is not suf-
ficient to take  diversion only Avhen we can  think no longer.   Every stu-
dious person should make it a part of his business, and should let nothing
interrupt  his hours of recreation more than those of study.
   Music has a very happy effect  in  relieving the mind when fatigued
with study.  It would  be well if every studious person were so far ac-
quainted with that science as to amuse himself after severe thought by
playing such airs as have a tendency to raise the spirits, aud  inspire
cheerfulness and good humour. 
AND  THE  STUDIOUS.
65
    It is a reproach to  learning, that any  of her votaries, to relieve the
 mind after study, should betake themselves to the use of strong liquors.*
 This indeed is a remedy; but it is a desperate one, and always proves de-
 structive.  Would such persons, Avhen their spirits are low,  get on horse-
 back, and ride ten or a dozen miles, they  Avould  find it  a more effectual
 remedy  than  any cordial medicine in the apothecary's  shop, or all the
 strong liquors in the Avorld.
    The folloAving is my plan, and I cannot recommend a better to others.
 When my mind is fatigued with study, or other serious business, I mount
 my horse, and ride ten or tAvelve miles into the country, Avhere I spend a
 day, and sometimes two,  with a cheerful friend;  after which I never fail
 to return to toAvn with neAV vigour, and -to pursue my  studies or business
 Avith fresh  alacrity.
    It is much  to be regretted, that learned men,  while in health, pay so
 little regard to these things!   There is not  any thing more  common than
 to see a miserable object over-run with nervous diseases, bathing, walking,
 riding, and in a Avord, doing every thing for health after it is gone; yet,
 if any one had recommended these things to him by way of prevention,
 the advice  would, in all probability, have been treated with contempt, or,
 at least,  Avith  neglect.   Such is the Aveakness and folly  of mankind, and
 such the Avant of foresight, even in those Avho ought to be wiser than others!
    With regard to tlie diet of the studious, we see no reason  why  they
 should abstain from any kind of food that is Avholesome, proAided they use
 it in moderation.   They ought, hoAvever, to be sparing in tjie use of every
 thing that is windy, rancid, or  hard of digestion.   Their suppers should
 ahvays  he light,  or  taken soon in the evening.  Their drink may be
 water, fine malt liquor, not too  strong, good cyder,  wine  and water, or, if
 troubled with acidities, water mixed with  a  little brandy, rum, or any
 other genuine  spirit.
   We shall only observe, with regard to those kinds of exercise which are
 most proper for the studious;  that they should  not be  too violent,  nor
 ever carried to the degree of excessive fatigue.   They ought likewise to
 be frequently varied so as to  give action to all the  different  parts of the
 body; and should, as often as possible, be  taken in the open  air.  In ge-
 neral, riding on horseback, Avalking, working in  a garden, or playing at
 some active diversions, are the best.
   We Avould likeAvise recommend the use of  the cold bath to the studious.
 It Avill, in some measure, supply the place of exercise, and should not be
 neglected by persons of a relaxed habit, especially in the warm season.
   No person ought either to take violent exercise  or to study immediately
 after a full meal.

   *  " To such persons," says Dr. Rush, " it may be  a discovery to know, that
tea is a much better remedy for that purpose.   By its grateful andgentle sti-
mulus, it removes fatigue, restores the excitement of the mind, and invigorates
the whole system   I am no advocate for the excessive use of tea.  When
laken too strong, it is hurtful, especially  to the female constitution; but when
taken of a moderate degree of strength, and in moderate quantities, with sugar
and cream, or milk, I believp it is, in general, innoxious, and,  at all times, to
be preferred to  ardent spirits, as a cordial for studios men."
9 
66
                          CHAP.  III.

                         OF  ALIMENT.

       UNWHOLESOME  food, and irregularities of diet, occasion
 many diseases.   There is  no doubt but the whole constitution of body
 may be changed by diet alone.   The fluids may be thereby attenuated
or condened, rendered mild or acrimonious, coagulated or diluted, to al-
most any degree.   Nor are its  effects upon the solids less considerable
They  may be braced or relaxed, have tlieir  sensibility, motions, «fcc.
greatly increased or diminished, by different kinds of aliment.  A very
small attention to these things will be sufficient to shew, how much the
preservation of health depends upon a proper regimen of the diet.
   Nor is  an attention to diet necessary for the preservation of  health
only :  it is like vise of  importance in the cure of diseases.   Every in-
tention in  the cure of many diseases,  maybe answered by diet  alone.
 Its ellects,  indeed, are not always so quick as those of  medicine, but
they are generally  more lasting: besides, it is neither so disagreeable to
the patient, nor so  dangerous as medicine, and is always  more easily
 obtained.
   Our intention  here is not to inquire minutely into the nature and pro-
perties of the various kinds of aliment in  use among  mankind;  nor to
sIicav their effects upon the different constitutions of the  human  body;
 but to mark some of the most pernicious errors Avhich people are apt to
fall into, with respect both to the quantity  aud quality of their food, and
 to point out their influence upon health.
   It is not indeed an easy matter to ascertain the exact quantity of food
 proper for every  age, sex, and constitution: but a scrupulous nicety here
 is by  no  means necessaiy.  The  best  rule  is to  avoid all extremes.
 Mankind were never intended to weigh and measure their food.  Nature
teaches every creature Avhen it has enoujrh;  and the calls of  thirst and
 hunger :-re sufficient to inform them when more is. necessaiy.
   Though moderation is the chief rale with regard to the quantity, yet,
 the quality of food merits a farther consideration.   There are  many
 ways by which provisions may be rendered unwholesome.  Bad seasons
 may  ei her prevent the  ripening of grain,  or  damage  it afterwards.
 These, indeed, are  acts of  Providence, and Ave must, submit to them ; but
 surely no punishment can be too severe for  those who suffer provisions to
 spoil by hoarding them, on purpose to  raise the price, or who promote
 their own interest by adulterating the necessaries of life.*
   Animal, as well as vegetable food, may be rendered unwholesome,
 by being  kept too long.  All animal substances have a constant tenden-
 cy to  putrefaction;  and, Avhen  that  has proceeded too far, they  not
 only become offensive to the  senses,  but  hurtful to  health.    Di-
  * The poor, indeed, are generally the first who suffer by unsound provisions;
but the lives of the labouring poor are of great importance to the state: besides,
diseases occasioned by  unwholesome food often prove  infectious,  by which
means they reach people in every station.  It is therefore  the interest of all
to take care that no spoilt provisions of any kind be exposed to sale. 
OF  ALIMENT.
67
seased animals, and such as die of themselves ought never to be  eaten.
It is a common practice, however, iu  some grazing  countries, for ser-
vants and poor people to eat such animals as die of any disease,  or are
killed by accident.   Poverty, indeed, may oblige people to do tl is; but
they had better eat a smaller quantity of what is sound and w holesome; it
Avould both afford a better nourishment, and be attended with less danger.
   The injunctions given to the Jews, not to eat any creature which died
of itself, seemed to have a strict regard to health; and ought to  be ob-
served by Christians as well as Jews.  Animals never die themselves
without some  previous  disease; but how a diseased animal should be
wholesome food, is inconceivable :  even  those which die b) accident
must be hurtful, as then blood is mixed with the flesh, and soon turns
putrid.
   Animals Avhich feed grossly, as tame ducks, hogs, &c. are neither so
easily digested, nor afford such Avholesome nourishment as others.  No
animal can be wholesome which does not take sufficient exercise. Most of
our stalled cattle are crammed with gross food, but not alloAved ex< rcise
nor free air; by which  means they indeed grow fat, but  their juices not
being properly prepared or assimilated,  remain crude, aud occasion in-
digestions, gross humours, and oppression of the spirits, in those who feed
upon them.
   Animals are often rendered unwholesome by being over-heated.   Ex-
cessive heat causes  a fever, exalts the animal salts, and  mixes the blood
so intimately with the flesh,  that it cannot be separated.  For this  rea-
son,  butchers  should be severely punished Avho over-drive  their  cattle.
No person Avould chuse to eat the flesh of an animal which hac\ died in
a high fever;  yet that  is the case with all over-drove cattle; apd the
fever is often raised even to the degree of madness.
   But this is not the only Avay by which butchers .endcr meat unwhole-
some.  The abominable custom of filling the cellular membrane of ani-
mals with air, in order to make them appear fat, is every day practiced.
This not only spoils the  meat, and renders it unfit for keeping, but is such
a dirty trick,  that the very idea of it is sufficient to di <-;ust  a per on of
any delicacy at every thing which comes I, ;m the shambles.   Who can
bear the thought of eating meat v.liich has been blown up with air from
the  lungs of a dirty felloAV, perhaps labouring under the vc ry worst of
diseases i'
   Butchers have likewise a method of filling the cellular membranes of
animals with blood.  This makes  the  meat  seem  fatter, and likewise
weigh more, but is notwithstanding a very pernicious custom, as it both
renders the meat unwholesome and unfit for keeping.   I seldom  see  a
piece of meat from the shambles, where the blood is not diffused through
the cellular texture.  I shall  not say that  this is always the effect of
design; but am certain it is not the  case with animals that are killed for
domestic use, and properly blooded.
   Veal seems to be most  frequently spoilt in this way.   Perhaps that
may in some measure be owing to the practice of carrying calves from a
great distance to market, by  which means their tender flesh is bruised,
and many of their vessels burst.
   No people in the world  eat such quantities of animal food as the Eng-
lish, Avhich  is one reason why they are so generally tainted with i!.e
acujt'vy, aud iU numerous train of  consequences, indigestion, low spin:-; 
6S                     OT  ALIMENT.
hypochondriacism, Sec.  Animal food was surely designed for man, and
with a proper mixture of vegetables, it will be found the must whok^ome;
but to gorge beef, mutton, pork, fish, and fowl, twice or thrice a-da), is
certainly too much.  All Avho value health ought to be contented with
making one meal of flesh in twenty-four hours, aud this ought to consist
of one kind only.
  The most obstinate scurvy has often been cured by a vegetable diet;
nay, milk alone will frequently do more in that disease thau any medicine.
Hence it is evident, that if vegetables  and milk Avere more used  in diet,
we should have less scurvy, and likeAvise fewer putrid and inflammatory
fevers.   Fresh vegetables, indeed come to  be daily more used in diet;
this laudable practice  Ave hope will  continue to gain ground.
  Our aliment ought  neither to be  too moist nor too dry.   Moist aliment
relaxes the solids, and renders the body feeble.   Thus Ave see females,
who live much on tea and other Avatery diet, generally become weak nnd
unable to digest solid food: hence proceed hysterics, and all their dread-
ful consequences.   On the other hand, food that is too dry, renders the
solids in a manner rigid, and the humours viscid, Avhich disposes the body
to inflammatory fevers, scurvies, and the like.
  Much has beeu said on the ill effects of tea  in diet.   They are, no
doubt, numerous; but they proceed rather from the imprudent use of it,
than from any bad qualities in the  tea itself.  Tea is noAV the universal
breakfast in this part of the world; but the morning is surely the most
improper time  of the  day for drinking it.  Most delicate  persons, Avho,
by  the bye, are the greatest tea drinkers, cannot eat any thing in the
morning.  If such persons, after fasting ten or tAvelve hours, drink four
or five cups of green  tea without eating scarcely any bread, it must hurt
them.   Good  tea, taken in a moderate quantity, not too strong, nor too
hot, nor drank upon  an empty stomach, will seldom do harm;  but if it
be bad, which is often the case, or substituted in the  room of solid food,
it must have many ill effects.
  The arts  of  cookery render many things unwholesome,  which are not
so in their own nature.   By jumbling together a number of different in-
gredients, in order to make a poignant  sauce, or rich soup, the composi-
tion proves  almost a poison.   All  high seasoning, pickles, A.C. are only
incentives to luxury,  and never fail  to hurt the  stomach.   It were well
for  mankind,  if cookeiy,  as an  art,  were entirely prohibited.   Plain
roasting  or boiling  is all that the  stomach requires.  These alone are
sufficient for people in health, and the sick have still less need of a cook.
  The liquid part of  our aliment likewise claims our attciition.   Water
is not only the basis of most liquors, but also composes a great part of our
solid  food.  Good water must therefore be of the greatest importance in
diet.   The  best Avater is that which is most pure, and free from any mix-
ture of foreign bodies.  Water takes up part of  most bodies with which
it comes into contact;  by this means it is often impregnated  with metals or
minerals of a hurtful or poisonous nature.   Hence the inhabitants of some
hilly  countries have peculiar diseases, which iu all probability proceed
from the water.  Thus the  people who live near the Alps in Switzer-
land,  and the inhabitants of the Peak of Derby in England, have large
tumours or wens on their necks.  This disease  is generally imputed to
the snoAv Avater; but there is more reason to believe it is owing to the mi-
ueralsin the mountains through which the waters pass. 
OF ALIMENT.
69
   When water is impregnated with foreign bodies, it generally appears
by its weight, color,  taste, smell, heat, or some other sensible quality.
Our business therefore  is to chuse  such water,  for common use, as is
lightest, and without any particular color, taste, or smell.  In most pla-
ces 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 use of the  water that is nearest to them, without considering  its
qualities.
   Before Avater is brought into great toAvns, the strictest attention ought
to be paid to its qualities, as many diseases may be occasioned or aggra-
vated by  bad  water; and when once it has been procured at a great
expense, people are unwilling to give it up.
   The common methods of rendering water clear by filtration, or soft,
by exposing it to the sun and air, 8cc. are so generally known that it is
unnecessary to spend time in explaining them.  We  shall only, in ge-
neral, advise all to avoid waters which stagnate long in small lakes, ponds,
or the like, as such  waters often become putrid, by the corruption of
animal aud vegetable bodies with which they abound.  Even cattle fre-
quently  suffer by drinking, in dry seasons,  water which has stood long
in small reservoirs, Avithout being supplied by springs,  or freshened with
showers.  All wells ought to be kept clean, and to have a free commu-
nication  Avith the air.
   As fermented  liquors, notwithstanding they have  been  exclaimed
against by many Avriters,  still  continue to be the common drink of al-
most (.very person Avho can afford them; we shall rather endeavour to
assist people in the choice of these liquors,  than  pretend  to condemn
Avhat custom has so firmly established.   It  is  not the  moderate use of
sound fermented liquors  which  hurt3  mankind :  it is excess, and using
such as are ill  prepared or vitiated.
   Fermented liquors, which are too strong, hurt digestion: and the body-
is so far  from being strengthened by  them, that it is Aveakened and re-
laxed.   Many imagine that hard labor could  not  be supported Avithout
drinking strong liquors; this is a very erroneous notion. Men who never
taste strong liquors arc not only able to endure more fatigue, but also live
much longer than those who use  them daily. But, suppose strong liquors
did  enable a man to do more work, they must nevertheless AVaste the
powers of life, and occasion premature old  age.   They keep up a con-
stant fever,  Avhich exhausts the spirits, inflames the blood,  and disposes
the body to numberless diseases.
   But fermented  liquors may be too weak  as well as too strong: when
that is the case, they must either be drank new, or  they become sour and
dead: when such liquors are drank new, the fennentati on not being over,
the)- generate air in the bowels, and occasion flatulencies;  and, when
kept till stale,  they turn sower on the stomach, and hurt digestion.   For
this reason all malt-Hqour, cyder, «fcc. ought to be  of such strength as to
keep till they be ripe, and then they should  be  used.  When such li-
quors are kept too long,  though they should not become sour, yet the)
generally contract a hardness Avhich renders them unwholesome.
 " All families, Avho can, ought to prepare their own liquors.   Since pre
 parin^ and  vending of liquors beGame one of the most general branches
 of busim -:s, every  method has beeu  tried  to adulterate  them.   The 
70                      OF  ALIMENT.
 great object both to the makers and venders of liquor i.>, to render it  in-
 torucathig, and give it the appearance of age.   But it is well known thai
 this may be done by  other ingredients, than those which ought  to be
 used for making it strong.  It Avould be imprudent  even  to  name  those
 things which are daily made use of to render liquors heady.  Suffice it to
 say, that the practice  is very common, and that  all the ingredients used
 for this purpose  are of a  narcotic or stupefactive  quality.   But as all
 opiates are poisonous, it is easy to see what must be the consequence of
 their general use.   Though they do not kill suddenly, yet they hurt the
 nerve*, relax and weaken the stomach, and spoil the digestion.
   Were fermented liquors faithfully prepared, kept to a proper  age, and
 used in moderation,  they would  prove real blessings to mankind.  But,
 while they are ill prepared, various ways adulterated, and taken to ex-
 cess, they must have many pernicious effects.
   We  would recommend it to families not only to prepare their own li-
 quors, but likewise their bread.  Bread is so necessaiy  a  part of diet,
 that  too much care cannot be bestowed  in order to have it sound and
 wholesome.  For this purpose, it is  not only  necessary that it  be  made
 of good grain, but likewise  properly prepared, and kept free  from all un-
 wholesome ingredients.   This, however, we have reason to believe  is not
 always the case with bread  prepared  by those who make a trade of vend-
 iug it.   Tlieir object  is rather to please the  eye,  thau to  consult the
 health.   The best bread is  that Avhich is neither  too coarse nor  too  fine;
 well fermented,  and made of wlieat flower, or rather of wiieat aud rye
 mixed together.
   To specify the different kinds of aliment, to explain their nature and
 properties, and to point out their effects  in different constitutions Avould
 far exceed the limits of our design.   Instead of a detail of this kind,
 which Avould not be generally uiulerstood, and  of  course, little  attended
 to, Ave shall only mention the following easy rules  with  respect to the
 choice of aliment.
   Persons whose solids are weak and relaxed, ought to avoid all viscid
 food, or such things as are hard of digestion.  Their diet, however, ought
 to be nourishing;  and they should take sufficient exercise in the open air.
   Such as abound with blood should be sparing in the use.of  every  thing
 that is highly nourishing, as  fat m eat, rich wines, strong ale, -and  such
 like.   Their  food should consist chiefly of bread and other vegetable
 substances ; and their drink ought to be  water, whey or small  beer.
   Fat people should  not eat freely of oily n6urishing diet.   They ought
 frequently .to use horse-radish, garlic, spices, or such  things as  are heating
 and promote perspiration and urine.   Their drink should be water, cof-
 fee, tea, or the like; and they ought to  take much exercise and little sleep.
   Those who are too lean must folloAV an opposite course.
   Such as are troubled with acidities, or whose food is apt to sour on the
 stomach, should  live much on animal  food; aud those who are  afflicted
 with hot bilious eructations, ought to use a diet consisting chiefly of acid
 vegetables.
   People who are afflicted  v. ith the gout, low spirits, hypocondriac or
hysteric  disorders, ought  to avoid all flatulent food; (very thing that
 is viscid, or hard of digestion,  all  salted or smoke dried  provisions, 
OF ALIMENT.
71
and whatever is austere, acid, or apt to turn sour on the stomach.  Their
food should be light, spare, cool, and of an opening nature.
   The diet ought not only to be suited to the age and constitution, but
also to the manner of life : a sedentary or studious  person should  live
more sparingly than one who labours hard without doors.  Many kinds
of food will nourish a peasant very well which would be almost indiges-
tible to a citizen ; and the latter will live upon a diet on which the for-
mer would starve.
   Diet ought not to be too uniform.  The constant use of one kind of
food might have some bad effects.  Nature teaches us this, by the great
variety of aliment which she has  provided for man, and likewise  by <iiv-
ing him an appetite for different kinds of food.
   Those who labour under any particular disease, ought to avoid such
aliments as have a tendency to increase it: for example, a gouty per-
son should not indulge in rich wines, strong soups, or gravies, and should
avoid all acids.   One who is troubled with the gravel ought to shun  all
austere and astringent  aliments:  and those who are scorbutic should be
sparing in the use of salted brovisions, &c.
   In the  first period of life, our  food ought to be light, but nourishing,
and frequently taken.  Food that is solid, Avith a sufficieut degree  of te-
nacity, is most proper for the state of manhood.  The diet suited to the
last period of life, wlwm natuie is upon the  decline,  approaches neurly
to that  of the first.   It should  be  lighter and more succulent thau that
of vigorous age, and likewise more frequently taken.
   It is not only necessary for health that  our diet be Avholesome, but al-
so that it be taken at regular  periods.  Some imagine long fasting will
atone for  excess; but this, instead of mending the  matter, generally
makes  its worse.   When the stomach and intestines are over distended
with food, they  lose their proper  tone, and, by loi g fasting, they  become
weak, and inflated with wind.  Thus, either gluttony or tasting destroys
 the powers of digestion.
   The frequent repetition of aliment is not only necessary lor repairing.
 the continual waste of our bodies, but likewise to keep the  fluids sound
 and sweet.  Our humours, even in the most healthy state, have a con-
 stant tendency to putrefaction,  which can only be prevented by frequent
supplies of fresh nourishment: when that is wanting too long,  the putre-
 faction often proceeds so  far as to occasion very dangerous h vus.  1? rom
 hence we may learn the necessity of regular meals.  No person can eu-
 ioy a good state  of health, Avhose vessels  are  either frequently over-
 charged,  or the humours long deprived of fresh supplies of chyle.
   Long fasting  is extremely hurtful to young people;  it not only vitiates
 their humours,  but prevents their growth.   Nor is it  less injurious to the
 a«red.  Most persons, in  the decline of life,  are afflicted with wind: this
 complaint is uot only increased,  but even rendered dangerous, and often
 fatal, by long fasting.  Old people, when their stomachs are empty,  are
 frequently seized with giddiness, head-achs,  and ta.ntness.   These com-
 plaints may generally l,-  removed by a piece of bread and a glass of wine
 or taking any Mher'solid food; which plainly points out the  method ot

 ^Ii^nwrethan probable, that many of the sudden deaths, which hap-
 pen in the advanced periods of life, are  occasioned by fasting  too long,
 as  it exhausts the  spirits, and  fills the bowels with wind; we  would
 therefore advice people  in the decline of  life, never to allow their sto- 
72
OF ALIMENT.
 raachs to be too long empty.   Many people take nothing but a few cup*
 of tea and a little bread, from nine o'clock at night till two or three next
 afternoon.  Sucli may be said to fast almost  three fourths of their time.
 This can hardly fail to ruin  the appetite, vitiate the  humours, and fill
 the bowels with Avind; all Avhich might be prevented by a solid break-
 fast.
   It is a very common practice to eat a light breakfast and a  heavy sup-
 per.   This custom ought to be reversed.  When people sup  late, their
 supper should be very light;  but the breakfast ought always to be solid.
 If any one eats a light  supper, goes soon to bed, and rises betimes in the
 morning, he will be sure to find an appetite for his breakfast,  and he
 may freely indulge it.
   The strong and healthy do  not indeed suffer so much from fasting as
 the weak and delicate;  but  they run great hazard from  its opposite,
 viz. repletion.  Many diseases, especially fevers, are the effect of a ple-
 thora, or too great fulness of the vessels.  Strong people, in high health,
 have generally a great quantity of blood and other humours.   When
 these are suddenly increased,  by an overcharge of rich and nourishing
 diet, the  vessels become too much distended, and obstructions and inflam-
 mations ensue.  Hence  so many people are seized with inflammatory
 and eruptive fevers, apoplexies, &c.  after a feast or debauch.
   All great and sudden changes in diet are dangerous.  What the sto-
 mach has been long accustomed to digest, though less Avholesome,  will
 agree better Avith it than food  of a more salutary  nature to Avhich it has
 not been used.  When therefore a change becomes necessary, it oughtal-
 ways to be made gradually; a sudden transition from a poor and Ioav, to a
 rich and  luxurious diet, or the contrary, might so disturb the functions
 of the body as to endanger health,  or even to occasion  death  itself.
  When avc recommend regularity  in  diet, Ave would not be understood.
 as condemning every small deviation from  it.  It is next to. impossible
 for people at  all times to avoid some  degree,of excess, and living too
 much by rule might make even the smallest deviation dangerous.  It
 may therefore be prudent to vary a little, sometimes taking more, some-
 times less, than the usual quantity of meat and drink, provided  always
 that a due regard be had to moderation.

  § Notwithstanding our  author's omission  of a general account of the
 qualities of the different kinds of animal and vegetable food  most com-
 monly used in diet, Ave think the folloAving not unworthy attention.
  " Beef.  When  this is the flesh  of a bullock of middle age it affords
 good and strong nourishment, and is peculiarly well adapted to those who
 labour, or take much exercise.  It will often sit easy upon stomachs that
 can digest no other kind of food; and  its" fat is almost as easily digested
 as that of veal.
  " Veal is a proper food for persons recovering from an indisposition, and
 may even be given to febrile patients in a very weak state, but it affords
less nourishment than the flesh of the same animal in a state of  matu-
rity.  The fat of it is lighter than  that of any other animal, and  shews
the  least disposition to putrescency.   Veal is a very suitable food in cos-
tive habits;   but of all meat it is the least calculated for removing an
acid from the stomach.
  '■'■Mutton, from the age of four to six years, and fed on diy pasture,
is an excellent meat.  It is of a middle kind between the firmness  of 
OF  ALIMENT.
73
beef and the tenderness of veal.   The lean part  of mutton, however, is
the most  nourishing  and conducive to  health; the fat being hard of di-
gestion.  The head of the sheep, especially w hen divested  of the skin,
is very tender; and the feet, on account of the jelly they contain, highly
nutritive.
  " Lamb is not so nourishing as mutton; but it is light, and extremely
suitable to delicate stomachs.
  " House-lamb; though much esteemed by many, possesses the bad quali-
ties common to the flesh of all animals reared in an unnatural Avay.
  " Pork affords rich and substantial nourishment; and its juices are
wholesome when properly fed,  and when the animal enoys pure air and
exercise.   But the flesh of hogs reared in towns is both  hard of diges-
tion and unwholesome.  Pork is particularly improper for those who are
liable to any foulness of the skin.   It is almost proverbial,  that a dram
is good for promoting its digestion:  but this is an erroneous notion  ; for
though a dram may give a momentary stimulus  to  the coats of the sto-
mach, it tends to harden the flesh, and of course to make it more indi-
gestible.
   " Smoked-hams are a strong kind of meat, and rather fit for a relish
than for diet.  It is the quality of all salted meat that the fibres become
rigid, awl  therefore  more difficult of digesion; and Avhen to this is add-
ed  smoking, the heat of the chimney occasions the  salt to concentrate,
and the fat between  the muscles to become rancid.
   " Bacon is also of an indigestible quality, and is apt to turn rancid on
weak stomachs.
   " The flesh of goats is hard and indigestible; but that of kids is tender
as well as delicious,  and affords good nourishment.
   " Venison, or the flesh of deer, and that of hares, is of a nourishing
quality,  but  is  liable to one inconvenience;  which is, that though
much disposed to putrescency  of itself,  it must be kept for a little time
before it becomes tender.
   " The blood of animals is used as aliment by the common people :
but they could not long subsist upon it unless mixed  with oat-meal, &c
for it is not soluble alone by the digestive powrers of the human stomachy
and therefore cannot be nourishing.
   " Milk is of very different  consistence in different animals; but that
of  cows being the kind used in diet, is at present the object of our at-
tention.  Milk,  where it agrees with the stomach, affords excellent
nourishment for those who are weak and cannot digest other aliments.
Though an animal  production, it  does not  readily become putrid, as
being possessed of the properties of vegetable aliment; but it is apt to
become sour on the stomach, aud thence  to produce flatulence, the heart-
burn, or gripes, and, in some constitutions,  a looseness.  The best milk
is from a cow  at three or four  years of age, about two months after pro-
ducing a calf.  It is lighter, but more Avatery, than  the milk of sheep
and goats; while, on the other hand, it is more  thick  and  heavy than
the milk of asses and mares, which are the next in consistence to hu-
man milk.
   " On account of the acid which is generated after digestion, milk co^
agulatts in all stomachs; but the caseous or cheesy part is again dissol-
ved by the digestive juices and rendered fit for the purpose of nutrition.
It is however, improper to eat acid substances with milk, as  these would
tend to prev eut the due digestion of it. 
74
OF ALIMENT.
  " Cream is very nourishing, but on account of its fatness is difficult to
be digested in  Aveak  stomachs.   Violent exercise, after  eating it, will
in a little time convert it into butter.
  " Some writers inveigh against the use of  Bidtcr as universally  per-
nicious;  but they might with equal reason condemn  all vegetable oils,
which form a considerable part of diet in the southern climates, and seem
to have been beneficently intended by nature for that purpose.   But-
ter, like  every  other  oily substance, has doubtless a relaxing quality,
and, if long retained in the stomach, is  liable to become rancid; but, if
eaten in moderation, it will not produce those effects in any hurtful  de-
gree.   It is however, improper  in bilious constitutions.—The worst
consequence produced by butter, when eaten with bread, is, that it ob-
structs the discharge of the saliva in the act of mastication or chewing;
by which means the food is not so readily digested.   To obviate this
effect,, it would be a commendable practice at breakfast, first to eat some
dry bread,  and  chew it well, till the salivary glands were exhausted, and
afterwards to eat it  with butter.   By these means such a quantity of sa-
liva might  be carried into the stomach as Avould be sufficient for the pur-
pose of  digestion.
  " Cheese is likewise reprobated by many as extremely unwholesome.
It is doubtless not  easy of digestion; and, Avhen eaten in a great quan-
tity, may load the stomach; but if taken sparingly, its tenacity may be
dissolved by the digestive juices, audit may yield a wholesome, though
not a very  nourishing  chyle.  Toasted cheese is agreeable to most pa-
lates, but is rendered more indigestible by that  process.
  " The flesh of Birds differs in quality according to the food on which
they live.   Such as feed upon grain and berries afford, in general, good
nourishment, if avc except geese and ducks, which are hard of digestion.
A young hen or chicken is tender and delicate food, and extremely Avell
adapted  Avhen the digestive  powers are weak.    But of all tame foAvls
the capon is the most  nutritious.
  " Turkics, as well as Guinea or India fowls, afford a substantial aliment,
but are not so easy of digestion as the common domestic  fowls.  In all
birds those  p^rts ;>re the most firm which are most  exercised;  in the
small birds, therefore, the  wings,  and in the  larger kinds, the legs, are
commonly the most difficult of  digestion.
  " The flesh of wild birds, in general, though  more easily digested, is
less nourishing thau that of  quadrupeds, as being more dry, on  account
of their  almost constant exercise.  Those birds are not Avholesome which
subsist upon worms, insects aud fishes.
   " Eggs.  In  the  last class of terrestrial animal food, Ave may rank the
eggs of birds, which  are a simple and  Avholesome aliment. Those of the
tu. key  are superior in all the qualifications of food.  The Avhite of eggs
is dissolved in a warm temperature, but by much heat it is rendered tough
and hard.   The yolk contains much oil, and is highly nourishing, but
has a strong tendency to putrefaction ; on which account eggs  are im-
proper for  people of weak stomachs, especially when they are not quite
fresh.    Fggs hard boiled or fried are difficult of digestion, and are ren-
dered still more indigestible bv  the addition of butter.  All eggs require
a sufficient quantity of salt, to promote their solution in the stomach.
   " Fish,  though some of  them be light, and easy of digestion, afford
lers nourishment than vegetables or the flesh of quadrupeds, and  are of 
OF  ALIMENT.
75
all the animal tribes the most disposed to putrefaction.  Salt-water fish>
are, in  general the best; but when salted, though less disposed to pu-
trescency, they become more difficult of digestion.  Whitings and floun-
ders arc  the most easily digested.  Acid sauces and pickles, by resisting
putrefaction, are a proper addition to fish, both as they retard putrescen-
cy, and correct the relaxing tendency of  butter, so generally used with
this kind of aliment.
   " Oysters are eaten  both raw and dressed; but in the  former  state
they arc preferable; because heat dissipates considerably their nutritious
parts as  Avell  as the salt-water, Avhich promotes their digestion in the
stomach; if not eaten  very sparingly, they generally prove laxative.
   " Muscles are far inferior to oysters, both in point of digestion and nu-
triment.   Sea  muscles are by some  supposed to be of a poisonous na-
ture; but though this opinion is not much countenanced by experience,
the safest way is to eat them with vinegar, or some other vegetable acid.
   " Bread. At the head of the vegetable class stands bread, that article
of diet,  which, from general  use, has received the name of the staff of
fife.  Wheat is the grain chiefly used for the purpose in this country, and
is among the most nutritive of  all the farinaceous kinds, as it contains a
great deal of mucilage.  Bread is very properly eaten with animal food,
to correct the disposition to putrescency; but is most expedient  with such
articles in diet as contain much nourishment in a small bulk, because it
then seives to give the stomach a proper degree of expansion.   But as
it produces a slimy chyle, and disposes to  costiveness, it ought not to be
eaten in  a large quantity.  To render bread easy of digestion, it ought
to be  well fermented and baked; and it never should be used till it has
stood twenty-four hours after being taken ought of the oven, otherwise it
is apt to  occasion various complaints in those who have  weak boivels;
such  as flatulence,  the  heart-burn,  watchfulness, and the like.   The
custom of eating butter with bread hot from the  oven is compatible only
a\ ith strong digestive powers.
   " Pastry, especially when  hot, has all the disadvantages of hot bread
and butter; and even buttered toast, though the  bread is stale, is scarce-
ly inferior in its effects on a weak stomach.  Dry toast Avithout  butter
is by  far the wholesomest breakfast.
   " Bread made of Rye is apt to sour on the stomach, and to excite
heart-burn in certain constitutions—is of a laxative nature, and, there-
fore,  better suited to costive habits, either alone, or mixed with Avheat:
But on account of its  disposition to acescency, fermentation, and flatu-
lency, may not be so Avell adapted for persons of choleric temperaments,
and those afflicted with dyspeptic, hypochondriac, and hysteric symp-
toms: yet,  is the best to prevent or cure the scurvy.
   " That made of Indian Corn appeal's to agree well with most people
who like it; and when mixed Avith Wheat or Rye,  or both, it  makes
them  palatable, and keeps moist a considerable time.
   " Buckwheat being somewhat liable to  an ascesceut fermentation  in
the stomach, does not  agree  well  with all constitutions.   The  grain
should, previous to being ground, be  freed  from the  dust and grit.   It
is supposed that its use occasions itchings and cutaneous eruptions—aud
constantly used is not thought as wholesome as other bread.
   " Oats, when deprived  of the husk, aud  particularly  barley,  when 
76
OF  ALIMENT.
properly prepared, are each of them  softening, and afford wholesome
and cooling nourishment.  Rice likewise contains a nutritious mucilage,
and is less used in this country than it deserves, both on account of its
Avholesomeness and economical utility.  The notion of its being hurtful
to  the sight is a vulgar error.  In some constitutions  it tends to make
them costive;  but this seems to be OAving chiefly to flatulence, and may
be corrected by the addition of some spice, such as caraway, anise seed,
and the like.
  " Potatoes are an agreeable and wholesome food, and yield  as much
nourir-hment as any of the roots used in diet.   The  farinaceous or mealy
kind is in general the most easy of digestion;  and they are  much inv
proved by being roasted.
  " Green pease, and Turkey beans, boiled in their fresh state, are both
agreeable to the taste and Avholesome; being neither near so flatulent, nor
difficult of digestion,  as  iu their ripe state;  in which they resemble the
other leguminous  vegetables.   French  beans possess  much  the 6ame
qualities, but yield a more watery  juice, and have  a greater disposition
to produce flatulence.   The leguminous vegetables iu general ought to
be eaten with some spice.
  " Salads, being eaten  raw, require good digestive poAvers,  especially
those of  the cooling  kind; and the addition of oil and vinegar, though
qualified with mustard, hardly renders the free use  of them  consistent
with the  Aveak stomach.
  l' Spinagc affords a soft lubricating aliment, but contains little nourish-
ment.  Iu weak stomachs it is apt to  produce acidity,  aud frequently a
looseness.  To obviate  these effects, it ought always to be well beaten,
and but little butter mixed Avith it.
  " Aspa;ra°us is a nourishing article in diet, and promotes urine;  but,
in common Avith the vegetable class, disposes a little to flatulence.
  " Artichokes resemble asparagus in their qualities, but seem to be more
nutritive, and less diuretic.
  " White  cabbage is one of  the most conspicuous  plants in the garden.
It does not afford  much nourishment, but is an  agreeable addition to ani-
mal food, and not quite so flatulent as the common greens.  It is likeAvise
diuretic, and somewhat laxative.   Cabbage  has  a stronger tendency to
putrefaction than most other vegetable substances ;  and, during their pu-
trefying state, sends forth  an offensive smell, much resembling that  of pu-
trefying animal bodies.  So far, however, from promoting a putrid dis-
position in the human body, it is on the contrary, a Avholesome aliment
in the true  putrid scurvy.
  " Turnips are a nutritious article of vegetable  fcod,  but  not  very
easy of digestion, and are flatulent.   This effect, is in  a great measure,
obviated by pressing the  water out of them before they are eaten.
  " Carrots contain a considerable quantity of nutricious juice, but are
among the most flatulent of vegetable productions.
  " Parsnips are  more nourishing and less flatulent than carrots, which
they also exceed in the sweetness of  their mucilage.   By boiling them
in two different waters, they  are rendered less flatulent, but their other
qualities are the-eby diminished in proportion.
  " Parsley is of a stimulating and aromatic nature, Avell calculated to
make agreeable sauces.   It is also a gentle diuretic, but preferable in all
its qualiies when bo led.
  '• Celery affords a root both Avholesome and fragrant, but is difficult 
                         OF  ALIMENT,   v.                   77

ef digestioi in its raw state.  It gives an agreeable taste to  soups, as
well as renders them diuretic.
  " Onions, garlic, and shallots, are all of a stimulating nature, by which
they  assist  digestion,  dissolve  slimy  humours,  and expel flatulency.
They are, however, most suitable to persons of a cold and phlegmatic
constitution.
  " Radishes of all kinds, particularly the horse-radish, agree Avith the
three preceding articles in powerfully dissolving slimy humours.  They
excite the discharge of air lodged in the intestines; but this  proceeds  „
from the expulsion of the air contained in themselves.
  " Apples are a Avholesome vegetable aliment, and in many cases medi-
cinal, particularly in diseases of the breast  and complaints arisuig from
phlegm.   But, in general, they agree best with the stomach w hen eaten
cither roasted  or  boiled.  The more aromatic kinds of apples are the
fittest for eating raw.
   " Pears resemble  much in their effects the sAveet kind of apples, but
have more of a laxative quality, and a greater tendency to flatulence.
   " Chenies are, in genera!, a  wholesome' fruit, Avhen  they agree with
the stomach,  and they are beneficial in many  diseases, especially those
of the putrid kind.
   " Plumbs are nourishing, and have besides an attenuating, as Avell  as
a laxative, quality ; but are apt to produce flatulence.   If eaten fresh,
and before they are quite ripe, especially in large quantities, they occa-
sion cholics and other complaints of the bowels.
   " Peaches are not of a very  nourishing quality, but they abound  in
juice, and are  serviceable in bilious complaints.
   41 Apricots are more pulpy than peaches,  but are apt to ferment and
produce acidities in  weak stomachs.  Where they do not disagree they
are cooling, and tend likewise to correct a disposition to putrescencey.
   " Gooseberries,  as well as currants,  when ripe, are similar in their
qualities to cherries, and, when used in a  green state, they are  agreeably
cooling.
   " Strawberries, are an agreeable, cooling aliment,  aud are accounted
good against the gravel.
   " Cucumbers are cooling,  and agreeable to the palate in hot  weather;
but to prevent them  from proving hurtful to the stomach, the juice ought
to  be squeezed out after they are sliced, and vinegar, pepper, and salt*
afterwards  added.
   " Tea.   By some the use of this exotic is condemned in  terms the
most vehement and unqualified,  while  others have  either asserted its
innocence, or gone so far as to ascribe to  it salubrious aud even extraor-
dinary virtues.  The truth seems to lie  between these  extremes: there
is however an essential difference in the effects of green  tea and of black.
or  bohea ; the former of which is much more apt to affect the  nerves of
the stomach than the latter, especially wheu drunk without cream, aud
likewise without bread and butter.  That when taken  in a large quan-
titv, or at a later hour than usual,  it often  produces watchfulness, is  a
point which cannot be denied; but if used in moderation, and  accompa-
nied with the addition just now mentioned, it does not sensibly discover
any hurtful effects,  but  greatly relieves au oppression  of the stomach,
and abates a pain of the head.   It ought always to be made of a mode-
rate degree of streugth; for if too weak it certainly relaxes the stomach. 
78
OF  AIR.
As it has au astringent taste, which seems  not  very consistent with a
relaxing power, there is ground for ascribing this effect not so much to
the herb itself, as to the hot water, which not being impregnated with a
suii.cient quantity of tea to correct its own emolient tendency, produces
a relaxation unjustly imputed to some noxious quality  of the plaut.
But tea, like every other commodity, is liable to damage, and when this
happens it may produce effects not necessarily connected with its ori-
ginal  qualities.
   " Coffee.  It is allowed that coffee promotes digestion, and exhiliratcs
the animal spirits; besides which, various other qualities are ascribed
to it, such as dispelling flatulency, removing dizziness of the head,  at-
tenuating viscid humours, increasing the circulation  of the  blood, and
consequently perspiration; but if drank too strong, it effects the nerves,
occasions watchfulness, and tremor of the hands; though in some phleg-
matic constitutions it is apt to produce sleep.  Indeed it is to persons of
that habit that coffee is well accommodated: for to people of a thin and
dry habit  of body it seems to be  insurious.  Turkey  coffee is greatly
preferable  in flavour to that of the West Indies.  Drank only  in  the
quantity of one disk after dinner to promote digestion, it ansivers best
without either sugar or milk : but if taken at other times it should have
bofh, or in place of the latter rather cream, which not only improves the
beverage, but tends to mitigate the effect of coffee upon the nerves.
   44 Chocolate is a nutritive and wholesome composition if taken in small
quantity, and  not repeated too often;  but is generally hurtful to the
stomach of those with whom a vegetable diet disagrees.   By  the addi-
tion of vanilla and other ingredients it is made too heating, and so much
effects particular constitutions as  to excite nervous symptoms, especial-
ly complaints of the head."
                          CHAP. IV.

                             OF AIR.

         Xj NWHOLESOME air is a very common cause of diseases.
Few are aware of the danger arising from  it.   People generally pay
some attention to Avhat they eat or drink, but seldom regard what goes
into the lungs, though the latter proves often more suddenly fatal than
the former.
   Air, as well as water, takes up parts of  most bodies Avith which it
comes  in contact, and is often so replenished with those of a noxious
quality,  as to occasion immediate death.   But such violent effects sel-
dom happen, as people are generally on their guard against them.  The
less perceptible influences of bad  air prove more generally  hurtful to
mankind; Ave shall therefore endeavour to point out some of these,  and
to sheiv Avhence the danger chiefly arises.
   Air  may become  noxious  many Avays.   Whatever  greatly alters
its degree of heat, cold, moisture, Sic.  renders it unAvholesome:  for
example, that which  is too hot, dissipates  the watery parts  of  the
blood,  exalts the bile, and renders the whole humours adust and thick.
Hence proceed bilious and inflammatory levers, cholera  morbus,  &c. 
OF AIR.
79
Very cold air obstructs the perspiration, constringes the solids, and con-
denses the fluids.  It occasions rheumatisms, coughs, and catarrhs, with
other diseases of  the throat and breast.   Air that is too moist destroys
the elasticity or spring of the solids, iuduces phlegmatic or lax consti-
tutions, and disposes the body  to agues,  or intermitting fevers,  drop-
sies, &c.
   Wherever great numbers of people are crowded into one place,  if the
air has not a free circulation, it soon becomes unwholesome.  Hence it
is that delicate persons are so apt to turn sick or faint in crowded churches,
assemblies, or any place Avhere  the  air is  injured by breathing,  fires,
candles, or the like.
   In great cities so many things tend to contaminate the air, that it is no
wonder it proves  so fatal to the inhabitants.   The air in cities  is uot only
breathed repeatedly over, but  is likewise loaded Avith sulphur, smoke,
 and other exhalations, besides the vapours continually arising  from in-
 numerable putrid substances,  as dunghills, slaughter-houses, &c.  AH
 possible care should be taken to keep the streets of large towns open and
 Avide, that the air may have a free current through them.   They ought
 likewise to be kept very clean.   Nothing tends more to pollute and con-
 taminate the air of a city than dirty streets.
    It is very common in this country to have church-yards in  the middle
 of populous cities.   Whether  this be the effect of ancient superstition,
 or owin«r to the increase of such toAvns, is a matter of no consequence.
 Whatever gave rise to  the custom,  it is a bad one.   It  is habit alone
 which reconciles us to these things;  by means  of which the most  ridicu-
 lous,  nay pernicious customs, often become sacred.   Certain it is, that
 thousands of putrid carcases, so near the surface of the earth, iu a place
 where the air is  confined, cannot fail to taint it; and that such air, when
 breathed into the lungs, must occasion diseases.*
    Burying  within churches is  a practice still more detestable.   The
 air in churches  is seldom  good,  and the effluvia from putrid  carcases
 must  render it  still worse.    Churches  are  commonly  old buildings
 with  arched roofs.   They are seldom open  above once a week, arc
 never ventilated by fires  nor  open  windows,  and  rarely  kept clean.
  This occasions that damp, musty, unwholesome smell which one  feels
 upon  entering a church and  renders  it a very unsafe  place  for the
 weak and valetudinary.   These  inconveniences  might,  in  a  great
 measure, be obviated,  by prohibiting all  persons from burying within
 churches,  by  keeping them  clean,  and permitting  a  stream  of  fresh
  air to pass frequently through them, by opening opposite doors and win-
  dows.!                                                   „     ,.
    Wherever air stagnates  long,  it becomes unwholesome.  Hence tne
  unhappy persons confined in jails not only contract  malignant fevers
  themselves, but often communicate them to others.   Nor are many of the
  holes, for we cannot call  them houses,  possessed  by the poor in  great
  towns, much better than jails.   The e low dirty habitations are the very
  • In most eastern countries it was customary to bury the dead at some dis-
tance from any town.  As this practice obtained among the Jews, the Greeks
and also the Romans, it is strange that this country should not have followed
their example in a custom so truly laudable.
  f One cannot  pass through a large church or cathedral,  eveu in summer,
without feeling quite chilly. 
80
OF AIR.
lurking places of bad air and contagious diseases.   Such as live in them
seldom enjoy good health; and their children commonly die young.   In
the choice of a house, those who have it in their power ought always to
pay the greatest attention to open free air.
   The various methods Avhich luxury has  invented to make houses close
and warm, contribute uot a little to render them unwholesome.  No house
can be wholesome unless the air has a free passage through it. For which
reason houses ought daily to be ventilated  by opening opposite windows,
and admitting a current of fresh air  into every room.   Beds, instead of be-
ing made up as soon as people rise out of them, ought to  be turned down,
aud exposed to the fresh air from the open windows through the day. This
would expel any noxious vapour, and could not fail  to promote the health
of the inhabitants.
   In hospitals, jails, ships, &c. where that cannot be conveniently done,
ventilators should be used.  The method of expelling foul, and intro-
ducing fresh air, by means of ventilators, is a most salutary invention,
and is indeed the most useful of  all our  modern medical  improvements.
It is capable of  universal application, and is fraught with numerous ad-
vantages, both  to those  in health  and  sickness.   In all  places Avhere
numbers  of people are crowded together, ventilation becomes absolutely
necessary.
   Air which  stagnates in  mines,  wells,  cellars, &c.  is  extremely
noxious.   That kind  of air is to be avoided as the most deadly poison.
It often  kills  almost  as  quickly as lightning.  For this reason, people
should be very cautious iu opening cellars that have been long  shut, or
going down into  deep wells or pits, especially if they have been kept close
covered.*
   Many  people who have splendid  houses, chuse to sleep in small apart-
ments.   This  conduct is very imprudent.   A bed-chamber ought always
to be well aired; as it is generally occupied in the night  only, wiien all
doors and windows are shut.  If a fire  be kept in  it, the danger from a
small room becomes still greater.  Numbers have been stifled when asleep
by a fire in a small apartment, which is always hurtful.
   Those who are obliged, on account  of business, to spend the day in
close toAvns, ought,  if possible, to sleep  in the country.   Breathing free
air in the night will, in some measure, make up for the Avant of it through
the day.   This  practice would  have a greater effect in preserving the
health of citizens than is commonly imagined.
   Delicate  persons ought,  as much as possible,  to avoid the air of
great towns.  It is peculiarly hurtful  to  the asthmatic  and consump-
tive.  Such  persons should avoid  cities  as they  Avould the  plague.
The hypochondriac are  likewise much  hurt  by it.   I  have often seen
persons so much afflicted with this malady while in town, that it seem-
ed impossible  for them to live, who, upon being removed to the coun-
try,  were immediately relieved.   The same observation holds with
regard to nervous and hysteric  ivomen.  Many people,  indeed, haVe
it not in  their power to change their situation iu quest of better air.
  * We have daily accounts of persons who lose their lives by going down into
deep wells and ot\er places where the air stagnates; all these accidents might
be prevented by only letting down a lighted candle before them, and stopping.
when they perceive it go out; yet this precaution, simple as it is, is seldom used. 
OF AIR.
81
All we can say to such persons is, that they should go as often abroad
into the open air as they can,  that they should admit fresh air frequent-
ly into their houses, and take  care to keep them very clean.
   It was necessary in former times, for safety, to surround cities, col-
leges, and even single houses, with high walls.   These, by obstructing
the free current of air, never  fail to render such places  damp and  un-
wholesome.  As such walls are now, in most parts of this country, become
useless, they ought to be pulled doivn, and every method taken to admit
a free passage to the air.   Proper  attention to Air and Cleanliness
would  tend more to preserve the health of mankind, than all the pre-
scriptions of the faculty.
   Surrounding houses too closely with planting of thick woods, likewise
tends to render the air unwholesome.   Wood not only obstructs the free
current of the air, but sends forth great quantities of moist exhalations,
which render it constantly damp.  Wood is very agreeable at a proper
distance from a house, but should never be planted too near it, especially
in a flat country.   Many of the gentlemen's seats in England are ren-
dered  very unwholesome from the great quantity of wood which sur-
rounds them.
   Houses situated in low marshy countries, or near large lakes of stagnat-
ing Avater are likewise imAvholesome.   Waters which stagnate not only
render the air dampPfiroad it with putrid exhalations, which  produce
the most  dangerous aud fatal diseases.   Those who are obliged to inhabit
marshy countries, ought to make choice of the dryest situations they can
find, to live generously, and to pay the strictest regard to  cleanliness.
   If fresh air be necessaiy  for those in health, it is still more so for the
sick, who often loose their lives for want of it.   The notion that  sick
people must be kept very hot, is so common that one can hardly enter a
chamber where a  patient lies,  without  being ready to faint, by reason  of
the hot suffocating smell.  How  this  must affect the sick, any  one may
judge.    No medicine is so beneficial to the sick as fresh air.  It is the
 most reviving of all cordials,  if it be administered with prudence.  We
 are not however, to throw open doors and windows at random upon tne
 lick.   Fresh air is to be let into the chamber gradually, aud if  possible,
 by opening the windows of  some other apartment.
    The air^of a sick person's chamber  may be greatly freshened, and the
 patient much revived, by sprinkliug the floor,  bed, &c. frequently with
 virtilr, Juice of lemon, or  any other strong vegetable acid.
    In places where numbers of sick are croudedinto the same house, or,
 which  is often the case, into the  same apartment, the frequent admission
 of fresh  air becomes absolutely necessaiy.   Infirmaries, hospitals, Arc.
 are often rendered so noxious, for want  of proper ventilation, that the
 sick run more hazard from them than from the disease.   This is particu-
 cularly the case when putrid fevers, dysentaries, and other infectious
 diseases prevail.                                                  .
    Physicians, surgeons, and others who attend hospitals, ought, for their
 own sVft tv, to take care that  thev he properly ventilated.   Such persons
 as are  oblWd to spend the most of their time amongst the sick, run great
 ha' ml of bein* themselves infected when the air is bad.   All hospitals,
 and'daces of reception for the  sick, ought to have an open  .ituation,
 at some distance from any groat town, and such patients as labour under 
82
OF EXERCISE*
any  infectious disease ought  never  to be suffered to come near th<*
resL*
                            CHAP.  V.

                          OF EXERCISE.
        JVT AN Y people look upon the necessity man is under of ea rn-
 mg his bread by  labour, as a curse.   Be this as it  may, it is  evident
 from the structure of the body, that exercise is not less necessaiy than
 food for the preservation of health : those whom poverty obliges to la-
 bour for daily bread, are not only the most healthy, but generally the most
 happy part of mankind.  Industry seldom fails to place them above want,
 and activity serves them instead of physic.   This is peculiarly the case
 with those avIio live  by  the culture of the ground.  The great increase
 of inhabitants in infant colonies, and  the longevity  of such as follow
 agriculture, every where, evidently prove it  to be the most  healthy as
 well as the most useful employment.
   The lovre of activity sbeAVs itself very early in  man.   So strong is
 this principle, that a healthy youth cannot be restrained  from exercise,
 even by the fear of punishment.   Our love of motion is surely a strong
 proof of  its utility.  Nature implants no dispsMfti in vain.  It seems
 to be a catholic laAV  throughout the whole animal creatiou, that no crea-
 ture, without exercise, should enjoy health, or be able to find subsistence.
 Every creature, except  man, takes as much of it as is necessaiy.  He
'alone, and such animals as are  under his direction, deviate from this
 original law, and they suffer accordingly.
   Inactivity  never fails to induce  au universal relaxation of the solids,
 which disposes the body to innumerable diseases.   When the solids are
 relaxed, neither the digestion nor any of the secretions can be duly per-
 formed.   Io this case, the  worst consequences must  ensue.   Hoav can
 persons who loll all day in easy chairs, and sleep all  night  on beds of
 oWn, fail to be relaxed?  Nor do such greatly mend the matter, Avho
 never stir abroad but in a coach, sedan, or such like........These  elegant
 pieces of luxury are become so common, that the inhabitants of  great
 towns seem to be in  some danger of losing the use of their  limbs alto-
 gp'her.  It is noAV beloAv any one to walk, Avho can afford to  be carried.
 How ridiculous Avould it seem, to  a person unacquainted wffli fAm
 luxury, to behold the young and healthy swinging along on the shoulders
 of their fellow creatures! or to see a fat carcase, over-run with diseases
 occasioned by inactivity, dragged  through the streets by half a dozen
 horses.f                            #
  * A year seldom passes that we  do not hear of some hospital physician or
surgeon having lost his life by an hospital fever, caught from his patients.  For
this they have themselves alone to blame.  Their patients are either in an im-
proper situation, or they are too careless with regard to their own conduct.
  j- It is not necessity, but fashion, which makes the use of Carriages so com-
mon.  There are many people who have not exercise enough to keep their  hu-
mours wholesome, who yet dare not venture to make a visit to their next neigh-
bours, but in a coach or sedan, lest tbey should be looked down upon. Strange,
that  men should be such fools as to be laughed out of the use of their limbs'
or to throw away their health, in order to gratify a piece of vanity, or to comply
with a'ridiculous fashion ! 
OF EXERCISE."
83
  Glandular obstructions, now so common, generally proceed from in-
activity .  These are the most obstinate maladies.   So long as the liver,
kidnies, and other glands, duly perform their functions, health is sel-
dom impaired; but when they fail, nothing can restore it.  Exercise is
almost the only cure we know for glandular obstructions; indeed, it does
not always  succeed as a remedy: but there is reason to believe that it
would seldom fail to prevent these complaints, were it used in due time.
One  thing  is certain, that  amongst those Avho take sufficient exercise,
glandular diseases  are very little known; whereas the indolent and in-
active are seldom free from them.
   Weak  nerves are the constant companions of  inactivity.   Nothing
but exercise and open air cau brace aud strengthen the  nerves, or pre-
vent the endless train of diseases which proceed from a relaxed state of
these organs.   We  seldom  hear  the active or laborious complain of
nervous diseases; these are reserved for the sons  of  ease and affluence.
Many have been completely cured of these disordeis by being reduced,
from a state of opulence, to labour for their daily bread.  This plai.ily
points out the sources from Avhence nervous diseases flow, and the means
by which they may be prevented.
   It is absolutely impossible to enjoy health, Avhere  the perspiration is
not dnly  carried on : but that can never be the case where exercise is
neglected.  When the matter Avhich ought to be  thrown off by perspi-
ration is  retained in the body, it vitiates the humours, and o£tasi<ms the
gout, fevers, rheumatism, &c.   Exercfse alone would prevent many of
those diseases which «aanot be cured, and would remove others where
 medicine proves ineffectual.
   A late author,* in his excellent treatise on health, says that the weak
 and  valetudinary ought to make exercise a part of their religion.   We
 would recommend this, not only to the Aveak and valetudinary, but to
 all  Avhom  business does not oblige them  to take  sufficient exercise,
 as sedentary artificers,! shopkeepers, studious persons, &c.....Such ought
 to use exercise as regularly as they take food.  This might generally be
 done without any  interruption to. business or  real loss of time.#
   No piece of indolence hurts the health more than the modern custom
 of lying a-bed  too long in a morning.  This is the general practice, in
 great towns.   The inhabitants of cities seldom rise before eight or nine
 o'clock;  but the morning  is undoubtedly  the best  time for exercise,
 while the  stomach is empty, and the body refreshed.with sleep.   Be-
 sides the morning  air braces and  strengthens the nerves, and, in  some
  • Cheyne.                       '
  + Sedentary occupations ought chiefly to be followed by women.  They bear
confinement much better than men, and are fitter for every kind of business
which does not require much strength.  It is ridiculous enough to see a lusty
fellow making pins, n«dles, or watch wheels, while many of the laborious parts
of husbandry are carHed on by the other sex.  The fact is, we Want  men for
laborious employments, while one half of the other sex are rendered useless for
want of occupations suited to their strength, &c.  Were girls bred to mecharu-
cal employments, we should  not see such numbers of them prostitute them-
selves for bread, nor find such a want of men for the important purposes of na-
vigation, agriculture, &c  An eminent silk manufacturer told me, that he lound
women answer better for that business than men ; and that he had lately taken a
great many girls apprentices as sijk weavers.  I hope his example will be fc*
iwwed by many others* 
84
OF  EXERCISE.
 measure answers the purpose of a cold bath.   Let any  one  who has
 been accustomed to lie a-bed till eight or uine o'clock,  rise by six or
 seven, spend a couple of hours in walking, riding, or any active diver-
 sion  without  doors, and  he will find his spirits cheerful  and serene
 through the day, his appetite keen, and his body braced and strengthen-
 ed.   Custom soon renders early rising agreeable, and nothing contributes
 more to the preservation of health.
   The inactive are continually complaining of  pains of the stomach,
 flatulencies, indigestions, &c.   These complaints, w hich pave the way
 to many others, are not to be removed by medicines.   They can only be
 cured by a vigorous course of exercise, to which indeed they seldom
 fail to yield.
   Exercise, if possible, ought always to be taken  in the open air.  When
 that cannot be done, various methods  may be contrived for exercising
 the body within doors, as the dumb bell, dancing, fencing, &c.   It is not
 neces ary to adhere strictly to any particular kind of exercise.   The
 best way is to take them  by turns, and to use that longest which is most
 suitable (o the strength and constitution.  Those kinds of exercise which
 give  action to most of the bodily organs, are always  to be preferred, as
 Avalking. running, riding, digging, rubbing furniture, and such like.
   It  is much to be regretted, that active and  manly diversions are now
 so littje practised.  Diversions make people  take more exercise  than
 they  otherwise Avould do, and are of the greatest  service to such as are
 not under the necessity of labouring for their bread.  As active diver-
 sions lose ground, those of a sedentary kind seem  to prevail.  Sedentary
 diversions are of no other use but to consume time.  Instead of relieving
 the mind, they often require more thought than either study or business.
 Every thing that induces people to sit still, unless it be some necessary
 employment, ought to be avoided.
   The diverions which afford the  best exercise  are, hunting, shooting,
 playing at cricket, hand-ball, golff,* &c.  These exercise the limbs, pro-
 mote  perspiration and  the other secretions.   They likewise strengthen
 the lung% and give firmness an.d agiJity.to the whole body.
   Such as can, ought to spend tAvo or three hours a  day on horseback;
 those Avho cannot ride, should employ the same time in walking.    Ex-
 ercise should never be contmued too long.   Over fatigue prevents the
 benefit of exercise, and instead of strengthening the body tends to weak-
 en it.          •
   Every man should lay himself under some sort of necessity to take
 exercise.  Indolence, like other vices when indulged, gains ground, and
 at length becomes agreeable.   Hence ntany vyho were fond of exercise
 iu the early part of life, become quite averse to it afterwards.  This is
 the case of most hypochondriac and gouty people, which*renders their
 diseases in a great measure incurable.
  In  some countries laAvs  have been  made, obBging every  man, of
 Avhatever rank, to learn some mechanical  employment.   Whether
such  laAvs were designed for the preservation of health, or the encou-
ragement of manufacture, is a question of no importance.   Certain it
  * GolfFis a diversion very common in North Britain.  It is well calulated for
exercising the body, and may always be taken in such moderation, as neither to
over-heat nor fatigue.  It has greatly the preference over cricket, tennis, or any
^f those  games which cannot be played without violence. 
OF SLEEP  AND CLOTHING.             85
is, that if gentlemen were frequently to amuse aud exercise themselves iu
this Avay; it might have many good effects.  They would at least de-
rive as much honour from a few masterly specimens of their own work-
manship, as from the character of having ruined most of their compan-
ions by gaming or drinking.   Besides, men of leisure, by applying them-
selves to the mechanical arts, might improve them, to the great benefit
of society.
  Indolence not only occasions diseases, and renders men useless to so-
ciety, but promotes all manner of vice.  To say a man  is idle, is little
better than to call him vicious.   The mind, if  not engaged in some use-
ful pursuit, is constantly in quest of idle pleasures, or impressed with the
apprehension  of some imaginary  evil.   From  these sources proceed
most of the miseries of mankind.   Certainty man was never intended to
be idle.   Inactivity frustrates the very deign  of his creation ; wlu -(as
an active life is  the best guardian of virtue, and the*greatest preservative
of health.
                          CHAP. VI.

                OF  SLEEP AND CLOTHING.

          SLEEP, as well as diet,  ought  to be duly regulated.  Too
tittle sleep weakens the nerves, exhausts the spirits,  and occasions dis-
eases;  and too much renders the mind dull, the body gross, and disposes
to apoplexies, lethargies, and other complaints of a similar nature.  A
medium ought therefore  to be  observed; but this  is not easy to fix.
Children require more sleep than grown persons, the laborious than the
idle, and such as eat  and drink freely, than those who live abstemious-
ly.  Besides the real quantity of  sleep cannot be measured by time; as
one person will be more refreshed by five or six hours sleep, than another

  ^ Children may always be allowed to take as much sleep as they please;
but for adults, six or seven hours is certainly sufficient, and no one ought
to exceed eight. Those avIio lie a-bed more than eight hours may slum-
ber  but they can hardly be said  to sleep; such generally toss and dream
away the fore-part of the night, sink to rest towards morning, and dose
till noon.   The best way to make sleep sound and refreshing  is to rise
betimes.  The custom of laying  a-bed for  nine or tea hours, not on ly
makes the  sleep  less refreshing,  but relaxes the solids,  and greatl>
 Aveakens the constitution.                               ivr^w™ ™,«™
   Nature points out night as the proper  season for sleep.  ISothmgmoie
 certainly destroys the constitution than night-watching.   It is a great
 nHWhat a practice so destructive to health should be so much m fashion.
 C qu cWy the want of rest in due season will blast the most  bloommg
 complexion,  or  ruin the  best constitution, is evident from the  ghastly
 Stances  of those who, as the  phrase  is,  turn day into night, and

 ''^TVmakfsleep  refreshing, the following things  are requisite: First,
 to take sufficient exercise in the  open air:  to avoid strong tea or coffee;
 uckMo eat a P=ht supper; and lastly to lie down with a mind as cheer-
 ful and serene as possible. 
86
OF  SLEEP  AND  CLOTHING.
   It  is certain that too much exercise will prevent sleep, a,s well as  too
little.  We seldom however hear the active and laborious  complain of
restless nights.  It is the indolent and slothful who generally have these
complaiuts.   Is it any wonder  that a bed of down should uot be refresh-
ing to a person who sits all day in an easy chair ? A great part of the
pleasure of life consists in  alternate rest aud motion; but they Avho ne-
glect  the latter can never relish the former.  The labourer enjoys more
true luxury iu plain food and sound sleep, than is to be found in sumptu-
ous tables and downy pillows, where exercise is wanting.
   That light suppers cause sound sleep, is true  even to a proverb.   Ma-
ny persons, if they exceed the least at that meal, are sure to have un-
easy nights;  and, if they  fall asleep, the load and  oppression on their
stomach and spirits occasion frightful dreams, broken and disturbed repose,
the night-mare, &c.   Were the same persons  to go to bed Avith a light
supper, or sit up till tflat meal  was pretty Avefl  digested, they  would en-
joy sound sleep, and rise refreshed and cheerful.  There are indeed some
people avho cannot sleep, unless they have eat some solid  food at night,
but this does not imply the necessity of a heavy supper;  besides, these
are generally persons who have accustomed themselves to  this method,
and Avho do not take a sufficient quantity of solid food and exercise.
   Nothing more certainly disturbs our repose than anxiety.   When  the
mind  is not at ease, one seldom  enjoys sound sleep.   This greatest of hu-
man blessings flies the wretched, and visits the happy, the cheerful, aud
the gay.  This is a sufficient reason why every man should endeavour to
be aseasy in his mind as possible when he goes to rest.   Many, by «>
dulging grief and anxious thought, have banished sound sleep so long, that
they  could never  afterwards enjoy it.
   Sleep, Avhen taken in the f^re-part of the night, is generally reckoned
most  refreshing.    Whether this be the effect of habit or not, is hard to
say;  but  as most people  are accustomed to go early to bed when young,
it may be presumed that sleep, at this season,  will prove most refreshing
 to them ever after.  Whether the fore-part of the night be best for sleep
or not, surely the fore-part of the day is fittest both for business and
amusement.   I hardly ever knew an early riser, who did not enjoy a good
state  of health.*

                            Of  Clothing.
   The clothing ought to be suited to the climate.  Custom has  no doubt
a very great influence in this  article; but no  custom can  ever change
the nature of things so far, as to render the same clothing fit for an inha*
bitant of  Nova Zembla and the island of Jamaica.   It is not indeed ne-
 cessary to observe an exact proportion betAveen the  quantity of clothes
 we Avear and the degree of latitude which we inhabit; but, at the same
 time, proper attention ought to  be paid to it, as  well as to the openness of
 the country, the frequency and violence of storms, &c.
   In  youth,  wiiile the blood  is hot and the perspiration free, it is less
accessary to  cover the  body  with a gieat  quantity of clothes;  but in

   • Men of every occupation, and every situation of life, have  lived to a good
 old age; nay some have enjoyed this blessing whose plan of living was by no
 means regular: but it consists with observation, that all very old men have been
 early risers.  This kuhe-only circumstanQe attetidmg longevity to which I nevet
 knew an exception. 
OF  SLEEP  AND  CLOTHINCr             87
the decline of life, when the skin becomes rigid and the humours more
cool, the clothing should be increased.   Many diseases in the latter pe-
riod of life proceed from a defect of perspiration: these may, in some
measure, be prevented by a suitable addition to the clothing, or by wear-
ing such as are better calculated for promoting the discharge from the
6kin, as clothes made of cotton, flannel, &c.
   The  clothing ought likewise to be suited  to the season of the year.
Clothing may be warm enough for summer, which is by no means suffi-
cient for winter.   The greatest caution, however, is necessary in making
these changes.   We ought neither to put off our winter clothes too soon,
nor to Avear our summer ones too long.   In this country, the winter often
sets in very early with great rigour, and we have frequently cold Aveather
even after the commencement of the summer months.   It would like-*
wise be prudent not to make the change all at once, but do it gradually;
and indeed the changes of apparel in  this climate ought to be very in-
considerable, especially among those who have passed the meridian of
life."
   Clothes often become hurtful by their being made subservient to the
purposes of pride or vanity. Mankind in all ages seem to have consider-
 ed clothes in this vieAv;  accordingly their fashion and figure have been
continually"  varying,  with  very little regard either to health,  the cli-
mate, or conveniency; a farthingale, for example, may be very necessa-
ry in hot southern climates, but surely nothing can be more ridiculous
in the cold regions of the north.
   Even the  human shape is often attempted to be mended by dress, and
those who know no better  believe that mankind Avould be monstrous
w ithout its assistance.   All attempts of this nature are highly pernicious.
 The  most destructive of them in this country is that of squeezing the
stomach and boAvels into as narroAV a compass as possible, to procure,
what is falsely called, a fincsJrape.f   By this practice the action of the
 stomach and bowels, the motion of the heart and lungs,  and almost all
 the vital functions, are obstructed.   Hence proceed indigestions, syn-
 copes or fainting fits, coughs, consumptions of the lungs, and other com-
 plaints so common among females.
    The feet  likewise often suffer by pressure.   How a small foot came
 to be reckoned genteel, I will not pretend to say; but certain it is, that
 this notion has made many persons lame.   Almost nine-tenths of man-
 kind are troubled with corns: a disease that is seldom or never occa-
 sioned but by strait shoes.  Corns are not only very troublesome, but
 by rendering people unable to walk, they may  likewise  be considered
 as the remote cause of other diseases.!
  * That colds kill more than  plagues, is an old observation .- and,
with regard to this country, it holds strictly true.  Every person of discern-
ment, however, will perceive, that most of the colds which prove so destructive
to the inhabitants of Britain,  are owing to their imprudence in  changing
clothes   A few warm days in March or April induce them to throw off their
winter garments, without considering that our most penetrating colds general*
ly happen in the spring                       .
  -j This madness seems to have pervaded the minds ot mothers in  every age
and country.  Terence-, in his Comedy  of the Eunuch, ridicules the Roman
matrons for attempting to mend the shape of their daughters
  $ We often see persons, who are rendered quite lame by the nails of their
toes having grown into the flesh, and frequently hear of mortifications proceed- 
88              OF  SLEEP  AND  CLOTHING.
   The size and figure of the shoe ought certainly to be adapted to the
 foot.  In children the feet are as well shaped as the hands, and the mo-
 tion of the toes as free and easy as that of the fingers; yet few persons
 in  the advanced period of life are able to make any use of their toes.
 They are generally, by narrow shoes, squeezed all of a heap, and often
 laid over one another in such a manner as to be rendered altogether  in-
 capable of motion.   Nor is the high heel  less hurtful than the narrow
 toe.   A lady may seem taller for walking on her  tiptoes, but she will
 never w alk well in this manner.   It strains her joints, distorts her limbs,
 makes her stoop, and utterly destroys all her ease and gracefulness of
 motion :  it is entirely owing to shoes with high heels  and narrow toes,
 that not one female in ten can be said to Avalk well.
•  In  fixing on the clothes, due care should be taken to avoid all tight
 bandages.  Garters, buckles, &c. Avhen drawn too tight, not only pre-
 vent the free motiou and use of the parts  about which they  are bound,
 but likewise obstruct the circulation of the blood, which prevents the
 equal nourishment  and growth of these parts,  and occasions various di-
 seases.  Tight bandages about the neck,  as stocks, cravats, necklaces,
 &e. are extremely dangerous.   They obstruct the blood in its course
 from the brain, by which means head-achs, vertigoes, apoplexies, and
 other  fatal diseases are often occasioned.                  #
   The perfection of dress is to be easy and clean.   Nothing can be more
 ridiculous,  than for any one to make  himself a slave to fine clothes.
 Such a one, and many  such there are, Avould rather remain as fixt as a
 statue from morning till  night, than discompose a single hair, or alter
 the position of a pin.   Were Ave to recommend any particular pattern
 for dress, it would  be that which is worn by  the people called Quakers.
 They are always neat, clean, and often elegant, without auy thing su-
 perfluous.  What others lay out upon tawdry laces, ruffles, and ribands,
 they bestow upon superior cleanliness.   Finery is only the affectation of
 dress, and very  often covers a great deal of dirt.
   We shall only add, with regard to clothing, that it ought  not only to
 be  suited to the climate, the season of the year, and the period of fife;
 but likewise to the temperature and constitution.  Robust persons are
 able to endure either cold or heat better than the delicate; consequently
 may be less  attentive to their clothing.   But the precise quantity of
 clothes necessary for any person cannot  be determined by reasoning.
 It is entirely a matter of experience,  and every man is the  best judge
 for himself what quantity of clothes is necessary to keep him warm.*

 ing from this cause.   All these, and many other  inconveniences attending the
 feet, must be imputed solely to the  use of short and strait shoes.
  * The celebrated Boerhaave used to say, that nobody suffered by cold save
 fools and beggars; the latter not being able to procure clothes, and the former
 not having sense to wear them  Be this as it may, I can with the strictest truth
 declare, that in many cases where the powers of medicine had been tried in
 vain, I have cured the patient by recommending thick shoes, a flannel waistcoat
 and drawers, a pair of under stockings, or a flannel petticoat, to be worn during
 the cold season at least   Where warmer clothing is wanted, I would recom-
 mend the fleecy hosiery to be worn next the skin. 
&9
                         CHAP.  VII.

                     OF INTEMPERANCE.

         A  MODERN author ■ observes that temperance and  ex-"
crcise are the two best physicians in the world.  He might have added,
that if these were duly regarded, there Avould be little occasion for any
other.   Temperance   may justly be  called the parent of health;  yet
numbers of mankind act as if they thought diseases and death too slow
in their progress, and by intemperance and debauch seem as it were to1
solicit their approach.
   The  danger of intemperance appears from the veiy construction of
die  human body.  Health  depends  on  that  state of the  solids  and
fluids which fits them for the due performance of the vital  functions;
and  Avhile these go regularly on, we are  sound and w ell; but whatever
disturbs them necessarily impairs health.   Intemperance never fails to
disorder the Avhole animal economy; it hurts the  digestion, relaxes  the
nerves, renders  the different  secretions irregular, vitiates the humours,
aud occasions numberless diseases.
   The analogy  between the nourishment of plants and  animals affords
a striking proof of the danger of intemperance.  Moisture and manure
greatly promote vegetation;  yet an ovev-quaatity of either will entirely
destroy it.   The best  things become hurtful, nay,  destructive,  when
carried to excels.   Hence we learn,  that the  highest degree of human
Avisdom cousists in regulating our appetites and passions so as to avoid
all extremes.   It is that chiefly Avhich entitles us to the character of ra-
tional beings.   The slave of appetite will ever be  Uie disgraee of  lift*
man nature..
   The Author  of Nature hath endued us with various passions, for the
propagation of the species, the preservation of the individual, Sec.  In-
temperance is the abuse of these passions; and moderation consists in the
proper regulation of them.   Men, not contented Avith satisfying the sim-
ple calls of Nature, crer.te artificial Avants, and are perpetually in search
after something that may gratify them; but imaginary Avants  can never
be gratified.    Nature "ib  content  with little; but luxury knoAvs no
Mounds.   Hence the  epicure, the drunkard, and the debauchee seldom
stop in  (heir career  till their  money or their constitution fails: diep
indeed they generally see their error when too late.
   It is impossible to lay down fixed rules with regard to diet,  on account
of the different constitutions of mankind.  The most ignorant person^
however,  certainly knows  what is meant by excess;  and it is in the
power of every man, if he chooses to avoid it.
   The great rule of diet is  to study simplicity.  Nature delights in the
most plain and simple food, and every animal,  except man, follows  her
dictates.  Man  alone  riots at large, and ransacks  the vvliote  creation in
(piest of  luxuries, to  his oavh destruction.  An elegant writerf  of  the
last  age. speaks thus of intemperance  in diet:  " For my part, Avhen I be-
hold a fashionable table set  put iu all its magnificence, I fancy that I see
•-•outs and dropsies, levers and lethargies, with other innumerable  dis-
temper.-, lying in ambuscade among the dishes."

                * Kosseau.                 t  Addison.
                               12 
90
OF  INTEMTER ANCE.
   Nor is  intemperance in other things less  destructive  than in diet.
 How quickly does the  immoderate pursuit  of carnal pleasures,  or the
 abuse of intoxicating liquors,  ruin the best contistution!   Indeed these
 vices generally go hand in hand.   Hence it is that we so often  behold
 the votaries of Bacchus aud Venus,  even before they have arrived at
 the prime  of life, Avorn out with diseases, and hastening with swift pace
 to an untimely grave. Did men reflect on the painful diseases and prema-
 ture deaths, which are daily occasioned by intemperance, it would be
 sufficient  to  make  them shrink back Avith honor from the indulgence
 even of their darling pleasures.
   Intemperance does not hurt its votaries alone;  the  innocent too ofteu
 feel the direful  effects  of it.   How  many  wretched orphans are to be
 seen embracing dung hills, Avhose parents, regardless of the future, spent
 in riot and debauch what might have served to bring up their offspring
 in a decent manner!   Hoav often do we behold the miserable mother,
 with  her helpless  infants, pining in want, Avhile the cruel father is in-
 dulging his insatiate appetites!
   Families are not only reduced to misery, but  even extirpated, by in-
 temperance.  Nothing tends so much prevent propagation, and shorten
 the lives of children, as the intemperance of parents.  The poor man Avho
 labours all day, and at night lies doAvn contented with his humble fare, can
 boast  a numerous offspring, while his pampered lord,  sunk in ease and
 luxury, often languishes  Avithout an  heir to his ample fortunes.   Even
 states and empires feel the  influence of intemperance,  and rise or fall as
 it prevails.
  Instead of  mentioning the different kinds of intemperance, and point-
 ing out tlieir influence upon health, Ave shall only, by way of example,
 make a feAV observations  on one  particular species  of that vice, viz.
 the abuse  of intoxicating liquors.
   Every act of  intoxication puts nature to the  expense of a fever, iu
 order to discharge the poisonous- draught.  When this is repeated almost
every  day, it is  easy  to  foresee  the consequences.  That constitution
 must be strong indeed,  which is  able long  to hold out under a daily
fever! but fevers occasioned by drinking do not ahvays go off in a day;
 they frequently  end in an inflammation of the breast,  liver, or brain, and
 produce fatal effects.
  Though  the drunkard  should not fall by  an acute  disease, he  seldom
escapes those of  a chronic kind.   Intoxicating liquors, when used  to
 excess, Aveaken  the boAvels and spoil the digestion; they  destroy the
power of the nerves, and occasion paralytic and convulsive disorders;
 they likeAvise heat and inflame the blood, destroy its balsamic quality,
render it unfit for circulation, and the nourishment of  the body.   Hence
obstructions, atrophies, dropsies, and consumptions of the lungs.   These
are the common ways in which drunkards make their exit.   Diseases of
 this kind, when  brought on by hard drinking, seldom admit of a cure.
  Many people injure their health by drinking, who  seldom get drunk.
 The continual habit of  soaking, as it is called, though its effects be not
 so violent, is not less  pernicious.    When the  vessels are kept con-
stantly full and upon   the stretch,  the different digestions can nei-
ther  be duly  performed, nor  the humors properly prepared.   Ih nee
most people of this character are afflicted with  the  gout,  the gravel,
njcerous sores in the legs, &c.   If these disorders do not  appear, they 
OF  INTEMPERANCE.
91
are seized with low spirits, hypochondriacal affections, and other symp-
toms of indigestion.
   Consumptions are now so common, that it is thought one-tenth of the
inhabitants of great towns die  of that disease.   Hard drinking is no
doubt one of the  causes to which we must  impute the increase of con-
sumptions.  The great quantities of viscid malt liquor drank  by the
common people of England, cannot fail to render the blood sizy and unfit
for circulation; from whence proceed obstructions, and inflammations of
the lungs.  There  are few great ale-drinkers w ho are not phthisical:
nor is that to be wondered at, considering the glutinous and almost in-
digestible nature of strong ale.
   Those  Avho drink ardent spirits or strong wines,  run still greater ha-
zard; these liquors heat and inflame the blood, and tear the tender ves-
sels of the lungs to pieces; yet so great  is  the consumption of them in
this country, that one w.ould almost be induced to think that the  inhabi-
tants lived upon them.*
   The habit of drinking proceeds frequently from misfortunes  in  life.
The miserable fly to it for relief.  It affords them indeed a temporary
ease.   But,  alas! this solace is short-lived; and when it is  over, the
spirits sink as much below their usual tone as they had before been rais-
ed above  it.   Hence a  repetition of the dose becomes necessary, and
every fresh dose makes way for another, till the unhappy wretch becomes
a slave to the bottle, and at length falls a sacrifice to what at first perhaps
was taken only as a medicine.  No man is so dejected as  the drunkard
when his  debauch  is  gone off.   Hence it  is, that  those who have the
greatest Aoav of spirits while the glass circulates freely, are of all others
the most  melancholy  Avhen  sober,  and often put  an end to their own
miserable existence in a fit of spleen or ill  humour.
   Drunkenness not only proves destructive to health, but likeivisetothe
faculties of the mind.   It is  strange  that  creatures  Avho  value them-
selves on  account of a superior degree of reason to that of brutes, should
take pleasure in sinking so far beloAV them.  Were such as voluntarily
deprive themselves of the use of reason, to continue ever after in that
condition, it ivould seem  but a just punishment.   Though this be uot
the consequence of one act of intoxication,  it seldom fails to succeed a
course of  it.   By a  habit of drinking, the greatest genius is often redu-
ced to a mere idiot.f
    * We may form some notion of the immense quantity of ardent spirits con-
  sumed in Great-Britain from this circumstance, that in  the city of Edinbui-g
  and its environs, besides the great quantity of foreign spirits duly entered, and
  the still greater quantity which is supposed to be smuggled,  it is  computed
  that above two thousand private stills are consantly employed in preparing a
  poisonous liquor called Molasses.  The common people have got so univer-
  sally into the habit of drinking this base spirit, that when a porter or labourer
  is seen reeling along the streets, they say, he has cot molassed.
    ■j- It is amazing that our improvements in arts, learning and politeness, have
  not put the barbarous custom of drinking to excess  out of fashion.  It is in-
  deed less common in South-Britain thun it was formerly ; but  it still prevails
1  very much in the North, where this relic of barbarity is mistaken for hospitali-
  ty.  There no man is supposed to entertain his guests well, Avho does not make
  them drunk.  Forcing people to drink is certainly the greatest piece of rudeness
  that any man can be guilty of.  Manliness, complaisance, or mere good-nature,
  may induce a man to take his glassT if urged to it, at a time when he might as
  well take poison.  The custom of drinking to excess has long been out  of f*- 
92                   OF CLEANLINESS.
   Intoxication is peculiarly hurtful to young persons.   It  heats  theif
blood, impairs their strength,  aud obstructs tlieir growth ; besides, the
frequent use of strong liquors in the early part of life destroys any bene-
fit that might arise from them afterwards.   Those who make a practice
of drinking generous liquors when young, cannot expect to reap an>  be-
nefit from them as a cordial in the  decline of life.
   Drunkenness  is uot only in itself a most abominable vice,  but is an
inducement  to many others.   There is hardly any crime so horrid that
the drunkard will not perpetrate for the love of liquor.   We  have knpwn
mothers sell their children's clothes, the food that they should have eat,
and afterwards even  the  infants themselves, in order to purchase  the
accursed draught.


                          CHAP.  VIII.

                       OF CLEANLINESS.

        X HE want  of cleanliness is a fault which admits of no excuse.
Where Avater can be had  for nothing, it is surely in the power of every
person to  be clean.   The continual  discharge from our bodies by per-
spiration,  renders frequent change of apparel necessary.  Changing ap-
parel greatly  promptes the secretion  from the  skin, so necessary for
health.  When that matter Avhich ought to be carried off  by  perspira-
tion is either retained in the body, or reabsorbed from dirty clothes, it
must occasion diseases.
   Diseases of the skin are chiefly owing to want of cleanliness.*  They
may indeed be caught by infection, or brought on by  poor living,  un-
wholesome food, &c.  but  they Avill seldom continue long Avhere  clean-
liness prevails.  To the same cause must avc impute the various kinds
of vermin which  infest the human body, houses, Ac.   These may al-
ways  be banished by cleanliness alone, and Avherever they  abound, Ave
have reason to believe it is neglected.
   One common  cause  of putrid  and malignant fevers is the Arant of
cleanliness.   These fevers commonly begin among the inhabitants of
close, dirty houses, Avho breathe unwholesome air,  take little  exercise,
and wear dirty  clothes.    There  the infection is generally  hatched,
which often spreads far and Avide, to the destruction of many.  Hence
cleanliness may be considered as  an object  of public attention.  It k
not sufficient that I be  clean myself, while the want of it in my neigh-
bour affects my health as  well as his.  If dirty people  cannot  be remo-
ved as a common nuisance, they ought at least to be avoided as infec-
tious.  All who regard their health should keep at a distance even from
their habitations.
   In  places where great  numbers of people are collected, cleanliness
shion in France ; and, as it begins to lose ground among the politer part of the
English, we hope it will soon be banished from every part of this island.
  * Mr. Pot, in his surgical observations, mentions a disease which he calls the
chimney sweeper's cancer, as  it is almost peculiar to that unhappy set of peo-
ple. This he attributes to neglect of cleanliness, and with great justness.  I am
convinced, that if that part of the body which is the seat of this cruel  disease
was kept clean by frequent washing, it would never happen-   The climbing
boys, as they are called, are certainly the most miserable wretches on the face
of the earth ; yet, for cleaning chimnies, no such persons are necessary. 
OF CLEANLINESS.
93
b< comes of the utmost importance.  It is Avell known that infectious di-
seases are commuidcated by tainted air.   Every tiling, therefore, which
tends to pollute the air, or spread  the infection, ought with the utmost
care to be guarded against.   For this reason, in great towns, no filth, of
any kiud, should be permitted to lie upon the streets.  Nothing is more
apt to convey infection than the excrements of the diseased.
  In many great towns the streets  are  little better than dunghills, being
frequently covered with ashes, dung, and nastiness of every kind.  Even
slaughter-houses, or killing shambles, are often to be seen in the very cen-
tre  of great  towns.   The  putrid  blood,  e:- elements, &c. Avith Avhich
these places are generally covered, cannot fail to taint the air, and render
it unwholesome.  How easily might this be prevented by active magis-
trates who have it always in their power to make proper laws relative to
things of this nature, aud to enforce the observance of them!
  We are sorry to say,  that the importance of general cleanliness does
not seem to be sufficiently understood by the magistrates of most great
towns in Britain; though health,  pleasure, and delicacy, all conspire to
recommend an attention  to it.   Nothing  can be more agreeable to  the
senses more to the honour of the inhabitants, or more conducive to-their
health,  than a clean town; nor can any thing impress a  stranger with a
more disrespectful idea of any people  than its opposite.   Whatever pre-
tensions people may make to learning, politeness, or civilization, Ave Avill
venture to affirm, that Avhile they neglect cleanliness, they rre in a state
of barbarity.'-1
   The  peasants in most countries  seem to hold cleanliness in  a sort of
contempt.   Were it not for the open situation of the houses, they would
often feel the  bad effects of this disposition.   One seldom sees a farm-
house Avithout a dunghill before the door,  and frequently the cattle and
their masters lodge under the same roof.   Peasants are likeAvise extreme-
ly careless  with respect to change of apparel, keeping their houses, «fcc.
clean.   This is merely the  effect of indolcneo and ti dirty disposition.
Habit  may indeed  reudcr it less disagreeable to them, but no  habit can
ever make it  salutary to Avear dirty clothes or breathe unwholesome air.
  As many articles of diet come through the hands of peasants, eveiy
method should be taken to encourage and promote habits of cleanliness
among them.    This, for example, might be done by giving a small pre-
mium to the person  who brings the cleanest and best  article of any kind
to market, as butter,  cheese, Ac. and by punishing severely those who
bring it dirty,   The same  method should be taken with butchers, ba-
ke rs^ brewers, and all who are employed in preparing  the necessaries of
life.
   In camps the strictest  regard should be paid to cleanliness.   By negli-
gence in this matter, infectious diseases are often spread amongst a whole
army;  and frequently more die of these than by the sword.  The Jews,

  * In ancient Rome the greatest  men did not think cleanliness an object un-
worthy of their attention.  Pliny says, the Cloaca;, or common sewers for the
conveyance of filth and nastiness from the city, were the greatest of all the pub-
lic works; and bestows higher encomiums upon Tarquinus, Agrippa, and others
who made and improved them, than on those who achieved the greatest con-
quests.                               .           ......
  How truly great does the emperor Trajan appear,/when  giving directions to
Pliny, hi9 proconsul, concerning the making of a common sewer for the health
and convenience of a conquered city! 
94
OF CLEANLINESS.
 during their encampments in the wilderness, received particular iu*truo
 lions Avith  respect to cleanliness.   The rules enjoined them ought to be
 observed by all in the like situation.    Indeed the Avhole sj stem of laws
 .delivered to that people has a manifest tendency to promote cleanliness.
 Whoever considers the nature of their climate, the diseases to Avhich they
 were liable, and their duty disposition, will  see  the  propriety of such
 laAvs.
   It is remarkable that,  in most eastern countries, cleanliness  makes a
 great part of their  religion.   The Mahometan as av<;11 as the Jewish reli-
 gion enjoins various bathings,  Avashings,  and purifications.—No  doubt
 these might be designed to represent inward purity; but they were at the
 same time  calculated for the  preservation of health.   However  Avhim-
 sical these  Avashings  may appear to some, feAV things would tend more to
 prevent diseases than a proper attention to many of them.  Were every
 person, for example, after visiting  the  sick, handling a dead  body, or
 touching any thing that might convey infection, to wash before he went
 into company, or sat doAvn to meat, he Avould run le*s hazard cither of
 catching the infection himself, or of communicating it to others.
   Frequent Avashing  not  only removes the filth and sores which adhere
 to the skin, but likeAvise promotes the perspiration, braces the body, and
 enlivens the spirits.   How refreshed, how cheerful, and agreeable does
 one feel on being shaved, washed, and shifted: especially Avhen these of-
 fices  have been neglected longer than  usual!
   The eastern custom of  washing the feet, though less necessary in this
 country, is  nevertheless a very agreeable piece of cleanliness, and contri-
 butes greatly to the  preservation of health.   The sAveat  and dirt with
 which these parts are frequently covered,  cannot fail to obstruct the per-
 spiration.   This piece  of cleanliness  Avould often prevent colds and fe-
 vers.  Were people  careful  to  bathe  then- feet and legs in luke-Avann
 water at night, after being exposed to  cold or wet through the day, they
 Avould seldom experience the ill effects which often proceed from these
 causes.
   A proper attention, to cleanliness is no  Avhere more necessary than on
 ship board.   If epidemical distempers break out there, no one can be safe.
 The best  Avay to prevent them, is to take care that the Avhole companv be
 cleanly in their clothes, bedding, Ac.  When infectious diseases do bn ak
 out, cleanliness is the most likely means to prevent their spreading: it is
 likeAvise necessary to prevent their returning afterwards, or being conveyed
 to other places.   For this purpose the clothes, beddinsr, &c. of the sick
 ought to  be carefully washed, and fumigated with brimstone.  Infection
 Avitl  lodge a long time in dirty clothes, and  afterwards break out  in the
 mott terrible manner.
   Iu  places Avhere great  numbers  of sick  people are  collected  toge-
 ther,  cleanliness  ought to be  most religiously  observed.   The  veiy
 smell in such places is often sufficient to make one sick.  It is easy to
 imagine what effect that is  likely  to have  upon the diseased.   In an
 hospital or infirmary, where  cleanliness is neglected, a  person in per-

  * Thou shalt have a place also without the camp, whither thou shalt go forth
 abroad ; and thou shalt have a paddle upon thy weapon: and it shall be when
thou shalt ease thyself  abroad, thou shalt dig therewith, and shall turn back,
 and cover that which cometh from thee, 8tc.
                                         Dexter, chap. xxii. ver. 12, 13. 
OF  INFECTION.
95
feet health has a greater chance to become sick, than a sick person lias
to get well.
   FeAv things are more unaccountable than that neglect, or rather dread
of cleanliness, which appears among those who have the care of the sick ;
they tliiidv  it almost criminal to suffer  any thing that is clean to come
near a person in a fevers; for example, they Avould rather allow him to
wallow in all manner of filth, than change the least bit of  his linen.   If
cleanliness be necessaiy for persons in health, it  is certainly more  so  for
the sick.  Many diseases may be cured by cleanliness alone; most of them
might be  mitigated by it;  and, where it is neglected, the slightest disor-
ders are often changed into the  most malignant.  The same mistaken
care wliich prompted people to prevent the least admission of fresh air to
the sick,  seems to have induced them to keep them  dirty.  Both these
destructive prejudices will, Ave hope,  be  soon eradicated.
   Cleanliness is certainly agreeable to our nature.  We cannot help  ap-
proving it  in others, even though we should not practice it  ourselves.
It sooner attracts  our regard than even finery itself,  and often gains es-
teem Avhere that fails.  It is an ornament  to the highest as well as to the
lowest station, and cannot be dispensed with in either.   Few virtues are
of more importance to society than general  cleanliness.  It ought to be
carefully cultivated eveiy where; but in  populous cities it should be al-
most revered.*1


                            CHAP.  IX.

                         OF  INFECTION.

          MANY diseases are infectious.  Every person ought* Uicnr-
 fore  as far as he can, to aviod all  communication with the diseased.  The
 common  practice  of  visiting the sick, though often Avell meant; has many
 Ul ^iseauences.   Far be it from me to  discourage any act of chanty or
   «»IvS^^ly toward* those in distress; but I cannot helpblam-
 ^  such as endanger their own or their neighbours lives, by a mistaken


 from moving till  night Avidi idle visitors.  It * ™WJ^£
 for servants and young people to ^U£^c gStoSdSE
 S^X^SS; te^cheTliisethe danger  of  this conduct,
 Sopte o^  «t* Avers in thb^yay, and communicate them to others.
 till at length  they become epidemic.__________________________________

 TX^ is impossible to be thoroughly^an widmut ^cie^quantity of
 water, we would earnestly recommend it to the  ™gr      {^AtSiln are so
 be particularly attentive to tins ^Jg^ who  will" not
 situated as to be easily supplied vriA *^i - Sr hand, certainly deserve to be
 make a proper use ^^"J^^^^m'* had, ought
 severely punished-  The streets oier■       ft.    , method for keeping them
 to be washed  every day.  1Jus a the only c"      d  .   -u  bc found ^
 thoroughly clean ; and, upon trial, we are  ptrsua

 ChIomeof the mos't dreadful' diseases incident to human nature, might, in my
 opinion, be entirely eradicated by clear! m«.■«« 
96
0J1  IM'ECTIO.N.
   It would be thought highly improper  for  one  Avho had not had ti:.-
smell-poXjto wait upon a patient in that disease ; yet many other fever*
are almost as  infectious as the small-pox,  and uot less fatal.   Some ima-
gine that fevers prove more fatal in villages than in great towns, for want
of proper medical assistance.  This may sometimes be the case; but  I
am inclined to think it oftener proceeds from the cause above-mentioned.
   Were a plan to be laid down for communicating infection, it could iw,t
be done more  effectually than by the common method of \ isiting the h< .'■..
Such visitors not only  endanger  themselves and  their  connections,  bi;;
likewise hurt the sick.. By croAvding the house they  render  the air  un-
wholesome,  and by their  private whispers and dismal countenances dis-
turb the imagination of the patient, and depress his spirits.   Persons who
are ill, especially in fevers, ought to be kept as  quiet  as possible.   The
sight of strange faces, and every thing that disturbs the mind, hurts them.
   The common practice in   country places of inviting great numbers of
people to funerals, and croAvding them into the same apartment where the
corpse lies,  is  another way of spreading  infection.  The infection does
not always die with the patient.   Every thing that comes into contact with
his body while alive,  receives the contagion, and some of them, as clothes,
blankets, &c. "will retain it for a long time.  Persons Avho die with infec-
tious disorders ought not to lie long unburied;  and people should keep a>
much as possible at a distance from them.
   It Avould tend greatly to pre\*ent the spreading of infectious diseases, if
those in health were kept at a proper distance from the sick. The Jcwidi
Legislator, among many other wise  institutions for preserving  health,  has
been peculiarly attentive to the means of preventing infection, or defile-
ment as it is called, either from a diseased person or a dead bod}. In ma-
ny cases the diseased were to be  separated from those in health ;  and it
was deemed a crime even to  approach their habitations.  If a person on-
ly touched a diseased or dead body, he was appointed to wash himself iu
water,  and to keep for some time  at a distance from society.
   Infectious diseases are often communicated by clothes.  It is extreme-
ly dangerous to wear apparel Avhich has been  Avorn by the diseased,  un-
less it has been Avell washed and fumigated, as infection may lodge a long
time in it, and afterwards produce very tragical effects.  This shews the
danger of buying  at random  the  clothes which have been worn by other
people.
   Infectious disorders  are  frequently imported.   Commerce, together
with the riches of  foreign climes,  bring us also their diseases.   These do
often more than counterbalance all the advantages of that trade by means
of which they are introduced. It  is to be regretted, that so little care
iscommonly bestowed, either to prevent the introduction or spreading of
infectious maladies.   Some  attention  indeed is generally paid to  the
plague; but other diseases pass unregarded.*

  * Were the tenth  part of the care taken to prevent the importation of di-
seases, that there is to prevent smuggling, it would be attended with many hap
py consequences. This might easily be done by appointing a physician at every
considerable sea-port, to  inspect the ship's  company, passengers, &c before
they came ashore, and, if any fever or other infectious disorders prevailed, to
order the ship to perform a short quarantine, and to send the sick to some hos-
mtal or proper place to be cured. He might like wise order ail  the clothe*, 
OF  INFECTION*
97
   Infection is often spread through cities, by jails, hospitals, &c.  These
are frequently situated in the very middle of populous towns; and Avhen
infectious diseases break out in them,  it is impossible for the inhabitants
to escape.   Did magistrates pay any regard to the health of the people,
this evil might be easily remedied.
   Many are the causes which tend to diffuse infection through populous
cities.   The  whole atmosphere of a large town is one  contaminated
mass, abounding with various kinds of infection,  arid must be pernicious
to health.   The best advice that we can give to such as are obliged to
live in large cities, is to cbuse an open situation;  to avoid narrow, dirty,
croAvded streets;  to keep their own houses 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  spreading of infectious diseases,
were proper  nurses every where employed to  take care of the sick.
This might often save a family, or even a whole toAvn, from being in-
fected by one person.  We do  not mean that people  should  abandon
their friends or relations in distress, but only to put them on their guard
against being too much in company with those Avho  arc  afflicted with
diseases of an infectious nature.
   Such as wait upon  the  sick in infectious diseases run very great  ha-
zard.   They should stuff their noses with tobacco, or some other strong
smelling herb, as rue, tansy, or the like.   They ought likewise to keep
the patient very clean, to sprinkle the room where he lies with vinegar,
or other strong acids, frequently to admit a stream of fresh air into it,
and to avoid the smell of his breath as much as they can.  They ought
never to go into company without having changed their clothes and wash-
ed their hands; otherwise, if  the disease be infectious,  they will in all
probability carry the contagion along Avith them.*
   However trifling it may appear to inconsiderate persons, we will  ven*
ture to affirm, that a due  attention to those things which tend to diffuse
infection Avould be of great importance in preventing diseases.  As most
diseases are in some degree infectious, no one should continue long  w ith
the sick, except the necessaiy attendance.   I mean not, however, by
this caution, to deter those Avhose duty or office leads them to wait upou
the sick, from such a laudable and necessary employment.
   Many things are in the poAver of the magistrate Avhich would tend to
prevent the spreading of infection; as the promoting of public cleanli-
ness ; removing jails, hospitals, burying-grounds, and other places where
bedding, &c. which had been used by the sick during the voyage, to be either
destroyed, or thoroughly cleansed by fumigation, 8cc. before any of it were sent
ashore.  A scheme of this kind, if properly conducted, would prevent many
fevers, and other infectious diseases, from being brought by sailors into sea-
port towns, and by this means diffused all over the country.
  * There is reason to believe that infection is often conveyed from one place to
another by the carelessness of the faculty themselves.  Many physicians afl'ect
a familiar way of sitting upon the patient's bed-side, and holding his arm for a
considerable "time.  If the patient has the small-pox, or any other infectious di-
sease, there is no doubt but the doctor's hands, clothes, &c. will carry away
some of the infection ; and, if he goes directly to visit  another patient without
washing his hands, changing his clothes,or beingexposed to the open air, which
is not seldom the case, is it any wonder that he should carry the disease along
with him ? Physicians not only endanger others, but also  themselves, by this
practice.  And indeed they sometimes suffer for their want of care. 
9ti
OF  THE  PASSIONS.
infection may be generated at a  proper distance from great towns f
widening the streets; pulling down useless walls, and taking all methods
to promote a free circulation of air through every part  of the toAvn, &c.
Public hospitals, or proper places of reception for the sick, provided they
were kept clean, well ventilated, and placed iu an open situation, would
likewise tend to prevent the spreading of infection.   Such  places of re-
ception Avould prevent the  poor, when sick, from beiug visited by their
idle or officious neighbours.  They would likeAvise render it unnecessa-
ry for sick servants to be kept in  their master's  houses.  Masters had
better pay for  having their servants taken care of in  an liospital, than
run the hazard of having an infectious disease diffused among a numer-
ous family.  Sick servants and poor people,  when placed  in hospitals,
are not only  less apt to diffuse infection among their neighbours,  but
have likewise the advantage of being well attended.
   We are not, however,  to learn that  hospitals, instead of preventing
infection, may become the means of diffusing it.   When they are placed
in the middle of great towns;  when numbers of patients are crowded to-
gether in small apartments; when there is  a constant communication
kept up between the citizens  aud the patients; and when cleanliness
and ventilation are neglected, they become nests for  hatching diseases,
and every one who goes into them not only runs a risk of receiving in-
fection himself, but likewise of communicating it to others.  This how-
ever is not the fault of the hospitals, but of those who have the manage-
ment ot them.   It were to be  wished, that they Avere both  more numer-
ous, and upon a more respectable footing, as  that would induce  people
to go into them with less reluctance.   This is  the more  to be desired,
because most of the putrid fevers and other  infectious disorders break
out among the poor, and are by them communicated to the more cleanly,
and the wealthy.   Were proper attention paid to the first appearances
of such disorders, and the patient's early conveyance to an hospital, we
should seldom see a putrid fever, which is almost as infectious  as  the
plague, become epidemic.



                           CHAP.  X.

                       OF THE PASSIONS.

           J/HE passions have great influence  both  iu the cause and
 Core of diseases.   Hoav the mind affects the body, will in all probability
 ever remain  a secret.   It is  sufficient for us to know, that there is es-
 tablished a reciprocal influence between the mental and corporeal parts,
 and that Avhatever injures the one disorders the other.

                             Of Anger.
    The passion of anger ruffles the  mind,  distorts the countenance,
 hurries on the circulation of  the  blood, and  disorders the whole  vital
 and animal functions.   It often  occasions fevers,  and other acute di-
 seases; and sometimes even sudden death.   This  passion is peculiarly

    * The ancients would not suffer even the temples of their gods, where the
 sick resorted, to be built within the walls of a city. 
OF  THE  PASSIONS.
99
hurtful to the delicate, and those of weak nerves.  I have known such
persons frequently lose their lives by a violent fit of anger, and would ad-
vise them to guard against the excess of this passion with the utmost care.
   It is not indeed always in  our power to prevent being  angry;  but we
may  surely avoid harbouring resentment in our breast.   Resentment
preys upon the mind, and occasions the most obstinate chronical disor-
ders,  which gradually waste the constitution.  Nothing sheAVs true great-
ness of mind more than to forgive injuries; it promotes the peace of so-
ciety, and  greatly conduces to our own ease, health, and  felicity.
   Such as value health should avoid violent gusts of  anger, as they
would the  most deadly poison.  Neither  ought they  to  indulge resent-
ment, but to endeavour at all times to keep their minds calm and serene.
Nothing tends so much to the health of the body as a constant iranqidlity
 of mind.
                             Of Fear.
    The influence of fear,  both in occasioning and aggravating diseases, is
 very great.  No man ought to be blamed  for a  decent concern  about
 life; but too  great a desire to preserve it is often the cause of losing  it.
 Fear and  anxiety, by depressing the spirits, not only dispose us to disea-
 ses, but often render those diseases fatal Avhich an undaunted mind Avould
 overcome.
    Sudden fear has generally violent effects.   Epileptic fits, and other
 convulsive disorders, are often occasioned by it.  Hence the danger of
 that practice, so common among young people of frightening one another.
 Many have lost their lives, and others have been rendered miserable, by
 frolics of this kind.  It is dangerous to tamper with the human passions.
 The mind may easily be thrown into  such  disorder as never again to act
 with regularity.
    But the gradual effects of fear prove  most hurtful.  The  constant
 dread of  some future evil, by dwelling upon the mind, often occasions
 the  very  evil itself.  Hence it comes to pass, that so many die of those
 very diseases of which  they long had a dread, or which had been im-
 pressed on their minds  by some accident,  or foolish prediction.  This,
 for example, is often the case with women  in childbed.   Many of those
 who die in that  situation, are impressed with a notion of their death a
 long time before it happens; and the*e is reason to believe that thy?  im-
 pression is often the cause of it.
    The methods taken to impress the minds of women with the apprehen-
  sion of the great pain and peril of child-birth,  are very hurtful.  Few
  women die in labour, though many lose their fives after it; which  ma*
  be thus accounted for.   A  woman after delivery finding herself weak
  and exhausted, immediately apprehends she is in danger; but  tins fear
  seldom fails to obstruct  the necessary evacuations,  upon which her re-
  coverv depends.   Thus the sex often fall  a sacrifice to their own imagi-
  nations, when there would be no danger, did they apprehend none.   ^
    It  seldom happens that two or three women  in a  great town die m
  child-bed, but tlieir death is followed by  many  others.  Every woman
  of their  acquaintance who is with child dreads the same fate, and  the
  lease becomes epidemical by the mere force of *«^»™
  should induce pregnant women  to  despise  fearandb> g™™*
   avoid those tattling gossips who are continually buzzing in their eai* 
100               OF  THE  PASSIONS.
the misfortunes of others.  Every thing that may iu the least  alarm a
pregnant or child-bed woman, ought with the greatest care to be guarded
against.
  Many Avomen have lost their lives in child-bed by the old supersti-
tious custom, still kept up in most parts of Britain, of tolling the parish
bell for every person who dies.  People Avho think themselves in dauger
are very inquisitive;  and if they come to know that the bell tolls for one
who died in the same situation with themselves, what must be the conse-
quence ? At  any rate they are apt to suppose that this is the case, and
it Avill often be found a  very  difficult matter to persuade  them of the
contrary.
  But this custom is not pernicious to child-bed women only.  It  is
hurtful to many other cases.  When low fevers in Avhich it is difficult  to
support the patient's spirits, prevail, what must be the effect of a funeral
peal sounding five or six times a day in his ears : No doubt his imagina-
tion will suggest that others died of the same disease under which he
labours.   This apprehension  will  have a greater tendency to  depress
his spirits,  than all the cordials of which medicine can boast, will have
to raise them.
   If this useless piece of ceremony cannot be abolished, we ought  to
keep  the sick as much from hearing it as possible,  and from every other
tiling that may tend  to alarm them.  So far however is this from  being
generally attended to, that many make it their business to visit the sick,
on purpose to whisper dismal stories in their ears.   Such  may pass for
sympathizing friends, but they ought rather to be considered as enemies.
All who Avish well to the sick ought to keep such persons at the  greatest
distance from them.
  A custom has long prevailed among physicians  of prognosticating,  as
they call it,  the  patient's fate,  or foretelling the  issue of the  disease.
Vanity no  doubt introduced this practice,  and still supports it,  in spite
of common  sense and the safety of mankind.  I have known a physician
barbarous enough  to boast, that he  pronounced more sentences than all
his majesty's judges.  Would to God that such sentences Avere  not often
equally fatal! it may indeed be alleged, that the doctor does not declare
his opinion before the patient.   So much the Avorse.  A sensible patient
had better  hear what the doctor says, than learn it from the disconsolate
looks, the watery eyes, and the broken Avhispers  of those about him.
It seldom happens, Avhen the doctor gives an unfa\rourable opinion, that
it can be concealed from the patient.   The very  embarrassment which
the friends and attendants shew  in disguising Avhat he has said, is  gene-
rally sufficient to discover the truth.
   Kiud heaven has, for the wisest ends, concealed from mortals their fate;
and Ave do not see what right any man has to announce the death of ano-
ther, especially if such a declaration has a chance to kill him.   Mankind
are indeed veiy fond of prying into future events, and seldom fail to fo-
Iicit the  physician for his opinion.  A  doubtful ansAver, hoAvever, or one
thaf may tend rather to encourage the hopes of  the  sick, is surely the
most proper.  This conduct could neither  hurt the patient nor the phy-
siciau.   Nothing tends more to destroy the credit of  physic  than those
bold prognosticators, Avho, by the bye, are generally the most ignorant of
the faculty.  The mistakes Avhich daily happen in this way are so many
standing proofs of human vanity, and the weakness of science. 
OF  THE  PASSIONS.
101
  We readily admit, that there are cases where the physician ought to
give intimation of the patient's danger to some of his near connections;
though even this ought always to be done with the greatest caution: but
it never can be necessary  in any case that the whole toAvn and country
should know immediately after the doctor has made his first visit, that he
has no hopes of his patient's recovery.   Persons Avhose impertinent curi-
osity leads them to question the physician, with regard to  the fate of his
patient, certainly deserves no other than an evasive answer.
   The vanity of foretelling the fate of  the sick is not peculiar to the fa-
culty.  Others folloAV their example, and those Avho think themselves
wiser than their neighbours, often do much hurt in this Avay.—Humanity
surely  calls upon every one to comfort the sick, and not to add to their
affliction by alarming their fears.   A  friend,  or even a physician, may
often do more good by a mild and sympathising behaviour than by me-
 dicine, and should never neglect to administer that greatest of all cordials,
 Hope.

                             Of Grief.

    Grief is the most destructive of all the passions.  Its  effects are per-
 manent ; and when it sinks deep into  the mind, it generally proves fatal.
 Anger and fear being of a  more  violent nature,  seldom  last long; but
 grief often changes into a fixed melancholy, which preys upon the spirits,
 and wastes the constitution.  This passion ought not to be indulged. It
 may generally be conquered at the beginning; but when it has  gained
 strength, all attempts to remove it are vain.
    No person can prevent misfortunes in life; but it sIicavs true greatness
 of mind to bear them with serenity.   Many persons make a merit of in-
 dul«nn<r  grief, and when misfortunes happen, they obstinately refuse all
 consolation, till the mind, overwhelmed with melancholy, sinks under the
 load.   Such conduct is not only destructive to health,  but inconsistent
 with reason, religion, and common sense.
    Change of ideas  is as  necessary  for health as  changes  of posture.
 When the mind dwells long upon one subject, especially of a disagreeable
 nature it hurts the whole functions of the body.   Hence grief indulged
 spoils the digestion and  destroys the appetite; by which means the
 spirits are depressed, the nerves relaxed, the bowels inflated with wind,
  and the humours,  for want  of fresh supplies of chyle, vitiated.   Thus
 many an excellent constitution has been ruined by a family  misfortune,
 or any thing that occasions excessive grief.
    It is utterly impossible that any person of  a dejected mind should en-
 iov health.  Life indeed may be dragged out for a few years;  but who-
 ever would live  to a good  old age, must be good humoured and cheerful.
  This indeed is not altogether in our own power; yet our temper ot mind,
  as well  as our actions, depend greatly upon ourselves.    We can either
  associate with cheerful or melancholy companions, mmgle m the amuse-
  ments and offices in life, or sit still aud brood over  our calamities as we
  choose.  These, and many such things, are certainly in our power, aud
  from these the mind generally takes its cast.
     The variety of scenes which  present themselves to  the senses, were
  certainly designed to prevent our attention from being too long fixed up- 
 102                 OF  THE PASSIONS.

on any one object.   Nature abounds with variety, and the mind, unless
fixed down by habit, delights  in contemplating new objects.    This at
once points out the method of relieving the mind iu distress.    Turn the
attention  frequently to neAV objects.   Examine them  for some time.
When the mind begins to recoil,  shift the scene.   By this means a con-
stant succession of neAV ideas may be kept up, till the  disagreeable ones
entirely  disapper.  Thus travelling, die study  of  any art or science,
reading, or Avriting on such subjects as deeply engage the attention, Avill
sooner expel grief thau the  most  sprightly amusements.
  It has already been observed,  that the body cannot be healthy u less
it be exercised; neither can the mind.  Indolence nourishes grief. When
the mind has nothing else to think of but calamities, no wonder that it
dwells there.  Few people who pursue business with attention are hurt by
grief.  Instead therefore of abstracting ourselves from the world or bu-
siness when misfortunes happen, we ought to engage  in it with more thau
usual attention, to discharge with double diligence  the functions of our
station, and to mix with friends of a cheerful and social temper.
  Innocent amusements are by no means  to be  neglected.   These, by
leading the miod insensibly to the contemplation of agreeable objects,
help to dispel the gloom  which misfortunes  cast over  it.  They make
time seem less tedious, and have many other happy effects.
  Some  persons, Avhen overwhelmed with  grief, betake themselves to
drinking.  This is making the  cure worse than  the  disease.  It seldom
fails to end in the ruin of fortune, character, and constitution.

                              Of  Love.

  Love is perhaps the strongest of all the passions;  at least when it be-
comes violent, it  is less subject to the control either of the  understand-
ing or will, than any of the rest.   Fear, anger, and several other passions,
are necessary for  the preservation of  the individual, but love is necessary
for the continuation of the species itself: it was therefore proper that this
passion should be deeply rooted in the human breast.
   Though love be a strong  passion, it is seldom so rapid in  its  progress
as several of the others.  Few persons fall desperately in love all at once.
Wc would therefore  advise every one, before he tampers with this passion,
to co.isider well the probability of his being  able to obtain the  object of
his Avishes.  When that is not likely, he should avoid every occasion of
increasing it.  He ought immediately to flee the company of  the beloved
object; to  apply  his  mind attentively to business or study; to take every
kind of amusement; and above all, to endeavour, if possible, to find ano-
ther object which may engage his affections, and which it may be in his
 power to obtain.
   There is no passion with which  people  are so ready to tamper as
love, although none is more dangerous.    Some men  make   love for
amusement, others from mere  vanity,  or  on  purpose  to  sheAV  their
consequence with the  fair.  This is perhaps the greatest piece of cru-
 elty which any one  can be guilty of.    What we eagerly wish for we
 easily credit.  Hence the too  credulous fair are  often betrayed into a
situation which is  truly  deplorable, before they arc  able to discover
that the pretended lover was only in  jest.  But there  is no jesting with
this passion.   WThen  love  has got to a certain height, it admits  of  no 
OF THE COMMON EVACUATIONS.         103
other cure but the possession of its object, which in this case ought al-
ways, if possible, to be obtained.*

                  Of Religious Melancholy.
   Many persons of a religious turn of mind behave as if they thought it
a crime to be cheerful.    They imagine the whole of religion consists in
certain mortifications, or  denying  themselves  the  smallest indulgence,
even of the most innocent amusements.  A perpetual gloom hangs  over
their countenances, while the deepest melancholy preys upon their minds.
At length the fairest prospects vanish, every thing puts on a dismal ap-
pearance, and those very objects which ought to give delight, afford no-
thing but disgust.  Life itself becomes a burden, and the unhappy wretch,
persuaded that no evil can equal what he feels, often puts an end to his
 miserable existence.
   It is great pity that ever religion should be so far perverted, as to be-
 come the cause of those very evils which  it was designed to cure.  No-
 thing can be beter calculated than True Religion, to raise  and support
 the mind of its votaries under every affliction that can befal  them.  It
 teaches men that  even the sufferings of this life are preparatory to the
 happiness of the next; and that all who  persist in a course of virtue shall
 at length arrive at complete felicity.
   Persons whose business it is to  recommend religion to others, should
 beware of dwelling too much on gloomy subjects.   That peace and  tran-
 quility of mind, Avhich true religion  is  calculated to inspire,  is a  more
 powerful argument in its favour than all the terrors that can be uttered.
 Terror may indeed deter men from outward acts of wickedness, but can
 never inspire £hem  with  that love of God, and real goodness of heart,
 in which alone true  religion consists.
   To conclude; the best Avay to counteract the violence  of any passion k
 to keep the  mind closely engaged  in some  useful pursuit.


                           CHAP.   XI.

             OF THE  COMMON EVACUATIONS.

       THE principal evacuations from  the human body are those by
 stool, urine, and insensible perspiration.   None of these can be long ob-
 structed without  impairing  the health.   When that which ought to be
 thrown off the body is long'retained,  it not only occasions a plethora, or
 too great fulness of the vessels, but acquires qualities which are hurtful to
 the health, as acrimony, putresence, &c.
                  Of the Evacuation by Stool.
   Few things conduce more to health than keeping the body  regular.

   • The conduct of parents with regard to the disposal of their children in mar-
 riaee is often very blameable.  An advantageous  match is the constant aim of
 parents •  while their children often suffer a real martyrdom betwixt their inch-
 nations and duty.  The first thing which parents ought to consult in disposing
 their children in marriage, is certainly their inclinations.  Were due regard al-
 ways paid to these, there would be fewer unhappy couples, and parents would
 not have so often cause to repent the severity of their conduct, after  a ruined
 constitution,  a lost character, or a distracted mind, has shewn them their mistake. 
104
OF THE COMMON  EVACUATIONS.
When the faces lie too long in the boAvels they vitiate the humours; aud.
when they are too soon discharged, the body is uot sufficiently nourished.
A medium  is therefore to be desired,  which can only be obtained by re-
gularity in  diet, sleep,  and exercise.  Whenever the body is not regu-
lar, there is reason to suspect a fault in one or other of these.
  Persons  Avho eat and drink at irregular hours, and who eat various
kinds of food, and drink of several different liquors at every meal, have
no reason to expect either that their digestion will be good, or their dis-
charges regular.  Irregularity in eating and drinking disturbs every part
of the animal economy, and never fails to occasion diseases.   Either too
much or too little food will have this effect.   The former indeed gene-
rally occasions looseness, and the  latter  costiveness; but both have a
tendency to hurt the health.
  It would be difficult to ascertain  the  exact number of stools which
may be consistent with health, as these  differ in the different periods of
life, in different constitutions, and even in the same constitution under a
different regimen of diet, exercise, &c.  It is however generally allowed,
that one  stool a day is sufficient for an  adult,  and that less is hurtful.
But this, like most general rules,  admits  of many exceptions.  I have
known persons  in perfect health  avIio did  not go to stool above  once
a-Aveek.*   Such a degree of costiveness hoAvever is not safe; though the
person Avho labours uuder it may  for some time enjoy  tolerable health,
yet at length it may occasion diseases.
  One method of procuring a stool every day is to rise betimes, and go
abroad in the open air.   Not only  the posture in bed is unfavourable to
regular stools, but also the warmth.  Tins,  by promoting the perspira-
tion, lessens all the other discharges.
  The method recommended for this purpose by Mr. Locke is likewise
very proper, viz.  to solicit nature, by going regularly to stool every morn-
ing whether  one has a call or not.   Habits of this kind may be acquired,
which will in time  become natural.
  Persons who have  a frequent recourse to medicines for preventing
costiveness,  seldom fail  to ruin their constitution.   Purging medicines
frequently repeated Aveaken the bowels,  hurt  the  digestion, and  every
dose makes way  for another, till at length they become as necessary as
daily bread.  Those who are troubled with costiveness ought rather, if
possible, to remove it by diet than drugs.  They should likewise go thinly
clothed, and avoid every thing of an astringent or of  an heating na-
ture.  The diet  and  other regimen necessary in this case will be found
under the article Costiveness, where this state of the bowels is treated as
a disease.
   Such persons as are troubled with an habitual looseness ought likewise
to suit their diet to the nature of their complaint.   They should use food
which braces and strengthens the bowels,  and which is rather  of an as-
tringent quality,  as Avheat bread made of the finest flour, cheese, eggs, rice
boiled in milk, &c.   Their drink should be red port, claret, brandy and
water, in which toasted bread has  been boiled, and such like.
   As an habitual looseness is often  owing  to an  obstructed perspira-
 tion, persons affected with  it ought to keep their feet Avarm, to Avear
flannel next their  skin, and take every other  method to promote the
* Some persons have told me that they did not go to stool above once a month, 
OF  THE  COMMON  EVACUATIONS.         105
perspuation.  Further directions with  regard to the treatment of this
complaint, will be found under the article Looseness.

                             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 firtermined rules for
judging of either:*   Dr. Cheyne  says, the urine ought to be equal  to
three-fourths of the liquid  part  of owr aliment.  But  suppose any one
were to  take the trouble  of *neaflM% both, he Avould find that every
thing Avhich altered the degree of  perspiration, would alter this propor-
tion,  aud  likewise that different kinds of  aliment Avould afford very dif-
ferent quantities of urine.   Though for these, and other reasons, no rule
can be given for judging of the precise quantity t>f urine which ought to
be discharged, yet a person of common sense will seldom be at a loss to
know when it is in either extreme.
   As a fjjpe discharge of urine not only prevents but actually cures many
diseases, it ought by all means to be promoted; and every  thing that
may obst^fc it  should be carefully avoided.   Both the secretion and
discharge of urine are lessened by a sedentary life, sleeping on beds that
are too soft and  warm, food of a dry and  heating quality, liquors which
are astringent and  heating, as red port, claret, and such like.   Those
 who  have reason to suspect that their urine is in too fpiall quantity,  or
Avho have any symptoms of the gravel, ought not  only to avoid these
things, but whatever else they find has a  tendency to lessen the quantity
of their uriiie.
   When the urine is too long retained, it is not only reabsorbed, or taken
 up again into the mass of fluids, but by stagnating in the bladder it be-
 comes thicker, the more watery parts flying off first, and the more gross
and earthy remaining behind.  By the constant tendency which these
have to concrete, the formation of stones and gravel in the bladder is pro-
moted.   Hence  it comes to pass that indolent and sedentary people are
much more liable to these diseases, than persons of  a more active life.
    Many persons have  lo>t their lives, and others have  brought on very
 tedious,  and even incurable disorders by retaining their urine too long,
from a false delicacy.   When the bladder has been over-distended,  it
often loses its power of action altogether,  or becomes paralytic, by which
means it is rendered unable either to retain the urine,  or  expel  it pro-
perly.   The calls of nature ought never to  be postponed.  Delicacy is

   * It has long been an observation among physicians, that the appearances  of
the urine are very uncertain, and very little to be depended on   No one will be
 surprised at this, who considers how many ways it may be affected, and conse-
fluently have its appearance altered. The passions, the state of the atmosphere,
the quantity and quality of the food, the exercise, the clothing, the state of the
other  evacuations? and  numberless  other causes, are  sufficient to induc^a
change either in the quantity or appearance of the urine.   Any one who attends
to this will be astonished at the impudence of those daring quacks, who pre-
tend to find out diseases, and prescribe to patients, from the bare inspc»n of
their urine   These impostors, however, are very common all over Britain, and,
by the amazing credulity of the populace,  many  of them amass considerable
fortunes   Of all the medical prejudices which prevail in this country, that  in
favour of urine  doctors is the. strongest.  The common people have still  an
unlimited faith in their skill, although it has  been demonstrated that no one ot
them is  able to distinguish the urine of a horse, or any otiier animal, from that
 of a  man. 
106        OF  THE  COMMON  EVACUATIONS.
doubtless a virtue, but that can never be reckoned true delicacy, which
induces any one to risk his health or hazard his life.
  But the urine may be in too great as Avell as too small a quantity.
This may be  occasioned  by drinking  large quantities of weak watery
liquors, by the exces§ive use of alkaline  salts, or any thing that slinnu
lates the kidnies, flutes the blood, Ac.   This disorder veiy soon weak-
ens the body,  and induces a consumption.   It  is difficult to cure, but
may be mitigated by strengfhenin«gji^_and astringent medicines,  such
as are recommended under the axHtWDiaoetes, or excessive discharge
of urine.

                     Of the Perspiration.

  Insensible perspiration is generally reckoned the  greatest of all the
discharges from the human body.   It is of so great importance to health,
that few diseases attack us Avhile it goes  properly on; but avJjcii it is
obstructed, the whole frame is soon  disordered.  This  discharge,  how-
ever, being less perceptible  than  any of the rest, is consequejA less at-
tended to.   Hence it is, that acute fevers, rheumatisms, a» es, &c.  often
proceed  from obstructed perspiration before we are aw are of its having
taken place.
  On examiningflpatients, Ave find most of them impute  their diseases
either to violent colds Avhich they had caught,  or to  slight  ones which
had been neglected.  For this reason, instead of a critical inquiry into
the nature of the  perspiration, its difference in different seasons, climates,
constitutions, &c. we shall endeavour to point out the causes which most
commonly obstruct it, and to sheAv hoAV far they may either be  avoided,
or have tlieir influence counteracted by timely care.   The Avant of a due
attention to these, costs Britain annually some thousands of useful  lives.

                  Changes in  the Atmosphere.

   One of the  most common causes of obstructed perspiration, or catch-
ing cold in this country, is the changeableness of the Aveather, or state
of the atmosphere.  There is no place Avhere such changes happen more
frequently than in Great-Britain.   With us the degrees of heat  and cold
are not only very different in the  different seasons of the year, but often
change almost from one extreme to another in a feAv days,  and sometimes
even in the course of one day.  That such changes must affect  the state
of the perspiration is obvious to every one.*
   The best method  of fortifying the  body against  the  changes of the
weather, is to be abroad every day.  Those who keep most Avithin doors
are most liable to  catch colds.  Such persons generally render them-
selves so delicate as to feel even the slightest changes \y the atmosphere,
aft by then- pains, coughs, and oppressions of the breast, &c.  they be-
come a kind of living barometers.
  * I never knew a more remarkable instance of the uncertainty of the weather
in this country, than happened when I was writing these notes.  This morning,
August 14,1783, the thermometer in the shade was down at fifty-three degrees,
and a very few minutes ago it stood above e?ghty.  No one who reflects on
.such great and sudden changes in the atmosphere, will  be surprised to find
colds, coughs, rheums, Avith other affoctions of the breast and bowels, so com-
mon in tiiis country. 
              OF  THE   COMMON  EVACUATIONS.       107

                          Wet  Clothes.
   Wet  clothes not only  by  their  coldness  obstruct the perspiration,
but their moisture by  being absorbed, or taken up into the body, great-
ly increases the danger.  The most  robust constitution  is not proof
against  the danger arising from wet clothes; they daily occasion fevers,
rheumatisms, aud other fatal disorders, even in the young and healthy.
   It is impossible for people who frequently go abroad to avoid some-
times being wet.  But the danger  might generally be lessened, if not
wholly  prevented, by changing their clothes  soon; Avhen this cannot be
done, they should keep in motion till they  dry.   So far are many from
taking this precaution, that they often sit or lie down in the fields with
their clothes Avet, and frequently sleep even whole nights in this condi-
tion.   The frequent instances which Ave have of the fatal effects of this
conduct, ought certainly  to deter all from being guilty of it.

                             Wet Feet.
   Even wet feet often occasion fatal diseases.  The cholic, inflammar
fions of the breast and of  the boAvels,  the iliac passion, cholera morbus,
&c. are often occasioned  by Avet feet.   Habit will, no doubt, render this
less dangerous; but it ought  as far as possible, to be avoided.   The de-
licate, and those Avho are not accustomed to have their clothes or feet wet,,
should be peculiarly careful in this respect.

                           Night  Air.

 ,  The  perspiration is often obstructed  by night air;  even in  summer,,
this  ought to be avoided.    The deAvs which fall plentifully  after the
hottest  day, make the night more dangerous than Avhen the weather is
cool.   Hence, in warm countries,  the  evening  dews  are more hurtful
than Avhere the climate is more temperate.
   It is very agreeable after a Avarmday to be abroad in a cool evening j.
but this is a pleasure to be avoided by all Avho value their health.  The
effects of evening dews are gradual indeed, and almost imperceptible 5
but they  are not  the less to be dreaded : Ave would therefore advise tra-
vellers,  labourers, and all who  are much heated  by day, carefully to
avoid them.  When the perspiration  has been great, these  become dan-
gerous in proportion.   By not attending to this, in flat marshy countries,
where the exhalations and deAvs are copious, labourers are often seized
with intermttting fevers, quinseys, and other dangerous diseases.

                          Damp  Beds.
   Beds become damp, either from Uieir not being used, standi* in damp
houses,  or in rooms without fire, or  from the linen not beirff dry when
laid on the bed.   Nothing is more to be dreaded by travellers than damp
beds, which are very common in all places where fuel is scarce.  When
u traveller, cold  and  wet, arrives  at an inn, he may by means of a good
fire, warm diluting liquor, and a dry bed, have the perspiration restored;
but if he be put into a cold room, and laid in a  damp  bed, it will be more
obstructed, awl the  worst  constquences  will ensue.  Travellers should
avoid inns which are noted for damp beds,  as they would a house infec-
ted with the plague, as no man, however robust,is proof against the daua-
ger arising from them. 
108        OF  THE  COMMON  EVACUATIONS.
  But inns are not  the  only  places where  damp beds  are  to  be mef
with.  Beds  kept  in private families for the reception of strangers are
often equally dangerous.   All kinds of linen and  bedding, when not fre-
quently used, become damp.   How then  is it possible that beds, which
are not slept in above two or  three times  a year,  should be safe ?   No-
thing is more common than to hear  people complain of  havuig caught
cold by changing their bed.  The reason  is obvious i  were they careful
never to sleep in a bed but what was frequently used, they Avould seldom
find any ill consequences from a change.
  Nothing is more to be dreaded by a delicate person when on a visit,
than being laid in a bed which  is kept on purpose for strangers.—That
ill-jugded piece of complaisance becomes a real injury.  All the bad con-
sequences from this quarter might easily be prevented in private families,
by causing their servants to sleep in the spare beds, and  resign them  to
strangers when they come.   In inns, Avhere the  beds, are used almost
every night,  nothing else is necessary than to keep the rooms well season-
ed by  frequent fires, and the linen dry.
   That baneful custom  said to be  practised in  many inns, of damping
sheets, and pressing them in order to save washing, and afterwards laying
them on the beds, ought, when discovered,  to be punished with  the utmost
severity.   It is really a species of murder, and will often prove as fatal
as poison or gun-shot.  Indeed linen, especially if it has  been washed iH
winter, ought not to be used till it has been exposed  for  some  time  to
the fire; nor is this operation less necessary for linen washed in  summer,
provided it has lain by for any length of time.   This  caution is the more
needful, as gentlemen are often exceedingly attentive to Avhat they  eat or
drink at an inn,  yet pay no regard to a circumstance of much more im-
portance.*
                          Damp Houses.
   Damp houses frequently produce the  like ill  consequences j for this
 reason those who build should be careful to chuse a diy situation.  A
 house Avhich stands on  a damp  marshy soil or deep  clay, Avill never be
 thoroughly dry.   All houses, unless where the ground is exceeding dry,
 should have the first floor a  little raised.   Servants  and others Avho are
 obliged to live in cellars and  sunk stories, seldom  continue long in health:
 masters ought surely to  pay  some regard to the health of their servants,
 as Avell as to their own.
    Nothing is more common than for people, merely to avoid some trifling
 incouveniency, to hazard tlieir lives,  by inhabiting a house almost as
 soon as tile masons, plasterers, &c. have done with it: such houses are
 not only^angerous from their dampness,  but likewise from the smell of
 lime,  rJainly  &c.   The asthmas, consumptions, and other diseases of the
 lungs, so  incident to people who Avork in these articles, are sufficient
 proofs of  their being unwholesome.
    Booms are often rendered damp by an unseasonable, piece of cleanli-
 ness; I mean the pernicious  custom of Avashing them immediately be-
 fore company is put into them.   Most people catch cold,  if  they  sit
 but  a very  short  time in  a room thai has been lately washed; the
   •"if a person suspects that his bed is damp, the simple precaution of taking"
-off the sheets and lying in the blankets, with all, or most of his clothes on, will
 prevent all the danger.  I have practised this'for many years,  and never have
 been hurt by damp beds, though no constitution, without care, is proof against
 their baneful influence. 
OF THE COMMON EVACUATIONS.
109
delicate ought carefully to avoid such a situation, and even the robust
are not always proof against its influence.*

          Sudden  Transitions from Heat to  Cold.
  The perspiration  is  commonly obstructed  by sudden transitions
from  heat to cold.   Colds are seldom caught, unless Avhen people have
been  too much heated.   Heat  rarifies the blood, quickens the circula-
tion, and increases the perspiration;  but when these are suddenly check-
ed, the consequences must be bad.  It is indeed impossible for labourers
not to be hot upon some occasions :  but it is generally in their power to
let themselves cool gradually, to put on their clothes when they leave off
work, to make choice of a dry place to rest  themselves in, and to avoid
sleeping in the open fields.  These easy rules if observed, would often pre-
vent fevers, and other fatal disorders.
   It  is very common for people when hot, to  drink freely of cold water.
or small liquors.   This conduct is extremely dangerous.   Thirst indeed
is hard to bear, and the inclination to gratify that appetite frequently
gets the better of reason,  and  makes us do  what  our judgment disap-
proves.  Every peasant, however, knows, if  his horse be permitted to
drink his belly full of cold water after violent exercise, and  be immedi-
ately put into the stable, or suffered  to  remain at rest, that it will  kill
him.  This tfcey take the utmost care to prevent.   It were well if they
Avere equally attentive to their oavh safety.
   Thirst may be  quenched many ways Avithout swallowing  large quan-
tities of cold liquor.   The fields afford variety of acid fruits and plants,
the very cheAving of which would abate thirst.  Water kept in the mouth
for some time, and spit out again, if frequently repeated,  will have the
same effect.  If a bit of bread  be eaten along with a few mouthfuls of
water, it will both  quench thirst more effectually, and make the danger
less.   When a person is extremely  hot, a mouthful of brandy or other
spirits, if it can be obtained, ought be preferred to any thing else.  But if
any one has been so fotlish, when hot, as to drink freely of cold liquor,
he ought to continue his exercise  at  least till what he drank be tho-
roughly warmed upon his stomach.
   It  would  be tedious to  enumerate all the bad effects which Aoav from
drinkingcold liquors when the body is hot.   Sometimes this has ccca-
sionecPimfNidiate death.   Hoarseness,  quinseys, and fevers  of various
kinds, are its common consequences.   Neither is it safe Avhen warm to
eat freely of raw fruits, salads, or the like.  These indeed have not so
niiddeu an effect  upon the body as  cold liquors, but they are  notwith-
standing dangerous, and ought to be avoided.
   Sitting in a warm room, and drinking hot  liquors  till  the pores are
quite opeu,  and immediately goins into the cold air, is extremely danger-
ous.  Colds, coughs, and inflamnmious of the breast, are the usual effects
of this conduct; yet nothing  is more common than for people, after they
have drank warm liquors for several  boms, to Avalk or ride a number oi
miles in the coldest night, or to ramble about in the streets.?
  • People imagine if a  good fire is made in a room after it has been washed,
that there is no danger from sitting in it; but they must give me leave to say
that this increases the danger.  The evaporation excited by the fire generates
cold, and renders the damp more active.
  | The hecr-lwuses in great towns, where such numbers of people spend thei* 
110         OF THE  COMMON EVACUATIONS.
   People are very apt, Avhen a room is hot, to throw open a window, and
 to  sit near it.  This is the most dangerous practice. • Any person had
 better sit without  doors than in such a situation, as the current of air is
 directed against  one particular part of the body.  Inflammatory fevers
 and consumptions have often been occasioned by sitting or standing thinly
 clothed near an open Avindow.  Nor is sleeping Avith  open Avindows less
 to be dreaded.  That ought never  to be done, even in the hottest season,
 unless the windoAv is at a distance.   I have known mechauics frequently
 contract fatal diseases, by workiug stript at an open Avindow, and would
 advise all of them to beAvare of  such a practice.
   FeAV things expose people more  to catch cold than  keeping tlieir own
 houses too warm: such persons may be said to live in a sort of hot-houses;
 they can hardly stir abroad to vi'it  a neighbour but at the hazard of their
 lives.  Were there no other reason for keeping houses moderately cool,
 that alone is sufficient: but no  house that is too hot can be Avholesome;
 heat destroys the spring and elasticity of the air, renders it less fit for ex-
 panding the lungs,  and the other purposes of respiration.  Hence it is
 that consumptions and other diseases of the lungs prove so fatal to people
 Avho Avork in forges, glass-houses, and the like.
   Some are even so fool-hardy,  as  to plunge themselves when hot, in cold
 water.  Not only fevers, but madness itself, has frequently been the ef-
 fect of this conduct.   Indeed it looks too like the action q§ a madman to
 deserve a serious  consideration.
   The result of all these observations is, that eveiy one ought to avoid,
 with the utmost attention, all sudden transitions from heat to  cold, and to
 keep the  body in as  uniform a  temperature as  possible; or Avhere that
 cannot be done, to take care to let it cool gradually.
   People may imagine that too strict an attention to these things would
 tend to render them delicate.   So far however is this from being my de-
 sign, that the very first rule proposed for preventing colds is to harden the
 body,  by enuring  it daily to the open air.
   I shall put an end to Aviiat relates to this part of my  subject, by giving
 an abstract of the  justly celebrated advice of Celsus, Avith respect to the
 preservation of health.   "A man," says he, " who is  blessed Avith  good
 health, should confine himself to no  particular rules, either Avith respect to
 regimen  or medicine.  He ought frequently to  diversify His manner of
 living; to be sometimes in town, sometimes in the country ;*»GiiBt, sail,
 indulge himself in rest, but more frequently to use exercise.  "Tie ought to
 refuse no kind of food that is commonly used, but sometimes to eat  more
 and sometimes less;  sometimes to  make one at an entertainment, and
 sometimes to forbear it; to make rather two meals a-day than one, and al-
 ways to eat heartily, provided he can digest it.   He should be careful in
 time of health not to destroy, by  excesses of any kind, that vigour of con-
 stitution which should support him  uider sickness."

evenings, are highly pernicious. The breath of a number of people crowded into
a low apartment, with the addition of  fires, candles, the smoke of tobacco, and
the fumes of hot liquor, &c. must not only render it hurtful  to continue in such
 places, but dangerous to go out of them into a cold and chilly atmosphere. 
PART II.


OF  DISEASES.
                          CHAP.  XII.

   OF  THE KNOWLEDGE AND CURE OF DISEASES.

      JL HE cure of diseases does not depend so much upon the scientific
principles, as many imagine.  It is chiefly the result of experience and
observation.   By attending the sick, and carefully observing the various
occurrences in diseases, a great degree  of accuracy *nay be aoqufced,
both in  distinguishing their symptoms,  and in the application of medi-
cines.   Hence sensible nurses,- and other persons who  wait upon the
sick, often foresee the patient's fate sooner than those who have been
bred to physic.  We do not however mean to insinuate that a medical
education is of no use : It is doubtless of the greatest importance; but it
never can supply the place of observation  and experience.
  Every disease may be considered as an assemblage of symptoms, and
must be distinguished by  those which are  most obvious and permanent.
Instead therefore of giving a classical arrangement of diseases, according
to the systematic method, it will be more  suitable, iu a performance of
this nature, to give a full and accurate description of each  particular
disease  as it occurs; and, Avhere any of  the  symptoms of one disease
have a near resemblance to those of another, to take notice of that cir-
cumstance, and at the same  time to point out the peculiar or characteristic
symptoms by  Avhich it may  be  distinguished.  By a due  attention to
these, the  investigation of diseases will  be found  to be  a less difficult
matter than most people would at first be ready to imagine.
  A proper attention to the patient's age;  sex, temper of mind, constitu
lion, and manner of life, will likewise greatly assist,  both in the  investi
gation and treatment of diseases.
  In childhood the fibres are lax and soft, the  nerves  extremely irrita-
ble, and the fluids  thin; Avhereas in old age the fibres  are  rigid, the
nerves become almost insensible, and many of the  vessels imperviable.
These and other peculiarities render the diseases of the young and  aged
very different, aud of course they must require a  different method of
treatment.
  Females are liable to many diseases which do not  afflict the  other sex :
besides, the nervous  system being  more irritable in them than in  men,
tlieir diseases require to be  treated with greater caution.  They are less
able to bear large  evacuations;  and all stimulating medicines ought to
be administered  to them with a sparing hand.
  Particular constitutions not only dispose persons to peculiar diseases,
but likewise  render it necessary to treat these diseases in a peculiar
Planner.  A delicate person, for example,  with weak nerve.-,  who  lj|es 
112               OF THE  KNOWLEDGE
mostly within doors, must not be treated, under any disease, precisely in
the same manner as one Avho is hardy and robust, and Avho is much ex-
posed to the open air.
   The temper of mind  ought to be carefully attended to in diseases.
Fear, anxiety, and a fretful temper both occasions and aggravate (lipa-
ses.  In vain do  we apply medicines to the body  to remove maladies
Avliich proceed from the mind.   When it is affected,  the best medicine is
to soothe the passions, to divert the mind from anxious thought, and to
keep the patient as easy and cheerful as possible.
   Attention ought likewise to be paid to the climate,  or plate  where
the patient lives, the air he  breathes, his diet, Ac.   Such  as live  in low-
marshy situations  are subject  to many diseases which are unknown to
the inhabitants of high countries.  Those who breathe  the impure air
of cities,  have many  maladies to which the more happy rustics are en-
tire strangers.  Persons who feed grossly, and indulge in strong liquors,
are liable to diseases  which do not  affect the  temperate and abste-
mious, &c.
   It has'aheady fe^pp observed, that the different occupations and situa-
tudPidPlife  dispose men to peculiar diseases.  It  is therefore necessary
to enquire into the patient's occupation, manner of  life, Ac.  This will
not only assist us in finding out the disease, but will  likewise direct us
in the treatment of.it.  It Avould be veiy imprudent to treat the laborious
and the sedentary precisely in  the same manner, even supposing them to
labour under the same disease.
   It will likewise be proper  to inquire, Avhether the disease be consti-
tutional or  accidental; whether it  has  been of long  or short duration;
whether it  proceeds  from  any great and sudden  alteration in the diet,
manner of life, &c.  The state of the patient's body, and of the other
evacuations, ought also to be inquired into; and  likeAvise Avhether he
can Avith  ease perform all the vital and animal functions,  as  breathing,
digestion, &c.
   Lastly, it Avill be proper to inquire Avhat diseases the patient has for-
merly been  liable to, and  what medicines Avere most beneficial to him;
if he has  a strong aversion to  any particular drug, &c.
   As many  of  the  indications of cure  may be answered by diet  alone,
it is always  the first thing to be attended to in the treatment of diseases.
Those who know no better,  imagine that every thing which goes  by the
name of a medicine possesses some Avonderful power or secret charm, and
think, if  the patient  sAvalloAVs enough  of drugs,  that he must do well.
This mistake has many ill consequences; it makes people trust to drugs,
and neglect their own endeavours;  besides it discourages all attempts to
relieve the sick Avhere medicines cannot be obtained.
   Medicines are no  doubt useful in their places; and when adminis-
tered with prudence,  they  may do much good; but when they are put
in place of every thing else,  or administered at  random, which is not
seldom the case, they must do mischief.  We  would  therefore  wish to
call the attention of mankind  from  the pursuit of secret  medicines, to
such things as they are acquainted with.   The proper regulation of these
may often do much good, and there is little danger  of their ever doing
hurt.
   Eveiy  disease  weakens the  digestive  poweis.  The diet  ought
therefore, in all cases, to be light and easy of digestion.  It would be 

                  AND  CURE  OF  DISEASES.              113

its prudent for a person with a broken leg to attempt to walk, as for one in
a fever to eut the same kind of food, and in the same quantity, as when
he Avas in perfect heatyh.   Even abstinence  alone will often cure a fever,
especially when it has been occasioned by excess in, eating or drinking.
  I^all fevers attended with inflammation,  as  pleurisies, peripneumcu-
nies,  &c. thin gruels, wheys,  watery infusions ©f mucilaginous pleats,
roots, &c. are not only proper for the patient's food, but they are bitwise
the best medicines Avhich can be administered.            *         *
  In fevers, of a slow, nervous, or putrid kind, where there are no symp-
toms of inflammation, and where the patient must be supported with cor-
dials, that intention can always be more effectually answered by nourish-
ing diet and generous wines, than by any medicines yet known.
  Nor is a proper attention to the diet of less importance in chronic than
in acute diseases.  Persons afflicted with low spirits, wind, weak nerves,
and other hypochondriacal affections, generally find more benefit from the
use of solid  food and generous liquors, than from all  the  cordial and
carminative medicines, which can be administered to them.
   The scurvy, that most bbstinate malady, will  sooner yield to a pro-
per vegetable diet, than to all the boasted antiscorbutic  remedies  of  the
shops.
  In consumptions,  when the humours are vitiated,  and the stomach so
much weakened  as to be unable to digest the,solid fibres  of animals, or
even to assimilate the juices of vegetables, a diet consisting chiefly of
milk, Avill not only support the patient, but will often cure the disease after
every other medicine has failed.
  Nor is an attention to other things  of  less importance than to diet.
The strange infatuation Avhich has  long induced people  to shut up  the
sick from all communication with the external air has done great mischief.
Not only in fevers, but many other diseases,- the patient will receive
more benefit from having the fresh air prudently admitted into his cham-
ber, than from all the medicines which can be given himA
   Exercise  may likeAvise in  many cases be consideredWra medicine.
Sailing, ©r riding on horseback, for example, will be of more service in
the cure of consumptions, glandular obstructions, &c. than any medicine
yet known.   In diseases Avhich proceed from a relaxed state of the solids,
the cold bath, and other  parts of the gymnastic regimen, will be found
equally beneficial.                      •
  Few things are of a greater importance in the cure of diseases than
cleanliness.   When a patient is suffered to  lie in dirty clothes, whatever
perspires from hisbody is again re-absorbed, or taken up into it,  which
serves to nourish^he disease and increase the danger.   Many  diseases
may bctfured by cleanliness alone;  most of them may be mitigated by it,
and in all of them it is highly necessa^r both for the patient and those
who attend  him.                   *#         ,,•,■,•.,»
  Many other observations, were it necTssary, might be adduced to prove
the importance of a proper regimen in diseases.  Regimen will often cure
diseases Avithout medicine, but medicine will seldom succeed where a pre-
per re«imen  is neglected.   For this reason, in the treatment of; diseases,
we  have* always given the first place to regimen.  Those  who are igno-
rant of medicine may confine themselves to  it only.  For others who have
more knowledge, Ave have recommended  some of the  most simple but
approved forms of medicine in every disease.  The*e however *re never 
 114            OF FEVERS  IN  GENERAL.

 to be administered but by people of better understanding; nor even by
 fliem Avithout the greatest precaution.




  *.                *   CHAP.  XIII.


                 OF FEVERS IN  GENERAL.


        AS more than one half of  mankind is said to perish by fevers,
 it is of  importance to  be acquainted  with  their cases.    The  most
 general  causes of fevers  are, infection, errors  in  diet, unwholesome
 air,  violent  emotions  of  the mind,  excess  or  suppression of  usual
 evacuations, external or internal injuries, and extreme degrees of heat or
 cold.   As  most of these have already been treated of at considerable
 length, and their effects sheAvn, we shall not now resume the consideration
 of them, but shall only recommend it to  all, as they would Avish to avoid
 fevers and other fatal diseases, to pay the most punctual attention to these
 articles.
   Fevers  are  not  only the  most  frequent of all diseases, but they are
 likewise the most complex.    In  the  most simple  species of  fever
 there is  always  a combination of several  different  symptoms.    The
 distinguishing  symptoms of  fever  are,  increased heat, frequency  of
 pulse, loss of appetite, general debility, pain in the head, and a difficulty
 in performing  some of  the vital or animal functions.   The symptoms
 usually  attendant  on  fevers are,  nausea,  thirst, anxiety,  delirium,
 weariness, wasting of the" flesh, want of sleep, or the sleep disturbed and
 not refreshing.
   When thajterer comes on gradually,  the patient generally complains
 first of langorJRind listlessness, soreness of the flesh, or the bones, as the
 country  people express it, heaviness of  the head, loss of appetite, sick-
"ness, with  claminess of the mouth;  after some  time  come on excessive
 heat, violent thirst, restlessness, &c.
   When the fever attacks suddenly, it always begins with an uneasy sen-
 sation of excessive cold, accdmpanied with debility and loss of appetite;
 frequently the cold is attended with shivering, oppression about the heart,
 and sickness at stomach, oivvomiting.
   Fevers  are   divided into continual,  remitting,' intermitting, and
 such as  are attended  with cutaneous  eruption or top^al inflammation,
 as the small-pox, erysipelas,  &c.    By a continual fever is meuit that
 which never leaves  the  patient during the whole  course of the  di-
 sease, or Avhich sheAVs no remarkable increase or abatement in the symp-
 toms.   This kind of fever is likeAvise divided into acute, sIoav, and ma-
 lignant.   The fever is  called acute  when its  progress is  quick, and
 the symptoms violent; but  when these  are  more gentle, it is  generally
 denominated slow.   When  livid  or  petechial  spots  shew  a putrid
 state of the  humours,  the fever  is called malignant,  putrid, or pete-
 chial.
   A remitting  fever  differs  from  a  continual only  in a  degree.  It
 has   frequent  increases and decreases, or  exacerbations  and  remis- 
OF FEVERS  IN GENERAL.
115
sions, but never Avholly leaves  the patient during the course of  the di-
sease.   Intermitting fevers or agues are those Avhich, during the time
that the patient may be said to be ill, have evident intervals or remis-
sions of the symptoms.
  As a fever is only an effort of Nature to free herself from an offend-
ing cause, it is the business of  those who have the care of  the  sick to
observe Avith diligence which Avay Nature points, and to endeavour to
assist her operations.  Our bodies are so framed, as to have a constant
tendency to expel or throAV off Avhatever is injurious to health.   This is
generally done by urine, sw eat stool, expectoration, vomit, or some other
evacuation.
  There is reason to believe,  if-the efforts of Nature, at the beginning
of a fever, Avere duly attended to and promoted,*it Avould  seldom conti-
nue long; but when her attempts are neglected or counteracted,  it is no
wonder if the disease proves fatal.   There are daily instances of  persons
who,  after, catching cold, have all the symptoms of  a beginning ftHer;
but by keeping warm,  drinking  diluting liquors, bathing their feet in
Avarm  water, &c. the symptoms in a few hours disappear, and the danger
is prevented.   When fevers of a putrid kind threaten, the best  method
of obviating their effects is  by repeated vomits.
  Our design is not to enter into a critical enquiry into the nature and
immediate causes of fevers, but  to mark their most obvious symptoms,
and to point out the proper treatment of the patient with respect to his
diet, drink, air, Ac. in the different stages of the disease.   In these ar-
ticles the inclination of the patient will in a  great measure  direct our
conduct.
  Almost every person in a fever complains of great thirst, and calls out
for drink, especially of a cooling nature.  This at once points  out the
use of water, and other cooling liquors.  What is so likely to abate the
heat, attenuate the humours, remove spasms and obstuctions, promote per-
spiration, increase the quantity of urine,  and in short produce every sa-
lutary effect in an ardent or inflammatory fever, as drinking plentifully
of water, thin gruel, or any other AVeak liquor, of Avhich Avater is the ba-
sis ?  The necessity of diluting liquors, is pointed out by the dry  tongue,
the parched skin, and the burning heat, as well as by the unquenchable
thirst of the patient.
  Many cooling liquors, Avhich are extremely grateful to patients in a
fever  may be prepared from fruits, as  decoctions of tamarinds, apple tea,
orange whey, and the like.   Mucilaginous liquors might also be prepared
from marsh-mallow roots, linseed, limetree buds, aud other mild vege-
tables.   These liquors, espe#tily when acidulated, are  highly  agreea-
ble to  the patient, and should never be denied him.
  At the beginning of a fever the patieut generally complains of great
lassitude or weariness, and has no inclination  to move.  This evidently
sIioavs the propriety of keeping him easy, and if possible in bed.  Lying
in bed relaxes the spasms,  abates the violence of the circulation, and
gives  nature  an opportunity of exerting all her force to overcome the
disease.  The bed alone would often  renWve a fever at the  beginning;
but  when the patient struggles with the  disease, instead of driving  it
off, he only fixes it  the deeper, and renders it more dangerous.   This
observation is too  often verified in  travellers, who happen when on  a
journey to be  seized with a fever.  Their anxiety to get home  induces 
116             OF FEVERS IN  GENERAL,
them to travel with the fever upon them, which conduct seldom fails to
render it fatal.
  In fevers the mind as well as the body should be kept easy.   Com-
pany is seldom agreeable to the sick.   Indeed eveiy  thing that dis-
turbs the imagination, increases the disease;  for which  reason  every
person in a fever ought to be kept  perfectly quiet, and ueither allowed
to see nor hear any thing that may in the least affect or discompose his
mind.
  Though the patient in a fever has the greatest inclination for  drink,
yet he seldom  has any appetite for solid food: hence the impropriety
of urging him to take victuals  is evident.   Much solid food in a fever
is every way hurtful.  It oppresses nature, and instead  of  nourishing
the patient, serves only  to feed the disease.   What food the patient
takes should be in small quantity, light, ahd of easy digestion.  It ought
to be chiefly of the vegetable kind,  as panada^ roasted apples, gruels,
and such like.
  Poor people; when any of their family are taken ill, run  directly to
their rich neighbours for cordials, and pour wine, spirits, &c. into the
patient, who. perhaps never  had been accustomed to taste such  liquors
when in health.  If there be any degree of  fever, this conduct must in-
crease-it, and if there  be none,  tins is the ready way to raise one.
Stuffing the patient with sAveetmeats and other delicacies is likewise very
pernicious.   These are always harder to digest  than common food, and
cannot fail to hurt.
  Nothing  is  more desired by a patient in a fever than fresh air.  It
not only removes his anxiety^ but cools the blood, revives the spirits, and
proves every way beneficial.  Many patients  are in a manner stifled to
death in fevers, for want of  fresh air;  yet such is the unaccountable in-
fatuation of most people, that the moment they think a person in a fever,
they imagine he should be kept in a close chamber, into which not one
particle of fresh air must be admitted.   Instead of this, there ought to be
a constant stream of fresh  air into a sick person's chamber, so as to keep
it moderately cool.  Indeed its  degree of Avarmth ought never  to be
greater thau is agreeable to  one in perfect health.
  Nothing spoils the air of a sick person's chamber, or hurts the patient.
more, than a number of people breathing in  it.   When the blood is in-
flamed, or the humours in a putrid state, air that has been breathed re-
peatedly will jrreatly increase the disease.  Such air  not only loses its
spring, and becomes unfit for the purpose of respiration,  but acquires a
noxious quality, which renders it in a manner poisonous to the sick.
  In fevers, Avhen the parent's spirits alt. low and depressed, he is not
only to be supported with cordials, but every method should be taken to
cheer and comfort his  mind.   Many from  a mistaken zeal,  when they
think a person in danger, instead  of  solacing his mind with the  hopes
and consolations  of religion, fright him  with the views of hell and dam-
nation.  It  would be unsuitable  here to dwell upon the impropriety and
dangerous consequences of  this conduct; it often  hurts the body, and
there is reason to br Peve seh%m benefits the soul.
  Amo-ig common  people, the very  name of  a fever  generally  sug-
gests the necessity of bleeding.  This notion  seems  to have taken its
rise from most fevers in this  country having been formerly of  an in-
flammatory  nature j  but  trae  inflammatory fevers arc now  seldom to 
                OF  INTERMITTING  FEVERS.           117

 »)€ met with-  Sedentary occupations, and  a  different maimer of living,
 have so changed the state of diseases in Britain, that there is noAV hardly
 one fever in ten where the lancet is necessary.   In most low, nervous, and
 putrid fevers, which are noAV so common, bleeding is really hurtful, as it
 Aveakens the patient,  sinks his  spirits, &c.  We  would recommend this
 general rule,  never to bleed at the beginning of a fever, unless there be
 evident signs of inflammation.   Bleeding is an excellent medicine when
 necessary, but should never be wantonly perfo*Ad.
   It is likewise a common notion, that sAveating is always necessary in
 the  beginning of a fever.  When the fever proceeds from an obstructed
 perspiration, this notion is not ill-founded.  If  the patient only ties in
 bed, bathes his feet and legs in Avarm water, and drinks freely of warm
 w ater-gruel, or any other Aveak diluting liquor, he will  seldom fail to per-
 spire freely.   The warmth of  the bed, and the diluting drink, will relax
 the universal spasm,  which generally affects the skin at the beginning
 of a fever; it will open the pores, and promote the perspiration, by means
 of which the fever may often be carried off.  But instead of this, the
 common  practice is  to heap clothes upon the patient,  and to give him
 things of a hot nature, as spirits, spiceries, &c. which fire his blood,  in-
 crease the spas-fls, and render  the disease more dangerous.
   In all  fevers a proper atteution should be paid  to the patient's longings.
 These are  the  calls of Nature, and often point out what may be of real
 use.  Patients are not  indeed to  be indulged in every thing that the
 sickly appetite may crave;  but it is generally right to let them have a
 little of Avhat they eagerly desire, though it may  uot seem altogether pro-
 per.  What the patient longs  for, his stomach will generally digest; and
 such things have sometimes a  very happy effect.
   When a patient is recovering from a fever, great «care is necessaiy to
 prevent  a  relapse.   Many  persons, by too soon imagining themselves
 well, have lost their lives,  or contracted other  diseases of an obstinate
 nature.   As the body after a fever is weak and  delicate, it is necessary
 to guard against catching  cold.  Moderate exercise in the open air will
 be  of use, but  great  fatigue is by all  means to  be avoided; ajrrecable
 company will  also  have  a good  effect.   The  diet  must be  light but
 nourishing.  It should be taken frequently, but  in small quantities.  It
 is dangerous, at such a time, to eat as much as the stomach will crave:



#                        CHAP.  XIV.

          OF  INTERMITTING  FEVERS,  OR  AGUES.

          INTERMITTING fevers afford the  best opportunity both of
 observing  the  nature of a fever, and  affb the effects of medicine.   No
 person can be  at a loss to distinguish an intermitting fever from any other,
 and the  prop^medicine  for it is now almost universally known.
    The  several ki^kof  intermitting fevers  take their names from  the
 period in Avhich trn^t returns, as quotidian, tertian, quaVtan, cvc.
    CAUSES.—Agues^re occasioned by effluvia from putrid stagnating
 water.   This is evident from their  abounding in rainy seasons,  and
 being most frequent iu countries where the soil fe marshy, as in Holland. 
 118           OF  INTERMITTING  FEVERS.

 the fens of Cambric'geshire, the Hundreds of Essex, &c.  This disease
 may also be occasioned by eating too much stone fruit, by a poor watery
 diet, damp houses, evening dews, lying upon the damp ground, watching,
 fatigue, depressing passions, and the like.  When the  inhabitants of ;i
 high country remove to a Ioav one, they are generally seized with inter-
 mitting fevers, and to such the disease is most apt to prove fatal.   In a
 word, whatever relaxes the solids, diminishes the perspiration,  or ob-
 structs the circulation^iiifthe capillary or small vessels, disposes the body
 to agues.
   SYMPTOMS.—An intermitting fever generally begins with  a paiii
 of the head and loins, weariness of the limbs, coldness of the extremities,
 stretching,  yawning,  with sometimes  great sickness and  vomiting; to
 which succeed shivering and violent shaking.   Afterwards the skin be-
 comes moist, and a profuse sweat breaks out, which generally terminates
 the fit or paroxysm.   Sometimes indeed the di.ease comes on suddenly,
 when the person thinks himself in  perfect health; but it is  more com-
 monly preceded by listlessness, loss of appetite, and the symptoms men-
 tioned above.
   REGIMEN.—While  the fit continues, the  patient ought  to  drink
 freely of water-gruel, orange-whey, weak camomile tea ;*or, if his spirits
 be low, small wine-whey, sharpened with  the juice of lemon.   All his
 drink should be warm, as that will assist in bringing on the sweat,  and
 consequently shorten  the paroxysm.'
   BetAveen the paroxysms the patient must be supported with  food that
 is nourishing, but light and easy of digestion,  as veal or chicken broths,
 sago, gruel with a little wine, light puddings, and such like.  His drink
 may be small negus, ascidulated with the juice of lemons or oranges, and
 sometimes a little weak punch.  He may bkeAvise drink infusions of bit-
 ter herbs,  as camomile,  Avormwood, or watertrefoil, and may  now and
 then take a glass of small Avine, in which gentian root, centuary, or some
 other bitter, has been infused.
   As the chief intentions of cure in an ague are to brace the solids, and
 promote perspiration, the patient ought to take as much exercise between
 the fits as he can bear. If he be able to go abroad, riding on horseback,
 or in a carriage, Avill be of great service.  But if he cannot bear that
 kind of exercise,  he  ought  to take such as his strength  will permit-
 Nothing tends more to prolong an intermitting fever, than indulging a
 lazy indolent disposition.                                             ^
   intermitting fevers, under a proper  regimen,  will often go off without
 medicine: and Avhen the disease is  mild,  in  an open and dry country?
 there is4teldom any danger from allowing it to take its course; but when
 the patient's strength  seems to decline, or tub  paroxysms are so violent
 that his life is iu danger, medicine ought immediately to be administered.
 This however should never be done till the disease be  properly formed,
 that is to say, till the patient ha^ had several fits of shaking and sweating.
   MEDICINE.—The first thing to be  done in the cure of  an inter-
 mitting fever, is to cleanse tiie stomach  aud boAvels. ^Trhis not only
 --------.------------------^------------------*-----------------
  * Dr. Lind says, that twenty or twenty-five drops of laudanum put into a cup
 of the patient's drink, and given about half an hour IPterthe commencement of
 the hot fit, promotes the sweet, shortens  the fit, relieves the head, and tends
^greatly to remove the disease. 
OF INTERMITTING  FEVERS.          119
  renders the application of other medicines more safe, but likewise more
  efficacious.   In this disease the stomach is generally loaded Avith cold
  viscid phlegm, and frequently great quantities of bile are discharged by
  vomit; which plainly points out the necessity of evacuations.  Vomits
  are therefore to be administered before the patient takes any other medi-
  cine.  A dose of ipecacuanha will generally ansAver this purpose very
  well.  A scruple or half a drachm of the powder will be sufficient for an
  adult, and  for  a younger person the dose must be less in  proportion.
  After the vomit begins  to operate, the patient ought to drink plentifully
  of weak camomile tea.   The vomit should be taken tAvo or three hours
  before the return of the fit, and may be repeated at the distance of two
   or three days.   Vomits not only cleanse the stomach, but increase the
   perspiration, and all the other secretions, which render them of such im-
   portance, that they often cure intermitting fevers wi%out the assistance
   of any other medicine.
      Purging medicines are likewise useful and often necessary ininternnt-
 1  ting fevers.  A smart  purge has  been known to cure an obstinate ague,
   after the  Peruvian bark and  other  medicines had been used in vain.
    Vomits however are more suitable in this disease, and  render purging
   less necessary; but if the patient be afraid to take a  vomit, he ought in
   this case to cleanse the bowels by a dose or two of Glauber's salt, jalap.
   or  rhubarb.                                          ....
       Bleeding may sometimes be proper at the beginning of an intermitting
   fever, when excessive  heat, a delirium,  &c. give reason to suspect an in-
   flammation ; but as the blood is seldom in au inflammatory state in inter-
   mitting fevers, this operation is rarely necessary.   When frequently re-
    peated, it  tends to prolong this disease.
       After proper evacuations the patient may safely use the Peruvian bark,
    which may be taken in any way that is most agreeable to him.   No pre-
    paration of the bark seems to ausw er better than the most simple form in
*»• which M can be given, viz. in powder.                              _
       Two ounces of the best Peruvian bark, finely powdered, may be divi-
    ded into twenty-four  doses.   These may either be made into boluses as
    they are used, with a little syrup of lemon, or mixed in a  glass of red
    wine, a cup of camomile tea, water gruel, or any other drink that is more
    agreeable to the patient.*
       In an ague which  reJ»s every day,  one of the above doses may be
     taken every two hoursdu#g the interval of the fits.   By this method
     the patient will be able to We five or six doses between each paroxysm.
     Ina teyiau or third day ague it will be sufficient to take  a dose every
     third hour during the interval, and in a quartan every fourth.   If the
     patient cannot take so large a, dose of the bark, he may divide each of the
     powders into two parts, aud  take one eveiy  houi>vc.  For a young per-
     son a smaller quantity of this medicine  will be sufficient,  and the dose
     must be  adapted to the age, constitution and violence of the symptoms.f

       • It has lately been observed, that  the red bark is more powerful than that
     which haatffoMome time been in  common use. Its superior efficr.cy seems to
     arise fronTMUng of a more perfect growth than the quill banc, and  cons* (
     ouentlv morfffullv impregnated with the medical properties of the plant.
       + In intermitting fevers of an obstinate nature, I have found  it necessary to
     throw in the bark much taster.  Indeed the benefits arising from th-.s medicine
     depends chief! v upon a large quantity of it being administered in a short time.
     -several ounces of bark given in a few days will do more than as many pounds 
120
OF INTERMITTING  FEVERS.
     The above quantity of bark will frequently cure  an ague; the pi*
  tient, however, ought not to leave off taking the medicine as soon as the
  paroxysms are stopped, but should continue to use it till there is reason
  to believe the disease is entirely overcome.  Most of the failures in the
  cure of this disease are owing to  patients not continuing to use the me-
  dicine long enough.   They are generally directed to take  it till the fits
  are stopped, then to leave it  off,  and begin again at some distance of
  time; by which which means the  disease gathers strength and.often re-
  turns with  as  much violence  as before.   A relapse may always be prc=-
  vented by the patient's continuing to take doses of the medicine for some
  time after the symptoms disappear.   This is both the most safe and ef-
  fectual method of cure.
    An-ounce of gentian root,  calamus aromaticus, and  orange-peel, of
  each half an ounc% with  three or four handsful of camomile-flowers, and
  an handful of coriander-seed, all bruised together  in a mortar, may be
  used in form of infusion or tea.   About hall' an handful of these ingre-
  dients may be put  into a tea-pot,  and an English pint of  boiling Avater
  poured on them.  A cup of this infusion drank three or four times a day
  will gready promote the cure.  Such patients as cannot drink the watery
  infusion,  may put two handsful of the same ingredients into a bottle of
  white Avine, and take a glass of it twice or thrice a day. If patients drink
  freely of the above, or any other proper infusion of bitters, a smaller quan-
  tity of bark than is generally used will be sufficient to cure an ague.*
    Those Avho cannot sAvallow  the bark in substance, may take it in de-
  coction or infusion.  An ounce of bark in poAvder may be infused iu a
  bottle of Avhite wine for four or five days, frequently shaking the bottle,
  afterwards  let the  powder subside, and pour off the clear liquor.  A
  Avine glass may be drank  three or four times a day, or oftcner, as there is
  occasion.   If a decoctior 'ie more agreeable, an ounce of the bark, and
  two drachms  of  snake-root" bruised, Avith an equal quantity j>f%alt of   t
  AVorniAiood, may  be  boiled in a quart  of water to an English pint.  To •
  the strained liquors may be added, an  equal quantity of red Avine, and a
 glass of it taken frequently.
    In obstinate agues, the  bark  will be found much more efficacious
 when assisted  by brandy, or  other warm cordials, than taken alone.
  This I have had frequently occasion to observe in a country Avhere in-
 termittent fevers were  endemical.  The bjpijfr, seldom succeeded un-
 less  assisted by snake root,  ginger, canellfliroa, or  some other warm
 aromatic.   When the fits are  frequent andviolent, iq tfhich case the
 fever often  approaches towards an inflammatory natuie, it avU| be sa-
 fer to keep out the aromatics, and to  add salt of tartar in their stead.

 taken in the course of so«ne weeks.  When this medicine is intended either to
 stop a mortification, or cure an obstinate ague, it ought to be thrown in as fast
 as the stomach can possibly bear it   Inattention to this circumstance has hurt
 the reputation of one of the best medicines of which we are in possession.
  * There is reason to believe, that sundry of our own plants or barks, which
 are very bitter and astringent, would succeed in the cure of intermittent fevers,
 especially when assisted by aromatics.  But as the Peruvian barlAa^been long
^approved in the cure of this disease, and is now to be obtained at a \efy reason-
 able rate, it is  of less importance to search after new medicines.' JVe cannot
 however omit taking notice, that the»Peruvian bark is very often adulterated,
 and that it  requires considerable skill to distinguish between the genuine and
 fhg false.  This ought to make people cautious of whom they purchase it. 
               OF  INTERMITTING  FEVERS.            12^

But in an obstinate tertian or quartan, in the end of auiumn or beginning
of winter, warm and cordial medicines are absolutely necessary.*
   As autumnal  and winter agues generally prove  much more obstinate
than those which attack the patient in spring or summer, it will be neces-
sary to continue the use ot medicines longer hi the former than ii. the lat-
ter.   A person who  is seized with an intermitting fever in the liegiiuimg
of winter, ought frequently, if the season proves rainy, to take a little me
dicine, although the disease may seem to be cured,  to prevent a relapse,
till the return of the warm season.  He ought likewise to take care not
to be too much abroad in wet weather, especially in cold easterly wii.ds.
   When agues are not properly cured, they ofteu  degenerate into obsti-
nate chronical diseases, as the dropsy, jaundice, Ax.  For this reason ?11
possible care should  be  taken to have  them radically cured, before  die
constitution has been too much weakened.
   Though nothing is more rational than the method of treating intermit-
ting fevers, yet by some strange infatuation, more charms and whimsical
remedies are daily used  for removing this than any  other disease.
There is hardly an old woman who  is not in possession of a nostrum
for  stopping an ague; and it is amaz'ng with what readiness their pre-
tensions are believed.   Those in distress eagerly grasp at any thing that
promises sudden relief; but the shortest way is not always the best in the
treatment of diseases.   The only method to obtain a safe and  lasting
cure, is gradually to assist nature in removing the cause of the dir order.
   Some indeed tiy bold, or rather  fool-hardy experiments  to  cure
agues, as drinking great quantities of strong liquors, jumping into a river.
taking arsenic, &c.   These may sometimes have the desired effect, but
must always be attended with danger.f  When there is any degree of in-
flammation, or the least tendency to it, such experiments may prove fa-
tal. The only patient whom I remember to have lost in an intermitting
fever, evidently killed himself by  drinking strong liquor, which some
person had persuaded him would prove an infallible remedy.
   Many dirty things are extolled for the cure of intermitting fewer?, as
spiders cobwebs,  snuifings of candles, Ac.    Though these may  some-
times succeed, yet their very nastiness is sufficient to set them aside, es-
pecially when cleanly  medicines will answer the purpose better.   The
only medicine that can be depended upon for tlioroughly curing an inter-
mitting fever, is the Peruvian bark.   It may always be used with safety:
and I can honestly declare, that in all my practice  I never I. new it iail,
when combined with the medicines mentioned above, and duly persisted

   Where agues are endemical, even children are often afflicted with that
disease.   Such patients are very difficult to cure, as they can seldom be
prevailed upon to take the bark, or any other disagreeable nied.ciue.
One method of rendering this medicine more palatable, is to make it in-

   * In obstinate agues, when the patient is old, the habit phelgmatic, the sea-
son rainy, the situation damp, or the like, it will be necessary to mix with two
ounces of the bark, half an  ounce of Virginia snake-root, and a quarter of a><
mince of cinffer, or some other warm aromatic ; but when the symptoms arc ot
an inflammatory  nature, half an ounce of salt of worm-wood or salt of tartar
mav be added to the above quantity of bark.    .„„.,_,      ,  .  .,
   + Arsenic has of late been recommended as an infallible remedy in the ague.
 but I would advise that it should be usedonly under the eye of a  physician
                                     16 
122           OF  INTERMITTING  FEVERS.
to a mixture with distilled waters aud syrup, and afterwards to give it
aa agreeable sharpness Avith the elixir or spirit of vitriol.  This both im-
proves the medicine, and takes off the nauseous state.   In cases where
the bark cannot be administered, the saline  mixture may be given with
advantage to children.*                •
  Whine-whey is a veiy proper drink for a child in an ague; to half ap
English pint of which may be put a tea spoonful of the spirit of harts-
horn.   Exercise is likeAvise of  considerable service; and  when  the
disease proves too obstinate, the child ought, if  possible, to be removed
to a warm dry air.   The  food ought to be nourishing,  and sometimes a
little generous wine should be allowed.
  To children, and  such  as  cannot swallow the bark, or when the sto-
mach will not  bear it, it may  be given by clyster. Half an ounce of the
extract of bark, dissolved in four ounces of warm Avater,  with the addition
of half an ounce of sAveet oil, aud six or eight drops of  laudanum, is the
form recommended by Dr. Lind for an adult,  and this  to be repeated
every fourth hour, or oftener, as the occasion shall require.  For  chil-
dren the quantity of extract and  laudanum  must be proportionably les-
s^ued.   Children  havTe been cured of agues by making them wear a
waiscoat with powdered bark quilted between the folds of it; by bathing
them frequently in a strong  decoction of  the bark, and by nibbing the
spiue with strong spirits, or with a mixture  of equal parts of laudanum
and the saponaceous liniment.
  We  have been the more full upon this disease, because it is very com-
mon, and because  few patients in an ague apply to physicians unless in
extremities.   There  are,  however,  many cases in Avhich the disease is
very irregular, being complicated with other diseases,  or attended with
symptoms Avhich are both very daegerousand  very difficult to understand.
All these we have purposely passed  over, as they  would only bewilder
the generality of readers.   When the  disease is veiy irregular, or the
symptoms dangerous,  the patient ought immediately to apply to a physi-
dm, and strictly to follow his advice.
  To prevent agues, people must endeavour to avoid their causes—These
have been already pointed out in  the beginning of this section: Ave shall
therefore only add one preventative  medicine, which may be of use to
such as are obliged to live in low  marshy  countries, or ivho are liable to
frequent attacks of this disease.
  Take an ounce of the best Peruvian bark; Virginia snake-root, and
orange  peel, of each  half an  ounce ; bruise them all together, and in-
fuse for five or six days in a bottle of brandy, Holland gin, or any good
spirit; afterwards pour off the clear liquor,  and take a Avine  <dass  of it
twice or thrice a day.  This indeed is recommending a dram;  but the
Irtter ingredients in a great  measure take  off the ill effects of the spirit.
Those who do not chuse it in brandy, may infuse it in  Avine • and  such
as can bring themselves to chew the  bark, Avill find that method succeed
very well.   Gentian root or  calamus aromaticus, may also be chewed by
(urns for the purpose.  All bitters seem to be antidotes to agues, especial-
Ihose that are  Avarm and astringent.
* See Appendix, Saline mixture.' 
125
                          CHAP. XV.

           OF  AN ACUTE CONTINUAL FEVER.   •

       JL HIS fever is denominated acute, ardent, or inflammatory.  It
most commonly attacks the young, or persons about the prime and vigour
of life, especially such  as live high, abound with blood, and whose fibres
are strong and elastic.  It seizes people  at all seasons of the year; but
is most frequent in the spring and beginning of summer.
  CAUSES.—An ardent fever  may be occasioned by any  thing that
overheats the body, or produces plethora, as violent exercise, sleeping
in the suu, drinking strong liquors, eating spiceries; a full diet, with lit-
tle exercise, &c.   It may likeAvise be occasioned by whatever obstructs
the perspiration, as lying on the damp ground, drinking cold liquor when
the body is hot, night watching, or the like.
  SYMPTOMS.—A rigour or dullness generally ushers in this fever, ■
which is soon succeeded by great heat,  a frequent and full pulse, pain of
the head, dry skin, redness of the eyes,  a florid countenance, pains in the
back, loins, &c.  To these succeed difficulty of breathing, sickness, with
an inclination to vomit.   The patient complains of great thirst,  has  no
appetite for solid food, is restless, and his tongue generally appears black
and rough.
  A delirium, excessive restlessness, great oppression of the breast, with
laborious respiration, starting of the tendons,  hickup, cold clammy sAveats,
an involuntary discharge of urine, are very dangerous symptoms.
  As this disease is always attended with danger, the best medical assist-
ance ought to be procured as soon as possible.   A physician may be of
use at the beginning, but his skill is often  of no avail afterwards.  No-
thing can be  more unaccountable than the conduct of those who  have it
in their poAver, at the beginning of a fever,  to procure the best medical
assistance, yet put it  off  till things come to an extremity.  When the
disease, by delay or wrong treatmeut,  has  become incurable, and has
exhausted the strength of  the patient, it is  vain to hope for relief from
medicine.  Physicians may  indeed assist Nature; but their attempts
must ever prove fruitless, Avhen she is no longer  able to co-operate Avith
their endeavours.
   REGIMEN.—From the symptoms of this disease, it is evident, that
the blood and other humours require to be attenuated; that the perspira-
tion, urine, saliva, and all the other secretions,  are in too small quanti-
ty ; that the  vessels are rigid, and the heat of the whole Body too great:
all these clearly point  out the necessity  of a regimen calculated to dilute
the blood, correct  the acrimony  of the  humours, allay the excessive
heat,  remove the spasmodic structure of the vessels, and  promote the
secretions.
   These important  purposes may  be  greatly promoted  by drinking
plentifully of diluting liquors;  as water-gruel,  or  oatmeal-tea, clear
whey, barley-Avatcr, balm-tea, apple-tea, &c.   These  may be sharp-
ened  with juice of orange, jelly of currant.-, raspberries, and such like:
oranse-wliey  is likewise  an excellent  cooling  drink.  It is made by
boiling among milk and   water a bitter orange sliced, till the  curd
separates.  If no orange  can be had, a lemon,  a little cream of tartar. 
124       OF  AN  ACUTE  CONTINUAL  FEVER.

or a few spoonsful of vinegar, will have the same effect.  Two or three
spoonsful of Avhite Avine  may occasionally be added to  the liquor Avhen
boiling.
   If tlie patient be costive, an ounce of tamarinds, with two ounces of
stoned raisins of the sun, and a couple of figs, may be boiled in three
English pints of Avater to a quart.   This makes a  very pleasaut drink,
and may be used at discretion.  The common pectoral  decoction is like-
Avise a very proper drink in this disease.   A tea-cup full of it may be
taken  every tivo hours,  or ottener,  if the patient's heat aud  thirst be
very great.*
   The above liquids must all  be drank a little warm.  They may be
Hsed in  smaller quantities at the beginning of a fever,  but more  freely
afterwards, in  order to  assist in carrying off the disease by promoting
the different exrretious.   We  have mentioned a variety of drinks,
that the patient may ha/e it in his power to chuse those which  are most
agreeable,  and that,  when tired of one,  he may have recourse to ano-
Iher.
   The patient's diet must be very spare  and light.  All sorts of flesh-
meats, and even chicken-broths, are to be avoided.   He may be allowed
groat-gruel, panado,  ov  light bread boiled in water;  to which may be
added a feAv grains of common salt, aud  a  little sugar, which will render
it more palatable.   He may eat roasted apples with a little sugar, toast-
ed bread with jelly of currants, boiled primes, &c.
   It will greatly relieve the patient, especially in an hot season, to have
fresh  air frequently let into his chamber.   This, however, must always
be done iu such a manner as not to endanger his catching cold.
   It is too common in fevers to load the patient Avith bed-clothes, under
the prcieace of making him sAveat, or defending him  from the cold.   This
custom has many ill effects.  It increases the heat of the body, fatigues
the patient, and retards, instead of promoting, the perspiration.
   Sitting upj igiitin bed, if the patient is able to bear it, will often have
a good effect.   It relieves the head, by retarding the motion of the blood
to the  brain.   But this posture ought never to be  continued  too long s
and if the patient is inclined to sAveat, it will be more safe to let him lie,
only raising his head a little with pillows.
   Sprinkling the chamber with vinegar, juice of lemon, or vinegar and
rose-water,  with a little 'nitre dissolved in  it, will greatly refresh the
patient.   This ought to be done frequently, especially if the Aveather is
hot.
   The patient's mouth should be often washed with a mixture of water
and honey, to which a little vinegar may be added, or Avith a decocdon
of figs iu barley-water.   His feet and hands ought likewise frequently to
be bathed in luke-warm water; especially if the head is affected;
   The patient should be kept as quiet and easy as possible.  Company,
noise,  and every  thing  that disturbs the  mind,  is  hurtful.   Even too
much  light, or auy tiling  that effects the senses,  ought to be avoided.
His attendants should be as few as possible, and  they ought  not to be
too often changed.   His inclinations ought rather to be soothed than
contradicted;  evei the promise of what he craves will  often satisfy him
as much as its reality.
* See Appendix, Pectoral decoction. 
OF  AN  ACUTE  CONTINUAL  FEVER.       125
   MEDICINE.—In  this and all other fevers, attended with a hard,
full, quick pulse, bleeding is of the greatest importance.   This operation
ought always to be performed as  soon as the symptoms of an inflamma-
tory fever appear.   The quantity of blood  to be taken away, hoAvever,
must be in proportion to the strength of the patient and the violence of
the disease.  If after  the fu'st bleeding the fever should increase, and
the pulse become more frequent  and hard,  there will be a necessity fos
repeating it a second, and perhaps a third, or even a fourth time, which
may be done at the  distance of tAvelve, eighteen, or twenty-four  hours
from each  other, as  the symptoms require.  If the pulse continues soft,
and the patient is tolerably easy  after the first bleeding,  it ought not to
be repeated.
   If the heat and fever be very great, forty or fifty drops of the dulcified
or sweet spirit of nitre may be made iuto a draught, with au  ounce, of
rose water, two ounces of common Avater, and half an ounce of 6implc
syrup, or a bit of loaf-sugar.   This draught may be given to the patient
every three or four  hours while the fever is violent; afterwards once iu
five or six hours will be sufficient.
   If the patient be afflicted with reaching, or an inclination to vomit, it
 will be right to assist Nature's attempts, by giving him Aveak camomile-
 lea, or luke-Avarm Avater to drink.
   If the body is bound, a clyster of milk and water, with a little salt, and
 a spoonful of sAveet-oil o»r fresh butter  in it, ought daily to be administer-
 ed.  Should this not have the desired effect, a tea-spoonful of magnesia  •
 alba, or cream of tartar,  may be frequently put into his drink.  He may
 likewise eat tamarinds, boiled prunes,  roasted apples, and the like.
   If about the tenth, eleventh, or twelfth day,  the  pulse becomes more
 soft, the tougue moister,  and the urine begins to let fall  a reddish sedi-
 ment, there is reason to expect  a favourable issue to the disease.   But
 if, instead of these symptoms, the patient's spirits giw languid, his pulse
 sinks, and his breathing becomes difficult; with a  stupor, trembling of
 the nerves, starting of  the tendons, &c. there is reason to fear Uiat the
 consequences  will be fatal.  In  this case blistering plasters must be ap-
 plied to the head, ancles, inside of the legs or thighs, as there may be
 occasion; poultices of wheat-bread, mustard,  and vinegar, may likewise.
 be applied to the soles  of the feet,  and the patient must be supported
 with cordials,  as strong wine-whey, negus, sago-gruel,  with wine in it,
 and such like.
    A proper regimen is not only necessary during the fever, but likewise
 after the patient begins to recover.  By neglecting this, many relapse,
 or fall into other diseases, and continue .valetudinary for life.  Though
 the body is weak after a fever,  yet the diet for some time ought to be
 rather  light than of too nourishing a nature.   Too much food,  drink,
 exercise,  company, Ac. are carefully to be avoided.   The mind ought
 likewise to be kept easy, and the patient should not attempt to pursue
 study, or any business that requires intense thinking.
    If  the  digestion  is bad, or the  patient is  seized at times with  fever-
 ish heats, an infusion of Peruvian bark in cold water will be of use.  It
 will strengthen the stomach, and  help to subdue the remains  of the

    When the patient's strength is pretty Avell recovered,  he ought to take
 some ^entle laxative.   An ounce of tamariuds and a  drachm of  sena 
 l2^t>                 OF THE  PLEURISY.

may be boiled for a few minutes in an English pint of water, and an ounce
of manna dissolved in the decoction; afterwards it may be strained, and
a tea-cupful drank every hour till it operates.  This dose may be re^
peated twice or thrice, five or six days intervening.
  Those who follow  laborious employments ought not to return too soon
to their labour after a fever, but should keep easy  till their strength and
spirits are sufficiently recruited.
                            CHAP.  XVL

                        OF THE PLEURISY.

             X HE true pleurisy is an  inflammation of that membrane
   called the pleura, which lines the inside of the breast.   It is distinguish-
   ed into the moist and dry.   In the former, the patient spits freely; in the
   latter, little or none at all.  There is likewise a species of this disease,
   which is called the  spurious,  or bastard pleurisy, in which the pain  is
   more external, and chiefly affects the muscles between the ribs.  The
   pleurisy prevails among labouring people, especially such as Avork with-
s   out doors, and are of a sanguine constitution.  It is most frequent in the
   spring season.
     CAUSES.—The pleurisy may be occasioned by Avhatever obstructs
   the perspiration;  as cold northerly winds; drinking cold liquors when
   the body is  hot; sleeping Avithout doors on the damp ground;  wet
   clothes; plunging the body into cold water,  or exposing it to the cold
   air, when covered with sweat, &c.  It may likewise be occasioned by
   drinking strong liquors; by the stoppage of the usual evacuations;  as old
   ulcers, issues, sweating of the feet or hands, &c. the sudden striking in
   of an eruption, as the itch, the measles, or the small-pox.  Those who
   have been accustomed to bleed at a certain season of the  year, are apt,
   if they neglect it, to be seized  Avith a pleurisy.   Keeping the body too
   Avarm by means of fire, clothes, &c. renders it more liable to this diseare.
   A pleurisy may likewise be occasioned  by violent exercise, as  running,
   wrestling, leaping, or by supporting great weight,  blows on  the breast,
   &c.   A bad conformation of the body renders persons more liable to this
  disease, as a narrow chest, a straitness of the arteries of the pleura, &c.
     SYMPTOMS.—This, like  most other fevers,  generally begins with
  chilliness and shivering, ivhich are followed by heat, thirst, and restless-
  ness.   To these succeeds  a violent pricking  pain in one of the sides
  among the ribs.   Sometimes  the pain  extends towards the backbone,
  sometimes toAvards the forepart of the breast, and at other times towards
  the shoulder-blades.   The  pain is generally most  violent  when the pa-
  tient draws his breath.
     The pulse  in this disease is commonly quick and hard, the urine high
  coloured; and if blood be let, it is covered Avith a tough crust, or buffy
  coat.   The patient's spittle is  at first thin, but aftenvards it  becomes
  grosser, and is often streaked with blood.
     REGIMEN.—Nature «£eneialJy*endeavours to carry off this disease
  by a critV.d  discharge of  bleod from some part  of the body, by ex- 
OF THE  PLEURISY.
127
pcctoration, sweat, loose stools, thick  urine, or the  like.  We  ought
therefore to second  her intentions by lessening the  force of the circula-
tion, reLxing the vessels, diluting the humours, and promoting expectora-
tion.
   For these purposes the diet, as in the former disease, ought to be cool,
slender, and diluting.   The  patient must avoid all food that  is viscid,
hard of digestion, or  that affords much nourishment: as flesh, butter,
cheese, eggs, milk, and also every thing that is of a heating nature. His
drink may be whey, or an infusion of pectoral and balsamic vegetables. ■
   Barley-water, Avith  a little honey or jelly of currants mixed with it,
is likewise a very proper drink in this  disease.  It is made by  boiling an
ounce of  pearl-barley in three  pints of water to two, Avhich must after-
wards be strained.   The decoction of figs,  raisins and barley, recom-
mended in the preceding disease, is here  hkeAvise very proper.   These
and other diluting liquors are not to be drank in large quantities at a time;
but the patient ought to keep  continually sipping them, so  as to  render
 his mouth and throat always moist.   All his food and drink should be
 taken a little w arm.
    The patient should be kept quiet, cool, and eveiy way easy, as direct-
 ed under the foregoing disease.  His feet  and hands ought daily to be
 bathed in lukewarm Avater;  and he may sometimes sit  up Li bed for a
 short space, in order to relieve his head.
    MEDICINE.—Almost every person knoAvs Avhen a fever is attended
 with a violent pain of the side, and a quick hard pulse, that  bleeding is
 necessary.   When these symptoms come  on, the sooner this operation is
 performed the better; and the  quantity at first must be pretty large, prc-
 vided the patient is able  to bear it.   A large quantity of blood let  at
 once, in the beginning of a  pleurisy,  has a much better effect than re-
 peated small bleedings.  A  man may  lose twelve  or  fourteen ounces of
 blood as soon as  it is certainly known that he is rcized with  a pleurisy.
 For a younger person, or one of a delicate constitution, the quantity miiLt
 be less.
    If, afterthefirstblceding,thcstichwUh  the other violent symptoms,
 should still continue, it will be necessary, at the distance of twelve  or
 eighteen hours, to let eight or nine ounces more.   If the symptoms do not
 then a bate, and the blood shews a  strong buffy coat, a third or  even a
 fourth bleeding may be requisite.    If the pain of the  side  abates, the
 pulse becomes softer, or the patient begins  to spit freely, bleeding ought
 not to be repeated.   This operation is seldom necessary after the third
 or fourth day of the fever,  and ought not then to be performed, uuless in
 the most urgent circumstances.
    The blood may be many ways attenuated Avithout bleeding.   There
  are likewise many things that may be done to ease the  pain of the side
  without this operation, as fomenting, blistering, Ac.   Fomentations may
  be made by boiling a handful of the flowers of elder, camomile, and com-
  mon mallows, or any other  soft vegetable in a proper quantity of water.
  The herbs may be either put into a flannel bag, and  applied warm to the
  side or flannels may be dipped iu die decoction, afterwards wrung out
   iid applied to the part affected, with as much warmth as the patient on
  carily bear.  As  the clothes grow cool,  they must be changed, and great
  care taken that the patient do not catch cold.   A bladder may be filled

                     * See Appendix, Pectoral ifnusion. 
128
OF  THE  PLEURISY.
 with Avarm milk and water, and applied to the side, if the above method
 of fomenting be found inconvenient.    Fomentations not only ease the
 pain, but relax the vessels, and prevent the stagnation of the blood and
 other humours.   The side may likewise be frequently rubbed with a lit-
 tle of the volatile liniment.*
   Topical bleeding has often a very good effect in this disease.  It may
 either be performed  by applying a number  of leeches to the p^rt affect-
 ed, or by cupping, which is both a more certain  and expeditious method
 than the other.
   Leaves of various kinds might likewise be applied to the patient's side
 with advantage.  I have often  seen great benefit  from young cabbage
 leaves applied ivarm to the side in a pleurisy.  These not only relax the
 parts, but likewise draw off a little moisture, and may prevent the neces-
 sity of blistering-plasters;  which  however, when other things fail, must
 be applied.
   If the stitch continues  after repeated bleedings,  fomentations, &c. a
 blistering-plaster must be applied over the part affected,  and suffered to
 remain for two days.  This not only procures a discharge from the side,
 but takes off the spasm, and by that means assists in removing the cause of
 the disease.   To prevent a stranguary when the blistering-plaster is on,
 the patient may drink freely of the Arabic emulsion.f
   If the patient is costive, a clyster of thin Avater-gruel, or of barley-water,
 in Avhich a  handful of mallows,  or any other emollient  vegetable has
 been boiled, may be daily administered.  This  Avill not only empty the
 bowels, but have the effect of a warm fomentation applied to the inferior
 viscera,  Avhich will help to make a derivation from the breast.
   The expectoration may be prompted by sharp oily, and mucilaginous
 medicines.  For this purpose an ounce of  the  oxymel, or the  vinegar
 of squills,  may be added to  six ounces of the pectoral  decoction, and
 two table spoonsful of it taken every two hours.
   Should the squill disagree with the stomach, the oily emulsions may be
 administered ;\ or, in place of it, tAvo ounces of the oil of sAveet almouds,
 or oil of olives, and two ounces of syrup of violets may be mixed with as
 much sugar-candy poivdered, asAvill make an electuary of the consistence
 of honey.  The patient may take a tea-spoonful  of this frequently, Avhen
 the cough is troublesome.   Should oily medicines prove  nauseous, which
 is sometimes the case, two  table spoonsful of the solution of gum ammoniac
 in barley water may be given three or four times a-day§
   If the patient does not perspire, but has a burning heat upon his skin,
 and passes very little water, some small  doses of purified nitre and cam-
phire Avill be of use.  Two drachms of the former may be rubbed with five
or six grains of the latter in a mortar,  and the  Avhole divided  into six
doses, one of which may be taken every five or six hours, in a little of the
patient's ordinary drink.
   We  shall only mention one medicine  more,  Avhich  some  reckon
almost a  specific  in the  pleurisy, viz. the decoction  of the seneka
* See Appendix, Volatile liniment.
f See Appendix, Arabic emulsion-
i See Appendix, Oily emulsion.
§ See Appendix, Solution of gum ammoniac 
OF THE PLEURISY.                 12y
rattle-snake root.*   After bleeding and other evacuations have been
premised, the patient  may take two, three,  or four tible-spoonsful  of
this decoction, according as his stomach will bear it, three or four times
a-day.   If it  should  occasion vomiting,  two or three ounces of simple
cinuamou-water may be mixed with the quantity of decoctiou here di-
rected,  or it may be taken in smaller doses.  As this  medicine pro-
motes perspiration and urine, and likewise keeps the body easy,  it may
be of some service  in a pleurisy, or  any other inflammation of the
breast.
   No one will imagine that these medicines are all to be used at the
same time.   We have mentioned different things, on purpose that peo-
ple may have it in their power to  chuse;  and likewise, that when one
cannot be obtained they may make use of another.   Different medicines
are no doubt necessary in the different periods of a disorder; and where
one fails of success, or disagrees with the patient, it will be proper to try
another.
   What is called the crisis or height of the fever,  is sometimes attended
with very alarming symptoms, as difficulty  of breathing, an irregular
pulse, convulsive motions, &c.  These are apt to frighten the attend-
 ants, and induce them  to do improper things, as bleeding the patient,
giving  him  strong  stimulating mediciues, or the  like.  But  they  are
only the struggles of nature to overcome the disease, in which she ought
 to be assisted by plenty of diluting drink, which is then peculiarly ne-
cessary.  If the patient's strength hoivever be much  exhausted by the
 disease, it will be necessary at this time  to  support him with frequent
small draughts of wine-whey, negus, or the l\t. ■■
   When the pain and fever are gone,  it w,n k be proper, after the patient
 has recovered sufficient strength,  to give' him some  gentle purges, as
 those directed towards the end of the acute continual  fever.   He ought
 likewise to  use  a light diet,  of easy digestion, and his drink should be
 butter-milk, whey, and other things of a cleansing nature.

                    Of the Bastard Pleurisy.
    That species of pleurisy which is called the bastard or spurious gene-
 rally goes oil" by keeping warm for a few  days, drinking plenty of dilu-
 ting liquors, and observing a  cooling regimen.
    It is known by a dry cough, a quick pulse, and a difficulty of lying
 on the affected side, which last does not always happen in the true pleu-
 risy.  Sometimes indeed this disease proves obstinate, and requires bill-
 ing, with cupping, and scarifications of the part affected.  These, toge»
 ther with the use of nitrous aud other cooling medicines, seldom fail to
 effect a cure.

                       Of the Paraphrenitis.
    The paraphrenitis, or inflammation of the diaphragm, is  so nearly
 connected with the pleurisy,  and resembles it so much in the manner cf
 treatment, that  it is  scarce  necessary to consider it as a separate di-
 sease.
    It is attended with a very acute feATer, and an extreme pain in the
 part affected,  Avhich is generally augmented by  coughing,  sneezing,

                 '  See Appendix, Decoction of Seneka root)
                                   17 
130               OF A PERIPNEUMONY.

drawing  in the breath, taking food, going to stool, making water, Ac.
Hence the patient breathes quick, and draAvs in his bowels to prevent the
motion of the diaphragm; is restless, anxious, has a dry cough,  a hickup,
and often a delirium.  A convulsive laugh, or rather a kind of involun-
tary grin, is no uncommon symptom of this disease.
  Every method must be taken to prevent a suppuration, as it is impos-
sible to save the patient's life when this  happens.  The regimen and me-
dicine are in all respects the same as iu the pleurisy.  We shall only add,
that in this disease, emollient clysters are peculiarly useful, as they rela*
the bowels, and by that means make a derivation from the part  affected.
CHAP.  XVII.
  OF A PERIPNEUMONY,  OR  INFLAMMATION OF  THE
                              LUNGS.


          -A.S this disease affects an organ which is absolutely necessary
  to life, it must always be  attended with  danger.  Persons ivho abound
  with thick blood, whose  fibres are tense and rigid, who feed upon gross
  aliment, and drink strong viscid liquors, are most liable to a peripneumo-
  ny.  It is  generally faJ->l  to those who have  a  flat breast, or narrow
  chest, and to such  as art?afflicted with an asthma, especially in the de-
  cline of life.  Sometimes th^Hnflammation reaches to one  lobe  of the
  lungs only, at other times  the whole  of the organ is affected; in  which
  case the disease can hardly fail to prove fatal.
    When the dise?se proceeds from a viscid pituitous matter obstructing
  the vessels of the lungs, it is called a spurious or bastard peripneumony.
  When it arises  from a thin acrid  deflunction ou the lungs, it is denorai-   ^
  nated a catarrhal peripneumony, Ax.
    CAUSES.—An inflammation of the lungs,  is sometimes a primary
  disease, and sometimes it is the consequence of other diseases, as a quin-
  sey, a pleurisy, &c.  It  proceeds  from the same  causes as the pleurisy,
  vis. an obstructed  perspiration  from cold, Avet clothes, <fcc. or from an
  increased circulation of the blood by violent exercise, the use of spice-
, rffc, ardent spirits, and such like.  The pleurisy and peripneumony are
 *)ften complicated;  in which case the disease is called a pleuro-peripnm-
■  nwny.
    SYMPTOMS.—Most of the symptoms of a pleurisy likeAvise  attend
  an inflammation of the lungs; only in the latter the pulse is more soft,
  and the pain less acute;  but the difficulty of breathing, aud oppression
  of the breast, arc generally greater.
    REGIMEN.—As the  regimen and medicine are in all respects tlic
  same in  the true peripneumony as in  the pleurisy, Ave  shall not here
  repeat  them but refer the reader to the  treatment  of  that disease.
  It may not however be improper  to  add, that the  aliment ought to be
  more slender and  thin in this  than  in any other inflammatory disease.
  The learned Dr.  Arbuthnot  asserts, that  even  common  whev  is'suf-
  ficient to support the patieut,  and that decoctions of barley/ and iu- 
                    OF A  PERIPNEUMONY.              131

fusions of fennel roots in warm water with milk, are the most proper both
for drink and nourishment.   He likewise recommends the steam of warm
Water tak^n in by the breath, which serves as a kind of internal  fomen-
tation, and helps to attenuate the impacted humours.  If the patient has
loose stools, but is not weakened by them, they are not to be stopped,
but rather promoted by the use of emollient clysters.
  It has already been observed, that the spurious or bastard peripneu-
mony is occasioned by a viscid  pituitous matter obstructing the  vessels
of the lungs.  It commonly attacks the old, infirm, and phlegmatic,  in
winter and wet seasons.
  The  patient at the beginning is cold and hot by turns, has a small
quick pulse, feels a sense of weight upon his breast, breathes with diffi-
culty,  and sometimes complains of a paiu and giddiness  of  his head.
His urine is usually pale, and his colour very little changed.
   The diet, in this as well as in the true peripneumony,  must be very
slender, as Aveak broths, sharpened with the juice of orange or lemon, or
such like.   His drink may be thin water-gruel sweetened with honey, or
a decoction of the roots of fennel, liquorice, and ([uick grass.  An ounce
of each of these may be boiled in three English pints of water to a quart,
and sharpened with a little currant-'elly, or the like.
   Bleeding and purging are generally  proper at the beginning  of this
disease; but if  the  patient's spittle is  pretty thick, or  well concocted,
neither of them are necessaiy.   It will be sutcieut to  assist the expec-
toration by  some of the sharp medicines recommended  for  that  purpose
in the pleurisy, as the solution of gum-ammoniac with oxymcl of squills,
Ac.  Blistedug-plasters have generally a good effect, and ought to  be
applied pretty early.
   If the patient does not spit, he must be bled according as his strength
will permit, and have a gentle purge administered.   Afterwards his body
may be kept open by clysters, and the expectoration promoted by ta-
king every four hours two table spoonsful  of the solution mentioned
above.
   When an inflammation  of the breast does not  yield to bidding, blis-
tering,  and other evacuations, it commonly ends in a suppuration, which
is more or less dangerous,  according to the part where it is situated.
When  this happens in the pleura,  it sometimes breaks outwardly, and
the matter is discharged by the wound.
   When the suppuration happens within the substance or body of  the
lungs, the matter may be discharged by (xpectoration ;  but if the matter
floats in the cavity of the breast, between the plura and the lungs, it can
only be discharged by an incision made between  the ribs.
   If the patient's  strength does not return after the inflammation is to
all appearance  removed;  if his  pulse continues quick though soft,  his
breathing difficult and oppressed; if he has cold shiv erings at times, his
cheeks flushed, Ids lips dry ; and if he complams of thirst, and want of
appetite, there is reason to fear a suppuration, and that  a phthisis or con-
sumption of the lungs will  ensue.  We shall  therefore  next proceed to
consider the proper treatment of that disease. 
132
                       CHAP.  XVIII.

                     OF CONSUMPTIONS.

       A CONSUMPTION is  a wasting or decay of the  whole
body from an ulcer, tubercles, or concretions of the lungs, ail empyema,
a nervous atrophy, or cachexy.
  Dr. Arbuthnot observes, that in his time consumptions made up above
one tenth-part of the bills of mortality in and about London.  There is
reason to believe they have rather increased since;  and we know from
experience, that they are not less fatal in some other towns of England
than in London.
  Young persons, between  the age of fifteen  and thirty, of a sleuder
make, long neck, high shoulders,  and flat breasts,  are most liable to
this disease.
  Consumptions prevail more in England than in any other part of the
world, owing perhaps to the great use of animal food aud malt liquors,
the general application to sedentary employments, and the great quan-
tity of pit-coal Avhich is there burnt; to Avhich we may add the perpe-
tual changes in the atmosphere, or variableness of the weather.
   CAUSES.—It has already been observed, that  an inflammation of
tl«e breast often ends in an  imposthume: consequently Avhatever dis-
poses people to this disease, must likewise be  considered as a cause of
consumption.
   Other diseases,  by ATliating the habit, may likewise occasion con-
sumptions; as the scurvy, thft scrophula, or king's evil, the venereal di-
sease, the asthma, small-pox, measles, &c
   As this disease is seldom cured, Ave shall endeavour the more parti-
 cularly  to point out its causes, in order that people may be enabled to
 avoid it.  These are:
   -----Confined or unwholesome  air. When this fluid is impregnated
 Avith the fumes of metals or minerals,  it proves extremely hurtful to the
 lungs, and often corrodes the tender vessels of that necessary organ.
    -----Violent passions, exertions, or affections of  the mind:  as grief,
 disappointment, anxiety, or close application to the study of abstruse
 arts or sciences.
    -----Great evacuations; as SAveating, diarrhoeas,  diabetes, excessive
 venery, the  fluor albus,  an over-discharge of the menstrual flux, giving
 suck too long, &c.
    -----The sudden stoppage of customary evacuations; as the bleeding
  piles, sweating  of  the feet, bleeding at  the nose,  the menses, issues.
 ulcers,  or eruptions of any kind.
    -----Injuries done to the lungs, calculi, Ac.  I lately saAv the symp-
  toms of a phthisis occasioned by a small bone sticking in  the bronchia.
  It was afterwards vomited along with a considerable quantity  of puru-
  lent matter,  and the patient, by a proper regimen, and the use of the
  Peruvian bark, recovered.
    -----Making a sudden  transition from a hot to a very cold  climate,
  change of apparel,  or whatever greatly lessens the perspiration.
    -----Frequent  and  excessive  debaucheries.  Late watching, and
  drinking strong liquors, which generally go together, can hardly fan. 
OF CONSUMPTIONS.
133
to destroy the lungs.   Hence the bon companion generally falls a sacrifice
to this disease.
  ----Infection.  Consumptions are likewise  caught by sleeping with
the diseased; for which reason this should be  carefully avoided.  It
cannot be of great benefit to the sick, and must hurt those in health.
  -----Occupations in life.   Those artificers who  sit much, and  are
constantly  leaning forward, or pressing  upon the stomach and breast, as
cutlers, tailors, shoe-makers, seamstresses, Ac. often die of consumptions.
They likewise prove fatal to singers, and all avIio have occasion to make
frequent and violent exertions of the lungs.
   -----Cold.  More consumptive patients date  the beginning of their
disorders from Avet feet, damp beds, night air, wet clothes,  or catching
cold after the body had beeu heated, than from all other causes.
   Sharp,  saline, and  aromatic aliments, which  heat and  inflame the
 blood, are likeAvise frequently the cause of consumptions.
   We shall only add, that this disease  is otten owing  to an hereditary
 taint, or a scrophulous habit; in which case it is generally incurable.
    SYMPTOMS.—This disease generally begfos  with a  dry cough,
 which often continues for some months.   If a  disposition to vomit after
 eating be  excited by it, there is still greater reason to fear an approach-
 ing consumption.  The patient complains of a more than usual dej ree of
 heat, a pain and oppression of the breast, especially after motion; his
 spittle is of a saltish taste,  and sometimes mixed  with  blood.  He  is
 apt to be sad ; his appetite i* bad, and  his thirst great.  There is gene-
 rally a quick, soft, small pulse; though sometimes the pulse is pretty full,
 and rather hard.  These are the common symptoms of a beginning  con-
  sumption.
    Afterwards the  patient begins  to  spit a greenish,  white, or bloody
  matter.   His body is extenuated by  the hectic fever, and  colliquative
  sweats, which mutually succeed one another, vis. the one towards night,
  and the other in the  morning.  A looseness, and an (xcessive discharge
  of urine, are often troubh some symptoms at this time, and greatly weakens
  the patient.   There is a burning Ik at in the palms of the hands, and the
  face generally flushes after eating;  the  fingers become remarkably small,
  the naib  are bent inwards, and the hair falls off.
    At last the swelling of the feet and  legs, the total tors of strength, the
  sinking of the  eyes, the difficulty  of   swallowing,  and the  coldness of
  the extremeties, shew the immediate approach of death, which however
  the patient seldom brieves to be so near.  Such is the usual progress of
  this fatal d'sease,  which,  if not early checked,  commonly sets  all medi-
  cine at defiance.
     REGIMEN.—On the first appearance of a consumption, it the pa-
  tient lives in a large town, or am  place where  the  air is  confined,  he
  ou«*t  immediatelv  to quit it, aiid to make choice of a situation in the
  country, where the a;r is pure and free.   Here he must not remam in-
  active, but take every dav as much exercise as he can bear.
     The best method of taking exercise is to ride  on horseback, 'as this
  gives the body a  great deal of motion Avithout much fatigue.  Such as
  cannot bear this kind of exercise, must make use of a carriage.  A long
  journey,  as it amuses the mind by a continual change of objects, is great-
  ly preferable to riding the same ground over and over.  Care how • ver
  must be  taken  to avoid catching cold from wet clothes, damp beds, or 
134                  OF  CONSUMPTIONS.
Ihe like.   The patient ought always to finish his ride in the morning, or
 at least before dinner; otherwise it will oftener do more harm than good.
   It is a  pity those who attend the sick seldom recommend riding in this
disease, till the patient is either unable to bear it, or the malady has be-
come incurable.  Patients are likewise apt to trifle with every thing that
is in  their power.   They cannot see how one  of the common actions of
fife should prove a remedy in an obstr.ate disease, and therefore they re-
ject it, while they greedily hunt after relief from  medicine,  merely be-
cause they do not understand it.
   Those  Avho  have strength  and  courage to undertake a pretty long
voyage, may expect great advantage from it.   This, to my knowledge,
has frequently cured a consumption after the patient was, to all appear-
ance, far advanced in that disease,  and Avhere medicine had proved in-
effectual.   Hence  it is  reasonable to conclude, that if a voyage were
undertaken in due time, it would seldom fail to perform a  cure.*
   Such as try this  method of  cure  ought to carry as much fresh provi-
sions  along with them as Avill serve  for the Avhole time they are at sea,
As milk is not  easily obtained in this situation, they ought to live upon
fruits, and the broth of chickens, or other young animals which can be kept
alive oa board.  It is scarcely necessaiy to add, that such voyages should
be  uudertaken, if possible in the mildest  season, and that  they  ought to
be  towards a Avarmer climated
   Those who have not courage for a loug voyage may travel into a more
southern climate, as the south of Fiance, Spain, or Portugal; and if they
find the air of these countries agree with them, they should continue there
at least till their health be confirmed.
   Next to proper air and exercise Ave Avould recommend a due attention
to diet.   The patient should neither eat nothing that is either heating or
hard  of digestion,  and his drink must be of a soft cooling nature.  All
the diet ought to be calculated to lessen  the acrimony of the humours,
and to nourish and support the patient.  For this purpose he must keep
chiefly to the use of  vegetables and milk.   Milk alone is of more value
in this disease than the Avhole materia medica.
   Asses' milk is commonly reckoned preferable to any  oUier; but it can-
not ahvays be  obtained; besides, it is generally taken in a veiy  small
quantity; whereas, to produce any effect,  it ought to make a considera-
ble part of the patient's diet.  It is hardly to be expected, that a gill or
two of asses'  milk, drank in the  space of twenty-four  hours, should
be  able to produce  any  considerable change in flumours of an  adult;
aud Avhen people do not perceive its effects  soon, they  lose hope, and so
leave it off.  Hence it happens that this medicine, hoAvever valuable,
very seldom performs a cure.  The reason  is obvious; it is commonly
used too late, is taken in  too small quanties, and is not  duly persisted in.

  * Two things chiefly operate to prevent the benefits which would arise from
sailing. The one is that physicians seldom order it till the disease is two far ad*
vanced; and the other is, that they seldom order a voyage of a sufficient length.
A patient may receive no benefit by crossing the channel, who, should he cross
the Atlantic, might be completely cured. Indeed we have reason to believe,
that a voyage of this kind, if taken in due time, would seldom fail to cure a con-
sumption.
  -f Though I do not remember to have  seen one instance of a genuine consump-
tion of the lungs cured by medicine, yet I have  known a West-India vogage
work wonders in that dreadful disorder. 
OF CONSUMPTIONS.
135
  I have known very extraordinary effects from asses' milk in obstinate
coughs, Avhich  threatened a consumption  of the lungs; and do verily
believe, if used at this period, that it would seldom fail; but if it be de-
layed till an ulcer is formed, which is generally the case, how can it be
expected to succeed ?
  Asses' milk ought to be drank, if possible, in its natural warmth, and
by a grown person, in the  quantity of half an English  pint at a time.
Instead of taking this quantity night and morning only, the patient ought
to take it four times, or at least thrice a-day, and to eat a little light bread
along with U, so as to make it a kind of meal.
  If the milk should  happen to purge,  it may be mixed with cold con-
serve of roses.  When that cannot be obtained,  the powder of  crabs'
claAvs may be used in its stead.   Asses'  milk is  usually ordered to be
dhank Avarm in bed; but as it generally  throAvs the patient in a  sweat
when takeu in this way, it would perhaps be better to give it after he rises.
  Some extraordinary cures in consumptive cases have been performed
by  Avomcn's milk.   Could  this be obtained in  a sufficient quantity, we
would recommend it in preference to any other. It is better if the patient
can suck it from the breast, than  to drink it afterwards.  I knew  a man
who was reduced  to such a degree of weakness iu a consumption, as not
to be able to turn himself in bed.   His wife was at that time giving suck,
and the child happening to die, he sucked her breasts, not with a view
to reap any advantage from the milk, but to  make her easy.   Finding
himself however greatly benefited by it, he continued to suck her  till he
"became perfectly well, and is  at present a strong and healthy man.
   Some prefer butter-milk to any other,  and it is indeed a very valuable
medicine, if the stomach be able to bear it.  It does not agree Avith every
person at first; and is therefore often laid aside without a sufficient trial.
It should at first be taken  sparingly, and  the quantity gradually increa-
sed, until it comes to be almost the sole  food.  I never kneiv it succeed
unless where the patient almost lived upon it.
   Cows milk is  most readily obtained of any, and though it be not so
easily digested as  that of asses or mares, it may be rendered  lighter by
adding to it an equal quantity of barley-water, or allowing it to stand for
some hours, and afterwards taking off the cream.   If it should notwith-
standing  prove heavy on  the stomach,  a small quantity of brandy or
rum, with a little  sugar, may be  added, which will render it both more
light and nourishing.
   It is not to be ivondered, that milk should for some time disagree Avith
a stomach that has not been  accustomed  to digest any thing but flesh
and strong liquors, which is the case with many of those  who fall into
consumptions.  We do not hoAvever advise those who have been  accus-
tomed to animal food and strong liquors,  to leave them off all at once.
This  might be dangerous.   It will  be necessaiy for such to eat a little,
once a day of  the flesh of some young animal, or rather to use the broth
made of chickens, veal, lamb, "or such like.  They  ought likeivise 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.
   These must be used only  as preparatives to a  diet consisting chiefly
of  milk and veirt tables, Avhuh the sooner the patient can be brought
to bear, the better.   Rice aud milk, or barley and  milk, boiled with 
136                 OF  CONSUMPTIONS.
a little sugar, is veiy proper food.  Ripe fruits roasted, baked or boiled,
are likewise proper, as gooseberry or currant tarts, apples roasted  or
boiled in milk, Ac.   The1 juices, conserves, and  preserves, Ac. of ripe
subacid fruits, ought to be eaten plentifully, as the jdly of currauts, con-
serves of roses, preserved plumbs, cherries, Ac.
   Wholesome air, proper exercise, and a diet consisting chiefly of these
aud other vegetables, with milk,  is the only course that can be depended
on in a  beginning consumption.   If the patient  has strength and suffi-
cient resolution to persist in this course, he will seldom be disappointed
of a cure.
   In a populous toivn in England,1" where consumptions ar? very com-
mon, I have frequently seen consumptive patients, who had been sent to
the country with orders to ride, and live upon  milk  and  vegetables, re-
turn in a few months quite  plump, and free from any complaint.  This
indeed was not always the case, especially when  the disease ivas heredi-
tary, or far advanced; but it .was the only method in which success Avas
to be expected :  where it failed, I never knew medicine succeed.
   If the patient's strength aud spirits flag, he must be supported by strong
broths, jellies, and such like.   Some recommend  shell fish in  this  disor-
der, and with some  reason,  as they are nourishing and restorativcf  All
the food and drink ought however to be taken in small quantities, lest an
over charge of fresh chyle  should oppress the lungs, aud too much ac-
celerate the circulation of the blood.
   The patient's mind ought to be kept as easy and cheerful as possible.
Consumptions are often occasioned, and always aggravated, by a melan-
choly cast of mind;  for which reason music, cheerful company, and every
thing that inspires mirth, are highly beneficial.—The patient ought sel-
dom  to be le.t  alone, as brooding over his calamities is sure to render
him worse.
   MEDICINE.—Though the cure of this disease depends chiefly upon
regimen and the  patient's own endeavours, yet  we  shall mention  a few
things which may be of service  in relieving some  of the more violent
symptoms.
  In the first stage of a  consumption, the cough may sometimes be ap-
peased by bleeding; and the expectoration may be promoted by the fol-
lowing medicines.   Take fresh squills, gum-ammoniac,   and  powdered
cardamum seeds, of each a quarter of an ounce; beat them together in
a mortar, and if the  mass proves too hard  for pills, a little of any kind of
syrup may be added to it.   This may be formed  into pills of a  moderate
size, and four or five of them taken twice or thrice a-day, according as
the patient's stomach will bear them.
   The lac anunoniacum, or milk of gum-ammoniac, as it is called, is like-
w ise a proper medicine in this stage of the disease.   It  may be used as
directed in the pleurisy.
  A mixture made  of equal parts of lemon-juice, fine honey, and syrup
of poppies, may likewise be used.   Four ounces of  each of these  may
be si'iimered tcgether  in a sauce-pan, over a gentle fire, and a  table-
spoonful of it taken at any time when the cough  is troubh some.

  * Sheffield.
  f I have often known persons of a consumptive habit,  where the symptoms
were not violent, reap great benefit from the use of  oysters.   Tla-y genei'ally
eat them raw, and drink the juice along with them. 
OF CONSUMPTIONS.                 137
   It is common in tins stage of the disease to load the patient's stomach
with oily and  balsamic  medicines.   These, instead of removing the
cause  of the disease, tend rather to  increase it by heating the blood,
Avhile they pall the appetite, relax the solids, and prove every way hurt-
ful to the patient.  Whatever is used for removing the cough,besides ridiug
and other proper regimen, ought to be medicines of a sharp and cleansing
nature; as oxymel, syrup of lemon, &c.
   Acids seem to  have peculiarly good effects in this disease;  they both
tend to quench the patient's thirst and to cool the blood.  The vegeta-
ble acids, as  apples, oranges, lemons, &c. appear to  be the most proper.
I have kuown patients suck the juice of several lemons every day with
manifest advantage,  and ivould for this reason recommend acid vegeta-
bles to be taken in as great quantity as the stomach will bear  them.
   For the patient's drink, we would recommend infusions of  the bitter
plants, as ground-ivy, the  lesser centuary, camomile-flowers, or water-
trefoil.  These infusions may be drank at pleasure.  They strengthen
the stomach, promote digestion, and at the  same time  answer all the
purposes  of dilution, and  quench thirst much better than things  that
are luscious or sweet.  But if the patient spits  blood, he ought to use for
his ordinaiy drink, infusions or decoctions of the vulnerary roots, plants,
&c. ■■
   There are many other mucilaginous plants and seeds, of a healing and
agglutinating nature, from which  decoctions or  infusions may be  pre-
pared  with the same intention; as the others, the  quince-seed, colts-
foot, linseed, sarsaparilla, Ac.   It is not necessary to mention  the differ-
ent ways in which these may be prepared.  Simple infusion or boiling is
all that is necessary, and the dose may be at discretion.
   The conserve  of roses is  here peculiarly proper.  It may either be
put into the decoction above prescribed, or eaten by itself.  No benefit
is to be expected from trifling doses of  this medicine.   I  never kneiv
it of any service, unless where three" or four ounces at least were used
daily for a considerable time.   Iu this ivay I have seen it produce very
happy effects, and would recommend it Avherever there is a discharge of
blood from the lungs.
   When the spitting up of gross matter, oppression of the breast, and the
hectic  symptoms,  shew that an imposthumc is formed in the  lungs, we
would  recommend the Peruvian bark, that  being the only drug which
has any chance to counteract the  general  tendency which the humours
then have to putrefaction.
   An  ounce of the bark hi powder may be  divided into eighteen or
twenty doses, of Avhich one may be taken every three hours through the
day, in a little syrup, or a cup of horehound tea.
   If the bark should happen  to purge, it may be made into an electuary,
with the conserve of roses, thus: Take old conserve of roses  a quarter
of a pound, Peruvian bark a quarter of an ounce, syrup of orange or le-
mon, as much as will make it of the consistence of honey.  This quanti-
ty Avill serve the patient four or five days, and may be repeated as there
is occcasion.
  Such as cannot take the bark in substance, may infuse it in cold wa-
ter.  This seems to be the best menstruum for extracting the virtues of
* See Appendix, Vulnerary Decoction.
                 18 
138
OF  CONSUMPTIONS.
that drug.  Half an ounce of bark iu powder may be infused for twenty-
four hours in half an English pint of water.   Afterwards let it be passed
through a fine strainer, and an ordinary tea-cupful of it taken three 01
four times a-day.
  We would not recommend the bark while there are any symptoms of
an inflammation of the breast;  but when it is certainly known that mat-
ter  is  collected there, it is  one of the best medicines Avhich can be used.
Few patients indeed have resolution enough to give the bark a fair trial
at this period  of the disease, otherwise  we have reason  to believe that
some  benefit might be reaped from it.
  When it is evident that there is an imposthume in the breast, and the
matter can neither  be spit  up  nor  carried off by absorption, the patient
must  endeavour to make it break imvardly, by drawing in the steams of
Avarm water, or vinegar, with his breath, coughing, laughing, or bawling
aloud, &c.   When it happens to burst within the lungs, the  matter may
be discharged  by the mouth.  Sometimes indeed the bursting of the vo-
mica  occasions immediate death by suffocating the patient.   When the
quantity of matter is great, and the patient's strength exhausted, this is
commonly  the  case.  At any rate the  patient is ready to fall into a
swoon, and shoidd have volatile salts or  spirits held to his nose.
  If  the matter discharged be thick, and  the cough and breathing be-
come easier, there may be some hopes of a  cure.  The diet at this time
ought to be light, but restorative, as chicken-broths, sago-gruel, rice-milk,
Ac. the  drink,  butter-milk or whey, sweetened with honey.   This is
likewise a proper time for using the Peruvian bark, which may be taken
as directed above.
  If the  vomica or  imposthume should discharge itself  into the cavity of
the breast, between the pleura and the lungs, there is no way of getting
the matter out but by an incision, as has already been observed.   As this
operation must always be performed by the surgeon, it is not necessarj
here  to describe it.   We shall only add, that it is not so dreadful as peo-
ple are apt to  imagine, and that it is the only chance the patient in this
case  has for his life.

  A  NERVOUS CONSUMPTION is a  wasting or decay of the whole
body, Avithout any considerable degree  of  fever, cough, or difficulty of
breathing.  It is attended with indigestion, weakness, and want of appe-
tite, &A.
   Those who are of a fretful temper, who indulge in spiritous liquors, or
who breathe an unwholesome air, are most  liable to this disease.
  We would chiefly recommend, for the cure of a nervous consumption,
a light and nourishing diet, plenty of exercise in a free open air, and the
use of such bitters as brace and strengthen the stomach ; as the Peruvian
bark, gentian root, camomile, horehound, &c.  These may be infused in
water or wine, and a glass of it drank frequently.
  It Avill greatly assist the digestion, and promote the cure of this disease,
to take twice a-day twenty or thirty drops of the elixir of vitriol in a glass
of wine or Avater.  The chalybeate Avine  is likewise an excellent medicine
in this case.   It strengthens the solids,  and powerfully assists Nature in
the preparation of good blood.*
* See Appendix, Chalybeate nine. 
OF THE  NERVOUS FEVER.
139
  Agreeable amusements,  cheerful company,  and riding about,  are
however preferable to all medicines in this disease.  For which reason,
when the patient can afford it, Ave would recommend a  long journey of
pleasure, a6 the most likely  means to restore his health.
  What is called a symptomatic  consumption, canuot be cured Avithout
first removing the disease by Avhich it is occasioned.   Thus, when a con-
sumption proceeds from the scrophula, or king's evil, from  the  scurvy,
the asthma, the venereal disease, &c  a due  attention must be paid to the
malady from Avhence it arises, and the  regimen and medicine  directed
accordingly.
  When excessive evacuations of auy kind occasion  a consumption, they
must  not only be restrained, but the patient's strength must be  restored
by  gentle exercise, nourishing diet, and  generous cordials.   Young and
delicate mothers often fall into consumptions, by giving suck  too  long.
As soon as they perceive their strength and appetite begin to fail,  they
ought immediately to wean  the child, or provide another nurse, otherwise
they  canot expect a cure.
   Before we quit this subject, we Avould earnestly recommend it to all, as
they  wish to avoid consumptions,  to  take as much  exercise, without
doors,  as  they can, to avoid unwholesome air,  and to study sobriety.
Consumptions OAve their present increase not a little to the fashion of sit-
ting up late, eating hot suppers, and  spending every evening over a
bowl  of hot punch or other strong liquors-   These liquors, Avhen too free-
ly used, not only hurt the digestion, and spoil the appetite, but heat and
inflame the blood, and set the Avhole constitution on fire.


                          CHAP.  XIX.

           OF THE SLOW OR NERVOUS FEVER.

         NERVOUS fevers have increased greatly  of  late years hi
this island, owing doubtless to our different manner  of living, and the in-
crease of sedentary employments;  as they commonly  attack persons of
a weak relaxed habit,  avIio neglect exercise, eat little solid food, study
hard, or indulge in spiritous liquors.
   CAUSES.—Neivous fevers may be occasioned by Avhatever de-
presses the spirits, or  impoverishes the blood;  as grief, fear, anxiety,
want of sleep, intense thought, living on poor watery diet, unripe fruits,
cucumbers, melons, mushrooms, Ac.  They may likewise be occasioned
by damp, confined, or unwholesome air.  Hence they are very common
in rainy seasons, and prove  most fatal to  those who live  in  dirty low
houses, crowded streets, hospitals, jails, or such like places.
   Persons  whose constitutions have been  broken by excessive venery,
frequent salivations, too free use of purgative medicines,  cr any  other
excessive evacuations,  are most liable to this disease.
   Keeping on wet  clothes, lying on the damp ground, excessive fatigue,
and whatever obstructs the perspiration, or  causes a spasmodic stricture
of  the  solids,  may likewise occasion nervous  fevers.  We shall only
add  frequent and great irregularties in diet.  Too  great abstinence, as
well  as excess, is hurtful.  Nothing tends so much  to preserve the body
in a sound state as a regular diet; nor can any thing  contribute more to
occasion fevers of the worst kind than its opposite. 
140           OF  THE  NERVOUS  FEVER.
  SYMPTOMS.—Low spirits,  want of appetite, weakness, Avearine.-s
after motion, watchfulness, deep sighing, and dejection of mind, are gene-
rally the forerunners of this  disease.   These are succeeded by a quick
low pulse, a dry tongue  Avithout  any considerable thirst, chilliness  and
flushing in turns, Ac.
   After  some time the patient complains of a giddiness and pain of the
head, has a nausea, with retchings aud vomiting;  the pulse is quick, and
sometimes intermitting;  the  urine pale, resembling dead small beer, and
the breathing is difficult, with oppression of the breast, and >light aliena-
tions of the mind.
   If towards the ninth,  tenth, or twelfth day, the tongue becomes more
moist, with  a  plentiful spitting, a gentle purging, or a moisture upon tlie
skin; or if  a suppuration happens in one or both ears, or  large pustules
break out about the lips and nose, there is reason to hope for a favoura-
ble crisis.
   But if there  is an excessive  looseness  or  Avasting sweats, with fre-
quent  fainting fits; if the tongue, when put out,  trembles excessively,
and the extremities  feel cold, Avith a fluttering or slow creeping pube;
if there is a starting of the tendons, an almost total  loss of sight and hear-
ing, and an iuvoluntary discharge by stool, and urine, there is great rea-
son to  fear  that death is approaching.
   REGIMEN.—It is veiy  necessary in this disease to keep the patient
cool and quiet.  The least motion would fatigue him, and will be apt to
occasion weariness, and even huntings.  His mind ought not only to be
kept easy but soothed and comforted with the hopes of a speedy recovery.
Nothing is more hurtful in Ioav fevers of this kind than presenting to the
patient's imagination gloomy or frightful ideas.   These of  themselves of-
ten occasion nervous fevers,  aud  it is not to be doubted but they will  like-
Avise aggravate them.
   The patient must not be kept too low.   His strength and spirits ought
to  be supported by  nourishing diet and generous cordials.   For this
purpose his gruel, panada, or whatever food  he  takes, must be mixed
with wine according as the symptoms may require.  Pretty strong wine-
Avhey, or small negus sharpened  with the juice of orange  or lemon, will
be proper for his ordinary drink.  Mustard-Avhey is likewise a very pro-
per drink in this fever, and may  be rendered an  excellent cordial medi-
cine by the addition of a proper quantity of white wine.*
   Wine in  this disease, if it could be obtained genuine, is almost the only
medicine that would be necessary.   Good wine  possesses all the virtues
of the  cordial mediciues, while it is free from many of their bad quali-
ties.   I say good wine; for however common this article of luxury is now
become, it is rarely to be obtained genuine, especially by the poor, who
are obliged to purchase it in small quantities.
   I have often seen patients in low nervous fevers where the pulse could
hardly be felt, with a constant delirium, coldness  of the extremities, and
almost every  other mortal symptom,  recover by using in  whey, gruel,
aud negus,  a bottle or two of strong wine every  day.   Good old sound
claret is the best, and may be made into negus, or given by  itself, as cir-
cumstances may require.
   In a word, the  great aim in  this disease is to support the  patient's
strength, by giving him frequently small  quantities  of the above,  or
* See appendix, Mustard-whey. 
OF  THE  NERVOUS  FEVER.             141
other drinks of a warm and cordial nature.  He is not however to be
overheated cither with liquor or clothes; and his food ought to be light,
and given in small quantities.
  MEDICINE.—When a nausea,  load, and  sickness at the stomach,
prevail  at the beginning  of the fever, it will be necessary to give the
patient a gentle vomit.  Fifteen or twenty grains of ipecacuanha  in fine
powder, or a few spoonsful of the vomiting julep,* will generally answer
this  purpose very  well.    This may be repealed any time  before the
third or fourth day, if the above symptoms continue.   Vomits not only
clean tlie  stomach,  but  by the general shock Avhich they give,  promote
the perspiration, and have many  other excellent effects in slow  fevers,
where there are no signs  of inflammation, and nature Avants rousing.
   Such as  dare not venture upon a vomit may clean the bowels by a
small dose of Turkey rhubarb, or an infusion of senna and manna.
   In all  fevers, the great point is to regulate  the symptoms, so as to
prevent them from going to either extreme.  Thus, in fevers of»the in-
flammatory kind, Avhere the force of the circulation is  too great,  or the
blood dense, and the fibres too rigid, bleeding and other evacuations are
necessary.   But in  nervous fevers, Avhere nature flags, where the blood
is vapid and poor, and the solids relaxed, the lancet must be spared, and
wine, with other cordials, plentifully administered.
   It is the more necessary to caution people against bleeding in this dis-
ease, as there is generally at the  beginning an universal stricture upon
the  vessels, and sometimes an  oppression and  difficulty of breathing,
which suggest the idea  of a plethora, or too great a quantity of blood.
I have  known even some of the faculty deceived by their own feelings^
in this respect,  so far as to insist upon being bled, when it Avas evident
from the consequences that the operation was improper.
   Though bleeding is generally improper in this disease, yet blistering
is highly necessaiy.  Blistering-plasters may be applied at all times of
the  fever with great advantage.   If  the patient is delirious he ought to
be blistered on the neck or head,  and it will be the safest course, when
 the  insensibility continues, as soon as the discharge occasioned  by one
 blistering-plaster abates, to apply another to some other part of the body,
 and by that means keep up a continual succession of them till he be out
 of danger.
   I have been more sensible of the advantage of blistering in this than
 in any  other disease.   Blistering-plasters not only stimulate the solids to
 action, but likeAvise occasion a continual discharge, which may in some
 measure  supply the want of critical  evacuations, which seldom happen
 in this kind of fever.   They are most proper, however, either  towards
 the beginning, or after  some degree of stupor has come on, in Avhich last
 case it will always be proper to blister the head.
   If the patient is costive through the course of the disease, it  will be
 necessary to procure a stool, by giving him every other day  a clyster of
 milk and water, with a little sugar, to  which may be added a spoonful
 of common salt, if the above does not operate.
   Should a violent looseness come on, it may be checked by small quan-
 tities of Venice treacle, or giving the patient for his ordinary drink the
 Avhite decoction.f
• See Appendix, Vomi ing Julep.
t Sec Appendix, White decoction. 
142             QF  THE  NERVOUS  FEVER.
   A  miliary  emption sometimes breaks out about the niuth or tenth
day.   As eruptions are often critical, great care should be  taken  not
to retard Nature's operation in this particular.   The  eruption  ought
neither to be checked by bleeding nor other evacuations, nor pushed out
by a hot regimen;  but  tlie patient should  be supported by gentle cor-
dials, as  wine-whey, small  negus, sago-gruel with a little wine in it, and
such like.  He ought not to be kept  too warm; yet a kindly breathing
sweat should by no means  be checked.
   Though blistering and the use of cordial liquors are the chief things
to be depended on  in this kind of fever; yet for those who may chuse to
use them, Ave shall  mention one or  two of the forms of medicine which
are commonly prescribed in it.*
   In desperate cases, where the hickup and starting of the tendons have
already  come on,  Ave  have  sometimes seen extraordinary effects from
doses of  musk frequently repeated.    Musk is doubtless an antispasmodic,
and may be given to the quantity of  a scruple three or four times a day,
or oftener if necessary.  Sometimes it may be proper to add to the musk
a few grains of camphire, and salt of  hartshorn, as these tend to promote
perspiration and the discharge of urine.  Thus fifteen grains of  musk,
Avith three grains of camphire, and six grains of salt of hartshorn, may
be made into a bolus with  a little syrup," and given as above.
   If the fever should  happen to intermit,  w hich it frequently does to-
wards the decline, or if the patient's strength should be w asted with col-
liquative sweats, &c. it will be necessary to give him the Peruvian bark.
Half a drachm, or  a whole drachm, if the stomach will  bear  it, of the
bark iu fine powder, may be given  four or five times a-day in a glass of
red port  or claret.  Should tlie bark in substance not sit  easy on  the
stomach, an ounce of it in  poAvder may be infused in a bottle of Lisbon
or Rhenish Avine for two or three days, afterwards it may be strained,
and a  glass of it taken frequently.!
   Some give the bark in this and other fevers, where there are no symp-
toms of inflammation, Avithout any regard to the remission or intermission
of the fever.   How far  future observation  may  tend to establish this
practice, we will not pretend to say;  but Are have reason to believe that
the bark  is a very universal febrifuge,  and that it may be  administered
Avith advantage in most fevers Avhere  bleeding is not necessary, or where
there are no symptoms  of topical inflammation.
  * When the patient is low, ten grains of Virginian snake-root, and the same
quantity of contrayerva-root, with five grains of Russian castor, all in fine pow-
der, may be made into a bolus with a little of the cordial confection of syrup of
saffron.' One of these may be taken every four or five hours
  The following powder may be used with the same intention : Take wild Vale-
rian-root in powder one scruple, saffron and castor each four grains.   Mix these
by rubbing them together in a mortar, and give one in a cup of wine-whey tliree
or four times a-day
  f The bark may likewise be very properly administered, along with other cor-
dials, in the following manner : Take an ounce of Peruvian bark, orange-peel
half an ounce, Virginian snake-root two drachms, saffron one drachm.  Let all
of them be powdered, and infused in a pint of the best brandy for three or four
days.  Afterwards the liquor may be strained, and two tea-spoonsful of it given
three or four times a-day in a glass of small wine or negus. 
143
                         CHAP.  XX.

OF  THE MALIGNANT, PUTRID OR  SPOTTED FEVER.

        TlIIS  may be called the pestilential fever of Europe, as in
many of its symptoms it bears a great resemblance to that  dreadful di-
sease the plague.   Persons of a lax habit, a melancholy disposition, and
fhosc whose vigour has been wasted by long fasting, watching, hard la-
bour, excessive venery, frequent salivations, Ac. are most liable to it.
   CAUSES.—This  fever is occasioned by foul air, from a number of
people being confined in a narrow  place, not properly ventilated: from
putrid animal and vegetable effluvia, Ac.   Hence it prevails in camps,
jails, hospitals, and infirmaries  especially where such places are too much
crowded, and cleanliness is neglected.
   A close constitution of die air, with long rainy or foggy Aveather, like-
wise occasions putrid  fevers.  They often succeed great inundations iu
low and marshy countries, especially when these are preceded or foUoAV-
ed by a hot and sultry season.
   Living too much upon auimal food, without a proper mixture of vege-
tables, or eating fish or flesh that has been kept too long, are likewise apt
to occasion this kind of fever.  Hence sailors on long voyages,  and the
inhabitants of besieged cities, are very often visited with putrid fevers.
   Corn that has been  greatly damaged by  rainy seasons, or long keep-
ing, and water which  has  become  putrid by stagnation, Ac. may like-
 wise occasion this fever.
   Dead carcases tainting the air, especially in hot seasons, are very apt
 to occasion putrid diseases.  Hence this kind of fever often prevails in
 countries which are the scenes  of war and bloodshed.   This  shews the
 propriety of removing burying-grounds, slaughter-houses, Ac. at a proper
 distance from great toAvns.
    Want of cleanliness is a very general cause of putrid fevers.   Hence
 they prev ail  amongst the  poor inhabitants of large towns, who breathe a
 confined unwholesome air, and neglect cleanliness.   Such mechanics as
 carry on dirty employments, and  are constantly Confined within doors,
 are likewise very liable to this disease.
    We shalbonly add, that putrid, malignant, or spotted fevers are highly
 infectious, and are therefore  often communicated  by contagion.   *or
 which reason all persons ought to  keep at a distance from those affected
 with such diseases, unless their attendance is absolutely necessary.
    SYMPTOMS.—The  malignant fever is generally preceded by a re-
 markable weakness or loss of strength, without any apparent cause.  This
 is  sometimes so great, that the  patient  can scarce walk, or even sit
 uprinht, without being in danger of fainting  away.   His mind too is
 Treatly dejected; he sighs, and is  full of dreadful apprehensions.
 & There is a nausea,  and sometimes  a vomiting of bile;  a violent pain
 of the head, with a strong pulsation or throbbing of the  temporal arte-
 ries • the eyes often appear red and inflamed, with a pain at the bottom
 of tlie orbit; there is a noise  in the ears, the breathing is laborious, and
  often interrupted with a sigh; complaints of a pain about the  region ot
 Ihe stoinach, aud iuthe back  and  loius; the tongue  is at  first white, but, 
144
PUTRID OR SPOTTED FEVER.
afterwards it  appears  black and chaped; and his teeth  are  covered
with  a black  crust.   He  sometimes passes  worms both  upwards and
downwards, is affected with tremours  or shaking,  and often  becomes
delirious.
   If  blood is let, it appears dissolved, or with a very small degree ol
cohesion, and  soon becomes putrid; the  stools smell  extremely foetid,
and are  sometimes of a  greenish, black, or reddish cast.   Spots of
a pale purple, dun, or black colour, often  appear upon  the skin, and
sometimes there are violent  hemorrhages or discharges of blood from
the mouth, ejes, nose, &c.
   Putrid fevers may  be distinguished from, the  inflammatory  by the
smallness of the pulse, the great dejection of mind, the dissolved state
of the blood, the petechia?, or purple spots,  and the putrid smell of
the excrements.   They may likewise be distinguished  from the low
or nervous fever,  by  the  heat aud  thirst being greater, the urine  of
a higher colour, and  the  loss of  strength, dejection  of mind,  and all
the other symptoms more violent.
   It  sometimes  happens,  however, that the  inflammatory, nervous,
and putrid  symptoms are s6 blended together,  as to render  it verj
difficult to determine to  which class the fever belongs.  In this casr
the greatest caution and  skill are  requisite.  Attention must  be paid
to those symptoms which  are  most  prevalent, and both the regimen
and medicines 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  uncertain;  sometimes
they  terminate between the  seventh and fourteenth day, and at other
times they are prolonged  for five or six weeks.    Their duration de-
pends greatly upon the  constitution of  the patient,  and the  manner
of treating the disease.
   The most  favourable  symptoms  are,  a gentle  looseness after tlie
fourth or fifth day, with a Avarm mild sweat.  These, Avhen  continu-
ed for a considerable time, often  carry  off  the  fever, and  should
never be imprudently stopped.  Small miliary pustules  appearing be-
tween the petechia? or purple spots, are  likeivise  favourable,  as also
hot scabby eruptions,  about the mouth and nose.  It is a good sign
when the pulse rises upon the use of wine, or other cordials, and the ner-
vous symptoms abate;  deafness coming on towards the decline of the fe-
ver, is likewise often a favourable symptom,* as are abscesses in the groin
or parotid glands.
  Among the unfavourable symptoms may be reckoned an excessive
looseness, with  a  hard  swelled belly; large  black or livid blotches
breaking out upon the  skin; aphthae in the mouth;  cold clammy
sweats; blindness;  change of the voice;  a Avild starting of the eyes;
difficulty of awallowing; inability to put out  the tongue; and a con-
stant  inclination  to  uncover the breast.  When the sweat and saliva
are tinged with blood,  and the  urine is black, or deposits  a black sooty
sediment, the  patient  is  in  great danger.   Starting  of the tendons,
  * Deafness is not always  a favourable symptom in this disease.  Perhaps it
is only so when occasioned by abscesses formed within die ears. 
PUTRID  OR  SPOTTED  FEVER.         145
and foetid, ichorous, involuntary stools, attended with coldness of the ex-
tremities, are generally the forerunners of death.
   REGIMEN.—In the treatment of this disease we ought to endeavour
as far as  possible to counteract the putrid tendency of the humours; to
support the patient's strength and spirits;  and to assist nature in  expelli g
the cause of this disease, by gently promoting perspiration and the other
evacuations.
   It has been  observed,  that putrid fevers are often occasioned by un-
wholesome air, and of course they must be aggravated by it.  Care should
therefore be taken to prevent the air from stagnating in the patient's cham-
ber, to keep it  cool, aud renew it frequently, by opening the doors or win-
doAvs of some adjacent apartment.   The breath and perspiration of  per-
sons in perfect health soon render the air of a  small apartment noxious;
but this will sooner  happen from the perspiration and breath  of a person
Avhose whole mass of humours are in a putrid state.
   Besides the frequent admission of fresh air,  we would recommend the
use of vinegar, verjuice, juice of lemon, Seville orange, or any  kind of
vegetable acid  that can be most readily obtained.   These ought frequent-
ly to be sprinkled on the floor, the bed, and every part of the room. They
may also be evaporated with a hot iron, or by boiling, Ac.  The fresh
skins of  lemons  or oranges ought likewise to be laid in different parts of
the room, and they should be frequently held to the patient's nose.  The use
of acids in  this manner Avould not only prove very refreshing to the patient,
but Avould likewise tend to prevent the infection from spreading among those
who attend him.  Strong  scented herbs, as  rue, tansy,  rosemary, Avorm-
Avood, &c. may likewise be laid in different parts of the house, and smelled
to by those who go near the patient.
   The patient must not only be kept cool,  but likewise quiet and easy.
The least noise will affect his  head, and the smallest fatigue will be apt
to  make him faint.
   Few things  are  of  greater  importance in this disease  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 inclination.  They may be rendered
cordial by the addition of wine in such quantity as the patient's strength
seems to  require.  When  he is very low, he may drink negus, with on-
ly  one half Avater,  and sharpened with the juke of orange or lemon.
In some cases a glass of Avine may now and then be allowed.   The most
proper wine is Rhenish, or Madeira; but if the  body be open, red-port or
claret is to be preferred.
   When the body  is bound, a tea-spoonful of  the cream of  tartar may
be  put into a cup of the patient's drink, as there is occasion ; or he may
drink a decoction of tamarinds, Avhich will both quench his thirst, and  pro-
mote  a discharge by stool.
   If  camomile-tea will sit upon his stomach, it is a very proper driuk in
this disease.  It may be sharpened by adding to every cup of the tea ten
or fifteen drops of the elixir of vitriol.
   The food must be light, as panado, or groat gruel, to Avhich a little wine
may be added,  if the patient be weak an 1 low;  and they ought all to be
sharpened Avith the juice of orange, the jelly of currants, or the  like.
The patient ought likewise to eat freely of ripe fruits, as roasted apple? ■
currant or sroosberrv tarts, preserved cherries, or  plumbs, Ac
                                  19 
146          PUTRID  OR  SPOTTED  FEVER.
   Taking  a  little  food or  drink  frequently, not oidy supports the
spirits,  but  counteracts the putrid tepdcucy  of  the humours; tor which
 reason  the  patient ought  frequently to be  sipping small quantities of
some 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 fo-
mented  with a strong infusion of camomile flowers.  This or an infu-
sion  of  the  bark;  to such as can  afford it, cannot fail to have a good
effect.   Fomentations of this  kind not only relieve the head, by re-
laxing the vessels in the extremities, but as their contents are  absorb.
ed, and taken into  the system, they may assist  iu preventing the  pu-
trescency of the humours.
   MEDICINE.—If a vomit be  given at the beginning of  this fever,
it  will hardly fail to have a  good  effect; but if  the  fever has gone
on for some days, and the symptoms are violent, vomits are uot quite
so safe.   The  body however, is always to be kept  gently open by
clysters, or mild lax dive medicines.
   Bleeding is seldom  necessary in putrid fevers.   If there be  signs of
an inflammation, it may sometimes be  permitted at the first onset;  but the
repetition of it generally proves hurtful.
   Blistering-plasters  are never to  be used unless in the greatest extre-
mities.   If  the petechias or spots  should suddenly disappear,  the pa-
tient's pulse sink remarkably, and a delirium, with other bad symp-
toms, come  on, blistering may  be permitted.  In this case the blistering
plasters are to be applied  to the head,  and inside of the legs or thighs.
But  as  they are sometimes apt to occasion a gangrene, we would ra-
ther recommend warm cataplasms  or poultices of mustard and vinegar
to be applied to the feet, having recourse to blisters only in  the utmost
extremities.
   It is  common in the  beginning of this fever to  give the emetic
tartar in small doses, repeated every  second  or  third hour, till  it shall
either vomit, purge,   or throw the patient into a  sAveat.  This prac-
tice  is very  proper, provided it be  not pushed so far as to weaken the
patient.
   A very  ridiculous notion has long prevailed of  expelling the poi-
sonous matter of  malignant diseases by  trifling doses of cordial  or
alexipharmic  medicines.   In consequence of  this notion, the  contra-
yerva-root,  the cordial confection, the mithridate,  &c. have been ex-
tolled as infallible remedies.    There  is  reason however to believe,
that  these seldom  do much good.   Where cordials  are necessary, we
know none  that is superior to good  wine; and therefore again recom-
mend it both  as the safest and the best.   Wine, with acids and antisep-
tics,  are the only things to be relied on in the cure of malignant fevers.
   In the most dangerous species of this disease,  when it is attended Avith
purple,  livid, or black spots, the Peruvian  bark must be administered.
I have  seen it, when joined with acids, prove successful,  even in cases
where the  petechias had the most  threatening  aspect.    But to  answer
this  purpose it must not only be given iu large doses, but duly  persist-
ed in.
   The  best method  of administering the bark is  certainly in substance.
An ounce of it in  powder may be mixed with half a pint of  ivater,  and
the  same quantity of red wine, and  sharpened with the  elixir or the 
PUTRID  OR  SPOTTED FEVER.           147
 spirit of vitriol, winch will both make it sit easier on the stomach, and ren-
 der it more beneficial.   Two or  three  ounces of the syrup  of  lemon
 may be added and two table spoonsful of the mixture taken every two
 hours, or  oftener, if the stomach is able  to bear it.  Those who cannot
 take the bark in substance may infuse it in wine, as recommended in the
 preceding disease.
   If there  be a violent looseness, the bark must be boiled in red wine
 with a little cinnamon, and sharpened Avith the elixir of vitriol, as above.
 .Nothing can be  more beneficial in this kind of  looseness than plenty of
 acids, and such things as promote a gentle perspiration.
   If the patient be troubled with vomiting, a drachm of the salt of worm-
 wood, dissolved in an ounce and a half of fresh lemon juice, and made
 iuto a draught with  an ounce of simple cinnamon-water, and a bit of su-
 gar, may be given and repeated as often as it is necessary.
   If swellings of the glands appear,  their suppuration is  to be  pro-
 moted  by the application of poultices, ripening cataplasms, Ac.  And
 as soon as there is any appearance of matter in them, they  ought to be
 laid open and the poultices continued.
   I have knoAvn 1 rge  ulcerous sores break out in various parts of the
 body, iu the decline of this fever, of a livid gangrenous appearance, aud
 a most putrid cadaverous smell.   These gradually healed, and the pa-
 tient recovered,  by the plentiful use of Peruvian  bark and Avine, sharp-
 ened with the spirits of vitriol.
   For  preventing putrid fevers we would recommend  a strict regard
 to cleanliness;  a dry situation;  sufficient  exercise in the  open  air;
 wholesome  food and a moderate  use of generous liquors.   Infection
 ought  above  all things to   be avoided.  No constitution  is  proof
 against it.  I have known persons seized  with a putrid  fever, by  only
 making a  single visit to a  patient in it;  others have c-ught  it by
 lodging for one night in a town  where  it prevailed; and some by at-
 tending the funeral  of such as died of  it.*
   When a putrid fever seizes any  person in  a family, the greatest at-
 tention is  necessary  to prevent the disease from spreading.   The sick
 ought to be placed in  a large apartment, as remote from the rest of the
 family as possible;  he ought likewise to be  kept  extremely  clean, aud
 should have fresh  air frequently let into  his  chamber; whatever comes
 from him shouhl be immediately removred, his Unen should be frequently
 changed, and  those in health ought to avoid all unnecessary communica-
 tion with him.
   Any  one who is apprehensive  of having caught the infection, ought
 immediately to take a vomit, and to work it off  by drinking plentifully
 of camomile  tea.   This  may be  repeated in a  day or two,  if the ap-
 prehensions still continue, or  any unfavourable  symptoms appear.
   The person ought likewise to take an infusion  of the bark and ca^
 momile floivers for his ordinary drink; and before he goes to bed, he may

   • The late Sir John Pringle expressed a concern lest these cautions should
 prevent people from attending their friends or relations when afflicted with pu-
 trid fevers.  I told him I meant only to discourage unnecessary attendance, and
 mentioned a number of instances where putrid fevers had proved fatal to per-
sons, who were rather hurtful than beneficial to the sick. This sagacious phy-
 sician agreed with me, in thinking that a good doctor and a careful nurse were
the only necessary attendants ;  :.nd that all others not only endangered them-
selves, but generally, by their solicitude and ill-directed care, hurt the sick. 
148
OF THE  MILIARY  FEVER.
drink a pint of pretty strong negus, or a few glasses of generous w hie. I
have been frequently obliged to follow this course when malignant fevers
prevailed, and have likewise recommended it to others with constant suc-
cess.
   People generally fly to bleeding and purging  as antidotes against in-
fection;  but these are so far from securing them, that they often by de-
bilitating the body, increase the danger.
   Those who  wait upon the sick in putrid fevers, ought always to have
a piece of spunge or a handkerchief dipt in vinegar, or juice of lemon,
to smell  to while near the patient.  They ought likewise to wash their
bauds, and, if  possible, to change their clothes, before they go into com-
pany.
                          CHAP. XXI.

                  OF THE MILIARY FEVER.

       J. HIS fever  takes its name from the small pustules or bladders
 which appear on the skin, resembling,  in shape and' size, the seeds of
 millet.   The  pustules are either red or white,  and sometimes both are
 mixed together.
   The whole body is sometimes  covered with pustules; but they are
 genei'ally more numerous  where the sweat is most al uudant, as on the
 breast, the back, Ac.  A gentle SAveat, or moisture on the skin, greatly
 promotes the eruption;  but when the skin is dry,  the  eruption is both
 more painful  and dangerous.
  Sometimes this is a primary disease; but it is much oftener only a symp-
 tom of some other malady, as the small-pox, measles, ardent, putrid, or
 nervous fever, &c.  In all these cases it is generally tlie effect of too hot
 a regimen or medicines.
  The miliary fever chiefly attacks the idle and phlegmatic, or persons
 of a relaxed habit.   The young and the aged are more liable to it than
 those in the vigour and prime of life.  It is also more incident to women
 thau men, especially  the delicate and the indolent, who, neglecting exer-
 cise, keep continually witlun doors, and live upon weak  and watery diet.
 Such females are extremely liable to be seized with this  disease in child-
 bed, arid often lose their lives by it.
  CAUSES.—The  miliary  fever  is sometimes occasioned by violent
 passions or   affections of  the mind;  as   excessive  grief,   anxiety,
 thoughtfulness, Ac.  It may likewise be occasioned by  excessive watch-
 ing, great evacuations, a weak watery diet,  rainy  seasons, eating too
 frequently of  cold, crude, unripe fruits,  as plumbs,  cherries, cucumbers,
 melons, Arc.   Impure waters, or provisions which have been spoiled by
 rainy seasons, long keeping, &c. may likeAvise cause miliaiy fevers.  They
 may also be occasioned by the stoppage of any customary evacuation, as
 issues, setons,  ulcers, the bleeding  piles in men,  or the menstruel flux in
 Avomen, &c.
  This disease in childbed-Avomen is sometimes the effect of great cos-
 tiveness during pregnancy; it may likeAvise be occasioned by  their ex-
cessive use of green trash, and  other   unwholesome things, in which 
OF  THE  MILIARY FEVER.
149
pregnant women are too apt to indulge.  But its most general cause 19
indolence.   Such women as  lead a sedentary life, especially during
pregnancy, and at the same time live  grossly,  can hardly escape this
disease in childbed.   Hence  it proves  extremely fatal to women of fa-
shion, and likewise to those women iu manufacturing towns, who, in or-
der to assist their husbands, sit close Avithin doors for almost the whole
of their time.   But among women Avho are active and  laborious,  who
live in the country, and take  sufficient exercise without doors, this dis-
ease is very little known.
   SYMPTOMS.—When this is a primary disease, it makes its attack,
like most other eruptive fevers, with a slight shivering, which is succeed-
ed by heat, loss of strength, faintishness, sighing, a. low quick pulse, diffi-
culty of breathing, with great anxiety and oppression of the breast.   The
patient is restless, and sometimes delirious; the tongue appears white, and
the hands shake, with often a burning heat in the palms; and in childbed-
women the milk generally goes away,  and the other discharges stop.
   The. patient feels  an  itching or pricking pain under the skin,  after
which innumerable  small pustules of a red or white colour begin to ap-
pear.  Upon this the symptoms generally abate,  the pulse becomes more
full and soft, the skin grows  moister,  and the sweat, as the disease ad-
vances,  begins to have a peculiar foetid smell; the great  load on the
breast, and oppression of the spirits, generally go off, and the customary
evacuations gradually return.   About the sixth  or seventh day from the
eruption, the pustules begin to  dry, and fall off,  Avhich occasions a very
disagreeable itching in the skin.
   It is impossible to ascertain the exact  time when  the  pustules will
either  appear or go off.  They generally come out on the third or fourth
day, Avhen the  eruption is critical; but, when symptom atical, they may
appear at any time of the disease.
   Sometimes the pustules appear and vanish by turns.  WThen that is
the case, there is always danger; but when they go in all  of a sudden,
and do not appear again, the danger is very great.
   In childbedrwomen the pustules are commonly at first  filled Avith clear
water, afteiwards they grow yellowish.  Sometimes they are interspersed
with pustules of a red colour.  When  these only appear the disease goes
by the name of a rash.
   REGIMEN.—In all eruptive fevers of whatever kind, the chief point
is to prevent the sudden disappearing of the pustules,  and to  promote
their maturation.   For this purpose the patient must be kept in such
temperature, as neither to push out the eruption too fast, nor to cause it
to retreat prematurely.  The diet and drink ought therefore to be in a
moderate degree nourishing and cordial; but neither strong nor heating.
The  patient's  chamber  ought neither to be kept too hot  nor too cold:
and he should  not be too much covered with clothes.  Above all, the
mind is to be  kept easy aud cheerful.  Nothing so certainly makes an
eruption go in as fear.
   The food must be  Aveak chicken broth with  bread, panado,  sago, or
groat-gruel, Ac. to a gill of  which may be  added a spoonful or two of
wine, as the patient's strength requires, with a few grains of salt  and a
little sugar.  Good apples roasted or boiled, Avith other ripe fruits of an
opening cooling nature may be eaten.
   The drink  may be suited to the state of the patient's  strength and 
150
OF  THE  MILIARY  FEVER.
 spirits.   If these be pretty high, the drink ought to be weak; as Avater-
 gruel, balm-tea, or the decoction mentioned beloAV.*
   When the patient's spirits are low, and the eruption does not rise suf-
 ficiently, his drink must be a little more generous;  as wine-whey,or
 small negus; sharpened with the juice of orange or  lemon, and made
 stronger or weaker as circumstances may require.
   Sometimes the miliary fever approaches toAvard  a putrid nature, in
 which case the patient's strength must be supported with generous cor-
 dials, joined with acids; and,  if the degree of putrescence be great, the
 Peruvian bark must be administered.  If the head be much affected, the
 body must be kept open by emolient clysters, f
   MEDICINE.—If the food and drink be properly regulated, there
 will be  little occasion for medicine in this disease.   Should the eruption
 however not rise, or the spirits flag,  it will not only be necessary to sup-
 port the patient with cordials, but  likewise  to apply blistering plasters.
 The most proper cordial, in this case, is good wine, which may either be
 taken in the patient's food or drink;  and if there be signs of putrescence,
 the bark and acids maybe mixed with wine, as directed in the putrid fever.
   Some recommend blistering through the whole course of this disease;
 and where Nature flags, and the eruption comes and goes, it may be ne-
 cessary to keep up a stimulus, by a continual succession of small blister-
 ing plasters; but  we  would not  recommend above one at a time.  If
 however the pulse should sink remarkably,  the pustules fall in, and the
 head be affected, it will be necessary to apply several blistering plasters
 to the most sensible parts, as the inside of the legs and thighs, &c.
   Bleeding  is seldom necessary in  this disease, and sometimes it does
much hurt, as it  Aveakens the patient,  and  depresses his spirits.  It
is therefore never to  be attempted unless by  the advice of a physician.
We  mention this,  because it has been customary to treat this disease
in child-bed women,  by plentiful  bleeding,  and other evacuations,  as
if it were highly  inflariimatory.   But this  practice is generally  veiy
unsafe.   Patients in this situation bear evacuations very ill.   And in-
   * Take two ounces of the shavings of hartshorn, and the same quantity of
 sarsaparilla, boil them in two English quarts of water.  To the strained decoc-
 tion add a little white sugar, and let the patient take it for his ordinary drink.
   •j- In the Commercium Literarum for the year 1735, we have the history
 of an epidemical miliary fever* which raged at Strasburg in the months of No-
 vember, December, and January ; from which we learn the necessity of a tern-
 perate regimen in this malady,  and likewise that physicians are not always the
 first who discover the proper treatment of diseases.  " This fever made terrible
 havock even among men of robust constitutions, and all medicine proved in
 vain.   They were seized in an instant with shivering, yawning, stretching, and
 pains in the back, succeeded by a most intense heat; at the  same time there
 was a great loss of strength and appetite.  On the seventh or ninth day the mi-
 liary eruptions appeared, or spots like flea-bites, with great anxiety, a delirium,
 restlessness and tossing in bed.   Bleeding was fatal.  While matters were in
 this unhappy situation, a midwife, of her own accord,  gave to a patient, in the
 height of the disease, a clyster of rain water and butter without salt, and for
 his ordinary drink a quart of spring water, half a pint of generous wine, the
juice of a lemon, and six ounces of the whitest sugar, gently boiled till a scum
 arose, and this with great success ; for the belly was soon loosened, tlie griev-
 ous symptoms vanished, and the patient was restored to his senses,  and snatch-
 ed from the jaws of death."  Thispractice was imitated by others with the like
 happy effeet 
OF  THE  REMITTING FEVER.
151
deed the disease seems often to be more of a putrid than of an inflamma-
tory nature.
   Though this fever is often occasioned in child-bed women by too hoi
a regimen, yet it would be dangerous to  leave that off all of a sudden
and have recourse to a very cool regimen, and large evacuations.   We
have reason to believe, that supporting the patient's spirits, and promo-
ting the natural evacuations, is here much safer than to have recourse
to artificial ones, as these, by sinking the spirits, seldom fail to increase
the danger.
   If the disease proves tedious, or the recovery slow, we would recom-
mend the Peruvian bark, which may either be taken in substance or in-
fused in wine or water, as the patient inclines.
   The miliary fever, like other^eruptive diseases, requires gentle purg-
ing, which should not be neglected, as soon as the fever is gone off, and
the patient's strength will permit.
   To prevent this disease, a pure dry air, sufficient exercise, and whole-
tome  food, are necessary.   Pregnant women should  guard against cos-
tiveness, and take daily as much exercise as they can bear, avoiding all
green trashy fruits, and other unwholesome things;  and Avhen  in child-
bed, they ought strictly to observe a cool regimen.
                         CHAP.  XXII.

               OF THE REMITTING FEVER.

         1 HIS  fever takes its name from a remission of the symptom's,
which happens sometimes sooner, and sometimes later, but generally be-
fore the eighth day.  The remission is commonly preceded by a gentle
sweat, after which the  patient seems  greatly  relieved,  but in a few
hours the fever returns.   These  remissions return at very irregular pe-
riods,  and are sometimes of longer, sometimes of shorter duration:  the
nearer how ever that the  fever approaches to  a regular intermittent, the.
danger is the less.
   CAUSES.—Remitting fevers prevail in low marshy countries, abound-
ing with wood and stagnating waters; but they prove most fatal in places
w here great heat aud moisture are combined, as in some parts of Africa,
the province of Bengal in the East-Indies, &c. where remitting fevers are
generally of a putrid kind, and prove  very fatal.  They are most fre-
quent  iu  close calm weather, especially after rainy seasons, great inun-
dations, or the like. No age, sex, or constitution is exempted from the
attack of this fever; but it chiefly seizes persons of a relaxed habit, Avho
live in Ioav dirty habitations, breathe an impure stagnating air,  take little
exercise, and use  unwholesome diet.
  SYMPTOMS.—The first symptoms of this fever,  are  generally
yaw ning, stretcliing, pain, and  giddiness  in the head, with alternate fits
of heat and cold.   Sometimes the patient is affected with a delirium  at
the first attack.   There is a pain, and sometimes a SAvelling,  about the
region of the stomach, the tongue is white, the  eyes and skin frequently
appear yellow, and the patient is often afflicted with bilious vomitings.
The pulse is sometimes a little hard, but seldom full, and the blood, when 
152            OF THE  REMITTING FEVER.
let, .rarely shews any;signs of inflammation.  Some patients are exceed-
ingly  costive, and others are afflicted with a very troublesome looseness.
  It is impossible to describe all  the symptoms of this disease, as they
vary according to the situation, the season  of the year, and the constitu*
tion of the patient.   They may likewise be gre«tly changed by the me-
thod of treatment, and  by many other circumstances too tedious to men-
tion.   Sometimes the bilious symptoms predominate,  sometimes the ner
vous, and at other times the putrid.   Nor is it at all uncommon to find a
succession of each  of these, or even a complication of them at the same
time, iu the same person.
  REGIMEN.—The regimen must be adapted to the prevailing symp-
toms.   When there are any signs of inflammation, the diet must be slen-
der, and  the drink  weak and diluting.  But when any nervous or putrid
symptoms prevail, it will be necessary to support the patient with food and
liquors of a more generous nature, such as are recommended in the  imme-
diately preceding fevers.  We must however be very cautious in die use
of things of a  heating quality, as this fever is frequently changed into a
continual by an hot regimen, and improper medicines.
  Whatever the  symptoms  are, the patient  ought to be kept cool,
quiet,  and clean.   His apartment, if  possible, should  be  large and
frequ'endy ventilated by letting in fresh air at  the doors and windows.
It ought likewise  to be sprinkled with vinegar, juice of lemon,  or the
like.   His linen, bed-clothes,  &c. should be  frequently changed, and
all  his excrements  immediately  removed.  Though  these things have
been recommended before, we think it necessary to repeat them here, as
they are  of more importance to the sick than practitioners are apt to ima«
gine.*
   MEDICINE.—In order to aire this fever, we  must endeavour to
bring it to a regular intermission.   This intention may be promoted by
bleeding if there be any signs of inflammation;  but when that is not the
case  bleedin^ ought by no means to be attempted, as it will weaken the
patient and prolong the  disease.   A vomit however will seldom  be im-
proper, and is generally of great service.   Twenty  on thirty grains  of
ipecacuanha will ansAver this purpose very well; but  where it can be ob-
tained, we Avould rather recommend a grain or two of tartar emetic, with
five or six 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 sickness or nausea continues.
   The body ought to be kept  open either by clysters or gentle laxa-

  * The ingenious Dr. Lind, of Windsor, in his inaugural dissertation concern-
in? the putrid remitting fever of Bengal, has the foUowing observation: " In-
dusia lodices, ac stragula, sxpius sunt mutanda, ac aeri exponenda; feces sor-
desque quam primum removends oportet etiam ut loca quibus sgri decumbent
sint salubria et aceto conspersa; denique ut sgris cura quanta maxima, pros-
piciatur.   Conpertum ego habeo, medicum haec sedulo observantem, qwque ea
exequi potest multo  magis sgris profuturum, quam medicum pentiorem his se
commodis, destitutum."                                              .
  « The  patient's shirt, bed-clothes,  and  bedding,  ought frequently to  be
changed  and exposed to the air, and all his excrements immediately be remo-
ved ;  the bed-chamber should be well ventilated, and frequently sprinkled with
vinetrar, in short, every attention should be paid to the patient.  I can amrm,
that a physician who puts  these in practice will much oftener succeed than on*
wfho rs even more skilful, but lias not opportunity of using these means " 
OF THE  YELLOW  FEVER.             153
lives, as weak infusions of senna and manna, small doses of the lenitive
electuary, cream of tartar, tamarinds, stewed prunes,  or  die  like; but
all strong or drastic purgatives are to be carefully avoided.
  By this course the fever in a few days may generally be brought to a
pretty regular or distinct intermission, in which case the Peruvian bark
may be administered, and it will seldom fail to perfect the cure.   It is
needless here to repeat the methods of giving the bark, as we have al-
ready had occasion frequently to mention them.
  The most likely way to avoid this fever is to use  a wholesome and
nourishing diet, to pay the most scrupulous attention  to  cleanliness,  to"
keep the body Avarm, to take sufficient exercise and in hot countries to
avoid damp situations, night air, evening dews, and the like.  In coun-
tries where it is endemical, the best preventative medicine which we can
recommend is the  best  Peruvian bark, Avhich may either be chewed, or
infused in brandy or wine, Ac.  Some recommend smoking tobacco  as
very beneficial in marshy countries both for the prevention of this and
intermitting fevers.


                        CHAP.  XXIII. §

                  OF THE  YELLOW  FEVER.

       JL O  enter into a minute  investigation of  the  disputed origin of"
 (his disease, (and whether it be imported and contagious, or domestic and
epidemic,) under  existing circumstances, would be to assume a province^
unwarrantable as it regards the present work.
   So early as the year  1699, we  learn the existence  of Yellow Fever
 in Uiiscity.  At  that, and for  some time subsequent itwas  considered an
infectious distemper, and in 1748, Dr. Lining pronounced it an imported
 disease and contagious.—The most learned of the faculty agree, " That
 as most all fevers are generally epidemic, it is probable that some mat-
 ter floating in the atmosphere, and applied to the bodies  of men, ought
 to be considered as the remote cause of fevers: And these matters pre-
 sent in the  atmosphere and  thus  acting upon  men, may  be  considered
 either as contagions, (that is, effluvia arising directly or  originally from
 the body of a man under a particular disease, and exciting the same kind
 of disease in.the body to whom they are applied,)  or  miasmata, that is
 effluvia arising from other substances than the bodies of men, producing
 a disease in the  person to whom they are applied1'—Hence we may in-
 fer, that this latter term embraces what is meant by Epidemic when ap-
 plied to divers places, or Endemic when we speak of any  one  place.
   It is however evident, that the terms  Epidemic and Contagious are
 so connected, as not to be capable of an entire disjunction: The effluvia
 arising from other substances than die body of man,  contaminating the.
 air, and producing disease  iu persons predisposed,—what is  the conse-
 quence ? By the accumulation of  disease, a combination of Causes pro*
 ceeding from miasmata, combined with the effluvia arising from the bo-
 dies of the diseased—or in other words, Animal and Vegetable effluvia
 uniting—must of necessity  produce a species of contagion or at least a
 variety.
   Dr. Cullcn admits the probabilitv of a varfo'v io contagions.  Yet ob-
                                 '20 
154             OF  THE  YELLOW  FEVER.
server, that though  they have now been observed and distinguished for
many ages, and in many different parts of the world, they have been al-
ways found to retain the same general character, and to differ only in cir-
cumstances, that may be imputed to season, climate, and other external
causes, or to the peculiar constitutions of the  several persons affected.
He rather inclines to admit the probability, that in each of these speciea
the contagion is of one specific nature, which we apprehend consists in the
union of  the two effluvias already  mentioned.   Hence,  whenever it can
be  proved, that any disease has been communicated from a combination
of these, we may pronounce it contagious, and vice versa.
   Then with respect to the Contagious or Non-Contagious nature of the
Yellow  Fever, as it occurred in Charleston, we need only demand, has it
in any known instance been communicated from one person to another?"
The' learned and experienced Dr. Ramsay of Charleston,  in a letter to
Dr. Miller of  NeAv-York, says " There is  but one  opinion  among the
physicians and inhabitants, aud that is, that the disease  was neither Im-
ported, nor Contagious.   This Avas the unanimous sentiment of the Medi-
cal Society, who  in pursuance of it, gave their  opinion to the govern-
ment last summer"  (i. e. the summer of 1800) " that the rigid enforce-
ment of the quarantine laws was by no means necessary on account of
the Yellow Fever."  The doctor concludes  by observing " my private
opinion is, that our YelloAV Fever is  a local disease originating in the ait
of Charleston."   Correspondent  to  this is the opinion  of  Dr. Tucker
Harris, communicated to Dr. Currie: " with respect to the contagious na-
ture of Yellow Fever, so far as it  has occurred in this city, there  is no
instance, which can be cited to induce the smallest suspicion thereof.  It
appears,  that not only Europeans and strangers from different states, who
visit our city, take the disease and die, Avithout communicating it to the
physicians, nurses,  or attendants, but that people from the country, stran-
gers to our atmosphere, on  coming to  town, often sicken on  their way
home, and die in houses on the road; yet in  no one instance, hath the
disorder been  transferred to  any of the individuals of  the family Avho
received them  in.   This in my opinion, is an undeniable and convincing
proof of the non-contagious nature of Yellow Fever.   Indeed I strongly
doubt Avhether any disease, originating from vegetable  or marsh miasma,
can be contagious, for as yet it  has never been demonstrated: while, on
the other hand I am inclined to believe, that animal, perhaps it would be
more correct to say human effluvia, under certain modifications, prove the,
source of all such diseases as are of a contagious kind; and the operation
of this contngion is not, as happens in the case of Yellow Fever confined
to the autumnal months, but will exist at any season.  This may prr:
haps, serve in some  measure, to discriminate  between epidemic  and
contagious disorders," Ac.   These facts corroborated by  such  high
and undoubted testimonies,  will  establish what  I  have  already ad-
vanced  with regard to Uie locality of this disease, and proceed to give
the
   Defimtion.—The Yellow Fever derives its appellation from  the yellow
suffusion, which commouly appears in the eyes aud on the skin, howe\*er,
as this appearance is not universal, and frequently happening in many other
cases, the term may  not be strictly proper.  It was during the Revolution.
termed Camp-fever.  It appears to "be a/ever of the Typhus ki-id, aud by
Dr.  Cullea is very properly called  TiQihus icterodes.   The term Yellov 
OF  THE  YELLOW FEVER.             155
Fevri is most generally applied to it, and as such we presume it will
continue to be handed down to the latest posterity.
  CAUSE.—Authors appear to  be divided as to the cause of Yellow
Fever, which may be collected from Avhat has been already said.  It is
however believed that a particular idiosyncrasy, i. e. constitution or de-
rangement of the atmosphere, probably effected by the strong light and
intense heat of the  sun, depriving that portion nearest the earth of its
proper quantity 01 vital air, leaving the mephitic or heavier part near to
the surface of the earUi, forms one not among die least of causes.   The
loss of a small portion of vitai air renders this lower stratum  very unfit
for respiration, consequently  very unwholesome; when this circumstance
takes place, and the atmosphere seems vitiated slowly and by degrees,
the effect of Yellow Fever or indeed any other, is not so considerable, in
proportion to the suddenness  and  degree of this idiosyncrasy and vitiated
state of the atmosphere, so is the violence  of its  appearance.  Marsh
miasma, as has been already  observed, is productive of Epidemics, and
none deny that  contagious disorders are produced by the exhalations
from  putrilying  animal aud vegetable substances.   It may also be re-
marked, that  most climates experience an unhealthy  and pestilential at-
mosphere,  soon  or immediately after the exhalations from the putrifying
collections of vegetable and  animal matter begin to rise, winch diffusing
themselves in the air, bring on diseases of different forces of malignity
according to the contaminated state of the  atmosphere,  in conjunction
with  other  predisposing circumstances,  and that these exhalations are
principally produced by heat combined with some peculiar state of the
atmosphere, is an opinion backed by good authority.   Dr. Harris, Avhose
opinion I have before taken the liberty to introduce, observes, after hav-
ing objected to the generally assigned causes, " I am however decidedly
of opinion, that  heat combining with some unknown modification of the
atmosphere of our city, has,  in ten out of the last Uiirteen years, given
existence to this dreadful disease."
   SYMPTOMS.—There is little or no difference among authors of the
present day with regard to these, I have consulted eight or ten  of the
greatest celebrity, and observe an almost unique of opinion—Before the
fever forms itself, the  most  usual sign of its approach is a sudden  and
universal pain of the head generally above one or both eyes, which in
some remit with  short intervals, causing a giddiness or vertigo,  rather
thau  sharp pain, attended with an unusual feebleness and languor of t he
body.  Dr. Rush states among other premonitory symptoms, a sudden
drying up, or breaking out of an old sore,  fresh eruptions in different
parts of the body; a cessation of a chrome disease, or a conversion of a
periodical into a continual disease—a peculiar sallowness of  the com-
plexion—a head-ach, a decay or increase  of appetite, costiveness; a
diminished or increased secretion of  urine,  a hot and offensive breath,
constant sweats, and sometimes of a foetid nature, or a dry skin ;  wake-
fulness, or a  disposition to early or protracted sleep, apreternaturally
frequent pulse;  unusual vivacity, or depression  of. spirits,  fatigue or
sweats from light exertions;  the  hands when rubbed, emitting a smell
like hepar (liver) of sulphur, and lastly a sense of burning iu the mouth.
 The fever is  commonly ushered  iu with alternate slight chills and heats,
nausea, pains of  the head, back, loins,  and at the pit of the  stomach.
 These symptoms arc often folloAved, iu less than 24 hours, with violent 
156*             OF  THE  YELLOW  FEVER.
 retchings and vomiting of a green or yellow bile,  the smell of Avhich n
 very offensive.
   The learned Dr. Mitchell very ingeniously arranges the pathognomic,
 (peculiar or always attendant) symptoms of this disease into the six fol-
 lowing particulars.  1. A very great and sudden debility without any
 manifest cause.   2.  A feverish anxiety, generally very grievous.  3. A
 short, quick and difficult orthopnaic respiration, (i. e. the patient cannot
 draw his breath with ease unless in an upright posture) after the fever is
 formed.   4.  A contracted deep pulse; the artery feels tense, but  the
 pulse is compressible,  to which succeeds a depressed, or soft arid low
 pulse, after the state of the disease, or after the yelloAV effusion appears.
 5. A  pain of the soorbieulus cordis, (pit of the stomach) either much
 complained of or to be felt  on squeezing  that part;  and more or less se-
 vere according to the  severity of the disease.   6. A yellowness in the
 eyes, or all over the body at the height of the disease; unless prevented
 by colliquative or critical discharges, to which may be added, a violent
 and unusual kind of pain of the head, unless it is drowned as it were in
 the more grievous complaint about the priecordia, (the vitals or particu-
 larly the heart.)   The three latter  are symptoms most peculiar to  this
 fever.  At other times the  patient  is attacked with very great anxiety,
 sickness and pain of the stomach,  attended Avith an excessive convulsive
 vomiting, which no medicine seems likely to relieve—After the first day
 the surface of the body is generally either cold, or dry and parched, the
 liead-ach and stupor often ending in a delirium which proves suddenly
 ratal in many cases.   It is  to be  observed ,that the vomiting sometimes
 occurs as early as the first or second day, but  more commonly on the
 third, when it brings on hickup,  inflammation of the stomach and viscera,
 with a large discharge by vomit of a black atrabilious matter,  (anciently
 denominated  black choler) like  coffee grounds,  mixed Avith a bloody
 lymph,  or coagulated blood.   The atrabilious humour is often highly
 acrid;  sometimes viscid, in  which latter case it is difficultly ejected, and
 hence by its  great acrimony it renders this symptom violent  and often
 fatal.
   We have  been thus prolix in describing the symptoms, because we
 think much depends thereon, and indeed much more might be said did
 we not presume, a due attention to  these, would discover to any careful
 observer the premonitory  as well as  concomitant advances thereof—with
 regard to Prognostics, Ave decline advancing any observations, and pro-
 ceed to the
   REGIMEN.—It may not be  amiss to describe under this particular,
 what  are considered  as  preventatives  of fever,—these  are severally
 pointed out  by that eminent physician,  Dr.  Rush,  He advises first,
 where it is practicable, the  flight  of persons  exposed  to  its attack,
l)ut  where this is impracticable, safety  should be sought for in such
 means as reduce the  preternatural tone and fulness induced in the
 blood vessels by the stimulus of  the  miasmata and the  suppression of
 customary secretions.   These  are, 1.  A diet accommodated to the
 greater or less exposure of the  body to the action of the miasmata and
 to the greater or less degree of labour  or exercise, ivhich are taken.
 fn cases of great exposure to  an  infected  atmosphere,  with but little
 exercise, the  diet should be simple in  its  quality and small in its
 quantity.  Fresh meats and wines  should be avoided.   A little  salted
 meat ant} Cayenne pepper  with vegetables, prevent an undue languor 
                  OF  THE  YELLOW FEVER.              157

of the stomach, from the want of its usual cordial aliments.   But where
a great deal of exercise is taken, broths, a little wine or malt liquors may
be used with the fruits  and garden vegetables of the seasons with safety
and advantage.  The change from a full to a low diet  should be made
gradually.  When made suddenly it predisposes to an attack of the disease.
2. Laxative medicines—3. A plentiful  perspiration  kept up by means
of warm clothing and bed-clothes.   The excretion which takes place by
the pores is of the first necessity;  as is a particular attention to clean li-
nen or flannel; and 4. Blood-letting.  All these depleting remedies, whe-
ther used separately or together, induce such an artificial debility in the
system, as disposes it to vibrate more readily under the impression of the
miasmata.
   A second class of preventives, are such as obviate the internal action
of miasmata, by excititing a general or partial determination to the exter-
nal surface of the body.   These are—1. The warm bath; it serves the
treble purposes of keeping the skin clean, the pores open, and of defend-
ing what are called the vital  organs from disease, by inviting its remote
cause to the external  surface of the  body.  This cannot be too highly
recommended.  2.  The cold bath.  3.  Washing  the body morning and
evening with salt water.  4.  Anointing the body with oil or fresh butter.
 5. Issues,  setons, and blisters.
   A third class of preventives are such as excite a general action, more
 powerful than that which the miasmata are disposed to create in the sys-
tem, or an action of a contrary nature.   These are—1. Onions and gar-
lick.  The  liberal use of these condiments  in food hath  exempted all
those who used them in 1793, from yellow fever.   2.  Calomel taken in
 such small doses as gently to affect the gums.   Several other controvert-
 ed or at least doubtful particulars are enumerated, which we pass over in
 order to point out the necessity of avoiding all its exciting causes.  These
 are—1. Heat and cold:  While the former has  excited the yellow fever
 in thousands, the latter has excited  it  in ten thousands.   It  is not in
 middle  latitudes  only, that  cold awakens this  disease in the  body.
 2. The early morning and evening air, even in warm weather.   3. Fa-
 tigue from amusements; such as fishing,  gunning, dancing, and from unu-
 sual labour or exercise.   4.  Intemperance in eating and drinking.  5.
 Partaking of new aliments and drinks.   6. Violent emotions or passions
 of the mind.  7. The entire cessation of moderate labour. 8. The continu-
 ance of hard labour.   These are the principal means of prevention Avhich
 have been enumerated as necessary.   The Regimen to be observed after
 an attack, consists in tne following: The patient should abstain from animal
 food; the diet should consist of gruel, pan&do, sago, chicken-broth, and
 other spoon-meats: he should use cool diluting drinks, such as barley-
 water, toast and water, lemonade, apple-tea, tamarind-water, hop-tea, and
 also small quantities of ripe fruits, which tend to keep the bowels soluble.
 The chamber of the sick should be spacious and airy, and frequently ven-
 tilated through the day: vinegar, sprinkled on hot bricks, should be in-
 troduced into the  apartment  frequently, and impregnated with aromatic
 herbs repeatedly sprinkled  over the floor, bed-clothes, Ac.   The pas-
 sions of the mind ought also  to be regularly attended to, and the excre-
 ments should not  be suffered to remain a moment in the apartment.
 These circumstances  are of infinite importance, as well to the sick, as to
 ^hose who frequent them. 
158
OF THE  YELLOW FEVER.
  MEDICINE.—Here a particular necessity compels us to be miuutc
in our observations.—This publication was originally and is now intend-
ed,  as an assistant  and guide to Families, and to such as are  out of the
reach of Physicians.  Happily for mankind, where this disease prevails,
there are generally a sufficient number of eminent physicians.   Need wc
observe the importance  of an early application to an honest  and skilful
practitioner ?—Where however this highly prudent plan is neglected, or
impracticable, we would recommend  the following mode of treatment.
In this fever the first indication is to subdue it by the most speedy means
in our power.   The second is to prevent the putrescent state that follows
so rapidly after  the febrile stage, or to oppose its progress Avhen begun,
and at  the same time to support the strength of the patient.   The first
intention  is best accomplished by bleeding and  purgatives; bleeding is
best performed Avithin the first twenty-four hours from an  attack,  or at
most within thirty-six.   Some practitioners have pointed out the  exact
quantity of blood to be  drawn, but as an implicit attention to that ride
may subject us to error, Ave decline the insertion. In general, when the
use of the lancet  is indicated, one or more bleedings  may be admitted,
with a view to alleviate the violent pains of the head, eyes, Ac. provided
it be performed within  the time prescribed.  In order to moderate the
violent determination to the head, the feet should be bathed in Avarm wa-
ter, and an opening clyster administered immediately.  As obstinate cos-
tiveness generally prevails, and the stomach is seldom long capable to re-
tain the common purgatives, Ave ought to improve the time to advantage.
It may be here observed that if the perspiration  can be promoted soon af-
ter the attack, it  may be a means to subdue the fever: with this vieAv,
if there be no inclination to vomit, and the skin is diy and parched, the
following may be administered to advantage, during the first twenty-four
hours.   Take autimonial powder, and calomel,  of each one scruple, sy-
rup enough to make a mas^ of 'tfhicb eight pills  may be made.   Four of
these may be taken immediately, and two more repeated every second or *
third hour after, till they either procure a due  discharge, or  free perspi-
ration.   Should however the first dose occasion a retching or vomit-
ing, Ave should immediately  desist and resort  to the other means here-
after  laid  down.   If the  prescription  operates  plentifully by  sweat
and stool, the patient will  in all probability recover, as by this  mea;is
the fever is  often prevented  from forming itself.   Should the stomach
not retain the foregoing, forty grains of jalap and  tAventy  of calomel,
or  tAventy of  calomel with the like quantity of  crabs-eyes or magnesia,
may be rubbed together, and divided into ten powders; one of these
may be given every tAvo hours, in a little cold tea, or they may be form-
ed into ten pills, one of which  to be taken at the same periods, and conti-
nued during the Avhole of the febrile stage, or until the gums are affected.
When  this fortunate  circumstance takes place, the  medicine must be
suspended,  and nourishment with a  little wine given.   2.  As bark in
substance will rarely remain  on the stomach, decoctions  are to be pre-
ferred, and   a3 in  this stage it is necessary  to exert  every effort to
resist a tendency to putrefaction, four  table^spoonsful of the decoction of
bark may be given every two hours.   If the  stomach should reject it,
or Avhether it does or  not,  we  ought not to neglect repeated clysters,
of it, acidulated with  vinegar or lime-juice, at least every two  hours,
nor would it  be  amiss  to rub the body with vinegar or lime-juice, as 
                     OF  THE  SMALL-POX.                159

often as practicable.  Some have recommended olive or sweet oil for this
purpose also.  Sometimes the strained juice of Avood sorrel given inters
nally and by Avay of clyster, has been attended with good effects in re-
straining the putrid tendency, and in one instance has been knoAvn to check
the black vomit.  Hops,  being possessed of great antiseptic properties,
an infusion of them may be taken in moderate draughts, at proper inter-
vals.   In case of vomiting,  a blister applied to the epigastric region, par-
ticularly the pit of the stomach, is almost alone to be relied on.  In this
fever, an inflammation of the stomach and viscera are almost always pre-
sent, and the tendency to putrescence is so great as to exclude the remedies
usually applied in other  cases attended with vomiting.   Here it is es-
sentially and absolutely necessary to avoid all heating medicine.  Where-
fore, if the gums are not already affected, frictions of strong mercurial
ointmetit, particularly over the hypochondriac and epigastric regions, may
be used; and if by this means the gums can be effected, a cure may  be
looked for.
   From Avhat has been said we may collect, that the general plan of treat-
ment for this Hydra-disease, consists of au«h remedies,  as tend to sub-
due the inflammatory diathesis already  pointed out.—Bleeding,  warm
bathing,  and purgatives, appear to be the most approved, to  which may
be added blistering and the mercurial friction.  Among the purgatives,
calomel appears to claim the preference, and when timely and prudently
administered, seldom fails to prove successful.  Hence Ave are again in»
duccd, earnestly to advise  timely application to a professional character.
   We shall now conclude with some remarks on the treatment of conva-
lescents.   They should avoid every thing which may tend to bring on a
relapse ;  among these may  be  reckoned a too early exposure to improper
exercise, food,  and drink.  They should eat but little at a time, and that
little should be easy of digestion.   Their exercise should  be gentle,
and introduction to the air gradual:  morning and  night  air should  be
avoided  at all events.   If wine had been used in the fever, it must be
now used more sparingly.   Bark in substance or decoction, should be coit
tinued in  moderate doses, until the debilitated system is invigorated, the
digestive  faculty repaired and strengthened, and the  patient returns to
his usual mode of  living.
                       CHAP.   XXIV;

                     OF THE  SMALL-POX.

          A HIS  disease which originally came from Arabia, is now be-
come so general, that very  few escape it at one time of life or  another.
It is a most contagious malady; and has  for  many years proved  the
scourge of Europe.
   The small-pox generally appears towards the spring.  They are very
frequent in summer, less so in autumn, andleast of all in ivinter. Children
are most liable to this disease; and  those  whose food is unwholesome,
who want  proper exercise, and abound with gross humours, run the great-
est hazard from  it.
   The disease is distinguished into the  distiuct and confluent kind;, the 
160               OF  THE  SMALL-POX.
latter of which is always attended with  danger.   There are likewise
other distinctions of the small-pox; as the  crystalline, the bloody, Ac.
   CAUSES.—The small-pox is commonly caught by infection—Since
the disease Avas first brought into Europe, the infection has never been
wholly  extinguished, nor have  any proper methods,  as far as I know,
been taken for that purpose: so that now it has become in a manner con-
stitutional. Children who have over-heated themselves by running, wrest-
ling, Ac. or adults after a debauch, are most apt to  be seized with the
small-pox.
   SYMPTOMS.—This disease is so generally known, that a minute de-
scription of it is unnecessary.  Children commonly look a little dull, seem
listless and drowsy for a feAV days  before  the more violent symptoms of
the small-pox appear.   They are  likewise more inclined to drink than
usual, have little appetite for solid food, complain of Aveariness, and, up-
on taking exercise, are apt to sAveat.   These are  succeeded by slight
fits of cold and heat in turns, which as the time of the eruption approaches,
become  more violent,  and are accompanied  with pains of the head and
loins, vomiting, Ac.   The pulse is quick,  with a great heat of the skin,
aud restlessness.   When the patient drops asleep, he wakes in a kind of
horror, Avith a sudden start, which is a very common symptom of the ap-
proaching eruption; as are also convulsion fits in  very young children.
   About  the  third or fourth  day  from  the  time of sickening, the
small-pox generally begin to appear; sometimes indeed they appear
sooner, but that is no favourable  symptom.  At first they very nearly
resemble  flea-bites,   and  are  soonest discovered  on  the  face,  arms,
and  breast.
   The most favourable symptoms are a slow eruption, and an abatement
of the fever as soon as the pustules appear. In a mild distinct kind of small-
pox, pustules seldom appear before the fourth day from the time of sick-
ening, and they generally keep  coming out gradually  for several days
after.  Pustules which are distinct, with  a florid  red basis, and  which
fill with thick purulent matter, first of a whitish, and afterwards  a yel-
lowish colour, are  the best.
   A livid brown  colour of the pustules  is an  unfavourable symptom;
as also  Avhen they are small and flat, with black  specks in the middle.
Pustules which contain a thin watery ichor are very bad.  A great num-
ber of pox on the face  is  always attended with danger.  It is likewise
a very bad sign when they run into one another.
   It is  a most unfavourable symptom when petechiae, or purple, brown,
or black spots are interspersed among the pustules.   These are signs
of a putrid dissolution of the blood,  and shew the  danger to be very
great    Bloody  stools  or urine, with  a  swelled  belly, are bad symp-
toms;  as  is also  a  continual  strangury.  Pale  urine  and a violent
throbbing  of the arteries of the  neck are signs  of an aproaching de-
lirium,  or  of  convulsion  fits.   When   the  face  does not swell, or
falls before the pox come to maturity, it  is very unfavourable.  If the
face begins to fall  about the 11 th or 12th  day, and  at  the same time the
hands  and feet  begin to swell  the  patient generally  does well; but
Avhen these do not succeed to each other, there is reason to apprehend
danger.   When the  tongue  is  covered  with  a brown  crust,  it is an
unfavourable  symptom.   Cold   shivering  fits   coming   on  at the
height of  the disease  are  likewise unfavourable.   Grinding  of the 
                     OF  THE  SMALL-POX.                 161

teeth, Avhen it proceeds from an affection of the nervous system, is a bad
sign;  but sometimes it is occasioned by Avorms, or a disordered stomach.
   REGIMEN.—WThen  the  first symptoms  of the  small-pox  appear,
people are ready to be alarmed, and often fly to the use of medicine, to
the great danger of the patient's life.   I have known children, to appease
the anxiety of their parents, bled, blistered, and purged, during the fever
which preceded the eruption of the small-pox, to such a degree that Na-
ture was not only disturbed in her operation, but rendered unable to sup-
port the pustules after they were out; so that the patient, exhausted by
mere evacuations,  sunk under the disease.
   When convulsions appear, they give a dreadful alarm.   Immediately
some nostrum is applied, as if  this were a primary disease;  whereas it is
only a symptom, aud far from being an unfavourable one, of the approach-
ing eruption.   As the fits generally go off before the actual appearance
of the small-pox,  it is attributed to the medicine, Avhich by this means
acquires a reputation Avithout any merit.*
   AH that is, generally speaking,  necessary  during the eruptive fever,
is to keep the patient cool and easy, allowing him to drink freely of some
weak diluting liquors; as balm-tea, barley-water, clear whey, gruels, &c.
He should not be  confined to bed, but should sit up as much as he is ablej
and should have his feet aud  legs frequently bathed in luke-warm water.
His food ought to  be veiy light; and he should be as little disturbed with
company as possible.
   Much mischief is  done at this period by confining the patient too soon
to bis  bed, and plying him with wrarm cordials or sudorific medicines.
Every thing that  heats and inflames the blood increases the fever,  and
pushes out the pustules prematurely.   This has numberless ill effects.
ft not only increases the number of pustules, but likewise tends to make
them  run into one another; and  Avhen they have been pushed out Avith
too great a violence, they generally  fall in before they come to maturity.
   The good women, as soon as they see the small-pox begin to appear,
commonly ply their tender charge with cordials, saffron, and marigold-
teas, wine, punch, and even  brandy itself.   All these are given Avith a
view, as they term it, to throw out the  eruption from the heart.  This.
like most other popular mistakes, is the abuse of a very just observation,
that  when  there is a moisture on the skin, the pox rise better, and the pa-
tient is easier, than when it continues dry and parched.  But that is no
reason for  forcing the patient into a sweat.   Sweating never relieves un
less avIkie it conies spontaneously, or is the effect of drinking weak di-
luting liquors.
   Children are often so  peevish, that they will not lie a-bed Avithout a
nurse constantly by them.  Indulging them in this, Ave have reason to
believe,  h.is many bad effects both upon the nurse and child.—Even  the
natural heat of the  nurse cannot fail to augment the fever  of the child;
but if she also proves feverish, which is often the case, the danger must be
increased.f
  * Convulsion fits are no doubt very alarming, hut their effects are often salu-
r.i.i'y.  They seem to ke one of the means made use of by Nature for breaking
ii»c forte of a fever;  I have always ohserved the fever abated, and sometimes
.iiiit.- removed, after one or more convulsion-fits.  This readily accounts for con-
vulsion* hcinjr a fivournMe symptom in the fever which precedes the eruption
of tjie sninll-pox, as every thinir tli.it mitigates this fever lessens the eruption.
  "'■ I have known, jffnmvn:-, who had  the small-pox l':'#i<*, so infected bv Iving
                                  iM 
1^2                 OF  THE  SMALL-POfc.
  Laying several children who have the small-pox in the same bed lia»
many ill consequeuces.   They ought if ^ofsible never to be in the same
chamber, as the perspiration, the heat, the smell, Ac. all tend to augment
the fever, and to heighten the disease.  It is common among the poor to
see two or three children lying in the same bed, Avith such a load of pus-
tules that even tlieir skins stick together.   One can hardly view a scene
of this  kind without being sickened by the sight.   But Iioav must the
effluvia affect the poor patients, many of whom perish by this usage/
  A very dirty custom prevails among the lower class of people,  of al-
lowing  children in the  small-pox to keep on the same  linen during the
whole period  of that loathsome disease.   This is done lest they should
catch cold; but it has many ill consequeuces.  The linen becomes hard
by the moisture which  it absorbes, and frets the  tender  skin.  It like-
wise occasions a bad smell,  which is very pernicious both to the patient
and those about him; besides, the  filth and sordes which adhere  to the
linen, being absorbed, or taken up again into the body, greatly augment
the disease.
   A patient should not be suffered to be dirty in an internal disease, far
less in the small-pox.   Cutaneous disorders are often occasioned by nas-
tiness alone, and are always increased by it.   Were the  patient's linen
to be changed ev. ry day, it would greatly refresh him___Care indeed is
to be taken that the linen be thoroughly dry.   It ought  likewise to be
put on when the patient is most cool.
  So strong is the  vulgar prejudice in this country, notAvithstanding all
that has been  said against the hot regimen in the small-pox, that numbers
still fall a sacrifice to that error.   I have seen poor Avomen travelling in
die depth of  Avinter, and carrying  tlieir children along with them  in the
small-pox, aud have frequently observed others begging by the way-side
with infants in their arms covered  Avith the pustules; yet I could never
learn that one of these children died by this sort of treatment.  This U
certainly a sufficient proof of the  safety, at least, of exposing patients
in the small-pox to the  open air.    There can be no reason however for
exposing them to public view.  It is uow very common in the environs
of great towns to meet patients in the  small-pox on the public  Avalks.
This practice, hoAvever well it may suit the purposes of boasting iuocula-
tors, is dangerous to the citizens, and contrary to  the laivs of humanity
and sound policy.
   The  food in this disease ought to be very light,  and of a cooling
nature, as  panado, or  bread boiled Avith equal quantities of milk and
constantly a-bed with a child in a bad kind of small-pox, tliat she had  not only
a great number of pustules which broke out all over her body, but afterwards a
malignant fever which terminated in a number of imposthumes or boils, and
from which she narrowly escaped with her life.  We mention this to put others
upon their guard against the danger of this virulent infection.
  * This observation is likewise applicable to hospitals, work-houses, &c where
numbers of children happen to have the small-pox at the same  time.   1 have
seen above forty children cooped up in one apartment all the while they had this
disease, without any of them being admitted to  breathe the fresh air,   No one
can be at a loss to see the impropriety of such conduct.  It ought to be a rule
not only in hospitals for the small-pox,  but likewise for other diseases, that no
patient should be within sight or hearing of another.  This is a matter to which
too little regard is paid.  In most hospitals and infirmaries, the sick, the dying,
and the dead, are often to be seen in the same apartment. 
OF  THE SMALL-POX.                  163
 water, good apples roasted or boiled with milk, and sweetened with a little
 f-ugar and such like.
   The drink may be equal parts of milk and water, clear sAveet whey,
 barley-water, or thin gruel, Ac.  Alter the pox are full, butter milk, be-
 ing of an opening .nd cleansing nature is a very proper drink.
   MEDICINE.—This disease is generally divided into four different
 periods, vis. the fever which precedes the eruption, the eruption  itself,
 the suppuration or maturation of the pustules, andi the secondary fever.
   It has already been observed, that little more is necessary during the
 primary fever than to keep  the patient cool  and quiet,  allowing him to
 drink diluting liquors, and bathing his  feet frequently in warm water.
 Though this be generally the  safest course that can be  taken with in-
 fants,  yet  adults, of a strong constitution and plethoric habit, sometimes
 require bleeding.  When a full pulse, a diy skin, and other symptoms
 of inflammation renders this operation necessary, it ought to be perform-
 ed ; but, unless these symptoms are urgent it is safer to let it alone; if
 the  body is bound, emollient clysters may be throivn iu.
   If there is a great nausea or inclination to vomit, Aveak camomile tea
 or lukewarm Avater may be drank, in order to cleanse the stomach.  At
 the  beginning  of a fever, Nature generally attempts a discharge, either
 upAvards or doAvnAvards, which if promoted by gentle means, would tend
 greatly to abate the violence of the disease.
   Though every method is to be taken during the primary fever, by a
 cool regimen,  &c.  to prevent too great an emption; yet after the pus-
 tules have made their appearance, our business is to promote the suppu-
 ration, by diluting drink, fight food, and if Nature seems to flag, by ge-
 nerous cordials.   When a  low creeping pulse,  faintishness, and  great
 loss  of strength, render cordials necessary, Ave would recommend  good
 wine,  which may be made into negus, Avith an equal quantity of water,
 and sharpened with the  juice of orange, the jelly of currants, or the
 like.   Wine-whey sharpened as above, is likeAvise a proper drink  in
 this case; great care however must be taken not to over-heat the patient
 by any of these things.  This, instead of promoting, would retard the
 eruption.
   The rising of the small-pox is often prevented by the violence of the
 fever;  in this case the cool regimen is strictly  to be observed.   The pa-
 tient's  chamber must not only be kept cool, but  he ought likewise fre-
 quently to be taken out of the bed, and to be lightly covered Avith clothes
 Avhile in it.
   Excessive restlessness, often prevents the  rising and filling of the
 sinall-pox.  When this happens, gentle opiates are necessary.  These
 however ought always to  be administered Avith a sparing hand.  To an
 infant, a tea-spoonful of the syrup of poppies may be given every five
 or six  hours till it has the desired effect.  An adult will require a table-
 spoonful in order to answer the same purpose.
   If the patient be troubled Avith a stranguary, or suppression of urine,
 Avhich often happens in the small-pox, he shoul1 be frequently taken out
of bed, and if he be able, should walk across the room with his feet bare.
 When he  cannot do  this he  may frequently set on his knees in bed,
and should endeavour to pass his urine as often as he can.  When these
do not  succeed, a tea-spoonful of the sweet spirits of nitre may be oc-
casionally  mixed with his drink.  Nothin? more certainly relieves the 
164                 OF  THE  SMALL-FOX.
patient, or is more beneficial in the small-pox, than a plentiful discharge
of urine.
  If the mouth  be foul, and the tongue dry and chapped, it ought fre-
quently to be washed, and the throat gargled  with water and honey,
sharpened with a litde vinegar or currant jelly.
  During the rising of the small-pox, it frequently happens that the pa-
tient is eight or ten days ivithout a stool.   This uot only tends to heat
and inflame the blood, but die faeces, by lodging  so long in the body, be-
come acrid, and even putrid;  from whence bad consequences must en-
sue.   It will therefore be proper, when the body is bound, to throw an
emollient clyster every second or third day through the whole course of
the disease.   This will greatly cool and relieve the patient.
  When petechias,  or purple, black,  or livid spots appear among the
small-pox, the Peru  ian bark must  immediately be administered in as
large doses as the patient's stomach can bear.  For a child, two draclims
of the bark in powder may be mixed in three ounces of common ivater,
one  ounce of simple cinnamon water, and two ounces of the syrup of
orange or lemon.  This may be sharpened  with the spirits of vitriol, and
a table-spoonful of it given every hour.  If it be given to an adult in
the same form, he may take at least  three or four spoonsful every hour.
This medicine ought not to  be trifled ivith, but must be administered as
frequently as the stomach can bear it; in Avhich case it Avill  often pro*
duce very happy effects.   I have frequently seen  the  patechiae disap-
pear, and the small-pox, which had a veiy threatening aspect, rise and
fill with laudable matter,  by the use of the bark and acids.
  The patient's drink ought likewise in this case to  be generous, as wine
or strong negus acidulated Avith spirits  of  vitriol, vinegar, the juice  of
lemon, jelly of currants, or such like.  His food must consist of apples,
roasted or boiled, preserved cherries, plumbs, and other fruits of an acid
natuie.
  The bark  and acids are not only necessary  Avhen the petechia or
putrid symptoms appear,  but likewise  in  the lymphatic  or crystalline
small-pox, Avhere the matter is thin, and duly prepared.   The Peruvian
bark seems to possess a singular power of assisting Nature in preparing
laudable pus; or Avhat is called good matter;  consequently it must be
beneficial both in this and other diseases, Avhere the crisis depends on a
suppuration.   I have often observed, where the small-pox  were flat, and
the matter contained in them quite clear and transparent, and where at
first they had the appearance of running into one another, that the Peru-
vian bark, acidulated as  above, changed the  colour and consistence of
the matter, and produced the most happy effects.
  When the eruption subsides suddenly, or, as the good Avomcn terms it,
when the small-pox strike in, before they have arrived  at maturity, the
danger is very great. In this case blistering-plasters must be immedi-
ately applied to the Avrists and ancles, and the patient's spirits supported
with cordials.
   Sometimes bleeding has a surprising effect in raising the pustules af-
ter they have subsided; but it requires skill to know when this is pro-
per, or to Avhat length the patient can bear it.   Sharp cataplasms how-
ever may be applied  tp the feet and hands, as they tend to promote the
swelling  of these parts, and by that means to draw the humours toward?
(he extremities. 
Of the  small-pox.                 165
  The most dangerous period of this disease is Avhat Ave  call the se-
condary fever.   This  generally  comes on Avhen the small-pox begin to
blacken, or turn on the  face; and most of those who die of the small-pox
are carried off by this fever.
  Nature generally attempts, at the turn of the small-pox, to relieve the
patient by loose stools.   Her endeavours this way are by no means to be
counteracted, but promoted, and the patient at tjje same time supported
by food and drink of a nourishing and cordial nature.
  If at the approach of the secondary fever, the pulse be  very quick,
hard and strong, the heat intense, aud the breathing laborious, with  other
symptoms of an inflammation  of the breast, the patient must immediate-
ly be bled.  The quantity of blood to be let must be regulated by the
patient's strength, age, and the urgency of the symptoms.
   But in the secondary fever, if the  patient be faiutish, the  pustules
become suddenly pale, and if there be great coldness of the extremities,
blistering-plasters must be applied, aud the patient must be supported Avith
generous cordials.  Wine and even  spirits have sometimes  been given in
such cases Avith amazing success.
   As the secondary fever is in great measure, if not wholly, owing  to the
absorption of the matter, it would seem highly consonant to reason, that
the pustules as soon as they come to maturity, should be opened.   This
is every  day practised in other phlegmons which teud  to  suppuration;
and  there seems to be  no cause Arhy it should be less proper here.  On
the contrary, Ave have  reason to believe that by this the secondary  fever
might always be lessened, and often wholly  prevented.
   The pustules should be  opened when they begin to turn of a yellow
colour.  Very  little  art is necessary for this operation.   They may
either be opened Avith  a lancet or a needle, and the  matter absorbed by a
little diy lint.    As the pustules are generally first ripe on the face it will
be proper to begin with opening these, and the  others in course as they
become ripe.   The pustules generally fill again, a second or even a third
time;  for Avhich cause the operation must be repeated, or rather continu-
ed as long as there is  any  considerable appearance  of matter in the pus-
 tules.  .,
   We  have reason to believe that this operation, rational as it is, has
 been neglected from a piece  of mistaken  tenderness in parents.   They
 believe  that it must  give great  pain to the poor child;  and  therefore
 would rather see it die than have it thus tortured.   This notion however
 is entirely Avithout  foundation.  I  have frequently opened the pustules
 when the patient did not see me, without his being in the least sensible
 of it; but suppose it were attended Avith a little pain, that is nothing in
 comparison to the advantages which arise from it.
   Opening the pustules uot  only prevents the resorption of the matter
 into the blood, but likewise takes off the tension of the skin and by that
 means greatly relieves the patient.   It likeivise tends to prevent the pit-
 ting, Avlnch is a matter of no small importance.   Acrid matter by lodging
 long iu the pustules, cannot  fail  to corrode the tender skin,  by which
 many  a handsome face becomes so deformed as hardly to   bear a resem-
 blance to the human figure.*

   *  Though this  operation can never do harm, yet it is only necessary when
 the  patient has a great  load of small-pox, or when the matter which they con-
 tain rs of sy thin and acrid a nature, that there is reason to apprehend bad con- 
166
OF   IKE  SMALL-POX.
    It is generally necessary, after the small-pox are gone off, to purge the
  patient.   If however the body has been open through the whole ccuix
  of the disease, or if butter-milk and other things of an open nature havt
  been drank freely after the height of  the  small-pox, purging  becomes
  less necessaiy;  but it ought never wholly to be neglected.
    For very young children, an infusion of senua and prunes with a little
  rhubarb, may be sAveetened Avith coarse sugar, and given in small quan-
  tities till it operates.   Those who are  farther advanced  must take me-
  dicines of a sharper nature.   For example, a child of five or six years
 of age may take eight or ten grains of finwaubarb in powder over night,
 and the same quantity  of jalap in powderrtext morning.   This  may be
 Avroughtoff Avith fresh brodi  or Avater-grucl, aud may be repeated three
 or four times, five  or  six  days intervening between each (lore. For
 children further advanced, and adults, the dose must be  increased in
 proportion to the age and constitution.*
    When imposthumes happen after the small-pox, which is not seldom
 the case, they must be  brought to  suppuration as  soon  as possible, by
 means  of ripening poultices:  aud Avhen they have been opened, or have
 broke of their own accord, the patient must be purged.   The Peruvian
 bark and a milk diet will likewise  be useful in this case.
   When a cough, a difficulty of breathing,  or other sj mptoms of a con-
 sumption, succeed to the small-pox, the patient must be  sent to a place
 Avhere  the air is good, and put  upon a  course of asses milk,  with such
 exercise as he can bear.  For further directions in this case, see the ar-
 ticle  Consumption.
                        ■ Of Inoculation.
   Though no disease, after it is formed, baffles the power  of medicine
 more effectually than the small-pox, yet more may be done before-hand
 to render this disease favourable than  any one we know,  as  almost all
 the danger from it may be prevented by inoculation.  This salutary in-
 vention has been known in Europe above half a century ; but, like most
 other useful discoveries, it has till of late made but slow progress.   It
 must  however be acknowledged, to the honour of this country,  that in-
 oculation met  with a more favourable reception here, than among' any of
 our neighbours.   It is still however far from being general, which we
 have  reason to fear will be the case, as long as the practice continues in
 the hands of the faculty.
   No discovery can be of general utility, Avhile the practice of it is kept
 iu the hands of  a feAV.  Had  the inoculation of the small-pox been in-
 troduced as a fashion, and  not as a medical discovery, or had it been
 practised by the same kind of operators here, as it is in those  countries
 from  whence we learned it, it had long ago  been universal.  The fears,
 the  jealousies,   the  prejudices, and  the  opposite  interests  of the
 faculty  are, and ever Avill be, the most effectual obstacles  to the pro-
 gress of any salutary discovery.  Heuce it is that the practice of inoc-
 culation never became in any measure general, even in  England, till

 sequences from its being too quickly resorbed, or taken up again into the mass
 of circulating humours.
  * I have of late  been accustomed, after the small-pox, to give one, two, tHfee,
four or five grains of calomel, according to tlie age of the patient, over night,
to work it off next morning with a suitable dose of jalap.  Or the jalap and
calomel may be mixed together, and given in the morning. 
OF THE  SMALL-POX.
167
uken up by men not bred to physic.  These have not only rendered
the practice more extensive, but likeAvise more safe, and by acting under
less restraint thau the regular practitioners,  have taught them that the
patient's greatest danger arose,  not from the Avant of care, but from the
i-xcess of it.
  They knoAv very little of the matter, who. impute the success of mo-
dern inoculators to any superior skill, either in preparmg the patient or
communicating the disease.  Some of them indeed, from a sordid desire
of engrossing the whole practice to themselves, pretend to have extraor-
dinary secrets or nostnims for .preparing  persons for inoculation, wrhich
never fail of success.  But this is only a pretence calculated to  blind
the ignorant  and  inattentive.   Common sense and prudence alone are
sufficient lioth in the choice of  the subject and management of the ope-
ration.   Whoever  is possessed  of these may perform this office for his
children whenever  he finds  it convenient, provided they be in  a good
state of health.
   This sentiment is not the result of theory, but of observation.  Though
few physicians have had more opportunities of trying inoculation  in all
its different forms,  so little appears to me  to depend on  those,  generally
reckoned important circumstances, of preparing the body, communicating
the infection by this or the other method,  Ac. that  for several years past
I have persuaded the parents or nurses to perform the ivhole themselves,
and have found that method followed with  equal success, while it is free
from any inconveniences that attend the other.*
  The small-pox may be communicated iu a great  variety of Avays with
nearly the same degree of safety and success.   In Turkey, from whence
Ave learned the practice, the women communicate the disease to children,
by opening a bit of the skin with a needle,. and putting into the Avound
a little matter taken from a ripe  pustule.  On the coast of Barbary they
pass a thread  Avet with the matter through the skin between the thumb
and fore-fiuger; and in some of the states of Barbary, inoculation is per-
formed by rubbing  in the variolous matter between the thumb  and fore-
finger, or on other  parts of the  body.  The practice  of communicating
the small-pox, by rubbing the variolous matter upon the skin,  has  been
long know n in many parts of Asia and Europe as well  as in  Barbary,
and has generally gone by  the name of buying ihe small-pox.
   The present method of  inoculating in Britain is to make  two or

  •  A critical situation, too often to be met with, first put me upon trying this
method.  A gentleman who had lost all his children except one son  by the na-
tural small-pox, was determined to have him  inoculated.  He told me his in-
tention, and tlesired I would persuade the mother and grandmother,  &c.  of its
propriety.  But that was impossible. They were not to be persuaded, and either
could not get the better of their fears, or were determined against conviction.
It was always a point with me not to perform the operation  without the consent
of the parties concerned.  I therefore advised the father, after giving his son a
dose or two of rhubarb, to go to a patient who had the small-pox ©f  a  good
kind, to open two or three of the pustules, taking up the matter with a little
cotton, and as soon as he came home to take his  son apart, and give his arm a
slight scratch with a  pin, afterwards to rub the place well with Uie cotton, and
take no farther notice of it.   All this he punctually performed: and at the usual
pcrkxl the small-pox made their appearance, which were of an exceeding good
kind, and so mild as not to confine the  boy an hour to his bed.  None of the
other relations knew but the  disease had come in the natural way, till the boy
was w<H. 
168
OF  THE  SMALL-POX.
three slanting incisions in the arm, so superficial as not to pierce quite
through the skin, with a lancet wet with fresh matter taken from a ripe
pustule;  afterwards  the  Avounds are closed up, and left Avithout auy
dressing.  Some make use of a lancet covered with dry matter; but this
is less certain, and  ought never  to be used unless  where fresh matter
cannot be obtained:  when this is the case, the matter ought to be moist-
ened by holding the lancet for some time in the steam of warm water.*
  Indeed if fresh matter be applied long enough to the skin, there is no
occasion for any wound at all.  Let a bit of thread,  about half an inch
long, wet with the matter,  be immediately^applied to the arm,  midway
between the shoulder and the elbow, and covered with  a piece of the
•ommon  sticking plaster, and kept on for eight or ten days.   This will
seldom fail to communicate the disease.  We mention this method, be-
cause many people are afraid of a Avound; and doubtless the more easily
the operation can be performed, it has the greater chance to become ge-
neral.  Some people imagine, that the discharge from^a Around lessens
the eruption; but there is no great stress to be laid upoii tliis notion ; be-
sides, deep Avounds often ulcerate, and become troublesome.
  We do not find that inoculation is at all considered as a medical ope-
ration in those countries from whence we learned it.  In Turkey it is
performed by the women,  and hi the East-Indies by the Brachniins or
priests.   In this country the custom is still  in its infancy; we make no
doubt, however, but  it  will soon  become so familiar, that parents will
think no more of inoculating their children, than at  present they do  of
giving them a purge.
  No set of  men have it so much in  their power to render the practice
of inoculation general as the clergy, the greatest opposition to it still
arising from some scruples of conscience, which  they alone can remove.
I would recommend  it to them not only  to endeavour to remove the re-
ligious objections which weak minds may have to this salutary practice,
but to enjoin It as a duty, and to point out the  danger of neglecting  to
make use of a mean  which Providence has put into our power, for saving
the lives of our offspring.   Surely such parents as  wilfully neglect the
means of saving their children's lives, are  as guilty as  those  who pu'
them to death.  I wish  this matter were duly weighed.  No one is more
ready to make allowance for human weakness and religious prejudices;
yet I cannot help recommending it, iu the Avarmest  manner, to parent',
to consider how great an injury they do  their children, by neglecting  te
give them this disease in the early period of life.
  The numerous  advantages arising from the inoculation of  the small-
pox have been pretty fully pointed out by»the  learned Dr. M'Kinzie,
in his History of Health.f  To those mentioned  by the Doctor we
  * Mr. Tronchin commupicates this disease by a little bit of thread dipt in
the matter, which he covers with a small blistering-plaster.  This method mar
no doubt be used with advantage in those cases where the patient is very much
alarmed at the sight of any cutting instrument.
  f " Many and great,"  says this humane author, " are the dangers attending
the natural infection, from all which the inoculation is quite secure.   The natu-
ral infection may invade weak or distempered bodies, by no means disposed Su-
its kindly reception.  It may attack them at a season of the year either violent-
ly hot or intensely cold.   It may be communicated from a sort  of small-po>:
impregnated wifh the utmost virulence.  Jt may lay hold  upon  people unex- 
OF  THE  SMALL-POX.                 169
 shall only add, that such as have not had the small-pox in the early pe-
 riod of life are not only rendered unhappy, but likew ise in a great mea-
 sure unfit for sustaining many of the most useful and important offices.
 Few people would chuse even to hire a servant who had not had the
 small-pox, far less to purchase a slave, who  had the chance of dying of
 this diease.  How could a physician or a surgeon, who had never had the
 small-pox himself, attend others under that malady ?   How  deplorable
 is the situation of females, who arrive at  mature age Avithout having had
 the small-pox!  A woman with child seldom survives this disease: and
 if an infant happens to be seized with the small-pox upon  the mother's
 breast, who has not had the disease herself, the scene must be distressing!
 Il she continue to suckle the child, it is at the peril of her  own  life;
 and if she Avean it, in all probability it will perish.   How often is the af-
 fectionate  mother forced to leave her house, and abandon her  children,
 at the very time Avhen her care is most necessaiy ?  Yet, should parental
 affection get the better of her fears, the consequences Avould ofen prove
 fatal.  I have known the tender mother and her sucking  infant laid in
 the same grave, both untimely  victims  to  this dreadful malady.   But
 these  are  scenes too shocking even to mention.  Let  parents who run
 away with their children to avoid the small-pox, or avIio refuse  to inocu-
 late them in infancy, consider to what deplorable situations they may be
 reduced by this mistaken tendern ess!
   As  the small-pox is now become an epidemical disease in most parts of
 the known world, no other choice remains but to render the malady as mild
 as  possible.   This is the only manner of extirpation  now left in our
 poAver; and though it may seem paradoxical, the artificial method of com-
 municating the disease, could it be rendered universal, would amount to
 nearly  the same thing as rooting it out.  It is a matter of small  conse-
 quence, whether a  disease be entirely extirpated, or rendered so mild as
 pectedly, when a dangerous sort is imprudently imported into amaratime place.
 It may surprise us soon after excesses committed in luxury, intemperance, or
 lewdness.  It may likewise seize on the innocent after indispensable watchings,
 hard labour, or necessary journies.  And is it a trivial advantage, that all these
 unhappy circumstances can be prevented by inoculation ? By inoculation num-
 bers are saved from deformity as well as from death.  In the natural small-pox,
 how often are the finest features, and the most beautiful complexions, misera-
 bly disfigured !   whereas inoculations rarely leaves any ugly marks  or scars,
 even where the number of pustules on the face has been very considerable, and
 the symptoms by no means favourable.    And many other grevious complaints
 that are frequently subsequent to the natural  sort, seldom follow the artificial.
 Does not inoculation also prevent those inexpressible terrors that perpetually
 harass persons who never had this disease, insomuch that when the small-pox
 is epidemical, entire  villages  arfe depopulated, markets ruined, and the face of
 distress spread over the whole country ?  From this terror it arises, that justice
 is frequently postponed, or discouraged, at sessions or assizes where the small-
 pox rages.  Witnesses and juries dare not appear : and by reason of the neces-
 sary absence of some gentlemen, our honourable and useful judges are not at-
 tended with that reverence and splendour due to their office  and merit.  Does
 not inoculation, in like manner, prevent our brave sailors from being seized with
 this distemper on ship-board, where they must quickly spread tlie infection
 among such of the crew who never had it before, and where they have scarce
 any chance  to escape, being half stifled with the closeness of their cabins, and
 but very indifferently nursed ?  Lastly, with  regard to the soldiery,  the misi-
ries attending these poor creatures, whan attacked by the small-pox on a march,
are inconceivable, without attendance, wiUiout lodgings, without any accommo-
dations j so that one of three commonly perishes."
                                 oo 
170
OF THE  SMALL-POX.
neither to destroy life nor  hurt  the  constitution; but that  this may be
done by inoculaion, does not now admit of a doubt. The numbers who die
under inoculation hardly deserve to be named.  In the natural way, one
in four or five generally dies; but by inoculation not one of a thousand.
Nay, some can boast of having inoculated ten thousand  without the loss
of a single patient.
   I have  often wished to see some plan established for rendering tin- sa-
lutary practice universal; but am afraid I shall never be so happy. The
difficulties indeed are-many; yet the thing is by no means impracticable.
The aim is great: no less than saving the lives of one fourth part of man-
kind.  What ought not to  be attempted in order to accomplish so desira-
ble an end ?
   The first step towards rendering the practice universal, must be to re-
.move the religious prejudices  against  it.   This, as already observed.
can only  be done by the clergy.  They must not only recommend it as
a duty to others,  but likewise practise it on their own children.  Exam-
ple will ever have more influence than precept.
   The next thing requisite is to put it in the power of all.  For this pur-
pose we  Avould recommend it to the faculty to inoculate the children of
the poor gratis.   It his hard that so useful a part of mankind should, by
their poverty, be excluded from such a benefit.
   Should this fail, it is surely in the power of any state to render the
practice general, at least as far as their dominion extends.  We do  not
mean that it ought to be enforced by law.   The best way to promote il
would be to employ a sufficient number of operators at the public ex-
pense to inoculate the children of the poor.   This would only be ne-
cessary till  the practice became general;  afterwards  custom, the strong-
est of all laws, would  oblige every individual to inoculate his children
 to prevent  reflections.
   It may be objected to this scheme, that the  poor would refuse to em-
ploy the inoculators; this difficulty is easily removed. A small premium
 to enable mothers to attend their children while under the disease, would
be a sufficient  inducement; besides, the success attending the operation
 would soon banish all objections  to it.  Even considerations 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 useful,
 they are snatched away  by  this  malady, to the great loss of their pa-
 rents, and detriment of the public.
    The British legislature  has of late years shewn gieat attention to  the
 preservation of infant lives, by supporting the foundling-hospital, Ax.
 But we will venture to say, if one tenth-part of the sums laid out in sup-
 porting that institution,  had been bestowed towards promoting the prac-
 tice of inoculation of the  small-pox among the poor,  that not only more
 useful lives had been saved, but  the practice,  ere now, rendered quite
 universal in this island.   It is  not to be imagined what effect example
 and a little money will have upon the poor;  yet, if left to themselves,
 they would go on for ever  in the old Avay, without  thinking of any  im-
 provement.  We only mean this as a hint to  the humane and  public-
 spirited.   Should such a scheme be approved, a proper plan might easi-
 ly be laid down for the execution of it.
    But as the public plans  are very difficult to bring about, and often, by
 the selfish  vieAvs and  misconduct of those entrusted  with  the execution
 of them, fail  of  answering the  noble purpose for which they Avere  de- 
OF THE  SMALL-POX.
171
signed; Ave shall therefore point out some other method by which the
benefits of inoculation may be extended to the poor.
   There is no doubt but  inoculators will daily become more numerous.
We would therefore have eveiy parish in Britain to allow' one of them a
small annual salary for inoculating all the children of the parish at a pro-
per age.  This  might be done at a very trifling expense, and it would
enable every one to enjoy the benefit of this salutary invention.
   Two things chiefly operate to prevent the progress of inoculation.
The one is a wish to put the  evil day as far off as possible.  This is a
principle in our nature ; and  as inoculation seems rather to be anticipa-
ting a future evil, it is no Avonder mankind are so averse to it.  But this
objection is  sufficiently  answered by the success.  Who in his senses
would not prefer a lesser evil to-day to a greater to-morroAV, provided
they were equally certain ?
   The other obstacle U  the  fear of reflections.   This has a very great
weight with the bulk of mankind.   Should the child die, they think the
world Avoidd blame  them.   This they cannot bear.   Here lies the diffi-
culty ;  and, till that be  removed, inoculation will make but small  pro-'
gress.  Nothing however can remove it but custom.   Make the practice
fashionable, and all objections will soon vanish.  It is fashionalone that
has lead the multitude since the beginning of the world, and will lead them
to the end.   We must therefore call upon the more enlightened part of
mankind to set a pattern to the rest.   Their example, though it may for
some time meet with opposition, will at length prevail.
   I am aware of an objection  to this  practice  from the  expeuse with
Avhich it may be attended:  this is easily obviated.  We do not mean that
every parish ought to employ a Sutton or a Dimsdale as inoculators.
These have by their success already recommended themselves to crowned
heads,  and are beyond the vulgar reach; but have not others an equal
chance to succeed ?   They certainly have.   Let them make the same
trial, and the difficulties  will soon vanish.  There is not a parish,  and
hardly a village in Britain, destitute  of some Avho can bleed.  But this
is a far more difficult operation, and requires both more skill and dexte-
rily than inoculation.
   The persons  to whom Ave would chiefly recommend the performance
of this operation are the clergy.   Most of them know  something of me-
dicine.   Almost all of them bleed, and can order a purge, which are all
the qualifications necessary for the practice of inoculation.   The priests
among the less enlightened Indians perform this office, and why should a
Christian teacher think himself above it ?  Surely the bodies of men, as
Avell as their souls, merit a part of the pastor's care; at least the greatest
teacher who ever appeared among men, seems to have thought so.
   Should all other methods  fail, ive would recommend it  to parents to
perform the operation themselves.  Let them take any method  of com-
municating the disease they  please; provided the subjects be healthy,
and of a proper age, they Avill seldom fail to succeed  to their Avish. I
have known many instances  even of mothers performing the operation,
mid never so much as heard of one bad consequence.   A planter in one
of the Weft-India islands is said to have inoculated, Avith his owrn hand,
in one year, three hundred of his slaves, who, notwithstanding the warmth
of the climate, and other  unfav otu able circumstances, all did well.  Com-
mon mechanics have often, to my knowledge, performed the operation 
1"2                OF  THE  SMALL-POX.
Avith as good success as physicians.  We do not hoAvever mean to dis-
courage those who have it in their power, from employing people of skill
to inoculate their children, and attend them while under the disease; but
only to shew, that where such  cannot be  had,  the operation ought uot
upon that account to be neglected.
   Instead of  multiplying arguments to recommend this practice,  I shall
just beg  leave  to mention the method Avhich I  took with my own son,
then an only child.  After giving him tAvo gentle purges, I ordered the
nurse to take a bit of thread which had been previously wet with fresh
matter from a pock, and to lay it upon his arm,  covering it with a piece
of sticking-plaster.   This remained on six or seven days, till it was rub-
bed off by accident.   At the usual time the small-pox  made their ap-
pearance, and were  exceedingly favourable.  Surely this, which is all
that is generally necessary, may be done without any skill in medicine.
   We have  been the more full on  this subject because  the benefits  of
inoculation cannot be extended to society by any other means than ma-
king the practice general.  While it is confined to a few, it must prove
hurtful to the Avhole.  By means of it the contagion is  spread, and is
communicated to many Avho might otherAvise never have had the disease.
Accordingly it is found that nearly the same number die of the small-
pox noAV as before inoculation was introduced;  and this important disco-
very, by which alone more lives might be saved than by all the endea-
vours of the Faculty, is in a great measure lost by its benefits not being
extended to the Avhole community.*
   The spring and autumn have been usually reckoned the most proper
seasons for inoculation, on account of the weather being then most tem-
perate ; but it ought to be considered that these are  generally the most
unhealthy seasons of the whole year.  Undoubtedly the best preparation
for the disease is a previous good state of health.   I have always obser-
ved that children in particular are more sickly towards the end of spring
and autumn, than at any  other time of the year.  On this account,  as
well as for the advantage of cool air, I Avould propose winter as the most
proper season for inoculation; though on every other consideration, the
spring would seem to be preferable.
   The most proper age for inoculation is betAveen three and  five.  Many
approve of inoculating on the breast, and Avhere no circumstances forbid
this practice, I have no objection to it.   Children, hoAvever, are more
liable  to convulsions at this time than afterwards; besides, the anxiety of
the mother or nurse, should the child be in danger, would not fail  te
heighten it by spoiling the milk.
   Children who have constitutional  diseases, must  nevertheless be ino-
culated.    It Avill often mend the habit of body;  but  ought to be perform-
ed at a time when they are most healthy.   Accidental  diseases should
always be removed before inoculation.
   It  is generally thought necessaiy to regulate the diet for some time
before the disease  be  communicated.   In  children, however, great
alteration in diet is seldom  necessaiy, their food  being commonly of
  * By a well-laid plan for extending inoculation, more lives might be saved at
a small expense, than are at present preserved by all the hospitals in England,
which cost the public such an amazing sum. 
OF THE COW-POX, &C.                173
the most simple and wholesome kind, as milk, water-pap, weak broths,
bread, light pudding, mild roots, and Avhite meats.
  But children who have bceu accustomed to  a richer diet, who are of
a gross habit, or bound with bad humours, ought to be put upon a spare
diet before they are inoculated.   Their food should be of a light cool-
ing nature, and their drink w hey,  butter-milk, and such like.
  We  would  recommend  no other medicinal preparation but two or
three mild purges, Avhich ought to  be suited to the age  and strength of
the patient.  The success of inoculators does not depend on  the pre-
paration of their patients, but on then management of them while under
the disease.  Their constant care is to keep them cool, and their bodies
gently open, by which means the fever  is kept Ioav, and tlie eruption
greatly lessened.   The danger is seldom great when the pustules ar% few;
and  their number is generally in proportion to the fever Avhich precedes
and  attends the eruption.   Hence the chief secret of inoculation consists
in regulating the eruptive fever, which generally may be kept sufficiently
low  by the methods mentioned above.
   The regimen during the disease is in all respects the same as under
the natural small-pox.  The patient must be  kept cool,  his diet should
be light, and his drink weak and diluting, &c. Should any bad symp-
toms appear, which is seldom the  case, they must be treated in the same
way as directed in the natural small-pox.  Purging is not less necessary
after the small-pox by inoculation than in the natural way, and ought by
wo means to be neglected.
                       CHAP.  XXV. §

      OF THE  COW-POX,  AND ITS INOCULATION.

       J.N the preceding chapter,  the  method of inoculating for the
small-pox has been retained, as  having hitherto been successfully prac-
tised during a number of years; but, by a fortunate discovery, it is now
found, that the infection may be introduced in a manner equally suc-
cessful,  and  the  disease rendered still less considerable  than  by the
former kind of inoculation.  This is done by inoculating with matter
either taken from a cow  affected with the disease, or from some person
Avho had received the infection originally derived from that animal.  It
may be proper here to give a general account of the manner in Avhich so
surprising a discovery has been made.
   In several parts of England, where cows are kept for  the purposes
of the dairy, a peculiar eruptive disease has been occasionally observed
among the herd, and Avhich affects iu particular the udders and teats of
those animals.  It has, therefore, pretty generally obtained the name of
the Cow-pox, (vaccinia, or vacciola.)
   Till within these last two years, the knowledge  of this distemper has
been chiefly confined to  the people employed in the dairies, and to far-
riers  and coAV-doctors in the neighbourhood;  but,  by the latter, it ap-
pears to have been observed with particular accuracy, and they have
even employed means for its removal.
   It  farther appears, that Avherever the existeoce of this disease Avas- 
   Lt%                  OF  THE  COW-POX,

  known, the fact Avas likewise ascertained, that the disorder was commu-
  nicated by the touch to the milkers who handle the teats of the diseased
  cows, and from them again is  often  spread through a numerous Ik rd ;
  that, when affecting the human species, it is not merely confined to the
  local disease of the hands and arms, but also occasions a general indispo-
  sition, often severe, but never fatal, which runs  a regular course; and
  that the person who has once undergone the disease  so communicated is
  ever after secure against the infection of the small-pox, either in the na-
  tural Avay by contagion, or by inoculation.
     AH these circumstances, however, though known, as we are told, from
  time immemorial in certain parts of the kingdom, still remained in obscu-
  rity till within these three years, when Dr. Jenner, of Berkley, in Glou-
  cestershire, conceived  the important  idea  of employing the cow-pox  to
  annihilate  the  small-pox, and published several interesting particulars
i jp concerning this disease, which works have ooav made it known to the
  public in general.
     It appears, from observations made by those who are most conversant
  with cows, that several causes  may produce sores upon the udder  aud
  teats of this animal, especially such as excite any irritation in those parts,
  during the season when the cows abound most in milk.  The stinging  of
  flies, or rough handling while milking, aud other such external irritations,
  will often occasion small Avhite  blisters on  the parts; Avhich, however,
  never extend more than skin-deep, and  are generally easy of cure.
     Another, and more serious disorder in those parts, is said to be some-
  times produced by suffering a cow, while in full  milking, to remain for a
  day or two unmilked; in order to distend the udder when naturally small.
   This, it appears, is a common  artifice  practised at the fairs and cattle-
  markets, with the view of increasing the price of the cow, a large udder
  being reckoned an important circumstance in the value of that animal.
  By this cruel and unwarrantable artifice, the vessels that supply the ud-
  der are kept for an unusual length of time in  a state of great distention.
  Avhich terminates frequently in a violent inflammation of those parts, suc-
  ceeded  by large  eruptions  upon  the  teats and udder that sometimes
  leave deep and troublesome sores.   The matter discharged from these
  ulcers will communicate a disorder, like the other, into the hands of the
  milkers, when  the skin is broken  in any part; and  often produces foul
1  and extensive ulcers, which sometimes occasion pustules on the arms and
  shoulders, and prove tedious and difficult of cure.
     The genuine cow-pox, hoAvever, is a distinct disease from those which
  have been  just mentioned.   It generally makes  its appearance in the
  spring, and shoAvs itself in irregular pustules on the teals or nipples ol
  the udder.   They are at first of palish blue, or rather a livid colour, and
  contain a thin, wateiy, and sharp fluid.   The surrounding parts are in-
  flamed and hardened.   These pustules, it seems are very apt to degene-
  ra te into deep corroding ulcers,  which, as the cow-doctors term it, eat in-
  to the flesh, and constantly discharge a matter, ivhich  commonly iucr«ise
  in thickness, aud hardens at last into a scab.  Noav and then the cow be-
  comes evidently indisposed, loses her appetite, and gives less milk than
  usual; but it often happens, that the disorder, though severe, is entirely
  locail.
    It appears  that the  cow-pox never proves fatal to cows, nor i~  it
  infectious  in the usual manner of contagious distempers, but can only 
AND  ITS INOCULATION.             175
he communicated to them or to the human species by  actually touching
the matter Avhich proceeds from the sores.  Hence, the cows which are
not in milk escape the disease entirely, though constantly in the same
field with those  that are highly infected; audit seems to be only from
the circumstance of the milker handling the teats of the sound cows, after
touching the diseased, that the cow-pox ever spreads among the herd.
   We are informed that the cow-pox is familiar to the inhabitants of the
hundred of Berkley in Gloucestershire.  It has likewise been discover-
ed in various  parts of the counties of Wilts, Somerset, Buckingham,
Devon, aud Hants:  in a few places of Suffolk and Norfolk, where it is
sometimes called the pap-pox; and in Leicestershire and Staffordshire.
Nor is  it unfrequeut in the very large milk-farms contiguous to the me-
tropolis on the  Middlesex side.   It is here obterved generally to  attack
first some cow newly introduced to the herd, and is  supposed to origi-
nate  in a sudden change from a poor to a very rich and partly unnatural
diet which it is the practice to use, in order to bring the yield of milk to
 its highest point.
    \ccording to  Dr. Jcnner, the  origin of the cow-pox is ascribed to a
 derivation from  the horse.   The horse is well known  to be subject to  an
 inflammation and swelling in the heel, called the grease, from which is
 discharged a very sharp matter, capable of producing  iritation  and ul-
 cers in any other animal to the surface of which it is applied.   It is sup-
 posed that this matter is conveyed to the cow by the men-servants of the
 farm, who, in several of the dairy counties, assist  iu milking.   One of
 there having dressed the  horse, goes immediately to his occupation ot
 milkin*; and  having upon his hand some particles of the discharge from
 the grease,  he,  of course,  applies it to the udder of the cow, where, if
 the  animal  be  iu a state for receiving the  infection,  it produces that
 specific change in those parts  which gives rise to  the disease of the
 cow-pox.                                     .  .
    The origin here ascribed to this disorder is principally founded on the
  circumstance, that wherever the cow-pox appears, the grease is generally
  found to have preceded it: and the opinion of the  propagation of  the
  disease from the horse to the cow is likewise current in some of the dairy
  counties w here the disease is known.  But this opinion requires to be
  ascertained by  further observations.
    This conjecture, respecting the origin of the cow-pox, was no sooner
  started by Dr. Jenner, than attempts were made repeatedly, but without
  success, to introduce the disease in the nipple of the cow by direct ino-
  culation of the recent matter of the grease from the horse s heel.   1 lie
   consequence  of this experiment, when it took any effect, was a slight in-
   flammation, and the production of a small pustule or pimple,  but which
   disappeared in a few days, without exciting the specific disease ot the
   pox   But the failure of these  experiments by no means overthrows the
   opinion for the ascertainment of which they were made; since it  is ad-
   mitted that a certain predisposition in the constitution of the cow to  re-
   ceive the disease is also requisite for its production.
     It is remarked, that the  matter discharged from the sores in the horse s
   heel is likewise found to occasion, at times, very troublesome ulcers on
   the hands of the men that dress them, attended with a very considerable
   decree of  indisposition; both of which appear to be full as severe as in
   the "enuinc cow-pox. aud  in many points to resemble this latter disorder. 
176
OF THE  COW-POX,
But the person who has been infected by the horse is not rendered there-
by entirely secure from afterwards receiving the small-pox.
   The pustular sores on the udder and teats of the cow, that constitute
the genuine cow-pox, whatever be the way  iu which they are produced,
are found by experience to  possess the  power of  infecting the human
species, when any part of the body, where the skin is broken, or natural-
ly thin, comes into actual contact with the matter which they discharge.
Hence it is, that with the milkers, the hands are the  parts that acquire
this disorder accidentally, and it there exhibits the following appearan-
ces : Inflamed spots  begin to appear on the hands, wrists, and especially
the joints and tips of  the fingers; and  these  spots at first resemble the
small blisters of a burn, but quickly  proceed to suppuration.   The pus-
tule  is quite circular, depressed in the middle, and of a blueish colour,
and is surrounded with a considerable redness.   The  blue colour which
the pustule almost invariably assumes, Avhen the disorder is communicated
directly from the cow, is one of the most  characteristic marks by Avhich
the cow-pox may be distinguished from other diseases which the milkers
are likeAvise liable to receive from the coav.   The matter of the pustule
is at first thin and colourless; but, as the disorder advances, it becomes
yellower and more purulent.   In a few days from  the  first eruption, a
tenderness and sAvelling of the glands in the arm-pit come on, and soon
after the whole constitution becomes disordered,  the  pulse is  increased
in quickness,  shivering succeed, Avith a sense of weariness, and  pains
about the loins, vomiting, head-ach, and sometimes  a  slight  degree of
delirium.
   These symptoms continue with more or less violence from one day to
three or four, and,  when they  abate, they leave sores  about the hands
which heal very slowly; resembling, in this respect,  the ulcers on the
nipple of the cow, from which they derive  their origin.
   It is to be observed, that the cow-pox  eruption, though very severe
on the hands,  and occasioning  much general illness,  never produces
a  crop  of pustules over distant parts of the body, arising spontaneous-
ly, as  in the  small-pox.  It often happens, however, that pustules are
formed in various parts which accidentally  come in contact with the dis-
eased hands, as on  the nostrils, lips, and  other parts of the face where
the skin is thin; or sometimes  on the forehead,  when the milker leans
Avith that part upon the udder  of  an  infected  cow.  \Frora this ac-
count it appears,  that  the cow-pox  as it affects the milkers,  or what
may be termed the  casual  coAV-pox in the human species, is often a
severe disorder, sometimes confining the patient to his bed during the
period of fever, and generally leaving troublesome sores, but it has never
been known to prove fatal;  nor are  these sores, if properly attended to,
followed with  any lasting injury of the  affected parts,  though they
sometimes leave scars  for life.
   In consequence of the close investigation which this disorder has late-
ly undergone, the following facts may be considered as fully ascertaiued
by the fairest experiments and most  accurate observations:
   First.—The cow-pox,  in its  natural state, or Avhen  propagated im-
mediately from an infected cow, to the hands of the milkers, is  capa-
ble of affecting the human  species from one to auother repeatedly to
an indefinitive number of times; but after the first  attack, it is  gene-
rally much  milder in its symptoms, and in  particular it  is much less 
AND  ITS  INOCULATION.
177
hable to produce the fever and general indisposition Avhich ahvays attend
the fust infection.  There are instances, however, where the second and
even third attack have been as severe in every respect as the first; but
these are very rare.
   Secondly.—The small-pox in a considerable degree secures a person
from the infection of the cow-pox; and in this respect appears to act in a
manner very similar to a previous attack of the latter disease; that  is, to
confine its operation to the forming of local pustules, but unattended with
general fever.   Hence it is, that w here all the servants of the dairy take
the infection from the cows, those of them who have previously undergone
the  small-pox are often the only persons among them able to go through
the usual  Avork.
   Thirdly.—The coAv-pox, in its genuine state, when it has been accom-
panied with general fever, and has run its regular course, ever after pre--
serves the person who has been infected with it from receiving the infec-
tion of the small-pox.  This assertion is, however, to be taken with exactly
the  same  limitations as that of re-infection with  the small-pox preventing a
second attack of the same disease.   No previous infection will entirely
counteract the local  effect on the arm, produced by the insertion of vario-
lous maUer in common inoculation ;  this may in a few cases go so far as
to induce a degree of general fever, slight indeed, but perhaps equal to
that of the mildest indisposition caused by a first infection with this disor<-
der.  By the  inoculation of either disease, however, the  small-pox  is
equally and completely disarmed of its virulence against any subsequent
attack, Avhich is  the circumstance that so much distinguishes and so strong-
ly recommends this  operation.
   Fourthly.—A comparison of the two diseases in respect of the mildness
of their symptoms, and the hazard to life which they may occasion, will
show a veiy great advantage in favour of the coiv-pox.  Compared Avith
the natural small-pox, the natural or casual cow-pox is both milder and
infinitely  more safe; no instance having ever been known of a fatal event
in the cow-pox,  so far as it affects the people employed  in the dairies.
When both diseases are introduced by artificial inoculation,  they are
each rendered much less severe;  and here too the superiority of the coav-
pox as a safer and milder disease is extremely evident.
   Fifthly.—The cow-pox, even in its most virulent state, is not commu-
nicable by the air, nor by any other of the ordinary means of contagion, but
can  only be propagated, by the actual contact of matter of a pustule from
the  cow-pox with some part of the body of the person who receives it.  It
is not yet ascertaiued, Avhether in all cases an  insertion of specific infec-
tious matter under the skin be necessary; but in its most active state, as it
is when formed in the cow's udder,  the skin which covers the lips and
nostrils readily receives the infection without being broken.   In this res-
pect the contagion of the  cow-pox seems to equal that of the small-pox in
activity;  but the striking difference between the two diseases in the cow-
pox not being communicated by tlie air, &c. is a circumstance fully and
satisfactorily ascertained.  In the  dairy-farms, infected servants sleep
with the uninfected :  infants at the breast have remained with their mo-
thers Avlnlst only one of the two have had the disorder upon them;  and in
no instance has the disease of one been communicated by contagion to the
other.   It is this circumstance which gives the cow-pox its decided su-
periority ; since, by adopting  this disease instead of the small-pox, all the
A                                23 
178                OF  THE COW-POX,  &C.

dread and all the mischief occasioned by the contagion of the latter are
entirely removed.
  The inoculated cow-pox appears to have almost as great a superiority
in point of mildness and security over the ordinary inoculation of the
small-pox, as this has over the natural  small-pox;  so that the same pre-
cautions which Avould be highly requisite in communicating the latter be-
comes less so where the disorder is to be introduced by inoculation ; aud,
still less where the cow-pox is substituted in the room of the other.
  With regard to the  method of performing Inoculation  in the Cow-pox,
Dr. Woodville, whose industry, judgment, and accuracy, appear to great
advantage  in  his observations on this subject, advises  " that the lancet
should be  held nearly at a right angle ivith the skin, in order that the in-
fectious fluid may gravitate to the point of the instrument, which, in this
direction, should be  made to scratch the cuticle repeatedly, until it reach
the true skin and become tinged with blood."
   The act of inoculation having been performed, the first proof of its suc-
cess is  a small inflamed spot at the part where the puncture has been
made, which is very distinguishable about the third day.   This continue*
to increase in size, becomes hard, and a small circular tumour is formed,
rising a little  above  the skin.   About the sixth day the centre of the tu-
mour shows a discoloured speck,  oAving  to the formation of a small quanti-
ty  of fluid; and this continues to increase, and the pustule or pimple to
fill, till about the tenth day.
   After the eighth day, Avhen the pustule is fully formed, the effects on
the constitution begin to show themselves; the general indisposition being
commonly preceded by pain at the pustule and in the arm-pit, followed by
head-ach, some shivering, loss of appetite, pain in the limbs, and a fever-
ish increase  of the  pulse.   These continue, with more or less violence,
for one or tAvo days, and always abate of their own accord, without leav-
ing any unpleasant consequence behind them.
   During, or a little after, the  general indisposition, the pustule in the
arm,  which  had been advancing in a  regular manner, becomes sur-
rounded with  a broad circular  inflamed margin, and this is a sign that
the body in general is affected.  After this period, the fluid in the pus-
tule gradually dries up, the surrounding redness  becomes fainter, and
in a day or two vanishes imperceptibly;  whilst the pustule no longer in-
creases in extent, but on its  surface a  hard  thick scab  of a brown co-
lour  is formed, which, if not pulled off, remains for nearly a fortnight;
till at length it falls  off, leaving the skin beneath perfectly sound and un-
injured.
   It  is a circumstance of great importance in favour of this method of
inoculation, that though some attention in choosing the  matter for inocu-
lation, and performing this slight operation in such a manner as to insure
success, be requisite, very little medical treatment is  necessary in or-
der to conduct the patient through it Avith perfect safety.   In most cases
it is attended with so little fever as scarcely to be detected by an attentive
 observer.
   To conclude this account of the coAV-pox Avith a repetition of  the
circumstances which gives it a decided superiority over the small-pox,
Dr.  Woodville affirms (and his authority  is unquestionable)  that  of
all the patients whom he inoculated with  the variolous matter, after. 
OF  THE  MEASLES.
179
they had passed  through the cow-pox, amounting  to upirards of four
hundred, not one was affected with the small-pox, though purposely and
repeatedly exposed to the infection of  the disease;  and what is not less
extraordinary, nearly a fourth part of this number were so slightly  af-
fected Avitii the cow-pox, that it neither produced any perceptible indis-
position, nor pustules.
  From the beginning  of the world, the coav has, in all countries, been
esteemed a valuable animal.  Besides cultivating the ground, which her
species performs, she supplies us with  an aliment of her own preparing,
the most wholesome as  well as nourishing  in nature; but never be-
fore was it known, except, as appears, in some particular districts in Eng-
land,  that, even from  a disease to which she is liable, she can likewise
be further useful, in preserving us from one of the most fatal calamities
that ever infested human kind.
                        CHAP.  XXVI.

                      OF  THE MEASLES.

           JL HE measles appeared in Europe about the same time with
the small-pox, and  have a great affinity to that disease.   They both
came from  the  same quarter of the world, are both infectious, and
seldom attack the same person more than once.  The measles are most
common in the spring season, and generally disappear in summer.  The
disease itself, Avhen properly managed, seldom proves fatal; but its con-
sequences are often very troublesome.
   CAUSE.—This disease, like the small-pox, proceeds from infectionj
and is more or less dangerous according  to the constitution of the patient,
the season of the year, the climate, &c.
   SYMPTOMS.—The measles, like other fevers, are preceded by al-
ternate fits of heat and cold, with sickness and loss of appetite.  The
tongue is ivhite,  but generally moist.   There is a short cough, heaviness
of the head and eyes, drowsiness, and a running at the nose.   Sometimes
indeed the  cough  does  not  come  before the eruption has appeared.
There is an inflammation and heat in the eyes, accompanied with a de-
fluxion of sharp rheum, and great acuteness of sensation, so that they
cannot bear the  light Avithout pain.  The eye-lids frequently sivell so as
occasion blindness.   The patient generally complains of his throat; and
a vomiting or looseness often precedes the eruption.   The stools in child-
ren are commonly greenish ; they complain  of an itching of  the skin,
and are remarkably peevish.   Bleeding at the nose is common, both be-
fore and in the progress of the disease.
   About the fourth day, small spots resembling flea-bites, appear, first upon
the face, then upon the breast, and aftenvards on the extremities .• these
may be distinguihed from the small-pox  by their scarcely rising above
the skin.   The fever, cough, and difficulty of breathing, instead of being
removed by the  eruption as in the small-pox,  are rather increased; but
the vomiting generally ceases.
   On  the  sixth  or seventh  day from  the  time  of sickening, the
measles begin to turn pale on the face,  and afterwards upon the body; 
lao
OF  THE MEASLES.
eo that by the ninth day they entirely disappear.   The fever, however,
and  difficulty of breathing often continue, and especially if the patient
Las been kept upon too  hot a regimen.  Petcchise, or purple spots, may
likewise be occasioned by this error.
  A violent looseness sometimes succeeds the measles, in which case the
patient's life is in imminent danger.
  Such as die of the measles, generally expire about the ninth day from
the invasion, and are commonly carried off by a  peripneumony, or  in-
flammation of the lungs.
  The most favourable symptoms are a moderate looseness, a moist skin,
aud a plentiful discharge of urine.
  When the eruption  suddenly falls in, and the patient is seized w ith a
delirium, he is iu the greatest danger.   If the measles turn too soon of a
pale colour, it is an unfavourable symptom, as are also great weakness,
vomiting, restlessness,  and  difficulty of swalloAving.  Purple or black
spots appearing among the measles are very unfavourable.  When a con-
tinual cough,  with hoarseness, succeeds the  disease, there is reason to
suspect an approaching consumption of the lungs.
  Our business in this disease is to assist  nature, by proper cordials,
in throwing out the eruption, if her efforts be too languid;  but ivhen
they are  too violent  they must  be  restrained  by evacuations, and
cool diluting liquors, &c.   We ought likewise to  endeavour to appease
the most urgent symptoms, as  the cough, restlessness, and difficulty of
breathing.
  REGIMEN.—The cool regimen is necessaiy here as well as in the
small-pox.   The  food  too must be light, and the drink diluting.  Acids,
however, do not answer so  well in the measles as in the small-pox, as
they tend to exasperate the cough.   Small beer likeAvise,though a good
drink in the small-pox, is here improper.  The most suitable liquors are
decoctions of liquorice with marsh-mallow roots and sarsaparella, infusions
of linseed, or of the flowers of elder, balm tea, clarified whey, barley-
water,  and such like.   These, if the patient is costive, may be sweeten-
ed Avith honey; or, if that should disagree, with the stomach, a little ma-
na may occasionally be added to them.
  MEDICINE.—The measles being an inflammatory disease, Avithout
any critical discharge of matter, as in the small-pox, bleeding is common-
ly necessaiy, especially when the fever  runs high, with difficulty of
breathing, and great oppression of the breast.  But if the disease be of
a mild kind, bleeding may be omitted.*
  Bathing the feet and legs  frequently iu lukeAvarm water, both tends to
abate the violence of the fever, and to promote the eruption.
  The patient is often greatly relieved by vomiting.   When there is a
tendency tlrs Avay, it ought to be  promoted by drinking lukewarm wa-
ter, or weak camomile tea.
  When the cough is very troublesome, Avith dryness of the throat, and
difficulty of breathing,  the patient may hold  lib head over the steam of
warm water, and draw the steam iuto his lungs.
  He may likewise lick a  little spermaceti  and sugar candy pounded
  * I do not know any disease wherein bleeding is more necessaiy than in the
measles, especially when the fever runs high : in this case I have always found
it relieve the patient 
OF THE  MEASLES.                  181
together; or take now aud  then a spoonful of the oil of sweet almonds,
with sugar candy dissolved in it.   These will soften the throat,  and re-
lieve the tickling cough.
  If at the turn of  the  disease the fever assumes neAV vigour, and there
appears great danger of suffocation, the patient  must be bled  according
to his strength, and  blistering-plasters applied, with a view to prevent the
load from  being throAvn on  the lungs, where  if an  inflammation  should
fix  itself, the patient's life will be in imminent danger.
  In case the measles should suddenly disappear,  it will be necessary to
pursue the same method Avhich we have  recommended when the small-
pox recede.   The patient  must  be supported  Avith wine and cordials.
Blistering  plasters must be applied to the legs and arms, and the body
rubbed all over with warm flannels.  Warm  poultices  may likewise be
applied  to the feet and palms of  the hands.
  When purple or black spots appear, the patient's drink should be sharp-
ened with  spirits of vitriol; and if the  putrid symptoms increase, the
Peruvian bark  must be administered in the same manner as directed in
the small-pox.
   Opiates are sometimes necessary, but should never be given except in
cases of extreme restlessness, a violent looseness, or when the cough is
very troublesome.   For children, the  6yrup  of  poppies is sufficient.  A
tea spoonful or two may be occasionally given according to the patient's
age, or  the violence of the symptoms.
   After the  measles are gone off, the  patient ought to be purged.  This
may be conducted  in the same manner as directed in the small-pox.
   If a violent looseness succeeds the measles,  it may be checked by
 taking for some days a gentle  dose of rhubarb  in the morning,  and an
opiate over night;  but if these do not remove it, bleeding will seldom
fail to have that effect.
   Patients recovering  after the measles should  be careful what they eat
 or drink.   Their  food for some time ought to be light, and  in small
quantities, and their drink diluting, and rather of an opening nature, as but-
 ter-milk, whey, and such like.  They ought also to beware of exposing
 themselves too soon to the cold air, least a suffocating cartarrh, an asthma,
 or a consumption of the lungs, should ensue.
    Should  a cough, w ith difficulty of  breathing, and other symptoms ot'
 a consumption, remain after the measles, small  quantities of blood may
 be  frequently let at proper intervals, as the patient's strength and consti-
tution wUl permit.   He ought likewise to drink asses milk, to remove to
 a free air, if in a large town, and to ride daily  on horseback.  He must
 keep close to a  diet consisting of milk and vegetables ;  and lastly, if these
 do not succeed, let  him remove to a warmer climate.*

   * Attempts have been made to communicate the measles, as  well as the
 small-pox,  by inoculation, and we make no doubt but in time the practice may
 succeed.  Dr. Home of  Edinburgh, says, he communicated the disease by the
 blood.  Others have tried this method, and have not found it succeed.   Some
 think the disease would be more certainly communicated by rubbing the skin
 of the patient who has the measles with cotton, and afterwards applying the cot-
 ton to a wound as in  the small-pox ; while others recommend a bit of flannel
 which had been applied to the patient's skin, all the time of the disease, to be
 afterwards laid upon the arm or leg of the person to whom the infection is to be
 communicated.  There is no doubt  but this disease, as well as the smallpox,
 m:ty be communicated various ways; the most probable, however, is eitherfroia 
182
                 OF  THE SCARLET  FEVER.

   THE scarlet fever is so called from the colour of the patient's skin,
which appears as if it Avere tinged with red wine.  It happens at  any
season of the year, but is most  common towards the end of summer; at
which time it often seizes whole families; children and young persons
are most subject to it.
  It begins  like other fevers, with coldness and shivering,  Avithout any
violent sickness.   Afterwards the skin is covered with red spots,  which
are broader, more florid, and less uniform than the measles.   They con-
tinue two or three days, and then disappear; after Avhich  the cuticle,or
scarf-skin, falls off.
   There is  seldom any occasion for medicine in this disease.  The pa-
tient ought  however to keep Avithin doors, to abstain from flesh, strong
liquors, and cordials, and to drink  freely of cool  and diluting liquors.
If the fever runs high, the body must be kept gently open by emollient
clysters, or small doses of nitre and rhubarb.  A  scruple of the former,
with five grains of the latter, may be taken thrice a day, or oftener, if ne-
cessary.
   Children  and young persons are sometimes seized at tlie beginning of
this disease with a kind of stupor  and epileptic fits.  In this case the
feet and legs should be bathed  in ivarm water,  a  large blistering-plaster
applied to the  neck, and a dose of the  syrup of poppies given  every
night till the patient recovers.*
   The  scarlet fever however is  not alivays of  so  mild  a nature.   It is
sometimes attended with putrid or malignant symptoms, in which case it
is always dangerous.   In the malignant scarlet fever the patient is not
only affected with coldness and shivering, but Avith languor, sickness,
and great oppression;  to these  succeed excessive heat, nausea, and vo-
miting, with asoreness of  the throat; the pulse is extremely  quick, but
small and depressed; the breathing frequent and laborious;  the skin hot,
but not quite dry;  the tongue moist, and covered with a whitish mucus;
the tonsils inflamed and ulcerated.  When the  eruption appears, it bring3
no relief: on the contrary, the symptoms generally grow worse, aud fresh
ones come on, as purging, delirium, &c.
   When  this disease is mistaken for a simple inflammation, and treated
with repeated   bleedings,  purging  and cooling medicines, it generally
proves fatal.  The only medicines that can be  depended on in this case,
are cordials and antiseptics, as the  Peruvian bark, wine, snake-root, and
the like.  The treatment must be in general similar to that of the putrid
fever, or of the malignant ulcerous sore throat.f
cotton rubbed upon the skin ;  as mentioned above, or by introducing a little of
the sharp humour which distills from the eyes of the patient into the blood. It is
agreed on all hands, that such patients as have been inoculated, had the disease
very mildly ; we therefore wish the practice were more general, as tlie measles
have of late become very fatal.
   *  Sydenham.
  | In the year 1774, during winter, a very bad species of this  fever prevailed
in Edinburgh.   It raged chiefly among young people.  The eruption was gene-
rally accompanied with a quinsey, and the inflammatory symptoms were so blend- 
183
               OF  THE BILIOUS  FEVER.

  WHEN a continual, remitting, or intermitting fever is accompanied
with a frequent or copious evacuation of bile, either by vomit or stool,
the fever is denominated bilious.   In Britain the bilious fever generally
makes its appearance about the end of summer,  and ceases towards the
approach of winter.   It is most  frequent  and  fatal in warm countries,
especially Avhere the soil is marshy, and when great rains are succeeded
by sultry  heats.  Persons who work Avithout doors, lie in camps, or avIio
are exposed to the night air, are most liable to this kind of fever.
  If  there are symptoms of inflammation  at the  beginning of this fever,
it will be necessary  to bleed, and to put the patient upon the cool di-
luting regimen recommended in the inflammatory fever.   The saline
draught may likewise be frequently administered, and the patient's body
kept open by clysters or mild purgatives.  But if the fever should remit
or  intermit, bleeding will seldom be necessary.   In this case a vomit
may  be administered, and if the  body be bound, a gentle purge;  after
which the Peruvian  bark will generally complete the cure.
   In case of a violent looseness, the patient must be supported  with
chicken broths,  jellies of hartshorn,  and the like;  and he may use the
white decoction for his ordinary drink.*  If a bloody flux should accom-
pany this fever, it must be treated in the manner recommended under
the article Dysentery.
   When there is a burning heat, and the patient  does  not  sweat, that
evacuation may be promoted by giving  him, three or four times a-day, a
table-spoonful  of Mindererus' spirit,f mixed in a cup of his  ordinary
drink.
   If the bilious fever be attended with the nervous, malignant, or putrid
symptoms, which  is sometimes  the  case, the patient must be treated
iu  the same manner as directed  unler these diseases.
   After this fever, proper care is necessary to prevent a relapse.  For
this purpose the patient, especially towards the end of autumn, ought
to  continue the use  of the  Peruvian  bark for some time  after he is
well.  He should likewise abstain from  all trashy fruits, new liquors,
and eveiy kind of flatulent aliment.
                       CHAP.  XXVII.

   OF THE ERYSIPELAS, OR ST. ANTHONY'S FIRE.

        TlIIS disease, which in  some  parts of Britain is called the
rose, attacks persons at  any period of life,  but is most common be-
tween  the age of thirty and forty.   Persons of a sanguine or plethoric

ed with others of a putrid nature, as to render the treatment of the disease very
difficult.  Many of the patients, towards the decline of the fever, were afflicted
with large swellings of the submaxillary glands, and not a few had a suppura-
tion in one or both ears.
  • See Appendix, white decoction.
  f See Appendix, Spirit of Mindererus. 
 *84,              OF  THE  ERYSIPELAS,  &C.

 habit are most liable to it.   It often attacks young people, and pregnant
 women;  and such as  have once been afflicted with it are very liable
 to have it again.  Sometimes it is a primary disease, and at other times
 only a symptom of  some other  malady.   Every part  of  the  body is
 liable to be  attacked  by an  erysipelas, but it most  frequently seizes
 the  legs or face, especially the  latter.   It is most  common in  autumn,
 or when  hot weather  is succeeded by cold  and wet.
   CAUSES.—The erysipelas  may be occasioned  by violent passions
 or affections of the mind; as fear, anger, Ac  When the body has been
 heated to a great degree, and is immediately exposed to  the cold air, so
 that the perspiration is  suddenly checked, an erysipelas will often ensue.*
 It may also be occasioned by  drinking to excess, by continuing  too Ion*
 in a Avarm bath, or by  any thing that overheats the blood.   If any of the
 natural evacuations be obstructed, or in too small quantity,  it may cause
 an erysipelas.   The same  effect will folloAV from the stoppage of artifi-
 cial evacuations; as issues, setons,  or the like.
   SYMPTOMS.—The erysipelas attacks  with shivering, thi st, loss of
 strength, pain in the  head and  back, heat,  restlessness, and a  quick
 pulse; to which may be added  vomiting,  and sometimes a delirium.
 On  the second,  third,  or fourth day,  the part swells, becomes red, and
 small pustules appear;  at which time the fever generally abates.
   When  the erysipelas seizes the foot,  the parts contiguous swell, the
 skin shines;  and, if the pain be violent, it will  ascend  to the leg,
 and will  not bear to be touched.
   When  h attacks the face,  it swells,  appears red,  and  the skin is
 covered Avith small pustules idled with clear Avater.   One or both eyes
 are  generally closed Avith  the  SAvelling; and there is  a difficulty  of
 breathing.   If the mouth and  nostrils  be  very dry, and  the  patient
 drowsy, there is reason to  suspect an inflammation of the brain.
   If the erysipelas affects the breast, it sivells and becomes  exceedingly
 hard, with great pain,  and is apt to suppurate.  There is a violent pain
 in the arm-pit, on the side affected, where an abscess is often formed.
   If in a day or two the swelling subsides, the heat and pain abate,
 the  colour of the part turns  yellow, and the cuticle  breaks and falls
 off in scales,  the danger is over.
   When the erysipelas is large, deep,  and affects a very sensible part of
 the body, the  danger is great.  If the red colour changes into a livid or
 black,  it will end in  a mortification.   Sometimes  the inflammation
 cannot be discussed, but comes to  a suppuration;  in  which case fis-
 tulas, a gangrene, or mortification,  often ensue.
   Sucli as die of this  disease are commonly carried off by the fever,
 which is  attended with difficulty of  breathing, and sometimes  wifh a
 delirium and great droAvsiness.   They generally die about the seventh
or eighth  day.
   * The country people in many parts of Britain call this disease a Blast, and
 imagine it proceeds from foul air, or ill wind as they term it.  The truth is they
 often lie down to rest them, when warm and fatigued, upon the damp ground,
 where they fall asleep, and lie so long as to catch cold, which occasions the
TM-ysipelas.   This disease may indeed proceed from otlier causes, but we may
 venture to say, that nine times out of ten it is occasioned by cold caught after
-the body has been greatly heated or fatigued.   , 
                OF  THE ERYSIPELAS,  &C.             ]85

  REGIMEN.—In the erysipelas the patient must neither be kept too
hot nor cold, as either of these extremes will tend to make it retreat,
which is always to be guarded against.  When the  disease is mild, it
Avill be sufficient to keep the patient within doors, without confining him
to his bed, a, id to promote the perspiration by diluting liquors, Ac.
  The diet  ought to be slender, and of a moderately cooling and moist-
ening quality,  as groat-gruel,  panado, chicken or barley broth, with
cooling herbs and  fruits, Ac. avoiding flesh, fish,  strong drink, spices,
pickles, and all other things that may heat and inflame the blood;  the
driuk may be barley-water, an infusion of elder flowers,, common whey,
and such like.
  But if the pulse be low, and the spirits sunk, the patient must be sup-
ported with  negus, and other things of a cordial nature.  His  food  may
be sago-gruel with a little wine and nourishing broths taken  in small
quantities, and often repeated.   Great care however must be taken not
to overheat  him. "
  ^ MEDICINE.—Iu this disease much mischief is often done by medi-
cine,  especially by  external applications.   People  when they see  an
inflammation, immediately think that something ought to  be applied to
it.   This indeed is necessary in large phlegmons;  but in  ap  erysipelas
the safer course is to apply nothing.  Almost all ointments, salves,  and
plasters, being of a greasy nature, tend rather to  obstruct and repel,  than
promote any discharge from the part.  At the beginning of this disease
it is neither safe to  promote a  suppuration, nor to repel the matter too
quickly.  The erysipelas in many respects resembles the  gout,  and is
to be treated Avith the greatest caution.  Fine wool, or veiy soft flannel,
are the safest applications to the part.  These  not only defend it from
the external air, but likewise promote the perspiration, which has a «reat
tendency  to carry off the disease.  In  Scotland the common people
generally apply a mealy cloth to the parts affected, which is  far from
being improper.
   It  is common to bleed  in the erysipelas; but this likeAvise  requires
caution.  If hoAvever the fever be high, the pulse hard and strong,  and
the patient vigorous, it Avill be proper to bleed; but the quantity  must
be regulated by these circumstances, and the operation repeated as the
symptoms may require.   If the patient has been  accustomed to strong
liquors, aud the disease attacks his head, bleeding is absolutely neces-
sary.
   Batlung the  feet and legs frequently in luke-warm Avater,  when the
disease attacks  the face or brain, has an excellent effect.  It tends to
make a derivation from the head, and seldom fails to  relieve the patient.
When bathing  proves ineffectual, poultices, or sharp sinapisms, may be
applied to the soles  of the feet, for the same purpose.
   Iu cases where bleeding is requisite,it is likeAvise necessary to keepthe
body open.   This may be effected by emollient clysters, or small doses
of nitre and rhubarb.  Some  indeed recommend very large doses of
nitre in the erysipelas; but nitre  seldom sits easy on the stomach ivhen
taken in large doses.  It is however one of the  best medicines Avhen the
fever and inflammation run high.  Half a  drachm of it, with four or
five grains of rhubarb, maybe taken in the patient's  ordinary drink, four
times a-day.
  When the erysipelas leaves  the  extremities, and seizes the head so
                                   24 
186              OF THE PHRENITIS, OR
 as to occasion a delirium or stupor, it is absolutely necessary to open
 tlie body.   If cljsteisand milk purgatives fail to have this effect, stron-
 ger ones must be given.   Blistering-plasters must likeAvise be applied to
 the neck, or behind the ears, and sharp cataplasms laid to the soles of the
 feet.
   When the inflammation cannot be discussed, and the part has a ten-
 dency to ulcerate,  it will then be proper to promote suppuration, which
 may be done by the application of ripening poultices with saffron, warm
 fomentations, and such like.
   When the black, livid, or blue colour of the part shews a tendency
 to mortification, the Peruvian bark must be  administered.   It may be
 taken along with acids, as recommended in  tlie small-pox, or in any other
 form more agreeable to  the  patient.   It must not however be trilled
 Avith, as the  patient's life is at stake.   A  drachm may be given  every
 tivo hours, if the  symptoms be threatening, and cloths dipped in Avarm
 camphorated spirits of wine, or the tincture of myrrh and aloes, may be
 applied to the part, and frequently renewed.   It may likewise be propei
 in this case to apply poultices of the bark, or to foment the part affected
 with a 6troug decoction of it.
   In Avhat is commonly called the scorbutic erysipelas,  which  continues
 for a considerable time, it will only be necessaiy to give gentle laxatives
 and such things as purify the blood and promote the perspiration.  Thus
 after the inflammation has been checked by opening medicines, the de-
 coction of  woods*  may be drank, alter which a course of bitters will be
 proper.
  Such as  are liable,to frequent attacks  of tlie erysipelas ought  care-
 fully to guard against all  violent passions, to abstain from strong liquors,
 and all fat, viscid,  and highly nourishing food.   They should likewise
 take sufficient exercise,  carefully avoiding  the extremes of heat or
 cold.  Their food should consist chiefly of milk, and such fruits, herbi
 and roots, as are of a cooling quality, and their drink ought to be small-
 beer, whey, butter-milk,  and such like.—They should  never suffer
 th emselves to be long costive.   If that cannot be prevented by  suitable
 diet, it will be proper to take  frequently a gentle  dose of rhubarb,
cream of tartar, the lenitive electuary, or some other mild purgative.
                        CHAP. XXVIII.

 OF THEPHRENTIS, OR INFLAMxMATIONOF THE BRAIN,

       X HIS  is sometimes a primary disease, but  oftener only a symp-
 tom of so ne other malady;  as  the inflammatory,  eruptive  or spotted
 fever, Ac.   It is very common hoAirever, as a primary  disease  in warm
 c|imates, and is most incident to  persons about  the prime  or vigour
 of life.   The passionate, the studious, and those whose nervous s)stcm
 is irritable in a high degree, are most liable to it.
   CAUSES.—This disease, is often occasioned by  night  watching, es-
pecially  when  joined  with hard study, it may likewise  proceed
from hard drinking,  anger, grief, or anxiety.  It is  often occasioned by
* See Appendix, Decoction of Woodf. 
INFLAMMATION  OF  THE  BRAIN.
187
the stoppage of usual evacuations;  as the bleeding piles in men, the
customary  discharges of Avomen,  &c.  Such as  imprudently expose
themselves to the heat of the sun, especially by sleeping without doors,
in a hot season, with  their heads uncovered, are often suddenly  seized
Avith an inflammation of the brain,  so as to  awake quite  delirious.
When repellents are imprudently used hi an erysipelas, an inflammation
of the brain is sometimes the consequence.  It may likewise be occa-
sioned by external injuries, as blows or bruises, upon the head, &c.
  SYMPTOMS.—The symptoms which usually precede a true inflam-
mation of the brain, are pain of the head, redness of the eyes, a violent
flushing of the face, disturbed sleep,  or a total want of it, great dryness
of the skin, costiveness, a retention of urine, a small dropping of blood
from the nose, singing of the cars, and extreme  sensibility of the ner-
 vous system.
  When the inflammation is formed, the symptoms in general are simi-
lar to those of the inflammatory fever.  The pulse indeed is often weak,
irregular,  and trembling; but  some times it is hard  and  contracted.
When the brain itself is inflamed,  the pulse is always soft and low; but
when the inflammation only  affects the integuments of the brain, viz. the
dura, and pia matter, it is hard.    A remarkable quickness of hearing is
a  common symptom of this  disease, but that seldom continues long.
Another usual symptom  is  a great throbbing or pulsation in  the ar-
teries of the neck and temples.    Though the tongue is often black and
dry, yet the patient  seldom complains of thirst, and even refuses drink.
The mind  chiefly runs upon such objects as have  before made a deep
impression on it;  and sometimes  from a sullen silence, the patient be-
comes all of a sudden quite  outrageous.
   A constant trembling and starting of the tendons  is  an unfavourable
symptom, as are also a suppression of mine ; a total Avant of sleep; a con-
stant spitting; a grinding of the teeth ; which last may be  considered
as a kind of convulsion.  When a phrenitis succeeds an inflammation of
the  lungs, of the  intestines, or of the throat, &c.   it is  owing to  a
translation of the disease  from these parts  to the brain,  and generally
proves fatal.   This shews the necessity of proper evacuations, and  the
danger of  repellents in all inflammatory diseases.
   The favourable symptoms are,  a free perspiration, a copious discharge.
of  blood from the nose, the  bleeding piles, a plentiful discharge of urine
which lets fall a copious sediment.  Sometimes the disease is  carried off
by a looseness, and in women by an excessive flow of the menses.
   As this disease often proves fatal in a feAv days, it requires the most
 speedy applications.   When it is prolonged, or improperly treated, it
sometimes ends in  madness, or a kind of stupidity  which continues for
 life.
   In the cure, two things are chiefly to be attended to, viz.  to lessen the
quantity of blood in the brain, and to retard the circulation toAvarda  the
head.
   REGIMEN.—The patient ought to be kept very quiet    Company,
noise, and every thing that affects the senses;or disturbs the imagniation
increases  the disease.   Even   too much  light  is  hurtful ;   for
which reason the patient's chamber ought to be a little darkened, and he
should neither be kept ko hot nor cold.  It is not however necessary to
exclude the company of an agreeable friend, as this has a tendency to 
18&               OF THE  PHRENITIS, &C.

sooth and quiet the mind.  Neither ought  the  patient to be kept too
much in the dark, lest it should occasion a gloomy melancholy, which
is too often the consequence of this disease.
   The  patient must, as far as possible, be  soothed and  humoured  in
every  thing.   Contradiction  will ruffle  his mind,  and  increase his
malady.  Even when  he calls for things which are not to be obtained,
or which might prove hurtful, he is not to be  positively dented them,
but rather put off with the  promise of having tiiem as soon as they can
be obtained, or by some other excuse.  A little of any  thing that the
mind is set  upou, though not quite  proper, will  hurt the patient less
than a positive refusal.  In a word, whatever he was fond of or used to
be delighted Avith, when in health, may here  be tried ; as  pleasing sto-
ries, soft  music, or  Avhatever has a tendency to sooth the passions and
compose the mind.   Boerhaave  proposes  several  mechanical  experi-
ments  for this purpose; as  the soft noise of water distilling by drops into
a bason, and the patient trying to reckon them, &c.   Any uniform sound
if low aud continued; has a tendency to procure sleep, and consequent-
ly may be of service.
   The aliment ought to be light, consisting  chiefly of  farinaceous sub-
stances ; as panado  and water gruel, sharpened  with jelly of currants,
or juice of  lemons,  ripe fruits roasted or boiled, jellies,  pre erves, Ac.
The drink small, diluting, and cooling as whey, barley Avater, or decoc-
tions of barley and tamarinds, Avhich latter not  only renders  the liquor
more palatable, but  likewise more beneficial, as they are of an  opening
 nature.
   MEDICINE.—In an inflammation of the brain, nothing more cer-
tainly relieves the patient than a free discharge of blood from the nose.
When this comes of its own accord, it is by no  means to be stopped, but
rather promoted, by applying cloths dipped in warm water to the part.
When bleeding at the nose does not happen spontaneously, it may be pro-
voked, by putting a  straAV or any other sharp body up the nostril.
   Bleeding in the temporal arteries greatly relieves the head: but as this
operation cannot ahrays be performed, we would recommend in its stead,
 bleeding iu the jugular veins. When the patient's pulse and spirits are
so Joav that he cannot bear bleeding with the lancet, leeches  may be ap-
plied to the temples.  These  not only draw off the blood more gradually
but by being applied nearer to the part affected, generally give more im-
mediate relief.
   A discharge of blood from the hemorrhoidal veins is likewise of great
service, and ought by  all means to be promoted.  If the patient has been
subject to the bleeding piles, and that a discharge has been  stopped,
 every method must  be  tried to restore it; as the application of leeches to
the parts, sitting over the steam of warm water, sharp clysters or suppo-
sitories made of honey, aloes, and rock-salt.
   If  the inflammation of  the  brain be occasioned by the stoppage of
 evacuations either  natural or artificial, as the menses,  issues, s-etons, or
such like, all means must be used to restore them as soon as possible,  or
 to substitute others  in their stead.
   The patient's  body must  be kept  open by stimulating  clysters  or
 smart purges ; and small quantities of nitre ought frequently to  be
 mixed with his d ink.   Two or three  drachms, or more, if  the case  be
dangerous, may be used in  the space of twenty-four hours. 
OF THE  OPHTHALMIA, &C.               189
  The head should be shaved and  frequently rubbed with vincar and
rose-Avater.  Cloths dipped in this mixture may likeAvise be applied to
the temples.  The feet ought frequently to be bated in lukew arm water,
and soft poultices of  bread and milk may be kept constantly applied  to
them.
  If the disease proves obstinate, and does not yield to these  medicines,
it will be necessary to apply a blistering-plaster to the whole head.
                       CHAP.  XXIX,


OF THE OPHTHALMIA,  OR  INFLAMMATION  OF THE
                              EYES.

          THIS disease  may  be occasioned by external  injuries  as
blows, burns, bruises, and the like.  It may likewise proceed from dust,
quick-lime, or other subitances, getting into the eyes,  It  is often  cau-
sed by the stoppage of customary evacuations; as the  healing  of old
sores, drying up of issues,  the suppressing of gentle morning  sweats,  or
of the sweating of the feet, Ac.   Long exposure  to the night  air, es-
pecially in cold northerly winds, or whatever suddenly checks the pers-
piration, especially after the body  has been much heated, is very apt  to
cause an inflammation of the eyes—VieAving suoav or other white bodies
for a long  time, or looking stedfasdy at the sun, aclear fire,  or any bright
otrect, will likewise  occasion this malady.   A sudden transition from
darkness to very bright light will  often have the same effect.
  Nothing more certainly occasions an inflammation of the eyes than
night-watching, especially reading or writing by candle-light.—Drink-
ing spirituous  liquors, and excess of venery are likeAvise very hurtful to
the eyes.  , The acrid fumes of metals, and of several kinds  of fuel,
are also pernicious.   Sometimes au inflammation  of the  eyes  proceed
from a venereal taint, and often from a scrophulous or gouty habit.  It
may likeivise  be occasioned by hairs in the eyelids turning inwards, and
hurting the eyes.  Sometimes  the disease is epidemic, especially after
wet seasons; and I have frequently knoAvn it prove infectious,  particu-
larly to those who lived in the same house with the patient.  It may be
occasioned by moist air, or living in low damp houses,  especially in per-
sons Avho  are not accustomed to such situations.  In children  it  often
proceeds  from imprudently drying up of  scabbed heads,  a  running be-
hind  the  ears, or any other  discharge of that kind.  Inflammations  of
the  eyes  often succeeds  the small-pox or  measles, especially in chil-
dren of a scroohulous habit.
   SYMPTOMS.—Au inflammation of the eyes is attended with acute
pain, heat, re  lness, and swelling.   The patient is not able  to bear the
light, and sometimes he feels a pricking pain, as if his eyes were pierced
Avith a thorn.   Sometimes he  imagines  his eyes are full  of motes, or
thinks he sees V'vs dancing before  him.   The eyes  are filled with a
scaltiius:  rheum,  avIu h rushes  forth in great quantities,  whenever the
patient attempts to lookup.  The pulse  is generally  quick and bard, 
190             dF THE  OPHTHALMIA, OR

with  some degree of fever.  When the disease is violent, the neigji
bouriug parts sivell,  and there is a throbbing or pulsation in the tempo-
ral arteries, &c.
   A slight inflammation of the eyes, especially from an external cause,
is easily cured ; but Avhen the disease is violent, and continues long, it
often  leaves specks upon the eyes, or dimness  of sight, and sometimes
total blindness.
   If the patient be seized with a looseness, it has a good effect; and
when the inflammation passes from one eye to another as it were by in-
fection, it is no unfavourable symptom.   But when the disease is accom-
panied Avith a violent pain of the head, and continues long, the patient is
in danger of losing his sight.
   REGIMEN.—The diet, unless iu scrophulous  cases,  can hardly be
too spare, especially at the beginning.   The patient must abstain from
eveiy thing of  a heating nature.    His  food should  consist chiefly of
mild vegetables, Aveak broths, and gruels.  His  drink may be barley-wa-
ter, balm-tea, common whey, aud such like.
   The  patient's chamber  must be darkened, or his eyes shaded by a
cover so as to exclude the light, but not to  press upon the eyes.   He
should not look at a candle, the fire or any luminous object; aud ought
to avoid all smoke, as the fumes of tobacco, or any thing that may caiue
coughing, sneezing, or vomiting.  He should be kept quiet,  avoiding all
violent efforts, either of body or mind, and encouraging sleep as much as
possible.
   MEDICINE*—This is  one of those  diseases wherein great hurt is
often done by external applications.  Almost  every  person  pretends
to be possessed of a remedy for the cure  of sore  eyes.  These remedies
generally  consist of  eye-Avaters and ointments, with other external  ap-
plications, Avhich do mischief tAventy times  for once  they do good.
People ought therefore to be very cautious how they use  such things, as
even the pressure upon the  eyes often increases the malady.
   Bleeding, in a violent inflammation of the eyes, is always necessary.
This should be performed as near the part affected  as possible.   An a-
dultmay loose ten or tAvelve ounces of blood from the jugular vein, and
the operation may be repeated according to the urgency of the symp-
toms.  If it should not be  convenient to bleed in the  neck, the same
quantity may be let from the arm, or any other  part of the body.
   Leeches are often applied to the  temples, or under  the  eyes, with
good effect.  The  wounds must  be suffered to bleed for some hours,
and if the bleeding stop soon, it may be  promoted by the application of
cloths dipt in warm  water.  In obstinate cases,  it will be necessary to
repeat this operation several times.
   Opening and  diluting medicines are  by no means to be neglected.
The patient may take a small dose of Glauber's salts, and cream of tar-
tar, every  scecond or third day, or a decoction of tamarinds with senna.
If these be not agreeable, gentle doses of rhubarb and nitre,  a little of
the lenitive electuary, or any other mild purgative,  will answer the same
end.  The patient-  at the same time must drink freely  of  water-gruel
tea, Avhe}', or any other weak diluting liquor.—He ought  likewise to
take, at bet';-time, a large draught of very Arcak  wine-whey, v\ order to
promote perspiration.  His feet and legs  must frequently be bathed in 
INFLAMMATION  OF  THE  EYES.
191
hike-warm water, and his head twice or thrice a-week, and  afterwards,
washed in cold water.  This has often a remarkable good effect.
   If the inflammation does not yield to these evacuations, blistering-
plasters must be applied to the temples, behind the ears, or upon the
neck, and kept open for some time by the mild blistering ointment.   I
have seldom known these, if long  enough kept open, fail to  remove the
most obstinate inflammation of the eyes; but for this purpose it is often
necessary to continue the discharge for several weeks.
   When the disease has been of long standing, I have seen very extra-
ordinary cfft cts from a seton in the  neck, or between the shotdders, es-
pecially the latter.  It should be put upwards and downwards, cr in the
direction of the spine, and in the middle between the shoulder-blades.  It
may be dressed twice a day Avith yelloAV basilicon.  I have known pa-
tients, who had been blind for a considerable time, recover sight by means
of a seton placed as above.  When the seton is put across the neck, it
soon wears  out, and is both more  painful and  troublesome than betAveen
 the shoulders; besides, it leaves a disagreeable mark;  and does not dis-
 charge so freely.
   When  the heat and pain of the  eyes are very great, a poultice of bread
 and milk, softened with sweet oil or fresh butter, may be applied to them,
 at least all night; and they may  be bathed Avith lukewarm  milk and
 water in the morning.
   If the  patient cannot sleep, which is sometimes the case, he may take
 twenty or thirty drops of laudanum, or two spoonsful of the syrup of pop-
 pies, over night, more or less according to his  age, or the violence of the
 symptoms.
   After the inflammation  is gone off, if the eyes still  remain  weak and
 tender, they may  be bathed every  night and morning Avith cold water
 and a little brandy, six parts of the  former to one of the latter.
   A method should be  contrived  by which  the eye can be quite immers-
 ed in the brandy and water, where it should be kept  for some time.  I
 have generally found this, or cold water and vinegar, as good a strength-
 ener of the eyes as any of the most celebrated collyriums.
   When an inflammation of the eyes proceeds from a scrophulous habit,
 it generally proves  very obstinate.  In  this case the patient's diet must
 not be too Ioav, and he may be allowed to drink small negus, or now and
 then a glass of wine.  The most proper medicine is the Peruvian bark,
 which may either be given in substance, or  prepared in the following
 manner:
   Take  an ounce of the bark in  powder, with tAvo drachms of Winter's
 bark, and boil them iu an English quart of water to a pint; when it has.
 boiled nearly long enough, add  half an ounce of liquorice-root sliced.
 Let the liquor be strained.  Two, three, or four table-spoonsful, accord-
 ing to the age of the patient, may  be taken three or four times a-day.  It
 is impossible to say how long this mediciue should be continued, as the
 cure  is sooner performed in some than  in  others; but in  general it re-
 quires a considerable time to produce any lasting effects.
   Dr. Cheyne says, " That JSthiop's mineral never fails in obstinate in-
 flammations of the eyes, even scrophulous  ones, if given in a sufficient
 dose, and duly persisted in."  There is no  doubt but this and other pre-
 parations of mercury may be of singular service in ophthalmias  of long
 continuance, but  they ought always to be administered with the greatest
 (Caution, or by persons of skill iu physic. 
iy^               OF  THE  QJJINSEY,  OR

  It will be proper frequently to look into the eyes, to see if any hairs
be turned upwards, or pressing upon them/   These ought to be removed
by plucking them out  with a pair of small pincers.
  Those who  are liable  to frequent  returns of this disease, ought con-
constantly to have an issue in one or both arms.  Bleeding or purging in
the spring and autumn, will be very  beueficial to  such persons.   They
ought likewise to live with the gieatest regularity, avoiding strong li-
quors, and every thing of a heating quality.  Above all let them av oid
the night air aud late  studies.f
                         CHAP.  XXX.

   OF  THE QUINSEY, OR INFLAMMATION OF  THE
                           THROAT.
          A HIS disease is very common in Britain, and is frequently
attended with great danger.  It prevails in the winter and spring, and is
most fatal to young people of a sanguine temperament.
   CAUSES.—In general it proceeds from the same causes as other in-
flammatory disorders, viz. an obstructed perspiration, or whatever heats
or inflames the blood.   An inflammation of the throat is often occasioned
by omitting some part of the covering usually ivorn about the neck, by
drinking cold liquor when the body is warm, by riding or walking against
a cold northerly wind, or any thing that greatly  cools the throat, and
parts  adj cent. 'It may likeAvise proceed from the neglect of bleeding,
purging, or any customary evacuation.
   Singing, speaking loud and  long, or whatever strains  the  throat, may
likewise cause an  inflammation of that organ.   I  have  often known the
quinsey prove fatal to jovial companions, who after sitting long in a warm
room, drinking warm liquors, and singing with vehemence, were so imr
prudent as to go abroad in the  cold night air—Sitting with wet feet, or
keeping on ivet clothes, are veiy  apt  to occasion  this malady.  It is
likewise frequently occasioned by continuing long in a moist place, sitting
near an open ivindow, sleeping in a damp bed, sitting in a room that has
been newly plastered, &c.  I know people who never fail to have a sore
throat, if they sit even but a  short time in a room that has been latejy
Avashed.
   Acrid or irritating food may likewise inflame the throat, and occasion
a  quinsey.  It may also proceed from bones,  pins, or  other sharp  sub-
stances  sticking in  the throat, or from the caustic fumes of metals or min-
erals, as arsenic, antimony, &c.  taken in by the breath.   This disease is
sometimes epidemic and infectious.
   SYMPTOMS.—The inflammation  of  the throat  is evident from
inspection, the  parts appearing red  aud swelled; besides, the patient
  * Any foreign body lodged in the eye may be expeditiously removed by pas-
sing a small hair pencil between the eye-lid, and the ball of the eye.  In some
places, the peasants do this very effectually, by using their tongue in the same
manner.
  f As most people are fond of using eye-waters and ointments in this and other
diseases of the eyes, we have inserted some of the most approved forms of these
medicines In the Appendix.  See Appendix, Eye-water and Eve-salve. 
INFLAMMATION  OF  THE  THROAT.
19S
  complains  of pains in swallowing.  His  pulse is quick and hard, with
  other symptoms of a fever.  If blood be let, it is generally covered with
  a tough coat of a whitish colour, and the patient spits a tough phlegm.
  As the sAvelling and inflammation increase, the  breathing aud swallow-
  ing become more difficult; the pain affects the  ears; the eyes general-
  ly appear  red; and  the face  swells.   The patient is often obliged to
  keep himself in an erect posture, being in danger of suffocation; there
  is  a constant nausea,  or inclination to vomit, a  >d the drink, instead of
  passing into the stomach, is often returned by the nose.   The patient is
  sometimes starved at  last, merely from an inability  to swallow any kind
  of food.
    When the breathing is laborious, Avith straightness of the breast, and anx-
  iety, the danger is great.   Though the pain in swallowing be very great,
  yet while the patient breaches easy, there  is not so much danger.  An
  external swelling  is no unfavourable symptom ;  but if it suddenly falls,
  and the  disease  affects theAbreast, the danger  is very great.   When a
  quinsey is the  consequence of some other disease, which  has  already
  weakened the  patient,  his situation is  dangerous.   A frothing  at  the
  mouth, with a SAvelled tongue, a pale, ghastly countenance, and coldness of
  the extremities, are fatal symptoms.                              ,
     REGIMEN.—The regimen in this disease is in all respects the same
  as in the  pleurisy, or peripneumony.  The  food must be light,  and in
  small quantity, and the drink plentiful, weak, and  diluting, mixed widi
  acids.
    It is highly necessary that the patient be kept easy and quiet.  Vio-
  lent affections of the mind, or great effort of the  body, may prove fatal.
  He should not even attempt to speak butan a low voice.   Such a degree
  of Avarmth as to promote a constant gentle sweat, is proper.  When the pa-
  tient is in bed, his head ought  to be raised a little higher than urual.
    It is peculiarly necessaiy that the neck be kept warm ;  for which pur-
  pose several folds of soft flannel may be wrapt round it.  That alone will
  often remove a slight complaint of the throat, especially if applied in due
  time.   We cannot here omit observing the propriety of a custom  Avhich
  prevails among the peasants of Scotland.   When they feel  any uneasiness
  of the throat, they wrap a stocking about it all night.   So effectual  is this
  remedy, that in many  places it passes for a charm, and the stocking is ap-
  plied Avith particular ceremomes:  the custom hoAvever, is  undoubtedly a
  good one, and should never be neglected.   When the  throat has beenthus
  wrapped up all night, it must not be exposed to the cold air through the
  day, but a handkerchief or a piece of flannel kept  about it till the inflam-
  mation be removed.
    The jelly of black currants is a medicine very much in esteem for com-
  plaints of die throat;  and indeed it is of some use.  It should be almost
  constantly kept in the mouth, and swallowed doAvn leisurely.   It may
  likewise be mixed in the patient's drink, or taken-any other way.   When
^it cannot be obtained, the jelly of red currants, o\ of mulberries, may be
  used in its stead.
    Jiargles for the throat ar^very beneficial.  They  may be made of
  sage-tea, with a little  vinegw and honey, or by adding to  half a p^nt
  of  the pectoral deooction, two or three spoonsful of honey, and  the
  same quantity  of  cyrraut  jelly.  This  may be used three or four times
  a-day j and if the patieut be  troubled  with tough  vise Id phlegm,  the
                                  25 
 *J*                01  THE  OJJINSEY,  OR
 gavgle may be rendered more sharp and cleansing, by adding to it a tea-
 spoonful of the sp rit of sal ammoniac.   Some recommend gargles made
 of a decoction of the leaves or bark of the black currant bush; but where
 the jelly can be had these are unnecessary.
   There is no disease wherein the benefit of bathing the feet and legs in
 lukewarm water is more apparent: that practice ought therefore never to
 be neglected.  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 use
 a spare diet, with diluting liquors,  at the  beginning  of this disease, it
 would seldom proceed to a great height, or be attended Avith any danger •
 but when these precautions are  neglected, and the disease becomes vio-
 lent, more powerful medicines are necessary.
   MEDICINE.—An inflammation of the throat being a most acute and
 dangerous distemper, Avhich sometimes takes off the patient very sudden*
 ly, it will be proper, as soon as the symptom^Fppear, to bleed  in the arm,
 or rather in the jugular vein, and to repeatthe operation if circumstan-
 ces require.
   The body should likeAvise be kept genfly open.  This may either be
 done by giving the patient for his ordinary drink a decoction of figs and
 tamarinds,  or small doses of rhubarb aud nitre, as  recommended in the
 erysipelas.   These may be increased according to the age of the patient,
 and repeated till they  have the desired effect.
   I have often known very good effects from a bit of sal prunel, or putri-
 fied nitre, held in  the mouth, and siralkrwed down  as it melted.  This
 promotes the discharge of saliva, by which means it answers the end of a
 gargle, while at the same time it  abates the  fever,  by promotiug the dis-
 charge of urine, &c.          •
   The throat ought likewise to oe rubbed twice or thrice a-day with a lit-
 tle of tlie \rolatile liniment.  This seldom fails to  produce some good ef-
 fects.   At the same time the neck ought to be carefully covered  with
 avooI or flannel, to prevent the cold from penetrating the skin, as this ap-
 plication  renders it very tender.  Many other external applications are
 recommended in this disease, as a swallow's nest, poultices made of the
 fungus called Jew's ears,  album Graecum, &c.  But as we  do not  look
 upon any of these to be preferable to a  common poultice of bread and
 milk, Ave shall take no farther notice of them.
   Some recommend  the gum-guaiacum as a specific in  this disease.
 Half a drachm of the gum iu powder may be made  into an electuary with
 the rob of elder berries, or the jelly of currants for a dose, and repeated
 occasionally.*
   Blistering upon the neck or behind (he ears in violent inflammations
 of the  throat is very beneficial; and in bad cases  it will be necessary to
 lay a blistering-plaster quite across the throat,  so as to  reach from ear to
 ear.  After the plasters are taken off, the parts ought to be kept ruuning
 by the application ofiss^e ointment, till the inflammation is gone; other-
 wise, upon their drying *ip, the patient will be  in danger of a relapse.
   When  the  patient has  been treated as above, a suppuration  seldom*
 happens.   This  however  is sometimes  the  case,  in spite of all In-  •
 deavours  to prevent  it.   When  the  inflammation and  swelling con-
 tinue,  aud it Ik evident that a suppuration  will ensue, it ought to  be
promoted by drawing the steam  of warm  Avater into  the throat through
 ----------.--------------------------M________,____-
                            * Dr. Home. 
             INFLAMMATION  OF THE  THROAT.        195

 a tunnel or the like.  Soft poultices ought likewi-e to be applied out-
 wardly, and the patient may keep a roasted fig constantly in his mouth.
   It sometimes  happens, before the  tumour breaks, that the  swelling is
 so great, as entirely to prevent any thing from getting doAvn into the sto-
 mach.   In this case the patient must inevitably perish, uule s he can be
 supported  in some other way.   This can only be done  by  nourishing
 clysters of broth, or gruel Avith milk, &c  Patients have  often been
 supported by these for several days,  till the tumour has broken ; and af-
 terwards they have recovered.
   Not only the swalloAving, but the  breathing, is often prevented by the
 tumour.  In this case nothing can save the patient's life, but opening
 the trachea or wind-pipe.  As that has been often done with  success, no
 person,  in such desperate circumstances, ought to  heitate  a moment
 about the operation ; but as it can only be performed by a surgeon, it is
 not necessary here to give any directions about it.
   When a difficulty of swallowing is not attended with an acute pain or
 inflammation, it is generally owing to an obstruction of the glands about
 the  throat, and  only requires that the part be kept warm, and the throat
 frequently gargled with something that may gently stimulate  the glands,
 as a decoction  of figs with vinegar and honey;  to Avhich  may be added
 a little mustard, or a small quantity of spirits.   But this  gargle is never
 to be used where  there are signs of an inflammation.  This species of
 angina has various»names among the common people, as  the pap of the
 throat, the falling down of the almonds of the ears, Ac.  Accordingly, to
 remove it, they  lift the patient up by the hair  of  the hAd, and thrust
 their fingers under his jaws, &c. all which practices are at best useless, aud
 often hurtful.
   Those who are  subject to inflammations of the throat, in order to avoid
 that disease, ought to live temperate.   Such as do not choose to observe
 this rule, must have frequent recourse to purging and other evacuations,
 to discharge the superfluous  humours.  They ought likewise to beware
 of catching cold, and should abstain from aliment or medicines of an as-
 tringent or stimulating nature.
   Violent  exercise, by encreasing the motion and force of tlie blood, is
 apt to occasion  an inflammation of the throat, especially if cold liquor be
 drank immediately after it, or the body suffered suddenly to cool.  Those
 Avho Avould  avoid this disease, ought therefore, after speaking aloud,
 singing, running, drinking warm liquor, or doing any thing that may strain
 the throat, or increase the circulation of the blood towards i't, to take care
 to cool gradually, and to wrap 6ome additional covering about their necks.
   I have often known persons Avho had been subject to sore throats en-
 tirely free  from  that complaint by only wearing a ribband, or  bit of flan-
 nel, constantly round their necks% or by wearing thicker shoes, a flannel
 waistcoat or the lnte.  These mayhem trifling, but the)  have great ef-
 fect.   There fc clanger  indeed  injSaving them  off after persons have
been accustomed to them ; but sfcreTy the inconvTeniency of using such
 things for life, is not to be compared Avith the danger Avhich may attend
 the neglect of them.
   Sometimes, after an inflammation,  the  glands  of the throat xon'inue
SAVrlled, and become hard and callous.   This complaint is not easily re-
moved, and is often rendered  dangerous by the too frequent application
of stron^ stimulating and styptic medicines.   The best method is tok^r; 
196       OF THE MALIGNANT  OJIINSEY, OR

it warm, and to gargle it twice a day Avith a decoction of figs, sharpened
a little with the elixir or spirit of vitriol.

OF  THE MALIGNANT QUINSEY,  OR PUTRID ULCER-
                     OUS SORE THROAT.

   THIS  kind of  quinsey is but little known in the northern parts of
Britain, though, for some time past, it has been fatal in the more south-
ern countries.   Children are more liable to it thau adults, females than
males, and the delicate than those who are hardy  and robust.  It pre-
vails  chiefly in autumn, and is  most frequent after  a long  course of
damp or sultry weather.
   CAUSES.—This is evidently a contagious distemper, and is generally
communicated by  infection.  Whole families, and even  entire villages,
often receive the infection from one person.  This  ought to put  people
upon their guard against  going near such patients as labour under  the
disorder; as by that means they endanger not only their own lives, but
likewise those of their friends and connexions. # Whatever tends  to pro-
duce putrid  or malignant  fevers, may likewise occasion the putrid  ul-
cerous sore throat, as unwholesome air, damaged provisions, neglect of
cleanliness, &c.
   SYMPTOMS.—It begins with alternate fits of  shivering and heat.
The  pulse is  quick, but low and unequal, and  generally  continues so
through the Avhole  course of the disease.   The patient complains greatly
of weakness and oppression of the breast; his spirits are low, and he is
apt to faint away when  set upright;  he is troubled with a uausea, and
often with a vomiting or  purging.  The tAvo latter are most common in
children.   The  eyes appear red and  watery, and the  face  swells.
The  mine is at first pale and crude;  but, as the  disease advances, it
turns more of a yellowish colour.  The tongue is white, and generally
moist, which distinguishes  this from an inflammatory disease.  Upoi
looking into the throat,  it  appears swelled, and  of a florid red colour.
Pale or ash-coloured spots however are here and there interspersed, and
sometimes one broad patch or spot, of an irregular figure, and pale white
colour, surrounded with  florid  red, only  appears.   These whitish spots
or sloughs cover so many ulcers.
   An efflorescence, or eruption upon the neck, arms, breast, and fingers,
about the second  or third  day, is a common symptom  of this disease.
When it appears, the purging and vomiting generally cease.
   There is often a slight degree of delirium, and the face frequently ap-
pears bloated, and the inside of the nostrils red and inflamed.—The  pa-
tient  complains, of a disagreeable putrid smell,  and his breath is very
offensive.
   The putrid ulcerous  sore throat  may be distingitfshed from  the in-
flammatory, by the vomiting and lo4fcness with which it is generally ush-
ered in;  the foul ulcers in the thro^TCflpered with a white or livid coat;
and by the excessive weakness of the patient; with  other symptoms of a
putrid fever.
   Unfavourable symptoms  are, an obstinate  purging,  extreme  weak-
ness,  dimness  of the sight; a  fivid  or black  colour  of the spots, and
freriui't  shiverh'gs, with  a weak fluttering pulse.   If  the eruption
ir;ou the skin suddenly disappears, or becomes of a livid colour will
                                                           #^ 
PUTRID  ULCEROUS  SORE  THROAT.        197
a discharge of  blood from the nose or  mouth,  the  danger  is veiy
great.                     •
  If a gentle sweat break out about the third or fourth day, and  con-
tinue with a slow, firm, aud equal pulse; if the sloughs cast off in a kind-
ly manner, and appear clean and florid at the bottom: and if the b"eath-
ing is soft and free,  with a lively colour of the eyes, there  is reason to
hope for a salutary crisis.
  REGIMEN.—The patient must be kept quiet,  and for the most pail
in bed, as he will be apt to faint w hen taken out of it.—His food must
be nourishing  and restorative; as sago-gruel  with red wine, jellies,
strong broths, &c.   His drink ought to be generous, snq^of antiseptic
quality t as red wine negus, white wine whey, andsuthl'.ke.
  MEDICINE.—The medicine in this ki id of quinsey is entirely dif-
ferent  from that Avhich is proper in the inflammatory.   All evacuations,
as bleeding, purging, Ac. which weaken the  patient, must  be  avoided.
Cooling medicines, as nitre and  cream of tartar, are likewise hurtful.
Strengthening cordials alone can be used  with safety; and these ought
never to be neglected.
  If at the beginning, there is a  great nausea, or inclination to vomit,
the patient must take an infusion of green tea, camomile flow ers, or car-
duus benedictus, in order to cleanse the stomach.  If these  are  not suffi-
cient,  he may take a few grains of the powder of ipecacuanha, or any
other gentle vomit
   If the disease is mild, the throat may be  gargled with an infusion of
sage and rose leaves, to a gill 0/ which may be added a spoonful or two of
honey; and as much vinegar as will make it agreeably acid; but  Avhen
the symptoms  are urgent,  tii\ sloughs large and thick, and the breath
very offensive, the following gargle may be used :
  To  six or seven ounces of the pectoral decoction, when boiling, add
half an ounce of contrayerva-root; let it  boil for some  time, and after-
wards strain the liquor; to which add two ounces of white wine vinegar,
an  ouuce of fine honey, and an ounce of  the tincture of myrrh.  This
ought  not only to be used as a  gargle, but a little of it should frequently
lie  injected with a syringe to clean the throat,  before the  patient takes
any meat or drink.   This method is peculiarly necessary for children who
cannot use a gargle.
  It Avill be of great benefit if the patient frequently  receives into his
mouth, throu^kan inverted funnel, the steams  of warm vinegar, myrrh,
aud honey.
   But when the putrid symptoms run high,  and the disease is attended
with danger, the only medicme that can be depended upoo is the Peru-
vian bark.  It may |je  taken in substance, if the patient's stomach will
bear it.   If not, an ounce of bark grossly powdered, with two drachms
of  Virginian snake root,  may  be boihd in an English pint and a half of
water to half a  pint; to which a tei-spoonful of the elixir  of vitriol may
be  added,  and an ordinary tea-cupful of it taken every  three or four
hours.  Blisterimr-plasters are very beneficial in this disease, especially
when  the patient's pulse and spirits are low.   They may  be applied to
the throat, behind the ears, or upon the back  part of the neck.
  Should  the vomiting prove  troublesome, it will be proper to give the
patient two table  spoonsful of the saline julep every hour.  Tea made 
198
OF COLDS  AND  COUGHS.
of mint and a little cinnamon will be very proper for bis ordinary drink,
especially if an equal quantity of red wim?be mixed with it.
   In case of a violent looseness, the size 6f a nutmeg of diascordium, or
the  japonic confection, may be taken  two or three times a day, or often-
er if necessary.
   If a discharge  of  blood  from the nose  happens, the steams of Avarm
vinegar may ffe received up the nostrils frequently ; and the drink must
be sharpened Avith spirits of vitriol, or tincture of roses.
   Iu case of a stranguary, the body must be fomented with warm water,
and emollient clysters given three or four times a-day.
   After the violence of the disease is over, the body should still be kept
open with mild purgatives;  as manna,  senna, rhubarb, or the like.
   If great weakness and dejection of spirits, or night-sweats, with other
symptoms of a consumption should ensue, we would  advise the patient to
continue the use of the  Peruvian bark, with the elixir of vitriol, and to
take frequently a glass of generous wine.  These together with a milk
diet, and riding on horseback,  are the most likely means for recovering
his strength.
                         CHAP.  XXXI.


                   OF COLDS AND-COUGHS.

          J.T has already been observed, that  colds  are  the effect of
an  obstructed perspiration; the common causes of Avhich we have like-
Avise endeavoured to point out, and shall not here repeat them.  Neither
shall we spend time in enumerating all the various symptoms of  colds,
as  they are pretty  generally known.   It may not however be amiss to
observe, that almost every cold is  a kind of fever, Avhich only differs in
degree from some of those that have already been treated of.
  No age, sex, or constitutution, is exempted from this disease; neither
is it in the power of any medicine or regimen to prevent it.   The  inha-
bitants of every climate are liable to catch cold, nor can even the greatest
circumspection defend them at all times from its attacks, ^mdeed, if the
human body  could be  kept constanly in an uniform degree of Avarmth,
such a thing  as catching cold would be impossible; but as  that cannot
be effected by any means, the perspiration must be liable to many changes.
Such changes, however, Avhen small, do not affect |he health; but, Avhen
great, they must prove hurtful.                             /
  When oppression of the breast, a stuffing of  the nose, unusual Avea-
riness, pain of the head,  &c. give ground to believe  that  the perspi-
ration is  obstructed, or,  in  other words,  that the person  has caught
cold,  he  ought  immediately  to lessen  his  diet, at least  the  usual
quantity  of his solid food, and to abstain  from  all strong liquors.  In-
stead of flesh, fish, eggs,  milk,  and other nourishing diet,  he may eat
light bread pudding, veal or chicken broth, panado, gruels, and such like.
His drink may be  A?atev gruel  sweeteued with, a  little  horiey; an 
•
OF COLDS AND  COUGHS.              199
 infusion of balm or linseed, sharpened Avith the juice of orange or lemon;
 a decoction of barley and liquorice, with tamarinds,  or any other cool,
 diluting, acid liquor.
   Above all, his  supper should be light; as small posset, or Avater-gruel
 sweetened with honey, and a little toasted bread in it.  If honey should
 disagree with his stomach, the gruel may be o.veetened Avith treacle or
 course sugar' and sharpened with the jelly of currants.   Those Avho have
 been accustomed to generous liquors may take A\ine-whey instead of gru-
 el, which may be sweetened as above.
   The patient  ought to lie longer than usual a-bed, and to encourage a
 gentle  sweat,* which is easily brought on towards morning, by drinking
 tea, or any kind of warm diluting liquor.   I have  often known this  prac-
 tice carry off a cold in one day, w hicb, in all probability, had  it been
 neglected, would have cost the patient his life, or have confined him  for
 some«ionths.   Would people sacrifice a little time to ease and  warmth,
 and practice a moderate  degree of abstinence  Avhen  the first symptoms
 of a cold appear, we have  reason to believe that most of the bad effects
 which flow from an obstructed perspiration might be prevented.   But, af-
 ter the disease  has gathered stmgth by delay, all attempts to remove it
 often prove vain.   A pleurisy, a peripneumony,  or a fatal consumption
 of the lungs, are the common effects of colds Avhich have either been to-
 tally neglected or treated improperly.
   Many attempt to cure a cold, by get|jpg drunk.  But this, to say no
 worse of it, is a very hazardous experiment.   No doubt it may sometimes
 succeed, by suddenly restoring the perspiration;  but  Avhen there is any
 degree  of inflammation, vv*hicli is frequently  the case, strong liquors, in-
 stead of removing the malady, will increase it.  By this means a common
 cold may be concerted into an inflammatory fever.
   When  those who  labour for their daily bread have the misfortune to
 catch cold, they camiot afford to lose a day or tAvo, in or^er to keep them-
 selves  Avarm, and. take a little medicine ; by which means the disorder is
 often so aggravated as to confine them  for a long  time, or even to render
 them ever after unable to sustain  hard labour.  But even such of the la-
 bouring poor as can afford to take care of themselves, are often too hardy
 to do it; they affect to despise  colds, and as long as they can craAvl about,
 scorn to be confined by what they call a common cold.   Hence it is, that
 colds destroy such numbers of mankind.  Like an enemy despised, they
 gather strength from delay, till at length they becomeifcvinciblc.   We of-
 ten see this verified in travellers, who,  rather than loV^day in the pro-
 secution of their business, throAV away their lives by pursuing their journey,
 even in the severest weather, Avith this disease upon them.
   It is certain hoAvever, that  colds may be tpo much indulged—When*
 a  person, for every  slight cold, shuts himself up  in a warm room, and
 drinks great quantities of Avarm  liquor, it may  occasion such a  general
 relaxation of the solids as will not be easily removed.   It will therefore
 be proper, when the disease  will permit, aud the iveather is mild, to jBio
 to the regimen  mentioned above gentle exercise  ;as walking, riding on
 horseback, or in a  carriage,  Ac.  An obstinate  cold which no medi-
 cine can remove, will yield to gentle exercise and a proper regimen of the
diet.
   Bathing the  feet and legs in warm Avater has a great tendency to re-
 nt ore the perspiration.  But care must be taken that  the  Avater be not 
200
OF  A COMMON  COUGH.
 too warm,  otherwise it will do hurt.  It should never be much  warmer
 than the blood, and the patient should go immediately to bed after usin«
 it.   Bathiag the feet in warm Avater, lying in bed, and "drinking warm
 water-gruel, or other Aveak liquors, will sooner  take off a spasm, and re-
 store the peivpiration, than all the hot sudorific medicines in the world.
 This  is  ad that is necessary for removing a common cold; and if this
 course be taken at the beginning, it will seldom fail.
   But when the symptoms do not yield #to abstinence, warmth, and dilu-
 ting liquors, there is reason to fear the approach of some other disease as
 an inflammation of the breast, an ardent fever, or the like.   If the pulse
 therefore be hard and  frequent, the skin hot and dry, and* the patient
 complains of his head or breast, it will be necessaiy to bleed, and to give
 the cooling powders recommended iu the scarlet fever every three or four
 hours, till they give a stool.
   It will likewise be proper to put a blistering-plaster on the bafit, to
 give two table-spoonsful of tlie  saline mixture every two hours,*and in
 short to treat the patient in all respects,  as for a slight fever.   I have
 often seen this course, when observed at the beginning, remove the com-
 plaints in two or three days, when the p Ant had all the symptoms of an
 approaching ardent fever, or an inflammation of the breast.
   The chief secret of preventing colds lies in avoiding,  as far as possible,
 all extremes either of heat or cold, and in taking care, when the  body
 is heated, to let it cool graduaflpt   These  and other circumstances re-
 lating to  this important subject, are so fully  treated of under the article
 Obstructed  Perspiration, that it is needless berg to resume the considera*
 tion of them.


                    OF A COMMON  COUGH.   •

   A  COUGH • generally the effect of a cold, which has either been
 improperly  treated,  or entirely  neglected.   When it  proves obstinate,
 there is always reason to  fear the consequences^as this shews a Aveak state
 of the lungs, and is often  the forerunner of a consumption.
   If the cough be violent, aud the patient young and strong, with a hard
 quick pulse, bleeding will be proper;  but in weak and relaxed habits,
 bleeding  rather prolongs the disqase.   When  the patient spits  freely,
 bleeding is unnecessary,  and sometimes hurtful as it tends to lessen that
 discharge.     ^A
   When  the co|^Pis not  attended with any degree of fever, and the
 spi^le is viscid and.tough, sharp pectoral medicines are  to be administer-
 ed, as gum  ammoniac, squils, &c.  Two table-spoonsful of the solution
 of gum ammoniac may be taken three or four times a-day, more or less,
 according to the age and  constitution of the patient—Squills may be given
 various ways: two ounces of the  vinegar, the oxymel, or the syrup, may
 be jnixed with the same quantity of simple  cinnamon  water, to which
 may be added an ounce  of common Avater and an ounce of balsamic sy-
 rup.  Two  table-spoonsful of this mixture may be taken three or four
 times a-day.
  A syrup made of equal parts lemon-juice, honey, and sugar-candy, is
likeAvise very proper in this kind of cough.   A table-spoonful of it may
be taken at pleasure. 
OF THE COMMON  COUGH.
201
  But when the defluxioii is sharp and thn, these medicines rather do
hurt.   In thi* case gentle opiates, oils, and mucilages are more proper.
A cup of an infusion of wild poppy leaves, and marsh-mallow  roots or
the flowers of colts-foot, may be t ken frequently;  or a tea-spoonful of
the paregoric elixir may be put  into the  patient's drink twice a day.
Fuller's Spanish infusion is also a very proper medicine in this case, and
may be taken in the quantity of a tea-cupful three or four times a-day.*
  When a cough is occasioned by acrid humours tickling the throat and
fauces, the patient should  keep some soft  pectoral lozenges, almost con-
stantly in his mouth;  as the Pontrefact liquorice cakes, barley-sugar, the
common balsamic lozenges, Spanish juice,  Ac.   These blunt the acrimo-
ny of the humours, and by takhig off their stimulating quality, help to
appe  se the cough, f
   In obstinate coughs, proceeding  from a flux of humours upon the lungs,
it will often be necessaiy, besides expectorating medicines, to have recourse
to issues, setons, or some other drain.  In this case I have ofteu observed
the mo t  happy effects  from a Burgundy-pitch plaster applied between
the shoulders.  I have ordered this simple remedy in the most obstinate
coughs, in a great  number of  cases, and in many different constitutions,
without ever knoAving it fail to give relief, unless Avhere there were evi-
dent  signs of an ulcer in the lungs.
   About the bulk of  a  nutmeg of  Burgundy-pitch may be  spread
thin  upon a piece  of soft  leather, about  the size of  the hand, and laid
between  the shoulder-blades.   It may be taken off and wiped every
three or  four days, and ought to be renewed once a fortnight or three
Aveeks.   This is indeed a  cheap and  simple medicine, and consequent-
ly  apt to be despised; but Ave will venture to  affirm,  that the Avhole
materia medica does not afford au application more efficacious  in almost
every kind of cough.  It has not indeed always au immediate effect;
but, if kept on for some time, it will succeed Avhere most other  medicines
 fail.
   The only iaconveniency attending this plaster is the itching Avhich it
 occasions; but surely this may be dispensed with, considering the advan-
tage which the patient may  expect to reap from the application; be-
 sides, when the itching becomes veiy uneasy, the plaster may be ta-
ken  off, and the part  rubbed with a  dry cloth,  or  washed  with a
 little wrarra milk and Avater.   Some caution indeed is necessary in dis-
continuing the use of such a plaster; this however may be safely done
 by making it smaller by degrees,  and at length quitting it altogether in a
 warm season.};
  • See Appendix, Spanish infusion.
  f In a former edition of this book  I recommended, for an obatinate tickling
cough, an oily emulsion, made with the paregoric elixir of the Edinburgh Dis-
pensatory, instead of tlie common alkaline spirit.  I have since been told by se-
veral practitioners, that they found it to be an excellent medicine in this disor-
der, and every way deserving of the character which I had given  it.  Where
this elixir is not kept, its place may be supplied by adding to the common oily
emulsion, an adequate proportion of the Thebaic tincture, or liquid laudanum.
  * Some complain that the pitch plaster adheres too fast, while others find dif-
ficulty in keeping it on.  This proceeds from the different kinds of pitch made
use ef, and likewise from the manner of making it.  I generally find it answers
best when mixed with a little bees-wax, and spread as cool as possible.   The
clear, hard, transparent pitch answers the purpose best.
                                   26 
202              OF  THE  HOOPING-COUGH,

   But coughs  proceed  from  many other c.mses besides  defluxioua
upon the lungs.  Iu these cases, the cure is not to be attempted by pec-
toral medicines.   Thus, in a cough proceeding from a foulness and debi-
lity of the stomach, syrups, oils,  mucilages, and all  kinds of balsamic
medicines do hurt.  The stomach cough may be knoAvn from  one that is
owing to a fault in the  lungs by this, that in tlie latter the patient coughs
whenever he inspires, or draws iu his breath fully; but in the former that
does not happen.
   The cure of this cough depends chiefly upon cleansing and strengthen-
ing the stomach;  for which purpose gentle vomits  and  bitter purgatives
are most proper.    Thus, after a vomit or two, the sacred tincture, as it h
called, may be taken for a considerable time  in the dose  of one or two
table-spoonsful twice a-day, or as often as it is found necessaiy, to keep
the body gently  open.   People may make this tincture themselves, by
infusing an ounce of hicra piera* in an English pint  of white wine, letting
it stand a few days and then straining it.
   In coughs which proceed from a debility of the stomach, the Peruvian
bark is likeivise of considerable service.  It may either be chewed, taken
in poAvder, or made into a tincture along with other stomachic bitters.
   A nervous cough can only be removed by  change  of air and proper
Cxercise;  to which may be added the use of gentle opiates.—Instead
of the saponaceous pill, the  paregoric elixir, Ac.  which  are only opi-
um disguised, ten, fifteen, twenty,  or twenty-five  drops of liquid lau-
danum, more or less,  as circumstances require, may be taken at bed-
time,  or  when  the  cough is most troublesome.   Immersing the feet
and hands in warm water will often appease the violence  of a nervous
cough.
   When a cough is only the symptom  of some other malady, it is in vain
to attempt to remove  it without first curing the disease from which it pro-
ceeds.  Thus when a cough is occasioned by teething, keeping the body
open, scarifying the gums, or Avhatever facilitates the cutting of the teeth,
likewise appeases  the  cough.  In like  manner when worms  occasion a
cough, such medicines as remove these vermin will generally cure the
cough; as bitter purgatives, oily clysters, and  such  like.
   Women, during the last months of pregnancy, are  often greatly afflicted
with a cough, which is generally relieved by bleeding,  and keeping the
body gently open.   They ought to avoid all flatulent food, and to wear a
loose easy dress.
   A cough is not only a symptom, but is often likewise  the forerunner of
diseases.   Thus, the gout is frequently ushered in bv a very troublesome
cough, which affects the patient for some days before  the coming on of
the fit.   This cough is generally removed by a paroxysm of the gout,
which should therefore be  promoted, by keeping the extremities Avarm,
drinking warm liquors, and bathing the feet and legs frequently in luke-
warm water.

     OF THE  HOOPING-COUGH, OR CHIN-COUGH.   ,

   THIS  cough  seldom  affects adults but proves  often fatal to child-
ren.   Such children as live upon  thin  watery diet, who breathe un-
* See Appendix, Hiera Pier a. 
OR  CHIN-COUGH.                     203
 wholesome air, and have  two little exercise, are most liable to this di-
 sease, and generally suffer most from it.
   The chin-cough is so well known, even to nurses, that a description of
 it is unnecessary.   Whatever hurts the digestion, obstructs the perspira-
 tion, or relaxes the solids,  disposes to this disease; consequently its cure
 must depend upon cleansing and strengthening the stomach, bracing the
 solids, and at the same time promoting  perspiration, and the different se-
 cretions.
   The diet must be  light and of easy digestion; for children, good bread
 made into pap or pudding,  chicken-broth, with other light spoon-meats,
 are proper;  but those who are farther advanced, may be allowed sago-
 gruel,  and if the fever be  not high, a little boilded chicken, or other
 while meats.  The drink may be hysop, or penny-royal tea,  sweetened
 with honey or sugar-candy, small whine-whey; or if the patient be Aveak,
 he may sometimes be allowed a little negus.
   One of the most effectual remedies in the chin-cough is change of air.
 This often removes  the malady, even when the  change seems to be from
 a  purer to a less wholesome air.   This may in some measure  depend on
 the patient's being removed from the place where the infection prevails.
 Most of the diseases 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 small distance, is quite free from it.   But whatever be the cause,
 we are sure of the fact.  No time ought therefore to be lost in removing
 the patient at some distance from the place where he caught the disease,
 and, if possible, into a more pure and Avarm air.*
   When the disease proves violent, and the patient is in danger of being
 suffocated by the cough, he ought to  be bled, especially if there  be a
 fever with a hard full pulse.   But as the chief intention of bleeding is to
 prevent au inflammation  of the lungs,  and to render it more safe to give
 vomits, it will seldom be necessary to repeat the operation;  yet if there
 are symptoms of au biflammation of the lungs,  a second or even a third
 bleeding may be requisite.
   It is generally reckoned  a favourable symptom when a fit of coughing
 makes the patient vomit.  This cleanses the stomach, and greatly relieves
 the cough.  It Avill therefore be proper to promote this  discharge, either
 by small doses of ipecacuanha, or the vomiting julep recommended in the
 Appendix, f
   It is veiy difficult to make children  drink after a vomit.   I have of-
ten seen  them happily deceived by infusing a scruple or half  a  drachm
 of the powder of ipecacuanha in  a tea-pot, with half a  pint of boiling
 Avater.  If this..be disguised with a few  drops of  milk and a little sugar,
 they will imagine it tea, and drink it very greedily.   A small tea-cupful
of this may be  given every quarter of  an hour, or rather every ten min-
utes, till it operates.
   When the child  begins to puke, there will be no occasion for drinking
any more, as the water already on die  stomach, will be sufficient.

  * Some think the air ought  not to be changed till the disease is on the decline;
but there seems to be no sufficient reason for this opinion, as patients have been
known to reap benefit from a  change of air at all periods of the disease.  It is
not sufficient to take the patient out daily in a carriage.  This seldom answers'
any good purpose; but often does hurt by giving him cold..
  t See Appendix, Vomiting  julep. 
^U4          OF  THE  HOOPING-COUGH,  &C.

  Vomits not only cleanse the stomach, which in this  disease  is  gene-
rally  loaded  with  viscid  phlegm,  but  they  likewise  promote  tlie
perspiration and other secretions, and ought therefore to be repeated ac-
cording to to the obstinacy  of the disease.  They should not  however
be strong; gentle vomits frequcutly repeated are  both lets dangerous,
and more beneficial than strong ones.
  The body ought to be kept gently open.   The best medicines for this
purpose are rhubarb  and its  preparations, as the  syrup,  tincture, A.c
Of these a tea-spoonful or two may be given  to an infant twice or thrice
a-day, as there is occasion.   To such as are farther advanced, the dose
mustbe proportionally increased, and repeated till it has the desired effect.
Those who  cannot be  brought to take the bitter tincture, may have au
infusion of senna and prunes, sweetened with  manna, coarse sugar, or ho-
ney;  or a few grains of rhubarb  mixed  with a tea-spoonful or two of
syrup, or currant jelly, so as to disguise the taste.    Most children  are
fond of syrups and jellies,  and seldom refuse even a disagreeable medi-
cine wheu mixed with them.
  Many people believe that oily  pectoral and balsamic medicines pos-
sess  wonderful virtues for the cure of the chin-cough, and accordingly
exhibit them plentifully to patients of every  age and constitution,  with-
out considering  that  every thing of this nature  must load the  stomach,
hurt the digestion, and  of course aggravate the disorder.*
  The millepedes, or wood-lice, are greatly recommended for the cure of
a chin-cough.  Those who  chuse to make use of these insects, may in-
fuse two ounces  of them bruised in a pint of small white Avine for one
night.  Afterwards the liquor may be  strained through a cloth,  and a
table-spoonfol of it given to the patient three or four times a-day.
  Opiates are sometimes necessary to allay the violence of the cough.
For this purpose a little of the syrup of poppies, or five, six, or seven
drops of laudanum, according to the age of the patient, may be taken iu
a cup of hyssop or penny-royal tea, and repeated occasionally.^
  Tne garlic ointment jg a well-knoAvn remedy in North-Britain for the
chin-cough.  It is made, by beating in  a  mortar, garljc, with an equal
quantity of hog's lard.  With this the soles of the feet may be rubbed
twice or thrice a-day;  but the best method is to spread it upon  a rag,
and apply it in the form of a plaster.  It should be renewed eveiy night
and morning at least,  as the garlic soon loses  its virtue.   This is an ex-
ceeding good medicine both in the chin-cough,;): and in most other coughs
of an obstinate nature.   It ought not however to be used ivheivthe pa-
tient is very hot or feverish, lest it should increase these symptoms.
  The feet  should be bathed once every tivo or three days in lukewarm
  * Dr.  Duplanil says, he has seen many good effects from the kermes mi-
neral  in this complaint, the cough being frequently alleviated even by the first
dose.   The dose for a child of one year old, is a quarter of a grain dissolved
in a cup of any liquid, repeated two or three times a-day.  For a child of two
years, the dose is hali a grain ; and the quantity must be thus increased in pre*
portion to the age of the patient.
  f Some recommend tlie extract of hemlock as an extraordinary remedy in
die hooping-cough; but so  far as I have been able to observe, it is no way supe-
rior to opium, which, when properly administered, will often relieve some of the
most troublesome symptoms of this disorder.
  t As this disease is evidently spasmodic, I am inclined to think that tonic
medicines will in time be found the most proper for its cure. 
        INFLAMMATION OF  THE  STOMACH,  &C.    205

water;  and  a Burgundy-pitch  plaster kept  constantly  between the
shoulders.  But when the disease proves very violent, it will be neces-
sary, instead of it, to apply a  blistering-plaster, and to keep the part open
for some time with issue-ointment.
  Wheu the disease is prolonged, and the patient is free from  a fever,
the Peruvian bark, and other bitters, are the  most proper medicines.
The bark may  eith< r be taken in substance, or in a decoction or infusion,
as is most agreeable.  For a child,  ten, fifteen, or twenty grains, accord-
ing to the age of the  patient, may  be given three or four times a-day.
For an adult, half a drachm or two scruples will be proper.   Some give
the extract of the bark with cantharides;  but  to manage this requires
considerable  attention.   It is more safe to give a few grains of castor
along with the  bark.   A child of six  or seven years of age may take
seven or eight grains of castor, with fifteen grains of powdered bark, for
a dose.   This may be made  into a mixture with two or  three ounces of
auy simple distilled Avater, and a little syrup,  and taken three or four
times a-day.
                      CHAP.  XXXII.

  INFLAMMATION  OF THE STOMACH, AND  OTHER
                            VISCERA.

       ALL inflammations of the bowels are dangerous, and require
the most speedy assistance; as they frequently end in a suppuration, and
sometimes in a mortification, which is certain death.
  CAUSES.—Au inflammation of the stomach may proceed from any
of the causes Avhich produce au inflammatory fever; as cold liquor drank
while the body is Avarm, obstructed perspiration, or the sudden striking
in of any eruption.   It may likewise proceed from the acrimony of the
bile, or from acrid and stimulating substances taken  into the stomach;
as strong vomits or purges, corrosive poisons,  and such like.  When the
gout has been  repelled from the extremities, either by cold or improper
applications, it often occasions an inflammation of the stomach.  Hard
or indigestible substances taken into the stomach, as bones, the stones of
fruit, Ace. may likewise have that effect.
  SYxMPTOMS.—It is attended with a fixed pain and burning heat in
the stomach; great restlessness  and anxiety;  a  small, quick,  and hard
pulse; vomiting, or, at least, a nausea and sickness; excessive thirst;
coldness of the  extremities;  difficulty of  breathing;  cold  clammy
sweats;  and sometimes convulsions and faintinir fits.  The  stomach is
swelled,  .and often feels hard to the touch.   One of the most certain signs
of this disease,  is the sense of  pain vthich the patient feels upon taking
any kind of food or drink, especially if it be either too hot or too cold.°
  Wheu the patient vomits every thing he eats or drinks, is extremely
restless, has a hkkup, with an  intermitting pulse, and frequent fainting-
fits,  the danger is very great.
  REGIMEN.—All acrimonious, heating aud irritating food and drink,
ar  carefully to be avoided.  The weaknes of  the patient may deceive
the bystanders, aud induce them to give wines, spirits, or other cordials; 
206
INFLAMMATION  OF  THE  INTESTINES.
but these never fail to increase the disease, and often  occasion sudden
death.  The inclination to vomit my likewise impose on the attendants,
and make them think a vomit necessary; but that too  is almost certain
death.
   The food must be light, thin, cool,  and easy of digestion.  It must be
given in small quantities, and should neither  be quite  cold, nor too hot.
This gruel made of barley  or oatmeal, light  toasted bread dissolved in
boiling water, or very weak chicken broth, are the most proper.   The
drink should be clear whey, barley-water, water in which  toasted bread
has been boiled, or decoctions of emollieut vegetables, as  liquorice and
marsh-mallow roots, sarsaparilla, or the like.
   MEDICINE.—Bleeding in this disease is absolutely necessary, and
is almost the only  thing that can be depended on.  When the disease
proves obstinate, it will often be proper to repeat  this  operation several
times, nor must the low state of tlie  pulse deter us from doing so.   The
pulse indeed generally rises upon bleeding, and  as long as that is the
case, the operation is safe.
   Frequent  fomentations  with  luke-warm  Avater, or a decoction of
emollient vegetables, are likewise beneficial.   Flannel cloths dipped in
these must be applied to the region of the stomach, and removed as they
grow cool.  They must neither be applied  too warm, nor  be suffered to
continue till they  become quite cold, as either of  these extremes would
aggravate the disease.
   The  feet and legs ought likewise to be  frequently bathed in luke-
Avarm water, and  Avarm bricks  or   poultices  may be applied  to the
soles of the feet.   The warm bath,  if it can be conveniently used, will
be of great service.
   In this,  and all other inflammations of  the boAvels,  an  epispastic, or
blistering-plaster,  applied over the part affected, is one  of  the best reme-
dies I know.  I have often used  it, and do not recollect one instance
Avherein it did not give relief to the patient.
   The only internal medicines Avhich  Ave shall venture  to recommend
in this disease, are  mild  clysters.   These  may be made of warm
water, or thin water-gruel; and if the  patient is  costive, a little sweet
oil, honey, or manna, may be added.  Clysters auswer the purpose of
an internal fomentation, Avhile  they keep the  body open,  aud  at the
 same time nourish the patient, Avho is often in this  disease unable to re-
 tain  any  food  upon his stomach.   For these reasons  they must  uot be
neglected, as the patient's life may depend on them.

          INFLAMMATION OF THE  INTESTINES.

   THIS is one of the most painful and dangerous diseases that mankind
 is liable to. It generally proceeds from the same cause  as the inflam-
 mation of the stomach; to which may be added costiveness, worms, eat-
 ing unripe fruits;  or great quantities of nuts, drinking hard windy malt
 liquors, as stale bottled beer or  ale,  sour wine, cyder, &c.   It  may like-
 wise be occasioned by a rupture, by schirrous tumours of the  intestines,
 or by their opposite sides  growing together.
    The inflammation  of  the intestines is denominated  Iliac passion,
 Enteritis,  &c.  according  to the name of  the  parts affected.   The
 treatment however is nearly the same whatever  part of the intestiuai 
         INFLAMMATION Ot  THE  INTESTINES.      207

canal be the seat of the disease; Ave shall therefore omit these distinc-
tions, lest they should perplex the reader.
   The symptoms here are nearly the same as in the foregoing disea-e;
only the pain, if possible, is  not  so acute, and is situated lower.   The
vomiting is likeAvise more violent, and sometimes even the excrements,
together Avith  the clysters are  discharged by the mouth.  The patient
is continually belching  up wind, and has often  an obstruction  of his
urine.
  While  the  pain shifts, and the  vomiting only turns at certain inter-
vals, and while the clysters pass downwards, there is ground for hope; but
when the clysters  and faces are vomited, and the patient is exceeding
weak, with a low fluttering pulse, a pale  countenance, and a disagreea-
ble or stinking breath, there is great reason to fear that the consequences
will prove fatal.  Clammy sweat, black foetid stools, with a small inter-
mitting pulse, and a total cessation of pain,  are signs  of a mortification
already begun, and of an approaching death.
   REGIMEN.—The regimen in this disease is in general the same as
in  an inflammation of the stomach.  The  patient must be kept quiet,
avoiding cold, and all violent passions of the mind.  His food ought to
be very light, and given iu  small quantities;  his drii;k Aveak and dilu-
ting ; as clear whey, barley-Avater,  and such like.
   MEDICINE.—Bleeding in this, as Avell as in the inflammation of the
stomach, is of the greatest importance.  It should be performed as soon
as the symptoms appear, and must be repeated according to the strength
of the patient, and the violence of the disease.
   A  blistering plaster is here  likewise to be applied  immediately over
the part where the most violent pain is.  This not only relieves the pain
of the bowels, but even clysters and purgative medicines, which before
had no effect, will operate when the blister begins to rise.
   Fomentations and laxative  clysters are  by no means to be omitted.
The  patient's feet and legs should  frequently be bathed iu warm Avater;
and  clothes dipped into  it applied to his belly.  Bladders filled with
Avarm water may  likewise be applied to the region  of the navel, and
warm bricks, or bottles  filled  with warm water, to the soles of the feet.
The clysters may be made of barley-Avater  or thin gruel with salt, and
softened with swreet oil  or fresh butter.   These may be administered
evTery two or three hours, or oftener, if the patient continues costive.
   If the disease  does not yield to clysters and fomentations, recourse
must be had to pretty strong  purgatives: but as these, by irritating the
boAvels,  often increase  their  contraction, and by  that  means frustrate
their own intention, it Avill be necessaiy to join them with opiates, Avhich
by allaying the pain, and relaxing the spasmodic contractions of the guts,
greatly assist the operation of purgatives in this case.
   What answers the purpose of opening the body very well, is a solution
of the bitter purging salts.  Two ounces of these may be dissolved in an
English pint of Avarm water,  or thin gruel, and a tea-spoonful of it taken
every half hour till it  operates.   At the same  time  fifteen, twenty, or
twenty-five drops of laudanum may be given in a glass of  peppermint
or simple cinnamon-water, to appease the irritation and  prevent the vomit-
ing, Ac.
   Acids have often a very happy effect in staying  the vomiting, and ap-
peasing the otlier violent symptoms of this disease.  It will therefore be 
208       INFLAMMATION  OF  THE  INTESTINES.
of use to sharpen the patient's drink with cream of tartar, juice of le-
mon ; or, when these cannot be obtained, with vinegar.
   But it often happens  that no  liquid whatever will stay on the sto-
mach.  In  this case the patient must take  purging pills.  1 have ge-
nerally found the  following answer very well:  Take jalap in powder,
and vitriolated  tartar, of each half a drachm, opium one grain, Castile
soap as much as will make the mass fit for pills.  These must be taken
at one dose, and if they do not operate in a few hours, the dose may be
repeated.                                                   ...
   If  a stool cannot be  procured by any of the above means, it will be
necessaiy to immerse the  patient in warm water up to the breast.   I
have  often seen this succeed when other means had  been tried in vain.
The patient must continue in the water as long as he can  easily bear it
without fainting, and if one immersion has not the desired effect, it may be
repeated as soon as the patient's strength and spirits are recruited.   It is
more  safe for him  to go frequently  into the bath, thaa to continue too
long at a time, and it is often necessary to  repeat it several times before
it has the desired  effect.
   It  has sometimes happened, after all other means of procuring a stool
had been tried  to no purpose,  that this was brought about  by immersing
the patient's lower extremities in cold water, or making him  walk on a
Avet pavement,  and dashing his legs and thighs with the cold water.
This method, when others fail, at least merits a trial.   It is  indeed at-
tended with some denser; but a  doubtful remedy is better than none.
   In desperate cases it is common to  give  quicksilver.   This may be
given to the quantity of  several ounces, or even a  pound, but should
not exceed that.*'   When there is reason  to suspect a mortification of
the guts, this medicine ought not to be tried.   In  that case it cannot
cure  the patient, and will  only hasten his death.  But when the obstruc-
tion is occasioned by any cause that can be removed by force, quicksilver
is not only a proper medicine, but the best that can  be adminstered, as
it is the fittest  body we know for making its way through the intestinal

   If the disease proceeds from  a rupture,  the patient must be laid with
 his head very  Ioav, and the intestines returned by gentle pressure with
 the hand.   If this, with fomentations and clysters, should not succeed,
 recourse might be had to  a surgical operation, which may give the patient
 relief
   Such as would  avoid this  excruciating and dangerous disease, must
 take care  never to be too long without a stool.   Some who have died of
 it had  several pounds of hard dry faces taken out of their guts.  They
 should likewise, beware of eating too freely of sour or unripe fruits or
 drinking stale windy liquors, Ac.  I have knewn it brouglit_on  by vy-
 ing too much  on baked fruits, which are seldom good   It hkew  se^no-
 reeds frequently from cold caught by wet clothes, &c but especially from
 wet  feet.
  • When quicksilver is given in too large quantities, it defeats its ^n mten
tion, as it drags down the bottom of the stomach, which P«^'"ffij
over the  Pylorus-  In this case the patient should be hung up by the heels, in
order that the quicksilver may be discharged by his mouth. 
209
                         OF THE  COLIC.

   THE colic has a  great  resemblance to the two preceding diseases
both in its symptoms  and method of cure.   It is generally attended
with costiveness and acute pain of the bowels; and requires diluting diet,
evacuations,  fomentations, Ac. *
   Colics are variously denominated according to  their causes, as the
flatulent, the bilious, the hysteric,  the nervous, Ac.  As  each of these
requires a particular method of treatment, we  shall point out  their most
general symptoms, and the means to be used for their relief.
   The flatulent, or wind-colic, is  generally occasioned by an  indiscreet
use of unripe fruits, meats of hard digestion, windy vegetables, ferment-
ing liquors,  and such like.  It may likewise proceed from an obstructed
perspiration, or catching cold.  Delicate people, whose digestive powers
are Aveak, are most liable to this kind of colic.
   The flatuleut colic may either  affect the stomach or intestines.  It is
attended with  a painful  stretching  of the affected part.  The patient
feels a rumbling in his guts,  and is generally relieved by a discharge  of
wind, either upAvards or  downwards.   The pain is seldom  confined  to
any particular part, as the vapour wanders from one division of the bowels
to another till it finds a vent.
   When the disease proceeds from windy liquor, green fruit, sour herbs,
or the like, the best medicine on the first appearance of the  symptom  is
a dram of brandy, gin,  or  any good spirits.   The patient should like-
Avise sit with his feet upon a warm hearth-stone,  or apply warm bricks
to them; and warm cloths may be  applied to his stomach and  bowels.
   This is the only colic wherein ardent  spirits, spiceries, or  any thing
of a hot nature may be ventured upon.   Nor indeed are they to be used
here unless at the very beginning, before any symptoms of inflammation
appear.  We have reason to believe, that a colic occasioned by wind  or
flatulent food, might always be cured by spirits and  warm liquors, if they
Avere taken immediately upon perceiving the first uneasiness;  but Avhen
the  pain has continued for  a considerable time,  and there is  reason  to
fear an inflammation of the bowels is already begun, all hot things are  to
be avoided as poison, and the patient is to be treated in the same man-
ner as for the inflammation of the intestines.
   Several kinds of food, as honey, eggs, &c. occasion colics in  some
particular constitutions.   I have generally found the best method of cure
for these, was  to drink plentifully of small  diluting liquors,  as Avater-
gruel, small posset, water  with toasted bread soaked in it, Ac.
   Colics Avhich proceed from excess and  indigestion generally cure them"
selves by occasioning vomiting or purging.  These  discharges  are by no
means  to be stopped, but promoted by drinking  plentifully  of warm
water,  or weak posset.   When their violence  is over, the patient may
take a dose of rhubarb, or any other gentle purge,  to carry off the dregs
of his debauch.
   Colics Avhich are occasioned by Avet feet, or catching  cold, may gene-
rally be removed at the beginniug, by bathing  the feet and legs in warm
water, and thinking such diluting liquors as will promote the perspiration,
as weak whey, or water gruel, with  a small quantity of spirits in it.
   Those  flatulent colics,  ivhich prevail  so much among country people,
might generally be prevented, were they careful to  change their cloth** 
210                    OF THE  COLIC.
when they get wet.  They ought likewise to take a dram, or to drink
some warm liquor after eating any kind of green trash.  We do not mean
to recommend the practice of dram  drinking, but in this case ardent spi-
rits prove a real medicine, and indeed the best that can be administered.
A glass of good peppermiin-water Avill have nearly the same effect as a
glass of brandy, and in some cases  is rather to be  preferred.
   The bilious colic is attended with very acute pains  about the region
of the naval.  The patient complains of great thirst, and is generally
costive.  He vomits a hot,  bitter, yellow coloured bile, w hich being dis-
charged, seems to afford some relief, but is quickly followed by the same
violent pain  as before.   As the distemper advances,  the  propensity to
vomit sometimes increases so as to become almost continual, and the pro-
per motion of the intestines is so  far perverted,  that there are all the
symptoms of  impending iliac  passion.
   If the patient be young  and strong, and the pulse full and frequent, it
will be proper to bleed, after which clysters may be administered. Cleat-
Whey or gruel, sharpened Avith  the juice  of lemon, or cream of tartar,
must be drank freely.   Small chicken broth, Avith a little mauna dissol-
ved in it, or a slight decoction of tamarinds, are likewise very proper, or
any other thin, acid, opening  liquor.
   Besides bleeding and plentiful dilution, it will be necessary to foment
 the belly with cloths dipped  in Avarm water, and  if this should not sue
 ceed, the patient must be immersed up to the breast in warm water.
   In  the bilious  colic  the vomiting is often very difficult to  restrain.
 When this happens, the patient may drink a decoction of toasted bread,
 or an infusion of garden mint iu boiling water.  Should these not have
 the desired effect, the saline draught, with a few drops of laudanum in it,
 may be given, and repeated according to the urgency  of the symptoms.
 A small quantity of Venice treacle may be spread  iu form of a cataplasm,
 and applied to the pit of the stomach.  Clysters, with a proper  quantity
 of Venice treacle or liquid laudanum in them, may likewise be frequent-
 ly administered.
    The hysteric colic bears a great resemblance to the bilious.   It is at-
 tended with  acute pains about the region of the  stomach, vomiting, Ac.
 What the patient vomits in this case is commonly of  a greenish colour.
  There is a great  sinking of the spirits, with dejection of mind and diffi-
  culty of breathing, which are the  characteristic symptoms of this disor-
  der.   Sometimes it is accompanied with the jaundice, but this generally
  goes off of its own accord in a few days.                 ^
     In this colic, all evacuations, as  bleeding, purging, vomiting, &c. do
  hurt.   Every thing that weakens the patient, or sinks  the spirits, is to be
  avoided.  If however the vomiting should prove violent,  hike-warm
  water, or small posset, may be drank tocleanse the stomach.  Afterwards
  the patient may take fifteen, twenty, or twenty-five drops of liquid lauda-
  num in a glass of cinnamon-water.  This may be  repeated every ten or
  twelve hours till the symptoms abate.
     The  patient may likewise take four or five of the fetid  pills every
  six hours, and drink a cup of penny-royal tea  after them.   If asata-
  tida  should  prove disagreeable,  which  is sometimes  the case  a tea-
  spoonful of the  tincture of castor in  a cup of penny-royal tea, ot
  thirty or forty drops of the  balsam of Peru dropped  upon a bit of loat- 
OF  THE  COLICi
211
*ugar, may be taken in its stead.   The anti-hysteric plaster may also be
used, which has often a good effect.*
   The nervous colic prevails among miners, smelters of lead, plumbers,
the manufacturers of white  lead, Ac.  It is very common m the cyder
counties of  England, and is supposed to be occassioned by the leaden
vessels used iu preparing that liquor.  It is likewise a frequent disease in
the West-Indies, where it is termed the dry  belly-ache.
   No disease of the bowels is attended with more excrutiating pain than
 this.   Nor is it soon at an end.  I have known it continue eight or ten
 days with very little  intermission, the body  all  the while  continuing
 bound in spite of  medicine, yet at length yield, and the patient recover.f
 It generally however, leaves the patient weak, and often ends in a patsy.
   The general treatment of this disease is so nearly the same with that
 of the iliac passion, or inflammation of the guts, that we shall not insist
 upon it.   The body is to  be opened by mild purgatives given m small
 doses, and frequently repeated, and their operation  must be assisted  by
 soft oily clysters, fomentations, Ac.   The caster-oil is reckoned peculiar-
 ly proper in  this disease.   It may both be mixed with the  clysters and
 given by the mouth.f:                                  .      ,.
 " The  Barbadoes tar is said to be an efficacious medicine in this com-
 plaint.   It may be taken to the quantity of two drachms three times a-
 day, or oftener if the stomach will bear it.  This tar, mixed Avith an equal
 quantity of strong rum, is  likewise proper for rubbing the spine, in case
 any tin-ling or other symptoms of the palsy,  are felt.   When the tar
 cannot  be obtained, the back may be rubbed with strong  spirits, or a lit-
 tle oil of nutmegs, or of rosemary.
    If the  patient  remains  weak and languid after this disease, he must
 take exercise on horseback, and use an infusion of the Peruvian bark in
 wine.  When the disease ends in a palsey, the Bath-waters are found to

 ^To'avouUM^kind of colic, people  must  shun all sour fruits  acids,
  and austere  liquors, Ac.   Those who vvork in lead ought never to go to
  their business fasting, and their food should be oily or fat.  They may
  take a  glass of salad oil, with a little brandy or rum  every morning, but
  should never take spirits alone.  Liquid  aliment is best for them; as
  fat broths, Ac but low living is bad.  They should frequently go a little
 out of the tainted air;  and should never suffer themselves to be costive
  In the West-Indies and on the coast of Guinea, U has been  found of
  great use for preventing this colic, to  wear a piece of flannel round the
  waist and to drink an infusion of ginger by way of tea.
    Sundry other kinds of  this disease might be mentioned, but too many
   distinctions wotdd tend only to perplex the reader   Those already men-
   tioned are the most  material, and  should indeed be attended to, as their
   treatment is very different.   But even persons who are not in a condi-
   tion to distinguish veiy accurately in these matters, may nevertheless be

    *  See Appendix. Anti-Hysteric plaster-  ,,,.„-.               ,
    + As the smoke of tobacco thrown into the bowels will often procure a stool
   when 'll other means have failed, an  apparatus for this purpose ought to be
   keot bv every surgeon.  It may be purchased at a small expense, and will be of
   service in several other cases, as  the recovery of drowned persons, &c
     * Tlie dose is from one table-spoonful to two or  three, if necessary to  open
   the body. 
212         INFLAMMATION  OF THE  KIDNEYS.

of great service to patients in colics of every kind, by  only observing
the following general rules, viz.   To bathe the feet and legs in warm wa-
ter, to apply bladders filled with warm Avater, or cloths Avrung out of it,
to the stomach and bowels;  to make the patient drink freely of diluting
mucilaginous liquors; and to give him an emollient clyster every two or
three hours.  Should these not succeed, the patient ought to be immersed
ju Avarm Avater.

            INFLAMMATION  OF THE KIDNEYS.

   CAUSES.—This disease may proceed from any of those causes which
produce an inflammatory  fever.   It may  likeAvise  be occasioned  by
wounds or bruises of the kidneys; small stones or gravel lodging within
 them;  by strong diuretic medicines, as spirits of turpentine, tincture of
 cantharides, &c.  Violent motion, as hard riding or Avalking, especially
 in hot weather, or whatever drives the  blood too forcibly into the kid-
 neys, may occasion the malady.  It may likewise proceed from 1) ing
 too  soft, too much on the back, involuntary  contractions, or spasms in the
 urinary vessels, Ac.
   SYMPTOMS.—There is a sharp pain about the region of the kid-
 neys, with some degree of fever, and a stupor or dull pain in the  thigh of
 the  affected side.  The urine is at first clear, and afterwards of a reddish
 colour; but in the Avorst kind of the disease it generally  continues pale,
 is passed with difficulty, and commonly in small quantities at a time. The
 patient feels great uneasiness when he endeavours to walk or sit upright.
 He lies with most ease on the affected side, and has generally a nausea or
 vomiting, resembling that which happens in the colic.
   This disease however may be distinguished from the colic by the pain
 being seated farther back, and by the  difficulty of passing urine with
 which it is constantly attended.
   REGIMEN.—Every thing of a heating or stimulating nature is to be
 avoided.   The food must  be thin and  light; as panado,  small  broths,
 with mild vegetables, and  the like.   Emollient and thin liquors must
 be  plentifully drank;   as clear Avhey,  or balm-tea sweetened with ho-
 ney, decoction of marsh-mallow roots;  with barley aud liquorice,  &r.
 The  patient notwithstanding the  vomiting,  must constantly keep  sip-
 ping small quantities  of these or other diluting liquors.   Nothing so
 safely and  certainly abates the inflammation, and expels the obstruct-
 ing cause, as copious dilution.  The patient must be kept easy, quiet,
 and free  from  cold, as  long  as any symptoms of inflammation  remain.
   MEDICINE.—Bleeding  is generally  necessary, especially at the
 beginning.  Ten or tAvelve ounces  may be let  from  the arm  or  foot
 with  a lancet, and if  the  pain and inflammation continue,  the oper-
 ation may  be  repeated in  twenty-four hours, especially if the patient
 be  of  a full habit.  Leeches may likewise be applied to the hemorrhoi-
 dal veins, as a discharge from these will greatly relieve the patient.
   Cloths dipped  in warm water, or bladders filled with it,  must be ap-
 plied as near as possible to the part  affected, and renew ed as they grow
 cool.   If the bladders be filled with a decoction of mallows  and camomile
 flowers, to Avhich a little saffron is added, and mixed with about a third of
 new milk, it will  be still more beneficial.
   Emolliept clysters ought frequently to be administered; and  if these 
           INFLAMMATION OF  THE  BLADDER.       213

tlo not open the body, a little salt and honey or manna may be added  to
them.
  The same course is to be followed where gravel or stone is lodged in
the kidney, but Avhen the gravel or stone is separated from the kidney,
and lodges in the Ureter,* it will be proper, besides the fomentations,
to rub the small of the back with sweet oil, and to give gentle diuretics;
as juniper-water,  sweetened with the syrup  of marsh-mallows:  a tea-
spoonful of the sweet spirits of nitre,  with a few drops of laudanum,
may now and then  be put in a cup  of the patient's drink.—He ought
likewise to take exercise on horse-back, or in  a carriage, if he be able to
bear it.
  When the disease is protracted beyond the seventh or eighth day, and
the patient complains of a stupor and heaviness  of the part, has frequent
returns  of dullness, shivering, Ac. there is reason to suspect that matter
is forming in the kidney, and that an abscess will ensue.
   When matter in the urine sheAvs that an ulcer is already formed in the
kidney, the patient must be careful  to abstain from all acrid, sour and
salted provisions, and to live chiefly upon mild mucilaginous herbs and
fruits, together  with the broth of young animals, made with barley, and
common pot-herbs, &c.   His drink may be whey, and butter-milk that
is not sour.  The latter is by some reckoned  a specific  remedy in ulcers
of the kidneys.   To answer this character however, it must be drank for
a considerable time.   Chalybeate waters have likewise been found bene-
ficial in this disease.  This medicine is easily obtained, as it is found iu
every part of Great-Britain.   It must likewise be used for a considerable
time, in order to produce any salutary effects.
   Those Avho are liable to freqent returns of inflammation, or obstruc-
tions of the kidneys, must abstain from Avines, especially such as abound
with tarter; and  their food ought to be light,  and  of easy digestion.
They should use moderate exercise, and should not lie too hot, nor too
much on their back.

           INFLAMMATION OF THE BLADDER.

   THE inflammation of the  bladder proceeds, in a great measure, from
the same causes as  that of the kidneys.   It  is known by an acute pain
towards the bottom of the  belly, and difficulty of passing urine, with some
degree  of fever, a constant inclination to go to stool, and a perpetual de-
sire to make Avater.
   This disease must be treated on the same principles  as the one imme-
diately preceding.   The  diet must be light and thin, and the drink of a
cooling nature.   Bleeding is very proper at the beginning, and in robust
constitutions it will often be necessary to repeat it.   The lower  part of
the  belly should be fomented with  warm water, or a decoction of mild
vegetables; and  emollient clvsters ought frequently to be administered,
Ac.
   The patient should  abstain from every thing that is of a hot, acrid
  * The ureters are two long and small canals, one on each side which carry
the urine from the bason of the kidneys to the bladder.  They are sometimes
obstructed by small pieces of gravel falling down from the kidneys, andlodg-<
ing in them, 
214
INFLAMMATION  OF THE  LIVER.
 and stimulating quality, and should live entirely upon small broths, gru-
 els, or mild vegetables.
   A stoppage of urine may proceed from other causes besides an inflam-
 mation of  the  bladder;  as  a swelling of the  hemorrhoidal veins, hard
fads lodged in the rectum,  a stone in the bladder, excrescences in the
 urinary passages, a palsy of the bladder, hysteric affections, ts:c.   Each
 of these requires a particular treatment,  which does not fall under our
 present consideration.   We shall only observe, that in all of them mild
 and gentle applications are  the  safest, as strong diuretic medicines, or
 things of an  irritating nature,  generally increase the danger.   I have
 knoivn some  persons kill themselves by introducing probes  into the
 urinary passages, to remove, as they thought, somewhat that obstructed
 the discharge of urine, and  others bring on a violent inflammation of the
 bladder, by using strong diuretics, as oil of turpentine, Ac. for that pur-
 pose.

              INFLAMMATION OF THE LIVER.

   THE liver is  less subject to inflammation than most of the other visv
 cera, as in it the circulation is slowrer; but when an  inflammation does
 happen, it is Avith difficulty removed, and often ends in a suppuration or
 scirrhus.
   CAUSES.—Besides the common causes of inflammation, we may here
 reckon the following, viz. excessive fatness, "a scirrhus of the liver itself,
 violent shocks from strong vomits when the liver Avas before unsound, an
 adust or  atrabiliarian state of the blood, any thing  that suddenly cools
 the liver after it has been greatly heated, stones obstructing the course of
 the bile, drinking strong wines and spirituous liquors, using hot spicy ali-
 ment, obstinate hypochondriacal  affections, &c.
   SYMPTOMS.—This disease  is knoAvn by  a painful tension of the
 right side under the false ribs,  attended with some degree of  fever,  a
 sense of weight or fulness of the part, difficulty  of breathing,  loathing
 of food, great thirst, with a pale or yellowish colour of the skin and eyes.
   The symptoms here are various, according to the  degree of inflamma-
 tion, and likewise according to the particular part of the liver where the
 inflammation happens.   Sometimes the pain is so inconsiderable, that an
 inflammation is  not so much as  suspected;  but when it happens in the
 upper or  convex part  of  the  liver, the pain is more acute,  the pulse
 quicker, and the patient is often troubled with  a dry cough, a hickup,
 and a pain extending to  the shoulder, with difficulty of lying on the left
 side, &c.
    This disease  may be distinguished from the pleurisy, by the pain be-
 ing less violent,  seated under the false ribs,  the pulse not so  hard, and
 by the difficulty of lying on the left side.   It may be distinguished from
 the hysteric and  hypochondriac disorders by the degree of fever with
 Avliich it is always attended.
    This disease  if properly treated,  is  seldom mortal.   A   constant
 hickuping, violent fever,  and  excessive thirst,  are  bad  symptoms—
 If it ends in a suppuration, and the  matter cannot be discharged out-
 wardly, the  danger is great.   When the scirrhus  of the  liver en-
 sues, the patient, if he observes a proper regimen,  may nevertheless
 live a -number  of years tolerably easy; but if he indulges in aqimal 
INFLAMMATION OF  THE  LIVER.         2l£
food and strong liquors, or take meelicines of an acrid or irritating nature,
the scirrhus will be converted into a cancer, which must infallibly prove
fatal.
   REGIMEN.—The same regimen is to be observed in this as in oth-
er inflammatory disorders.   All hot things are to be as carefully avoid-.
ed, and cool diluting liquors, as whey,  barley-water, Ac. drank freely.
The food must be light and thin, and the body, asAvell as the mind, kept
easy any quiet.                                                       -»
   MEDICINE.—Bleeding is proper at the beginning  of  this disease,  :
and it will often be necessaiy, even though the pulse should not feel hard,
to repeat it.  All violent purgatives are to be avoided; the body how-
ever must be kept gently open.   A decoction of tamarinds,  with a 1111*16
honey or  manna, will answer this purpose very well.  The  side affected
must be fomented in the manner directed in the foregoing disease.   Mild
laxative  clysters  should be frequently administered; and, if the pain  .
should notwithstanding continue  violent, a blistering plaster may be ap-
plied over the part affected; or rather a plaster made of gum ammoniac
 and vinegar of squills.
   Medicines which promote the secretion of urine have a very good ef-
 fect  here.   For tins purpose half a drachm of purified nitre, or  a tea-
 spoonful of the SAveet spirits of nitre, may be taken in a cup of the patient's
 drink three or four times a-day.
   When there is an inclination  to  sweat, it ought to be promoted, but
 not by warm sodorifics.   The only thing to be used for  that purpose, is
 plenty of diluting liquors drank about the warmth of human blood.   In-
 deed the  patient in this case, as well as in all other topical inflammations,
 ought to drink nothing that is colder than the blood.
   If the stools should be loose, and even streaked ivith blood, no means
 must be used to stop them, unless they  be so frequent as to Aveakeu  the
 patient  Loose stools ofteu prove  critical, and carry off the disease.
   If an abscess or imposthume is formed in the  liver, all methods should
 be tried to make it  break and discharge itself outwardly, as fomentations,
 the application of poultices, ripening cataplasms, Ac.—Sometimes indeed
 the matter of an abscess  comes away in the urine, and sometimes it is dis-
 charged by stool, but these are  efforts of nature which no means can pro-
 mote.  Wlien the abscess bursts into the cavity of the abdomen at large,""
 death must ensue, nor Avill the event be more favourable  Avhen the ab-
 scess is opened by an incision, unless in  cases Avhere the liver adheres to
 the peritonaeum, so  as to form a  bag for the matter, and prevent it fronr
 falling into the cavity of the abdomen;  in Avhich case  opening the  ab-
 scess by a sufficiently large incision will probably save the patient's life/'
    If the disorder, in spite of all endeavours to the contrary, should end
 in a scirrhus, the patient must be careful, to regulate his  diet, Ac. in such
 a manner as not to aggravate the disease.  He must not indulge in flesli,
 fish, strong liquors, or  any highly seasoned or  salted  provisions;  but
 should,  for the most part, live  on mild vegetables;  as  fruits and roots;
 taking gentle exercise, and drinking Avhey, barley-water, or butter-milk.
 If he takes any thing stronger, it should be fine mild ale, which is less
 heating than wines or spirits.
,< * I know a gentleman who has had several abscesses of the liver opened, and
is now a strong and healthy man, though above eighty years'of age.- 
  JlO         OF THE CHOLERA MORBUS,  &C.

     We shall take no notice of inflammations of the other viscera.—They
  must in general be treated upon the same principles, as those already
  mentioned.  The chief rule with respect to all of them, is to let blood, to
  avoid every thing that is strong, or of a heating nature, to apply warm
 ^fomentations to the parts affected, and to cause the patient to drink a suf-
  ficient quantity of warm diluting liquors.

r-                                  m

 l*                       CHAP.  XXXIII.

 ^OF THE  CHOLERA MORBUS, AND OTHER EXCESSIVE
    DISCHARGES FROM  THE STOMACH AND BOWELS.

 •J          J. HE cholera morbus is a violent purging ami vomiting, at-
  tended with gripes,  sickness, and a constant desire  to go to stool.  It
  comes on suddenly, and is most common in autumn.    There is hardly
  any disease that kills more quickly than this, when proper means are not
  used in due time for removing it.
     CAUSES.—It is  occasioned by a redundancy and putrid acrimony of
  the bile;  cold, food that easily turns rancid or sour  on the  stomach; as
  butter, bacon, sweet-meats, cucumbers,  melons, cherries, and other cold
  fruits.*  It is sometimes the effect of strong acrid purges or  vomits, or
  of poisonous substances taken into the stomach.  It  may likeAvise pro-
  ceed from violent passions or affections of the mind;  as fear, anger,  &c.
     SYMPTOMS.—It is generally preceded by a cardialgia, or heart
  burn, sour belchings, and flatulencies, with pain of  the stomach and in-
  testines.   To  these  succeed excessive vomiting and  purging of green,
  yellow, or blackish coloured bile, with a distention  of the stomach, and
  violent griping pains.  There is likewise a great thirst, with a very quick
  unequal pulse, and often a fixed acute pain about die region of the navel.
  As the disease advances, the pulse often sinks so low as  to become quite
  imperceptible, the extremities groiv cold or cramped,  and are often co-
  vered Avith a clammy sweat, the urine is obstructed,  and  there is a palpi-
 t* tation  of  the heart.   Violent hickuping, fainting, and convulsions, are
 * the signs of approaching death.
    MEDICINE.—At the beginning of  this disease, the efforts of Na-
  ture to expel  the offending cause should be assisted,  by promoting the
  purging and vomiting.   For this purpose  the patient  must drink freely
  of diluting liquors; as whey, butter-milk, warm water, thin water gruel,
  small posset, or, Avhat is perhaps preferable to any  of them, very weak
  chicken broth.   This should not only be elrank plentifully to promote
  the vomiting, but a clyster of it given every hour in order to promote
  the purging.
    After these evacuations have  been continued for some time, a de-
  coction of toasted oat-bread may be drank to stop the vomiting.   The
  bread should be toasted till it is of a brown  colour,  and afterwards
  boiled  in  spring Avater.  If oat-bread cannot be had,  wheat-bread, or
  oat meal  well toasted, may be used in  its stead.  If this does not put
  * I have been twice brought to the gates of death by this disease, and both
times it was occasioned by eating rancid bacon. 
OF A  DIARRHOEA, OR  LOOSENESS.       217
 a stop to the vomiting, two table-spoonsful of the saline julep, with ten
 drops of laudanum, may  be taken every hour till it ceases.
   The vomiting and purging hoAvever ought never to be stopped too soon.
 As long as these discharges do not weaken the patient, they are salutary,
 and may be alloAved to  go on, or rather ought to  be promoted.  But
 when the patient is weakened by the evacuations, which may be known
 from the sinking of his pulse, Ac. recourse must immediately be had to
 opiates,  as recommended above; to which may be added strong wines,
 with spirituous cinnamon waters, and other generous cordials.  Warm
 negus, or strong wine-whey, Avill likeAvise be necessary to support  (he pa-
 tient's spirits, and promote the  perspiration.   His legs should be bathed
 in warm water, and afterwards rubbed with flannel cloths, or Avrapped in
 warm  blankets, and Avarm bricks applied to the soles of  his feet.   Flan-
 nels wrung out of warm spirituous fomentations should likeAvise be  applied
 to the region of the stomach.
   When the violence of the disease is over, to prevent a relapse, it will
 be  necessaiy for some time to continue the use of small  doses of lauda-
 num.  Ten or twelve  drops  may be taken in a glass of wine, at least
 twice a-day, for eight or ten days.  The patient's food ought to be nou-
 rishing, but taken  in small quantities, and he should use moderate exer-
 cise.  As the stomach and intestines are generally much weakened, an
 infusion  of the bark, or other bitters, in small wine> sharpened with  the
 elixir of vitriol, may be  drank for some time.
   Though physicians are seldom called in due time  in this disease, they
 ought not to despair of relieving the patient even in the most desperate
 circumstances.   Of thisT lately saw a very striking proof in an old man
 and his son, who had been both seized  with  it about the middle of the
 night.  I did not see them till next morning, when they  had much more
 the appearance of dead  than of living men.   No pulse could be felt;
 the  extremities were cold and rigid, the countenance was ghastly, ande
 the strength almost quite exhausted.   Yet from this deplorable conditicn4
 they were both recovered by the use of opiates and cordial medicines.

            OF A DIARRHOEA, OR LOOSENESS.

   A LOOSENESS, in many cases,  is not to be considered as a\
 disease,  but  rather as a salutary evacuation.   It ought  therefore never
 to be stopped, unless when it  continues  too  long, or evidently weak-
 ens the patient.   As this however sometimes  happens,  we shall po:nt
 out the most common causes of a looseness,  with the pioper method of
 treatment.                                               e
  When a looseness is occasioned by  catching cold, or an obstructed
perspiration,  the patient  ought to keep  warm,  to drink  freely of Aveak
 diluting  liquors,  to  bathe his feet and legs frequently in luke-wami
 Avater,  to Avear flannel next his skin, and  to take every other method to
 restore the perspiration.
  In a looseness which proceeds from excess or repletion, a vomit is the
proper medicine.  Vomits not only cleanse the stomach,  but promote aU
 the secretions, which renders them of great importance in carrying off a
 debauch.   Half a drachm of ipecacuanha iu powder will  answer this
 purpose very well.  A day or tAvo after tlie vomit, the same quantity of
 rhubarb may be taken, and repeated two  or three times,  if the looscne* 
 218        OF A  DIARRHOEA,  OR  LOOSENESS.

 continues.  The patient ought to live upon  light vegetable food of easy
 digestion, and to drink Avhey, thin gruel, or barley-w ater.
    A looseness occasioned by the obstruction of  any customary evacua«
 tion, generally  requires bleeding.  If that  does  not succeed, other eva-
 cuations may be substituted in the room of those which are obstructed.
 At the same  time,  every  method is to be taken  to restore the usual dis-
 charges, as not only the  cure of the disease, but the patient's life, may
 depend on this.
    A periodical looseness ought never to  be stopped.   It  is always an
 effort of Nature to carry off some  offending matter, which, if retained
 in  the  body, might have fatal effects.  Children are very liable to this
 kind of looseness, especially while teething.  It is however so far from
 being  hurtful to them, that such children  generally get their teeth with
 least trouble.  If these  loose stools should  at  any time prove sour or
 griping, a tea-spoonful  of magnesia alba, with four  or five  grains of
 rhubarb, may be given to the child in a little panado, or any other food,
  This,  if repeated three  or four times,  will generally correct the acidity,
 and cany off  the griping stools.
    A diarrhoea, or looseness, which proceeds from violent passions or af-
  fections of the mind, must be treated with  the greatest caution.  Vomits
  in this case  are highly improper.  Nor are  purges safe, unless they be
  very mild, and given in small quantities.  Opiates, and other antispas-
  modic medicines are most proper.   Ten or twelve drops of liquid lauda-
  num may  be taken  in a cup of valerian or penny-royal tea every eight
  or ten hours, till the symptoms abate.  * Ease, cheerfulness, and tranquil-
  ity of mind  are here of  the greatest importance.
    When a looseness proceeds from  acrid  or poisonous substances taken
  into the stomach, the  patient must drink  large quantities of diluting li-
 4- quors, with  oil or fat broths, to promote vomiting and  purging.  After-
 v-.wards, if  there be reason to suspect that the bowels are inflamed, bleed-
  ing will be necessary.    Small doses of laudanum may likewise be taken
  to remove their irritation.
 in,-  When  the gout, repelled from  the extremities, occasions a loose-
 v ness, it ought to be promoted by gentle doses of rhubarb, or other mild
-jgpurgatives.  u  The  gouty matter is  likewise  to be  solicited towards
 t-'the extremities by warm fomentations, cataplasms, Ac.   The perspi-
  ration ought at the same time to be promoted by warm diluting liquors;
  as wine whey  with spirits of hartshorn, or a few drops of liquid laudanum
  in it.          <»■                                 i
    "When;  a  looseness  proceeds from worms, which may be knoAvn from
  the sliminess of the stools, mixed  with pieces of  decayed worms, Ac,
  medicines must  be given to kill and carry off these vermin, as the
  poAvder of tin with purges of rhubarb and calomel.   Afterwards lime'
  water, either alone, or with a small quantity of rhubarb infused, will be
  proper  to strengthen  the bowels,  and  prevent the neAV generation of
 worms.
    A looseness is often occasioned by  drinking  bad water.  When  this
 is the  case,  the disease generally proves epidemical.  When there is
 reason to  believe that  this or  any other disease proceeds from the use
 of unwholesome Avater,  it ought immediately to be changed, or, if that
 cannot be  done, it may be corrected by mixing with it quick lime, chalkj
 or the  like: 
OF VOMITING*
219
   In  people  whose  stomachs are weak, violent exercise immediately
after  eating will occasion  a looseness.   Though the cure of this is
obvious, yet it will be proper, besides  avoiding violent exercise, to
use such medicines as tend to brace and strengthen the stomach, as
infusions of the  bark,  with other  bitter and astringent ingredients, in
white wine.  Such persons ought likewise  to  take  frequently a glass
or two  of old red port,  or good claret.
   From whatever cause a looseness proceeds, when it is found neces-
sary to check it,  the  diet ought  to consist of  rice  boiled  with milk,
and flavoured with cinnamon;  rice-jelly, sago  with  red port; and the
lighter sorts of flesh-meat roasted.  The drink may be thin water-gruel,
rice-water, or weak broth made from lean veal, or Avith a sheep's head, as
being more gelatinous than  mutton, beef,  or chicken-broth.
   Persons who, from a peculiar weakness, or too great an irritability of
the bowels, are liable to frequent returns of this disease, should live tem-
perately, avoiding crude summer fruits, all unwholesome foods, and meats
of hard digestion.  They  ought likewise to beware of cold, moisture,tor
whatever may obstruct the perspiration, and should wear flannel next
the skin.  AU violent passions, as fear, anger, &c. are likewise care
fully to be guarded against.

                         OF VOMITING.

   VOMITING may proceed  from various causes;  as excess in eating
and drinking;  foulness of Uie stomach; the acrimony of the aliment; a
translation of the morbific  matter  of ulcers, of the gout, the erysipelas,
or other diseases, to the stomach.   It may likewise proceed from a loose-
ness having been two suddenly stopped;  from the stoppage of any  cus-
tomary evacuation, as the bleeding piles, the menses, &c. from a  weak-
ness of the stomach, the colic, the iliac  passion, a rupture, a fit of the
travel worms; or from any kind of poison taken into the stomach.  It
is an usual symptom of injuries done to the brain; as contusions,com-
pressions, &c.  It is likewise a symptom of wounds or inflammations ot
the diaphragm, intestines, spleen, liver, kidneys, &c.
   Vomitin* may be  occasioned by unusual motions,  as sailing, being
drawn backwardsiua carriage,&c.  It may likeAvise be excited by  vio
lent passions, or by the idea  of nauseous or disagreeable objects, especially
of sdch things as have formerly produced vomiting.^ometlmes it pro-
ceeds from a regurgitation of the bile into the stomach: in this case, what
the patient vomits is generally of a yellow or greenish colour, and has a
bitter taste.   Persons  who are subject to nervous affections are often sud-
denly seized with violent fits of vomiting.  Lastly  vomiting is a common
symptom of pregnancy.-In this case  it generally comes  on about  vvo
vveeks after the stoppage of the menses, and continues during the  first
three or four months.                             ...  ..     •»•„_„
   Wlu-n vomiting proceeds from a foul stomach or indigestion,  t is no
to be considered as a disease, but as the cure of a disease.  It ought  here.
fore to be promoted by drinking lukewarm Avater, or  thin gruel.  II this
does  not put a stop to the vomiting, a dose of ipecacuanha may be taken,
and worked off with weak  camomile-tea.
   When  the  retrocession  of die  gout, or the obstruction  of  cuiton, 
220                    OF  VOMTINC.
ary evacuations, occasion vomiting, all means must be used to restore
these discharges; or, if that canuot be effected, their place muet  be sup-
plied by others, as bleediug, purging, bathing die extremities in warm
water, opening issues, sctons, perpetual blisters, Ac.
   When vomiting is the effect ot pregnancy, it may generally  be miti-
gated by bleeding, and keeping the body gently open.  The bleeding
however ought to be in small  quantities at  a time, and  the purgatives
should be of the mildest kind, as figs, stewed prunes, manua, or sennn.
Pregnant women are  most apt to vomit in  the morning immediately af-
ter getting out of bed, which is owing partly to the change of posture, but
more to the emptiness of the stomach.—It may generally be prevented by
taking a dish  of coffee,  tea,  or some light breakfast in bed.  Pregnant
women who are afflicted Avith vomiting, ought to be kept easy both  in
body aud mind.  T hey should neither alloAv their stomachs to be quite
empty, nor should they  eat much at once.  Cold water is a very proper
drink in this case; if the stomach be weak, a little brandy may be added
to it.  If the spirits  are low, and the person apt to faint,  a spoonful of
cinnamon-water, with a little  marmalade of quinces or oranges, may be
taken.
   If vomiting proceeds from weakness of the stomach,  bitters will be  of
service.   Peruvian bark infused in wine or brandy, Avith as much rhu-
barb as will keep the body gently open, is an excellent medicine in this
case.  The elixir of vitriol is also a good medicine.—It may be taken
in the dose of fifteen or twenty drops, twice  or thrice a-day, in a glass of
wine  or water.   Habitual vomitings are sometimes alleviated by making
oysters a principal part  of diet.
   A vomiting which proceeds from  acidities in the  stomach, is relieved
by alkaline purges.   The best medicine of this kind is the magnesia alba,
a tea-spoonful of Avhich may be taken in a dish of  tea or a little milk,
three or four times a-day, or oftener if necessary, to  keep the body open.
   When vomiting proceeds from violent passions, or  affections of the
mind, all evacuants  must be carefully avoided, especially vomits.—
These are exceedingly dangerous.    The patient in this case ought  to
be kept perfectly easy and quiet, to have the mind soothed,  and to take
some gende cordial,  as negus, or a little brandy and water,  to which a
few drops of laudanum may occasionally be added.        ,
   When vomiting proceeds froirt spasmodic affections  of the stomach,
musk, castor, and other antispasmodic medicines are of use.   Warm and
aromatic plasters have likewise a good effect.   The stomach-plaster of the
London ot Edinburgh dispensatory  may be applied  to the  pit of the
stomach, or a plaster of thcriaca, which will answer rather better.  Aro-
matic medicines may likewise be taken inwardly, as cinnamon or miut
tea, wiue with spiceries boiled in it, Ac.    The  region of the stomach
may be rubbed with aether, or if that cannot be had, with strong brandy,
or other spirits.   The belly should be fomented with  Avarm water, or the
patient immersed up to the breast in  a warm bath.
   I  have ahvays found the saline draughts taken  in  the act of effer-
vescence, of singular use in stopping of vomiting, from whatever cause
it  proceeded.  These may be  prepared by dissolving  a drachm of the
salt of tartar in an ounce and a half of fresh lemon juice, and adding to it
an ounce  of pepper-mint  water, the same  quantity of simple  cinna-
mon water,  and a little white  sugar.  This  draught  must  be  swal- 
OF THE  DIABETES,  &C.
221
lowed before the effervescence is quite over, and may be repeated every
two hours, or oftener, if the vomiting be violent.   A violent vomiting
has sometimes been stopped by cupping on the region of the stomach af-
ter all other means had failed.
   As the least motion will often bring on the vomiting again, even after
it  has been stopped, the patient must avoid all manner of action.  The
diet must be  so  regulated as to sit easy upon the stomach, aud nothing
should be taken that is hard of digestion.   We do not however meau
that the patient should five entirely upon slops.  Solid food, in this cast,
often sits easier on the stomach than liquids.
                      CHAP. XXXIV.


OF THE DIABETES, AND OTHER DISORDERS OF THE
                 KIDNEYS AND BLADDER.

        TlIE  diabetes is a frequent  and excessive discharge  of
urine.   It is seldom to  be met  with among  young people; but often
attacks persons in the decline of life, especially those who follow  the
more violent employments,  or have been hard drinkers in then youth.
   C \USES.__A diabetes is often the consequence of acute diseases, as
fevers, fluxes, &c. where the patient has suffered by excessive evacua-
tions-  it may also be occasioned  by great fatigue, as riding long journies
upon'a hard trotting horse, carrying heavy burdens, Ac.  It may be
brought on by hard drinking, or  the use of strong stimulating diuretic
medicines, as tincture of cantharides, spirits of turpentine, and such like.
It is often the effect of drinking  too great quantities of mineral waters.
Many imagine  that these will do  them no service unless they be drank in
great  quantities, by which mistake it often  happens that they occasion
worse diseases  than those they were intended to cure.  In a word, this
disease may either proceed from too great a laxity of the ftrgan, wliich
secrete the urine, from something that stimulates the kidneys too much, or
from a thin dissolved state  of the blood, which makes too great a quanti-
ty of it run off by the urinary passages.
   SYMPTOMS.—In a diabetes, the urine generally exceeds m quan-
tity all the liquid food winch the patient takes.  It is thin and pale, of a
sweetish taste,  and a*i agreeable sn»ell.  The patient has a  continued
 thirst, with some degree of fever;  his mouth is  dry, and he  spits fre-
 quently a  frothy spittle.   The strength fails, the appetite decays, and
 the flesh wastes  away  .till  the patient is  reduced to skin and bone.
 There is a  heat of the bowels, and frequently the loins, aud feet are swel-

    This disease may generally be 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 not to be expected.
    REGIMEN.—Every  thing that stimulates the  urinary  passages,
 or tends to relax the habit, must be avoided.  For this reason the pa-
 tient  should live chiefly  on solid  food.   His thirst  may be quenched
 with  acids; as sorrel,* juice of  lemon, or vinegar.   The  mucibgin- 
222
OF THE  DIABETES,  &C.
ous vegetables, as rice, sago, and salop, with milk, arc the most proper
food.   Of animal substances, shell-fish are to be  preferred; as oj sters,
crabs, &c.
   The drink may be Bristol-Avater.  When that cannot be obtained, lime-
water, in which a due proportion of oak-bark has been macerated, may
be used.   The white decoction,* with isinglass dissolved in it, is like-
wise a very proper drink.
   The patient ought daily to take exercise,  but it should be so gentle as
not to  fatigue him.  He should lie upon a hard bed or matrass.  No-
thing hurts the kidneys more than lying too soft.   A warm, dry air, the
use of  the flesh-brush,  and every thing  that promotes  perspiration,
fa  of service.   For this  reason  the patient  ought to  wear flannel next
his skin.  A large strengthening plaster may be applied to the back; or,
what Avill ansAver better,  a great part  of the body may be Avrapped in
plaster.
   MEDICINE.—Gentle purges,  if the patient be not too much weak-
ened by the disease, have a good effect.  They may consist of rhubarb,
with cardamum seeds, or any other spiceries, infused in Avine, and may be
taken in such quantities as to keep the body gently open.
   The patient must next have recourse to astringents and corroborants.
Half a drachm of powder made of equal parts of alum and the inspissated
juice commonly called Terra Japonica, may be taken four times a-day, or
oftener, if the stomach  will bear it.   The alum must first be melted in a
crucible, afterwards  they may both be pounded together.   Along with
every  dose of this powder  the patient may take a tea-cupful of the tinc-
ture of roses.f
   If the patient's stomach  eannot  bear the alum in substance, Avhey
may be made of it, and taken in the dose of a tea-cupful three  or four
times a-day.   The alum  Avhey is prepared by boiliug two English quarts
of milk over a  slow fire,  with three drachms of alum, till the curd sepa-
rates.
   Opiates are of service in this disease, even though the patient rests
well.   They take off spasm and irritation, and at the same time lessen 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 best corroborants  Avhich  we know,  are the Peruvian bark,  and
wine.  A drachm of bark may  be taken in a glass of red port or claret
three times a-day.   The medicine will be both  more efficacious and less
disagreeable, if fifteen or  twenty  drops of the acid elixir of vitriol be ad-
ded to each dose.   Such as cannot take the bark in substance may use
the decoction, mixed with an equal quantity of red wine, and sharpened
as above.
   There is  a  disease incident  to labouring people in the deeline of
life, called incon?iNFScr  of urine.  But this is very different from
a diabetes, as the Avater  passes  off involuntarily by drops, and does not
exceed the usual  quantity.   This disease  is rather troublesome than
dangerous.   It is  owing to a relaxation of the sphincter of the blad-
der, and is often the effect of  a palsy.  Sometimes it proceeds from
hurts or injuries occasional  by blows,  bruises, preternatural  labours,
&c.  Sometimes it  is  the  effect of a fever.  It  may likewise be occa-
*■ See Appendix, White Decoction.
f See Appendix, Tincture of Rtttes 
OF A  SUPPRESSION OF  URINE.
22.3.
sioned by long use of strong diuretics, or of stimulating medicines itfr
jected into the bladder.
   This disease may be  mitigated by the use of astringent and  cor-
roborating  medicines, such as have  been mentioned above;  but we
do not remember ever to have seen it cured.
   In an incontinency of urine, from Avhatever cause,  a piece of sponge
ought to be worn, or a  bladder applied  in such a manner as to pre-
vent  the urine from  galling and excoriating  the parts.*

              OF A SUPPRESSION  OF URINE.

   It has already been observed, that a suppression of urine, may proceed
from various causes; as an inflammation of the kidneys, or bladder; small
stones or gravel lodging in the urinary passages, hard faeces lying in the
rectum, pregnancy, a spasm or contraction of the neck of the bladder, clot-
ted blood in the bladder itself, a swelling of the haemorrhoidal veins, &c.
   Some of these cases  require the  catheter,  both to remove the ob-
 structing matter, and to draw off the urine;  but as this instrument
 can  only be  managed with  safety by persons skilled in  surgery, Ave
 shall say nothing further of  its use.  A bougie may be  used by anv
 cautious hand,  and will often succeed better than the catheter.
    We  would  chiefly recommend,  in all  obstructions of urine,  fo-
 mentations and evacuations.   Bleeding^  as far as the patient's strength
 will permit, is necessary, especially where there are symptoms of to-
 pical inflammation.   Bleeding in this case not only abates the fever,
 by lessening the force of the  circulation,  but  by relaxing  the solids, it
 takes off the spasm or structure upon the vessels which occasioned the
 obstruction.
    After bleedings,  fomentations  must  be used.   Ihese may either
 consist of warm water alone, or of decoctions of mild vegetables; as
 mallows, camomile-flowers, &c.  Cloths dipped in these may either be
 applied to the part affected, or a large bladder filled  with the decoction
 may be kept  continually  upon it.   Some put the herbs themselves
 into a flannel-bag, and apply them to the part, which is  far from be-
 in<r a bad method.  These  continue longer  warm than cloths dipped
 in" the decoction, and at the same  time  keep the part equally  moist.
    In all obstructions of urine, the  body ought to  be kept open.   This
 is not however  to  be  attempted  by strong purgatives, but by emol-
 lient clysters, or gentle infusions  of senna  anfl manna.   Clysters in
 this case  not only  open the body, but  answer the purpose of an in-
 ternal fomentation, and greatly assist in removing the  spasms  of the
 bladder and parts  adjacent.                                    .
    The food must be fight,  and taken in small quantities.  The drink
 may be weak broth, or decoctions  and infusions of mucilaginous vegeta-
 bles as marsh-mallow roots, lime-tree buds, &c.  A tea-spoonful of the
 SAveet spirits  of nitre, or a  drachm of Castile soap, may be frequently put
 into the patient's drink; and if there be no inflammation, he may drink
 small gin-punch.                         .     ...  ..
    Persons subject to a suppression  of urine ought  to live very tempe-

    • A bottle made of tlie Indian rubber, and properly ap.pfied, answers this
 purpose best. 
S24
OF THE  GRAVEL AND  STONE.
 rate.   Their diet  should be light, and their liquor diluting.  They
 should avoid all acids aud austere wines, should take sufficient exercise.
 lie hard, and avoid study and sendentary occupations.

               OF THE GRAVEL AND  STONE.

   WHEN small stones are lodged in the kidneys, or discharged along
 with the urine, the patient is said to be afflicted with the gravel.  If one
 of these stones happens to make a lodgment iu the bladder for some time,
 it accumulates fresh matter, and at length becomes too large to pass off
 with the urine.   In this case the patient is said to have the  stone.
   CAUSES.—The stone and gravel  maybe occasioned by  high living;
 the  use  of strong astringent wines; a  sedentary life; lying too hot, soft,
 or too much on the back;  the  constant use of Avater impregnated  with
 earthy or stony p.rticles; aliments of  an astringent or windy nature, Are.
 It may likewise proceed  from an hereditary disposition.   Persons hi the
 decline of life, and those  Avho have been much afflicted with  the gout or
 rheumatism, are most liable to it.
   SYMPTOMS.—Small stones or gravel in the  kidneys occasion pain
 in the loin;  sickness, and sometimes bloody urine. When the stone de-
 scends into the ureter,  aud  is too large  to pass along with ease, all the
 above symptoms are increased; the pain extends towards the bladder;
 the  thigh and leg of  the affected side are benumbetl;  the  testicles are
 drawn upwards; and the urine is obstructed.
   A stone in the bladder is known from a pain, at the  time, as  ivell as
 before and after making Avater;  from  the urine coming  away  by drops,
 or stopping suddenly, when it Avas running in a full stream;  by a vio-
 lent pain in the neck of  the bladder upon  motion, especially on horse-
 back, or in  a carriage on a rough road, from a  white, thick, copious,
 stinking, mucous sediment in the urine; from an itching  in the top of the
 penis;- from  bloody urine;  from an inclination to go to  stool during the
 discharge of urine; from the patient's  passing his urine more easily when
 lying than in an erect posture;  from a kind of a  convulsive motion oc-
 casioned by the sharp pain in  discharging the last drops of the urine;
 and lastly, from sounding or searching with the catheter.
   REGIMEN.—Persons  afflicted Avith the  gravel  or stone should
 avoid aliments of a windy  or heating  nature, as salt meats,  sour fruits,
 &c.   Their diet ought chiefly to consist of such things  as tend to pro-
 mote the secretion of urine, and to keep the body open.  Artichokes,
 asparagus, spinnage, lettuce, parsley, succory, purslane, turnips, potatoes,
 earrots, and radishes, may be safely eaten.   Onions, leeks,  and cellery
 are, in this case, reckoned medicinal. The most proper drinks, are whey,
 butter-milk, milk and Avater, barley-water; decoctions or infusions of the
 roots of  marsh-mallows, parsley, liquorice, or of other mild mucilaginous
 vegetables, as linseed,  lime-tree buds or leaves, Ac.  If the person has
 been accustomed to generous liquors,  he may drink gin and water not
 too strong.
   Gentle exercise  is  proper;  but violent  motion is apt  to  occasion
 bloody urine.  We would  therefore advise  that  it should be taken in
 moderation.  Persons,  afflicted with gravel  often  pass a great number
of stones, after  riding on horseback,  or in  a carriage; but those  who
fcave a  stone in the bladder are seldom able to  bear  these  kinds of 
QF THE  GRAVEL  AND STONE.          225
exercise.  Where there is a hereditary tendency to this disease, a seden-
tary life ought never to be indulged.  Were people careful, upon the
first symptoms of gravel, to observe a proper regimen of diet, and to take
sufficient  exercise,  it might often be carried off,  or at least prevented
from increasing;  but if the same course which occasioned the disease is
persisted in, it must be aggravated.
   MEDICINE___In what is  called a fit of the gravel, which is com-
monly occasioned by a stone sticking in the ureter, or some part of the
urinary passages, the patient  must be  bled, warm fomentations should
likewise be applied to the part affected, emollient clysters administered,
and diluting  mucilaginous liquors drank, &c.   The  treatment of this
case has  beeu fully pointed out under the articles, infUanmation of the
 kidneys and bladder, to which we refer.
   Dr. Whyte advises patients who are subject to frequent fits of gravel
 in the kidneys,  but have no stone in the  bladder, to drink every morn-
 ing, two or three hours before breakfast, an English pint of oyster of
 cockle-shell lime-water.  The Doctor very justly observes, that though
 this quantity might be too small to have any sensible effect in dissolving
 a stone in the bladder, yet it may very probably prevent its growth.
    When a stone is formed  in  the bladder, the Doctor  recommends
 Alicant soap, and oyster or cockle-shell  lime-water*  to be taken in the
 following manner:  The  patient must swallow  eveiy day, in any form
 that is least disagreeable, an ounce of the internal part  of Alicant soap,
 and drink three or four English pints of oyster or cockle-shell lime-water.
 The soap is to be divided  into three doses; the largest to be taken fast-
 ing in the  morning early;  the second at noon;  and the third at seven in
 the evening; drinking above  each dose a large draught of the  lime-
 Avater; the remainder of which he may take any time betwixt dinner and
 supper, instead of other liquors.
    The patient should begin  with a smaller  quantity of the lime-water
 and soap than that mentioned above;  at first an English pint of the for-
 mer,  and three drachms of the latter, may be taken daily.  This quan-
  tity, however, he may increase by degrees, and ought to persevere in the
  use of these medicines, especially if he finds any abatement of his com-
  plaint, for several months; nay, if the stone be very large, for years.  It
  may likewise be proper for the patient, if he be severely pained, not only
  to begin with the soap and lime-water in small quantities, but to take the
  second or third lime-water instead of the first.  However, after he has
  been  for some  time accustomed to these medicines, he may not only take
   the first water, but, if he finds he can easily bear it, heighten its dissolving
  power still more by pouring it a second time on fresh calcined shells.
    The  caustic alkali, or soap lees  is the medicine chiefly in vouge at
   present for the stone.  It is of  a very acrid nature, and ought therefore
   to be given in some gelatinous or mucilaginous liquors; as veal broth,
   new-milk, linseed-tea, a solution of gum-arabic, or a decoction of marsh-
   malloAv roots.   The patient must begin with small doses of the leCs, as
   thirty or  forty drops, and increase by degrees, as far as the stomach can
   bear it.f
 * See Appendix, Lime-water.
 f The caustic alkali may be prepared by mixing two parts of quick-lime with
»»c of pot-ashes, and suffering' them to stand till the lixivium he formed, which
                                 20 
226        INVOLUNTARY  DISCHARGES,  &C.

  Though the soap-lees and lime-water are the most powerful medicine?
which have hitherto been discovered for the stone; yet there are some
things of a more simple nature,  Avhich in certaiu cases are found  to be
beneficial and therefore  deserve a trial.   An infusion of the  seeds of
daucas sylvestris, or wild  carrot, sweetened with honey, has been found to
give considerable ease in cases where the stomach 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 sweet spirits of nitre, has likewise been found very efficacious in
bringing away large quantities of earthy matter in  flakes.  Honey is
likewise found to be of considerable service, and may be taken  in gruel,
or in any other form that is more agreeable.
  The only other medicine which Ave shall mention is the leva ursi.  It
has been greatly extolled of late both for the gravel and stone.   It seems
however to be in all respects inferior to the soap and lime-Avater; but it is
less disagreeable, and has frequently  to my knowledge, relieved gravelly
complaints.   It is  generally 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 seven or  eight drachms a-day, Avith great safety and good
effect.
                       CHAP.  XXXV.

     OF INVOLUNTARY DISCHARGES  OF BLOOD.

         SPONTANEOUS  or  involuntary discharges of blood often
happen from various parts of the body.  These, however, are so far from
being always dangerous, that they often prove salutary.  When such dis-
charges are critical, which is frequently the case in fevers, they ought
not to be stopped.  Nor indeed is it proper at any time to stop them, un-
less they be so great as to endanger the patient's life.  Most people,
afraid of  the smallest discharge of blood from any part of the body, fly
immediately to the use of styptic and  astringent  medicines,  by Avhich
means  an inflammation of the brain, or some other fatal disease, is occa-
sioned, which, had the discharge been allowed to go on, might have been
prevented.
   Periodical discharges of blood, from Avhatever part of the body they
proceed,  must not be stopped.   They are always the effects of Nature to
relieve herself; and fatal diseases have often been the consequence of
obstructing  them.  It may indeed be sometimes necessary to check the
violence  of  such discharges; but even this requires the greatest caution.
Instances might be given where the stopping of a small periodical flux of
blood, from  one of the fingers,  has proved fatal to the health.
   In the early  period  of life, bleeding  at  the nose is  very common.
Those who are farther advanced in  years  are  more liable to hajmop-
toe, or discharge of blood from the lungs.   After the  middle period
must be carefully filtrated before it be used.  If the solution does not happen
readily, a email quantity of water may be added to the mixture. 
OF  BLEEDING  AT  THE  NOSE.           227
«f life, hemorrhoidal fluxes are most common; and in the decline of life,
discharges of blood from the urinary passages.
   Involuntary fluxes of blood may proceed from very different, and of-
ten quite opposite causes.  Sometimes they are owing to a particular con-
struction of the body, as a sanguine temperament, a laxity of the vessels,
a plethoric habit, &c.   At other times they proceed from a determination
ofthe blood, towards one particular part, as the head, the haemorrhoidal
veins, &c.  They may likewise proceed from an inflammatory  disposi-
tion of the blood, in which case there is generally some degree of fever;
this likewise happens  when the flux is occasioned by an  obstructed per-
spiration, or a structure upon the skin, the bowels, or any particular part
of the system.
   But a dissolved state ofthe blood will likewise occasion haemorrhages.
 Thus, in putrid fevers, the  dyssentery, the scurvy, the malignant small-
 pox, Ac. there are often very great discharges of blood  from different
 parts of the body.  They may likewise be brought on by  too liberal
 an use of medicine, which tend to dissolve the blood, as cantharides, the
 volatile alkaline salts, Ac.   Food of an acrid or irritating quality  may
 likewise occasion  haemorrhages; as also  strong purges and vomits, or any
 thing that greatly stimulates the bowels.
   Violent  passions or agitations of the mind will likewise have this ef-
 fect.  These often cause bleeding at the nose, and  I  have known them
 sometimes occasion an haemorrhage in the brain.  Violent efforts of the
 body, by overstraining or hurting the vessels, may have the same effect,
 especially when the body is  long kept in an unnatural posture,  as hanging
 the head very Ioav, Ac.                          ,
   The cure of  an haemorrhage must be adapted to its cause.   When  it
 proceeds from too much blood, or a tendency to inflammation, bleeding,
 with gentle purges and  other evacuations, will be necessary.  It will
 likewise be proper for the patient in this case to live chiefly  upon a ve-
 getable diet, to avoid all strong liquors, and food that is of an acrid, hot,
 or stimulating  quality.   The body  should be kept cool and the nund

    When an hemorrhage is owing to a putrid  or dissolved state of the'
 blood  the patient ought to live chiefly upon acid fruits with milk, and
 vegetables of a nourishing nature, as sago, salop, &c.  His drink may be
 wine diluted with water, and sharpened with the juice of lemon, vinegar,
 or spirits of vitriol.   The best medicine in this case is the peruvian bark,
 which may be taken  according to the urgency of tlie symptoms.
    When a flux of blood is  the effect of acrid food, or of strong stimulat-
  ing medicines, the cure is to be effected by soft mucilaginous diet.   The
  patient  may likewise take frequently  about  the  bulk of a nutmeg of
  Locatelli's balsam, or the same quantity of spermaceti.
    When an obstructed perspiration, or  a stricture upon any part of the
  system,  is the cause of an haemorrhage, it may be removed by drinking
  w-arm diluting liquors, lying a-bed, bathing the extremities in warm wa-
  ter, «fec.
                  OF  BLEEDING AT THE NOSE.
    BLEEDING at the nose is commonly preceded by some degree of
  quickness of the pulse, flushing in the face, pulsation ofthe temporal ar-
  teries, heaviness in the head, dimness of the sight,  heat and itching of
   the nostrils, &c. 
2-28
OF  BLEEDING  AT THE  NOSE.
  To persons who abound with  blood  this discharge is very salutary.
It often cures a vertigo, the head-ache, a phrenzy, and even an epilepsy.
In  fevers, where  there-  is a great determination of blood towards the
head, it is of the utmost service. It is likewise beneficial in inflammations
of the liver and spleen, and often in the gout and rheumatism.   In all di-
seases  where  bleeding is necessary, a spontaneous discharge of blood
from the nose is of much more service than the same quantity let with a
lancet
  In a discharge of blood from the nose, the great point is to determine
whether it ought to be stopped or not   Itis a common practice to stop the
bleeding, without considering whether it be a disease, or the cure of a
disease.  This conduct  proceeds  from fear; but it has often bad, and
sometimes fatal consequences.
  When a discharge of blood from the nose happens in an inflammatory
disease, there  is always reason to believe that it may prove salutary;
and therefore it should be suffered to go on, at least as long as the patient
is not weakened by it.
  When it happens to persons in perfect health, who are full of blood, it
ought not to be suddenly stopped, especially if the symptoms of plethora,
mentioned above, have preceded it.  In this case it cannot be stopped
without risking the patient's life.
  In fine, whenever bleeding at the nose relieves any bad symptom, and
does not proceed so far as to endanger the patient's life, it ought not to
be stopped.  But when it returns frequently, or continues till the pulse
becomes low, the extremities begin to grow cold, the lips pale, or the pa-
tient complains of being sick or faint, it must immediately be stopped.
  For  this purpose the patient should be set nearly upright, with his
head reclining a little, and his legs immersed in water about the warmth
of new milk.   His  hands ought likewise to be put in lukewarm water,
and his garters may be tied  a littie tighter than usual.    Ligatures may
be applied to the arms, about the place where they are usually made for
bleeding, and with nearly the same degree of tightness.   These must be
gradually slackened as the  blood begins  to stop and removed entirely
as soon as it gives over.
  Sometimes dry lint put up the nostrils will 6top  the bleeding.   When
this does not succeed, dossils of lint dipped in strong spirits of wine, may
be  put up the nostrils, or if that cannot be had, they may be dipped in
brandy.  Blue vitriol dissolved in Avater may likewise be used  for  this
purpose, 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 sugar, burnt alum, and
white vitriol,  and put up the nostril from whence the blood issues.
  Internal medicines  can hardly be of use  here,  as they have seldom
time to operate.    It may not however be  amiss to give the patient
half an ounce of  Glauber's salt, and the  same  quantity of  manna,
dissolved in four or five ounces of barley-water.  This may be taken
at  a draught and  repeated, if it  does not operate,  in a  feAv hours.
Ten or twelve grains  of nitre  may be taken in a glass of cold water
and vinegar every hour, or oftener, if the stomach will bear  it.   If
a stronger medicine be necessary, a tea-cupful of the tincture of roses,
with twenty or thirty  drops of the weak spirit of vitriol, may be taken
every  hour.   When these things cannot  be  had, the  patient may 
         OF  THE  BLEEDING  AND BLIND  PILES.    229

drink water, with a  little common salt hi it or equal parts of water and
vinegar.*
  If the genitals be immersed for some time in cold water,  it will gen-
erally stop a bleeding at the nose.  I have not knoAvn this fail.
  Sometimes when the bleeding is stopped outwardly, it continues in-
wardly.   This is very troublesome, and requires particular attention, as
the patient is apt to be suffocated with the blood, especially if he falls
asleep, which he is very ready  to do  after  losing  a great  quantity of
blood.
  When the patient is in danger of suffocation from the blood getting into
his throat, the passages may be stopped by drawing threads  up the nos-
trils, and bringing them out at the mouth, then fastening pieces of sponge,
or  small rolls of linen  cloth to their  extremities; afterwards drawing
them back, a.id tying them.outside Avith a sufficient degree  of tightness.
   After the bleeding is stopped,  the patient ought to be kept as easy and
quiet as possible.  He should not pick  his nose, nor take aAvay the tents
or  clotted blood, till they fall off of their own accord, and should not lie
with his head low.
    Those Avho are affected with frequent bleeding at the nose ought to
bathe their feet often in warm  water, and to keep them Avarm and dry.
 They ought to Avear nothing tight about their necks, to keep their body
 as  much in an erect posture as possible, and never to view any object ob-
liquely.   If they have too much blood, a vegetable diet with, now and
 then a cooling purge, is the safest way to lessen it.
    But when the disease proceeds from a thin dissolved state of the blood,
 the diet should be rich and  nourishing; as  strong broths  and jellies,
sago-gruel, with Arine and sugar,  &c.   Infusions  of the Peruvian bark
 in  Arine ought likewise to be taken and  persisted  in for a  considerable
 time.

           OF THE BLEEDING AND BLIND PILES.

    A DISCHARGE of blood from the haemorrhoidal vessels is called the
 bleeding piles.   When the vessels only swell, and discharge no blood, but
 are exceeding painful, the disease is called the blind piles.
    Persons of  a loose spungy fibre, of  a bulky size, Avho live high, and
 lead a sedentary, inactive life, are most subject to this  disease.  It is oft-
 en owing to an hereditary disposition.   Where this is the case, it attacks
 persons more early in life than Avhen it is accidental.  Men are more  li-
 able to it than Avomen, especially those of a sanguine,  plethoric, or scor-
 butic habit or of a  melancholy disposition.
    The  piles may  be occasioned by an  excess of blood, by  strong
 aloetic  purges, high-seasoned food, drinking great quantities of sweet
 wines,  the neglect  of bleeding,  or  other customary  evacuations,
 much  riding, great  costiveness,  as any thing that occasions hard  or
 difficult stools.   Anger, grief, or other violent passions, Avill likewise
 occasion the  piles.  I have  often known them  brought  on by sitting
 on the  damp ground.  A pair of thin breeches  will excite the dis-
 order in a person  who is subject to  it, and  sometimes even in those
  * From ten to twenty drops of the oil of turpentine in a little water given
frequently, seldom fails to stop a bleeding at the nose, or from any other part, 
 230    OF  THE  BLEEDING  AND  BLIND  PILES.

 who never had it before.  Pregnant women are often afflicted with tht
 piles.
   A flux of blood from the anus, is not always to be treated as a disease.
 It is evTen more salutary thau bleeding at the nose, and often prevents or
 carries off diseases.  It is peculiarly beneficial in the gout, rheumatism,
 asthma, and hypochondriacal complaint and often proves critical in colics,
 and inflammatory fevers.
   In the management  of the patient regard must be had to his habit of
 body, his age, strength, and manner of living.  A discharge which might
 be excessive aud prove hurtful to one,  may be very  moderate,  and
 even  salutary  to another.   That only is to be esteemed  dangerous,
 which continues too long, and is in such quantity as to Avaste the patient's
 ftrength, hurt the digestion, nutrition, and  other  functions necessary to
 fife.
   When this is the case,  the discharge must be checked by a proper re.
 gimen, and  astringent medicines.   The DIET must be cool but nourish-
 ing, consisting chiefly of bread, milk, cooling vegetables, and broths. The
 drink may be chalybeate water, orange-whey, decoctions or infusions of
 the astringent and mucilaginous plants, as the torraentil root, bistort, the
 marshmallow-roots, &c.
   Old conserve of roses is a very good medicine  in this case.  It may be
 mixed in neAV milk, and may be taken in the quantity of an ounce three
 or four times a-day.  This medicine is in no great repute, owing to its be-
 ing seldom taken in such quantity as  to produce any effects; but wheu
 taken as here directed, and  duly persisted in, I  have known it perform
 very extraordinary cures in violent haemorrhages, especially Avhen assist-
 ed by the tincture of roses:  a tea-spoonful of which may be taken about
 an hour after every dose of the conserve.
   The Peruvian  bark  is  likewise proper in this case, both as  a strength-
 ener and astringent.  Haifa drachm of it may be taken in a glass of red
 Avine, sharpened  with  a feAV drops of the elixir of vitriol, three or four
 times a-day.
   The bleeding piles are sometimes periodical, and return regularly once
 a  month, or once  in three weeks.  In this case they are  always to be
 considered as a salutary discharge, and by no means to be stopped. Some
 have entirely ruined their health by stopping a  periodical discharge of
 blood from the haemorrhoidal veins.
   Iu the blind piles bleeding is generally of use.   The diet must be light
 and thin, and the  drink cool and diluting.   It is  likewise necessary that
 the body be kept gently open.  This may be done by small doses of the
 flour of the brimstone and cream of tartar.   These may be mixed in equal
 quantities, and a  tea-spoonful taken two or three times a-day, or oftener if
 necessary.   Or an ounce of the flour of brimstone and half an ounce of
 purified  nitre may be  mixed with three or four ounces  of the lenitive
 electuary, and a tea-spoonful of it taken diree or four times a-day.
   Emollient clysters are here likeAvise beneficial; but there is sometimes
 such au astrictiou of the  anus, that they cannot  be thrown up.   In this
case I have known a vomit have a very good effect
   When the piles are exceeding painful aud  swelled, but discharge
nothing, the  patient must sit over the steams of  warm water.  He may
likewise  apply a  linen cloth dipped in  Avarm  spirits of#wine to  the
part or  poultices made of  bread and  milk,  or of leeks  fried with 
SPITTING  OF  BLOOD.
231
butter.   If these  do not produce a  discharge, and the piles appear
large, leeches must be applied as near them as possible, or, if they Avill
fix upon the  piles themselves so much the better.  When leeches will
not fix, the piles may be opened with  a lancet.  The operation is very
easy, and is  attended Avith no danger.   Various ointments, and other
external applications are recommended  in the piles;  but I do not re-
member  to  have  seen any effects from  these  worth mentioning.
Their principal use is to keep the part  moist, Avhich may be done as
well by a soft poultice, or an emollient cataplasm.  When the pain how-
ever 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 discharge of blood from the lungs only
which is called an hamoptoe or spitting of blood.   Persons of a slender
make, and a lax fibre, who have long necks and strait breasts  are most
liable to this disease.  It is most common in the spring and generally at-
tacks people before they are at the prime or middle period of life.  It
is a common observation, that those Avho have been subject to bleeding
at the nose when young, are afterwards most liable to an haemoptoe.
   CAUSES.—An haemoptoe may proceed from excess of blood, from a
peculiar weakness of the lungs, or a bad conformation of the breast.  It
is often occasioned by excessive drinking, running, Avrestling, singing, or
speaking aloud.   Such  as have Aveak lungs  ought to avoid all violent
exertions of that organ, as they value life.  They should likeAvise guard
against violent passions, excessive drinking, and every thing that occa-
sions a rapid circulation of the blood.
   This disease may likeAvise proceed from wounds of the lungs.—These
may  either be received from without, or they may be occasioned by
hard bodies getting into the wind-pipe, and  so falling  down upon the
lungs, and hurting that  tender organ.   The obstruction of any custom-
ary evacuation may occasion a spitting of blood; as ueglect of bleeding
or purging at the usual seasons, the stoppage of the bleeding piles in men.
or  the  menses in women, &c.   It may likewise proceed from  a po-
lypus, scirrhous concretions, or any  thing that  obstructs the circula-
tion of the blood in the lungs.  It is often the effect of a long and
violent cough; in which case it is  generally the forerunner  of a con-
sumption.  A violent degree of cold suddenly applied to the external
purts of the body will occasion an haemoptoe.   It may likeAvise be oc-
casioned  by breathing air which is too much rarified to be able proper
ly to expand the  lungs.  This is often the case with those Avho work in
hot places, as furnaces,  glass-houses, or the like.  It is likewise said to
happen to such as ascend to the top of very high mountains, as the Peak
of Teneriffe, Ac.
   Spitting of blood is not always to be considered as a  primary disease.
It is often only a symptom, and in some diseases not  an unfavourable
one.   This is the case  in pleurisies, peripneumonies, aud sundry other1
fevers.   In a dropsy, scurvy, or consumption, it is a bad symptom, and
shews that the lungs are ulcerated.                      '
   SYMPTOMS.—Spitting  of  blood  is generally  preceded  by a. 
232
SPITI ING  OF BLOOD.
sense of weight,  aud oppression of  the breast, a dry tickling cough,
hoarseness, and a difficulty of brtathi g.   Sometimes it is ushered in
with shivering, coldness of the extremities costiveness, great 1 issitudc,
flatulence, pain of the back and loins, Ac.  As these shew a general
stricture upon  the vessels,  and a  tendency of  the   blood  to inflam-
mation, they are  commonly the foreigners of a very copious discharge.
The above symptoms  do  not attend  a discharge of blood from the
gums or fauces,  by  which  means these may always  be distinguished
from au haemoptoe.   Sometimes the blood that is spit up is thin, and
af a florid red colour; and at other times it is thick, and of a dark
or blackish colour;  nothing  hoAvever  can  be inferred from this cir-
cumstance, but that  the  blood has  lain  a longer or shorter time in the
breast before it was discharged.
   Spitting of blood in  a strong healthy person, of a sound constitution,
is not very dangerous;  but when it attacks the tender and delicate, or
persons of a weak lax fibre, it is with difficulty removed.—When it pro-
ceeds  from a scirrhous  or polypus  of the lungs, it is bad.   The dan-
ger  is greater when the discharge proceeds from the rupture  of a large
vessel than a small one.   When the  extravasated blood  is not spit up,
but  lodges in the  breast, it corrupts, and greatly increases the danger.
When the blood proceeds from an ulcer in the  lungs it is generally fatal.
   REGIMEN.—The patient ought to be kept cool and easy.  Every
thing that  heats the  body or quickens the circulation, increases the dan-
ger.    The mind ought  likewise to be soothed, and every occasion of
exciting the passions avoided.  The diet should be  soft,  cooling, and
slender; as rice  boiled with milk,  small broths, barley-gruels, panado,
&c.   The diet in this case, can scarce be too low.   Even water-gruel is
sufficient to support the patient for some  days.   All strong liquors must
be avoided.  The patient may drink milk and water, barley-Avater, Avhey,
butter-milk, and such like.  Every thing hoAvever should be drank cold,
and  in  small quantities at a time.  He  should observe the  strictest si-
lence, or at least  speak with a very low voice.
   MEDICINE.—This, like  the other involuntary discharges of  blood,
ought  not  to  be suddenly stopped  by astringent  medicines.—More
mischief is often  done  by these than if  it were suffered to go on.  It
may however proceed so far as to  weaken the patient  and even en.
danger  his  life;  in which case proper means must be used for re-
straining it.
   The  body should  be  kept gently open by  laxative diet;  as roasted
apples, stewed  prunes and such like.   If these should  not have the de-
sired effect a tea-spoonful of the lenative electuary may be taken twice
or thrice a day, as is found  necessary.   If the bleeding proves voilent,
ligatures may be  applied to the extremities, as directed, for a bleeding
at the nose.  If the  patient be  hot or feverish, bleeding, and small doses
of nitre will be of use; a scruple or half a drachm of nitre may be ta-
ken  in a cup of his  ordinary drink  twice or  thrice a-day.   His drink
may likewise be  sharpened with acids, as juice of lemon, or a few drops
of the spirits of vitriol $  or he may take frequently a cup of the tincture
of roses.
  Bathing the feet and legs in lukeAvarm  water has  likewise a very
good effect in  this disease.   Opiates,  too, are sometimes beneficial;
but these must be administered with caution.  Ten  or twelve  drops 
VOMITING  OF  BLOOD.               233
of laudanum may be given in a cup of barley water twice  a-day,  and
continued for some time, proAided they be found beneficial.
   The conserve of roses is likewise a very good medicine in this case,
provided it be taken in sufficient quantity, and long enough persisted in.
It may be taken to the quantity  of three or four ounces a-day;  and, if
the p .tient be troubled with a cough, it should be made into an electuary
with balsamic syrup, and a little of the syrup of poppies.
   If stronger astringents be necessary,  fifteen or twenty drops of the
elixir  of vitriol may be given in a glass of water  three or four times
a-day.
   Those Avho are  subject to frequent returns of this disease should avoid
all excess.   Their diet should  be  light and cool, consisting chiefly of
milk and vegetables.   Above all, let them beware of vigorous efforts of
the body, and violent agitations of the mind.

                    VOMITING OF  BLOOD.

   THIS is not so common as the other discharges of blood which have
already been mentioned;  but it  is veiy dangerous, and requires particu-
lar attention.
   Vomiting of blood is generally  preceded  by pain of the  stomach,
sickness,  and  nausea; and is accompanied with great anxiety, and fre-
quent fainting-fits.
   This disease is sometimes periodical;  in which case it is less danger-
ous.   It often  proceeds from an obstruction of the  menses  in women;
' and sometimes from the stoppage of the  haemorrhoidal flux in  men.  It
may be occasioned by any thing that greatly  stimulates  or Avounds the
stomach, as strong vomits or purges,  acrid poison, sharp or hard substan*
ces taken into the stomach, Ac.  It is often the effect of obstructions in
the liver, the spleen, or some of the other viscera.
   It may likewise proceed from external violence, as blows, bruises, or
from any  of the causes which produced inflammation.  In hysteric  wo-
men, vomiting of blood is a very common, but by no means a danger-
ous symptom.
   A great part of the danger in this disease arise from the extravasated
blood  lodging in the bowels, and  becoming putrid, by which means a
dysentery or putrid  fever may  be  occasioned.  The best way of pre-
venting this, is to  keep the body gently open,  by frequently exhibiting
emollient clysters.  Purges must not be given  till the discharge is stopt,
otherwise they  will irritate the stomach, and increase the disorder.   All
the food and drink must be of  a  mild cooling nature, and taken in small
quantities.  Even drinking cold ivater Ins sometimes proved a remedy,
but it will succeed the better  when sharpened Avith  the Aveak  spirits of
vitriol.  When there are  signs of an inflammation, bleeding may be ne-
cessary : but the  patient's weakness  will seldom permit it.  Opiates
may be of n-e; but they must be given in very small doses, as four or
five drops of liquid laudanum twice or thrice a-day.
   After the discharge is ovi r,  as the patient is generally troubled with
gripes occasioned by the acrimony of the blood lodged in Uie intestines.,
"cude purges will  bo  nece^sarv.
                                30 
234
                     OF BLOODY  URINE.

  THIS is a discharge of blood from the vessels  of the kidneys or
bladder, occasioned by their being either enlarged,  broken, or eroded.
It is  more or less dangerous according to the  different circumstance!
Avhich attend it.
  When pure blood is voided suddenly without interruption and with-
out pain, it proceeds from the  kidneys; but if the blood be in small
quantity, of a dark colour, and emitted with heat and  pain about the
bottom of  the belly, it proceeds  from the bladder.  When bloody mine
is occasioned by a rough stone descending from the kidneys to the blad-
der, which wounds the ureters, it is attended with a sharp pain in the
back, and  difficulty of making Avater.   If the coats of the bladder arc
hurt by a stone, a.-d the bloody urine follows, it is attended with the
most acute pain, and a previous  stoppage of urine.
   Bloody  urine may likewise be occasioned by falls, Woavs, the lifuV
or carrying of heavy burdens, hard riding,  or any violent motion.  It
may  also proceed from ulcers of the bladder, from a stone lodged in the
kidneys, or from  violent purges, or sharp diuretic medicines, especially
cantharides.
   Bloody urine is always attended with some degree of  danger: but it
is peculiarly so when mixed with purulent matter, as this sheivs an ulcer
somewhere in the urinary passages.   Sometimes this discharge proceeds
from  excess of blood, in which case it is rather to  be considered as a
salutary evacuation thau a disease.  If the  discharge  however be very
great, it may waste the patient's strength, and occasion an ill habit of
body, a dropsy or a consumption.
   The treatment of this disorder must be varied according to the different
causes from which it proceeds.
   When it is owing to a stone in the bladder, the cure depends upon an
operation, a description of which would be foreign to our purpose.
   If it be at'ended with  a  plethora, and symptoms of inflammation,
bleeding  will be  necessary.  The body must likewise be kept open by
emollient  clysters, or cooling purgative medicines:  as cream  of tartar,
rhubarb, manna;  or small doses of lenitive electuary.
   When bloo.ly urine proceeds from a dissolved state of  the blood, it is
commonly the symptom of some malignant disease;  as the small-pox, a
putrid fever or the like.   In  this case the patient's life depends  on the
liberal use of the Peruvian bark and acids, as has already been shewn.
   When there is  reason to suspect an ulcer in the kidneys or bladder, the
patient's diet must be cool, and his drink of a soft healing, balsamic qual-
ity, as decoctions of marsh-mallow roots with liquorice, solutions of gum-
arabic, &c.   Three ounces of marsh-mallow roots, and half an ounce of
liquorice, may  be boiled in two  English quarts of water to one; two
ources gum-arabic, and half an ounce of purified nitre may be dissolved in
the s rained liquor, and a tea-cupful of it taken four or five times a-day.
   The early use of astringents  in  this disease has often bad conse-
quences.    When the  flux is stopped  too  soon,  the  grumous blood,
by being confined in the vessels, may produce inflammations,  abscess,
 and  ulcers.   If however the case  be urgent,  or the patient seems to
suffer from the  loss of  blood,  gentle  astringents  may be necessary. 
OF THE  DYSENTERY,  &C.            235
III this case 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.
       OF THE DYSENTERY, OR BLOODY FLUX.

  THIS disease prevails in the spring and autumn.  I< is most common
in marshy countries, where, after hot and diy summers,  it is apt to be-
come epidemic.   Persons are most liable to it who are much exposed to
the night air, or who live in places where the air is confined and unwhole-
some.   Hence it often proves fatal in camps, on shipboard, in jails, hos-
pitals,  and such like places.
  CAUSES.—The dysentery may be occasioned by  any thing that ob-
structs the perspiration, or  renders the humours putrid;  as damp beds,
wet clothes, unwholesome diet, bad air, &c.   But it is most frequently
communicated by infection.  This ought to make people extremely cau-
tious in going near such persons as labour under the disease.  Even the
smell ofthe patient's excrements has been known to communicate the in-
fection.
   SYMPTOMS.—It is known by a flux ofthe belly, attended by vu>
lent pains of the bowels, a constant inclination to go to stool, and generally
more or less blood in the stools.   It begins like other  fevers, with chilli-
ness, loss of strength, a quick pulse, great thirst, and an inclination to vo-
mit.  The stools are  at  first greasy and frothy, afterwards they are
streaked  with blood, and at last have frequently the appearance of pure
blood  mixed  with small filaments resembling bits of  skin.  Worms are
sometimes passed both upwards and downwards through the whole course
ofthe  disease.   When the  patient goes to stool, he feels a bearing doAvn,
as if the whole bowels were falling out, and sometimes a part of the intes-
tine is actually protruded, which proves exceeding troublesome, especially
in children.   Flatulency is likewise a troublesome symptom, especially
 towards the end of the disease.
   This disease may be distinguished from a diarrhoea or looseness, by the
 acute pain of the bowels,  and the blood which generally appears in the
 stools.  It may be distinguished from the cholera morbus by its not being
 attended with such violent and frequent fits of vomiting, Ac.
   When the dysentery attaeks the old,  the delicate, or such as have been
 wasted by the cout, the scurvy, or other lingering diseases, it generally
 proves fatal.  Vomiting and hickuping are bad signs,  as they sheAv an in-
 flammation of the stomach.  When the  stools are greei, black, or have an
 exceeding disagreeable cadaverous smell, the danger is very great, as it
 shews the disease to be ofthe putrid kind.   It is an unfavourable symp-
 tom when the clvsters are  immediately  returned;  but still  more so wh°o
 the passage is so obstinately shut, that they  cannot be injected, a feeble
 pulse, coldness of the extremities, with difficulty of swallowing, and con-
 vulsions, ire  siens of approaching death.
    REGIMEN.—Nothing is of more  import?nce in this disease,  than
 cleanliness.  It contributes greatly  to  the recovery  of  the  patient
 and no  less  to  the safety of such as attend  him.   In all contagious
 diseases  the danger is increased, and the infection spread, by the neglect
 of cleanliness;  but v\ no one more than this.   Every thing about the pa-
 tient  should  be frequently changed.  The  excrements should never be 
236
OF  THE  DYSENTERY.
suffered to continue in his chamfer, but removed immediately and buried
under ground.   A constant stream of fresh air should be admitted into the
chamber; aud it ought frequently to be sprinkled with vinegar, juice of
lemon, or some other strong acid.
   The  patient must not be discouraged, but his spirits kept up in hopes
of a cure.  Nothing tends more to render any putrid disease mortal, than
the fears and apprehensions of the sick.  All diseases of this nature have
a tendency to sink and depress the spirits, and when that is increased by
fears  and alarms from those whom  the patient  believes to be persons of
skill,  it cannot fail to have the worst effects.
   A flannel waistcoat worn next the skin has often a veiy good effect in
the dysentery.  This promotes the perspiration without over heating the
body.  Great caution however is necessary in leavimr it off. I have often
known a dysentery brought on by imprudently throwing off a flannel waist-
coat before the season was sufficiently Avarm.  For whatever purpose this
piece of dress is worn, it should never be left off but in a warm season.
   In this disease the greatest attention must be  paid to the patient's diet.
Flesh, fish, and every thing that has a tendency to turn putrid or rancid,
on the  stomach, must be  abstained  from.   Apples boiled in milk, water
pap;  and plain light pudding, with  broth made ofthe gelatinous parts of
animals, may constitute the principal part of the patient's food.  Gelatin-
ous broth not only answers the purpose of food,  but likewise of medicine.
I have  often known dysenteries, which were not of a putrid nature, cured
by it, after pompous medicines had  proved  ineffectual.*
   Another kind of food very proper in the dysentery, which may be used
by such as cannot take fhe broth mentioned above, is  made by boiling a
few handfuls of fine flour, tied in a cloth, for six or seven hours, till it be-
comes as hard as starch.   Two or three table spoonsful of this may be
<rated down, and boiled in such a quantity of new milk and  water, as to
be of  the thickness of pap.  This may be sweetened to the patient's taste,
and taken forhis ordinary food.f
  * The manner of making this broth is, to take a sheep's head and feet with
the skin upon them, and to burn the wool off with a hot iron ; afterwards to
boil them till the broth is quite a jelly.  A little cinnamon or mace may be ad-
rlerl to eive  the broth an agreeable flavour, and the patient may take a little ot
it warm with toasted bread three or four times a-day   A clyster of it may like-
wise be ffiven twice a-day. Such as cannot use the broth made in this way, may
have the head and feet skinned ; but we have reason to believe that this injures
thV medicine.  It is not our business here  to reason upon the nature and quali-
ties of medicine, otherwise this might be  shewn to possess  v.rtues every way
suited to the cure of a dysentery which does not proceed from a putrid state of
^humours.  One thing we know, which is preferable to all reasoning, that
whole families have often been cured by it, after they had used many other nje-
Sdnes in vain.  It will, however, be proper that the patent take a vomit, and a
dSe or two  of rhubarb, before he begins to use the broth.   It will hkew.se be
necessary to continue the use of it for a considerable time, and to make it the

PrTnCThe1le°amed and humane Dr. Rutherford, late professor of medicine in the
university of Edinburgh, used to mention this  food in  his public lectures.with
Seat  encomiums.  He  directed it to be  made by tying a  pound or two of
the finest flour, as  tight as  possible, in a linen rag, afterwards  to d.p it fre-
«ientiy in water, and to  dredge the outside with flour, till a cake or crust was
Irmed around it, which prevents the water from soaking mto it while boding. 
                      OR  BLOODY  FLUX.                   237

    In a putrid dyscntenf tlie patient may be allowed to eat freely of most
 k'nds of good ripe fruit; as apples, grapes, gooseberries, currant-berries
 straw-berries, Ac.   These may either be eaten raAv or b.-iied, with or
 without milk, as the patient chooses.  The prejudice against fruit in this
 disease is so ^rcat, that many believe it to be the common cause of dys-
 enteries.  This however is an egregious mistake.   Both reason and ex-
 perience show, that good fruit is one of the  best medicines, both for
 the prevention aud cure of the dysentery.  Good fruit is in every respect
 calculated to  counteract that tendency to putrefaction, from Avhence the
 most dangerous kind of dysentery proceeds.   The patient in such a case
 ought therefore to be allowed to eat as much fruit as he pleases, provided
 it be ripe.*
   The most proper drink  in this disorder is  whey.  The  dystentery
 has often beeu cured by the use of clear whey alone.  It may be taken
 both for drink and in form  of a  clyster.   When Avhey cannot be had,
 barley water sharpened Avith cream of  tartar may be drank, or a decoc-
 tion  of  barley and tamarinds; two ounces of  the former and one of the
 latter, may be boiled in two English emarts of  water to one.   Warm-wa-
 ter, 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
 stomach will bear it, is an exceeding proper drink.   It both strengthens
 the stomach, and its by antiseptic quality, tends to prevent a  mortification
 ofthe boivels.
   MEDICINE.—At the beginning of this disease it is always necessa-
 ry to cleanse the first passages.  For tiiis purpose  a  vomit of ipecacuan-
 ha must be  given, and  wrought off with Aveak camomile-tea.   Strong
 vomits are seldom necessaiy here.  A scrupel,or at most half a drachm
 of ipecacuanha, is generally sufficient for an adult, and sometimes a very
 few grains will suffice.   The day after the vomit, half  a drachm, or two
 scruples of rhubarb, must be taken; or what will answer the purpose ra-
 ther better, an  ounce or an  ounce and an  half of Epsom salt.   This
 dose  may be repeated every other day  for two or three times.   After-
 wards small doses of ipecacuanha may be taken for some time.   Two or
 three grains of the powder may be mixed in a table spoonful of the syrup
 of poppies,  and taken three times a-day.
   These evacuations, and  the regimen prescribed  above,  will often be
 sufficient to effect a cure.   Should it hoivever  happen otherwise the fol-
 lowing astringent medicines may be used:
   A  clyster of starch or fat mutton broth, with thirty or forty drops of

 It is then to be boiled till it becomes a hard dry mass, as  directed above. This
 when mixed with milk and water, will not only answer the purpose of food, but
 may likewise be given in clysters.
  * I lately saw a young man  who had been seized with a dysentery in North
 America.  Many things had been tried for his relief, but  to no  purpose.  At
 length tired out with disappointments from medicine, and reduced to skin 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 sundry medicines  here with no better
 success than abroad, I advised him to leave off the use of drugs, and trust en-
 tirely  to a diet of milk and fruits, with gentle exercise.  Strawberries were the
only fruit he could procure at that season.   These he ate with milk twice and
sometimes thrice a'day.  The consequence was, that in a short time his stools
were reduced from upwards of twenty in a day, to three or four, and sometimes
 not so many.  He used the other fruits as they came in, and was in a few weeks
 so well as to leave that part of the country where I  was with a view to *eturn to
 America. 
238            OF THE  DYSENTERY, &C.

liquid laudinum in it miy be administered twice a day.   At the same
time an ouuce  of  gum-arabic, aud  half an ounce  of guni-tragacanth,
may be dissolved  in an English  pint  of barley-water, over a slow tire,
and a table spooaful of it taken every hour.
   If these have not the desired effect, the patient may take,  four times
a-day, about the bulk of a nutmeg of the Japonic Confection, drinking
after it a tea-spoonful of the decoction of logwood.*
   Persons Avho have been cured of this disease are very liable to suffer a
relapse;  to prevent Avhich, great  circumspection with respect to diet is
necessary.  The patient must abstain from all fermented liquors, except
now and then a glass of good wine; but he must drink no kind of malt li-
quor.  He should likewise abstain from animal food, as fish  and flesh,
and live  principally on milk and vegetables.
   Gentle exercise and wholesome air are likewise of importance.—The
patient should go to the country as soon as his strength will permit, and
should take exercise daily on horseback, or in a carriage.  He may like-
wise use bitters infused in wine or brandy, and may drink twice a-day a
gill of lime-water mixed with an equal quantity of new milk.
   When dysenteries prevTail, we would recommend  a strict attention to
cleanliness, a spare use of  animal food, and the free  use of sound ripe
fruits, and other vegetables.   The night air is to be carefully avoided,
and all  communications with the sick.   Bad smells are likewise to be
shunned, especially those which arise  from putrid  animal substances.
The necessaries where the sick go are carefully to be avoided.
   When the first symptoms of  the dysentery appear, the patient ought im-
mediately to take a vomit, to  go to bed,  and drink plentifully of weak
Avarm liquor, to promote a sweat.   This with a dose or two of rhubarb at
the beginning, would often cany off the dieease.  In countries  where
dysenteries prevail we would advise such as are liable to them, to take
either a vomit or  a purge  every spring or autumn, as  a  preventa-
tive.
   There are sundry other fluxes of the belly, as the  lientf.ry and  co-
eliac passion, Avhich though less dangerous than the dysen'ery, yet mt rit
consideration.  These diseases generally proceed from a relaxed state of
the stomach and intestines, ivhich is sometimes so great, that the food pas-
ses through them with hardly any sensible  alteration; and  the patient
dies merely from the want of nourishment.
   When the lientery or cceliac passion succeeds to a dysentery, the case
is bad.   They are always dangerous in oil age, especially when the con-
stitution has bpen broken by excess or acute diseases.  If the stools be
very frequent, and qui'e crude, the thir -t great, wi'h little urine,the mouth
ulcerated, and the face marked with spots of different colours the danger
is very great.
   The treatment of the patient is in general the same as in the dysente-
ry.   In all obstinate fluxes of the belly, the cure must be attempted, by
first cleansing  the  stomach awl bowels with gentle vomits and purges;
afterwards such a diet as  has a tendency  to heal  and strengthen  tlie
bowels, with opiates and astringent medicines, will generally complete  the
cure.
See appendix, Decoction of Logwood. 
OF THE  HEAD-ACH.                 239
  The same observation holds with respect to a tenesmus, or frequent
desire of goi g to stool.   This disease resembles the dysentery so much,
both in its symptoms and method of cure, that Ave  think it needless to
Insist upon it.
                      CHAP.  XXXVI.

                     OF  THE HEAD-ACH.

      AciIES and pains proceed from very different causes, and may
affect any part of the body, but we shall point out those only which oc-
cur most frequently, aud are attended with the greatest danger.
   When the head-ach is slight, aud affects a particular part of the head
only, it is called cephalalgia ; w ben the Avhole head is affected, cephdoza;
and when on one side only, hemicrania.  A fixed pain in the forehead,
which may  be covered with the end of the thumb, is called the clavis
hystericus.
   There are also  other distinctions.   Sometimes the pain is internal,
sometimes external;  sometimes it is  an original  disease, and at other
times only  symptomatic.   When  the head-ach proceeds from a hot
bilious habit,  the pain is very acute and throbbing, with a considerable
heat of the part affected.   When from a cold phlegmatic habit,  the pa-
tient complains of a dull heavy pain, aud has a sense of coldness in the
part.   This  kind  of head-ach is sometimes attended with a degree of
stupidity or folly.
   Whatever obstructs the free circulation of the blood through the ves-
sels of the head, may occasion a head-ach.  In persons of a full habit,
who abound with blood, or other humours, the head-ach often proceeds
from the suppression of customary evacuations; as bleeding at the nose,
sweating of the feet, Ac.  It may likewise proceed from any cause  that
determines a  great flux  of blood towards the head;  as coldness of the
extremities, or hanging down the head for a long time.   Whatever pre-
vents the return of the blood from the head will likewise occasion a head-
ach ; as looking  long obliquely at any object, Avearing any thing tight
about the neck, a new hat or the like.
   When a head-ach proceeds from a  stoppage of a ruuning at the nose,
 there is a heavy,  obtuse, pressing pain in the fore part of the head, in
 which there seems to be such a weight, that the patient can scarce hold
 it up.  When it is occasioned by the caustic matter of the venereal dis-
 ease, it generally affects the skull, and often produces a caries of the
 bones.
   Sometimes  the head-ach  proceeds from the repulsion or retrocession
 of the gout, the erysipelas,  the small-pox, measles, itch, or other erup-
 tive diseases.  What is called a hemicrania generally proceeds from cru-
 dities or ind'gestion.  Inanition, or emptiness, will often also occasion
 head-achs.   I have often seen instances ef this in nurses who gave suck
 too long, or avIio did not take a sufficient quantity of solid food.
   There is likewise a most violent, fixed, constant, and almost intolera-
 ble heael-ach, which occasions great  debility both  of body and mind. 
240
OF THE  HEAD-ACH.
 prevents sleep, destroys the appetite, causes a vertigo, dimness of ^ight,
 a 'ioise in the ears, convulsions,  epileptic  fits, and sometimes vomiting,
 costiveness, coldness of the extremities, Ac.
   The head-ach is  often symptomatic in continud  and intermitting fe-
 vers, especially quartans.   It is likewise  a very common symptom in
 hysteric and hypochondriac complaints.
   When a head-ach  attends an acute fever, with pale urine, it is an un-
 favourable symptom.  In excessive head-achs, coldness of the extremi-
 ties  is a bad sign.
   When the disease  continues long,  and is very violent, it often termi-
 nates in blindness, an apoplexy,  deafness,  a vertigo, the palsy, or the
 epilepsy.
   In this disease the cool regimen in general is to  be observed.   The
 d!et ought to consist of such emollient substances as Avill correct the
 acrimony of the humours, and keep the body open;  as apples boiled in
 milk, spinage, turnips, and such like.  The drink ought to be diluting;
 as barley-water, infusions of mild mucilag;nous vegetables, decoctions of
 the sodorific woods, Ac.  The feet and legs ought to  be kept warm, and
 frequently bathed in hike-warm water; the head should be shaved, and
 bathed with water and vinegar.  The patient ought as  much as possible
 to keep in an erect posture, and  not to  lie with his head too low.
   When  the head-ach is owing to  excess of blood, or an hot bilious
 constitution,  bleeding is  necessary.   The patient may be bled in the
 jugular vein, and the operation repeated if there be occasion.   Cupping
 abo, or the application of leeches to the temples,  and behind the  ears,
 w*ll be of service.  Af'envards a blistering-pl ster may  be applied to the
 neck behind the ears, or to any part of the head that  is most affected.
 Iu some cases it will be proper to blister the whole head.  In persons of
 a gross habit, issues or perpetual blisters Avill be of service.   The body
 ought likeAvise to be kept open by gentle laxatives.
   But when the head-ach proceeds  from a copious vitiated serum  stag-
 nating iu the membranes, either ivithin or without the skull, with a  dull,
 heavy, continual pain,  which will neither  yield to bleeding  nor gentle
 laxatives, then more powerful purgatives are necessary, as pills made of
 a'oes, resin of jalap, or the like.  It will also be necessary iu this case to
 blister the Avhole head, and to keep the back part of  the  neck open for
 a considerable time by a perpetual blister.
   When the head-ach is occasioned by the  stoppage  of a running  at
 the  nose,   the  patient  should frequently  smell  to a bottle of volatile
 salts;  he may likewise take snuff, or any thing that will  irritate the nose,
 so as to promote a discharge from  it; as the  herb  mastich, ground
 ivy, Ac.
   A hemicrania, especially a periodical one, is generally owing to a  foul-
 ness of the stomach,  for which gentle vomits must be  administered,  as
 also purges of rhubarb.  After the bowels have been sufficiently cleared,
 chalybeate waters,  and such bitters as strengthen the stomach, will be
 necessary.  A ppriodical head-ach has been cured by wearing a piece
 of flannel over the forehead during the night.
   When the head-ach  arises from a vitiated state of  the humours,  as
in the scurvy and  venereal diseases, the  patient, after proper evacua-
tions, must drink freelv  of  the decoction  of woods, or the  decoctiow 
OF  THE  TOOTH-ACH.                241
of sarsaparHla, with raisins and liquorice.*   These, if duly persisted in,
will produce very happy effects.   Wheu  a collection of matter is felt
under the skin, it must be discharged by an incision, otherwise it will ren-
der the bone carious.
   When the head-ach is so intolerable as to endanger the patient's life,
or is attended with continual  watching and delirium, recourse must be
had to opiates.   These, after proper  evacuations  by clysters or mild
purgatives, may be applied both externally and internally.—The affect-
ed part may be rubbed with Bate's anodyne balsam, or a cloth dipped
in it may be applied to the part.  The patient may, at the same time,
take twenty drops of laudanum, in a cup of valerian or  penny-royal  tea,
twice or thrice a-day.   This is only to be done in case of extreme pain.
Proper evacuations  ought  always to  accompany and follow  the  use of
opiates.f
   When the patient cannot bear the  loss of blood, his  feet ought  fre-
quently to be bathed in lukewarm water, and well rubbed with a coarse
cloth.  Cataplasms with mustard or horse-radish, ought  likewise to be
applied to them.   This course is peculiarly necessary when the pain pro-
ceeds from a gouty humour affecting the  head.
   When  the head-ach is occasioned by great heat, hard labour  or vio*
lent exercise of any kind, it may be allayed by cooling medicines, as the
saline draughts Avith nitre, and the like.
   A little aether,  dropt into the palm of the hand, and applied to the fore-
head, will sometimes remove a violent head-ach.

                    OF THE TOOTH-ACH.

   THIS  disease is so well known, that it needs no description.   It  has
great affinity with the rheumatism, and often succeeds pains of the shoul*
ders and other parts of the body.
   It may proceed from obstructed perspiration, or any ofthe other causes
of inflammation.  I  have often known the tooth-ach occasioned by neg-
lecting some part of the usual  coverings of the head, by sitting with the
bead bare near an open windoAV, or exposing it 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 sugar, or other sireetmeats, are likewise hurtful. No-
thing is more desti'uctive to the teeth than cracking nuts, or chewing  any
kind of hard substances; picking the teeth with pins, needles, or any thing
that may hurt the enamel with which they are covered, does great mis-
chief, as the tooth is sure  to be spoiled whenever  the air  gets into it.
Breeding women are very subject to  the tooth-ach, especially during
the first three or four months'of pregnancy.  The  tooth-ach often pro-
ceeds from  scorbutic humours affecting  the gums.   In this case  the
teeth are sometimes wasted, and fall out Avithout any  considerable  de-
gree of pain.  The more immediate cause of the  tooth-ach is a rotten or
carious tooth.
   In order to relieve the tooth-ach, we must  first  endeavour to  lessen
  * See Appendix, Decoction of SarsaparHla.
  + When the pain is very violent, and does not yield to small doses of lauda-
nam, the quantity may be increased.  I have known a patient in extreme pain,
take three hundred drops in twenty-four hours; but such doses ought only to \>i
administered bv a person of skill.
                                 31 
242
OF THE TOOTH-ACH.
the flux of humours to the part affected.   This may be done by mild
purgatives, scarifying the gums; or applying leeches to them, and bath-
ing the feet frequently with warm water.  The perspiration ought like-
wise to be promoted, by drinking  freely of Aveak wine-whey, or other
diluting liquors, Avith 6mall doses  of nitre.   Vomits too have often an
exceeding good effect in the tooth-ach.  It is seldom safe to administer
opiates, or any kind of heating medicines, or even to draAV a tooth, till
proper evacuations  have been  premised;  and these alone will often ef-
fect the cure.
  If this fails, and the pain and inflammation still increase, a suppuration
may be  expected;  to promote Avhich  a toasted fig should be held be-
tween the gum and  the cheek; bags filled Avith boiled camomile-flowers,
flowers of elder, or the like may be applied near the part affected, with
as great a degree of  warmth  as the patient can bear, and renewed as
they grow  cool:  the patient may likewise  receive the steams 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, Ac-
   Such things as promote the  discharge of saliva, or cause  the patient to
spit, are generally of service.   For this purpose, bitter, hot, or pungent
vegetables may be  chewed; as gentian, calamus aronuticus, or pellitory
of Spain.   Allen recommends  the root of yellow water flower-de-luce in
this case.   This root may either be rubbed upon the tooth,  or a little of
it cheAved.   Brookes says he hardly ever knew it  fail  to ease the
tooth-ach.   It ought however to be used with caution.
   Many other herbs, roots, and seeds, are recommended for curing the
tooth-ach; as the leaves or roots or millefoil or yarrow cheived, tobacco
smoked or chewed, staves-acre, or the seeds of mustard  cheAved, Ac.
These bitter, hot, and pungent things, by occasioning a greater flow of sa-
liva, frequently give ease in the tooth-ach.
   Opiates ofteu relieve the tooth-ach.   For this purpose a little cotton
wet with laudanum, may be held between the teeth; or apiece of stick-
ing-plaster, about  the bigness of a  shilling, Avith a  bit of opium in
the middle of it, of  a size not to prevent the sticking of the other,
may be laid  on  the temporal artery,  Avhere the  pulsation is most sen-
sible.  De la Matte affirms, that  there are feAv cases Avherein this will
not give relief.  If there be a hollow tooth, a small pill made of equal
parts of camphire  and opium, put into  the  hollow, is often beneficial
When this cannot be had, the holloAV tooth may be filled with gum mas-
tich, wax, lead, or any substance  that will  stick in it, and keep out the
external air.
   Few applications give more relief in the tooth-ach than blistering-plas-
ters.   These, may be applied betAveen thfe shoulders; but they have the
best effect Avhen put behind the ears,  and made so large as to cover a
great part ofthe lower jaw.
   After all,  when  a tooth is  carious,  it,"is often  impossible to remove
the pain  without extracting  it; and, as a spoilt tooth never becomes
sound again,  it is prudent to draw it soon, lest it should affect the rest.
Tooth-drawing, like bleeding, is  very much  practised by mechanics,
as well as persons of the metlical profession.  The operation however
is not without danger, and ought always  to be  performed with care.
 ,\ person unacquainted with the structure  of the parts will  be in dan- 
OF THE  EAR-ACH.                  243
 ger of hurting the jaw-bone, or of drawing a sound tooth instead 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 ap-
 plication of an artificial magnet to  the affected tooth.   We shall not at-
 tempt to account for its mode of operation; but, if it be found to ansAver,
 though only in particular cases, it certainly  deserves a trial, as it is at-
 tended with no expense, and  cannot do any harm.   Electricity has like-
 wise been  recommended, and particular instruments have been invented
 for sending a shock through the affected tooth.
   Persons Avho have returns  of the tooth-ach at certain seasons, as spring
 and autumn, might often prevent it by taking a purge at these times.
   Keeping the teeth clean has no doubt a tendency to prevent the tooth-
 ach.   The best method of doing this is to wash them daily Avith salt and
 water, a decoction of the bark, or  with cold-water alone.   All brushing
 and scraping of the  teeth is  dangerous, and,  unless it be performed with
 great care, does mischief.

                       OF  THE EAR-ACH.
   THIS disorder chiefly affects the membrane wiiich lines the inner ca-
 vity of the ear, called the meatus auditorius.   It is often so violent as to
 occasion great restlessness, anxiety, and even delirium.—Sometimes epi-
 leptic fits,  and other convulsive disorders, have been brought on by  ex-
 treme pain in the ear.
   The  ear-ach may proceed from  any  of the causes which produce in-
 flammation.  It  often proceeds from a sudden suppression of perspiration,
 or from the head being exposed to cold when covered with  sweat.  It
 may also be occasioned by worms, or other insects getting into the ear, or
 being bred there; or from any hard body sticking in the ear.  Sometimes
 it proceeds from the translation of morbific matter to the ear.   This often
 happens in the decline of malignant fevers, and occasions deafness, Avhich
 is generally reckoned a favourable symptom.
   When the ear-ach proceeds from insects, or any  hard body sticking in
 the ear, every method must be taken to  remove them as soon as possible.
 The membranes  may be relaxed, by dropping into the  ear, oil of sweet
 almonds, or olive oil.  Afterwards the patient should be made to sneeze,
 by taking snuff, or some  strong sternutatory.  If this should not force out
 the body, it must be extracted by art.  I have seen insects,  Avhich had
 got into the ear, come out of their own accord upon pouring in oil.
   When Uie pain of the ear proceeds from inflammation, it must be treated
 like other topical inflammations, by a cooling regimen, and opening me-
 dicines.   Bleeding at the beginning, either in the arm or jugular vein, or
 cupping in the neck, will be proper.   The ear may likewise be fomented
 with steams of Avarm Avater; or flannel bags filled with boiled mallows
 and camomile-flowers may be applied to it Avarm;  or bladders filled with
 warm milk aud water.   An exceeding good method of fomenting the ear,
 is to apply it  close  to the mouth of a  jug filled with warm water, or a
strong decoction of camomile-flowers.

  •  This may always be prevented by the operator striking upon the teeth with
any piece of metal, as this never fails to excite the pain in the carious tooth. 
^44           PAIN 0F  TH£  STOMACH,  &C.

   The patient's feet should be frequently bathed in lukewarm water, and
he ought to take  small doses of nitre and rhubarb, viz. a scruple of the
former, and ten grains of the latter, three times a-da> —His drink may
be whey, or a decoction of  barley and liquorice, with figs or  raisins.
The parts behind the ear ought frequently to be rubbed with camphor-
ated od, or a little of the volatile liniment.
   When the inflammation cannot be discussed, a poultice of bread and
milk, or roasted onions, may  be applied to the ear, and frequently renew-
ed, till the abscess breaks, or can be  opened.  Afterwards the  humours
may be diverted from the part by gentle laxatives, blisters, or issues; but
the discharge must not be suddenly dried up by any external application.
               PAIN OF  THE STOMACH, &c.
   THIS may proceed  from various causes, as indigestion; wind; the
acrimony of the  bile; sharp, acrid,  or poisonous substances taken into
the stomach, &c.   It may likewise be occasioned by worms;  the  stop-
page of customary evacuations; a translation of gouty matter to  the sto-
mach, the bowels, &c.
   Women in the  decline of life are very liable to pains of the stomach
and bowels, especially 6uch as are afflicted with hysteric complaints.  It
is likewise very common to hypochondriac men of a sedentary and luxuri-
ous  life.   In such persons it often proves so extremely obstinate  as to
baffle all the powers of medicine.
   When the pain of the stomach i6 most violent after eating, there is rea-
son to suspect that  it proceeds from some fault, either in the digestion or
the food.   In this case the patient ought to change his diet, till he  finds
what kind of food agrees best with his stomach, and should continue chief-
ly to use it.  If a change of diet does not remove the complaint,  the pa-
tient may take a gentle vomit, and aftenvards a dose or two of rhubarb.
He ought likewise to take an infusion of camomile flowers, or some  other
stomachic  bitter, either in wine or water.   I have often knoAvn exercise
remove this complaint, especially sailing, or a long journey on horseback,
or in a carriage.
   When a pain  of the stomach proceeds from flatulency, the patient is
constantly belching up wind, and feels an uneasy distention of the stomach
after meals.   This is a most deplorable disease, and is seldom thoroughly
cured.   In general, the patient ought to avoid all windy diet, and every
thing that sours on the stomach, as greens, roots, &c.  This rule however,
admits of some exceptions.  There are many  instances of persons very
much troubled with iviud, who have received great benefit from eating
parched pease, though that grain is generally supposed to be of a w indy
nature.*
   This complaint may likewise be greatfy relieved by labour, especially
digging, reaping,  mowing, or any kind of active employment by which the
bowels are  alternately compressed and dilated.   The most obstinate case
of this kind I ever met Arith, was in a person of a sedentary occupation,
whom I advised, after he had tried  every kind of medicine, to turn gar-
dener ; which he did, and has ever since enjoyed good health.
   * These are prepared by steeping or soaking pease in water, and afterwards
 drying them in a pot or kiln, till they be quite hard.  They may be used at
.^pleasure. 
OF WORMS.                      245
  When a pain of the stomach is occasioned by the swalloAving of acrid
or poisonous substances, they must be discharged by vomit; this may be
excited by butter, oils, or other soft things, which sheath and defend the
stomach from the acrimony of its contents.
  When a pain of the stomach proceeds from a translation of gouty mat-
ter, warm cordials are necessaiy, as generous Avines, French brandy, Ac.
Some have drank a whole bottle of brandy or rum, in this case, in a few
hours, without being in the least intoxicated, or even feeling the stomach
warmed by it.   It is impossible to ascertain the quantity necessary upon
these occasions.  This must be left to the feelings and discretion of the
patient.  The  safer way however, is not to go  too far.  When there is
an inclination to vomit,  it may be promoted by drinking an infusion of
camomile-flowers, or carduus benedictus.
  If a pain of the stomach proceed from the stoppage of customary  eva-
cuations, bleeding will be necessary, especially in sanguine and very full
habits.  It will likeAvise be of use to keep the body gently open by mild
purgatives;  as rhubarb or senna.   When this disease affects Avomen in
the elecline of life, after die stoppage of the menses, making  an issue in
the leg or arm will be of peculiar service.
   When th^^isease is occasioned by Avorms, they must be destroyed, or
expelled by sucji means as are recommended in the folloAving section.
  When the dtomach is greatly relaxed, and the digestion bad,  which
often occasion  flatulencies, the elixir of vitriol will be  of singular service.
Fifteeu or twenty drops  of it may be taken in a glass of  wine or Avater
twice or thrice a-day.
  Persons afflicted with flatulency are generally unhappy unless they
be taking some purgative medicines;  these, though they may  give imme-
diate ease, tend to weaken aud relax the stomach aud bowels, and conse-
quently increase  the disorder.   Their best  method is to mix purgatives
and stomachics together.  Equal parts of Peruvian  bark and rhubarb
may be infused in brandy or Aviue, and taken in such quantity as to keep
the body gently open.
                      CHAP.  XXXVII.

                           OF  WORMS,

       J. HESE are chiefly of three kinds, viz. the taenia, or tape-worm;
the teres, or round and long Avorm; aud the ascarides, or round and short
Avorm.  There are many other kinds of worms found in the human body;
but as they proceed,  in  a great  measure,  from similar causes,  have
nearly the same symptoms, and require almost the same method of treat-
ment as these already mentioned, we shall not spend time in enumerating
them.
   The tape-Avorm  is white, very long, and full of joints.   It is generally
bred either in the stomach or small Intestines.   The round and long worm
is  likeAvise bred in the small guts, and sometimes in the stomach.  The
round and short worms,  commonly lodge in the rectum, or what is called
the end gut, and occasion  a disagreeable itching about the seat. 
246
OF  WORMS.
   The long round worms occasion squeamishness, vomiting, a disagree-
able breath, gripes, looseness, swelling of the belly, sAVooniugs, loathing
of food, and at other times  a voracious appetite,  a dry cough, convul-
sions, epileptic fits, and sometimes a privation of speech.   These worms
have been known to perforate the intestines, and get into the cavity of
the belly.   The effects of the tape-Avorm are nearly the same with those
of the long and round, but rather more violent.
   Andry says,  the  following symptoms particularly attend the solium,
which is a species of  the tape-worm, vis. SAVooniugs, privation of speech,
and a voracious appetite.   The round,, worms called ascarides, besides
an itching of the anus, cause swoonings, and tenesmus, or an inclination
to go to stool.
   CAUSE.—Worms may proceed from various  causes;  but they are
seldom found except in weak and relaxed stomachs, where the digestion
is bad.   Sedentary persons are more liable to them than the active and
laborious.  Those who eat great quantities  of unripe fruit, or Avho live
much on rawr herbs and  roots,  are generally subject to worms.  There
seems to be au hereditary disposition in some persons to this disease.  I
have often seen all the children of a family subject to worms of a parti-
cular kind.   They seem likewise frequently to be owing if> the nurse.
Children of the same family, nursed by one woman, have often worms,
wheu those nursed by another have none.
   SYMPTOMS.—The common symptoms of Avorms  are paleness of
the countenance,  and at  other times, an universal flushing of the face;
itching ofthe nose; this however is doubtful, as children pick their noses
in all diseases: starting, and grinding of the teeth in sleep; swelling of the
upper lip; the appetite sometimes bad,  at other times quite voracious;
looseness; a sour or stinking breath; a hard swelled belly; great thirst;
the urine frothy,  and sometimes of a  whitish colour; griping, or colic
pains: an involuntary discharge of saliva, especially when asleep; fre-
quent pains of  the side, with a dry cough,  and unequal pulse; palpita-
tions  of the heart; swoonings; cold sweats; palsy; epileptic fits,  with
many otlier unaccountable  nervous symptoms, Arhich were formerly at-
tributed to witch-craft, or the influence of evil spirits.   Small bodies in
the excrements resembling  melon or cucumber seed are  symptoms of
the tape-Avorm.
   I lately saw some very surprising effects of worms in a girl about five
years of age, who use  to lie for whole hours as if dead. She at last expired,
and  upon opening her body, a number of the teres or long round worms,
were found in her guts,  Avhich  were considerably inflamed;  and what
anatomists call an intus susceptio^ox involving of one part of the ffut
within another, had taken place in no less than four different parts of
the intestinal canal.*
  * That worms exist in the human body there can be no doubt; and that they
must sometimes be considered as a disease, is equally certain; but this is not
the case so often as people imagine.  The idea that worms occasion many dis-
eases, give an opportunity to the professed worm doctors of imposing on the
eredulity of mankind, and doing much mischief. They find worms in every
case, and liberally throw in tlieir antidotes,  which generally consist of strong
drastic purges.  I have known these given in delicate constitutions to the de-
struction of tlie patient, where there was not the least symptom of worms. 
OF WORMS.                          247
  MEDICINE.—Though numberless  medicines are extolled for ex-
pelling and killing worms,* yet no disease more frequently baffles the
physician's skill.   In general, the most proper medicines for tlieir ex-
pulsion are strong  purgatives;  and to  prevent their breeding,  stomach
bitters, with now and then a glass of good wine.
  The best purge for an adult is jalap  and calomel.   Five and twenty
or thirty grains of the former with six or  seven  of the latter, mixed in
syrup, may be taken early in the morning,  for a dose.  It will be proper
that the patient keep  the house all day, and drink nothing cold.  The
dose may be repeated  once or twice a Aveek for a fortnight or three weeks.
On the intermediate  days the patient may take a drachm of the powder
of tin, twice or thrice a-day, mixed with syrup, honey, or treacle.
  Those Avho do not chuse to take calomel, may make use of the bitter
purgatives ;  as aloes, hiera picra, tincture of  senna, and rhubarb, &c.
   Oily medicines are sometimes found beneficial for  expelling worms.
An ounce of  salad oil and a table spoonful of common  salt may  be taken
in a glass of red port wine thrice a-day, or oftener, if the stomach will
bear it.   But the  more common form of using oil is in  clysters.  Oily
clysters sweetened with sugar or honey, are very efficacious in  bringing
away the short round worms called ascarides, and likewise the  teres.
   The Haurowgate water is an excellent  medicine for expelling worms,
especially the ascarides.  As this water is impregnated with sulphur, we
may hence infer, that  sulphur alone must be a good medicine in this case;
which is found to be a fact.   Many practitioners give flour of sulphur in
very large doses, and  with great success.  It should be made into an elec-
tuary with honey or treacle, and taken in such quantity as to purge the pa-
tient.
   Where Harrowgate water cannot be obtained, sea Avater may be used,
which is far from being a contemptible medicine in this case.  If sea wa-
ter cannot be had, common salt  dissolved in water may be drank.   I
have often seen this used by country nurses with very good effect.   Some
flour of sulphur may be taken over night, and the salt water iu the morning.
   But worms though expelled, will soon breed again, if the stomach re-
mains weak  and relaxed; to prevent which, Ave Avould  recommend the
 Peruvian bark.  Half a drachm of bark in  powder may be taken in a
glass of red  port wine three or  four times a-day, after the above medicines
have been used.  Lime-water is likewise good  for this  purpose, or a ta-
ble-spoonful of the chalybeate  wine taken twice or thrice a-day.  Infu-
 sions or decoctions of bitter herbs may likewise be drank; as the infusion
 of tansy, water trefoil, camomile  flowers, tops  of wormwood,  the lesser
 centaury, Ac.
    For a child of  four or five years old, six grains of rhubarb,  five of ja-
 lap, and two of calomel, may be mixed in a  spoonful of syrup  or  honey,
 and given in the morning.   The child should  keep  ?he house all day,
 and take nothing  cold.  This dose may be repeated twice a week for
 three or four  weeks.  On the intermediate days the child may Jake a
 scruple  of powdeced tin and ten grains of aehiops mineral in a spoo <ful
 of treacle twice a-day.  This  do e must be increased or diminished ac-
 cording to the age of the patient.
 _________-----------------                                     *     i, .
   *  A medical writer of the present age has enumerated upwards of fifty Brit-
 ish plants, all celebrated for killing ana expelling worms. 
248
OF  THE  JAUNDICE.
   Bisset says, the great bastard black hellebore, or bear's fool, is a most
powerful vermifuge for the long round worms.  He orders the decoction
of about a drachm of the green leaves, or about  fifteen grains of the dri-
ed leaves in powder for a dose to a child between four and seven years
of age.   This dose is to be repeated two or three times.   He adds, that
the green leaves made into a syrup with coarse sugar, is almost the only
meelicine he has used for round Avorms for three years past.  Before pres-
sing out the juice he moistens the bruised leaves with vinegar, which cor-
rects the medicine.  The dose is a tea-spoonful  at bed time, and one or
two next morning.
  I have frequently known those big bellies, Avhich in children are com-
monly reckoned a sign of worms, quite removed  by giving them white
soap in their pottage, or other  food.  Tansy, garlic, and rue, are all good
against worms, and may be used various  ways.    We  might here men-
tion many  other plants, both  for external and internal use, as the cab-
bage-bark,  Ac. but think the powder of  tin with aethiops mineral, aud
the purges of the rhubarb and calomel, are more to be depended on.
   Ball's purging vermifuge poAvder is a very powerful medicine.   It is
made of  equal parts of rhubarb, scammony, and calomel, with as much
double refined sugar as is equal to the weight of all  the other ingredients,
These must be well mixed% together, and reduced to a fine powder. The
dose for a child is from ten grains to twenty, once or twice 4iweek.  An
adult may take a drachm for a dose.*
   Parents who would preserve their children from  worms ought to allow
them  plenty of exercise in the open air; to take care that their food be
wholesome and sufficiently solid;  and as far as possible, to prevent their
eatin«- raw herbs, roots, or green trashy fruits.   It will not be amiss to al-
low a° child who is subject to  Avorms, a glass of red wine  after meals; as
every thing that braces and strenghens the stomach is good both for pre-
venting and expelling these vermin-t
                      CHAP. XXXVIII.


                      OF THE JAUNDICE.

        THIS  'elisease is first observable  iu the  white of  the  eye,
which appears yellow.  Afterwards  the  whole skin puts on  a yellow
appearance.  The urine too is of a saffron hue, and dies a white cloth

  • A powder  for the tape-Worm resembling this, was long kept a secret on
the continent; it was lately purchased by the French king, and will be found
under the article Powder in the Appendix.
  f We think it necessary here to warn people of their danger who buy cakes,
powders, and other worm medicines, at random,  from quacks and  give them
to their children without proper care  The principal ingredients  in  most ot
these medicines  is mercury, which is  never to be trifled with.  I lately saw a
shocking instance of the danger of this conduct.  A girl who had taken a  dose
of worin powder, bought ot a travelling quack, went out, and perhaps was so
imprudent as to drink cold water during the operation.   She  immediately swel-
led, and died on the following day with aU the symptoms of having been pois-
oned. 
OF  THE  JAUNDICE.
249
 of the same colour.   There is likeAvise a species of this disease called
 the  Black Jaundice.
   CAUSES.—The  immediate cause of the jaundice is an obstruction
 ofthe bile.  The remote or occasional causes are, the bites of poisonous
 animals, as the viper, mad dog, Ac. the bilious or hysteric colic; violent
 passions, as grief, anger, Ac.  Strong purges or vomits will likewise oc-
 casion  the jaundice.   Sometimes  it proceeds  from obstinate agues,
 or from that disease being prematurely stopped by astringent medicines.
 In infants it is often occasioned by the meconium not being sufficiently
 purged off.  Pregnant women are very subject to it.   It  is likeAvise a
 fcymptom  in several kinds of fever.   Catching cold, or the stoppage of
 customary evacuations, as the menses, the bleeding piles, issues, Ac. Avill
 occasion the jaundice.
   SYMPTOMS.—The patient at first complains  of excessive weari-
 ness, and has great aversion to every kind of motion.  His skin is dry,
 aud he generally feels a kind of itching or pricking pain over the whole
 body.  The stools are of a whitish or clay colour, and the urine, as was
 observed  above, is yellow.  The breathing is difficult, and the patient
 complains of an unusual load or oppression on  his breast.   There is a
 heat iu his nostrils, a bitter taste in the mouth, loathing of food,  sickness
 of the  stomach,  vomiting, flatulency, and  other symptoms of indiges-
 tion.
   If the patient be young, and the disease complicated with no other ma-
 lady, it is seldom dangerous ;  but in old people, where it continues long,
 returns frequently,  or is complicated with the dropsy or hypochondriac
 symptoms, it  generally proves fatal.   The black jaundice is more dan-
 gerous than the yellow.
   REGIMEN.—The diet should be cool, light, and diluting, consisting
 chiefly of ripe fruits and  mild vegetables;  as apples boiled or roasted,
 -tewed prunes, preserved plumbs, boiled spinnage, &c.  Veal or chicken
 broth, Avith light  bread,  are  likewise very proper.   Many have been
 cured by living almost  avholly for some days on raw eggs.   The drink
 should be  butter-milk, whey sweetened Avith honey, or decoctions of cool
 opening vegetables;  or marsh-mallow roots, with liquorice, &c.
   The patient should take as much  exercise as  he can bear, either on
 horseback, or in a  carriage;  walking, running,  and  even jumping, are
 likewise proper, provided he can bear them without  pain, and there be
 no symptoms of inflammation.   Patients have been often cured of this di?
 sease by a long journey, after medicines had proved ineffectual.
   Amusements are  likewise of great use in  the jaundice.   The di-
 sease is often occasioned by a sedentary life, joined to a  dull melan-
 choly disposition.  Whatever therefore tends to promote the circulation^
 and to cheer the spirits, must have a good effect; as dancing, laughing,
 singing, Ac.
   MEDICI XE.—If the patient  be young, of  a full sanguine habit,
and  complains »f pain in the right side about the  region of the liver,
bleeding will  be necessary.   After  this a vomit must be  administer-
ed, and  if the disease  prove obstinate,  it  may be repeated once or
twice.   No medicines are more bei< ficial in the jaundice  than vomits,
especially win re it is not attended with inflammation.  Half a drachm of
ipecacuanha iu powder, will be a sufficient dose for an adult.   It  may be
wrought off with wrak camomile tea, or luke-warm Avater.  The body must 
250
OF THE  DROPSY.
likeAvise be kept open by a sufficient quantity of castile soap, or the pills
for the jaundice recommended in the Appendix.
   Fomenting the p.irts about the region of the stomach and liver, and
rubbing them Arith  a warm hand or flesh-brush, are likeAvise beneficial;
but it is still more so for the patient to sit in a bath of warm water up to
the breast.   He ought to  do this frequently, and should continue it as
lo.ig as his strength will permit.
   Many dirty things are recommended for the cure of the jaundice; as
lice, millepedes, Ac.   But these do more harm than good, as people trust
to them, and neglect more valuable medicines; besides they are seldom
taken in sufficient quantity t© produce any effects.   People always ex-
pect that such things should act as charms, and consequently seldom per-
sists in the  Hse  of them.   Vomits, purges, fomentations,  and exer-
cise will seldom fail to cure the jaundice when it is a simple disease; and
when complicated Arith the dropsy, a scirrhous  liver, or other chronic
complaints, it is hardly to be cured by any means.
   Numberless British herbs  are extolled for the cure of this  disease.
The author of the Medicina Britannica mentions near a hundred, all fa-
mous for curing the jaundice.  The  fact is, the disease often goes off of
its own accord; in Avhich case the last medicine is always said to have
performed the cure.   I have sometimes, however, seen considerable be-
nefit, in a very obstinate jaundice, from a decoction ofhempseed. Four
ounces of the sefed may be boiled in two English quarts of ale, and sweet-
ened with coarse sugar.  The doses is half an English pint every morn-
ing.  It may be continued for eight or nine  days.
   I have  likewise knoAvn Harrowgate sulphur water cure a jaundice of
very long standing.  It should be used for some Aveeks, and the patient
must both drink and bathe.
   The solube 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 dose may be in-
creased.
   Persons subject to the jaundice ought to take as much exercise as pos*
sible, and to avoid all heating and astringent aliments.
                      CHAP.  XXXIX.

                      OF THE DROPSY.

         THE dropsy is a preternatural swelling of the Avhole body,
or some part of  it occasioned by a collection of watery humour.   It is
distin«ndshed by different names, according to the part affected, as the
anasarca, or collection of water under the skin ;  the ascites, or collection
of water in the belly; the hydrops pectoris, or dropsy of the breast; the
hydrocephalus, or dropsy of the brain, &c.
   CAUSES.—The dropsy is often owing  to  an  hereditary disposi-
tion.   It may likewise proceed  from drinking ardent spirits, or other
strong liquors.   It is true  almost to  a proverb, that  great drinkers die
of the dropsy.   The want of exercise  is also a very common cause 
OF THE  DROPSY.                    251
 of the dropsy.   Hence it is justly  reckoned among the diseases of the
 sede .tary.  It often proceeds from excessive evacuations, as frequent and
 copious bleeding, strong purges often repeated, frequent salivations, Ac.
 The  sudden stoppage of customary or necessary  evacuations, as the
 menses, the haemorrhoids, fluxes of the belly, Ac. may likewise cause a
 dropsy.
   I have knoAvnthe dropsy occasioned by drinking large quantities of cold,
 weak, watery liquor, when the body was heated by violent exercise.  A
 low, damp, or marshy situation is likewise a frequent cause of it. Hence
 it is a common disease in moist, flat, fenny countries.  It may aho be
 brought on by a long use of poor wateiy diet, or of viscious aliment that is
 hard of digestion.  It is often the effect of other diseases, as the jaundice,
 a scirrhus ofthe liver, a violent ague of long continuance, a diarrhoea, dy-
 sentary, an empyema, or a consumption of the lungs.  Iu short, whatever
 obstructs the perspiration, or prevents the  blood from being duly prepar-
 ed, may occasion a dropsy,
   SYMPTOMS.—The anasarca  generally begins with a sAvelling of
 the ft et aud ancles towards night, which for  some time disappears in
 the morning.  In  the evening the parts, if pressed with the finger,  Avill
 pit.  The SAvelling  gradually ascends, and  occupies  the  trunk of the
 body, the arms,  and the head.  Afterwards the breathing becomes diffi-
 cult,  the  urine  is in small  quantity, and the thirst great; the body is
 bound, and  the  perspiration is greatly obstructed.  To these succeed
 torpor, heaviness, a slow Avasting fever, aud a troublesome cough.   This
 last is generally a fatal  symptom, as it  sheAvs that  the  lungs are af-
 fected.
   In  an ascites, besides the above  symptoms, there is a swelling  of the
 belly, and often a fluctuation, which may be perceived by striking the
 belly on one side, and laying the palm of the hand on the opposite.  This
 may be distinguished from a tympany ofthe weight ofthe SAvelling, as well
 as by the fluctuation.  When the anasarca and ascites are combined, the
 case is very dangerous.   Even a simple ascites seldom admits of a radical
 cure.  Almost all that can be done is, to let  off the water by tapping*.
 which seldom affords more than a temporary relief.
   When the disease comes suddenly on, and  the patient is  young and
 strong, there is reason, however, to hope  for a cure, especially if medi-
 cine be given early.  But if the patient be old, has led an irregular or se-
 dentary life, or if there be reason to suspect that the liver, lungs, or any
 of the viscera  are unsound, there  is great  reason to fear that the conse-
 quences will prove fatal.
   REGIMEN.—The patient must abstain as much as possible  from
 all  drink, especially  weak  and watery liquors, and  must quench his
 thirst with mustard-whey, or acids, as juice of lemons, oranges, sorrel,
 or  such like.   His aliment ought  to be diy, of a stimulating and
 diuretic  qudity, as toasted bread, the flesh  of birds, or  o'ber wild
 animals  roasted;  pungent  and  aromatic vegetables, as  garlic,  mus-
 tard,  onions,  cresses,  horse-radish,  rocambole, shalot, Ac.   He  may
 also eat sea-biscuit dipt in  wr«e  or a little brandy.  This is not  only
 nourishing,  but tends to  quench  thirst.   Some  have b"en  actually
cured  of  a  dropsy by a total abstinence  from all liquids, and  living
entirely upon such  tlungs  as are mentioned above.  If the patient 
252                   OF  THE  DROPSY.
must have drink, the Spa-water, or Rhenish wine, with diuretic medi-
cines infused in it, are the best.
   Exercise is of the greatest importance in a dropsy.   If the patient be
able to walk, dig, or the like, he ought to continue these exercises as
long as he can.  If he is not able to walk  or  labour,  he must ride ou
horseback, or in  a carriage, and the more violent the motion so mucb
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 coun-
try,  he ought to be removed into a dry one, and, if possible, into a
warmer climate.  In a word, every method should be taken to promote
the perspiration, and to brace the  solids.   For this purpose it will like-
wise be proper to rub the patient's  body two or three times a-day, with a
hard cloth, or the flesh-brush; and he ought constantly to wear flannel
next his i-kiu.
   MEDICINE.—If the patient be young, his constitution good, and the
disease has come on suddenly, it may generally be removed by strong vo-
mits, brisk purges, and  such medicines as promote a discharge by sweat
and urine.  For an adult, half a drachm of ipecacuanha in powder, and
half au ounce of oxymel of squills, will be a proper vomit.   This may be
repeated as often as is necessaiy, three or four days intervening between
the doses.  The  patient must not drink  much after  taking the  vomit,
otherwise he destroys its effect.  A cup or two of camomile-tea  will be
sufficient to work it off.
   Between each vomit, on one of the intermediate days, the  patient  may
take the following purge : Jalap iu powder half a drachm, cream of tartar
two drachms, calomel six grains.   These may be made into a bolus with
a little syrup of pale roses, and taken early in the morning.   The less the
patient drinks after  it the better.   If he be much griped, he  may  now
and then take a cup of chicken broth.
   The patient may likewise take every  night at bed-time, the following
bolus : To four or five  grains of camphor add one grain of opium, and
as much syrup of orange-peal  as is sufficient to  make them iuto a bolus.
This will generally promote a gentle sw eat,  which should be encouraged
by drinking now and then a small cup  of wine-whey, Avith  a tea-spoonful
of the spirits of hartshorn in  it.   A tea-cupful of the following di-
uretic infusion  may likewise be taken every four or five hours through
the day,
   Take juniper berries, mustard-seed, and horse-radish, of each  half an
ouuee, ashes of broom, half a ponnd; infuse them in a quart of Rhenish
wine or strong ale for  a few days, and afterwards strain  off the  liquor.
Such as cannot take this infusion, may use  the decoction of  sencka-root,
which is both diuretic and sudorific.  I have  known  an  obstinate  ana-
sarca cured by au infusion ofthe ashes of broom in wine.
   The above course will often cure an incidental dropsy, if the constitu-
tion be good ; but  when the disease proceeds from a bad habit, or an un-
sound state ofthe viscera, strong purges and vomits are uot to be ventured
upon.  In this case, the safer course is to palliate the  symptoms  by the
use of such medicines as promote the secretions, and  to support the pa-
tient's strength by warm and nourishing cordials.
   The secretion of urine may be greatly promoted by nitre. Brookes
■ays,  he knew a young woman who was  cured of a  dropsy by taking
a drachm of  nitre every  morning in a draught  of ale, after she  had 
                      OF  THE  DROPSY.                   253

been given over as incurable.  The powder of squills is likewise a good
diuretic.   Six or eight grains of it, with a scruple of nitre, may be given
twice a-day in a glass of strong cinnamon-Avater.  Ball says, a large
spoonful of unbruised mustard-seed taken eveiy night and morning, and
drinking half an English pint of the decoction of the tops of green broom
after it, has performed a cure alter other powerful medicines had proved
ineffectual.
  I have  sometimes seen good effects from cream of tartar in this dis-
ease.   It  promotes  the discharges by stool  and urine, and will at least
palliate,  if it does  not perform a cure.   The patient may  begin by ta-
king an ounce every second or third day, and may increase the quantity
to two or even to three ounces, if the stomach will bear it.   This quan-
tity is not however to be taken at once, but divided into three or four
doses.
  To promote perspiration, the patient may use the decoction of seneka-
root, as directed above ;  or he may take two table spoonsful of Minde-
rerus1 spirit in a cup of Avine-Avhey three or four times a-day.  To pro-
mote a discharge of urine,  the following  infusion of  the London hospi-
tals will likewise be beneficial:
   Take of zedoary-root two drachms; dried squills,  rhubarb, and juni-
per-berries bruised,  of  each a drachm;  cinnamon in powder,  three
drachms; salt of worm-wood, a drachm and a half; infuse  in an English
pint and a half of old hock wine, and when fit for use, filter the liquor.
A wine-glass of it  maybe taken three or four times  a-day.
   In the  anasarca it is usual to scarify the feet and legs.  By this means
the water is often discharged; but the operator must be cautious not to
make the incisions too  deep; they ought barely to pierce through the
skin, and especial care must be taken,  by spirituous fomentations and
proper digestives, to prevent a gangrene.
   In an ascites, when the disease does not evidently and speedily give way
to purgative and diuretic medicines, the water ought to be  let off by
tapping.  This is a very simple and safe operation, and would often suc-
ceed, if it were performed in  due time; but if it be delayed  till the hu-
mours are vitiated, or the  bowels spoiled, by  long  soaking in water, it
can hardly be expected that  any permanent relief will be procured.*
   After the  evacuation of  the Avater, the patient is to be put on a course
of  strengthening medicines;  as the Peruvian bark;  the elixir of vitriol;
warm aromatics, with a due proportion of rhubarb, infused in wine,  and
 such like.   His diet ought to be dry and nourishing, such as is recom-
 mended  in the beginning of  the chapter; and  he should  take as much
 exercise  as he can bear without fatigue.   He should wear flannel next
 his skm,  and make daily use  of the flesh-brush.

   • The very name of an operation is dreadful to most people, and they wish to
 try every  thing before they have recourse to it.  This is the reason why tapping
 so seldom succeeds to our wish.  I have had a patient who was regularly tap-
 ped once  a month for several years, and who used to eat her dinner as well after
 the operation, as if nothing had  happened.  She died at last rather worn out by
 age than by the disease. 
254
                          CHAP. XL.

                        OF  THE  GOUT.

       JL HERE is no disease which shews the imperfection of medicine,
or sets tlie advantages of temperance and exercise iu a stronger n«ht,
than the gout.  Excess and idleness are the true sources from whence it
originally sprung, and all Avho would avoid it must be active and temperate.
   Though idleness  and intemperance are the principal causes of the
gout, yet many other things may contribute to bring on the disorder in
those who are not, and to induce a paroxysm in those who are sub,cct to
it;  as intense study ; too free an use of acidulated liquors; night-watch-
ing; grief  or uneasiness of mind;  au obstruction  or  defect of any of
the customaiy discharges,  as the  menses, sweating of  the feet, per-
spiration, Ac.
   SYMPTOMS.—A fit of the gout is generally preceded by indiges-
tion, drowsiness, belching of Avind, a slight head-ach, sickness, and some-
times vomiting.  The  patient complains of weariness and dejection of
spirits, and has often a pain in the limbs, Avith a sensation as if  wiud or
cold water were passing down the thigh.   The appetite is often remark-
ably keen a day or two before the fit, and there is  a slight pain in pass-
ing urine, and frequently an involuntary shedding of tears.   Sometimes
these symptoms are much more violent, especially upon the near ap-
proach of the fit;  and it has been  observed, that as is the fever w hich
ushers in the gout, so Avill the fit be; if the fever be short and sharp, the
fit will be so likewise; if it be feeble, long, and lingering, the fit will be
such also.  But this observation can only hold with respect to  very re-
gular fits of  the gout.
   Te regular gout generally makes its attack in the spring or beginning
of winter, in the following manner: About two or three in the morning,
the patient is seized with a pain in his great toe, sometimes in  the heel,
and at other times  in the ancle or calf of the leg.  This pain is accom-
panied Avith a sensation as if cold water were poured upon the part, which
is succeeded  by a shivering, with some degree of fever.   Afterwards the
pain increases, and fixing among the small bones of  the foot, the patient
feels  all the different kinds of torture, as if the part were  stretched,
burnt, squeezed, gnawed, or torn to pieces.  The part at length  becomes
so exquisitely sensible, that the patient cannot bear to have it  touched,
or even suffer any person to walk across the room.
   The  patient is  generally in exquisite torture for twenty-four hours
from the time of the coming on of the fit; he then  becomes  easier, the
part begins to swell, appear red, and is covered with a little moisture.
Towards  morning he  drops asleep, aud  generally falls into  a  gentle
breathing sweat.   This terminates the first paroxysm, a number of which
constitutes a  fit of the gout; which is longer or shorter, according to the
patient's age, strength, the season of the year, and the disposition of the
body to this disease.
  The patient is  always worse towards night, and  ersier in  the  morn-
ing.   The paroxysms  however generally grow  milder  every day, till
at length  the disease  is carried  off by perspiration,  urine  and the
*v 
OF THE  GOTJT.
255
other evacuations.    In some  patients this happens in a few days; in
others it requires weeks, and in some months, to finish the tit.—These
whom age aud frequent fits of the gout have greatly debilitated,  seldom
get free from it before the approach of summer, and sometimes not till it
be pretty far advanced.
   REGIMEN.—As there are no medicines yet knoAvn that will cure
the gout, we shall confine our observations chiefly to regimen, bolh in and
out of the fit.
   In the fit if the patient be ycung and strong, his diet ought to be thin
and cooling,  and h s driuk of a diluting nature; but when the constitu-
tion is weak  and the patient has been accustomed to live high, this is
not a proper time to retrench.  In this case he must keep uearly to his
usual diet, and should take frequently  a cup of strong negus, or a glass of
generous wine.   Wine-whey is a  very pioper drink in this  case, as it
promotes the perspiratio.i without greatly heating  the patient.   It will
answer this  purpose better if a tea-spoonful of sal volatile oleosum, ox
spirits of hartshorn, be put in a cup of it twice a-day.   It will likewise
be proper to give at bed-time a tea-spoonful of the volatile  tincture of
guaiacum in a large draught of v> arm wine-whey.   This  will greatly
promote perspiration  through the night.
    As the most safe and  efficacious method of discharging the gouty mat-
ter, is by perspiration, this ought  to be kept up by all means, especially
iu the affected part.  For this purpose the leg and foot should be wrapt
in soft  flannel, fur, or  wool.   The last is most readily obtained, and
seems to answer the purpose better than any  thing else.   The people of
 Lancashire look upon  wool as a kind of specific in the gout.   They
 wrap a great  quantity  of it about the leg and foot affected, and cover it
 with a skin of soft dressed leather.  This they suffer to continue for
eight or ten days, and sometimes for a  fortnight or three Aveeks, or longer.
 if the pain  does not  cease.  I never  knew any external application ans-
 wer so well in the gout.  I have often seen it applied when the  swelling
 and  inflammation were very great, with violent pain, and have found all
 these symptoms relieved by it  in a few days.  The wool which  they
 use is generally greased,  and carded  or combed.   They choose the soft-
 est which can be had, and selelom or never remove it till the fit be entire-
 ly gone off.
    The patient ought likewise  to be kept quiet and easy during the fit.
 Every thing that affects the mind disturbs the  paroxysm, and  tends to
 throw  the gout upon  the nobler  parts.   All external applications that
 repel the  matter are  to be avoided as death.   They do not cure the di-
 sease, but remove it from a safer to a more dangerous part of the body,
 where it often proves fatal.  A fit of  the gout is  to be considered as na-
 ture's method of removing something  that might provre destructive to tlie
 body, and all that we can do with safety, is to promote her intention?,
 and to assist her in  expelling the enemy in her own Avay.   Evacuation
 by bleeding,  stool, Ac. are likewise to be used with caution,  they do not
 remove the cause of the  disease, aud sometimes by weakening the pa-
 tient, prolong the fit; but where the constitution is able to bear it,  it will
 be of use to keep the body gendy  opeu by diet, or very mild  laxative
 medicines.
    Many things will  indeed shorten a fit of the gout, and some will drive
 it off altogether: but nothing has yet been foune'. which will do this with 
256
OF THE  GOUT.
 safety to the patient.  In pain Ave eagerly grasp at  any thing that pro-
 mises immediate ease, and even hazard life itself for a temporary relief.
 This is the true reason why so  many infallible remedies have been pro-
 posed for  the gout, and why such numbers  have lost their lives by the
 use of them.  It Avould be as prudent^to stop the small-pox from rising,
 and to  drive them into  the  blood,  as to attempt  to  repel the gouty
 matter  after it  has been thrown upon  the  extremites.   The latter
 is as much an effort of nature to free herself fiom an offending cause as
 Uie former,  and ought equally to be promoted.
   When the pain however is very great, and the patient is restless, thir-
 ty or forty drops of laudanum, more  or less according to the violence of
 the symptoms, may be taken at bed-time.  This  will ease the pain, pro-
 cure rest, promote perspiration,  and forward the crisis of the disease.
   After the fit is over the patient ought to take a gentle dose or two of
 the bitter tincture of  rhubarb, or some other worm stomachic purge.  He
 should also drink a weak infusion of  stomachic bitters  iu small wine or
 ale, as  the Peruvian bark,  with cinnamon, Virginia snake-root, and
 orange-peel.  The diet at this time should be light  but nourishing, and
 gentle exercise ought to be taken on horseback, or in a carriage.
   Out of the fit, it  is in the  patient's power to do many things towards
 preventing a return of the disorder, or rendering the fit, if it should re-
 turn, less severe.   This, however, is not to be attempted by medicine, I
 have frequently ktfow n the gout  kept  off for several years,  by the Peru-
 vian bark and other  astringent medicines; but in all the cases Avhere I
 had occasion to  see this tried,  the persons died suddenly, and to all  ap-
 pearance, for Avant of a regular fit of the gout.  One Avould be apt, from
 hence, to conclude, that a fit of the gout to some constitutions, in the  de-
 cline of life, is rather salutary than hurtful.
   Though it may be dangerous to stop a fit of the gout by medicine, yet
 if the constitution can be so changed by diet and exercise, as to lessen
 or totally prevent its return, there certainly can be no danger in following
 such a course.   It is well known that the whole habit may be so altered
 by a proper regimen, as quite to eradicate this disease; and those  only
 who have sufficient resolution to persist in such a course have reason to
 expect a cure.
   The course which we would recommend for preventing the gout, is as
 folloAvs.  In  the first place, universal temperance.  In  the next place suf-
ficient exercise*.  By this we do  not mean sauntering  about in an indolent
 manner, but labour, sweat, and toil.  These only can render  the humours
 wholesome, and keep  them  so.   Going early  to bed,  and rising betimes,
 are also of great importance.  It  is likewise proper to  avoid  night studies-
 and all intense thought.   The supper should be light,  and taken early.
 AU strong liquors, especially generous wines and sour punch, arc to  be
 avoided.
   We would likewise recommend some doses  of magnesia alba, and
 rhubarb  to  be taken every  spring  and autumn;   and afterwards a
course of stomachic  bitters, as  tansy or water-trefoil  tea, an infusion
  * Some  make a secret of curing the gout by muscular exercise.  This
secret, however, is as old as Celsus, who strongly recommends that mode of
cure -, and whoever will submit to it, in the fullest extent, may expect to reap
aplid and permanent advantages. 
OF THE GOUT.                    257
 of gentian and camomile flowers, or a decoction  of burdock root, Ac.
 Any of these, or an infusion of any wholesome bitter that is more agree-
 able to the patient, may be drank for two or three weeks in March and
 October twice a-day. An issue or perpetual blister has a great tendency1!©
 prevent  the gout.    If these  were more geuerally used in the decline
 of life, they would uot only often prevent the gout, but also other chronic
 maladies.  Such as can afford to go to Bath, will find great benefit from
 bathing and drinking the water.   It both promotes eligestion and invigo-
 rates the habit
   Though there  is  little room  for  medicine  during a regular fit of
 the gout, yet when  it  leaves  the  extremities, and falls on  some of
 the  internal  parts,   proper applications  to recal  and fix it, become
 absolutely necessary.   When the gout  affects the head, the pain of
 the joints ceases, and the swelling disappears, while either  severe head-
 ach, drowsiness, trembling, giddiness, convulsions, or delirium come on.
 When it seizes the lungs, great oppression, with cough and difficulty of
 breathing, ensue.  If it attacks the stomach,  extreme sickness, vomitiug,
 anxiety, pain in the  epigastric region, and total loss of strength will suc-
 ceed.
   When the gout attacks the head or lungs,  every method must be taken
 to fix  it in the feet.   They must be  frequently  bathed in warm Avater,
 and acrid cataplasms  applied to the soles.   Blistering plasters ought
 likeAvise to be applied to the ancles or calves of the legs.  Bleeding in the
 feet or ancles is also  necessaiy, and warm stomachic purges.  The pa-
 tient ought to keep in bed for the most part, if there be any signs of in-
 flammation, and should be very careful not to catch cold.
   If it attack the stomach Avith a sense of cold, the most warm cordials
 are necessary; as strong wine boiled up with cinnamon or other spices;
 cinnamon-water; peppermint-water; and even branely or rum.*   The
 patient should keep his bed, and endeavour to promote a sweat, by drink-
 ing warm liquors;  and  if he should be troubled with a nausea, or incli-
 nation to vomit, he may drink camomile tea, or any thing that will make
 him vomit freely.
   When the gout attacks the kidneys, and imitates gravel-pains, the pa-
 tient ought to drink freely of a decoction of  marsh-mallows, and to have
 the parts fomented Avith  warm  water.   An emollient clyster ought like-
wise to be given, and afterwards  an opiate.  If the pain be very violent,
twenty or thirty drops of laudanum may be taken in a cup of the decoc-
tion.
   Persons who have had the gout should be very attentive  to any com*
plaints that may happen to them about the time  when they have reason
to expect a return of the  fit.   The gout imitates many other disorders,
 and by being mistaken for them, and treated improperly, is  often divertr
ed from its regular course, to the great danger ofthe patient's life.
   Those Avho never had  the  gout,  but  who,  from  their  constitution
or manner of living, have reason to expect it, ought likewise  to be
very circumspect  with regard to its first approach.   If  the disease,
by  wrong  conduct or improper medicines,  be  diverted from its regu-
lar course, the miserable  patient has a chance to  be ever after tor-
mented with  head-aches, coughs, pains of the stomach  and intestines;
/Fther is found to be an efficacious remedy in this case.
                     33 
258                OF  THE  RHEUMATISM.
and  to faH at last a victim  to its attack upon some  of the more noble
parts.*                                     "

 #                OF THE  RHEUMATISM.

   THIS  disease has often a resemblance to  the gout.   It  generally at-
tacks the  joints Avith exquisite  pain, and is sometimes  attended with in-
flammation and swelling.  It is most common in the spring, and towards
the end of autumn.   It is usually distinguished into acute and chronic •
or the rheumatism with or  without a fever.
   CAUSES.—The causes of  a rheumatism are frequently the same as
those of an inflammatory fever, viz. an obstructed perspiration,  the im-
moderate  use of strong liquors, and the like.   Sudden changes of the wea-
ther, and  all quick transitions from heat to cold, are very apt to occa-
sion the rheumatism.  The most  extraordinary case of a rheumatism
that I ever saw, where almost  every joint of the body was distorted, was
a man Avho used to Avork one part of the day by fire, and the other part
of it in Avater.    Very obstinate rheumatisms, have likeAvise been brought
on by persons not accustomed to it, alloAving their feet to continue  long
wet.   The same  effects  are  often  produced by wet clothes, damp
beds, sitting or lying on the damp ground, travelling in  the night, Ac.
   The  rheumatism may likeAvise be occasioned  by excessive evacua-
tions, or the  stoppage of customary discharges.  It is often the effect of
chronic diseases, which vitiate  the humours;  as the scurvy, the lues ve-
nerea, obstinate autumnal agues, Ac.
   The  rheumatism preArails in  cold, damp, marshy countries.  It is most
common among the  poorer sort of peasants, who are ill clothed,  live in
low damp houses, and eat coarse and unwholesome food, Avhich  contains
but little  nourishment, and  is not easily digested.
   SYMPTOMS.—The acute rheumatism  commonly begins with Avea-
riuess, shivering, a quick pulse, restlessness,   thirst, and other symptoms
of fever.   Afterwards the  patient complains of flying pains, which are
increased by the least motion.   These at length fix in the  joints, which
are often  affected with  swelling  and inflammation.  If blood be let in
this disease, it has generally the same appearance as in the pleurisy.
   In this  kind  of rheumatism the treatment  of the patient is nearly Ihe
same as in an acute  or inflammatory fever.   If he be young and strong^
bleeding is necessary, which may be repeated according to the exigencies
of the case. The body ought likeAvise to be kept open by emollient clysters,
or cool opening  liquors; as decoctions  of tamarinds, cream of tartar,
whey, senna-tea, and the like.   The diet should be  light,  and  in small
quantity,  consisting chiefly of roasted apples, groat-gruel, or Aveak chic-
ken broth.   After the feverish symptoms have abated, if the pain  still
continues, the patient must keep his bed, and  take such things as promote
perspiration, as wine-whey, with spiritus Mindereri, Ac.  He may like-
wise take, for a few nights, at bed-time, in a cup of Avine-whey, a drachm
ofthe cream of tartar, and half  a drachm of gum guaiacum in powder.
   Warm  bathing,  after prober evacuations,  has often an  exceeding

  • A late French writer (M. Cadet de Vaux) of some celebrity, for the cure
of this disease prescribes forty-eight glasses of warm water in twelve hours, a
glass every quarter, abstaining from every thing else during the time.  Thr«
practice is  already generally adopted in France.                     a.  e . 
                   OF  THE  RHEUMATISM.              259
                                                                   ■I
good effect.   The patient may either be put into a bath of warm wate*,
or have cloths wrung out*of it applied to the parts affected.   Great ca.e
must be taken that he do not catch cold after bathing.
  The chronic rheumatism is seldom  attended with any  considerable
degree of fever, and is generally confined to some particular part of the
body, as the shoulders, the back, or the loins.   There is seldom any in-
flammation or swelling in this case.   Persons in the decline of life are
most subject to the chronic rheumatism.  In such patients it ofteu proves
extremely obstinate and sometimes incurable.
  In this kind of rheumatism the regimen should be nearly the same as
in the acute.  Cool and diluting diet, consisting chiefly of vegetable sub-
stances, as stewed prunes, coddled apples, currants or gooseberries boil-
ed in milk, is most proper.   Arbuthnot says, " If there be a specific in
aliment for the rheumatism, it is certainly Avhey;" and adds,  " That he
knew a person subject to this disease, who could never be cured by any
other method but a diet of Avhey and  bread."   He likewise says, " That
cream of tartar in water gruel, taken for several days, will ease rheuma-
tic pains considerably."  This I have often experienced, but found it
always more efficacious when joined  with gum guaiacum, as already di-
rected.—In this case the patient may take the dose formerly mentioned,
twice a-day, and likewise a tea-spoonful of the volatile tincture of gum
guaiacum,  at bed-time, in wine-whey.
   This course may be continued for a week, or longer, if the case proves
obstinate, and the patient's strength  will permit.   It ought then to be
omitted for a few days, and repeated again.  At the same  time leeches,
or a blistering-plaster may be applied to the part affected.   What I have
"•enerally found answer  better than  either of these, in obstinate fixed
rheumatic pains, is the warm plaster*  I have likewise known a plaster
of  Burgundy pitch worn for some time on the part affected, give great
aelief in rheumatic  pains.  My ingenious friend, Dr. Alexander, of Edin-
burgh, says, he has frequently cured very obstinate rheumatic  pains, by
 rubbing the part affected, with tincture of cantharides.   When the com-
 mon tincture did not succeed, he used it of a  double or treble strength.
 Cupping upon the part affected, is likewise often very beneficial, and so
 is the application of leeches.                          .
   Thou'h fltis disease  may not seem to yield to medicines  for some
 rime, yet they ought still to be persisted in.  Persons who  are subject to
 frequent returns ofthe rheumatism, will often find their account in using
 medicines, whether they be immediately affected with the disease or not.
 The chronic rheumatism is similar to the gout in this respect^ that the
 most proper time for using medicines to extirpate it, is when the patient
 is most free from the disorder.
    To  those who can afford the expense, I would recommend  the warm
 baths of Buxton or Matlock in Derbyshire.   These have, often, to my
 knowledge, cured very obstinate rheumatisms, and are always safe either
 in or out of the fit.   When the rheumatism is complicated with scorbutic
 complaiuts, which is not seldom the case, the Harrovvgate waters, and
 those of Moffat, are proper.  They should both be drank and used as
 a warm bath.                                 ...     ,      ,  ...
    There  are several of our own domestic plants which may be used with
 advantage in the rheumatism.  One of the best is the white  mustard.
 ___________________a                                     11    i ■       -ii-
                     " See Appendix, Warm Platter. 
260
OF THE  SCURVY.
A table-spoonful of the seed of tiiis plant may be taken twice or thrice
a-day, in a glass of Avater or small wine.   The watertrefoil is likewise
of great use in this complaint.   It  may  be infused in wine or ale, or
(frank in form of tea.   The ground-ivy, camomile, and several other bit-
ters, are also  beneficial, and may be  used in the  same manner.   No
benefit however is to be expected from these unless they be taken lor a
considerable time.  Excellent medicines are often despised in this disease,
because they do not perform an immediate cure; Avhereas nothing would
be more certaiu than their effect, were they duly perfcisted in.  Want of
perseverance in the use of medicines, is one reason why chronic diseases
are so seldom cured.
   Cold bathing, especially in  salt  water, often cures the rheumatism.
We would  also recommend  riding  on horseback,  and wearing flannel
next the skin.   Issues are likeAvise very proper,  especially in chronic
cases.  If the pain affects the shoulders, an issue may be made in the
arm; but if it affects the loins, it should  be put into the leg or thigh.
   Persons afflicted Arith the scurvy  are very subject to rheumatic com-
plaints.   The best medicines in this  case are bitters and mild purgatives.
These may either be taken separately  or  together,  as  the  patient in-
clines.  An ounce of Peruvian bark, and half an ounce of rhubarb in
powder, may be infused in a bottle of wine; and one, two, or three Avine-
glasses of it taken daily, as shall be found necessary for keeping the body
gently open.  In cases where the bark itself proves sufficiently purga-
tive, the rhubarb may be omitted.
   Such as are  subject to frequent attacks of the rheumatism, ought to
make choice of a dry, warm situation, to avoid the night air, wet clothes,
and wet feet, as much as possible.  Their clothing should be Avarm, and
they should wear flannel next their  skin, and  make frequent use of the
flesh-brush.
                         CHAP. XLI.

                      OF  THE  SCURVY.

       x HIS disease prevails chiefly in cold northern countries, espe-
cially in low damp situations, near large marshes, or  great quantities of
stagnating water.  Sedentary people, of a  dull melancholy disposition,
are most subject to it.  It proves often fatal to sailors on long voyages,
particularly in ships that are not properly ventilated, have many people
on board, or where cleanliness is neglected.
  It is not necessary to mention the different species into which this dis-
ease has been divided, as they differ from one another chiefly in degree.
What is called the land scurvy, however, is seldom attended Arith those
highly putrid symptoms  which appear in patients who have been long at
sea, and which,  we presume, are  rather owing to confined  air, want of
exercise, and  the unwholesome food eaten by sailors on long voyages,.
than to any specific difference in the disease.
  CAUSES.—The  scurvy is  occasioned  by cold moist air;  by the
long use of  6alted  or  smoke dried provisions, or any kind of food
that is hard of  digestion, and affords little  nourishment.   It may al-
so proceed from the  suppression of customary evacuations;  as the 
OF THE SCURVY.
261
tnenses, hemorrhoidal flux, Ac.   It is sometimes owing to an hereditary
taint, in Avhich case a very small cause  will excite the latent disorder.
Grief, fear, and other depressing passions, have a great tendency both to
excite and aggravate thi3 disease.  The same observation holds with
regard to neglect of cleanliness; bad clothing; the want of proper ex-
ercise; confined air;  unAvholesome food; or  any disease which grea ly
weakens the body, or vitiates the humours.
   SYMPTOMS.—This disease may be known by unusual weariness,
heaviness; and difficulty of breathing, especially after motion; rotten-
ness ofthe gums, which are apt to bleed on the slightest touch; a stink-
ing breath ;  frequent bleeding at the nose; crackling of the joints;  diffi-
culty of walking; sometimes a swelling and sometimes a falling away of
the legs, on which there are livid, yellow, or violet coloured spots; the
face is generally of a  pale leaden colour.   As the disease advances,
other symptoms come on; as rottenness of the teeth, haemorrhages or dis-
charges of blood from different parts of the body, foul  obstinate ulcers,
 pains in various parts, especially about the breast, dry scaly eruptions
 all over the body, &c.   At last  a wasting or hectic fever comes on, and
 the miserable patient is often carried off by a dyscutary, a diarrhoea,  a
 dropsy, the palsy, fainting fits,  or a mortification of some of the bowels.
   CURE.—We know no way  of curing this disease but  by pursuing  a
 plan directly opposite to that which brings it on.  It proceeds from a vi-
 tiated  state of the humours, occasioned by errors in diet, air, or exer-
 cise ;  and this cannot be removed but by a proper attention to  these im-
 portant articles.
   If the patient has been obliged to breathe a cold, damp, or confined air,
 he should be removed, as soou as possible to a dry, open, and moderately
 warm one.   If there is reason to believe that the disease proceeds from
 a sedentary life, or depressing  passions, as grief, fear, Ac.  the patient
 must take "daily as much exercise in the open air as he can bear, and his
 mind should  be  diverted by cheerful  company and other amusements.
 Nothing has  a greater tendency either  to prevent or remove tins disease
 than constant cheerfulness and good humour.   But this, alas!  is seldom
 the  lot of persona afflicted with the scuivy;  they  are generally  surly,
 peevish and morose.
   When the scurvy has been brought  on by a long use of salted provi-
 sions, the proper medicine is a diet consisting chiefly of fresh vegetables;
 as oranges, apples, lemons, limes, tamarinds, water-cresses, scurvy-grass,
 brook-lime, &c.  The use of these, with milk, pot-herbs, new bread, and
 fresh beer or cyder, will seldom fail  to remove a scuivy of this kind,  if
 taken before it be too far advanced, but to have this effect^hey must be
 persisted in  a considerable  time.  When fresh vegetables cannot  be ob-
 tained, pickled  or preserved  ones may be  used;  and where these are
 wanting, recourse mm t be had to the chymical acids.  All the patient's
 footl and drink should in this  case be sharpened with cream of tartar,
 elixir of vitriol, vinegar, or the spirit of sea-salt.
    These things however will more certainly prevent than cure the scur-
 vy,  for which reason sea-faring people, especially on long voyages, ought
 to lay iu pleutv of  them.   Cabbages, onions,  gooseberries, and many
 other vegetables, may be kept a long time pickling, preserving, Ac. and
  when these fail the chymical acids, recommended above, which will keep
 for any length of time,  may be used.  We have reason to believe, if ships 
262
OF THE SCURVY.
Avere well ventilated, had got stores of  fruits, green?, cyder, Ac. laid in,
and if proper regard were  paid to cleanliness and warmth, that sailors
would  he the most healthy people in the Avorld, and Avould seldom  suf-
fer either from the scurvy or putrid fevers, which are so fatal to that  use-
ful set  of men; but it is too much the temper of such people to despise
all  precaution;  they will not think of any calamity  till  it overtakes
them,  when it is too late to ward off the blow.
  It must indeed be oAvned, that many of them have it not in their power
to make the provision we are speaking of; but in this case it is the duty
of their employer to make it for them; and no man ought to engage iu
a long voyage Avithout having these articles secured.
  I have  often seen very extraordinary effects in that land scurvy from a
milk diet.   This preparation of nature is a mixture of  animal  and vege-
table properties, Avhich of  all others is the most fit for  restoring a de-
cayed  constitution, and removing  that particular, acrimony of the hu-
mours, Avhich seems to constitute the very essence of the scurvy, and
many  other diseases.   But people despise this Avholesome and iioiuishiog
food, because it is cheap, and devour with greediness, flesh and ferment-
ed liquors, while milk is only deemed fit  for their  hogs;
   The most  proper drink in  the scurvy, is whey or butter-milk.—
When  these cannot be had, sound cyder, perry, or spruce-beer, may be
used.  Wort has likewise been found to be a proper drink iu the scurvy,
and may be used at sea, as malt will keep during the longest voyage.  A
decoction of the tops of the spruce fir is likewise proper.   It may be
drank  in the quantity of an English pint twice a-day.   Tar-water maj
be used for the same purpose, or decoctions of any  of the mild  mucilage-
nous vegetables ; as  sarsaparilla, marsh-malloAv roots, &c.  Infusions  of
the bitter plants, as ground-hy, the lesser centaury, marsh-trefoil, Ac.
are likewise beneficial.  I have seen peasants in some parts of Britain
express the juice of the last mentioned plant, and dirink it with good ef
feet in those foul scorbutic eruptions, widi Avhich they are often troubled
in the spring season.
   HarroAvgate water is certainly an excellent medicine in the land scur-
vy.  I have often seen patients who have been reduced to the most de-
plorable condition by this disease, greatly relieved by drinking the sul-
phur-water, and bathing in it.   The chalybeate-water may also be  used
Avith advantage, especially  with a view to brace the stomach after drink-
ing the sulphur-water, which though it sharpens the appetite, never  foil*
to weaken the powers of digestion.
   A slight degree of scurvy may be carried off by frequently sucking
a little of the juice of a bitter orange or lemon.  When the disease affects
the gums only, this practice, if continued for some time, will generally
carry  it off.  We would however recommend the bitter orange as greatly
preferable to lemon, it  seems to be as good a medicine, and is not  neat
so hurtful to the stomach.   Perhaps our oAvn sorrel may be little inferior
to either of them.
   All kinds of salad  are good in the scurvy, and ought to be eaten
very plentifully, as spinnage,  lettuce,  parsley, celery,  endive, radish,
dandelion, &c.   It is amazing to see how  soon fresh vegetables in the
spring, cure the brute  animals  of any  scab or  foulness  which is  npon
their skins.  It Is reasonable to suppose that  their effects woub! bo  its 
OF  THE  SCROPHULA,  &C.              263
great upon the human species, were they used in proper quantities for a
lufficieut length of time.
  I have seen good effects id scorbutic complaints of very long standing,
from the use of a decoction ofthe roots of water dock.  It is usually made
by  boiling a pound of the fresh root in  six English pints of water, till
about one third of it be consumed.   The dose  is from half a pint to a
Avhole pint of the decoction every day.   But in all tlie cases where I
have seen it prove beneficial, it Avas made much stronger, and drank in
larger quantities.  The safest way, however, is for  the patient to begin
with small doses, and increase  them both in strength and quantity as  he
finds his stomach will bear it.   It must be used for a considerable time.
I have known some take it for many months, and have been told of others
who had used it for several years, before they were sensible of any bene-
fit, but who nevertheless were cured by it at length.
  The leprosy,  which Avas so common in the country long ago, seems to
have been near a-kin  to the scurvy.  Perhaps  its appearing  so seldom
now, may be owing to  the  inhabitants of Britain eating more  vegetable
food than formerly, living more upon tea  and  other diluting diet, using
less salted meat, being more cleanly,  better lodged and clothed, Ac. For
the cure of this disease we Avould recommend the same course of diet and
medicine  as in the scurvy.

          OF THE SCROPHULA, OR KING'S EVIL.

  THIS disease chiefly affects the glands, especially those of  the neck.
Children and young persons of  a sedentary life are very subject to it.  It
is one of those diseases which  maybe removed by  proper regimen, but
seldom  yields to medicine.  The inhabitants of cold,  damp, marsh)
countries, are mo3t liable to the scrophula.
  CAUSES.—This disease may proceed from an hereditary taint, from
a scrophulous nurse, Ac.  Children who have the misfortune to be born
of sickly  parents, whose constitutions  have been greatly injured  by the
pox, or other chronic eliseases, are apt to be affected with the scrophula.  It
may likewise proceed  from  such diseases as Avealcen the habit  or vitiate
the humours, as the small-pox, measles, Ac.  External injuries, as blows,
bruises, and the like, sometimes produce scrophulous ulcers; but Ave have
reason to believe, when this happens, that there has been a predisposition
in the habit to this disease.  In short, whatever tends.to vitiate the hu-
mours or relax the solids, paves the way to the scrophula; as the want of
proper  exercise, too much heat or cold, confined air, unwholesome food,
bad water, the long use of poor, weak, watery aliments, the neglect  of
cleanliness, Ac.  Nothing tends more to produce this elisease in children,
than allowing them to continue long wet.*
  SYMPTOMS.—At first small knots appear under the chin, or  behind
the ears,  Avhich gradually  increase in number and size, till they form
oik: large hard tumour.  This often continues for a  long time Avith-
out breaking,  and when it does break, it only  discharges a thin sanies,
or  Avatery humour.  Other parts of the bod)'  are likeAvise liable to its
attack, as the arm-pits, groins, feet, hands, eyes, breasts, Ac.   Nor are
the internal parts exempt  from it.  It often afftxts the  lungs, liver,  or
  *  The scrophula, as well as the rickets, is found to prevail in large manufac-
'uring towns, where people live gross, and lead sedentary lives. 
 ^°*               Of  the  scrophula,

 spleen;  and I have frequently seen tlie glands of the mysentcry greatly
 enlarged by it.
   Those obstinate ulcers whch break out upon the feet and hands w ith
 swelling, and little or no redness, are of the scrophulous kind.  They sel-
 dom discharge good matter, and are exceedingly diificult to cure.  The
 white swellings ofthe joints seem likeAvise to be of this kind.  They are
 with  difficulty brought to a suppuration, and when opened, they only dis-
 charge a thin ichor.  There is not a more general symptom of the scro-
 phula than a swelling ofthe upper lip and nose.
   REGIMEN.—As this disease proceeds, in a great measure, from re-
 laxation, the diet ought to be generous and nourishing,  but at the same
 time  light and of easy digestion: as well fermented bread, made of sound
 grain, the flesh andbroth of young animals, with now and then a glass of
 generous wine, or good ale.  The air ought to be open, dry and not too
 cold, aud the patient should take as much  exercise as he  can bear.   This
 is of  the utmost importance.  Children avIio have sufficient exercise, are
 seldom troubled with the scrophula.
   MEDICINE.—The vulgar are remarkably credulous with regard to
 the cure of the scrophula;  many of them believing in  the virtue of the
 royal touch, that of the seventh son, &c.   The truth is,  we know but lit-
 tle either of the nature, or cure of this disease, and where reason or me-
 dicines fail, superstition ahvays comes in their place.  Hence it is, that in
 diseases  which are the most difficult to understand, Ave generally hear
 of the greatest number of miraculous cures being  performed.   Here,
 hoAvever, the deception is  easily accounted for.   The  scrophula, at  a
 certain period of life, often cures of itself; and if the patient happens to
 be touched about this time, the cure is imputed to the touch, and not to
 nature, avIio is really the physician.  In the same way the insignificant
 nostrums of quacks and old  Avomen, often gain applause when they deserve
 none.
   There is nothing more pernicious than the custom of plying children in
■the scrophula with strong purgative  medicines.  People imagine it pro-
 ceeds from humours which must be purged off, without  considering that
 these purgatives increase the debility, and aggravate the  disease. It
 has indeed been found, that keeping the body gently open for some time,
 especially  with  sea-water,  has a  good effect; but this  should only be
 ifiven in gross fyftUts, and in such quantity as to procure  one, or at most
 two stools every nay.
   Bathing in the sak-water has likewise a very good effect,  especially in
 the warm season.   I have  often known a  course of bathing in salt-Avater,
 and drinking it in such quantities as to keep the body gently open, cure a
 crophula,  after many other medicines had been tried in vain.  When
salt water cannof be obtained, the patient may be bathed in fresh water,
and his body kept open  by small quantities of salt  and  water, or some
other mild  purgative.
  Next  to cold bathing, and drinking the salt  water, Ave would  recom-
mend the Pemvian bark.   The  cold bath may be used in summer and
the b  rk  in  winter.   To an adult half a drachm ofthe bark in  powder
may be given iu a glass of red wine, four or five times a-day.  Children,
and such rs cannot take it in substance, may use the decoction, made in
i!u» following man!'--! : 
of the  itch.
265
   Boil an ounce of Peruvian bark, and a drachm of Winter's bark, both
grossly  powdered, in an English quart of  water to  a pint: toAvardsthe
end, half an ounce of sliced liquorice-root, and a handful of raisins may
be added, which will both render the decoction less disagreeable,  and
make it take up more of the bark.   The  liquor must be  strained,  and
two, three or four table spoonsful, according to the age of the patient,
given three times a day. •
   The Moffat and Harrowgate waters, especially the latter, are likeAvise
very proper medicines in the scroplmla.  They ought not, however, to be
drank in large quantities, but should be taken so as to keep the body
gently open, and must be used for a considerable time.
   The hemlock may sometimes be used with advantage in the scrophula.
Some lay It down as a general rule, that the sea-water is most proper be-
fore there are any suppuration or symptoms of tabes; the Peruvian bark,
when there are running sores, and a degree of hectic fever; and the hem-
lock in old inveterate cases, approaching  to the scirrhous or cancerous
state.   Either the extract, or the fresh juice of tins plant may  be used.
The dose must be small at first, and increased gradually as far as the
stomach is able to bear it.
   External applications are of little use.   Before  the tumour breaks no-
thing ought to be applied to it, unless  a  piece of  flanuel, or something
to keep it warm.  After it breaks, the sore may be dressed with some di-
gestive ointment.  What I have always  found to answer best, Avas the
yellow basificon mixed with about a sixth or eighth part of its Aveight of
red precipitate of mercury.  The sore  may be dressed Avith this twice
a-day; and if it be very  fungous, and does not digest well, a large pro-
portion of the precipitate may be added.
   Medicines Avhich mitigate this disease, though  they do not cure  it,
 are not to be despised.   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 ivell;
 but if he does uot recover at this time, in  all probability he never will.
    There is no malady which parents are so apt to  communicate  to  theis
 offspring as the scrophula, for Avhich reason people ought to  beware of
 marrying into families affected with this disease.
    For the means of preventing the  scrophula Ave must refer the reader
 to the observations on nursing at the beginning of the book.




    THOUGH this disease is commonly communicated by infection, yet
 it seldom prevails where due regard is paid to cleanliness, fresh air and
 Avholesome diet.  It generally appears in form of small watery pustules,
 first about the wrists or  between the fingers;  afterwards it affects the
 arms, legs, thighs, Ac.  These pustules arc attended with an intolerable
 itching, especially when the  patient is warm in bed, or sits by the fire.
 Sometimes indeedthe skin is covered with lar^e blotches or scabs, and at
 other times with a white  scurf, or scaly eruption.    This last is called the
 dry itch, and is the most difficult to cure.
    The itch is seldom a dangerous disease, unless Avhen it is rendered so by
 neglect or improper treatment.   If  it be suffered to continue too long, it
 may vitiate the whole mass of humours; and if it be suddenly drove in.
34 
266
of  the  itch.
 Avithout proper evacuations, it may occasion fevers, inflammations ni  Hi*
 viscera, or other internal disorders.
    The best medicine  yet known for the itch is sulphur, which ought to
 be used both externally and internally.  The parts most affected may be
 rubbed with an ointment made of the flour of sulphur, two ounces; crude
 sal ammoniac finely powdered, two drachms;  hog's lard, or butter, four
 ounces.  If a scruple or half a drachm of the essence of lemon be added,
 it will entirely take away the disagreeable smell.  About the bulk of a
• nutmeg of this may be rubbed upon the extremities at beel-time twice or
 thrice a-Aveek.   It is seldom necessary to rub the Avhole body; but when
 it is, it ought not to be done all at once, but by turns, as it is dangerous
 to stop too many pores at the same time.
    Before the patient begins to use the ointment, he ought, if he be of a
  full habit, to bleed or take a purge or two.   It will likewise be proper,
  during the use of  it, to take every night and morning, as much of the
  flour of  brimstone and cream  of tartar, in a little treacle or new milk, as
  Avill keep the  body gently open.   He should beware  of  catching cold,
  should Avear  more  clothes  than  usual, and  take  every  thing warm.
  The same clothes, the  linen excepted, ought to be worn  all the time of
  using the ointment; and such clothes as have been worn while the patient
  Avas under the disease, are not to be used again, unless they have been fu-
  migated with brimstone, and thoroughly cleansed, otherwise they will com-
  municate the  infection anew.*
    I never knew brimstone, when used as directed above, fail to cure the
  itch;  and I have reason to believe, that if duly persisted in, it  never
  will fail; but if it be only used once or twice, and cleanliness neglected,
   it is no  wonder if the disorder returns.  The quantity of ointment men-
   tioned above will generally be sufficient for the cure of one person;  but if
   any symptoms of the disease should appear again, the medicine must be
   repeated.  It is both more safe and efficacious when persisted in for a
   considerable  time than when a large quantity is applied at once   As most
   people dislike the smell of sulphur, they may use in its place the powder
   of white hellebore root made up into an ointment, in the same manner,
   which will seldom  fail to cure the itch.
     People ought  to be extremely cautious lest they take other eruptions
   for the itch;  as the stoppage of these may be attended with fatal conse-
   quences.  Many of the eruptive disorders  to Avhich children are liable,
v »ha_£ a^eiresemhitoce to this disease;  and I have often known infants
*  killed by being rubbed with* greasy ointments that make these eruptions *
   strike suddenly in, which nature had thrown out to preserve the patient's
   life, or prevent some other malaely.
     Much mischief is likewise done by  the use of mercury in this di-
   sease.   Some persons are  so fool-hardy  as to wash the parts affected
   with a stron" solution of the  corrosive  sublimate.    Others use the
   mercurial ointment, without taken the  least care  either to avoid cold,
   keep  the  body  open,  or observe a proper regimen.  The consequences

     • Sir John  Pringle observes, that though th'is disease may seem trifling, there
   is no one in the army that is more troublesome to cure,  as the  infection olten
   iurks in clothes &c. and breaks out a second, or even a third time  The same
   inconveniency occurs in private families, unless particular regard is paid to the
    changing or cleaning of their clothes, which lastis by no means aneasy operation. 
                       OF  THE  ASTHMA.                  26*?
                   «
of such conduct may be easily guessed.  I have known even the mercuri-
al girdles produce bad effects, and w ould  advise every person, as he va-
lues his health, to beware how he uses them.  Mercury ought never to
be used  as a medicine without the greatest care.  Ignorant people look
upon these girdles as a kind of charm, without considering that the mer-
cury enters the body.
  It is not to be told what mischief is done by using mercurial ointment
for  curing the itch and killing vermin; yet it is unnecessary for either:
the former  may be always more  certainly  cured by sulphur, and the lat-
ter  Avill never be found Avhere due regard is paid to cleanliness.
  Those who Avould avoid this detestable disease ought to beware of in-
fected persons, to use Avholesome food, and to study universal cleanliness.*
                         CHAP.  XLII.

                       OF THE ASTHMA.

        TllE asthma is a disease of the lungs,  which seldom admits
of a cure.  Persons in the decline of life are most  liable to it,   It is
distinguished into the  moist and dry, or humoural and nervous.   The
former is  attended with expectoration or spitting; but in the latter the
patient seldom spits, unless sometimes a little tough phlegm by the mere
force of coughing.
  CAUSES.—The asthma is sometimes hereditary.   It may  likewise
proceed from a bad formation of the breast; the fumes of metals or mine-
rals taken into the lungs; violent exercise, especially runniug; the ob-
struction of customary evacuations, as the menses, haemorrhoids, Ac. the
sudden retrocession  of the gout, or striking in of eruptions, as the small-
pox, measles, Ac. violent passions of the mind, as sudden fear or surprise.
In a word, the disease may proceed from any cause  that either impedes
the circulation of the blood through the lungs, or prevents their being du-
ly expaneled by  the air.
  SYMPTOMS.—An asthma is known by a quick laborious breath-
ing,  which  is generally performed with  a  kinel of wheezing noise.
Sometimes the difficulty of breathing is so great, that the patient is  obli-
ged to keep in an erect posture,  otherwise  he is in danger  of being
suffocated.   A fit or paroxysm of the asthma generally  happens after
a person has been exposed to cold easterly Avinds, or has  been  abroad
in thick foggy weather, or has got wet, or continued long in a damp place
under ground, or has taken some food which the stomach could not digest,
as pasteries, toasted cheese, or the like.
  • The itch is now by cleanliness banished from every genteel family in Bri-
tain.  It still however prevails among the poorer sorts of peasants in Scotland,
and among the manufacturers  in England.  These are not only sufficient to
keep the seeds of the disease alive, but to spread the infection among others.
It were to be  wished that some effectual method could be devised for extirpa-
ting it altogether  Several country clergymen have told me, that by getting such
as were infected cured, and strongly recommending- an attention to cleanliness,
they have  banished the itch entirely out of their  parishes.  Why might '' *
others do the same. 
268                  0f  THE  ASTHMA*

  The paroxysm is commonly ushered in with listlessness, want of sleep,
hoarseness, a  cough, belching of wind,  a sense of heaviness about the
breast, and difficulty of breathing.   To  these succeed heat, fever, pain
of the head, sickness and nausea, great oppression of the breast, palpita-
tion of die heart, a weak, and sometimes intermitting pulse, an involunta-
ry flow of tears, bilious vomitings, Ac.   All the symptoms grow worse to-
wards night; the patient is easier when up than iu bed, and is very de-
sirous of cool air.
  REGIMEN.—The food ought to be light, and  of easy digestion.
Boiled meats are to be preferred to roasted, and the flesh of young ani-
mals to that of old.  All windy food, and whatever is apt to swell in-the
stomach, is to be  avoided.   Light puddings, Avhite broths, and ripe fruits
baked, boiled, or roasted are proper.   Strong liquors of all kinds, espe-
cially malt-liquor, are hurtful.   The patient should eat a very light sup-
per, or rather none at all, and should never suffer himself to be long cos-
tive.   His clothing should be Avarm, especially iu the winter season.  As
all disorders of the breast  are much relieved by keeping the feet w arm,
and promoting the perspiration, a flannel shirt  or waistcoat, and  thick
shoes, Avill be of singular service.
   But nothing is of so great importance in the asthma, as pure and mode-
rately warm air.  Asthmatic people can  seldom bear either the close
heavy air of a large town,  or the sharp, keen atmosphere of a bleak hilly
country; a medium therefore, between  these is to be chosen.   The air
near a large town is often better than at a distance, provided the patient
be removed so far as not to be affected by the  smoke.  Some asthmatic
patients indeed, breathe easier in  town than in the country; but this is
seldom  the case, especially in towns where much coal is burnt.   Asthma-
tic persons who are obliged to be in  toAvn all day, ought at least to sleep
out of it.  Even tiiis will often prove of great service.  Those who can
afford it ought to travel into a warmer climate.  Many asthmatic per-
sons  Avho cannot live in Britain, enjoy very good health in the south of
France, Portugal, Spain, or Italy.
   Exercise is likewise of very great importance in the asthma, as it pro-
motes the digestion, preparation of the blood, Ac.  The blood of asthma-
tic persons is seldom duly prepared, owing to the proper action of the lungs
being impeded.   For this reason such people ought daily to take as much
 exercise, either on foot, horseback, or in a carriage, as they can bear.
   MEDICINE.—Almost all that can be done by medicine in this disease,
is to relieve the patient when seized with a violent fit.  This indeed re-
quires the greatest expedition, as the disease often proves suddenly fatal.
 In the  paroxysm or fit, the body is generally bound;  a purging clyster
with a solution  of asafcetida, ought therefore  to be administered, and il
 there be occasion, it may be repeated two or three times    The patient s
feet and le°s ought to be immersed in warm water, and afterwards rubbed
with a warm hand or dry  cloth.  Bleeding, unless extreme weakness or
old age should forbid it, is highly  proper.  If there be a violent spasm
 about the breast or stomach, warm  fomentations, or bladders filled witn
warm milk and water, may be applied to the part affected; and warm
cataplasms to the soles of the feet.  The patient must drink freely ot dilu-
ting  liquors, and may take a tea-spoonful of the tincture of castor and ot
 gaff-on mixed together, in  a cup of valerian tea, twice or thrice a-day.
 Sometimes a a omit has a very good effect, and snatches the patient,  aa it 
OF THE  APOPLEXY.                 260
were from the jaws of death.   This however will be more safe after other
evacuations have been premised.   A very strong infusion of roasted cof
fee is said to give ease in an asthmatic proxysm.
   In the moist asthma, such things as promote expectoration or spitting,
ought to be used; as the syrup of squills, gum ammoniac, and such like,
A common spoonful of the syrup or oxymel of squills, 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 asafcetida
and gum ammoniac, at beel-time.*
   For the convulsive or nervous asthma, antispasmodics and bracers are
the most proper medicines.  The patient may take a tea-spoonful of the
paregoric elixir twice a-day.   The  Peruvian bark  is sometimes found
to be of  use in this case.   It  may be taken  in substance, or infused in
wiue.   In short, every thing that braces the nerves, or takes off spasm,
may be of use in a nervous asthma.   It is often relieved by the use of
asses milk; I have Ukeivise known coav's milk drank warm in the morn*
ing, have a very good effect in this case.
   In every species of asthma, setons and issues have a good effect; they
may either be set in the back or side, and should never be alloAved to dry
up.   We shall here,  once for  all, observe, that not  only in the asthma,
but in most chronic diseases,  issues are extremely proper.  They are
both a safe and  efficacious remedy; and though they do not always cure,
the disease, yet they will often prolong the patient's life.
                        CHAP. XLIIL

                     OF  THE APOPLEXY,

      THE apoplexy is a sudden  loss of sense  and motion, during
which the patient is to all appearance dead; the heart and lungs however
still continue to move.  Though this disease  proves  often fatal, yet it
may be sometimes removed by proper care.  It chiefly attacks sedentary
persons of a gross habit, who use a rich and plentiful  diet, and indulge
in strong lyjuors.  People  in the decline of life are most subject to the
apoplexy.  It prevails most in winter, especially in rainy seasons, and
very low states of the barometer.
   CAUSES.—The  immediate cause of an apoplexy is a compression
of the brain, occasioned by au excess of blood, or a collection of watery
humours.   The former is called a sanguine, and the latter a serous apo-
plexy.  It may be occasioned by any thing that  increases the circula-
tion  towards the brain, or prevents the return of the blood from the head j
as intense study; violent passions;! viewing objects for a long time ob-

  * After copious evacuations, large doses of jether have been found very effica-
cious in  removing a fit of the asthma.   I have likewise known the following
mixture produce very happy effVcts : To four or five ounces of the solution of
gum-ammoniac, add two ounces of simple cinnamon-water, the same quantity
of balsamic syrup, and half an ounce of paregoric  elixir. Of thi», two  table-
spoonsful may be taken every three hours.
  f I knew a woman, who in a violent fit of anger was seized with a sanguine
apoplexy.  She at first complained of extreme pain, " as if daggers had been
thrust through her head," as she exprcssod iu  Afterwards she became coam- 
270
OF THE  APOPLEXY.
 liquefy; wearing any thing too tight about the neck;  a rich  and luxu-
 rious diet; suppression of urine; suffering die body to cool suddenly af-
 ter having been greatly heated; continuing long in a warm or cold bath;
 the excessive use of spiceries, or high seasoned food ;  excess of venery;
 the sudden striking in of any eruption; suffering issues, setons, kc. sud-
 denly to dry up, or the stoppage of airy customary evacuation; a mercu-
 rial salivation pushed too far, or suddenly checked by cold;  wounds or
 bruises on the head;  long exposure to excessive cold; poisonous exha-
 lations, Ac.
   SYMPTOMS, and method of cure.—The  usual  forerunners of an
 apoplexy are giddiness, pain and sAvimming of the head;  loss of memory;
 droAvsiness, noise in the ears, the night mare, a spontaneous flux of tears
 and laborious respiration.   When persons of an apoplectic make observe
 these symptoms, they have reason to fear the approach  of a fit, and should
 endeavour to prevent it by bleeding, a slender diet and opening medicines.
   In the sanguine apoplexy, if the patient does not die suddenly, the
 countenance appears florid, the face is swelled or puffed up, and the blood
 vessels, especially about the neck and temples, are turgid;  the breathing
 is difficult, and performed  with a snorting noise.   The  excrements and
 urine are often voided spontaneously, and the patient is sometimes seized
 with vomiting,
   In this species of apoplexy every method must be taken to lessen the
 force of  the circulation towards the head.   The patient should  be kept
 perfectly easy and cool.  His head should be raised  pretty high, and
 his feet suffered to  hang doAvn.  His clothes ought to be loosened, espe-
 cially  about the neck, and fresh air admitted into his chamber.  His
 garters should be tied pretty tight, by which means  the motion of the
 blood from the lower extremities Avill be retarded.   As soon as the patient
 is placed in a proper posture, he should  be bled freely in the neck or
 arm, and, if there be occasion, the cperation may be repeated in two or
 three hours.   A laxative clyster, with plenty of SAveet oil, or fresh but-
 ter, and  a spoonful or  two  of common salt in it,  may be administered
 every two hours;  and blistering plasters applied between the  shoulders,
 and to the calves of the legs.
   As soon as the symptoms are a little abated, and the patient is  able to
 swalloAV, be ought  to drink freely of some diluting opening liquor, as a
 decoction of tamarinds and liquorice, cream-tartar Avhey, or common
 whey with cream of tartar dissolved in it.   Or he may take any cooling
 purge, as Glauber's salts, manna dissolved in an infusion of senna, or the
 like.   All spirits and other strong liquors are to be avoided.  Even vola-
 tile salts held  to the  nose  do mischief.   Vomits, for  the same  reason,
 ought not to be given, or any thing that may increase the motion of the
 blood toAvards the head.
   In  the  serous apoplexy, the symptoms are  nearly  the same, only
 the pulse is not so strong, the countenance is less florid,  and the breath-
 ing less  difficult.  Bleeding is not so necessary here as in the former
 case.   It  may,  however,  generally be  performed  once with  safety
 and advantage, but should uot be  repeated.  The patient should be

tose, her pulse sunk very low, and was exceeding slow.  By  bleeding, blistering
and other evacuations, she was kept alive for about a fortnight.  When her
head was opened, a large quantity of extravasated blood was found in the left
ventricle of the brain. 
OF COsflt-IVENESS, &C.
271
placed in the same posture as directed  above,  and should have blis-
tering-plasters applied, and receive o, euiug clysters in the same man-
ner.  Purges here are likeAvise necessaiy, and  the patient may driuk
strong  balm-tea.   If  he  be inclined  to sAveat, it ought to be  promo-
ted by drinking small AVAe-Avhey, or  an infusion of carduus bcnedic-
tus.   A plentiful sAveat  kept up for a considerable  time, has often
carried off a serous apoplexy.
   When the apoplectic symptoms proceed from opium, or other nar-
cotic substances taken into the stomach, vomits are necessary.  The
patient  is generally relieved  as soon  as he  has  discharged the poi-
son in this way.
   Persons  of apoplectic  make, or those who  have been attacked  by
it, ought to use a veiy spare and slender diet, avoiding all strong liquors,
spiceries, and high-seasoned food.   They ought likeAvise to guard against
all violent passions,  and to avoid the extremes of heat  and cold.  The
head should be shaved, and daily washed with  cold water.   The feet
ought  to be kept warm,  and never suffered to  continue long Avet.  The
body must be kept open either by food or medicine, and a little blood
may be let eveiy spring and fall.   Exercise should by no means be
neglected;  but it ought to  be taken in moderation.    Nothing has a
more happy effect in preventing  an apoplexy than  perpetual issues
or setons; great care however, must  be taken, not to suffer them to
dry up, Avithout opening others in their stead.—Apoplectic persons ought
never  to go  to  rest with  a full stomach,  or  to fie with  their heads
low, or  to wear any  thing too tight  about their necks.
                       CHAP.  XLIV.

OF COSTIVENESS, AND OTHER AFFECTIONS OF THE
                  STOMACH AND BOWELS.

       VtE do not here mean to treat of those astrictions of  the
bowels, Arhich are the symptoms of disease, as of the colic,  the iliac
passion, Ac. but only to take notice of that infrequency of stools which
sometimes  happens,  and  which  iu some particular constitutions may
occasion  diseases.
   Costiveness may proceed from drinking rough  red  wines, or other
astringent liquors;  too much exercise, especially on horseback.  It may
likeAvise proceed from a long use of cold  insipid  food, which does not
sufficiently stimulate the intestines.  Sometimes it is owing to the bile
not descending to  the  intestines, as in the jaundice;  and  at other
times it proceeds from  diseases of the intestines themselves, as a palsy,
spasms, torpor, tumours, a cold diy state of the intestines, Ac.
   Excessive costiveness is apt  to occasiou pains of the head, \Tomit-
ins, colics, and  other  complaints of  the  bowels.   It  is peculiarly
hurtful to hypochondriac and hysteric persons, as it generates Avind
aud other _rievous symptoms.   Some people  however, can bear cos-
tiveness to  a great degree.   I know  persons who enjoy pretty good
health, yet do not go to stool above once  a week, and  others not above 
272                OF  COSTIVEN_fsS,  &.C.

once  a  fortnight.   Indeed I have heard of some who do not go above
once  a  month.
   Persons  who  arc generally costive,  should live upon a moistening
and laxative diet,  as  roasted  or boiled apples,  pears,  stewed prunes,
raisins,  gruels  with  currants,  butter,  honey,  sugar,  and such  like.
Broths  Avith spinnage,  leeks, and  other  soft pot herbs,  are likewise
proper.   Rye-bread, or that which, is made  of a mixture of wheat  and
rye together,  ought  to be  eaten.   No person  troubled with costive-
ness, should eat white bread alone, especially that which is made of fine
flour.   The best bread for keeping  the body soluble,  is what iusome
parts of England they call meslin.   It is niatle of a mixture of wheat and
rye,  and is very  agreeable to  those Avho arc accustomed to it.
   Costiveness   is  increased  by keeping  the  body too  Avarm, and by
every  thiug that  promotes the perspiration; as  wearing  flauuel, ly-
ing too long  a-bed, Ax.    Intense thought, and a sedentary life, are
likewise hurtful.   All the secretion and excretions  are promoted by
moderate  exercise Avithout doois, and by a  gay, cheerful,  sprightly
temper of mind.
   The drink should be of an opening quality.  All  ardent spirits, austere
and astringent wines, as port,  claret, Ac. ought to be avoided.   Malt li-
quor that  is fine,  and of a moderate  strength, is  very  proper.    But-
ter-milk,  whey, and other  watery  liquors,  are likewise  proper,  aud
may  be drank in  turns, as the patient's  inclination  directs.
   Those Avho are troubled with costiveness, ought if possible to remedy it
by diet, as the constant use  of medicines for that purpose is attend-
ed with many  inconveniencies, and  often  with  bad  consequences.'1
I never knew any  one get into a habit  of  taking medicine for keeping
the  body  open, Avho  could leave  it off.   In time the custom becomes
necessary, and generally ends  in a  total  relaxation of the bowels, in-
digestion,  loss  of  appetite, wasting  of  the strength, and death.
   When  the body cannot be kept open  without  medicine, we  would
recommend gentle doses of rhubarb  to  be  taken twice or thrice a-week.
This is not near  so  injurious  to the  stomach as aloes, jalap,  or the
ether drastic purgatives so much in  use.  Infusions of senna and man-
na may likewise be taken, or half an  ounee of soluble  tartar dissolved
  • The learned Dr. Arbuthnot advises those who are troubled with costiveness
to use animal oils, as fresh butter, cream, marrow, fat broths, especially those
made of tlie internal parts of animals, as the liver, heart, midriff, &c.  He like-
wise recommends the expressed oils of mild vegetables, as olives, almonds, pas-
taches, and the fruits themselves; all oily and mild fruits, as figs; decoctions of
mealy vegetables; these lubricate the intestines;  some Saponaceous substances
which stimulate gently, as honey, hydromel, or boiled honey and water, unrefined
sugar, &c.
  The Doctor observes, that such lenitive substances are proper for persons of
dry atrabilarian constitutions, who are subject to astriction ofthe belly, and the
piles, and will operate when stronger medicinal substances are sometimes inef-
fectual ; but that such lenitive diet hurts those whose bow els are weak and lax.
He likewise observes, that all watery substances are lenitive, and that even
common  water, whey, sour milk, and butter-milk have that effect: that new
milk, especially asses* milk, stimulates still more when it sours on the stomach;
and that whey turned sour, will purge strongly:—That most garden fruits are
likewise  laxative ;  and that  some of them, as grapes, will throw such as tajce
them immoderately into a cholera morbus, or incurable diarrhoea.

              i

              y 
       WANT  OF  APPETITE.--THE  HEART-BURN.   273

in water-gruel.  About the size of  a nutmeg of lenitive electuary, taken
twice or thrice a-day generally answers the purpose very well.

                    WANT OF APPETITE.

   THIS may proceed from a  foul stomach; indigestion; the want  of
free  air and  exercise; grief; fear; anxiety; or any of the depressing
passions; excessive heat;  the  usje of strong broths, fat meats, or any
thing that palls the appetite, or is hard of digestion;  the immoderate use
of strong liquors, tea, tobacco, opium,  Ac.
   The patient ought, if possible, to make choice of  an open dry air;  to
take exercise daily on horseback or in a carriage; to rise betimes; and
to avoid all intense thought. He  should  use a diet of easy digestion;
and should avoid excessive 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 nausea and retchings
shew that the stomach is  loaded with crudities, a vomit will be of ser-
vice.  After this a gentle purge or two of rhubarb, or  any of the bitter
purging salts,  may be taken.  The patient  ought next to use some of the
stomachic bitters infused in wine.  Though gentle evacuations be neces-
sary, yet strong purges and vomits are to be avoided, as they weaken the
stomach and hurt digestion.
   Elixir of vitriol is an excellent  medicine in most  cases of indigestion,
weakness.of the stomach,  or want of  appetite.   From  twenty to thirty
drops of it may be taken twice or thrice a-day in a glass of wine or Avater.
It may likewise  be mixed with the tincture of the bark, one drachm of
the former to an ounce of the latter, and two tea-spoonsful of it taken in
wine and water,  as above.
   The chalybeate waters, if drank in  moderation, are generally of con-
siderable service in this case.  The salt-Avater has likewise good effects;
but it must not be used too freely.  The waters of Harrowgate, Scarbo-
rough, Moffat, and most other spas in  Britain, may be used with advan-
tage.  We Avould advise all who are afflicfed with indigestion and want
of appetite, to repair to these places of public  rendezvous.  The very
change of air, aud the cheerful company, Avill be of service, not to mem
lion the exercise, amusements, Ac,

                   OF  THE  HEART-BURN.

   WHAT is commonly called  the heart-burn, is not  a disease of that
organ, but an uneasy sensation of heat or acrimony, about  the pit of the
stomach, Avhich is sometimes attended  with anxiety and vomiting.
   It may proceed from debility of the stomach, indigestion,  bile, the
abounding of an acid in the stomach, Ac.  Persons who are liable to this
complaint, ought to avoid stale  liquors, acids, windy or greasy aliments,
anel should never use violent exercise  soon after a hearty meal.   I know
many persons avIio never  fail to have the  heart-burn  if they ride soon
after dinner,  provided they have drank ale, wine, or any fermented li-
quor :  but  are never troubled  with it when they have drank rum,  or
brandy and water, Avithout any sugar  or acid.
   When the  heart-burn proceeds from debility  of the stomach, or indi-
gestion, the patient ought  to take a dose or two of rhubarb; afterwards
                                 35 
274              OF  NERVOUS  DISEASES.
he may use infusions of the Peruvian bark;  or any other of the  stoma:
chic bitters, in  Avine or brandy.  Exercise in the open air Avill likewbc
be of use, and every thing that promotes digestion.
  When bilious humours occasion the  heart-burn, a tea-spoonful of llir
sweet spirit of nitre in a glass of water, or a cup of tea, will generally
give ease.   If  it proceeds from the use of greasy aliments, a dram of
brandy or rum may hv taken.
  If acidity or sourness of the  stomach occasions the  heart-burn, absor-
bents are the pioper medicines.  In this  case  au ounce of powdered
chalk, half an ounce  of fine sugar, and a quarter of  an ounce of gum-
arabic, may be mixed in a quart of water,  and a tea-cupful  of it taken
as often as is necessary.  Such  as do not chuse  chalk may  take a tea-
cipful of prepare 1 oy&ter-shells, or of the powder called crabs-eyes, in a
glass of  cinnamon or peppermint water.  But the safest and best absor-
bent is magnesia alba.  This not only  acts as an absorbent, but likewise
as a purgative; whereas chalk  and other absorbents of that kiud, are apl
to lie in the intestines, and occasion obstructions.  'J1 his powder is not
disagreeable, and may be taken in a cup of tea, or a glass of mint-water.
A large tea-spoonful  is the usual dose; but it may be taken in a much
greater quantity when there is occasion.   These things are noAV general-
ly made up into lozenges for the  couveniency of being carried  in  the
pocket, and taken at pleasure.
  If wind be the cause of this complaint, the most proper medicines are
those called carnuuatives; as aniseeds, juniper  berries, ginger, ciiuclla
alba, cardamom seeds, Ac.   These may either be chewed, or infused in
Avine, brandy or othei spirits.   One of  the safest medicines of this kind
is the tincture made by infusing an ounce of rhubarb, aud a quarter of
an ounce of the lesser cardamom seeds, in  an English pint  of brandy.
After this has digested for tAvo or three days, it ought to be strained,  and
four ounces of white sugar-candy added to it.  It must stand to digest a
second time till the sugar be dissolved.  A table-spoonful  of it may be
taken occasionally for a dose.
  I  have frequently  knoivn the heart-burn  cured, particularly in preg-
nant women, by chewing green tea.   Two table-spoonsful  of what is
called the milk of gum ammoniac, taken once or twice a-day will some-
times cure the heart-burn.
                         CHAP.  XLV.

                   OF  NERVOUS DISEASES.

        Of all diseases incident to mankind,  those of  the  nervous
kind are the most complicated and difficult to cure.   A volume would
not be sufficient to point out their various appearances.   They imi-
tate almost every disease; and are seldom alike in two different per-
sons,  or  even the same  person at different times.  Proteus-like,  the)
are contbiually changing shape;  and upon every fresh attack, the pa
tient  thinks  he  feels symptoms which he never  experienced before.—-
Nor do  they only affect the body;  the  mind likewise suffers, and is
thereby  rendered Aveak and  peevish.   The low spirits,  timorousness,
V 
OF  NERVOUS  DISEASES.               275
melancholy  and fickleness of temper, which generally  attend nervius
disorders, induce many to believe that they  are en irely diseases of  the
mind;  but this change of temper is rather, a consequence, than the cause
of nervous eliseases.
   CAUSES.—Every thing  that tends to relax or weaken the body, dis-
poses it to nervous diseases, as indolence, excessive venery, drinking too
much tea or other  Aveak  watery liquors Avarm, frequeut bleeding, purg-
ing, vomiting, Ac   Whatever hurts the  digestion, or prevents the proper
assimilation of the  food, has likewise  this effect;  as long  fatting, excess
in eating or drinking, the use of Avindy, crude or unwholesome aliments, au
unfavourable posture of the  body, Ac.
   N ervous  disorders often proceed from  intense application to study.  In-
deed few studious  persons are entirely free from them.  Nor is this at all
to be wondered at; intense thinking  not only preys upon  the spirits-, but
prevents the person from taking proper exercise, by which means the di-
gestion is impaired,  the nourishment prevented, solids relaxed, and the
whole  mass of humours  vitiated.  Grief and disappointment likewise
produce the same effects.  I have known more nervous patients who dat-
ed the  commencement of their disorders from the loss of a husband, a favo-
rite child, or from some disappointment in life, than from any other cause.
In a Avord, Avhatever weakens the body, or depresses the spirits, may occa-
sion nervous disorders, as unwholesome  air, want of sleep, great fatigue,
disagreeable apprehensions, anxiety, vexation, Ac.
   SYMPTOMS.—We  shall only  mention some of the most general
symptoms of these disorders, as it wrould  be both an useless and an endless
task to enumerate the whole.  They generally begin Avith  windy infla-
tions or elistensions of the stomach and  intestines; the appetite and di-
gestion are usually bad; yet sometimes there is  an uncommon craving
for food, and a eutick digestion.   The  food often turns  sour on the sto-
mach;  and  the patient is troubled with vomiting of clear water,  tough
phlegm, or a blackish coloured liquor resembling the grounds of coffee.
Excruciating pains are often felt about the naval, attended with a  rumb-
ling or murmuring noise in the bowels.   The body  is sometimes  loose,
but more commonly bound, which occasions a retention of wind and great
uneasiness.
   The urine is sometimes in small quantity, at other times very copious
and quite clear.   There is a great straitness of the breast, with difficulty
of breathing; violent palpitations ofthe heart; sudden flushings of heat
in various parts of the body; at other times a sense of cold, as if water
were poured on them; flying pains in the arms and limbs, pains in the
back and belly, resembling those occasioned by the gravel; the pulse
very variable, sometimes uncommonly  slow,  and  at other  times  veiy
quick  ; yawning, the hickup, frequent sighing, aud a sense of suffocation,
as if from a ball or lump in the throat;  alternate fits of crying and
convulsive laughing; the sleep is unsound, and seldom refreshing; and
the patient is often troubled  with the night-mare.
   As  the disease  increases,  the patient is  molested with head-aches,
cramps, aid fived  pains hi various parts  of the boely; the eyes are cloud-
eel, a id often affected with pain and dryness;  there is a noise in the ears.
and 01  en n didness of  bearing; in short the whole animal functions are
iinpairc 1.   The mind i< disturbed on the most trivial occasions, and i» 
276            OF  NERVOUS DISEASES.

hurried into the most pen-crsc commotious, inquietude, terror, sadness,
anger,  diffidence, Arc.   Tiie patient is apt to entertain wild imaginations
and extravagant faucies;  the memory  becomes iveak and  the judgment
fails.
  Nothing is more characteristic of this disease tha i a constant dread ot
death.   This renders those unhappy persons who labour under 't peev-
ish, fickle,  impatient,  and apt to run from  one physician to another;
which  is one reason why they seldom reap any benefit from medicine, as
they frive not sufficient resolution to persist in any one course till it lias
time to produce its proper effects.  They are likewise apt  to imagine
that they labour under diseases from which they are quite free; and are
very angry if any one attempts to set  them right, or laugh them out of
their ridiculous  notions.
   REGIMEN.—Persons  afflicted with nervous diseases ought never
to fast long.  Their food  should  be solid and nourishing, but of easy di-
gestion.  Fat meats and heavy sauces are hurtful.  All excess should be
carefully avoided.  They ought never to eat more at  a time than they
can easily  digest;  but if they feel themselves weak and  faint between
meals, they ought to eat a bit of bread, and drink a glass of wine. Hea-
vy suppers are to be avoided.  Though wine in excess  enfeebles  the bo-
dy, and impairs the faculties of the mind, yet taken  in  moderation it
strengthens the stomach,  and promotes digestion.   Wine  and water is a
very proper drink at meals; but if wine sours on the stomach, or  the pa-
tient  is much troubled with wind, brandy and water will  answer better.
Every thing that  is windy or hard of digestion must  be avoided.  All
flfrak and Avarm  liquors are hurtful, as tea, coffee, punch, Ac.   People
may find a temporary relief in  the use of these, but they  always in-
crease the malady as they weaken the stomach, and hurt  digestion.
Above all things, drams are to be avoided.  Whatever immediate ease
the patient may feel from the use of ardent spirits, they are sure to ag-
gravate the malady, and prove certain poisons at last.  These cautious
are the more necessaiy; as most nervous  people are peculiarly fond
of tea and ardent  spirits, to the use of which many of them fall victims.
   Exercise in nervous disorders is superior to all medicines.   Riding on
horseback is generally esteemed the best, as it gives motion to the whole
body without fatiguing it.   I have known some patients, however, with
whom walking  agreed better, and others who were  most benefitted by
riding in a carriage.   Every one ought to use that which he finds most
beneficial.   Long sea voyages  have  an excellent effect; and to those
who have  sufficient resolution, we would by all means recommend this
course.  Even chauge of place,  and the sight of new objects,  by  divert-
ing the mind, have a great tendency to remove these complaints.   For
this reason  a long journey, or  a voyage, is of much more  advantage
than riding short journies near home.
   A  cool  and  dry air is proper,  as it braces and invigorates   he
whole body.   Few things  tend  more to relax and enervate than hot
air, especially that which  is rendered so by  great fires, or stoves in
small  apartments.   But when the  stomach  or bowels are   weak, the
body  ought to  be well guarded against cold, especially in winter, bj
wearing a thin flannel waistcoat next the skin.  This will keep up an
equal  perspiration, and defend  the alimentary canal  from   man)  im-
pressions to which it  would otherwise be subject,  upon ever)  Midden
change  from warm to cold  weather.  Rubbing the body frequently 
                      OF  MELANCHOLY.                   __77

with a flcsh-brudi, or a coarse fiiien cloth, is likewise beneficial, as it
promotes the circulation, perspiration, Arc.   Persons who have weak
nerves ought to rise early, and take exercise before breakfast,  as  lying
too long a-bed cannot fail  to relax the solids.   They ought likewise to
be diverted, and to be kept as easy and cheerful as possible.   There is
not any thing which hurts the nervous system, or Aveakens the digestive
powers more thau fear, grief or anxiety.
  MEDIC1N ES.—Thcugh nervous diseases are seldom radically cured,
yet the symptoms may sometimes be alleviated, and the patient's  life
rendered at least  more comfortable by proper medicines.
  When the patient is cotive, he ought to take a little rhubarb, or some
other mild purgative, and should never suffer his body to be long bound.
All strong  and violent purgatives are however to be avoided, as aloes,
jalap, &c.   I have  generally seen an infusion of senna and rhubarb iu
brandy, ansAver very avcII.   This may be made of any strength, and ta-
ken in such quantity as the patient finds necessary.  When digestion is
bad or the stomach relaxed  and weak, the following infusion of Peruvi-
an  bark and other bitters may  be used with advantage :
   Take of Peruvian bark an ounce, gentian-root, orange-peel, and cori-
ander seed, of each half an ounce;  let these ingredients be all bruised
in a morter, and infused in a bottle of brandy or rum, for the space of five
or six  days.   A  table-spoonful of the strained liquor may be taken in
half a glass of water, an hour before breakfast, dinner and supper.
   Few  things tend more  to  strengthen the  nervous system than cold
bathing.    This practice, if duly persisted in, will  produce  very  ex-
traordinary effects; but when the liver or other viscera are obstructed^
or otherwise unsound the cold bath is improper.  It  is therefore to
be  used Avith veiy great caution.   The  mest proper seasons for it are
summer and autumn.  It will  be  sufficient, especially for persons of a
spare 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 improper.
   Iu patient's afflicted with wind, I have always  observed the greatest
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 glass of wa-
ter.  This both expels wind, strengthens  the stomach, and promotes di-
gestion.
   Opiates are generally extolled in  these maladies;  but as they only
palliate the symptoms and generally afterwards increases the disease, we
would advise people to be extremely sparing in the use of them lest ha-
bit render them at last absolutely necessaiy.
   It would be au easy matter to enumerate many medicines Avhich have
been extolled for relieving nervous disorder;  but  whoever Avishes for a
thorough  cure, must expect it from regimen alone; Ave  shall therefore
omit mentioning more medicines, and again recommend the strictest at-
tention tO DIET, AIK, EXERCISE, and AMUSEMENT.
                      OF  MELANCHOLY.
   MELANCHOLY is that  state of alienation or weakness of mind,
which renders people incapable of enjoying the pleasures, or performing
the duties of life.   It is a degree of insanity, aud often terminates in ab-
solute madness. 
278
OF  MELANCHOLY.
   CAUSES.—It may proceed from an hereditary disposition;  intense
thinking, especially Avhere the mind is long occupied by one object; vi-
olent  passions or affections of the  mind, as love,  fear, joy, irrief, pride
and such like.  It may also be occasioned by excessive veiicry, narcotic
or stupefactive  poisons;  a  sedentary life;  solitude; the suppression of
customary evacuations; acute fevers or other diseases.   Violent auger
will change melaucholy  into madness; and excessive cold, especially of
the lowir extremities, avill force the blood into the brain, and produce all
die symptoms of madness.   It may likewise proceed, from the use of ali-
ment that is hard of digestion, or which cannot be easily assimilated, from a
callous state of  the integuments of the brain,  or a dryness of the brain it-
self.   To all which Ave may add gloomy and  mistaken notions of religion.
   SYMPTOMS.—When persons begin to  be melancholy they are  ti-
morous; Avatchful; fond of solitude; fretful; fickle; captious and in-
quisitive; solicitous about trifles; sometimes  niggardly, and at other
times prodigal.   The body is generally bound,  the urine thin, and in
small quantity; the stomach and bowels inflated with Aiind; the com-
plexion pale; the pulse slow and Aveak.   The functions of the mind are
also greatly perverted,  insomuch that the patient often imagines himself
dead, or changed  into some other animal.   Some have imagined then
bodies Avere made of glass,  or other brittle  substances, and were afraid
to move, lest they should be broken to pieces.   The unhappy patient, in
this case, unless carefully watched, is apt to  put an end to his own mise-
rable  life.
   When the disease is OAving to an obstruction of customary evacuations,
or any bodily disorder, it is easier cured than when it proceeds !rom af-
fections of the mind, or  an hereditary taint.   A discharge of blood from
the nose,  looseness, scabby  eruptions, the bleeding piles, or  the menses,
sometimes carry off this disease.
   REGIMEN.—The diet should consist chiefly of vegetables of a cool-
ing and opening quality.  Animal food, especially salted or smoke-dried
fish or flesh, ought to be avoided.  All kinds of shell-fish are bad.  Ali-
ments prepared with  onions, garlic,  or  any thing that  generates thick
blood, are likewise improper.   All kinds of fruits that are wholesome
may be eaten with advantage.   Boerhaave gives an instance of a pa-
tient  who, by a long use of whey, water, and garden-fruit, recovered, af-
ter having evacuated  a great quantity of black coloured matter.
   Strong liquors of every kind ought to be avoided as poison.  The
most  proper drink is  Avater, whey, or very small beer.   Tea and coffee
are improper.   If honey agrees with the patient, it may be eaten freely
or his drink may be sweetened with it.   Infusions of balm-leaves, penny-
royal, the roots of wild valerian, or the  flowers of the lime-tree,  may be
drank freely, either by  themselves, or sweetened with honey, as  the pa-
tient  shall chuse.
   The patient ought to take as much exercise as he can  bear.  1 his
helps  to  dissolve the  viscid  humours, it  removes obstructions, pro-
motes the perspiration, and all the oihyr  secretions.  Every kind ot
madness  is  attended  with  a  diminished  perspiration;   all  means
ought therefore to be used to promote that necessaiy and salutary dis-
charge.   Nothing can have a more direct tendency  to increase the
disease than confining  the  patient  to  a close   apartment.    vU-rc  lie
forced to ride  or walk a certain number of miles every day, it would 
OF  MELANCHOLY.                   279
und greatly to alleviate  his disorder;  but it would have still  a better
effect,  if  he  were obliged  to  labour a piece  of ground.   By  digging,
hoeing, planting, sowing, Ac.  both the body and  mind Avould be ex-
ercised.   A long /journey, or a Aoyage, especially tOAvards a warmer cli-
mate, with agreeable companions, have oiten very happy effects.  A plan
of this kind, with a strict attention to diet, is a much more rational method
of cure, than confining the patient within doors and plying him with me-
dicines.
   MEDICINE.—In the cure of this disease particular attention must be
paid to the mind.  When the patient is in  a Ioav state, his mind ought to
be soothed and diverted with variety of amusements, as entertaining sto-
ries, pastimes, music, At.  This seems to  have been the method of curing
melancholy among the Jews, as we learn  from the  story of King Saul;
and indeed it is a very rational one.  Nothing can remove diseases ofthe
mind so effectually as applications  to the mind itself, the most efficacious
of which is music.   The patient's  company ought likewise to consist  of
such persons as arc agreeable to him.   People in this state are apt to con-
ceive unaccountable aversions against  particular persons; aud the very
sight of such per; ons is sufficient to distract their minds, and throw them
into the utmost perturbation.
   When the patient's  strength is  high, or the pulse admits of it, eva-
cuations are necessary.  In this  case he must  be bled,  and have  his
body kept open by purging medicines,  as manna, rhubarb, cream  of
tartar, or  the  soluble tartar.   I have  seen the last have very happy
effects.  It may be taken in the dose of half an ounce, dissolved in watcr-
gruel,  eveiy  day, for several weeks, or even for months, if necessaiy.
More or less may be given according as it operates.   Vomits have like-
wise a good effect;  but  they must be  pretty strong, otherwise they will
not operate.
   Whatever increases the  evacuation  of  urine or promotes perspiration,
has a  tendency to remove this disease.   Both these secretions  may be
promoted by the use of nitre and vinegar.   Haifa drachm of purified ni-
tre may be given three or four times a-day, in any  manner that is most
agreeable  to the patient; and an  ounce and an half of distilled vinegar
may be daily mixed  with his drink.  Dr.  Locker seems to think vinegar
the best medicine that can be given in this disease.
   Camphire and musk have likewise been used in this case with advan-
tage.  Ten or twelve grains of camphire may be rubbed in a mortar, Avith
half a drachm of nitre, and taken twice a-day, or oftener, if the  stomach
will bear it.   If it will not sit upon the stomach in this form, it may be
made into pills Avith gum asafcetida and Russian castor, and taken in the
quantity above directed.  If musk is to  be administered, a scruple  or
twenly-five grains of it may be made  into a bolus Avith a little  honey or
common syrup, and  taken tAvice or thrice  a-day.   We do not mean that
all these medicines  should be administered at once; but Avhich ever  of
them is given, must be duly persisted in, and where one fails another may-
be tried.
   As  it is veiy difficult to induce patients in this disease to  take me-
dicines,  Ave  shall mention a few outward applications Avhich some-
times  do  good; the priucipal of these  are issues,  setons, and  warm
bathing.   Issues may be made in any part of the  body, but they ge-
nerally have the best effect near the  spine.   The  discharge from these 
280
OF  THE  TALSY.
may be greatly promoted  by  dressing them Avith  the  mild blistciiu«
ointment,  and keeping  Avhat are commonly  called  the orrice pease iu
them.  The most proper place for a seton is between the shoulder-blades:
and it  ought to be placed upwards and downwards, or in  the direction of
the spine.

                         OF THE PALSY.

   THE palsy is a loss or dimunition of sense or motion, or of both in one
or more parts ofthe body.   Of all the affections called nervous, this is tlie
most suddenly fatal.  It is more or less  dangerous, according to the im-
portance of the part affected.   A palsy of the heart, lungs,  or any part
necessary to life, is  mortal.  When  it affects the stomach, the intestines,
or the bladder, it is highly dangerous.  If the face  be affected, the case
is bad, as it shews that the disease  proceeds from the brain.   When the
part affected feels cold,  is insensible,  or Avastes away, or when the judgment
and memory begin to fail, there is small hope of a cure.
   CAUSES.—The immediate cause  of palsy is any thing that prevents
the regular exertion of the nervous power upon any particular muscle or
part of the body.   The occasional And  predisposing causes  arc various,
as drunkenness; wounds of the brain, or spinal marrow; pressure  upou
the brain, or nervTes; very cold or damp air; the suppression of custom-
ary evacuations;  sudden  fear;  want of exercise;  or Avhatever greatly
relaxes the system,  as drinking much tea'*,  or coffee.   The palsy may
likewise proceed from wounds of the nerves themselves, from the poison-
ous fumes of metals or minerals, as mercury,  lead, arsenic.
   In voting persons of a full habit, the  palsy must be treated in the same
maimer as the sanguine apoplexy.   The  patient must be  bled, blistered,
and have his body opened by sharp clysters or purgative medicines.   But
in old age, or when  the disease proceeds from relaxation or debility, which
is generally the case, a quite contrary course must be pursued.  The diet
must be warm and invigorating, seasoned with spicy and aromatic vegeta-
bles, as mustard, horse-radish,  Ac.   The drink may be generous wine,
mustard,  whey, or brandy and water.  Friction with the flesh brush or a
Avarm hand, is extremely proper, especially on the parts  affected.   Blis-
tering-plasters may  likewise be applied to the affected parts  with advan-
tage* When this cannot be done, they may be rubbed with the volatile
 liniment, or the nerve ointmeut of the Edinburgh dispensatory.   One of
 the best external  applications is electricity. The  shocks, or rather vi-
 brations, should be received on the  part affected, and they ought daily to
 be repeated for several weeks.
    Vomits are  verv beneficial in  this kind of palsy,  and  ought fre-
 quently to be  administered.  Cephalic snuff, or any thing  that makes
   * Many people imagine that tea has no tendency to hurt the nerves, and that
 drinkine; the  same quantity of warm water would be equally pern.c.ous. This
 howeve? seems to be a mistake.  Many persons drink three or four cups of
 warm milk and water daily, without feeling any bad "^J*"^**^
 same Quantity of tea will make their hands shake for twenty-four houis. lhat
iaTffects Se nerves, is likewise evident from its preventing  sleep, occasioning
 giddiness, dimness ofthe sight, sickness, &c. 
OF THE  EPILEPSY,  &C.              28l
Ifoc patient sneeze, is likewise of use.  Some pretend to have found great
benefit from rubbing the parts affected  with nettles;  but this does not
seem to be any way preferable to blistering.  If the tongue is affected,
the patient may gargle his  mouth frequently with brandy and mustard;
or he may hold a bit of sugar  iu his mouth wet with the palsy drops or
compound spirits of lavender.   The wild valerian-root is a very proper
medicine in this case.  It may either be taken  in an infusion with sage
leaves, or half a drachm of it in powder may be given in a glass of wine
three or  four times a-day.   If the  patient  cannot use the  valerian,  he
may take of sal volatile oleosum, compound spirits of lavender, and tinc-
ture of castor,  each half an ounce; mix these together, and take  forty
or fifty drops in a  glass of  wine, three  or  four  times a-day.  A table-
spoonful of mustard-seed taken frequently is a very good medicine.  The
patient ought likeAvise to chew  cinnamon,  bark, ginger,  another warm
spiceries.                                             **
   Exercise is  of the utmost importance in the palsy;  but the patient
must beware of cold, damp, and moist  air.   He ought to wear flannel
next  his skia;  and if possible, should remove into a warmer climate.

       OF  THE EPILEPSY, OR FALLING SICKNESS.

   THE epilepsy is a sudden deprivation of the senses, wherein  the pa-
tient falls suddenly down, and is affected  with violent convulsive motions.
Children, especially those who are  delicately brought up, are most sub-
ject to it.   It more frequently  attacks men than  women, and is very dif-
ficult to cure.  When the  epilepsy attacks children,  there is reason to
hope  it may go off about the time of puberty.
  When it attacks any person after twenty years of age, the cure is  diffi-
cult;  but when after forty, a cure is hardly to be expected.  If the fit
continues only for a small space, and returns seldom, there is reason to
hope; but if it continues long, and returns frequently, the prospect is bad.
It is a very unfavourable symptom  when the patient is seized Arith the
fits in Ins sleep.
   CAUSES.—The epilepsy is sometimes hereditary.  It may likeAvise
proceed from bloAVs, bruises, or Avounds on the head; a collection of wa-
ter, blood, or serous humours in the  brain;  a polypus;  tumours or con-
cretions Avithin the  skull;  excessive drinking; intense study; excess of
ATenery;  Avorms; teething;  suppression  of  customary  evacuations; too
great emptiness or repletion; violent passions or affections of the mind,
as fear, joy, &c. hysteric affections; coutagion received into the body,
as tlie infection of the small-pox, measles, Ac.
   SYMPTOMS.—An  epileptic fit is  generally preceded by unusual
weariness; pain ofthe head; didness; giddiness; noise in die ears;  dim-
ness of sight; palpitation ofthe heart; disturbed sleep; difficult breathing,'
the bowels are inflated with A?iud; the urine is in great quantity, but thin;
the complexion is pale; the extremities  are cold; and the patient oftei:
feels, as it ivcre, a stream of cold air ascending toAvards his head.
  In  the fit, the patient generally  makes an unusual noise;  his thumbs
are drawn in towards the palms of the hand; his eyes are distorted; he
starts, and foams at the mouth; his extremities are bent or twisted various
ways; he often discharges his seed,  urine, and faeces involuntarily;  and
is quite destitute of all sense and reason.   After the  fit is over, his senses
                                36 
282               OF  THE  EPILEPSY,  &.C.

gradually return, and he complains of a kind of stupor, weariuc^, and
pain of his head; but has  no remembrance  of what happened to liim
during the fit.
   The  fits are sometimes  excited by violent  affections of the mind, a
debauch of liquor, excessive heat, cold, or the. like.
   This disease,  from the  difficulty  of investigating its causes, and its
strange symptoms, was formerly attributed to the wrath of the gods, or
the agency of evil spirits.   In modern times it has often, by the vulgar,
been imputed to witchcraft or fascination.  It depends, however, as much
upon natural causes as any other malady; and its cure may often be ef-
fected by persisting in the use of proper means.
   REGIMEN.—Epileptic patients ought, if possible, to breathe a pure
and free air.   Their diet should be  light but  nourishing.  They ought
to drink nothing strong, to avoid swine's flesh, water-fowl, and likewise
all windy and  oily vegetables,  as cabbage, nuts, Ac.   They ought  to
keep themselves cheerful, carefully guarding against all violent passions,
as anger, fear, excessive joy, and the like.
   Exercise is likewise of great use; but the patient must be carefi.l to
 avoid aU extremes either  of heat or cold, all dangerous situations,  as
standing upon  precipices, riding, deep waters, and such like.
   MEDICINE.—The intentions of cure must  vary according to the
cause of the disease.   If the patient  be of a sanguine temperament, and
there be  reason to fear an obstruction in tlie brain,  bleeding and other
evacuations Avill be necessary.   When the disease is occasioned by the
stoppage of  customary evacuations, these, if possible, must be restored;
if this cannot be done, others may be substituted in  their place.   Issues
 or setons in  this case have often a very good effect.   When there is rea-
 son to believe  that the disease proceeds  from Avorms, proper medicines
 must be used to kill, or carry off these vermin.  When the disease pro-
 ceeds from teething, the body should be kept open by emollient clysters,
 the feet frequently bathed in warm water, and if the fits prove obstinate,
 a blistering-plaster may be put between the shoulders.   The same method
 is to be followed, when epileptic fits precede the eruption of the small-
 pox, or measles, &c.
   When the disease is hereditary, or proceeds from a Avrong  formation
 of the brain, a cure is not to be expected.  When it is  owing to a debili-
 ty, or too great an irritability of the nervous system, such medicines as
 tend to brace and strengthen  the nerves may  be used, as the Peruvian
 bark, and steel j or the anti-epileptic electuaries, recommended by Fuller
  and Mead.**
    The flowers of zinc have of late been highly extolled for the cure of
 the epilepsy.   Though this medicine will  not be found to answer the ex-
  pectations which have been raised concerning it, yet in obstinate epileptic
  cases it deserves a trial.   The dose is from one to  three or four grains;
  which  may be taken either iu pills  or a bolus,  as  the patient inclines.
  The best method is to begin with a single  grain four or five times a-day,
  and gradually to increase the dose  as far  as the patient cau bear it.  I
  have"known this medicine, when duly persisted in, prove beneficial.
    Musk has sometimes been  found  to succeed in  the  epilepsy.   1 en
  or twelve grains of it, with the same quantity of factitious cinnabar, may
  be made up into a bolus,  and taken every night and morning.________

                 * See Appendix, Electuary for the Epilepsy. 
OF  THE  JIICKUP.                    283
  Sometimes the epilepsy has been cured by electricity.        %
  Convulsion-fits proceed from the same  cause, and must be treated in
the same manner as the epilepsy.
  There is one particular species of convulsion-fits which commonly goes
by the name of St. Vitus's dance, wherein the patient is agitated Avith
strange motions and gesticulations, which by the common people are gen-
erally believed to be the effects of witchcraft.   This disease may be cured
by  repeated bleedings : nd purges; and afterwards using the medicines
prescribed above for the epilepsy, viz. the Peruvian bark and snake root,
&c.   Chalybeate-watei's are  found to be  beneficial in this case.  The
cold bath is likewise of singular service, and ought never to be neglected
when the patient can bear it.

                       OF THE HICKUP.

   TIIE hickup is a spasmodic or convulsive affection of the stomach
and midriff, arising from any cause that irritates their nervous fibres.
   It may proceed from excess in eating or drinking; from a  hurt of the
stomach; poisons;  inflammations or scirrhous tumours of the stomach, in-
testines, bladder, midriff, or the rest of the viscera.  In gangrenes, acute
and malignant fevers, a hickup is often the forerunner of death.
   When the hickup proceeds from the use of aliment that is flatulent, or
bard of digestion, a draught of generous wine, or a dram of any spirituous
liquor, will generally remove it.   If poison be the cause, plenty of milk
and oil must be drank, as has been formerly recommended.  When it pro-
ceeds from an inflammation of the stomach, Ac. it is very dangerous.  In
this case the cooling regimen ought to be strictly observed.  The patient
must be  bled, and take frequently a  feAV drops of the spirits of nitre in  a
cup of wine.  His stomach should likewise be fomented with cloths dip-
ped in warm water, or have bladders filled with warm milk and water ap-
plied to it.
   When the hickup proceeds from a gangrene or mortification, the Peru-
vian bark, with other antiseptics, are the  only medicines Avhich have a
chance to succeed.   When it is  a primary disease, and proceeds from a
foul stomach, loaded either Avith a pituitous or a bilious humour, a gentle
vomit aud purge,  if the patient be able to bear them, will be of service.
If it arises from flatulencies, the carminative medicines directed for the
heart-burn must be used.
   When the hickup proves very obstinate, recourse must be  had to the
 most powerful aromatic and  antispasmodic medicines.   The principal  of
 these is musk; fifteen or twenty  grains of which may be made into a bo-
 lus, and repeated occasionally.  Opiates are likewise of service; but they
 must be used with caution.   A bit of sugar  dipped in compound  spirits
 of lavender, or the volatile aromatic tincture, may be taken frequently.
 External applications are sometimes also beneficia  :as the stomach plas-
 ter, or a cataplasm ofthe Venice treacle cf the Edinburgh or London dis-
 pensatory, applied to the region of the stomach.
    I lately attended a patient who had  almost  a constant hickup for
 above  nine weeks.   It was  frequently stopped  by the use of musk,
 opium,  wine, and other cordial  and  antispasmodic medicines, but al-
 ways returned.   Nothing  however  gave the patient 60 much ease as 
 284          CRAMP  OF  THE STOMACH,  &.C.

 brisk small beer.  By drinking freely of this, the hickup was often kepi
 off for several days, Avhich was more than could be done by the most pow-
 erful medicines.   The  patient Avas at length seized with a vomiting of
 blood, Avhich soon put an end to his life.  Upon opening the body, a large
 scirrhous tumour was found  near the pylorus  or right orifice of the sto-
 mach.
   The hickup may be removed by taking vinegar; or by a few drops of
 the oil of vitriol taken in water.

                  CRAMP OF  THK STOMACH.

   THIS disease often seizes people suddenly, is very dangerous, and re-
 quires immediate assistance.   It is most incident to persons in the decline
 of life, especially the nervous,  gouty, hysteric, and hypochondriac.
   If the patient has any inclination to vomit,  he  ought to  take  some
 draughts of warm ivater, or weak camomile tea, to cleanse his stomach.
 After this, if he has been costive, a  laxative clyster may be given.  He
 ought then to take laudanum.  The best  ivay of administering it, is in a
 clyster. Sixty or seventy drops of liquid laudanum may be given in a clys-
 ter of warn Avater.  This is much more certain than laudanum given by
 the mouth, which is often vomited, and in some cases increases the paiu and
 spasms in the stomach.
   If the pains and cramps return Arith great  violence, after the effects of
 the anodyne clyster are over, another, Arith an equal or larger quantity of
 opium, may be given; and every four  or  five hours a bolus, with ten or
 twelve grains of musk, and half a drachm ofthe Venice treacle.
   In the mean  time the stomach ought to be fomented with cloths dipped
 in warm water, or bladders filled with warm milk and Avater shouhl be ap-
 plied to it.  I have often seen these produce the most happy effects.  The
 anodyne balsam may also be rubbed on the part affected;  and  an anti-
 hysteric plaster worn upon it for some time after the  cramps are removed,
 to prevent their return.
   In very violent and lasting pains of the  stomach, some blood ought  to
 be let, unless the weakness of the  patient forbids it.  When the pains  or
 cramps proceeds from a suppression of the  menses, bleeding is of use.  If
 they  be  owing to the gout,  recourse must be had  to spirits, or some
 of the warm cordial waters.   Blistering-plasters ought likewise in this
 case to be applied to the ancles.  I have  often seen violent cramps and
 pains of the stomach removed by covering it with a large plaster of Venice
 treacle.

                    OF THE NIGHT-MARE.

   In this disease tke patient, in  time of sleep, imagines  he  feels an un-
 common oppression or Aveight about his breast or stomach, which he can
 by no means shake off.   He groans and  sometimes cries out, though oft-
 ener he attempts to speak in vain.   Sometimes he imagines himself enga-
ged with an enemy, and in danger of being killed, attempts to run away,
but finds he cannot.  Sometimes he fancies himself in a house that is on
fire, or that he is in danger of being drowned in a river.  He often thinks
he is falling over a precipice, and the (head  of being dashed to nieces sud-
denly awakes him, 
OF SWOONINGS.
285
  This disorder has been supposed to proceed from  too much  blood;
from a stagnation of blood in the brain, lungs, Ac.   But it  is rather
a nervous affection, and  arises chiefly from indigestion.   Hence we
find that persons of weak nerves, who lead a sedentary life, and live full,
are most commonly afflicted with the night-mare.  Nothing  tends  more
to produce it thau heavy suppers, especially when eaten late, or the pa-
tient goes to bed soon after.  Wind is likewise a very frequent cause of
this disease;  for which  reason those who are afflicted with it ought to
avoid all flatulent food.   Deep  thought, anxiety,  or any thing that op-
presses the miud, ought also to be avoided.
  As persons afflicted with the  night-mare  generally moan,  or make
some noise in the fit, they should be waked, or spoken  to by such  as hear
them, as the  uneasiness generally goes off as soon as the patient is awake.
Dr. Whytt says, he generally found a dram of brandy, taken at bed-time,
prevent this disease.  That however is a bad custom, and in  time loses
its effects.   We would rather have the patient depend upon the use of
food of easy digestion,  cheerfulness,  exercise through the day, and a
light supper taken early, than to  accustom himself to drams.   A glass
of peppermint water will  often promote digestion as  much as a  glass of
brandy,  and  is much safer.  After a person of weak digestion, however,
has eaten flatulent food, a dram may  be necessary.
   Persons who are  young and full of blood, if troubled Arith the night-
mare, ought to take a purge frequently, and use a spare diet.

                        OF SWOONINGS.

   PEOPLE of  Aveak  nerves or delicate constitutions are liable to
swoonings or fainting-fits.  These indeed are seldom dangerous  when
duly attended to; but when wholly neglected, or improperly  treated,
they often prove hurtful, and sometimes fatal.
   The general causes of swoonings are, sudden transition from cold to
heat;  breathing air that is deprived of its proper spring or elasticity;
great  fatigue;  excessive weakness; loss  of blood;  long fasting; fear,
grief, and other violent passions or affections of the mind.
   It is well known, that persons who  have been long exposed to cold often
faint or fall into a swoon, upon coming into the house, especially if they
drink hot liquor, or sit near a large fire.  This might easily be prevented
by people taking care not to go into a Avarm room immediately after they
have been exposed to the cold air, to approach the  fire gradually, and
not to eat or drink any thing hot, till the body has been gradually brought
into a warm temperature.
   When any one, in consequence of neglecting these precautions, falls
into a swoon, he ought immediately to be removed to a cooler apartment,
to have ligatures applied above his knees  and elbows, and to have his
bands and face sprinkled Arith vinegar or cold water.   He should  like-.
wise be made to smell to viuegar, and should have a  spoonful  or tAvo of
water, if he canswalloAV, with about a third part of vinegar mixed with
it, poured iuto his mouth.  If these should not remove the complaint, it
lrill be necessaiy to bleed the patient, aud  aftenvards  to give him a clys-
ter.
   As air that is breathed frequently loses its elasticity or spring, it is no
Avonder if persons Avho respire in it often fall into a swoon or fainting fit, 
 286          OF FLATULENCIES, OR  WIND.

 They are in this case deprived ofthe very principle of life.  Hence U
 is that fainting fits are so frequent in all  crowded assemblies, especially
 in hot seasons.  Such fits, however, must be considered as a kind of tem-
 porary death ;  and to the weak and delicate they sometimes prove fatal.
 They ought therefore Avith the utmost care be guarded against.  The
 method of doing this is obvious.   Let  assembly  rooms,  and all other
 places of public resort  be large and Avell ventilated;  and let the Aveak
 and  delicate avoid such places, particularly in warm seasons.
  A person who faints,  iu such a situation, ought immediately to be car-
 ried into the open air;  his temples should be rubbed with strong vinegar
 or brandy, and volatile spirits of salts held to his nose.  He should be
 laid  upon his back with his head Ioav, and have a little  Avine or some
 other cordial, as soon as he is able to swallow it, poured into his mouth.
 If the person has been  subject to hysteric fits, castor or asafoetida should
 be applied to the nose, or burnt feathers, horn, or leather, Ax.
  When fainting fits proceed from mere weakness  or exhaustion, Avhich
is often the case after gieat fatigue, long fasting, loss of blood or the like,
 the patient must be supported with  generous cordials, as jellies, wines,
 spirituous liquors, &c.  These however must  be given at first in very
 small quantities, and increased gradually as the patient is  able to bear
 them. He  ought to be allowed to lie quite still and easy upon his back,
 with his head low, and  should have fresh air admitted  into his chamber.
 His food should consist of nourishing broths,  sago-gruel, with wine, new
 milk, and other things of a light and cordial nature.  These  things are to
 be given out of the fit.  All that can be done in the fit, is to let him smell
 to a  bottle of Hungary-Avater, eau de luce, or spirits of  hartshorn, and to
 rub his temples with  warm brandy, or to lay a compress dipped in it to
 the pit of the stomach.
  In fainting fits that proceed from fear, grief, or other violent passions or
 affections of the mind, the patient must be very cautiously managed.   He
 should be suffered to remain at rest, and only made to smell some vinegar.
 After he is come to himself he may drink freely of warm  lemonade,  or
 balm-tea, with some orange or lemon  peel in it. It will likewise be pro-
 per, if the fainting fits have been long and severe, to clean the bowels by
 throwing in an emollient clyster.
  It is commou in fainting fits, from whatever cause they proceed, to bleed
 the patient.  This practice may be  very proper in strong persons, of a
 full  habit; but in those who are weak and delicate, or subject to nervous
 disorders, it is dangerous.  The proper  method with such people is, to
 expose them to the free air, and to use cordial and stimulating medicines,
 as volatile, salts,  Hungary-water, spirits of lavender, tincture of  castor,
 and the like.

               OF FLATULENCIES,  OR WIND.


   All nervous patients, without  exception, are afflicted  with wind or
 flatulencies in the stomach  and  bowels, which arise chiefly from  the
 want of  tone  or vigour in  these organs.   Crude  flatulent aliment,
 as green peas, beans,  coleworts,  cabbages,  and  such like,  may  in-
 crease this complaint; but strong   and healthy  people are  seldom 
OF FLATULENCIES, OR  WIND.           287
troubled with wind, uuless they either overload their stomachs, or drink
liquors that are in a fermenting state, and consequently full of elastic air.
While therefore the matter of flatulence proceeds from our aliments, the
cause which makes air separate from them in such quantity as to occasion
complaiuts, is almost always a fault of the bowels themselves, which are
too weak either to prevent the production of elastic air, or to expel it af-
ter it is produced.
   To relieve this complaint,  such medicines ought to be  used as have a
tendency to expel wind, and  by  strengthening the alimentary canal,
to prevent its being produced there.*
   The list of medicines for expelling wind is very numerous; they often
however disappoint the expectations of both the physician  and his patient.
The most celebrated among the class of carminatives are juniper berries;
the root of ginger and zedoary; the seeds of anise, caraway, aud corian-
der;  gum asafcetida and opium;  the warm Avaters, tinctures, and spirits,
as the aromatic  water, the tinctures of woodsoot, the volatile  aromatic
spirit, aether, Ac.
   Dr. Whytt says, he found no medicines more efficacious in expelling
Avind than aether aud laudanum.   He generally gave the laudanum in a
mixture with peppermint-water and tincture of castor, or sweet spirits of
nitre.  Sometimes in place of this, he gave opium in pills  with asafcetida.
He observes that the good effects of opiates are equally conspicuous,
whether the flatulence be continued in the stomach or intestines; ^where-
as those warm medicines, commonly called carminatives, do not often give
immediate relief, except when the wind is in the stomach.
   With regard to aether, the Doctor says, he has often seen very good ef»
fects from it in flatulent complaints, where other medicines failed.   The
dose  is a  tea-spoonful, mixed with two table-spoonsful  of water, f   In
gouty cases he observes,  that aether, a glass of French brandy, or of the
aromatic water, or ginger, either taken iu substance or infused in boiling
water, are among the best medicines for expelling wind.
   When the case of flatulent patients is such  as makes it improper to
give them warm medicines inwardly, the Doctor recommends  external
applications, Avhich are sometimes of advantage.   Equal parts of the an-
ti-hysteric and stomach plaster may be spread upon a piece of soft leather,
of 6uch size as to cover  the greater part of the belly.   This should be
kept on for a considerable time,provided the patient be able to bear it;
 if it  should give great uneasiness it may be taken off, and the following
 liuiment used in its stead :
    Take of Bate's anodyne  balsam, an ounce; of the  expressed oil of
 mace, half an  ounce; oil of mint, two drachms.  Let these ingredients
 be mixed together, and about a table-spoonful well rubbed on the parts
 at bed-time.
    For strengthening the stomach and bowels, and consequently for less-
 ening the production of flatulence, the Doctor recommends the  Peruviau
  * Many nervous people find great benefit from eating a dry biscuit, especially
when the stomach is empty.  I look upon this as one of the best carminative
medicines;  and would recommend it in all complaints of the stomach, arising
from flatulence, indigestion, &c.
  f Though the patient may begin with this quantity, it will be necessary to in-
crease the dose gradually as the stomach can bear it.  Oilier is now given in
considerably greatec doses than it was in Dr. Whytt's time. 
288
OF  LOW SPIRITS.
bark, bitters, chalybeates,  and exercise.   In flatulent cases, he thinks
some nutmeg or ginger should be added to the tincture of the bark and
bitters, and that the aromatic poAvder should be joined  with the filings
of iron.
  When windy complaints are attended Avith costiveness, which is often
the case, few things Avill be found to  ansAver better than four or five ol
the folloAving pills taken every night at bed-time :
  Take of asafcetida two drachms; succotriue  aloes, salt of iron, and
powdered ginger, of each, one drachm; as much of the elixir proprietatis
as will be sufficient to form them into pills.
  On the other hand, when the body is too open, twelve  or fifteen grains
of rhubarb, with half a drachm or two scruples of the Japonic confection,
given every other evening, will have very good effects.
  In those flatulent complaints Avhich come on about the time the menses
cease, repeated small bleedings often give more relief than any other re-
medy.
  With regard to diet the Doctor observes, that  tea, and likewise all fla-
tulent aliments, are to be avoided; and that for drink, Avater with a lit-
tle  brandy or rum, is not only preferable to malt liquor, but in most cases
also to Avine.
  As Dr. Whytt has paid great attention to this subject,  and as his senti-
ments upon it in a great measure agree with mine, I have taken the li-
berty to adopt  them; and shall only add to his observations, that exer-
cise is in my opinion superior to all  medicine,  both for preventing the
production, and likewise  for expelling of flatulencies.   These  effects
hoAvever are not to be expected  from sauntering about, or  lolling in a *
carriage;  but  from labour or such  active  amusements as give exercise
to every part of the body.

                       OF  LOW SPIRITS.

   ALL who have weak nerves are subject to low spirits in a greater or
less degree.  Generous diet, the cold bath, exercise, and amusements,
are the most likely means to remove this  complaint.  It  is greatly in-
creased by solitude and indulging gloomy ideas, but may often be re-
lieved by cheerful company and sprightly amusements.
   When low spirits are owing to  a weak relaxed state of the stomach and
bowels, an infusion of Peruvian bark with cinnamon or nutmeg Avill  be
proper.  Steel  joined with aromatics may likewise in this  case be used
with advantage; but riding and a proper diet are most to be dependedon. l
   When they arise from foulness ofthe stomach and intestines, or obstruc-
tions in the hypochondriac viscera, aloetic purges will be proper.  I have
sometimes known the Harrowgate sulphur-Avater of service in this case.
   When low spirits proceed  from a suppression of the menstrual or of
the haemorrhoidal  flux, these evacuations may either be restored or some
other substituted in their place, as issues, setons or the like. Dr. Whytt
observes, that nothing has such sudden good effects in this case as bleed-
ing.
  When low spirits have been brought on by long continued grief, anxie-
ty,  or other distress of mind, agreeable company, variety of amusements,
and change of place, especially travelling into foreign countries, will af-
ford the most certain relief. 
OF  HYSTERIC  AFFECTIONS.
289
   Persons afflicted with low spirits should avoid all kinds of excess, es-
pecially of venery and strong liquors.   The moderate use of wine and
other strong liquors is by no means hurtful;  but when  taken to excess
they weaken the stomach, vitiate the humours, and depress the  spirits.
This caution is the more necessary, as the unfortunate and melancholy
often fly to strong liquors for relief, by  Avhich means they never fail to
precipitate their own destruction.

                OF  HYSTERIC  AFFECTIONS.

   THESE likewise  belong to  the numerous tribe of nervous diseases,
which may be justly reckoned the reproach of medicine.  Women of a
delicate habit, Avhose  stomach and intestines are relaxed, and whose ner-
vous system is extremely sensible, are most subject to hysteric complaints.
In such persons an hysteric fit, as it is called, may be brought on by an
irritation of the nerves of the stomach or intestines, by Avind, acrid hu-
mour, or the like.   A sudden suppression of  the menses often give rise
to hysteric  fits.   They  may likewise be excited  by violent  passions  or
affections of the mind, as fear, grief, anger, or  great disappointments.
   Sometimes the hysteric fit resembles  a  swoon or fainting fit,  during
which the patient lies as in a sleep, only the breathing is so Ioav as scarce
to be perceived.  At other times the patient  is affected  with catchings
and strong convulsions.  The symptoms which precede hysteric  fits are
likeAvise various in different persons.  Sometimes the fits come on with
coldness of the  extremities, yawning and  stretching, lowness of  spirits,
oppression and anxiety.   At other times the approach of the fit is fore-
told by a feeling, as if there were a ball at the loAver part of the belly,
which gradually rises toAvards the stomach, where it occasions inflation,
sickness, and sometimes vomiting; afterwards it rises into the gullet, and
occasions a degree of suffocation, to Avhich quick breathing, palpitation
of the heart, giddiness of the head, dimness of the sight, loss of hearing,
ivith convulsive motions of the extremities and other parts of the body,
succeed.  The hysteric paroxysm is often introduced by an immoderate
fit of laughter, and  sometimes it  goes off by crying.  Indeed there is not
much difference between the laughing and crying of an highly hysteric
lady.
   Our aim in the treatment of this disease, must be to shorten the fit or
paroxysm when present, and to prevent its  return.  The longer  the fits
continue, and the more frequently they return, the disease becomes the
more obstinate.   Their strength is increased by habit, and  they induce
so jjreat a rela: ation of  tlie system, that it is with difficulty removed.
   It is customary (Wring the hysteric fit or paroxysm, to bleed  the pa-
tient.  In strong persons of a plethoric habit,  and where the pulse is full,
this may be proper; but iu weak and delicate constitutions, or where the
disease has been of long standing, or arises from inanition, it is not safe.
The best course  in such case is to rouse the  patient by  strong smells, as
burnt feathers, asafcetida, or spirits of hartshorn, held to the  nose.  Hot
bricks may also be applied to the soles of the feet, and the legs, arms and
belly may be strongly rubbed with a warm cloth.  But  the best applica-
tion is to put the feet and legs into Avarm Avater.  This is peculiarly pro-
per Avhen the fits precede the flow of the menses.  Incase of costiveness,
a laxative clyster with asafcetida will be proper: and as soon a« the pa- 
-*yU            OF HYSTERIC  AFFECTIONS.

tient can swallow, tiro table-spoonsful of a  solution of  asafa-tidn, or ol
some cordial julep, may be given.*
   Tlie radical cure ol this disorder will be best attempted at a time when
the patient is most free from the fits.   It will be  greatly promoted by a
proper attention to diet.   A milk and vegetable diet, when duly persist-
ed in, will often perform a cure.   If  however  the  patieut has been ac-
customed to a more generous diet, it  will not be safe to leave it off all at
once, but by degrees.   The most  proper drink is water with a small
quantity of spirits.   A cool dry air is the best.   Cold bathing, and every
thing  that braces the nerves and invigorates  the  system, is beneficial;
but lying too long in bed, or whatever relaxes the  body, is hurtful.   It
is of the greatest importance to have  the mind kept constantly easy and
cheerful, and, if possible, to have it always eugaged in some agreeable
and interesting pursuit.
   The proper medicines are those Avhich strengthen the alimentary canal
and the Avhole nervous system, as the preparations of iron, the Peruvian
bark and other bitters.   Twenty drops of the elixir of vitriol, in a cup of
the infusion of the bark, may be taken twice or thrice a-day.   The bark
and iron may likewise  be taken in substance,  provided the stomach can
bear them; but they are generally given in too small doses to  have  any
effect.  The chalybeate  ivaters generally prove beneficial in this disorder.
   If the stomach is loaded with  phlegm, vomits Avill be of use;  but
they should  not be too strong, nor frequently repeated, as they  tend  to
relax and Aveaken the stomach.  If there be a tendency to costiveness,
it must be removed either by  diet, or by taking au opening pill as often
as it shall be found necessary.
   To lessen the irritability of the system, antispasmodic medicines will
be of use.  The best antispasmodic medicines are musk, opium, and cas-
tor.  When opium disagrees with the stomach,  it may  either be applied
 externally, or given in clysters.   It  is often successful  in removing those
 periodical head-achs to  which hysteric and hypochondriac  patients art-
 subject.  Castor has in  some cases been  found  to  procure sleep where
opium failed; for which reason, Dr.  Whytt advises, that they should be
joined together.  He likeAvise recommends the anti-hysteric plaster to be
 applied to the abdomen.^
   Hysteric  women are often  afflicted Avith cramps, in various parts of
 the body, Avhich are most apt to seize .them  in  bed, or when asleep.
 The most efficacious medicines in this case are opium, blistering-plas-
 ters,  aud Avarm  bathing or fomentations.   When  the  cramp  or spasm
 is very violent, opium  is the remedy most to be depended on.   In
 milder cases, immersing the feet and legs in  Avann  water,  or apply-
 ing a blistering-plaster  to the part affected, will  often be  sufficient to
 remove the complaint.    In  patients whose  nerves  are uncommonl)

   " When hysteric fits are occasioned by sympathy, they may be cured by ex-
citing an opposite passion. This is said to have been the case of a whole school
of young ladies in Holland, who were all cured by being told, that tlie first who
was seized should be burnt to death. But this method of cure, to my knowledge,
will not always succeed.  I would therefore advise, that young ladies who are
subject to hysteric fits should not be sent to boarding-schools, as the disease may
be caught by imitation.  I have known madness itself brought on by sympathy.
   ■f Though antispasmodics and anodynes are universally recommended in this
disease, yet all tlie extraordinary cures that I ever knew in hysteric cases, were
performed by means of tonic and corroborating medicines. 
            OF  HYPOCHONDRIAC  AFFECTIONS.        291

delicate and sensible, it will be better to omit the blistering-plaster, and
to attempt the cure by opiates, musk, camphire, and the warm bath.
   Cramps are often prevented or cured by compression.   Thus cramps
in the legs are prevented, and sometimes removed, by tight bandages;
and Avhen convulsions arise from a flatulent distention of the intestines, or
from spasms beginning in them, they may be often lessened or cured by
making a pretty strong compression upon the abdomen by means of a broad
belt   A roll of brimstone held in the hand is frequently used as a reme-
dy for  cramps.   Though this seems to owe its effects chiefly  to imagina-
tion, yet, as it  sometimes succeeds, it merits a trial.*  When spasms or
convulsive  motions arise from sharp humours in the stomach or intestines,
no lasting relief can be procured till these are either corrected or expel-
led.   The Peruvian bark  has sometimes curedjperiodic convulsions after
other medicines had filed.

            OF HYPOCHONDRIAC  AFFECTIONS.

   THIS disease generally attacks the indolent, the luxurious, the unfor-
tunate, and the studious.  It becomes daily more common in this coun-
try,  owing, no doubt, to the increase of luxury and sedentary  employ-
ments.   It has so near a resemblance to the immediately preceding, that
many authors consider them as the same disease, and  treat them accord-
ingly.   They require however, a very different regimen; and the symp-
toms ofthe latter, though less violent, are more permanent than those ofthe
former.
   Men of a melancholy temperament, Avhose minds are capable of great
attention, and whose passions are not easily moved, are in the advanced
periods of life, most liable to this disease.  I' is usually brought ou by
long and serious attention to abstruse subjects, grief, the  suppression of
custom try evacuations, excess of veuery,  the repulsion of cutaneous erup-
tions, long  continued evacuations, obstruction iu some of the viscera, as
the liver, spleen, Ac.
   Hypochondriac persons ought never to fast long, aud their food should
be solid and nourishing.   All ascescent and windy vegetables are to be
avoided.   Flesh meats agree best with them, and their drink should be
old claret,  or good madeira.   Should these disagree with the stomach,
water  with a little brandy or rum in it may be drank.
   Cheerfulness and serenity  of mind are  by all means to be cultivated.
Exercise of every kind  is useful.   The  cold bath is likewise beneficial;
and where it does not agree with the patient, frictions with the flesh-brush
or a coarse  cloth may be tried.   If the patient has  it in his power, he
ought  to travel either by sea or land.  A voyage or a long journey, espe-
cially  towards a warmer climate, will  be of more service than any medi-
cine.
   The general  intentions of cure in this disease,  are to strengthen the ali-
mentary canal, and to promote the secretions.  These intentions will be
be:t  answered by the different preparations of iron  and  the Peruvian
bark, Avhich, after proper evacuations, may be taken  in the same manner
as directed in the preceding disease.
   If the patient be costive,  it Avill be necessaiy to make use of some

   • Some persons  afflicted with cramps pretend to  reap great benefit from
small bundles of rosemary tied all night about their feet, ancles, and knees'. 
2*2        OF HYPOCHONDRIAC  AFFECTIONS.

gentle opening medicines, as pills composed of equal  parts  of  aloes,
rhubarb, and asafcetida,  with  as much of the elixir propnetatis  as is
necessaiy to form the ingredients into pills.   Two, three, or four of these
may be taken as often as it shall be fouud needful, to keep the body gent-
ly open.  Suoh as caunot bear  the asafcetida,  may substitute Spanish
soap in its place.
   Though  a cheerful glass may have good effects in this disease, yet all
manner of excess it. hurtful.   Intense study, and eveiy thing tliat depres-
ses the spirits, are likewise pernicious.
   Though the general symptoms and treatment of nervous disorders Avere
pointed out in the beginning of this chapter, yet, for the benefit of the un-
happy persons afflicted Avith those obstinate and  complicated maladies, I
have treated several of their capital symptoms under distinct or separate
heads.   These however are not to be considered as different diseases, but
as various modifications of the same disease.   They all arise from the
same general causes, and require nearly the same method of treatment.
There  are many other symptoms that  merit particular attention, Avhich
the nature of my plan will not permit me to treat of at full length.  I shall
therefore omit them altogether,  and conclude this chapter with a few gen-
eral remarks on the most obvious means of preventing or avoiding ner-
vous disorders.
   In all persons afflicted with nervous disorders, there is  a great delica-
cy, and sensibility of the whole nervous system, and an uncommon degree
of weakness of the  organs of digestion.   These  may be either natural or
acquired.   When owiug to  a  defect in the constitution, they are hardly
to be removed; but may be mitigated by proper care.  When induced by
diseases, as long or repeated  fevers, profuse haemorrhages, or  the like,
they prove also very obstinate, and will yield only to a course of regimen
calculated to restore and invigorate the habit.
   But nervous affections arise more frequently from causes, which it is
in a great measure  in our own power to avoid, than  from diseases, or an
original fault in the constitution, Ac.   Excessive grief, intense study, im-
prop*r diet, and neglect of exercise, are the great sources of this exten-
sive  class  of diseases.
   It h^s heen already observed, that grief indulged destroys the appetite
and  digestion, depresses the spirits, and induces an universal relaxation
and debility of the whole system.  Instances of this  are daily to be seen.
The loss of a near relation, or any other misfortune  in life, is often suffi-
cient to occasion the  most complicated series of nervous symptoms. Such
misfortunes indeed are not to be avoided, but surely their effects, by a vi-
gorous and proper exertion of the mind, might be rendered less hurtful
For  directions in this matter, we must refer the reader to the article
Grief, in the chapter on the passions.
   The effects  of intense study are pretty similar to  those occasioned by
gref.  It preys upon the animal spirits, and destroys the appetite and
digestion.   To prevent these  effects, studious persons  ought according
to the Poet, to toy with their books.*   They  should never  study  too
lo lg at a  time;  nor  attend long to one particular subject, especially if
it be of a  serious  nature.  They  ought likewise to be attentive  to
* Armstrong on Health. 
TETANUS,  OR  THE  LOCKED-JAW.
293
their posture, and should take care frequently to unbend their minds by
music, diversions, or going iuto agreeable company.
  With regard to diet, I shall only observe, that nervous diseases may be
induced either by excess or inanition.  Both of these extremes hurt diges-
tion, and vitiate the humours.  When nature is oppressed with fresh loads
of food, before she has  had time to digest and  assimilate the former meal,
her powers are weakened,  and the vessels are filled with crude humours.
On the  other hand, when  the food is  uot sufficiently  nourishing, or is
taken too seldom, the boAvels are  inflated with wind, and the humours,
for want of regular fresh supplies of wholesome chyle, are vitiated.  These
extremes are therefore with equal care  to be avoided.  They both tend
to induce a relaxation, and debility of the nervous  system, with all its
dreadful '.rain of consequences.
   But the most general cause of nervous disorders,  is  indolence.  The
active and laborious are seldom troubled with them.  They are reserv-
ed  for the chilehen of ease and affluence,  ivho generally feel their keen-
est force.  All we shall say  to such persons, is, that the means of pre-
vention and cure are both in their own power.   If the constitution of hu-
man nature be such, that man must either labour or suffer diseases, sure-
ly no individual has any right to expect an exemption from the  general
rule.
   Those however who are willing to take exercise, but whose occupa-
tions confine them to the house, and perhaps to an unfavourable posture,
really deserve our pity.  We have in  a former part of the  book, en-
deavoured to lay down rales for their conduct; and  shall only add, that
ivhere these cannot be complied  Avith, their place  may, in some mea-
sure, be supplied by the use of bracing and strengthening medicines, as
the Peruvian bark, Arith other bitters; the  preparations  of steel; the
elixir of vitriol, Ac.

       OF  THE TETANUS,  OR THE  LOCKED-JAW.§

   UNDER this term may be comprehended the spasmodic affections,
called  emprosthotouos, opisthotonos, and trismus, being one disease, dif-
fering only in the degree of its violence.  When the body and head are
bended fonvards, it is called cmprosthotonos, when they  are carried back-
wards, and immovably  fixed, it bears the appellation of opisthotonos; and
when the body is sustained in an erect position, by the muscle on the fore
and back part of the truuk acting with equal strength, the disease is cal-
led tetanus.   When the muscles of the  jaw become more particularly af-
fected,  it is called trismus, or locked-jaw.
   These spasmodic complaints affect both sexes, and no age is exempted
from their violence.   They affect the male oftener than the  female, and
more particularly those people  avIio  inhabit warm climates, and every
climate at the warm season of the year.   Sometimes they occur in winter,
independent of wounds.
   CAUSES.—Wounds in any part of the body are sometimes succeed-
ed by this disease.  But more particularly from those  intendons, Avhere
a,trifliiiginiury will not unfrequently produce this complaint, when it is
least expected.   Whereas, at other times, a wound of considerable mag-
nitude,  under apparently similar crcumstances, will have no such effect: 49
and, even after operations in tendcnous parts, it  by no means a frequent 
294
TETANUS,  OR  THE  LOCKED'JAW.
occurence; when at other times, a simple fracture of the leg will produce
it in all its force.  Cold. Avhen accompanied with moisture, will produce
this disease;  particularly when the body  is  exposed while asleep on a
damp pavement, or iu a damp cellar, immediately after being heated and
fatigued by exercise.   Children are frequently seized with this disease in
a short time after delivery.
  SYMPTOMS.—This disease, if it is from the effects of cold, general-
ly comes on of a sudden.  But when from  a  wound, it gradually ap-
proaches about the tenth, fourteenth, or twentieth days after the accident.
It often comes on at a time when the  Avound gives but little uneasiness,
and is nearly healed.  The patient first complains of an uneasy sensation
at the lower part of the breast bone, Avith a stiffness in the back part of
the neck and  muscles, of the loAver jaw, Avhich increase  with a painful
sensation at the root of the tongue, and a slight difficulty in swallowing.
But no appearance of swelling can be observed in the throat.   The mus-
cles of the back now becomes rigid.  This rigidity in a short time ex-
tends to those of the neck, attended with a  pain iu the direction of  the
spine of the back.  At length the head, neck, and back bone are forcibly
bent backwards.—The body becomes fixed in that position.   The mus-
cles of the jaiv are now violently affected, attended Avithan impossibility
of swallowing.  EAren liquids are  thrown  forcibly  back through  the
nose.   These symptoms generally take place on the second or third day,
Avhen the body is frequently seized with violent convulsive spasms; and
the pain at the lower part of the breast bone increases, Avhich shoots through
towards the back.
   The muscles of the limbs now become rigid, and the body is so muck
bent backwards as to rest on the back part of the head and  heels.  An
the disease advances, the convulsive spasms become more violent.  At
length tetanus is produced, from the muscles on the fore and back part of
the trunk, acting with an equal degree  of  vigour, sustaining the body in
an erect position.   The pulse is generally frequent with the other  symp-
toms  of fever, particularly when the disease is the consequence of cold.
 The  bowels are generally costive, attended Arith a retraction of the bel-
ly.   The uriue is discharged with difficulty, and sometimes a suppression
of  that evacuation takes place.—The  face  appears  pale, expressive of
great anxiety and distress.  The patient is seldom, if ever, delirious, al-
though he slumbers but little, from which he frequently awakes on a sud-
den,  with violent spasms.  At length, the muscular system becomes more
generally affected, and one universal convulsion  closes the miserable ex-
 istence of  the patient.
   MEDICINE.—In our attempt to cure this disease, the indications
 are nearly the same, when  produced from cold or the consequence of
 a wound,  except Avhen the Avound is Avithout swelling and inflamma-
tion.  It should then be dilated and dressed, with lint dipped in warn.
basificon,  or  any  other stimulating  application.    After  this, two,
three, or even four grains of  opium should be   given  three  or four
times a-day, according to the urgency of the symptoms, and tendency
to induce  sleep;  for  astonishing  quantities of this medicine  may be
given without  having the  least tendency  to make the patient  slum-
ber.   This  remedy  should be administered early, as well  as  large
quantities of Madeira  wine,  before  the  swallowing  becomes  inter- 
DISORDERS OF THE SENSES.
295
tupted; and the system should be charged with mercury, with as much
expedition as possible.   For this purpose  two or three drachms of mer-
curial ointment must be rubbed into the inside of the legs, thighs, and
arms, morning aud evening, and likewise into the muscles more particu-
larly albcted  with  spasms.   To co-operate with those  medicines, the
cold bath must  be  used,  or  cold water thrown over  the body.   The
bowels should be kept  open with calomel, castor-oil, and clysters.  All
those remedies must be used at an early period ofthe complaint, so as to
make as formidable an attack as possible on this very formidable disease,
which too frequently terminates in the death  of the patient, in spite of
every effort to save him.
   When it is about to  take  place in infants, the bowels must be opened
ivith calomel or castor-oil.   But Avhere it has actually taken place, little
can be done.   However a similar  plan may be used with that recom-
mended in grown persons.
                        CHAP.  XLVI.

                DISORDERS  OF THE SENSES.

        W E do not mean to treat of the nature of our sensations, or
to give a minute description ofthe various organs by which they are per-
formed, but to point out some  of the diseases to which these organs are
most liable, anel  to show how they maybe prevented or remedied.

                         OF  THE EYE.

   No organ of the body is subject to more  diseases than the  eye;  nor is
there any one of Avhich the diseases are more difficult to cure.—Though
more ignorant persons pretend to cure these than any other class of di-
seases ; yet a very superficial acquaintance Avith the structure of the eye,
and the nature of vision, will be sufficient to convince any one of the dan-
ger of trusting to them.   These diseases often exceed the skill of the
most learned physician; hence Ave may easily infer the danger of trusting
ihem to ignorant quacks, who, Avithout doubt put out more eyes than they
cure.  But, though the disease of the eye can  seldom be  cured, they
might often, by due care, be prevented; and, even Avhere the sight  is to-
tally lost, many  things might be done, which are generally neglected, to
render the unhappy person both more useful to himself and to society.*
   The eyes are hurt by viewing  bright or luminous objects;  keeping
the head too long in a hanging posture; violent head-ach-s; excessive

   * It is a pity those who have the misfortune to be born blind, or who lose their
sight when young, should be suffered to remain in ignarance, or to beg. This is
both cruelty and want of economy.   There are many employments of which
blind persons are very capable, as knitting, carding, turning  a wheel, teaching
languages, &c.   Nor'are instancas wanting of  persons who have arrived at the
highest pitch of learning, without having the least idea of light.  Witness the
late famous Nicholas Sanderson of Cambridge, and  my worthy friend Dr. Tho-
mas Blacklock of Edinburgh.  The former was one of the first mathematicians
of the age, and the latter, besides being a good poet and philosopher, is master
of all the learned  languages, and a very considerable adept in the  liberal arts. 
296
OF THE EYEi
venery; the long use of bitters; the elfluvia from acrid or  volatile sub-
stances; various diseases;  as the small-pox, measles, Ac but above all,
from night-Avatching aud candle-light studies.   Long fas'iag is likewise
hurtful to the eyes, and frequent heats and colds are no less pernicious.
The eyes are often hurt by the stoppage of customary evacuations; as
morning sweats; sAveating  of  the feet;  the menses in women;  and the
bleeding-piles in men.   All kind of excess are likewise hurtful to the
sight, particularly the immoderate use of ardent spirits, aud other strong
liquors.
   In all diseases ofthe eyes, especially those attended with inflammation,
the cool regimen ought to be observed.  The patient must abstain from
all spirituous liquors.   The smoke of tobacco, smoky rooms, the vapours
of onions and garlic, and  all vivid lights and glaring colours, are care-
fully to be avoided.   The drink miy be  water, w hey, or small beer; and
the aliment must be light and of easy digestion.
   For preventing disorders of the eyes, issues and setons  are of prime
use.   Every  person whose eyes are tender, ought to have one or more
of these in some part of the body.   It  will likewise be of use to keep
the body gently open, and either to bleed or purge eveiy spring and fall.
All excess and night studies are to be avoided.  Such as do not choose
a  seton or an issue, will reap benefit from wearing a  small Burgundy-
pitch plaster between the shoulders.
   A gutta serena or amaurosis is an abolition of tlie sight without any
apparent cause  or fault in  the eyes.  When it is oAving to a  decay or
wasting of the optic  nerve, it does not admit of a cure; but Avhen  it pro-
ceeds from a compression of the nerves by redundant humours, these may
in some measure be  drained off, and the patient relieved.  For this pur-
pose, the body must  be  kept open with the laxative mercurial pills.  If
the patient be young and of a sanguine habit he may be bled.   Cupping,
with scarifications on the back part of the head, will likeAvise be of use.
A running at  the nose may be promoted  by volatile  salts, stimulating
poAvders, &c.   But  the most likely means  for relieving the patient are
issues or blisters kept open for a long time on the back part of the head,
behind the ears, or on the neck.   I have known these restore sight, even
after it had  been for a considerable time  lost.
   Should these fail, recourse must be  had to mercurial salivations; or
what will perhaps ansAver the purpose better, ti/elve grains of corrosive
sublimate of mercury may be dissolved in an English pint and an half of
brandy, and a table-spoonful of it taken twice a-day, drinking half a pint
ofthe decoction of sarsaparilla after it.
   A  cataract is an obstruction of the pupil,  by  the interposition of
some  opaque  substance which either diminishes or totally extinguishes
the sight.   It is generally an  opacity  of  crystalline humour.   In  a
recent or beginning cataract,  the  same medicines are to be  used as
in the gutta  serena;  and  they will  sometimes succeed.   But Avhen
this  does  not  happen, and  the  cataract becomes  firm, it  must  be
couched, or rather extracted.  I have  dissolved  a recent cataract by
giving the patient frequent  purges with  calomel, keeping  a poultice of
fresh hemlock constantly upon the eye, and  a perpetual blister on the
neck.*
* In both these cases electricity merits a trial. 
OF THE  EAR.
291
   The myopia or short sightedness, and the presbyopia or seeing only at
 too great a distance, are disorders which depend on the original structure
 or figure of the eye, therefore  dmit of no cure.  The inconveniences
 arising from them may however be, in some  measure, remedied by the
 hel,/ of proper glasses.   The former requires the aid of a concave, and
 the  latter of a convex glass.
   A strabismus, or squinting, depends upon an irregular contraction of
 the  muscles of the eye from a spasm,  palsy, epilepsy, or an ill habit.
 Children often contract this disorder by having their eyes unequally ex-
 posed  to the light.   They may likewise acquire it by imitation from a
 squinting nurse or play-fellow, Ac.  As this disorder can hardly be cured,
 parents ought to be careful to prevent it.  Almost the only thing which
 can be done for it is to contrive a mask for the child to wear, which will
 only permit him to see in a straight direction.
   Spots or specks on the eyes are generally the  effect  of  inflammation,
 and often appear after the small-pox, the measles, or violent ophthalmias.
 They  are very  difficult to cure, and often occasion total blindness.  If
 the  specks are soft and thin, they may sometimes be taken off by gentle
 caustics and discutients;  as vitriol, the juice  of celandine, &c.   When
 these do not succeed, a surgical operation may be tried: the success of
 this however is always  very doubtful.
   The blood-shot eye may be occasioned by  a stroke,  a fall, retching,
 vomiting, violent coughing, Ac.   I have frequently knoAvn it happen to
 children in the hooping-cough.   It appears at  first like a bit of scarlet,
 and is  afterwards of a livid or blackish colour.   This disorder general-
 ly goes off without  medicine.  Should it  prove  obstinate, the patient
 may be bled,  and have his eyes fomented with a decoction of cumphry
 roots and elder  flowers.   A soft poultice may be applied to the eyes;
 and  the body  should be kept open by gentle purgatives.
   The watery or weeping eye is generally occasioned by  a relaxation or
 weakness of the glandular parts of  that organ.  These may  be braced
 and  strengthened by bathing  the eye with brandy and water,  Hungary-
 water,  rose-water,  with white vitriol  dissolved in it, Ac.—Medicines
 Avhich make a revulsion are likewise proper; as mild purgatives, perpetual
 blisters on the neck, bathing the feet frequently in luke-warm water, Ac.
   When this  disease proceeds from an  obstruction of the lachrymal
 duct, or natural passage of the teal's,  it is called a Jistula lachrymalis,
and can only be  cured by a surgical operation.^

                         OF THE  EAR.
   THE functions of the ear may be injured by wounds, ulcers, or any
 thing that hurts  its fabric.  The hearing may  likewise be hurt by exces-
 sive noise; violent colds in the head;  fevers;  hard wax, or other  sub-
 stances sticking in the cavity of the ear; too great a degree of moisture
or dryness  of  the ear.   Deafness is very often the effect of old age, and
is incident  to most people iu  the decline of life.   Sometimes it is owing
to an original fault in the structure or formation ofthe ear itself.   When
this  is  the case,  it admits of no cure;  and the unhappy person not only
continues deaf, but generally likewise dumb, for life.f

  * \ weeping or watery eye is often the mark of a scrophulous habit.
  y Though those whe have the misfortune to be born deaf are generally suffer*
ed to continue dumb, and consequently are in a great measure lost to society,
                                 38 
•2'98                      01  THE  EAJt.
  When deafness is the effect of wounds or ulcers ofthe earfr, or of old
age, it is not easily removed.   When it proceeds from cold of the head,
the patient must be careful to  keep his head warm, (specially in the
night; he should likewise take  some gentle purges, and keep his  feet
warm, and bathe  them  frequently in luke-Avarm water at bed-time.
When deafness is the effect of a fever, it generally goes off after the patient
recovers.  If it  proceeds from dry wax sticking in the ears, it may be
softened by dropping oil into them; afterwards they must be  syringed
with warm milk and water.
   If  deafness proceeds from  dryness of the ears, which may be known
by looking into them, half an ounce of the oil of sweet almonds, and the
same quantity of liquid opodeldoc, or tincture of asafcetida,  may  be
mixed together, and a few drops of it put into the ear every night at bed-
time, stopping them afterwards with a little wool  or cotton.—Some, in-
stead of oil, put a small slice of the fat of bacon into each ear, which is
said to answer the purpose very well.  When the  ears abound with mois-
ture, it may be  drained off by an issue or seton, which should be made
as near the affected parts as possible.
   Some, for the cure of deafness, recommend the  gall of an eel, mixed
with spirit of Avine, to be dropped into the ear; others,  equal  parts  of
Hungary-Avater, and spirit of  lavender.   Etmuller extols amber  and
musk;  and Brookes says, he has often knoAvn hardness of hearing cured,
by putting a  grain  or tAvo of musk into the ear with cotton-wool.   But
these and other applications must be varied according to the cause of the
disorder.*
    Though  such application may  sometimes be  of service,  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 re-
yet nothing is more certain than that such persons may be taught not only to
read and write, but also to speak and to understand what others say to them.
Teaching the dumb to speak will appear paradoxical to those who do not con-
sider that the formation of sounds is merely mechanical, and may be taught
without the assistance of the «ar.  This is not only capable of demonstration,
but it is actually reduced to practice by the ingenious Mr. Thomas Braidwood
of Edinburgh.  This  gentleman has, by the mere force of genius and applica-
tion, brought the teaching of dumb persons to such a degree of perfection, that
his scholars are generally more forward in their  education than those of the
same age who enjoy all their faculties.  They not only read and write with the
utmost readiness, but likewise speak, and are capable of holding conversation
with any person in the light.—What a pity any ofthe human species should re-
main in a 6tate of idiotism, who are capable of being rendered as useful and
intelligent as others!  We mention this not only from humanity to those who
have the misfortune  to be born deaf,  but also in justice to Mr Braidwood,
whose success ha'S. far exceeded all former attempts this way; and indeed it
exceeds imagination itself so far, that no person who has  not seen and examin-
ed his pupils, can believe what they are capable of—As  this gentleman, how-
ever willing, is only able to teach a few, and as the fair greater part of those who
are born deaf cannot afford to attend him, it would be an act of great humani-
ty, as well  as of public utility, to erect an academy for their benefit.
   * A gentleman,  on whose veracity I can depend, told me, that after using
many things to no purpose for an obstinate deafness, he was at last advised to
put a few drops of his own urine warm into his ears every night and morning,
from which he received great benefit.  It is probable that a solution of tal am ■
moniacy in water, would produce the same effect. 
OF  THE  TASTE  AND  SMELL.
299
quire a very delicate touch.   For this reason, what we avouM chiefly re-
commend in deafness, is, to keep the head Avarm.   From whatever cause,
the disorder proceeds, this is  ahvays proper; and I have known more
benefit from it alone, in the most obstinate cases of deafness, than from all
the medicines I ever used.*

               OF THE  TASTE AND SMELL.

  THOUGH these senses are not of so great importance to man  in a
state of society, as the sight  and  hearing; yet,  as the  loss of them is
attended Avith some  incouveniency,  they deserve our notice.  They
are seldom to be restored when lost; Avhich ought to make us very at-
tentive to  their preservation,  by carefully avoiding whatever may in
the least prove injurious.  As there is a very great affinity between the
organs of tasting and smelling, Avhatever hurts the one,  generally affects
the other.
   Luxury is highly injurious to these organs.   When the nose and palate
are frequently stimulated by fragrant and poignant dishes, they soon lose
the power of distinguishing  tastes and odours Avith any degree of nicety.
Man, in a state of nature, may perhaps  have these  faculties as acute as,
any other animal.
   The sense of smelling  may be diminished or destroyed by diseases;
as, the moisture, dryness, inflammation or suppuration of that membrane
which lines the inside of the nose, commonly called the olfactory mem-
brane ;  the compression of the nerves which supply this membrane, or
some  fault  in the brain itself at their origin.  A defect or too great a de-
gree of solidity of the small spungy bones of the upper jaw, the caverns
ofthe forehead, &c. may likewise impair the sense of smelling.  It may
also be injured by a collection of foetid  matter  in those  caverns, Avhich
keeps constantly exhaling from them.   FeAV things are  more hurtful to
the sense of smelling,  than taking great quantities of snuff.
   When the nose abounds with moisture, after gentle evacuations,  such
things as tend to take off irritation, and coagulate the thin sharp serum,
may be applied; as the oil of anise mixed Avith fine flour; camphire dis-
solved in oil of almonds, &c.   The vapours of amber; frankincense, gum-
mastic, and benjamin,  may likewise be received into the nose and mouth.
   For moistening the mucus when it  is  too dry, some  recommend
snuff made of the leaves of marjoram, mixed Avith the oil of amber,
mirjoram  and aniseed; or  a sternutatory  of calcined  white vitriol;
twelve  grains  of which may  be mixed with two ounces of marjoram-
Avater, and  filtrated.  The steam or vapour of vinegar upon hot iron re-
ceived up the nostril is likewise of use for softening the muscus, opening
obstructions, Ac.
   If  there is an ulcer in the nose, it ought to be dressed with some emol-
lient  ointment, to Avhich 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 case, the solutiou of the corrosive sublimate in brandy may
be taken, as directed in the gutta serena.  The ulcer ought likewise to
be  washed  with it; and the fumes of cinnabar may be received up the
nostrils.
* An obstinate deafness has been cured by electricity. 
300                    OF  THE  TOUCH.
   If there be reason to suspect that the nerves Avhich supply the organs
 of smellii g are inert, or Avant stimulating, volatile salts, strong suuffs, and
 other things which occasion sneezing, may be applied to the nose.  The
 forehead may likewise be anointed with balsam of Peru, to v. Inch may be
 added a little ofthe oil of amber.
   The taste may be diminished by crusts, filth, mucus,  apthae, pellicles,
 Warts, Ac. covering the tongue; it may be depraved by  a fault of he sa-
 liva, which being discharged into the mouth, gives the same sensations as
 if the food which the person takes had really a bad taste; or it may be en-
 tirely  destroyed by injuries done to the nerves of the tongue and palate.
 Few things prove more  hurtful either to the sense of tasting or smelling
 than obstinate colds, es.-ecially those Avhich affect the head.
   When the taste is diminished by filth, mucus, Ac. the tongue ought to
 be scraped and frequently washed Arith  a mixture of water, vinegar, and
 honey, or some other detergent.   When the saliva is vitiated,  which sel-
 dom happens unless in fevers or other diseases, the curing of the disorder
 is the cure of this symptom.   To relieve it however iu the mean time,
 the folloAving things may be of use;  if there be a bitter  taste,  it may be
 taken  aAvay by vomits,  purges, and  other things which evacuate bile.
 What is called a nidorous taste, arising from putrid humours, is corrected
 by the juice  of citrons, oranges, and  other acids.   A salt taste is cured
 by plentiful delution with watery liquors.  An acid  taste is destroyed by
 absorbents, and alkaline salts, as poAvder of oyster-shells, salt  of worm-
 wood, Ac.
   When the sensibility of the  nerves Avhich supply the organs  of taste is
 diminished, the ehewing of horse-ratlish, or other  stimulating substances,
 will help to recover it.

                        OF THE TOUCH.

   THE sense of touching may be hurt  by  any thing that  obstructs the
 nervous influence, or prevents its being regularly conveyed to  the organs
 of touching: as pressure, extreme cold, Ac.   It may likewise be hurt by
 too great a degree of sensibility, when the nerve is not sufficiently cover-
 ed by  the cuticle or scarf-skin, or where there is too great a tension of it,
 or it is too delicate.   Whatever disorders the functions of the  brain and
 nerves, hurts the sense of touching.  Hence it appears to proceed from the
 same general causes as palsy and apoplexy, and requires nearly the same
 method of treatment.
   In a stupor, or defect of touching, which arises  from an obstruction of
 the cutaneous nerves,  the patient must first be purged;  afterwards such
 medicines as excite the action of the nerves, or stimulate  the system, may
 be used.  For this purpose, the spirit of hartshorn,  sal volatile oleosum
horse-radish, &c. may be  taken inwardly;  the disordered parts, at the
same time,  be frequently rubbed with fresh nettles or spirit of sal ammo-
niac.   Blistering-plasters and sinapisms applied to the parts will likewise
be of use, as  also warm bathing, especially in the natural hot baths. 
301
                       CHAP. XLVII.


              OF  A  SCIRRHUS AND CANCER.

       A  SCIRRHUS is  a hard indolent tumour  usually seated in
some of the glands; as the breasts, the arm pits, Ac.  If the tumour be-
comes large, uuequal, of a  livid, blackish, or leaden  colour, and is at-
tended with violent  pain, it gets the name  of an occult  cancer.  When
the skin is broken and a sanies or ichorus matter of an abominable foetid
smell is discharged from the sore, it is  called an open or ulcerated can-
cer.   Persons after the age of fort) -five,  particularly women, and those
who lead an indolent sedentary life, are most subject to this disease.
   CAUSES.—This disease is often oAving to  suppressed evacuations;
hence it proves so frequently  fatal to women of a gross  habit,  particu-
larly old maids and widows, about the time when  the menstrual  flux
ceases.   It may likewise be occasioned by excessive fear, grief, anger,
religious melancholy, or any of the depressing passions.   Hence the un-
fortunate, the choleric, and those  persons, Avho devote themselves to a re-
ligious life  in convents  or monasteries, are often afflicted Avith it.   It may
aiso be occasioned by  the long continued use of food  that is too hard of
digestion, or of an acrid nature; by barrenness; indolence; celibacy;
cold; blows;mfriction;  pressure;  or the like.  Womeu often  suffer  from
the last of these by means of tlieir stays, which squeeze and compress their
breast so as to occasion great mischief.   Sometimes the  disease is owing
to an hereditary disposition.
   SYMPTOMS.—This disorder seems often very trifling at the beginning.
A hard tumour about the size of  a hazle-nut, or perhaps smaller, is gen-
erally  the first symptom.  This will often continue for a long time Avith-
out seeming to increase or giving the patient great uneasiness; but if the
constitution be hurt, or the  tumour irritated by pressure or improper
treatment of any kind, it begins to extend itself towards the neighbouring.
parts by pushing out a kind  of roots or limbs.   It then gets the name of
cancer, from a fancied  resemblance betAveen these limbs and the  claAvs, of
a crab.   The colour of the  skin begins to change, which is first red, af-
terwards purple, then bluish, livid, and at last black.  The patient com-
plains of heat, with a burning, gnawing, shooting pain.    The tumour is
very hard, rough, and  unequal, with a protuberance or rising in  the mid-
dle ; its size increases  daily, and the neighbouring veins become thick,
knotty, and of  a  blackish  colour.
   The skin at length  gives Avay,  and  a thin sharp  ichor  begins to flow
which corrodes the neighbouring parts till it forms a large unsightly ulser.
More occult cancers arise, aud communicate with the neighbouring glands.
The pain  and stench  becomes  intolerable;  the  appetite  fails;  the
strength is exhausted by a continual hectic  fever; at last a violent  hae-
morrhage,  or discharge of blood, from some part of the body, with fail-
ings, or convulsion  fits, generally  put au end  to the miserable  patient's
life.
   REGIMEN.—Tlie diet ought to be light, but nourishing.   All strong
Ijquors, and high seasoned or salted proyisons, are to be avoided.   The 
OU2         OF A  SCIRRHUS  AND  CANCER.

patient may take as much exercise as he  can easily bear;  and should
use every method to divert thought, and amuse his fa.icy.   All kiuds of
external injury are carefully to be guarded against, particularly of the
affected part, which ought to be defended from all pressure, and even
from the external air, by covering it with fur or soft flannel.
  MEDICINE.—This is one of those diseases for which no certain re-
medy is yet knoAvn.   Its progress however, may  sometimes be  retarded,
and some of its  most disagreeable symptoms mitigated, by proper appli-
cations.  One misfortune attending the disease is, that  the unhappy pa-
tient often  conceals it too long.  Were proper means used in due time, a
cancer might often be cured;  but after the disorder has arrived at a cer-
tain height, it generally sets all medicine at defiance.
  When a scirrhus tumour is first discovered, the patient ought to ob-
serve a proper regimen, and to take twice or thrice a-week a dose of the
common purging mercurial pill.  Some blood may also be let, and the
part affected may be gently rubbed twice a-day with a little of  the  mer-
curial ointment, and kept warm Avith fur or flannel.   The food must be
light, and a pint of the decoction of woods or sarsaparilla may be drank
daily.  I have sometimes discussed hard tumours, Avhich had the appear-
ance of beginning cancers, by a course of this kind.
   Should  the tumour however not yield to this  treatment, but, on the
contrary, become larger and harder, it will be proper to extirpate it, either
by the knife or  caustic.  Indeed, whenever this can be done with safety,
the sooner it is done the better.  It can answer no purpose to  extirpate
a cancer after the  constitution is  ruined,  or the Avhole mass of  humours
corrupted by it.  This, however, is the common way,  which makes the
operation so seldom scuceed.   Few people will submit to the extirpation
till death stares them in the face; whereas, if it were done early, the
patient's life would not be endangered by  the operation, and it would
generally prove a radical cure.
   When the cancer is so situated that it cannot be cut  off, or if the pa-
tient will not submit to the operation, such medicines as will mitigate or
relieve the most urgent symptoms may be used.   Dr. Home says, that
half a grain of the corrosive sublimate of mercury, dissolved in a proper
quantity of brandy, and taken night and  morning, will ofteu be of ser-
vice tin cancers of the face and nose.  He likewise recommends an in-
fusion of the solanum or night-shade, in cancers of the breasts.
    But the medicine most in repute at present for this disease is hemlock.
 Dr. Stork, physician at Vienna, has of late recommended the extract of
 this plant as very  efficacious  in  cancers of eveiy kind.   The doctor
says, he has given some hundred Aveights of it without  ever hurting any
 body, and often with manifest advantage.   He advises the patient  hoAV-
 ever to begin with very small doses, as  two or three grains, and to in-
 crease  the dose gradually till some good  effect be perceived, and there
 to  rest without further increase.   From two  or three grains at first, the
doctor says he has increased the dose to two, three, or four drachms a-day,
 and finds that such  doses  may be continued for several Aveeks without
 any bad consequences.
    The regimen which the doctor recommends during the use of  the me-
dicine,  is to avoid farinaceous  substances  not  fermented,  and . too
 acrid aromatics.  He says, good wine  will not be  hurtful  to thos^ 
OF A  SCIRRHUS AND CANCER.'           303
who are accustomed to it, nor a moderate use of acids; and adds, that
the patient should live in a pure free air, and keep his mind as quiet and
cheerful as possible.
   The Doctor does not pretend to fix the time in which a cancer may
be resolved by the use of hemlock, but says he has given it for above two
years in large doses without any apparent benefit; nevertheless the pa-
tient has been cured by persisting in the use of it  for half a year longer.
This  is at least encouragement to give it a fair trial.  Though we are
far from thinking the hemlock merits those extravagant encomiums which
the Doctor has bestoAved upon it, yet, in a disease which has so long baffled
the boasted powers of medicine, we think it ought always to be tried.
   The powder of hemlock is by some preferred to the extract.   They are
both made of the fresh leaves, and may be used nearly in the same man-
ner.  Dr. Nicholson of Benvick, says, he gradually increased the dose
of the powder from a few grains to half a drachm, and gave near four
drachms of it in a day with remarkably good effects.   The hemlock may
also be used externally either as a poultice or fomentation.   The sore
 may likewise be kept clean by injecting daily a  strong decoction of the
 tops and  leaves into it.
   Few things contribute more to the healing of foul sordid ulcers of any-
 kind than keeping them thoroughly clean.  This ought never to be neg-
lected.    The best application  for this purpose seems to be the carrot
 poultice.   The root of the common carrot may be grated, and moistened
 with as much water as will bring it to the consistence of a poultice or ca-
 taplasm.  This must be applied to the sore, and renewed twice a-day.  It
generally cleans the sore, eases the pain, and takes away the disagreea-
 ble smell, which are objects of no  small importance in such a dreadful
 disorder.*
   Wort,  or an infusion of malt, has been recommended uot only as a pro*
 per drink, but as a powerful medicine in this disease.   It must be fre-
 quently made fresh, and the patient may take it at pleasure.   Two,
 three, or  even four English pints of  it may be  drank every day for a
 considerable time.  No benefit can be expected from any medicine  in
 this disease, unless it be persisted in for a long time.  It is of too obsti-
 nate a nature to be soon removed;  and, when it admits  of a cure at all,
 it  must be brought about by inducing an almost total change of the habit.
 which must always be a work of time.   Setons or issues in the neighbour-
 hood of the cancer have sometimes good effects.!
    When all other medicines  fail, recourse must be had to opium, as
 a  kind of solace.   This will not indeed cure the  disease, but it will
  • London Medical Essays.
  f In a cancer which had set all medicines, and even surgery, at defiance, I
lately saw remarkable effects from an obstinate perseverance in a course of an-
tiseptics.  I ordered Uie deep ulcers to be washed to the bottom by means of
a syringe, twice or thrice a-day either with an infusion ofthe bark, or a decoc-
tion of carrot, and that the patient should take four or five times a-day, a glass
of good wine, with half a drachm of the  best powdered bark in it.  The
sores, after being washed, were likewise sprinkled with the same powder.
When the patient began this course, her death was daily expected.  She conti-
nued it for above two years with manifest advantage; but being told by an emi-
nent surgeon, that the bark would not cure a cancer, and that the sores ought
not to be washed, she discontinued the practice, and died in a few weeks. This
course was not expected to cure tlie cancer, but to  prolong the patient's life,
which it evidently did almost to a miracle. 
304                      OF  POISONS.
ea e the patient's agony,  and render life more tolerable while it con-
tinues.
   To avoid this dreadful  disorder, people ought to use Avholesome food ,-
to take sufficient exercise in the open air; to be as easy and cheerful aa
possible; and carefully to guard against all blows, bruises and every
kind of pressure upon the breasts, or other glandular parts.*
                       CHAP.  XLVIII.

                         OF POISONS.

        EVERY  person  ought, in some measure, to be  acquainted
with the nature aud  cure of poisons.   They are  generally taken una-
av; res, and their effects are often so sudden and violent, as not to admit
of delay, or allow time to procure the assistance of physicians.   Happily
indeed no great degree of medical knowledge is here necessaiy; the re-
monies for most poisons being generally at hand, or easily obtained, and
nothing but common  prudence needful in the application of them.
   The vulgar notion that every poison is cured by some counter poison,
as a specific, has done much hurt.   People believe they can do nothing
for the patient, unless they know the particular antidote to that kind of
poison which he has  taken.   Whereas the cure of all poisons taken into
the stomach, without exception, depends  chiefly on discharging them as
soon as possible.
   There is no case wherein the indications of cure are more obvious.
Poison is seldom long in the stomach before it occasions sickness, with
an inclination to vomit.   This shews plainly what ought to be done.   In-
deed  common sense dictates to every one, that if any thing has been ta-
ken into the stomach which endangers life, it ought immediately to be dis-
charged.   Were this duly  regarded,  the danger arising  from poison
might generally be avoided.   The method of prevention is obvious,  and
the means are in the hands  of every one.
   We shall 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 poisons; neither shall we mention the boasted antidotes,
which have been recommended either for preventing or obviating their
effects; but shall content ourselves with pointing out the poisons most
common in this country, and the means of avoiding their dangerous

COpoisonsCeither belong to the mineral, the vegetable, or the animal
kingdom.                        „       ..         .       ••♦,«.
   Mineral poisons are commonly of an acrid or corrosive quality; as
arsnic, cobalt, the corrosive sublimate of mercury, &c.
   Those  of the vegetable kind are generally of a  narcotic or stupe-
  * As hemlock is the principal medicine recommended m this disease,vve_wou d
have given some directions for the gathering and preparing of that piam , du
as its different preparations are now kept in the shops, we think .t mucn salcr
for people to get them there, with proper directions for using them. 
OF POISONS.                       JOS
 factive quality; as poppy, hem.ock, henbane,  berries of the deadly
 night-shade, &c.
   Poisonous animals  communicate their infection either by  the bite or
 sting.   This poison is veiy diffcre.it from the former, and only produces
 its effects when received into the  body by a wound.
   MINERAL 1 OISOJNS —Aiseuic is the most common of this class;
 and, as the whole of them are pretty similar both in their effects and me-
 thod of cure, what is said with respect to  it will  be applicable to every
 other species of corrosive poison.
   Wheti a person has been taking arsenic,  he soon  perceives a burning
 heat, and a violent pricking pain in his stomach and bowels, with an into-
 lerable thirst,  and au inclination to vomit.   The tongue and throat feel
 rough  and dry  ; and,  if proper means be not soon administered, the patieut
 is seized with  great anxiety, hickuping, huntings, and coldness of the ex-
 tremities.   To these  succeed black vomits, foetid stools, with a mortifica-
 tion of the stomach aud intestines, which are the immediate forerunners
 of death.                                          -.
   On the first appearance  of these symptoms  the patient should drink
 large  quantities of new milk and  salad oil till he vomits;  or  he may
 drink  warm w ater mixed with oil.   Fat broths are likewise proper, provi-
 ded they can be got ready in time.  Where no oil is  to be had, fresh butter
 may be melted and mixed with the milk or water.  These things are to
 be drank as long as the inclination to vomit continues.  Some have drank
 eight or ten Ei glish quart:, before the  vomitiig ceased; and  it is never
 safe to leave off driuking while  one particle ofthe poison remains in the
 stomach.
   These oily or fat substances not only provoke vomiting, but  likewise
 blunt the  acrimony of the poison, and prevent its Avounding the bowels ;
 but if they should not make the person vomit, half a drachm or two scru-
 ples of the powder of ipecacuanha must be given, or a few spoonsful ofthe
 oxymel, or  viuegar of K-uills may be mixed Avith  the water which  he
 drinks.  Vomiting ma) likewise be excited by  tickling the inside ofthe
 throat  with a feather.   Should these methods however fail, half a drachm
 of white vitriol, or five or six grains of emetic tartar, must be administered.
   If tormenting pains are felt in the lower belly, a :d there is reason to
 fear that the poison has got down to ihe intestines, clysters of milk and
 oil must be very frequently thrown up; and the patient must drink emol-
 lient decoctions of barley, oat-meal, marsh-mallows, and  such  like.   He
 must likeAvise take an infusion of senna and manna, a solution of Glauber's
 salts, or some other purgathre.
   After the poison has been evacuated, the patient ought for some time,
 to live upon such things  as are of a healing and cooling quality ; to ab-
 stain from fle.di and all strong liquors, and to live upon milk, broth, gru-
 el, light puckVngs, and other spoon meats of easy digestion.   His drink
should be barley water, linseed tea, or infusions of auy of the wild muci-
laginous vegetables.
   VEGETABLE POISONS.—-Besides heat and pain ofthe stomach,
comtro ily occasion some  degree of giddiness, and often a kind of stupi-
dity o.' folly.   Persons avIio have taken these poisons must be treated iu
the same manner as for tlie mineral or corrosive.
  Though the  vegetable  poisons,  when allowed  to remain in the sto-
                                39 
BITES  OF  POISONOUS  ANIMALS.
    mach,  often proves fatal;  yet the danger  is generally over as soon
    as they are discharged.  Not beiug of such a caustic or corrosive na-
    ture, they are less apt to Avound or inflame the bowels than the mineral
    substances: no  time,  however, ought to  be lost in having them dis-
    charged.
       Opium, being frequently  taken by mistake, merits  particular atten-
    tion.   It is used as a medicine both in a solid and liquid form, which lat-
    ter commonly goes by the name of laudanum.   It is indeed  a  valuable
    medicine when  taken in proper quantity ; but as an over-dose proves a
    strong poison, we shall point out its common effects, together with the me-
    thod of cure.
       An over-dose of opium generally occasions great drowsiness, with stu-
    por and other apoplectic symptoms.  Sometimes the person has so great
    an inclination to sleep, that it is almost  impossible to keep him aAvake.
    Every method  must however be tried for this purpose.   He should be
    tossed, shaked and moved about.   Sharp blistering-plasters should be ap-
    plied to his legs or arms, and stimulating medicines, as salts of hartshorn,
    &c. held under his  nose.  It will  also be proper to let blood.   At the
    same time every method must be taken to make him discharge the poison.
    This may be done in the manner directed above, viz. by the use ofstroii"
    vomits, drinking plenty of warm Avater with oil, Ac.
       Mead,  besides vomits, in this case, recommends  acid medicines with
    lixivial salts.  He says, that he has often given salt of wormwood mixed
    with juice of lemon in repeated doses with great success.
       If the body should remain  weak aud languid after the poison has been
*■   extracted, nourishing diet and cordials will be proper; but Avhen there i9
    reason to fear that the stomach or boAvels are inflamed, the greatest cir-
    cumspection is necessary both with regard to food and medicine.

            OF THE  BITES  OF POISONOUS ANIMALS.

       We shall begin with the bite of a mad dog, as it is both the most com-
    mon and dangerous animal poison in this country.
       The creatures naturally liable to contract this disease 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-madness.  It so seldom happens that any
    person is bit by the two first,  that they scarce deserve to be taken notice
    of.  If such a thing should happen, the method of treatment is  precisely
    the same as for the bite of a mad dog.
       The symptoms of madness in a dog are as folloAV :  At first he looks
    dull, shew6 an aversion to  food  and company; he does not  bark as
    usual,  but seems to murmur, is peevish, and apt to bite strangers;  his
    ears and tail droop more than usual, and he appears drowsy.   Afterwards
    he begins to loll out his tongue, aud froth at the mouth, his eyes seeming
    heavy and watery.  He now, if not confined, takes off, runs panting along
    with a kind of dejected  air, and endeavours to bite every one he meets.
    Other  dogs are said to fly from him.  Some think this a certain  sign of
    madness,  supposing  that  they know him by the smell; but  it is not
    to  be   depended on.   If he  escapes  being  killed,  he seldom runs
    above  two or three days, till he  dies exhausted with heat, hunger and
    fatigue.                        v 
BITES OF POISONOUS ANIMALS.         307
   This disease is most frequent after long, dry, hot seasons;  and such
dogs as live upon  putrid stinking carrion,  without  having enough of
fresh water, are most liable to it.
   When any person has been bit by a dog, the strictest inquiry ought to
be made whether the animal was really mad.  Many disagreeable conse-
quences arise from neglecting to ascertain this point.  Some people have
lived in continual anxiety for many years, because they had been bit by
a dog which they believed  to be mad; but, as he had been killed on the
spot, it was impossible to ascertain the fact.  This should induce us, in-
stead of killing a dog the moment he has bit any person, to do all in our
power to keep him alive, at  least till we be certain whether he be mad or
uot.
  Many circumstances may contribute to make people imagine a  dog
mad.   He loses his master, runs about in quest of him, is set upon by
other dogs, and perhaps by men.   The creature, thus  frightened, beat
and abused, looks wild, and lolls out his tongue  as he runs along.  Im-
mediately a crowd is after  him; Avhile he, finding himself closely pur-
sued, and taking eveiy one he meets for an enemy, naturally attempts to
bite in self-defence.  He soon gets  knocked on the head, and it passes
currently that he was mad, as it is then impossible to prove the contrary.
   This being the true  history ot; by far, the greater part of those dogs
which pass for mad, is it any wonder that numberless whimsical medi-
cines have been extolled for preventing the effects of their bite ?   This
readily accounts for tiie great variety of infallible remedies for the bite
of a mad dog, which are to be met with in almost every family. Though
not one iu a thousand has any claim to merit, yet they are all supported
by numberless vouchers.  No wonder that imaginary diseases should be
cured by imaginary remedies.  In this way, credulous people first im-
pose; upon themselves, and  then deceive others.  The  same medicines
which  was supposed to prevent the effects of the bite, when the dog was
not mad,  is recommended to a person Avhohas had the misfortune to be
bit by a dog that was really mad.   He takes it, trusts to it, and is undone.
   To these mistakes we must impute the frequent ill success of  the medi-
cines used for preventing the effects of the bite of a mad dog.  It is not
owing so much to a defect in medicine, as to wrong applications.   I am
persuaded, if proper medicines were administered  immediately after the
bite is received, and continued for a sufficient length of  time, we should
not lose  one iu a  thousand of  those who  have the misfortuue   to be
bit by a mad dog.
   This poison is generally communicated by a wound, which neverthe-
less heals as soon as a common wound :  but afterwards  it begins to feel
painful, and as the pain spreads towards the neighbouring parts, the per-
son becomes heavy and  listless.  His sleep is unquiet  with frightful
dreams; he sighs, looks  dull, and  loves solitude.  These are the fore-
runners or rather the first symptoms of that dreadful disease occasioned
by the bbe of a mad dog.  But as we do not propose to treat fully of the
disease itself, but to point out the method of preventing it, we shall not
take up time in shewing its progress from the first invasion to its com-
monlv fi'al end.                                  u  .  ,  ,
  The  common notion, that this poison may he in the boefy for many
years, and  afterwards  prove fatal, ;s both hurtful and  ridiculous. It
must render such  persons as have  had  the misfortune  to be bit very 
308         BITES OF  POISONOUS  ANIMALS.
unhappy, and can have no good effects.  It the person  takes proper
medicines for forty days after the time of his being bit, and  feels uo
symptom of the disease, there is reaso.i to believe bun out of danger.
   The  medicines recommended  for prevc>i <g the  effects  of the bite
of a mad dog, are chiefly such as promote the d'fferent secretions, and
antispasmodics.
   Dr. Mead recommends a preventive medicine, which be says he never
knew fail, though in the space of  thirty jears he had used it a thousand
times.
   The Doctor's prescription is as follows:
   " Take  ash-coloured ground  liver-wort, cleaned, dried, and powdered,
half an ounce;  of  black pepper powdered,  a (|uater  of an  ounce.
Mix these well together, and divide the powder into four doses ; one of
which must  be t. ken every morning fasting, for four mornings  succes-
 sively, in half a pint of cows milk warm.
   " After these four doses are  taken, the patient must go into the cold
 bath, or a cold spring or river, every morning  fasting, for a month;  he
 must be dipped  all  over, but  not stay in (with his head above water)
 longer  than half a minute, if the Avater be very cold.   After this he.
 must go in three times a-week  for a fortnight longer.
    " The person  must be bled before he begins to use the medicine.*"
    We shall next mention the famous East-India specific as it is called.
 This mediciue is composed of cinnabar and musk.  It is esteemed a great
 antispasmodic ;  and, by many, extolled as an infallible remedy  for pre-
 venting the effects of the bite of a mad dog.
    "Take native and  factitious  cinnabar, of each twenty-four grains,
 musk sixteen grains.  Let these be made into a fine powder, and taken
 in  a glass of arrack or brandy."
    This single dose is said to secure the person for  thirty  days, at  the
  end of which it must be repeated ; but if he has any symptoms  of the
  disease, it must bo repeated in three hours.
     The folloAving is likeAvise reckoned a good antispasmodic medicine :
     " Take  of Virginian snake-root in poAvder, half a drachm, gnm asa-
  fcetida twelve grains, gum camphire seven grains; make these into a bo-
  lus Avith a little syrup  of saffron."
     Camphire may also be given in the following manner :
     « Take purified nitre half an ounce, Virginian snake-root  in powder
   two drachms,  camphire one  drachm; rub  them together in a mortar,
   and divide the  Avhole into ten  doses."
     Mercury is  likewise recommended as of great efficacy,  both in the
   prevention and cure of this kind of  madness.   When uesd as a preven-
   tive, it will be sufficient to  rub daily a drachm of the  ointment into the
   parts about the wound.
     Vinegar is likewise of considerable service, and should be taken free-
   ly, either in the patient's food or drink.
     These are the principal medicines recommended  for preventing the
   effects of  the bite of  a mad dog. We  would not however advise  peo-

     * Though we give this prescription on the credit of Dr. Mead, yet we
   would not  advise any person, who has reason to believe that  he nas oeen oit
   bv a doe; which was really mad, to trust to it alone.   Mead was  an able phy-
   sician, but he seems to have been no  great philosopher, and was sometimes
   the dupe of his own credulity. 
BITES OF  POISONOUS  ANIMALS.           309
pie to trust any one of them; but from a proper combination of their dif-
ferent powers, there is the greatest reason to hope for success.
   The great error in the use of these medicines, lies in not taking them
for a sufficient length of time.   They are used more like charms,  than
medicines intended to  produce any change in the body.   To this, and
not to the insufficiency of the medicines, we must impute their frequent
want of success.
   Dr. Mead says, that the virtue of his medicine  consists in promoting
urine.   But how  a poison should be expelled by urine, with  only three
or four doses of any medicine,  however powerful, it is not easy to con-
ceive.   More time is certainly necessaiy, even though the medicine  Avere
more powerful than that which  the Doctor prescribes.
   The East-India specific is still more exceptionable on this account.
   As these and most other medicines, taken singly, have frequently been
found to fail, we shall recommend the following course:
   If a  person is bit in a fleshy part, where there is no hazard of hurting
any large blood-vessel, the pails adjacent to the Avound may be cut away.
But if this be not done soon after the bite has been received, it will be
 better to omit it.
   The wound may be dressed with salt and water, or a pickle made of
 vinegar and salt, and afterwards dressed twice a-day with yellow basifi-
 con, mixed ivith red precipitate of mercury.
   The patient should begin to use either Dr. Mead's medicine, or some
of the others mentioned above.   If he  takes Mead's medicine, he may
use  it as the  Doctor directs for four days successively.  Let him then
 omit it for two or three days, and again repeat the same number of doses
 as before.
   During this course, he must rub into the parts about the wound, daily,
 one drachm of the  mercurial  ointment.  This may be done for ten or
 twelve days at least.
   When this course is over, he may take a purge or tAvo, and wait  a few
 days till the  effect of  the mercury be gone  off. He must then begin to
 use the  cold bath, into which he may go every morning for  five or  six
 weeks.   If he should feel cold and chilly for a long time after coming
 out of the cold bath, it will be better to use a tepid one, or to have  the
 water a little warmed.
   Iu the meantime Ave would advise him not to leave off all internal me-
 dicines, but to take either one of the boluses of snake-root, asafcetida, and
 camphire; or one of the powders of nitre, camphire, and snake-root, twice
 a-day.   These may be used during the whole time he is bathing.
   During the use of the mercurial ointment, the patient must keep within
 doors, and take nothing cold.
   A proper regimen must be observed throughout the whole course. The
 patient should abstain from flesh, and all salted aud high-seasoned provi-
 sions,   lie must avoid strong licniors, and live mostly upon a light and ra-
 ther spare diet.   His mind should be kept as easy and cheerful as  possi-
 ble, and all excessive heat and violent passions avoided with the utmost
 care.
   I have never seen this course of medicine, with proper regimen, fail to
 prevent the hydrophobia, and cannot help again observing, that the want
 of success must  generally be owing  either to  the application of improper
 medicines, or not using proper ones for a sufficient  length of time. 
BITES  OF  POISONOUS  ANIMALS.
   Mankind are extremely fond of every thing that promises a sudden or
miraculous cure.   By trusting to these they often lose their lives, when
a regular course of medicine would have rendered diem absolutely sale.
This holds remarkably in the present case.   Numbers of people, for ex-
ample, believe if they or their cattle were once dipped iu the sea, it is
suikcient;  as  if the  salt Avater  were a charm against the effects of the
bite.  This, and such like whims, have proved fatal to many.
  It is a common notion, if a person be  bit by a dog which is not mad,
that, if he should go matl  afterwards, the person Avould be affected with
the disorder at the same time ; but this notion is too ridiculous to deserve
a serious consideration.   It is a good rule, however, to avoid dogs as
much as  possible, as  the disease  is often upon them for some time before
its violent symptoms appear.   The hydrophobia has been occasioned by
the bite of a dog Avhich sheAved no otlier symptoms of the disease but list-
lessness and a  sullen disposition.
   Though we do uot mean to treat fully of the cure of the hydrophobia,
yet Ave are far from reckoning it incurable.   The notion that this disease
could not be cured, has been productive of the most horrid consequences.
It was usual either to abandon the unhappy persons, as soon as they were
seized Avith the disease, to their fate, to bleed them to death, or to suffo-
cate them between mattrassesor feather-beds, Ac.  This conduct certain-
ly deserved the severest punishment!  We hope, for the honour of human
nature, it "will never again be heard of.
  I have never had an opportunity of treating this disease, and therefore
can say nothing of it from my own experience ;  but the learned Dr. Tissot
says, it may be cured in the folloAving manner:
   1.  The patient must be bled to a considerable quantity, and  this may
be repeated twice, or thrice, or even  a fourth time, if circumstances  re-
quire it.
   2.  The patient should be put, if possible, into a warm bath; and this
should be used tAvice a-day.
   3.  He should every day  receive tAvo, or even  three emollient clys-
ters.                                                             .
   4.  The wound, and the parts adjoining to it, should  be  rubbed with
the mercurial ointment twice a-day.
   5.  The  whole limb Avhich contains the wound should be  rubbed with
oil, and be wrapped up in an oily flannel.
   6.  Every three hours a dose of Cob's powder should be taken in a
cup of the infusion of lime-tree  and elder flowers.   This powder is
made, by rubbing together in a  mortar, to  a very fine powder of native
and factitious cinnabar,  each  twenty-four grains;   of  musk,  sixteen

^V" The  following bolus is to be given  every night,  and to be  re-
peated in  the morning, if  the patient  is  not eas/, washing it down
with  the infusion mentioned above:  Take one drachm of Virginian
snake-root  in  powder;  of camphire  and asafcetida,  ten grains each;

  * The Qrmskirk medicine, as it is called, seems to me to consist chiefly of
cinnabar.   Though it is said to  be  infallible, a* a preventive j yet I wouiu not
advise any one to trust to it alone.   Indeed it is ordered to be taken in a ™"™r
which gives it more the appearance of a charm  than of a medicine   surei) n a
medicine is to produce any change in the  body, it must be taken tor some con-
siderable time, and in sufficient quantity. 
LUTES OF POISONOUS ANIMALS.          311
of opium, one grain; and, with a sufficient quantity of conserve, or rob
of elder, make a bolus,
   8. If there be  a great nausea at the stomach, with a bitterness in the
mouth,  thirty-five or forty grains of ipecacuanha, in  powder, may be
taken for a vomit.
   9. The patient's food, if he takes any, must be light: as panada, soups
made of farinaceous or mealy vegetables, Ac.
   10.  If the patient should long continue weak  and subject to terrors,
he may take half a drachm of the Peruvian  bark thrice a-day.
   The next poisonous animal which we shall  mention is the VIPER.
The grease of this animal rubbed into the wound, is said to cure the bite.
Though that is ail the viper-catchers generally do when  bit, we should
not think it sufficient for the bite of an enraged viper.   It would surely
be more safe to  have the wound well sucked,* and afterwards rubbed
with warm salad-oil.f   A poultice of bread and milk, softened with sa-
lad-oil, should  likeAvise 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 sAveat.   Vinegar is one of the best medicines which can be used in
any kind of poison, and ought to be taken very liberally.   If the patient
be sick he may take a vomit.  This course will be sufficient to cure the
bite of any of the poisonous animals of this country.
   With regard to poisonous insects, as the bee, the  Avasp, the hornet,
Ac. their stings are seldom attended with danger, unless Avhcn a person
happens to be stung by a great  number of them  at the same time; in
which case something  should  be done to  abate the inflammation and
swelling.   Some, for this purpose, apply lioney, others lay pounded
parsley  to the part.   A mixture  of  vinegar  and Venice  treacle ir-
likewise recommended;  but  I have  always found rubbing the part with
Avarm  salad-oil succeed  very well.   Indeed, when the stings are so nu-
merous as to endanger the patient's life, Avhich  is sometimes the case, be
must not only have oily poultices applied to the part, but should like-
Avise be bled,  and  take some cooling medicines,  as nitre, or cream of
tartar, and should drink plentifully of diluting  liquors.
   It is the  happiness of this island to have  very few poisonous animals,
and those which  we have are by no means  of the most virulent kind.
Nine-tenths of the effects attributed to poison or venom in this country
are really other diseases, and proceed from quite different causes.  .
   We cannot however make the same observation with regard to poison-
ous vegetables.   These abound every  Avhere, aud prove often fatal to
 the ignorant and unwary.  This indeed is chiefly OAving to carelessness.
Children ought  early to be  cautioned against eating any kind of fruit,

   • The practice  of sucking out poisons is very ancient;  and indeed nothing
can be more rational.  When the bite cannot be cut out, this is the most likely'
way for extracting the poison.  There can be no danger in performing this of-
fice, as the poison does no harm unless it be taken into the body by a wound.
The person who sucks the wound, ought however to wash his mouth frequently
with salad-oil, which will secure him from even  the least inconveniency  The
Psvlli in Africa, and the Marsi  in Italy, were famed for curing the bites of
poisonous animals by sucking the wound ; and we are told, that the Indians in
North-America practise the same at this day.
   f Salad or sweet qil, not only applied outwardly, but taken inwardly, is not
only efficacious in  curing the bite ofthe Viper, but  also ofthe rattle-snake.
                                                             a. x. 
312
BITES OF POISONOUS ANIMALS.
 roots, or berries, which they do not know; and all poisonous  plants to
 Avhich they can have  access, ought, as far as possible, to be destroyed.
 This would not be so difficult a task as some people imagine.
   Poisonous plants have no doubt  their use, and they ought to be pro-
 pagated in proper  places; but  as they often prove destructive to cattle,
 they should be rooted  out of all pasture-grounds.   They ought likewise,
 for the safety of the human  species, to be destroyed in the neighbourhood
 of all towns and villages; which, by the bye, arc the places where they
 most commonly abound.   I  have seen the poisonous hemlock, henbane,
 wolfs-bane, and deadly nightshade, all growing within the environs of a
 small town, where, though several persons, Avithin the memory of those
 living in it, had lost their lives by one or other of these 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 expense.
   Seldom a year passes but we have accounts of several persons poisoned
 by eating hemlock-roots instead  of parsnips,  or some kinds of fungus
 Avhich they had gathered, for mushrooms.   These examples ought to put
 people upon their guard with respect to the former, and to put the latter
 entirely out of use.   Mushrooms may be  a delicate dish, but they arc
 a dangerous one, as they are generally gathered by persons who do not
 knoAv one kind of fungus from another, and take every  thing for a  mush-
 room which has that appearance.
   We might here  mention many other plants and animals of a poison-
 ous nature which are found in foreign countries; but as our observations
 are chiefly  intended for this island, we  shall pass these over.   It may
 not however be amiss to observe, for the benefit of such of our country-
 men as go to America, that an  effectual remedy is hoav said to be  found
 for the bite of the  rattle-snake.—The prescription is as  follows:  Take
 of the  roots of plantain and horehound, in summer, roots and branches
 together, a sufficient quantity;  bruise them in a mortar, and squeeze out
 the juice, of which give, as  soon as possible, one large spoonful;  if the
 patient be swelled, you must force it down his throat.   This generally
 will cure;  but if he finds no relief in an hour after, you may give ano-
 ther spoonful, Avhich never fails.—If the roots are dried, they must  be
 moistened with a little water.   To the Avound may be applied a leaf of
 *ood tobacco moistened with rum.
 B  We give this upon the faith  of Dr. Brookes, who says it was the in-
 vention of a negro; for the  discovery of which  he had his freedom pur-
 chased, and a hundred pounds  per annum settled upon him during life,
 by the general Assembly of  Carolina.
   It is possible there may be in nature specific remedies for every kind of
 poison; but as we  have very little faith  in any  of those which have yet
 been pretended to  be discovered,  we shall  beg leave again to recommend
 the most strict attention to the following rules, vis.  That when  any poi-
sonous substance has been taken into the  stomach, it  ought as soon as
 possible to be discharged by vomits,  clysters,  and purges; aud, when
 poison has been received into the body by a wound, that it be expelled
by medicines which promote the different  secretions, especially tho^e of
sweat, urine, and insensible  perspiration;  to which maybe joined anti-
spasmodics, or such medicines as take off tension and irritation;  the duel
of ishich are opium, musk, camphire, and asafcetida. 
PF THE VENEREAL  £>iSEASE.
313
  KETTERING'S SPECIFIC  FOR THE HYDROPHOBIA.

  Extract from  the Journals of the Legislature of Pennsylvania, of
                         March 6, 1802.

  «' The committee appointed to hear the communication of Valeutine
Kettering, relative to his cure of the bite of a mad animal,
  Report—" That they conferred with the said Kettering on that sub-
ject, who informed them, that he uses the herb called Red Chickweed,
which, when ripe, or in full bloom, he gathers, and dries in the shade,
reduces it to a powder, and gives a small table-spoonful at one time, to a
grown persou, in beer or water, in weight one drachm and one scruple:
for  a child, an equal dose, but given at three different times, or it may
be eaten on bread with butter, honey, or molasses, as the person chuses.
For a beast, a large  spoonful;  if by weight, two drachms and one  scru-
ple.  When used green for a beast, cut the herb fine, and mix with bran,
&c.  When given to sivine,  mix the powdered herb with meal  of any
kind (dose as above) in little balls.
  " He assures us that he ha6 given it to persons many Aveeks after they
were bitten, and  never knew it fail; and never gives  more than a single
dose, unless to children, as above.  He further says, that it is an excel-
lent cure for cuts or wounds on the human body.
  " When green, mash it; drop of  the juice into the wound, and bind
the herb, so mashed, on.   The proper time to sow the seed is about the
beginning of April, and it should be sown thin.
  " They also learn, from the Rev. Henry Muhlenberg, that it is  an
annual plant, known in Switzerland and Germany, by the name of Gauch-
heil, Rother Meyer, or Rother Hunerdarm; in England, Red Pimper-
neil; by botanists, as he is informed, Anagallis Phoenicea.  That it should
be gathered in Juue, when in full blossom.  In Germany, he understands
the usual dose Avas thirty grains of the powder, taken four times a-day,
and continued one week, in smaller doses; the wound washed with a de-
coction of the herb, and some of the powder strewed in it.  That the
plant is cultivated in many gardens, and grows near Baltimore and Havre-
de-Grace, spontaneously, in great plenty."
                       CHAP.  XLIX.

               OF THE VENEREAL DISEASE.

       IN" the first edition of  this book,  the venereal disease Was
omitted.   The reasons however which at that time induced me to leave
it out, have upon more mature consideration vanished.  Bad consequen-
ces, no doubt, may arise from ignorant persons tampering with medicine
in this disorder; but the danger from that quarter seems to be more than
balanced by the great and solid advantages, which must arise to the  pa-
tient from an early knowledge of  his case, and an attention to a plan of
regimen, Avhich, if it dors  not cure the disease, will be sure to re«Jer it
more mild, and  less hiufful to the constitution.
                               40 
3JL4r       OF  THE  VIRJJLENT  GONORRHOEA.

  It is peculiarly unfortunate for the unhappy persons who contract this
disease, that it  lies under a sort of  disgrace.  This renders disguise \n--
cessary, and makes the patient  either conceal his disorder altogether, or
apply to those  who-promise a sudden and  secret cure;  but who-in fact
only remove the symptoms for a time, while they fix the disease deeper
in the habit.  By this means a slight infection, Avhich might have been
easily removed, is  often convertedinto an obstinate, and sometimes an
incurable malady.
   Another unfavourable circumstance  attending this  disease  is,  that
it assumes  a variety of different  shapes,  and may  with more  proprie-
ty  be called an  assemblage of diseases, than a single  one.   No two
diseases can require a  more different method  of  treatment than this
does in  its different stages-  Hence the folly of trusting to any parti-
cular nostrum  for the cure of it.  Such nostrums are however generally
administered in the  same manner to all who apply for them, without the
least regard to the state of the disease,  the constitution of the patient,
the degree of  infection, and a thousand other circumstances of the  ut-
most importance.
   Though  the venereal disease is generally the fruit of unlawful em-
braces,, yet it may be communicated to the  innocent as Avell as the guilty.
Infants, nurses, midwives, and  married women whose husbands  lead dis-
solute lives, are often affected with it, and  frequently lose their lives by
not being aware of their danger in due time.   The  unhappy condition
of  such  persons will certainly plead our excuse, if any excuse be neces-
sary, for endeavouring to point out the symptoms and  cure of this too
common disease.
   To enumerate all its different symptoms, however, and to trace the
disease minutely through its various  stages, would  require  a much
larger space than falls to this part  of my subject; I shall therefore con-
fine my observations chiefly to circumstances of importance,  omitting
such as are either trifling, or which occur  but seldom.   I shall likewise
pass over the history of the disease, with the different methods  of treat-
ment which it has undergone  since it Avas first introduced into Europe,
and many other circumstances of  a similar nature; all of which though
they might tend to amuse the reader, yet could afford  him little or no>
useful knoAvledge.

            OF  THE  VIRULENT  GONORRHOEA.

   THE virulent Gonorrhoea  is an involuntary discharge of infectious
matter from the  parts of generation in  either sex.   It generally makes
its appearance within eight or ten days after the infection has  been re-
ceived ; sometimes indeed it appears in two or three days, and at  other
times not before the end of four or five Aveeks.  Previous to the discharge
the patient feels an itching, Avith a small degree of pain in the genitals.
Afterwards a thin glary matter begins to distil from tlie .urinary passage,
which stains the linen, and occasions a small degree of titillation,  parti-
cularly at the time, of making water; this gradually increasing, arises at
length to a degree of heat and pain, which are chiefly perceived about
the extremity of  the  urinary passage,  Avhere a slight degree of redness
and inflammation likewise begin to appear.
   As the disorder adAances, the pain, heat of urine,  and running,  in* 
             OF THE  VIRULENT  GONORRHOEA.       315

•crease, while fresh symptoms daily ensue.   In men, the erections become
painful and involuntary, and are  more frequent and lasting than when
natural.   This symptom is most troublesome when the patient is warm in
bed.   The pain which was at first only perceived toAvards the extremity,
now begins to reach all up the urinary passage,  and is most intense just
after the patient has done making water.   The running gradually recedes
from the colour of seed, grows yellow, and at length puts on the appear-
ance of mucus.
   When the disorder has arrived  at its  height, all the symptoms are
more intense ; the heat of the urine is so great, that the patient dreads
the making Avater;  and  though he feels a constant inclination this way,
yet  it is rendered  with the greatest difficulty, and often only by drops:
the involuntary erections noAV become extremely painful and frequent;
there is also a pain, heat, and sense of fulness about the seat, and the run-
ning is plentiful and sharp, of a brown,  greenish,  and sometimes of a
bloody colour.
   By a  proper treatment, the violence  of  the symptoms  gradually
abates;  the heat of urine goes off;  the involuntary and painful erections,
and the  heat and pain about the seat,  become  easier;  the running also
gradually  decreases, grows whiter and tlticker, till at last it entirely dis-
appears.
   By attending to  these symptoms the gonorrhoea may be generally dis*
tinguished from any  other disease.   There are however some few disor-
ders for which it may be mistaken, as an ulcer in the kidnies or bladder,
the fluor albus,  or whites in Women, &c.   But in the former of these, the
matter comes away only Avith the urine, or  when the sphincter of the
bladder is open; whereas  in the  gonorrhoea  tlie discharge is constant.
The latter is more  difficult to distinguish, and  must be known chiefly
from its effects, as  pain, communicating the infection, Ac.
   REGIMEN.—When a person has reason to expect that he has caught
the venereal infection, he ought  most strictly  to observe a  cooling regi-
 men, to avoid every thing of a heating nature, as Avines, spiritous liquorg,
rich sauces, spices, salted, high seasoned and smoke-dried provisions, Ac.
 also all aromatic and stimulating vegetables, as onions, garlic, shallot, nut-
 meg, mustard, cinnamon, mace, ginger,  and such like.   His food ought
 chiefly to  consist of mild vegetables, milk,  broths, light puddings, panada,
 gruels, &c.  His drink may be barley-water, milk and water, decoctions
 of nnrsh-mallows and liquorice, linseed tea, or clear whey.   Of these he
 ought to drink plentifully.   Violent exercise of all kinds, especially riding
 on horse-back, and venereal pleasures,  are to be avoided.   The patient
 must  beware of cold, and when die inflammation is violent, he ought to
 keep his bed.
   MEDICINE.—A virulent gonorrhoea cannot always be cured speed-
 ily and effectually at the same time.  The patient ought therefore not to
 expect, nor the physician to promise it.   It AriU often continue for two
 or three weeks, and sometimes for five or six, even where the treatment
 has been very proper.                                £
   Sometimes indeed a slight infection may be carried offin It tew days,
 by bathing the  parts in warm milk and water, and  injecting frequently
 up the urethra a little sweet oil or linseed tea, about tlie warmth of new
 milk.  Should  these not succeed in carrying off the infection, they will
 at least have a  tendency to lessen its virulence. 
316         OF  THE  VIRULENT  GONORRHOEA.

   To effect a cure, howevTer, astringent injections will be found necessa-
ry.  These may be various ways prepared, but I think those made with
the white vitriol are both most safe and efficacious.  They can be made
stronger or Aveaker as circumstances  may require; but it is best to begin
with the more gentle, andincrease their poAver if uecessary.   I generally
order a drachm of white vitriol to be dissolved in eight or nine ounces of
common or rose Avater, and an ordinary syringe full of it to be thrown up
three or four times a-day.   If this quantity does not perform a cure, it may
be repeated, aud the dose increased.*
   Whether injections be used or not, cooling purges are always proper in
a gonorrhoea.  They ought not,  however, to  be of the strong or drastic
kind.   Whatever raises a  violent commotion in the body increases  the
danger, and tends to drive the disease deeper into the habit.   Procuring
two or three stools every second or third  day for the first fortnight, and
the same number every fourth  or fifth day for the second, will generally
be sufficient to remove the inflammatory symptoms, to diminish the run-
ning, and to change its colour and consistence.  It gradually becomes more
Avhite and ropy as the virulence abates.f
   When the  inflammatory  symptoms run  liigh,  bleeding  is always
necessary  at the beginning.  This operation, as in other  topical in-
flammations,  must be repeated according to the strength  and  consti-
tution  of  tlie patient, and the  vehemence, aud urgency of the symp-
toms.
    Medicines Avhich promote  the secretion of  urine  are likewise  pro-
 per iu this stage of the disorder.   For this purpose  an ounce of nitre
 aud  two ounces of gum  arabic, pounded  together,  may  be divided
 into  twenty-four doses, one of which may be taken frequently in a cup
  * Although it is now very common to cure the gonorrhoea by astringent injec-
tions, there are  still many practitioners who do not approve this mode of prac-
tice. I can, however, from much experience, assert that it is both the most easy,
elegant, and efficacious method of cure; and that any bad consequences arising
from it must be owing to  the ignorance or misconduct of the practitioner him-
self, and not to the remedy.   Many, for example, use strong preparations of
lead, all of which are dangerous when applied to the internal surfaces of the bo-
dy ; others use escharotics, which inflame and injure the parts.   I have known a
gonorrhoea actually cured by an injection made of green tea, and would always
recommend gentle methods where they will succeed.
  f If the patient can swallow a solution of salts and manna, he may take six
drachms, or, if his constitution requires it, an  ounce of the former, with half an
ounce of the latter.  These may be dissolved in an English pint of boiling wa-
ter, whey, or thin water-gruel, and taken early in the morning.
  If an infusion of senna and tamarinds be more agreeable, two drachms ofthe
former,  and an ounce of the latter, may be infused all night in an English pint of
boiling water.  The infusion may be strained next morning, and half an ounce
of Glauber's salts dissolved in it.  A tea-cupful of this infusion may be taken
every half hour til it operates.
  Should the patient prefer an electuary, the  following will be found to answer
very well.  Take of the  lenitive electuary four ounces, cream of tartar, two
ounces, jalap in powder, two drachms, rhubarb, one drachm, and as much ofthe
syrup of pale i%ses as will  serve to make up the whole into a'soft electuary. Two
or three tea-spoonsful of this may be taken over night, and about the same quan-
tity next morning, every day that the patient chuses  to take a purge.
  The doses of the above medicines may be increased or diminished according
as the patient finds it necessary.  We have ordered the salts to be dissolved in a
large  quantity of water, because it renders their operation more mild. 
OF THE  VIRULENT GONORRHOEA.        317
of the patient's drink.  If these should make him pass his urine so often
as to become troublesome to him, he may either take them less frequently,
or leave out the nitre altogether, and take equal parts of gum arabic and
cream of tartar.   These may be  pounded  together, aitfr a tea-spoonful
taken in  a cup of the patient's drink four or five times a-day.  I have
generally found this ansAver extremely well, both as  a  diuretic and for
keeping the body gently open.
   When the pain and inflammation are seated high, towards the neck of
the bladder, it Avill be proper  frequently to throw up an emollient clys-
ter, which, besides the benefit of procuring stools will serve as a fomenta-
tion to the inflamed  parts.
   Soft poultices, Avhen they can  conveniently be applied  to  the parts,
are of great service.  They may  be made of the flour of  linseed, or of
wheat-bread and milk, softened with fresh  butter, or sweet oil.   When
poultices cannot be conveniently  used, cloths wrung out of warm  Avater,
or bladders filled with warm milk and ivater, may be applied.  I have
known most excruciating  pains, during the inflammatory state of the go-
norrhoea, relieved by one or other of these applications.
   Few things tend  more to keep  off inflammation in the spermatic ves-
sels than a proper truss for the scrotum.  It ought to be so contrived as
to support  the testicles, and should be worn from the first appearance of
the disease till it has ceased some  weeks.
   The above treatment Avill sometimes remove tho gonorrhoea so quick-
ly, that the person will be in doubt Avhether he really laboured under that
disease.   This however is too favourable a turn to  be often  expected.
It more frequently happens, that  we are only able to procure an  abate-
ment or remission of the inflammatory symptoms, so far as to make it safe
to have recourse to the great antidote mercury.
   Many people on the first appearance  of a gonorrhoea, fly to the use of
mercury.   This is  a bad  plan.  Mercury is often not at all necessary in
a gonorrheal; and Avhen taken too early it  dors mischief.
   It may be necessary to complete the cure, but can never be proper at
the commencement  of it.
   When bleeding,  purging, fomentations, and the other things recom-
mended as above, have eased the pain, softened the pulse, relieved the
heat of urine, and render the involuntary erections less  frequent, the pa-
tient may begin to use mercury in any form that is least disagreeable to
him.
   If he takes the common mercurial pill,  two at night and one in tlie
 morning Avill be a sufficient dose at  first.  Should they affect  the mouth
 too much, the dose must be lessened; if not at all it may be gradually-
 increased  to five or six pills in the day.  If calomel bethought prefera-
 ble, two or three grains  of it, formed into a bolus Avith a little of the con-
 serve of hips, may be taken at bed-time, and the dose gradually increased
to eight or ten grains.  One of the most common preparations of mercury
uoav iu use is the corrosive sublimate.   This may be taken in the manner
afterwards recommended under the confirmed lues or pox^' I haAte always
found it one of the most safe and efficacious medicines Avhen properly used.
   The above medicines may either be  taken  every day or every other
day, as the patient is able to bear them.   They ought never to be taken
 in such quantity as to raise a  salivation, unless in a  very  slight degree.
 The disease may be more safely, and as certainly cured ivithout a sali- 
318         OF  THE  VIRULENT  GONORRHOEA.
vation as with it.  When the mercury runs oil'by the mouth, it is not sn
successful in carrying off the disease, as when  it continues longer in the
body, and is ducharged gradually.
  Should theTptient be purged or griped in the night by the  mercury,
he must take an infusion of senna, or some other purgative, and drink
freely of water-gruel,  to  prevent  bloody stools, which are veiy apt to
happen should the patient catch cold, or if the  mercury has not been du-
ly prepared.  Wlien the bowels are weak and the mercury is apt to gripe
or purge, these disagreeable consequences may be prevented by  takiug,
with the above pills or bolus, half a drachm or two scruples of diascor-
dium, or ofthe Japonic confection.
   To prevent the disagreeable circumstance of  the  mercury's affecting
the mouth too much, or bringing on a salivation, it may be combined with
purgatives. With this view tlie laxative mercurial pill has been contrived,
the usual dose of which is half a drachm, or three pills, night and morn-
ing, to be repeated every other day;  but the safer  way for the patient
to begin Avith two, or even Avith one pill, gradually increasing the dose.
   To such persons as  can neither swallow a  bolus nor a  pill, mercury
may be given in a liquid form, as it can be suspended even in a watery ve-
hicle, by means of gum-arabic; which not only serves this purpose, but
likewise prevents the mercury from affecting  the mouth, and renders it
in many respects a better medicine. *
   It happens very fortunately for those who cannot be  brought  to take
mercury inwardly, and likeAvise for persons Avhose bowels are too tendeT
to bear it, that an external application of it will answer equally well, and in
some respects better.   It must  be acknowledged, that mercury, taken
inwardly  for any length of time, greatly weakens and disorders the bow-
els; for which  reason, when a plentiful use of it becomes necessary, Ave
Avould prefer rubbing to the mercurial pills.  The common mercurial or
blue ointment will answer very well.   Of that which is made by rubbing
together equal quantities of hog's lard and quicksilver, about  a  drachm
may  be used at a time.  The best time for  rubbing it on is at night,
and the most  proper  place the inner side of  the thighs.   The patient
should  stand before the fire when he rubs, and should Avear flannel draw-
ers next his skin at the time he is using the ointment.  If ointment of a
Areaker or stronger kind be  used,  the quantity must  be increased or di-
minished in proportion.
   If during the  use  of  the ointment,  the inflammation of the  genital
parts, together  with the heat  and feverishness,  should  return,  or if
the mouth  should  grow  sore, the gums  tender,  and the breath  be-
come  offensive, a  dose  or  two  of  Glauber's salts,  or some other
cooling purge, may be taken and the rubbing intermitted  for a feAV
days.   As  soon hoAvever as  the  signs of spitting are gone off, if the
virulency be not quite corrected, the ointment must be  repeated, but
in smaller quantities, and at  longer intervals than  before.   Whatever
  * Take qufcksilver one drachm, gum-arabic reduced to a mucilage two
drachms; let the quicksilver be rubbed with the mucilage, in a marble inortar,
until the globules of mercury entirely disappear;  afterwards add gradually,
Still continuing the trituration, half an ounce of balsamic syrup, and eight
ounces of simple cinnamon-water.  Two table-«poonsful of this  solution may
be taken night and morning.  Some reckon this the best form in which quicks
silyer can be exhibited for the cure of a gonorrhaa. 
OF GLEETSr                     gig
way mercury is administered, its use may be persisted in as long as any
virulency is suspected to- remain.
   During this which may be  called the second stage of the disorder,
though so strict a regimen is not necessary  as in the fijr_j_ox inflammato-
ry state, yet intemperance  of every kind  must be avoided   The food
must be light, plain, and of easy digestion; and the greatest indulgence
that may be allowed with respect to drink is, a little wine diluted with a
sufficient quantity  of  water.   Spirituous   liquors are to be avoided in
every shape.  I have often known the inflammatory symptoms renewed aud
heightened, the running increased,  aud the  cure rendered extremely dif-
ficult and tedious, by one fit of excessive drinking.
   When the above treatment has  removed the heat of urine, and the
soreness of the  genital  parts; when the quantity of running is considera-
bly lessened, without any paiu or sAvelling  in the groin or testicle super-
vening; Avhenthe patient is free from involuntary erections; and lastly,
when the running becomes pale, whitish, thick, void of  ill smell, and  te-
naceous or ropy; when all or most of these symptoms appear, the gonorr-
hoea is arrived at its last stage, and Ave may gradually  proceed  to treat it
as a gleet with astringent and agglutinating medicines.


                          OF  GLEETS.


   A Gonorrhoea frequently repeated, or improperly treated, often ends
in a gleet, which may either proceed from  a relaxation, or from some re-
mains of the disease.   It is however of the greatest importance in the
cure of  the  gleet,   to know  from  which of these causes it  proceeds.
When the discharge proves very obstinate, and receives little or no check
from astringent remedies, there is ground to suspect that it is owing to
the latter; but  if the drain is inconstant, and is chiefly observable Avhen
the patient is stimulated by lascivious ideas, or upon straining to go to
stool, we may reasonably conclude that it is chiefly owing to the former.
   In the cure of a  gleet proceeding from relaxation,  the principal de-
sign is to brace, and restore a proper degree of tension to the debilitated
and relaxed vessels.  For this purpose, besides the medicines recommend-
ed in the gonorrhoea, the patient may have  recourse to stronger and more
powerful astringents, as the Peruvian bark,* alum, vitriol, galls, tormen-
til, bistort, baldustines,  tincture of gum kino, Ac.  The injections may
be rendered more astringent by the addition of a few grains of alum,  or
increasing the quautity of vitriol as far as the parts are able to bear i'..
   The last remedy  Avhkh we shall mention in this case  is the cold bath
than which there is not perhaps a more powerful bracer in the whole com-
pass of medicine. .  It ought never to be omited in this species of gleet,
  * The Peruvian bark may by combined with other astringents, and prepar-
ed in the following manner :■                               , *
  Take of Peruvian bark bruised  six drachms, of fresh galls  bruised two
drachms,  boil them in a pound and an half water to a pound : to tlie strained
liquor add three ounces'ot* the simple tincture ofthe bark:  A small tea cup
ful of this may be taken three times a-day, adding to each cup fifteen or twenty
drops of the acid elixir af vitriol. 
320
OF CLEETS.
 unless there be something in the constitution ofthe patient which renders
 the use of it unsafe.   The  chief objections to the use of the cold bath
 are a full habitiand an unsound  state of the viscera.   The danger from
 the former  majl always be  lessened,  if  not removed, by purging and
 bleeding; but "the latter is  au insiumountable obstacle, as the  pressure
 of the Avater, and the sudden contraction of the external vessels, by throw-
 ing the blood with too much force upon the internal  parts are apt to oc-
 casion ruptures of the vessels, or a flux of humours upon the diseased or-
 gans.  But where no objection of this kind prevails, the patient  ou«ht to
 plunge over head in water every morning fasting, for three or four weeks
 together.   He should not however stay long in the water, and should take
 care to have his skin dried as soon as he comes out.
   The regimen proper in this case is the same as was mentioned  in the
 last stage of the Gonorrhoea: the diet must be drying and astringent, and
 the drink Spa, Pyrmont, or Bristol  waters, with which a little  claret or
 red Arine may sometimes be mixed.   Any  person  may noAV afford to
 drink these  waters, as they can  be every  Avhere  prepared at almost no
 expense, by a mixture of common chalk and oil of vitriol.
   When the gleet does not in the smallest degree yield to these medi-
 cines, there  is reason to suspect that it proceeds from ulcers.   In this
 case recourse must be had to mercury, and such medicines as tend to
 correct any  predominaut acrimony  with  Avhich the juices may  be affec-
 ted, as the decoction of China, saTsaparilla, sassafras, or the like.
  Mr. Fordyce says, he has seen many obstinate  gleets, of two,  three or
four years standing, effectually cured by a mercurial inunction,  when al-
most every other medicine has been tried in vain.  Dr. Chapman seems
to be of the same opinion; but says, he has always  found  the mercury
succeed best in this case when joined with terebinthinate and other ag-
glutinating medicines.   For  which reason the Doctor recommends pills
made of calomel and Venice turpentine ;*  and desires that then- use may
be accompanied with a decoction of  guaiacum or sarsaparilla.
  The last  kind of  remedy Avhich we  shall mention for the cure of ul-
cers in the urinaiy passage, are the  suppurating candles or bougies: as
these are prepared various ways, and are generally to be bought ready
made, it is needless to spend time in enumerating the different ingredients
of which they are composed, or  teaching the manner of preparing them.
Before a bougie be introduced into  the urethra, however, it should be
smeared all over with sweet oil, to prevent it from stimulating too sudden-
ly; it may be suffered to continue in from one to seven or eight hours, ac-
cording as the patient can bear it.   Obstinate ulcers are  not only often
healed, but tumours and excrescences  in  the urinary passages  taken
away, and an obstruction of urine removed by means of bougies.   Ob-
stinate gleets may be removed by the use of bougies.
  * Take Venice turpentine, boiled to a sufficient degree of hardness, half an
ounce, calomel half a drachm.  Let these be mixed and formed into sixty pills,
of which five or six may be taken night and morning.  If, during the use of
these pills,  the  mouth should grow sore, or the breath become offensive, they
must be discontinued until these symptoms disappear. ' 
321
               OF THE SWELLED TESTICLE.

  TIIE swelled  testicle may either proceed  from infection lately con-
tracted, or from the venereal poison  lurking in the body: the  latter in-
deed is not very common, but the former frequently happens both in the
first aud second stages of a gonorrhoea; particularly when the running is
unseasonably checked by cold,  hard drinking,  strong drastic purges,
violent exercise, the too early use of astringent medicines, or the like.
  In the inflammatory stage, bleeding is necessary, Avhich must be repeat-
ed according to the urgency of the symptoms.*  The food must be light^
and the  drink  diluting.   High  seasoned food, flesh, Avines, and every
thing of a heating nature, are to be avoided.  Fomentations are of sin-
gular service.  Poultices of  bread and  milk,  softened with fresh butter
or oil, are likewise very proper, and ought constantly to be applied Avhen
the patient is in bed; when he  is up the  testicles  should be kept warm,
and supported by a bag or truss, which may easily be contrived in such
a manner as to prevent the weight of the  testicle from having any effect.
   If it should be found impracticable to clear  the testicle by the cooling
regimen now pointed  out, and  extended according to  circumstances, it
will be necessary to lead the patient through such a complete anti-vene-
real course as shall ensure him against any future uneasiness.   For this
purpose, besides  rubbing the mercurial ointment  on the part, if free from
pain, or on the  thighs,  as directed in the gonorrhoea, the patient must be
confined to bed, if necessary, for five or six weeks, suspending the testicle
all the Avhile with a bag or truss, and plying him  inwardly  Arith strong
decoctions of sarsapavilla.
   When these  means  do not succeed,  and there  is reason to suspect a
scrophulous or  cancerous habit,  either of Avhich may support a scirrhous
induration, after the vrenereal poison is corrected, the  parts should be
fomented daily Avith a decoction of hemlock, the bruised leaves of which
may likeAvise be  added to the poultice,  and  the extract at the same time
taken inwardly.f  This practice is strongly recommended by Dr. Stork
in scirrhous  and cancerous cases: and Mr. Fordyce assures us,  that by
this method  he has cured diseased  testicles of two or three years stand-
ing, even when ulcerated, and  w hen the scirrhous had begun  to be af-
fected with pricking aud lancing pains.

                           OF BUBOES.

   VENEREAL  buboes are hard tumours  seated in the groin,  occa^
 sioned by the  venereal poison  lodged in this part.  They are of two
 kinds; viz.  such as proceed from a recent infection, aud such as accom-
 pany  a confirmed lues.
   The cure of recent buboes, that is, such as appear so soon after impure
 coition, may be first attempted by dispersion, and, if that should not suc^
 ceed,  by suppuration.  To promote the dispersion of a buboe, the same
 regimen must be observed as was directed in  the first stage of a gonorrhoea.
  * I have been accustomed for some time past to apply leeches to inflamed
testicles, which practice has always been followed by the most happy effects.
  f The extract of hemlock may be made into pills, and  fakt-n in the nrarmor
directed under the article Cancer.
                                  t! 
522
OF CHANCRES.
The patient must likewise be bled, and take some cooling purges, as the
decoction of tamarinds and senna, Glauber's salts, and  the like.  II, by
this  couise, the swelling and other inflammatory symptoms abate, vye
may safely proceed to the use of  mercury which must be continued till
the venereal vims is subdued.*
  But if the bubo should, from the beginning, be attended with great
heat,  pain,  and pulsation, it will be proper to promote its suppuration.
For this purpose the patient may be allowed to use his ordinary diet, and
to take now and then a glass of wine.  Emollient cataplasms, consisUng
of bread and milk softened with oil or fresh butter, may be applied to the
part; and in cold constitutions, where the tumour advances slowly, white
lily-roots boiled, or sliced onions raw, and a sufficient quantity of  yel-
low basilicon, may be added to the poultice.
  When  the tumour is ripe, Avhich may be known by its conical figure,
the softness of the skin,  and a fluctuation of matter plainly to be felt
under the finger, it may  be opened either by a caustic or a lancet, and
afterwards dressed  with  digestive ointment.
   It sometimes however happens, that buboes can  neither be dispersed
nor brought to a suppuration, but remain  hard, indolent tumours.  In
this case the indurated glands must be  consumed by caustic; if they
should become scirrhous, they must be dissolved by the application of
hemlock, both externally aud internally, as directed hi the scirrhous
testicles.

                         OF CHANCRES.

   CHANCRES are superficial,  callous, eating  ulcers;  which may
happen  either with or without  a  gonorrhoea.   They are commonly
seated  about the glans, and make their appearance  in  the following
manner: First a little red pimple  arises,  which soon  becomes pointed
at top, and is filled with a whitish matter inclining to yellow.   Tins
pimple is hot, and itches generally before it breaks: afterwards it de-
generates into an obstinate ulcer, the bottom of which is usually covered
with a viscid mucus, and whose edges gradually become hard and callous.
Sometimes the first appearance  resembles a simple exocnation of the
euticle;  which, however, if the cause be venereal, soon becomes a true

   A chancre is sometimes a primary affection, but it is  much oftener
symptomatic, and is the mark of a confirmed lues. Primary chancres
discover them: elves  soon after impure coition, and  are generally seated
in p;uts covered with a  thin cuticle, as the lips, the nipples of women,
 the glans penis of men,  Act                                „_*„„.•
    When a chancre appears soon  after  impure coition, its treatment
is nearly similar to that of the  virulent gonorrhoea.   The  patient

   *  For the dispersion of a bubo, a  number of leeches applied to the part af-
fected will be found equally efficacious as in the inflamed testicle.
   + When venereal ulcers are seated in the lips, the infection may be comma-
nicated by  kissing.   I have seen very obstinate venereal  ulcers irne lips,
which I have all tlie reason in  the world te believe were communicated in tnu

m Nurses ought to beware of suckling infected children, or having thdr k"a»t3
drawn bv persons tainted with the venereal disease   This  caution is very ne-
cessary for muses who reside in the neighbourhood of great towns. 
OF CHANCRES.
623
must observe the cooling regimen, lose a little blood, and take some gen-
tle doses of salts and  manna.   The  parts affected ought frequently to
be  bathed, or rather soaked in warm milk and water,  and, if the in-
flammation be  great,  an  emollient poultice or  cataplasm may be ap-
plied to them.   This  course will, in most cases, be sufficient  to abate
the inflammation, and prepare  the patient for  the  use of mercury.
  Symptomatic chancres are commonly accompanied with ulcers in the
throat, nocturnal pains, scurvy eruptions about the roots of the hair, and
other symptoms of a confirmed lues.   Though they may be seated in any
of the parts meutioned above, they commonly appear upon the private
parts, or tlie inside of  the thigh.  They are also less  painful,  but fre-
■quently much larger andharder than primary chancres. As their cure must
depend upon that of the pox, of Avhich they are only a symptom,  we shall
take no further notice  of them, till we come to treat of a confirmed lues.*
   Thus we have related most of the symptoms which accompany or suc-
ceed a violent gonorrhoea, and have given also a short view- of their proper
treatment; there are, however, several others which sometimes attend
this disease, as a strangury, or obstruction of urine, a phymosis, para-
phymosis, <Cr.
   A strangury may either be occasioned by a spasmodic constriction, or
4xn inflammation, of  the urethra and parts about the neck of the  bladder.
in the former case, the patient begins to void his urine ivith tolerable ease^
but, as soon as  it touches the galled or inflamed urethra, a sudden con-
striction takes place, and the urine is voided by spurts, sometimes  hydrops
only.  When the strangury is owing to an inflammation about the neck
of the  bladder, there is a constant heat or uneasiness of  the part, a per-
petual desire to make Avater, Avhile  the patient can only render a few
drops, and a troublesome  tenesmus, or constant inclination  to go to stool.
  When the strangury is owing to spasms, such  medicines as tend to di-
lute and blunt  the salts of the urine will be proper.  For this  purpose,
besides the common diluting liquors, soft and cooling emulsions, sweetened
with the syrup of poppies, may be used.   Should these not have the de-
sired effect, bleeding and  emollient fomentations, will be necessary.
   When the complaint is evidently owing to an inflammation about the
neck of the bladder, bleeding must be more liberally performed, and re-
peated according to the urgency of the symptoms.  After bleeding, if the
strangury still continues,  soft clysters, with  a proper quantity of lauda-
num in them, may be administered, and emollient fomentations applied to
the region of the bladder.   At the same time the patient may take eveiy
four hours a tea-cupful of barley-water, to an English pint of which six
ounces of the  syrup of  marshmallows, four ounces of the oil sweet al-
monds, and half an  ounce of nitre, may be added.  If these remedies
-should not relieve the complaint, and a total suppression of urine should
come on, bleeding must be repeated, and the patient set in a warm bath
up to the middle.   It  will be proper in this case to discontinue the diu-
retics, and to draw off the water Avith a catheter; but  as the patient is
seldom able to bear its being introduced, Ave Avould rather recommend the
  • I have found it answer extremely well to sprinkle chancres twice a-day with
calomel.  This will often perform a cure without any other application what-
■;ver.  If tlie chancres are upon the clans, they may be washed with milk and
vvater, a little warm, and afterwards the calomel may be applied as above. 
^24              OF A CONFIRMED  LUES.

the use  of mild  bougies.    These  often lubricate  the  passage, and
greatly facilitate the  discharge of urine.    Whenever they begin to
stimulate or give any uneasiness, they may be  withdrawn.
   The phymosis is such a constriction of the prepuce over the glans,
as hinders it from  being drawn backwards; the paraphymosis, on the
coutrary,  is such a constriction of  the  prepuce behind the glans, as
hinders it from being brought forward.
   The treatment of these symptoms is so nearly the  same with that
of the virulent gonorrhoea, that we have  no occasion to  cularge upon
it.   In general, bleeding, purging, poultices, and emollient fomenta-
tions  are  sufficient,   Should these however  fail  of removing the stric-
ture, and the parts be threatened with a mortification, twenty or thirty
grains of ipecacuanha, and one grain of emetic  tartar, may be  given
for a vomit, and may be worked off with warm Avater or thin gruel.
   It  sometimes happens, that, in spite of all  endeavours to the con-
trary, the inflammation  goes on,  and  the  symptoms of a beginning
mortification  appear.   When this is the case,  the  prepuce  must be
scarified Avith  a lancet,  and if necessary, divided, iu order to prevent
a strangulation, and  set the imprisoned glans at liberty.  We shall
not describe the manner of performing this operation, as it ought al-
ways  to be  done by a  surgeon.   When a  mortification  has  actually
taken place, it will be necessaiy, besides performing the above ope-
rations, to foment  the  parts freeaiently  with  cloths wrung ont of a
strong decoction of camomile floAvers and  bark,  and to  give  the pa-
tient  a drachm of  the bark  in powder every tivo or three hours.
   With regard to  the priapism, chordee, and other distortions of the
penis,  their treatment is no way different from that of  the gonorrhoea.
When they  prove very troublesome,  the  patient   may  take a few
drops  of  laudanum at night, especially after the operation of a pur-
gative through  the day.

                   OF A CONFIRMED  LUES.

   WE have hitherto treated of those affections in which the venereal
poison is  supposed to be confined chiefly  to the particular part by
which it Avas received, and shall next take a view of the lues in  its con-
firmed state;   that is, when  the  poison is  actually received  into the
blood, and circulating with it through every pail of the body, mixes
with  the several secretions, and renders the whole habit tainted.
   The symptoms of  a confirmed lues are, buboes iu  the groin, pain
of the head, and joints, which are peculiarly troublesome in the  night,
or when the  patient is warm  in bed;  scabs and scurfs in  various parts
of the body, especially on the head, of a yellowish  colour, resembling
a honey-comb;  corroding ulcers in various  parts of the  body, which
generally  begin about tlie throat, from whence they creep gradually,
by the palate,  towards the cartilage of the nose, which they destroy;
excrescences or exostoses arise in the middle  of the bones, and  their
spongy ends  become brittle,  and break upon the least  accident; at
other times they are  soft, and  bend like wax; the conglobate glands
become hard and callous, and  form, in the neck, armpits, groin, and
Diesentary, hard moveable tumours, like  the  king's evil; tumours of
different kinds  are  likewise formed in  the  lymphatic v< sseJs. tendons, 
A  CONFIRMED  LUES.                325
ligaments, and nerves, as the gummata, ganglia, nodes, tophs, Ac.; the
eyes are affected with itching,  pain, redness, and sometimes with total
blindness, and  the ears with a  singing  noise, pain, aud deafness, ivhilst
their internal substance is ulcerated and rendered carious;  at length all
the animal, vital, and natural functions are depraved;  the face becomes
pale aud livid ; the body emaciated and unfit for motion, and the misera-
able patient falls into an atrophy or wasting consumption.
   Womeu have symptoms peculiar to the sex; as cancel's of the breast;
a suppression or overflowing of the menses;  the w hites ; hysteric  affec-
tions ;  an inflammation, abscess,  scirrhous, gangrene, cancer,  or  ulcer of
the womb; they are generally either barren or subject to abortion;  or, if
they bring children into the world, they have an universal erysipelas, are
half rotten, and covereel with ulcers.
   Such is the catalogue of symptoms attending this dreadful disease in its
confirmed state.  Indeed they are seldom all to be met with in the same
person, or at the same time; so many of them, however, are generally
present as are sufficient to alarm the patient; and if he has reason to sus-
pect the infection is lurking in his body, he ought immediately to set about
the expulsion of it, otherwise the most tragical consequences will ensue.
   The only  certain remedy hitherto  known in Europe, for the cure of
this disease, is mercury, which may be used in  a great variety of forms,
with nearly the same success.*   Some time ago it was reckoned impossi-
ble to cure a confirmed  lues without a salivation.  This method is now
hoAvever pretty generally laid aside, and mercury is found to be as effica-
cious, or rather more so, in expelling the venereal poison, when adminis-
tered in such a manner as not to run off by  the salivary glands.
   Though many are of opinion, that the mercurial ointment is as effica-
cious  as any  other preparation of that mineral; yet experience has taught
me to think  otherwise.  I have often seen  the most  obstinate venereal
cases,  where great quantities of mercurial  ointment had been used in
vain,  yield to  the  saline preparations of mercury.   Nor am I singular
in  tliis opinion.   My ingenious friend, Mr. Clare, an eminent surgeon
of this  city,  assures me, that  for  some  time past he  has  employed, in
venereal cases, a  saline preparation of mercury with most happy suc-
cess.   This  preparation rubbed Avith a  sufficient quantity of any mild
powder, he  applies, in small portions to the tongue, Avhere, with a gen-
tle degree of friction, it is immediately absorbed,  and produces its full ef-
fect upon the system,  without doing  the  least injury  to the stomach or
boAvels; a matter  of the greatest  importance in the application of this
most active and powerful remedy.
   It  is impossible  to  ascertain either the  exact quantity of medicines
ffiat must be taken, or the time they ought to be continued, in order
to perform a cure.   These will ever vary according to the constitution
of the patient, the  season of the year, the degree of infection, the time
it has lodged in the boby, A:c.   But though it is difficult, as  Astruc ob-
serves,  to determine a priori,  what quantity of mercuiy  Avill, in the
whole,  be necessary to cure tins distemper completely; yet  it may be
judged of a posteriori, from the  abatement and ceasing of the symp-
toms.   The same  author adds,  that commonly not less thau two ounces
  • The preparations which I now chiefly use, in tlie confirmed lues, are caloT
inel and calcined mercury. 
Y26
A  CONFIRMED  LUES.
 of the strong mercurial ointment is sufficient, and not more than three or
 four ounces necessary.
   The only chemical preparation of mercury which Ave shall take notice
 of, is the corrosive sublimate.   This was some time ago brought into use
 for the venereal disease, in Germany, by  the illustrious Baron  Van
 Swieten; aud was soon after introduced into Britain by the learned Sh
 John Pringle, at that time physician to the army.   The method of giving
 it is as follows:  One grain of corrosive sublimate is dissolved in two oun-
 ces of French  brandy or malt spirits; and of this solution, an ordinal y
 table-spoonful, or the quantity of half an ounce, is to be taken twice a-day,
 and to be continued  as long as any symptoms of the disorder remain.  To
 those whose stomach eaunot bear the solution, the sublimate may be giv -
 en iu form of a pill.*
   Several roots, woods, and barks, have been recommended for  curing
 the venereal disease; but none of them have been found, upon experience,
'to ansAver the high   encomiums Avhich  had been  bestowed upon  them.
 Though no one of these is to be depended upon alone, yet, when joined
 with mercuiy, some of them have heen  found  to be veiy beneficial in
 promoting a cure.  One of the best we know yet is sarsaparilla, which may
 be  prepared and taken according to the directions in the Appendix.f
   The mezereon-root is likewise found to  be a powerful assistant to the
 sublimate or any other mercurial.  It may either  be  used along  with
 sarsaparilla, as directed in the Appendix, or by itself.  Those who choose
 to use the mezereon  by itself, may boil an ounce of the fresh bark, taken
 from the root, in  twelve English pints of water to eight, adding towards
 the end an  ounce  of liquorice.   The dose  of this is the same as of the
 decoction of sarsaparilla.
   We have been told that tlie  natives of America cure the venereal dis-
 ease, in every stage, by a decoction ofthe root of a plant called Lobelia.
 It is used either fresh or dried ; but we have no certain accounts with re-
 gard to the proportion.  Sometimes they mix other roots with it, as those
 of the ranauculus, the caenothus, Ac. but whether  these are designed to
 distinguish or assist  it, is doubtful.  The patient takes a large draught of
 the decoction early  in the morning, aud continues to use it for his ordina-
 ry drink through the dayj.

  * The sublimate may be given m distilled water, or any other liquid that the
 patient chooses.  I  commonly order ten  grains to be dissolved in an ounce of
 the spirit of wine, for the conveniency of carriage, and let the patient take twen-
 ty orUiirty drops of it night and morning in half a glass of brandy or other
 spirits.  Mr. Debra, an ingenious chymist  of this place, informs ine, that he
 prepares a salt of mercury much more mild and gentle in its operation than the
 sublimate, though equally efficacious.
  f See Appendix, Decoction of Sarsaparilla.
  $ Though we are still very much in tlie dark with regard to the  method of
 curing th"i3 disease  among the natives of  America, yet  it i* generally affirmed
 that they do cure it with speed,  safety and success, and that without the least
 knowledge of mercury. Hence itbecomes an object of considerable importance
 to discover their method of cure.  This might 6urely be done by making trials
 ofthe various plants which are found in those parts, and particularly of such
 as the natives are known to make use of.  All people in a rude  state take theiv
 medicines chiefly from the vegetable kingdom, and are often possessed of valu-
 able secrets with regard to the virtues of plants, of which more enlightened na-
 tions are ignorant Indeed we make no doubt but some plants of our own growth,
 were  proper pains taken to discover them, would be found as efficacious m cu-
 ring the venereal disease as those in America,  It must however be remember- 
A CONFIRMED  LUESi

   Many other  roots and  woods might  be mentioned, Avhich have been
extolled for c;:ring  the venereal disease, as  the china-root, the roots of
soap-wort, burdock, Ac.  as also the Avood of guaiacum and sassafras;
but as none of these have been found to possess virtues superior to those
already mentioned,  we shall, for  the sake  of brevity, pass them over,
and shall conclude  our observations on this disease, with a few general
remarks concerning the pioper management of the patient, and the na-
ture of  the infection.

                 GENERAL OBSERVATIONS.

   THE condition of the patient ought  always to be considered previous
to his entering upon  a course of mercury in any form.   It  would be
equally rash and dangerous to administer mercury to a person  labouring
under any violent acute disease, as a putrid  fever, pleurisy, peripneumo-
ny, or the like.  It Avould likewise be dangerous in some chronic cases;
as a sIoav hectic fever, or the last stage of a consumption.   Sometimes,
however, these diseases proceed from a confirmed lues; iu Avhich case
it will be necessary to give mercury.  In chronic diseases of a less dan-
gerous nature, as the asthma, the gravel, and such like, mercury, if ne-
cessary, may be s*afely administered.  If the patient's strength has been
greatly  exhausted by sickness,  labour,  abstinence, or any other cause,
the use  of mercury must be postponed, till by time, rest, and a nourish-
ing diet, it can be sufficiently restored.
   Mercury ought not to be administered to Avomen during the menstrual
flux, or  Avhen the period is near at hand.  Neither should it be given in
tlie last  stage of pregnancy.  If, however, the woman be not near the
time of  delivery, ami circumstances render  it necessary, mercury may
be given, but in smaller doses, and  at greater intervals than usual: with
these  precautions,  both the mother and  child may be cured at  the same
time; if uot, the disorder Avill at least be kept from groiving Avorse, till
the woman be brought to bed, and sufficiently recovered,  when a more
effectual method may be pursued,  which,  if she suckles her child, w ill
hi all probability be sufficient for the cure of both.
   Mercury  ought always to be administered to infants with the greatest
caution.  Their tender condition unfits  them for supporting a salivation.
and makes it necessaiy to administer even the mildest  preparations of
mercury to them with a sparing hand.   A similar conduct is recommend-
ed in the treatment of old persons, Avho have the  misfortune to  labour
under a confirmed lues.   No doubt the infirmities of age must render
people less able to  undergo the fatigues of a salivation ; but this, as ivas
formerly observed, is never necessaiy ; besides, we have generally found,
that mercury had much less effect upon veiy old persons, than on those
who were younger.
   Hysteric  and hypochondriac persons, and such as  are  subject to an
habitual diarrlura or dysentery, or to frequent and violent attacks of the
epilepsy, or who are afflicted with the scrophula, or the scurvy, ought to
be cautious  iu the use of mercury.  Where  any one of these disorders
prevails, it  ought  either, if possible, to be  cured, or at least palliated.
ed, that what will cure the venereal disease in one country, will not always be
found to have equal success in another. 
328
A  CONFIRMED LUES.
before the patient enters upon a course of  mercury.  When this cannot
be done, the mercury must be administered in smaller doses, and at longer
intervals than usual.
  The most proper seasons for entering upon a course of mercuiy, are
the spring and autumn, when the air  is of a moderate Avarmth.  If the
circumstances of the  case, however,  will not admit of  delay, Ave must
not defer the cure on account  of the season,  but  must  administer the
mercury; taking care  at the  same  time to keep the patient's chamber
warmer or cooler, according as  the season of the year requires.
  The next thing to be considered  is the preparation  necessary  to be
observed before we proceed to administer a course of mercury.  Some
lay great stress upon this circumstance, observing, that by previously
relaxing the vessels,  aud correcting any disorder  which  may happen to
prevail in the blood, not only the mercury Avill be  disposed to act more
kindly, but many other inconveniences will be prevented.
   We have already recommended bleeding and gentle  purges, previous
to the administration of mercury, and shall only now add, that these are
always  to be repeated  according to  the age, strength, constitution, and
other circumstances of the patient.  Afterwards, if it can be conveniently
done, the patient ought to bathe once  or twice a-day, for a few days, in
luke-Avarm water.   His diet in  the  mean time must be light, moist, aud
cooliugi   Wine, and all  heating liquors, also violent  bodily exercise,
and all great exertions  of the mind, as carefully to be avoided.
   A proper regimen is likewise  to  be observed by such as arc under a
course of mercury.  Inattention to this not only endangers  the  patient's
life, but often also  disappoints  him of a cure.  A much smaller quantity
of  mercury Avill be sufficient for the  cure of  a person who lives low,
keeps warm,  and avoids all manner of excess, than of  one who cannot
endure to put the smallest restraint upon his appetites; indeed it but rare-
ly  happens that such are thoroughly cured.
    There is hardly any thing  of more importance, either for preventing
 or removing venereal infection, than cleanliness.    By an early attention
 to this,  the infection might  often be prevented from entering the body;
 and, where it has already taken place, its effects may be greatly mitiga-
 ted.  The moment any person has reason to suspect that he has received
 the infection, he ought to Avash the parts with water and  spirits, sweet-oil,
 or milk and water;  a small quantity of the last may likewise be injected
 up the  urethra,  if it can be conveniently done.   Whether this disease
 at first took its rise from dirtiness, is hard to say;  but Avherever that pre-
 vails, the infection is found in its greatest degree of virulence,  which
 aives ground to believe, that a strict  attention to cleanliness, Avould go far
 towards extirpating it altogether.*
  * I have not only seen a recent infection carried off in a few days by means of
.leanliness, viz. bathing, fomentations, injections, &c  but have likewise found
it of the greatest advantage in the more advanced stages of the disease.  Of
this I had lately a very remarkable instance, in a man whose penis was almost
wholly consumed by venereal ulcers ; the matter had been allowed to continue
on the sores, without any care having been taken  to clean them, till, notwith-
standing the use of mercury and other medicines, it had produced the effects
above mentioned.  I ordered warm milk and water to be injected three or four
times a-day, into all the sinuous ulcers, in order to wash out all the matter j 
A  CONFIRMED LtJES.
320
   When the venereal disease has beeu neglected,  or improperly treated,
4 often becomes a disorder of the habit.   In this case the  cure must  be
attempted by restoratives, as a  milk diet, the decoction of sarsaparilla,
and such like, to which mercury may be occasionally  added.  It is a
common practice in North  Britain to send such patients  to drink goat
whey.  This is a very proper  plan, provided the infection has been  to-
tally eradicated before hand; but  when  that is not the  case, and the pa-
tient trusts to the whey for  finishing his cure, he will often be disappoint-
ed.   I have frequently known the disease return with all its virulence
after a course of goat whey, even Avhen that course  had  been  thought
quite sufficient for  completing  the cure.
   One of the most  unfortunate eircumstances attending patients in this
disease, is the necessity they are often laid under of hurrying the cure.
This induces them  to take  medicine too  fast, and to leave it off too soon.
A few grains more of mediciue, or a few days longer  confinement, would
often be sufficient  to perfect the  cure;  w hereas, by  neglect of these, a
small degree of virulence is still left in the humours,  which gradually
vitiate*,  and at length contaminates the whole mass.  To  avoid this,  we
ivould advise, that  the patient should never leave off taking medicine intf.
mediately upon the disappearing of the symptoms, but continue  it  for
some time after, gradually  lesseuiug the quantity, till there is  sufficient
ground to believe that the disease is entirely eradicated.
   It is not only difficult, but absolutely impossible to  ascertain the exact
degree of virulence that may attend the disease; for which reason  it will
always be a  much safer rule to continue  the use of medicine too long,
than to leave it off too soon.  This seems to be  the leading  maxim of a
modern practitioner of some note for the venereal disease, Avho always
orders his patient to perform  a quarantine of at least forty days, during
which time he takes forty bottles of, I suppose, a strong  decoction of sar-
saparilla, or some  otlier anti-venereal simple.   Whoever takes this me-
thod, and adds a sufficient quantity of corrosive sublimate, or some other
active preparation of  mercury to the decoction, Avill seldom fail to cure a
confirmed lues.
   It is peculiarly unfortunate for the cure of this disease, that not one id
ten of those  who contract it, are either able or Arilfing to submit to  a pro-
per plan of regimen. The patient is willing to take medicine; but he must
follow his business, and, to prevent suspicions, must eat and drink like
the rest of the family.  This is the true source of nine-tenths of all the
mischief arising'from the venereal disease.    I never kneAV the cure at-
tended with any great difficulty or danger Avhere the patient strictly
after which they were stuffed with dry lint to absord the fresh matter as it was
generated.  The patient at the  same time took every day half a grain of the
corrosive sublimate of mercury, dissolved in an ounce of brandy, and drank an
English quart of the decoction of sarsaparilla.  By this treatment in about six
weeks, he was perfectly cured ; and, what was very remarkable, a part of the
penis Avas actually regenerated.
  Doctor Gilchrist has given an account of the species of lues venerea which
prevails in the West of Scotland, to which the natives give the name of Sibbint
or Sivvirts.  The Doctor observes, that the spreading of this disease is chiefly
owing to the neglect of cleanliness, and seems to think, that by due attention to
that virtue, it might be extirpated.   The treatment of this disease is similar to
that of a confirmed lues or pox. The yavis, a disease now very common both
in America and the West-India islands, may also be cured in (he same maws*?
                                 42 
330
DISEASES OF WOMEN.
followed the physician's advice; but a volume would uot be sufficient p>
point out the dreadful consequences which proceed from au opposite coiW
duct.  Scirrhous testicles, ulcerous sore throats, madness, consumptions',
carious bones, and a rotten progeny, are a few of  the blessings derived
from this source.
   There is a species of  false reasoning, with  regard to this  disease,
which proves fatal to many.   A person of a sound constitution contracts
a slight degree of the disorder.  He gets well without taking any great
care, or using much medicine, and In nee concludes that this will always
be the  case.  The next time  the disease occurs; though ten times more
virulent, he pursues the same  course, and his constitution is ruiucd.  In*
deed, the different degrees of virulence in the small-pox are not  greater
than in this disease,  though,  as the learned Sydenham observes, in some
cases the most skilful physicians cannot cure, and in others the most ig-
norant old  woman cannot kill the patient in that  disorder.   Though a
good constitution is always in favour of the patient, yet too  great stress
may be laid upon it.   It does not appear from observation, that the most
robust constitution is able to overcome the virulence of the venereal con-
tagion, after it has got into the habit.   In  this  case  a proper course of
medicine is always indispensably necessary.
   Although it is impossible, on account of the different degrees of viru-
lence, &c.  to lay down fixed and  certain rules for the cure of  this di-
sease, yet the following general plan will always be found safe, and often
successful,  viz. to bleed and administer gentle purges with diuretics during
the inflammatory state, and as soon as the symptoms of inflammation are
abated, to administer mercury, in any form that may be most agreeable
to the  patient.   The same medicine, assisted by the decoction of sarsa-
parilla, and a proper regimen, will not only secure the constitution against
any further progress of a confirmed pox, but will generally perform a
complete cure.
                           CHAP.  L.

                    DISEASES OF WOMEN.

       tvOMEN in all civilized nations, have the management of do-
mestic affairs, and it is very proper they should, as nature has made them
less fit for the more active and laborious employments.   This indulgence
however, is  generally carried too  far; and females, instead of being
benefited by  it, are greatly injured from the want of exercise  and free
air.   To be satisfied of this, one need only compare the fresh and rud-
dy looks of  a  milk-maid, with  the pale complexion  of those  females
whose whole time is spent within doors. Though nature has made an
evident distinction between the male  and female with regard to bodily
strength and  vigour, yet she certainly  never meant, either  that the one
should be always Avithout, or the other always within doors.
   The confinement of females, besides hurting  their  figure and  com-
plexion, relaxes tlieir  sofids,  iveakeus their minds,  and disorders all 
OF THE  MENSTRUAL  DISCHARCU."       331
the functions of the  body.  Hence  proceeds obstructions, indigestion,
flatulence, abortions, and the whole train of  nervous disorders.  These
not only unfit women  from being mothers and nurses, but often render
them whimsical and  ridiculous.   A sound  mind depends so much  upon
a healthy body, that where the latter is Avauting, the former is rarely to
be found.
  I have always observed that women who were chiefly employed  with-
out doors, in the different branches of husbandry, gardening and the like,
were almost as hardy as their husbands, and that their children were like-
wise healthy.  But  as  the bad effects of confinement and inactivity  up-
on both sexes have been already shewn, Ave  shall proceed to point  cut
those circumstances  in the structure and design of females, which subject
them to peculiar diseases; the chief of which are their monthly evacua-
tions, pregnancy, and child-bearing.   These  indeed cannot properly be
called  diseases, but, from the delicacy  of the sex, and this being  often
improperly managed in such situations, they become the source of nu-
merous calamities.

            OF THE MENSTRUAL  DISCHARGE.

   FEMALES generally begin to menstruate about the age  of fifteen,
and leave it off about fifty, which renders these two periods the most  cri-
tical of their lives.   About the first appearance of this discharge, the con-
stitution undergoes a veiy considerable change, generally  indeed for  the
better, though sometimes for the Avorse.   The greatest care is now neces-
sary, as the future  health and happiness of the female depends in a  great
measure upon her conduct at this period.*
   If a girl about this time of  life be confined to the house, kept constant-
ly silting, and neither  allowed to romp about, nor employed in any ac-
tive business, which gives exercise to the whole body, she becomes w eak,
relaxed, and puny; her blood not being duly  prepared,  she looks pale
and wan; her health, spirits, and vigour decline, and she sinks into a va-
letudinarian for life.   Such is the fate of numbers of  those unhappy  fe-
males, who, either from too much indulgence, or their own narroAV  cir-
cumstances, are, at this critical period, denied the benefit of exercise  and
free air.
   A lazy indolent disposition proves likewise very  hurtful to girls at  this
period.  One seldom  meets with complaints from obstructions among
the more active  and industrious  part of the sex;  whereas  the indolent
and lazy are seldom  free from them.    These are in a  manner eateu up
by the chlorosis, or green sickness, and other diseases of this nature.    We
would therefore recommend it to all who  Avish to escape these calamities,
to avoid indolence and inactivity, as their greatest enemies, and to  be as
much abroad in the open air as possible.
   Another  thing which proves very hurtful  to girls  about this period

  • It is the duty of mothers, and those  who are intrusted with the education
of girls, to instruct  them early in the conduct  and management of themselves
at this critical period of  their lives  False modesty, inattention and ignorance
of what is beneficial or hurtful at this time,  are the sources of many diseases
and misfortunes in  life,  which a few sensible lessons from an experienced ma-
tron might have prevented.   Nor is care less necessary in the subsequent  re-
turns of this discharge.  Taking improper food, violent affections of the mind,
or catching coKl at this period, is often sufficient to ruin the health, or to ren-
der the female ever after incapable of procreauc*. 
332
OF THE  MENSTRUAL  DISCHARGE.
of life, is unwholsome food.  Fond of all manner of trash, they often in-
dulge in it, till their whole humours, are quite vitiated.   Hence  ensue
indigestions, want of appetite, and a  numerous train of evils.  If the
fluids be not duly  prepared, it is utterly  impossible that the secretions
should go properly on.   Accordingly we find; that such girls as lead an
indolent life, and eat gieat quantities of trash, are not only subject to ob-
structions of  the menses, but likewise to glandular obstructions; as the
scrophula, or king's evil, Ac.
  A dull disposition is also very hurtful to girls at this period.  It is a
rare thing to see a sprightly girl who does not enjoy good health, while
the grave, moping, melancholy creature, proves the very prey of vapours
and hysterics.  Youth is the season for mirth and cheerfulness.   Let it
therefore be indulged,   It is an absolute duty-  To  lay in a stock of
health in time of youth, is as necessary a piece of prudence, as to make
provision against the decays of old age.—White, therefore, wise nature
prompts the happy youth to join in sprightly amusements, let not the
severe dictates of hoary age forbid tiie  useful impulse, nor damp with
serious gloom, the season destined to mirth and innocent festivity.
   Another thing very  hurtful to females about this  period  of fife, is
strait clothes.  They are fond of a fine shape, and foolishly imagine that
this can be acquired by lacing themselves tight   Hence, by squeezing
the stomach and bowels, they iiurt the digestion, and occasion many in-
cureable maladies.  This error is not indeed so common as it has been;
but, as fashions 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 direful effects of that wretched  custom which  prevailed some
years ago, of squeezing  every girl into as small a size in the middle as
possible.  Human invention could not possibly have  devised  a practice
 more destructive to^health.
    After a female has arrived at that period of life when the menses usu-
 ally begin to flow,  and they do not appear, but, on the contrary,  her
 health and spirits begin to decline, we  would advise, instead of shutting
 the poor girl up in the  house, and dosing her with steel, asafcetida,  and
 other nauseous drugs,  to place her  in  a  situation where she  can enjoy
 the benefit of fresh air and agreeable  company.  There  let her  eat
 wholesome food, take  sufficient exercise, and amuse herself in the most
 agreeable manner;  and we have little reason to fear, but nature, thus as-
 sisted, will do her proper Avork.—Indeed she seldom fails, unless where
 the fault is on our side.
    This discharge in the beginning is seldom so instantaneous as to sur-
 prise females unawares,   It is generally preceded by symptoms which
 foretel its approach; as a sense of heat,  weight, and dull pain in the loins;
 distension and hardness of the breasts; head-ache; loss of appetite;  lassi-
 tude;  paleness of the  countenance ; and sometimes a  slight degree of
 fever.  When  these symptoms appear about the age at which the men-
 strual flux usually begins, every thing should be carefully avoided which
 may obstruct that necessary and salutary evacuation; and all means used
 to promote it; as sitting frequently  over  the steams  of warm  water,
 drinking warm diluting liquors, Arc.
    After the menses, have once begun to flow, the greatest care should be
 taken to  avoid eveiy thing  that  may tend to obstruct  them.   Fe-
 males ou°ht to be exceeding cautious of what  they eat or drink at
 the time thev are out  of order.   Eveiy  »"«ig 'bat  is  cold, or apt to 
OF  THE  MENSTRUAL  DISCHARGE.        333
sour on the stomach, ought to be avoided;  as fruit, butter-milk, and such
like.   Fish, and all kinds of food that are hard of digestion, are also to
be avoided.   As it is impossible to mention every thing that may disagree
with individuals at this time, we would recommend it to every female to
be veiy attentive to what disagrees with  herself, and carefully to avoid it.
  Cold is extremely hurtful at this particular period.  More of the sex
date their diseases from colds, caught while they are out of  order, than
from all other causes.   This ought surely to put them upon  their guard,
and to make them very circumspect in their conduct at such times.  A
degree of cold that will not in the least hurt them at  another time, will
at this period be sufficient entirely to ruin their health and constitution.
  The  greatest attention ought  likewise to  be paid to the mind, which
should be kept as easy and cheerful as possible.   Every part of  the ani-
mal economy is influenced by the passions,  but none more so than this.
Anger, ft  ir, grief, and other affections of the mind,  often occasion ob-
structions of the menstrual flux, which prove absolutely incurable.
  From whatever cause  this flux is obstructed,  except in  the  state of
pregnancy, proper means  should be used to restore it.  For  this purpose
we would recommend sufficient exercise, in a dry, open, and rather cool
air; wholesome diet,  and, if the body be weak and languid, generous
liquors; also cheerful company and all manner of amusements.  If these
fail, recourse must be had to medicine.
  When obstructions proceed from a weak  relaxed state  of the solids,
such medicines as tend to promote digestion, to brace the solids, anel
assist the body in  preparing good blood, ought to be  used.   The princi-
pal of these are iron and the Peruvian bark, with other bitter and astrin-
gent medicines.  Filings of iron may be infused in wine or ale, two or
three ounces to an English quart, and after it has stood for two or three
weeks it may be filtered, and  about half a  wine glass of it  taken twice
a-day:  or prepared  steel may be taken in  the dose of half a drachm,
mixed with  a little honey or treacle, three or four times a-day.  The
bark and other bitters may either be taken in substance or infusion, as is
most agreeable to the patient.
  When  obstructions proceed from a viscid state of  the blood;  or from
women  of a  gross or  full habit, evacuations, and  such medicines as
attenuate the humours, are necessaiy.   The  patient in this case ought to
be bled, to bathe her feet frequently in warm water, to take noAV and then
a cooling purge, and to live upon a spare thin diet.  Her drink should
be whey, water, or small beer; and she ought to take sufficient exercise.
A tea-spoonful of the tincture of black hellebore may also be taken twice
a-day in a cup of warm water.
  When obstructions proceed from affections  of the  mind, as grief, fear,
anger, Ac. every method should be taken to  amuse and divert the patient.
And that she may tlie more readily forget the  cause of her affliction, she
ought, if possible, tp be removed from the place where it happened.  A
change of place, by presenting the mind with a variety  of  new objects,
has often a very happy influence in relieving it from  the deepest distress.
A soothing,  kind, and affable behaviour to  females in this  situation, is
also of the last importance.
  An obstruction of the menses is  often the effect of other maladies.
When this is the case, instead  of giving medicines to  force  that dis-
charge, Avhich  might be dangerous, we ought by all means to endeavour 
334        OF  THE  MENSTRUAL  DISCIIARGE.
to restore the patient's health and strength.   When that is  effected, tlie
other will return of coui-se.
  But the menstrual flux may be too great as Avell as too small.   When
this  happens, the patient becomes weak,  the  colour pale,  the appetite
and  digestion  are  bad,  and cedematous swellings of the feet, dropsies
and  consumptions  often ensue.   This frequently happens to women
about the age of forty-five or fifty, and is very difficult to cure.  It may
proceed from a sedentary life;  a full diet, consisting  cliiefly of salted,
high-seasoned,  or  acrid food;  the  use of spirituous liquors; excessive
fatigue; relaxation; a dissolved state of the blood; violent passions of
the mind, Ac.
  The treatment of this disease must be varied according to its cause.
When it is occasioned by any error in the patient's regimen,  an opposite
course to that  Avhich induced  the disorder must be pursued, and such
medicines taken as have a tendency to restrain the flux, and counteract
tlie  morbid affections of the system from whence it proceeds.
   To restrain the flux, the patient should be kept quiet and easy both
in body and mind.   If it be very violent, she ought to lie in bed, with
her  head Ioav; to  live  upon a cool and slender diet, as veal or chicken
broths with bread; and to drink decoctions of nettle-roots, or the greater
comfrey.   If these be  not  sufficient to stop  the flux, stronger  astrin-
gents may  be used, as Japan earth, alum, elixir of vitriol,  the Peruvian
bark, &c/
   The uterine flux may offend in quality as well as in quantity.  What
is usually called ihefluor albus, or whites, is a very common disease, and
proves extremely hurtful to delicate women.   This discharge, however,
is not always white, but sometimes  pale, yellow, green, or  of a blackish
colour; sometimes it is sharp and corrosive, sometimes foul and  foetid,
&c.   It is attended with a  pale complexion, pain in the back, loss of ap-
petite, swelling of the  feet, and other signs  of debility.   It generally
proceeds from a relaxed state of the body, arising from indolence, the
excessive use of tea, coffee, or other Aveak and watery diet.
   To remove this  disease, the patient must  take as much exercise as
she can bear Avithout fatigue.   Her food should be solid and nourishing,
 but of easy digestion; and her drink rather generous, as  red  port or
 claret mixed  with  Pyrmout, Bristol, or  lime-water.   Tea and  coffee
 are to be avoided.  I have often known strong broths have an exceeding
 good effect, and sometimes  a milk  diet alone will perform  a cure.  The
 patient ought not to lie  too long a-bed.  When medicine is necessary, we
 know none preferable to the Peruvian bark, which in this case ought al-
 ways to be taken in substauce.   In warm  weather the  cold bath will be
 ©f considerable service.
   That period of life at which the menses cease to flow, is likewise veiy
 critical to  the sex.  The  stoppage of any customary evacuation, how-
  * Two drachms of alum and One of Japan earth may be pounded together
and divided into eight or nine doses, one of which may be taken three times
a-day.
  Persons whose stomachs cannot bear the  alum, may take two table-spoonsful
of the tincture of roses three or four times a-day, to each dose of which ten
drops of laudanum may be added
  If these should fail, half a drachm of the Peruvian bark, in powder, with ten
drops of tlie elixir of vitriol may be taken in a glass of red wine, four times a-day. 
OF PREGNANCY.                   335
eyer small,  is sufficient  to  disorder the whole frame, and often to de-
stroy life itself.   Hence it comes to pass, that so many women either
fjUI into chronic disorders, or die about this time.  Such of them, how-
ever, as survive it,  without contracting any chronic disease, often be-
come more healthy and hardy thau they were before, and enjoy strength
and vigour to a very great age.
  If the menses cease  all of a sudden  in women of a full habit,  they
ought to abate somewhat of their usual quantity of  food, especially of
the more nourishing kind, as flesh, eggs, &c.   They ought likewise to
take sufficient exercise, and to keep the body open.   This may be done
by taking, once or twice a week, a little rhubarb, or aninfosionof hiera
picra in wine or brandy.
  It often happens that women  of a gross habit, at  this period  of life,
have ulcerous sores break out about their ancles, or in other parts of the
body.   Such ulcers ought to be considered as critical, and should either
be suffered  to continue open, or have artificial drains substituted in their
stead.  Womeu who will have such sores dried up, are often soon after
carried off by acute diseases, or fall into those of a chronic nature.

                        OF PREGNANCY.

   THOUGH pregnancy is not a disease, yet that state is often attend*
ed ivith a variety of complaints which merit attention,  and which some-
times requires the assistance of medicine.  Some Avomen indeed are more
healthy during their pregnancy than at any other time;  but this is by
no means the general case;  most of them breed in sorrow, aud  are fre-
quently indisposed  during the whole time of pregnancy.  Few fatal di-
seases, hoAvever,  happen during that period;  and hardly any, except
abortion, that can be called dangerous.   We shall therefore pay parti-
cular attention to it, as it proves generally fatal to the child, and some-
 times to the mother.
   Pregnant Avomen are often afflicted with the heart-burn.  The method
 of treating  this complaint has been already pointed out.  They are like-
 Avise,  in the more early periods  of pregnancy, often harrassed with sick-
 ness and vomiting, especially in  the morning.   The method of relieving
 these complaints has also been shewn.   Both the head-«ch and tooth-ach
 are very troublesome symptoms of pregnancy.  The former may gene-
 rally  be removed by keeping the body gently open, by the use of prunes,
 figs, roasted apples, aud such like.   When the pain is very violent, bleed-
 in0, may be uecessary.  For the treatment ofthe latter, Ave must refer to
 that article.   Several  other complaints incident to pregnant women
 might be mentioned, as a cough and difficulty of breathing, suppression
 aud incontiueucy of urine, Ac; but as all of these have been taken no-
 tice of before, it is needless to repeat them.
    Every pregnant Avoman is more  or less in danger of abortion.  This
 should be guarded against with the  greatest care, as it not only weakens
 the constitution, but' renders the woman liable to the same misfortune af-
 terwards.*  Abortion may happen  at any period of preguaucy, but it is
  • Ever mother who procures an abortion does it at the hazard of her life:
vet there are not a few who run this r'nk merely to prevent the trouble of bear-
ing and bringing up children.  It is surely a most unnatural crime, and cannot, 
336
OF  PREGNANCY.
most common in the second or third month.   Sometimes, however, it hap*
pens in the fourth or fifth.   If  it happens within the first month it is
usually called a false conception; if after the seventh mouth, the child
may often be kept alive by proper care.
   The common  causes  of abortion are, the death of the child; weak-
ness or relaxation of the mother; great evacuations; violent exercise;
raising great weights;  reaching too high; jumping or stepping  from an
eminence; vomiting; coughing; convulsion  fits;  blows on the belly;
falls;  fevers;  disagreeable smells; excess of  blood* indolence; high
living, or the  contrary;  violent passions or  affections of the mind, as
fear, grief, Ac.
   The signs of approaching abortion are, pain in the loins, or about the
bottom of the belly; a dull heavy pain in the inside of the thigh; a slight
degree of coldness, or shivering; sickness, palpitation of the heart; the
breasts becomes flat and soft; the belly falls; and there is a discharge
of blood  or watery humours from the womb.
   To prevent abortion,  we would  advise Avomen of a weak or relaxed
habit to  use solid food, avoiding great quantities of tea  and other Aveak
aud watery liquors; to rise early and  go  soon to bed; to shun damp
houses;  to take frequent exercise in the open air,  but to avoid fatigue;
and never to go abroad in damp foggy weather, if they can shun it.
   Women of a full habit ought to use a spare  diet, avoiding strong li-
quors, and every thing that may tend to heat the body, or increase the
quantity of blood.   Their diet should be of an opening natuie, consist-
ing principally of vegetable substances.  Every woman Avith child ought
to be kept cheerful and easy in her mind.   Her appetites, even though
depraved, ought to be  indulged as far as prudence will permit.
   When any signs of abortion appear, the woman ought to be laid in bed
on a mattress Avith her head low.  She should  be  kept quiet, and  her
mind soothed and comforted.   She ought not, to be kept too hot,  nor to
take any thing of a heating nature.   Her food  should consist of broths,
rice and  milk, jellies, gruels made of oat-meal and the like, all of which
ought to  be taken cold.
   If she  be able to bear it, she should lose at least half a pound  of blood
from the  arm.   Her drink ought to be barley-water sharpened with juice
of lemon; or she  pay take half a drachm of poAvdered nitre, iu a cup of
water-gruel, every five or six hours.   If the woman be seized with a
violent looseness,  she ought to drink the decoction of calcined hartshorn
prepared.  If she be affected with vomiting, let her take frequently two
table-spoonsful ofthe saline mixture.  In general, opiates are of service;
but they should always be given with caution.
   Sanguine robust women, who are liable to miscarry at a certain time of
pregnancy, ought always to be bled a few days before that period arrives.
By this means, and observing the regimen above prescribed, they might
often escape that misfortune.
   Though we recommend due care for preventing abortion, we would
not  be  understood  as  restraining pregnant women from their  usual
exercises.   This Avould  generally  operate a quite  contrary  Avay.

even in the most abandoned, be viewed without horror; but in the decent mat-
ron, it  is  still more unpardonable.—Those wretches who  daily advertise th< ir
assistance to women in this business, deserve,  in my opinion, the most severe
of .all human punishments. 
OF CHILD-BIRTH.                  337
Want of exercise not only  relaxes the body, but induces a plethora, or
♦oo great a fulness of the vessels, which are the two principal causes of
abortion.   There  are, however,  some Avomen of so delicate a texture,
that it  is necessaiy for  them to  avoid almost every  kind of exercise
during the whole period of pregnancy.

                       OF  CHILD-BIRTH.

  MANY diseases proceed from the want of due care in child-bed; and
the more hardy part of the sex are most apt to despise the necessary
precautions in this state.   This is peculiarly the case with young Avives.
They think,  Avhen the labour-pakis are ended,  the danger is over;  but
in truth it may only then be said to be begun.  Nature, if left to herself,
Avifl seldom fail to  expel the foetus;  but proper care aud management are
certainly necessaiy for the recovery of the mother.  No doubt mischief
may be done by too  much  as  well as by too little care.  Hence females
who have the greatest number of attendants in child-bed generally reco-
ver Avorst.  But this is uot peculiar to the state of child-bed.  Excessive
care always  defeats its own intention, and is generally more dangerous
than none at  all.*
   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 toast and water, or thin groat gruel.   Spirits, wines, cordial-waters,
and other things Avhich are given Avith a view to strengthen the mother,
and promote  the birth, for the most part, tend only to increase the fever,
inflame the womb, and  retard the labour.  Besides, they endanger the
woman afterwards, as they often occasion violent and mortal haemorrhages,
or dispose her to eruptive and other fevers.
  When the  labour proves  tedious and  difficult,  to prevent inflamma-
tions, it will  be proper to bleed.   An emollient clyster ought likewise
frequently to he administered; and the patient should sit over the steams
of  warm water.   The  passage ought to be geutly rubbed with a little
soft pomatum or fresh butter,  and cloths wrung out of warm water ap-
plied over the belly.  If nature seems to sink, and the woman is greatly
exhausted with fatigue, a draught of generous Avine, or some other cor-
dial, may be  given, but not otherwise.   These directions  are sufficient
in natural labours; and in all preternatural cases,  a skilful surgeon, or
man-midwife, ought to be called as soon as possible.
   After delivery, the woman ought to be kept  as quiet and easy as
  * Though the management of women in child-bed has been practised as an
employment since the earliest accounts of time ; yet it is still in most countries
on a very bad footing.   Few women think of following this employment tilt
they are reduced to^he necessity of doing it for bread.   Hence not one in an
hundred of them have any education,  or proper knowledge of their business.
It is true, that Nature, if left to herself, will generally expel the foetus ; but it
is equally true, that most women in child-bed require to be managed with skill
:tnd attention, and  that  they are often hurt by the superstitious prejudices of
ignorant and officious midwivcs. The mischief done in this way is much greater
than is generally imagined; most of which might be prevented by allowing no
woman to practise midwifery but such as are properly qualified. Were due at-
tention paid to thisf it would not only be the means of saving  many lives,  but
wauld prevent the necessity of employing men in this indelicate and disagree-
able branch of medicine, which is, on many other accounts, more proper for the
oth<*r ?cv.
                                  13 
338
OF  CHILD-BIRTH.
possible.*  Her food should be light and thin, as gruel, panada, Ac. and
her drink weak  and diluting.  To this rule, however, there are many
exceptions.   I havTe known several Avomen, Avhose  spirits could not be
supported in child-bed Avithout solid food and generous liquors; to such,
a glass of Avine and a bit of chicken must be allowed.
  Sometimes an excessive haemorrhage or flooding happens after delivery.
In this case the patient should be laid with her head low, kept cool, and
be in all respects treated as for an excessive flux of the nunses.  If the
flooding proves  violent, linen cloths,  which have been Avrung out of a
mixture of equal parts of vinegar aud Avater, or red w ine, should be ap-
plied to the belly, the loins, and  the thighs; these  must  be changed as
they glow dry;  and may be discontinued as soon as the flooding abates.*
  If there be  violent  pains after delivery, the patient  ought to drink
plentifully of warm diluting liquors, as gruel or tea with a little saffron
in it; and to take small broths, with carraway-seeds, or a bit of an orange-
peel in them; an ounce of the oil of SAveet almonds may likewise be fre-
quently taken in a cup of any of the above liquors;  and if the patient be
restless, a spoonful of the syrup of poppies may now and then be mixed
with a cup of her drink.   If she be hot or feverish, one of the following
powders may be taken in a cup of her usual drink every five or six hours.|
   An inflammation of the womb is a dangerous and not unfrequent dis-
ease after delivery.   It is known by pains in the lower part of the belly,
which are greatly increased upon touching; by the tension or tightness
of the *-~rts; great weakness;  change of countenance; a constant fever,
with a  Aveak and hard pulse; a slight delirium or raving; sometimes
incessant vomiting;  a hickup; a  discharge  of  reddish, stinking, sharp
water from the Avomb;  an inclination to go frequently to stool;  a heat,
and sometimes total suppression of urine.
   This must be treated like other inflammatory disorders, by bleeding
and plentiful dilution.  The drink may be thin gruel or barley-water;
in a cup of which half a drachm of nitre may be dissolved, and taken
three cr four times  a-day.   Clysters of warm milk and Avater must be
frequently administered;  and the  belly should be fomented  by cloths
wrung out of Avarm Avater, or by applying bladders filled with Avarm milk
and water to it.
   A suppression of  the lochia, or usual  discharges  after delivery, and
the milk-fever must be treated  nearly in the same manner  as an in-
flammation of the womb.   In all these cases, the safest course is  plen-
  * We cannot help taking notice of that ridiculous custom which still prevails
in some parts ofthe country, of collecting a number of women together on such
occasions.  These, instead of being useful, serve only to crowd the house, and
obstruct the necessary  attendants.  Besides they hurt the patient with their
noise :  and often, by their untimely and impertinent advice, do much mischief.
  t In  a violent flooding after delivery, I have seen very good effects from the
following mixture: Take of penny-royal water,  simple cinnamon-water, and
syrup of poppies, each two ounces, elixir of vitriol a drachm.  Mix, and take
two table-spoonsful every two hours, or oftener, if necessary.
  * Take of crabs' claws prepared half an ounce, purified nitre two drachms,
saffron powdered half a drachm;  rub them together in a mortar, and divide the
whole into eight or nine  doses.                       \
  When the patient is low spirited, or troubled with hysterical complaints, sho
ought to take frequently twelve or fifteen drops of the tincture of asaf&tida in
a cup of penny-royal tea. 
OF CHILD-BIRTH.                  339
 tiful dilution, gentle evacuations, and fomentations of the parts affected.
 In the milk-fever, the breasts may be embrocated with a little warm lin-
 seen-oil, or the leaves of red cabbage  may be applied to them.   The
 child should be often put to the breast, or it should be drawn by some
 other person.
   Nothing would tend more to prevent the milk-fever than putting the
 child early to the breast.  The custom of not allowing children to suck
 for the first tAvo or three days, is contrary to Nature, and common sense,
 and is very hurtful both to the mother and child.
   Every mother who has milk in her breasts, ought either to suckle her
 own  child, or to have her breasts frequently drawn, at least for the first
 mouth.  This  Avould prevent many of the diseases Avhich prove fatal to
 Avomen hi child-bed.
   When an inflammation happens in the breast, attended with redness,
 hardness, and other symptoms of suppuration, the safest application is a
 poultice of bread and milk,  softened with oil or fresh butter.  This may
 be renewed twice a-day, till the tumour be either discussed or brought
 to suppuration.   The  use  of repellents, in this case, is very danger-
 ous; they often occasion fevers, and sometimes cancers; whereas a sup-
 puration is seldom attended Arith any danger, and has often the most sa-
 lutary effects.
   When the nipples are fretted or chapt, they may be  anointed with a
 mixture of  oil and bees-wax, or a little powdered gum arabic may be
 sprinkled on them.   I have seen Hungary water applied to the nipples
 have a veiy good effect.  Should the complaint prove obstinate, a cool-
 ing purge may  be given, which generally removes it.
   The miliary fever is  a disease incident to women in child-bed;  but
 as it has been treated of already, we shall take no further  notice of it.
 The celebrated Hoffman observes, that this fever of child-bed Avomen
 might generally be prevented, if they, during their pregnancy, were re-
 gular in tlieir diet, used moderate exercise, took noAV and  then a gentle
 laxative of manna, rhubarb, or cream of tartar; not forgetting to bleed in
 tlie first months, and to avoid all sharp air.   When the labour is coming
 on, it is not to be hastened with forcing medicines, which inflame  the
 blood  and humours, or put them into  unnatural  commotions.   Care
 should be taken, after the birth, that the natural excretions proceed re-
 gularly; and if the pulse be quick, a little nitrous powder, or some otlier
 cooling medicines, should be administered.
   The most fatal disorder consequent upon delivery is the puerperal, or
 child bed fever.  It generally makes its attack upon the second or third
 day  after delivery.   Sometimes indeed it comes on sooner,  and at other
 times, though rarely, it does not appear before the fifth or sixth day.
   It begins like most other fevers, with a  cold or shivering  fit, which
 is succeeded by restlessness, pain of the head, great sickness at the sto-
 mach, and bilious, vomiting.   The pulse is generally quick, the tongue
 dry, and there  is a remarkable depression of spirits and loss of strength.
 A great pain is usually felt  in the back, hips, and  region of the womb;
 a  sudden change in the quantity or quality of the lochia also takes
 place;  and the patient is  frequently troubled Avith a tenesmus, or con-
stant inclination to go to stool.  The urine, which is very high coloured,
is discharged in small  quantity, and generally with pain.   The belly
sometimes swells to a considerable bulk, aud becomes susceptible of pain 
340
OF CHILD-BIRTH.
from the slightest touch.  When the fever has contiuucd for a few day?,
the symptoms of inflammation usually subside, and the disease acquires a
more putrid form.   At this period,  if uot sooner, a bilious  or putrid
looseness, of an obstinate and dangerous nature, comes on, and accom-
panies the disease through all its future progress.
   There  is not any disease that requires to be treated  Arith more skill
and attention than  this;  consequently the  best  assistance  ought ahvav
to be obtained as soon as possible.  Iu women of plethoric constitutions,
bleeding will generally be prooer at tlie beginning;  it ought however to
be used Avith caution, and not to be repeated unless where the signs of in-
flammation rise high;  in which case it will also be necessaiy, to apply a
blistering plaster to the region of tlie Avomb.
   During the rigour, or cold fit, proper means should be used to abate its
violence  and shorten its duration.   For this purpose  the patient may
drink freely of warm diluting liquors, and, if low, may take noiv and then
a cup of wine Avhey;  warm applications  to the extremities, as  heated
bricks, bottles or bladders filled with warm water, and suchlike, may al-
so be used with advantage.
   Emollient clysters of milk and water, or of chicken water, ought to be
frequently administered through the course of the disease.   These prove
beneficial by promoting  a  discharge from the intestine, and also by act-
ing as a kindly fomentation to the womb and parts adjacent.  Great care
however is requisite in giving  them, on account  of the tenderness of the
parts in the pelvis at this time.
   To  evacuate the  offending bile from the stomach, a vomit is  ge-
nerally given.   But as this  is apt to increase the irritability of  the
stomach, already  too great,  it will be  safer to  omit it,  and to give
in its  s'.ead a gentle laxative, which will both tend to cool the body,
and to  procure a  free discharge of the  bile.*
   The medicine Avhich I have always found to succeed best in this di-
sease, is the saline draught.   This, if frequehtby repeated, Avill often  put
a stop  to the vomiting, and at the same time lessen the violence of  the
fever.   If it runs off by stool, or if the patient be restless, a few drops of
laudanum, or some syrup of poppies, may occasionally be added.
   If the stools should  prove  so  frequent as  to Aveaken  and exhaust
the patient, a starch clyster,  with thirty or forty drops of laudanum
in it,  may be  administered as occasion  shall  require; and  the drink
may be  rice-water, in every English pint of which half an ounce of
gum-arabic has been dissolved.   Should these fail, recourse must be
had to  Columbo-root, or some other strong astringent.
   Though in general the food ought to be light,  and  the drink di-
luting,  yet when  the disease has  been long protracted,  and the  pa-
 tient is greatly spent by evacuations, it will  be necessary  to support
 her with nourishing diet aud generous  cordials.
   It Avas observed that this fever, after  continuing for some time, of-
ten acquires a putrid form.   In tliis case the Peruvian bark must be
given,  either by itself,  or joined with cordials, as  circumstances  may
  * Midwives ought to be very cautious in administering vomits or purges to
women in child-bed   I have known a woman who was recovering extremely
well, thrown into the most imminent danger, by a strong purge which was give n
her by an officious midwife. 
OF BARRENNESS.
341
require.   As the bark in substance Avill be apt to purge, it may be given
in decoction or infusion mixed with the tincture of roses, or other gentle
astringents; or a scruple of the extract of bark with half an ounce of spi-
rituous ciunamon-Avater, two ouuces of common water,  and  ten drops of
laudanum, may be made into a draught,  and given every second, third,
or fourth hour, as shall be found necessaiy.
   When the stomach will not bear any kind of nourishment, the patient
may be supported for some  time by clysters of beef-tea, or chicken-water.
   To avoid this fever, every woniau in child-bed ought to  be kept per-
fectly easy; her food should be light and simple, and  her bed-chamber
cool, and properly ventilated.  There is  not any thing more hurtful to a
woman in this situation than being kept too warm.   She ought uot to have
her body bound too tight, nor to rise too soon  from bed after delivery;
catching cold is also to be avoided; and a proper attention should be paid
to cleanliness.
   To prevent the milk fever, the breasts ought frequently to be drawn;
and if they are filled previous to the onset of a fever, they  should, upon
its first appearance, be drawn, to prevent the milk from becoming acrid
and its beiug absorbed in this state.   Costiveness is likewise to be avoided.
This will be best effected  by the use of mild clysters and a laxative diet.
   We shall couclude our observations on child-bed women by recommend-
ing it to them, above all things, to beAVare of cold.   Poor Avomen,  whose
circumstances oblige them to quit their  bed too soon, often contract dis-
eases from cold, of which they never recover.   It is  a pity the poor are
not better taken care of in  this situation.
   But the better sort of women run the  greatest  hazard from  too much
heat.  They are generally kept in a sort of bagnio for the first e'ght  or
ten days, and then dressed out to see company.  The danger of this con-
duct must be obvious to every one.
   The superstitious custom of obliging Avomen to keep the house till they
go to church, is likewise a veiy common cause of catching cold.  All
churches are damp, and most of them cold ; consequently they are the
very Avorst places to ivhich a Avoman can go to  make her first visit, after
having been confined in a  warm room for a month.

                       OF BARRENNESS.

   BARRENNESS may be very properly reckoned among the diseases
of females, as few married Avomen who  have not children enjoy  a good
state of health.  It may  proceed from various causes, as high living,
grief, relaxation, &c. but it is chiefly OAving to au obstruction  or irregu-
larity of the menstrual flux.
   It is very certaiu that high living vitiates the humours,  and prevents
fecundity.   We seldom find a barren Avoman among the labouring poor,
while nothing is more common  among  the  rich and affluent.  The in-
habitants of every country are  prolific iu  proportion to their poverty ;
and  it  would be an easy matter to adduce many instances of women,
who, by being reduced to live entirely upon a milk and vegetable diet,
have conceived and brought forth children, though  they never had any
before.  Would  the rich  use the same sort of food and  exercise as the
better sort of peasants, they would seldom have cause to envy their poor 
^^             DISEASES OF  CHILDREN.

vassals and dependants, the blessing of a numerous and healthy offspring
while they pine in sorrow for the want of even a single heir to their ex-
tensive domains.
   Affluence begets indolence, which not only vitiates the humours, but
induces a general relaxation of the solids;  a state highly unfavourable to
procreation.   To remove this, we would recommend  the folloAving course:
First, sufficient exercise in the open air;  secondly, a diet  consisting
chiefly of milk  and vegetables*; thirdly, the use  of astringent medi-
cines, as steel, alum, dragon's  blood, elixir of vitriol, the SpaAv or Tun-
bridge waters, Peruvian bark, Ac.;  and lastly, above all, the cold bath.
   Barrenness is often the consequence of grief, sudden fear, anxiety, or
any of the passions which tend to  obstruct the  menstrual  flux.   When
barrenness is suspected to proceed from affections of tiie mind, the person
ought to  be kept as easy and cheerful as  possible:  all  disagreeable ob-
jects are to be avoided, and every method taken to amuse  aud entertain
the fancy.
CHAP.  LI-
                  DISEASES OF CHILDREN.

      .MISERABLE indeed is the lot of man in the state of infancy _
He comes into the world more helpless than any other animal, and stands
much longer in need of the protection and care of his parents;  but, alas!
this care is not alivays bestowed upon him;  and when it is, he often  suf-
fers as much from improper management as he avouUI have done from neg-
lect.   Hence  the officious care of parents, nurses, and midwives, becomes
one ofthe most fruitful sources of the disorders of infants \.
  It must  be  obvious to every attentive person, that the first diseases
of children arise chiefly from their bowels.  Nor is this in  the least to
be  Avondered  at, as they are  in a manner poisoned with indigestible
drugs  and improper diet as soon as they come into the  Avorld.  Every
  * Dr. Cheyne avers, that want of children is oftener the fault of the male than
of the female, and strongly recommends a milk and vegetable diet to the former
as well as the latter ; adding, that his friend Dr. Taylor, whom he calls the
Milk-doctor of Croydon, had brought sundry opulent families in his neighbour-
hood, who had continued some years after marriage without progeny, to have
several fine children, by keeping both parents,for a considerable time, to a milk
and vegetable diet.
  f Ofthe officious and ill judged care of midwives, we shall adduce only one
instance, viz. the common  practice of torturing infants, by squeezing their
breasts, to draw off the milk, as they call it.  Though a small quantity of mois-
ture is generally found in the breasts of infants, yet, as they are certainly not in-
tended to give suck, this ought  never  to be drawn off.   I have seen this cruel
operation bring on hardness, inflammation, and suppuration ofthe breasts ; but
never knew any ill consequences from its being omitted.  When the breasts are
hard, the only application that we would recommend, is a soft poultice, or a lit-
tle ofthe diachylon plaster, spread thin upon a bit of soft  leather, about the
size of half a crown, and applied over each nipple.  These may be suffered to
continue till the hardness disappears. 
OF  THE  MECONIUM.                  343
thing that the stomach cannot digest may be considered as a poison; and
unless it can be thrown up, or voided by stool, it must occasion sickness,
gripes, spasmodic affections of the bowels, or what the good women call
inward fits, and at last convulsions and death.
   As these symptoms evidently arise from somewhat that irritates the in-
testines, doubtless the proper method of cure must be to expel it as soon
as possible.   The most safe and effectual method of  doing  this is by
gentle vomits.  Five or six grains of the poAvder of ipecacuanha may be
mixed in two table spoonsful of water, and sweetened Avith a little sugar.
A tca-6poonful of this may  be given to the infant every  quarter of an
hour till it operates; or, ivhat Avill more certainly answer the purpose,  a
grain of emetic tartar may be  dissolved in three ounces of water, SAveel-
cned Avith a  little syrup, and given as above.   Those who are willing to
use the emetic tartar, may give six or seven drops of the antimonial wine,
in a tea-spoonful of Avater or  thin gruel.  Small  doses of ipecacuanha
Avine will be found more gentle  than any of the above, and ought to be
preferred.
   These medicines will not  only cleanse the stomach, but will generally
likewise open the body.   Should this  hoAvever not happen, and  if the
child be costive, some gentle purge Avill be  necessary; for this purpose,
some manna and pulp of  cassia  may be dissolved in boiling water, and
given in small quantities till it operates;  or, what will answer rather bet-
ter,  a feiv grains of magnesia  alba may be mixed in  any kind of food
that is given to the child, aud continued till it has the desired effect.  If
these medicines be properly administered and the child's belly and limbs
frequently rubbed with a warm hand before the  fire, they will seldom fail
to relieve those affections  of the stomach and bowels from  which infants
suffer so much.
   These general directions include most of what can be done for reliev-
ing the internal disorders  of infants.  They will likewise go a considera-
ble  way in  alleviating those which appear externally,  as the rash, gum,
or fellon, Ac.   Tliese; as was formerly observed, are principally owing
to too hot a regimen, and consequently will be most effectually relieved by
gentle evacuations.   Indeed, evacuations of one kind or other constitute
a principal  part of the medicine of  infants, and will seldom,  if adminis-
tered Arith prudence, in any of their diseases, fail to give relief.

                     OF THE MECONIUM.

   THE stomach and bowels of a new-born infant are filled with a black*
 ish  coloured matter of the  consistence of syrup,  commonly called tlie
meconium.   This is generally passed  soon after the birth, by the  mere
effort of nature; in Avhich case  it is  not necessary  to give the infant any
kind of  medicine.  But if it ebould be retained, or not sufficiently car-
ried off, a  little manna or magnesia alba may be gi\Ten as mentioned
above; or,  if these should not be at hand, a common spoonful of whey,
sweetened with a little honey, or raw sugar, will answer the purpose.
   The most proper medicine for expelling the  meconium is the mother's
milk, which is always at first of  a purgative quality.  Were children al-
lowed to suck as soon as they  shew an inclination for the breast, they
 would seldom  have occasion for medicines to discharge the meconium; 
344
THE  APHTII-E.--OF  ACIDITIES.
but even where this is not allowed, they ought never to have  daubs of
syrup, oils, and other indigestible stuff, crammed down tlieir throats.

                 THE APHTILE, OR  THRUSH.

   The aphtha? are little whitish ulcers affecting the  whole inside of the
mouth, tongue, throat, and  stomach of  infants.  Sometimes they reach
through the whole intestinal canal; in which case they are veiy danger-
ous,  and often put an  end to the infant's life.
   If the aphthae  are  of a pale colour, pellucid, few  in number, soft, su-
perficial, and  fall easily off, they are not dangerous; but if opakc, yel-
low,  brown, black, thick, or running together, they ought to be dreaded.
   It is generally thought that the aphtha; oAve their  origin to acid  hu-
mours;  wre have reason however to believe, that they are more frequent-
ly oAving to tooiiot a  regimen  both of the mother and  child.   It is a rare
thing to find a child who is not  dosed Avith wine, punch,  cinnamon-waters.
or some otlier hot and inflaming liquors, almost as soon as it is born.   It
is Avell knoAvn that these will  occasion inflammatory disorders even in
adults;  is it any wonder then  that they  should heat and inflame the ten-
der bodies of  infants, and set  as it Avere  the  whole constitution in  a
blaze ?
   The most proper medicines for the apthhae are vomits, s uch as have
been already recommended, and gentle  laxatives.  Five grains of rhu-
barb and half  a drachm of magnesia alba may be  rubbed together,  and
divided into six  doses, one of which may be given  to the infant every
four  or five  hours till they  operate.   These powders may either be
given in the child's food, or a  little  of the syrup of pale roses, and ma)
be repeated as often as is found necessary to keep the body open.  It  is
common in this case  to administer  calomel; but as that medicine some-
times occasions gripes, it ought ahvays  to be given  to infants Arith cau-
tion.
   Many things have  been  recommended  for gargling the  mouth and
throat iu this disease; but  it  is not easy to apply these in very young
children;  Ave would therefore  recommend it to the nurse 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, rose Avater  two drachms;  mix them together.   A  veiy pro-
per application in this case, is a solution of tenor twelve grains of white
vitriol in  eight ounces of  barley-water.  These may  be applied with
the finger, or  by  means of a  bit of soft rag tied to tlie end of a probe.-

                         OF ACIDITIES.

   THE food of  children being for  the most part of  an acescent nature,
it readily turns sour  upon the  stomach, especially if  the body  be any
way disordered.  H^nce most diseases of children are accompanied w ith
evident signs of acidity, as greens 6tools, gripes, Ac  Thes" appearances
have induced ma:y to  believe, that all the diseases of children were owing
to an acid abounding in the stomach and bowels; but whoever considers
the matter attentively, will  fin 1 that the?e symptoms of acidity  are ot
tener the effect than the cause of their  diseases. 
               GALLINC AND EXCORIATION.          345

   Nature evidently intended that  the food of children should be aces-
cent ; and unless the body be disordered, or the digestion hurt, from some
other cause,  we will venture to say, that the acescent quality of their
food is seldom injurious to them.  Acidity, however, is often a symptom
of disorders in children, and, as it is sometimes a troublesome one, we
shall point out the method of relieving it.
   When green stools,  gripes,  purging,  sour  smells, Ac. sheAV that the
boAvels abound Avith an acid, let the -child have a little small broth, with
light white bread in it; and it should have sufficient exercise in order to
promote  the  digestion.   It has been customary in this case to give the
pearl-julep, chalk, crabs' eyes, and other testaceous powders.   These,
indeed, by their absorbent quality, may correct the acidity; but they
are attended with this inconvenience, that they are apt to  lodge  in the
bowels, and occasion costiveness, which may prove very hurtful to the
infant.   For this reason they should never be given unless mixed with
purgative medicines: as rhubarb, manna, and such  like.
   The best medicine which we know in all cases of acidity, is that fine
insipid powder called  magnesia alba.  It purges, and at the same time
corrects  the  acidity; by which means it not only  removes the disease,
but carries off its cause.   It may be given in any kind of food,  or in a
mixture, as recommended in the Appendix.*
   When an infant is troubled Avith gripes, it ought not at first to be dosed
Arith brandy, spiceries, and otlier hot things; but should have its body
opened with an emollient clyster, or the medicine mentioned above;  and
at the same time a little brandy may be rubbed on i|s belly with a warm
hand before the fire.  I have seldom seen this fail  to  ease  the gripes of
infants.  If it should happen, however, not to succeed, a little brandy or
otlier spirits may be mixed  with thrice the quantity of warm Avater, and
a tea-spoonful of it given frequently till the infant be easier.  Sometimes
a little peppermint water Avill answer this purpose very well.

                GALLING AND EXCORIATION.

   THESE  are very  troublesome to children.   They happen  chiefly
about  the groin and wrinkles of the neck,  under the arms, behind the
ears, and in other parts that are moistened by the sweat or urine.
   As these complaints are, in  a great measure, owing to want of cleanli-
ness, the most effectual means of preventing them, are, to Avash the parts
frequently with cold water, to change the linen often, and,  in a word, to
keep the child in all respects thoroughly clean.  When this is not suffi-
cient,  the  excoriated parts may be sprinkled with absorbent or  drying
poAvders; as burnt  hartshorn, tutty, chalk, crabs'  claAvs prepared, and
tlie like.   When the parts affected are very sore, and tend to a real ul-
ceration, it Avill be proper to add a little sugar of lead  to the powders;
or to anoint the place Avith  the camphorated ointment.   If the parts be
washed with  spring-water, in which a little white vitriol has been dissol-
ved, it will diy and heal them very powerfully.  One of the best appli-
cations for this purpose, is to dissolve some fuller's earth in a sufficient
quantity of hot water; and after it has stood till it is cold, to rub it gent-
ly upon the galled parts, once or twice a-day.
* See Appendix, Laxative absorbent Mixture.
                  44 
 346   STOPPAGE OF  THE  NOSE--OF  VOMITING.

                  STOPPAGE  OF THE  NOSE.

   THE nostrils  of infants  are often plugged up  with a gross mucusy
which  prevents their breathing freely,  and  likewise renders it difficult
for them to suck  or swallow.
   Some  in this case order,  after a suitable purge, two or three grains
of white vitriol  dissolved in  half  an  ounce of  marjoram-water, and
filtered,  to be applied  now  and then to the nostrils  with a linf-n rag.
Wedelius says,  If tAvo grains of Avhite  vitriol, and the same quantity
of elaterium,  be dissolved in half an ounce of marjoram-water, and ap-
plied to the nose, as above directed, that it brings aAvay the mucus Avith-
out sneezing.
   In obstinate cases these  medicines may be tried; but I have never
found any thing  necessary,  besides rubbing the nose at bed-time with a
little sweet oil, or fresh butter.  This resolves the filth, aud renders tlie
breathing more free.*

                         OF VOMITING.

   From the  delicate state of children, and the great sensibility of their
organs, a vomiting or looseness may be induced by any thing  that irri-
tates the nerves of the stomach or intestines.   Hence these disorders are
much more common  in childhood, than in the more advanced periods of
life.   They are seldom, however, dangerous, and ought never to be con-
sidered as diseases, tmless when they are violent, or continue so long as
to exhaust the strength of the  patient.
   Vomiting  may be excited by an over-quantity of food; by  food that
is of such a nature as to irritate the nerves of the stomach too much;  or
by the  sensibility of the  nerves being so much increased as to render
them unable  to bear the stimulus of even the mildest element.
   When vomiting is occasioned by too much food, it ought to be promo-
ted, as the cure will depend upon cleansing the stomach.   This may be
done either by a  few grains of ipecacuanha, or a Aveak solution of emetic
tartar, as mentioned before.   When it is owing to  food of an  acrid  or
irritating quality, the diet ought to be changed, and aliment of  a milder
nature substituted in its stead.
   When vomiting proceeds from  an  increased degree of  sensibility,
or too great  an  irritability  of the nerves of the stomach, such medi-
cines as have a tendency to brace and strengthen that  organ, and to
abate its sensibility, must be used.  The first of these intentions  may
 be answered by a slight infusion of the Peruvian bark,  with the ad-
dition of a little rhubarb and orange-peel; and the second by the saline
 draughts, to  which a few drops of liquid laudanum may be occasionally
 added.
   In obstinate  vomitings the operation  of internal medicines may  be
 assisted  by aromatic fomentations made with  wine, applied warm to the
 pit of the stomach; or the  use of tlie stomach-plaster, with the addition
 of a little Theriaca.

   *  Some nurses  remove this complaint by sucking the child's nose  This is
 by no means a cleanly operation ; but when nurses have the resolution to do it,
 1 am far from discouraging the practice 
             of a  Looseness—of  eruptions.        34,7


                       OF A LOOSENESS.

    A LOOSENESS may generally be reckoned salutary Avhen the stools
 are sour, slimy, green or curdled.  It is uot the discharge, but the pro-
 duction  of such stools, which  ought to be remedied.  Even Avhere the
 purging is thin and watery, it  ought not to be checked too suddenly, as
 it often proves critical, especially when the child has caught cold, or au
 emption on the  skin has disappeared.  Sometimes an evacuation of this
 kind succeeds a humid state of the atmosphere, in Avhich case it may also
 prove of advantage, by carrying off a quantity of watery humours, Avhich
 Avould otherwise tend to relax the habit.
   As the principal intention ofthe cure of a looseness is to evacuate the
 offending matter, it is customary  to give the patient a gentle vomit of
 ipecacuanha, and afterwards to exhibit small and frequent doses of rhubarb;
 interposing absorbent medicines? to mitigate the acrimony of the humours-
 The best purge, however,  in this case, is magnesia alba.   It is at the
 same time absorbent and laxative, and operates without exciting gripes.
   The antimonial wine, which acts both as an emetic and purge, is also
 an excelleut  medicine in this case.  By being diluted with Avater, it may
 be proportioned to the weakest constitution; and, not  being disagreeable
 to the palate, it may be repeated as often  as  occasion requires.  Even
 one dose will frequently mitigate the disease,  and pave the Avay for the
 use of absorbents.   If, however, the patient's strength will permit, the
 medicine ought to be repeated every six or eight hours, till the stools
 begin to assume a more natural appearance; afterwards  a longer space may
 be allowed to intervene between the doses.  When it is necessary to re-
 peat the medicine frequently,  the dose ought  always to be a little in-
 creased, as its efficacy is generally diminished by use.
   Some  upon the first appearance of a loosen, ss, fly immediately to
 the  use  of absorbent medicines  and astringents.  If these be adminis-
 tered before  the offending  humours are discharged,  though the disease
 may appear to be mitigated for  a  little  time, it soon aftenvards breaks
 forth with greater riolence, and often proves fatal.  After proper evacu-
 ations, however, these medicines  may be administered with considerable
 advantage.
   Should any gripings or  restlessness  remain  after  the stomach and
 bow els have been cleansed,  a tea-spoonful of the syrup  of poppies may be
 given in a little simple cinnamon-water,  three or four times  a-day, till
 these symptoms have ceased.

                       OF ERUPTIONS.

   CHILDREN, while on  the breast, are seldom free from eruptions of
 one  kind or other.    These,  however, are not often dangerous, and
 ought never to be dried up but with the greatest caution.   They tend
to free the bodies of  infants from hurtful humours, which, if retained,
might produce fatal disorders.
  The eruptions of children are chiefly oAring  to improper food and neg-
lect of cleanliness.  If a child be stuffed at all hours  with food that its
stomach is not able to digest, such food not being properly assimilated,
instead of nourishing the body, fills it with gro"s  humours.   "These mus!" 
343
of eruptions.
either break out in form of eruptions upon the skin, or remain in the
body, and occasion fevers and  other internal disorders.  That neglect
of cleanliness is a very general cause of eruptive disorders, must be ob-
vious to every one.   The children of the poor,  and  of  all who despise
cleanliness, are almost constantly found to swarm with  vermin, and are
generally covered with the scab, itch and otlier eruptions.
  When eruptions are the effect of improper food, or want of cleanliness,
a proper attention to these alone will generally be sufficient to remove
them.   If this should not be the case, some  drying medicines Avill be ne-
cessary.  When they are applied, the body ought at the same time to be
kept open, and cold  is carefully  to be avoided.  We knoAv  no medicine
that is more safe for diying up cutaneous eruptions than sulphur, provi-
ded it be prudently used.  A little ofthe flour of sulphur may be mixed
with  fresh  butter, oik or hog's lard, antl the parts affected frequently
touched with it.*
  The most obstinate of  all  the  eruptions incident to children, arc
the tinea capitis, or scabbed head, and chilblains.   The scabbed head
is often exceeding  difficult  to  cure, and  sometimes indeed  the cure
proves  Avorse than  the  disease.    I have  frequently knoAvn  children
seized with internal   disorders,  of which  they died  soon after their
scabbed heads had been healed by the application of drying  medicines.!
The cure ought always first to be attempted by keeping the head very
clean, cutting off the hair, combing and brushing away the scabs, &c.
   * The following method for drying and curing cutaneous eruptions, is deem-
 ed not unworthy of attention—It is an extract of a letter (taken from a Calcutta
 paper,) from a Gentleman of the Faculty, at Fort St. George, to the Doctor of
 the Bengal Establishment:—
   " Sir Paul Joddrel, from his skill in  botany, has made a discovery which is
 likely co prove of importance to the health and ease of the Europeans in India ,-
 and will tend to the extirpation of that cruel malady, the ringworm ; and the
 remedy is as simple as it is  efficacious.  It consists in nothing more than a fre-
 quent embrocation, or friction of the parts  where the eruption prevails, with
 common mushroom ketchup.  This remedy, simple as it appears, has never been
 known to fail in removing the ring-worm, itch, or any other cutaneous eruption,
 after every nostrum has failed.
   " Sir Paul accounts for this efficacy of the vegetable curative, in the known
 noxious property of the mushroom to all animalcula.  The solution or essence
 of tills fungus is proved, by this discovery, to bear such  enmity to the minute
 insect which is the occult cause of this disorder, that it immediately perforates
 the cuticle, and totally exterminates the infection.  The experiment is easy,
 and a trial is recommended  to those afflicted with ring-vsorms, tetters or erup-
 tions of any kind."                                               A. E.
   -f-1 some time ago saw a very striking instance of the danger of  substituting
 drying medicines in the place of cleanliness and wholesome food, in the Found-
 ling Hospital at Ackworth,  where  the children were grievously afflicted with
 scabbed heads, and otlier cutaneous disorders.  Upon inquiry it was found, that
 very little attention was paid either to the propriety or soundness of their pro-
 visions, and that cleanliness  was totally neglected; accordingly it was advised,
 that they should have more wholesome food, and be kept thoroughly clean.
 This advice, however, was not followed   It was too troublesome to the ser-
vants, superintendants, &c.  The business was to be done by medicine; which
was accordingly attempted,  but had nearly proved fatal to the whole house.  Fe-
vers, and other internal disorders immediately appeared, and at length a putrid
dysentery, which proved so infectious, that  it carried off a great many of the
 children, and spread over a considerable part ofthe neighbouring country. 
                OF  THE  CROUP,  OR  HIVES.            349

If this is not sufficient, let the head be shaved once a-week, washed daily
With  so:ip-suds, and gently anointed with a liniment made of traiu oil
eight ounces, red precipitate, in fine powder, one drachm.   And if there
be proud flesh, it should be touched with a  bit of blue vitriol, or sprin-
kled with a little burnt alum.   While these things are doing, the patient
must be coufined to a regular light diet, the body should be kept gently
open; and cold, as far as possible, ought to be avoided.  To prevent any
bad consequences from stopping this discharge, it will be proper, espe-
cially in children of a gross habit, to make an issue in the neck or arm,
which may be kept open till the patient becomes more strong,  and  the
constitution be somewhat mended.
   Chilblains commonly attack children in cold weather.   They are ge-
nerally occasioned by the feet or hands being kept long wet or cold, and
afterwards suddeuly heated.   When children are cold, instead of taking
exercise to warm themselves gradually, they run to the fire.   This oc-
casions a sudden rarefaction ofthe humours, and an infraction of  the
vessels; which being often repeated, the vessels are at last overdistended,
and forced to give Avay.
   To prevent it, violent cold and sudden heat must be equally avoided.
When the parts begin to look red and swell, the  patient ought to be
purged, and to have the  affected parts frequently rubbed  with mustard
and brandy,  or something of a warming nature.   They ought likewise
to be covered with flannel, and kept warm and dry.  Some apply warm
ashes between cloths, to  the swelled parts, which frequently help to re-
duce  them.  When  there is  a sore, it must be dressed with  Turner's.
cerate, the ointment of tutty, the  plaster of  eerus, or some other drying
ointment.  These sores are indeed troublesome, but seldom dangerou ■<.
They generally heal as soon as the Avarm weather sets in.

                OF THE CROUP,  OR HIVES.
                            i
   CHILDREN are often ^sized very suddenly with this disease, Avhich,
if not quickly relieved,  proves  mortal.  It is known by various names
in different parts gf Britain.   On the east coast of Scotland, it is called
the croup.  On the- Avest they call it the chock or stuffing.   In some parts
of England,  where I have observed it, the good women call it the rising
of the lights, and  in America,  the hives.   It seems to be a species of
asthma, attended with very acute and violent catarrhal symptoms.
   This disease generally prevails in cold and Avet  seasons.  It is most
common upon the sea-coast, and in low marshy countries.   Children of a
gross and lax habit are most liable to it.   I have  sometimes known ir
hereditary.  It generally attacks children in the night, after having been
much exposed to damp cold easterly winds through the  day.  Damp
houses, Avet feet, thin shoes, wet clothes, or  any thing that obstructs the
perspiration, may occasion the croup.
   It  is attended with a frequent  pulse,  quick and  laborious breathing,
which is performed Avith a peculiar kind of croaking noise, that must be
heard at a considerable distance.   The voice is sharp and shrill, and
the face  is genei'ally much flushed, though  sometimes it  is of a livid
colour.
   When  a child is seized with  the above symptoms, his feet  should
be immediately put  into warm Avater.    lie  ought likewise to be 
350
OF  TEETHING.
bled,* and to have a  laxative cljster  administered as soon as possible.
He should be made to breathe over the steams of warm water and vine-
gar; or an emollient decoction, and emollient cataplasms or fomentation*
may be applied round his neck.   If the sjmptoms do uot abate, a blis-
tering-plaster must be applied round the neck, or between the shoulders,
and the child may take frequently a table-spoonful ofthe following julep:
Take penny-royal  water three ounces, syrup of althea and of poppies,
each one ounce, mix them together.
  Asafcetida is found to have a good effect iu tills case.   It may be both
given in form  of clyster, and taken by the  mouth.  Two drachms  of
asafcetida may be dissolved in one ounce of Mindererus's spirit, and three
ounces of penny-royal water.   A table-spoonful of this mixture may be
given every hour, or oftener, if the patient's stomach be able to bear it.
If the child cannot be brought to take this medicine, two  drachms of the
asafcetida may be dissolved in a common clyster, and administered every
six or eight hours, till the violence of  the disease abates, f
   To prevent a  renin of the disorder, all those things which occasion it
must carefully be avoided; as wet feet, cold, damp, easterly winds, Ac.
Children who have  had frequent returns of  this disease, or whose con-
stitutions seem to dispose them to it, ought to have their diet properly
regulated; all food that is viscid or hard of digestion, and  all  crude,
raw,  trashy fruits are to be avoided.   They ought  likewise to have a
drain constantly kept open in some part of their body,  by means of a
seton or issue.   I have sometimes known a Burgundy-pitch plaster, Avorn
continually between the shoulders for several years, have a very happy
effect in preventing the return of this dreadful disorder.

                         OF TEETHING.

   Dr. Arbuthnot observes, that above a tenth  part of infants  die  in
teething,  by symptoms  proceeding from the  irritatidn of  the tender
nervous parts  of tlie  jaws,  occasioning inflammations, fevers,  convul-
sions,  gangrenes, Ac.    These  symptoms   are in  a  great  measure
owing to the great  delicacy, and  exquisite  sensibility  of the nervous
system at  this time of  life,  Avhich is too often increased by an  effe-
minate education.    Hence  it comes to pass,  that children who are
  • In this disease bleeding is not always proper; but in very full habits it cer-
tainly must be of use.
  f I was lately favoured with a letter from Dr. William Turnbull in London,
a physician of great experience, and who, from his former situation on the
north-east coast of England, had many opportunities of observing the symptoms
and progress of this dangerous disease.  I am sorry the letter came too late to
be inserted at length; but as the Doctor's sentiments differ very little from my
own, this misfortune is the less to be regretted.  The Doctor indeed observes,
that he never  found blistering of any service; but recommends cataplasms of
garlic, camphor and Venice treacle, to be applied both to the throat and soles
of the feet.  He likewise recommends bolusses of camphor,  castor, valerian
root, salt of hartshorn, and musk, adapted to the age, strength, &c. df the pa-
tient; after which he advises two spoonsful ofthe following decoction: Take ot
garlic and distilled vinegar each an  ounce, hysop-water eight ounces; beat up
the ingredients together, gradually mixing the water, and adding three ounces
of honey.  Let tlie whole be simmered over a gentle fire, and afterwards strain,
ed for use. 
OF  TEETHING.                    351
 delicately brought up, always suffer most in teething, and often fall by
 convulsive disorders.
   About the  rixth or seventh month the teeth generally  begin to make
 their appearance; first, the incisores, or fore-teeth; next, the canini, or
 dog-teeth; and lastly, the molares, or grinders.  About the seventh year,
 there comes a new set;  aud about the twentieth, the two inner grinders,
 called denies sapient*, the teeth of Arisdom.
   Children about the lime of cutting their teeth, slaver much, and have
 generally a looseness.  When the teething is difficult, especially when
 the dog-teeth begin to make their way through  the gums,  the child  has
 starlings  in  his sleep,  tumours of the gums, watchings,  gripes, green
 stools, the thrush, fever, difficult breathing, and convulsions.
   Difficult teething requires nearly the same treatment as an inflamma-
 tory disease.   If the body be bound, it must be opened either by emol-
 lient clysters or gentle purgatives; as manna,  magnesia alba, rhubarb,
 senna or the like.   The food should be light, and in small quantity;
 the drink plentiful,  but weak and diluting,  as infusions of  balm, or  of
 the  lime-tree  flowers; to Avhich  about a third or fourth part of milk
 may be  added.
   If the fever be high, bleeding will be necessaiy; but this in very
 young children ought always to be sparingly performed.   It is an evacu-
 ation which they bear the worst of any.  Purging, vomiting, or sweat-
 ing, agree much better  Avith  them, and are  generally more beneficial.
 Harris, however, observes, that when an inflammation appears, the phy-
 sician will labour in vain, if the cure be not begun with applying a leech
 under each ear.   If the child be seized with couvulsive-fiis,  a blisteritg-
 plaster may be applied  betAveen ,the shoulders,  or one behind each ear.
   Sydenham says, that in fevers occasioned by  teething, he never found
 any remedy 80 effectuat as two, three, or four drops of spirits of hartshorn
 in a spoonful of simple  water, or other convenient vehicle, given every
 four hours.  The number of doses may be four, five, or six.   I have of-
 ten prescribed this medicine with success, but always found a larger dose
 necessary.  It may be given from five drops to  fifteen or tAventy, accord-
 ing to the age of the child, and  when costiveness does not forbid it, three
 or four drops of laudanum may be added to each  dose.
   In Scotland, it is very commou, when children are cutting their teeth,
 to put a  small Burgundy-pitch plaster betAveen  their shoulders.  This
 generally eases  the tickling cough which  attends teething, and is  by
 no means an useless  application.  When the teeth  are  cut with diffi-
 culty, it  ought to be kept on during the whole time of teething.   It
 may be enlarged as occasion requires, and  ought  to be reneAved  at least
 once a fortnight.
   Several things  have  been recommended  for  rubbmg the gums, as
 oils,  mucilages,  Ac. but from these,  much is not to  be expected.
 If any  thing of  this kind is  to be  used,  we  would  recommend a lit-
 tle fine  honey,  which may  be  rubbed  on with the finger three or
 four times a day.  Children are generally at this time disposed to chew
 whatever they get into their hands.  For this reason they ought never
 to be Avithout somewhat that will yield a Utile  to the pressure of their
 isrms af  a crust of bread, a wax candle, a bit of liquorice-root, or such
like. 
352
OF THE  RICKEIS.
   With regard to cutting  the gums, we have seldom known il of any
great benefit.  In obstinate cases, however, it ought to be tried.   It may
be performed by the finger nail,  the  edge of  a six-penny piece that is
worn thin, or any sharp body which can be  with safety introduced iuto
the mouth;  but a lancet, in a skilful baud, is certainly the most proper.
   In order to render the teething less difficult, parents ought to take care
that their children's food be light and Avholesome, and that tlieir nerves
be braced by sufficient exercise without doors, the  use of the cold
bath, Ac.   Were  these things duly regarded,  they  would have a much
better effect than teething necklaces, or other  nonsensical amulets worn
for that purpose.

                       OF THE  RICKETS.

   THIS disease  generally  attacks  children between the  age of nine
months and two  years.   It appeared first in  England, about the time
when  manufactures began to flourish, and still prevails most  in towns
where the inhabitants follow sedentary 'employments, by Avhich means
they neglect either to take proper exercise themselves, or to give it to
their children.
   CAUSES.—One cause  of  the rickets is diseased parents.   Mothers
of a weak relaxed habit, Avho neglect exercise, and  live upon Aveak wa-
tery diet, can neither be expected  to  bring forth  strong and  healthy
children,  or to be  able  to nurse  them after they are brought forth.
Accordingly Ave find, that  the children of such women generally die of
the rickets, the scrophula, consumptions or such like diseases.  Chil-
dren begotten by  men  in  the decline of life, who are subject to the
gout, the gravel or other chronic diseases, or who have  been often afflict-
ed with the venereal disease iu  their  youth are likewise very liable to
the  rickets.
   Any disorder  that weakens the  constitution, or relaxes  the habit of
children,  as the small-pox, measles,  teething, the  hooping-cough, Ac.
tlisposes them to this disease.  It may likewise be occasioned by impro-
per diet, as food that is either too Aveak and wratery,  or so viscid that the
stomach cannot digest it.
   Bad nursing is the chief cause of  this disease.   When the nurse is
either  diseased, or has not enough of milk to nourish the child, it cannot
tlirive.  But children suffer oftener by want of care in nurses than want
of food.  Allowing an infant to lie or sit too much, or not keeping it tho-
roughly clean in its clothes, has the most perniciouseffects.
   The want of free air is likewise Arery hurtful to children in this res-
pect.  When a nurse lives in a close small house, Avhere the air  is damp
and confined, and is too indolent to carry her child abroad into the open
air, it  will hardly escape this disease.  A healthy child should always
be in motion, unless when asleep;  if it be suffered  to lie or  sit, instead
of being tossed and dandled  about, it will not thrive.
   SYMPTOMS.—At the beginning of this disease the child's flesh grows
soft and flabby; its strength is diminished;  it loses its wonted cheerful-
ness, looks more  grave and composed than is natural  for its age, and
does not chuse to be moved.  The head and belly become too large in pro-
portion to the other parts;  the face appears full, and the complexion flo-
rid. Afterwards the bones begin to be affected, especially  in the more
I 
OF CONVULSIONS.                 353
soft and spungy  parts.  Hence the wrists  and ancles become thicker
than  usual;  the spine  or back-bone puts  on an  unnatural  shape;
the breast is likewise often deformed; and  the bones of the  arms and
legs grow crooked.  All these symptoms vary according to the violence
of the disease.  The pulse is generally quick, but  feeble; the appetite
and digestion for the most part bad ; the teeth come slowly and with dif-
ficulty, aud they often rot and fall out afterwards.   Ricketty children
generally  have great acuteness of mind, and  an understanding above
tlieir years.   Whether this is owing to their being more in  the company
of adults than other children, or to the preternatural enlargement ofthe
brain, is not material.
  REGIMEN.—As this disease is always attended with  evident signs
of weakness  and relaxation, our chief aim in tlie cure must be to brace
and strengthen the solids, and to promote digestion  and the due prepa-
rationof the  fluids.   These  important ends will be best  answered by
wholesome nourishing  diet, suited to the age and strength of the patient,
open dry air, and sufficient  exercise.  If  the child has  a bad nurse,
who either neglects her duty, or does not understand it, she  should be
changed.   If the season be cold, the child ought to be 'kept warm;  and
when the weather is hot, it ought to be kept cool;  as SAveating is apt to
weaken it, and  too great a degree of cold has the same effect.'  The
limbs should be rubbed frequently with a warm hand, and the child kept
as cheerful as possible.
   The diet ought to be dry and nourishing, as good bread,  roasted flesh,
Ac.   Biscuit  is generally reckoned the best bread; and pigeons, pul-
lets, veal, rabbits, or mutton roasted or minced, are  the most proper flesh.
If the child be too young for flesh meats, he may have rice, millet, or
pearl-barley boiled  with raisins, to Avhich  may  be added a little wine
and spice.  His drink may be good claret mixed with an equal quantity
of water.  Those Avho cannot afford claret, may give the child now and
then  a Avine-glass of mild ale, or good porter.
   MEDICINE.—Medicines are here of little avail.  The disease may
often be cured by the nurse, but seldom by the physician.   In children
of a gross habit, gentle vomits and repeated  purges of rhubarb may some-
limes be of use, but they will seldom carry off the disease;  that must de-
pend chiefly upon such things as brace and strengthen the system: for
Avhich purpose, besides the regimen mentioned above, we  would recom-
mend the cold bath, especially in the warm season.   It must hoAvever be
used  with prudence, as some ricketty children cannot bear it.  The best
time  for using the cold bath is in the morning, and the child should bes
Avell rubbed Arith a dry cloth immediately after he  comes out of it.  If
the child  should be Aveakened by the cold  bath, it must be  discontinued.
   Sometimes  issues have been found beneficial in this disease.  They
are peculiarly necessary  for children Avho abound with gross humours.
An infusion of the Peruvian bark in  wine or ale  would be of  service,
were it possible to bring them to take it.  We might here mention many
other medicines which have been recommended, for the rickets;  but as
there is far more danger in trusting to  these than in neglecting them al-
together, we chuse rather to pass them over, and to  recommend a proper
regimen as the thing chiefly to be depended on.
                      OF CONVULSIONS.
   THOUGH more children are said to die of convulsions than of  any
other disease, yet they are for  the most part only a symptom of some
                                 45 
354
OF WATER IN  THE  HEAD.
other malady.  Whatever  greatly  irritates or  stimulates the nerves,
may occasion convulsions.   Hence infants whose nerves are easily af-
fected, are often thrown into  convulsions by any thing that irritates the
alimentary canal;  likewise by teething; strait clothes; the approach of
the small-pox, measles, or otlier eruptive diseases.
  When convulsions proceed from an irritation of the stomach or bowels,
whatever clears them of their acrid contents, or renders these mild ami
inoffensive,  will generally perform a cure: wherefore, if the child be
costive, the best Avay will be to begin  Avith a clyster and  afterwards to
give a gentle vomit, which may be repeated occasionally, and the body in
the mean time kept  open  by gentle doses of magnesia  alba,  or small
quantities of rhubarb mixed with the poAvder of crabs' claws.
  Convulsions which precede the eruption of the small-pox  or measles
generally go off upon these making their appearance.   The principal
danger in this case arises from the fears and apprehensions of  those who
have the care of the patient.   Convulsions are very alarming, and some-
thing must be done to  appease  the affrighted parents, nurses, Ac.  Hence
the unhappy  infant often  undergoes  bleeding, blistering, and several
other operations,  to the great danger of its life, Avhen a little time, bath-
ing the feet in warm Avater, and throAving  in a mild clyster, would have
set  all to rights.
  When convulsion-fits arise  from the cutting of  teeth, besides gentle
evacuations, avc would recommend blistering, and the use of antispasmo-
dic medicines, as the tincture of soot, asafcetida, or castor.   A  few drops
of any of these may be mixed in a cup of white-wine whey,  and given
occasionally.
  When convuMons  proceed from any external cause, as the pressure
occasioned by strait clothes or bandages, &c.  These ought immediately
to be removed; though in this case taking away the cause will not al-
ways remove the effect, yet it ought to be done.  It is not likely that
the patient Avill recover, as long as the cause which first gave rise to the
disorder continues to act
  When a child is seized with convulsions Avithout having any complaint
in the bowels, or symptoms  of teething; or any rash  or other  discharge
which has been suddenly dried up; we have reason to conclude that it
is a primary disease, and proceeds immediately from the brain.   Cases
of this kind, however, happen but seldom, which is very fortunate, as
little can be done to relieve the unhappy patient.  When a disease pro-
ceeds from an original fault in the formation or structure of the  brain
itself, we cannot expect that it should yield to medicine.  But as this is
not always the cause, even  of  convulsions which proceed  immediately
from the brain, some attempts  should be made to remove them.   The
chief intention to be pursued  for this purpose, is to make some deriva-
tion from the head, by blistering, purging, and the like.    Should these
fail, issues or  setons may be put in the neck, or between the shoulders.

                 OF WATER IN THE HEAD.

  THOUGH water  in  the head, or a dropsy of the brain, may affect
adults as Avell  as children, yet, as the latter are more peculiarly liable to
it, we thought that it would be most proper to place it among the diseases
of infanti. 
OF SURGERY.
355
   CAUSES.—A dropsy of the brain may proceed from injuries done to
the brain itself by  falls, blows, or the like; it may also proceed from an
original laxity or weakness of the  brain;  from scirrhous tumours or ex-
crescences within the skull: a thin watery state of the blood :  a dimin-
ished secretion of urine; a sudden check ofthe  perspiration; and lastly,
from tedious and lingering diseases, which waste  and consume the patient.
  SYMPTOMS.—This disease has at first the appearance of a sIoav fe-
ver ; the patient complains of a pain in the croAvn of his head or over his
eyes; he shuns the light; is sick, and sometimes vomits;  his pulse is ir-
regular and generally low: though he seems heavy and dull, yet he does
not sleep : he is sometimes delirious, and frequently sees objects double;
towards the end of this commonly fatal disease, the pulse becomes more
frequent, the pupils are generally dilated, the cheeks flushed, the patient
becomes comatose, and convulsions ensue.*
   Ml'.DICINE.—No medicine has hitherto been found sufficient to car-
ry off a dropsy ofthe brain.   It is laudable,  however, to make some at-
tempts, as time or  chance may bring many things to light, of which at
present  we have no idea.   The medicines generally used are, purges of
rhubarb or jalap, with calomel or blistering-plasters applied to the neck or
back part of the head.   To which we would beg leave to add diuretics,
or  medicines which promote the secretion of urine, such as are recom-
mended in the common dropsy.   A discharge  from the nose ought like-
wise to be promoted by causing the patient to snuff the poAvder of asarum,
white hellebore or the like.
  Some practitioners have of late  pretended to cure this disease by the
use- of mercury.   I have  not been  so happy  as to see  any instances of a
cure being performed in a confirmed dropsy of  the brain ; but in so des-
perate a malady every thing deserves a trial.f
                          CHAP.  LII.

                         OF  SURGERY.}

       1 O describe all the operations of surgery, and to point out the
different diseases in Avhich these operations  are necessary, would extend
this  article for beyond the  limits allotted to it:  we  must therefore
confine our observations to such  cases as  most  generally occur, and

  • I very lately lost a patient intthis disease, where a curious metastasis seemed
to take place.  The water at first appeared to be in the abdomen, afterwards in
the breast, and last of all it mounted up to the brain, where it soon proved fatal.
  f One reason why this disease is seldom or never cured, may be, that it is sel-
dom known till too far advanced to admit of a remedy.  Did parents watch the
first  symptoms, and call a physician in  due time, I am inclined to think that
something might be done  But these symptoms are not yet sufficiently known,
and are often mistaken even by physicians themselves.  Of this I lately saw a
striking instance in a patient, attended by an eminent practitioner of this city,
who had all along mistaken the disease for teething.
  * Late Practice has fully proven, that all Surgical Instruments, except the
lancet for Vaccination, dipped in oil at the instant of using, lessens the pain—It
is salutary also to have all instruments at blood heat. 
Joa»                   OF  BLEEDING*

in which proper assistance is either not asked, or not always to be obtain
ed.
  Though an acquaintance with the structure ofthe human body is in
dispensably necessary to qualify a man for being an expert surgeon;  yet
many things may be done to save the lives of tlieir fellow-men, in  emer-
gencies, by those Avho are no adepts in anatomy.  It is amazing with what
facility the peasants daily perform operations upon brute animals, which
are not of a less difficult nature than many of those performed on the hu-
man species;  yet they seldom fail of success.
  Indeed every man is in some measure a surgeon whether he will or not.
He feels an inclination to assist his fellow-men in distress, and accidents
happen every hour  which give occasion to exercise this feeling.   The
feelings of the heart, hoAvever, when not directed by the judgment,  are
apt to mislead.   Thus one, by a rash  attempt to  save  his  friend, may
sometimes destroy him; while another, for fear of doing amiss, stands still
and sees his bosom  friend expire without so much as attempting to re-
lieve him, even  when the means are in his poAver.   As every good mati
would wish to steer a course different from either of these, it will no doubt
be agreeable to him to know what ought to be done upon such emergencies

                         OF  BLEEDING.

   NO operation of surgery is so  frequently necessary as bleeding;  i!
ought therefore to be very generally understood.   But though practised
by midAvives, gardeners, blacksmiths, Ac. Ave have reason to believe that
very few know Avhen it is proper.  Even  physicians themselves have
been so much the dupes of theory in this article, as  to render it the sub-
ject of ridicule.   It is however an operation of great importance, and
must, when seasonably aud properly performed, be of singular service  to
those in distress.
   Bleeding is proper at the beginning of all inflammatory fevers, as pleu-
risies, peripneumonies, &c.  It is  likewise  proper 4n all topical inflam-
mations, as those ofthe intestines, Avomb, bladder, stomach, kidnies, throat,
eyes, Ac. as also in the asthma, sciatic pains, coughs, head-achs, rheuma-
tisms, the apoplexy, epilepsy, and bloody-flux.   After falls, blow s, bruises,
 or any violent hurt received either externally or internally, bleeding  is
necessary.   It is likeArise necessary for persons who have had the misfor-
tune to be strangled, drowned, suffocated Avith foul air, the fumes of metal
 or the like.  In a Avord, whenever  the vital motions have been suddenly
 stopt from any cause whatever, except in swoonings occasioned by mere
 weakness or hysteric affections, it is proper to open a vein.   But in all
 disorders proceeding from a relaxation of the solids, and an impoverished
 state of the blood, as dropsies, cacochymies, &c. bleeding is improper.
   Bleeding for topical inflammations ought always  to be performed  a«
 near the part affected as possible.  When this can be done with a lan-
 cet, it  is to be preferred to any otlier method; but where a vein caunot
 be found, recourse must be had to leeches or cupping.
   The  quantity of blood to  be let must  always be regulated by tiie
 strength, age, constitution,  manner of life,  aud  other circumstances
 relating to the patient.  It would be ridiculous to suppose  that a child 
                        OF  BLEEDING.                    357

could bear to lose as much blood as a groAvn person,  or that a delicate
lady should be bled to the same extent as a robust man.
  From whateAer part ofthe body blood is to be let, a bandage must be
npplied between  that  part and the  heart.  As it is often necessary, in
order to raise  the vein, to make the bandage pretty tight, it will be pro-
per in such cases, as soon as the blood begins to flow, to slacken it a lit-
tle.  The bandage ought to be applied at least an inch,  or an inch and
an half, from  the place ay here the wound is intended to be made.
  Persons  not skilled 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
easily be kuown from  its pulsation or beating, and the  latter  from  its
feeling hard or tight like a whip cord under the finger.
  It was formerly a rule, even among those who had the character of
being regular practitioners, to bleed their patients in certain diseases till
they fainted.   Surely a more ridiculous rule could not be proposed.  One
person will faint  at the very sight of a lancet, Avhile  another will lose?
almost the Avhole blood of his body before he faints.   Swooning depends
more upon the state of the mind thau of the body: besides, it may ofteu
be occasioned or prevented by tlie  manner in which the operation is
performed.
   Children are generally bled with leeches.  This, though sometimes
necessary, is a very troublesome and uncertain practice.   It is impossible
to know what quantity of blood is taken aAvay  by leeches; besides, tin*
bleeding is often  very difficult to stop,  and the  wounds are not easily
healed.  Would  those avIio practice bleeding take a  little more pains,
and accustom themselves to bleed children,  they would not find it such
a difficult operation as they imagine.
  Certain hurtful prejudices Avith regard to bleeding still prevail among
the country-people.  They talk, for  instance, of head-veius, heart-veins,
breast-veins, Ac. aud believe that bleeding  iu  these Avill certainly cure
all diseases of the parts from Avhence they are supposed  to come, Avith-
out considering that all the blood vessels arise from the heart and return
to it again; for Avhich reason, unless in topical  inflammations, it signifies
very little from   Avhat part of the body the blood is  taken.   But this,
though a foolish prejudice,  is not near so  hurtful as the vulgar  notion
that the  first bleeding ivill perform wonders.   This belief makes them
often postpone the operation when necessary, iu order to reserve it for
some more important occasion, and, when they think  themselves in ex-
treme danger, they fly to it for relief whether it be proper or not. Bleed-
ing at certain stated periods or seasons has likewise bad  effects.
   It is a common  notion  that bleeding in the feet draws the humours
downwards, and consequently cures diseases of the head and  other supe-
rior parts; but we have already observed that, iu all topical affections,
the blood ought to be drawn as near the  part  as possible.   When it is
necessary, however, to bleed in the foot or hand, as the veins are small,
and the bleeding is apt to stop too soon, the part ought to be immersed hi
warm-water,  aud kept there till a sufficient quantity of blood be let.
   We ; hall uot spend time in describing the manner  of  performing this
operation: that will be better learned by example thau precept.  TAven-
ty pages of description Avould not convey so just an idea of the operation
a> seeing it once performed by an expert hand.  Neither is it necessary 
358     OF  INFLAMMATIONS  AND  ABSCESSES.

to point out the different parts of the bod) from whence blood may be
taken, as the arm, foot, forehead, temples, neck, Ac.  The^e will readily
occur to every intelligent person, and the foregoing observations av'iII be
sufficient for determining which of  them is most proper upon any parti-
cular occasion.  In all cases Avhere the intention is merely to lessen the
general mass of blood, the arm is the most commodious part of the body
hi Which the operation can be performed.

         OF  INFLAMMATIONS  AND ABSCESSES.

  FROM  Avhatever cause an inflammation  proceeds, it must terminate
either by dispersion, suppuration, or gangrene.  Though it is impossible
to foretel Avith certainty in Avhich of these Avays any particular inflamma-
tion will terminate, yet a probable conjecture may be formed with regard
to the event, from a knoAvledge of the patient's age and constitution.   In-
flammations happening  in a slight  degree  upon colds, and  without any
previous indisposition,  will  mos,!  probably be dispersed;  those Avhich
follow  close upon a fever,  or happen to persons of a gross habit of
body, -will generally suppurate; and those  which attack very old people,
or persons  of a dropsical habit, will have a strong tendency to gangrene.
  If the inflammation be slight, and the  constitution sound, the disper-
sion  ought always  to be attempted.   This Avill be best promoted by  a
slender diluting diet, plentiful bleeding, and repeated purges.  The part
itself must be  fomented, and, if the skin be veiy tense, it may be embro-
cated with a mixture of three-fourths of sweet oil, and one-fourth of vine-
gar, and afterwards covered Avith a piece of Avax-plaster.
   If,  notAvithstanebnj: these applications,  the  symptomatic fever in-
creases, and the tumour becomes  larger,  with violent pain aud pulsa-
tion, it will be  proper to promote the suppuration.   The best  appli-
cation for this purpose is  a soft poultice,  Avhich may be reneAved  twice
a-day.  If the suppuration proceeds but  sloAvly, a raw onion cut small
or bruised may be spread upon  the  poultice.    When the abscess  is
ripe or fit for opening, whioh may easily be known from  the thinness
of the skin in the most  prominent  part  of it, a  fluctuation of matter
which may be felt under the finger,  aud, generally speaking, an abate-
ment of the pain, it may be opened either with a  lancet, or by means of
caustic.
   The last Avay in which an inflammation terminates, is in  a gangrene
or mortification, the approach of Avhich may be known by the following
symptoms i the inflammation loses  its redness,  and becomes duskisn
or livid;  the tension  of  the skin goes off, and  it  feels flabby; little
bladders filled with ichor of different colours sprerd all  over  it; the
tumour subsides,  and  from a duskish complexion  becomes black;  a
quick low  pulse, with cold clammy sweats, are the immediate forerunners
of death.
   When  these symptoms first  appear,  the part ought  to  be  dressed
with  London treacle,  or a cataplasm made of lixivium and bran.—
Should the symptoms  become  worse, the  part must  be scarified  and
afterwards dressed  with tosiicum  softened  with oil  of turpcuthe.  All
 the dressings must be applied warm.   With  regard to internal medic;n'-s,
 the patient must be supported with generous cordials, and the Peruvian 
OF WOUNDS.                     359
bark exhibited  iu as large doses as  the stomach will bear it.   If the
mortified parts should seperate, the wound will become a common ulcer,
and must be treated accordingly.
   This article includes the treatment of all those diseases, which, indif-
ferent parts of the country, go by the names of biles, imposthumes, whit-
Iocs, &c.  They are all  abscesses in consequence of a previous inflam-
mation, which, if possible, ought to be discussed; but when this cannot be
done, tlie suppuration should be promoted, and the matter discharged by
an  incision, if necessary; afterwards the sore may be dressed  with
yellow basilicum, or some other digestive ointment.

                          OF  WOUNDS.

   NO  part of medicine has  been more  mistaken than the treatment or
cure of wounds.  Mankind in general believe that certain herbs, ointments,
and plasters are possessed of wonderful healing powers, and imagine that no
wound can be cured Avithout the application of them.  It is howev; r a fact,
that no external application whatever  contributes tow aids the cure of a
wound, any other way than by keeping the parts soft, clean, aud defend-
ing them from the e ■xtcrnal air, which may be as effectually done by dry
lin , as by the  most pompous applications, while it is exempt from many
of the bad consequences attending them.
   The same  observation holds with respect  to  internal applications.
These only  promote the cure of wounds as far as they tend to prevent a
fever,  or to remove any cause that might obstruct or impede the opera-
tions of Nature.  It is Nature alone that cures wounds !  All that art can
do is to remove obstacles, and to put the parts in such a condition  as is
the most favourable to Nature's  efforts.
   With this simple view  we shall consider the treatment of wounds, and
endeavour to point out such steps as ought to be taken to facilitate their
cure.
   The firet thing to be done Avhen a person has received a wound,  is to
examine whether any foreign body be lodged in it, as Avood, stone, iron,
lead, glass, dirt, bits of cloth or the like.   These, if possible, ought to be
extracted, aud the  Aiound cleaned, before any dressings  be applied.
When that cannot be effected with  safety, on  account  of the patient's
weakness, or loss of blood, they must  be suffered to remain in the Avound,
and afterwards extracted when he is more ante to bear it.
   When a Avound penetrates into any of the cavities of the body, as the
breast, the bowels, &c. or where any considerable blood-vessel is cut, a
skilful  surgeon ought immediately  to be  called, otherwise  the  patient
may lose his life.   But sometimes the discharge of blood is so great, that
if not stopt, the patient may die even  before a surgeon, though at no great
distance, can arrive.  In this case, something must be done by those Avho
are present.   If the wouud be in any of the limbs, bleeding may gener-
ally be stopt by applying a tight ligature or bandage round the member a
little above the wound.  The best method of doing this is to put a strong
broad garter round tlie part, but ?o slack as easily to admit a 6inall piece of
stick to be put under it, Avhich must be  twisted, in the same manner as a
countryman does a cartrope to secure his loading, till the bleeding stops.
Whenever this is the case, he must take care to twist it no longer, as strain- 
360
OF  WOUNDS.
ing it too much might occasion an inflammation of the parts, and cndan
ger a gangrene.
  In  parts where this bandage cannot be applied,  various otlier  me-
thods  may be tried to stop the bleeding, as the application of styptics,
astringents, &c.   Cloths dipped in a solution of blue  vitriol in water, or
the styptic  water of  ihe Dispensatories, may be applied to the  wound.
When these cannot be obtained, strong spirits of Avine may be used.
Some  recommend the agaric* of the oak as preferable to any of the other
styptics; and indeed it deserves considerable encomiums.
  It is easily obtained, and ought to be kept in every family, in  case of
accidents.   A piece of it must be laid upon the wound, ami  covered with
a good deal of lint, above which a bandage may be applied so tight as to
keep  it firmly on.
   Though spirits, tinctures, and hot balsams may be used, in order to
stop the bleeding Avhen it is excessive, they are improper at other times.
They do not promote,  but retard  the cure, and often change a simple
Avound into an ulcer.  People imagine, because hot balsams congeal the
blood, and seem, as it ivere, to soleler up the Avound,  that they therefore
heal it;  but this  is only a deception.  They may indeed stop the Mow-
ing blood, by searing the mouths of the vessels; bub, by rendering the
parts callous they obstruct the cure.
   In  slight wounds,  which do not penetrate much deeper than the skin,
tlie best application is a bit of the common black sticking-plaster.   This
keeps the sides ofthe Avound together, and prevents the air from  hurting
it, Avhich is all that is necessary.   When a wound penetrates deep,  it is
not safe to keep its lips quite  close: this keeps in the matter, and is apt to
make the wound fester.   In this case the best way is to fill the wound
with  soft lint, commonly called caddis.   It however must not be stuffed
in too bar 1, otherwise it will do hurt.  The lint may  be covered with a
cloth dipped in oil, or spread with the common wax-plaster ;t and the
whole must be kept  on by a  proper bandage.
   We shall not spend  time in describing the different bandages  that
may be proper for ivounds in different parts of the body; common sense
will generally suggest the most commodious method of applying  a band-
age ;  beside, descriptions of  this kind are not easily understood or re-
membered.
   The first dressing ought  to continue on for at least two days;  after

   * Dr. Tissot, in his " Advice to the people," gives the  following directions
for gathering, preparing, and applying the  agaric.—" Gather in autumn," says
he, " while the fine weather lasts," the agaric ofthe oak, which is a kind of fun-
gus or excresence issuing from the wood  of that tree.   It consists at first of
four parts, which present themselves successively:—1. The outward rind, or
skin, which may be thrown away.  2. The part immediately under this  rind,
which is the best of all.  This is to be beat well with a hammar,  till it becomes
soft and pliable.  This is the only preparation it requires, and a  slice of it ot a
proper size is to be applied directly over the bursting open blood vessels.  It
constringes and brings them close together, stops the bleeding,  and generally
falls off at the end of two days.  3. The third part adhering to the second may
serve  to stop the bleeding from the smaller vessels; and the fourth  and lasb
part may be reduced  to powder as conducing to the same purpose.' —w,Jer<-
the agaric cannot be had, sponge may be used in its stead.  It must be appli<-<!
in the same manner, and has nearly the same effects.
   | See Appendix, Wax-Plaster. 
OF BURNS  AND  SCALDS.            661
which  it may be removed, and fresh lint applied as before.  If any part
of the first dressing sticks so close as not to be removed with ease or safe-
ty to the patient, it may be allowed to continue, and fresh lint dipped in
sweet oil laid over it.  This Avill soften it so as to make it come off easily
at the next dressing.   Afterwards the wound may be dressed twice a-day
ifl the same manner till it be quite healed.  Those  who are fond of salves
or ointments, may, after  the wound is become very superficial, dress it
with the yellow basilicum ;* and if fungus, or Avhat is called proud-flesh,
should  rise in the Avound, it may be checked, by mixing  Arith the oint-
ment a little burnt alum or red precipitate of  mercury.
  When a wound is* greatly inflamed, the  most proper application is a
poultice of bread and milk, softened with a little sweet oil or fresh butter.
This must be applied instead of a plaster, and should be changed twice a
day.
  If the Avound be large, and there is reason to fear an inflammation, the
patient should be kept on a very low diet.   He must abstain from flesh,
strong liquors, and every thing that is of a heating  nature.   If he be of a
full habit, and has lost but little blood from the wound, he must be bled;
and, if the symptoms be  urgent, the operation  may be  repeated.   But
when the patient has been greatly weakened by loss  of blood from  the
wound, it Avill be dangerous to bleed him, even though a fever should ensue.
Nature should never be  too far exhausted.  It is always more safe to al-
low her to struggle with the disease in her OAvn way, than to sink the pa-
tient's strength by excessive evacuations.
  Wounded persons ought  to  be kept perfectly quiet and easy.   Every
thing that ruffles the mind or moves the passions, as love, anger, fear, ex-
cessive joy,  Ac. arc  very hurtful.   They ought  above all things to ab-
stain from venery.  The body should be kept gently open, either by lax-
ative clystei's, or by  a  cool vegetable diet,  as roasted  apples, stewed
prunes, boiled spinage, and such like.

                    BURNS AND SCALDS.§

   VARIOUS remedies  are  recommended  for the treatment of these
accidents;  and it happens fortunately for the pressure of such an emer-
gency, that  some of the most common things are also the most useful on
the occasion.  The pain of burns and scalds may  be instantly abated by
immersing the part affected in cold water, or indeed in any cold fluid, or
in spirits of Avine.  An excellent application likewise is Ainegar, with or
without powdered chalk  in it.  If the  injury be on the fingers or hands,
the application  may be made  by  immersion, but if  in any part where
this Avould be inconvenient, the viuegar may be applied by means of linen
togs dipped in it.   In slight injuries, the vinegar, if early and assiduously
applied, Avill of itself soon effect  a cure; but should any  degree of pain
return, the immersion or  fomentation must be repeated.
  In recent bums or scalds, attended with large blisters, excoriations, or
loss of substance, the vinegar ought  to be applied till the pain nearly
ceases, avIi'ch generally  happens within eight hours.   Many practitioners
recommend  spirits of turpentine instead of vinegar; on  lime-water and
'  See.Appendix, Yellow Basilicum.
                 46 
362
OF BURNS  AND  SCALDS.
linseed-oil.  The vinegar need not be employed longer than twelv e hours,
except on the outside of the sores, Avhich, while they continue to be swel-
led or inflamed, should be fomented for a minute or two before tlie) are
dressed.
  For dressing the sores which arise from burns or scalds, one ofthe best
applications is a poultice of bread, water, and sweet oil.   This should be
removed in six hours, when the sores are to be covered with chalk finelk
powdered, till it has absorbed the matter, and appears quite dry.   A fresfr
poultice must  be laid over the whole, wliich,  with the sprinkling of the
chalk, is to be repeated morning and evening  till  the sores are  healed.
  After the second or third day, if  the sores  be on a  part of the  body
where it is difficult to keep the poultice from shifting, a  plaster of cerate
thickly spread, may be used as a substitute in the day-time.
  When there are large blisters upon the part  they should be opened with
a lancet before the application of the vinegar;  and the water they con-
tain be pressed out with  a  linen cloth,  that the  vinegar may act more
closely upon the burnt flesh, which in this case it does efficaciously,  hi
severe cases, and in cold weather, the vinegar should be  nearly blood-
 warm.
   If the patient will not suffer the vinegar to be applied immediately to the
surface, on account of the pain it excites, a linen rag soaked in SAveet oil
may be previously laid on tlie part, covering the whole with cloths dip-
 ped in vinegar; and these  applications  are to be occasionally repeated
till the pain and inflammation be entirely removed; after which the parts
should be dressed, or if the  burning be  veiy  deep,  with mixtnre of that
and yellow basilicum.
   When  the burn or scald is violent, or has produced a high degree of
 inflammatioh, so that there is reason to be apprehensive of a gangrene,
 the same method of cure becomes necessary as in other violent inflamma-
 tions.   The patient in this case, must be put upon a low ftliet, and drink
 plentifully of weak diluting liquors.  He must likewise be bled, and his
 body be kept  open.   But if the burnt parts should become  fivid or black,
 with  other symptoms of mortification, it Avill be necessary  to apply to
 them camphorated  spirits of  wine, tincture of myrrh, and other antisep-
 tics, or correctors of putrefaction, mixed Avith a decoction of the Peru-
 vian bark.   Iu this  case,  the bark must likeAvise be  taken  internally;
 the patient at the same time using a more generous diet, with wine, spice-
 ries, &c.
   When burns are  occasioned by  the explosion of gunpowder, some of
 the grains of the poAvder are apt  to  be forced into  the  skin.  At first
 they  produce much  irritation; and, if they  be  not removed, they com-
 monly leave marks Avhich remain during life.  They should therefore be
 picked out as soon as possible after the accident; and to prevent inflam-
 mation, as well as to dissolve any poAvder which may remain, the pails
 affected,  should be covered for a day or two  with emollient poultices.
   A strong solution of soap in water has long been in use with artificers
 employed in  any business exposing Avorkmen to veiy bad scalds.  Thin
 is allowed  to  be an excellent remedy.  But,  as the soap would take
 some  time in dissolving,  and the solution  some time in cooling, Dr.
 Underwood recommends a  mixture of six  ounces of oil to ten of iva-
 ter, with two drachms of the  ley of kali,  or pot-ash.   This quantity
 may be sufficiemt for a burn on  the hand or foot, which is to be un- 
OF BRUISES.
363
 mersed, and kept about half an hour in the liquor, which will remove the
 injury, if recourse to it immediately be had;  but must be repeated, as the
 pain may require, if the scald or burn be of some standing.
   As example teaches better than precept, I  shall relate the treatment of
 the most dreadful case of this  kind that has occurred in my practice.  A
 middle-aged man, of a good constitution, fell into a large vessel full of boil-
 ing water, and miserably scalded about  one half of his  body.  As his
* clothes were on, the burning in some parts was very deep before they could
 be got off.  For the first two  days the scalded parts had been frequently
 anointed with a mixture of lime-Avater aud oil, which is a very proper ap-
 plication for recent burnings.   On the third day, Avhen  I first saAV him,
 his fever was high, and his body costive, for which he was bled, and had
 an emollient clyster administered.  Poultices of bread and milk, softened
 Arith fresh butter, Avere likewise applied to the affected parts, to abate the
 heat and inflammation.  His fever still continuing high, he was bled a
 second time, was  kept strictly on the  cooling regimen, took the saline
 mixture with small doses of nitre, and had an emollient clyster adminis-
 tered once a-day.  When the  inflammation began to abate,  the parts
 Avere dressed with a digestive composed of broAvn cerate and yellow basi-
 licum.   Where any black spots appeared, they  were slightly  scarified,
 and touched with the tincture of myrrh, and to prevent their spreading,
 the Peruvian bark was administered.  By this course, the  man was so
 well in three Aveeks as to be able to attend his business.
   The most useful application, we are told, with Avhich families can be
 provided against any emergency of this kind, is  a strong brine, made by
 placing sliced potatoes and common salt in alternate layers  in a pan, al-
 io Aving them to remain until the whole ofthe salt is liquified; which must
 be then drained off, and kept in bottles, properly labelled, ready for im-
 mediate use.

                           OF  BRUISES.

   BRUISES are  generally productive of worse consequences than
 wounds.   The danger from them does not appear immediately, by which
 means it often happens that they are neglected.   It is needless to give
 any definition of a disease so universally known; Ave shall therefore pro-
 ceed to point out the method of treating it.
   In slight bruises it will be sufficient to bathe the part with warm vinegar
• to which a  little brandy or rum may occasionally be added, and to keep
 cloths Avet Avith this mixture constantly applied to it.   This is  more pro-
 per than rubbing it  with brandy, spirits of Avine, or other ardent spirits,
 which are commonly used in such cases.
   In some parts of the countiy the peasants apply to a recent bruise a ca-
 taplasm of fresh cow-dung.  I have often seen this cataplasm applied to
 violent contusions occasioned by blows, falls, bruises, and such like, and
 never knew it fail to have a good effect.
   When a bruise  is very  violent, the patient ought immediately to be
 bled, and put upon  a proper regimen.  His food should be  light and
 cool, and his drink weak, and of an opening nature; as whey sAveetened
 with  honey, decoctions of tamarinds, barley, cream-tartar whey, and such
 like.  The bruised  part must be bathed with vinegar aud water,  as di-
 rected above;  and a poultice made by  boiling crumbs of bread,  elder-
 flowers', and camomile floAvers, in equal quantities of vinegar and water., 
364
OF  ULCERS.
applied to it.  This poidtice is peculiarly proper Avhen a avouihI is joined
to the bruise.  It may be renewed two or three times a-day.
  As the structure of the vessels is totally destroyed by a violent bruise,
there often ensues a great loss of substance, which produces an ulcerous
sore very difficult to cure.   If the bone be  affected, the sore will not heal
before an exfoliation takes place ;  that is, before the diseased part of tlie
bo.ie separates, and comes out through the wound.   This is often a very
Blow operation,  and may even  require several years to be completed.
Hence it happens, that these sores are frequently mistaken for the king's
evij, and treated as such, though in fact they proceed solely from the inju-
ry which the solid parts received from the blow.
  Patients in this situation are pestered with different advices.  Every
one who sees them proposes a new remedy, till the sore is so much irrita-
ted with various and opposite applications, that it is often at length render-
ed absolutely incurable.  The best method of managing such sores is, to
take care that the patient's constitution  does uot suffer by  confinement or
improper medicine, and to apply nothing to them besides simple ointment
spread upon soft lint, over which a  poultice  of bread and milk, with boiled
camomile fioAvers, or the like, may be put to nourish the part, and keep it
soft and warm.   Nature, thus assisted,  will generally in time operate a
cure, by throwing off the diseased parts of the bone, after  which the sore
soon heals.

                           OF ULCERS.

  ULCERS may be the consequence of wounds, bruises, or imposthumes
improperly treated ; they may  likewise proceed from an  ill state of the
humours,  or what may be called a bad habit of body.
   In the latter case they ought not to be hastily dried up, otherwise it
may prove fatal to  the patient.  Ulcers happen most commonly  in the
decline of life; and persons who  neglect exercise, and live grossly, are
most liable to them.   They might often be prevented by retrenching
some part of the solid food, or by opening artificial drains, as issues, setons,
or the like.
   An ulcer may be distinguished from a wound by its discharging a thin
watery humour, which is  often so acrid  as to inflame and corrode the
skin ;  by  the hardness and perpendicular situation of its sides or edges;
by the time of its duration, Ac.
  It  requires considerable skill to be able to judge whether or not an
ulcer  ought to be  dried  up.  In general, all ulcers  which proceed
from  a bad habit  of  body, should be  suffered to continue  open,  at
least  till  the constitution has been so  far changed by proper regimen,
or the use  of medicine, that  they seem disposed to heal of their own
accord.  Ulcers  which are  the  effect of malignant fevers  or other
acute  diseases, may generally be healed  with  safety after the health
has been  restored for some  time.  The cure  ought not hoAvever to be
attempted too soon, nor  at any time without the use of purging me-
dicines and  a  proper regimen.  When wounds  or  bruises have, by
wrong treatment,  degenerated  into ulcers,  if the constitution be good,
they  may  generally be  healed  with  safety.  When  ulcers either ac-
company chronic  diseases,  or come  in  their stead, they  must  be  cau-
tiously  healed.  If  an ulcer conduces to the patient's  health,  from 
                          OF ULCERS.                       365

whatever cause it proceeds,  it ought not to be healed; but if, on the
contrary, it wastes the strength, and consumes the patient by a sIoav fever,
it should be healed as soon as possible.
  We would earnestly recommend a strict attention to these particulars
to all who have the misfortune to labour under this disorder, particularly
those in the decline of life; as we have frequently known people throAv
away their lives by the want of it, while they Avere extolling and  gene-
rously rewarding those Avhom they ought to have looked upon as their
executioners.
  The most proper regimen for promoting the cure of ulcers, is to avoid
all spices, salted  and high seasoned food, all strong liquors, and to lessen
the usual  quantity of flesh meat.   The  body ought to be kept gently
open by a diet consisting chiefly of cooling laxative vegetables, and by
drinking butter-milk, Avhey sweetened with honey, or the  like.  The
patient ought to be kept cheerful, and should take as much exercise as he
«'an easily bear.
  When the bottom and sides of an ulcer seem  hard  and  callous, they
may be sprinkled twice a-day with  a  little  red precipitate of mercury,
and afterwards dressed  with the yellow basiliciim ointment.  Sometimes
it  will be necessary to  have  the edges of  the  ulcer scarified with the
lancet.
  Lime-water has frequently been known to have happy effects in the
cure of obstinate ulcers.  It  may be used in the same manner as direct-
ed for the stone and gravel.
  My late learned and ingenious friend Dr. Whytt strongly recommends
the use of the solution of corrosive sublimate of mercury in brandy, for
the cure of obstinate ill-conditioned ulcers.   I have  frequently found
this medicine, when given according to the Doctor's directions, prove very
successful.  The dose is a table-spoonful night and morning; at the same
time washing the sore 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  observed Avashing the sore thrice a-day with the solution of a triple
strength was very beneficial."*
   A fistulous ulcer can seldom be cured without an operation.   It must
either be laid open so as to have its callous parts destroyed by some cor-
rosive application, or they must be entirely cut aAvay by the knife; but
as this operation  requires the hand of an expert surgeon, there is no oc-
casion to describe it.   Ulcers about the anus are most apt to become
fistulous, and are very difficult to cure.  Some indeed pretend to have
found Ward's fistula paste very successful in this complaint.  It is not a
dangerous medicine, and being easily  procured, it may deserve a trial;
but as these ulcers generally proceed from an ill habit of body, they will
seldom  yield to any thing except  a  long course  of regimen, assisted by
medicines Avhich are. calculated to correct that  particular habit, and to
induce an almost total change in the constitution.
—»————»..              ■—————.■»—                       «»—___»■
  • In ulcers ofthe lower limbs great benefit is often received from tight roll-
ers, or wearing a laced stocking, as this prevents the flux  of humours to the
sores, and disposes them to heal. 
366
                         CHAP.  LIII.

                      OF  DISLOCATIONS.

      VtHEN a bone is moved out of its  place  or  articulation, so an
to impede its proper functions, it is said to be luxated or dislocated.  As
this often happens to persons iu situations Avhere no medical assistance can
be obtained, by which means limbs,  and even lives, are frequently lost,
we shall endeavour  to point out the method of reducing the most com-
mon luxations, and those which require immediate assistance.  Any per-
son of common sense and resolution, who is present when a dislocation
happens, may often be of more service to the patient, than the most ex-
pert  surgeon can after the  swelling  and inflammation have come on.
When these are present, it is difficult to know the state of the joint, and
dangerous to attempt a reduction,  and by waiting till they are gone off,
the muscles become so relaxed, aud the cavity filled up, that the bone
can never afterwards be retained in its place.
   A  recent dislocation may generally be reduced by extension alone,
which must ahvays be greater or  less according to the strength  of the
muscles which move the joint, the age, robustness, and other circumstan-
ces of the patieut.   When the bone has been out of its place for a con-
siderable  time, and a SAvelling or  inflammation  has come on, it  will be
necessary to bleed the patient, and,  after fomenting the  part, to apply
soft poultices with vinegar to it for some time before tlie reduction is at-
tempted.
   All that  is  necessary after the reduction, is to apply cloths dipt in
vinegar or camphorated spirits of wine to the part, and to keep it per-
fectly easy.   Many bad  consequences proceed from the neglect of this
rule.  A  dislocation seldom happens without the tendons and ligaments
of the joint being stretched and sometimes torn.   When these are kept
easy  till they recover their strength and tone, all goes on very well; but
if tlie injury be increased by too  frequent an exertion of the parts, no
wonder if they be found Aveak and diseased ever after.

                DISLOCATION  OF TIIE  JAW.

   THE lower jaw may be luxated by yaAvning, blows, falls, chewing
hard substances, or the like.  It is easily knoAvn from the patient's be-
ing unable to shut bis mouth, or  to eat any thing, as the teeth  of the
under jaw do not correspond with those of the upper; besides, the chin
either hangs down, or is throAvn toward one side, and the patient is neither
able to speak distinctly, nor to swallow without considerable difficulty.
   The usual  method of reducing a  dislocated jaw is to set the  pa-
tient  upon a Ioav stool, so  as an  assistant may hold  the  head firm by
pressing  it   against  his breast.   The  operator is then  to thrust  his
two thumbs, being first wrapped  up Avith linen cloths that they may
not slip, as  far back into the  patient's  mouth  as he  can,  Avhile his
fingers are applied to the jaw  externally.   After  he has  got firm hold
of the jaw,  he is to press  it strongly downwards and backwards fey 
        DISLOCATION  OF THE  NECK  AND  RIBS.     367

 which means the elapsed heads of the jaw may be easily pushed into
 their former cavities.
   The peasants in some part of the country have a peculiar way of per-
 forming 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 so as to suspend him from the ground.  This method often
 succeeds, but we think it a dangerous one, aud therefore recommend  the
 former.

               DISLOCATION OF THE NECK.

   THE neck may be dislocated by falls, violent bloAvs or the like.  In
 this case, if tlie patient receives no assistance, he soon dies, which makes
 people imagine the  neck was broken; it is however,  for the most part
 only partially dislocated, and may be reduced by almost any person who
 has resolution enough to attempt it.  A complete dislocation of the neck
 is instantaneous death.
   When the neck is dislocated, the patient is immediately deprived of
 all sense and  motion; his neck sivells; his countenance appears bloated;
 his  chin  lies upon his breast, and his face is generally turned towards
 one side.
   To  reduce this dislocation, the unhappy person should immediately be
 laid upon his back  on the ground,  and, the operator must place himself
 behind him so as to be able to lay hold of his head with both hands, while
 he makes a resistance by placing his knees against the patient's shoulders.
 In this posture he must pull the  head with considerable  force, gently
 twisting it at the same time, if the face be  turned to  one side, till he per-
 ceives that the joint is replaced,  which may  be  known from the noise
 which  the bones generally make when going in, the patient's beginning
 to breathe, and the head continuing in its natural posture.
   This is one of  those operations which it is more easy  to perform than
 elescribe.  I have known instances of its being happily performed even
 by women, and often by men of no medical education.  After the neck
 is reduced, the patient ought to  be bled, and should be suffered to rest
 for some days, till the parts recover their proper tone,

                DISLOCATION OF THE RIBS.

   AS  the  articulation of tlie ribs  with  the back-bone is very  strong,
 they are not often dislocated. It does however sometimes happen, which
 is a sufficient reason for our  taking notice of it.  When a rib is disloca-
 ted either upwards or downwards, in order to replace it, the patient should
 bolaid upon his belly on a table, and the operator  must endeavour  to
 push the  head  of  the bone into its proper place.   Should this method
 not  succeed,  the arm of the  disordered side may be suspended  over  a
 gate or ladder, and,  while the ribs are thus stretched asunder, the heads
 of such as are out of place may be  thrust into their former situation.
   Those dislocations wherein the  heads of the ribs  are  forced inwards,
 are both more dangerous and the most difficult to reduce, as neither the
 hand nor any instrument can be applied internally to direct the luxated
 heads  of the ribs.  Almost the only thing that can be done i., to lay  the
patieut upon his belly over  a cask, or some gibbous body, and to move 
OObJ     DISLOCATION Ol   IHE  SHO.ULDLRS,  &C.

the fore part of the rib inward toAVards the back,  sometimes slinking it;
by this means the heads of the luxated ribs may  slip into their former
place.

           DISLOCATION  OF THE SHOULDER.

  THE humerus or upper bone of the arm may be dislocated in Arariou?
directions: it happens however most frequently  doAvnwards, but veiy
seldom directly upAvards.   From the nature of its  articulation, as well as
from its exposure to external injuries, this bone  is the  most subject to
dislocation of any in the body.   A dislocation of  the  humerus may be
knoAvn by a depression of  cavity on the top of the shoulder, and an ina-
bility to move the arm.  When the dislocation is  downward or forward,
the arm is elongated, and a ball or lump is jierceived under the arm p't;
but when it is backward, there appears a protuberance behind the should
cr, and the arm is throAvn forwards towards the breast.
   The usual method  of reducing dislocations of  the shoulder is to seat
the patient upon a low stool,  and to cause an assistant to hold his body
so that it may not give way to the extension, Avhile another lays hold of
the arm a little above  the elbow, and gradually extends it.  The opera-
tor then puts a napkin under the patient's arm, and causes it to be tied be-
hind his own neck; by this, while a sufficient extension 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 surgeon is always  more safe.  In
young and delicate  patient's I have generally found it a very easy mat-
ter to reduce the shoulder, by extending the arm with one hand, and
thrusting in the head of the  bone with the  other.  In  making the ex-
tension, the arm ought always to be a little bent.

               DISLOCATION OF THE ELBOW.

   THE bones of the fore-arm  may be dislocated in any direction.
When this is  the case, a protuberance may  be observed on  that side of
the arm to ATards which the bone is pushed, from which, and the patient's
inability to bend his arm, a dislocation of this joint may easily be known.
   Two assistants are generally necessary for reducing a dislocation of
the elboAV;  one of them must lay hold of the arm above, and the other
beloAv the joint, and make a  pretty strong extension, while the operator
returns the bones into their proper place.   Afterwards the arm must be
bent, and suspended for some time with a sling about the neck.
   Luxations of the wrist and fingers are to be reduced in the same man-
ner as those of the elbow; viz. by making an  extension in different di-
rections, and thrusting the head of the bone  into its place.

               DISLOCATION OF  THE THIGH.

   WHEN the  thigh-bone is  dislocated  forward and  downward,  the
knee and foot are turned out, and the  leg  is longer than  the other; 
OF  BROKEN  BONES,  &C.
369
but when it is displaced backward, it  is usually pushed upwards at the
same time,  by which means the limb is shortened, and  the foot is turned.
inwards.
   When the thigh bone is displaced forward and doAvnward, the patient
in order to have it reduced, must be laid u; on his back and made fast by
bandages, or held by assistants, while  by others an extension is made by
means of sfings fixed about the bottom ofthe thigh a little above the knees
While the extension is made,  the operator must push the head of the bone
outward, till it gets into the socket.   If the dislocation be outward, the
patient must be laid upon his face, aud, during the extension, the head of
the bone must be pushed inward.
  Dislocations ofthe knees, ancles and toes, are reduced much in the same
manner as those of the upper  extremities, vis. by making an extension in
opposite directions, while the operator replaces the bones.  In many cau-
ses, however, the extension alone is sufficient and  the bone will slip into
its place merely by pulling the limb with sufficient force.  It is not here*
by meant, that force alone is sufficient for the reduction of dislocations?
Skill and address will often succeed better than force.   I have known a
dislocation of the thigh reduced by one man, after all the force that coul<J
be used by six liad proved ineffectual-
                          CHAP. LIV,

                   OF BROKEN BONES, &c

         JL HERE is, in most villages, some person who pretends to tlii
art of reducing fractures.   Though in general such persons are very igc
norant, yet some of them are very successful; which evidently proves^
that a small degree of learning, with a sufficient share of common sense
and a mechanical head, will enable a man to be useftd in this way.  We
would, however, advise people never to employ such operators, when an
expert and skilful surgeon can be had; but when that is impracticable,
they must be employed:  we shall therefore  recommend the following
hints to their consideration :
   When a large bone is broken, the patient's diet ought in all respects to
be the same as in an inflammatory fever.   He shonld likeAvise be kept
quiet and cool, and his body open by emollient clysters; or, if these can-
not be conveniently administered, by food that is of an  opening quality f
as stewed pruues, apples boiled in milk, boiled spinage, and the like.  It
ought however to be here  remarked,  that persons who have been  accus-
tomed to live high, are not  all of a sudden to be  reduced  to a very low di-
et.   This might have fatal effects.   There is often a necessity for indul*
ging even bad habits, in some measure, where the nature of the disease
might require a different treatment.
  It will generally be necessaiy to  bleed the patient immediately after a
fracture, especially if he be young, of a full habit, or has at the same time
received any bruise or contusion.  This operation should not only be
performed soon after the accident happens, but if the patient be very fe-
verish, it may be repeated next day.  When <rvcral of  the ribs are bro-
ken, bleedins is peculiarly  neeessary.
                                4 7 
3<70               OF  BROKEN  BONES, &X.

   If any ofthe large bones which support the body are broken, the pa
tient must keep his bed for several Aveeks.  It is  by no means necessary,
however, that he should lie all that time, as is customary, upon  his back.
This situation sinks the spirits, galls anil frets the patient's skin, and ren-
ders him very uneasy.   After the second week he may be gently raised
up, and may sit several hours, supported by a bed-ehair, or the like, which
will greatly relieve him.  Great care, however, must be taken in raising
him up and laying him dowu, that he make no exertious himself, other-
wise the action ofthe muscles may pull the bone out of its place.*
   It is of great importance to keep the patient dry aud clean while iu this
situation.   By neglecting this, he is  often so galled and excoriated, that
he is forced to keep shifting places for ease.  I have  known a fractured
thigh-bone, after it had been kept straight for above a fortnight, displaced
by this means, and continue bent for  life, in spite  of all that could be done.
   It has been customary when a bone Avas broken, to  keep the limb for
five or six Aveeks continually upon the stretch.  But this is a bad posture.
It is both uneasy to the  patient, and unfavourable to the cure.  The best
situation is to keep the limb a little bent.  This is the posture into ivhich
every animal puts its limb6 when it goes to rest, aud in which fewest mus-
 cles are upon the stretch.  It is easily effected,  by either laymg the pa-
tient upon his side, or making the bed so as to favour this position  of the
limb.
   Bone-setters ought carefully to examine whether the bone be not shat-
 tered or  broken into several pieces.  In this case  it Avill sometimes be
necessaiy to have the limb immediately taken off, otherwise a gangrene or
mortification may ensue.  The horror which attends the very idea of an
 amputation, often occasions its being delayed in  such  cases  till too late.
 I have known this principle operate so strongly, that a limb,  where the
 bones were shattered into more than twenty pieces, was not amputated be*
 fore the third day after the accident, when the gangrene had  proceeded
 so far as to render the operation useless.
   When a fracture is accompanied with a wound, it must be  dressed id
 all respects as a common wound.
   All that art  can do toAvaxds the cure of a broken bone, is to  lay it
 perfectly straight, and to keep  it quite  easy.  All  tight bandages do
 hurt.   They had much better be wanting altogether.  A great ma-
 ny  of the  bad  consequences which  succeed  to  fractured  bones  are
 owing  to  tight bandages.   This ,is  one of the  Avays  in  which  excess
 of art, or rather the abuse of it, does more mischief than  would be
 occasioned  by  the  want  of it.  Some  of the most  sudden cures of
 broken bones which were ever known, happened  Avhere  no  banda.
  * Various pieces of machinery have been contrived for counteracting the force
ofthe muscles, and retaining the fragments of broken bones ;  but as descrip-
tions of these without drawings would be of little use, I shall refer the reader to
a cheap and useful performance " on the nature and cure of fractures," lately
published by my ingenious friend Mr. Aitken, surgeon in Edinburgh ; wherein
that gentleman has not only given an account of the machines recommended in
fractures by former authors, but has likewise added several improvements of
his  own,  which are peculiarly useful in  compound  fractures,  and in cases
where patients  with broken bones are obliged to be transported from one place
to another.
• 
OF STRAINS.                    371
*gcs were applied at all.  Some method however must be taken to keep
 the member steady; but this may be done many Avays without bracing
 it with a tight bandage.
   The best method of retention is by two or more splints made of leather
 or pasteboard.   These if moistened before they be applied, soon  as-
 sume the  shape of the included  member, and  are sufficient, by the as-
 sistance of a very slight bandage, for all the purposes of retention.  The
 bandage which we would recommend, is that made with twelve or eigh-
 teen tails.  It is much  easier  applied  and taken off than rollers, and
 answers all the purposes of retention  equally well.   The splints should
 always be as  long as the limb, Arith holes cut for  the  ancle wheii the
 fracture is in  the leg.
   In fractures of the ribs, where a bandage cannot be properly used,
 an adhesive plaster may be applied over the part.   The patient in this
 case  ought to  keep himself quite easy, avoiding eveiy thing that may
 occasion  sneezing, laughing, coughing, or the like.   He ought to keep
 his body in a  straight posture, and should take  care that his stomach be
 constantly distended, by taking frequently some light food, and drinking
 freely of weak watery liquors.
   The most proper external application for a  fracture  is oxycrate or a
 mixture of vinegar and water.   The bandages should be wet with this at
 every dressing.

                          OF STRAINS.

   STRAINS are often attended with worse consequences than broken
 bones.  The reason is obvious;  they are generally neglected.  When
 a bone  is broken, the patient  is obliged  to keep the member easy, be-
 cause he cannot make use of it;  but when a joint is only strained, the
 person, finding he can still make surshift 16 move it, is sorry to lose his
 time for so trifling  an ailment.   Iii this  way he deceives  himself, and
 converts into an incurable malady what might have been removed by
 only keeping the part easy for a few days.
   Country people generally immerse a strained limb  in cold  water.
 This is very proper provided  it  be  done immediately,  and not kept in
 too long.   But the custom of keeping  the part immersed in cold water
 for a long time is certainly dangerous.  It relaxes instead of bracing the
 part, and is more likely to produce a disease than remove one.
   Wrapping a garter, or  some other bandage, pretty  tight about the
 strained part, is likewise of use.   It helps to restore the proper  tone of
 the vessels and prevents the action ofthe parts from increasing the disease.
 It should  not  however be applied too tight  I have frequently  kuoAvn
 bleeding near  the affected  part have  a very good effect; but what we
 would recommend above all is ease.   It is more to be depended on than
 any medicine, and seldom fails to remove the complaint.*
  • A great many external applications are recommended for strains, some of
which do good, and others hurt  The following are such as may be used with
the greatest safety, viz  poultices made  of stale beer or vinegar and oat-meal,
camphorated spirits of wine,  Mindererus's  spirit, volatile liniment, volatile
aromatic spirit diluted with a double quantity of water, and the common fomen-
tation, with the addition of brandy or spirit of wine, 
372
                        OF RUPTURES.
   CHILDREN and old people are most liable to tliis disease.   In the
former it is generally occasioned by excessive crying, coughing, vomit-
ing, or the like.  In the latter,  it is commonly the effect of blows or vi-
olent  exertions of the strength, as leaping, carrying great weights, &c.
In both a relaxed habit, indolence, and an oily ot very moist diet, dis-
pose the body to this disease.
   A rupture sometimes proves  fatal before it  is discovered.  Whenever
sickness, vomiting,  and  obstinate costiveness  give reason to suspect au
obstruction of the  boAvels, all  those places were ruptures usually hap-
pen ought carefully to be examined.   The protusion of a veiy small
part of the gut Avill occasion all these symptoms, and if not returned in
due time, will prove fatal.
   On the first appearance of a rupture in an infant, it ought to He laid
upon its back, with its head very low.   While in this posture, if the gut
does not return of itself, it may easily be put up by gentle pressure.  Af-
ter it is returned, a piece of sticking plaster may be applied over the part,
and a proper truss  or bandage must be constantly worn for a consiekra-
ble time.   The  method of making and applying these rupture bandages
for children is pretty Avell known.  The child must as far as possible, be
kept from crying, and from all violent exertions, till the rupture is quite
healed.
   In  adults, Avhen the gut has been  forced down with great violence, or
happens from any cause to be inflamed, there  is often.great difficulty iu
returning it, and sometimes  the  thing is quite impracticable without au
operation; a description of which is foreign to our purpose.   As 1 have
been  fortunate  enough, however, always  to  succeed in my attempts to
return  the gut,  without having recourse  to any other means than what
are in the  power of every  man, I  shall  briefly mention the  method
which I generally  pursue.
   After the patient has been bled, he must be laid upon his back, with
his head very Ioav,  and his breech raised high with pillows.  In this sit-
uation flannel cloths Avrung  out of a decoction of mallows and camomile
flowers, or, if these are not at hand, of warm  water, must be applied for
a  considerable time.  A clyster made  of this decoction, with a large
spoonful of butter and an ounce or two of salt, may be afterwards thrown
up.   If these should not prove successful, recourse must be had to pres-
sure.  If the tumour be very hard, considerable force will be necessaiy:
but it is not force alone which succeeds  here.   The operator,  at the
same time that he makes a  pressure with the palms of his hands,  must
with his fingers  artfully conduct the gut in by the same aperture through
which it came out.   The manner of doing this can be much easier con-
veyed  than  described.   Should these  endeavours  prove ineffectual,
clysters of the smoke of tobacco may be tried.   These have been often
knoAvn to succeed where every other method failed.
   There  is reason to  believe that, by  persisting in the  use of these,
and  such other  means  as the  circumstances of the case may suggest,
most hernias might be reduced without au operation-  Cutting for the
hernia is  a nice and  difficult matter.  I would therefore advise sur-
geons to try every method  of returning the  gut before they have re-
course to the knife. I have once and  again succeeded by persevering 
OP CASUALTIES*                  373
in my endeavours, after eminent surgeons had declared the reduction of
the gut impracticable without an operation.*
  An adult, after the gut has been returned, must wear a steel bandage.
It is needless to describe this, as it may always be had ready made from
the artists.  Such bandages are generally uneasy to the  wearer for some
time, but by custom they become  qu^te easy.  No person who has had a
rupture after he arrived at  man's estate should ever be without one of
those bandages.
  Persons who have a rupture ought carefully to avoid all violent exei*-
cise, carrying great weights, leaping, running, and the like. They should
likewise avoid windy aliment and strong liquors; and should carefully
guard against catching cold.
                          CHAP. LV.

                        OF CASUALTIES.

         IT is certain that life, when to all appearance lost, may often,
by due care be restored.  Accidents  frequently prove fatal, merely be-
cause proper means are not used to counteract their effects.
   No person ought to be looked upon as killed by  any accident unless
where the structure of the heart, brain,  or some organ necessary to life,
is evidently destroyed.  The action of these organs may be so  far im-
paired as even to be for some time imperceptible, wheu life is by no means
gone.  In this case, however, if the   fluids be suffered to  groiv  cold, it
will be impossible to put them again in motion,  even  though the solids
should recover their power of acting.  Thus, when the motion of the
lungs has been stopt by unwholesome vapour, the action of the heart by a
stroke on the breast, or the functions of the brain by a blow on the head,
if the person be  suffered to grow cold, he will  in all probability continue
so; but if the body be kept warm, as s*on as the injured part has recov-
ered its poAver of acting, the fluids will again begin to  move, and all the
vital functions will be restored.
   It is a horrid custom immediately to consign over to death every per-
son who has the misfortune, by a fall, a  bloAV, or the like, to be deprived
of the appearance of life.  The unhappy person instead of being  carried
into a warm house, and laid by the fire or put to a Avarm bed, is generally
hurried away to church, or a barn,  or some other cold  damp house,
where, after  a fruitless attempt has been made to bleed him, perhaps by
one who  knew nothing of the matter, he is  given  over for  dead, and no
further notice taken of him.  This conduct seems to be the result of ig-
norance, supported by au ancient superstitious notion, which forbids the
body of any person killed by accident to be laid in an house that is in-
habited.   What the ground of this superstition may be, we shall uot pre-

  * I would hece beg leave to recommend it to every practitioner, when his pa-
tient complains of pain in the belly with obstinate costiveness, to examine the
groins and every place where a rupture may happen, in order that it may be
immediately reduced.   By neglecting this,  many perish who were not suspect-
ed to have had ruptures till after they were dead.  I have known this happen
wh'.re half a dozen of the faculty were in attendance. 
374         SUBSTANCES STOPT  BETWEEN
tend to inquire;  but surely the conduct founded upon it is  contrary to
all the principles of reason, humanity, and common sense.
  When a person seems to be suddenly deprived of life, our first business
is to inquire into the  cause.  We  ought carefully to observe  whether
any substance be lodged in the wind pipe or gullet;  and if that is the
case, attempts must be made to remove it.  When unwholesome air is the
cause, the patient ought immediately to be removed out of it.   If the
circulation be suddenly stopped, from any cause whatever, except mere
weakness, the patient should be bled.  If the blood does not flow, he
may be immersed iu warm w atcr, or rubbed with warm cloths, Ac. to pro-
mote the circulation.   When the cause cannot be  suddenly removed,
our great aim must be to keep up the vital ivarmth, by  rubbing the pa-
tient with hot cloths, or salt, and covering his botly with warm sand, ashes
or the like.
  I should now proceed to treat more fully  of those accidents, which
without immediate assistance, would  often  prove fatal, and to point out
the most likely means for relieving the unhappy sufferers;  but as I have
been happily  anticipated  in this part of my subject by  the learned and
humane Dr.  Tissot, I  shall content myself with selecting such of hie ob-
servations as seem to  be the most important, and adding  such of my own
as have occurred in the course of practice.

OF  SUBSTANCES STOPT BETWEEN THE MOUTH AND
                           STOMACH.

  THOUGH accidents of this kind are very common, and extremely
dangerous, yet they  are generally the  effect of carelessness.   Children
should be tausht to chew their food  well, and to put nothing into their
mouths which it would be dangerous  for them to swallow.  But children
 ire not the  only  persons guilty of  this piece of  imprudence.   I know
many adults who put pins, nails, and other sharp-pointed substances  in
their mouths upon every occasion, and  some  who even sleep with the
former there all night.   This conduct is exceedingly injudicious, as a  fit
 »f coughing, or twenty otlier accidents, may force over the substances be-
 fore the person is aware.*
  When any substance is retained in the gullet, there are  two ways ol
 removing it,  viz. either by extracting it, or pushing it down.  The saf-
 est and most certain way is to extract it; but this is not  always the easi-
 tst  it may therefore be more eligible sometimes to  thrust it down, es-
 pecially when the obstructing body is of such a nature, that there is  no
lander from  its reception  into the stomach.  The  substances which
may°be pushed down without danger  are, all common nourishing ones, as
 bread, flesh, fruits, and the like.   All indigestible  bodies, as cork wood,
bones  pieces of metal, and such like, ought if possible  to be extracted,
especially if these bodies be sharp pointed, as pins, needles, fishbones,
bite of glass, &c.                             ,         ,   ., „„j„„
   When such substances have not passed in too deep, we should endea-
 voir  to  extract  them  with   our  fingers  which   method often  suc-
 ceeds.   When  they  are  lower,  we  must make  use of nippers,  or a

  • Awomaninoneofthehospitals of  this city lately dischargeda great num-
ber of pins, which she had swallowed in tlie course of her business, througn an
 ulcer in her side. 
TIIE  MOUTH AND STOMACH.            375
small pair of forceps, such as surgeons use.   But this attempt to extract
rarely succeeds, if the substance be of a flexible nature, and has descend-
ed far into the gullet.
  If the fingers aud nippers fail, or cannot be duly applied, crotchets, a
kind of hooks, must be employed.   These may be made at once, by bend-
ing a piece of pretty strong iron wire at one end, it must be introduced in
the Hat way; and for the better conducting it, there should likewise be a
curve or bending at the end it is held by, to serve as a kind of handle to
it;  which has this further use, that it may be secured  by  a string tied to
it, a circumstance not to be omitted in any instrument employed on such
occasions, to avoid such ill accidents as have sometimes ensued from these
instruments slipping out of the operator's hand.  After the crotchet has
passed below the substance that obstructs the passage, it is drawn up
again,  and hooks up the body along with it.  The crotchet is also very
convenient, when a substance somewhat flexible, as a pin or fish-bone
sticks across the gullet, the hook, in such cases, seizing them about their
middle part, crooks and thus disengages them ; or, if they are very brit-
tle substances, serves to break them.
   When the obstructing bodies are small, and only stop up a part of the
passage, and which may either easily elude the hook,  or straighten it by
their resistance, a kind of rings, made either of wire, wool, or silk, may
be used.  A piece of fine wire of a proper length may be  bent into a cir-
cle, about the middle, of about an inch diameter, and the long unbent sides
brought parallel,  and near each other : these  are to be held in the hand,
and the circular part or ring introduced into the gullet, in order to be con-
ducted about the obstructing body, and so  to extract it.  More flexible
rings may be made of wool, thread, silk, or small pack-thread, which may
be waxed for their greater strength and consistence.  One of these is to
be tied fast to a handle of iron  wire, Avhale-bone, or any kind of flexible
wood, and by this means introduced, in order to surround the obstructing
substance, and to draw it out.   Several of these rings passed through one
another may be used, the more certainly to lay hold of the  obstructing bo-
dy, which may be involved by one, if another should miss it.  These
rings have one  advantage, which is, that when the substance to be extract-
ed is once laid hold of, it may then, by turning the handle, be retained so
strongly in the ring thus twisted, as to be moved every way, which must in
many cases be a  considerable advantage.
   Another material employed on these unhappy occasions, is the sponge.
Its property of swelling considerably on being wet is the principal founda-
tion of its usefulness here.  If any substance is stopt  in the gullet, but
without filling up the  whole passage, a bit  of sponge may be introduced
into that part winch is unstopt, and beyond the substance.  The sponge
soon dilates, and grows larger in this moist situation; and indeed the en-
largement of it may be forwarded by making the patient swallow a feiv
drops of water.   Afterwards it is to be drawn back by the handle to which
it is fastened;  and  as it is iioav too large to return through the small ca-
vity by which it  was conveyed in, it draws out the obstructing body alon*'
with it.                                                          ,
   The compressibility of sponge is another foundation  of its usefulness in
such cases.   A pretty large piece of sponge may be compressed or squeez-
ed  into a small size, by winding a string of tape closely about it, which
may be easily unwound, and withdrawn, after the sponge has been intro- 
 376       SUBSTANCES STOPT  BETWEEN,  &CC.

 duced.  A bit of sponge may likeAvise be compressed by a piece of whale-
 bone split at one end; but this can hardly be introduced in such a man-
 ner as not  to hurt the patient.
   I have often known pins  and other  sharp bodies, which had stuck iu
 the throat, brought up by  causing the person to swallow a bit of tougli
 meat tied to  a thread, and draAving it quickly up  again.   This is safer
 than  swallowing sponge, and will often  answer  the purpose  equally
 well.
   When all these methods  prove unsuccessful, there remains one more,
 which is, to make the patient vomit: but this can scarcely be of any ser-
 vice, unless when such obstructing bodies are simply engaged in, and  not
 hooked or  stuck into the sides of the gullet, as in this case vomiting might
 sometimes  occasion further  mischief.   If the patient can swallow, vomit-
 ing may be excited by taking half a drachm or two scruples of ipecacuan-
 ha in poAvder made into a draught.  If he is not able  to SAVallow, an at-
 tempt may be made to excite vomiting, by tickling his throat with a feath-
 er ;  and, if that should not succeed, a clyster of tobacco may be adminis-
 tered.  It  is made by boiling an ounce of tobacco in a sufficient quantity
 of wrater; this has often been found to succeed, when other attempts to ex-
 cite vomiting had failed.
   When the obstructing body is of such a nature that it may with safety
 be pushed  downwards, this may  be attempted by means of a Avax-candlc
 oiled, and  a little heated, so as to make it flexible;  or a piece of whale-
 bone, wire, or flexible wood, with a sponge fastened to one end.
   Should it be impossible to extract even those bodies which it is danger-
 ous to admit into the stomach, we must then prefer the least of two evils,
 and rather run the hazard of pushing them down than suffer the patient
 to perish in a few minutes;  and we ought to scruple this  resolution the
 Seas, is a great many instances have happened, where the  swallowing of
 such huitful and indigestible substances have been followed by no disor-
 der.
   Whenever it is manifest that  all endeavours, either to extract or push
 doAvn the substance, must prove ineffectual, they should be discontinued;
 because the inflammation occasioned by persisting  in them  might be as
 dangerous  as the obstruction itself.   Some have died in consequence of
 the inflammation, even after the body which  caused the obstruction had
 been entirely removed.
   While the means recommended above are  making use  of, the  patient
 should often swallow, or, if he caunot, he should frequently  receive by  in-
 jection  through a crooked tube or pipe that may reach down to the gullet,
 some emollient liquor, as warm milk and water, barley-water, or a decoc-
 tion of mallows.  Injections of this kind not only soften and sooth the ir-
 ritated parts, but, when throAvn iu with force, are often more successful in
 loosening the obstruction than all attempts with instruments.
   When5, after all our endeavours, we are obliged to leave the obstruct-
 ing body in the part, the patient must be treated as  if he had an inflam-
matory disease.  He should be bled, kept upon a low diet, and have his
 whole neck surrounded with emollient poultices.  The like treatment must
 also be used, if there be any reason to suspect  an inflammation ofthe pas-
 sages, though the obstructing body be removed.                   #
   A proper degree of agitation has sometimes loosened  the inhering
 body more effectually  than instruments.  Thus a  blow  on the back 
                   OF  DROWNED  PERSONS*-              377

has often forced  up a substance which stuck in the gullet; but this is
still  more proper and efficacious Avhen tlie substance gets into the Arind-
pipe.  In this  case vomiting  and sneezing are likewise to be excited.
Pius Avhich stuck in the gullet have been frequently discharged by riding
on horseback, or in a cai ria^e.
   When any indigestible  substance  has been  forced  down  into the
stomach, the patient should use a very mild and smooth diet, consisting
chiefly of fruits and farinaceous substances, as puddings,  pottage, and
soups.  He should avoid all heating and irritating things, as wine, punch,
pepper, and such like; and his drink should be milk and water, barley-
water, or whey.
   When the gullet is so strongly and  fully  closed, that the patieut can
receive no food by the mouth, he must be nourished by clysters of soup,
jelly, aud the like.
   When the patient is in danger  of being immediately suffocated, and
all hope  of freeing  the passage is vanished, so that de,:dh seems at ha id,
if respiration be not restored; the operation of bronchotomy, or opening
of the  wind-pipe, must  be directly  performed.  As  this operation  is
neither difficult to an expert surgeon, nor veiy painful to the patient, and
is often the  only method which can be taken  to preserve file  in  these
emergencies, we thought proper to mention it, though  it should only be
-attempted by persons skilled iu surgery.

                   OF DROWNED PERSONS.

   WHEN a person has remained above a quarter of an hour under wa-
ter, there can be no considerable hopes of his recovery.  But as several
circumstances may happen to have continued life, in such an unfortunate
situation, beyond the ordinary term, Ave should never too soon resign the
unhappy object to his fate, but try every method for his relief, as  there
are  many Avell attested proofs of the recovery  of persons to  life and
health, who had been taken out of the water apparently dead, and who
remained a considerable time Avithout exhibiting any signs of life.
   The first thing to be done, after the body is taken out of the Avater,  is
to convey it as soon as possible to some convenient place where the ne-
cessary operations for its recovery may be performed.  In doing this,
care must be taken not to bruise or injure the body by carrying it in any
unnatural posture with  the Itead  downwards, or the like.  If an adult
body, it ought to  be laid on a  bed, or on straiv with the  head a little rais-
ed, and carried on a cart or men's shoulders, and kept in as natural and
•  :iy a position as possible.  A small body may be carried in the arm6.
   In attempting  to recover persons apparently drowned, the principal
intention to be pursued  is, to restore the natural warmth, upon which all
the  vital functions depend; and to excite  these functions by the ap-
plication of stimulants, not only to the skin, but likewise to the lungs, in-
tesiii'.es, Ac.
   Though  cold Avas by no means the cause of the person's death, yet
it will prove  an effectual obstacle*to his recovery.   For  this reason,
stripping him of his wet clothes, his body must be strongly rubbed for
a considerable time with  coarse linen cloths,  as warm as they can be
made;  and, as soon as  a well-heated bed ctm be got ready, he mav be 
378              OF  DROWNED  PERSONS.
laid into it, and the rubbing should be continued.  Warm cloths ought
likewise to be frequently applied to the stomach  and bowels, and hot
bricks,  or bottles of warm-water, to the soles of his feet,  and to the
palms of his hands.
.  Strong volatile spirits should be frequently applied to the nose ; and
tlie spine of the back and pit of  the stomach may be nibbed with warm
brandy  or spirit of Avine.  The  temples ought also to be chafed  with
volatile spirits;  and stimulating powders, as that of tobacco or marjoram,
may be blown up the nostrils.
   To renew;  the breathing a strong person may blow his own breath into
the patient's  mouth with all the force he can, holding his nostril at the
same time.   When it can be perceived by the rising of the chest or belly
that the lungs are filled with air, tlie person ought to desist from blowing,
and  should press the  breast and belly so as  to expel  the air  again; and
this  operation may be  repeated for some time, alternately inflating and
depressing the lungs so as to imitate natural respiration.
   If the lungs cannot be inflated iu this manner, it may be attempted
by blowing through one of the  nostrils, and at the same time keeping
the other close.  Dr. Monro for this purpose recommends a Avooden pipe
fitted at one  end for filling the nostril,  and at  the other for being blown
into by a person's mouth, or for receiving the pipe of a pair of bellows,
to be employed for the same purpose, if necessary.
   When air cannot  be forced  into the chest by the mouth or nose, it
may be necessary to make an opening  into  the wind-pipe for this pur-
pose.   It is  needless,  hoAvever, to spend time in describing this ope-
ration,  as it should not be  attempted unless by persons skilled in sur-
gery.
   To stimulate the intestines, the fume of tobacco may be thrown up iu
form of clyster.  There  are various pieces of apparatus contrived for
this purpose, Avhich may be used when at hand; but where these cannot
be obtained, the business may be done by a common tobacco pipe.   The
bowl of the pipe must be filled with tobacco well kindled, and, after the
small tube has been introduced  into the fundament, the smoke may be
forced  up by blowing through  a piece  of  paper full of holes wrapped
round the mouth of the pipe, or by blowing through an empty pipe, the
mouth  of Avhich is applied close to that of the other.   This may also be
done iu the  following manner.   A  common  clyster-pipe with a bag
mounted upon it may be  introduced into the fundament, and  the mouth
of the  ba«r may be applied rotmd the small  end of a tobacco-pipe, in the
bowl of which  tobacco is to be  kindled, and the smoke blown up aa di-
 rected above.   Should it be found  impracticable to throw up the smoke
of tobacco, clysters of warm water, with the addition of a little salt and
some wine or spirits,  may be  frequently administered.   This may be
done by a common clyster-bag and  pipe; but,  as it ought to be thrown
well up, a pretty large syringe will answer  the purpose better.
    While these things are doing,  some of the attendants ought to be
preparing a warm bath, into which  the person should be put, if the above
endeavours  prove ineffectual.   Where  there  are no conveniences for
using the warm bath,  the body may be covered with  warm salt, sand,
ashes,  gi'ains, or such like.   Tissot mentions an instance of a girl who
was restored to life, after she had been taken out of the water, swelled. 
OF  DROWNED PERSONS.
379
bloated, and to all appearance dead, by laying her naked body upon hot
ashes, covering her with others  equally hot,  putting a bonnet round her
head, and a stocking round her neck, stuffed with the same, and heaving
coverings over all. After she had remained half an hour in this situation.
Iier pulse returned, she recovered speech,  and cried out, / freeze; I
freeze ; a little cherry-brandy was given her and she remained buried
as it were under the ashes for eight hours;  afterwards she was taken out,
without any other complaint except that of lassitude or weariness, Avhich
went off in a feAV days.  The Doctor mentions likeAvise an instance of
a man who was restored to life, after he had remained six hours under Ava-
ter, by the heat of a dunghill.
   Till the patieut shews some  signs of life, and is  able to SAvallow, if
would be useless and even dangerous to pour liquors into his mouth. His
lips however,  and tongue, may  be frequently wet Arith a feather dipt in
warm brandy  or other strong spirits; and, as soon as he  has recovered
the power of swallowing, a little warm  wine, or some other cordial, ought
every now and then to be administered.
   Some recommend a vomit after the patient is a tittle re-animated; but
if he can be made to puke Avithout tlie sickening draught, it will be  more
safe: this may generally be done by tickling the throat and fauces Arith
an oiled  feather,  or some  other soft substance, Aihich will not injure the
parts.   Tissot in this case recommends the oxymel  of squills, a table-
spoonful of which, diluted Arith  Avater, may be given eA'ery quarter of an
hour, till the patient has taken five or six doses.   Where that medicine
is not at hand, a  strong infusion of sage,  camomile-flowers, or  carduus
bemdictus, sweetened with honey, or some Avarm  water,  with the  addi-
tion of a little salt, may,  he says, supply its place.   The Doctor does
not intend that any of these things should be given in such quantity as to
occasion vomiting. He thinks emetics in this situation are not expedient.
   We are by  no means to discontinue our assistance as soon  as the pa-
tients discover some  tokens of life, since they sometimes expire after
these first appearances of  recovering.  The Avarm  and  stimulating ap-
plications are  still to be continued, and small quantities of some cordial li-
quor ought frequently to  be administered.  Lastly, though  the person
should be manifestly re-animated, there sometimes remains an oppression,
a cough, and feverishness, which effectually constitute a disease.   In this
case it will  be necessary to bleed the patient  in the arm and to  cause
him to driuk  plentifully of barley-water,  elder-flower tea, or any other
soft pectoral infusions.
   Such persons as have the misfortune to be deprived of the appearan-
ces of life, by a fall, a bloAV, suffocation,  or the  like, must  be treated
nearly iu the  same manner as those who have been for some  time  under
Avater.  I once  attended  a patient  Avho was so stunned by a fall from a
horse, that for above six  hours he scarcely exhibited any signs of life;
yet this man,  by  being bled, and proper methods taken to keep up the vi-
tal warmth, recovered, and  in a few days was perfectly well.   Dr.  Alex-
ander gives an instance to the same purpose in the Edinburgh Physical
and Literary  Essays, of a man who Avas  to all appearance  killed by a
bloAv on the breast, but recovered upon being immersed for some time in
warm  Avater.   These, and  other instances of a similar  nature, which
might be adduced, amount to a full proof of this fact, that many of those 
J0U               OF  NOXIOUS  VAPOURS.

unhappy persous who lose their lives by f.db, blows, and other acinic utv
might be saved by the use of proper means duly persisted in.


                   OF NOXIOUS VAPOURS.

  AIR may be many Avays rendered noxious or even destructive to ani-
mals.   This may either happen from its vivifying principles being de-
stroyed, or from subtle exhalations with Avhich it is impregnated.   Thus
aflr that has passed  through burning fuel is neither capable of supporting
fire nor  the  life of animals.   Hence the  danger of  sleeping in  close
chambers Avith coal fires.  Some indeed  suppose the  danger here pro-
ceeds from the sulphureous oil contained in the coal, which is set at liber-
ty and diffused all over the chamber; Avhile others imagine it is owing to
the air of the r  om being charged with phlogiston.  Be this as it may,
it is a situation carefully to be avoided.  Indeed it is dangerous to sleep
in a small apartment with a fire of any kind.  I lately saw four persous
who had been suffocated by sleeping in an apartment Avhere a small fire of
coal had been left  burning.
   The vapour which exhales from wine,  cyder, beer, or other  liquors
in the state of fermentation, contains something poisonous, which kills in
the same manner as the vapour of coal.  Hence there is always danger
in going into cellars where a large quantity of these liquors, is in a state
of fermentation, especially if they have been close shut up for some time.
There have been many instances of persons struck dead on entering such
places, and of others who have Arith difficulty escaped.
   When subterraneous caves, that have been veiy long shut, are opened,
or when deep wells are cleaned, which have not been  emptied for  sever-
al years, the vapours arising from them produce the same effects as those
 mentioned above.   For this reason no person  ought to venture into a
 Avell, pit,cellar,  or  any place that  is damp, and has been  long shut up, till
 the air has been sufficiently purified, by burning gunpowder in it.   It is
easy to knoAv, as has been observed  in a former part of  this work, when
 the air of such  places is unwholesome, by letting down a lighted candle,
 throwing in burning fuel, or  the like.  If  these continue to burn,  people
 may s 'fely venture in; but where they are suddenly extinguished, no
 one ought to enter till the air has been first purified by fire.
   The offensive smell of lamps and of candles, especially when their flames
 are extinguished, operate like other vapours, though with less violence, and
 less suddenly.  There have however been instances of people killed by
 the fumes of lamps which had been extinguished in a close chamber, and
 persons of weak delicate  breasts generally  find themselves quickly op-
 pressed in apartments illuminated with many candles.
   Such as are sensible of their danger in these  situations, and  retreat
 seasonably  from  it, are generally relieved as soon as they get  into the
 open air, or, if they have any remaining  uneasiness,  a little water and
 vinegar, or lemonade, drank hot, affords them relief.   But when they are
 so far poisoned as to have lost their feeling and understanding, the fol-
 loAving means must be used for their recovery.
    The patient  should  be exposed to a  very  pure, fresh, and open ail,
 and  volatile salts, or  other  stimulating  substances, held to his nose.
 He should next be bled in the arm, or if  that does not succeed, in  the 
EFFECTS OF  EXTREME  COLD.         381
neck.  His leg* ought to be put into warm water, and Avell rubbed.  As
soon as he can swallow, some lemonade, or water  and vinegar with  the
addition of a little nitre, may be given him.
  Nor arc sharp clysters by any means to be neglected; these may be
made, by adding to the common clyster, syrup of buckthorn and tincture
of senna, of each  two ounces; or, in their stead, half an ounce of Venice
turpentine dissolved in the yolk of an egg.   Should these things not be
at hand, two or three  large spoonsful of common salt may  be put into the
clyster   The same means, if necessaiy, Avhich Avere recommended in
the former part of this chapter, may be used to restore  the circulation,
warmth, Ac.
  Mr. Tossach, surgeon at  Alloa, relates the case of a man  suffocated
hy the steam of burning coal, whom he recovered by blowing his breath
into the patient'6 mouth, bleeding him in the arm, and causing him to be
•.veil rubbed  aud  tossed about.   And  Dr. Frewen, of Sussex, mentions
the case of a young  man who was stupified by the smoke of sea-coal,
but was recovered by being plunged into cold water, and  afterwards  laid
in a Avarm bed.
   The practice of plunging  persons suffocated by  noxious  vapours in
cold water, would seem  to be supported by the common experiment of
suffocating dogs in the grotto del  cani, and afterwards recovering them,
by  throwing them into the neighbouring lake.

               EFFECTS  OF EXTREME COLD.

  WHEN cold is extremely severe, and a person is exposed to it for a
long time, it proves mortal, in consequence of its stopping the circulation
in the extremities, and  forcing too great a proportion of blood towards
the brain;  so  that the patient dies of  a kind of apoplexy, preceded by
great sleepiness. The traveller, in this situation, who finds himself begin to
grow drowsy, should redouble his efforts to extricate  himself from the im-
minent danger he is exposed to.   This sleep, which  he might consider as
gome alleviation of his sufferings, Avould, if indulged, prove his last.
  Such violent effects of cold are happily not A'ery common in this country;
it frequently happens, however, that the hands or feet of travellers are so
benumbed or frozen, as to be in danger of a mortification,  if proper means
are not used to prevent it.   The chief danger in this situation arises  from
the sudden application of heat.   It is very common, when the hands or
feet are pinched with cold, to hold  them to the fire; yet reason and ob-
servation shew that  this is a most dangerous and imprudent practice.
   EArery peasant knows, if frozen meat, fruits, or roots of any kind be
brought near the  fire, or put into warm Avater, they will be  destroyed, by
rottenness or a kind  of mortification;  and that the only way to recover
them, is to immerse them for some time in very cold water.   The same
observation holds Avith regard to animals in this condition.
   When the hands or feet are greatly benumbed with cold,  they ought
either to be immersed in cold water, or nibbed with snoAV,  till they re-
cover their natural warmth and sensibility: after which  the  person  may
be removed into  an apartment a little Avarmer, and may drink some  cups
of  tea, or an infusion of elder flowers  sweetened  Arith honey.  Every
pcivon uiu-'t have observed, when his hands Avere even but slightly af- 
3$2
EFFECTS OF  EXTREME  HEAT.
fected with cold,  that the best way to warm them was by washing them
in cold water, and continuing to rub them well for some time.
  When a person has  been so long exposed to the cold, that all appear-
ances of life are gone, it will be necesssary to rub him all over with snow
or cold water; or, what Avill answer better,if it can be obtained, to immerse
him in a bath of  the very coldest water.  There is the greatest encour*
agement to persist in the use  of these means, as Ave are assured that per-
sons who had remained in the snoAV, or had been exposed to the free/ing
air during five or six successive days, and who had discovered no marks
of life for several hours; have nevertheless been revived.
  I have always thought that the Avhitloes, kibes, chilblains, and othrr
inflammations of the extremities, which are so common among the pea-
sants in the cold season, were chiefly occasioned by their sudden transi-
tions from cold to heat.  After they have been exposed to an extreme de-
gree of cold, they immediately apply their hands and feet to the fire, or,
if they have occasion, plunge them into warm water, by which means, if
a mortification does not happen, an  inflammation seldom fails to ensue.
Most of the  ill consequences from this  quarter might be easily avoided,
by only observing the precautions mentioned above.

              EFFECTS  OF EXTREME  HEAT.

  THE effects of extreme heat, though not so  common in this country,
are no less fatal, aud much more sudden  than those of cold.  In hot
countries people frequently drop down dead in the streets, exhausted with
heat and fatigue.  In  this case, if any Avarm cordial can be poured into
the mouth, it ought to be done.  If this cannot be affected, they may be
thrown up in form of a clyster.  Volatile spirits  and other things of a
stimulating nature, may be applied to the skin, which should be well rub-
bed with coarse  cloths, ivhipped with nettles, or other stimulating things.
Some of the ancient physicians are said to  have  restored to life person*
apparently dead by beating them with  rods.
                        CHAP.   LVII.

   OF  FAINTING FITS, AND OTHER CASES WHICH

           REQUIRE  IMMEDIATE ASSISTANCE.

         STRONG and healthy persons, who abound with blood, are
often seized Arith sudden fainting fits, after violent exercise, drinking free-
ly of warm or strong liquors, exposure to  great heat, intense application
to study, or the like.
  In such cases the patient should be made to smell some vinegar.  His
temples, forehead and Avrists, ought at the same time to be bathed with
vinegar mixed with an equal quantity of warm water; and tiro or three
spoonsful of vinegar, with four or five times as much water, may, if he
can swallow, be poured into his mouth. 
OF FAINTING  FITS,  &C.               383
  If the fainting proves obsthjate, or degenerates into a syncope, that is,
an abolition of feeling and understanding, the patient must bo bled.  After
the bleeding, a clyster will be proper, aud then  he should be kept easy
and quiet, only giving him every half hour a cup or two of an infusion of
any mild vegetable, with the addition of a little sugar and vinegar.
  When swoonings, which arise from this cause, occur frequently in the
same person, he should, in order to escape them, confine himself to alight
diet, consisting chiefly of bread, fruits, and other vegetables.  His drink
ought to be water or small beer, and he should sleep but moderately, and
lake much exercise.
  But fainting fits proceed much vftener from a  defect than an excess of
blood.  Hence they are very ready to happen after great evacuations of
any kind, obstinate watching, Avant of appetite, or  such like.  In these,
an almost directly opposite course to that mentioned above must be pur-
sued.
   The patient should be laid in bed, Avith his head  Ioav, and being cover-
ed, should have his legs, thighs, arms, and his whole body rubbed strong-
ly with flannels.  Hungary-Avater, volatile salts, or strong smelling herbs,
as rue, mint, or rosemary, may be held  to his nose.  His mouth must be
wet vrith a little rum or brandy;  and if he can  swallow, some hot wine,
mixed with sugar and cinnamon, Avhich is an excellent cordial, may be
poured into his mouth.  A compress of flannel dipt in hot wine or brandy
must be applied to the pit of his stomach, and warm bricks, or bottles filled
with hot water laid to his feet.
  As soon as the patieut is recovered a  little, he should take some strong
soup or broth, or a little bread or biscuit soaked in  hot spiced Avine.   To
prevent the return of the fits, he ought to take often, but in small quanti-
ties, some light yet strengthening nourishment, as panada, made with soup
instead of Avater, neAV laid eggs  lightly poached, chocolate, light roast
meats, jellies, and such like.
   Those fainting fits, which are the effect of bleeding, or of the violent
operation of purges, belong to this class.   Such  as happen after artificial
bleeding are seldom dangerous, generally terminating as soon as the pa-
tient is laid upon the bed; indeed persons subject to this kind should al-
ways be bled tying, in order to prevent it.  Should the fainting however
continue longer than usual, volatile spirits may  be held to the nose, and
rubbed on the temples, &c.
   When fainting is the effect of too strong or acrid purges or vomits, the
patient must be treated in all respects  as if he  had taken poison.   He
should be made to drink plentifully of milk, warm water, and oil, barley
water, or such like emollient clysters Avill likewise be proper and the pa-
tient's strength should  afterwards be recruited,  by giving him generous
cordials, and anodyne medicines.
   Faintings are often occasioned by indigestion.  This may citherproceed
from the quantity or quality of the food. When  the  former of these is
the cause, the cure Avill  be best performed by vomiting,  which may be
promoted by causing the patieut  to drink a weak infusion of camomile-
flowers, car dims  bencdictus, or  the  like.  When  the  disorder  pro-
ceeds from the nature of the food, the patient as in the case of weak-
ness, must  be  revived by strong smells, Ac.  after which he should be
made  to  swalloAV  a large quantity of light  warm fluid,  Avhich  may
v-we  to drown,  as it wore, thr* offending matter, to soften its acrimonv, 
384               OF  FAINTING  FITS,  &X.

and either to effect a discharge of it by vomiting, or force it doAvn into the
intesdnes.
  Even  disagreeable smells  will sometimes occasion swoonings, espe-
cially in people of weak nerves.   When this happeus, the patient should
be carried in the open  air,  have stimulating  things held to  his nose,
and those substances which are disagreeable  to him ought immediately
to be removed.  Bn< avc have alreatly taken  notice of swoonings which
arise from nervous disorders, and shall therefore say no more upon that
head.
  Fainting-fits often happen in the progress of diseases.  I n the beginning
of putrid diseases they generally denote an oppression at the stomach, or
a mass of corrupted humours, and they cease after evacuations either by
vomit or stool.   When they  occur at the beginning of malignant fevers,
they indicate great danger.   In each of these  cases, vinegar used  both
externally and internally is  the best remedy  during the paroxysm,  and
plenty of lemon juice and Avater after it.  Swoonings which happen i  dis-
eases accompanied with great evacuations, must be treated like those
which are owing to Aveakness, and the evacuations ought to be restrained.
When they happen towards the  end of a violent fit of au intermitting fe-
ver, or at that of each exacerbation of a continual fever, the patieut must
be supported by small draughts of Avine and Avater.
  Delicate and hysteric women are very liable to swooning or fainting fits
after delivery.   These might be often prevented by generous cordials,
and the admission of fresh air.   When they arc occasioned by excessive
flooding, ii ought by all means to be restrained.   They are generally the
effect of mere weakness or exhaustion.  Dr. Englcman, relates the case
of a Avoman  " in child-bed, who, after haviugbeen happily delivered, sud-
" denly fain ed and lay upwards oi' a quarter of au hour appareutly dead.
" A physician was sent for;  her own  maid, in the mean while, being out
" of patience at his delay, attempted  to assist her herself, and  extending
" herself upon her mistress, applied her mouth to hcr's, blew in as much
  ' breath as she possibly  could, and in a very short time the exhausted wo-
" man awaked  as out of a profound sleep; Avhen pioper things beinggiv-
" en  her, she soon recovered.
   " The maid being asked how  she came to think of this expedient, said
" she had seen  it practised at Aldenburgb, by  midwives, upon children,
-■ with the happiest effect."
   We mention this chiefly that other  midwives may be induced to follow
so  laudable an  example. Many children are boru without any signs of
life, and others expire soon after the birth, who might without all doubt, by
prober care, be restored to life.                       ...
   From  whatever cause faiutins-fits  proceed, fresh air   is always ol
 the neatest importance to  lhe"patient-   By  not attending to this cir-
 cumstance,  people often kill their friends while they are endeavour-
 io" to save them.  Alarmed at the  patient's  situation, they call  in  a
 crowd of people  to  his assistance,  or perhaps to  witness  his  exit.
 whose breathing exhausts  the air,  and increases the danger.  Then
  is  not the  least doubt  but  this practice, which is very common anions
 the lower sort of people, often proves fatal,  especially to the debca.c,
  aud such persons  as  fall into fainting-fits from mere exhaustion or the
  violence of  some disease.   No more persons ought ever  to be admitted
  into  the room  where a patient lies in  a swoon than are absolutely n« 
OF  INTOXICATION.                  385
Cessary  for his assistance, and  the  windows  of the apartment should
always be opened, at least as far as to admit a stream of fresh air.
   Persons subject to frequent swoonings, or fainting-fits, should neglect
r.o means to remove the cause of them, as their consequences are always
injurious to the constitution.  Every fainting*fit leaves the person iu de-
jection and weakness; the secretions are thereby suspended, the humours
disposed to stngnation,  coagulations and obstructions are formed, and, if
the motion of  the blood be totally intercepted, or  very considerably
checked, polypuses are sometimes formed in the heart or larger vessels.
The only  kind of swoonings not to be dreaded are those which same
time mark the crisis in fevers; yet even these: ought, as soon as possible,
to be removed.

                      OF INTOXICATION.

   THE effects of intoxication are often fatal.   No kind of poison kills
more certainly than an over dose of ardent spirits.  Sometimes, by de-
stroying the nervous energy, they put an end to life at once; but in
general their effects are more slow, and in many respects similar to those
of opium.  Other kinds of intoxicating liquors may  prove  fatal Avhen
taken  to excess, as Avell as  ardent spirits;  but  they  may generally be
discharged by vomiting, which ought always  to be  excited when the
stomach is over-charged with liquor.
   More of those unhappy persons, Avho die intoxicated,  lose their lives
from inability  to conduct themselves,  than from the destructive quality
ofthe  liquor.   Unable to ivalk, they tumble down, and lie in some awk-
Avard posture,  Avhich obstructs the circulation  or breathing, and  often
continue in this situation till they die.  No drunken person should be
left by himself, till his clothes have been loosened, and his body laid iu
such a posture as is most favourable for continuing the vital motions, dis-
charging the contents of the  stomach, Ac.   The best posture for dischar-
ging the contents of the stomach is to lay the person upon his belly; when
asleep he may be laid on his side,  with  his head a little raised,  and par-
ticular care must be taken that  his  neck be no wray bent, tAvisted, or
have any thing too tight about it.
   The excessive degree  of thirst occasioned by drinking strong liquors,
often  induces people to quench it by taking Avhat is hurtful.   I  have
known fatal  consequences even from drinking freely of milk after  a de-
bauch of Avine or sour punch; these acid liquors, together with the heat
of the stomach, having  coagulated the milk in such  a manner that it
could never be digested.   The safest drink after  a debauch is water
Avith a toast, tea, infusions of balm, sage, barley-water, and such like.   If
the person wants to vomit, he may drink a weak infusion of camomile flow-
ers, or lukewarm water and oil; but in this condition vomiting may gen-
e-rally be excited by only tickling the throat with the finger or a feather.
   Instead of  giving a detail of all the different symptoms of intoxication
 which indicate danger, and proposing  a general plan of treatment for
 pers6ns in this situation, I shall briefly relate the history of a case which
 latelv  fell under my own observation, Avherain  most  of those symptoms
usually reckoned dangerous concurred, and where  the treatment was
 successful.
    4 youns man. about fifteen years of age, had, for a hire,  drank ten
                                 40 
^>86       OF  SUFFOCATION  AND STRANGLING.

glasses of strong brandy.   He soon after fell fast asleep, and continued
in that  situation for several hours, till at length his uneasy manner of
breathing, the coldness of the extremities, and other threatening symp-
toms, alarmed his friends, and  made  them seud for me.   1 found him
still sleeping, his countenance ghastly, and  his  skin covered with cold
clammy sweat.  Almost the only signs of life remaining were, a deep la-
borious breathing, and a convulsive motion or agitation of his bowels.
  I tried to rouse him, but in vain, by pinching, shaking, applying vola-
tile spirits, and other stimulating things to his nose, Ac. A few ounces of
blood were  likewise taken from his arm, and a mixture of  vinegar and
Avater was poured into his mouth; but, as he could not swallow, very lit-
tle of this got into the stomach.  None of these things having the least ef-
fect, and the danger seeming to  increase, I ordered his legs to be put into
warm Avater, and a sharp clyster to be immediately administered.  This
gave him a stool, and Avas the  first thing that relieved him.  It was af-
terwards repeated with the same happy effect, and seemed to be the chief
cause of his recovery.   He then began to shew some signs of life, took
drink  when it was offered  him and  came gradually to his senses.  He
continued, however, for several days weak and feverish, and complained
much of a soreness in his bowels, which gradually went off,  by means of
a slender diet, and cool mucilaginous  liquers.
   This young man would probably have been suffered to  die Avithout
any assistance being called, had not a neighbour a few days before, who
bad been advised to drink a bottle of spirits, to cure him of an ague, ex-
pired under very similar circumstances.

          OF SUFFOCATION AND STRANGLING.

   THESE may some times proceed from an infraction of the  lungs,
produced by viscid clammy humours, or spasmodic affection  of the nerves
of that organ.  Persons who feed grossly, and abound in rich blood, are
 very liable to suffocating fits from the former of these causes.   Such ought
as soon as they are attacked, to be bled, to receive  an emollient clyster,
and to take frequently a cup  of diluting liquor with a little nitre in it.
They should likeAvise receive  the steams of hot vinegar into their lungs
by breathing.
   Nervous asthmatic persons are most subject to spasmodic affections of
the lungs.   In this  case  the patient's legs should be immersed in warm
 ivater, and  the steams of vinegar applied as  above.  Warm diluting  li-
 quors should likewise be drank; to a cup of which a tea-spoonful  of the
 parygoric elixir may occasionally be added.  Burnt paper, feathers, or
 leather, maybe held to the patient's nose, and  fresh air should be freely
 admitted to him.
   Infants are often suffocated  by the carelessness or inattention of their
nurses*.  An infaut when in bed  should always be laid so, that  it can
not tumble down with its head under the bed-clothes; and when in a
  * These accidents are not always the effects of carelessness.  I have known
an infant overlaid by its mother being seized in the night with an hysteric fiu
This ought to serve as a  caution against employing hysteric women as nurses,
and should likewise teach such women never to lay an infant in the same bed
with themselves, but in a small adjacent one. 
          OF SUFFOCATION AND  STRANGLING.      3B7

cradle, its face ought never to be covered.  A small degree of attention
to these two simple rules would save the lives of many infants,  and pre-
vent others from being rendered weak and sickly all their days by the
injuries done their lungs.
   Instead of laying down a plan for the recovery of infants who are suf-
focated, or over-laid,  as it is termed by their nurses,  I shall give  the
history of a case related by  Monsieur Janin, of  the Royal College of
Surgery at  Paris, as  it was attended with success, and contains almost
every thing that can be done on such occasions.
   A nurse having had the misfortune to over-lay  a child, he Avas called
in, and found the infant Avithout any signs of life;  no  pulsation in  the
arteries, no respiration, the face livid, the eyes open, dull, and tarnished,
the nose full of snivel, the mouth gaping, in  short, it was almost  cold.
Whilst some linen clothes and a parcel  of ashes'  were warming, he had
the boy unswathed, and  laid  him in a warm bed,  and on the right side.
He then was rubbed all over  with fine linen, for fear of fretting his ten-
der and delicate skin.   As soon as the ashes had  received their due de-
gree of heat, Mr. Janin buried him in them, except the face, placed him
<m the  side opposite to that on which he had been at first laid, and co-
vered him with a blanket.  He had a bottle of eau de luce inhjs pocket,
Avhich he  presented to his nose from time to time; and between whiles
some puffs of tobacco were  blown up his nostrils: to these succeeded
the blowing into his mouth, aud squeezing tight his nose.  Animal heat
began thus to be excited gradually; the pulsations of tlie temporal arte-
ry were soon felt, the breathing became more frequent and free, and  the
eyes closed and opened alternately.  At length the  child  fetched some
cries expressive  of  his want of the breast, which being applied to his
mouth, he catched at it with  avidity,  and sucked as if nothing had hap-
pened to him.  Though the pulsations of the arteries were by this time
very well re-established, and it Avas hot weather,  yet Mr. Janin thought
it advisable to leave  his little patient three quarters of an hour longer
under the ashes.   He was afterwards taken out, cleaned and dressed as
usual;  to which a gentle sleep succeeded, and he continued perfectly well.
   Mr. Janin mentions likewise an example of a young man  who had
hanged himself through despair, to whom he administered help as ef-
fectually as in the preceding case.
   Mr. Glover, surgeon in Doctors  Commons, London, relates the case
of a person who  was restored to life after tAventy-nine minutes hanging,
and continued in good health for many years after.
   The principal means used to restore this man to life were, opening
the temporal artery and the external jugular; rubbing the back, mouth,
and neck, with  a quantity of volatile spirits and oil; administering the
tobacco clyster by  means of lighted pipes, and strong frictions of the legs
and arms.  This course had been continued for about four hours, when
an incision was  made into  the Avind-pipe,  and  air blown strongly
through a canula into the lungs.   About twenty  minutes after this, the
blood at the artery began to run doAvn the face, and a slow pulse was just
perceptible at the wrist.  The frictions were continued  for some time
longer; his pulse became more frequent, and his  mouth and nose being
irritated Avith spirits  of sal amoniac, he opened  his eyes.  Warm cor-
dials were then administered to him, and in two  days he was so well as
to be able to walk  eight miles. 
388
OF PERSONS WHO  EXPIRt
  These cases are sufficient to shew what may be done for the rccov ery
of those unhappy persons who strangle themselves in a fit of despair.

  OF  PERSONS WHO  EXPIRE IN CONVULSION FITS.

  CONVULSION fits often constitute the last scene of acute or chronic
disorders.  When this is the case there can  remain but small  hopes of
the patient's  recovery after expiring in a fit.  But Avhen a person who
appears to be in perfect health, is suddenly seized with a convulsion fit,
and seems to expire, some  attempts ought always to be made to restore
him to life.  Infants are most liable to convulsions, and arc often car-
ried off very suddenly by  one  or more fits about the time  of  teething.
There are many well authenticated accounts  of infants having been re-
stored to life, after they had to  all appearance expired in convulsions;
but Ave shall  only relate the folloAving instance, mentioned by Dr. Johnson,
in his pamphlet on the practicability of recovering persons visibly dead.
   In the parish of St. Clemens iu Colchester, a child of six mouths old,
lying  upon its mother's lap, having  had the breast, Avas seized with a
strong convulsion  fit, which lasted so long, and eneled with so total a pri
vation of motion in the body, lungs, and pulse, that it Avas deemed abso-
lutely dead.   It was accordingly stripped,  laid out, the passing  bell
ordered  to be tolled, aud a  coffin  to be made;  but a neighbouring gentle-
woman Avho used to aelmire the child, hearing of its sudden death, hasten-
ed to the house, and upon examining the child, found it not cold,  its joints
limber, and  fancied  that  a glass she  held to its mouth and nose was a
little damped with the breath; upon which she took the child in her lap,
sat down before the fire, rubbed it, and kept it in gentle agitation.  In a
quarter  of an  hour she felt  the heart begin to beat faintly;  she then
put a little of  the mother's milk into its mouth, continued to rub its
palms and soles, found the child begin to move, and the milk Avas sAral-
loAved;  and  in another quarter of au hour she  had  the satisfaction of
restoring to  its disconsolate mother  the babe quite recovered, eager to
lay hold of the breast,  and able  to suck again.   The child throve, had
no more fits, is grown up,  and at present alive.
   These means, Avhich are certainly in the power of every person, were
sufficient to  restore to life an infant to all appearance dead, and who in
all probability,  but for the use of these simple endeavours,  Avould havo
remained so   There are  however many other things which  might be
done  in case the  above should not succeed; as rubbing the body with
strong spirits, covering it with Avarm ashes or salt, bloAving  air into  the
lungs, throwing up warm stimulating clysters or the  smoke of tobacco
into the intestines, and  such like.
   When children are dead born, or expire soon after the birth, the same
means ought to be used for their  recovery, as if they had expired in cir-
 cumstances similar to those mentioned above.
   These directions may likewise be  extended to adults, attention being
always paid  to the age  and other circumstances of the patient.
   The  foregoing cases and observations  afford sufficient proof of tlie
success  which may attend the endeavours  of persons  totally ignorant
of medicine, in assisting  those who are suddenly  deprived of life by
any accident or  disease.   Many facts of a  similar nature might be ad-
duced, were it necessary; but these,  it  is hoped,  will  be sufficient to 
IN CONVULSION  FITS.
389
call up the attention of the public, and to excite the humane and benevo-
lent to exert their utmost endeavours for the preservation of their fellow-
men.
  The socidyfor tiu; recovery ofdrowned persons, instituted at Amsterdam
in the year 1767, had the satisfaction to find that no fewer than 150 per-
sons, in the space of four years, had been saved by the means poiuted out
by them, maoy of whom owed their- preservation to peasants and people
of no medical knowledge.   But the means used with so much efficacy in
recovering drowned persons are, with equal success, applicable to a num-
ber of cases where the powers of life seem in reality to be only suspended,
and to remain capable of renewing all  their functions, on being put into
motion again.   It is shocking to reflect, that for want of this consideration
many persons have been committed to the grave in whom the principles
of fife might have beeu revived.
  The cases wherein  such endeavours are most likely to be attended with
success, are  all those called sudden deaths from an inevitable cause,, as
apoplexies, hysterics, faintings, and many other disorders  wherein per-
sons in a moment sink down and expire.  The various casualties in Avhich
they may be tried are, suffocations from the sulphureous damps of mines,
coal-pits, Ac. the unwholesome  air of long unopened Avells or caverns;
the noxious vapours arising from fermenting liquors; the steams of burn-
ing charcoal; sulphureous mineral acids; arsenical effluvia, Ac.
  The various accidents of drowning, strangling, and apparent deaths, by
blows, falls, hunger, cold, &c. likewise furnish opportunities of trying such
endeavours.   Those perhaps Avho  to appearance are killed by lightning,
or by any violent agitation of the passions, as fear, joy, surprise, and such
like, might also be frequently recovered by the use of proper means, as
blowing strongly into  their  lungs, &c.
  The means to be used for the recovery of persons suddenly deprived of
life, are nearly the same in all cases; they ave practicable  by every
one Avho happens to be  present at the accident, and require  no great ex-
pense, and less skill.   The great aim is to restore the warmth and vital
motions.  This may  in general  be attempted by means of heat, frictions,
bleeding, blowing air  into the lungs, administering clysters and generous
cordials.   These must  be varied according to circumstances.  Common
sense, and the situation of  the patient, will suggest the proper manner of
conducting them.  Above all we would recommoud perseverance.  People
ought never to despair on account of discouraging circumstances, or to
leave off their endeavours  as long as there is the least hope of success.
Where much  good and no  hurt can be done, no one ought to grudge his
labour.
  It  were greatly  to be Avished, that an institution similar  to that of
Amsterdam, Avas established, upon a more extensive plan, in  Great
Britain; and  that a  reward  was  allowed to every one Avho should be
instrumental  in  restoring  to life a  person  seemingly dead.*   Men

  • The Author is happy to observe, that since the first publication of this work,
several societies hare been institute J in Britain with the same benevolent inten-
tion as that of Amsterdam, and that their endeavours have proved no  less suc-
cessful.   He is also happy to observe,  that premiums have been awarded to
those  who have been active  in their endeavours to restore to life persons who
had been drowned, or suddenly deprived of life by any accident.   How much is
this superior to the superstitious institution, which allows any man a premium
who brings a dead person out of the water, so  that he  may receive Christian 
JW             ON  COLD  BATHING,  AND

will do much for fame, but still more for money.  Should no profit, how-
ever, be annexed to those beuevolent offices, the heartfelt pleasure Avhich
a good man must enjoy on reflecting that  he has been the  happy instru-
ment of saving one of his felloAv-creatures from an untimely  grave, is itseh
i sufficient reward.
                        CHAP. LVII.

    CAUTIONS CONCERNING COLD BATHING AND
           DRINKING THE MINERAL WATERS.

      -A.S it is now fashionable for persons of all ranks to plunge into
ihe sea, and elrink the mineral waters, I was  desirous of rendering this
work still more extensively useful, by the addition of some practical re-
marks on these active and useful medicines.   Finding it impossible to
bring these  observations  Avithiu so narroAv a compass as not to sivell the
book, already too  large, into an enormous size,  I resolved to confine my-
self to a few hints or cautions; Avhich may  be of service to persons who
bathe, or drink the mineral Avatcrs, Avithout being able to put themselves
under the care of  a physician.
  No part of the  practice of medicine is of greater importance, or merit?
more the attention of the physician, as many lives are lost, and numbers
ruin their health, by cold bathing, and an imprudent use of mineral  wa-
ters.  On some future occasion I may probably resume this subject, as I
know not any Avork that contains a sufficient number of practical observa-
tions to regulate the patient's conduct in the use of these active and im-
portant medicines.
   We have indeed many books on the mineral waters, and some of them
are Avritten with much ingenuity; but they are chiefly employed in ascer-
taining the contents of the waters by chymical analysis.  This no doubt
has its use, but it is by no means of such importance as s,ome may imagine.
A man may know the chymical analysis of all the articles in the materia
medico, without being able properly to apply any one of them in the cure
of diseases.   One page of practical observations is worth a whole volume
of chymical aualysis.  But where are such observations to be met with ?
FeAv physicians are in a situation to make them, and fewer still are qualifi-
ed for such a task.  It can only be accomplished by practitioners who re-
side at the fountains, and who possessing minds superior to local prejudi-
ces, are capable of distinguishing diseases with accuracy, and of forming
a sound judgment respecting the genuine effects of medicines.
   Without  a  proper discrimination with regard to  the diseases  and
the  constitutiou  of the  patient, the most powerful medicine is  more
likely to do harm than good.   Every one knows that tlie same phy-
sician Avho, by cold  bathing, cured  Augustus, by an imprudent use of
the  same medicine,  killed his  heir.   This induced  the Roman senate
to make laAvs  for regulating the baths, and.   preventing  the  numerous
burial; but allows nothing to the persbn who brings him out alive, or who reco-
vers him after he has been to all appearance dead. 
              DRINKING  MINERAL  WATERS.          391

Tils which arose from an imprudent and promiscuous use of those elegant
and fashionable pieces of luxury.  But as no such laws exist in this coun-
try, every one does that which is right in his own eyes,  and of course ma-
uy must do wrong!
   People are apt to imagine that the simple element of Avater can do no
hurt, and that they may plunge into it any time with impunity.  In this,
however, they are much mistaken.  I have known apoplexies, occasioned
by going into the cold bath, fevers excited by staying too long in it, and other
maladies so much aggravated by its continued use, that they could never
be wholly eradicated.  Nor are examples wanting, either in  ancient or
modern times, of  the baneful consequences which have arisen also from an
injudicious application of the warm bath; but as warm baths are not so
common in this country, and are seldom used but under the direction of a
physician, I shall not enlarge on that part of the subject.
   Immersion in cold  water is a custom  which lays claim to the most remote
antiquity: indeed it must have been coeval Arith man  himself.  The ne-
cessity of Avater for the purpose of  cleanliness, and the pleasure arriving
from its application to the body  in hot countries, must veiy early have re-
commended it to the  human species.   Even the example of other animals
was sufficient to give the hint to man.  By  instinct many of them are
led to apply cold water in this manner;  and some, Avhen deprived
of its use, have  been known to  languish  and even to  die.  But
whether  the practice of cold  bathing arose  from necessity,  reasoning,
or imitation,  is an inquiry of  no importance; our business is to point
out the  advantages which may  be derived from it, and to  guard
people against  an improper use of  it.
   The cold bath recommends itself in  a  variety of cases,  and is pe-
culiarly  beneficial to  the inhabitants of populous cities, Avho indulge
in idleness,  and  lead  sedentaiy lives.  In  persons  of this description
the action of the solids is always too weak,  which induces  a  languid
circulation, a  crude indigested mass  of  humours, and  obstructions in
the  capillary  vessels  aiid  glandular  system.    Cold water, from
its gravity as Avell  as its  tonic power, is well calculated  either to ob-
viate  or remove these symptoms.   It accelerates  the  motion  of the
blood, promotes  the  different secretions,  and  gives permanent vigour to
the solids.  But all these  important purposes  will be more  essentially
answered by the application  of salt water.   This ought not  only to
be preferred on  account of its superior gravity, but  likewise for its
greater power  of stimulating  the skin,  Avhich promotes the perspira-
tion,  and prevents the patient from catching cold.
   It is necessary, however, to  observe, that cold bathing is more likely
to prevent, than  to remove obstructions of the glandular or  lymphatic
system.  Indeed, ivhen these have arrived at a certain pitch, they  are
not to be removed by any means.   In this case the cold bath will only
aggravate the symptoms,  and hurry the unhappy patient into an untimely
grave. It is therefore of the utmost importance, previous to the patient's
entering  upon  the use of the cold bath, to determine Avhether or not he
labours under any obstinate obstructions ofthe lungs or other viscera ; and
where this is the  case cold  bathing ought strictly to be prohibited.*'
  • The late celebrated Dr. Smollet has indeed said, that if he were persuaded
liehad an ulcer in the hinirs, he would iumpinto'.!.? c»ld bath; but here the Dr. 
392           ON  COLD  BATHINC,  AND

  In Avhat is called a plethoric state, or too great a fullness of the bod),
it is likewise dangerous to use the cold  bath,  Avithout due preparation.
In this case there is great danger of bursting a blood-vcs. el, or occasion-
ing an inflammation of the brain or some of the visvera.  This precaution
is the more necessary to citizens, as most of  them live full, and are of a
gross habit.  Yet, what is very remarkable, these people re ort in crowds
every season to the sea-side, and plunge in the Avater without the least
consieleration.   No doubt they .often escape with impunity; but does this
give a sanction to the practice ?   Persons of this description ought by no
means to bathe, unless the body has been previously prepared by suitable
evacuations.
   Another class of patients, who stand  peculiarly in need of the bracing
qualities of cold water, is the nervous.   This includes a great number
of the male, and almost all the female inhabitants of great cities.  Yet
even those persons  ought to be cautious in using the cold bath.  Ner-
vous people have often Aveak bowels,  and  may, as  well as  others, be
subject to congestions aud  obstructions of  the  viscera;  aud   in this
case they Arill not  be able  to  bear  tlie effects of cold Avater.  For
them, and indeed for all delicate people,  the  best plan Avould be  to
accustom  themselves to it by  the most pleasing awl gentle degrees.
They ought to begin Avith  tlie  temperate  bath,  and gradually use it
cooler, till at  length the  cold proves  quite agreeable.  Nature revolts
against all great  transitions;  aud those  avIio do violence to her dic-
tates, have often cause to repent of their  temerity.
   Wherever  cold battling is  practised, there  ought  likewise to be
 teped baths for the purpose mentioned above.  Indeed it is the prac-
 tice of some countries to throw cold water  over  the patieut  as  soon
 as he comes out of  the warm bath; but though this may  not injure  a
 Russian peasant, Ave dare not recommend it to the inhabitants of this coun-
 try.  The ancient Greeks and Romans, we are told, when covered with
 sweat and dust, used to plunge into rivers, without receiving the smallest  '
 injury.   Though they might often escape danger  from this imprudent
 conduct,  yet it was certainly contrary to sound reason.  I jiave known
 many robust men throw away their lives by such an attempt.   We would
 not however  advise patients to  go into the cold water when  the body is
 chilly;  as much exercise, at least ought to he taken, as may excite a gen-
 tle glow all over tlie body, but  by no  means so as to ov. 1 heat it.
    To  young people  and  particularly to children, cold bathing is  of
 the last importance.   Their lax  fibres render  its tonic  powers  pecu-
 liarly proper.  It promotes  their growth,  increases their strength*,
 and prevents  a variety of diseases incident to  childhood.   Where in-

 evidentlv  shews more courage than discretion; and that he was more a man of
 wit than a physician, every one will allow.  A  nervous asthma, or an atrophy
 may be mistaken for a pulmonary consumption; yet, in the two  former,  the
 cold bath proves often beneficial, though  I never knew it so in die latter.  In-
 deed all the phthisical patients I  ever saw, who had tried the cold bath, were
 evidently hurt by it.                          .            . .    , e  -l,,
    * The celebrated Galen says, that immersion in cold water is fit only lor in«
 young of  lions and bears ; and recommends warm bathing, as conducive to the
 rfowth and strength  of infants.  How  egregiously do tlie greatest men err
 -whenever they losesight of facts, and substitue reasoning in physic in piacc
 'ijbservation and experience. 
Of  DRINKING  MINERAL  WATERS.       693
 fants early accustomed to the cold bath, it Avould seldom  disagree with
 them; and we should see fewer instances ofthe  scrophula, rickets, and
 otlier diseases which prove fatal to many, and make others miserable for
 life.  Sometimes indeed, these disorders render infants incapable of bear-
 ing the shock of cold water;  but this is owing to their not having been
 early and regularly accustomed to it.   It is however necessary here to
 caution young men against too frequent bathing, as I have known many
 fatal consequences result from the daily practice of plunging into rivers,
 and continuing there too long.
   The most proper time of the day for using the cold bath is no doubt
 the morning, or  at least before dinner;  and the best  mode,  that of quick
 immersion.   As cold bathing has a constant tendency to propel the blood
 and other humours towards the head, it ought to be a rule  always to wet
 that part as soon as possible.  By due attention to this  circumstance,
 there is reason to believe, that violent heaei-achs, and other complaints,
 which frequently proceed from cold bathing, might be often prevented.
   The cold bath, Af hen  too long continued in, not only occasions an ex-
 cessive flux of humours  towards the head, but chills the blood,  cramps
 the muscles, relaxes the nerves, and \. holly defeats the intention of bathing.
 Hence, by not adverting to this circumstance, expert swimmers are often
 injured,  and sometimes even  lose their lives*  All the  beneficial purpo-
 ses  of cold bathing are  answered  by one immersion at a time;  and the
 patient ought to be rubbed dry the moment he comes out  of the Avater,
 and should continue to take exercise for some time after.
   When cold bathing occasions chilness,  loss of appetite, listlessness,
 pain of the breast or boAvels, a prostration of  strength, or  violent head-
 achs, it ought to be discontinued.
   Though these hints are by  no means intended to point out all the cases
 where cold bathing may be hurtful, nor to  illustrate its extensive utility
 as a medicine; yet it is  hoped they may serve to guard people  against
 some of  those errois into which, from mere inattention, they are apt to
 fall, and thereby not only endanger their oAvn lives, but bring an excel-
 lent medicine into disrepute.

         OF DRINKING  TIIE MINERAL WATERS.

   THE internal use of water, as a medicine,  is  no less an object of the
 physician's attention than the  external.   Pure elementary Avater is indeed
 the most inoffensive of all liquors,  and constitutes a principal part of the
 food of every animal.  But this element is often impregnated with sub-
 stances of a very active  and penetrating  nature; and of  such an  insi-
 dious quality, that, while they promote certain secretions, and even alle-
viate some disagreeable symptoms, they weaken the powers of life, un-
dermine the constitution, and  lay the foundation of Avorse  diseases than
those which they Avere employed to remove.   Of this every practitioner
must have seen instances; and physicians of eminence  have more than
once declared that they have known more diseases occasioned than re-
moved by the use of mineral waters*   This  doubtless has proceeded
from the abuse of these powerful medicines, which evinces  the necessity
of using them with caution.
   By examining the contents of the mineral waters which are most
used in tliis couutrv, avc  shall be enabled to form an idea of the danger
                                 50 
394
OF DRINKING  MINERAL  WAiERS.
which may arise from an improper application of them either externally
or internally, though it is to the latter of these that the present observa-
tions arc chiefly confined.
   The vraters most in use for medical purposes in Britain, arc those im-
pregnated with salts, sulphur, iron, and mephitic air, cither separately,
or variously combined.  Of these the most  poAverful  is the saline sul-
phureous water of  Harrowgate, of which I have had more occasion to
observe the pernicious consequences, Avhen improperly used, than of any
other.  To this, therefore, tlie following remarks will more immediately
relate, though they will  be found applicable to all the purging waters iu
the kingdom which are strong enough to merit attention.*
   The errors which so  often  defeat the intention of drinking the pur-
gative mineral waters, and  which so frequently prove injurious to the
patient, proceed from the manner of using  them, the quantity taken, the
regimen pursued, or using them in cases Avhere they are not proper.
   A very hurtful prejudice stills prevails in this country, that all diseases
must  be cured by medicines taken into the stomach, and that the  more
violently these medicines  operate', they are the more likely to have the
desired effect.   This opinion has proved fatal to thousands, ajjd will, in
all probability, destroy many more before it  can be wholly eradicated.
Purging is often useful in acute diseases, and in chronical cases may  pave
the way for the operation of other medicines;  but it will seldom perform
a cure;  and by exhausting the strength of the patient, w ill often leave
him in a worse condition than it found him.  That  this is frequently the
case Avith regard to the more active mineral waters, every person  con-
versant in these matters  will readily alloAV.
   Strong stimulants applied to the stomach  and bowels for a length of
time,  must tend to weaken and destroy their energy; and what stimulants
are more active than salt and sulphur, especially when these substances
are intimately combined; and carried  through the system by the pene-
trating medium of  water ?   Those bowels must be strong indeed, which
can withstand  the  daily operation of such active  principles for months
together, and not be injured.   This however is the  plan pursued by mo.->t
of those Avho drink the purging mineral waters, and whose circumstances
will permit them to continue  long enough at those fashionable places
of resort.
   Many people imagine that  every thing depends on the quautity of
water taken, and that the more they drink  they will the sooner get  well.
This  is  an  egregious error; for while  the unhappy patient thinks  he is
by this means  eradicating his disorder, he is often in fact undermining
the poivers  of life, aud  ruining his  constitution.  Indeed nothing can
do this so  effectually as weakening the powers of digestion by the im-
proper application  of strong stimulants.   The very essence of health
  • The greatest class of mineral waters In this country is the chalybeate.  In
many parts of Britain these are to be found in almost every field ; but those
chiefly in use, for medical purposes, are the purging chalybeates, as the waters
of Scarborough, Cheltenham, Thorp  Arch, Nevil Holt, &c. Of those winch
do not purge, the waters of Tunbridge stand in the highest repute   The Saline
purging waters, as those of Acton, Epsom, Kilbum, &c. are also in very gene-
ral esteem ; but the fountains most frequented by the  sick in this  country, are
those to which the minerals impart a certain degree of heat, as Bath, Bristol,
Buxton, &c. 
             OF  DRINKINC  MINERAL  WATERS.        395

 depends on the digestive organs performing their due functions, and the
 most tedious maladies arc all connected with indigestion.
   Drinking the water in too great quantity, not only injures the bowels
 and occasions indigestion, but generally defeats the intention for Avhichit
 is taken.   The diseases for the cure of Avhich mineral Avaters are chiefly
 celebrated, are mostly  of  the  chronic kind; and it is  Avell knoAvn that
 such diseases can only be cured by the slow operation of alternatives, or
 such medicines as act by inducing a gradual change in the habit.  This
 requires length of time, and never can be effected by medicines Avhich
 run off by stool, and operate chiefly on the first passages.
   Those who wish for the cure of any obstinate malady  from the mineral
 Avaters, ought to take them in such a manner as hardly to produce any ef-
 fect whatever  on the boAvels.   With this view a half-pint glass may  be
 drank at bed time*, and tlie same quautity an hour before breakfast, din-
 ner, and supper.   The dose, however, must vary according to circum-
 stances. Eve-u  the  quantity mentioned  above  will purge some persons,
 Avhile others will drink twice as much without being in the least moved by
 it.   Its operation on  the bowels is the only standard for using the water
 as an alternative.   No more ought to be taken than  barely to move the
 body;  nor is it always necessaiy to carry it this length, provided the
 water goes off  by the other emunctorics, and does not  occasion a chil-
 ness, or flatulency in the stomach or bowels.   When the  water is  in-
 tended to purge,*"the quantity  mentioned  above may  be  all takcu before
 breakfast.
   I would  not only caution patients who drink the purging mineral Avaters
 over night to avoid heavy  suppers, but also from  eating heavy meals at
 any time.   The stimulus of water, impregnated with salts, seems to cre-
 ate a false appetite.  I  have seen a delicate person, after drinking the
 HarroAvgate waters of a morning, eat a breakfast sufficient to have served
 two ploughmen, devour a plentiful dinner of flesh and fish, and,  to crown
 all, eat such a supper as might have satisfied an hungry porter.
   All this, indeed, the  stomach seemed to crave; but this craving had
 better remain not quite satisfied, than that the stomach should be loaded
 with what  excceels its powers.   To starve patients Avas never my plan;
 but I am  clearly of opinion, that in the use of all the  purging mineral
 waters, a light  and  rather  diluting diet is the most proper;  and that  no
 person, during such a course, ought to eat to the full extent to Avhat his
 appetite craves.
   To promote the operation of mineral waters, and to carry them through
 the system, exercise is indispensably necessary.   This  may be taken in
 any manner that is most agreeable to the patient; but he ought never to
 carry it to excess.   The best kinds of exercise are those connected Arith
 amusement.  Every  thing that tends to  exhilarate the spirits, not only
 promotes the operation  of  the Avaters, but acts as a medicine.   All who
 resort to the mineral waters ought therefore to leave every care behind,

  * When I speak of drinking a glass ofthe w:iter over-night, I must beg leave
to caution those who follow this plan against eating heavy suppers.  The late
Dr. Daultry of York, who was the first that  brought the Harrowgate waters
into repute, used to advise his patients to drink a glass before they went to
bed; the consequence  of which was, that having eat a flesh  supper, and the
water operating in  the  night, they were often tormented with gripes  and obli-
ged to call for medical assistance. 
396
OF DRINKING  MINERAL  WATERS.
to mix with the company, and to make tlnmselvcs as cheerful and happy
as possible.  From this conduct, assisted by the free and wholesome air
of those fashionable places of resoit, and also the regular and early hours
which are usually kept, the patient often receives more benefit than from
using the waters.
  But the greatest errors in drinking the purging mineral Avaters arise
from their being used  in cases  where they are absolutely improper, and
adverse to the nature of the disease.  When people hear of a wonderful
cure having been performed by some mineral water, they immediately
conclude  that it will cure every thing, and accordingly swallow it down,
Avhen they might as well take poison.   Patients ought to be well inform-
ed,  before they begin to drink the more active kinds of mineral  waters,
of the propriety of the course, and should uever persist in using them
when they are found to aggravate the disorder.
  In all cases where purging is indicated, the saline 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 arc
neither found to irritate the nerves, nor debilitate the patient so much
 as the other purgatives.
  As a purgative, these Avaters are chiefly recommended in diseases of
the first passages, accompanied with,  or proceeding from,  inactivity of
the stomach and boAvels, acidity, indigestion, vitiated bile, worms, putrid
sores,  the piles, and jaundice.  In most cases of this kind they are the
best medicines that can be administered.   But when used with this view,
it is sufficient to take them twice, or at  most three times a-week, so as to
move the body three or four times; and it will be proper to continue this
course for some weeks.
   But the operation of the more active mineral Avaters is not confined to
the bowels.   They often promote the discharge  of urine, and not unfre-
quently increase the perspiration.  This shows that they are capable of
penetrating into every part ofthe body, and of stimulating the whole sys-
tem.   Hence arises their efficacy in removing the most obstinate of all
disorders, obstructions of  the glandular and lymphatic system.   Under
this class is comprehended the  scrophula or Kings-evil, indolent tumours,
obstructions of the liver, spleen, kidnies, and mesenteric glands.   When
these great  purposes are to be effected, the waters must be used  in the
gradual manner mentioned above, and persisted in for a length of time.
It will be proper however  now and then  to discontinue tlieir use for a
few days.                               .
   The next great class of diseases where mineral waters are found to be
beneficial, are  those of the skin, as the itch, scab, tetters, ring-worms,
scaly  eruptions, leprosies, blotches, foul ulcers, Ac.  Though these may
seem superficial, yet they  are often the most obstiaate which the phy-
sician has to encounter, and not unfrequently set his skill at defiance: but
they will sometimes yield to the  application of mineral waters for a suf-
ficient length of time,  and in most cases of this kind these waters deserve
a trial.   The saline sulphureous water, such as those of Moffat in Scot-
land, and Harrowgate in England, are the most likely to succeed in dis-
eases of the skin ;  but for this purpose it  will be necessary  not only to
drink the waters, but likewise to use them externally.
  To enumerate  more particularly the qualities  of the different mi-
neral waters, to specify those diseases in which they  are  respectively 
         OBSERVATIONS  CONCERNING  DIET,  &C.   397

indicated, and  to point out their proper  modes of application, Arould
lie an  useful,  and  by no means a disagreeable  employment; but as
the limits prescribed  to these remarks will not allow me  to  treat the
subject at more length, I  shall conclude  by observing, that whenever
the mineral waters  are found  to  exhaust  the  strength,  depress the
spirits, take away the appetite, excite fevers, distend  the bowels, or
occasion  a cough,  they ought to be discontinued.
                         CHAP.  LVIIL

 OBSERVATIONS  SONCERNING  THE  DIET OF THE COMMON PEOPLE, RE-
   COMMENDING A METHOD  OF  LIVING  LESS EXPENSIVE,  AND MORE
   CONDUCIVE TO HEALTH, THAN THE PRESENT.

        EXPERIENCE proves that not a few of the diseases incident
 to the inhabitants of this couutiy, are OAving to their mode of living.
 The vegetable productions they consume, fall considerably  short of the
 proportion which they ought  to  bear to the animal p^rt of their food.
 T he constant use of bread, and animal substances, excites an unnatural
 thirst, and leads to the immoderate use of beer and other stimulating li-
 quors, which generate disease and reduce the loAver orders of people to a
 state of hidigence.   To teach the poor man how  to live cheaper and
 bitter, is the design of the folloAving pages.
   Though the common people of this country live at a greater expense
 than any where else, it does  not follow that they live better.   They are
 strong indeed, but by no means healthy ; and it  is found  that, from an
 attachment to a particular mode of living, they are more liable to disease
 and  death in foreign climes, than the inhabitants  of any other country.
   It is certainly proper that the poor  man should be instructed in every
 thing that can make his little earnings go as far as possible,  or which can
 add to the comfort of himself and family.   Nor can cteonomy in living
 be deemed trivial, in a country where the riches depend on the cheapness
 of labour.
   It is alleged that  the  English are so much  attached to their  own
 modes of living, that no argument will induce them to make tlie smallest
 change.  Habits are indeed obstinate things, espeically those which re-
 late  to diet; but there are proofs that the English are not inflexible even
 in this matter.  The mode of living  among the  loAver orders has been
 greatly changed in my time, and I am sorry to say, not for the better.
   The people of England have too much good sense not to listen to rea-
 son,  provided due care were taken to instruct them.  But here the people
 may be truly said " to perish for want\of knowledgeJ"  No means have
been used to give them proper instruction.  Hurtful customs have been
suffered to prevail, till they have struck such deep roots that it will not
be an easy matter to eradicate  them.  The difficulty, however, is not
unsurmountable.  A few experiments of reform would have the effect to
render it as agreeable as it is salutary.
   Adults have  many old prejudices  to overcome,  but the case is
different in regard to  children.   They may be taught to use any kind of 
398    GENERAL  OBSERVATIONS ON  ALIMENT.

food, and Avhat they use when young, they Avill love when old.   If I can
introduce a different method of feeding  children, my purposes will br
answered.  This alone will, in time effect a  total change iuthe general
mode of living.
  The late distress of the poor has called forth many publications intend-
ed for their relief.   Most of them however, were  adapted  only for the
particular occasion, aud not calculated to prevent the return of like evils.
The following observations, it is hoped,  will have a more permanent ef-
fect.  They are intended to recommend a plan of living, which will ren-
der the people less dependent on bread and animal food  for their subsist-
ance, and consequently not so liable to suffer from a scarcity or dearth
of either of these articles in future.
  Particular attention has been paid to tlie substitutes for bread, as the
scarcity of this article proves peculiarly distressing to the poor.  It will
appear from the following pages, that bread is by no means so much a ne-
cessaiy of life as generally imagined, and that its place may, in many in-
stances, be supplied by a variety of other farinaceous substances.
        GENERAL  OBSERVATIONS ON  ALIMENT.
  NO creature eats such  a variety of food as man.  Intended for an in-
habitant of eveiy climate, he  devours the productions of them all;  and
if they  do not suit his palate, or agree with his stomach, he calls in the
aid of cookery, an art peculiar to himself; by which many things that,
hi a crude state, Avould prove  hurtful, or even  poisonous, are rcudered
Avholesome and salutary.
  The  obvious division of food is into animal and vegetable.  To say
that man Avas intended by  nature for using cither the one or the other
alone, would be  absurd.  His structure and  appetite prove that he was
formed  for both.   Judgment, however, is requisite in adjusting the  pro-
portions of each, so as to avoid the inconveniences arising from an ex-
treme on either hand.
  Though animal food is more nourishing than vegetable, it is not safe to
live on  that alone.  Experience has shewn that a diet consisting solely
of animal food, excites thirst, and nausea, occasions putrescence iu the
stomach and bowels, and  finally brings  on  violent griping pains^ Avith
cholera and dysentery.
  Animal food is less adapted to the sedentary than the laborious,  and
least of all to the studious, Avhose diet ought to consist chiefly of vegeta-
bles.   Indulging in animal food renders men dull,  and unfit for the  pur-
suits of science, especially when it is accompanied with the free  use of
strong liquors.
  The  plethoric, or persons of a full habit, should eat sparingly of ani-
mal food.  It yields far more blood  than vegetables taken in the same
quantity, and of course may induce inflammatory  disorders.  It acts as
a stimulus to the Avhole system,  by which means the circulation of the
blood is greatly accelerated.
  I am inclined to think, that consumptions so common iu England, arc
in part owing to the great use of animal food.   Though the phthisis pul-
monalis properly speaking, is not an inflammatory disease, yet it general-
ly begins Avith symptoms of inflammation, and is often accompanied with
them throusrh its whole progress.
  But tlie disease most common to this country  is  the  scuivy.   One 
OF  BREAD.                       399
finds a dash of it  in almost every family, and in some the taint is very
deep.  A disease so general must have a general cause, and there is none
so obvious as the great quantity  of animal food elevoured  by the na-
tives.  As a proof that scurvy arises from  this cause, we are in pos-
session of no remedy for that disease equal to the free use of fresh vege-
tables.
  By the uninterrupted use of animal food a putrid diathesis is induced
in the system, Avhich predisposes to a variety of disorders. I am fully con-
vinced that many of those obstinate complaints for which Ave are at a loss
to account, anel  find it still more  difficult to cure,  are the  effects of a
scorbutic taint lurking in the  habit.
  Improper diet affects the mind as well as the body.  The choleric dis-
position ofthe English is almost proverbial.  Where I to assign a cause,
it Avould be, their living so much on animal food.   There is no doubt but
this induces a ferocity of temper  unknown  to men Avhose food is chiefly
taken from the vegetable kingdom.
  Though these and similar consequences  may arise from the  excess of
animal diet, Ave  are far from discouraging its use in  moderation.   In  all
cold countries it is certainly necessary; but the major part ofthe aliment
ought nevertheless to consist of vegetable substances.  There is a continu-
al tendency in animal food, as well as in the human  body itself, to  putre-
faction, which can only be counteracted by the free use  of vegetables.
  With regard to the proportion of vegetable food to  that of animal, great
nicety is by no means required.   It must vary according to  circumstan-
ces, as the heat ofthe weather, the warmth ofthe climate, and the like.
The vegetable part, however, where nothing forbids, ought certainly to
preponderate,  aud I think in  the proportion of at least  two to one.
  The excessive consumption of animal food is  one great cause of the
scarcity of grain.   The  food that a bullock afford bears but a small pro-
portion to the quantity of vegetable matter he consumes.
   I  am no enemy to good fruit,  as an article of diet; but the greater
part of what is used in this country, by the lower orders ofthe people, is
mere trash.  Fruit should be eaten in the early part of the day, Avhen
the stomach is not loaded with food, and  it never ought to.be eaten raw
till it be thoroughly ripe.                 ,

                           OF  BREAD,
                       \
  BREAD, or something resembling it, makes a part of the diet  of  all
nations.   Hence it is emphatically denominated the  staff of life.  It may.
however, be used  too freely.  The late Dr. Fothergill Avas of opinion,
and  1 perfectly agree with him, that most people eat more bread than is
conducive to their health.  I do not mean to insinuate that bread is un-
w holesome, but that the best thj&gs may prove hurtful  Avhen taken  to ex-
cos.   A  surfeit of bread is more dangerous than of any other  food.  Omis
replclio mala replctio panis pQsima.  The French consume  vast quanti-
ties of bread; but its bad effects  are prevented by their copious  tee of
soups and fruits, Avhich have little or no share in the diet of the common
people of England.
  One  important  use of bread is to  form a mass fit for filling up the
alimentary canal, aud carrying  the  nutritious juices along that pas-
sage  in such a state, as to render them fit  to be  acted  upon by the 
400                       OF  BREAD.
lacteal absorbents, Avhich take up the nourishment  aud convey it to the
blood.  In this light bread may be cousidered as a soil frem whence the
nourishment is drawn.  I do not say that bread contains no nourishment,
but that its use, as an article of diet, does uot solely depend on the quan-
tity of nutriment it contains, but in some measure on its fitness as a vehi-
cle for conveying the nutritious particles through  the intestinal tubes.
Hence it follows, that the finest bread is not always the best adapted  for
answering the purposes of nutrition.
   The richest food will not nourish an animal, unless  the alimentary
canal is  sufficiently  distended.  A dog has been fed  on the richest
broth, yet could not  be kept alive; while another, which had only the
meat boiled  to chip and water, throve very  well.   This shews tlie folly
of attempting to  nourish men on alimentary powders and other concen-
trated food.
   The great art therefore of preparmg food, is to blend the nutritive part
of the aliment with  a sufficient quantity of some light farinaceous sub-
stance, in order to fill up the canal,  without overcharging it with more
nutritious particles than are necessary for the support of the animal.  This
may be done either by bread,  or other farinaceous substances, of which
there is a great variety, as  Avill appear from the sequel.
   Bread is one  of the most expensive modes of using grain, and not
adapted  to  the  narrow  circumstances  of the lower orders of the peo-
ple,  as  it is burthened with two heavy additional charges, in passing
through the  hands of both the miller  and  the  baker.  Besides, the
former often grinds down extraneous matter with the Avheat, and the lat-
ter as frequently bakes it up with the addition of lime, chalk, alum, and
other pernicious substances. Since the articles of diet have become branch-
es of  manufacture, the public neither know what they eat, uor Avhat they
drink.
   People imagine, as the finest flour contains the greatest quantity of nou-
rishment, that it must therefore be the most proper for making into bread;
but this by  no means follows.  The finest  flour  comes the nearest to
starch, which, though it may occasionally prove a good medicine, makes
bad bread.   Household bread, which is made by grinding down the ivhole
grain, and only separating  the  coarser bran, is without doubt tlie most
wholesome.
   The best household bread I ever remember to have eat, Avas in the coun-
ty of York.  It was what they call meslin brvtfl, and consisted of irhcat
and rye ground together.   I am not quite certain  as  to the proportion ;
but I think there might be two parts of the former to one  of the latter.
This  bread, when well fermented, eats light, is of a pleasant taste, and so-
luble  to  the bowels.   After using it for some years, I found that bread
made entirely of flour was neither so agreeable to the palate, nor so con-
ducive to health.                     rfju
   Bread is often spoiled to please the ey*.   The artificially whitened,
drying, stuffing bread, though made  ofthe {teartof the wheat, is in reali-
ty the worst of any;  yet this is the bread which most people prefer, and
the poorer sort will eat no other.
   All the different kinds  of grain are  occasionally  made  into bread,
some  giving  preference  to one  and some  to another, according  to
early  custom and prejudice.  The people of South  Britain °;cn<-) ally
prefer bread made of the finest wheat flour, while those of the no 
OF BREAD.                      401
them counties eat a mixture ef flour and oatmeal, or ryemeal, and many
give the preference to bread made of oatmeal alone.  The common peo-
ple of  Scotland also eat  a mixed bread,  but more  frequently bread of
oatmeal only.   In Germany the common bread is made of rye, and  the
American labourer  thinks no bread so strengthening  as  that which is
made of Inelian corn; nor do I much  doubt but the Laplander thinks
his bread, made of the bones of fishes,  is the best of any.
   Bread  made  of different kinds of grain is more wholesome than Avhat
is made of oae only, as their qualities serve to correct one another.  For
example,  Avheat flour, especially the finer kind,  being of a starchy  na-
ture, is apt to occasion constipation.   Bread made of ryemeal, on  the
other hand, proves often too slippery for the bowels.  A due proportion
of these makes the best bread.
   For  the more active aud laborious I would  recommend a mixture of
rye with the  stronger grains, as peas, beans, barley, oats, Indian corn,
and  the  like.  These may be  blended in many different  ways; they
make a hearty  bread for a labouring  man, aud to use his own  language,
they lie longer  on his stomach  than  bread made of wheat flour  only.
Barley breael passrs  too quickly through the alimentary canal to afford
time for  conveying the proper  nourishment; but bread maele  of barley
mixed  with peas is very nourishing.
   When  potatoes, or boiled grain,  are used, bread  ceases to be a neces-
sary article of diet.   During the late scarcity of bread, I made it a rule
not to eat above one half the  quantity  I used to  do, and I found  no in-
couveniency whatever from the change.   Nay, some told me,  that for a
considerable time they had left  off the use of bread altogether, Avithout
experiencing  any change in the state of their health.
   A great part of  the bread consumed  in this  country is by children.
It is ahvays ready,  and  when the child calls for  food,  a piece of bread
is  put into its hand, to save the trouble  of dressing any  other kind of
victuals.   Of many children this  is the principal food, but it is far from
being the most  proper.  Children are often troubled with acidities ofthe
stomach and  bowels; and it is well known that bread mixed with water,
and  kept in a degree of heat equal to  that of the human stomach, soon
turns sour.
   During the late scarcity, many of the labouring men, and even artifi-
cers, could not  earn as much money as Avas sufficient to keep their fami-
lies in  the article of bread only.   It is certain, however, that on a  dif-
ferent plan, such families might  have lived very comfortably.   Many of
the articles of diet  are  cheaper  than  bread,  and equally wholesome.
Above one half of the expense  of living might be saved by a due selec-
tion  of the article of diet.
   The English labourer  lives chiefly on  bread,  which being  accompa-
nied with other dry, and often salt food, fires his blood, and excites  an
unquenchable thirst, so that the perpetual  cry is for  drink.
   But  the greatest consumption of  bread is occasioned by tea.   It is
said  that the subjects of Great-Britain consume a greater quantity of that
herb, than the lriiole inhabitants of all the other nations of  this quarter
of the  globe.    The poorest woman in England must have her tea, and
the children  generally share  it with her.  As tea contains  no nourish-
ment, either  for young or old, there  must of course be bread and butter
to cat along with it.   The quartern loaf ■will not go far among a family
                                 51 
402
OF BOILED  GRAIN.
of hungry children, and if avc  add the cost  of tea, sugar, butter, and
milk, the expense of one meal Avill be more than would be sufficient to fill
their bellies with wholesome food three times a-day.
   There is reason to believe that one half tlie  bread  cousumed in En-
gland is used to  tea, Avithout one hearty meal ever being made  of it.
The higher ranks use tea as a luxury, Avhile the lower orders  make a
diet  of  it.  I had lately occasion to see a striking instance of this in a
family that wras represented to me as in distress for want of bread.   I sent
them a little money, and was informed that they ran with  it directly to
the tea-shop.
   To a heavy, sluggish, phlegmatic man, a moderate use of tea may not
prove pernicious; but where there is  a debilitated  stomach and an irri-
tability of fibre,  it never  fails to do much hurt.  With many it has the
effect to prevent  sleep.
   Tea  will produce a total change of constitution in  the  people of this
country.  Indeed it  has  gone  a great Avay towards effecting that evil
already.  A debility, and consequent  irritability of fibre, are become so
common, that not only Avomen, but even men, are affected with  them.
That class of diseases which, for  want of a better name, we call nervous,
has made almost a complete conquest of the one sex, and is making hasty
strides towards vanquishing the other.
   Did women know the train of diseases induced by debility, and how
disagreeable these diseases render them to the other sex, they would shuu
tea as the most deadly poison.   No man can love a woman eaten up with
vapours, or washed doivn  with diseases arising from relaxation.
   It is not tea taken as a beverage after a full meal, or in a crowded
assembly, that I so much condemn, though I think something as elegant
and less pernicious might be substituted in its place.   The mischief oc-
casioned by tea, arises chiefly from its being substituted  for solid food.
This is so much  the case  at present,  that, had I time to spare,  I  think
it could not  be better employed than  in writing against this destructive
drug.

                      OF BOILED GRAIN.

   THOUGH farinaceous substances of one kind or another,  make a
necessary part of the food of man, yet there  can be no reason why
such substances  should always assume  the  name and  form of bread.
Many of them are  more  wholesome, and not  less agreeable in  other
forms.  Bread is often used merely to  save the trouble of cookery:
and being portable, is the most convenient article of diet for carrying
abroad.
   It does not, however, admit of a doubt, that more grain is eaten boiled,
though not in this country, than is made into bread; and that this  mode
of cookery is the  most wholesome.  Simple boiling precludes all adultera-
tion, and is an operation much less laborious and artificial than baking.
   The most general article of diet among mankind, is rice.   This
may be made into a variety of dishes; but simple boiling is all that
is required,  to render it a proper substitute  for bread.   It may either
be eaten alone or with milk.  In  the  east, it is used with meat, in the
same manner as Ave do bread.   The people of this country believe that
rice proves injurious to the eyes, but this seems to  be  without  foun- 
OF BOILED  GRAIN.
403
 dation;  as it has no such effect on those who make it the principal part
 of their food.
   Many other kinds of grain will, Avhen boiled, make good substitutes
 for bread.   Even those which make a harsh and unpleasant sort of bread,
 are often rendered very palatable by boiling.  This is the case Avith all
 the  leguminous class of plants, as peas, beans, &c.  Even oats and bar-
 ley are more agreeable, as Avell as more wholesome,  when boiled, than
 made into bread.
   All allow that peas and beans boiled, when young, are a great luxury.
 But when  old, they are equally wholesome, and, when properly cooked,
 by no means unpleasant.  There are few who do not relish  peas pud-
 ding, aud even prefer it to bread.   Beans are not so fit for this purpose;
 but  they make an excellent ingredient in the poor man's broth, and who-
 ever eats this broth,  will  find little occasion for bread.
   Peas  and beans contain an equal quantity of sugar with wheat, oats, or
 barley, and at the same time a greater proportion of oil, consequently
 are  more nourishing.  This fact is confirmed by daily experience.
   On those farms Avhere peas and beans are raised in great abundance,
 the  labourers are much fed  on  that  sort of grain; but when removed
 to farms where they are fed with other kinds of grain,  they soon com-
 plain of a diminution of  strength, and request a supply of peas meal as
 formerly.
   Nature  seems to have pointed out the propriety of the extensive use
 of peas and beans, it  being a fact, that when crops of that kind are duly
 alternated Arith crops of wheat, barley, or oats, the fertility of the soil
 may be maintained, without rest or manure,  for many years together;
 whereas, if the latter be raised  on the same  soil for several years suc-
 cessively, they render it barren, so that, without rest or manure, its fer-
 tility cannot be preserved.
   The people in England are but little accustomed to the use  of boiled
 grain, though in many countries  it is eaten as a luxury.  Boiled barley
 is a  great favourite with the  Dutch, and is eaten with milk, butter, or
 molasses.  It is the principal  food of the Dutch sailors, who, in general,
 are both healthy and robust.
   Barley is one of the best ingredients in soup.  Count  Rumford says,
 it possesses the quality of lithing, or thickening soups, in a superior de-
 gree to any other grain.  We have reason, however, to believe,  that grits,
 or coarse oatmeal,  will ansAver that purpose still better.
   Oatmeal is frequently made into bread;  but it is a much more whole-
 some, as well as agreeable food, Avhen made into hasty pudding, and eaten
 Arith milk.   The peasants in many parts of  Britain make two meals a
 day  of it, while their children almost wholly  subsist on it; and it is well
 known that both old and young who are thus fed, are healthy and robust.
   The opinion of  oatmeal being heating, and occasioning skin diseases,
 is wholly without foundation.  Bread made of oatmeal, when not leaven-
 ed, will sometimes occasion the heart-burn; but this is  no proof  of its
 heating quality.  Unleavened bread, of wheat or any other  grain, pro-
duces  the same effect on a  debilitated stomach.  Oatmeal  thoroughly
boiled seldom gives the heart-burn.
   Persons  who are fed  on  oatmel bread,  or hasty  pudding, are not
more  subject to diseases  of  the skin, than  those lvho live on  wheat 
^u*                 OF  BOILED GRAIN.

meal.   Cutaneous disorders proceed more from  tlie want of  cleanli-
ness, than  from any particular  aliment,   The French,  so far from
thinking  that oatmeal  is heating, speak of it as possessed  of a cooling
quality;  and even the  English give oatmeal,  or grit gruel, to  lying-in
women, aud sick people of every description, which shews that they are
inconsistent with themselves, in alleging Jhat the blood is fired  by the
use of  oatmeal.
   A lieuteuant of the army, residing at a country village  within a few-
miles of Edinburgh, with a wife and ten children, having no other income
than his  half pay, fed the Avhole of his children with hasty  pudding and
butter-milk only, from a conviction that it Avas the  most Avholesome and
full diet, that fell within the reach of his narroAV circumstances.  They
greAV apace, and it was the universal remark of the neighbourhood, that
they Avere as sprightly, healthy, and robust as other children, and at tlie
same time perfectly  free from all skin diseases.
   Children are seldom well, unless  when their bodies are  gently open.
But this is more likely to be the case Avhen fed on oatmeal and milk,
than  when their bellies are crammed with a  starchy substance made of
the finest flour ; yet this  in  England is the common food of children.
I have. ?een an infant stuffed four or five times a-day with this kind of
food.  There needs no conjurer to tell the consequence.
   A late author, a man of  learning, but the dupe of prejudice, has, by a  :\
ridiculous definition, endeavoureel to represent  oats  as proper food for
horses only.  I wish the horses in England devoured a smaller quantity
of that grain, and the people more.  Few things would  have a greater
tendency to lessen the expense of living.  The oats in  North  Britain
 are of a superior quality, and I hope the people will long have  the sense
 to use them as an article of diet.
    Lilian  co-n is likewise said to make the  best  food  Avhen boiled.
 Count Rumford observes, that of  all things it makes  the best  pud-
 ding,  and  that he has made a hearty meal  of it, sauce  included, for
 five  farthings.   What makes  good puddings  Avill  make good dump-
 lings  ad  these will, at any  time,  supply  the  place of  bread.   The
 Count also remarks,  that the negroes  in America prefer Indian  corn
 to rice;  and that the Bavarian peasants prefer it to wheat;  that it might
 be imported from North  America at about  four or five shillings j»r
 bushel; tha^, when made  into flour, it would cost  only  one peunyfar-
 thing per pound;  and that it  is highly nutritious, and the cheapest food
 known.   During the late scarcity  a large quantity of  this grain was
 imported;  but such is the aversion of the common people  of this coun-
 try to every sort of food  to which  they are  not accustomed, that  they
 refused  to purchase it, and the  merchants were very great losers by the
 importation.   On the same principle the Germans, till within these few
 years, could not be  induced to eat potatoes, though now they are become
 extremely fond of them.
    The  American,  the Italian, and the  German, all cook Indian corn
 in the same  wav as the  North  Britain does his oatmeal, by making
 it into  hasty pudding.  It may be  eaten iu a variety of  ways.  Some
 eat it Arith a >-aure  composed  of butter and broAvn sugar, or butter and
 molasses.  Others eat it with milk only.   In  cither way it makes a good,
 ehoap and wholesome  diet, by no means disagreeable to those who are
 accustomed to it. 
OF  BUTTER                      405
  The only other grain we shall mention as best when  boiled, is buck-
wheat:  It is of a veiy mucilaginous nature, and of course highly nutri-
tious.  In  several parts of  Europe  it constitutes a principal part of
the food of the lower people.  In former times it Avas  eaten  in Russia,
not by the lower classes only, even the nobility made use of it.   Boiled
and buttered, it was so great a favourite of the great Czar Peter, that he
is said to have seldom supped on any thing else.

                          OF BUTTER.

  IT has been said that the English have a  thousand  religions and but
one sauce.   It must be allowed that they use  butter with almost every
kind of food.   Butter,  though a good  article of diet  may be used too
freely, and in this country, I am convinced,  that is the case.   ToAveak
stomachs it is hurtful, even in  small emantilies, and when used freely it
proves prejudicial to the strongest.
   Butter, like other things of an oily nature,  has a constant tendency to
turn  rancid.   This process,  by the heat of the stomach, is greatly ac-
celerated, insomuch that many people, soon after eating butter, complain
of its rising in their stomach, in a state highly disagreeable.
   Oils of every kind are with difficulty mixed Avith watery fluids. This
is the reason Avhy butter floats on the stomach, and rises in such an unpleas-
ant manner.
   Persons afflicted with bile should use butter veiy sparingly.   Some
sceptical authors doubt whether or rot aliment of any kind has an effect
on the bile.   One  thing, however is certain, that many patients, afflicted
with complaints, which were supposed to be oceasioned by bile, have been
completely cured by a total abstinence from butter.
   The  most violent bilious complaints that I ever met with, were  evi-
dently occasioned by food that became rancid on the stomach,  as the cho-
lera morbus and the like.  Nor can  such complaints  be cured, till the
rancid matter is totally evacuated by vomiting and purging.
   But supposing butter did not possess the quality of becoming rancid on
the stomach, it may nevertheless, prove hurtful to digestion.   Oils of all
kinds are of a relaxing quality, and tend to impede the action of digestion.
Hence the custom of giving rich broths and fat meats to  persons who have
a voracious appetite.
   The free use of butter, and other oily substances,  not only tends to
relax the stomach, and impede Its action, but to induce a debility of the
solids, Avhich paves the Avay to many maladies.  In a country where two
thirds of the inhabitants lead sedentary lives, a debility of fibre must pre-
dominate.   Whatever increases that debility ought to be avoided.
   Children, without exception, are disposed to diseases arising from re-
laxation.   Butter, of course, ought to be given to them  with a sparing
hand.  But is this the case ?  By no means.   Bread  and buttei consti-
tute a great part of the food of children, and I am convinced that the
gross humours with which they are frequently troubled, are partly owing
to th's food.   As children abound Avith moisture, bread alone is, generally
speaking, better for them than bread and butter.
   I have be^n astonished to see the quantities of butter eateu by gross
women  who lend sedentary lives.   Their tea bread  is generally contriv-
ed so as to suck up butter like a sponge. What quantities of crumpets and 
406
OF  BITI1LR.
   muffins they vrill devour in a  morning, soaked  with this oil;  and aid r
   wartls complain of indigestion, when  they have eaten what would over-
   load the  stomach of a ploughman.   Dr. Fothergill  is of opinion, that
   butter produces the nervous or sick head-ache, so common among the
   women of this country.  As a  proof of this, it is  often cured by an
   emetic.
      Oils in certain quantities, excite nausea, and even vomiting.   They
   most of course prove unfrieutlly  to digestion.  A Dutch sailor,  we are
   told can digest train oil.  So may an English sailor J but it would be very
   improper food for a London lady.
      To some of the leaner farinaceous substances, as the potatoe and the
   like, butter makes a very proper addition; but eating it to flesh and fish
   of almost every description, is certainly wrong.   The flesh eaten in this
   country is generally fat enough without the  addition of butter, and the
   more oily kinds of fish, as salmon or herrings, are lighter on the stomach,
   and easier digested when eaten without it.
      Butter is rather a gross  food,  and  fitter for the athletic and  laborious,
   than the sedentary and delicate.  It is less hurtful wheu eaten fresh than
   salted.  Salt butter certainly tepds to induce skin diseases, and I am in-
   inclined to think, the free use of it at sea may have some share in bringing
   on that dreadful malady, so destructive to our brave sailors, the sea scurvy.
      There is a method of rendering salt butter  less  hurtful, but it seems
   not to be known in England.   What I  mean is to mix it with an equal
*  quantity of honey, and keep it for use.   In this  lvay it may be given  to
   children with greater freedom.   In north Britain this method of  mixing
   butter Arith honey is well known,  aud from a common  proverb, I take the
   custom to be very ancient.
      Butter, in itself, is not near so hurtful, as when combined Arith certain
   other things.   For example : bread made with butter is almost indigesti-
   ble, and pastries of every kind are little better:  yet many people almost
   live upon pastry, and it is universally given to children.  It is little bet-
   ter, however, than poison,  and  never  fails to disorder their stomachs.
    The fond mother cannot pass a pastry shop, without  treating her  darling
    boy Avith some of the dainties, and then wonders how he got the cough,  or
    cholic.
       I have know  a  man seemingly  in perfect health, who, by eating a
   penny-worth of pastry, as he passed along the street, was seized with such
    an asthmatic fit, that he was obliged to be carried  home, and had nearly
    lost his life.  This occurred whenever he, inadvertently ate any thing
    baked with butter.
      Every thing that  proves very injurious to health ought, as far as pos-
    sible, to be prohibited, by laying a high duty upon it.   A duty on pas-
 '   try would be serving  the public in more respects than one.  It would
    save many Jives, and lessen some tax on necessaries.
       Cheese, as a diet, is likewise  injurious to health.  It should never  be
    eaten but as a desert.   It occasions  constipation, fires the blood,  and ex-
    cites a constant  craving for drink.   It is very improper for the sedenta-
    ry, and hardly to be digested even by the athletic
       If men will live  on dry  bread,  poor  cheese,  salt butter,  broiled
    bacon and such  like parching food,  they will find their way to the ale-
    house, the bane of the lower orders, and the source of half the beggary
    iu the nation. 
407
                   OF FRUITS AND ROOTS.

  FRUITS  and roots form a large class of substitutes for bread.   The
latter, being produced underground, are  less liable to suffer from the in-
clemency of the seasons than grain. Men who wish to inflame the minds
of tlie multitude may inveigh against the substitutes for bread;  but rea-
son and  sound  sense  say,  the  more substitutes for bread the better.
When one fails, recourse can be had to another.
  In warm climates the inhabitants have many substitutes for bread, and
as their seasons are more uniform than ours, they  can generally depend
on tlie plant, or  whatever it i6, proving productive.  The plantain-tree,
commonly called the Indian-fig, Avhich has from  time immemorial been
cultivated in South America, bears  fruit  of a sweetish taste, which will
dissolve hi the mouth  without cheAving.   It is eaten either raw, fried or
roasted.   When intended  to supply the place of bread, it is gathered be-
fore it is ripe, and eaten either boiled or roasted.   The banana  is nearly
of the same natuie, but its fruit is greatly superior both in taste and fla-
vour.
   The inhabitants of  the South Sea,  or Ladrone islands, are  supplied
with bread from a  tree, Avhich has been  lately imported into our West-
India islands, and will it is hoped, be found to ansAver the same purpose
there.   It has a slight degree of sweetness, but not much flavour.  It re-
sembles neAV bread,  and requires to be roasted before  it is eaten.  Those
avIio have tasted it say, that it is in no respect superior to the potatoe.
   In some of the West-India islands  the inhabitants supply the place of
grain by making bread from the root of a shrub called  the cassada, or
cassava.   Though, to my  taste, this bread is veiy insipid, yet the natives
are fond of it to such  a degree that I  have known some of them eat it,
during their residence in England, in preference to  the  finest London
bread.
   But the most general substitutes  for bread in the West-Indies are the
yams.  There are  three different species of this plant, the roots of which
are promiscuously  used for bread.  They are 6aid to be very nutritious,
of easy digestion, and, Avhcn properly dressed, are by some preferred  to
the best wheateu bread.  The taste is someAvhat like the potatoe, but more
luscious.   The negroes generally cat them boiled, aud beaten into a mash.
The Avhite people have them ground into flour, and make bread and pud-
dings of them.  They can be preserved for several seasons, without los-
ing any of their primitive goodness.
   Of  all the substitutes for bread in Europe, the potatoe  is the most ex-
 tern ively useful.   This plant is  a native of Peru, and has been in Eu-
rope about two hundred years.   Like most other important discoveries,
 it made but a slow  progress, and is still far from being ?o generally culti-
vated as it  deserves to be.  It is indeed  known in most parts of Europe,
but  its culture  is  best understood in Irelanel and the northern parts of
Eugland.   At Harwich, hoivevcr, the preference  is given to the Dutch
potatoes,  brought over by the packets between  that place and Helvoet
Sluys.   There is a light sandy  soil  in Holland  very favourable to the
culture of that inestimable  root.
   As this plant thrives in every soil, and seldom suffers from the inclem-
ency of seasons, we must  blame ourselves if avc suffer a famine to exist.
Indeed no such thing ever  can be, where due  -mention is paid to the 
^U°               OF  FRUITS  AND  ROOTS.
the culture of  potatoes.   A far greater quantit) of farinaceous food cau
be raised on au acre of ground planted wi h potatoes, than soavo with any
kind of grain.  It is not uncommon to have a return of forty for one.
They are not so hearty a food as corn, but no  man will ever perish for
hunger who can have potatoes.
  Potatoes abound with an  insipid juice, which induces some  to think
that they are not very nutritious.  Facts, however are against this opin-
ion.   Some of the stoutest men we know, are brought up on milk and po-
tatoes. Dr. Pearson, who has bestoAved some pains in analizing this root
says, that potatoes and  water alone, with common salt, can nourish men
completely.   They differ in colour and consistence,  but not materially
Avith regard to their nutritive qualities.
   Some think the firm  kind are the most nutritious; but the Irish who
must be good judges, give the preference to the mealy.  The difference
however, depends much on the mode of cooking them.
 ^ More than half the substance of  potatoes consists of water, and expe-
rience sheAvs, that that mode of cooking, Avhich most diminishes tlieir
moisture, is to be preferred.   In London they are drenched in water and
washed before they are brought to market, vriiich  accounts in  a great
measure, for the bad quality of the London potatoes.
   They are dressed in a variety of ways,  but simple boiling or roasting
seems to be all the cooking they  require, to render them a proper substi-
tute for bread.  Some are fond of making bread of them.   This, in my
opinion, is marring both.   Why manufacture any thing into bread, which
requires only the aid of fire to make it such ?  Nobody thinks of making
dough of the bread fruit; but the potatoe might with as great propriety
be called the bread root, as it is made into bread  by the same process.
   Stewed mutton and potatoes make not only a nourishing but a very pa-
latable dish.   The excess of fat of the mutton, which Avhen otherwise
cooked sustains great loss is thus preserved, by being absorbed by the po-
tatoes.   It is, however, to be observed, that Avhen potatoes  are used in
broth or steAVS, they ought previously to be boiled, and the water thrown
away,  as it contains something deletereous. Simple boiling or roasting is
sufficient to prepare potatoes to supply the place of bread, but when they
are intended to serve as a meal, they require something of a softening na-
ture, as milk, butter, or  both.  What a treasure  is  a milch cow and a
potatoe garden, to a poor man with a large family, who lives iu the coun-
try !   Yet, Arith  a little attention from landlords and  farmers,  almost
every  man might be so accomodated.   What a source of real Avcalth and
population!   Men would multiply, and poverty, unless among the profli-
gate, be unknown.   Horses are sometimes fed with potatoes,  and  become
very fond of them.  With the addition of a small quantity of hay, they
are found  to be sufficiently nourishing.
  I would beg leave to recommend,  both to landlords and farmers,  a
careful perusal of Earl Winchelsea's excellent letter to Sir John Sin
clair, on the advantages of cottagers renting lands. This humane noble-
man takes up the matter iu a truly patriotic light,  and shews that farmers,
instead of lessening the number of poor, do every thing they can  to mul-
tiply them; and  I am sorry to  say, that so far as my observation goes,
it agrees entirely with his lordship's.
  Some think that the potatoe,  unless it  is made into bread, will not
keep.   An accident taught me the contrary.  Many years ago a friend 
OF  FRUITS  AND ROOTS.              409
of mine sent me a potatoe, after it had been roasted in an oven, on ac-
count of its singular figure.  I laid it on a shelf among some other things
of the like kind, and was surprised,  on removing them many years after,
to find the potatoe quite fresh  though as dry as a bone.   On grating it
down it was perfectly sweet; and as fit for making soup as the day it was
roasted.  I apprehend that nothing made into bread would have kept so
long.
  Posterity will hardly believe that a scarcity of bread could be felt in
Britain, at a time when it was known that a sufficient quantity of farina-
ceous food could be raised in one county for the inhabitants ofthe whole
island.  Let proper encouragement be given to the culture of potatoes,
and set famine at defiance.
  Many  other domestic roots,  sprouts, &c. are very wholesome and may
occasionally supply the place of bread.   Of these  Mr. Bryant of Nor-
wich,  reckons above forty; but we shall only take notice, by  way of
specimen, of the most useful and productive.  It is worthy of remark,
that no nation  can be very populous, which does not draw a great part of
its food from under ground.
  The Jerusalem artichoke is a native of Brazil; but, having been long
cultivated in this country, it is too  well  known to need any description.
From its taste, which is like that of artichoke  bottoms, it would seem to
be nutritious, and is far from being unpleasant to the palate. Some reckon
it windy, but this may be corrected iu the cooking, by warm spices, and
as tlie plant is very proeluctive, we would recommend it to be used in the
same manner as potatoes and the other farinaceous roots.
  Ofthe esculent roots in this country, the parsnip is reckoned the most
nourishing.  It  is  likewise of easy digestion, and is agreeable to most
palates.  Some indeed dislike it on account of its sweetness; but that is
a proof of its nutritive quality, sugar being the most nourishing thing in
nature.  We are told that, in the north of Ireland, the poor people make
beer from this root.
  There is not any plant that affords a  more striking proof of the bene-
fits  of culture than the turnip.  In its wild state it is good for little or
nothing; but,  Avhen  properly cultivated, it not only affords Avholesome
nourishment for man, but furnishes the  principal winter food for  cattle.
There is a species of this plant which groAvs in North Britain, called the
y elloAV turnip, which is sweet, and of a superior quality to those produced
in the south, particularly about  London, which are bitter and stringy.
The yellow turnip is the most nourishing, and also the most hardy in sus-
taining the wiuter.   It is eaten with  milk to cure the consumption and
scurvy.  Margraaf says, he  could  extract no sugar from the turnip,
which affords  ground to conclude,  that  it is not so nutritive as certain
other roots.   Not only the root of the turnip, but the tops, Avhen young,
make veiy pleasant greens.  The sprouts, if gathered Arhen very tender,
make an excellent salad.
  The carrot, like the turnip, is good for little in its5 natural state, being
small, tough and stringy.   Manured,  it  grows hrge, succulent, and of a
pleasant flavour.   It ought, however, to  be eaten young, otherwise it lies
on the stomach,  and is hard of digestion. It is an ingredient in several
soups, and being solid, may in some measure supply the place of bread.
  Salsafy, skirrcts, aud the several kinds of beets, are all pleasant and
nourishing.  The v are likeAvise of  ea<y dbestion. and mav be dressed
                                52 
410
OF FRUITS  AND  HERBS.
in a variety of Avays.   Margraaf has by experiments discovered, that
both skirrets and beets contain a considerable quantity of sugar.   Though
the extracting a saccharine salt from these plants may be no object while
Ave possess the West-India islands, yet it serves to shew that they possess
a quantity of nutritious matter, sufficient to give them a rank among the
articles calculated to supply the place of bread.
   The onion,  Ave are told, was a great favourite in Egypt four thousand
years ago, and Dr. Hasselquest says, it is not to be Avouderedat, for who-
ever has tasted the onions of Egypt must allow, that none can be better
in any part ofthe globe.   There, he says, they arc sweet, though in many
countries they are strong and nauseous.   There they are soft, whereas in
northern countries  they are hard; and their coats so compact, that they
are elifficult to digest.  This very quality may however recommend
them in countries where food is scarce.  The Doctor observes, that the
Turks eat them roasted Arith their meat as Ave do bread, and arc so fond
of them that they wish to be indulged with this elish in paradise.
   From the Doctor's account one would be induced to believe, that the
onion used in Egypt was of a different species from ours;  but I am rather
inclined to think it may depend on the moele  of culture, as well as on the
warmth of climate and the difference of soil, as we find in the southern
parts of Europe they are milder than in the  more northerly.  Iu Spain
they are veiy mild, and a root weighing two pou./ds will grow from a single
seed.
   Onions are dressed in a variety of ways, but in regard to  Avholesome-
ness, there is no method better thau simple boiling.  By this method of
cooking,  they are rendered mild, of easy digestion, and go off without
leaving any disagreeable  heat in the stomach or bowels.  Many shun
them on  account of the strong disagreeable  smell they communicate to
the breath.   Mr. Bryant says, this may be remedied, by  eating a few
raw parsley leaves immediately after, which will effectually  overcome
the scent  of the onions, and likewise cause them to sit more easy on the
stomach.
   The leek is generally reckoned among pot-herbs; but as the root is
the part  chiefly used,  the consideration of it comes under the present
head of discussion.  Indeed, it is as  properly a root as the onion, which
groAVs chiefly  above ground.  The  leek, as well  as the onion, is said to
be a constant  dish at the tables of the Egyptians,  who chop them small,
and eat them  with their meat.
   The leek is used as a  pot-herb in most parts of Britain, especially
in Wales, Avhere  the natives are said to be fond of it.  In Scotland a full
grown fowl and a small piece of salt beef, stewed Arith a large quantity
of leeks, is a very favorite dish.   In my opinion the leek is not so gen-
erally used any Avhere as it deserves td be.  There is no ingredient goes
into soup that is  more wholesome, or that gives it a better flavour, than
leeks.   They are in many res;>ects medicinal, and to my taste, as an in-
gredient in soups, they are greatly superior to the onion,  or  any other
pot-herb whatever.
   It is a fact  worthy of observation, that the boiiing of vegetable sub-
stances thcidiighly, extricates a considerable quantity of air, and makes
them less  liable to produce flatulency.
   I could mention  a  great many more esculcut plants which  might
occasionally supply  the place of bread, but the above specimen issufli- 
OF BROTHS  AND  SOUPS.               411
cient to shew hoAV liberal nature is in supplying man with food, provided
he will take the trouble of cultivating and cooking it.  Mr. Bryaut, in his
history of esculent plants, enumerates above four hundred and fifty, each
of which affords a wholesome nourishment; and may occasionally be used
in place of bread.

                  OF  BROTHS AND SOUPS.

  THESE  may likewise be considered as substitutes for bread.  If pro-
perly made they Avill serve both for bread and driuk.  Though broth is
a dish ofthe greatest antiquity, and may be considered as extremely de-
licious, yet it is not a favourite iu this country.   Here the people are fond
of what they call solids; yet those very solids they make into broth by
swallowing as much drink after them as they cau get.   The only differ-
ence is, the  foreigner makes hi& broth in a pot, and the Englishman makes
his in  the stomach.
   A very sensible anonymous writer observes, that in  England a pound
of meat makes simply a pound of food; whereas in any other country in
Europe, that quantit) of anim.l food, Avhen stewed down with vegetables
and Scotch  barley, Avill produce an ample meal for half a dozen people.
Hence he justly infers that among the variety of schemes which may have
been devised by the humane for relieving the distresses of the poor, a bet-
ter and more extensive charity cannot be devised than that of instructing
them  in a new mode of cookery.
   The same author adds, that the result of his experiments on  this sub
ject hail exceeded his most sanguine expectations, and that each day gave
him fresh proofs of the  excellency of his plan for teaching the poor and
needy to find themselves in a wholesome and palatable  diet, at the cheap
est rate, iu  which little or no bread was required.  He concludes by as
serting that there is scarce a place in this kingdom where tAventy persons
may not have  a Avholesome, hearty, and palatable meal  for three shillings.
   The Avriter who has paid most attention to the improvement of cookery
for the benefit of the poor, is Count Rumford.  In his  economical and
philosophical essays, he has given such a  variety of forms  for making
wholesome, cheap and nourishing soups, stews,  and other dishes for com-
mon use, that little more seems necessaiy to be said on the subject.   I
shall ouly observe that the mode of living on broths, soups, hasty-pudding,
and such like, so warmly and justly recommended by the Count, has been
practised in the  northern parts of this kingdom from time immemorial.
There the  food of the common  people is hasty-pudding ivith milk  for
breakfast and supper, and broth, with vegetables and meat, for  dinner.
The  poorer sort often make broth without meat; but they all use vegeta-
bles in great  abundance,  and sometimes they  supply  the place of meat
with  butter.  As  the hasty-pudding and milk make a  complete meal, no
breael is necessary either at supper or breakfast; nor is much required
at dinner, as  the broth  is  made thick with barley, cabbage, and a variety
of other vegetables or  pot-berbs.  Cabbage is a favourite ingredient in
the Scotchman's broth.  It is seldom made without this article, which is
not eaten so early as in England.  It is there suffered to grow  to mafuri-
tv, and when that is the case there is no pla'it more productive.  Th's the
 Germans know well, and make it into sour crout, oue of the best antidotes
aganist the scurvy with which  we are acquainted. 
412
OF BROTHS  AND  SOUPS.
  This kind of diet not only saves bread but drink.  The labourer who
lives on hasty-pudding and soups, seldom has occasion for drink; w hilc he
who is burnt up  with dry bread and cheese,  or  salt meat broiled, has a
continual thirst, and spends the greater part of his earnings in liquor.  This,
by acting as a powerful stimulus, may make him do more work ior some
time, but it generally cuts him off iu the middle of his days.  The English
labourer, Avho Avorks hard and drinks hard, seldom lives long,  and is an
old man when he should be in his prime.
   The roasting of meat is a wasteful mode of cookery, which ought  t«
be avoided by the poorer sort of people,  as  much of the substance, and
the most nutritive parts, are lost by scorching, aud fly off by evapora-
tion.
   I knoAv it Avill be said, that I recommend slops in place of solid food.
 They are such slops, however, as the greatest heroes of antiquity lived up-
 on ; and though I ha\Te visited most parts of the island, I know of no bet-
 ter men than  those who five in the manner described above, nor are the
 people any where more healthy, or longer lived.
   Broth is not only a dish of great antiquity, but one that can be made in
 a great variety of ways.  It receives into its composition, animal and ve-
 getable substances of every kind that are used in diet, and it may be sea-
 soned so as to suit every palate.  Indeed, people early accustomed to eat
 broths properly made, are generally fond of them for their whole lives.
   It Avoufd be  difficult to assign a reason why  the inhabitants of South
 Britain should dislike a dish so much relished by other nations.   Cus-
 tom, no  doubt,  settles all these  things; but how customs  arise is not so
 clear a matter.   If an alteration in diet is to be  introduced with effect, it
 must begin with children.   Whatever men are accustomed to eat when
 young, they generally  prefer for the rest of their  lives.  Were the chil-
 dren in South  Britain taught to eat hasty-pudding, Arith milk, for break-
 fast and supper; and broth with vegetables and meat boiled in it, for din-
 ner, they would relish  these dishes as long as they lived, would find little
 occasion for bread, and still less for drink; and Avould thrive better than
 on their present food.
   What parents love  themselves, they generally give to their children,
 without any  regard to its being proper for them or not.  I have seeu a
 father who was fond of strong beer, make his son, an infant, guzzle it at
 every meal;  and the mother who delights in tea, does not fail to give it
 to her daughter whenever  she takes it to herself.   By this conduct, the
 son becomes a tippler, and daughter sips tea in the place of solid food, un-
 til she is eaten  up with vapours aud other nervous disorders.
   Count Rumford says, brown soup is the common breakfast of the Bava-
 rian peasants, to which they occasionally add  bread.  This he avers is
 infinitely preferable in all respects to that pernicious wash, tea, with which
 the lower classes of  the inhabitants of this island drench their stomachs,
 and ruin their constitutions.  He adds, that a simple infusion of this drug,
 drank boiling hot, as the  poor generally drink it, is  certainly poison,
 which, though it be sometimes slow in its operation, never fails to produce
 fatal effects, even in the strongest constitution, where the free use of it is
 continued for a considerable length of time.
   The  German on  his polenta, the  American on his mush, and the
 North Briton on his hasty-pudding, can  make  a hearty breakfast for a
 tenth part of what  a  tea-breakfast Avould cost,  while  it  is infinitely 
CONCLUSION.
413
more  wholesome.  It has likeAvise the advantage  that no bread is ne-
cessary.
  I have been often  told, Avhen recommending soups to the poor, that
they had no time to make them, and  that  they could not afford fuel on
account of its price, as it is dear iu great  towns.   They can, however,
find fuel twice a-day to boil a tea-kettle, and time to make the tea, which
is a more tedious operation, by far, than making a mess of hasty-pudding.
For a great part of the year even the poorest person must have a little
fire:  and it would require no more to make a comfortable mess of soup,
which is always best when made with a slow fire.
   The mode of living  that  I  would recommend to the lower orders
of the people, with a view to save expense and improve their health,
is to substitute occasionally other farinaceous  substances in the place of
bread, as potatoe, &c. to give up in a great measure the use of roasted,
baked, and broiled meats, and to  supply their place with  broths, soups,
stews, and such  like, made Arith a little meat and plenty of vegetables; to
give to children, and to grown people Avho  will eat it, for breakfast, milk-
porridge, or hasty-pudding with milk, small beer, or molasses.   This will
be found a more wholesome breakfast, than tea, while it is much cheaper
and requires no bread.*

                          CONCLUSION^

  AFTER a long attention to the cure of diseases, it is mortifying to
reflect hoAV much this arduous province is infested by a race of ignorant
and shameless empirics,  Avho are daily tampering with the public credu-
lity, to the destruction of numbers of lives.   It may be safely affirmed,
that a considerable part of the annual deaths are occasioned by the pro-
fligate temerity of these unprincipled impostors.   There is hardly a
news-paper that does not teem with the audacious  falsehoods, and pom-
pous pre'ensions, of this imposing class of  mercenary, and yet (I use uot
too harsh an expression) tolerated murderers.  What man who is con-
versant with physic can peruse without indignation the public advertise-
ments of these quacks, in Avhich every one arrogates to himself the pos-
session of superlative knowledge, and ascribes to his  respective nostrum
  * The celebrated Dr Huffland, in his Art of prolonging Life, says, a mode-
rate use of soups is certainly not hurtful; and  it is singular that people should
imagine it tends too much to relax tlie stomach.   Does not all our drink, even
though cold, become in a few minutes a kind of warm soup in the stomach ; and
does not the stomach retain the same temperature during the whole day ?  Be
careful only not  to use it hot, in too great quantity at one time, or too watery.
It is attended even with great advantages.  It supplies the place of drink, par-
ticularly to men of letters, women,  and all those  who do drink very little ex-
cept at table, and who, when they give over soup, receive into their blood too
little moisture   And it is here to be remarked, that fluids used in the form of
soups unite much better and sooner with our juices than when drunk cold and
raw  On this account soup is a great preventive of dryness and rigidity in the
body; and therefore the best nourishment for  old people, and those who are of
an arid temperament   It even supplies the place of medicine.  After catching
cold, in nervous head-aches, cholics, and different kinds of cramp in the stomach,
warm soup is of excellent sen ice.   It may serve as a proof of the utility, or at
least harmlessnes8  of soup, when 1 remark that our forefathers, who certainly
had more strength than we have, used soup; and that it is used by rustics, who
are still stronger than  those in refined life ; and  that  all  the old people with
whom I ever was acquainted were great friends to it. 
414
CONCLUSION.
such contradictory aud inconsistent qualities as Avere never yet united
in any one medicine in the world ?
   To the disgrace, however, of the public credulity, not a lew of these
impostors attain to a degree of opulence that is seldom acquired even in
the scientific and legitimate prosecution of medical practice.   The arti-
fices Avhich they employ to delude tlie multitude are Avell known to  ma-
ny.  Having  picked up the name of some extremely active medicine,
the bold and indiscriminate use of which must therefore be proportionally
dangerous, they immediately resolve on converting it into a nostrum,
and endeavour to  disseminate its unrivalled praises either by advertise-
ments or hand-bills.   But being themselves totally illiterate, they have,
for this purpose, recourse to some  other person, ay horn they engage for a
stipulated reward to fabricate the pernicious illusion.  A hyperbolical
panegyric on the Avonderful remedy is accordingly vamped up, and pre-
parations are made for commencing a  lucrative trade with the public.
Should the channel of communication be the public papers, it is a settled
point, that if daily or frequent advertisements can be  supported for the
space  of some months, the fame of the medicine,  Avhatever  be its  real
character, is established.  The better to promote this purpose, innume-
rable authorities in favour of the nostrum are asserted in general terms;
venality is again  exerted  to furnished specific testimonials in its  sup-
port;  and  if, among the number  of  unfortunate purchasers, or pa-
tients, there exists any person who has not only taken  it with impunity,
but even with some advantage, (and Avhat  extremely powerful medi-
cine may uot sometimes by chance have good  effects ?)  tiie fortuitous
incident is  immediately blazoned with all the ostentation  of interested
zeal and affected popularity; and a reference to uncorrupted testimo-
ny resounded  through every channel of information.   By a strange
association, truth noAV  is  confidently adduced in  support  of falsehood;
and the recovery of one or two persons \? rendered the unhappy means
of draining the purse, undermining the  health, and destroying the lives
of thousands.
    Such, in fact, is the general progress of empiricism.  Were the  task
not invidious, and the objects too despicable for any other than juridical
cognizance,  which they merit in a superlative degree, the  representation
here given might be supported by unquestionable authority.  It is hoped,
however, that enough has been said to influence the minds of the judi-
cious with respect to this iniquitous practice, which becomes every day
more alarming, and threatens the more credulous part of the community
with the most fatal effects.
    This country, through the blessing of Providence, has been exempted
from the horrors of famine, and for  years the  sword; but the infatua-
tion of a numerous body of the people has subjected  it to the ravages
of another public calamity, which, though generally  more  slow i;i its
operation than any of the former, is  equally destructive in the  end.
Humanity shudders at the horrible depredations committed  on the hu-
man constitution  by this  empirical tribe, who  subsist by public delu-
sion, and riot, where they can,  in the irreparable ruin of those whom
they intice into their  snares.   What  consumptive visages,  what en,
ferbied frames,  what mutilated  bodies, and what palsied limbs, are the
miserable monuments of that ignorance and criminal temerity by which
they are actuated! 
CONCLUSION.
415
   in certain diseases, it is doubtless an object of importance  to the un-
fortunate patients, that tlieir cure should be conelucted Arith secrecy, and
likewise to many, fit the smallest possible expense; but  they do not con-
sider that,  while they are economical in this article, they are fatally pro-
digal of health.   They  grasp with  eagerness the pill-box or  the phial,
which they are assured contains the  elixir of speedy and effectual conva-
lescence ;  but, alas! the flattering hope proves of short duration.   They
may feel perhaps, for a little, a suppression of the symptoms of their di-
sease; but the destructive embers are smothered, not extingushed; and,
while preying upon the vitals, are acquiring a malignity  which will again
break forth with redoubled violence.
   It is not, however, in one disease only, nor  in the lower class of the
people,  that  th'-s infatuated credulity  operates;  Ave find it prevail  even
amongst those from Avhose  superior  situations in life more eliscernment
might be expected; but who have nevertheless become  voluntary dupes
to the meanest artifices  of empiricism.   Witness the successful imposture
practised with regard to the inspection of urine; the visionary notion of
charms, &c.
   But it is time that such chimerical doctrines should be consigned to the
regions  of barbarism, and flourish no longer in a soil where almost every
other physical prejudice has been rooted up and explored  by- the pro-
gress of science.   To effect this  salutary purpose, nothing can have a
more powerful tendency than the view  which has been given, in the pre-
ceding  pages, of the causes and  cure of diseases.  By removing the
mysterious veil which for a long time  concealed this useful  branch of
knowledge from the eyes of the  public, it ought, on one hand, to preclude
for ever all resources to empirical impostors, and on the other, to show in
what cases it will be  proper to call in  the assistance  of a  physician.
Within  the bounds prescribed by this limitation any person of an ordina-
ry capacity may act in conformity to the rules which have been delivered.
By this  means a prudent economy will be consulted, unhappy patients Avill
no longer be  shipwrecked on the  dangerous rocks of empiricism, with
all their deceitful allurements, but will be conducted through the  safest
and  most direct road to the recovery of health, when that desireable ob-
ject  is practicable.

            " Ah ! in what perils is vain life engag'd!
            What slight neglects, what trivial faults destroy
            The hardiest frame !  Of indolence, of toil,
            We die, of want, of superfluity:
            Tlie all-surrounding heaven, the vital air,
            Is big with death.  And though the putrid south
            Ke shut; though no convulsive agony-
            Shake, from the deep foundations of the world,
            Th' imprison'd plagues;  a secret venom oft
            Corrupts the air, the water, and the land." 
 
APPENDIX:
                   CONTAINING

A List of Simples and of such Medicinal Prepara-
   tions as ought to be kept in  readiness for private
   Practice.
The method of preparing and compounding such
  Medicines as are  recommended  in  the former
  part of the- Book,  with the addition of several
  others of a similar  nature.

Pemarks on the Doses, Uses,  and Manner of ap-
  plying the different  Preparations.

 Medicamentorum varietas ignorentiae filia est.       Bacon. 
INTRODUCTION.
         XGNOR ANCE and superstition have attributed extraordinary me-
dical virtues to almost every production of nature.   That such virtues were of-
ten imaginary, time and experience have sufficiently shewn.  Physicians, how-
ever, from a veneration for antiquity,  still retain in their lists of medicine ma-
ny things which owe their reputation entirely to the superstition and credulity
of our ancestors.
  The instruments of medicine will  always be multiplied, in  proportion  to
men's ignorance of the nature and cure of diseases; when these are sufficient-
ly understood, the method of cure will be simple and obvious.
  Ignorance of the real nature and permanent properties of those  substances
employed in the cure of diseases, is another reason  why they have been so great-
ly multiplied.   Physicians thought they could effect  by a number  of ingredi-
ents, what could not be done by any one of them.   Hence arose those amazing
farragos which have so long disgraced the medical art, and which were esteem-
ed powerful in proportion to the number of simples that entered their compo-
sition.
  The great variety of forms into which almost every article of medicine has
been manufactured, affords another proof of the imperfection ofthe medical art.
A drug which is perhaps most efficacious in the simplest form in which it can
be administered, has been nevertheless served  up in  so many  different shapes,
that one would be induced to think the whole art of physic  lay in exhibiting
medicine unde^as many  different modes as possible.
   Different forms of medicine, no doubt, have their use; but they ought never
to be wantonly increased   They are by no means  so  necessary, as is generally
imagined.   A few grains of powdered rhubarb, jalap, or ipecacuanha, will ac-
tually perform all that can be done by the different preparations of these roots,
and may also be exhibited in as safe and agreeable  a manner.   The same obser-
vation holds with regard to the Peruvian bark, and many other simples, of which
the preparations are very numerous.
   Multiplying the ingredients of a medicine, not  only renders it more expen-
sive, but also less certain, both in its dose and operation.   Nor is this all. The
 compound, when kept, is apt to spoil, or acquire qualities of a different nature.
When a medicine is rendered more safe, efficacious, or  agreeable, by the addi-
tion of  another, they ought, no doubt, to be joined; in all otlier cases, they are
better kept asunder.  The combination of medicines  embai asses the physician
and retards the progres of medical knowledge.  It is impossible to ascertain
the precise effect of  any one medicine, as long as it is combined with others,
either of a similar or dissimilar nature.
   In the exhibition of medicine, regard should not  only be had to simplicity,
but likewise to elegance.  Patients seldom reap much benefit from  things that
are highly disagreeable to their senses.  To taste or smell like a drug, is be-
come a proverb ; and to say truth, there is too much ground for it    Indeed no
art can take away the  disagreeable taste  and flavour of  some drugs, without
entirely destroying their  efficacy : it is possible, however, to render many me-
dicines  less disgustful, and others' even agreeable} an object highly  deserving
the attention of all who administer medicine.
   The  design of the following pages is, to exhibit such a list of drugs and me-
dicines  as may be necessary for private practice.   They are considerably more
numerous indeed than those recommended in the former part of tlie book, but
are still greatly within the  number contained in the most reformed dispeneato-
ries. The same medicine is seldom exhibited under different forms ; and where
different medicines answer nearly the same intention, there is commouly no more
than one of them retained.  Multiplying forms of  medicine for Uie same inten-
tion tends rather to bewilder than assist the young practitioner, and  tlie experi-
enced physician can never be at a loss to vary his prescriptions as occasion re-
quires.
   The chemical and other difficult preparations are  for the most p.Tt omited.
All of them that are used by any private practitioner are not worth preparing" 
APPENDIX.                         419
 He will buy them much cheaper than he can make them.  Great care however
 is necessary to obtain them genuine.  They are often adulterated, and ought
 never to be purchased unless from persons of known veracity   Such of them
 as are in common use, are inserted in the list of drugs and medicines.   Their
 proper  doses, and manner of application are mentioned in the practical part of
 the Book, wherever they are prescribed.
   Such articles of medicine as are to be found in the house or garden of almost
 every peasant, as barley, eggs, onions, &c. are likewise, for the most part, omit-
 ted.  It is needless to swell a list of medicines with such things as can be ob-
 tained whenever they are wanted, and which spoil by being kept.
   The preparations made and sold by distillers and confectioners are also gen-
 erally left out.  These people by operating 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 small as could be well prepared,
 both  to prevent unnecessary expense, and that the medicine might not spoil by
 keeping.  Almost every medicine suffers by being kept,  and should be used as
 soon  after it has been prepared as possible. Even simple  drugs are apt to  spoil,
 and should therefore be laid in in small quantities ; they either rot, are consu-
 med  by insects, or evaporate so as to lose their peculiar taste or flavour, and of-
 ten become quite insignificant.
   In  the preparations of medicines, I have generally followed the most approved
 dispensatories ; but have taken the  liberty to differ from them whenever my own
 observations, or those of other practical writers, on whose judgment I could de-
 pend, suggested an improvement.
   In  several compositions, the ingredient on which the efficacy of the medicine
 chiefly depends is increased, while  the auxiliaries, which are generally ordered
 in such trifling quantities as to be of no importance, are left out, or only such of
 them retained as are necessary to give the medicine a proper consistence or the
 like.
   The colouring ingredients are likewise for the most part omitted.   They in-
 crease the price and bulk  of the medicine, without adding any thing to its va-
 lue.  It  would be well if they were never used at all.  Medicines are often adul-
 terated  for the sake of a colour.   Acrid and even  poisonous substances are, for
 this purpose, sometimes introduced into those medicines which ought to be most
 bland and emollient.  Verdigrease, for example, is often mixed with ointment
 of elder to give it a fine green colour, which entirely frustrates the intention of
 that mild ointment.   Those who wish to obtain genuine  medicines should pay
 no regard to their colour.
   Some regard is likewise paid to expense.  Such ingredients as greatly in-
 crease the price of any composition, without adding considerably to its virtue,
 are generally either omitted, or somewhat less expensive  substituted in their
 place.  Medicines are by no means powerful in proportion to their price.   The
 cheapest are often the best, besides, they are the least apt to be adulterated, and
 are always most ready to be obtained.
   With regard to the method of compounding medicines, I have generally fol-
 lowed that which seemed to be the most simple and natural, mentioning the dif-
 ferent steps of the process in the same order in which they ought to be taken,
 without paying an implicit regard to the method of other  dispensatories.
  For many ofthe remarks concerning the preparation, &c.  of medicines, I have
 been obliged to the author ofthe New Dispensatory.  The other observations are
 either such as have occurred to myself in practice, or have been suggested in the
 course of reading, by authors whose names I am not able distinctly to recollect.
  I have followed the alphabetical  order, both with regard to  the simples and
 preparations.  A more scientific method would  have  been agreeable to  some
persons, but less  useful to the generality of readers.   The different classes of
medicine have no great dependance upon one another, and, where they have, it
is hard to say which should stand first  or  last;  no doubt the  simple prepara-
tions ought  to precede the more compound.  But all the advantages arising
from this method of arrangement, do not appear  to be equal to that single one,
of being able, on the first opening of the book, to find out any article, which, by
the alphabetical order, is rendered quite easy. 
420
APPENDIX.
  The dose of every medicine is mentioned whenever It appeared necessary.
When this is  omitted it is to be understood that the medicine may be used at
discretion The dose mentioned is always for an adult, unless when the contrary
is expressed.   It is not an easy matter to proportion the doses of medicine ex-
actly to the different ages, constitutions, &c. of patients;  but, happily for man-
kind,  mathematical exactness is by no means necessary
  Several attempts have been made to ascertain the proportional doses for the
different ages and constitutions of oatients; but after all that can be said on this
subject, a great deal must be left to the judgment and skill of tlie person who
administers the medicine. The following general proportions may be observed;
but tbey  are by no means intended for exact rules.  A patient between twenty
and fourteen may take two thirds ofthe dose ordered for an adult; from fourteen
to nine, one half; from nine to six, one  sixth ; from two to one, a tenth ; and
below one, a twelfth.*
  Dispensatories are usually written in the Latin language.  Even authors who
write in English, generally give their prescriptions in Latin ;  and some of them
shew  so great an attaclimentto that language, as first to write their recipes in it,
and afterwards translate tliem ; while others, to compromise the matter, write
the one half in Latin and  the other in English   What peculiar charm a medi-
cal prescription, when written In Latin, may have, I shall not pretend to say ;
but have ventured to make use of the plainest English I could, and hope my pre-
scriptions will succeed no worse for it.
  N.  B. The Apothecary s weights, and the English wine measures,  are used
throughout the whole book, the different denominations of which will appear
from uie following Table:
                      A pound contains twelve ounces.
                      An ounce  - - - -  eight drachms.
                      A drachm - -  - -  three scruples.
                      A scruple - -  - - twenty  grains.
                      A gallon contains eight pints.
                      A pint......sixteen ounces.
                      An ounce  - - - - eight drachms.
              A table spoonful is the measure of half an ounce.
              A tea spoonful is one fourth  of a table spoonful.
              Sixty drops make one tea-spoonful.
   * The following Table of Doses for different Ages, is given by Dr.
 Thomson:
           [The Common  Dose being  taken  at one drachm.]
Weeks

Months
Years  <J
Agei.
   7
   7 .
  14 .
  28 .
   3|
   5  .
   7  .
  14  .
  21  .
  63 .
  77 .
 100  .
 Parts of the
Common Dose.
tj
common dose.
n
TS
 5
 6
    Proportions
  of a Drachm.
.   .  4  •)
.  .  5
■   ■  n
.   . 12
.   .15   ( grains.
.   . 20
.   . 30
.   .  40   j
one drachnv
.   .55)
.   .50) grains,
.   . 40)       * 
                              421

A LIST OF  SIMPLES,  AND OP  SUCH  MEDICINAL  PREPARATIONS,
     OUGHT TO BE KEPT IN READINESS FOR PRIVATE PRACTICE.
AGARIC
Alum
Antimony, crude
-------- cinnabar of
--------sulphur of
Balsam of Capivi
------of Peru
------ of Tolu
Bark,  cascarilla
-----cinnamon
-----Mezerion
-----Peruvian
-----Winter's, or can ell a alba
Borax
Calamine stone, levigated
Castor, Russian
Caustic, common
■------lunar
Earth, Fuller's
------ Japan
------Armenian bole
------French ditto
Extracts of gentian
-----of  guaiacum
----- of  hellebore, black
---- of hemlock
----- of jalap
----- of  liquorice
----- of  Peruvian bark
----- of  poppies
----- of  wormwood
Flowers of camomile
  ■      colt's foot
------- elder
 Gum camphor
 ---- galbanum
 ----gamboge
 -----guaiacum
 ----kino
 ----- myrrh
 —— opium
 Hartshorn, calcined
 ----------shavings of
 Herbs, lesser centaury
 ---- peppermint
 ---- spearmint
 ---- penny-royal
 —— savin
 ---- trefoil
   ■   uvaursi
 ----- wormwood
 Lead, Litharge
 ---- white
 ---- sugar of
 Lemon-peel
 Mace
 Magnesia alba
 Manna
 Mercury, crude
 ---------calcined
 ---------iEthiop's mineral
 ---------calomel
 -         corrosive sublimate
 ---------red precipitate
 ---------white ditto
 Musk
 Oil,  essential, of amber
 ------—— of annise
   i          of cinnamon
     ■        of juniper
 -----------of lemon-peel
 -----------of peppermint
 Oil,  expressed, of almonds
 —■            of linseed
 Oil of  Olives, or Florence oil
 -------------- of palms
 --------------of  turpentine
 Orange-peel
 Oyster shells prepared
 Poppy-heads
 Resins benzoin
 -------------flower of
 ------- Burgundy pitch
-------dragon's blood
 ------- rosemary
 ------- damask and red roses
 Fruits, almonds
 -------bitter apple
 -------cassia fistularis
 -------Curassao oranges
 -------Figs dried
 -------French prunes
 ■■       Jamaica pepper
 ------- Juniper berries
 -------nutmegs
 -------tamarinds
 Gum, aloes
 —— ammoniac, in tears
 —— arabic
—— asafcetida 
 *<"              LIST  OP

Resins, frankincense
-------liquid storax
-------white, or rosin
----■— scammony
Roots, birthwort
—— calomus aromaticus
----- contrayerva
     ■ garlic
■---- gentian
----- ginger
-----hellebore, black, white
-----jalap
----- ipecacuanha
----- lily, white
-----liquorice
---- marshmallow
----- mezerion
■      rhubarb
----- sarsaparilla
■     seneka
----- squills
-----tormentil
——— tumeric
-----Virginian snake
----- wild valerian
----- zedoary
Saffron
Sal ammoniac, crude
---------— volatile
Salt, Epsom
-----of Glauber
-----of hartshorn
-----nitre, purified, or prunel
-----Polychrest
-----Rochel
----of tartar
Seeds, anise
-----caraway
—— cardamom
-    coriander
—— cummin
-----mustard
SIMPLES, ckc.

    Seeds,  sweet fennel
    -----wild carrot
    Senna
    Spanish flies
    Spermaceti
    Spirits, xtherial, or aether
          ■ of hartshorn
    -------of lavender compound
    -------of nitre
    ------ditto dulcified
    -------of sal ammoniac
    -------of sea salt
    -------of vinegar
    -------of vitriol
    -------of wine rectified
    -------volatile aromatic
    Steel, filings of
    —    rust of,  prepared
    -----soluble, salt of
    Sulphur vivum
    -------balsam of
    -------■ flower of
    Tar
    ---Barbadoes
    Tartar, cream of
    ---:— emetic
    -------soluble
    -------vitriolated
    Tin, prepared
    Tutty, levigated
    Turpentine, Venice
    Verdigrease
    Vitriol, green
    -------blue
    -------white
    Wax, white
    —— yellow
    Woods guaiacum
       .    logwood
    -------sassafras
    ------saunders, red
    Zinc, flowers of 
423
           MEDICINAL  PREPARATIONS.

                            BALSAMS.

       J. HE subject of this section is  not the natural  balsams, but certain
compositions, which, from their being supposed to  possess balsamic qualities,
generally go by that name.
  This class of medicines was formerly very numerous, and held in great es-
teem : modern practice, however, has justly reduced it to a very narrow com-
pass.
                           •Anodyne Balsam.
  Take of white Spanish soap, one ounce ; opium unprepared, two drachms;
rectified spirit of wine, nine ounces.   Digest them togetlier in a gentle heat for
three days, then strain off the liquor, and add to it three drachms .of camphor.
  This balsam, as its title expresses, is intended to ease pain. It is of service in
violent strains" and rheumatic complaints, when not attended with inflammation.
It must be rubbed with a warm hand on the part affected ; or a linen rag mois-
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 Saponaceous
Balsam.
                          LocatelWs Balsam.
  Take of olive oil, one  pint; Strasburgh  turpentine and yellow wax, of each
half a pound; red saunder, six drachms.   Melt the wax with some part of the
oil over a gentle fire; then adding the remaining part ofthe oil and the turpen-
tine; afterwards mix in the Saunders previously reduced to a powder, and keep
them stirring together till the balsam is  cold.
  This balsam is recommended in erosions ofthe intestines, the dysentery, hae-
morrhages, internal  bruises, and in some complaints of the breast.  Outwardly
it is used for healing and cleansing wounds and ulcers.  The dose when taken
internally, is from  two  scruples to two drachms.
                        The  vulnerary Balsam.
  Take of benzoin, powdered, three ounces { balsam of Peru, two ounces ;  he-
patic aloes, in powder, half an ounce; rectified spirit of wine, two pints. Digest
them  in a gentle heat for three days, and then strain the Balsam
  This balsam, or rather tincture, is applied externally to heal recent wound$
and bruises   It is likewise employed internally to remove coughs, asthmas
and other complaints of the breast.   It is said to ease the  colic, cleanse  the
kidnies, and to heal internal ulcers, &.c
  The dose is from twenty to sixty drops.
  This, though a medicine of some value, does not deserve the extravagant en-
comiums which have been bestowed on it.  It has been celebrated under  the
different names of The  Commander's Balsam,  Persian Balsam,  Balsam of
heme, Wade's Balsam, Friar's Balsam, Jesuit's Drops, Turlington's Drops,

                             BOLUSES.
  AS boluses are intended for immediate use, volatile salts and other ingredi-
ents improper for being kept, are admitted into  their composition.  They  are
generally  composed of powders, with a proper quantity of syrup, conserve, or
mucilage.  The lighter powders are commonly made up with syrup, and  the
more ponderous, as mercury, &c. with conserve ; but those of the lighter kind
would be more conveniently made up with mucilage, as it increases their bulk
less than the otlier additions, and likewise occasions the medicine to pass down
more easily.
                           Astringent Bolus.
  Take of alum, in powder, fifteen grains ; gum kino, five grains; syrup a suf-
ficient quantity to make a bolus.
  In an excessive  flow of the menses, and other violent  discharges of Wood
proceeding from relaxation, this bolus may be given every four or five hours'
till die discharge abates.                                               ''
                          Diaphoretic  Bolus.
  Take of gum guaiacum, in powder, ten grains ,• flowers of sulphur and cream
of tartar, of each  one scruple; simple syrup,  a sufficient quantity. 
424
APPENDIX.
  In rheumatic complaints and disorders of the skin, this bolus may be taken
twice a-day.  It will also  be of service in the inflammatory quinsey.
                           Mercurial Bolus.
  Take of calomel, six grains; conserve of roses, half a drachm. Make a bolus.
  Where mercury is necessary, 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 julap
Will be proper next day to carry it off.
                   Bolus  of Rhubarb  and Mercury.
  Take of the best rhubarb in powder, from a scruple to half a drachm; of ca-
lomel, from four to six grainss; imple syrup, a sufficient quantity to make a bolus.
  This is a proper purge in hypochondriac constitutions ; but its principal in-
tention is to expel worms.  Where a stronger purge is necessary, jalap may be
used instead of the rhubarb.
                             Pectoral Bolus.
  Take of spermaceti, a scruple; gum  ammoniac, ten grains; salt of hartshorn,
six grains ; simple syrup, as much as will make them into a bolus.
  This bolus is given in  colds and coughs of long standing, asthmas, and be-
ginning consumptions of  the lungs.  It is generally proper to bleed the patient
before he begins to use it.
                            Purging  Bolus.
  Take of jalap in powder, a scruple; cream of tartar, two scruples.  Let
them be rubbed together, and formed into a bolus, with simple syrup.
   Where a mild purge is wanted, this  will answer the purpose very well.  If a
stronger dose is necessary, the jalap may be inoreased to half a drachm or up-
wards.
                 CATAPLASMS AND SINAPISMS.
  CATAPLASMS possess few or no virtues superior to a poultice, which may
be so made, as in most  cases, to supply their place.   They are chiefly intend-
ed either to ;»ct as discutients, or to promote suppuration; and as they may be
of service in some cases, we shall give a specimen of each kind.
                         Discutient Cataplasm.
   Take of barley-meal, six ounces ; fresh hemlock leaves, bruised, two ounces;
 vinegar, a sufficient quantity.   Boil the meal and hemlock in the vinegar for a
 little, and then add two drachms of the sugar of lead.
                          Ripening Cataplasm.
   Take of white lily root, four ounces  ; fat figs and raw onions, bruised, of each
 one ounce; yellow basilicum ointment, two ounces, gum  galbanum, ,halt an
 ounce • linseed meal, as  much as necessary. Boil the roots along with the figs
 hiTsuflSt quanti y of water ; then bruise and add to them the other .ngre-
Slents! so as tVform the whole into a soft cataplasm.  The  galbanum  must be
 oreviouslv dissolved with the yolk of an egg.                     .,,,-„
 P Whereat is necessary to promote suppuration, this cataplasm may be usedby
 those who chuse to be  at the trouble and expense of making it.  For my part i
 have n^found any application more proper for this purpose than a poultice
 of^breTandS with a sufficient                              onion in .t,
 and softened with oil or  fresh butter.
                               Sinapisms.
  SinaDisms are employed to recal the blood and spirits to a weak part,as in the
  Sinapisms areempioyeu                         ^^      a9 th 8Ciat,.

 Sc   wtnt go^sS the°head or the stomach, they are W1^*!
 feet to bSe disorder to these parts.  They «= ^ewise applied * hepa
  fent's soJin the low  state of fevers.  They "I^^^S^S wU
 however, till they have raised blisters, but till the parts become rea, a
 continue so when pressed with the finger.          -„d^„j ne m\\k and ren*
   The sinapism isonly a poultice ^.^ ViSl^ hSiS^o^Uc.
 dered warm and stimulating by the addition of ™^hZ™F£d mu',tard-8eed
   The common sinapism is made by taking crumb of ^Jf ^ 8ufficient;
 in powder, of each equal quantities;  strong vinegar, as much as »
 and mixing them so as to make ajpouluce.                    B ,c b  .^
   When sinapisms, of a more sUmulating nature are wamw,
 garlic ro»y be added to the above. 
APPENDIX.
425
                             CLYSTERS.

  THIS class of medicines is of more importance than is generally imagined.
Clysters serve not only to evacuate Uie contents ofthe belly, but also to convey
very active medicines into the system. Opium, for example, may be administer-
ed in this way when it will not sit upon the stomach, and also in larger doses
than at any time it can be taken by the mouth.  The Peruvian bark may likewise
be, with good effect, administered in form of clyster to persons who cannot take
it by the mouth.
  A simple clyster can seldom do hurt, and there are many cases where it may
do much good.  A clyster even of warm water,  by serving as a fomentation to
the parts, may be of considerable service in inflammations ofthe bladder, and the
lower intestines,  &c
  Some substances, as the  smoke of tobacco, may be thrown into the bowels in
this way, which  cannot by any other means whatever.  This may easily be ef-
fected by means  of a pair of hand-bellows, with an apparatus fitted to them for
that purpose.
  Nor is the use of clysters confined to medicines.  Aliment may also be con-
veyed in this way.  Persons unable to swallow, have been, for a considerable
time, supported  by clysters.
                            Emollient Cylster.
  Take of linseed tea and  new milk, each six ounces.  Mix them.  If fifty or
sixty drops of laudanum be added to this, it will supply the place ofthe Anodyne
Clyster.
                            Laxative Clyster.
  Take of milk and water each six  ounces;  sweet-oil or fresh butter, and brown
sugar, of each two ounces.  Mix them.
  If an ounce of Glauber's salt, or two table-spoonsful of common salt, be added
to this, it will be the Purging Clytter.
                          Carminative Clyster.
  Take of camomile flowers, an ounce ; anise-seeds,  half an ounce.  Boil in a
pint and a half of water to one pint.
  In  hvsteric and hypochondriac complaints this may be administered instead
of the Fittid Clyster, the smell of which is so disagreeable to most patients.
                             Oily Clyster.
  To four ounces ofthe infusion of camomile flowers, add an equal quantity of
Florence oil
  This clyster is beneficial in bringing off the small worms lodged in the lower
parts ofthe alimentary canal. When  given to children the quantity must be
proportionably lessened.
                             Starch  Clyster.
  Take jelly of starch, four ounces ; linseed oil, half an ounce.   Liquify the jel-
ly over a gentle fire, and then mix in the oil.
  In the dysentery or bloody flux, this clyster may be administered after every
loose stool, to heal the ulcerated intestines and blunt the sharpness of corroding
humours.  Forty or fifty drops of laudanum may be_added;  in which case it
will generally supply the place ofthe Astringent  Clyster.
                           Turpentine Clyster.
  Take of common decoction, ten ounces ; Venice turpentine, dissolved with
the yolk of an egg, half an ounce, florence oil, one ounce.  Mix them.
  This diuretic  clyster is  proper in obstructions ofthe urinary passages, and in
colicky complaints proceeding from gravel.
                            Vinegar Clyster.
  This clyster is made by mixing three ounces of vinegar with five of water-
gruel.
  It answers all the purposes of a common clyster, with the peculiar advantage
of being proper either in inflammatory or puU'id disorders, especially in the latter.
  {ry We think it unnecessary to give more examples of this class of medicines,
as ingredients adapted to any particular intention may be occasionally added to
one or other of thv above forms.
                                    54 
420                        APPENDIX.
                  COLLYRIA, or  EYE-WATERS.

  EYE-WATERS have been multiplied without number, almost every person
pretending to be possessed of some secret preparation for the cure of sore eyts.
I have examined many of them, and find that they are pretty much alike, the ba-
sis of most of them being either alum, vitriol, or lead.  Their effects evidently
are, to brace and restore the tone of the parts : hence they are principally of
service in slight inflammations ; and in that relaxed state ofthe parts which is
induced by obstinate ones.
  Camphor is commonly added to these compositions ; but as it seldom incor.
porates properly with the water, it can be of little use.  boles and other earthy
substances, as they do not dissolve in water, are likewise unfit for this purpose.
                           Collyrium  of Alum.
  Take of alum, half a  drachm; agitate it well together with the white of one

  This is the Collyrium of Riverius.   It is used in inflammation ofthe eyes, to
 allay heat, and  restrain the flux of humours.  It must be spread upon linen, and
 applied to the eyes, but  should not be kept on above three or four hours at a time.
                           Vitriolic  Collyrium.
  Take of white vitriol, half a drachm ; rose water, six ounces.   Dissolve the
 vitriol in the water, and filter the liquor.
  This, though simple,  is perhaps equal in virtue to most ofthe celebrated col-
 lyria.  It is an  useful application in weak, watery, and inflamed eyes.   Though
 the slighter inflammations will generally yield to it, yet in those of a more obsti-
 nate nature, the assistance of bleeding and  blistering will often be necessary.
  When a strong astringents judged proper, a double or triple quantity of the
 vitriol may be used.   I have seen a  solution of four times the strength of the
 above used with manifest advantage.
                           Collyrium  of Jjead.
  Take sugar of lead, and crude  sal ammoniac, of each four grains.  Dissolve
 them in eight ounces of common water.
  Forty or fifty drops of laudanum may be occasionally added to this collyrium.
  Those who chuse may substitute instead of this the collyrium of lead recom-
 mended by Goulard ; which is made by putting twenty-five drops of his Extract
 of Lead to eight ounces of water, and adding a tea-spoonful of brandy.
  Indeed,  common water and brandy, without any other addition, will in many
 caises answer very well as a collyrium.  An ounce ofthe latter may be added to
 five or six ounces of tlie former ;  and the eyes, if weak, bathed with it night and
 morning.
                           CONFECTIONS.
  CONFECTIONS containing  above sixty ingredients are still to be found in
 some ofthe most reformed dispensatories. As most of their intentions, how-
 ever, maybe more certainly, and as effectually answered by a few glasses of wine
 or grains of opium, we shall pass ewer this class of medicine very slightly.
                           Japvnic  Confection.
   Take  Japan  earth, three ounces ; tormentil root, nutmeg, olibanum, of each
 two ounces ; opium  dissolved in a sufficient quantity of Lisbon wine, a drachm
 and a half; simple syrup and conserve of roses, of each fourteen ounces.  Mix
 and make them into  an electuary.
   This supplies the place ofthe  Diascordium.
   The dose of this electuary is from a scruple to a drachm.
                   CONSERVES and PRESERVES.
  EVERY Apothecary's shop was formerly so full of these preparations, thatit
 might have passed for a confectioner's ware-house.  They possess very few me-
 dicinal properties, and may rather be classed among sweetmeats than medicines.
 They are sometimes, however, of use-, for reducing into boluses or pills some of
 the more ponderous powders, as the preparations of iron, mercury, and tin.
   Conserves are compositions  of fresh vegetables and sugar, beaten together into 
APPENDIX.                        427
 an uniform mass.  In making these preparations, the leaves of vegetables must
 be freed from their stocks, the flowers from their cups,  and the yellow part
 of orange-peel taken off with  a rasp.  They are then to be pounded in a mar-
 ble mortar,  with a wooden pestle,  into a smooth mass; after  which thrice
 their weight of fine sugar is commonly added by  degrees, and the  beating
 continued till they  are uniformly mixed; but the conserve will be better if
 only  twice its  weght of sugar be added.
   Those who prepare large quantities of conserve generally reduce the vegeta-
 bles to a pulp by the means of a mill, and afterwards beat them up with the su-
 gar.
                          Conserve of Red Roses.
   Take a pound of red rose buds, cleared of their heels; beat  them wetl in
 a mortar, and, adding by  degrees  two pounds of  double-refined sugar, in
 powder, make a conserve.
   After the same  manner are prepared the  conserves of orange-peel,  rose-
 mary-flowers, sea wormwood, of the leaves of wood-sorrel, &c.
   The conserve of roses is  one  of the most agreeable  and useful prepara-
 tions belonging to  this class.   A  drachm or two  of it, dissolved in warm
 milk, is ordered to be given as  a  gentle restringent in  weakness of the sto-
 mach, and  likewise in phthisical coughs, and spitting of blood.  To have any
 considerable effects, however, it must be taken in  larger quantities.
                            Conserve of Sloes.
   This may be made  by boiling the sloes gently in water, being careful to
 take  them out before  they burst; afterwards expressing the juice, and beat-
 ing it up with three times its weight of fine sugar.
   In  relaxation of  the uvula and glands of the throat, this makes an excel-
 lent gargle, and may  be used at discretion.
   Preserves are made  by steeping or boiling fresh  vegetables first in water,
 and afterwards in syrup, or  a solution of sugar.   The subject is either pre-
 served moist in the syrup, or taken out and dried, that the sugar may can-
 dy upon it.  The last is the most useful method.
                          Candied Orange-Peel.
   Soak Seville orange-peel in several waters, till it loses its bitterness ; then
 bod it in a solution of double-refined sugar in water, till it becomes tender
 and transparent.
   Candied lemon-peel  is prepared in the same manner.
   It  is needless to add  more to  these preparations, as they belong rather
 to tlie art of the confectioner than that of the apothecary.
                            DECOCTIONS.
   WATER readily extracts  the  gummy and saline parts of vegetables ; and
 though its action is  chiefly confined to these, yet the resinous and oily being in-
 timately blended with the gummy and saline, and  in great part taken up along
 with them.   Hence watery decoctions and infusions of vegetables, constitute a
 large, and not unuseful class of medicines. Although most vegetables yield their
 virtues to water, as  well by infusion as decoction, yet the latter is often necessa-
 ry, as it saves time, and does in  a few minutes  what the other would require
 hours, and sometimes days, to effect.
   The medicines of this class are all intended for immediate use.
                          Decoction of Althaea.
   Take ofthe roots of marsh-mallows, moderately dried, three ounces; raisins
 ofthe sun, one ounce, water three pints.
   Boil the ingredients in the water till one third of it is consumed; afterwards
 strain tlie decoction and let it stand for some time to  settle.   If the roots be
 thoroughly dried, they must be boiled till one half the water be consumed.
   In coughs, and sharp defluctions  upon tlie lungs, this decotion may be used
 for ordinary drink.
                         The Common Decoction.
   Take of camomile flowers, one ounce ; elder flowers, and sweet fennel seeds
 of each half an ounce, water, two quarts.  Boil them for a little, and then strain
 the decoction.
  A medicine equally good may be prepared by infusing the ingredients for some
hours in boiling water. 
428
APTEND1X.
  This decoction Is chiefly intended as the basis of clysters, la which other in-
gredients may be occasionally added.  It will likewise serve as a common fo-
mentation, spirit of wine or other things being added in such quantity as the
case may require.
                        Decoction  of Logwood.
  Boil three ounces ofthe shavings, or chips of logwood, in four pints of water,
till one half the liquor is wasted.  Two or three ounces of simple cinnamon
water may be added to this decoction.
  In fluxes of the belL, w here the stronger astringents are improper, a tea-cup-
ful of this decoction may be taken with advantage three or four times a-day.
                         Decoction  of  the  hark.
  Boil an ounce ofthe Peruvian bark, grossly powdered, in  a pint and a half of
water to one pint, then .strain the decoction   If a tea-spoonful ofthe weak spi-
rit  of vitriol be added to this medicine, it renders it both more  agreeable and
efficacious.
                    Compound Decoction of the Bark.
  Take  of Peruvian bark and  Virginian snake-root, grossly powdered, each
three  drachms.  Roil them in a pint of water to one half.   To the strained li-
quor add an ounce  and a half of aromatic water.
  Sir John Pringle recommends this as a proper medicine towards the decline
of  malignant fevers, when the pulse is low, the voice  weak, and the head affect-
ed with  a stupor but with little delirium.
   This dose is  four  spoonsful every fourth or sixth hour.
                        Decoction oj Sarsaparilla.
   Take of fresh sarsaparilla root, sliced and bruised, two ounces; shavings of
guaiacum wood, one ounce.  Boil over a slow fire, in three quarts of water, to
one; adding towards  the  end, half  an  ounce of sassafras wood,  and three
drachms of liquorice  Strain the decoction.
  This may either be employed as an assistant to a course of mercurial altera-
tives, or taken after the mercury has been used for some time.   It strengthens
the stomach, and restores flesh and vigour to habits emaciated by the venereel
diseases  It may  also be taken in the rheumatism,  and cutaneous disorders
proceeding from foulness ofthe blood and juices.  For all these intentions it is
greatly preferable to the Decoction of Woods.
  This decoction may  be taken from a pint and a half to two quarts in the day.
   The following decoction is said to be similar to that used by Kennedy, in tlie
cure of the venereal disease, and may supply the place of Lisbon diet drink .
   Take of sarsaparilla, three ounces ; liquorice and mezerion root, of each half
an  ounce ; shavings of guaiacum and sassafras wood,  of each one ounce; crude
antimony, powdered,  an ounce and a half.  Infuse these ingredients in eight
pints of  boiling water for twenty-four hours, then boil them  till one half of the
water is  consumed.-  afterwards strain the decoction
   This decoction may  be used in the same manner as the preceding.
                           Decoction of Seneka.
  Take of Seneka rattle-snake root one ounce ; water, a pint and a half.  Boil
to one pint, and strain
  This decoction is  recommended in  the pleurisy, dropsy, rheumatism, and
some obstinate disorders of the skin.  The dose is two ounces  three  or four
times  a-day, or oftener, if the stomach will bear it.
                            White Decoction.
  Take ofthe purest chalk, in powder, two ounces; gum arabic, half an ounce i
water, three pints.   Boil to one quart, and strain the decoction.
  This is a proper drink in acute diseases, attended with, or inclining to a loose-
ness, and where acidities abound in the  stomach or  bowels  It is peculiarly
proper for children when afflicted with sourness ofthe stomach, and for persons
who are subject to the  heart-burn  It maybe sweetened with sugar,  as it is
used, and two or three ounces of simple cinnamon-water added to it
  An ounce of powdered chalk, mixed with two pints of water, will occasional-
ly supply the place  of this decoction, and also of the chalk julep.
                              DRAUGHTS.
  THIS is a proper form for exhibiting such medicines  as areintended to operate
immediately, and which do not need to be frequently repeated, as purges, vomits,
j 
APPENDIX.                        429
and a few others, which  are to be taken at one dose.  Where a medicine re-
quires to be used for any length of time, it is better to make up a larger quan-
tity of it at once, which saves both trouble and expense.
                          Anodyne Draught.
  Take  of  liquid laudanum,  twenty-five drops;  simple  cinnamon-water,  an
ounce; common syrup, two  drachms  Mix them.
  In excessive pain, where bleeding is not necessary, and in great restlessness,
this composing draught may be taken artd repeated occasionally.
                          Diuretic Draught.
  Take  of the diuretic salt, two scruples ;  syrup of poppies, two drachms;
simple cinnamon-water, and common water, of each an ounce.
  This  draught is of service in an obstruction or deficiency of urine.
                          Purging Draughts.
  Take of manna an ounce ; soluble tarta*,  or  Rochel salt, from three to four
drachms.   Dissolve in three ounces of boiling water ; to which add Jamaica
pepper-water, half an ounce.
   As manna sometimes will not sit upon the stomach, an ounce or ten drachms
of the bitter  purging salts, dissolved in four ounces of water, may be taken in-
stead of the above.
   Those who cannot take salts, may use the following draught :
   Take of jalap in powder, a scruple ; common water, an ounce; aromatic tinc-
ture, six drachms.  Rub tlie jalap with twice its weight of sugar, and add to it
the other ingredients.
                          Sweating Draughts.
   Take spirit of Mindererus, two ounces ; salt of hartshorn five grains ; sim-
ple cinnamon-water, and syrup of poppies, of each half an ounce.   Make them
into a draught.                .                         .
   In recent colds and rheumatic complaints, this draught is ot service.   To
promote its effects, however, the patient  ought to drink freely of warm water-
gruel, or of some other weak diluting liquor.
                          Vomiting  Draughts.
   Take of ipecacuanha in powder, a scruple;  water an ounce ; simple syrup a
drachm.  Mix them—Persons who require a stronger vomit, may add to  the
above half a grain, or a grain, of emetic tartar.
   Those who do not chuse the powder, may take ten drachms ofthe ipecacuanha
wine; or half an  ounce ofthe wine, and an equal quantity ofthe syrup of squills
                           ELECTUARIES.
   ELECTUARIES are generally composed of the lighter  powders, mixed
 with syrup, honey, conserve, or mucilage into such a consistence, that the pow-
 ders may neither separate by  keeping, nor the mass prove too stiff for swallow-
 ing.  Thev receive chiefly the milder alterative medicines, and such  as are not
 ungrateful to the pala' e.
   Astringent electuaries, and  such as have pulps of fruit in them, should be
 prepared only in small quantities ; as astringent medicines lose their virtues by
 being kept in this form, and the pulps of fruits are apt to ferment.
   For the extraction of pulps it will be necessary  to boil unripe fruits, and ripe
 ones if they are dried, in a small quantity of water till they become soft.  The
 pulp is then to be pressed out through a strong hair sieve, or thin cloth, and af-
 terwards boiled to a due consistence, in an earthen vessel, over a gentle fire,
 taking care to prevent the matter from burning by continually stirring it.  The
 pulps of fruit that are both ripe and fresh, may be pressed out without any pre-
 vious boiling.
                           lenitive Electuary.
   Take of senna, in fine powder, eight ounces—coriander seed, also in powder,
 four ounces—pulp of tamarinds and French  prunes, each a pound.   Mix the
 pulps and powders together, and with a sufficient quantity of simple syrup, re-
 reduce the whole into an electuary.
    A tea-spoonful of this electuary, taken two or three times a day, generally 
430                       APPENDIX.
proves an agreeable laxative.  It likewise serves as a convenient vehicle for ex-
hibiting more active medicines, as jalaps, scamrr.ony, and such like.
  This may supply the place of the electuary of Cassia.
                       Electuary for the Dysentery.
  Take of the Japonic confection,  two ounces ; Locatelli's balsam, one ftunce;
rhubarb in powder, half an ounce; syrup of marsh-mallows, enough to make an
electuary.
  It is often dangerous in dysenteries to give opiates and  astringents, without
interposing purgatives.  The purgative is here joined with these ingredients,
which renders this a very safe and useful medicine for the purposes expressed in
the title.
  About the bulk of a nutmeg should be taken  twice  or  thrice a day, as the
symptoms and constitution may require.
                       Electuary for the Epilepsy.
  Take of Peruvian bark in powder, an ounce—of powdered tin and wild vale.
rian root, each half an ounce—simple syrup, enough to make an  electuary.
   Dr. Mead directs a drachm of an electuary similar to this to be taken even-
ing and morning, in the epilepsy, for the space of three months.   It will be pro-
per, however, to discontinue the use  of it for a few days every now and then.  I
have added the powdered tin, because the epilepsy often proceeds from worms.
                     Electuary for the Gonorrhoea.
   Take of lenitive electuary,  three ounces—jalap and  rhubarb  in powder, of
each two drachms—nitre, half an ounce—simple syrup, enough to make an elec-
tuary.
  During the inflammation and tension of the  urinary passages, which accom-
pany a virulent gonorrhoea; this cooling laxative may be used with advantage.
  The dose is a drachm or about  the bulk of a nutmeg, two or three times a-
day—more or less, as may be necessary to keep the body gently open.
  An electuary  made of cream of tartar and simple syrup will occasionally
supply the place of this.
   After the inflammation is gone off, the following electuary may be used :
   Taks of lenitive electuary two ounces—balsam of capevi,  one ounce—gum
guaicum and rhubarb, in powder, of each two drachms—simple syrup, enough
to make an electuary.  The dose is the same  as of the preceding.
                         Electuary  of tlie Bark.
   Take of Peruvian bark, in powder, three ounces—cascarilla half an ounce-
syrup of ginger, enough to make an electuary.
   In  the cure of obstinate intermitting fevers, the bark is assisted by the casca-
rilla.   In hectic habits, however, it will be better to leave out the cascarilla, and
put three drachms of crude sal ammoniac in its stea d.
                         Electuary for the  Piles.
   Take flowers of sulphur, one ounce—cream  of tartar half an ounce—treacle
 a sufficient quantity to  form an electuary.
   A tea-spoonful of this may be taken three or four times a day.
                         Electuary for the palsy.
   Take of powdered mustard seed, and conserve of roses, each an ounce—syr-
 up of ginger, enough to make  an electuary.
   A tea spoonful of this may be taken three or four  times a day.
                     Electuary for the  Rheumatism.
   Take of conserve  of roses two ounces—cinnibar of antimony, levigated, an
ounce and a half; gum guaiacum in powder,  an ounce—syrup of ginger, a suffi-
cient quantity to make  an electuary.
   In obstinate rheumatisms, which are not  accompanied  with a fever, a tea
spoonful of this electuary may be taken twice a-day with  considerable advan-
tage.
                             EMULSIONS.
  EMULSIONS, besides their use as medicines, are also proper vehicles for
certain substances, which could not otherwise be  conveniently taken in a liquid
form.  Thus camphor, triturated with almonds, readily unites with water into
an emulsion.   Pure oils, balsams,  raisins,  and other similar substances, are
likewise rendered miscible with water by the intervention  of mucilages. 
APPENDIX.
431
                          Common EmuUion.
   Take of sweet almonds, an ounce ; bitter almonds, a drachm ; water, two pints.
Let the almonds be blanched, and beat up in a marble mortar, adding the water
by a little and little, so as to make i;ii emulsion, afterwards let it be strained.
                           Arabic Emulsion.
   This is made in the same manner as the above, adding to the almonds, while
beating, two ounces and a half of the mucilage of gum arabic.
   Where soft cooling liquors are necessary, these emulsions may be used as or-
dinary drink.
                        Camphorated Emulsion.
   Take of camphor, half a drachm ; sweet almonds, half a dozen ; white sugar,
half an ounce •, mint water, eight ounces.  Grind the camphor and almonds well
together in a stone mortar, and add by degrees the mint water; then strain the
liquor, and dissolve it in the sugar.
   In  fevers,  and other disorders which require  the use of camphor, a table-
spoonful of this emulsion may be taken every two or three hours.
                     Emulsion of Gum  Ammoniac.
   Take of gum ammoniac, two drachms ; water, eight ounces.  Grind tlie gum
with the water poured upon it by little and little, till it is dissolved.
   This emulsion is used for attenuating tough, viscid phlegm, and promoting
expectoration.  In obstinate coughs, two ounces of the syrup of poppies  may
be added to it.   The dose is two table-spoonsful three or four times a-day.
                            Oily  Emulsion.
  Take of soft water, six ounces;  volatile aromatic spirit, two drachms; Florence
oil, an ounce ; shake them well togedier, and  add of simple syrup, half an ounce*
   In recent colds and coughs, Uiis emulsion is generally of service ; but if the
cough proves obstinate, it will  succeed better when made with the paregoric
elixir of the Edinburgh  Dispensatory, instead of the volatile aromatic spirit.
A table-spoonful of it may be taken every two or three hours.

                            EXTRACTS.
  EXTRACTS are prepared by boiling the  subject in water, and evaporating
the strained decoction to a due consistence.  By this process some ofthe more
active parts of plants are freed from the useless, indissoluble easthy matter,
which makes the larger  share of their bulk.   Water, however, is not the  only-
menstruum used in the preparation of extracts ; sometimes it is joined with spi-
rits, and at other times rectified  spirit alone is employed for that purpose.
   Extracts arc prepared from a variety of different drugs, as the bark, gentian,
julap, &c. but, as they require a troublesome and tedious operation, it will be
more convenient for  a private practitioner to purchase what hevneeds of them
from a professed druggist, than to prepare them himself.   Such of them as are
generally used, are inserted in our list of such drugs and medicines as are to be
kept for private practice.

                         FOMENTATIONS.
   FOMENTATIONS are generally intended either to ease pain, by taking off
tension and spasm ; or to brace  and restore the tone and vigour of those parts
to which they are applied.  The first of these  intentions may generally be an-
swered by warm water, and the  second by cold.  Certain substances, however,
arc usually added to  water  with a  view to heighten its effects, as anodynes,
aromatics, astringents, &c.  We shall therefore subjoin a few of the most  use-
ful medicated fomentations, that people  may  have it in their power to make use
of them if they chusc.
                         Anodyne Fomentation.
  Take of white poppy-heads, two ounces ; elder flowers, half an ounce ;  wa-
ter, three pints.  Boil till one pint is evaporated,  and strain out the liquor.
  This fomentation, as its title expresses, is  used for relieving acute pain.
                        Aromatic  Fomentation.
  Take of Jamaica pepper, half an ounce : red wine, a pint.  Boil them for a
little, and then strain tlie liquor. 
432
APPENDIX.
  Thislis iutended, not only as a topical application for external complaints,  but  bIci
for  relieving  the internal parts.   Fains of ihe  bowels, which  accompany dyseiurru s
and diarhoeas,  flatulent cliulics, uneasiness of the stomach, and  retchings to vomit, are
frequently abated by fomenting the abdomen and region of the stomach with the warm
liquor.
                           Common Fomentation.
  Take tops of wormwood and camomile flowers, dried, of each two ounces; water two
quarts.  After a slight boiling pour off the liquor.
  Brandy or spirit of  wine may be added  to  this fomentation, in such quantity  as
the  particular circumstances of the case shall require:  but these are not always neces-
sary.
                           Emollient  Fomentation.
  This is the same as the common decoction. .
                        Strengthening  Fomentation.
  Take of oak, bark one ounce :  pranate peel,  half an ounce ; alum,  two  drachms :
Smith's forge water three pints.  Boil the water with the bark and peel to the consump-
tion of ono-third:  then strain the remaining decoction and dissolve alum in it.
  This astringent liquor is employed as an  external fomentation to weak parts:  it  may
also be used internally.
                                 GARGLES.
  HOWEVER trifling this class of medicines  may appear, thqgr are by no means with-
out their use.  They seldom indeed cure diseases,  but they often alleviate very disa-
greeable symptom»:  as parchedness of the moulh, foulness of the tongue and  fauces,
&c. they are peculiarly useful in fevers and sore  throats.   In  the latter a gargle will
sometimes remove the disorder ;  and in the former few  things are more refreshing  ot
agreeable to the patient, than to have his mouth frequently  washed  with some soft de-
tergent gargle.
  One advantage of these medicines is, that they are easily prepared.   A little barley
water and honey may  be had any where, and if to these be  added as  much  vinegar  as
will give them an agreeable sharpness, they will make a very useful gargle for softening
and cleansing the mouth.
  Gargles have the best effect when injected with a syringe.
                             Attenuating  Gargle.
  Take  of  \jater, six ounces; honey, one ounce;  nitre, a drachm and a half.  Mil
them.
  This cooling gargle may be used either iu the inflammatory quinsey,  or in fevers, for
cleaning the tongue and fauces.
                               Common  Gargle.
  Take of rose-water, six ounces;  syrup of clove, July flowers, half an ounce; spirit  of
vitriol, a sufficient quantity to give it an agreeable sharpness.  1Mi\ them.
  This gargle, besides cleansing  the tongue and fauces, acts as a gentle repellent, aud
will sometimes remove  a slight quinsey.
                             Detergent  Gargle.
  Take of the emollient gargle, a pint, tincture of myrrh, an ounce, honey, two ounces.
Mix them.
  When exulcerations require to be cleansed, or the excretion of tough  viscid saliva
promoted, this gargle  will be of service.
                              Emollient Gargle.
  Take an ounce  of  marshmallow roots, and two or three figs, boil them in a quart of
water till near one half of it be consumed, then strain out the liquor.
  If  an ounce of honey, and ball an ounce of spirit of  sal ammoniac, be added to the
above, it will then be  an exceeding good'attenuating gargle..
  This gargle is beneficial jd. fevers, wher ? the  tongue and fauces are rough and parch-
ed, to soften these parts, and promote the' discharge of saliva.
  The  learned  and  accurate Sir John Pnngle observes,  that in  the inflammatory
quinsey, or  strangulation of the fauces,  little benefit  arises fiom  the common  gar-
gles,  that such as are  of an acid  nature do more harm than good,  by  contracting  Ihe
eraunctories of the  saliva  and mucus, and thickening those  humours, that a detoc-
tiou of figs in milk and  water has  a contrary  effect, especially if  some sal-ammo- 
APPENDIX.
433
 aiac be added ;  by which the saliva is made thinner, and the glands brought to
 secrete more freely ; a circumstance always conducive to the cure.

                             INFUSIONS.
  VEGETABLES yield nearly the same properties to water by infusion as by
 decoction ; and though they may require a longer time to give out their virtues
 in this way, yet it has several advantages over the other ; since boiling is found
 to diss'pate the finer parts of many bitter and aromatic substances, without more
~f\illy extracting their medicinal principles.
   The author of the New Dispensatory observes, that even from those vegeta-
 bles which arc weak in virtue, rich infusions may be obtained, by returning the
 liquor upon fresh quantities of die subject, the water loading itself more and
 more with the  active parts  ; and that these loaded infusions are applicable to
 valuable purposes in medicine, as they contain in a small compass the finer,
 more subtle, and active principles of vegetables, in a form readily miscibie with
 tlie fluids of the human body.
                             Bitter Infusion.
   Take tops of the lesser centaury and camomile flowers, of each half an ounce ;
 yellow rind of lemon and orange peel, carefully freed from the inner white part,
 of each two drachms.  Cut them in small pieces, and infuse them in a quart of
 boiling water.
   For indigestion, weakness ofthe stomach, or want of appetite, a tea-cupful of
 this infusion may be taken twice or thrice a-day.
                          Infusion ofthe Bark.
   To an ounce ofthe bark, in powder, add four or five table-spoonsful of bran-
 dy, and a pint of boiling water.   Let them infuse for two or three clays.
   This is one ofthe best preparations ofthe bark for weak stomachs.   In dis-
 orders where the corroborating virtues of that medicine are required, a tea-cup-
 ful of it may be taken two or three times a-day.
                          Infusion of Carduus.
   Infuse an ounce of the dried leaves of the  carduus benedictus, or  blessed
 thistle, in a pint of  common water, for six hours, without heat; then filter the
 liquor through paper.
   This light infusion may be  given with great benefit, in  weakness ofthe sto-
 mach, where the common bitters do not agree.  It may be flavoured at pleasure
 with cinnamon, or other aromatic materials.
                          Infusion of Linseed.
   Take of linseed, two spoonsful;  liquorice root sliced, half an ounce ;  boiling
 water, three pints.   Let them stand to infuse by the fire  for some hours,  and
 then strain off the liquor.
   If an ounce ofthe leaves of colt's foot be added to these ingredients, it will
 then be the Pectoral Infusion.  Both these are emollient mucilaginous liquors,
 and may be taken with advantage as ordinary  drink in difficulty of making wa-
 ter ; and in coughs and other complaints ofthe breast.
                            Infusion of Roses.
   Take of red-roses, dried, half an ounce ; boiling water, a quart; vitriolic aoid,
 commonly called oil of vitriol, half a drachm ;  loaf sugar, an ounce.
   Infuse tlie roses in the water four hours, in an unglazed earthen vessel: af'
 terwards pour in the acid, and having strained the iiquor,  add to it the sugar.
   Iu an excessive flow ofthe menses, vomiting of blood, and other haemorrha-
 ges, a tea-cupful of this gently astringent infusion may be taken every three or
 four hours.  It likewise makes an exceeding good gargle.
   As the quantity of roses used here can have little or no  effect, an equally va-
 luable medicine may be prepared by mixingthe acid and water without infusion.
                    Infusion of Tamarinds and Senna.
   Take of tamarinds, one ounce, senna and crystals of tartar, each two drachms.
 Let these ingredients be infused four or five hours in a pint of boiling water,
 afterwards let tlie liquor be strained, and an ounce or two ofthe aromatic tinc-
 ture added to it.  Persons who are easily purged may leave out either the tam-
 :uinds or the crystals of tartar.
  This is an agreeable cooling purge.  A tea-cupful  may be given every half
                                 5-1—2 
434
APPENDIX.
hour till it operates.  Thisrsupplies the place of the Decoction of Tamarinds
and Senna.
                           Spanish Infusion.
  Take of Spanish juice, cut into small pieces, an ounce, salt of tartar three
drachms.  Infuse in a quart of boiling water for anight.  To the strained li-
quor add an ounce and an half of the syrup of poppies.
.  In recent colds, coughs, and obstructions ofthe breast, a tea-cupful of this
infusion may be taken with advantage, three or four times a-day.
                         Infusion for the Palsy.
  Take of horse-radish root shaved, mustard-seed bruised, each four ounces,
outer rind of orange-peel, one ounce.  Infuse them in two quarts of boiling wa-
ter, in a close vessel for twenty-four hours.
  In paralytic complaints, a tea-cupful of this warm stimulating medicine rcay
be taken three or four times a-day.  It excites the action of tlie solids, proves
diuretic, and if the patient be kept warm, promotes perspiration.
  If two or three ounces ofthe dried leaves of marsh-trefoil be used instead of
mustard, it will make the Antiscorbutic Infusion.
                               JULEPS.
  THE basis of juleps is generally common water, or some simple distilled wa.
ter, with one-third or one-fourth its quantity of distilled spirituous water, and as
much sugar or syrup as is sufficient to render die mixture agreeable.  This is
sharpened with vegetable  or mineral acids, or impregnated with other medi-
cines suitable to the intention.
                          Camphorated Julep.
  Take of camphor, one drachm ; rectified spirit of wine, ten drops ; double  re-
fined sugar, half an ounce ;  boiling distilled water, one pint  Rub the camphor
first with the spirit of wine, then with the sugar ; lastly, add the water by de-
grees, and strain the liquor.
  In hysterical and  other complaints where camphor is proper, this julep may
be-taken in the dose of a spoonful or two as often as the stomach will bear it.
                             Cordial  Julep.
  Take of simple cinnamon-water,  four ounces :  Jamaica pepper-water, two
ounces ;  volatile aromatic spirit, and compound spirit of lavender, of each two
drachms ; syrup of orange-peel, an ounce.   Mix them.
  This is given in the dose of two spoonsful three or four times a-day, in disor-
ders accompanied with great weakness and depression of spirits.
                          Expectorating Julep.
  Take ofthe emulsion of gum ammoniac, six ounces ; syrup of squills, two
ounces.  Mix them.
  In coughs, asthmas, and obstructions of the breast, two table-spoonsful of this
julep may be taken every three or four hours.
                              Musk Julep.
  Rub half a drachm of musk well together with half an ounce of sugar, and add
t*> it gradually, of simple cinnamon and peppermint water, each two ounces ; of
the volatile aromatic spirit, two drachms.
  In the low state of nervous fevers, hickupping, convulsions, and other spasmo-
dic affections, two table-spoonsful of this julep may be taken every two or three
hours.
                              Saline Julep.
  Dissolve two drachms of salt of tartar in three ounces of fresh  lemon juice,
strained; when the  effervescence is over,  add, of mint-water,  and common
water, each two ounces, of simple syrup, one ounce.
  This removes sickness at the stomach, relieves vomiting, promotes perspira-
tion, and may be of some service in fevers, especially of the inflammatory kind.
                             Vomiting Julep.
  Dissolve four grains of emetic tartar in eight ounces of water, and add to it
half an ounce ofthe syrup" of clove July-flowers.                #    ....
  In the beginning of fevers, where there is no topical inflammation, this julep
may be given in the dose of one table-spoonful every quarter of an hour till it
operates.  Ajitimonial vomits serve not only to evacuate tbv contents 0f the sto- 
APPENDIX.
435
  y <rii, bat likewise to promote the different excretions.  Hence they are found
  in fevers to have nearly die same effect as Dr. James' Powder.
                              MIXTURES.
    A MIXTURE, differs from a julep in this respect, that it receives into ite
  composition not only salts, extracts and other substances dissoluble in water,
  but also earths, powders, and such substances as cannot be dissolved.  A mix-
  ture is seldom either an elegant or agreeable medicine.  It is nevertheless ne-
  cessary.  Many persons can take a mixture, who are not able to swallow a bo*
  lus or an electuary:  besides, there are medicines which act better in this than
  in any other form.
                           Astringent  Mixture.
   Take simple cinnamon  water and common water, of each three ounces ;
  spirituous  cinnamon water, an ounce and a half; Japonic confection half ant
  ounce.   Mix tiicm.
   In dysenteries which are not of long standing, after the necessary evacuations,
  a spoonful or two of this mixture may be  taken every four hours, interposing;
  e\ cry second or third day a dose of rhubarb.
                             Diuretic Mixture.
   Take of mint-water, five ounces ; vinegar  of squills, six  drachms ; sweet
  spirit of nitre, half an ounce; syrup of ginger, an ounce and an half. Mix them.
    In obstructions of the urinary passages,  two spoonsful of this mixture may
  be taken twice or thrice a-day.
                        Laxative absorbent  mixture.
   Rub one drachm of magnesia alba in  a mortar with ten or twelve grains of,
  the best Turkey rhubarb, and add to them three ounces of common water j
  simple cinnamon water, and syrup of sugar, of each one ounce.
   As most diseases of infants are  accompanied  with aciditieSj this mixture
  may either be given with a view to correct these, or to open  the body.  A ta;-
  ble-spoonful may be  taken for a dose, and repeated three times a-day.  To a
  very young child half a spoonful will be sufficient.
   When tlie mixture is intended to purge, the dose may either be increased^
  or the quantity of rhubarb doubled.
   This is one of the mostsgenerally useful medicines for children with which 1
  aiu acquainted.
                           Saline   Mixture.
   Dissolve a drachm of the salt of tartar in four ounces of boiling water; and
 when cold, drop into it spirit of vitriol till the effervescence ceases ;  then add!
 of pepper-mint water, two ounces; simple syrup, one ounce.
   Where fresh lemons cannot be had, this mixture may oc«asional]y supply ti^g
 place of die saline julep.
                             Squill Mixture.
   Take of simple cinnamon water, five ounces; vinegar of squills, one ounce£
 S} rup of marshmallows, an ounce and a half.  Mix them.
   This mixture, by promoting expectoration, and the secretion of urine, proves
 serviceable in asthmatic and dropsical habits.   A table-spoonful of it may Jje
 taken frequently.

          OINTMENTS, LINIMENTS,  AND CERATES.
   NOTWITHSTANDING  the extravagant encomiums which have been be-
 stowed on different preparations of this kind,  with  regard to their efficacy in
 the cure of wounds, sores, &c. it is  beyond a doubt, that the most proper ap-
 plication to a green wound is dry lint. But though ointments do not heal wounds
 and sores, yet Uiey  serve to defend them from the external air, and to retain
 such substances as may be necessary for drying, deterging,  destroying proud
 flesh, and such like.  For these purposes,  however, it will be sufficient to insert
 only a few of the most simple forms, as ingredients of a more active nature can
 occasionally be added to them.
                      Yellmv  Basilicum  Ointment.
  Take of yellow wax, white resin, and frankincense,, each a quarter of a pound;
 melt them together over a gentle fire, then  add of hogs' lard prepaid* eflc
pound* Strain Uie ointment white warm.
1    ■   Itt'V   m!
0.
E/4>/*.
4.
"■—•'—   urn i \m* 
436
APPENDIX.
  This ointtnentis employed for cleansing and healing wouuds and ulcer*.
                       Ointment  of  Caliminc.
  Take of olive oil, a pint and a half, white wax, and calamine stone levigated,
of each half a pound.  Let the calamine stone, reduced into a fine powder, h<-
rubbed with some part of die oil, and afterwards added to the rest ofthe oil and
wax, previously melted together, continually stirring 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 cause.
                          Emollient  Ointment.
  Take of palm oil, two pounds, olive oil a pint and a half, yellow wax half a
pound, Venice turpentine, a quarter of a pound.   Melt the wax in the oils over
a gentle fire, then mix in the turpentine, and strain the ointment.
  This supplies the place of  Althaea Ointment.   It may be used for anointing
inflamed parts, &c.
                              Eye Ointment.
   Take of hogs' lard prepared, four ounces, white wax two drachms, ttttty pre-
pared, one ounce, melt the wax with the lard over a gentle fire, and then sprin-
kle in the tutty, continually stirring them till the ointment is cold
   This ointment will be more efficacious, and of  a better consistence, 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 stone levigated, each six drachms, verdi-
grease well prepared, of each two drachms,  hogs' lard and mutton suet prepar-
ed, of each two ounces. Rub the camphor well with the  powder, afterwards
 mix in the lard and suet continuing the triture till they be perfectly united.
   This  ointment has been long in esteem for diseases of the eyes.  It ought
 however, to be used with caution, when the eyes are much inflamed or very
 tender.
                             Issue Ointment.
 ' Mix half an ounce of Spanish flies, finely powdered, in six ounces of yellow
 basilicum ointment.
    This  ointment is chiefly intended for dressing blisters, in order to keep them
 open during pleasure.
                            Ointment of Lead.
    Take of olive oil half a pint, white wax  two ounces, sugar of lead, three
 drachms.  Let the sugar of lead, reduced  into a fine powder, be  rubbed up
 with some part of  the  oil, and afterwards added to the other ingredients, pre-
 viously melted together, continually stirring them till quite cold.
    This cooling and gentle astringent ointment may be used  in  all cases where
  the intention is to dry the skin over the part, as in scalding, &c.
                            Mercurial Ointment.
    Take of quicksilver, two ounces, hogs' lard, three  ounces, mutton  suet, one
  ounce   Rub the quicksilver, with an ounce of the hogs' lard in a warm mortar.
  till the globules be perfectly extinguished;  then rub it up with  the rest of the
  lard and suet, previously melted together.
    The principal intention of this  ointment is to convey mercury into  the body
  by being rubbed upon die skin.
                            Ointment of Sulphur.
    Take of hogs'lard prepared, four ounces, flowers of sulphur an ounce  and
  an half, crude sal  ammoniac, two drachms, essence of lemon, ten or twelve
  drops.   Make them into an ointment.
    This ointment, rubbed  upon the parts affected, will  generally cure the itch.
  It is both the safest and best application for that  purpose, and when made in
  this way, has no disagreeable smell.
                              White Ointment.
    Take of olive oil, one pint, white wax and spermaceti, of each three ounces
   Melt them with a gentle heat, and keep them con>t antly and briskly stirring to-
  gether, till quite "cold.
    If two drachms of camphor, previously rubbed with a small quantity ot oi.-,
  he added to  the above, it Will make the White Camphorated Omtmc»!

                                              .« • -t^T  /;.„.,    C 
APPENDIX.
437
                          lAnimtnt  Ointment.
  Take equal p.irls of Florence oil, or fresk drawn linseed oil, and lime-water :
shake them well togrtber in a wide mouthed bottle, so as to form a liniment.
  This is found to be an exceeding proper application for recent scalds or burns.
It may either be spread upon a cloth, or the parts affected maybe anointed with
it twice or thrice a-day.
                            White Liniment.
  This is made in the same manuer as the white ointment, two thirds of  the
wax being left out.
  This liniment may be applied incases of excoriation, where, on account of the
largeness of the surface, the ointments with lead or calimine might be improper.
                        Liniment for the Piles.
  Take of emollient ointment, two ounces, liquid laudanum, half an ounce. Mix
these ingredients with the yolk of an egg, and work them well together.
                           Volatile Liniment.
  Take of Florence oil, an ounce ; spirit  of hartshorn, half an ounce.  Shake
them together.
  This liniment, made  with equal parts ofthe spirit and oil, will be more  effi-
cacious, where the patient's skin is  able to bear it.
   Sir John Pringle observes, that in the inflammatory quinsey, apiece of flannel,
moistened with this liniment, and  applied to the throat, to be  renewed every*
four  or five hours, is one ofthe most efficacious remedies, and that it seldom
fails, after bleeding, either to lessen or carry off the complaint.  The  truth of
this observation I have often experienced.
                            Camphoratea Oil.
   Rub an ounce of camphor,  with  two ounces  of Florence oil, in a mortar, tili
the camphor be entirely dissolved-
  This antispasmodic liniment may be used in  obstinate rheumatisms, and in
some other cases accompanied with extreme pain and tension ofthe parts.
                                 PILLS.
   MEDICINES which operate in a small dose, and whose disagreeable taste,or
smell, makes it necessary that they should be concealed from the palate, are
most commodiously exhibited in this form.  No medicine, however, that is in-
tended to operate quickly, ought to be made into pills, as they often lie for a
considerable time on the stomach before they are dissolved, so as to produce any
 effect.                                                                 <
   As the ingredients which enter the composition of pills are generally so  con-
 trived,  that  one pill of an ordinary size may  contain about five grains of the
 compound, in mentioning the dose  we shall only specify die  number of pills tq
 be taken, as one, two, three, &c.
                             Composing Pill.
   Take of purified opium, ten grains, Castile soap, half a drachm.  Beat them
 together, and form ihe whole into twenty pills.
   When a quieting draught will not sit upon the stomach, one, two,  or three of
 these pills may be taken, as occasion requires.
                               Foetid Pill.
   Take of asafcetida, half an ounce; simple syrup, as  much as is necessary  to
 form it into pills.
    In hysteric complaints, four or  five pills, of an ordinary size, may be taken
 twice or thrice a-day.  They may likewise be of service to persons afflicted with
 the  asthma.
    When it is necessary to keep the body open, a proper quantity of rhubarb,
 aloes, or jabp, may occasionally be added to the above mass.
                              Hemlock Pill.
    Take any quantity of the extract of hemlock, and adding to it about a  fifth
 part its weight ofthe powder of die dried leaves, form it into pills of the ordina-
 ry size.
    The extract of hemlock maybe taken from  one grain to  several drachms in
 the day.  The best method,  however, of using these pills,  is to begin with one
 or two, and to increase the dose gradually, as far as the patient can bear them,
 witlnui any remarkable degree of stupor or giddiness. 
438                        APPENDIX.
                              Mercurial  Pill.
    Take of purified quicksilver and honey, each half an ounce.  Rub them to-
  gether inamortar, till the globules of mercury are perfectly extinguished ; then
  add of Castile soap, two drachms ; powdered liquorice, or crumb of bread, a
 (Sufficient quantity to give the mass a proper consistence for pills.
    When stronger mercurial pills are wanted, the quantity of quicksilver  may
  be doubled.
    The dose of these pills is different, according to the intention with which f hey
  are given.  As an alterant, two or three may be taken daily.  To raise a saliva-
 tion, four or five will be necessary.
   Equal parts ofthe above pill and powdered rhubarb made into a mass, with ;<
 sufficient quantity of simple syrup, will make a Mercurial purging Pill.
                        Mercurial Sublimate Pill.
   Dissolve fifteen grains ofthe corrosive sublimate of mercury in two drachms
 ofthe saturated solution of crude sal-ammoniac, and make  it  into a paste, in a-
 glass mortar, with a sufficient quantity of the crumb of bread.  This mass must
 be formed into one hundred and twenty pills.
   This pill, which is the most agreeable form of exhibiting the sublimate, has
 been found efficacious, not only in curing the venereal disease, but also in kil-
 ling- and expelling worms, after other powerful medicines had failed *.
   For the veneral disease, four of these pills may be  taken twice a day, as an
 alterant three, and for worms two.
                              Plummets PHI.
   Take of Calomel, or sweet mercury, and precipitated sulphur and antimony,
 each three drachms ; extract of liquorice, two drachms.  Rub the sulphur and
 mercury well together ; afterwards add the extract, and with a sufficient quaii
 tity of the mucilage of gum-arabic make them into pills.
   This pill has been found a powerful, yet safe, alterative in obstinate cutane-
 ous disorders ; and has completed a cure after salivation had failed.  In vene-
 real cases it has likewise produced excellent effects.  Two or  three pills of an
 ordinary size may be taken night and morning, the patient keeping moderately
 warm, and drinking after each dose a draught of decoction of  the woods, or of
 sarsaparilla.
                             Purging Pills.
   Take of succotorine aloes, and  Castile soap, each two drachms ; of  simple
 syrup, a sufficient quantity to make them into pills.
   Four or five of these pills will generally prove a sufficient purge. For keep-
 ping the  body  gently open, one may be taken night and morning.   They are
 reckoned both deobstruent and stomachic, and will be found to answer all the
 purposes of Dr.  Anderson's pills, the principal ingredient  of which is  aloes.
   Where aloetic purges are improper, the following pills may be used:
   Take extract of jalap, vitriolated tartar  of each two drachms; syrup  of
 ginger, as much as will make them a proper consistence for pills.
   These pills may be taken in the same quantity as the above.
                          Pill for the Jaundice.
   Take of Castile soap, succotorine aloes, and  rhubarb, of each one drachm.
 Make them into pills with a sufficient quantity of syrup or mucilage.
   These pills,  as their title express, are  chiefly intended for the jaundice,
 which, with the assistance of proper diet, they will often cure  Five or six  of
 them may be taken twice a-day, more or less, as is necessary to keep  the body
 open.  It will be proper, however, during  their use,  to interpose a vomit  ot
 ipecacuanha or tartar emetic.
                             Stomachic Pill.
   Take extract of gentian, two  drachms; powdered rhubarb and vitriolated
 tartar, of each one drachm : oil of mint, thirty drops ; simple syrup, a sufficient
 quantity.                                                    .        .l
   Three or four of these pills may be taken twice a-day, for  invigorating tne-
stomach, and keeping the body gently open.
                              Squill Pills.
   Take powder of dried squills, a drachm and a half; gum ammoniac, and car-

   * See a paper on this subject in the Edinburgh Physical and- literary Essay t,
 by ijie ingqiiqus Dr, John Gardener. 
APPENDIX.                          435
•ktmom seeds, in  powder, of each three  drachms, simple syrup, a sufficient
quantity.
   In dropsical and asthmatic complaints, two or three of these pills may be tab-
en twice a-day, or oftener, if the stomach will bear them.
                          Strengthening Pills.
   Take soft extract of the bark,  and salt  of steel, each a drachm.  Make inte
pills.
   In disorders arising from excessive debility, or  relaxation of the solids, as
the chlorosis, or green sickness, two of these pills may be taken three  times
a-day.
                             PLASTERS.
 .PLASTERS ought to be of a different consistence, according to the purposes
for which they are intended.   Such as  are to be applied to the breasts or sto-
mach ought to be soft and yielding ; while those designed to the limbs should
be firm and adhesive.
   It has been supposed, that plasters might be impregnated with the virtues of
different vegetable, by boiling the recent vegetables witii the oil  employed for
the composition of the plaster; but this treatment does not communicate  to the
oils any valuable qualities.
   The calces of lead boiled with oils unite with them into a plaster of a proper
consistence, which make the basis of several other plasters.   In  boiling these
compositions, a quantity of hot water  must be added from time to time to pre-
vent the plaster from burning or growing black.   This,  however, should  be
done with care, lest it cause the matter to  explode.
                          Common  Plaster.
   Take of common olive oil, six pints ; litharge reduced to a fine powder, two
pounds and a half.   Boil the litharge and oil together over a gentle fire, con-
tinually stirring them, and keeping always about half a gallon of water  in the
vessel:  after they have boiled about three hours, a little of the plaster may be
taken out and put into cold water, to try if it be of a proper consistence ;  when
that is the case, the whole may be suffered to cool, and the water  well pressed
out of it with the hands.
   This plaster is generally applied in  slight wounds  and excoriations  ofthe
skin.   It keeps the part soft and warm, and defends it from the air, which is
all that is necessary in  such cases.  Its principal use, however, is  to serve as a
basis for other plasters.
                            Adhesive Plaster.
   Take of the common plaster, half a  pound, of Burgundy pitch, a quarter of
a pound.  Melt them together.
   This plaster is principally used for keeping on other dressings.
                            Anodyne Plaster.
   Melt an ounce  of adhesive plaster, and when it is cooling, mix with it a
drachm of powdered opium, and the same  quantity of camphor, previously rub-
bed up with a little oil.
   This plaster generally gives ease in acute pains especially ofthe nervous kind.
                            Blistering  Plaster.
   Take of Venice turpentine, six  ounces; yellow wax, two ounces ; Spanish
flies in fine powder, three ounces ; powdered mustard, one ounce.  Melt die
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 sufficiently  incorpora-
ted, sprinkle in the powders, continually stirring the mass till it be cold.
   Though this plaster  is  made in a variety of ways, one seldom meets with it
of a proper consistence.  When compounded with oils and other greasy sub-
stances, its effects are  blunted, and it  is apt to run; while pitch and resin ren-
der it too hard and very inconvenient.
   When Uie blistering plaster is not at hand, its place may be supplied by mix-
ing with any soft ointment a sufficient  quantity of powdered flits, or by form?
ing them into a paste with flour and vinegar.
                             Gum  Plaster.
   Talfe of the common plaster, four pounds; gum ammoniac and galbanuft,
strained, of each half a pound.   Melt  tbem together, and add, of Venice tuj-
pentinc, sis ounces. 
440
APPENDIX.
  This plaster is used as a digestive,  and hkewise for discussing indolent tu>
mows.
                          Mercurial,  Plaster.
  Take of common  plaster, one pound; of gum ammoniac,  strained, half a
pound  Melt them together, and when cooling, add eight ounces of quick-sil-
ver, previously extinguished by triture, with three ounces of hogs' lard.
  This plaster is recommended in pains  of the  limbs arising  from a venereal
cause.  Indurations of the glands, and other violent tumours, are likewise found
sometimes to yield to it.
                            Stomach Plaster.
  Take of gum plaster, half a  pound, camphorated oil, an ounce and a-half;
black pepper, or capsicum, where it can be had, one ounce. Melt the plaster,
and mix with it the oil, then sprinkle in the pepper, previously reduced to a fine
powder.
  An ounce or  two  of this plaster, spread on soft leather and applied to the
region of the stomach, will be of service, in flatulencies arising from hysteric
and hypochondriac  affections.   A little  of  the expressed oil of mace, or a few
drops of tlie essential oil of mint, may be rubbed upon it before it is applied
  This may supply  the place of the Antihysteric Plaster.
                             Warm Plaster.
  Take of gum plaster, one ounce; blistering  plaster, two  drachms.  Melt
them together over a gentle fire.
  This plaster is useful in the sciatica  and other fixed pains of the rheumatic
kind: it ought, however, to be worn for some time, and to be  renewed  at least
once a week.  If this is found to blister  the part, which is sometimes the  case,
it must be  made with a smaller proportion of the blistering plaster.
                              Wax  Plaster.
  Take of yellow wax, one pound ; white resin, half a  pound; mutton  suet,
three quarters of a pound.  Melt them together.
  This is generally used instead of the Mel Hot plaster.  It is a proper applica-
tion after blisters, and in other cases  where a gentle digestive is necessarv.
                              POWDERS.
  THIS is one of the most simple forms in which medicine can be administer-
ed. Many medicinal substances, however cannot be reduced into  powder, and
others are too disagreeable to be taken in this form.
   The lighter powders may be mixed  in any agreeable thin  liquor, as tea or
water gruel.  The  more ponderous will require a more consistent vehicle, as
syrup, conserve, jelly, or honey.
   Gums, and other substances which are difficult to powder, should be pounded
along with the drier ones, hut those which are too dry, especially aromatics,
ought to be sprinkled during their pulverization, with a few drops of any pro-
per water.                                             . .        . -%
   Aromatic powders are to be prepared only in small quantities at a time, ami
kept in glass vessels closely stopped.  Indeed no powders ought to be exposed
to the air or kept too long, otherwise  their virtues will be in a great measure
destroyed.
                          Astringent Powder.
   Take of alum and japan earth, each two drachms. Pound them together, and
divide the  whole into ten or twelve doses.
   In an immediate  flow  of the menses, and other hemorrhages, one of these
powders may be taken every hour, or every half hour, if the discharge be  violent.
                           Powder of Bole.
  Take of bole armenic, or French bole,  two ounces; cinnamon, one ounce;
tormentil root and gum arabic, of each six drachms;  long pepper, one drachm.
Let all these ingredients be reduced into a powder.
  This warm glutinous astringent powder, is given in fluxes,  and other -elisor-
iers where medicines of that class are necessary, in the dose of a scruple, or
half a drachm.                                                 . ,
  If a drachm of opium be added, it will make the powder of  bole vit hop >um,
which is a medicine of considerable efficacy.  It may be  taken  in  the s.imc
quantity as the former, but not above twice or thrice a-d.\v. 
APVENDlX.
441
                           Carminative  Powder.
   "i »ks of coriander-seed, { oz.; ginger, one drachm ;  nutmegs, half a drachm,
 fine sugar, a drachm and a half.  Reduce them into  powder for twelve doses.
   This powder is employed for expelling flatulencies  arising from indigestion,
 particularly those to which  hysteric and hypochondriac persons are so liable.
 It may likewise be given in  small quantities to children  in their food, when
 troubled with gripes.
                           Diuretic Powder.
   Take of gum arable, four ounces;  purified  nitre, one ounce.  Pound them
 together, and divide the whole into twenty-four doses.
   During the first stage ofthe venereal diseases, one of these cooling powders
 ir.ay be taken three times a day, with considerable advantage.
                       Aromatic Opening Powder.
   Take of the best  Turkey rhubarb, cinnamon, and fine sugar,  each  two
 drachms   Let the ingredients be pounded, and afterwards mixed well together.
   When flatulency  is accompanied with costiveness,  a  tea-spoonful of  this
 powder may be taken once or twice a-day, according to circumstances.
                        Saline laxative Ponder.
   Take of soluble tartar, and cream of tartar, each one drachm-  Purified ri-
 frc, half a dfachm.   Make them into a powder.
   In fevers and other inflammatory disorders,  where it is neeessary to keep
 tlie  body gently open, one of these cooling luxative powders, may be taken m a
 little gruel, and repeated occasionally
                             Steel  Powder.
   Take filings of steel, and loaf sugar, of each two ounces: ginger, two drachms.
 Pound them together.
 •  In obstructions of the menses, and other cases  where steel is proper, a tea-
 spoonful of this powder may be  taken twice a day, and washed down with a
 little wine or water.
                           Sudorific Powder.
   Take purified nitre and vitriolnted tartar, of each half an ounce ; opium and)
 ipecacuanha, of each one drachm.  Mix die ingredients and reduce them to a
-dine powder.                          *
   This is generally known by the name of Dover's  Powder.   It is a powerful
.sudorific.   In obstinate rheumatisms, and other  cases where it is necessary to>
 excite a copious sweat, this powder may be administered in the dose of a scru-
 ple or half a drachm.  Some patients will require two scruples.  It ought to bo
 accompanied with the plentiful use of some warm diluting liquor.
                            Worm  Powders.
   Take of tin reduced into a  fine powder, an ounce; i£thiop's mineral, two
 drachms.   Mix them well togetlier, and divide the whole into six doses.
   One of these powders may be taken in a little syrup, honey, or treacle, twice
 a-dayt]kr\fter they have  been all used, die following anthelmintic purge ma^
 be proper.
                        Purging Worm Powder.
   Take of powdered rhubarb a scruple; scammony and  calomel, of each five
 grains. Rub them together in a mortar for one dose.
   For children, die above doses mu6t be lessened, according to their age.
   If the powder of tin be given alone, Its dose may be considerably increased,
 The late Dr. Alston gave it to the amount of two ounces in three days, and
 says, when thus administered, that it proved an  egregious anthelmintic.  He
 purged his patients both before they took the powder, and afterwards.
                     Powder for the  Tape  Worm.
   Early in  the morning the patient is to take in any lituiid, two or three drachms,
 according to bis age and constitution, of the root of  the male fern pduced mtc*
 a fine powder.   About two hours afterwards he is to take of calomel and resin,
 of scammony, each ten gi'ains, gum gambouge,six grains.  These ingredients)
 must be finely powdered and given in a little syrup, honey, treacle, or any thing
diat is most agreeable to the patient.  He is then to walk gently about, now and
then drinking a dish of green tea,  till the worm is passed. If the powder ofthe
fern produces nausea, or sickness, it may be-removed by sticking the. JT*ice pf
 an orange ov lemon.
                                 53 
 14&                         APPENDIX.
  This medicine which had been long kept a secret abroad for the cure ol tin»
tape worm, was some  time ago purchased by the French King, and made pub-
lic for the benefit of mankind.  Not having had an opportunity of trying it, 1
can say nothing from experience concerning  its  efficacy.  It seems however,
from its ingredients, to be an active medicine, and ought to be taken with care
The dose here prescribed is sufficient for the strongest patient; it must, there
fore, be reduceel according to the age and constitution.
                               SYRUPS.
  SYRUPS were some time ago looked upon as medicines of considerable va
lue.  They are at present, however, regarded chiefly as vehicles for medicines
of greater efficacy, and are  used for sweetening draughts, juleps, or mixtures;
and reducing the lighter powders into  boluses, pills, and electuaries.  As all
these purposes may be answered by the simple syrup alone, there is little occasion
for any other; especially as they are seldom found but in a'4state of fermentation;
and as the dose of any medicine given in this form is very uncertain.  Persons
who serve the public must keep whatever their customers call for; but to the
private practitioner nine-tenths of the syrups usually kept in the shops arc un-
necessary.
                              Simple  Syrup,
   Is made by dissolving in water, either with or without heat, about double it*
weight of fine sugar.
   If twenty-five drops of laudanum be added to  an ounce of the simple syrup,
it will supply die place of diacodium, or the syrup of poppies, and will be found
a more safe and certain medicine.
   The lubricating virtues ofthe syrup of marshmallows may likewise be applied,
by adding- to the common syrup a sufficient quantity of mucilage of gum arabic.
   Those who chuse to preserve the juice of lemons in form of syrup, may dis-
solve in it, by the heat of a warm bath, nearly double its weight  of fine sugar.
The juice ought to be previously strained, and suffered to stand till it settk's.
   The syrup of ginger is sometimes of use as a  warm vehicle for giving medi-
cines to persons afflicted with flatulency.  It may be made by infusing  two
ounces of bruised ginger  in two pints of boiling water for twenty-four hours.
After the liquor has been strained, and has stood to settle for some time, it may
be poured off, and a little more than€ouble its weight of fine powdered sugar
 dissolved in it.
                      TINCTURES, ELIXIRS, &c.
   RECTIFIED spirit is  the direct menstrum of the resins  and essential oils
 of vegetables, and totally extracts these active principles  from sundry sub-
 stances, which yield them to water, either not at all or only in part.
   It dissolves likewise those parts of animal substances in which their peculiar
smells and taste reside. Hence the tinctures prepared with rectified spirits form
 an useful and elegant class of medicines, possessing many of  the most essential
virtues of simples, without being clogged with their  inert or useless parts
   Water, however, being the proper menstrum of the gummy, saline, flS sac-
 charine parts of medicinal substances, it will be necessary, in  the preparation ot
 several tinctures, to  make  use of a weak spirit, or a composition of rectified
 spirit and water.                   #
                           Aromatic  Tincture.
   Infuse two ounces of Jamaica pepper in two pints of brandy, without heat,
for a few days, then strain off the tincture.
    This simple tincture will sufficiently answer all the intentions of the more
 collv preparations of this kind.  It is rather too hot to be taken by itself, but
 is very proper for mixing with such medicines  as might  otherwise prove too
 cold for the stomach                      ..,.,»  »
                      Compound Tincture of the Bark.
   Take of Peruvian bark, two ounces ; Seville  orange-peel and cinnamon, of
 eachfif an  ounce.   Let the bark  be powdered  and the  other ingredien .
 bruised ; then infuse the whole in apint and a half of brandy, for five  or six
 days, in a close vessel, afterwards strain off the tincture
   The tincture is not only beneficial in intermitting fevers, but also in the slow,
 netrous and putrid kinds, especially towards then- decline 
                              appendix.                       443
    The dose is from one drachm to three or four, every fifth or sixth hour,  it
 may be given in any suitable liquor,  and occasionally sharpened with a  few
 drops ofthe spirit of vitriol.
                         Volatile Foetid Tincture.
   Infuse two ounces of asafcetida in one pint of volatile aromatic spirit, fop eight
 days, in a close botde, frequently shaking it  Then strain the tincture
   This medicine is beneficial in hysteric disorders, especially when attended
 with lowness of spirits, and faintings.  A tea-spoonful of it may be taken in a
 glass of wine, or cup of penny-royal tea.
                   f olatile  Tincture of Gum  Guaiacum.
   Take of gum guaiacum, four ounces ; volatile aromatic spirit, a pint. Infuse
 without heat in a vessel  well stopped for a few  day6; then strain off the tinc-
 ture.*
   In the rheumatic complaints, a tea-spoonful of this tincture may be taken in
 a cup of the infusion of water trefoil, twice or thrice a day.
                      Tincture  of Black Hellebore.
   Infuse two ounces of the roots of black hellebore, bruised, in a pint of proof
 spirit, for seven  or eight days, then filter the tincture through paper.  A scru-
 ple of cochineal may be infused along with the  roots, to give the tincture a cc*
 lour.
   In obstructions of the menses, a tea-spoonful  of this tincture may be taken in
 a cup of camomile  or penny-royal tea twice a day.
                           Astringent Tincture.
   Digest two ounces of gum kino, in a pint and  a half of brandy, for eight
 days ;  afterwards strain it for use.
   This tincture though not generally known,  is  a  good astringent medicine.
 With this view, an ounce or more of it may be taken three or four times a day.
                      Tincture of Myrrh and Aloes.
   Take of gum myrrh, an ounce and a half, hepatic aloes, an ounce.  Let them
 be reduced  to a powder, and infused in  two  pints  of rectified spirits, for six
 days, in a gende heat; then strain the tincture.                 x
   This is principally used by surgeons for cleansing foul ulcers, and restraining
 the progress of gangrenes.  It is also, by some,  recommended as a proper ap-
 plication to green wounds.
                Tincture of  Opium or, Liquid Laudanum.
   Take of crude opium, two ounces;  spiritous  aromatic water  and mountain
 w ine, each ten ounces.  Dissolve the opium, sliced in the wine, with a gentle
 heat, frequently stirring it, afterwards add the spirit, and strain off the tincture.
   As twenty-five  drops of this tincture contain about a grain of opium, the com-
 mon dose may be from twenty to thirty drops.
              Sacred Tincture, or Tincture of Hirca  Picra.
   Take of succotorine aloes in powder,  one  ounce; Virginian snake-root and
 gingeri of each two drachms.  Infuse in a pint  of mountain wine,  and half a
 pint of Brandy, for a week, frequently shaking the botde, then strain off the
 tincture.
   This is a safe and useful purge for persons  of a  languid and phlegmatic ha-
 bit ; but is thought to have better effects, taken  in  small doses as a laxative.
   The dose, as a purge, is from one to two ounces.
                      Compound  Tincture of Senna.
   Take of senna, one ounce ; jalap, coriander seeds, and cream of tartar, of
 each half an ounce.  Infuse them in a pint and  a half of French  brandy fetfa
 week ;  dien strain the tincture, and add to it four ounces of fine  sugar.
   This is an agreeable purge, and answers all the purposes of the  Elixir salu-
 t.:s, and of Daffy's Elixir.  The dose is from one  to two or tliree oimces.
                       Tincture  of Spanish  Flies.
   Take of Spanish flies, reduced to a fine powder, two ounces; spirit of wine,,
 one pint.  Infuse for two or three days ; then strain off the tincture.
   This  is intended  as an  acrid stimulant for external use.  Parts affected with
 the palsy or chronic rheumatism may be frequently  rubbed with it.

   A very good tincture of guaiacum, for domestic use, may be made, infusing two
t>>. thrtf ounces ofthe gum in a bottle of rum or brandy. 
444.-                      appendix.
                    Tincture of  the  Balsam of  Tolu.
  Take of the Balsam of Tolu, an ounce and a half; rectified spu-it <>i  wine, a
pint.  Infuse in a gentle heat until  the balsam is dissolved, then strain the tinc-
ture.
  This tincture possesses all die virtues ofthe balsam.   In coughs, and other
complaints of die  breast, a tea-spoonful or two of it may  be taken in  a bit of
loaf sugar.  But the best way of using it is in syrup.  An ounce of the tincture,
properly mixed with two pounds of simple syrup, will make what is commonly
called the Balsamic Syrup.
                         Tincture of Rhubarb.
  Take  of rhubarb two ounces and a half;  lesser cardamom  seeds, half an
ounce; brandy  two pints   Digest for a week, and strain the tincture.
  Those who chuse to have a vinous tincture of rhubarb, m:i> infuse the abovo
ingredients in a bottle of Lisbon wine, adding to it about two ounces of proof
spirits.
  If half an ounce of gentian root, and a drachm of Virginian snuke-root be ad-
ded to the above ingrediests, it will make the bitter tincture of  Rhubarb.
  All these tinctures are designed as stomachics and corroborants as well ns
purgatives. In weakness of the  stomach, indigestion, laxity of the intestines,
fluxes,  colicky and such like complaints, they are  frequently of great service
The dose is from half a spoonful to three or four spoonsful or more, accordiif
to the circumstances ofthe patient, and the purposes it is intended to answer.
                           Paregoric Elixir.
   Take  of flowers of benzoin, half an ounce ; opium two drachms.  Infuse in
one pound ofthe volatile aromatic spirit, for four or five days, frequently shak-
ing the bottle ; afterwards strain the elixir.
   This is an agreeable and safe way of administering opium.  It eases pain, al-
lays tickling coughs, relieves difficult breathing, and is useful in  many disor-
ders of  children, particularly the hooping-cough.   Ihe dose to  an  adult is
from fifty  to a hundred drops.
             y              Sacred Elixir.
   Take of rhubarb, cut small, ten drachms ; succotorine aloes, in powder, six
drachms;  lesser  cardamom seeds, half an ounce; French brandy, two pints.
Infuse for two or  three days, and then strain the elixir.
   This useful stomachic purge may be taken from one ounce to an ounce and
a half.
                           Stomachic Elixir.
   Take  of gentian root two ounces  ; Curassao oranges, one ounce ; Virginian
snake-root half an ounce.  Let the  ingredients  be bruised, ai;d infused for
three or four days in two pints of French brandy, afterwards strain out the elixir.
   This is an excellent stomachic bitter.  In flatulencies, indigestion, want
 of appetite, and such like complaints, a small glass of it may be taken
twice a day.  It likewise relieves the gout in  the  stomach, when taken
 in a large dose.                             #
                         Acid Elixir of Vitriol.
   Take of the aromatic tincture, one  pint, oil of vitriol, three ounces.
 Mix them gradually,,  and after the fxces have subsided, filter the elixirt
 through paper, in a glass funnel.
   This is one of the best medicines which I know for hysteric and hypo-
chondriac patients afflicted with flatulencies arising from relaxation or de-
biMty of the stomach and intestines.  It will succeed where the mostcele-
brSted stomachic bitters have no effect   The dose is from ten  to forty
 drops, in  a glass of wine or water, or a cup of any  bitter infusion, twice
 or thrice  a day.  It-should be taken when the stomach is most empty.
                     Camfihprated Spirit  of  Wine.
   Dissolve an ounce of camphor in a pint of rectified spirits.
   This  solution is chiefly employed as an embrocation in  bruises,  palsies,
the chronic rheumatism, and for preventing gangrenes.
   The  above quantity of camphor, dissolved in half a pound of the vola-
tile aromatic spirit, makes Ward's essence.
   Take of volatile sal ammoniac, any  quantity.   Pour on it gradually,
distilled vinegar, ti:l the effervescence ceases-. 
                            APPENDIX.                          445
                         Sjririe of Mindererun.
  Tiib medicine ftusdTul in promoting adischarpc both by the skin and urinary
passages.   It is also a good external application in strains and bruises.
  When intended to raise a sweat, 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 desired elicet.
                              VINEGARS.
  VINEC A R is an acid produced from vinous liquors by a second fermentation.
It is an  useful medicine both in inflammatory and putrid  disorders-  Its effects
are, to cool the blood, quench thirst, counteract a tendeney to putrefaction, and
allay inordinate motions ofthe system.  It likewise promotes the natural secre-
tions, and in some cases excites a copious sweat, where the warm medicines call-
ed alciipharmic, tend rather to prevent  that salutary evacuation.
  Weakness, faintings, vomitings, and other  hysteric affections, are often re-
lieved by vinegar applied to the mouth and nose, or received into the stomach.
It is of excellent use also in correcting many poisonous substances, when takerj,
into the stomach ;  and in promoting their expulsion,  by the different emuncto-
rics, when received into the blood
  Vinegar is not only an useful medicine, but serves likewise to extract, in to-
lerable  perfection, the  virtues of several other  medicinal substances.   Most of
the odoriferous flowers impart to it their fragrance, together with a beautiful
purplish or red colour.  It also assists or coincides with the intention of squills,
garlic,  gum-ammoniac, and several other valuable medicines.
  These effects, however, are not to be expected from every thing that is sold
under the name of vinegar, but from such as is sound and well prepared.
  The best vinegars are those prepared from French wines.
  It is necessary for some purposes that the  vinegar be distilled,  but as this
operation requires a particular chemical apparatus, we shall not insert it.
                          Vinegar of Litharge.
  Take of litharge, half a pound ;  strong vinegar two pints.  Infuse them to-
gether in a moderate heat for three days,  frequently shaking the vessel; then
filter the liquor for use.                                     -^
  This  medicine is little  used, from a general notion of its being dangerous.
There is reason, however, to believe, that the preparations of lead with vine-
gar are  possessed of some valuable properties, and that they may be used in
main cases with safety and success
  A preparation of a similar nature with the above has of late been extolled by
Goulard,  a French surgeon, as a safe and extensively useful medicine,  which
he  calls the Extract of Saturn, and orders to be made in the following manner .
  Take of litharge one pound ; vinegar made  of French wine,  two pints. Put
them together in  a glazed earthen pipkin, and let them boil or rather simmer,
for  an hour, or an  hour and  a quarter taking care to  stir them all the while
with a wooden spatula.  After the whole has stood to settle, pour off the liquor
which is upon the top into the bottles for use.
  With this extract  Goulard makes his vegeto-mineral water*, which he recom-
 mends in a great  variety of external disorders,  as inflammations,  burn?,
 bruises, sprains, ulcers,  &c.
   He likewise prepares with it a number of otlier forms of medicine,  as poul-
 tices, plasters, ointments, powders, &c
                            Vinegar of Roses.
  Take of red  roses, half a pound ; strong vinegar,  half a gallon.  Infuse,in a
plose vessel for several weeks, in a gentle heat; and then  strain off the liquor.
   This is principally used as an embrocation for head achs, &c.            >*
                            Vinegar of Squills.
  Take of dried squills, two ounces; distilled vinegar,  two pints.  Infuse for
ten days or a fortnight in a gentle degree of heat; afterwards strain off' the li-
quor :  add to it about a twelfth part its quantity of proof spirits.
   This medicine has good effects in disorders of the breast, occasioned by a
load of viscid phlegm.  It is also of use in hydropic cases for promoting a dis-
 charge of urine.
   The  dose is  from two drachms to two ounces,  according to the intention for
which it is given.  When intended to act as'a vomit, the dose ought to  be large.
 In  other case*;, it must not only be exhibited in small doses, but also mixed with
                     |>                  ■          ..I,..    i  .     ..-,
                          * Sec Collyrium of Lead. 
**6                         APPENDIX.
cinnamon water.or some otkf r agreeable aromatic liquor, to prevent the nausea
a. might otherwise occasion.                            Y
                   WATERS  BY  IXFUSION, &c
                             Lime-Watcr.
  POUR two gallons of water gradually upon apound of fresh burnt quicklime,
and when the ebullition ceases, stir them well together ;  then suffer the whole
to  stand at rest,  that the lime may  settle,  and afterwards filter the liquor
through paper, which is to be kept in vessels closely stopt.
  The lime-water from calcined oyster shells, is prepared in the same manner
  Lime*wa.tcr is principally used for the gravel; in which case, from a pint or
two, or more of it, may be drank daily.  Externally it is  used for  washing foul
ulcers, and removing the itch, and other diseases of the  skin.
                         Compound Limc-Water.
  Take shavings of guaiacum wood, half a pound ; liquorice root, one ounce ;
(Sassafras bark, half an ounce ;  coriander seeds, three drachms ; simple lime-
water, six pints.
  Infuse, without heat, for two days,  and then strain off  the liquor.
  In the same manner may lime-water be impregnated witii the virtues of other
vegetable  substances.   Such impregnation not  only renders the water more
agreeable to the palate,  but also a  more  efficacious  medicine,  especially in
cutaneous  disorders and foulness of the blood and juices.
  It may be taken in the same quantity as the simple water.
                            Sublimate  Water.
  Dissolve eight grains of the corrosive sublimate in a pint of cinnamon water
  If a  stronger solution be wanted, a double or triple quantity of sublimate may
be used.
  The principal intention of this is to cleanse^bul ulcers, and consume proud
flesh.
                             Styptic Water.
  Take of bhje vitriol and alum, each an ounce  and a half; water,  one pint
Boil them unfc die salts are dissolved ; then filter the liquor, and add to it a
drachm of the oil of vitriol.
  This water is used for stopping a bleeding  at the nose, and other hemorrhages,
ior which purpose cloths or dossils dipt in it must be applied to the part.
                               Tar   Water.
  Pour a gallon of water on two pounds of  Norway tar, and stir them strongly
together with a wooden rod: after they have stood to settle for two days, pour
©if the water for use.
  Though tar water falls greatly short of the character which has been given of
it, yet it possesses some medical virtues. It sensibly raises the pulse,  increases
 tlie secretions, and sometimes opens the body, or occasions vomiting.
  A pint of it may be drank daily, or more, if the stomach can bear it.  It is
generally ordered to be taken on an empty stomach : viz. four ounces morning
and evening, and die same quantity about two hours after breakfast and dinner:
                  SIMPLE DISTILLED WATERS.
   A GREAT number of distilled waters were formerly kept in the shops, and
are still retained in some dispensatories. But we consider them chiefly in th#
light of grateful dilutents, suitable vehicles for medicines of greater efficacy or for
rendering disgustful ones more agreeable to die palate and stomach.  We shall
therefore insert only a few of diose which are best adapted to these intentions.
  The management of a stid being now generally understood, it is needless to
spend time in giving directions for that purpose.
                            Cinnamon   Water.
  Steep one pound of cinnamon bark, bruised, in a gallon and a half of water,
and one pint of brandy, for two days,  and then distill off one gallon.
  This is an agreeable aromatic water, possessing, in a high degree, the fra.
grance and cordial virtues of the spice.
                          Penny-royal   Water.
  Take of penny-royal leaves, dried, a pound and a half; water from a gallon
and a half to two gallons.  Draw off by distillation one gallon.
  This water possesses,  in a considerable degree, the  smell, taste and  virtue?
rf the plant.  It isjgiven in mixtures and juleps to hysteric patients. 
APPENDIX.                        447
   An mfhsion of tMkcrb in boiling water answers nearly the same purpose*.
                          Peppermint Water.
   I his is made in the same manner as the preceding.
                           Spearmint  Water.
  This may also be prepared in the same way as the penny-royal water.
  Both these are useful stomachic waters, and will sometimes relieve vomiting,
especially when it proceeds from indigestion, or cold viscid phlegm.  They are
likewise useful in some colicky complaints,  the gout in the stomach, &c. parti-
cularly the peppermint-water.
  An infusion of the fresh plant is frequendy found to have the same effect its
the distiUed water.
                              Rose  Water.
  Take of. roses, fresh gathered, six pounds; water two  gallons.  Distil off
one gallon.
  This water is principally valued on account of its fine flavour.
                         Jamaica Pepper  Water.
   Take of Jamaica pepper, half a pound ; water,  a gallon and a half.   Distil
off one gallon.
   This is a very elegant distilled water, and may,  in most cases, supply the.
place of die more costly spice-waters.
               SPIRITUOUS DISTILLED  WATERS.
                      Spirituous Cinnamon Water.
   TAKE of  cinnamon bark, one pound;  proof spirit, and common water, <Tf
each one gallon.  Steep the cinnamon in the liquor for two days ; then dis^jp off
one gallon.
                    Spirituous Jamaica Pepper Water.
   Take of Jamaica pepper, half a pound :  proof spirit, three gallons : water,
two gallons.  Distil off' three gallons.
   This is a sufficiently agreeable cordial, and may supply the place of the Aro-
matic Water.                                              *&
                        WHEYS.—Alum Whei/.
   BOIL two drachms of powdered  alum in a pint of milk till it is curdled;
then strain out the whey.
   This whey  is beneficial in an immoderate flow ofthe menses, and in a diabetes,
or excessive discharge of urine.                                       .^
   The dose is two, tiiree or four ounces, according as the stomach will bejpfcj
three times a-day.  If it should occasion vomiting, it may be diluted.
                             Mustard Whey.
   Take milk and water, of each a pint; bruised mustard seed, an ounce and a
lialf: boil them togetlier till the curd is perfectly separated ; afterwards strain
the whey through a cloth.
   This is the most elegant, and by no means the least efficacious method of ex-
hibiting musurd. It warms and invigorates the habit, and promotes the different
secretions.  Hence,  in the low state of nervous'fevers, it will often supply'tiwj
place of w inc.  It is also of use in the  chronic rheumatism, palsy, dropsy,  &c.
The addition of a little sugar will render it more agreeable.
   The dose is an ordinary tea-cupful four times a-day.
                            Scorbutic Whey.
   This whey is made by boiling half a pint of tlie scorbutic juices in a quarjjof
cow's milk.   More benefit, however, is to be expected from eating the plants,
tiian from their expressed juices.
   The scorbutic plants arc, bitter oranges, brooklime, garden  scurvy-gra^
.i;ni water cresses.
   A number  of other wheys may be  prepared nearly in the same manner, as,
orange whey, cream of tartar whey, &c.  These  are cooling, pleasant drink*
in fevers, and may be rendered cordial, when necessary, by the addition of wiae.
                                WINES.
   THE  effects of wine are to raise  the pulse, promote perspiration, warm the
habit, and exhilarate the spirits.  The red  wines, besides these effects, have an
astringent quality, by which they strengthen the tone ofthe stomach and intes-
tines, aud by this means pro\ c serviceable in restraining immoderate secrctioOi. 
448
APPENDIX".
  The thin slurp w'.nes Jiave a different tendency."  Tlicy gfts ofFfroely bylho
different emunctorics, and gently open the body.  The eifcen of the full bodied
wines are, however, much more durable than those of the thinner.
  All sweet wines contain  a glutinous substance,  ami do not pass off freely.
Hence they will heat die body more dian an equal quantity of any other wine,
though it should contain fully as much spirit.
  From the obvious qualities of wine it must appear to be an excellent cordial
medicine.  Indeed, to say the truth,  it is worth all the rest put together.
  But to answer this character, it must be sound and gooel.  No benefit is to be
expected from the common trash that is often sold by the name of wine, with >ut
possessing one drop of the  juice of  the grape.  Perhaps no medicine is  more
rarely obtained genuine than wine.
  Wine is not only used as a medicine, but is also employed as ameMstrum for
extracting the virtues of other medicinal substances ;  for which if  is not ill
adapted, being a compounel of water, inflammable spirit,  and acid ; by which
means it is enabled to act upon vegetable and animal substances,  and also to
dissolve some bodies of the metallic  kind, so as to impregnate itself with their
virtues, as steel, antimony, 8tc.
                            Anthelmintic   Wine.
   Take of rhubarb, half an ounce ;  worm-seed, an ounce.  Bruise them, anil
infuse without heat in two pints of red port wine for a few days ; then  strain off
the wine.
   As the stomachs of  persons afflicted with worms are always debilitated, red
wine alone will often prove serviceable.  It must, however, have  still  better tt-
fects_^vhen joined with bitter and purgative ingredients, as in the above form.
   A glass of this wine may be taken  twice or thrice a-day,
                            Anthnonial  Wine.
   Take a glass of antimony, reduced to a fine powder, half an ounce.   Lisbon
wine, eight ounces.  Digest, without heat, for three or four days, now  and then
shaking the bottle.; afterwards filter  the wine through paper.
   The  dosoibf this wine varies according to the intention. As an alternative
and diaphoretic,  it may be  taken from ten  to fifty  or. sixty drops.  In a  large
dose it genei'ally proves cathartic, or excites vomiting.
                              Bitter  Wine.
   Take of gentian root, yellow rind of lemon-peel, fresh, each one ounce; long
penper, two drachms;  mountain wine, two pints.  Infuse withoutheat for a week,
anflirtrain out the wine fin* use.
   In complaints arising from weakness of the stomach, or indigestion, a glass
of this wine may be taken an hour before dinner and supper.
                          Ipecacuanha  Wine.
   Take of ipecacuanha, inpowder, one ounce ; mountain wine, a pint.  Infuse
 for three or four days ; then filter the tincture.
   This is a safe vomit, and answers extremely well for such persons as cannot
    fallow the powder, or whose stomachs are too irritable to bear it.
    The  dose is from one ounce to an ounce and a half.
                        Chalybeate  or Steel  Wine.
   Take filings of iron two ounces ; cinnamon and mace, of each  two  drachms.
 Rhenish wine two pints.  Infuse for three  or four weeks, frequently shaking
the bottle ; then pass the wine through a filter.
   fijbbstructions of the menses, this preparation of iron may be taken, in the
dose of half a wine-glass twice or thrice a-day.
   The  medicine would be as good if made with Lisbon wine, sharpened with
Half  an ounce ofthe cream of tartar, or a small quantity ofthe vitriolic acid.
                              Stomach Wine.
   Take of Peruvian bark, grossly powdered, an ounce ; cardamom seeds and
orange-peel, bruised, of each two drachms.  Infuse in a botde of white port or
Lisbon wine, for five or six days ; then strain oft'the wine.
   This wine  is not only of service  in debility of  the stomach and intestines,
but may also be taken as a preventative, by persons liable to the intermittent
fever, or who resides in places where this  disease prevails.  It  will  be of  iise
likewise to thoss who recover slowly after  fevers of any kind, as it assists 01;
gestion; and helps to  restore the tone and vigour of die system*
   A  glass, of it may be taken two  or three times o-day.
N 
449
                   A   GLOSSARY.

  ALTHOUGH terms of art have been sedulously avoided in the composition
of this treatise, it is impossible entirely to banish technical phrases when writing
r,n medicine, a science that has been less generally attended to by mankind, ana
continues therefore to be more infected with the jargon ofthe schools, than per-
haps any other.  Several persons having expressed their opinion that a Glossary
would make this work more generally intelligible, the following concise expla-
nation ofthe few terms  of art that occur, has been added in compliance with
their sentiments, and to fulfil the original intention of this treatise, by rendering
ft intelligible and useful to all ranks and classes of mankind.
 ABDOMEN, The belly.
 Absorbents,  Vessels that convey the
   nourishment from the intestines and
   the secreted fluids from the various
   cavities into die mass of blood.
 Acrimony, Corrosive sharpness.
 Acute, A disease, the symptoms of
   which  are  violent, and tend  to a
   speedy termination, is called acute.
 Adult, Of mature age.
 Adust, Dry, warm.
 Antispasmodic,  Whatever  tends to
   prevent or remove spasm.
 Aphthx,  Small whitish ulcers appear-
   ing in the mouth.
 Astriction, A tightening or lessening.
 Atrabilarian,  An epithet commonly
   applied to people of a certain tempe-
   rament, marked by a dark complex-
   ion, black  hair,  spare habit,  &c.
   which the ancients supposed to arise
   from the atra Mis, or the black bile.
 BIL.F. or G.ILL,  A  fluid which is
   secreted by the liver into  the gall
   bladder, and from thence passes in-
   to  the intestines,  in order to pro-
   mote digestion.
 CACOCHYMIE, An unhealthy  state
   ofthe body.
 Caries, A rottenness ofthe bone.
 Chyle, A  milky  fluid separated from
   the aliment in the intestines, and
   conveyed by die  absorbents into
   the blood to supply the waste of
   the animal body.
 Chronic, A disease whose progress is
   slow, in opposition to acute.
 Circulation, The motion ofthe blood,
   which is driven by the heart through
   the arteries and returns by the veins*
Comatose,  Sleep}-.
Conglobate Gland, A simple gland.
Conglomerate,  A compound gland.
Contagion, Infectious matter.
Cutis,  The skin.
Qutaweei's, Of or '""''in.jingtothe  skin.
                                  50
 Crisis,  A certain period in the pro-
   gress of a disease, from whence a
   decided alteration either for the
   better or the worse takes place.
 Critical, Decisive or important.
 Gritical Days, The fourth, fifth, se-
   venth, ninth, eleventh, thirteenth,
   fourteenth, seventeeth.and twenty-
   first, are by some authors denomi-
   nated critical days, because febrile
   complaints have  been  observed to
   take a decisive change at these pe;
   riods.
 DEBILITY, Weakness.
 Delirium, A  temporary disorder of
   the mental faculties.
 Diaphragm, A membrane separating
   the cavity of the  chest from that
   of the belly.
 Diuretic,  A medicine that promotes
   the secretion of urine.
 Drastic, Is applied to such purgative
   medicines as are violent or harsh in
   their operation.
 EMPYEMA, Acollection of purulent
   matter in the cavity of  the breast.
 Endemic,  A disease  peculiar  to  a
   certain district of country.
Epidemic, A disease generally infec-
   tious.
 Exacerbations,  The increase of any
   disease.
 FOECES, Excrements.
Fatid, Emitting an offensive smell.
Fatus,  The child before birth, or
  when born before the proper period;
  is thus termed.
Flatulent, a-oducing wind.
Fungus,  Protid flesh.
GANGRENE, Mortification.
Gummata,~> ,,      ,
Ganglia,  j Vcnereal excrescences.
6>mna.rfr'c,Exercise taken  with a view*
  to preserve or restore health.__The
  ancient  physicians reckoned  this
  an important branch of medicine.
# 
450
A  GLOSSARY.
HECTIC FEVER, A slow consum-jl Perspiration, The matter  discharged
  ing fever, generally attending a bad
  habit of body, or some incureable
  and deep rooted disease.
Hemorrhoids,  The piles.
Hemorrhage, Discharge of blood.
Hypochondriacism, Low spirits.
Hypochondriac  viscera,  The
  spleen,  &c.  So termed from their
  situation in the hypochondriac or up-
  per and lateral parts of the belly.
ICHOR, Thin bad matter.
Imposthume,  A collection of purulent
  matter.
Inflammation,  A surcharge of blood,
  and an increased  action of the ves
  sels, in any particular part  of  the
  body.
LIGATU RE, Bandage.
Lixivium, Ley.
MILIARY  JERUPTION, Eruption
  of small  pustules resembling  the
  seeds of millet.
Morbific, Causing disease, or diseased
Mums, The matter discharged from
  the nose, lungs, &c.
Mytentery, A double membrane which
  connects the intestines  to the back
  bone.
NERVOUS, Irritable.
Nausea,  An inclination to vomit.
JSTodes, Enlargement of the bones pro-
  duced by the venereal disease.
PECTORAL, Medicines  adapted to
  cure diseases of the breast
Pelvis, The bones situated at the lower
  part of the trunk; thus named from
  their resembling  in some measure a
  bason.
Peritonaeum,  A membrane lining the
  cavity of the belly and covering the
  intestines.
Pericardium,  Membrane  containing1
  the heart-
        from the  pore* of the skin in fonn
        of vapour or sweat.
      Phlogiston,   Is here used to  signify
        somewhat rendering die air unfit for
        the purposes of re spiration.
      Phlegmatic, Watery, relaxed.
liver, \\ Plethoric, Replete with blood.
     1 Polypus, A  diseased excrescence,  or a
        substance  formed   of coagulable
        lymph, frequently found in the large
        blood-vessels.
      Pus, Matter contained in a bile.
      REGIMEN, Regulation of diet.
      Pedum, The straight gut in which the
        fceces are contained.
      Respiration, The act of breatiiing.
      SALIVA,  The fluids secreted by the
        glands of the mouth.
      Sanies, A thin bad matter, discharged
        from an ill-conditioned sore.
      Scirrhous, A state of diseased hardness.
      Slough, A  part separated and thrown
        oft'by suppuration.
      Spasm, A diseased contraction.
      Spine, The back bone.
      Styptic, A medicine for stopping  the
        discharge of blood.
      Syncope, A fainting-fit attended with a
        complete  abolition of sensation  and
        thought.
      TABS,  A species  of  consumption.
      Temperament,  A peculiar habit of bo-
        dy,  of which there are  generally
        reckoned four,  viz.  the  sanguine,
        the bilious, the melancholic, and the
        phlegmatic.
      VERTIGO, Giddiness.
      ULCER, An dl-conditioned sore.
      Ureters, Two  long and small canals
        which convey the urine from the kid-
        nies to the blader.
      Urethrea, The canal which conveys the
        urine from the bladder/ 
INDEX.
ABLUTIONS, Jewish and Mahometan, well calculated for the preset
   vation of health, 94.
Abortion, causes and symptoms of,  335.  Means of prevention, 336.
   Proper treatment in the case of, ibid.
Abscesses, how to b»Jreated, 215, 358.
Accidents.  See Casualties.
Acitls, of peculiar service in  consumptions, 137.   In putrid fevers, 145.
   Not suitable to the measles, 180.
Acidities in tlie bowels of infants, the origin of,  344.  Method of cure,
   345.
Ackworth, foundling hospital at, cause of the children there being afflict-
   ed with scabbed heads, and fatal consequences of  their ill treatment,
   348, note.
Addison, his remark on the luxury of the table, 89.
Mther, very serviceable in removing fits of the asthma, 269.   Is excel-
   lent for flatulencies, 287.
JEthiops  mineral, strongly recommeuded by Dr. Cheyne in inflammations
   of the eyes, 191.
Africans, their treatment of children, 38, note.
Agaric of the oak, its merit as a styptic, 360.   Method of gathering,
   preparing, and applying it, ibid, note.
Agriculture, a  healthful, constant, and profitable employment, 58*   Is
   too much neglected in favour  of Manufactures, ibid.   Gardening the
   most wholesome amusement fiur sedentary persons, 61.
Ague, a species of fever no person can mistake, and the proper medicine
   for, generally known, 117.   Causes of, ibid.  Symptoms, 118.  Regi-
   men for, ibid.  Under a proper regimen will often go off without medi-
   cine, ibid.  Medical treatment of, ibid.   Often degenerates into obsti-
   nate chronical diseases, if not radically cured, 121.  Peruvian bark the
   only medicine to be relied on, ibid. Children how to be treated iu, 122.
   Preventative medicine for those who live in marshy countries, ibid.
Air, confined, poisonous to children, 49.   A free open air  will sometimes
   cure the most obstinate disorders in children, 50.   Occupations which
   injure the health by unwholesome air, 52, 59.   The qualities of,  act
   more sensibly on the body than is generally imagined, 78.  The seve-
   ral noxious qualities of, specified, ibid.  In large cities, polluted by
   various circumstances, 79.  The air in churches, how rendered un-
   wholesome, ibid.  Houses ought to be ventilated daily,  80. The dan-
  ger attending small apartments, ibid.  Persons whose business confines
 *lhem to town ought to  sleep in the country, ibid.  High walls obstruct
 %e free current of air, 81—Trees should not be planted too near to
  houses, ibid.   Fresh air peculiarly necessary for the sick, ibid. The
  sick in hospitals in more danger from  the want of fresh air, than from
  their disorders, ibid,  Wholesomeness of the  morning  air, 83. The 
452
INDEX.
 changeableness of, one great cause of catching cold, 106. Those wliw
 keep most within doors, the most sensible of these changes, ibid.   Of
 the night, to be carefully  guarded against, 107.  Fresh air often of
 more efficacy in diseases than medicine, 113.   Its importance  in fe-
 vers, 116, 124.  States of, liable to produce putrid fevers, 143.   Mu-t
 be kept cool and fresh in sick chambers  under this disorder, 145.
 Change of, one  of the most effectual remedies for the hooping cough,
 203.   The qualities of, a material consideration for asthmatic patients,
 268.   The various ways by which it may be  rendered noxious, 380.
 Confined, how to try, and purify, ibid.   Method of recovering persons
 poisoned by foul air, ibid.   Fresh, of the greatest importance in faint-
  ing fits, 384.
Aiken,1 Mr. his treatise on the nature  and cure of (fractures, recommend-
  ed, 370, note.
Alkali, caustic, recommended in the stone, 225.   How to prepare it, ibid.
  note.
Aliment, is capable of changing the whole constitution of  the body, Gt>.
  Will in many cases answer every intention in the cure of diseases, ibid.
  The calls of hunger and thirst, sufficient for regulating the due quanti-
  ty of, ibid.    The quality of, how injured, ibid.   A due mixture of ve-
  getables necessary with our animal food, 68.  To what the bad effects
  of tea  are principally owing, ibid.  Water, good and bad,  distinguished,
  69.   Inquiry into the qualities of fermented liquor, with instructions
  for the due making of them, ibid.  The qualities of good bread, and
  why adulterated by bakers, 70.  General rules for the choice of food,
  ibid.   Ought not  to be too uniform, 71. Meals ought to be taken at
  regular times, ibid.   Long fasting injurious both to old and young, ibid.
  Breakfasts  and suppers, 72.  Changes of diet ought to be gradually
  made, ibid.   General observations on,  397.
 Amaurosis.   See Gutta serena.
 American Indians, their method of curing the venereal disease, 326.
 Amusements, sedentary, improper for sedentary persons, 60.  Ought al-
  ways to be of an active kind, 84.
 Anasarka.   See Dropsy.
 Anger, violent fits of, injurious to the constitution, 98.  Tranquility of
   mind essential to health, 99.
 Animal food, cautions in giving it to children, 42.   Injurious effects when
   used  by nurses, 50,  note.   Animals that  die of themselves, unfit for
   food,  67.   Overdriven cattle rendered unwholesome, ibid.   The ar-
   tifices of butchers exposed, ibid.  Too great a  quantity of, generates
   the scurvy, ibid.  Injurious to many habits, 398.
 Animals and plants, the analogy in the nourishment of, stated, 89.
 Anthony's firf, St.   See Erysipelas.
 Aphtha.  See Thrush.
 Apoplexy, who most liable to this  disorder, 269.   Causes, ibid— Symp-
   toms  and method of cure, 270.   Cautions to persons of an apoplectic
 "  make, 271.
 Apothecaries weights,  a table of, 420.                            *
 Apparel.  See Clothing.
 Appetite, want of, causes and remedies for, 273.
 Arbuthnot, Dr. his advice  in the  inflammation of the lung?. 130.   His
   advice for persons troubled with costiveness, 272, note. 
INDEX.
453
Arsenic, the effects of,  on the stomach, 305.  Medical treatment when
  the symptoms appear, ibid.
Arts.  See Manufactures.
Ascites.  See Dropsy.
Asses milk, why it seldom does any good, 134.  Instructions for taking
  it, 135.
Asthma, the different kinds of this disorder distinguished, with its causes,
  267.  Symptoms, ibid.  Medical treatment, 268.  Remedies proper
  in the moist asthma, 269.
Atmosphere.  See Air.
HALL'S purging vermifuge powder, preparation  of, 248.
Balsams, how to  prepare. Anodyne balsam,  423.  Locatelli's balsam,
  ibid.   Vulnerary balsam, ibid.
Bandages, tight, produce most of the bad consequeuces attending fractu-
  red bones, 370.
Bark, Peruvian, the best antidote for sailors against disorders on a fo-
  reign coast, 58.   How to be administered in the ague, 119.   Distinc-
  tion between the red bark and quill bark, ibid, note.   A decoction or
  infusion  of, may be taken by those who cannot*swallow it in substance,
   120.  Is often adulterated, ibid, note.  Is the only medicine to be de-
  pended on in agues, 121.  How it may be rendered more palatable,
   122.  May be administered by  clysters, ibid.  Cold water the  best
  menstrum for extracting the  virtues of this drug, 137.  How to be
  administered in the putrid fever, 146;  and in the erysipelas, 186.   In
  an inflammation of the eyes, 171.  Its efficacy in a malignant quinsey,
  197.   In the hooping  cough, 205.   A good medicine in  vomiting,
  when it proceeds from weakness of the stomach, 220.  Its efficacy in
  a diabetes, and how to take it, 222.  Is good against the piles, 230;
  and worms,247.  Its use dangerous for preventing a fit ofthe gout, 25Q.
  A good remedy in the King's evil, 265, and in the fluor albus, 334.
 Barley water, how made,  127.
Barrenness in women, the general causes of, 341.  Course of relief, 342.
   Dr. Cheyne's observations on, ibid, note.                              +
Bath waters good in the gout, 257.
Bath, cold, the good effects of, on children, 48.   Recommended to the
   studious, 65. Is  peculiarly excellent for  strengthening the nervous
   system, 277.  Therefore should never be omitted in gleets, 320.  Is
   good for rickety children, 353.  Cautious concerning Uie improper use
   of, in adults, 390, 393.
Bath, warm, of great service in an inflammation  of the  stomach, 206.
Jiathing, a religious duty under the Judaic and Mahometan laws, 93.  Is
   conducive to health, ibid.
Bears foot recommended as a powerful remedy against worms, 248.
Beds, instead of being  made up again as 60on as persons rise from them,
   ought to be  turned down  and exposed to the air, 80.   Bad effects of
   too great indulgence in bed, 83.  Damp, the danger of, 107.  Soft.,
   are injurious to the kidneys, 222.
Beer, the ill consequences of making it too weak, 69.  Pernicious artifices
   of the dealers in, ibid.
 Bells, parish, the tolling them for the dead, a  dangerous custom, 100.
 Biles, 359.
 Bilious colic, symptoms and treatment of, 210. 
*°4i                         INDEX.
     Bilious fever.  See Fever.
     Bile of a mad dog.  See Dog.
     Bitters, warm and astringent, antidotes to agues, 120.  Are scrvici able iu
        vomiting when it proceeds from weakness in the stomach, 220.
     Bladder, inflammation  of,  its geueral causes, 213.  Medical  treatment
        of, ibid.
     Bladder, stone in.   See Stone.
     Blast.  See Erysipelas.
     Bleeding, cautions for the operation of, in fevers, 116.   In the a«ue, 119.
        Its importance in the acute continual fever, 125.  In the pleurisy', 127.
        When necessary in au inflammation ofthe lungs, 131.   Caution against]
        in a nervous fever,  141.   In the putrid fever, 146.  In the miliary
        fever, 150  When necessary in the small-pox, 163.   When useful in
        the measles, 181.  When necessary in the bilious fever, 183.  Under
        what circumstances proper in  the erysipelas, 185.   Mode of, proper
        in an inflammation of the brain, 188.  Is always necessary in an in-
        flammation ofthe eyes,  ] 00   When proper and improper, in a cough,
        200.   When proper in the hooping cough, 203.   Is almost the  only
        thing to be depended on in an inflammation of the stomach, 206.   And
        in an inflammation of the  intestines, 207.  Is necessary in an inflam-
        mation of the kidneys, 212.   Its use in a suppression  of urine, 223.
        Is proper in an asthma,  268.  Is dangerous in fainting fits, without due
        caution, 286.  Cautions proper in the puerperal fever, 340.  Is an
        operation generally performed by persons who do uot understand when
        it is proper, 356.   In what cases it ought to  be had recourse to, ibid.
        The quantity  taken away, how to be regulated, ibid.  General rules
        for the operation, 35 7.   Objections to bleeding by leeches, ibid.  Pre-
        vailing prejudices relating to bleeding, ibid.   The arm  the most com-
        modious part to take blood from, 358.
      Bleeding at the nose, spontaneous, is of more service, where bleeding is
        necessaiy, than  the  operation  with the lancet, 228.   Ought not to he
        stopped Avithout due  consideration, ibid.  How to stop it when neces-
♦      sary, ibid.  Cautions to prevent frequent  returns of, 229.
      Blind persons, when born so might be educated to employments suited to
        their capacity, 295,  note.
      Blisters,  peculiarly advantageous in the nervous fever,  141.  When
        only to be applied iu the putrid fever,  1 16.  When  proper in the
        miliary fever,  150.   Seldom fail to remove the most obstinate inflam-
        mation of the eyes, 191.  A good remedy in the quinsey, 194.  Pro-
        per for a violent hooping  cough, 204.  Is one of the  best remedies
        for an inflammation  of  the  stomach.  207.   Are efficacious in the
        tooth-ach, 242.
      Blood, involuntary discharges of, often salutary, and ought not to be
        rashly stopped,  226.  The several kinds of these discharges, with
        their usual causes, ibid.   Methods of cure, 227.
     Blood, spitting of, who  most subject to, and  at what seasons, 231.  Its
        causes,  ibid.   Symptoms,  ibid.  Proper regimen in, 232.   Medical
        treatment, ibid.   Cautions for persons subject to it,  233.
     Blood, vomiting of, its causes aud symptoms, ibid.  Medical treatment,
        ibid.
      Blood-shot eye, how to cure, 297.
      Bloody-VM*.  See Dysentery. 
INDEX.                           455
Boerhaave, his  observations on dress, 88, note.  His mechanical expedi-
  ents to relieve an inflammation of the brain, 188.
Bolusses, general rules for the preparing of, 423.   The astringent bolus,
  ibid.  Diaphoretic bolus, ibid.   Mercurial bolus, 424.   Bolus of rhu-
  barb and mercury, ibid.  Pectoral bolus, ibid.  Purging bolus, ibid.
Bones, the exfoliation of, a very slow operation, 364.  Bones, broken, oft-
  en successfully undertaken by  ignorant operators, 369.   Regimen to
  be adopted  after the accident,  ibid.   Hints of conduct if the patient
  is confined to his bed, 370.  Cleanliness to be regarded during this
  confinement, ibid.   The limb not to be kept continually on the stretch,
  ibid.   Cautions to  be observed insetting a bone, 371.  Tight banda-
  ges condemned, ibid.  How to keep the limb steady by an easy method,
  ibid.   Fractures of the ribs, ibid.
Bowels, inflammation of.  See Stomach.
Boys, the military exercise proper for them, 46.
Braidwood, Mr. his skill in teaching the dumb to speak, 298, note.
Brain, inflammation of, who most liable to it, with its causes and symp-
  toms, 186.  Regimen, ibid.   Medical treatment, 187.
Bread, proper food for children, as soon as they can chew it, 41.  Crust
  of, Uie best gum-stick, 42.   The best modes of preparing itiu food, for
   children, ibid.   Good, the qualities of and for what purpose  adulterat-
  ed by the bakers, 70, 75.   Toasted, a decoction of, good to  check the
  vomiting in a cholera morbus, 216.   A surfeit of, more dangerous thau
  any other food, 399.  The finest not always the best adapted for nutri-
  tion,  400.   Household bread the most wholesome, ibid.   Wheat flour
  apt to occasion constipation, 401.  Rye is apt to excite heart-burn, and
  is laxative, but excellent to prevent the scurvy, 75.   Different kinds of
  grain make the best bread, 401.  Consumption of bread  increased by
  drinking tea, ibid.   Indian coin the best food when boiled, 404. Buck-
   wheat highly nutritious, 405. Does not agree with all constitutions, 73*
   Various substitutes for bread, 407.
Brimstone.  See Sulphur.
Broth, gelatinous, recommended in the dysentery, how to make, 236.
 Broths and Soups various ingredients in the composition of,  411.  Gene-
   ral observations on, ibid.  The most wholesome diet for the $oor,ibid.
   Warmly recommended by Count Rumford, ibid.  Brown soup recom-
   mended for breakfast in place of tea, 412.
 Bruises, why of worse consequence than wounds, 363.   Proper treat-
   ment of, ibid.  The exfoliation of injured bones, a very slow operation,
   364.  How to cure sores  occasioned by, ibid.
 Buboes, two kinds of distinguished, with their proper treatment, 321.
 Burdens, heavy, injurious to the lungs, 54.
 Burgundy pitch, a plaster of, between the shoulders, an excellent remedy
   in a cough, 201.   In a hooping-cough, 204.  Aud for children in teeth-
   ing,  351.
 Burials, the dangers attending their being allowed in  tlie midst of popu-
   lous towns, 79.
 Burns, how instantly to abate the pain, 361.  Slight, hoAv to cure, ibid.
   Treatment of, when violent,  362.   Dr, Underwood's remedy, ibid.
   Extraordinary case of, 3C3.  Liniment for, 437.
 Butchers,  their professional artifices explained and condemned, 67. 
456                          INDEX.

Butter, ought to be very spariugly given  to children, 43.   Used in largi
  quantities very injurious to the stomach, having a constant tendency to
  turn rancid,  405.   Bread made with butter not easily digested, 406:
  Pasties of every kind improper for children, ibid.
GABBAGE leaves, topical  applications of, in a pleurisy, 128.
Camphor, why of little use in eye-waters, 426.
Camphorated oil, preparation of, 437.
Camphorated spirits of wine, 444.
Camps the great necessity of consulting cleanliness in, 93.
Cancer,  its different  stages described, with the producing causes, 301.
  Symptoms, ibid.  Regimen,  and medical treatment, 302.  Dr. Storck's
  method of treating  this disorder, ibid.  Cautious for avoiding it, 304.
Cancer scroti, a disorder peculiar to chimney-sweepers, owing to want of
  cleanliness, 92, note.
Carriages, the indulgence of, a sacrifice of health to vanity, 82.
Carrot, wild, recommended iu the stone, 226.
Carrot poultice for cancers, how to prepare, 303.
Carrot, properly manured, may supply the place of bread, 409.
Casualties, which apparently  put  au end to life, necessary cautions res-
   pecting, 373.
■------------- substances stopped in the gullet, 374.
-----------—- drowning, 377.
--------------noxious  vapours, 380.
--------------extremity of cold, 381.
                extreme heat, 382.
Cataplasms, their general inteution, 424.   Preparation of the discutient
  cataplasm, ibid.   Ripening cataplasm, ibid.
Cataract, the disorder and its proper treatment described, 263.
Cattle, stall fed, are unwholesome food, 67.   Over-drif en, are killed in
  a high fever, ibid.   The artifices of butchers exposed, ibid.
Cellars, long shut, ought to be cautiously opened, 80.   And sunk stories
  of houses, unhealthy to live in, 108.   Of liquors in a state of fermcn
  tation, dangerous to enter, 380.   How to purify the air in, ibid.
Celsus, his rules for the preservation of health, 110.
Chancres, described, 322.   Primary, &c. how to treat, 323.
Charcoal fire, the danger of sleeping in the fume of, 380.
Charity, the proper exercise of, 56.
Cheese, as a diet, injurious to health, 406.
Cheyne, Dr. his persuasive to the use of exercise, 84.   His judgment or
  the due quantities of urine, pot to be relied on, 105.  Strongly recom-
  mends the vEthiops  mineral in inflammations  ofthe  eyes, 291.  His
  observations on barrenness, 342, note.
Chilblains, cause of, 349.  How to cure, ibid.
Child-bed women, how to be treated under a miliary fever, 146.
Child-bed fever.   See Fever.
Child-Birth,  the season of, requires  due care after the labour pains arc
  over, 337.  Medical advice to  women in labour, ibid.  Ill effect of
  collecting a number of women on such occasions, 338, note.   How to
  guard against the miliary fever, 339.  Symptoms of the puerperal fe-
  ver, ibid.  Proper treatment of that fever, 340.  General cautions for
  women at this season, 341. 
INDEX.
457
(hildren,  their  diseases generally acute, and delay  dangerous,  35.   *
   Their disorders less complicated, and easier cured, than those of adults,
   36. Are often  the heins of the diseases of their parents, ibid.   Those
   born of diseased parents require peculiar care in the nursing, 37.  Are
   often killed or deformed by injudicious clothing, ibid.  How treated
   in Africa, 38,  note.  The usual causes of deformity in, explained,  39.
   Their cloths ought to be fastened on  with strings, ibid.   General rule
   for clothing them, 40.   Cleanliness, an important article in their dre.-ig,
   ibid.   The milk of tlie mother the most natural food for, ibid.   Absurd^
   ity of giving them drugs as their first food, 41.  The bes'. method of
   expelling the meconium, ibid.   How they ought to be weaned from  the
   breast, ibid. A crust of bread the best  gum-stick for them, 42.   How to
   prepare bread in their food, ibid.   Cautions as to giving them a.iimal
   food, ibid.  Cautions as to the quantity of the food, ibid.  Errors in
   the quality of their food more frequent than in the quantity, 43.  The
   food of adults improper for children, ibid.  Strong liquors expose them
   to inflammatory disorders, ibid. Ill effects of unripe fruit, ibid.  But-
   ter, ibid.   Honey, a wholesome article of food for them, ibid.  The
   importance of exercise to promote their growth and strength, 44. Rules
   for their exercise, ibid. Poverty of parents occasions their neglect of
   children, 45.   The utility of exercise demonstrated from the organic-
   al structure of children, ibid.   Philosophical arguments showing  the
   nccesjHy of exercise, ibid.   Ought not to be sent to school  too  soon,
   46.  Nor be put too soon to labour, 47.  Dancing an excellent exercise
   for them, 48. The cold bath, ibid.   Want of Avholesome air destruc-
   tive to children, 49.  To wrap them up close in cradles pernicious,ibid.
   Are treated like plants in a hot house, 50. The usual faulty conduct
   of nurses pointed out,  ibid.  Are crammed with cordials  by indolent
   nurses, 51.  Eruptions ignorantly treated  by nurses, ibid.   Loose
   rtools, the proper treatment of, 52.   Every method ought to be taken
   to make them strong and hardy, ibid.   Indications of the small-j^x in,
   159. Chin-cough.   See Cough.                              •
Cholera morbus, the disorder defined, with its causes and symptooB, 216.
   Medical treatment, ibid.
Churches,  the several circumstances that render the air in,  urni-hole-
   some,  79.
Churching of women after lying in, a dangerous custom, 341.
Church-yards, the bad consequences of having them iu large towns, 79.
Cities, large, the air  in, contaminated by various means, 79.   The bad
   effects of burying the dead in,  ibid.  Houses  ought to be ventilated
   daily, 80.  The danger attending small apartments, ibid.  All Avho
   can ought to sleep in the country, ibid. Disorders that large towns
   are peculiarly hurtful  to, ibid.  Cleanliness  not sufficiently attended
   to in, 92.  Should be  supplied  Avith  plenty  of ivater, 95, note. The
   best means to guard against infection in, 97.
Clare, -Mr. his method of applying saline preparations of mercury in ve-
   nereal case?, 325.
Cleanliness, an important article of attention in the dress of children, 40.
   and to sedentary artists, 60.  Finery  iu dress often covers dirt, 88.  Is
   neces-ary to health, 92.  Disorders originating from the Avant of, ibid.
   Is  not stifhVuntly attended to in large towns, 93. Nor by country
   peasants, ibid.   Groat attention paid  to, by the ancient Romans,  ibid
                                 57 
458
INDEX.
  note.  Necessity of consulting cleanliness in  camps,  ibid.  Was tin:
  principal ob ect  of the  Avhole system  of the Jewish laws, 94.  Is a
  great part of the religion of the Eastern countries, ibid.   Bathing and
  Avashinggreatly conducive to health, ibid.  Cleanliness peculiarly ne-
  cessary on board of ships, ibid, and to the sick, ibid.   General remarks
  on, 95. Many disorders may be cured by cleanliness alone, 113.  The
  want of, a very general cause of putrid  fevers,  148.  Is a great pre-
  servative  against  venereal infection, 328;  and against  galling in in-
  fants, 345. Cutaneous disorders proceed from a want of, 404.
Clergy, exhorted to remove popular prejudices against inoculation, 168.
  Might do great good by undertaking the practice of it themselves, 171.
Clothing, the only natural use of, 37.  That of children,  has become a
  secret art, ibid.   Ought to be fastened  on infants with strings iustcad
  of pins, 39.  Pernicious consequences of stays,  40.   Importance ol
  cleanliness to children, ibid.   The due  quantity  of, dictated by the
   climate, 86.  Should be increased in the decline of life, 87; and adap-
   ted to the seasons, ibid,   fc  often hurtful by being made subservient
   to the purposes of vanity, ibid.   Pernicious consequences of attempt-
   ing to mend the shape by dress, ibid. Stays, ibid. Shoes, ifttt^-Garfers,
   buckles,  and  other bandages, 88.  The perfection of, to be easy and
   clean, ibid.  General remarks on, ibid.   Wet, the danger of, and how
   to guard against it, 107.
 Clysters, proper in  an inflammation ofthe stomach,  206.   And in an in-
   flammation of the intestines, ibid.  Of tobacco smoke,  its efficacy in
   procuring a stool, 211, note.   Of chicken broth  salutary in the cholera
   morbus, 216.   Their use in  suppression of urine, 223.   Ought to be
   frequently administered in the puerperal fever, 340.  Of tobacco, to
   excite a vomit, 376.   Of tobacco fumes, to stimulate the  intestines,
    378.  The general intention of, 425.  Preparation of the emolient
    clyster,  ibid.  Laxative clyster, ibid.   Carminative clyster, ibid. Oily
    clvster,  ibid.   Starch clyster, ibid.  Turpentine  clyster, 426.  Vine-
    gar clyster, ibid.
  Ceeliac passion, proper treatment for, 238.
  Coffee-berries, recommended in  the stone, 226.
  Cold, extreme, its effects on the human frame, 381.   The sudden appli-
     cation of heat dangerous in such cases, ibid, How to recover frozen or
     benumbed limbs, ibid.
  Cold Bath.  See Bath.
  Colds, frequently occasioned by imprudent changes of clothes at the first
     approach of summer, 8 7 note.  Various causes of, specified, 106.  Their
     general causes,  198.  Proper regimen on the symptoms of, appearing,
     ibid.  Danger of neglecting the disorder,  199.  The chief secret for
     avoiding, 200.
  Colic, different species of, 209.  Medical treatment of according to tlieir
     species and causes,  210.   Bilious  colic, ibid.   Hysteric colic, Hid.
     Nervous colic,  211.   Cautions necessary to guard against the nervous
     colic, ibid.   General advice in colics,  ibid.
  Collyria.   See Eye-waters.
  Commerce, often imports infectious disorders, 96.  Means suggesfi d to
     guard against this danger, ibid. note.
  Confections,  often very needlessly  compounded, 426.   Preparation ol
     the Japonic confection, ibid. 
INDEX.
459..
Conserves and  Preserves,  general remarks on,  and their composition.
  426.   Of red  roses, 427.  Of sloes, ibid.   Candied orange-peel,  ■
  ibid.
Constitution, good or bad, the foundation of, generally laid during infan-
  cy, 33.
Consumptions, the increase of this disorder may  be attributed to hard
  drinking, 91.   Who most liable to, and its causes, 132.  Symptoms,
  133.   Regimen, ibid.   Riding,  ibid.   Much benefit to be  expected
  from going a long voyage, 133.   Travelling, ibid.  Diet, ibid.  Great
  efficacy of milk in, ibid.   Medical treatment,  136.
Consumptions, nervous, defined, and the persons most liable to, 138. Pro-
  per treatment of, ibid.
Consumptions, Symptomatic,  the  treatment of, must be directed to the
  producing cause, 139.
Convulsions, why ncAV-born infants are so liable to, 39.   Those preced-
  ing the eruption in the  small-pox, faA'ourable symptoms, 160.  The
  general causes of, 353.   Proper treatment of,  ibid.   Extraordinary
  recovery of an infant seemingly killed by, 388.   Farther instructions
  in like cases, ibid.
Cook, Captain,  the circumnavigator, his means of preserving the health
  of his men, 57, note.
Cookery, the arts of, render many things univholesome*^hat are not natur-
  ally so, 68.   Roasting meat, a wasteful mode of, 412.
Cordials, ought not be given to infants,  41.  Are the common refuge of
  nurses who neglect their duty to children, 51.   Are often fatal  in an
  inflammation of  the  stomach,  206.   When good in the colic, 209.
  Ought not to be given to a pregnant woman during labour, 337.
Corn, damaged, will produce the putrid fever, 143.
Corns in the feet, are occasioned by wearing tight shoes, 87.
Cortex.  See Bark.
Costiveness, a frequent recourse to medicines for the prevention of, inju-
   rious to the constitution, 104.   Is rather to  be removed by diet than
   by drugs, ibid. Its general causes, and ill effects, 271.  Regimen, 272.
   Remedies for, ibid.
 Cough, the proper remedies for, 200.  A plaster of Burgundy pitch laid
   between the  shoulders an excellent remedy for,  201.  The stomach
   cough, and cough of  the lungs, distinguished, 202.—Treatment for
   the nervous  cough,  ibid.
 Cough, hooping, who most liable to, with its disposing causes, 202.  Re-
   medies, 203.  Is infectious, ibid.  Vomits, their use, and how to ad-
   minister  them to children,  ibid.  Garlic ointment, a good  remedy
   for, 204.
 Cough,  phthisical, incident to sedentary artificers, from their breathing
   confined air, 59.
 Cradles, on many accounts hurtful to children, 49.
 ('ramp,  proper remedies for, 291.
 Cramp of the stonuich,v;ho most subject to, 284.  Medical treatment of,
   ibid.
 Crotchets, how to  use for extracting substances  detained in the gul-
   let, 375.
 Croup or hives in  children, described, 349.  Its symptoms and proper
   treatment, 350.
 Cider, the ill consequences of making it too weak, 69. 
460                         INDEX.
Dancing, an excellent kind of exercise for youug persons,  48.
Daucus sylvestris.   See Carrot.
Deafness, wheu a favourable symptom in the putrid fever, 114, »o/c
  Methods of cure, according to its causes, 298.
Death, the evidences of,  sometimes fallacious, and  ought  not  to be too
  soon credited, 373, 377,378, 389.   The means to be used for the re-
  covery of persons from, nearly the same in all cases, ibid.
Decoctions, general remarks on,  427.  Preparation of the decoction of
  althaea, ibid.  Common decoction, ibid.  Of logwood, 428.  Of bark,
  ibid.  Compound decoction of bark, ibid.   Of sarsaparilla, ibid.  Of
  senaka, ibid.  White decoction, ibid.
Deformity, often occasioned by the injudicious manner of dressing chil-
  dren, 37.   Is seldom  found among savage nations, 38.  The usual
  causes of, explained, 39.
Dews, night, dangerous to health,  107.
Diabetes, who most liable to this disorder, 221.  Its  causes and symp-
  toms, ibid.   Regimen,  and medical treatment,  ibid.   Distinguished
  ' from the incontinency  of urine,  222.
Diarrhma.   See Looseness.
Diet, will often ansAver all the indications of cure in diseases,  112.  Il-
  lustrations, 113. General observations on, 398.  Improper diet affects
  the mind as wel! as the body, 399.  Vegetable ought to preponderate
  over animal food,' ibid.  See Aliment.
Digestion, the powere of, equally impaired by repletion, or inanitiou, 71,
Diseases,  hereditary, cautions to  persons afflicted Avith, 36.  Peculiar
  disorders attending particular occupations, 52. Many of them infec-
  tious, 95.   The knowledge of, depends more upon experience and ob-
  servation than upon scientific principles, 111.  Are to be distinguish-
  ed by the most obvious  and permanent symptoms, ibid.   The differ-
  ences of sex, age, and  constitution, to be  considered,  ibid.  Of the
  mind, to be distinguished from those of the body,  112.  Climate, situ-
  ation, and occupation, to be attended to, ibid.  Other collateral  cir-
  cumstances, ibid.   Many indications of cure, to  be ansAvered by diet
  alone, ibid.  Cures often effected by fresh air, by exercise, or by clean-
  liness, 113.  Nervous diseases,  of a complicated nature, and difficult
  to cure, 274.
Dislocations, should be  reduced before the  SAvelling and  inflammation
  comes on, and how, 336.  Of the jaw, ibid.   Ofthe neck, 367.  Of
  the ribs, ibid.   Of the shoulder, 368.  Of the elbow  ibid.  Of the
  thigh, ibid.  Of the knees, ancles, and toes, 369.
Diuretic infusion for the Dropsy, how to prepare, 252.
Dog, symptoms of madness in, 306.  Ought to be  carefully preserved
  after biting any person, to ascertain whether he  is  mad or not, 307.
  Is often reputed mad, when he  is not so, ibid.  Symptoms of the bite
  of a mad dog, ibid.  The poison cannot be many years dormant in the
  body, as is supposed, ibid.   Dr. Mead's recipe for the bite, 308.  The
  famous East Indian specific for, ibid.  Other recipes, ibid.  Vinegar
  of considerable service in  this disorder,  ibid.  Medical course  of
  treatment, recommended, 309.    Regimen, ibid.   Dipping in the sea
  Dot to be relied  on, 310.  Dr. Tissot's medical course for the cure of
  the hydrophobia, ibid.  Remarks on the Ormskirk medicine, ibid, note.
  Kitteriog's specific for the cure  of the hydrophobia, 313. 
INDEX.
461
Doses of medicines, the relative proportions of, for different ages, 420.
   Dr. Thompson's table of doses for different ages, ibid, note.
Drams ought to be avoided by persons afflicted Avith nervous disorders,
   276.
Draught, is the proper form for such medicines  as are intended for imme-
   diate  operation, 428.   Hoav to  prepare the  anodyne draught, 429.
   Diuretic draught, ibid. Purging draught, ibid. Sweating draught, ibid.
   Vomiting draught, ibid.
Dress.  See Clothing.
Drinking,  persons who  are seldom intoxicated may nevertheless injure
   their constitutions by, 90.   The habit of drinking frequently originates
   from  misfortunes, 91.  Frequently destroys the powers of the mind,
   ibid.   Persons often forced to it by  mistaken hospitality, ibid, note.
   Leads to other vices, 92.
Dropsy, the several distinctions of, with its causes, 250.  Symptoms, 251.
   Regimen, ibid.  Medical treatment, 252.  Tapping, a safe and simple
   operation, 253.
Dropsy ofthe Brain.   See Water in the head.
Drowned persons, ought not to be rashly given up for dead, 377—Proper
   trials for the recovery of,  ibid.  Endeavours  ought not to be suspended
   upon the first returns of life, 379.   Success ofthe  Amsterdam society
   for the recovery of, 389.
Drunkenness.   See  Intoxication.
Dumb persons, may be taught to read, write, and discourse, 298, note.
Dysentery, where, and when most prevalent, 235.  Its causes and symp-
   toms,  ibid.  Regimen, ibid.  Fruit, one of the best remedies for, 237.
   Proper drink for, ibid.  Medical treatment, ibid.   Cautions to prevent
   a relapse, 238.
EAR, the several injuries it is liable to, 297.   Deafness, medical treat-
   ment  of, according to its causes, 298.    Ought not to be tampered with,
   ibid.
Ear-ach, its causes, and proper treatment for, 243.  How to drive insects
   out of^ ibid.
Education of children, should be begun at home by the parents, 46, note.
   That of girls hurtful to their coustitution, 47.
Effluvia, putrid, will occasion the spotted fever, 143.
Electricity, beneficial in the palsy,  280.
Electuaries, general rules for making,  429.  Preparation of lenitive elec-
   tuary, 430.  Electuary for the dysentery,  ibid.   For the epilepsy,
   ibid.   For the gonorrhoea, ibid.  Of  the bark, ibid.  For the piles,
   ibid.   For the palsy, ibid.  For the rheumatism, ibid.
Elixir,  paregoric, hoAv to prepare, 444.   Sacred elixir, ibid.   Stomachic
   elixir, ibid.   Acid elixir  of vitriol, ibid.
Empirics, their gross imposition, and fatal effects, 413.
Emulsions, their use,  430.   Preparation ofthe common emulsion, 431.
   Arabic emulsion,  ibid.  Camphorated  emulsion,  ibid.   Emulsion  of
   gum ammoniac, ibid.  Oily emulsion, ibid.
Fugleman, Dr. his account  of the  German method of recovering persons
   from fainting-fits, 384.
Entrails.   See Intestines.
Epilepsy, the disorder defined, 440.  Its causes and symptoms, ibid.  Due
   regimen, 4 11.  Medical treatment, ibid. 
^62                        INDEX.

Eruptions in children often free them from bad humours, but are mistakeu
  and ill-treated by nurses, 51.   Ought never to be stopped without pro-
  per advice, ibid.  In  fe\ers, how to be treated, 142, 146, 14«), 150.
  In  the small-pox, 161,163.   In children, the causes of, 347.  How to
  cure, 348.
Erysipelas, a disorder incident to the  laborious, 54.  Its causes explain-
  ed, and avIio most subject to it, 183, 184.   Its symptoms, ibid.  Regi-
  men, 185.  Medical treatment, ibid.  The scorbutic erysipelas, 180,
  Instructions for those who are subject to this disorder, 186.
Evacuations of the human body, the principal, specified, 103.  By stool,
  ibid.  Urine,  105.   Perspiration,  106.
Exercise, the importance of, to promote the groAvth and strength of chil-
  dren, 44. All young animals exert tlieir organs of motion as soon as they
  are able, ibid.  The utility of, proved from anatomical considerations,
   45.  And from philosophical deductions, ibid: Military exercise recom-
   mended for boys, 46. Benefits of dancing, 48. Is better for sedentary
   persons under loivness of spirits, than  the tavern, 60.   Gardening the
   best exercise for the sedentary, 61.  Violent, ought not to be taken im-
   mediately after a full meal, 65.  Is as necessary as food for the preser-
   vation of health, 82.   Our love of activity, an evidence of its utility,
   ibid.  Indolence relaxes the solids, ibid.  The indulgence of carriages
   as absurd as pernicious, ibid.  Is almost the only cure for glandular ob-
   structions, 83.  Will prevent and remove those  disorders that medi-
   cine cannot cure, ibid.   Is the best cure for complaints in the stomach,
   84.  Hoav to be taken within deors, when  not to be done in the open
   air, ibid.  Active sports better than sedentary amusements, ibid.  The
   goff, a better exercise than cricket, ibid, note.  Exercise should not be
   extended to fatigue, ibid.  Is as necessary for the mind as for the body,
   102. Is often of more efficacy than any medicine whatever, 113. The
   beit mode of taking it iu a consumption, 133.   Is ofthe greatest import-
   ance in a dropsy, 252.   Muscular, for the gout, 256.  Is necessary
   for the asthmatic, 268.  Is superior-to all medicine in nervous disor-
   ders, 276.   And iu the  palsy, 281.   Is proper for pregnant women,
   unless they are of a very delicate texture, 336.  Want of, the occasion
   of rickets in children, 352.
 Extracts, general rules for making;  but are more conveniently purcha-
   sed ready made, 431.                                 .,.,»» V 1
 Eyes, inflammation of, its general causes,  189.  Symptoms, ibid.  Medical
   treatment, 190.  How to be treated when it proceeds from a scrophu-
   lous habit, 191. Advice  to those who are subject to this complaint, 102-
   Are subject to  many diseases which are difficult  to cure, 295.   The
   means by which they are frequently injured, ibid. General means ot pre-
   vention, 296.  The several disorders of, with  their  medical treatment,
    297
 Eye-waters, general remarks on, and their principal intentions, 426. Col-
   lyrium of alum, ibid. Vitriolic collyrium, ibid. Collyrium of lead, ibid.
 FAINTING FITS,  how to cure, 286, 382.  Cautions  to persons, sub-
   ject to them, 385.
 Falling sickness.   See Epilepsy.                              ,  ,
 Fasting, long, injurious to  those who labour hard, 55.   Is hurtful both to
    old and young, 71.                                 .   ,.,,     „r
  Fathers,  culpably inattentive to the management of  theu children,^.
    The* irregular lives often injure the constitution of their children, 36. 
INDEX.                         463
Fear, The influence of very great, in occasioning and  aggravating dis-
  eases, 99.  Its various operations,  100.
Feil, injured by Areaiing tight shoes, 87.  The washing of, an agreeable
  article of cleanliness, 107.  Wet, the danger of, 94.   Bathing them
  iu warm Avater, a good remedy in a cold, 199.  And  in  the hooping
  cough, 204.
Fermentation, the vapour of liquors in a state of, noxious, 380.
Fevers, of a bad kind, often occasioned among labourers by poor living,
  55.  Frequently attacks sedentary persons after hard drinking, 60.
  Nervous,  often the consequence of intense study,  03.  Putrid and
  malignant, often occasioned by want of cleanliness, 92.  The most
  general cause of, enumerated,  114.  The distinguishing symptoms of,
  ibid.   The several species  of, ibid.  Is an effect  of nature, Avhich
  ought to be assisted, 115.  How this is to be done, ibid.  Cordials and
  sweetmeats improper in, 116.  Fresh air of great importance in, ibid.
   The mind of the patient ought not  to. be alarmed Avith religious ter-
   rors, ibid.   Cautions as to bleeding and sweating in, ibid, 117.   Long-
  ings in, and  the calls of nature, deserve attention, ibid.  Cautions to
  prevent a relapse, ibid.
Fever, acute continual, Avho most liable to, 88.  Causes, ibid.   Symp-
   toms,  ibid.   Regimen, ibid.   Medical  treatment, 125.   Symptoms
   favourable and unfavourable,  ibid.   Regimen to  be observed during
   recovery, 126.
 Fever, bilious, general time of its appearance, 183.   Proper treatment
  of, according to its symptoms, ibid.
Fever, intermitting.   See Ague.
Fever, miliary,  from  what the name derived, and its general appearan-
   ces, 148.  Who most  liable  to it, ibid.  Causes,  ibid.  Symptoms,
   149.  Regimen, ibid.   Accouut of a  miliary fever at Strasburgh, 150,
   note.  Proper medical treatment, ibid.   Cautions  for avoiding this
   disorder, 151.   How  to prevent, in child-bed-AVomen, 339.
 Fever, milk.   How to prevent, 339.
 Fever, nervous, Avhy more common noAV than formerly, and who most
   liable to it,  139.  Its causes,  ibid.   Symptoms and  proper regimen,
   140.  Medical treatment, ibid.
 Fiver, puerperal, or child-bed, the  time  of its attack,  and symptoms,
   339.  Medical treatment of, 340.  Cautions for Uie prevention of this
   lever, 341.
 Fever, putrid, is of a  pestilential nature, and who most liable to it, 14:5.
   Its general causes, ibid.  Symptoms, ibid.   Other fevers may be con-
   verted to this,  by improper treatment, 144.  Favourable and unfa-
   vourable symptoms of, ibid.   Regimen, 145.   Medical treatment, 146.
   Cautious for the prevention of this disorder, 147.
 F(t<cr, remitting, derivation of its name, 551.  Its causes and symptom?,
   ibid.  Proper regimen, 152.  Medical  treatment, ibid.  Cautions for
   avoiding this fever, 153.
 Fever, scarlet, Avhy so named, and its usual season of attack, 18C.  Pro.
   per treatment of, ibid.   Is sometimes attended with  putrid and malig-
   nant .symptoms,  ibid.    Medicines adapted to this stage of the malady,
   ibid.  History of  a fever of this kind at Edinburgh, ibid,  note.
 Fircr, secondary, in  the small-pox, proper treatment of, 165.
 Fever, yelloAV, definition, 154.  Its causes, 155.  Symptoms, ibid.   Re-
   gimon, 156.   Preventative, 157.   Medicine, 158. 
464                         INDEX.
Flatulencies in the stomach, remedies against, 244.   The sevci.tl caust .*
  of, 286.   Medical treatment of, 287.
Flatulent colic, its causes, and seat of the disorder, 209.   Remedies for,
  ibid.
Flower-de-luce,  the yellow Avater, the  root  of, recommended for the
  tooth-ach, 242.
Fluor albus described, Avith its proper treatment, 334.
Fomentations, how to make and apply, 431.   General intentions of, ibid.
  Anodyne  fomentation,  ibid.   Aromatic fomentation,  ibid.   Common
  fomentation, 432.  Emolient fomentation, ibid.  Strengthening fomen-
  tation, ibid.
Food.   See Aliment.
Forgiveness of ^injuries, ought to be  practised from a  regard to our own
   health, 99.
Fractures.   See Bones, broken.
Frozen limbs, hoAV to recover, 381.
Fruit, unripe, very hurtful to children,  43.   Ripe, one of the best medi-
   cines, both for the prevention and cure of a dysentery, 237.  Fruits
   occasional substitutes for bread, 407.   The plantain tree used for that
   purpose in Avarm climates, ibid.   Yams, a proper substitute for  bread
   in the West-Indies, ibid.
Funerals,  the  great number of visitors attending  them, dangerous to
   their health, 96.
 GALLING, in infants, the cause and cure of, 445.
Gangrene, proper treatment of, 358.
Gardening, a wholesome amusement for sedentary persons,  61.
Gargles for the throat, hoAv to make, 193, 195.  General intentions of
   432.  Method of making the attenuating gargle, ibid.  Common gar-
   gle,  ibid.  Detergent gargle, ibid.   Emolient gargle, ibid.   For  the
   mouth of infants in the thrush,  344.
 Garlic ointment,  a North-British remedy for the  hooping-cough, how
   to apply it,  204.
 Generals of armies, Iioav they ought to consult the health of the men
   they command, 56.
 Gilders.   See Miners.
 Ginger, syrup  of, hoAV  to prepare, 443.
 Girls,  The common mode of education prejudicial to their  constitu-
   tion, 47.  Means of rectifying it recommended, ibid.
 Gleet  how occasioned,  and its symptoms,  319.  Method of  cure, ibid.
   Regimen, 320.   Obstinate  gleets   cured  by mercurial inunctions,
   ibid.  How  to apply bougies, ibid.
 Glover Mr. his course of treatment for the recovery of a hanged man, 38,
 Gonorrhoea, virulent, the nature of, and its symptoms, 314.   Regimen,
   315   Medical treatment, ibid.  Is often cured by astringent injections,
   316*  Cooling purges always proper iu, ibid.  Mercury seldom neces-
   sary in a gonorrhoea, 317.   How to  administer it when needful, ibid.
 Goulard,  M. preparation of his celebrated  extract  of  Saturn, 445.-
   His various applications of it, ibid.                        .    ,
 Gout,  the  general causes of, 62.   How to treat a  looseness  occasioned
   by repelUng it from the extremities  318.   The  source*so   this
   disorder, and  its symptoms, 254.   Regimen for, 255.   Wool the
   best external  application  in,  ibid.   Why there are so  many  nos- 
INDE*.                         465
  Inirns for, 255, 256.  Proper medicine after the fit, ibid.  Proper re-
  eimen iu the intervals between fits to keep off their returns, ibid. How
  to remove it from the nobler  parts to the extremities, 257.  General
  cautious to prevent danger by mistaking it for other disorders,  ibid.
  M. Cadet de Vaux's prescription, 258, note.
Grain, various kind of,  when  boiled a good substitute for bread, 402.
Gravel, how formed in the bladder, 105.  How  distinguished from the
  stone, 224.  Causes and symptoms, ibid.  Regimen, ibid.  Medical
  treatment, 225.
Green-sickness, originates in indolence, 331.                       ,
Grief, its effects permanent, and often fatal, 101.  Danger of the  mind
  dwelling long upon one subject, especially of a disagreeable nature, ibid.
  The mind requires exercise as well as the body, 102.  Innocent amuse-
  ments not to be neglected, ibid. Is productive of nervous diseases, 27 j.
Gripes in infants, proper treatment of, 345.
Guaiacum, gum, a good remedy  for the quinsy, 194 ;  and the rheuma-
   tism, 258.                                          .    >.  ,
Gullet how to remove substances detained  in, 374.  Cautions for the use
   of crotchets with this intention, 375.  Other  mechanical expedients,
   ibid.  Treatment if the obstruction cannot be removed, 376.
Gums of children, application to, during teething, and  how to cut them,
   351, 352.
Gutta serena, proper treatment of, 296.
H/EMOPTOE, spitting of blood.   See Blood.
Ilxmorrhases.  See Blood.                                         ,
Harrowgate water, an excellent medicine for expelling worms, 247. And
   for the iaundice,  250.   In the scurvy, 262.                    #
Head-ache, the species of, distinguished, 239. Causes of, ibid.  Regimen,
   ibid.  Medical treatment, 240.                  .
 Health of  the people in general, a proper object of attention for the magis-
   trates, x.   Ought to be attended to in matrimonial contracts, 37.  Is
   often laboured' for after it is destroyed, 65.   Rules given by Celsus
   for the preservation of, 110.
 Heart-burn, the  nature of this disorder, with its caus#s, and remedies
   for, 273, 274.
 Heat, extreme, how to recover persons overcome by, 382.
 Hemlock, a good  remedy in the king's evil, 265.. Js recommended by Di.
   Storck for the cure of  cancers,  302.        *               .™„,OM.
 Hemp-seed, a decoction of, good  in the jaundice, and how to prepare
   it, 250.
 Hickup, its causes,  and method of treatment, 283.
 Hoffhmn, his rules  for guarding child-bed women against the miliary te-

 HoZy, a wholesome article of food for children, 43.   Is recommended in
    the stone, 226.

 S&Sfr- «ta£frrfll restore sensibility to the organ, oftaste

 H^KoX fre* * i„, more  danger„„s  to the pa.iemsthan
    their disorders,  81.   Cleanliness peculiarly necessary in, 94.  Utten
        ad  iletion by being situated in the middle of popu ous towns 97.
    How  they might  be rendered proper receptacles  for the sick, ibid.
                                  58 
466
INDEX.
  Particularly in infectious disorders, 98.  The sick in.oi^ht not to be
  croAvded together, 102, note.         ♦
Houses, instead of contrivances to make them close and warm, ought to
  be regularly ventilated,  80.  "In marshy situations unwholesome, 81.
  Ought to be built in a dry situation, 108.  Danger of inhabiting new-
  built houses before thoroughly dry, ibid.  Are often rendered damp by
  unseasonable cleanliness, ibid.  Are dangerous Avhen kept too close and
  hot, 110.
Husbandmen, Uie peculiar disorders Uiey are exposed  to from the vicis-
  situdes of the Aveather,  54.
Huxham, Dr. recommends the study of the dietetic part of medicine, xi.
Hydrocephalus.   See  Dropsy.
Hydrophobia, Dr. Tissot's method of curing,  310.   Kittering's  speci-
  fic, 313.  .
 Hydrops pectoris.   See Dropsy.
Hypochondriac affections, frequently produced byjintense study, 63. Tlieii
  causes, and who most subject to them, 292.   The  general intentious
   of cure, ibid.  Regimen, 293.
 Hysterics, a disorder produced  by the habitual use of tea,  68.  General
   causes of, 289.   Symptoms, ibid.   Proper treatment of, ibid.  Regi-
   men, 290.  Medicines  adapted to, ibid.
 Hysteric colic, symptoms and treatment of, 210.
 Jails, Avhy malignant  fevers are  often generated in them, 79.  Often
   spread au infection by being situated in the middle ol* populous towns,
   97.  Ought to he removed, ibid.
 Janin, M. his relation of the recovery o| an overlaid infant, 387.   And
   of a man who had hanged himself, ibid.
 Jaundice, the different stages of its appearance, Avith  the causes of this
   disorder, 248,  249.  Symptoms, and regimen,  ibid.  Medical treat-
   ment, ibid.
 Jesuits bark.   See Bark.
 Jews, the Avhole system of their laws tending to promote cleanliness, 94,90.
 Iliac passion, a particular kind of  inflammation iu the intestines, 206.
 Imposthume in thgbreast, iu consumptions, how to make it break uwardly
   Afhen not to be discharged by other means, 138.   Imposthumes  after
   the small-pox, proper treatment of, 166.
 Inconlinency of urine, distinguished from  a diabetes, 222.  Experiment
   for relief, 223.
 Indigestion, is one consequence of intense study,  63.   General causes,
   and remedies for, 271.
 Indolence, its bad effects on the constitution, 82.   Occasions glandular
   obstructions,  83.   Ill consequences of too much indulgence in  bed,
   ibid.  Is the parent of vice,  85. Cause of most nervous disorders, 293.
 Infancy, the foimdation of a good or bad  constitution, generally laid in
   this season of life,  33.
 Infants, nearly one half of those born in Great-Britain die under twelve
  years of age, 33.   Perish mostly by art, ibid.    Ought not to be
   suckled  by  delicate  women,  ibid.   Importance of  their being
   nursed  by  their mothers, 34.    Often  lose their  lives,  or become
   deformed, by errors in closing them, 37.  How the art  of bandag-
   ing them  became  the province of die midAvife, ibid.   How treated 
INDEX.                          467
   in Africa, 38, note.   Philosophical observations  on their  organical
   structure, and  on the causep of deformity,  ibid.   Why they so fre-
   quently die of  convulsions, 39.  Why exposed to fevers, ibid.   And
   colds, 40.  Rules for their dress, ibid.  Their food, ibid.   Reflections
   ou the many evils they are exposed to, 342.  Why their first disor-
   ders are  in  their boArels, ibid.   How to cleanse their bowels, 343-.-
   The meconium, ibid.  Thrush, 344.  Acidities, ibid.   Gripes, ibiel.
   Galling and excoriations, 345.  Stoppage of the nose, 346.  Vomit-
   ing,  ibid.   Looseness, 347.   Eruptions,  ibid.   Scabbed heads, 348.
   Chilblains, 349.  The croup, ibid.   Teething,  350.   Rickets, 352.
   Convulsions, 353.  Water in the head, 354.   Hoiv to recover infants
   seemingly dead, 384.   Ought never to sleep in the same  beds with
   their mothers or nurses, 386, note.   Case of the recovery of an over-
   laid infant, 387.   Case of an infant seemingly killed by  a strong con-
   vulsion fit, and recovered, 388.  See Children.
Infection, the danger of, incurred by injudicious or unnecessary attend-
   ance on the sick, 95.   Aud on funerals, ibid.   Is often communicated
   by clothes, 96.   Is frequently imported, ibid.   Is spread by hospitals
   and jails being situated in the middle of populous towns, 97.  Hoiv to
   prevent infection iu sick chambers, ibid.  Physicians liable to spread
   infection, ibid,  note.   In Avhat respects the spreading of infection might
   be checked by the magistrates, ibid.  Bleeding  and purging increase
   the danger of, by debilitating the body, 148.  Small-pox, 160.
Inflammations, how the laborious part of mankind expose themselves to,
   55.  Proper treatment of, 358.
Inflammation of the bladder.  See  Bladder.
-----------of the brain.  See Brain.
-----------of the eyes.  See Eyes.
___________of the intestines.  See Intestines.
-----------of  the kidneys.   See  Kidneys.
-----------of  the liver.  See Liver.
-----------of  the lungs.  See Peripneumony.
-----------of  the stomach.   See  Stomach.
-----------of  the throat.  See  Quinsey.
-----------of  the Avomb.  See  Womb.
Infusion,  advantages of, over decoctions, 433.   Hoav to obtain rich  in-
   fusion from weak vegetables, ibid.   Preparation of the bitter infusion,
   ibid.   Infusion of the  bark, ibid.   Infusion of carduus, ibid.  Of lin-
   seed, ibid.  Of roses, ibid.   Of tamarinds and senna, ibid.   Spanish
   infusion,  434.   For the palsy, ibid.
Inns, the  great danger of meeting with damp beds in them, 107.   The
   sheets in, Iioav  treated to save washing, 108.
Inoculation  of  the small-pox, more  favourably received here than in
   neighbouring countries, 166.   Cannot prove of general utility while
   kept in the hands of a few, ibid.   No mystery in the process, 167.
   May safely be  performed by  parents or  nurses, ibid.  Various me-
   t hods of doing  it, ibid.   The clergy exhorted to remove the prejudices
   against the operation, 168.  Arguments cited from Dr. Mackenzie in
   favour of inoculation, ibid, note.  Ought to be rendered universal, 169.
   Means  of extending the practice of, 170.  Two obstacles to the pro-
   gress of, stated, 171.   Might be performed  by clergymen, or by parents
   themselves, ibid.   The proper seasons and age for performing it, 172. 
468                         INDEX.
  Will often mend the habit of body, ibid.  Necessaiy preparation and
  Tegimen for, ibid.
Inoculation of the coAV-pox, 173—178.
Insects, Avhen they creep  into the ear, Iioav to force  them out, 243
  Poisonous, Uie bites of, hoAV to be treated, 311.
Intemperance, one great cause of the diseases of seamen, 57.  The danger
  of, argued from the construction of the human body, 89.   The analo-
  gy in the nourishment of  plants and animals,  ibid.  Is the abibe of
  natural passions, ibid.  In diet, ibid.  In liquor and carnal pleasures,
  00.   The bad consequences of, involve Avhole families, ibid.   Effects
  of drunkenness on the constitution, ibid.  Persons who seldom pot
  drunk, may nevertheless injure their constitutions by drink, ibid.  TIn-
  habit of drinking frequently acquired under misfortunes, 91.   Is pe-
  culiarly hurtful to  young persons,  92.  Leads to all other vices, ibid.
Intermitting fever.   See Ague.
Intestines, inflammation of, general causes from Avhence it proceeds, 206.
   The symptoms, regimen, aud medical treatment, 207.   Cautions to
   guard against it, 208.
Intoxication produces a fever, 90.   Fatal  consequences of a daily repe-
   tition of this vice  ibid.   Persons who seldom get  drunk, may never
   theless injure their constitution by  drinking, ibid.   Getting drunk, a
   hazardous remedy for a cold, 199.   Often produces fatal effects, 385.
   Proper cautions for treating persons in liquor, ibid.  The safest drink
   after a debauch, ibid   Remarkable case,  386.
Johnson, Dr. extraordinary recovery of an infant seemingly killed by a
   strong convulsion fit} related by, 388.
Issues, how to make them  take the best effect, 279.
Itch, the nature and symptoms of this disease described, 265.  Sulphur.
   the best remedy against, 266.   Great danger of the injudicious use  of
   mercurial preparations for, ibid.   Cleanliness the best preservative
   against, 267, note.
 Juleps, the form of, explained, 434.  Preparation of the camphorated ju-
   lep, ibid.  Cordial julep, ibid.  Expectorating julep, ibid.  Musk julep,
   ibid.   Saline julep, ibid.   Vomiting julep, ibid,
 KERMES  MINERAL, recommended by  Dr.  Duplanil, for the hoop-
   ing-cough, 204, note.
 Kidneys, inflammation of,  its general causes, 212.   Its symptoms and
   proper regimen, ibid  Medical treatment, ibid.  Where it proceeds
   from the stone and gravel, 213.  Cautions for those subject  to this
   disorder, ibid.  See Gravel.
 King's evil.  See  Scrophula.
 LABORIOUS EMPLOYMENTS, the peculiar disorders incident to,
   54.  The fojly of men emulating each  other in trials of strength, ibid.
   Disadvantages attending their diet, 55   How they expose themselves
   to  inflammations,  ibid.   Danger of sleeping in the sun, ibid.  Long
   fasting hurtful to them, ibid.   Injuries  arising from poor living, ibid.
   Many of the diseases of labourers, not only occasioned, but aggravated
   by poverty, 56.
 labour should not be imposed too early on children, 47.
 Labour in child-bed, medical advice for,  337.  Inconveniences of col-
   lecting a number of ivomen at, 338, note.
  laudanum, its efficacy in fits  of an ague, 181, note.  How to be ad-
   ministered in a cholera morbus, 217. In a looseness, 218.  In a dia- 
INDEX.
469
   betes, 222.  When proper for the head-ach, 241.   How to apply  for
   the tooth-ach, 242.  Will ease pain in the gout, 256.   Hoav to admin-
   ister for the cramp in the stomach, 284.  Is good for flatulencies, 287.
   Effects of an over dose of 306.   Medical treatment in this case, ibid.
 Leading-strings, injurious to young children, 44.
 Leeches, may be successfully applied to  inflamed testicles, 321, note.
   And to disperse buboes, ibid, note.  Are proper to apply to children
   where inflammations appear iu teething, 351.   Objections to bleeding
   with them, 357.
 Ixeks, a proper ingredient in soups,  410.
 Lemons. See Oranges.
 Leprosy, why less frequent in this country hoav than formerly, 253—
   Requires the same treatment as the scurvy,  ibid.
 Licntcry, proper treatment for, 238.
 Life may frequently be restored, when the appearances of it are suspend-
   ed by sudden casualties, 373, 377, 388.
 Lightning, persons  apparently killed by, might possibly be recovered by
   the use of proper means, 389.
 Lime-water recommeuded to prevent gravel in the  kidneys from degene-
   rating to the stone in the bladder, 225.   Is  a good remedy for Avorms,
   247.  Happy effects of, in the cure of obstinate  ulcers, 365.
 Lind, Dr. his prescription to abate  fits of an  ague, 118, note.  His di-
   rections for treatment of patients  under  putrid remitting fevers, 152,
   note.
 Liniment for bums, preparation of, 437.  White liniment, ibid.  For the
   piles, ibid.  Volatile.liniment, ibid.
 Liquors strong,  expose children to inflammatory  disorders, 43.   Fer-
   mented, the  qualities of, examined, 69.  The  bad consequences of
   making them too weak, ibid.  Why all families ought to prepare their
   oavii liquors, ibid.   Cold, the danger of drinking, when a person is hot,
   109.
 Liver, scirrhous, produced by sedentary employments, 62.
 Liver, inflammation of, its causes and symptoms, 214.   Regimen and me-
   dical treatment, 215.   Abscess in, how  to be treated, ibid.  Cautions
   in the event of a scirrhous being formed, ibid.
 Lobelia, an American plant used by the natives in the venereal diseases,
   326.
 Lochia, a suppression of, how to be treated, 338.
 Locked Jaw.  See Tetanus.
 Longings, in diseases, are the calls of nature, and often point out  what
   may be of real use,  117.
 Looseness, habitual, general direction  for  persons subject to, 104.  Its
   general causes, 217. A periodical looseness  ought never to be stopped,
   218.   Medical treatment  of,  according to its  various causes,  ibid.
   Means of checking it when necessary, 219.   In children, proper treat-
   ment of, 347.
Love,  why perhaps the strongest of all the passions,  102.  Is not rapid
  iu its progress,  aud may therefore  be guarded against  at its  com-
  mencement, ibid.   To pretend to it for amusement, cruelty to the ob-
  ject, ibid.  Children often real martyrs  between inclination and duty
   103, note.
Lues,  confirmed, symptoms of, 324.  Mercury  the only  certain re. 
470
INDEX.
  medy known in Europe for this disease, 325.   Sainie preparations of
  mercury more efficacious than Uie ointment, ibid.   How to administer
  corrosive sublimate, 326.   American method of curing this disease,
  ibid.
Lungs, injured by artists Avorking in benduig postures, 59.   Studious per-
  sons liable to consumptions of,  62.
Luxury, highly injurious to the organs of taste and smell, 299.
MACKENZIE, Dr. his arguments iu favour of inoculating iu the small.
  pox, 168, note.
Mad Dog.  See Dog.
Magnesia alba, a remedy  for tlie heartburn,  274.  Is the best medicine
  in all cases of acidity, 345.
Magnets, artificial, their reputed virtue iu Uie tooth-ach, 243.
Malt liquors, hurtful in the asthma, 268.   See Beer.
Man, Avhy inferior to brutes in the mauagement of his young, 33—^88
  never intended to be idle, 85.
Manufactures, the groAvth of, produced the rickets in children, 44—Men
  favourable to riches than to health, 47.  Some, injurious to health by
  confining artists in unwholesome  air, 52.   Cautions to the workmen,
  ibid.   Compared with agriculture, 58.   Are injurious  to health from
  artists being crowded  together, 59.  And from then- working in con-
  fined postures, ibid.  Cautions  offered to sedentary artists, 60.  Se-
  dentary arts better suited  to women than  to men, 83, note.
Matrimony ought not to  be contracted without a due attention to health
  and form, 37.
Mead, Dr. his famous recipe for the bite of a mad dog, 308. His cha-
  racter as a physician, ibid, note.
Meals ought to be taken at regular times, 71.  Reasons for this uniformi-
   ty, ibid.
Measles, have great affinity with the small-pox, 179.  Cause and symp-
  toms, ibid.   Proper regimen and medicine, 180.  Inoculation of, might
   prove very salutary, 181, note.
Mechanics ought to employ their leisure hours in gardening, 62.
Meconium, the best mode of expelling it, 41, 343.
Medicine, the origin  of the art  of, xi.  The operation of, doubtful at best,
   ibid.   Is made a mystery of by its professors, xv.   The study of, neg-
   lected by gentlemen, xvi.   This ignorance lays men open to preten-
   ders, ibid   Ought to be generally understood, ibid.  A diffusion of the
  knoAvledge of, Avould destroy  quackery,  xviii.  Objections to the cul-
  tivation of medical knowledge answered,  ibid—The theory of, can ne-
   ver supply the Avant of experience and observation, 33.
Medicines, have more virtue attributed to them than  they deserve, 112.
   Ought not to be  administered by the  ignorant,  nor without caution,
   114.  Want of perseverance in the use of, one reason  Avhy chronic
   diseases are so seldom cured, 260.  Many retained, which owe their
  reputation to credulity, 418.  Are multiplied and compounded in pro-
  portion to ignorance of the causes and nature of diseases, ibid  Disad-
  vantages of compounded medicines, ibid.  Are often adulterated for
  the sake of colour, 419.  The relative proportions of, for different age?,
   420.   A list of medical preparations as ought  to  be kept for private
  practice, 421.
Blelanchob/, religious, its effects,  103.   Leads  to  suicide, ibid.  Dt- 
INDEX.
474
   fined, with its  causes,  277,  278.  Symptoms and  regimen, ibid.
   .Medical treatment, 279.
Menstrual discharge in women, the commencement and decline  of the
   most critical period of their lives,  331.  Confinement  injurious to
   growing young women, ibid, and tight  lacing for a fine shape, 332.
   Symptoms ofthe first appearance of this  discharge, ibid.   Objects of
   attention in regimen at this time, ibid.  Ought to be restored whenever
   unnaturally obstructed, aud hoAV, 333.  When an obstruction proceeds
   from another malady, the  first cause is to be removed,  ibid.   Treat-
   ment under a redundancy of the discharge, 334.   Regimen and medi-
   cine proper at the final decline of the menses, 335.
Mercury  may  be given in desperate cases  of an inflammation of the in-
   testines, 208.  Cautious for administering it, ibid, note.  Great caution
   necessary in using mercurial preparations for Uie  itch, 266.  Is seldom
   necessaiy in a gonorrhoea, 317.  How to administer it  when needful
   in  that disorder,  ibid. Solution of mercury,  how to make, 318 note.
   Is  the only certpin remedy knoAvn in Europe for  the cure of a confirm-
   ed  lues, 325.   Saline preparations, of, more  efficacious than the mer-
   curial ointment, ibid.   Hoav to administer corrosive sublimate in vene-
   rial cases, 326.  Necessaiy cautions in the use of mercury, 327. Pro-
   per seasons for entering on a course of, 238. Preparations for, ibid.
   Regimen under a course of, ibid.
Mezereon root, a poiverful assistant in venereal cases, ibid.
Midwifery, ought not to be allowed to be practised by any Avoman not
   properly qualified, 337, note.
Midwives, historical vietv of the profession,  37.  Hoav they  became in-
   trusted Avith the care of bandaging infants, Aviih  the ill effects of tlieir
   attempts at dexterity  in this office, 38. Instances of their rashness and
   officious ignorance, 342, note.
Miliary Fever.  See Fever.
Milk, that of the mother, the most natural food for an infant, 40. Cows
   milk, better unboiled than boiled, 42.  Is a good antidote against the
   scurvy, 68.   Of more value in consumptions than the Avhole  Materia
   Mcdica,134. Its great efficacy in the scurvy,  262. A milk diet proper
   both for men and women, in cases of barrenness, 342.
Milk  Fever.  See Fever.
Millipedes, how to administer for the hooping-cough, 204.
Mind, diseases of, to be distinguished from  those of the body, 112. See
   Passions.
Miners, exposed to injuries from unwholesome air, and mineral particles,
   52. Cautions to,  ibid.
Mineral waters, the danger of drinking them in too large quantities, 221.
   Are of  considerable service in iveakness of the stomach, 273. Cautions
   concerning the drinking of,  393.
Mixtures, general remarks on this form of medicine, 435.   Composition
   of the astringent  mixture,  ibid.   Diuretic  mixture,  ibid.   Laxative
   absorbent  mixture, ibid. Saline mixture, ibid.   Squill mixture, ibid.
Molasses, an intoxicating spirit much used by the common people at Ed-
   inburgh, 91, note.
Mothers,  preposterous,  when  they think it below them to nur?e their 
472                         INDEX.
  oAvn children, 33.  Uudcr Avhat circumstances they may be really un-
  fit to perform this task, ibid.  Importance of their suckling their own
  children, 34, note.  Delicate mother produce unhealthy short lived
  children, 36.  Their milk, the best food for childreu, 40.   Ought to
  give their childreu proper exercise. 45;  and air 49.
Mouth, cautions  against putting pins or other dangerous articles into,
  374.
Muscular exercise a cure for the gout 256.
Mushrooms, a dangerous article of food, as other funguses are often gath-
  ered instead of them  312.
Music, the performance of, recommended as a proper amusement for stu-
  dious persons, 64.
Musk, extraordinary effects produced by, under particular circumstances,
  in  the nervous fever, 142.   Is a good remedy iu the epilepsy, 282:
  And for the hickup, 283.  Deafness cured by, 298.
Mustard, Avhite, a good remedy in the rheumatism, 260.
NATURAL  history,  the study  of, necessary  to  the improvement of
  agriculture, xiv.
Nervous diseases, the most complicated and difficult  to cure of all others,
  274.  General causes of,  275.   Symptoms  of, ibid.  Regimen, 276.
  Medical treatment, 277.  A  cure only to be expected from regimen,
  ibid.   The several symptoms of, though differently named, all  modifi-
  cations of the same disease, 292.
Nervous colic, its causes and symptoms, 211.  Medical treatment of ibid.
Nervous fever.  See Fever.
Night-mare, its causes and symptoms  described,  284.  Proper treat-
  ment of, 285.
Nitre, purified, its good effects in a quinsey, 194.   Is an efficacious re-
  medy for  the  dropsy,  252. Promotes  urine and perspiration, 279.
Nose, ulcer in, how to cure, 299.   Stoppage of, in childreu, how to cure,
  346.   See Bleeding at.
Nurses, their superstitious prejudices in bathing of children, 48. The only
  certain evidence of a good one, 50.  Their usual faults pointed out, 51.
  Administer cordials to remedy their neglect of duty towards children,
  ibid.  Their mistaken treatment of eruptions,  ibid.  And loose stools, 52.
  are apt to conceal the disorders of children that arise from their own
  ne*li*ence, ibid.  Ought to be punished for the misfortunes  they thus
  occasion, ibid.  Sensible, often able to discover diseases sooner than
  persons bred to physic,  111.   Are liable to catch  the small-pox agaiu
  from  those they nurse in that disorder, 161, note.
Nursery ought to be the largest and best aired room in a house, 49.
OATS and barley, more wholesome  when boiled, 403.
Oatmeal, frequently made into bread, and  peasants fed on it, are healthy
  and robust, 403, 404.  Erroneously supposed to occasion skin diseases
  ibid.  Oatmeal and milk a proper food  for children, ibid  Oil  an anti-
  dote to the injuries arising from working in mines or metals, 53.  t>aiau
  oil, the best application to the bite of a wasp or bee,  311. Gampfioia-
  ted, hoAv to prepare, 437.
Oils, essential, of vegetables, the proper menstruum tor, 442.
Ointment  fo. the  itch, 266.  Use of ointments when applied  to  wounds
  and sores.  435.   Preparation  of yellow basilicum, ibid.   Uinumni
   of Calamine,ibid. Emolieut ointment, 436.   Eye oiutment, tfitf. 
INDEX.                         473
  Issue  ointment,  ibid.  Ointment of lead, ibid.   Mercurial ointment,
  ibid.  Ointment of sulphur, ibid.  White ointment, ibid.  See Liniment.
Opthalmia.  See Eye.
Opiates, efficacious in a cholera morbus, 217.  In a diabetes, 222.  When
  proper for the head-ach, 241.  Recommended for the tooth-ach, 242.
  Are delusive remedies in nervous diseases, 277.   See Laudanum.
Orange and lemon peel, Iioav to candy,  427.  How to preserve orange
  and lemon juice in the form of syrup, 442.
Ormskirk mediciue for the bite of a mad-dog, remarks on, 310, note,
Oxycrate, the most proper external  application in a fracture, 371.
Oysters of great service in consumptions, 136, note.
PAINTERS.   See Miners.
Palsy, the nature of this disorder explained, 280.  Its causes, ibid.  Me-
  dical treatment, ibid.
Paraphrenitis, its symptoms and treatment, 129.
Parents, their interested  vieAvs in the disposal of their children in mar-
  riage, often a source of bitter repentance, 103,  note.   See Fathers
  and Mothers.
Parsnips, a nourishing food, 409.
Passions, intemperance the abuse of, 89.  Have great influence both in
  the cause and cure of diseases, 98.  Anger, ibid.   Fear, 99.  Grief,
  101.  Love,  102.   Religious melancholy, 103.    The best method ot
  counteracting the violence of any of the passions, ibid.
Peas, parched, good in cases of flatulency, 244.
Peruvian bark.   See Bark.
Penis, ulcerated, cured,  and  partly regenerated, by a careful attention
  to cleauliness, 238, note.
Peripneumony,  who most subject to, 130*  Its causes,  symptoms, and
  proper regimen, ibid.
Perspiration, iusensible,  the  obstruction  of, disorders the whole frame,
  106.  The various causes of its being checked, ibid.   Changes in the
  atmosphere, ibid.  Wet clothes, 107.   Wet feet, ibid.   Night air, ibid.
  Damp beds,  ibid.   Damp houses, 108.   Sudden transitions from heat
  to cold, 109.
Philosophy, advantages resulting from the study of, xiv.
Phrenitis.  See Brain.
Phymosis described, and hoAv to treat, 324.
Physicians, ill  consequences of  their inattention to the management of
  childreu, 35.   Are liable to spread infection, 97, note.   Their custom
  of prognosticating the fate  of their patients, a bad practice, 100.   Are
  seldom called in, until medicine can give no relief, 123.
Pickles, provocatives injurious to the stomach, 68.
Piles, bleeding and blind, the distinction between, 229. , Who most sub*
  ject to the disorder, ibid.   General causes, ibid.  Medical treatment of,
  230.  Periodical discharges of, ought not to be stopped, ibid.  Proper
  treatment of the bliud piles, ibid.  External ointment's of little use, 231.
Pills, purging, proper form of, for an inflammation of the intestines, 208.
  The general  intention of  this class  of medicines, 437.  Preparation
  of  the composing  pill, ibid,  Foetid pill, ibid.   Hemlock  pill, ibid.
  Mercurial pill,  438.   Mercurial sublimate pills, ibid.  Plummet's
  pill, ibid.  Purging pills,  ibid.   Pill for  the  Jauudice, ibid. Squill
  pills, ibid.   Strengthening pills, 439. 
474                         INDEX,

Pins ought never to be used in the dressing of children, 39.   Swallowed,
   discharged from an ulcer in the side, 374, note.
Plasters, the general intentions of, aud their usual basis, 439.  Prepara-
   tion of the common plaster, ibid.  Adhesive plaster, ibid.  Anodyne
   plaster, ibid.  Blistering plaster, ibid.   Gum plaster, ibid.  Mercu-
   rial plaster, 440.  Stomach plaster, ibid.  Warm plaster, ibid.   Wax
   plaster, ibid.
Pleurisy, the nature of the disorder explained,  Avith  its causes, 126.
   Symptoms, ibid.  Regimen, ibid   Medical treatment, 127.  A de-
   coction of seneka reckoned a specific iu, 128.  Bastard pleurisy, 129.
Plumbers.  See Miners.
Poisons, the nature and cure of, a general concern, and easily acquired,
   304*   Mineral poisons  305.  Vegetable poisons, ibid.  Bites of poi-
   sonous animals. 306.   Bite of a mad-dog, ibid.   Bite of a viper, 311.
   The practice of sucking the poison out of ivounds recommended, ibid,
   note.   Poisonous plants ought to be destroyed in the neighbourhood of
   toAvns, 312.  Negro remedy to cure the bite of a rattle snake, ibid.
   General rules for security against poisons, ibid.
 Poor living, the dangers of, 56.
 Porters subject to disorders of the lungs, 54.
 Postures, confined, injurious to the health  of sedentary artists, 59.
 Potatoe, the best  substitute for bread, 407.  The mealy  kind deemed
   most  nutritious, 408.   Simply boiling  or roasting, the  best mode of
   cooking them, ibid.  SteAved mutton and potatoes a  nourishing and
   palatable dish, ibid.
 Poverty, occasions parents to neglect giving their children  proper exer-
   cise,  45.   Destroys parental affection, ibid, note.  Not only occasions,
   but aggravates, many of the diseases of labourers, 56.   The poor great
    sufferers by the sale of bad provisions, 66, note.  And by bad air iu
    large cities,  79.
  Poultices proper for inflamed wounds, 361.
  Powders, general instructions for making and administering, 440.  As-
    tringent powder, preparation and dose of, ibid.   Powder of bole, ibid.
    Carminative powder,  441.  Diuretic powder, ibid   Aromatic pur-
    ging powder, ibid.  Saline laxative powder ibid  Steel powder, ibid.
    Sudorific powder, ibid. Worm powder, ibid.   Purging worm powder,
    ibid.   Powder for the  tape-worm, ibid.
  Pox, small, who most liable to, and at what seasons, 159.  Its causes and
    symptoms, 160.   Favourable and unfavourable symptoms in, ibid.
    Reeimen  161.  How the patient ought to be treated during the erup-
    tive  fever, ibid.   Children in this disorder ought not to  he together in
    the  same bed,  162.  Should be allowed clean linen, ibul   PatienU
    urder this disorder ought not to appear in public  view, ibid.  Medical
    Treatment, 163.  Thc.econdary fever, 165   When and how to open
    the pustules, ibid.   Of inoculation 166   Of the «"W "J.
  Pregnancy, how to treat vomiting when the effect of,  220.   ^ °
    conduct for women under the disorders incident to, 335.  Cause, and
    symptoms of abortion, 336.  How to guard  against abortion, ibid.
    Treatment in cases of abortion, ibid   Child-birth,  337.
  Prescriptions, medical, patients exposed to danger by their being writtco.
    in Latin, xvii.                       . .
  Provisions, unsound, the sale of, a public injury, 6b.
  Puerperal fever.   See Fever. 
INDEX.
475
Purges, the frequent taking of them renders the habitual use of them ne-
  cessary, 104.   Their efficacy in agues, 119.  Proper form  of, for an
  inflammation of the intestines, 207.  Cooling purges always proper in
  a gonorrhoea, 316.  Midwives  too rash in the giving of purges,  340,
  note.   Form of a gentle purge for infants disordered in their bowels,
  343.   For the thrush, 344.
Pustules, in the small-pox, favourable and unfavourable appearances of,
  160.   The suppuration of, to be promoted, 163.  When and how to
  open, 165.
Putrid fever.  See Fever.
Quacks put out more eyes than they cure, 295.  See Empirics.
Qn 'ckcry, Iioav to destroy, xvii.
Quakers, their mode of  dressing recommended, 88.
Quinsey, a common and dangerous disorder, and to whom most fatal, 192.
  Its causes,  ibid.  Symptoms, ibid.  Regimen,  193.   Medical appli-
  cations, 194.   How to  promote suppuration,  ibid.   Hoav to nourish
  the patient when he cannot swallow, 195.   Advice to persons  subject to
  this disorder, ibid.
-------------malignant, who most subject to,  and its causes, 196.  Its
  symptoms, ibid.   Regimen and medical treatment, 197.
Rattle Snake, Negro remedy for the cure of its  bite, 312.
Regimen ought to co-operate with  medicine to accomplish  the cure of di-
  seases, xi.   Will often cure diseases without medicine, 113.  See Ali-
  ment.
Religion, true, calculated to support the mind under every affliction, 103.
  The iustructors in, ought not to dwell too  much on  gloomy  subjects,
  ibid.
Remitting fever.   See Fever.
Repletion, impairs the  digestive  powers, 71.   Diseases occasioned by,
  72.   How  to treat a  looseness produced by, 217.
Resentment, the indulgence of,  injurious to the constitution, 98.
Resins, and essential oils, the proper menstruum for, 442.
Respiration, how to restore in  a drowned person, 377.
Rheumatism, acute and chronic, distinguished, 258. Causes, ibid. Symp-
  toms, ibid.  Medical  treatment, ibid.   Cautions to persons subject to
  this disorder, 260.
Rice, contains a nutritious  mucilage, 76.   A general  article of diet, 402.
  Simple boiling of, renders it a substitute for bread, ibid.
Rickets, the  appearance  of, in Britain, dated from the groAvth of manufac-
  tures, and sedentary employments, 44.  The causes of, 352.  Symp-
  toms, ibid.  Regimen and medical treatment, 353.
Rollers, pernicious tendency of applying  them round the  bodies of in-
  fants,  39.
Romans, ancient,  their  great atteution  to  the  cleanliness  of  their
  towns, 93.
Roses, conserve of, its great virtue against haemorrhages, 230, 233.
Ruptures, are chiefly incident to children and very old persons, 372. The
  causes respectively, ibid.   Method of treatment, ibid.  Cutting should
  be a\roided if  possible, ibid.   Cautions for persons  afflicted with a
  rupture, 373.  Oftener prove fatal before discovered, ibid, note.
Rutliaford,  Dr. his preparation for the cure of a dysentery, 236.
Sailors, their health injured by change of climate, hard  weather, and 
476
INDEX.
  bad provisions, 56, 57.  Many of their diseases spring from iutemper-
  ance, ibid   Ought to guard against wet  clothes, ibid.   How the ill
  effects of salt provisions might be corrected, ibid   Peruvian bark, the
  best antidote to sailors on a foreign coast, 58.   Cleanliness greatly con*
  ducive to their health, 94.
Sal-prunnelce, its good effects in a quinsey, 194.
Saline draughts, of good use for stopping a Aomiting, 220.   Preparation
  of, for this purpose, ibid.  Peculiarly good in the puerperal fever, 340.
Salivation, not necessary in the cure of the veiusrcal disease, 325.
Sarsaparilla, a poAverful assistant in venerel cases, 326.
Scabbed head in children, difficult to cure and treatment, 348.
Scarlet fever.   See Fever.
Scalds.   See Burns.
School sending children there too young, its bad consequences, 46. Ought
   to be seated in a dry air, and ought not to be too much crowded, 50.
Scirrhous in the liver, proper regimen in the case of, 215.   See Cancer.
Scrophula, nature of this disease, and its causes, 263.   Symptoms, ibid.
   Regimen and medical treatment, 264.
Scurvy, why prevalent among the English, 67.   Where most prevalent,
   and the two distinctions of, 260.  Causes of, ibid.   Symptoms and
   cure, 261.  Instructions  to  seafaring men, ibid.  Extraordinary ef-
   fects of milk, 262.   Proper liquors, ibid.
Spdentary life includes the greater part of the human species, 58.—Few
   persons follow agriculture  Avho are capable of other business, ibid.
   Sedentary and active employments ought to be intermixed for  the sake
   of health ibid.   Artists suffer from unAvholesome air, by being crowd-
   ed together, 59.  The postures  artists are confined to, injurious to
   health, ibid.    Disorders produced by, ibid.   Cautions offered to the
   sedentary, 60.   Sedentary amusements improper for sedentary persons,
   ibid.   Hints relating to improper food, ibid.   Exercise, a surer relief
   for Ioav spirits than drinking,  ibid.  Gardening a wholesome amuse-
   ment for the sedentary 61.  Disorders occasioned by intense  study,
   ibid.  Dietetical advice to the sedentary, 71.   Sedeutary occupations
   better adapted to women than men, 83, note.
 Sea water, a good remedy in the king's evil, 264.
 Senses, disorders of, 295.
 Seton, has sometimes  extraordinary effects in inflammations of  the eyes,
    191.  Is of sei-vice for pi-eventing apoplexies, 271.   The best method
   of making it, 280.
 Shoes, tight, the bad consequences resulting from, 87.    The high heels
   of women's shoes, 88.
 Sibbins, a venereal disorder so termed in the  vest of Scotland, how to
    cure, 329, note.
 Sick, the mutual danger incurred by  unnecessary visitors to, 96.—Per-
    sons in health, to be kept at a distance  from  the  sick, ibid.   Proper
    nurses ought to be employed about them, 97.   Instructions for avoid-
    ing infection, ibid.   Physicians too ungarded in their visits  to them,
    ibid, note.  Tolliog of bells for the  dead very dangerous  to,  100.
    Their fears ought not to be alarmed, ibid.
 Sight, injured by studying by candle-light, 63.
 Simples, a list of those proper to be kept for private practice, 421.
 Sinapisms, the general intentions of, 424.  Directious for making of,  ibidt 
INDEX.
477
Sleep, the due proportion of, not easy to fix, 85.  How to make it refresh-
  ing, ibid.  Complaints of the Avant of,  chiefly made by the indolent,
  ibid.  Heavy suppers cause uneasy nights, ibid.   Anxiety desti'uc-
  tive of sleep, ibid.  That in the fore part of the night most refreshing,
  ibid.  Early risers the longest livers, ibid, note.
Sleeping'm the sun, danger of, 55.
Small-pox.   See Pox.
Smell, injuries to which the sense of, is liable, with the remedies appli-
  cable to, 299.
Soap, Alicaut, recommended in the stone, 225.   Soap-lees, how to take,
  ibid.
Soldiers, exposed to many disorders from  the  hardships they undergo,
  56.  Ought to be employed in moderate labour in times of peace, ibid.
  note.
Soups.  See Broths.
Spine, often bent by artists Avorking in unfavourable postures, 59.
Spirit, rectified, the direct menstruum for resins and essential oils of ve-
  getables, 442.   Of wine, camphorated, how to  prepare, 444.   Spirit
  of Mindererus, ibid.
Spirits, lowness of, the general forerunner of a nervous fever, 193. The
  proper  remedies for, 238.   Cautions to persous under this complaint,
  ibul.
Spirituous liquors, when good  in  the colic,  209.  And  for gouy com-
  plaints in the stomach, 245.   Should be avoided by all persons  afflict-
  ed with  nervous disorders, 276.  The use  of, often fatal, 385.
Spitting of blood.  See Blood.
Sponge, may be used to supply the want of agaric as a styptic, 360, note.
  Ith use in extracting substances stopped in the  gullet, 375.
Sports, active, far more Avholesome thau sedentary amusements, 84. Golff,
  a better exercise than cricket, ibid, note.
Spots in the eye, how to treat, 297.
Squinting,ho\r to correct the habit of, 297.
Stays, a ridiculous and pernicious article of female dress, 40, 87.  The
   wearing of, tends to produce  cancers in the breast,  301.
Sternutatories, preparations of, recommended for restoring lost  smell,
   299.
Sticking-plaster is the best application for  slight wounds, 360.
Stomach, exercise the best cure for disorders of, 84.   Inflammation of,
   a  disorder  that calls for speedy assistance, 205.   Its causes, ibid.
   Symptoms, ibid.   Regimen, ibid.  Medical treatment, 206   Pain in,
   its causes, 244.  Remedies  for, ibid.   Instructions for persons subject
   to, 245.
 Stone, the formation of, in the bladder, explained, 105.   This disorder
   how distinguished from the gravel, 224.   Causes and symptoms, ibid.
   Regimen, ibid.   Medical treatment, 225.   Alicant soap and lime-iva-
   ter, how to take for this disorder, ibid.  The uva ursi, a remedy in
   present request for, 226.
 Stool, loose, the benefit of, to children, 52.  Proper  treatment of, when
   excessive, ibid.  The discharge by, cannot be regular, if the mode of
   living  be irregular, 104.  One in a day generally sufficient  for an
   adult, ibid.  How to produce a regularity of, ibid.  Frequent recourse
   tt> medicines for costiveness, injurious to the Constitution, ibid. 
**'°                         INDEX.
Storck, Dr. his method of treating cancers, 302.
Strabismus, See Squinting.
Strains, proper method of treating,  371.  The safest external applica-
   tions, ibid, note.
Stranguary, from a blistering-plaster, how to guard against, 128.  In the
   small-pox, hoiv to relieve, 103.  From a venereal cause, described,
   Avith its proper treatment, 323.
Strangulation, course of treatment for the recovery of persons from, 387.
Strasburgh, successful treatment of a miliary fever there, 150, note.
Strength, the folly of trials of, from emulation, 54.
Study, intense, injurious to health, 61.  The disorders occasioned by, 62.
   Character of a mere student,  63.   Hints of advice to studious persons,
   64.  Danger of their having  recourse to cordials, 65.   Health often
   neglected while iu possession, and laboured for after it is destroyed,
   ibid.  No  person ought to study immediately after a full meal, ibid
   Dietetical advice  to the  studious, 71.   The general effects of,  on
   the constitution, 275.
 Sublimate, corrosive, how to administer in Acnereal cases, 326.
 Suffocation, by  the  fumes of charcoal,  liable  to happen in close cham-
   bers, 380.   General causes  of suffocation, 386.  Overlaying of in-
   fants, ibid.
 Sugar, an improper article in the food of children, 42.
 Sulphur, a good remedy for expelling Avorms, 247. And for the itch, 266.
 Suppers, ought not to destroy the appetite for breakfast, 72. Heavy sup-
   pers sure to occasion uneasy nights, 86.
 Surgery, many of the operations of, successfully performed by persons
   unskilled in anatomy, 356.  Humanity induces every one more or less
   to be a surgeon, ibid.
 Sweating, generally excited in  an improper manner in fevers, 117. 124.
 Swoonings, the  several causes of, described, 281.285. Proper treatment
   of this disorder, 286, 384.   Cautions to persons subject to them, ibid.
 Sydenham, Dr. his method of treating fevers in children from teething,
   351.
 Symptoms, diseases better distinguished by, than by the systematical ar-
   rangement of, 111.  The differences of sex, age,  and constitution,  to
   be considered, ibid.  Diseases of the mind to be distinguished from
    those of the body, 112.
 Syncope, proper treatment in, 383.
 Syrup, the general intention of, 442.   How to make simple syrup, and
    to modify  it  for particular purposes, ibid.
 TACITUS,  his  remarks ou the degeneracy of the Roman-ladies, 34,
    note.
 Tallow-chandlers, and others working on putrid animal substances, cau-
    tions to, 54.
 Tapping,  for the dropsy, a safe and simple operation, 253.
 Tar, B .rbadoes, its efficacy in the uervous colic, 211.
 Tartar, soluble, a good remedy for the jaundice, 250.  Cream of, a good
    remedy in a dropsy, 253.   And rheumatism, 258.
  Taste, how to restore the sense of, when injured, 300.
  Taylors, are exposed to injuries from  breathing confined air, 59.  Are
    subject to consumptions, ibid, note. Often lose the u>e of their legs, ibid.
    Hints of instruction offered to them in regard to their health, 60; 
INDEX.                          479
 Tea, the customary use of, injurious to female constitutions,  36.  De-
   stroys their digestive powers, and produces hysterics, 68.   The bad
   qualities  of, principally oAving to imprudence  in  the use of it, ibid.
   Green, chewing of, a remedy for the heart-burn, 274.   Has a poAver-
   ful effect upon the nerves, 280, note.   Is bad for persons troubled with
   flatulencies, 288.   Occasions  an unnecessary consumption  of bread,
   402.  Bad effects of au immoderate use of,  ibid.
 Teithing, the disorders attending, 350.  Regimen,  and medical treat-
   ment in, 351.  Applications to the gums,  and how to cut them, ibiel,
   352.
 Temperance, the parent of health, 89.
 Testicles, swelled, the cause of  321.   Regimen and medicines in, ibid.
   Treatment under a cancerous or scrophulous habit, ibid.
 Tetters, Sir Paul Joddrell's prescription for, 343, note.
 Tetanus, or the locked-jaw, the causes, 293.   Symptoms and medicine,,
   294.
 Thirst, how it may be quenched ivhen a person is hot, Avithout danger, 109.
 Thought, intense, destructive of health, 61.
 Thrush in infants, the disorder and its causes described, 344.   Medical
   treatment of, ibid.
 Tinetures and elixirs,  the proper medicines to exhibit in the form of,
   412.  Preparations ofthe aromatic tincture, ibid.   Compound tincture
   of the bark, ibid.  Volatile foetid tincture, 443.  Volatile tincture of
   gum guaiacum, ibid.   Tincture of black hellebore, ibid.  Astringent
   tincture, ibid.   Tincture of myrrh and aloes, ibid.   Tincture of opium,
   or liquid  laudanum, ibid.   Tincture of hiera picra, ibid.  Compound
   tincture of senna, ibid.   Tincture of  Spanish flies, ibid.  Tincture of
   the balsam of Tolu, 444.   Tincture of rhubarb, ibid.
 Tissot, Dr. character of his Avis aupeuple, xii.   His medical course for
   the cure of the hydrophobia, 310.  His directions for gathering, pre-
   paring, and applying agaric of the oak as a styptic, 360, note.  In-
   stances from, of the recovery of drowned  persons, 378, 379.
 Tobacco, a clyster of a decoction of, useful to excite a vomit, 376.   A
   clyster of the  fumes of,  will stimulate Uie intestines, and produce a
   stool, 211, note.
 Toes, the free motion of, destroyed by wearing tight shoes, 87.
 Tooth-ach, the general cause of, 241.  Medical treatment of, 242. When
   to be extracted, ibid.   Directions for cleaning, 243.
 Towns, great, the air of, destructive  to the children of the  poor, 49.
   Children  bred in  the  country,  ought not to be sent too early into
   toAvns, 50.  Cleanliness not sufficiently attended to in, 92.   Ought to
   be supplied with plenty of water for  washing the streets, 95, note.
   The best means to guard  against infection in, 97, 98.
Trades, some injurious to health by making artists breathe unwholesome
   air, 53, 59.
Transitions, sudden, from heat to cold,  the ill effects of,  to the constitu-
   tion, 109.
Travellers, the use of vinegar recommended  to, 57.   Ought to be very
   careful not to sleep in damp beds, 107.   Fevers ivhy often fatal to, 115-
Trces should not be planted too near to houses,  81.
Trefoil water, a good remedy in the rheumatism. 260. 
480
INDEX.
Tumours, proper treatment of, 358.
Turnips, properly cultivated, afford Avholesome nourishment, 409.
Turnbull, Dr. his method of treating the croup in children, 350, note.
Turner's cerate, preparation of, 436.
VACCINATION.  See Inoculation.
Vapour of, fermenting liquors, noxious, 380.
Vegetables, Avholesome correctors of the bad qualities of animal food, 68.
  Their extraordinary effects iu the scuivy, 262.
Venereal disease, why omitted in the first edition of Uiiswork, 313.   Un-
  favourable circumstances attending this disorder, 314.   The virulent
  gonorrhoea, ibid.  Gleets, 319.   Swelled testicles, 321.   Buboes, ibid.
  Chancres,  322.   Stranguary,  323.  Phymosis, 324.   A confirmed
  lues, ibid.   American method of curing this  disease, 326.  General
  observations,  327.   Cleanliness a great preservative  against,  328.
  The use of medicines ought not to be hastily dropped, 329.  I soften
  too much disregarded, 330.
Ventilator, the most useful of all modern medical improvements, 80.
Vertigo often produced by intense study, 63.
Vinegar, a great antidote against diseases, and ought to  be used by all
  travellers,  57.  Should be spriukled in sick chambers, 97,  124,  145.
  Is of considerable service  in the bite of a mad-dog, 308; and hi any
  kind of poison, 311.   Its  medical properties, 445.  Is of use  to ex-
  tract the virtues of several medicinal substances, ibid.   How to  pre-
  pare vinegar of litharge,  ibid.   Vinegar  of roses, ibid.  Vinegar  of
  squills, ibid.
Viper, the bite of, the sufficiency of the grease for the cure of, doubted,
  311.  Method of treatment recommended, ibid.
Vitriol, elixir of, an excellent medicine in weakness of the stomach, 273.
  And for windy complaints, 277.
Vitus,  St. his dance, method of cure of, 283.
Vomits, their use in agues, 119; and in the nervous fever, 141.  Cautions
  for administering in the putrid fever. 146.   Ought by no means to be
  administered in an inflammation of the stomach, 206.   Are useful  in
  cases of repletion, 213.  Are powerful remedies, in the jaundice, 249:
  Are the first object to be  pursued when poison has been received into
  Uie stomach, 305.  Their use in the hooping-cough, and how to admi-
  nister them to children, 203.  Midwives too rash in the use of, 340,
  note.  Form of a gentle one for infants disordered in the bowels, 343.
Vomiting, the several causes of, 219.   Medical treatment  of, 320.  Sa-
  line draught for stopping of, 220.  Causes of, in children, 346.   How
  to be treated, ibid.   Of blood.   See Blood.
Voyage, a long one frequently cures a consumption, 134.  Voyages have
  an excellent effect on persons afflicted with nervous disorders, 276.
URETERS  and their use,  described, 213, note.
Urine, the appearances  and quality of, too uncertain to form any de-
  termined  judgment  from,  105.   Dr.  Cheyne's judgment  as to the
  due  quantity of,  not  to be relied on, ibid.   The  secretion and dis-
  charge of, how obstructed, ibid.   Bad consequence of retaining  it
  too long. ibid.  Too great quantity of, tends to a consumption, 106.
  Stoppage of, its general causes,  241.   Cautions  as to the  treatment
  of, ibid.   Diabetes, 221.   Iucoutinency of, 222,   Suppression of, 
INDEX.
481
   medical treatment in, 223.  Cautions  to persons subject to this dis-
   order,  ibid.   Bloody,  causes of,  234.  Medical treatment of, ibid.
   An obstinate deafness cured by warm urine, 298, note.
 Urine doctors,  their impudence, and great success from the credulity of
   the populace, 105, note.
 Uva ursi, a remedy in present request for the stone, 226.
 WALLS, high, unwholesome, by obstructing the free current of air, 81.
 Ward's essence, preparation of, 444.   His fistula  paste,  a popular re-
   medy that may deserve trial, 365.
 Wars occasion putrid  fevers,  by tainting the air with the effluvia of
   dead carcases, 143.
 Wasps, hornets, or bees, how the bite of, ought to be treated, 311.
 Water, frequently unwholesome by mineral impregnation , 63.   Cautions
   for the choice of, 69.  Cold, the  danger of drinking when a person
   is hot, 109.
 Water iu the head, is a disorder chiefly incident to children, 354.  Its
   causes,  symptoms, and proper treatment, 355.   The  nature  of the
   disorder seldom discovered in due time for cure,  ibid, note.
 Waters by infusion,  how to prepare ; Lime  Avater,  446.  Compound
   lime Avater,  ibid.  Sublimate water, ibid.  Styptic water, ibid.  Tar
   water, ibid.
 Waters, simple distilled, their  medical  uses, 446.   Preparation of cina-
   mon Avater,  ibid.  P^nyroyal water, ibid.   Peppermint water, 447.
   Spearmint Avater, ibuj.^  Rose  water,  ibid.   Jamaica pepper Avater,
   ibid.               "t\
 Waters, spirituous disth^id, how to prepare. Spirituous cinnamon water,
   447.  Spirituous Jamaica pepper water, ibid.
 Watery eye, how to cure,-297.
 Weaning of children from the breast, the proper mode of, 41, 42.
 Weather, states of, which produce the putrid fever, 143.
 Wells, caution  to persons going down in them, 80  note.  Deep, ought
   not to be entered till the air in, is putrified, 380.
 Whey, an excellent drink in  a dysentery, 237, and in the rheumatism,
   259.  Orange whey, hoAv  to make, 123.  Alum whey, 222. 447.
   Mustard Avhey, ibid.   Scorbutic Avhey, ibid.
 Whitlow, 358.   How to cure, ibid.
 Weytt, Dr. his remedies-for flatulencies, 287.
 Wind.  See Flatulencies.-''
 Windows, the danger of throwing them open on account of  heat,  and
   sitting near them, Mgr
 Wine, good, almost the only medicine necessary in a nervous fever, 140.
 Wines, the medical properties  of, 447.  Their use in extracting the
   virtues  of medicinal substances, 448.   Preparation of anthelmintliic
   wine, ibid.    Antimonial wine, ibid.   Bitter Avine, ibid.   Ipecacuanha
   Mme,ibul.   Chalybeate or steel Avine, ibid.  Stomachic Avine, ibid.
 Womb, inflammation of, its symptoms, 338.  Medical treatment of, ibid.
Women, errors in Uieir education pointed out, 34.  Why subject to hys-
  terics, 68.   Are better adapted to follow sedentary  occupations than
  men, 83, note.  In child-bed, often die from their  apprehensions of
  death, 99.  Their disorders rendered epidemical by the force of ima-
  gination, ibid.  Every thing that  can  alarm them to  be carefully
  guarded against, 100.  Evil tendeucv of tolling  bells for th*  deadv
                               00 
482
INDEX.
   ibid.   How exposed to a miliary fever during pregnancy, 148. Their
   constitutions injured by living too  much within doors,  330.   Those
   avIio work in  the open air almost as hardy as men, 331.   Advice to,
   with reference to the menstrual discharge, ibid.  At the commence-
   ment, ibid.   Fluor albus, with its  proper  treatment, described, 334.
   Advice to, at the ceasing of the menses, ibid.   Rules of conduct dur-
   ing pregnancy, 335.  Causes and symptoms of  abortion,  336.  How
   to guard against abortion, ibid.   Treatment in cases of abortion, iUd.
   Instructions at the time of child-birth, 337.   Causes ofthe milk fever"
   339.   Hoav  to guard against the miliary fever, ibid.   The puerperal
   feATer, ibid.   General cautions for women in child-bed, 341.  Causes
   of barrenness, ibid.
 Wool, the best external application in the gout, 255.
 Workhouses, poisonous to infaijts, 49.
 Worms, how to treat  a looseness produced by, 218.   Three principal
   kinds of, distinguished, 245.  Causes, 246.  Symptoms of, ibid.   Me-
   dical treatment for, 247.  Remedy for children, ibid.  General cau-
   tions for preserving children from them, 248.  Danger  of taking
   quack medicines for them, ibid, note.
 Wort, recommended for the scurvy, aud proper to drink at sea, 262.   Is
   a powerful remedy in cancerous cases,  303.
 Wounds, are not cured by external  applications, 359.   Are  cured by
   nature,  ibid.  Proper  course of treatment, JMd.   How to stop the
   bleeding,  ibid.  Caution against improper styptics, 360.   Method of
   dressing them, ibid. Poultices for inflamed wounds,  361.   Regimen
   in, ibid.                                   **
 Writing, hints of advice  to those Avho are much employed in, 62.  64.
 YAWS, general hint  for  the cure of, 328, note.    *
 Young animals, all exert tlieir organs of motion as soon as they are able,
   44.
ZINC, the flowers of, a popular remedy for the epilepsy, 282.
FINIS. 
                  ADVICE







         MOTHERS*



                         ON



THE SUBJECT  OF THEIR OWN HEALTH,



            AND ON THE MEANS OF PROMOTING



    THE HEALTH, STRENGTH, AND BEAUTY


              OP THEIR OFFSPRING.


                   -------->SNS'./\S,,/<--------

         ------Auditse voces,  vagitus et ingens.
         Infantumque anima? flentes in limine primo;
         Quos dulcis vitae exsortes, et ab ubere raptos,
         Abstulit atra dies,  et funere mersit accerbo.
                                VlBG. JENEID. VI.

                     i.."N.l"trt»'«M**«M«"i.  -


          BY WILLIAM BUCHAN, M. DV

    FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS, AND

            AUTHOR OF " DOMESTIC MEDICINE."
        NEW-YORK;


PUBLISHED BY RICHARD SCOTT,

        276 Pearl-street.
1815: 
 
CONTENTS.
INTRODUCTION.       ......Page 5
                          CHAP. I.
Hints to Women before Marriage.       ....          7
                         CHAP. II.
Rules of Conduct during Pregnancy.....         11
                         CHAP III.
A few Remarks on Child-birth......        26
                          CHAP IV.
Of  the Nursing and Rearing of Children    ...         33
Sect. I.  Of the influence of Air on  the Health and Lives of Chil-
           dren.     ........    ib.
Sect. II. Of  Warm and Cold Bathing.....37
Sect. III.  Of Children's Dress......41
Sect. IV.  Of the injury done to Children by the too early and un-
           necessary use of Medicines.....52
Sect. V. Of the Food proper for Children.       ...     59
Sect. VI.  Of Exercise and Rest during Infancy.    .      .     66
                          CHAP  V.
Of Dwarfishness and Deformity.......69
                          CHAP  VI.
 Baneful effects of Parental Tenderness, or what may be called an
   extremely delicate and enervating Education.     ...    73
                         CHAP VII.
 Of Employments unfavourable to the  Growth and Health of Chil-
   dren...........82
                         CHAP. VIII.
 Of Accidents.......•  •     -    87
                          CHAP. IX.
 Of Foundling Hospitals, and other Charitable Institutions for the
   Rearing of Poor or Deserted Children.....93
                           CHAP X.
 Sketch of a Plan  for the Preservation and  Improvement of the
   Hum-in  Species......-    •    . ■    98
 APPENDIX..........101 
 
INTRODUCTION.
       TlIE preservation of the lives of infants was the first subject
I wrote upon at the openiog of my medical career;  after forty years
practice, I now resume  it  with increased zeal aud  pleasure,—zeal,
prompted by a just sense of its importance,—and pleasure, arising from
the hope of its beneficial and lasting effects.   I am sure of being listened
lo with kind attention  by  the  tender and  rational mother, while I am
pointing out to her the certain means of preserving  her own health, of
securing the attachment of the man she holds dear, and of promoting the
health, strength and beauty of  her offspring.  She will not take alarm at
the idea of medical advice, when I tell her that  my object is to enable
her to do without medicine, and to obtain every  desireable end without
any painful sacrifice.   The  path along which I propose to conduct her
is plain and easy, the prospects all rouud are delightful, and it leads to the
purest sources of happiness.
   The more I reflect on the situation of a mother, the  more I am struck
with the extent of her power, and the inestimable value of her  services.
In the language of love,  women are called angels: but  this is a weak
and a silly compliment; they approach nearer to our ideas of the Deity :
they not only create, but sustain their creation, and  hold  its future des-
tiny iu their hands: eveiy man is what Ills mother has  made him, and to
her he must be indebted for the greatest blessing  in life, a healthy and  a
vigorous constitution.
   But while I thus speak of the dignity of the female character, it must
be understood, that by a mother  I  do not mean the woman who merely
brings a child into the world, but her who faithfully discharges the duties
of a parent,—whose chief concern is the well-being  of her  infant,—and
who feels all her cares amply repaid by its growth and activity.   No
subsequent endeavours can remedy or correct the evils occasioned by a
mother's negligence; and the skill of the physician is exerted in vain to
mend what she, through ignorance  or inattention, may  have unfortunate-
ly marred.
   Several books have been  written on the cure of diseases incident to
children.   The natural effect of such publications is to excite terror,
and to prompt mothers and nurses  to keep dosing poor infants with drugs
on every trifling occasion, w:d  to place more reliance en the efficacy of
medicine than on their own best endeavours.  One of  the objects which
f have in view is to relieve mothers from  groundless  fears,—to  teach
them how to prevenl diseases that are almost always the consequences of
mismanagement.—to inspire them with  the  fullest confidence in proper
nursi ig, and with strong prejudices against  the use of medicines, which
do m's;■hief twenty times for once Uiat they do good. 
VI
INTRODUCTION.
  Quackery in the nursery is not the only error in which I shall endca*
vour to undeceive mothers.   The want of proper instructions at an early
period of life betrays them  into a variety of fatal  mistakes respecting
their own health, as well as that of their children.  These mistakes
and the means of rectifying them, form a considerable part of the follow-
ing work.  The language is adapted to every capacity, it being of con-
sequence that eveiy woman should understand it; and the rules laid down
are practicable in every condition,  except  that of cheerless  poverty.
With the hope of removing  this exception, I shall point out the most ef-
fectual method of assisting  women so circumstanced;  and I do not know
any manner, in which humanity, charity, and patriotism can be more laud-
ably exerted, or even  a part of the public revenue more usefully em-
ployed, than in enabling mothers to bring up a healUiy aud hardy race of
men, fit to earn their livelihood by useful employments,  aud to defend
Their country iu the hour of danger. 
           ADVICE  TO MOTHERS.




                              CHAP.  I.


          HINTS TO WOMEN BEFORE  MARRIAGE.


         I HE desire of preserving and improving personal beauty, which
  discovers itself at an early period in the female breast, is wisely designed
  by nature for the best and most important ends; it is a powerful check.
  on excesses of every kind, and is the strongest incitement to cleanliness,
  temperance, moderate exercise, and habitual good humour.   All that is
  necessary is to convince young people that these are the true means of
  rendering them lovely, because  they  are the only means of securing the
  enjoyment of  health, the very essence of beauty; instead of sourly dis-
  couraging so natural a wish, let  us  point out the  way to its  full accom-
  plishment, and thus prevent many amiable women from taking a wrong
  road, and from destroying both  health and beauty by an absurd pursuit
  of the latter alone.
    One of the first truths to  be impressed upon the minds of young  wo-
 men is, that beauty cannot  exist without heal'.h,  and that the one is ab-
 solutely unattainable by any practices  inconsistent with the other.   In
 vain do they hope to improve their skin, or to give a lively redness to
 their cheek, unless they take care to keep the blood pure, and the whole
 frame active and vigorous.  Beauty,  both of shape and  countenance,
 is nothing more thau visible health,—the outward mirror of the state of
 things within,—the certain  effect of good air, cheerfulness, temperance
 aud exercise.
   There is nothing perhaps, so pernicious to women  as the use of creams,
 and pastes, and powders, and lotions, and numberless  other contrivances
 to bleach the skin, or  to produce an artificial white and red.  All of
 them act with  double iujury, not only in destroying the surface which
 they were expected to beautify,  but iu poisoning  the habit, and causing a
 fatal neglect of the great preservatives of life itself.   A  blotch or a pin*
 pie, however offensive to the eye, gives timely notice of the impure state
 of the fluids, and of the kind efforts of nature to expel the noxious mat*
 ter.  Ought not these efforts then  to be assisted oy a judicious plan of diet
 and regimen, instead of throwing back the impurity into  the  blood, and
 converting the very mcansof health into the seeds of infection and disease?
 Besides, lead or mercury is the chief ingredient iu all those boasted cos-
 metics,  and, being  absorbed  through  Uie  skin, cannot fail to occasion
 cramps, spasms, convulsions,  colics,  and  the incurable train of nervous
 aud consumptive complaints.
  Beauty is impaired, and health too often destroyed, by other absurd
practice*  Mich as drinking vinegar to produce what is called a genteel or
                                61 
8
HINTS  TO  WOMEN
slender form, and avoiding exposure to the opeu air, for fear of its  in
juring the fancied delicacy of a fme skin.  Vinegar, used as a sauce and
in moderate quantities,  serves to correct the putrescent tendency of  va-
rious articles of food, and is equally agreeable aud wholesome; but when
swallowed in draughts for the purpose of reducing plumpness,  it proves
highly injurious, causing excessive perspiration, relaxing the bowels im-
parting no small degree of acrimony to the blood, and very much enfeeb-
ling the whole system.   The dread of  open air  is still more ridiculous
and detrimental.   Look at the healthy texture of the milk-maid's skin,
and at the roses  ever blooming on her cheek, and  then consider whether
the open air can be unfavourable  to beauty.  The votaries of fashion
may affect to despise these natural charms,  and to call them vulgar: the
heart of man feels their irresistible attraction, and  his understanding con-
firms him in so just a preference.   Surely, the languid sickly delicacy
 produced by confinement, cannot be compared to  the animated  glow  of a
 lace often fanned by the refreshing breeze!
    The woman therefore, who feels a laudable wish to look well, and to
 be so in reality must place no confidence in the silly doctrines, or the de-
 ceitful arts of fashion.   She must  consult nature and reason, and seek
 for beauty in the temple of health ; if she looks for  it elsewhere, she
 will experience the most mortifying disappointment: her charms will fade;
 her constitution will be ruined;  her husbands love will vanish with her
 shadowy attractions, and her  nuptial  bed will  be unfruitful, or cursed
 with a puny  race, the  hapless victims of a mother's imprudence.  She
 cannot transmit to her children what she does uot herself possess; weak-
 ness and disease are entailed upon her posterity; and even in the midst of
 wedded joys, Uie hopes of a healthy and vigorous issue are blasted for ever.
     The only way to prevent such evils is, to  pay  a due regard to those ra-
  tional means of promoting health which 1 have already hinted at,—tem-
  perance, exercise, open air, cleanliness,  and good-humour.  These sub-
  jects are pretty fully discussed in my " Domestic Medicine ;" yet a few
  remarks may be proper on the present occasion.
     In laying down rules of temperance, I do not wish  to impose any re-
  straint on the moderate use of good and  Avholesome food or drink : but
  under these heads we  must  not  include spirituous  liquors;  relaxing
  and often repeated draughts of hot tea and coffee; salted, smoked-dried,
  and highly seasoned  meats;  salt fish; rich gravies;  heavy sauces;  al-
  most indigestible pastry; aud sour unripe fruits, of which women in
  general are immoderately fond.    We pity the green-sick  girl, whose
  longing for such trash is one of the causes as well as one of the effects of
  her disease; but can  any woman capable of the least reflection, con-
  tinue to gratify a perverse appetite by the use of the  most  pernicious
  crudities?   Fruit, in the season of its maturity, is no less salutary than
   delicious.   By plucking and  eating it before it is ripe, you defeat the
   beui«mant  purposes of  nature,  and will severely feel her  resentment.
   The morning is  the best time  to eat fruit,  when the  stomach is not
   loaded with other aliment.  Even in  the evening I had rather sec it
   introduced, thau the  enervating luxuries of the tea-table,  or the  still
   worse preparations  for  a supper of animal food.  A meal of this sort
   should not be made twice in one  day.   After a  hearty  dinner, a  long
   interval is uecessary  before nature  can recjuire, or even bear without 
BEFORE  MARRIAGE.                   9
injury, another substantial repast.  Suppers are doubly prejudicial on
account of the lateness of the hour, and the danger of going to bed with
a full stomach.   Apoplexies are often occasioned by such inconsiderate
and unseasonable indulgence, but its certain effects are restless nights,
frightful dreams, broken and unrefreshing slumbers, an incapacity of ear-
ly rising next morning, head-achs, paleness of aspect, and general  relax-
ation.  Whoever sets any value on health or beauty, will always make
very light repasts at night, and  will go to bed early; that is to say, never
later than ten or eleven o'clock, in order to enjoy sweet repose, and to
rise  betimes, with renovated strength and alacrity, to the pleasures and
duties of  the e 6uing day.
   Pure air and moderate exercise are not of less  importance than  food
and drink.  Women are much confined by their domestic employments
and  sedentaiy pursuits: for  this very reason they ought to go out fre-
quently, and tike exercise in the open air,—not in a close carriage, but
on foot or on  horseback.  When prevented by the weather from going
abroad, dancing, provided it be not continued to fatigue, is the most
cheerful and healthy amusement within doors.   The only sedentary di-
versions proper  for women are  playing  on some musical instrument,
singing, and reading aloud  delightful pieces of poetry or  eloquence.
Young ladies and  mothers should wholly resign  the card-table  to old
maids, who can only injure their own health, and who have no taste for
any other mode of social intercourse.
   It may  seem a little strange that I should think it in any sort necessa-
ry to recommend cleanliness  to the fair sex: I am far from intending to
convey the most distant insinuation of their negligence  in this respect -,
I only wish to heighten their idea of its utility, and to  point out farther
methods of increasing its benefits.  They are rather too  sparing of water,
from an apprehension of its injuring the skin or giving  it a disagreeable
roughness.  This is a great mistake.   Pure water may be truly consi-
dered as  a fountain of  health,  and its frequent use is the best means of
improving the skin and strengthening the whole frame.  The offices per-
formed by the skin are of greater importance than most people imagine.
It is not merely a covering or shield to guard the fine  organs of feeling
from irritation or external injury, but one of the grand outlets admirably
contrived by nature for expelling the noxious and superfluous humours
of the body.  The perspirable matter thus thrown out  will of itself clog
the pores, and relax the skin, unless care is taken to promote its easy
escape by keeping the entire surface of the body perfectly clean,  well-
braced and elastic, which can  only be done by frequent washing, and in-
stantly wiping Uie parts dry.   Those who have not a bath to plunge into,
should wash the face, neck, hands, and feet, every morning and night;
and experience will soon convince them,  that, the more they accustom
themselves even to this partial  applicatiou of clean water, the more  com-
fortable and enlivening they will find it.   If misguided tenderness has
produced an extreme delicacy of habit as well as of skin, it will be pro-
per to use luke-warm water for some time;  and then gradually to dimi-
nish its temperature, till cold water can be employed, not only with safe-
 ty, but with benefit.   As a preservative of health, it is far more bracing
and more invigorating than  warm water, though tlie latter may be often
advisable in cases  of particular infirmity, indisposition,  or disease.
   All women  of delicacy and good sense are sufficiently attentive to 
10
felNTS  TO  WOMEN
remove any outward soil or visible dirt from their person; but they da
not all know, that a vapour, too fine to be perceived by the eye, is con-
stantly issuing from the pores, the little orifices or mouths of which must
therefore be  kept clean and unobstructed.   For the same iea*on, the
linen and interior articles of dress shouhl be often changed, as they be-
come impregnated with the perspirable  matter, and, when foul, would
not only prevent the escape of any more, but would even have a part of
what they had received re-absorbed by the skin, aud thrown back into
the system.  The whole dress also should be loose, and as  light as may
be found consistent with due warmth, so  as not to increase perspiration
too much by its  heaviness, nor to check either that or the free circulation
of the blood  by its pressure.
   Among  many improvements in  the modern fashions of female  dress,
equally favourable to health, to graceful ease and elegance, the disconti-
nuance of  stays is entitled to peculiar approbation.  It is, indeed, im-
possible to think of the old straight waistcoat of whalebone, aud of tight
lacing, without astonishment and some degree of horror.   We are sur-
prised and shocked at the folly and perverseness of employing, as an ar-
ticle of dress, and even as a personal ornament, what must have checked
youthful growth—what must have produced distortions and deformity—
besides occasioning various irregularities and diseases.  I need not point
out the aggravated mischief of such a pressure on the  breasts  and  womb
in a state of pregnancy; but I must notice a defect very prevalent among
young women of the present day in London, who, though they have not
worn stays, may be  fairly presumed to inherit from their mothers some
of the pernicious effects of such a custom.
   The injury to which I allude, is the want of nipples.  This unnatural
defect seems to have originated from the use of laced stays; and as chil-
dren so often resemble their parents in outward form, it is not improbable
that the daughter may bear this mark of a  mother's imprudence, and
may even  transmit it to her own female children.—Where stays  have
never been used, the want of a nipple is as extraordinary as the want of
a limb; and no mother is found thus disqualified from  discharging  one of
her most sacred duties.  But, in London, the instances are too frequent
to be ascribed to accident, and canuot, perhaps, be accounted for more
satisfactorily than in the manner here suggested.
   In my summary of the means of promoting health and beauty, cheer-
fulness or good humour is mentioned the  last, though certainly it  is not
the least in point of efficacy.  It has the happiest influence on the body
and mind; it gives a  salutary  impulse to the circulation of  the  blood,
keeps all the vital  organs in easy and agreeable play, renders the out-
ward  deportment  highly pleasing, while the perpetual sunshine within
spreads  a  fascinating  loveliness over the countenance.—Its opposite,
peevishness,  or  ill-humour, imbitters life, saps the constitution,  and ia
more fatal to beauty than the small-pox, because its ravages are more
certain, more disgusting, and more permanent.
   Such  are  the chief points which I wish to impress upon the  minds
of women  before marriage.   Objects of so much importance in  every
state or  period  of  life, are  deserving of  peculiar  regard when  an
pinion  of the sexes is proposed.  It is little short of intentional  mur-
der on the part of  a  weak, langu;d, nervous, or deformed  woman to
approach  the marriage-bed.  Improper passions may urge her to be- 
BEFORE
MARRIAGE.
11
come a wife; but she is wholly unfit to become a mother.  She risks her
own life,—Bhe disappoints the natural wishes of a husband,—and should
she have children, her puny, sickly offspring, as I before observed, will
have little cause to thank her for tlieir wretched existence.  The evil is
not  confined  to her own family; society at large is materially injured;
its well  being depends on  the vigour of the  members that compose it;
and  universal experience  has fully  proved, that the frame of a  hus-
bandman or a hero is not to be moulded or cherished  in the womb of de-
bility, and that the bold eagle will never be brought  forth by the timid
dove.
  I  cannot conclude these hints without adding a few words on the choice
of a husband.  Having  endeavoured to prove that health is so indispen-
sible a requisite in females  before marriage, they may well suppose that I
deem it no less necessary in  the other sex.   I am always sorry to see
that precious blessing sacrificed in an alliance with infirmity, or youth and
beauty consigned to Uie frozen arms of age.  Misery must be the inevit-
able consequence of such unnatural matches.   But I fear that my remon-
strances will  have little effect in restraining the undue exercise of paren-
tal authority, or iu attempting to open the eyes of a woman to her certain
destruction,  when she suffers herself to be dazzled by the splendour of
riches, or charmed by the sound of an empty titie.
                        CHAPTER  II.

      RULES OF  CONDUCT DURING PREGNANCY.

      A.FTER  what  I have already said  on the subject of health, I
hope I need not make use of any new arguments to convince women of its
increased importance the moment thej conceive,—a moment from which
they may begin to date  the  real perfection of their being.—Nature
has now entered  upon her grandest work,  and uothing is wanting but
the  mother's care to complete it.  The exertions of this care are not
left  to whim, to  caprice, or even to the strong  impulses of parental
love.  The self-preservation of the mother is made dependant on the pro-
per  discharge  of her duty, her  own  health, her strength, her  very
life are closely entwined with the well being of the embryo in her womb;
nor can slie be guilty of the least neglect, without equal danger and injury
to both.
   I  am sorry to think  that any awful warning  should be necessary to
check the commission of so wicked an outrage upon nature, as an attempt
to procure abortion.   This can never be effected without either the pro-
bable death of  the mother, or the certain ruin of her constitution: the
stimulants which are used  to force the womb prematurely to discharge
its sacred deposit, must inflame the parts so as to cause a mortification; or
will convulse and enfeeble Uie whole system in such a manner as to leave no
chance of future health or enjoyment to the destroyer of her own child.
  In the ancient  history of the Jews, we read of two harlots  warmly
contending for a living child.  How  different is the case with  our wo-
men  of that description!—Their wish, ifthry conceive,  is to  prevent 
12                 RULES  OF CONDUCT
or to destroy the life of the embryo, even at the risk of then own.   Is a
moDster of this sort to be pitied, when, in the execution of her shocking
purposes, she brings on those deadly symptoms which must soon close Iht
guilty career ?
   The  unnatural  mother,  however, is not always the  only  monster
concerned in those scenes of  horror;  her  ba-e seducer is too often the
adviser of the  despe.ate resolution, and crowns  his guilty  joys  with
double  murder.   A.iother ruffian, some male  or female practitioner
in midwifery, is also engaged in the hellish plot,  and lends  a  hand to
perpetrate the  foul deed, alike regardless  of  the  mother's danger, and
deaf to the cries of infant biood !  I never read, without shuddfring, any
advertisement of temporary retreats  or pretended accommodations for
pregnant  ladies.   I always view  it  as a wicked allurement  to unfortu-
nate  women, and as a  daring hint  from some ready  assassin  of inno-
cence.   It  is not long since oue of those wretches was convicted of kil-
ling both mother and child; and I have myself seen a great number of
embryos exhibited by a man, who, I  firmly believe, obtained them in this
way.
   The dread of public  shame or of private scorn, though no excuse for
 murder, may urge the victim  of seduction  to commit a crime at once so
 abominable and so dangerous.   But is it possible that a married woman
should madly and wickedly attempt  to procure abortion, merely from an
apprehension of a large family,  or  to  avoid  the trouble of bearing and
bringing up children ? Can she hope to taste the joys, and yet destroy the
fruits of love ? What a frantic idea!—The same  poison puts an end to
both.  And in vain does she flatter herself that her guilt is concealed, or
 that no law exists to punish it.  The laws of nature are never violated with
 impunity ; and in the cases alluded to, the criminal is made at ouce to
 feel the horrors of late remorse, and the keenest pangs of a torn,  disorder-
 ed, and incurable frame.
    But suppose that a miscarriage brought about by such detestable means
 did not endanger  the health  and life  of the mother, suppose that an act
 held iu such just abhorrence, both by earth and heaven, could  possibly es-
 cape punishment: suppose a woman, deaf to the cries of nature, incapa-
 ble of tender emotions, and fearless of  any immediate suffering in her own
 person,__I have one argument more to make her stop her murderous hand:
 perhaps the embryo, which she  is now going to destroy,  would, if che-
 rished in her womb, and afterwards reared with due attention,  prove the
 sweetest comfort of her future years, and repay all her maternal  care with
 boundless gratitude.   It may be a daughter to nurse her in her old age,
 or a son to swell her heart with joy at his honourable and successful ca-
 reer in life.  I only wish her to pause  for a moment, and to consider, that
 by the wilful extinction ofthe babe in her womb, all her fairest  hopes are
 'extinguished also, and that the present danger is aggravated by the certain-
 ty of future despair.                            '     ,    .  ,    ,
    A wish to prevent even one act of so much horror has  induced me
 to dwell on this unpleasant part of  my subject.   But folly, ignorance,
 and carelessness, are  often  productive of as fatal effects  as a  crimi-
 nal  design;  and  though  I may not be able to restrain the latter, yet  I
 hope  the  former may  be corrected by better information.   With this
 view,  I shall make some farther remarks  on  the great preservatives
 ef  health mentioned   in  the  preceding  chapter.  The general rules 
                   DURING  PREGNANCY.          *'«*    A3

there laid down hold good in every condition of life; but a state of preg-
nancy requires a greater degree of care and judgment in their practical
application.
  Cheerfulness,  or good  humour, which before  was placed last in the
order of discussion, must now take the lead, being superior to  all other
considerations during pregnancy.   In this state, more than in any other,
the changes of bodily health seem to be almost wholly under the influ-
ence of the mind; and the mother appears well or ill, according as she
gives way to pleasaut or to fretful emotions.  I admire that fragment of
ancient history, in which we are informed, that the eastern sages, while
their wives were pregnant, took  care to keep them constantly tranquil
aud cheerful, by sweet and innocent amusements, to the end, that, from
the mother's womb, the fruit might receive no impressions but what were
pleasing, mild, and agreeable to order.  So fine  a lesson of wisdom, aud
of  parental,  as well as conjugal love  and duty, cannot be too closely
studied,  or too diligently carried into practice, by the husband who sets
any value on his wife's health,—who wishes to secure her affection and
gratitude—and who pants for Uie exquisite happiness of being the father
of a lively, well-formed, and vigorous child.
   It is during pregnancy also that every woman should be doubly at-
 tentive to  preserve the utmost sweetness and serenity of temper, to dispel
 the glooms of fear or melancholy, to calm the rising  gusts of anger, and
 to keep  every other unruly passion or desire under the steady controul
 of mildness aud reason.  The joy of becoming a mother, and the antici-
 pated pleasure of presenting a  fond husband with the dearest pledge of
 mutual  love, ought naturally to  increase her cheerfulness, and would
 certainly produce that effect, were not those emotions too often checked
 by a false alarm at the fancied danger of her situation.   It is therefore of
 the utmost importance to convince her, that her terrors are groundless;
 that pregnancy is not a state of infirmity or danger, but affords the strong-
 est presumption of health and security; that the few  instances she may
 know of  miscarriage or of death, were owing to Uie improper conduct
 of the women themselves, besides being too inconsiderable to be Compared
 with the countless miliums of persons  in the like condition,  who enjoy
 both then and afterwards a greater degree of health than they ever be-
 fore experienced; and, lastly, that the changes which she feels in herself,
 and her quick perceptions of uneasiness, are not symptoms of weakness,
 but the consequences of an increased sensibility of her womb, and timely
 warnings ofthe effects of indiscretion or intemperance.
    A late writer on this subject very justly observes, that, when such an
  increase of sensibility takes place iu a woman of a very irritable frame
  and temper, it must certainly aggravate her former complaints and weak-
  nesses,  and product a variety of feverish effects.  She grows more in>
  patient and fretful: her  fears as  well as her angry passions  are more
  readily excited: the body necessarily suffers with the mind,  debility,
  emaciation, and many hectic symptoms, follow.  But the only rational
  inference to be drawn from these facts is, that Uie feelings are more acute
  in a state of pregnancy :  aud tiiat any previous indisposition, either of
  body or mind, now requires a  more than ordiuary  degree of care and
  tenderness.
    Though the chilling influence of fear, and the. depressions of melan- 
14                 RULES  OF  CONDUCT
choly, are very iujurious to the  mother's healUi and to the growth of Uie
fcetus in her womb; yet anger is a still more formidable enemy.  It con-
vulses the whole system, and  forces the blood into the face and head
with a great impetuosity.   The danger is increased l>y Uie usual fullness
of the habit in pregnancy.  When the blood runs high and rapid, a ve»-
sel may burst, and in such a part as to terminate, or bring into great per
il, the existence of both the mother and the child.   Cases often occur of
the bursting of a blood-vessel in the brain, occasioned by a violent gust
of  passion.  How  much more likely is it to rupture those tender vessels
that conuect the mother and the child!   Yet to the latter this is certain
death.  I  knew a female who had the aorta, or great artery,  so distended
that it  forced its way  through the breast bone,  and rose externally to the
size of a quart bottle.  This extraordinary distention was chiefly owing to
the violence of her temper.   I have also met with a  most  shocking in-
stance of a fighting woman, who, in the paroxysm  of rage and revenge,
brought forth a child, with all its bowels hanging  out of its little body.
There is  no doubt but that passionate women are most subject to  abor-
tions, which are oftener owing to outward violence or internal tumult, than
to  any other cause.  An accident of this sort is the  more alarming, as the
woman who once miscarries,  has the greatest reason ever after to dread
the repetition of the same misfortune.
   Cards  or any kind of gaming, at all times, the  worst of  amusements,
should be particularly avoided during pregnancy.   The temper is  then
more liable to be ruffled by the changes of luck, and the mind to be fa-
tigued by constant exertions of the judgment and memoiy.   Old maids,
as  I before observed, are the only class of females who may be allowed
to spend some of their tedious hours in such absurd and such unhealthy
pastimes.
   Without entering into farther details, it will be  easy for the sensible
mother, to apply the principle here laid down, to every passion and pro-
pensity which may  tend to excite painful emotions of the mind, and to
impair in the same degree the health  of the body.   She must learn to
keep even natural desires within due bounds, lest pleasure itself, if im-
moderately indulged, may produce Uie same effect as pain.   Among ma-
ny excellent hints to pregnant ladies contained in a latin poem translated
by Dr. Tytler, we meet with Uie following just admonition:

       Subdue desires;  nor let your troubled mind,
       Immod'rate love, or fear, or sadness find:
       Give not yourselves ev'n  to the nuptial joy,
       Or aught that may your strength or peace destroy.

   And again,
                          ----Curb each loose desire,
       Lest added fuel quench the former fire :
       Lest ye should loose the fruits of pleasure gone,
       And love itself undo what loTe had done.

   The enjoyments of the table must also be kept  under the uice  cou-
troul of moderation, in a state of pregnancy.  Any excess  01 any de-
ficiency of proper supplies, will now be most severely  felt.  Ineweii
being of both the mother and child will depend on her pursuing a  hap-
py medium  between painful restraint or unnecessary self-denial, on 
DURING  PREGNANCY.
15
the one hand, and the indulgence of a depraved or intemperate appetite
on the other.   But, as the natural desire of aliment increases with  the
growth  and increasing wants of the child, it will be proper to consider
those variations as they appear in the different stages of pregnancy: and
to shew how far it may be also adviseable to gratify the involuntary, and
often very wild and whimsical desires, which are known by the name of
longings.
  Before  I enter into particular details concerning the diet of pregnant
ladies,  I  must beg leave  to urge with increased earnestness my  former
general prohibition against strong liquors, unripe fruits,  pastry,  and all
sorts of food that are high-seasoned, inflammatory, or hard of digestion.
If these are improper before marriage, they must be  doubly pernicious
afterwards, when they may not only injure the mother's health, but poi-
son, infect, or impoverish the fountain of life and nutriment, whence her
child is to derive support.  Every female, therefore, will see the impor-
tance of guarding against bad  habits, or the indulgence of a vitiated taste
at an early period; that she may not have any painful restraints to sub-
ject herself to when a mother, or be then uudcr the necessity of making
any great change from her former mode of living.
   I have  already laid it down as a fixed principle, that a state of preg-
nancy  is not a state of infirmity or disease, but of increased sensibility;
arid that the changes which a woman then feels in herself, though some-
times accompanied with a little pain or uneasiness, are but notices of her
situation,  or warnings against indiscretion or intemperance.   Let us now
apply this principle to the regulations of diet,  and we shall find it to be
the most unerring guide to pregnant women in all their conduct, but more
especially in the choice and quantity of their food and drink.
   The  whole term of pregnancy may be divided into two nearly equal
parts, the  one  comprehending the four months that immediately follow
conception, and the other, the remaining five  months that precede deli-
very.   During the first period, when there is in most women a strong
tendency  to an extreme  fulness of the habit,  nature  gives the  plainest
cautions against improper indulgence, by a weakness of the stomach, fre-
quent returns  of nausea and vomiting;  head-achs, costiveness; and the
other symptoms  and effects of indigestion.  It is a very absurd and a
very fatal mistake, to suppose that women are then  in greater need of
nourishing things; when, on Uie contraiy, in consequence of the ceasing
of  the imnses, and the redundancy of blood in the system, the strictest
temperance is not only proper, but absolutely necessaiy to prevent illness.
When this is neglected,—when no regard is paid to the hints of the state
of  the stomach  and of the  whole habit, so kindly given by nature,—
bleeding becomes the only expedient to save the life of the thoughtless or
obstinate  glutton; but she should remember, that it is  her own intem-
perance which renders that operation adviseable.
   The alleged  or fancied wants of the child may be urged as a plea for
some little excess, or an incitement to more than ordinary gratification $
but the frivolity of such an excuse will appear, upon considering, that
Uie foetus, for the first two months, does not exceed a hen's c^  in sjze>
and that  its growth for the next two months,  even to the ascent of the
womb, or  the usual  time of quickening, is so small  as to require very
little nourishment.   This is amply supplied from the  natural fulness of
                                62 
16
RULES  OF  CONDUCT
the system before noticed, without the dangerous aid of the mother's in-
temperance.  It requires but a moments reflection on the part of  any
women of common  sense, to be convinced that what disorders herself
must injure the contents of her womb; and that the injury is the greater,
in proportion to the delicacy and slow expansion of those contents.  To
overstep the bounds of temperance in the early stage of pregnancy, from
an idea of the embryo's wanting such supplies, would be almost as frantic
as to drown an iufant for the purpose of quenching its supposed thirst,
or to gorge it even to bursting, in order to satisfy the cravings  of  ima-
ginary hunger.
   But the absurd notion of the embryo's wants has been attended with
incalculable mischief of another kind;—it  has given a sanction to the
most whimsical and the most pernicious desires.   Green-sick girls do not
indulge in such silly and such hurtful fancies as many pregnant women:
yet the propensities of the  former are checked by the force of ridicule,
of argument, or of authority, while the longings ofthe latter bid defiance
to all control;  and it is even deemed the height of cruelty not to gratify
 them in their wildest extent.  To the candid discussion of this very in-
 teresting part of my subject, I hope I ueed not request the serious atten-
 tion of every female reader.
    One  of the uatural consequences of conception is the ceasing of the
 menses, which is accompanied with a redundancy of blood greater or less
 in proportion to the previous fulness of the  habit.  Such a swell in the
 vital stream gives rise to feverish appearances; such as heat in the palms
 of the hands, flushings in the face, and a  slight head-ach.   But the sto-
 mach is most affected by the changes which then take place in the womb
 and the whole habit.   It is often disturbed by the complaints  already
 described,—nausea, vomiting, heart-burn, and the like.  These, as I said
 before, are not symptoms of indisposition or disease, the  most healthy
 woman being  as  subject to them in the early months of pregnancy,  as
 those who are delicate and infirm.   It is thus that every mother receives
 timely notice  of  her situation, with proper warnings not to overcharge
 her stomach, when its powers of digestion are so weak, and a fulness of
 the habit is so manifest.
    Unhappily all pregnant Avomen are not alike disposed to attend to those
 kiud intimations  of nature:  and, perhaps,  many  of them  do not know,
 that the uneasiness arising  from  the above causes would be removed by
 perseverance in a temperate cooling diet.   They  think they ought to eat
 more, instead of  less, in their new state, and torture their invention  to
 find out something to conquer the squeamishness of their appetite.  This
 is a very fruitful source of whims and fancies, the indulgence of which is
 almost always injurious.  It cannot indeed be otherwise;  as the weak-
 ness or dimiiution of any woman's usual appetite, on such occasions, is
 not owin» to a mere dislike of common or ordinary food, but  to a real
 unfitness°of the stomach to receive much of any food.   What then are
 we to expect,  when  things equally improper, perhaps,  both in quantity
 and quality, are forced upon it, to satisfy some artificial craving, or some

     As  soon as a woman begins to consult her  caprice,  instead of at-
  tending to nature, she is  sure  to  be encouraged  in absurdity by old
 nurses, or female  gossips, who take a delight  in amusing her creduli-
  ty by  the relation of many wouderful  and alarming injuries, said  to 
DURING  PREGNANCY.                17
 have been done to children, through the unsatisfied desires of their mo*
 tiurs.   Every fairy tale, however repugnant to common sense, gains im-
 plicit belief; for reason dares not intrude into the regions of fancy:  &id
 were a man bold enough to laugh at such fictions, or to remonstrate with
 a pregnant Avoman on the danger of giving way to any of her extravagant
 wishes,  he would certainly be considered as a conceited fool, or an unfeel-
 ing monster.   Argument is lost, and ridicule has no force, where people
 pretend to produce a host of  facts in support of their opinion.   Every
 woman, who brings into the world a marked child, can  immediately as-
 sign the cause; yet no mother was ever able, before the birth, to say Avith
 Avhat her child would be marked;  and I believe it Avould be equally dif-
 ficult afterwards, without the aid of fancy, to discover in a flesh-mark any
 resemblance to the object whence the impression had been supposed to ori-
 ginate.
   On examining  various  instances of  flesh-marks, and other dreadful
 events, said to be  caused by disappointed longings, it has appeared  that
 most of them were the effects of obstructions, of pressure, or some external
 iuury; and that none  could be fairly traced to the influence of imagina-
 tion.  Similar accidents are observable in Uie brute species; and even in
 plants uncouscious of their propagation or existence. It is also well known,
 that several childreu are born with marks on their skin, though their mo^
 thers never experienced any longings; and that, in other cases, where
 Avomen  had been refused the indulgence of their longings, no effect was
 perceptible iu the  child, though  the  mother's imagination had continued
 to dwell on the subject for a considc table time.
   The  doctrine of imagination, like every thing founded in absurdity, con-
 futes itself by being carried too far.   The same poAver of marking or dis-
 figuring the child is ascribed to the sudden terrors and the ungratified cra-
 vings of pregnant Avomen.   The abettors of this doctftue are not even con-
 tent with a few specks or blemishes on the skin, but maintain that the
 mother's imagination may take off a  leg or an arm, or  even fracture eve-
 ry bone in the child's  body.   I have seen a child born without a head;
 but it Avas not alleged that the mother had been present at the beheading
 of aqy person, or had ever been frightened by the spectacle of a  human
 body deprived of its head.   If shocking sights  of this kind could have
 produced such effects Iioav many headless babes had been born iu France
 during Robespierre's reign of terror !
   In order to sheAv that the fancy, however agitated or strongly impres-
 sed with the dread of any particular object, cannot stamp its resemblance,
 or even the smallest feature of it on the  child in the womb, Dr. Moore re-
 lates the following story of a remarkable occurrence within the sphere of
 his OAvn knowledge :—
   A lady, who had  great  aversion to monkies,  happened unfortunately,
 during  the course  of her pregnancy, to visit in  a family where one of
 those animals Avas the  chief favourite.  On being shewed into a room,
 Bhe seated herself on a chair, which stood before a table upon which the
 favourite was already placed:  he not naturally of a reserved disposition,
 and rendered more petulent and wranton by long indulgence suddenly
jumped on the lady's shoulders.   She screamed, aud was terrified;  but
on perceiving who had treated her with such indecent familiarity, she ac-
 tually  fainted; and  through the remaining course of  her pregnancy,
 she had the most painful conviction that her child would be deformed by 
18
RULES  OF  CONDUCT
some shocking feature, or perhaps the Avhole countenance ol* this odioin-
monkey.
   " The pangs of labour did not overcome this impression,  for in the
midst of her pains she often lamented the fate  of her unfortunate child,
who was doomed Uircugh life to carry about a human soul in the body of
an ape.  When the child was born, she called to the midwife with a la-
mentable voice for a sight of her unfortunate offspring, and was equally
pleased and surprised when she received a fine boy into her arms.  After
having enjoyed for a few minutes all  the rapture of this change to ease
and happiness from pain and misery, her pains  returned, and the midwife
informed her that there was still another child.  ' Another!'  exclaimed
she, ' then it is as I have dreaded, and this must be the monkey after all.'
She Avas however, once more happily undeceived, the second was as fine
a boy as the first.   I knew them both:—they  grew to be  stout comely
youths, Avithout  a trace of the monkey in either  their faces  or disposi-
tions."                                                         !
   Having before enlarged on the dangerous effects ofthe passions, and of
fear in particular during pregnancy, it cannot be supposed that I look up-
on frightful  objects, scenes of horror, or any  other causes  of a sudden
shock, as matters of indifference.   On the contrary, I Avould have them
very carefully avoided as they have  often caused abortion,  or otherwise
injured the health both of the mother  and child,* though they cannot dis-
colour the  skin, derange the limbs, or alter the  shape of the latter.  It is
from this silly apprehension, in consequence of any  fright, that I wish to
relieve the minds of credulous and timid poor Avomen, who may do them-
selves a real injury by the dread of an imaginary evil.
   It was precisely Avith  the same view that  I endeavoured  to expose
the absurdity of believing that flesh-marks on a  child  were  the  con-
sequences  of his mother's fancies or unsatisfied longings.  This silly
doctrine has been the cause of great uneasiness in many families, and
has done  much mischief to several pregnant Avomen,  sometimes by
giving a sanction to the indulgence of their most improper Avhims, and al
other times by making them pine for  extravagaut unattainable gratifica-
tions.
   It  is another great  mistake to suppose, that  the prevalence of such a
belief can  ansAver any one good purpose.   Surely  the fictions of igno-
rance, superstition, or imposture,  are not necessary to secure to women
in a state  of pregnancy those kind compliances, and that tenderness of
treatment, which their situation  requires.   The foud husband  Avill em-
brace  with eagerness every opportunity of  supplying  the real wants of
the wife noAV doubly dear to him, and even of anticipating her silent Arish
for any rational enjoyment.  But she should also know, Uiat the tyranny
of caprice  will prove no less injurious to herself  than  disagreeable to
others.
   Let not pregnant ladies imagine that I am  for  confining the sphere
of indulgence within  very narrow limits.  I  should be more inclined
to enlarge than  to contract its boundaries, as far as nature  and  rea-

  * I knew an  instance of a mother, who not only lost ihefcetus tiirough a fright,
but was otherwise so much affected as never to enjoy ah hour's health. I can-
not therefore too strongly censure the frantic impulse  which so often urges
pregnant women, and nurses with infants at the breast,  to rush among crowds
at a dreadful fire, aa execution, or any other shocking spectacle. 
DURING  PREGNANCY.                  19
e"on would allow.  I would not even be particularly strict, except in cases
of evident danger.  While I discouraged capricious desires, or impro-
per whims aad fancies, I would distinguish them from real and involunta-
ry longings, Avliich are sometimes occasioned by that Aveakness and dis-
order of the  stomach  so usual, as I before observed, for three or four
months after conception.   There can be no doubt as to the cause of such
longings; for a similar effect is  known to take  place at  other times, and
not only  in ivomen, but in men,  Avhen their stomachs are Aveakened or dis-
ordered by intemperance, illness, or any accident. I have often met ivith
cases of  this kind in fevers, epilepsies, and other nervous diseases; and
where the craving often recurred, or steadily continued, I have ahvays
directed that it should be indulged, though the object of desire might not
appear consistent Avith the  regimen commonly  prescribed in those com-
plaints.  When  the longings are involuntary,  and the   feelings acute, a
patient may  suffer much from disappointment or delay; and cases fre-
quently occur of persons who recovered from the most hopeless state, af-
ter having disobeyed the doctor's  commands,  and been freely  indulged
in Avhat  they had so  ardently  desired.  I do  not say that the  cure was
absolutely effected by the use of the  forbidden food or drink;  but I am
convinced from repeated observations that the strong and sudden appetite
for such food or drink, however strange it might seem, was a symptom of a
favourable change in the complaint, and a  sure indication  of returning
health.
  On  the same  principle,  therefore, that rigid prohibitions />r denials
might be attended with much pain in a state of pregnancy, a state of ex-
quisite sensibility, I strongly recommend a speedy  compliance not only
with what may be deemed  the  natural and reasonable desires of Uie mo-
ther, but even with all her involuntary longings, Avhich do not evidently
arise from caprice, and are uot directed to things of a noxious quality.
I Avould  pay little regard, for instance, to the Avhim of such a lady  as is
represented by Smollet, longing for a hair from  her  husband's beard, and
what was worse, wanting to have  the pleasure of  plucking it out her-
self; or to the more disgusting Avish of another lady, described by Addison,
who longed to partake Avith a flock  of  carrion-crows, which  she  saiv
feasting on the flesh of a dead horse.
  It Avould be also carrying my plan of compliance too far to let a preg-
nant woman live chiefly on unripe fruits, raw onions, or any other acid
and acrimonious substances; which could not fail to injure her oav n health
and that of her child.   An opinion prevails that a Avoman in such a state
can digest every thing she likes or longs for;  but  supposing this  to be
true, it does not folloiv that living on trash, or on  improper articles of
food or drink, will not be detrimental to the foetus in her Avomb.  Slight
or momentary deviations from the rules of  wholesome diet or strict tem-
perance  may be occasionally allowed, but perverse habits are never to be
indulged.
  I hope therefore it will not be deemed needlessly severe to recommend,
in the early period of pregnancy, a becoming check on absurd or pernici-
ous desires, and a moderate use of such things as have been always found"
to agree  Avith the stomach and constitution.   I do not insist  upon a total
change from  former  mode* of living; but unless the appetite  be very
much vitiated, it will direct ivomen at that time to ivhat is most proper
and salutary.  They have generally a dislike to apimal food; and, if in- 
20
RULtfS OF  CONDUCT
duced to eat it freely, from a  mistaken notion of their being then ia
greater need of such aliment, they are sure  to buffer some inconvenience.
On the contr. ly, their natural relish for ripe fruits and boiled veugtablcs
may be safely gratified.   Milk, jellies, veal-broths, and the like liquids,
which afford easy  nourishment, being  converted into chyle without any
great effort  of the stomach, are also very allowable.   Should a particu-
lar desire for solid auimal substances be felt at  dinner, fresh meat  of the
young and tender kind, veal,  lamb,  capons, pigeons, pheasants, and pa-
tridges,  may now and  then  afford an  innocent  and  grateful variety.
But  I must again beg, that temperance may always preside at the table;
and that  the refinements of cookery may never be exerted to raise a false
appetite  by  artificial provocatives.
   While I  am thus tracing the boundaries of rational indulgence, which
should not be overstepped by those who have it in their power to command
every gratification, I »ee also the necessity of some admonitions to Avomen
whose uarrow  circumstances may appear to require  no additional re-
straint.   It has been very truly observed, that, in the lowest classes of
society,  especiaUy in  great cities, we often meet with a sort of luxury
more baneful than any Avhich prevails in high  life,—a luxury that con-
sists in the immoderate use of strong liquors; to which the miscarriages,
the fevers, and the death of so many  poor married Avomen in London and
other populous towns must be ascribed.  There is uothing, in fact, so per.
nicious to the mother, and to the foetus in her womb, as drinking- ardent
spirits, especially Aihen carried to excess.   It is administering poison to
the embryo, and is certainly a species of murder.
   The taste of such persons is not more depraved with regard to their
drink than their food.   The latter perverseness is indeed very frequently
the consequence of the former.  Spirituous liquors destroy the natural ap-
petite, and leave no relish but for bacon, or otlier salted and smoke-dried
meats, salt fish, or red herrings, than which nothing can be much more sti-
mulating, inflammatory, and indigestible.  But suppose that their fondness
for this worst of aliment is not always the effect of swallowing liquid fire,
but of habit; and that  the stomach, strengthened by the hardy employ-
ments of some of those poor Avomen, may be  able to  digest  any thing;
why should its powers be exerted in such unproductive efforts ?   A
greater quantity of food is certainly requisite, in proportion to the greater
quantity of labour; but let  that food be of the  most wholesome kind.
Plenty of vegetables with the addition of a little fresh  meat,  will  satisfy
every natural craving, and will afford both the mother and child the purest
supplies of  health and vigour.
   After  the fourth month of pregnancy, the growth of the foetus becomes
very rapid, and the demands for nourishment, made by a thriving child
on Uie constitution of its mother, are proportionably strong and incessant.
Nature noAV, with  wonderful care, invigorates the organs of digestion to
answer those increasing demands,   The stomach is no  longer so apt to be
disordered as before; its functions are performed with ease and effect; and
a more liberal mode of  living is not  only allowable, but  necessaiy.  All
the restraint which should be imposed is a little attention to  the quality
of the food.   Provided it be cooling and  nutritious,  it may be used
freely, and  as  often as the appetite  requires.  I need not repeat what
I  have already  said  in   favour  of ripe fruits, boiled  Aegetables,
railk, jellies,  veal-broth.   and  animal  substances of  the  youug aud 
DURING  PREGNANCY.                 21
tender kind.   The bill of fare may be enlarged rather than contracted at
this time; and variety may be allowed to present her sweetest stores to
the taste and fancy, but Avithout the aid of any pernicious seasoning.
  I have just hinted at the propriety of indulging the appetite as often
as the desire of food is  strongly felt.   It is even adviseable tp prevent
importunate cravings.  Emptiness is more to be dreaded in the  advan-
ced stages of pregnancy than a little excess.  Instead, therefore,  of con-
tinuing my former prohibition against suppers, I ivould now recommend
agreeable repasts,  consisting of biscuits, fruit, oysters, eggs not  boiled.
hard, or any other light  food  and easy of digestion.—But meat suppers
must  never follow a late or hearty dinner: an unseasonable load Avould
oppress the stomach : moderate supplies, on the contrary,  are necessary
to satisfy the child's strenuous demands for sustenance, which do not cease
even by  night.   These, if neglected, will cause uneasy sensations iu bed,
and often prevent sleep.   It is justly remarked  by Dr. Denman, Avhen
speaking of this restlessness, which is generally troublesome towards the
conclusion of pregnancy, that those women Avho suffer most from it, though
reduced  in appearance,  bring forth lusty children, and have easy labours.
But if the mother  has little uneasiness, and groivs corpulent during preg-
nancy, the child is generally small;  and if the child should die before
the time of parturition, the inquietude entirely ceases.  In the first case,
as this judicious writer observes, the absorbing powers ofthe child seem
too strong  for the parent; but, in the latter, the  retaining powers of the
parent are stronger than the absorbing ones of the child;  so that, on the
whole, it appears natural that Avomen should  become thinner when .they
are pvegnaiit.
   One direction more is necessaiy Avith regard to suppers.  They should
never be later than nine o'clock; after Avhich an hour may be spent in
cheerful conversation, as the best meaus of preparing for  the enjoyment
of sound repose.   I hope tlwt the custom of going to bed early,  and of
rising early, which is one of the best preservatives of health at all times,
will be particularly adhered to during pregnancy.  Women in this con-
dition should not,  upon any account, be tempted to sit up after ten, and
they will find no difficulty in rising  at six, though, towards the conclu-«
sion of their  term, they may safely remain an hour longer in bed every
morning.
   In  my former hints to women  before marriage,  I  pointed out the pe-
culiar importance of open air and frequent exercise to females, avIio, in
general, spend too much of their time in  domestic  and  sedentary em-
ployments.  I recommended a variety of active diversions both  without
doors and within, according  to the state of the weather.   I would have
young ladies dance and jump about as much as they please, and as na-
ture  wisely prompts.   But, when they become wives  and mothers, their
deportment must be different, or they will risk the loss of the embryo in
their womb,—a loss always attended with irreparable injury to their oivn
health.  Miscarriages are often occasioned  by great bodily exertions
though in the form of amusement, as  Avell as by the straining efforts of
hard labour.  It was not without the justest  reason Uiat Hippocrates for-
bade dancing and all violent exercise during pregnancy:  he himself had
been witness  to  a  foetus being dropt on the stage by a performer in the
dancing line.—Let not pregnant women then attempt to vie Avith other
females in the lively dance:  the former should  even  avoid all crowded 
22                   RULES  OF  CONDUCT

assemblies, Avhpther gay or serious; for besides the impurity of the air
in such places,  of the bad effects of  Avhich they are very susceptible,
they are exposed to great danger from any accidental, pressure.  I have
known a lady to suffer abortion in conse uencc of an elbow at entering a
church door.  Hoav much more likely is this to happen at balls, at play-
houses, and other  places of amusement, which are commonly more fre.
quented than places of worship!
   When I say that violent exertions and hard labour arc  apt to occasion
miscarriages, I  do not mean to recommend indolence and inactivity to
pregnant Avomen.  This Avould be running  into the opposite extreme,
which is still more dangerous than the other.  Indolence in pregnancy
is not only one  of Uie great causes of abortion, but of the  puerperal or
  hild-bed fever, so fatal  to delicate mothers.   A woman who lives fully,
 and neglects exercise, cannot fail to bring on  a plethora, or a fulness of
  ~ie habit and redundancy of humours, Avhich must be productive of very
  jfcd  effects.  The  whole  frame becomes languid: all the vital organs
    m  to lose their energy:  the poAvers of the  womb in  particular, are
    eebled or perverted;  aud though a miscarriage should not take ^-!ace,
     labours are  sure to be long, severe, and dangerous; and tho offspring
  any and deformed.  In order, therefore, to secure the blessings of a
  tappy delivery, and a healthy child,  a pregnant woman ought to take
 every day a moderate degree of exercise, such as she has been most ac-
 customed to, only using less exertion, and guarding against fatigue.
    Some Avriters on midwifery have asserted, that in the early months of
 pregnancy, the  exercise  should be very moderate, but might be safely
 increased in the latter months.   The absurdity of such a notion has been
 very ably exposed by the fairest reasoning, and the incontrovertible evi-
 dence of facts.
    The  example  of the  brute  species has first been referred to, as, in
  every thing that respects the preservation of life, their instinct is  more
  unerring than the fanciful speculations of man.  It is observable of the
  quadrupeds in our fields and parks, that the most frisky of them,  when
  pregnant, assume a grave and steady deportment:  their natural fondness
  for going together in herds  and flocks is suspended ;  and, if left to their
  oAvn inclinations, they gradually lessen their usual exercise as they ad-
  vance in pregnancy.                              «..,.,
    The same thing is well known to be equally true of wild animals.  In
  a state of pregnancy, they  take  no more exercise than  is necessary to
  procure their food.  If  forced to greater exertions in self defence, or
  Avhen hard pursued, they often drop their young; and though beasts of
  prey .have no claim to pity, yet surely the harmless and timid hare  ought
  not in that state to be worried, merely  to gratify a cruel or  inconsiderate
  sportsman's fondness for the chase.  It is  still more inexcusable to over-
  load, or to strain by ill-timed labour, a mare  in foal, which has frequently
  caused a premature expulsion of her young.
     From these remarks on the instinctive  conduct  of  brutes, a very
  wise lesson has been drawn for  the  guidance of  pregnant lyomen.—
  They are not,  for  some  time after conception,  more  sensible ol  la-
  tigue than  at  any other period, nor have  they any  certain proofs of
  their own  condition.   What then,  it  has  been  reasonably asked
  should direct  them to  make any change in their customary exercises. 
DUItING  PREGNANCY.
23
 These may  be continue*!, but never to a violent or immoderate degree*
 for at least lour months, not only uith  safety, but with the u most bene*
 fit.   When the contents of the womb begin to increase very perceptibly,
 the same degree of exercise, which pregnant Avomen before enjoyed with
 pleasure, will now make  them  faint and  weary; a strong hint  to  di-
 minish it.  Their own feelings uUl direct them better than the caprice
 of others;  and uo subtlety of argument should  induce them to believe,
 that n -lure in this case alone deviates from her uniform course of action,
 and  requires them to exert themselves more in proportion as  '.hey are
 los capable of it;  or, in plainer words, to run the fatter the greater weight
 they c.irry.  Slow, short walks in the country, or gentle motion in an open
 carriage, must be far better suited to the advanced period of pregnancy,
 by uniting the advantages ol frerii air Avith those of agreeable and saluta-
 ry  exercise.                                                          ■ _  .
   In order to leave no doubt upon this subject,  an appeal has been made • ^- .x
 10 facts,  and par icularlyr to the experience of women who folloiv very hard  O.   .
 occupations in the lountry.   They feel no inconvenience from the usual, .-J*",
 employments in the early months of pregnancy, and require uo induh ence-j^gS
 but a little abatement of tlieir toil when they become unwieldy.  Thej^frlj^
 know nothing of artificial precepts which would  teach them to invert the^Lti
 order of nature.   Temperance and moderate exercise, pioper periods of'^J-^ *
 labour and of rest, the country air, and the cheering influence of a content- -^,"r~**
 ed  mind, insure to them the continuance of heal h in every stage,  an ex-
 emption  from Uie common diseases of pregnancy, an easy I) ing-in, and a
 speedy recovery from child-bed.  The vigour  also  of their offspring is
 justly proverbial.
  It would be painful to contrast with this picture the enervating effects of
 indolence and luxury in high life, or the truly pitiable condition of poor
 married  Avomen iu manufacturing towns, aud in great cities.  The confi-
 ned impure air which they breathe in these places, relaxes the frame and
 destroys  its activity.   What they cat, what they drink, is often improper,
 sometimes  pernicious.  Their meals and their hours of rest  are equally
 irregular.  The victims of poverty are seldom able to procure the  means
 of scanty subsistence, without the sacrifice of necessary sleep.'  Their con-
 dition is  really more  distressing than that of female slaves iu the West In-
 dies.   These experience a little mercy Avhen pregnant, tin ir oivners  be-
 ing actuated by the double impulses of self-interest, and  of humanity to-
 wards breeding women : but, in  London, the wretched hireling experien,-
 ces no lenity on  account of her pre.aiaicy ; sin- is even obiiged to conceal
 her situation as much as she can, iu order to jcet employment: and has often
 no alternative but to perish with famine,or to run the risk of miscarrying
 by continued exertions at the washing-tub, or at some other toilsome work
 for sixteen  or eighteen hours, according to the caprice ofthe sordid vipws
 of her unfeeling employer.   To impose such tasks on the hungry and dis-
 tressed,—to cause abortion by oppre-sive labour,—under Avhat pretence)
 the inhuman mistress m3y strive to justify her own conduct,—is certainly
 murder !
  Though  my former remnrks  on  dress may  be easily  applied to a
 state  of  pregnancy,  yet this is a matter of so much ooncern to mothers
 and to tli* ir  childreu, that 1 hope my  female r.aders will  pardon me
 for  troubling  them with some farther ob ervaions  on tiie subject.  £je„
Jfbrc marriage,  errors in  drets  can  only injure  their own health  or
                                63 
24                  rules  of Conduct
disfigure their persons; but, after  conception, the form, the health, and
tlie very existence of the child, will greatly depend upon  the mother's
dress.   Indeed, were I to assign a cause not only for the diminutiveness,
debility, and distortion of infants, but for those fiesh-marks which an; su-
perstitiously ascribed to disappointed longings, I should be much more in-
clined to impute these evils to pressure upon the womb, than to Uie alle-
ged influence of the mother's fancy.  The gradual asceut of the womb, af-
ter the fourth month, is wisely designed by nature, to acquire more space
for easy growth and expansion.  But her benignant purposes are defeat-
ed, if the body be girded by tight bandages,  or squeezed within the nar-
row circle of a whale-bone press.
   I  need not stop to explain a thing in  itself so obvious, as the opera-
tion of such fatal checks on the  increasing size of the foetus;  but how
they should be productive of flesh marks and deformity may require some
little illustration.   It is Avell known that young trees and plants, and, in
a word, vegetables of eveiy  kind, Avhen confined in then groAvth, get dis-
torted,  or take on a bad shape; and that the tender bark as well as tlie
fruit will be marked, if they suffei the least compression or restraint. Why
should not compression have similar effects on the fetus  iu the ivomb,
where it is almost in the state of jelly ?  The great Avonder is, that it
should ever escape bearing the marks of a tight-laced mother's indiscre-
tion.
   The doctrine here laid down does not rest solely even upon the fairest
reasoning by analogy, but is supported by facts. Nations that go almost
naked are strangers to flesh-marks and deformities, except what may
arise from accidental injury, or external violence.   But in proportion as
men remove from a state of  nature, and false refinement  introduces, as
personal ornaments, tight and oppressive incumbrances of  dress, He etc
a  pigmy or deformed race crawl  about, to  publish their mother's folly,
and to reproach them with having thwarted or cramped nature in  her
operations.
   In my " Domestic Medicine,"  as well as in  a former part of the pre-
sent work, I felt great pleasure in paying a just compliment to the taste
and good sense of the ladies,  so admirably displayed in the present fash-
ions of dress.  The high-heeled shoes, in  which  they used to totter about
as upon stilts,  and the tight-laced stays, Avhich gave them the appearance
of insects cut  almost asunder in the middle, are happily exploded; the
poet's fiction is realized,—the philosopher's wish is gratified,  in seeing
Beauty arrayed by the Graces;  and health, ease,  and elegance, alike
consulted in the  dresses of our fair country-women.
   But as fashion is very  changeable ;—as there is nothing however ri-
diculous or hurtful, to which it cannot give a sanction ;—and as the re-
turn to old absurdities and old prejudices may be dreaded unless the  pro-
priety and importance of the present reform  are strongly impressed upon
the mind, I shall endeavour to heighten these by a  view of the dreadful
evils which arose from the former system of tight bandages, and of stiff
and cumbrous clothing.
   It  is  not many years since the sugar loaf shape wa3 uiuvcr-ally
admired, and  the small waist, though  contrary to  nature, was looked
upon as the  distinguishing  mark of elegance.  Husbands ip:d of cr\
to  make  it their  boast, that,  when  they married their wives, they
could span them round the middle.  It was then  thought that nothing- 
DURING  PREGNANCY.
25
could produce a flue shape but tight lacing, though it never failed to have
tlie contrary effect.   Not only deformity without measure, but death it-
self was often the consequence.   Ladies Avere known to drop down life.
less iu the dance, when no other cause could be assigned but the tightness
of the dress.   Miscarriages were frequently occasioned by the same cause;
and various other injuries to the fatus must have far exceeded all power
of calculation.
  Yet, during the prevalence of so strange an infatuation, while deformi-
ty was deemed beauty, all remonstrances on Uie subject would have prov-
ed unavailing.   It would then  have been useless to  employ such argu
ments as now  carry conviction to the unprejudiced mind.  We may at
preseut  observe, ivith the hope of being listened to, that nature when left
to herself, gives eveiy animal, except those that are formed for swiftness,
a prominency about the middle.   If this is not only compressed, but the
belly squeezed close to die back-bone, obstructions of the viscera must
ensue :  and no great knoAvledge of the human frame is necessaiy to sa-
tisfy any  person,  that such obstructions  must prove fatal to health.
When the vessels that take up and convey the nourishment to the body,
have their functions by any means impeded, the whole system must suffer,
and at length perish by a gradual decay.  But nothing can so effectually
impede the functions of those soft parts as pressure.   Thestomach becomes
incapable of performing the grand office of digestion: the midriff is  for-
ced upwards: the cavity of Uie chest is thereby lessened, and sufficient
room is not left for a proper play of Uie lungs.   A difficulty of breathing,
coughs, and pulmonary consumptions are the natural  consequences.
  All those dangers occasioned by tightness round Uie waist, are obvious?
ly increased during pregnancy, when the heart, the  lungs, the stomach,
and all the adjoining parts are in a state of tender sympathy with  the
womb;  and when the growth of the foetus  necessarily requires more room
as before observed, for easy expansion.  To confine  it at  that period
must evitably produce weakness, deformity, or abortion.   " Remember/1
says the ingenious author of Pcedotraphia.
                Remember not to gird too tight
      Your swelling waist, though pleasing to the sight;
      Nor for a shape, within the straighten d womb;
      Like Gallic mothers, the poor child entomb.—

But young English  wives have often  been guilty of the  same fatal i«-
prudence, not indeed, so much for the sake of " a shape," as from im-
pulses of false modesty,  and for fear of appearing either indecent, or too
proud of the happy proofs of their fecundity.
   I hope, however,  that the days of folly and of absurdity in  those
respects are  past;  and that the evils, which were  then  so frequent
will operate as a Avarning  against any possible restoration  of  that
most awkivard  and most pernicious contrivance called stays.  Let me
also very  earnestly forbid  Uie use of tight  necklaces, tight garters,
or  any  ligatures vvhich  may  restrain  the  easy  motion of  the  limbs,
or  obstruct the free  circulation of the blood and  juices.  I should
farther  observe, that  it  is not enough to  have discontinued the high-
heeled shoe,  unless the shape of the  foot and toes  is a little attended
to.   Trifling  as  this  circumstance  may appear,  the  neglect of it has
often been attended not only Arith pain, with .cramps,  and with  corns.. 
26                   A FEW  REMARKS
but Avith many still more  distressing  consequences.   Of these I shall
have occasion to speak more fully in my observations on the dress of chil-
dreu.
   To sum up in a few words the chief part of my advice on this subject
to pregnant women, and to the fair sex in general, I need use but a single
assertion, that a flowing dress,  sustained by the  shoulders,  and geutly
compressed by a zone round the middle, with only as much  tightness as
is nece^.ary to keep the clothes in contact with the body, ever  was, and
ever will be,  Uie most healthy,  comfortable, and truly elegant habit that
females cau wear, or fancy invent.
   The  hints concerning cleanliness, which are given in the  last chapter,
Avill  be  found no less useful after marriage than before, with this single
exception, that during  pregnancy, lukewarm water, is preferable to cold,
not only for a total immersion of the body, but also for  partially bathing
the upper and loAver extremities, more especially the  latter.  I have in-
deed, known many pregnant women,  avIio  always  used cold  water od
these occasions, and who plunged into the sea tAvo  or three times a iveek
during the summer months, Avithout injury.   Yet  I  think their example-
tpo hold, and too dangerous to be recommended to general imitation.
                          CHAP.  III.

           A  FEW REMARKS  ON CHILD-BIRTH.

      jHEUE is not any part of medical science which has been cul-
tivated with greater assidu'-ty, and finally with greater success, thau mid-
Av'fery.   The errors of ignorance,  the rashness of presumption, Uie
amusmg  theories of ingenious fancy, have at length given  way to the un-
erring dictates of reason and experience.  By these it has been clearly
proved, that, in every healthy and well-formed subject, the powers of na-
ture alone are fully adequate to the accomplishment of her greatest work,
the preservation ofthe human species; and that the busy interference of
a mv> is  more likely  to  ui^urb and impede  than  to assist  her efforts.
Whatever differences of opinion may prevail on other points  merely spe-
culative, as well informed practitioners are now agreed  in this, that Uie
regular process of a labour must never be hurried on  by artificial means,
nor interrupted by the meddling hand of indiscretion  or officiousness.
   It is painful to reflect  on the numbers that must have perished, while
a contrary method was pursued.   People had taken  it into their heads,
tivt a woman in labour could not use too much exertion on her own part,
nor be too much aided.by others, to quicken delivery.  In the poem be-
fce referred to, this notion is inculcated in Uie form of medicial precept,
The poor woman is there desired,

      " To grasp some strong support with all her pow'r,
      " T' increase her efforts in  that painful hour."

   A happy revolution has now,  however,  taken  place  in  the system
of midwifery; and the most eminent professors have made  it Uie first 
ON
CHILD-BIRTH.
27
object of their public duty to reprobate the abominable custom of giving
assistance, as it was called, by dilating the  internal and external parts
artificially; anil of exciting patients, uot only by the strongest persua-
sions, but by the stimulus of hot cordials, to help themselves, as they term-
ed it, and to exert all their voluntary force beyond the dictates of nature;
" as if," says Dr. Dcnham,  " a labour was a trick to be learned, and not
a regular process of the constitution."
   Though the  Avriter now quoted, and  many others of no less celebrity
have omitted nothing  of importance in their directions both to mid-
wives and lying-in women,  yet as their books,  from being deemed
works of  professional science, are  seldom read by  the latter, I shall se-
lect a feAV  of their most useful  remarks, and exhibit them in the plain-
est form I can,  to guard women in labour against the fatal consequences
of their oavu errors, on  the improper  advice which may be given them by
others.
   On the first signs of approaching  labour,  pregnant Avomen are too apt
to take alarm, and instantly prepare  as for a  work ofthe greatest toil and
danger.   Their fears are as groundless as their preparation is unnecessa-
ry.  If they have nothing to injure their health during the previous state
of preguancy, they may rely with perfect confidence on the admirable re-
sources of nature.   When left to herself, her efforts are always adapted to
the constitution of the patient, and to the state of those delicate aud acute-
ly sensible parts, which would suffer the greatest injury from sudden or
ill-timed violence.   All that is required of Avomen in labour, is a becoming
submission to her course of operations.   The steps, by which she advan-
ces to her great end, are sometimes sIoav, but ahvays safe ; and she is not
to be hurried or disturbed, with impunity.
  It is true in almost every situation, but particularly in child-birth, that
those who are most patient actually suffer the least.   If they are resign-
ed to their pains, it is  impossible for them to do wrong; but if, from too
much eagerness to shorten those  pains and to hasten the final effect,  a wo-
mau should keep in her breath, and strain with all her might to increase,
as she may imagine, the instinctive action of the womb, the  consequences
must always be injurious, and often fatal.
   In the first place, such improper efforts of the patient may exhaust her
strength, so as to render her incapable of undergoing the necessary fatigue
which attends the complete expulsion of the child.   On the other haud, if
the parts are not duly prepared, violence is more likely to tear than to di-
late them; and accidents of this kind have often occasioned a fever, or
have rendered  a woman miserable for the remainder of her life.
   The imprudence of taking hot and cordial nourishment during labour,
is no less reprehensible.  In  plethoric habits, it must have a feverish ef-
fect : in any  constitution, it is at that time a  dangerous stimulant.   The
nature of  the principle, which should actuate the Avomb, is immediately
changed;—the pains are rendered disorderly aud imperfect;—and the
foundation of future mischief and difficulties, in some form or other, is in-
variably laid.  A  labour may be so sIoav, or of such long duration as to
render a little refreshment from time to time necessaiy; but this should
always be of a mild and cooling quality, the very reverse of inflammatory
food or spirituous liquors.
   I have  already  intimated, that,  all ordinary cases, Uie  chief duty
of a midAvife is to let nature take her  regular course without busy in- 
28
A  FEW  REMARKS.
terference; to restrain, rather thau  encourage Uie exertions of the pa-
tient's strength;  and, when these  may be iu voluntarily carried  too far
from the impulse of acute pain, to  resist them by the application of some
equivalent force.   But I am very  sorry to add, Uiat the conu ury method
is too often pursued, especially by practitioners in country-plates, when
the patients are so widely scattered, that dispatch is the first objVt i of
consideration, and the dictates of humanity are disregarded from sirooger
views of interest.  The moment an order comes for the man-midwife, he
packs up his bag of tools, which may be .justly called the instrumeuts of
death;  he mounts his  horse, and gallops away, resolved to hasten Uie
process by all practicable means, that he may be the sooue r ready to at-
tend to another call.  At whatever stage of labour he arrives, he spurs on
nature  with as much eagerness as  he  had before spurred on his home,
though the closely entwined lives of the mother and her offspring may be
endangered by his precipitancy.   Yet such, perhaps  is the  impatience
ofthe poor woman herself,  and such very often the ignorance of the by-
standers, that the quicker he is in getting through his work, if no obvious
injury be done  at the moment, the greater reputation he undeservedly
acquires, and the more  he enlarges the sphere of his murderous practice.
Instruments are sometimes necessary, but Uiey should be-used as seldom
as possible.
   One method of preventing .the  evils which must always arise from
the hurry of professional men, would be to pay them more liberally for
their patient attendance.   They  have nothing but  the full employment
of their time to trust to for the means of support: and it is just that they
should have an adequate compensation for so valuable  a sacrifice.  But
as this  cannot be generally expected, I would recommend  the cheaper
encouragement of female midwives, none of whom, however, ought to be
permitted to practice, Avithout a regular license, obtained—not by money
—but by proofs of real qualifications.   Such persons  could spare more
time, and would  be found much  fitter assistants to lying-in women thau
any surgeon, whatever may be his skill or talents.   I do not insist on the
point of delicacy, but of absolute safety, being persuaded that hundreds
of lives are destroyed for one that is preserved by the use of instruments
in a labour.
   At such times  also, it is highly improper to admit any person but tlie
midwife and a discreet nurse into the apartment.  To  say nothing ofthe
noxiousness of the breath and perspiration  of several people  in a close
room the officious folly, the silly tattle, the inconsiderate lauguagc, the
fluctuating hopes and fears of so many gossips, must be productive of the
very woret effects.  Let me therefore, conjure pregnant women never to
comply Avith the request, however well-meant, of their female friends, to
be sent for at the moment of labour; they are sure to  do some harm; it
is impossible they can do any good.  The patient will find qinetnes- and
composure, of far greater service than the noisy rallying round her of her
friends to aivaken and cherish the idea of danger.
   After delivery, when repose is  the chief restorative of fatigued na-
ture,  and Avhenthe purity ofthe  air  in  the patient's chamber■ «, t:hc
best preservative from fever,  the  exclusion of visitants  must be  st 11
mot^tronlly insisted  upon.  The  whisper of fond congratu *,on
from the man she holds dear,  and whom  she  has made happy, i. all
«at should be allowed even for  a moment.   With  the same view  of 
ON  CHILD-BIRTH.                   J29
Quieting any flutter of the spirits,  and of  preventing the uneasiness
which a mother uaturally feels from the cries of her child, the operation
of washing and dressing the infant should for a few days be performed
in au adjoining room.
   As  the pains of labour,  hoAvever regular in its progress, and happy
in its issue, must produce some irritation of  the system, and a tendency
to fever, external quietness, and perfect composure of mind as well as of
body, are certainly the first objects.   But our care should  be extended
to some other points also.   Too much  attention cannot  be paid to clean-
liness :  all  impurities are to be instantly removed.  It  is equally neces-
saiy to change the  lineu often, on  account of its retaining  the perspira-
ble matter, which Avould soon be thrown back into the  habit, and there
produce the worst  effects.  Whenever the  weaUier permits, the upper
sashes of the ivindows are to be let down a  little to admit the fresh air;
yet so as not to expose the patient to its direct current,  for fear of check-
ing Uie gentle and salutary perspiration, which  naturally  follows  the
fatigue of a labour, and is designed to abate any inflammatory or febrile
symptoms.   It would be no less dangerous to think of  increasing or of
forcing this natural discharge by large fires,  a load of bed-clothes, close-
ly drawn curtains, or the still more pernicious heat of caudle impregna-
ted with spices, wine, or spirits.  A fever is almost sure to be the conse-
quence of such ill-judged expedients, in ivhatever manner they may act.
Sometimes  they will put a total stop to perspiration, though they set the
body on fire, and thus produce the very evil which they were foolishly
employed to prevent.   At oUier times they cause so profuse and violent
a sweat, as  must not only  exhaust the  strength of the patient, and fre-
quently destroy the power  of suckling her child, but  prepare the Avay
for the  ready attacks  of a fever upon the least exposure to  cold.
   A temperate degree of Avarmth,  therefore, will  best promote that dis-
position both to sleep  and  to  perspire, which every Avoman feels after
labour.  The fires should be suited to  the season, or rather to the state
of the weather, and made  barely  sufficient  to counteract the effects of
cold, and of dampness or moisture.  The drinks should be  mild and di-
luting;  aud the bed-clothes should  be light and porous,  to favour the es-
cape of the perspirable matter, while they afford a comfortable covering.
A due regard to this regulation is the more necessary, as the patient must
not be in a hurry to quit her bed, even when she may fancy her strength
and spirits perfectly recovered.  She should be informed, that the womb
does not resume its natural state for two or three Aveeks; and that her
lying in bed for that time is most  conducive to so desirable a purpose.
A sofa  is very convenient to recline upon, while her bed is at any time
adjusting, or to afford some relief  from a long coutinuance in the same
position.  But I would by no ineaus advise sitting up in a chair, or remo-
val into another room for the reception of company, till the end of the
third week, and then only in case  of the  most perfect consciousness of
health and vigour.
   The  opposite extreme of too much indulgence is, indeed,  more preva-
lent.    It is a lamentable truth, that numbers of women, after havin* been
safely brought  to  bed, are killed  by  imaginary  kindness.   They are
smothered,  iustead of being Kept moderately  warm.   The action of heat
from  Avithout, is increased within by inflammatory  food and  drink.
•N.-ithcr of these should be in any case allowed;.   Women of strong and, 
30                    A  FEW  REMARKS
full habits have nothing to fear from empuuess or fatigue; but may be
said to invite danger and disease by improper gratificatioiib of the palate.
They t..Duid confine themselves for at least three or four day*, to barley-
water, gruel, and beef-tea.  Very Aveak and delicate women may  be al-
lowed something more nutritious, such as calves-feet jellies, or veal and
chicken broths Avhich  are much better suited to the Aveakuiss of their
stomachs, and  will sooner afford the wanted nourishment than  solid ani-
mal substances.
  If the rules  of temperance before laid down have been followed during
pregnancy,  the patient  will be easily reconciled to abstemious living for
a few days.   Indeed the relaxed state of  the  stomach  at  this time com-
monly  prevents any natural craving for animal food.   But, if a woman
has been unhappily accustomed to luxuries, or if soups should disagree
with her, she may be indulged in a little fish, a little boiled veal or  chick-
en, and bread pudding.   Every succeeding day will render such  indul
gence safer.  Hot spices, however, and ardent spirits in any form or mix-
ture, are to be absolutely prohibited during the whole  time of lying-in.
Wine itself  is liable to do much mischief till every symptom of fever or
inflammation disappears; aud, even then, should be very sparingly used,
not more than a glass or two being allowable at the principal meal  only.
   But though quietness,  repose, the admission of fresh air, strict cleanli-
ness, and a  temperate cooling.regimen,  must contribute veiy much to
prevent fever, and to promote a woman's safe and speeely recovery from
child-bed;  yet all these prudent measures will often faU, without her oavii
faithful discbarge of one of the most sacred duties of a mother, that of
suckling her infaut.  Unless the milk, which is ready to  gush  from her
nipples, finds the proper vent, it will not only distened and inflame the
breasts, but  excite a great degree of feveriu the whole system.  Every at-
tempt to disperse it by artificial means, being an act of flagrant rebellioa
against  nature, is as dangerous to the mother herself, to say  nothing  of her
child, as au  attempt to procure abortion.   The evident determination of
the blood to the breasts, for the Avisest and most benignant purpose, cau
never be repelled  with  safety.  It is either deposited upon some other
part, there to produce inflammation: or, if purgatives and sudorifics are
used to carry  it  off by different outlets, the violence of their action must
be attended with dangerous shocks, even to the firmest  habit.
  It may be  said, that there are instances Avithout number, of mothers
who enjoy perfect health, though they never suckled their children.  I
positively deny the assertion;  and maintain, on  the  contrary,  that a
mother, who is not prevented by any particular ueakness or disease from
discharging that duty, cannot neglect it  without material injury  to her
constitution.  The same midwives who Avould assist her  in procuring a
miscarriage, if she wanted it, may now also undertake to disperse her
milk with the utmost ease and safety.  Let her not trust to the wicked
delusion.  The  mischief is not the less  certain from its  being perhaps
uoperceived at the time, and cruelty to one  child, often destroys  the
power of procreating another.
   If we take a view of all animated nature, it is shocking to find,
that woman should be  the  only  monster capable of withholding the
nutritive fluid from her young.  Such  a monster, however, dors not
exist among savage nations.   They cannot separate the idea  of  bring-
ing forth a child, from the necessity of giving it suck.  The  wives of 
ON  CHILDBIRTH.
81
  the American savages are said to extend this mark of motherly tenderness
  and solicitude even to bifants that die upon the breast.   After having be-
  stowed upon them the rites of burial, they come once  a-day for several
  weeks and press from the nipple a few drops of milk upon the grave of the
  departed ruckling. I have seen a drawing taken from nature by a gentle-
  man at Botany Bay : it represented a female of that country, after hav-
  ing opened one of her veins,  aud made an incision in the naval of her
  sickly child, endeavouring to transfuse her blood into its body, and hop-
  ing thereby to restore its health, and to prolong its existence.   Observa-
  tion and  experience had taught her that  the umbilical cord, or naval-
  string, Avas the medium through which the foztus, while in the Avomb, re-
  ceived nourishment from  its mother: she fancied, therefore,  that she
  could transfuse her blood through the same channel, and  renovate a life,
  which Avas dearer to her than her own!   Let the mother in civilized so-
  ciety,  who,  from  moti\*es of selfish ease aud imaginary pleasure, denies
  her infant the vital stream  with Avhich she is abundantly supplied for its
  sustenance, think of the poor  savage and start with horror at her own un-
  natural depravity.
    It is also a great mistake on the part of such selfish mothers, to fancy
  that they can take more pleasure by abandoning their infants to the care
 of hirelings.  Some of them may he callous to all reproaches of conscience
  for the frequent diseases of those children;  but leaving moral sentiment
 and natural  tenderness out of the question', pleasure  is inseparably con-
  nected with the enjoyment  of health; and I have already sheivn  how
  much this is endangered by  a mother's unAvillingness to become a nurse.
  I  need not repeat  ivhat I  said of Uie inflammation  and suppuration
 of the breast;  but my hint on barrenness, as one of the probable conse-
 quences of an attempt to disperse the milk, may be farther enforced by
 observing, that the Avomb is the part most likely to be  affected iu such.
 cases:  the repelled humour has often been deposited  on that delicate or-
 gan, and has there produced deep seated and frequently incurable ulcers.
 Many instances of this sort, as well  as of other  disorders arising from
 the same cause, and equally fatal to fecundity, gaAre ri.-c: to my former as-
 sertion, however hareh-'itmay sound in the ear of fashionable perverse-
 ness.                 ;*
   But  I can with cqual^onfidence assure the fond parent, faithful to her
 trust, aud eager to cherish her infant with the  vital  fluid  which nature
 has kindly given her for ihat purpose, that nothing else can so effectually
 promote her recovery from child-bed, the  speedy return of good health,
 aud the long continuation  of that  invaluable blessing.   Besides,  all
 nurses concur in declaring,  that the act itself is  attended with sweet,
 thrilling, and delightfoj: sensations of which  those only Avho have felt
 them can form any idea*.
   I have already  admitted,  that a mother may be prevented from giving
 suck, by some particular Aveakness or disorder; and  in touching on the
 same subject in another ivork, I observed that women of delicate consti-
 tution.-;, subject to  hysteric fits, or other nervous affections, made very
bad nurse*.   Lest that remark might give too great a scope to excuses,
on the ground of pi; tended  weakness or  delicacy, I added, that every
moth< i who could, ought certainly to perform so tender aud agreeable an
office.   I now go  farther, and maintain that every  woman Avho is not
abk  and willing to discharge the duties of a mother, has no right to b&- 
32
A  FEW  REMARKS
come one.   The same personal defect, or constitutional infirmity, whicfc
may disqualify her for nursing, ought to be  considered  as an equally
strong disqualification for marrying.  But if, after marriage, any  subse-
quent disease or accident should render the discharge of  a  mother's first
duty impracticable or dangerous, she is, in such cases only blameless for
calling in the aid of  another to suckle her child.
  In the next chapter, I shall have occasion to  speak < f the  salutary
effects of the mother's milk on  the neAV born infant.  The aim  of my
present observations is to convince lying-in Avomen, that the free and na-
tural discharge of that precious current is essential to their oavo health
and safety.  But as some young mothers, hoAvever well-inclined, may be
discouraged' from persevering in their attempts to  give  suck, by the
difficulty, awkwardness, or pain, attending the first experiments,  1 shall
subjoin for  their  direction in such cases, a few rules laid down by the
most approved writers on midwifery.
   The first advice given by those eminent practitioners is, to put the child
to the breast as soon after delivery and due repose as the strength ofthe mo-
therwill permit, care having been previously taken to Avash the brenstswith
a little warm milk and water, in order to remove the bitter viscid substance,
which is furnished round the  nipple to defend the parts from excoriation
or soreness.   When the ivoman has never nursed before, the  nipples at
first are sometimes not sufficiently prominent  to  afford a proper hold for
the child.   The  ends also of the small tubes, through  which the milk
passes, are  contracted, to  prevent its flowing out spontaneously.   From
these circumstances, as well as from the inexpertness both of the  mother
aud the  infant, some pain and difficulty may arise.   But the common
practice of having the breasts drawn by an old child, or some grown person
is deemed improper, because  the degree of violence used on these occa-
 sions will often irritate  and inflame the parts, and frighten the  Avoman
 against  the reneAval of such painful experiments.   Much  gentler m. aim
 will produce the  desired effect.  The  breast  should be  fomented with
 flannels dipt in Avarm water; and then a glass or ivory  cup, mounted on
 a bag of elastic gum, ought to be applied iu such a manner to  the nipple,
 that it will draAV it out gently and gradually, while,  by moderate pres
 sure on the sides of the breast with the hands, tlie milk av ill be pushed for-
 ward.   In obstinate cases, instruments of more attractive  power  may be
 used, though  with caution, for fear of injuring Uie breast.
    If the difficulty  be not owing to a flatness of the nipple (upon the
 principal cause of which  I before hazarded a conjecture), but to a little
 rigidity of the milk vessels, nothing more is necessary than the warm fo-
 mentation  above recommended.  The stiffnesH'^or contractions of the
 nedsof those fine tubes will gradually yield to fjie natural efforts of the
 infant.  They will soon become straight, so as do longer  to impede the
 egress of the milk, which is drawn into them by  the suction. Impatience
 or excessive  eagerness, in these cases,  as in all others, defeats its own end.
 The attempts at first should neither be too  often repeated, nor too long
 continued; and when the child is put to the  breast, the mother ought to
 be supported by pillows in bed,  in a reclining posture, and with due pre-
 cautious against catching cold.
    Such are  the dictates of enlightened practice, of which 1  am happy
 to avail myself, as  an  additional incitement to mothers not  to shrink 
ON  CHILD-BIRTH.
33
from their duty.  A  little pain is  easily surmounted, and  is followed
by  lasting pleasure.  I must not omit another caution given by  the
same writers, in case  of any particular soreness of the nipples, ahvays
to procure the best medical assistance, as Uie modes of treatment pur-
sued by ignoraut persons are, in these instances more especially, no  less
injurious than absurd.
                          CHAP.  IV.

  OF  THE NURSING AND REARING OF CHILDREN.

      EVERY thing is perfect, says Rosseau, as it comes out of the
bands of God; but every thing degenerates in the hands of man.  This
is particularly true of  the human  species.   If the mother during preg-
nancy,  has not suffered any injury from accident, or from her oavo im-
prudence ;  and if, after the accession of labour, neither she nor the mid-
Avife has disturbed  or impeded the efforts of nature: the offspring of
strong and healthy parents is sure at the birth to be Avell-formed, healthy
and vigorous.  Any instances to the contrary are so rare and extraordi-
nary, as almost to leave some doubt of the possibility of such an eAent:
yet it appears from the best calculations,  that at least one half of the
children born, die before they are twelve years old.  Of the  surviving
half at that  period, how  many perish before they attain to maturity!
How many others are stunted in their growth, distorted in tlieir figure,
or too much  enfeebled ever to enjoy the real  sweets of life!  What a
train of ills seem to await the precious charge, the moment it is taken
out of the hands of nature!  But as the most of these calamities are the
consequences of mismanagement or neglect,  I shall endeavour to shew
how they may be prevented by tender aud rational attention.

                           SECTION I.

     Of the influence of Air on the Health  and Lives of Children.

   THE first Avant of a new-born infant is clearly manifested by its cries,
 not arising  from  any sense of pain,  but from a stimulus or impulse to
 expand the lungs, and thereby open a free passage for the circulation of
 the blood, and for admission of air, so essential to  the existence of every
 living creature.  While the child lay in the womb, its lungs were in a
 collapsed or shrivelled state:  it received all its supplies through the me
 dium of the naval-string.  But at its birth a very obvious change takes
 place.   The pulsation or throbbing of this cord first ceases at the remo-
 test part, and then by slow degrees, nearer  and nearer to the child, till
 the whole string becomes quite flaccid, all circulation being confined to
 the body of the infant.   It is then  that  the cries of a healthy child are
 heard; in consequence of Avliich the air  rushes  into  the lungs; their
 tubes and cellular spaces are dilated; the bosom heaves; the cavity of
 the chest is  enlarged; and the blood flows  with the utmost ease.  But
 as Uie air passes out, the lungs again collapse, and the course of the blood 
34
OF THE  NURSING  AND
receives a momentary check,  till a fresh influx or inspiration of air i>
concurrence with the  action of the heart and arteries, renews the former
salutary process, which never  ceases during life.
   The air thus inhaled,  after imparting its vital properties to  the whole
frame, takes up the perspirable matter constancy issuing from the interior
surface of the lungs, aud carries off, on its expulsiou, a considerable part
of the noxious and superfluous humours of the body.   Its purity is of
course destroyed, and, in consequence of being frequently breathed, it
becomes unfit for respiration.  In a confined place, therefore, it is not
air we inhale, but our own effluvia; and every other cause, \\ Inch tends
to waste or pollute the  air, renders  it in some degree  injurious to the
strength and health of those Avho breathe it.
   Iu this account of one of the most important of the vital function?,
I have avoided Uie minute details of  anatomical science,  which would,
indeed, have  made it more accurate, but less intelligible to the generality
of my female readers.   I thought it far better to explain to them, in as
familiar language as I could, the cause of an infant's cry at the moment
of its birth, with the hope of rendering thcin attentive  to the purity of
what nature so strenuously demands.   The quality ofthe air avc breathe,
is of much greater consequence than  our food or drink, at every period
of life, but particularly in infancy, a state of the utmost delicacy and
Aveakness.   Good air braces,  bad air relaxes, the tender frame; the for-
mer is a source of health and vigour, the latter of infirmity and disease.
   It should therefore be the first object of a pregnant woman's care,
to secure, at least for the time of her lying-in, a Avholesome  ritual ion.
Instead of flying from  the country  to  town, as many  do, she  should
 fly from toAvn to the  country.   If  her circumstances will  not admit  of
 this, she must fix her abode in as open and airy a street as she can, and
 at as great  a distance  as  possible from noise, from tumult,  and  from
 those nuisances tvhicti  contaminate  the atmosphere of great cities.—
 Let  her apartments  be lofty aud  spacious,  dry rather than warm, and
 exposed to the sun's  morning rays.   I  have already explained  the im-
 portance of cleanliness, and of occasionally letting dmvn the upper sashes
 of the bed-room Avindows in fine Aveather, to admit fresh air, and to pre-
 vent fever.   An attention to these points is not less  necessary on die
 neAV-born infant's account, than on Ids mother's.   Let not the  first air he
 breathes be foul from confinement, too  much rarefied by heat, or char-
 ged with any noxious exhalations.  The mild temperature to which he
 has been used in the womb, renders it very pioper to  preserve for some
 time the same moderate degree of warmth in  his new place of residence.
 But he is not, on that account, to be roasted before a great fire,  or kept
 panting in steam and pollution.
   If  the room be kept  properly ventilated and free from impurity, the
 infant will soon  get hardy enough to  be taken out into  the open air,
 not only  without' the least danger,  but with  the  greatest advantage;
 provided  always that the season of the year, and  the  state of the
 weather, encourage  such early experiments.   A  month  spent within
 doors, is confinement  long  enough  in almost  every case;  and the
 nursery is then to be frequently exchanged  for green  fields  and sunny
 eminences.    There  your child will  drink,  as it   wire,  the  viti.1
 stream pure  from its source;  he will draw in at every breath  fresh 
REARING  Off  CHILDREN.
35
 mpplics of strength and alacrity ; while the  bracing action of the air on
 the surface of his body, will give a degree of firmness unattainable by any
 other means.
   In the  course  of a feiv mouths,  the state of the Aveather need not be
 much regarded;  and its unfavourable changes, unless the heat or cold be
 intense, must uot operate as a check on those daily excursions from the
 nursery.  Our climate is very fickle;  we shall suffer much  iion. its ra-
 pid variations, if Ave are not freely exposed to them in early life : do not
 therefore  tacrifi.ee the future comfort and safety of the grown man, to mis-
 taken tenderness  for the infant.   If your child be  accustomed from the
 cradle to go out in all v eathere, be will have nothing to fear from the
 bleak north, or the sultry south, but will bear every change of season, of
 climate, and ofatmospheie,  not only Avithout danger, butwiUiout pain or
inconvenience.
   What is here said of the importance of fresh air, and of frequent expo-
 sure to all sorts of weather, in early life, must derive additional Aveight from
 a  consideration of the bad effects of confinement and of unwholesome air
 upon children,   'i his part  of the subject is pretty fully discussed in my
 "  Domes ic Medicine."   I  there explained the reason Avhy so few of the
 infants that are put iuto hospitals  or parish w'ork-houses live.   Such pla-
 ces are generally croud ed with old, sickly and infirm people, by nhich
 means the air is rendered so extremely pernicious, that it becomes a poison
 to young children.   I also took  notice of one of the worst afflictions of
 poverty in great towns, Avhere the poorer  sort of inhabitants live in  Ioav,
 dirty, confined houses,  to Avhich the fresh air has hardly any aeccts.
 Though groivn people, who are hardy and robust, may live in such situa-
tions, Act they generally prove fatal to their offspring, feiv of whom arrive
 at maturity, and  those who do are Aveak and deformed.
   While  I  was considering the hard lot of the poor, most of whose chil-
 dren perish, because the Avretched parents are not in a condition to  tako
 them often out into the. open  air, I could not but observe that the rich were
 Avithout auy excuse for neglecting so essential a part of their duty.   It is
 their business to see that their children be daily carried abroad, and that
 Uiey be kept in tlie open air for a sufficient time.   This will ahvays suc-
 ceed better, if the mother goes along with them.   Servants are often neg-
 ligent in these matters, and alloAV a child to sit or lie on the damp ground,
 instead of leading or carrying it about.  The mother surely needs air as.
 Avell as her children ; and how can she be better employed than in attend-
 ing them ?
   In the same chapter I had farther occasion  to censure a very bad, though
 a Aery pre vailing custom, of making children sleep in small apartments, or
 croAvding two or  three beds  into  one chamber.   Instead of this, the nuiv
 scry and the sleeping-rooms  ought ahvays to be the largest and most airy
 apartments in the house.   When children are shut up in small rooms, the
 air not only becomes unwholesome, but the heat relaxes their solids^ ren-
ders them delicate,  and dispones them to colds, aud many  other disorder?,
 particularly ofthe convulsive kind.  All medical men, who have had much
practice iu the treatment of children, agree in opinion, that couvuhion-fils,
of which so many infants die, are to be chiefly ascribed to a confined and
impure air.   I  w i.-h to  impress this truth on the inmds  of mothers and
nurses, to make  them sensible ofthe danger of small or close rooms, and
of the pernicious folly of covering an infant's face in bed, or the front of it* 
36                OF  THE  NURSING  AND
cradle, and thereby making it breathe the same air over and over all the
lime it sleeps.
   It may be of no less consequence to repeat and enforce my cautions to
parents against sending their children, while very young, or indeed at any
age, to crowded schools, the atmosphere of Avhich is reallj a floaungmass
of putrid effluvia.   The breath and perspiration of so many persons in a
room, even supposing them all to be in good health, must Avaste and cor-
rupt the air, destroy its vital properties, aud of course render it wholly un-
fit for the  support of animal life.  But  should auy one child happcu to
be diseased, atl the rest are very likely to catch the infectiou.  When 1
see a poor baby,  before it can well walk, carried in a nurse's arms to
school, I really feel stronger emotions of pity, and of alarm for  its salety,
than if I had seen it conveyed to a pest-house.  In the latter place, chil-
dren Avould be kept separate, and proper means would be used to prevent
the spreading of contagion : in tlie  former, all are thrown togetlier, and
there remain with relaxed lungs, open pores, and steaming bodies, to as to
render it almost impossible for any to escape.
   As thousands of children die eveiy year the victims of diseases caught
at schools, and as the health aud constitutions of still greater numbers are
irretrievably ruined by the confinement and  the bad  air of such places,
parents must not be offended at the seeming harshness of my language iu
reprobating so absurd, so cruel, and so unnatural a practice.  I know that
as soon as children begin to run about, they require the most watchful care
to prevent mischief.   Will any mother urge this as a reason for being ti-
red of them, and for confining, as it Avere in stocks, that restless activity
which is wisely designed by nature to promote their growth and vigour ?
Will she,  from a  wish to save herself some trouble, or to gain  time for
other business infinitely less important, send her little babes to school, un-
der the  silly pretence of keeping them out of barm's way ?  I hope what 1
have already said is sufficient to convince persons of common understand-
ing, that they cannot be exposed to  greater harm, than by being fixed to
 a seat in the midst of noxious steam for six or seven hours a day, which
should be  spent in the open air aud cheerful exercise.
   Should  it be alleged,  that children  are sent  young to school, from a
 becoming zeal for their early improvement, I  need only reply, that learn-
 ing, hoivever desirable, is too dearly bought at the expense ofthe con-
 stitution.  Besides, learning can never be  acquired by such preposterous
 means.  Confinement and bad air are not  less injurious to the mind, than
 to the body; and nothing so effectually prevents the  growth of the intel-
 lectual faculties, as premature application.—Sending  a child to school in
 his nurse's arms, is the  sure Avay to make him  an idiot, or to give him an
 unconquerable disgust  to books: the ouly  book he should then look at, is
 the great volume of nature.—This is legible at every  age, and is as grati-
 fying to a child as to a man: It abounds with the  most delightful and most
 useful information : it is equally conducive to pleasure, health, and know-
 ledge.
   A thousand  absurdities iu the fashionable modes of education  pre-
 sent themselves now to my view; but I must  only take notice of er-
rors in  the  physical  treatment of children:  and surely no  error  of
 this sort can be  more reprehensible, than that which I have been just
 describing.   Debility of body  and mind is the certain consequence of
 y ading very young children to school;  and of ? ending them, at  any 
BEARINC  OF  CHILDREN.
37
age, to crowded or confined schools.   The terms of instruction are in
general so low, that a master or mistress of a school  is obliged to take a
great i.umber of scholars, in order to get a living: and can  seldom af-
ford to rent a spacious room in au open and  elevated situation.   \' et not
only this is as absolutely  necessary for health, but a large play-ground al-
so : where even day-scholars should be permitted to go out frequently to
taste the freshness  of  the vital breeze.—The  plants of genius and of
manhood cannot flourish but by frequent exposure to the enlivening rays
ef the sun.

                          SECTION  II.

                    Of warm and cold Bathing.

   IN observing  the regular succession of an infant's wants,  after the
supply of air procured by it's first cries,  it's seeming uncleanliness at-
tracts our notice.   The skin appears covered with a slippery glue which
soon dries and forms a kind of scurf.   This should be  washed off very
gently with a soft spunge and warm water, having a little soap dissolved
in it.   Nurses, in general, are as eager to remove  every speck of it, as if
it was the most offensive impurity, though it is perfectly harmless, and
Avill easily come aivay in three or four Avasliings,  without the  daDger of
hard rubbing, or the aid of improper,  and sometimes very injurious, con-
trivances.   Ointments or greasy substances cannot fail to fill up the little
orifices of the pores, and to put a stop to insensible perspiration. Spirits of
any kind are still worse,  on account of their inflammatory effect.  Even
Galen's advice to sprinkle the child's body with salt, that the glutinous
matter  may be more effectually rubbed  off, is at best unnecessary.  I
have no particular objection to the modern improvement on that hintj
which consists in dissolving salt in the warm bath, with a view of giving
it the agreeable stimulus, as well as the cleansing and bracing properties
of  sea-water;  but I Avould not encourage any solicitude in  this respect,
as the easiest and simplest  mode of proceeding will fully answer the de-
sired end.
   In the hardy ages of  antiquity, we  are told Uiat the Germans used te
plunge their new-born infants, into the freezing waters of the Rhine, to
inure them betimes to the severe cold of their native country.   I need not
take any pains to point out the danger of following such an example in our
times, w hen mothers and nurses are too apt to run into the opposite extreme
of unnerving effeminacy.  In this, as in every thing else, the golden mean
 is the line of Avisdom—the  line to be pursued by rational affection.  It
 would be extremely hazardous  to dip the tender body of a child, reeking
 from the Avomb, in  cold water,  and to keep it there during the necessary
 operation of washing: but the use of  the cold bath may be safely brought
 about by degrees in five or rix months after the birth, and  will then be
 found not only one of the best means of promoting health and strength,
 but of preventing  also many of the most distressing complaints to which
 children are subject.   The following method I can confidently  recom-
 mend, having had frequent opportunities of observing its salutary effects.
    The tempera!ure ef the bath proper for a new-born infant, should ap-
 proach nearly Uiat of the situation  which  she has  just quitted.   It is.
 proper to acquaint tiiose who may not have an instrument to ascertain the 
 58                OF  THE  NURSING  AND

degree of he?A, that absolute precision in that respect is by no means no-
cessary; their  feelings will inform them with suiticicnt  exactness when
the water is rather warmer than  new milk: a litde solution of coap, as
I before observed, is all that is avanted to increase its softness aud its
purifying effect.  The operation of washing  should be performed in a
vessel large  enough to allow room, for the expansion of the infants limbs,
and for easily discovering any  defect in its structure, or any  accident
which may have happened to it during labour: either may  be ofien re-
medied  by tinv.-ly care, but may become incurable through delay or ne-
glect.   The child should not be kept in the bath  longer than five  or six
minutes; and the moment it is taken out, it should be wrapped up in a
soft warm blanket, and there ke^t for a few minutes in a state of gentle
 motion.
   I Avould not have any difference made, either  in the  temperature of
 the bath, or the time of the iufants continuance in it, for the first month.
 The uncleanliness of young children renders frequeut washing neces-
sary.   It should be the .first object of attention in the morning, and the
 last at night; but it should not be  performed  with a full stomach, even
 when the child receives  all its  supplies from the breast.  This is the
 only caution which need be added to those already given concerning
 gentleness in the manner of  Avashing, space euough in the bathing  vessel,
 and strict care to wipe the child dry,  and wrap it Avarm  the instant it is
 taken out of the bath, Avhen exposure to cold would be  doubly danger-
 ous, from the natural delicacy, of the infant, and  from  the immediately
 preceding warmth and the openness of the pores.
   After the first month the Avarmth of the  water may be lessened, but
 almost imperceptibly so as to guard against the risk of sudden changis
 or too rash experiments.  The mildness of the weather and the evident
 increase of  the child's  strength, must be  taken into consideration; for,
 though cold water is very serviceable, in bracing weak and relaxed habits,
 yet, Ff tried too soon, its stimulus on the surface may be too strong, and
 the'powersof reaction wiUiiu too weak, so that the worst consequences
 may follow.   These will be prevented by a gradual diminution  of  the
 temperature of the water, and  by close  attention  to it's effects,  when re-
 duced  nearer and still nearer to a state of coldness.   If immersion in the
 bath be quickly followed by a glow all over the body, and a perceptible
 liveliness in the child, we may be sure that the water has not been too
 cold for his constitution, and that we have proceeded with due care.  But
 should  it produce chilliness, evident languor, and depression,  we nim-t
 make the water a little warmer next time, and not venture upon the cold
 bath till we are encouraged by  more favourable appearances.
   It Avould tend rather to increase than to clear up the doubts of mothers
 and nurses,  were I to enter into a detail of all the infirmities and diseases,
 in which the  cold bath would  be serviceable or injurious, not only
 during  infancy, but  at a more  advanced  period  of  life.  1 hen-
 are many nice distinctions in a variety of complaints, where the greatest
 medical skill  and experience  are necessary   to decide on the pro-
 priety or impropriety of resorting to so powerful, but at the  sameitn e
 To hazardous, a remedy.  I must, however, forbid its use in  coinjrfwut,
of the  bowels; affections of the  lungs;  eruptions on Uie infont■•*«!{
 and  in cases of extreme weakness, indicated  by the k-^"£™£d
 symptoms of dullness and apparent loss of strength and spirits alter im- 
REARING  OF  CHILDREN.
39
mersion.  With such restraints on iudiscreet rashness, it is hardly possi-
ble that a woman  can  do Avrong in pursuing the plan  which I  have
pointed out,  for reducing the warmth of the water by veiy slow and
almost imperceptible  degrees, till it can be employed quite cold with
safety and benefit.
  , There is no doubt but a great deal of mischief has resulted from the
too early and injudicious use of  the  cold bath.   I perfectly agreG Avith
Dr. Underwood in his equally sensible and humane remark, that " to see
a little infant, three or four days old, Uie offspring perhaps of a delicate
mother, who has not strengtii even to suckle it, Avashed up to the loins and
breast in  cold Avater,  exposed for several minutes, perhaps in the rnidst
of Avinter, (when children are more  inclined to  disease than those born
in summer) itself in one continued scream, and the fond mother covering
her ears under the bed-clothes, that she may  not be distressed by its cries,
has ever struck me as a piece of unnecessary severity,  and  savours as
little of kindness, as plunging an infant a second or third time into a tub
of Avater, with its mouth open and gasping for breath, in the old-fashioned
mode of cold bathing: both of which often  iuduce cramps and pains in
the bowels,  and Avcaknees of the lower extremities, but rarely an in-
crease of strength."
   I hope the advice which I have given respecting the proper tempera-
ture of the  bath during  the first  months  of infancy AvilJ operate as a
check on the " unnecessary severity" so justly censured in the first part
of this observation.   But the error pointed out in the  old-fashioned
mode of cold bathing, may not be so easily corrected, unless  some strong
and  clear reasons are assigned for discontinuing Uie dangerous  part of
that practice.
   Women should therefore  be  informed that the immediate effect of
immersion in  cold Avater, at any age, is a sudden contraction of the  pores
and blood-vessels of the skin, and a general repulsion or throwing back
of the fluids  towards the internal parts.  The chilling sensation  excites
the most vigorous efforts of the organs of life, particularly Uie heart and
arteries, to increase the heat Aiithin the body, aud resist the shock given
to the surface.   This is what is called action and re-action,  the degree
of the latter being always in proportion to the violence of the former, and
to the strength  of the constitution.   Hence arises that delightful  glow,
which folloAvs the first impression of cold;   and,  so far, the full play of
tke vital organs is as  pleasant as it is salutary.   But, as the increased
heat soon passes off from the  body,  if it be  continued  in the water, or
taken out aud directiy plunged into  it again,  the animal powers are lia-
ble to be exhausted by incessant or repeated  efforts to produce more heat,
and to overcome the action of Uie external  cold.  Grown persons have
often experienced the fatal consequences of  too long a stay in the water.
What then must the effects of a second and  third dip be upon the tender
and delicate frame of an infant, whose vital  power is proportionally fee-
ble ?   Besides  the risk of extinguishing the faint sparks of life, an accu-
mulation of humours in the head, stagnations ofthe blood in other parte,
and convulsion fits, are very likely to take  place.  But though none of
these  melaucholy  circumstances should happeu at the moment,  a stop-
page of growth, and a puniness of habit, must certainly follow so incon-
siderate an abuse of the very means best calculated, under pioper ma-
nagement, to  promote health, expansion, and vigour. 
40                OF  THE  NURSING  AND
  In  cases  of previous indisposition, or disease;  Avhere tiie cold  bath
may be prescribed as a remedy, the danger to a  poor infant must be
still greater from an injudicious mode of proceeding.   I took no small
pains in my  " Domestic Medicine," to expose the ivhims and  prejudice
of nurses in  this respect.   They would be objects of ridicule, were they
not  often attended with the most serious consequences.   I should smile,
for instance, at the remains of superstitious weakness, in beheviug that
the  Avhole virtue  of the water depend upon its  being consecrated to a
particular saint, were it  not that most of those holy wells, as they are
called, are very unfit for bathing, and, ivhat is Avorse, that the child  is
kept too long in the water, and that due atteution is not paid to frictic/n
and warmth afterwards.    Some of those silly women place their confi-
dence in a certain uumber of dips, as three seven or nine, though every
dip after the first, at each time of bathing,  not only defeats the hope of
benefit, but  increases the  strong probability of much mischief.   This may
indeed be avoided, by dipping the infant only once at  a time; but even
in that case, the magical number of dips is very insufficient for any de-
sirable  purpose.   I  have also knoAvn nurses Avho would not dry a child's
skin after bathing, lest it should destroy the effects of the water; others
will even put cloths  dipt in the  water upon the child, and either put it to
bed, or suffer it to go  about iu that condition.  This is sometimes done with
impunity by grown persons, Avho resort to the famous spring at  Malvern
in Gloucestershire,  for the cure of particular complaints of the cutane-
ous class;  but it Avould be little short of frenzy to make such an experi-
ment upon children.
  The only Avay of securing to an'infant  all the salutary effects of the
cold bath, without the least possibility of harm, is to prepare him for it in
the slow and cautious manner before  recommended.    This may be ac-
complished, under favourable circumstances, in five or six months.   Rain
or river water is fitter for  the purpose of bathing, than pump or  spring
water; though the latter, in case of necessity, may be used, after having
been exposed for some hours to the sun or the atmosphere.   The  child
must not be dipped  when  its  body  is hot, or its stomach full, and should
be put only ouce under the water at each time of bathing.   All the bene-
fit  as before observed, depends upon the first shock,  and the  re-action of
the system.  In order to prevent a  sudden and strong  determination of
 of  the blood to the  head, it is always advisable  to  dip the  child with
this part foremost, and to be as expeditious as possible in  washing away
all impurities.   I  have been  already so particular in my directions to
have the young bather instantly wiped dry, and  wrapped up in a soft
warm blanket that I need not repeat them;  but I  must add  another in-
junction which is, not to put the child to bed, but to keep it for some time
in gentle motion, and to accompany the whole process with  lively sing-
ing.   It is of far greater importance than most people may be aware of,
to associate in early life the idea of pleasure and cheerfulness with so sa-
 lutary an operation.                                              .
   During the use of the lukewarm bath, the whole body is to be  im-
mersed in  it every night as well as morning.   But when  recourse is
had to cold bathing, it must be used in the  manner above prehcribed
in  the morning only.  At  night,  it will  be enough  to wash the lower
 parts;  and even for this purpose a little warm  water may be  added to
 the cold in severe weather.  Every danger will thus be avoided; eve- 
REARINS  OF  CHILDREN.               41
 ry benefit will be secured ;  and the habit of personal cleanliness being
 rendered familiar in childhood, will be retained through life, aud wUl con-
 tribute very much to its duration and enjoyment.

                         SECTION  III.

                        Of Children's  Dress.

   THERE is not any part of my professional  labours which I  review
 with greater pleasure, than  my exertions in  early life to rescue iufants
 fijpni the cruel tortures of swathing, of rollers, and of bandages.   When I
 first ventured  to take up Uie subject, about half a century  ago, it certain-
 ly required the ardour, the courage, Uie enthusiasm of youth, to animate
 my opposition, not only to the prevalence of custom and the stubborness
 of old prejudices, but to the doctrines of Uie Faculty themselves.   Absurd
 as  avc may now think the practice of swaddling and wrapping up a child,
 till it was as stiff us a log of wood; the arguments in favour of a loose
 and easy dress, which I made use of in my Inaugural Dissertation,* were
 vehemently combated by the most eminent men, who at that time taught
 medicine in the University of Edinburgh.  The reform Avhich has since
 taken place, though not earned to the extent that it ought to be, is an en-
 couragement to use less reserve in condemning the remains of so pernicious
 a system.
   It cannot be deemed a matter of astonishment, while medical men de-
 clared themselves advocates for such a mode of clothing,  that it  should
 be carried to the most dangerous excess by ignorant, busy,  or self-conceit-
 ed  women.  They fancied that the shape, beauty, and health of the in-
 fant depended Avholly on the expertness of the person employed  in dres-
 sing it.    The midwife tvasto new-mould the head, and to shape every
 limb, according to her own fancy,  and then to  retain the parts, in  the
 form she gave  them, by close pressure.   Her stupid presumption was far-
 Uier encouraged by the vanity of parents, who, too often desirous of ma-
 king a show of the infant as soon as it Avas born, were ambitious to see it
 made up in perfect trim, and to have as much finery heaped upon it as
 possible.   Thus is came to be thought as necessary for a midwife to ex-
 cel in bracing aud dressing an infant, as for a surgeon to be expert in ap*
 plying bandages to a broken limb;  and the poor child, as  60on as it came
 into the ivorld, had as  many rollers and wrappers applied to its body, as if
 eveiy bone had been fractured in the birth; while those cruel  ligatures
 were often so tight, as not only to gall and Avound its tender frame, but
 even to obstruct the motion ofthe heart, lungs, and other organs necessa-
ry for life.
  In  the progress of folly and vice, Avhen the influence of depraved
 iociety had extinguished iu  the breasts of many mothers every  spark
 of natural affection, and had prompted them  tp  abandon their children
 to the  care of hirelings,  the mercenary nurse  was glad, for the sake
of her  oAvn ease, to follow what physicians taught and midwives prac-
 tised.  The  infant Avas kept  swathed  in  the form  of an  Egyptian
mummy,  as incapable of motion as  the latter, and  almost as destitute
of every  symptom or  indication of  life,  except  its unavailing cries.—

                    * De infantum vita CQiiservamla. 
42
OF THE  NURSING   AND
Though dwarfishness, deformity,  diseases,  or death,  must have fre-
quently been the cousequencc,  yet the nurse escaped all blame, as the
bandages  prevented any  limbs from being broken, and  the poor  vic-
tim bound hand  and foot, might be thrown any  where, and there left
with  the  utmost indifference,  while she attended  to her  private con-
cerns.
   The  only thing relating to the dress of infants which seemed to arise
from any tenderness, was a regard to its warmth: Unfortunately this was
carried too far : and children suffered from  the quantity, as well as from
the tightness of their clothes.   Every child has some degree of fever af-
ter the  birth; and  if it be loaded with too many clothes, the fever must
be increased, often to such a degree, from the concurrence of other cau-
ses of heat,  as to endanger the life ofthe infant.   Even though no fever
should  be excited,  the greatest debility must be the consequence of keep-
ing a child in a state of perpetual waste by excessive perspiration.  Be-
sides, in such a condition, a child  is liable to catch cold upon exposure
to the least breath  of air;  and its  lungs, relaxed by heat, and never suf-
ficiently expanded, are apt to remain weak and flaccid for life, so that
every cold will have the most  alarming  tendency, and probably  termi-
nate in  an asthma,  or a consumption.
   All the former evils, arising  from  the fallacy of  medical theories, from
the presumption of midwives,  the folly of parents, the unwillingness of
some  mothers to do their duty in  becoming nurses, the selfish views of
hirelings, and the quite opposite, though no Jess fatal suggestions of mis-
guided tenderness, were farther aggravated by the imperious dictates of
fashion.   Reason, experience,  and true taste, would have long since tri-
umphed over silly speculations, ignorance, and caprice,  had not every
consideration  been  sacrificed to prevailing forms; so that from the  in-
fant to its  swaddling clothes, to  its grand-mother in  her shroud, dress must
be Avholly regulated by the etiquette  of fashion.   Against this species
of hitherto  unshaken tyranny,  I shall  therefore point the  chief force of
my arguments; after a  few more strictures on the absurdity and pemi-
ciousness  of the other cause,—of tight and oppressive clothing, Avhich has
really inflicted deeper Avounds on population, than  famine, pestilence, and
the sAvord.
   To begin with the error of physicians: it  is  almost  inconceivable,
hoAv any set of men, who  professed to be the admirers and followers
of nature,  should have been so totally  blind  to  her obvious  mode of
proceeding  in the  preservation of  infant  life.   She forms the  body
soft and flexible,  to facilitate its future growth:  she surrounds the foe-
tus in the womb with fluids, to prevent its receiving any  injury from
unequal pressure,  and to defend it against every thing  that might in
the least cramp or confine its motions; she  adapts the same means to
the safe delivery of the child,  all whose bones are so gristly and ela--
tic as to yield with  surprising pliancy to cAery  obstruction in  the  act
of  labour,  and  afterwards to  resume  their  proper form, unless  re-
strained or distorted by the busy interference of man.   Yet people ol
pretended scieuce have been  bold enough to assert, that a child, when
it comes  into the  world,  is almost a round ball;  and that it is the
nurse's  part to assist nature in  bringing  it  to  a proper shape.   We
should rather say,  let the  meddling hand  be amputated, which  dares
to offer violence to  the works of nature.  If,  through the inexper: 
                  REARING OF  CHILDREN.               43

ne«s or impatience of the midwife, any ofthe child's delicate limbs have
been fractured or put out of joint, they will require immediate care and
proper bandages:  but let not presumptuous felly attempt to mend what
nature has made perfect, or perversely confine  what was formed for the
utmost freedom of motion and expansion.
   1 have often had occasion to observe that the instinct of brutes is an
unerring guide iu whatever regards the preservation ot animal  lite.  Do
they employ any artificial means to mould the limbs of their young, or to
bring them to a proper shape ?  Though many of these are extremely de-
licate when they come into the world, yet we never find them grow weak
or crooked for want of swaddling-bands.   Is nature less kind or less at-
tentive to the human species ? Surely not: but we take the business out of
nature's hands, and arc justly punished for our arrogance and temerity.
   This argument may be rendered still  more unanswerable by an appeal
to the conduct of those nations that approach nearest to a state ot nature.
They have no idea of the necessity  of  rollers or bandages to strengthen
the imaginary weakness, or to bring  to a proper shape the  imaginary de-
formities of their infants.  They allow them from their birth the full use ot
every organ; cany them abroad in the  open air;  wash their bodies dai-
ly iu cold water; and give them no other food or  physic  but the  truly
medicinal and  nutritive fluid, with which the mothers are bemgnantly
supplied  by nature.   Such management tends to render their  children
so strong and hardy, that by  the time our  puny  infants  get out ot  the
 nurse'slrms, theirs are able to shift for themselves.  I  reserve  come  re-
 marks on the perfect shape of those  savages for  a distinct chapter, in
 which I mean to contrast it with the  dwarfishncss and deformity  of civil-
 ized nations.                       ,  ,. ,          ,.«,-{     i.
   Instead of considering a child at its birth as a round ball, winch ought
 to be  brought to a proper shape by a midwife's or a nurse's assistance, I
 would have both these descriptions of  people look  upon its little body
 as a bundle of soft pipes, replenished with fluids in continual motion, Uie
 least stoppage of which is attended with imminent danger.  Tight pres-
 vUie alw ays weakens, and may sometimes suspend, with deadly effect, the
 action of the heart, the lungs, and  all the vital  organs:  it impedes the
 circulation of  the blood, and the equal distribution of  nourishment to the
 different  parts of the body; it distorts the pliant bones,  cramps  the
 muscular powers, prevents growth,  and renders the whole frame equally
 feeble and misshapen.
    Even were reason silent on those  points, and were Ave unwarned ot  the
 bad effects of swathes and fillets by past experience,  humanity ought to
  i ustt-ain  us from putting  a helpless  innocent  to the most  cruel  torture,
  squeezing its tender body into a press at the instant  of  its release from
  former confinement, and loading it with chains as the first mark of our at-
  tention.  1 have often been astonished at the insensibility o f midwives
  and nurses to the cries of infants while dressing—cries  that seldom ceased
  till the poAvers of the poor creatures were exhausted.  Yet so far from
  feeling any emotion of pity, it is usual for the midwife or the nurse to
  smile "at such cri<«, and to  endeavour  to persuade the mother, if within
  hearing, that  the violence of the scream is a subject of joy, not of sorrow,
  rs it proclaims the child's health and vigour. I have already explained
  the caiKo and important purpose of a new-born infant's  first cry, to promote
  respiration aud circulation.  The  loudness of that cry is indeed a proof 
44                OF  THE  NURSING  AND
of the strength ofthe child's lungs;  but every subsequent cry is Uie lan-
guage of pain, the expressive tone of irritation and  suffering.  If aou
do not instantly attend to it, you  may  be  guilty of murder.   Think of
the immense number of children that  die of convulsions soon after the
birth; and be assured, that these are much oftener oAving to galling pres-
sure, or some external  injury, than to any urward cause.  I have know n
a child seized with convulsion fits soon after the midwife had done swad-
dling it, and immediately relieved by taking off the rollers aud bandages.
A loose dress prevented the return of  the disease; and though tins will
not always cure fits produced by  tight clothing, as the effect ofthe injury
may continue after the removal of  the cause, yet it  is one of the  neces-
sary means of relief,  il being  impossible that a patient can recover, as
long as the cause which first gave rise to the disorder continues to  act.
  It may be  proper in this place to give as clear, simple, and concise an
account as I can ofthe nature  of convulsions, that midwives and mines
may learn to shudder at the idea of occasioning, by their misconduct, the
most  fatal, as well as the most frequent diseases incident to childhood.
The heads of infants being proportionably  larger, and the nervous sys-
tem more extended than in grown persons, their nerves are more suscep-
tible of irritation; and convulsion fits are the consequences of keen ir-
ritation, however excited.  The  great Boerhaave Avas of opinion, that
most of the disorders of children  might be ranged under the class of con-
vulsions.   It is certain that  all the different  causes of uneasiness to a
child, form but one general or undistinguished sensation of pain, which he
has  also but  one way of expressing, namely, by his  cries; and if these
are not attended to, and no relief is or cm be given,  acute  and unmiti-
gated pain commonly produces a fit.  If any stronger reason need bo
urged for immediately atteuding to an infant's cries, it is that they arc
almost ahvays owing to mismanagement.
   I admit that the most incureable couAulsious are those which proceed
from some original fault in the structure of the brain itself, whence the
nerves issue.  But such cases  seldom  occur, though the brain has un-
questionably been often injured,  and convulsions occasioned, by a mid-
wife's presumtuous attempts to model the scull of Uie new-born infant. I
have already hinted at this detestable practice, and shall presently make
some farther remarks on its baneful prevalence, and its horrid effects.
   Children are also subject to convulsions from cutting the  teeth with
difficulty, or from a feverish irritation of the system at the  approach  of
the small-pox, measles, and other  eruptive diseases.   I am far from being
disposed to blame nurses for  what they cannot prevent; though I believe
that the dangerous symptoms, which often attend teething in particular,
are chiefly, if not wholly owing to the previous improper and enervating
treatment of the child.   The other convulsions here alluded  to generally
go off as the eruptive  disease, of which they may be called the forerun-
ners, makes its appearance.
   There is  another  cause  of convulsions,  for  which midwives and
nurses flatter themselves that they  are  not in any sort blameable, »
mean acute pain  in the stomach or bowels.   But  Avhence does this pain
arise? either from  the  tight  pressure of  those pa^; from  the re-
laxing  effect of  a hot and  impure atmosphere;  or  from   some acrid
substance in the shape of food or of physic conveyed into the stomas!!, 
REARING  OF  CHILDREK.               45
and  irritating the alimentary canal.  If you atteud to the directions be-
fore given on the subject of air, AVashiug, and cleanliness;—if you pour
nothing dowu the infant's throat but the wholesome unvitiated juice,
designed for him  by nature;—if you slacken, instead of bracing your
Avrappcrs rouad his body; you may depend upon it that his stomach and
bowels will never be ditoruered as to occasion convulsions.
   The only part of au infants dress or covering which may be applied
pretty close, is a broad piece of thin  flannel round the  naval, to guard
against any protrusion there, from the accidental violence of the child's
cries.  But take care not to make the pressure too tight, or you will not
only hurt the bowels, but, perhaps, cause in another place a much worse
rupture than that to which your precaution is directed.  This is what hap-
pens in many similar cases, when people  act from narrow or contrasted
views of the subject, aud in their eagerness  to prevent some  trifling and
merely  possible inconvenience, too often occasion irreparable mischief.
Again, then  let  me  caution midwives  and nurses against retaining any
part of the old system of tight swathing,  as the injury it must do is cer-
tain, and the good or inconvenience, to which it may 6eem adapted, is ima-
ginary.  I am now speaking of its  immediate bad effects,  in squeezing
the infant's delicate body, fretting his tender skin, keeping his little  limbs
in a state of painful confinement,  exciting  his  cries, and, by all  these
causes of nervous irritation, throwing him into convulsions.   The female
who can hear and see these effects of her own folly, and will yet persist
in it,  after it is pointed out, certainly does not deserve the name of a mo-
ther.
   But the most censurable part of the usual conduct of midAvives and
nurses still remains to be minutely examined and reprobated.  It is not
enough for them to keep up the show of helping nature, as  they call it,
during the process of a labour, though she has been truly said to disdain
and abhor assistance; but they presume to mend her Avork after delivery,
and  to give a more proper form to the heads ol  new-born infants.   The
midwife will tell you, that the soft bones of  a child's scull, are often so
displaced and squeezed together in coming  into the Avorld, that the head
would be shapeless and frightful, were it not for her improving touches.
Another  reason  is  assigned  to the nurse  for  her  meddling.   She
takes alarm  at the imperfect indentation of the bones on the croAvn of
the head, and not only strives to press them closer and to brace them by
means of fillets, but is careful to keep the head warmly covered, to pre-
vent the poor baby, as she says, from catching his death by the exposure
of those open parts to the air.  Deformity is the least of the evils that
attend such acts of astonishing infatuation.  The delicate texture of the
brain is peculiarly liable to be affected; and though neither convulsions
nor any oUier perceptible complaint may immediately follow, yet  a weak-
ness of understanding,  or a diminution of the meutal powers, is often the
consequence, and  defeats all the efforts of the best education afterwards.
   The ossification or growing hardness of the bones of a child, and par-
ticularly those of the scull, is incomplete in  the womb, to favour the pur-
poses of easy and  safe delivery.   In consequence of their softness and
pliancy, they admit of being squeezed together, and even of lapping over
without injury, so  as to make the head conform to the shape and  dimen-
sions of the parts  through Avhich it is  to  be expelled.   They will soon
resume their proper place, if left to Uie kind management of nature, and 
46
OF THE  NURSING AND
not tampered  with by the profane fiuger  of a conceited  mid wife or a
silly nurse.
   As to the opening or imperfect indentation of the bones of the scull,
it is owing to  the same cause, aud dcsigued for the same important pur-
pose, to facilitate the birth of  the infant.  The free action of the external
air is then necessary  to promote the firmness aud  compactness of tho.-e
bones, and to make them press into each other, and form sutures for the
perfect defence ofthe brain, uot only against blows and bruises, but colds
and delluxions.  Warm and tight covering directly counteracts all these
benignant intentions of nature, and renders the scull a very weak shield
for  the security of its precious  contents.
   The curious distinction made by Herodotus in the field  of battle, be-
tAveen the sculls ofthe Egyptians and the Persians has often been quoted
to illustrate aud confirm this doctrine.  That historian havino- Visited
the  scene of action, where th« slain of  those  two nations had been sepa-
rated, says that on examining their remains, he found  the sculls of the
Egyptians so firm that the largest stones could hardly crack them, while
those of the Persians Avere so thin and weak as to be easily fractured by
a small pebble.   After stating the fact,  he  accounts for it by observing,
that the Egyptians were accustomed  from  tlieir  infancy  to go bare-
headed ; Avhereas the Persians, on the  contrary, always wore thick tiaras.
These were like  the heavy  turbans which  they  still use,   and which
some travellers thing the air of the country renders necessaiy.   I believe
with Rousseau, that the generality  of mothers will pay more regard to
the suggestion of such travellers than to the remark of the judicious his-
torian, and "will fancy tlie air of  Persia to be universal.
   In opposition, however, to silly conceits and prejudices, I must assure
my female readers, that there is  no part of the human frame which suf-
fers more from heat and pressure than the head, and none of course Avhich
ought to be kept cooler and less encumbered.  A thin, light cap, slightly
fastened with  a bit of tape,  should  constitute the  Avhole of an infant's
head-dress, from the moment of its birth till the increased growth of the
hair renders any other protection unnecessary.  As soon as  nature sup-
plies your  child with  this best of all coverings, never think of  any thing
more, even when you take him out into the open air, unless rain or intense
heat or cold should make the occasional use of a very light and easy hat
advisable.  I  must also forbid the use of  stay-bands to keep die poor
infant's head as fixed  and immoA'able  as if it were placed in  a  pillory.
One would suppose Uiat our heads were so badly secured by the  Author
of our being, that they would fall off if  they were not held fast by those
pernicious contrivances.  It is strange  that women  should be  so blind to
the importance of letting the head move freely in every direction, ia
order to facilitate the discharge ofthe fluid excretions voided at the mouth.
   It is  not necessary to euter into minute details   respecting the  other
parts of an infants dress.  Any  nurse  of  common  sense and docility
Aril I easily catch the  spirit of my former arguments on  the subject, and
will pay due  regard  to the  following  general direction, with the  wri-
ter's very plain  and sensible remarks,  " Rational  tenderness," says
the  author, " shews itself in  making the drsss light, simple, and loose.
By  being as  light as is consistent with due  Avarmth,  it will  neither
encumber  the  infant,  nor  cause any  waste of his powers;—in conse-
quence of  its  simplicity,  it will be  readily and easily put on, so as tp 
                  REARING  OF  CHILDREN.               4*7

prevent many cries and tears, an object of infinite importance :—and its
looseness will leave full room for moAing and stretching those little limbs
which have been long heaped together, and for the groivth and expansion
of the entire frame."  I before desired the nurse to have always  a soft
Avarm blanket in readiness to wrap up the infant on being taken out of the
bath.  In that wrapper the child should be kept for at least ten minutes,
in gentle motion and  then dressed.  A piece of fine flannel  round  the
navel, a linen or cotton shirt, a flannel petticoat, and a linen or cotton
robe, are soon put on ; and w here fastenings are requisite,  they should
consist of tape, without the dangerous use of pins.   Their punctures and
scratches are very irritating ;  and I believe the fact Mentioned in  my
" Domestc Medicine" is far from being singular or extraordinary, where
pins were found sticking above half an inch into the body of a child, af-
ter it had  died of convulsion fits, which in all probability proceeded from
that cause.
  No part of an infant's dress should hang doivn above two or  three
inches lower than the feet.   Long robes aud long petticoats  serve only to
conceal the nurses inattention to cleanliness, and  are,  even on  that  ac-
count, very improper, asAvell as cumbersome.  The night clothes should
be much lighter than those worn by day, from a due regard te the situa-
tion of the infant, who should at all  times either in bed or out, experience
nearly the same degree of Avarmth.   Every moisture or impurity should
be instantly removed, and as those parts of Uie dress which are next the
skin are constantly imbibing perspirable matter, they should be  changed
frequently.  Indeed, the same clothes ought never to be kept on for-mauy
days together.   AAvay with finery; but take care that the  child is al-
ways clean and dry.
   I wish  I could  here close my  remarks on dress, without having any
just cause to apprehend a stronger resistance to all  my precepts from
fashion, than from folly, ignorance and prejudice.  Folly may be  laugh-
ed  out of its errors; ignorance may  be instructed; and  even  the stub-
bornness of prejudice may be borne  doAvn by the irresistible force of
argument.  But fashion bids defiance to the combined efforts of ridicule
aud reason.  The only favourable  circumstance is, that,  being fickle as
well as  imperious,  it may in  its changeful  Avhims,  sometimes  fall in
with the  dictates of true tase, and give  both  ease and elegance to  the
human form.  This has been happily the case  in the  discontinuance
of some of the  most  painful, awkward, and disfiguring articles of  female
dress; I mean the high-heeled shoe, and the whale-bone  stays, which I
hope, will never again make their frightful appearance.
   But though fashion has lately carried the loose and light attire  of our
fair countiy women almost  to  the extreme of nudity,  yet it cruelly
aud absurdly retains too much of the braci: g  method iu childhood and
youth, when the tender and grow ing  frame requires the utmost ease and
freedom.   It is true, we no longer  sec the once familiar spectacle of a
mother laying  her daughter doAvn  upon a carpet, then putting her foot
upon the girl's back, and breaking  half a dozen laces  in  lightening her
stays, to give her a slender ivaist.   But the absurdity of the contrivance
is only changed from stays, to diagonal bandages, or ribbands, fastened
across the breast and shoulders with straining a iolencc, to cause an unna-
tural promine or before, a frightful indention behind,  and  a wirey stiff-
ness in the motions of the pinioned arms.   Yet  this is called grace and
                               fifi 
*°                of  tiie  Nursing  and*

elegance.  The poor sufferer in such chains feels no relief from the dis-
continuance of the  whalebone niv-s, when she finds that  <l rilken fetters
bind as fast."
   The breast and shoulders are not the only parts which are thus cord-
ed.  The  necks  of youug  females seldom escape some ligature, that
must impede the free access of the blood to the head, and its return thence.
Ribbands or other fastenings of gloves above the elbow, bracelets on Uie
wrists, and garters  either above or below the knee, seem  as if purposely
contrived to obstruct circulation  in the upper and  lower  extremities.
The toes also, the motion of which is  as  free and easy in infancy as Uiat
of the fingers, are soon squeezed  together, for fear of the young ladies
becoming splay-footed.  Even  this is not enough, without occasionally
putting the  feet into wooden stocks, to make a child turn  out her toes, af-
ter all  power of motion has been previously destroyed in them!
   Boys, indeed, escape  some of those  partial bandages;  but Uiey are
subjected to a general pressure no less  injurious in the tight hussar dresses
before  alluded to.  Silly mothers are very impatient to strip them of
their loose frocks,  and to make them look like little men, which is  often
the cause of a much nearer resemblance to monkeys.  It is really ■as-
tonishing that  health and groivth  should  be  perversely  sacrificed to
fashionable smartness.  All that  nature  requires  iu  dress, is  ease and
comfortable warmth.  In the progress of society to refinement, decency
and elegance are united with the former.   At length, false taste becomes
dissatisfied with natural  simplicity and beauty, and introduces in  their
stead fantastic finery and  cumbrous ornaments.  The way to reform is
plain and easy, if we have  courage enough to  shake  off the tyranny of     \
fashion, and to consult our reason and our feelings.  To mothers so dis-
posed, the following details will not appear uninteresting.
   The proper dress of infants has been already described with sufficient
minuteness.   Very little alteration need be made for five or six years,
except that of shortening the  frocks and petticoats, when children begin
to learn to walk; and soon after supplying them with easy shoes, adapt-
ed to the natural shape of the foot, neither  too large, which would cause
a shuffling kind of pace, nor too small  so as to cramp motion, give present
pain, and prepare the  parts for greater sufferings.  Were this caution re-
specting the proper form  of shoes to be attended to during life, it would
not only prevent corns, and the painful consequences of nails growing in-
to the flesh,  but many excruciating maladies which  may be traced to the
tight pressure of the toes,  and suspended circulation in the feet.   A well
made shoe answers  the two-fold purpose  of  cleanliness, and  of defence
against external injuries, including cold aud moisture.  But when  fash-
ion is more regarded than ease, we have no reason to wonder at the num-
ber of cripples we meet with tottering  about, the victims of their own fol-
lv.  Whatever changes   maybe thought necessary in the substance or
materials of shoes,  according  to  the  age of the wearer, the difference
of exercise, of weather, or  of  the ground for which  they are intended,
the grand principle of having them made easy, and suited to the shape ot
the foot, should never be lost sight of. The different direction also of the
toes on each foot, renders it advisable to have a corresponding difference
in the  form  of each shoe, which should  not be  afterwards changed  from
one foot to the other.  It may be said, that shoes will thus get a  littlt 
REARING  OF  CHILDREN.
49
 crooked, and will the sooner Avear out on one side; but surely ease aud
 health are infinitely superior to such trifling considerations.
   It being of the first importance to keep the feet always clean, dry, and
 warm, children should Avear flannel  or  Avorsted socks in  cold and Avet
 weather.  Besides the other advantages attending this practice, it Avill be
 found one ofthe best preservatives from  chilblains, especially if children,
 when cold, are not permitted to run to  the  fire,  but are accustomed to
 warm themselves with proper exercise.  The socks should be fitted to
 the foot, as well as the shoes, and should touch even part with  gentle
 pressure.  If too short or too tight, they Avill produce the  effect already
 described; and if too  big, so as to make folds within the shoes, they "will
 gall and irritate the skin.   It is farther  desirable to have socks and th^
 feet of stockings made  with different divisions or spaces, like the fingers
 of gloves, to absorb the perspirable matter between the toes, and thus pre-
 vent the equally unpleasant and unwholesome effect of its settling there.
 Will the trouble of having the toes as Avell as the fingers fitted with proper
 covering, be deemed, an objection of any consequence by people who take
 infinite pains to  adapt their dress,'in a  thousand other iustai.ee..,  to the
 most inconvenient and unhealthy fashions ?
   I leave grown persons  to be as silly as they  please in the covering of
 tlieir feet and legs,  and in predisposing those parts for the gout, rheuma-
 tism, dropsy,  and a variety of other complaints.   But it is the  height of
 cruelty to make children  suffer through the ignorance, folly, or  perverse-
 ness of tlieir parents.   I must therefore insist on the importance of wool-
 len socks and of woollen  stockings, as soon as this  additional  article o
 dress shall be found necessaiy.  Silk, cotton, or thread stockings, are far
 from being so well  calculated  to promote insensible perspiration in the
 loAver extremities, or to favour the motion of the fluids to the upper parts.
 They are even injurious  in case of sweat, either from exercise, or the na-
ture of any individual's constitution.   Instead of suffering the oflensive
 moisture to escape, as worsted would, they retain it in close contact with
 the skin, increase its putrescent tendency, and not only clieck all farther
 perspiration, but cause a  re-absorption  of a part of the matter already
 perspired.  Worsted stockings may be Avorn thicker or thinner accord-
 ing to the state  of the weather; and if the show of greater finery be
thought indispensable for  young gentlemen or young ladies in their teens,
 a pair of silk  stockings may be drawn over the Avoollen ones, to gratify
parental vranity.  Instead of garters, the bad effect of Avhich I have al-
ready noticed, stockings may be easily kept up by slips of tape fastened
to the band that encircles the waist in the dress of either sex.
  My former remarks on the tight hussar dresses of little boys, Avho  ought
to be kept much longer in  petticoats, and on the diagonal braces  of young
 ladies, Avhoare thus cramped and distorted, preclude  the necessity of any
farther obsei'Aations concerning the due  degree of ease which should al-
ways be considted in the  body-clothes of both sexes.   But it is proper to
say something of the changes in point of Avarmth, Avhich may be  requisite
in different states of the Aveather.  I have met with several plausible ar-
guments in favour of an uniformity of dress  in all sea^ofts : aud the ex-
ample! of the great Newton has been  urged, to induce us,  like him, to
Avear camlet in winter as well as in summer.  But though that illustrious
philosopher made himself immortal by his  amazing discoveries, yetJiK 
50
OF THE  NURSING AND
natural life did not greatly exceed the ordinary perioil of threescore
years and ten.   He cannot therefore be mentioned as a remarkable in-
stance of longevity; and even had he lived many years longer, the num-
ber of his days might be more reasonably ascribed to his temperance, bi»
regularity,  the habitual  sweetness  of bis disposition,  and the exquisite
pleasure arising from his successful researches, thau  to the uuvarying
sameness of his dress.
   It does not  therefore imply  the smallest diminution of our reverence
for the great Newton, if we  look upon nature as a more unerring guide
than any philosopher.  Observe how kindly she varies the covering of
animals, according to the temperature of the climate, and the difference
of seasons.   Their hairy coat is longer and thicker in cold countries than
in hot;  and its growth and warmth are evidently increased, at the ap.
proach of Avinter, in the  chilly regions of the north.   Her care of the
feathered  race is displayed in  a  different manner.   She  gives the in-
 stinctive impulse  that makes  them anticipate the rigours of ivinter,  and
 wing their  Avay to milder climates.  Though men cannot shift their pla-
 ces of abode at every season Avith the facility  of birds of passage,  they
 can profit by the example of nature's kind protection of other animals, and
 can accommodate their clothing  to the sensible changes of the season and
 weather.
   Let it not be supposed that I am for recommending those periodical
 fashions of dress which are regulated by the dates of an almanac, in such
 a country as ours, where the weather is so changeable,—where the close
 of autumn is frequently severe,—and where, not only in the spring, but
 even after the commencement of the summer months, we may say in tiie.
 words of the poet,
             That Avinter oft at  eve resumes the breeze,
             Chills  the pale morn, and bids his driving sleets
             Deform the day delightless.

    I should be still less inclined to encourage a ridiculous attention to
 every little change ofthe air and weather, as indicated by barometers and
 thermometers.  Our senses will afford us all necessary information on
 this head, Avithout the aid of mathematical instruments.   It is only  in
 case of considerable transitions  from  heat to cold, or the contrary, that
 our feeliugs will direct us to guard against danger, by suitable changes of
 apparel.   Poor nervous, delicate beings, are affected by a passing cloud,
 or a shifting breath of wind.   But ray rules are intended for healthy
 children, habituated to the cold bath every morning, and thus prepared to
 bear without  uneasiness or injury, any slight variations of the weather
 which  may take place in the course of the day.  Yet even such children
 are not to be exposed  iu thin cottons to the keen action of the winter's
 cold, nor smothered with Avoollens in  the  sultry heat of summer.  Both
  those manufactures, which are  carried to great perfection in England,
  are Avell suited  to the different seasons.    But I must observe, that fine
  linen is at all times the most proper covering next the skin on every part,
  except the feet and legs, for the reasons before mentioned:  it sufficiently
 increases internal warmth, Avithout  any unnecessary stimulus, or disagree-
  able  friction.  Particular infirmities, or a defective  perspiratioii natural
  in old age, may render flannel or fleecy hosiery advisable;  but linen next
  the skin is best suited to early life, aud requires little trouble to keep il
  always clean*. 
REARING  OF  CHILDBEN.               51
    The upper parts of the human frame do not stand in need of much co-
  vering.  Nature takes care of the head; so that even the thin cap, re-
  commended  at an infant's birth, becomes wholly unnecessary, either by
  day or by night, in three or four months.   When children are taken out*
  according  to my former  intimation, a light, easy hat, made of straw or
  beaver-fur, is veiy proper; and if the under  side of the brim be dyed
  green, it will afford  a pleasing relief to the eyes, and  prevent the injuri-
  ous effects of two glaring a light.   The pink, or vivid  colours, sometimes
  used by females in the  linings of their hats or bonnets, may give lor the
  moment a seeming freshness to the cheek, but must very much impair the
  sight by their dazzling brilliancy.
    We should not apply any covering whatever to the necks of young
  persons of either sex.  When they  grow up,  in order  to avoid being
  pointed at for singularity, they may preserve some little show of con-
  forming to fashion, but without checking the circulation in so daugerous
  a part.  Females must never be induced to Avear tight  necklaces;  nor
  must males brace their collars,  or use any stiffening  in  their stocks or
  cravats, through weak  compliance  with the . him of the day.   Even
  keeping the neck very warm, though without any close pressure, iucreases
  its delicacy, or rather its sensibility, and renders it  susceptible  of cold
  upon the least exposure.
    The sleeves of frocks, gowns, and  coats, should be  made loose,  to
  leave the motion of the  arms perfectly  free and unconfined.  Though
  gloves are unnecessaiy except  in very cold weather, yet I have not any
  strong objection to their use, provided they slip on easily, and are made
  of porus materials, to facilitate the evaporation of the  perspirable matter.
  Leather is of all substances the least adapted to this  important purpose.
    I shall conclude these observations on dress, Avith a picture of fashion-
  able absurdities given in the last edition of my  " Domestic Medicine."
  It is not from an over-weening fondness for my own remarks, that I occa-
  sionally refer to, or make extracts from that work;  but as some of the
  points there  touched upon are here more fully discussed, it would be the
  effect of false delicacy on my part,  to suppress now  any thing useful or
  pertinent Avhich then occurred to  me.
    After having applauded the judicious  reforms of female dress, for their
  attention to health,  simplicity, and real elegance, I expressed some con-
  cern at not being able to pay my own sex the same compliment; " An af-
  fectation,"  I observed, " of what is called military smartness, seems to
  have converted their Avhole apparel into a system of bandages.   The hat
  is as tight as if it was intended for a helmet, or to defy the fury of a hurri-
  cane.   Its  form also beiug by no means suited to the natural shape of the
  head, it must be worn for a considerable time, Arith very  painful and un-
  equal pre-sure, before it  can be made to fit its new block.   The neck is
  bolstered up and swathed with the most unnatural stiffness.   Easy  mo-
  tion without, and free circulation within, are alike obstructed.  Blotches
  and eruptions in the face, head-achs, apoplexies, and  sudden deaths, may
  be often traced to this" cause; and if Ave vieiv its effects  in another light,
  Ave  shall not be surprised at any inconsistency in the language or conduct
  of people, Avho take so  much pains to suspend all intercourse between the
  head and the heart."
    " The  close pressure,"  I added, " of the other articles of dress is
  equally reprehensible.    Navroir sleeves  are a great check upon the
4 
52                OF  THE NURSING  AND
muscular exercise of the arms.  The Avaistcoat in its present form  may
be very properly termed a strait one, and no doubt is, in many instances.
an indication of some mental derangement.  The Avrists, aud knees, but
more particularly  the latter,  are braced with ligatures or tight IriUoii-
ing; and the legs,  which require the utmost freedom of motion, arc
screwed into leathern cases, as if to convey an idea Uiat the wearer is
sometimes mounted on horseback.  To complete the whole, and in order
that the feet may be kept in as tight a press as the head, when shoes are
to be worn, the shape of the foot and the easy expansion of  the toes are
never consulted, but fashion regulates the form of the shoe sometime.
square-toed, more frequently pointed, and always sure to produce cramps
and corns,  the keen, the  sensible announcers of  every change of the
weather.  I have so long employed serious argument upon these subjects
in vain, that I  am now  accustomed to view them Avith pleasantry; and
when I meet with such figures,  disguised, and  rendered truly auk ward
both in their  motions  and appearance,  I cannot help thinking with
Shakspeark, "that some of Nature's journeymen had made them, and not
made them well, they imitate humanity  so abominably!**

                          SECTION  IV.

 Of the injury  elonc to Children by the two early and unnecessary  use of
                             Medicines.

    OF all the absurdities that prevail in the treatment of infants, there is
 none so grossly repugnant to common sense, as the  frenzy of giving them
 physic before  we give them food.  They scarcely begin to breathe, when
 some purgative slop is forced down their throats, and the tender stomach
 and bowels are thrown  into a state of the most unnatural irritation.  It
 often appeared tome very strange, how people came to tlriuk that the first
 thing given to a  child  should be drugs; but  after duly considering the
 matter, I perceived it to be  the  effect  of superficial knowledge.  The
 more I examined this point, the more I  was struck with the truth of the
 philosopher's remark, that  mere ignorance hath never done any material
 injury; that error alone is destructive;  and that we do not err, in things
 we are professedly ignorant of, bid in those which we conceive wc know.
 To begin with medicines at the birth, is a strong illustration of the mis-
 chief of conceited skill.
    It would never enter into the minds of persons wholly unacquainted
 with medical science, that evacuations ought to precede the first supplies
 of nourishment.  But  a little smattering of physic gave rise to the idea
 of cleansing the first passages as soon as possible, in order to bring away
 the black, viscid, syrup-like substance  contained  iu the intestines ot a
 new-born infant.   The  fallacy of such a suggestion can only appear up-
 on a more accurate aud comprehensive view of the subject.
    In the first place, the meconium, as it is called, generally passes soon
 after  the birth;  without any excitement but the mere effort of nature.
 When this does not take place,  every desirable purpose is sure to be ef-
 fected by the  thin, waterish, and purgative quality of the mothf.-mik.
 Do you suppose that any chemical process can equa  this i  ur no you
 imagine that Uie retention of  the meconium for a few hours, can do hail so 
HEARINC  OF  CHILDREN.              53
 mach mischief, as your oils and your syrups, your indigestible or your
 acrimonious trash, must occasion ?   But it was enough for midwives and
 nurses to hear physicians, who knew very little more of the matter than
 themselves, prescribing things of an opeuiug nature to purge off the re-
 mains of the meconium.   This acquisition of imaginary ecience was too
 flattering to female vanity, not to be displayed upon every occasion; and
 many a severe twinge have poor infants suffered, from a midwife's desire
 10 sheiv her profound skill in physic.
   I was once sent for by au intimate friend, to  look at a new-born in"
 fant who appeared to be in great agony.  I soon discovered that the com-
 plaint Avas the belly-ache, caused  by some injudicious purgative.  As
 the midwife was present, I remonstrated with her on Uie rashness of thus
 tampering Avith an infant's delicate constitution.   She  replied  in a tone
 of self-sufficiency and surprise, " Good  God! Doctor, I only gave  the
 proper physic to bring away the economy.'"  I should have smiled at her
 affectation of  medical cant, and her ridiculous attempt to catch at  the
 sound of  the word meconium, had not the serious  mischief she had done
 suppressed every emotion of laughter.   I  reprimanded  her in  very
 pointed terms, and made her feel the burning blushes of confusion, when
 I shewed that poison was as likely to  be used for physic, as economy for
 the word meconium,  from the same impulse of conceited folly.
   But the whole blame in such cases, is not, as I have already intimated,
 to be laid to the charge of midivives and nurses; the faculty themselves
 have paid too tittle attention to the medical treatment of children; and,
 iu consequence of their superficial knowledge of these important sub*
jects, have sanctioned errors of the most fatal tendency.  I once heard a
 medical professor of great celebrity say,  that he had met with a  case,
 where the meconium was not brought  away for three months after Uie
 child's birth, and then only by means of strong drastic purges.  Though
 one of the first anatomists iu Europe, he was led into this mistake by the
 blackish colour of the child's stools, which, for want of practical observ-
 ation and experience, he could  not account for but by ascribing it to the
 supposed remains of  the meconium.  There is nothing so absurd, says an
 ancient writer, which has  not been uttered by some philosopher.   I  am
 sorry to add, that a  similar assertion might be made with still greater
 truth concerning the professors of physic.
  It  would  be well, however, if Uie idea ofthe necessity of giving medi-
 cines to children, Avas confined  to  one open dose to purge off the meco*
 nium.  Unfortunately, Uie error committed at the birth is repeated again
 aud again; and seldom ceases but with Uie poor creature's life.  Opiates
 are deemed  uecessary  to make it sleep; carminatives to expel tvind,
 or to cure the gripes; laxatives and emetics, to cleanse the stomach; and
 ten thousand other unavailing  and pernicious contrivances to relieve
 complaints, which are entirely the effects of bad nursing, and which ad-
 mit of no remedy but by a complete reform in that department.
  When a medical man is Bent for  to atteud  an infant, his first duty is to
 inquire into Uie  conduct of the  nurse;  and if there are faults, to have
them  rectified.   He will seldom find occasion to prescribe any thing else.
 There cannot be  a greater error than  to ?u,>pose that the faults of nurses
 may be repaired by drugs.  Nfrdio'ne, however skillfully administered, 
54
OF THE  NURSING  AND
cannot supply the place of proper nursing; and ivhen given Avithout skill,
which I fear is too often the case, it must be productive of much mischief.
The following facts will pi ice this matter in the clearest light.
   About fort) years ago Avhen I undertook the charge of a large branch
of the Fotiu ling hospital at AckAvorth in  Yorkshire,  I found that the
children at nurse had till then been attended by the country apothecaries,
who, sure of being paid for their drugs, always took care to exhibit them
with a liberal hand.   Every cupboard and  every shelf in  the house was
filled Avith  phials and gallipots.   Under such treatment half the children
died auuually.  As it was evident to me, that  this mortality could not be
natural, I suggested  to the governors, that  the children had little or no
occasion for medicines, and that with proper care they Avould thrive aud
do well.   A new arrangement took place.   The nurses were forbidden,
at their peril, to give any medicine, but what should be ordered by me;
and were advised to rely more on  the  faithful discharge of their duty
than  on doses of  physic.   The consequence Avas, that the expense for
drugs did  not amount to a  hundreth part of what it  had  been before,
and that not above one in fifty, of  the children died annually.  Au op-
portunity of making experiments on so extensive a scale seldom occurs.
I had at that time  the sole superintendance of an immense number of chil-
dren spread over a fine healthy countiy, where the nurses found it their
interest to do in every respect what I desired,  as they lost  tlieir appoint-
ment in case of  the least neglect.  The happy result of the plan left no
doubt of its propriety.   It was theory  verified by practice.
   A  little reflection would soon satisfy an attentive observer of nature,
that she never designed the young of any species to be brought up by the
aid of medicine.   Other animals, following the  guidance of instinct,
never fail in this important business:  but man becomes in all thingB the
creature of art, and is misled by it.   I have  frequently met with instances
of families, Avho had  lost every child Avhile they trusted to physic and
employed  the faculty, but who at length becoming wise through despair,
and considering that their offspring could only die, left off the use of me-
dicine altogether, and from  that time  never lost  a  single child.  If we
wish for a more general illustration of the  effects of those two different
modes of treatment, we shall find  it in  that part of the  island where I
was born (North  Britain) and where  the common  people have  a strong
and very just aversion to giving their children medicines. The fruits of
their good sense are displayed in a numerous  and healthy progeny. But
puniness, sickness, and death, find  their way, in company with the doc-
tor, into the houses of parents of higher rank.   As the  children of the
latter are  often observed not to thrive, the common remark is, No won-
 der ! they gave the poor things physic.
   It is indeed possible, that cases  may occur to justify tlie use of medi-
 cinee; but this veiy seldom happens when  children are properly nursed,
 unless the poor creatures may have inherited debility  from Uie enervat-
 ed constitutions of their parents.  I may go farther and as erf, that even
 Avhen the frequent or continued use  of medicines is deemed necessary, a
child kept in existence by the help  of drugs  has little reason to tlnik its
parents for preserving its life.   It  lives only  to be a burthea to society ;
and never can be  said to enjoy life so  much as to render the possession of
it a blessing.  In all other cases of slight and accidental indisposition I do 
                  REARING- OF  CHILDREN.              5?

not hesitate to give a decided opinion that medicines do injure  at least
twenty times for once that they do good.
   \ late writer ou the management of children (Nelson; thinks it a mat-
ter of regret that they can  seldom be  brought to  take physic without
force.  When I consider the almost infinite number of young martyrs to»
medicine,  instead of lamenting the circumstance here stated, I rejoice
at it, from the fullest conviction,  that if children had no reluctance  to
swallow drugs, we should lose a great many more of them.   I know it ia
a common practice with many mothers, to lay a child on its back, to stop*
its nose, and force  the medicine down its  throat.   This is adding the
danger of suffocation, and  the certainty of disgust, to the hazard of a
dose" too often in its own nature injurious.   Bribing and coaxing children,
as soon as they become susceptible of such impressions, are almost equal-
ly bad.  Telling a child, that, if it will take its physic, it shall have a,
reward, is informing it before-hand, that the  potion is unpleasant; and,
after that, the child is sure to refuse it, be it rendered ever so palatable.
Where medicine  is absolutely necessary, which, as I said before, is very
seldom the case, it may be so contrived as to make a part of the child's
food.  Besides a child should be accustomed very early to refuse nothing,
and it will not refuse to take medicine*.  It will act from  habitual sub-
mission to authority,—not  from the cruel impulse of force, or the perni-
cious allurement  of a bribe.
   I could here point out many easy contrivances to make children take
physic, were I not assured that they  are already too often poisoned  by
it.  If drugs do  not directly produce infirmity, diseases, or death, these
are sure to be ultimately the consequence of substituting medicine in  the
 place of proper nursing, and foolishly supposing that the former can sup-
 ply the defects of the latter.   Art opens all her resources in vain;  nor
 can the greatest efforts of human ingenuity make amends for  the want
 of good air, cleanliness, healthy breast-milk,  wholesome food, and pror
 per exercise.  The neglect of any of these  essential points is attended
 with irreparable mischief; and on the contrary, a due attention to these
 precludes the necessity of any medical aid.   Yet so strangely addicted,
 are some women to drench infants  with drugs, that when I employed
 nurses in my own  family, it was with difficulty I could prevent them from
 giving medicines privately to  the children.  I hope that fathers  will
 profifby this hint, to exert their utmost  vigilance and authority in Uie
  like situation.
    There is not  any notion Avhich I have found it more difficult to  root
  out of the minds of mothers, than that children abound with ill humours,
  and that  these can be carried off only by purging medicines.  If a spot
  appear on the skin, the child must have his guts scoured out, to make the
  offensive pimple vanish, and  to sweetenhis blood, as the mother calls it-
  They little know, and can hardly be made to conceive, that all purgatives,
  however  mild in  their operation, throw the stomach into immediate dis-
  order, weaken its digestive powers,  vitiate  the juices designed for the
  solution of food, and thus prevent the due preparation ofthe chyle whence
  the blood is formed.  This is the sure way to generate noxious humours,
  instead of expelling them, and to taint or impoverish the vital stream, in-
  stead of purifying it.
     The other  mediciDes, which the  fears and follies of mothers have in-
  troduced in'.o the nursery,  are almost as pernicious.  Had f leisure to
                                   67 
56
OF  THE  NURSINO  AND.
»ake out the long list of them, with  a description of their effects at an
early age, it Avould appear that they ought to be more properly  denomi-
nated poisons than remedies.   They always do  some injury; they can-
not do any good: they are administered either frivolously, or for the relief
of complaints Avhich are caused by  bad nursing, and ivhich do not ad-
mit of a medical  cure.  To trust to physic for ivhat physic cannot ef-
fect, is aggravating the evil of former errors by a still greater  one, and
quickening a poor infant's career to the grave.   Were a laiv to  be made-
and strictly enforced, which should absolutely prohibit Uie administering
of drugs to children, I am sure it Avould save the lives of thousands every
year, in tfiis metropolis alone.
   I have elsewhere made a few remarks on the usual conduct of Lon-
don mothers, whose faith in medicine does not seem in the least abated
by the most  striking aud the most lamentable proofs, not merely of its
inefficacy, but of its  perniciousness.  Whenever  auy of their children
appear indisposed, or do not seem to thrive, Avhich  must be  frequently
the case where they are so badly nursed,  away the mothers run to the
apothecary.  His candor is too often checked, and even his judgment is
liable to be biassed by his immediate interest.   He derives his support
from the sale of his drugs, and Avill seldom resist the temptation to send
large supplies Avhere he knows the  parents are in  a condition to pay.
Physic,  in  a variety of forms, is substituted for the only  rational means
of restoring Uie child's health, some necessary  change of  air,  exercise,
dothing, or diet: the mischief begun by the nurse is completed by the
doctor; and death comes sooner or later to put an end to the sufferings of
 the tortured victim.
   It gives  me pain to Avrite any strictures on the  interested views and
reprehensible practice of even the lower orders of the faculty: but the
 evil is of such magnitude, and  so truly alarming, that it cannot be pas-
sed over in silence,  nor mentioned Avithout bursts of strong indignation.
The weakness and the fears of mothers bring in the apothecary; and it
 requires an effort, to  which not one in a  thousand is equal, to get him
 out again.  A bold busy man of that profession wants only a feiv timid
 mothers to make his fortune.  But,  mercy on the  poor babes who, to
 make his chariot roll, must swallow  drugs every day !  Yet, such is the
juafatuation of mothers, that, if riiisbe not done, they think their children
 neglected, and dismiss one apothecary to make way for auother, ivho ad-
 ministers medicines with a more liberal, or rather a more destructive
 band.                                               #
    If the apothecary be a dangerous man, the quack is still more so. Yet
 I hardly ever kneiv a mother or nurse who had not by her the nostrum of
 some quack, with which she every now and then  kept dosing the infant.
    Were the boasted specific, like the anodyne necklace, a mere chip in
 porridge, it would do no harm to the child, and Avould serve only to
 amuse the mother, and to levy a contribution on her credulity.   But
 it is very often made up of active ingredients, which ought to be adminis-
 tered with the greatest circumspection.  Most of the nostrums given to
 children are strong opiates or purgatives, of a nature very different from
 the innocent efficacy of a good nurse's lullabies.    They may quiet or
 compose the infant, and seem to give it ease for a time, but they never
 fail to destroy Uie powers of digestion, and t» induce universal debility,
 with all its baneful consequences^ 
REARING  OF  CHILDREN.               5?
    There is, however,  another class or description of quack medicines,
  .vhich, though  Uiey cannot kill Avith greater ultimate certainty than the
  former, are more sudden and violent in their fatal mode of operation, I
  mean the cakes and powders, aud various other compositions, which are
  advertised for the pretended cure of worms.  A child's palelooks frighten
  the mother into a belief that worms are the  cause ;  and she goes imme-
  diately to the worm-doctor, who administers his drastic doses, without the
  least regard to  the delicacy of the patient's constitution.  His sole aim is
  to expel worms ; and if any appear, he triumphs in Uie show of success,
  though always  attended with great danger, and sometimes Avith death.
  I have known a nostrum of  this kiud to kill in twenty-four hours:—but
  that was nothing to the quacks; he  had  sold his medicine; and he gave
 himself little concern about the injury it might do in particular cases.
    I would  not have said so much of this shocking indifference to mur-
  der, had I not seen proofs of it, and in some  too, who pretended to emi-
  nence  in that line.   I  once told a lady, that her daughter  Avas iu a deep
 consumption, and that she ought to go into the country, to  take exercise
 on horseback, drink asses' milk, and use a light restorative diet.  But,
 instead of following this advice, she took her daughter to a very celebra.
 fed Avorm-doctor, w ho soon relieved her from all her trouble.
    Here  I cannot help  lamenting  that confidence in Avorm powders cr
 worm-cakes is not confined to  the weakest of the fair sex,  but  is  discov-
 ered even in men of rank and talents.   I have seen, though with  heart-
 felt concern, names of the first respectability subscribed to the certificates
 of the  efficacy  of some of   these  nostrums.   I am far from  questioning
 the integrity of the persons avIio signed such papers; but they certainly
 knew not what they did.   They fancied they Avere only attesting a plain
 matter of fact, though  the thing Avas far beyond Uie possible reach of their
 judgment or knowledge.   They  had seeu a quack medicine given to a
 child, and had  also seeu worms afterwards voided by that child.   What
'then ?   As the  same effect might be produced by veiy dangerous poisons,
 Iioav could people, wholly  ignorant of the ingredients, tell whether the
 operation ascribed to them was not at the risk of Uie child's constitution,
 or of its life ? Even  supposing that some apparent good  and no percepti-
 ble mischief attended the experiment in one or two cases, are they  suffi-
 -cient grounds for the general recommendation of any secret medicine, to
 ivhich the lives of thousands of children yet unborn may be sacrificed ?
 I hope these remarks will prevent men of character from rashly giving a
 sanction to the  possible deceptions of quackery, and will also lessen the
 respect which individuals or the public at largejnay.feel for such incon-
 siderate testimonials.
    To resume now my detail of various instances of maternal weakness i;
 1 have to observe, that the strangest, and not the least mischievous infat-
 uation  of  all, consists in giving medicines to children in good health, with
 the silly view of preventing diseases.  The spring and fall are the peri-
 ods consecrated to physic in the  calender of mothers and nurses.  At
 those seasons, if childern  are ever so well, they must have  a dose or two
 of what  is  falsely called an  innocent  purge, to  keep them  pure and
 hearty.  Thus  they are made really sick, for fear they should become
 so; and  their  constitutions are enfeebled by the perverse means em-
 ployed to strengthen  them.  I have already said so much of the bad
 consequences which must result from tbe use of laxatives,  especially in 
58
OF THE  NURSINC  AND
childhood, that no farther dissnasives against so absurd a practice seem
necessary, except this one remark;  that purging, like bleeding, induces
a habit which cannot be left off with safety.  Every purge paves the way
for another, till the bowels are destroyed.  Such  medicines, therefore,
should never be administered but in cases of actual illness, and  to expel
some greater poison than themselves.
   As this is a point which cannot be too strongly euforced, I  shall lay
before the reader Mr. Locke's sentiments on tlie same subject.  They
derive double weight from his medical skiU, aud from  the extraordinary
precision of his manner  of  reasoning upon any topic.   As he was regu-
larly bred to  physic, he is exempt from the suspicion incurred by some
later philosophers, of having  written under  the influence of prejudice
against the faculty.   " Perhaps," says he, " it Avill be expected that I
should give some directions of physic, to prevent  diseases; for which I
have only this one, very  sacredly to be observed,  never to give children
any physic for prevention.   The observation of what I have already ad-
vised will, I suppose, do that better, than the ladies' diet-drinks, or apoth-
ecaries medicines.  Have a great care of tampering that Avay, lest, instead
of preventing, you  draw on diseases.  Nor even upon every little indis-
position is physic to be given, or the physician to  be called to  childreu,
especially if he be a busy man, that will presently fill their windows with
gallipots, and tlieir stomachs Avith drugs.  It is safer to leave them wholly
to nature, than to put them into the hands of one forward to tamper, or
that thinks children are to be cured, in ordinary distempers, by any thing
but diet, or a method veiy little differing from it; it seeming  suitable
both to my reason  and experience, that the tender constitutions of chil-
dren should have as little done to them as is possible, and as the absolute
necessity of the case requires."
   To add any  thing by way  of comment or illustration to language
 at once so clear and  so forcible,  Avould  betray the  greatest weakness. (
 It is enough for  me to quote so unexceptionable  an  authority in sup-
 port of my favourite  doctrine.   The chief design of the present trea-
 tise is to supercede the use of medicines in  early  life,  and  to  shew
 how health may be effectually preserved by good nursing  alone.  Aa
 attention to the rules here laid down is the only  method  of preventing
 diseases, with which  I am acquainted.   A child  used to the cold bath,
 and to the  full enfoyment of fresh  air. cannot  be liable  to coughs,
 colds, sore eyes, or defluxions.  A clean dry skin,  never  relaxed  by
 foulness or heat, will favour  the  escape of noxious  or redundant hu-
 mours  while exercise Avill not suffer  the seeds  of corruption to lurk
 in any part of the frame.  Instead of  baneful physic, let your  infant
 have the aliment prepared for  him by nature; and you  may be sure
 that the  milk of  a healthy, temperate nurse,  will never give him the
 gripes or  the cholic;  it will nourish, but  not inflame him ;  it will keep
 the habit pure, the  action  of the blood  regular, and the surface of the
 whole  body  free from  blotches  or eruptions.   Indeed,  I  know ot no
 disease against which a child may  not be secured by the rational con-
 duct of his  nurse.   The  pre-disposing causes of  all  the complaints
 of  infants,  are  the  weakness  of all the digestive  powers,  and
 the irritability  of the  nervous  system.  Both  are obviated  by the
 method I propose.  The  stomach  is supplied,  but  not over-charged,
 ATith  such  food  as  is  suited  to its  strength;   and  every  thing 
REARING OF  CHILDREN.               59
that may  irritate the nerves, or give rise to convulsions, is averted with
all possible care.   Even in the midst of contagion, or of epidemical dis-
tempers, the purity of a well-nursed child's habit will correct the malig-
nity of the infection, and disarm it of its ufiial terrors.
  The earnestness Avith which I  have recommended inoculation in ano-
ther work, may geem a little  inconsistent with the  doctrine here laid
down : but it is because very few children are nursed according to my
plan, that  I think it adviseable to guard them all against the possible dan-
ger of catching the small-pox by accident.  Besides, it is of importance
to be able to command time, place, and circumstances, particularly as I
have sheAvn in my " Domestic Medicine," with what ease and safety the
operation  may be performed by  mothers and nui'ses, Avithout the least
<*ccasion for any farther medical advice or assistance.

                          SECTION  V.

                  Of the food proper for Children.
  THE pernicious folly of making  physic precede  food at an infant's
birth is, I hope, sufficiently exposed in the former section; and  notice
is there taken of the admirable manner, in  which the thin diluted, and
gently opening properties of the mother's milk, are adapted  to  every
medicinal  as  well as  alimentary purpose.  Nature does  not afford,
nor can art contrive, any effectual substitute for that delicious fluid.
By  degrees Uie  milk  acquires  consistence,  and  affords greater nou-
rishment to the child, as he becomes more capable of digesting it.  At
length, his bodily strength increasing, and his teeth bursting through the
gums, he can take more solid aud substantial food, Avhich requires still
greater  powers of digestion.   These changes are so obvious, that they
cannot be  mistakeu.   Ignorance is pleaded in vain, and the least devia-
tion from so plain a road to health, is punished  with lasting injury.  The
infant after having derived its whole sustenance and groivth, while in the
Avomb, from the mother's juices, cannot without the greatest danger have
its supplies  totally altered at its birth.  It must still  be fed from the
same  congenial source, or the shock of a sudden and unnatural change
Avill prove very trying to its tender constitution.
  In my advice to mothers at the time of lying-in, I endeavoured to con-
vince them of the imminent  danger to tlieir  own health, which would
arise from their neglect of the most sacred of all duties, that of suckling
their children-   It is an obligation so strongly  enforced by nature, that
no Avomau can evade the performance  of it with impunity.  But cheer-
ful obedience  to this sovereign law is attended with the sAveetest pleasure
of Avhich the humau heart is  susceptible.  The thrilling sensations, as
before observed, that accompany  Uie act of giving suck, can be conceiv-
ed only by those Avho have felt them, Avhile the mental raptures of a fond
mother at such moments are far beyond the powers of description or fan-
cy.   She  thus also ensures the fulfilment of the  promises made by the
best writers on this subject—speedy recovery  from  child-bed, the firm
establishment of good health,  the exquisite sense of wedded joys, the
capacity of bearing more children, the steady attachment of her husband,
the esteem and respect of the public, the warm returns of affection and
gratitude from the objects of her  tender care, and, after all, the satisfac-
tion to see her daughters follow her example, and recommend it to others. 
CO
OF THE  NURSING AND
   Though I expressed myself pretty fully on tiiis head in the place
above referred to, yet when I consider it,  new ideas arise in my mind,
and I am more aud more impressed Avith a sense of its importance.   Peo-
ple have been'often amused with illusions of universal remedies,  Lornr
experience has almost destroyed my faith in Uie efficacy of even the. best
specifics.   But were I  called upon to point out any one remedy for the
   featest part, uot only of Uie diseases, but of  the vices also of society.
  would declare it to be  the strict attention of mothers to the nursing and
rearing of their children. " Would  you have mankind return all to their
natural duties," says the eloquent Rosseav, in one of his fine sallies of seu-
timental enthusiasm, " begin with moUiers of families: you will be astou-
ished at Uie  change  this will produce.  Almost every kind of deprava-
tion flows successively from this source:  the moral order of things is
broken, and nature  quite subverted in our hearts : home is less cheerful
and engaging: the affecting sight of a rising family no more attaches the
husband, nor attracts the eyes of the stranger: the mother is less truly
respectable,  Avhose children are  not about her:  families are  no louger
places of residence : habit no longer enforces  the ties of blood:  there
are no  father?, nor mothers, children, brethren, nor sisters: they hardly
know, Iioav should they  love, each other? each cares for no one but him-
self; and when home affords only a melancholy solitude, it is natural to
seek diversion elsewhere.
   " But," continues he, «• should mothers again condescend to  nurse
vreir childreu,  manners would form themselves: the sentiments
of nature Avould revive in our hearts: the state would be re-peopled : this
principal point, this  alone, woidd reunite  every tiling.  A taste for the
•charms of a domestic life, is the best antidote against corruption of man-
ners.   The noise and bustle of children, Avhich is  generally thought
troublesome, becomes hence agreeable:  they render parents more neces-
sary, more dear to each otlier, and strengthen the ties of conjugal affec*
stien.   When a family is all lively and animated, domestic concerns af-
ford the most delightful  occupation to a Avoman and the  most  agreeable
amusement to a man. ^Hence, from the correction of this one abuse, Avill
soon result a general reformation: nature will quickly re-assume all her
rights: let wives but once again become  mothers; and the men Avill pre-
sently  again become fathers and husbands."
   To this sketch, draAvn by the pencil of so great a  master, I shall on-
ly add, that the happy  consequences  of such a reform would be  no
iess striking in a medical than in a moral point of view.   A stop would
be put  to the cruel ravages of death  io early  life.  The long  cata
logue of  infantile  afflictions would almost become  a  blank, or con-
tain  nothing  to excite alarm.    Every child  invigorated  by  his
mother's  milk, would,  like the  young Hercules, have force  suffi-
cient to strangle in  his  cradle  any serpents  that might assail him.—
Occasional illness would be to him only part of a necessary course ol
discipline, to enure him by times to  bear  pain  with  manly fortitude.—
In short, health, strength, and beauty, would take place of puniness, de-
formity, and  disease; society  would be  renovated; and man, instead
of dwindling away,  as  he now  docs, by a gradual degeneracy,  would
soon rise to the original perfection of his nature.
   If you entertain any doubt of the truth of what is here advanced
look«at  other parts of the animated creation, and your doubts will im 
REARING  OF CHILDREN.               61
 nediately vanish.   Wild animals never degenerate: they bring  forth
Hud rear their young with undiminished strength.  And why ?  Because
the females, obedient in every thing to the impulses of nature, nurse their
offspring, and watch over them with the most tender solicitude, till they
can provide for themselves.   Not  only the inhabitants of the howling
Avildemess, the shc-Avolf  and the fell tygress, but even  the monsters of
the great deep, draAV out their breast and give suck  to their young.  Will
woman then suffer herself to be stigmatized as  the only unfeeling  mon-
ster that can desert the issue of her own womb, and abandon it to the
care of  another ?  Will she alone entail the curse of her unnatural con-
duct on her hapless posterity ?
  But let me vindicate the female character from so foul a reproach.
It is not so much the fault of the women, as of what is  improperly cal-
led civilized society.  In its ruder  state, this never  happened.  It never
happens among savage nations.  I  have already mentioned some remar-
kable instances of their parental tenderness.  The influence of so strong
a principle can be iveakened only by the prevalence of vice, and of ar-
tificial refinement.  Wherever  an  innocent simplicity of manners pre*
vail, the children are not brought up by proxy:  the Avomen are not sa-
tisfied to be mothers by halves, as  an old Avriter  expresses it,—to  bring
forth, and then cast off their offspring.   They think Avith him, that no-
thing cau be more contrary to nature, than such an imperfect sort Of mo-
ther, Avho,  after having  nourished in her Avomb, and with her blood,
something which she did uot see, refuses hoav her breast-milk to What she
sees liAting,  become a human creature, and imploring the assistance of its
parent!
  In the polished, or rather the depraved circles of social life,  thos^.
sentiments are either unfelt or disregarded.   Women enervated by  luxu-
ry, allured by a false taste  for  mistaken pleaure,  and encouraged by
shameless example, are eager to get rid of their children as soon as born,
in order to spenel the time thus gained from the discharge of their duty
in dissipation or indolence.  Let not husbands be deceived: let them not
expect  attachment  from wives, who, in neglecting  to suckle their  chil-
dren, rend asunder the strongest ties in nature.  Neither conpigal love,
fidelity, modesty, chastity, nor any other virtue, can take deep root in
the breast of a female Uiat is callous to the feelings of a mother.  I am
aware of the little tricks that are so often played off by neAv-married
women to keep up the show of a uish to nurse their children, while every
engine is secretly employed to make the deluded husband conjure her to
relinquish her design, for fear of the injury it might do her constitution.
If she has not injured her health by vice, nursing Avill not lessen, but in-
crease her strength; and if any constitutional defect renders her wholly
unfit for suckling her child, she ought to abstain from procreation.  The
woman avIio cannot discharge the  duties of a  mother, ought again and
again to be told, that she has no right to become a Arife.
   Iu cases of accidental injury or disease, where it may be impossi-
ble for the mother,  or highly improper on her  part, to  give  the  child
the breast,  she is to be pitied in being thus deprived of tlie greatest
pleasure of life, the pleasure of feeding and rearing her own offspring.
But the number of those women who really cannot suckle is very small,
compared with those avIio will not.   The latter excite our indignation__
not our pity: they stifle every emotion of tenderness: they are deaf to 
 *r                Or THE NURSING AND
 the voice of  nature: they  sacrifice the most important duty to vicim..-
 pursuits; and madly barter joys that Avill please on every  reflection  io
 such as never can bear to be recalled.
   Little do those dissipated mothers think of what their poor infanta arc-
 likely to suffer, Avhen committed to the care of hirelings.   Ought they
 not to consider, that the woman who parts with her own babe lo sufklr
 one of theirs, unless she is  impelled by the keenest distress, r.ivesa proof
 in the first instance of her not being a good mother ?   How then is it  to
 be expected that she should become a good nurse ?   Even should she ac-
 quire, in time and from  habit, a tender  affection for  her foster-child,
 ought not a mother of aay sensibility to take alarm at the idea of having
 that child's love transferred from  herself to a  stranger?  Indeed, the
 claims of the nurse  who does her duty faithfully, are greatly superior to
 those of the parent Avho neglects her's.  It was a saying of Scipjo Af-
 ricanus, that he took her to be more his mother who had nursed him for
 two years, though she had not brought him forth, than her who, after she
 had brought him into the world, deserted and abandoned him.  But I  am
 still better pleased Avith the auecdote related by  Van Sir ie-Ten, of a
 Queeu of France, who gave her son suck, and would not desist from  so
 doing even  when she was taken ill of an intermitting fever.  It happen-
 ed during one of the fits,  that another matron gave her breast to the
 thirsty and crying child;  at which the queen  was so much displeased,
 that she thrust her finger into the child's mouth, in order to excite a vo-
 miting, being unwilling that another should perform any part of a mo-
 ther's office.
   I shall not enlarge any farther on this subject, I hope  I  have said
 enough to excite good mothers to the most assiduous observance of their
 duty,  and to warn others of the evils inseparable from Uie neglect of  it.
 Such as may  resolve to obey  the dictates of nature and reason, will find
 the following directions of some use in the prosecution of so laudable a
 purpose.
   The mother, after delivery, should be indulged with a few hours sleep,
 to recover  from the fatigue Avhich she has lately undergone, and to  al-
 low due time for the secretion of the milk, before the infant is put to the
 breast.  The child  can suffer no inconvenience from this delay.  Being
 replete Avith blood and juices, he has not the least occasion for any fresh
 supply of nutriment, till the mother is prepared by necessaiy repose to
 give him the grateful and spontaneous beverage.  I before pointed out
 the means to be employed when the nipples are not sufficiently promi-
 nent to afford a proper hold.  But whatever the form of the nipples may
 be, they should be Avashed with a little warm milk  and water, in order
 to remove the bitter  viscid substance, which is furnished round  them to
 defend the tender parts from excoriation.   I would also advise  the mo-
 ther, during the Avhole time of her nursing, to Avash the nipples, imme-
 diately after giving suck, in warm water.  Whenever this can be conve-
 niently procured; and,  in case the  supplies of the nutritive fluid are
 very copious," or  seem to exceed the infant's wants, she may always pre^s
 out a little of  the milk before the child is put again to the breast, as the
first drops issuing from the fountain at every treat are the most  liable  to
sourness and putrescency.
  I need not urge a  fond  mother freely to give  her child what  nature
freely produces.  The only check in this respect is not to suffer the in- 
REARING  OF  CHILDREN.                63
font to sleep at the breast, or to suck till vomiting ensues.   But any at-
tempts to entice the baby to the Use of spoon-meat are still more impro-
per.  This is a commou practice, not only Avith hired  i.urses. but  even
with affectionate mothers,  from a  foolish though  prevalent idea of les*
sening the demands on the  breast, or of strengthening the child with ad-
ditional nourishment.  If Uie nurse be not irregular in her own manner
of living, she need not fear having a plentiful supply for the infant; and
she may re6t assured that her  milk is far better suited to his young sto-
mach, and will afford a greater quantity of nutritious chyle, than any pre-
paration  which art can device.
   Another error no less prevalent, and more injurious than the former, is
the idea that a woman, when nursing, cannot eat  and drink too heartily,
as it is termed, to support her own  strength and that of the ufaut.   On
the contrary, the tainted stream of  intemperance must enfeeble and  dis-
order the  child, while the nurse really lessens her own power of giving
suck, aud invite-, the attacks of a  fever by  her thoughtless indulgence.
The cooling regimen before recommended must be strictly complied with
for the first week  after delivery;  aud  though a  more  liberal  diet may
then be alloAved,   yet this  allowance must not  extend  to gross meats or
heating liquids.   A pint of porter or ale  twice a-day for  at least a fort-
night more, will be quite sufficient, and animal food should be  veryspa-
ingly used for a much longer period.   Indeed it would  be happy for the
children, as well as for their nui'ses, if the latter would confine themselves
without any painful restraint, to the salutary varieties of  a milk and ve-
getable diet.  It is a great  mistake to suppose, that a nurse is  better fit-
ted for her office  by  living on animal substances:  the  reverse is  the
truth.  The  milk  of women who  live  wholly  on vegetables, is more
abundant  in  quantity, will keep longer,  and is far  siveeter  and more
wholesome than what is prepared from animal food, which besides its in-
flammatory tendency, must 6ub;ect the children to gripes and worms.
   These remarks  are merely designed to correct  some vulgar errors re-
specting the quantity and quality  of the  aliment most proper for nurses,
but not to impose upon any women the necessity of a t< tal change from
her former and usual manner of living.    I would  have her continue the
temperate u^e of  what she has found by experience to be most conducive
to her health :  and that will also agree  best with her child.   Her  na-
tural appetite may be safely indulged; but gluttony must be repressed,
and a depraved taste for spirituous liquors, or high-seasoned food, must
never be gratified.
   11 has been ;ust hinted that the breast-milk of a woman in good health
is abundantly sufficient for  an  infant's support.  Nothing else should en-
ter his lips for at least three or four months after the birth. A little thin
pap or panada may then be occasionally  introduced, with a view of fa-
miliarising it  to the child's  taste, and thereby lessening the difficulty and
danger of a comple'e and  sudden alteration at the time of  weaning.
But  no spices, no wine, no sugar, should at any time be  mixed  with his
food or drink.  These and the like contrivances of silly women to make
an infant's spoon meat what they call palatable aud nourishing, are sure
to vitiate his  natural taste,  to  inflame his blood, aud to fill the  stomach
Avith slime and acidities.   Suj,ar,in particular, has another very bad ef-
fect : its frequent use not only gives children a disrelish for a w holesome
simplicity, but entices them to  swallow m^v than they otherwise w«ald, 
m*
OF THE  NURSING  AND
or than they want, and thus makes gluttons of them even before thry caa
bes'victly said to eat.
   Infants are commonly deprived of the breast too soon.   What people
Call solid food is supposed to contribute more to their growth and health.
But in the first place, milk, though  a fluid, is immediately convs rted iu-
to a solid substance in the stomacli, w here it is soon after digested, and
then affords the best nutriment possible.   It also appears contrary to na-
ture to put solid  substances  into the  mouth of a child, before it is fur-
nished with teeth to chew them.  I should therefore look upou the  pre-
vious cutting of the teeth as the surest indication of the , roper time for
weaning children.  I do not mean to lay this down as an invariable rule.
The state of theuurse's health, as well as of the  child's *houldbe duly
considered.   It seems  only that the cutting of the teeth gives a .0: of
hint of the use to which they may  be  applied.  It is farther remarkable
that, during the coutinuance of this usually sharp and painful operation,
children, as it were instinctively, carry every thing that is put into their
hands up to their mouths.  Give them on such occasions crusts of bread,
pieces of biscuit, dried fruits, or fresh liquorice root, which they  may
suck, and chew.   Corals, glass, and the like hard bodies,  are very im-
 proper,  as they will either bruise the gums,  and cause an  inflammation,
 or make them hard and callous by  continual rubbing, so as to render the
 cutting  of the teeth still more difficult, aud the pain more acute aud las-

    A few weeks before the intended time of weaning, that is to say,  in
 the interval between the first symptoms of cutting the  teeth and the ap-
 pearance of at least four of them, spoon-meat should be given more fre-
 quently, and in greater quantity, reducing in the like degree the propor-
 tion of  breast-milk, till the gradual increase of the one and diminution
 of the other render the change almost imperceptible.   The best  spoon-
 meat that I kiioiv consists of  bread and milk, prepared in the manner
 pointed out in my Domestic Medicine;  that is, first boiling the bread in
 water, afterw ards pouring the tvater off, and then  mixing with the  bread
 a proper quantity of new milk unboiled.  I there observed, that milk
 used this Avay was more Avholesome and nourishing than when boiled, and
 was less liable to occasion costiveness.
    It is  not necessaiy,  however, to confine children, after they are wean-
 ed, to one  particular sort of food.   The bill of fare  may be gradually
 enlarged with the child's growth, provided always that it consist of au
 innocent variety.   He may have bread and milk at one time, bread pud-
 din" at another, and bread sliced in broth, or in the gravy of roa3t meat,
 diluted with water, now and then, till at length hi teeth being properly
  "lown, and fit to chew meat itself, he may  be allowed a little of it at
 dinner, with  a  due proportion of bread and  of  wholesome vegetables.
 But I must forbid in the most positive manner any artificial sweetening of
  his food, all spices or  cearoning, except salt, all sorts of pastry, butter iu
  every form, unripe fruits, and fermented liquors
     As  I have great reliance on the  discretion of good  mothers,  when
  we'! informed of their duty, I should be sorry to tire them by too 111a-
  n  details, or to fetter them by  unnecersary restraints;  I shall  tbere-
  ft- « only  add one caution more on this  part of the subject, and that
 is, not  to ::dopt  the  pernicious  custom of givins food or dri k to^chil-
  dren during the  night.  Even in the course of the day, they should 
^REARING  OF  CHILDREN.
65
oot be crammed every hour,  and trained up in  habits of early glutto-
ny.   Temperance is that sure preservative of health, which they can-
not be taught to practice too soon.  Let them eat freely at proper inter-
vals; and the longer they are kept from the things already forbidden;
the more rapidly will they thrive, and  the greater number  of diseases
will they escape.
   As I hive admitted that cases may occur, in Avhicb it  Avould be im-
possible or improper  for  a mother to suckle her own child, I shall sug-
gest a feAV bints  ou the choice of a nurse, and  the remaining duties  of
the parent.   From what I have said of the admirable manner in ivhich
the milk of a woman newly delivered is adapted to the various wants  of
a child newly born, it. will be easily inferred, that, when the  mother cau-
not discharge that important  duty, a nurse who has just l.ti.wn ought ts
be preferreel.  Otherwise the milk will not have the purgative  quaiitie
proper to bring away any remains of the meconium, nor Avill it be exact"
ly suited to the infant's weak powers of digestion.   Inconvenieucies al-
ways arise the  moment  we oppose the intentions of nature.   This is
Avhat obliges us to have  recourse to the precarious aid of  art.  When
there is a difference  of more than a iveek in  the time  of delivery  be-
tween the mother aud the nurse, some opening meelicine may be necessa-
iy  to cleanse the  first passages :   A  table-spoonful  of whey  or ivater,
with the addition of a little honey or raw sugar, will commonly answer
the purpose.   But the infant's stomach cannot be so easily reconciled to
foreign sustenance, or made strong enough to digest tlie thick milk prer
pared for an older child.
   On the other hand, many difficulties must attend the very expedient
wdiich I propose.  It will not  be easy, except in cities like  London
where there  are several  lying-in hospitals, to get nurses newly delivered
for new-born infants.  Then  as  the  nurse cannot be remoA^ed  to  the
child, the latter must be  taken to the nurse,  and must remain with her
till she can go to the parent's house.  If an exact coincidence  as to the
lime of delivery be made the leading consideration, an improper person
may be fixed upon from  that circumstance alone, though  unqualified  in
all other respects.  Thus, as I before hinted, whatever course  Ave  take,
when we deviate from nature, we shall find numberless perplexities and
obstacles in our way.
   Almost every body is a judge of the other requisites in a  nurse, such
as  health,  plenty of breast-milk, the thriving state  of her own child,
cleanliness and  good temper.   The last ejuality, though  of very great
importance, is seldom inquired  into.   Parents are commonly satisfied
with the healthy appearance of the nurse and her child, or  with amid
wife's favourable account of her milk; and  seem to forget that a good
disposition is as  essential as a good constitution.   I do not  say that an
infant will suck in Uie vices of his nurse ; but  he will certainly suffer
from  them.   They are doubly iujurious in spoiling her  milk,  and  les-
sening her tender care of the child that  is at  her mercy.  The twin
founders of the  Roman empire were said to have been suckled  by a she-
wolf ; I should  think it  much more  unlikely  that an infant  could be
properh nursed by  apas^oiiate or ill tempered woman.
   The mother is  not to suppose herself relieved from  all trouble by
 he cho'ce of even  a good nurse.  The latter may give the child  the
breast; but  she should  be directed and  zealously assisted by the for* 
36                 OF  THE  NURSING  AND

roer  in  the  discharge  of every other duty.   This will  render  her
labour easy, and  her  situation comfortable.  She should also have
every indulgence  consistent with good sense and Avith the  rules before
laid  down.  She should not be debarred from the  occasional compan>
of her husband : a rigorous chastity, or  a  total  abstinence from wed-
ded  joys, is often as hurtful o the  nurse and  child  as  immoderate
gratification.  It is  by humouring her  that  you  will  engage her to
humour you in the strict observance of all your  reasonable injunc-
tions.
   The  child's  father also should  pay very assiduous attention to  the
proper  treatment of his offspring.  His  advice,  his encoursigemcnt,
his superintending care, will have  the happiest effect.   Is  not our ad-
miration of C^ro's character  increased,  when Ave read in  Purr arch,
that the man, Avho governed in Rome with so much glory, would  quit
everv business in order to be present avIt n the nurse washed and  rub-
bed his child ?   Such instances are seldom to be met with in our times ;
Ave  hink ourselves far  above all the trifling concerns  of  the nursery.
Yet, according to the remark I made on the same  subject in another
Avork, it is  not so  with the kennel or the stables: people of the first
 rank are  not  ashamed  to visit these places,  and  to see  their orders
 for the management of their dogs and their horses  obeyed, though any
of those sportsmen would blush ivhere he supprised  in  performing the
same office for  that being Avho derived its existence from himself,  who
is the heir of his fortunes, and the future hope of his country.
   If CAfo's wisdom  and  parental  a flection could be heightened by
 contrast,  I might easily point to a  noble duke  who is more  attentive  to
 the breed of dogs  than to that  of the human species, and  who has
 laid out more raouey upon  f< e magidficcnce of a kennel, than he  ever
expended for the relief of poverty.  I  am  told that his  grace is very
 particular in the choice  of skilful nurses  to  Avait upon  the females  of
 his canine family, when they are sick, or in the straw.   I do  not blame
 his  tende'ness for brute  animals; but I am sorry it  should be con-
 fined to tin m  when a more natural sphere lies open for  the exercise  ol
 his humanity.   This hint wiU be taken by those for whom it i» intended;
 quifacit  ilk capit.

                             SECTION VI.

                Of Exercise and Rest during Infancy.

    I MADE use of the plainest reasoning I could in the  first Chapter
 of my " Domestic  Medicine,'.' to  show  how much the  health,  the
 growth, and the  strerg'h of children,  depended  on exercise ; and to
 warn parents of the melancholy  effects of inaction, and  of sedentary
 employments  in  early  life.  It does not  appear to me that  any new
 arguments on that subject  are necessaiy; but it may be of service to
 mothers and nurses  to be informed how  the principles there laid  down
 should be  reduced to  practice during  infancy.   They are otherwise
 apt to fall into great errors, not considering that as  much mitchief may
 often arise from untimely and violent exercise, as from  the ufglect ol it
 when most  essential.                                         .     .
   It has beeu justly observed, that children require   uo exercise  lor 
REARING OF CHILDREN.
67
ihe first and second months after the:r birth, but a gentle motion some-
what like that to which they had been acuslomed in the mother's womb.
A frequent change of posture, however, is  advneable, lest by always
laying them on the same 6ide, or carrying them  on the same arm, their
soft limbs may be moulded into an improper shape.  But violent agita-
tions ol  a.iy sort may do  them  much greater  injury, by deranging the
fine structure of the brain, and giving rise to the incurable evils  of intel-
lectual or nervous weakness.
   Other parts ofthe body, as Avell as the brain, arc exposed to great danger
by tossing infants on h~gh, or rapidly dancing them, as it is called, before
their little limbs have gained some degree of firmness.  A great deal of
the spine is gristly, and the breast entirely so.  Consider then what may
be the  effect of the grasp  or strong pressure of your hauds against those
places  in order to prevent the child  from falling.  As he advances in
age, his bones acquire solidity, and his whole body becomes able to en-
dure a little shock.   Brisk, liv< ly, and  frequent exercise, will  then be
of the  greatest service to him ;  and you run no risk of  laying the founda-
tions of any disease, cr of destroying any part of that admirable sym-
metry in the human frame on which  health and beauty alike depend.
   In the course of a few months, a Avell-nursed child,  unfettered by
any check on  the free moti n of his limbs, will be able to exercise him-
self, and to gather  strength from eveiy new effort.   \\ hen you  take
him into the fields,  which you should do every day in  fine Aveather, let
him roll upon  the dry grass ;  and, tvhen in the nursery, upon the carpet.
He will soon  learn the use  of his legs, without the least possibility of
making them crooked by the pressure of so light a body.   When be be-
gins to  walk, you must help him a little in  his first experiments :  lead
him about with the i-upporl of your hands, and then by the finger only,
till you pirccivo he can  do without your assistance.   Go-carts and  lea-
ding strings not only retard the increase of a child's activity, and  pro-
duce an aukAvardness of gait very hard  to be corrected afterwards,  but
ofteu affect the chest, lungs, and bowels, in such a manner as to pave the
way for habitual indigestion or costiveness, aud for asthmatic or cousump-
tive complaints.
  Nothing can be more ridiculous than the numberless contrivances of
mothers to teach th(4r children to walk, as if it was a  thing to be learn-
ed by their instruction; and to keep them  propped up by  wooden  ma-
chines, or suspended by back strings, as if their lives and  limbs were
to be endangered by the lean tumble.  They are  too  near  the  ground,
and too light to hurt themselves by.  falling.   Besides, the oftener  they
fall, the sooner they will learn, when down to get up again;  and  the only
way to make them surefooted, is to accustom them betimes to trust more
to the proper management of their own legs, than to any artificial support.
   As to the best time for exerc'se during infancy, it admits of a Aery sim-
ple regulation.   That sort of passive exercise, which cr iibits of agreeable
motion in a nurse's arnir, must never be  omitted afer the use ofthe bath
in the  morning, and cannot be  too often repea'ed in the course of the
day.   But when the child is able  to take  exercise himself, it will be
easv to manage matters so as to let him have as much as he likes before
meals,  and never to rorze him into  action upon a full stomach.   If left to
himself, or to nature, he  will then be more inclined to stillness and repose.
   The subject of rest require* some  farther consideration.   A  healthy, 
68                OF  THE  NURSING  AND
thriving child sleeps more than two-thirds of his time for a few  weeks
after his birth.   So strong a propensity must be indulged by day as well
as by night;  but,  with  judicious  management, he  will  be gradually
brought to want and to enjoy repose by  night  only.   This is evidently
the order of nature; and such a habit, begun in childhood, and continued
through life, will contribute more to its enjoyment and duration, than auy
one maxim or rule of health  ever yet laid down by human w isdom.
   Nurses, indeed, are  too apt, for their oAvn ease, or to gain time  for
other concerns, to cherish the sleepy  disposition of infants,  and to  in-
crease it by various things of  a stupefactive quality.   All these are ex-
tremely pernicious.   I  would not suffer opiates, under the name of cor-
dials or carminatives, or in auy shape or form whatever, to be given to a
child in health.   The only composing means  which  art may  at any
time be allowed to employ, are gentle motion and soft lullabies.   I very
 much approve  of the  little  cots now in fashion, which being suspended
 by cords, are easily moved from  side to side, and  promote the  desired
 end, without the danger which violent rocking was often attended with.
 Those swinging cots are in exact conformity to the suggestions of the
 best medical writers, ancient  and  modern.  Galen mentions the  pro-
 priety of placing children to sleep in  lectulis  pendentibus,  or hanging
 little beds;  and the reason for such a contrivance is thus explained, with
 great clearness and simplicity, by Van Swieten :                   #
    « \s the  foetus*' says  this accurate observer of nature,  "  hanging
 fromthe naval-string in the womb, is easily  shaken  this  way and that,
 while the mother moves her body ; hence it  has been reasonably  pre-
 sumed, that new-born infants delight in such a vibrating motion.   1 liey
 have therefore been laid in crad.es, that they might enjoy this gentle ex-
 ercise  and be more and more strengthened.  Daily experience teaches
 us, that the worst-tempered children are soothed by this motion, and  at
 last sink into a  sweet sleep.  But the shaking ofthecradle thouWbe
 eentle and uniform : on which account, those cradles that hang  by cords
 Ire the best of all, as they may by a slight force be moved equably, and
 without any noise.   At the same  time, the motion communicated to these
 cradles is imperceptibly diminished, and at last ceases without any shock.
 ^^^Mwellasinmostother parts of  Europe,  cradles  fixed
  upon wooden rockers,  have been in use from time immemorial.  Noevi
  couTd  arise  from their continuance, while  in the hands of careful
  and affectionate  mothers ; but,  when  left to the management  of impa-
  tient nurses, or of  giddy boys and  girls, the delicate texture  of an in-
  ^sS woiddSftc/be^expoMdto  great danger   The  agitation
  of a cradle by such  persons has been  compared to the yotingof a
  °Le-coach basket: and I  believe  that a poor child would  suffer as
  much from the one as from the other, where be not  a little more con.
  fiTed in the former.  Is it possible to conceive a ...ore shocking object
  than an ill-tempered nurse,  who, instead of soothing the accidental  un-
    asTness or iSposition to sleep  of her baby, ^^™«^
  often waked up  to the highest pitch of rage ;  and, in  ll,e f c^s "'  ' ,
  folly and brutality, endeavours by loud  harsh threats, and the^ mpeu
  ous rattle of the cradle, to drown the infant's cries  and to^force him nito
  slumber !-She  may sometimes  gain her  point, but never  till the poo.
  victim's strength is exhausted.                            ,.     fi   ,
     To guard against this evil the transition from  rocking-cradles to fixed 
REARING  OF  CHILDREN.              69
bed-steads was  not necessary.   The gentle moiion before described, at
unci  so natural  and so pleasing to infants, may be given them  with ease
and safety iu little baskets suspended by cords, as used in the Highlands
of Scotland under the name of creels, or in the more elegant contrivances
of swinging cots, which are noAV coming  into  fashion.  I am sorry to
see any of the latter surrouuded ivith close curtains, which have almost
as bad an affect as confining the infant in  a room of the same dimensions.
One gree,; curtain may be hung at some distance from his face,  so as to
intercept the light iu the day-time but not to obstruct the free  communi-
cation of air, or to reverberate the exhalations frem his lungs and body.
Green windoAV-blinds in the sleeping-room will answer the same purpose.
Care should also  be taken not to expose infants either in bed or out of
bed to an oblique light, or they will become squint-eyed.  They should
be kept facing it when up, and exactly the reverse, when laid down to rest.
If the light come upon them from one side, their eyes will take that di-
rection, and thus they ■will get the habit of looking crosswise.
   It is of still  greater moment  to pay strict attention to their bedding.
Nothing cau have a more relaxing  tendency, or be at  the same time
more unfavourable to cleanliness, than beds and pillows stuffed with fea-
thers.  These absorb and retain the perspirable matter, as well as every
other impurity, so that the child who  sleeps upon them  must  inhale  the
most noxious vapour, while its action on the surface of his body must de-
stroy the energy of the skin, and render his whole frame both within and
Avithout the ready  receiver of disease.   Horse-hair cushions and mat-
tresses are far preferable; but if soft bran were used instead of  hair for
the stuffing of children's beds  and p'llows, these Avould more readily let
any moisture pass through them, would never be too much heated, and
might be frequently changed or reneAved  without any great  trouble or
expense.  My  former hints  concerning a child's dress are  equally  ap-
plicable to  his bed-clothes, which should be loose, easy, and  as light as
may be consistent with  due warmth.  I  say  the less on the  subject of
cold, as most mothers are too apt to run into the opposite extreme.
                           CHAP. V.

          OF DVVARFISHNESS  AND DEFORMITY.

       Hi HE chief causes of delects in the size and form of Children:,
have been occasionally touched upon in the preceding chapters, but  the
prevalence of such evils, and the lamentable consequences with Avhich
they are followed, require to be more fully and distinctly considered. I
must not weaken the influence of important truths  by suppressing any
pa-.' of them, or by  leaving them too widely scattered.   I must shake
off  the  restraints of  false delicacy, and by candidly  pointing out
the  grand source of so  many  private and public calamities, endeavour
to prevail on parents to adopt the most effectual remedy.   Let not the
fairest part  of th<> creation be offended with me for saying, that, in all
casos of dwarfishucss and deformity, ninety-nine out of a hundred are
owing to the folly, misconduct or neglect of mothers.  The following re-
marks are not written in the spirit of reproach,  but  with a view to tlie
Jtiost desirable reform.- 
70                  OF DWARTISHNESS
  It would be d!fficult to mention any thing in which society U so deep-
ly interested, as in the proper union of the sexes.   This has often eu-
gaged the attc ition of legislator?, and marriages have been prohibited in
various diseases and personal disqu tiificatiuns.   We htve  even an in-
stance upon record, where the community interposed, when degeneracy in
the royal line was likely to be the consequence of their king's injudicious
choice of  a wife.   History tells us, that ihe  Lacedaemonians condemn-
ed their ki g  Archidamus  for  having married  a weak,  puny woman;
"because," said they, " instead of propagating a race of heroes, jou
will fill the throne with a progeny of changelings."
   I am aware that any checks oa the liberty of individuals in tlieir ma-
trimonial  contracts, would be deemed  inconsistent with the freedom of
Uie British constitution; and indeed,  it  is strange that laws should be ne-
cessaiy to convince men, that health and form are, or ought to be,  pow-
erful considerations in the choice of a wife.  Eve y part of animated na-
ture proclaims aloud, that like begets like; and though a puny, dwarfish,
or distorted woman, may become  a  mother, it will oft>n be at  the risk
of her own life, and nhvays with  a certainty of transmitting some of her in-
firmities to her inaocent and ill-iated offspring.
   But the inheritance of parental Aveakness and  deformity is one of those
curses which  argument or expostulation  cannot avert.  The voice of
reason is  disregarded, and objects of natural desire are over-looked, by
avarice and pride. I shall therefore confine my observations to such  evi Is
as may be presumed to admit of a cure, because they arise rather from
error and folly, than  from depravity  or wilful perverseness.
   I; seems to be the natural wish of every pregnant woman to bring forth
 stout,  healthy, and beautiful infauts.   Yet, ilfr. Locke did not hesitate
 to assert, that, if mothers had the formation of their own children in the
 Avomb, we should see  nothing any where but deformity.  The foetus is
 happily place 1 in better hands, and under the guardian care of nature.
 But though it cannot be new-moulded, altered in its shape, or disfigured
 by  the mere fancies and capricious desires of the mother, it may  suffer
 no less ' injury from her ignorance, her folly, or misconduct.  I hope I
 made it sufficiently evident in my cautions to women during pregnancy,
 that the foetus may not only be  checked in its growth, but marked also
 and distorted by tight or heaAy  pr. ssure on the womb,—by stays, girdles,
 or the like improper  ligatures.  In vain does nature provide for the easy
 and gradual enlargement of the embryo, if her  benignant purposes are
 counteracted by the bracing restraints  of a silly  mother's dress.
 '  \fter  the birth, as I  before observed, still greater danger awaits  the
 Infant from attempts to mend bis shape,—to keep his head and  limbs in
 moper form,—and to secure him  against  accident.   The worst accident
 that can befal  him is far less alarming than the certain consequences ot
 such presumptuous  improvements and ill-dVected care.   He  becomes
 puny, stunted, deformed, diseased; and, though perhaps cast in nature s
 hanpiest  mould," is sure to be spoiled by the disfiguring  touch of man
    I have alreadv explained the fa  al effects of meddling with the  soft
 bones of  an infant's skull at the  birth ; of  confining them by any check ;
 or coverl~ the.v. too w .r.nlv.   I showed Imw wonderfully the pliancy
 of  those  bones w.,s contrived to yield to  ohstructio '8, for the purpose ot
 promotion e.sy and > afe deliver  v, and  afterwards to resume of themselves
 Iheh  proper  place and form, if  they had  been  squeezed togetlier  ia the 
AND  DEFORMITY.                    71
 act of parturition.  I also insisted on the importance of a thin and light
 cap, that the air may act upon them freely, to render them hard and com-
 pact, and of course fitter to defend the brain from cold or any external
 injury.   But while  midwives and nurses are suffered to pursue a con-
 trary plan, ive  need not wonder at meeting with so mauy instances  of
 early convulsions, of idiotism, and of heads misshapen, infirm, or suscep-
 tible of cold upon exposure to the least breath of air.
   I was no less earnest in my cautions against the use of bandages, or
 of oppressive covering for any other part of  the tender frame.   I did
 uot magnify the danger, but simply stated the result of frequent observa-
 tion.   I never  kneAV a single instance of a child's attainment to full size
 and vigour, after having been cruelly confined during iufancy in swathes
 or  swaddling-clothes.   How,  indeed, is it possible,  when the action of
 the heart, the lungs, the arteries, and of all the vital organs,  is cramped
 and enfeebled  :—when the free circulation of the blood and  secretion
 of  the humours are prevented; and ivhen the impatience of restraint ur-
 ges the infant to waste all his strength in continual but unavailing efforts to
 burst his fetters.
   As I kneiv that external objects  were more likely to make some im-
 pression on the minds of my female readers, than arguments drawn from,
 the structure of the human frame, I endeavoured, to fix  their atteution
 first on the young of brute animals, many of which, as kittens, puppies, &c.
 though very delicate when brought into the  world, never Avant to  be
 strengthened, kept in due form, or preserved from accidents, by means of
 swaddling bands.  Childreu have as little occasion for any such defence
 against- danger.  In reply to the idle  objections of mothers and  nurses,
 founded on the difference in point of alertness between kittens and in-
 fants, it has been admitted, that the latter are certainly heavier than the
 former, but they are more feeble in the same  proportion : they are inca-
 pable of moving  with  sufficient force to hurt themselves; and if their
 limbs set into a  wrong situation, the uneasiness they feel soon induces them
 to < hange it.  Is it not absurd to put them to real pain by galling ligatures
 for fear of imaginary bruises ; and to distort their tender bodies effectu-
 ally by squeezing  them into a press, lest they should grow distorted from
 being left at liberty to stir ?
  While  I ivas Avriting on  this part of the subject last autumn, I  could
 not help being struck wiUi another illustration of it, Avhich presented itself
 every day to my  vieiv.  Above three hundred cattle were grazing in a
 field before my windoiv, all of them nearly of the same size, well for-
 med and  vigorous, without the least mark of feebleness or  distortion.
 They had not been kept panting, when young, in tight and cumbersome
 wrappers, nor had they been stunted  in their growth by improper man-
 agement.  They might be truly called the offspring of  nature, reared
 and brought up in conformity to her laivs.  How painful and humilia-
 ting did I feel  the contrast, Avhen I  compared them  with the foster-chil-
 dren of art, Avith  bipeds of various shapes and  sizes,—with the hunch-
backed, crooked-legged, lame, ricketty, diminutive, and deformed human
beings, ivhom I  often saw walking through the same field !
  Should it be  alleged, that inforences drawn from a species  so differ-
ent  from  our own are  not conclu-ive, let us next turn our eyes to what
tikes place iu  savage nations, who are all known to be tall, robust, and
well proportioned.   Indeed, anv instance to the contrary is so very rare,
                              69 
72
OF DW ARFISHNESS
and extraordinary among them, Uiat it was vulgarly believed they put all
their puny and misshapen children to death.   The fact is Uiat they have
not any such, because they  never thwart the purposes of nature, or dis-
obey her dictates  in the treatment of tlieir infant progeny.
   The perfect form of the North American savages will be more clearly
conceived  from the following anecdote of the president of the Royal
Academy,  than from a whole volume of travels.   This justly admired
painter, Avho is a native of America, having displayed in his youth strong
proofs of uncommon talents was sent to Italy, at that time the grand school
for the imitative arts.  Upon his first seeing the Apollo Bclvidere, he is
said to have exclaimed, " O ! Avhat a fine  Mohawk Indian  !"  Almost
every body has  at least heard,  that the Apollo Belvidere is one of the
most beautiful and exquisite pieces of statuary in  tho world.
   I must not  here omit Buffon's account  of the method of bringing
up their young, pursued by otlier unpolished nations, as we proudly call
them.  " The ancient Peruvians," says he,  "in loosely sivathing their
children, left their arms at full  liberty.  When  they threw aside this
dress, they placed them  at  freedom in a hollow',  dug iu the earth, and
lined with clothes.  Here their children, unable to get out and crawl into
danger,  had their arms quite loose, aud could move their heads and bend
their bodies, without the risk of falling or hurting themselves.   As soon
as they Avere able to stand, the nipple Avas shewn them at a distance, and
thus they were enticed to learn to walk."
   The same Avriter observes, " that the young negroes are often in a sit-
uation in Avhich it is with more difficulty they come at the breast.  They
cling round the hip of the mother Avith their knees and feet, and by that
means stick so close, that they stand in no need of  being supported, while
they reach the breast with tlieir hands, and thus contiuue to suck, with-
out letting go their hold, or being in any danger of falling, notwithstand-
ing the various motions of the mother, Avho all the while is  employed in
he*r usual labour.  These children begin to walk at the end of the sec-
ond month or rather  to shuffle along on their hands and knees; an ex-
ercise that gives them ever afterwards a facility of running almost as swift
 in that manner as on their feet."
    To this very interesting description, I can add, upon the testimony of a
 friend of mine who had been senral years on the coast of Africa, that the
 natives  neither put any  clothes  on their children, nor apply to their
 bodies bandages of any kiud, but lay them on a pallet, and suffer them to
 tumble  about at  pleasure.  Yet  they  are  all  straight,   and  srldo:n
 have any complaint.  Good health, as well as a good shape,  is tlie
consequence of  their free, unconfined  motion  during infancy : while
 among us, on the contrary, restraint, or, what is the same  thing, tight
pressure, checks growth, distorts the frame, and renders it at once dimi-
 nutive, unsightly and infirm.   There is always a close and very natural
 connection between  deformity, weakness and disease.
   The more we enlarge our survey of the human species in various parts
of the world  the less doubt shall we entertain of the principal  cause ot
dwarfishness and deformity.  We  shall find that  mankind are stunted
and distorted  in  proportion to their degree of civilization; that people.
who go  almost naked from  their birth, and live in a state of iis.'ure, an-
well-shaped, strong, and healthy :-aud  that  among others who bo;^ ot 
AND  DEFORMITY.                    73
higher refinements, the greater atieation is paid to dress, the nearer are
the approaches to the stature and to the Aveakness of pigmies.
  Sterne, who knew so well how to enliven the most  serious subjects,
! .-presents himself as struck with the number of dwarfs he saw at Paris.
  lam very sorry to observe, that we need not go so far as Paris to be
convinced of the lamentable  effects of tight clothes, bad  nursing, ai:d
confined impure air.   Many of these matters are not much better ordered
in the English metropolis : every narrow lane in London  swarms with
ricketty children; and though we  caunot  say of the people  Avhom we
meet Avith in the streets, that  every third man is  a  pigmy, yet we mfcy
with strict truth assert, that many of Uie ivomen are evidently stunted in
their growth, and, both in size anil robustness, are below the standard of
mediocrity.  With regard to females, indeed, born and bred in this city,
as more  attention is unfortunately  paid to  the tightness of their dress,
and to the  artificial moulding or pretended  improvement of their shape
when young, the far greater part of them must be of a diminutive stature,
and numbers are distorted either in body or limbs.
                          CHAP.  VI.

BANEFUL  EFFECTS OF PARENTAL TENDERNESS,  OR OF  AVHAT  MAT BE
  CALLED AN EXTREMELY DELICATE AND ENERVATING  EDUCATION.

       HAVING repeatedly had occasion to  point out the evils that
must arise from the inattention of mothers to any part of their duty, and
especially from  abandoning their children to the management of  hired
nurses.   I shall  now proceed to explain the bad consequences of the op-
posite extreme.   Too much care operates in the same manner as too lit-
tle, and produces similar effects.   A  case or two. selected from many
which have occurred to me in the course of  practice,  will sufficiently
illustrate the  truth of tiiis assertion.
   The grand  rule of life, which  reason  and  experience concur to re-
commend  is always to pursue the golden mean; to  steer a mieldle course
between dangerous extremes; and to take care, in avoiding any one Aice
or folly, not to run into its opposite.  Mothers are too apt to forget this
admirable lesson, in nursing and  rearing  their children.  They do not
seem to know Uie proper medium between cruel neglect or indifference on
the one  hand, and  the  fatal excesses of anxiety and fondness on the
other.  In giving Avay to the strong impulses of natural affection, they com-
monly go too far, and do as much mischief to their offspring by  misguid-
ed tenderness, as by total insensibility.
   It is not my intention to combat those fine feelings of mothers, without
Avhich the human race would soon be extinct.  I only wish to see them,
kept a little more under the controulof reason.   I wish to see the most
amiable of all passions, maternal love, displayed iu promoting the health
and fortifying the constitutions  of  children,—not in relaxing them by
rvery species of softness and  effeminacy.  When  this passiou is carried
beyond the proper bounds, it ceases to  be love: it becomes a sort of
blincTinfatuation, always injures, and often destroys the object of its re-
gard.   Mothers sliould never forget  the fable of the moakey snatching up 
74                BANEFUL  EFFECTS  01
one of its young in a moment of alarm, and, in order to save it from dan-
ger, squeezing it with so close au embrace as to occasion its death. What
a just picture of darling children so frequently killed by kindness!
   Nature provides for the helpless state of infancy in the strong attach-
ment of parents.   A  child comes into the world, chiefly dcpcudeut ou
the mother's care for the preservation of its being.   She is trembliugly
alive to all its  Avants.  Every tender  office  she performs increases her
fond solicitude, till at length it gains the full possession of ber affections,
and her sole wish is to make it happy.   What a lamentable thing it ia that
she should so frequently mistake the means!
   Indeed there cannot be a greater mistake than to imagine Uiat extreme
 tenderness or delicacy of treatment will promote the health,  Uie growth,
 the  present  or the   future happiness of a child.   It must have quite a
 contrary effect.   Instead of supplying the real calls of nature,  it creates
 a thousand  artificial Avants: instead of guarding the infant from  paio
 and disease, it renders him much more susceptible of both, and less capa-
 ble of  enduring either:  instead of  happiness,  it  ensures  miser)'  in
 every Btage of  his  existence,  as the  infirmities of body  and  miud,
 which are contracted in the cradle, will follow him with  incurable obsti-
 nacy to the grave.
   The writer, whom I quoted on the subject of suckling, is no  less forci-
 ble in  his censure of maternal fondness.  He says, the obvious paths of
 nature are alike forsaken by the woman who  gives up the care of her
 infant to a hireling, or, mother words, who neglects the duties of a mo-
 ther ; aud by her who carries these duties to excess;—who makes an idol
 of her child ;  increases his weakness, by preventing his sense of it: and,
 as if she could emancipate him from the laws of uature, hinders  every
 approach of pain or distress: without thinking that, for the sake of pre-
 serving him at present from a few trifling inconveniences,  she is accumu-
 lating on his head a  distant load of anxieties and misfortunes ;—without
 thinking that  it is  a barbarous precaution to enervate and  indulge  the
 child at the expense of the man.
    He then be°-s of  mothers to attend to nature, and  follow the track  slie
 has delineated;—she continually  exercises her children, and fortifies
 tiieir constitution by experiments of every kind;  inuring them betimes
 to grief and pain.   In cutting their teeth, they experience the  fever;
 gripin*  colics throw them into convulsions; the hooping-cough  suffo-
 cates "and  worms torment them;  surfeits corrupt their blood; and  the
 various fermentations to Avhich their humors  are subject, to cover them
 with troublesome eruptions; almost the whole period of childhood is sick-
 ness and danger.   But,  in passing through  this course of experiments
 Uie child gathers strength and fortitude ; and as soon as he is  capable ot
 lhrinff, tbe8principles of  life become less precarious.
    « This" he adds,« is the law of nature.  Why should you act contra-
 ry to it ? ' Do you not see that, by endeavouring to correct her work, you
 spoil it,  and prevent the  execution of her designs ?  Act you  from with-
 out, as sh» doe, within.   This, according to you, would increase the dan-
 ger ; on the contrary, it  will create a diversion, and lessen it.  Lxpen-
 iuce shews, that children delicately educated die in a greater  Portion
 than others.  Provided  you do not make them exert themselves be>ond
 thei-' powers, less-risk is run in exercising, than indulging them uf ease
 Iqure them therefore by degrees to those inconveniencies which thoy 
PARENTAt  TENDERNESS.                  75
 must one day suffer.  Harden  their bodies to the intemperature of the
 seasons, climates, and elements ; to hunger, thirst, and fatigue."
   As the philosopher was aware that the latter part of his advice would
 stir up all  the fears and alarms of fond mothers, he takes some pains to
 convince them that it may be followed with perfect safety.   He very just-
 ly observes, that, "  before Uie  body has acquired a settled  habit, we
 may give it any we  please, Avithout danger;  though when it is once ar-
 rived at full growth  and consistence, every alteration  is hazardous.  A
 child will  bear those vicissitudes, which to a man would  be insupporta-
 ble.   The soft and pliant fibres of the former readily yield to impression:
 those of the latter are more rigid, and are reduced only  by violence to
 recede from the forms they have assumed.  We may therefore," he con-
 cludes, " bring up a  child robust and hearty, without endangering  either
 its life or health; aud though even  some risk were run in this respect, it
 would not  afford sufficient cause of hesitation.   Since they are risks in-
 separable from human life, can we do better, than to run them during that
 period of it wherein we take them at the least disadvantage ?"—I leave
 this question to be duly considered  by every  mother who is not blind to
 the clearest evidence of truth, or wilfully deaf to the most commanding
 tones of eloquence and argument.
   The  familiarity of any object lessens our suprise at it, or there are
 few instances of human folly which would astonish us more, than that
 of a fond mother, ivho, in order to protect her child from  a little pain or
 uneasiness while he is young, multiplies his sufferings when he comes to
 maturity.   Strange infatuation ! to sacrifice the  man to the infant, and,
 through over-solicitude for a year or two after his entrance into life ; to
 shorten its natural extent,  and to fitl up that contracted span of existence
 with  Aveakness,  irritability, and disease I  Did any body ever  think of
 rearing  an oak plant in a hot-house, thence to  be removed to the  bleak
 mouotaiu ?  And is  the puny, enervated nursling better prepared  to en-
 dure the transition from Uie lap of softness to all the accidents of a rug-
 ged and a stormy world ?
   As strong examples often make  some impression where other modes
 of reasoning fail,  I shall here beg leave to introduce  the history of a
 young gentleman, whom I attended at a very early  period of my  prac-
 tice, and who fell a victim to  the excessive  fondness of an indulgent
 mother.  With every wish to promote her son's health and happiness, she
 was as far as respected intention, Uie innocent but absolute cause of total-
ly destroying both.   She brought on relaxation and debility, by her mis-
 guided endeavours to avert pain; and while she hoped  to prolong the
 life of an  only  son,  the  means which she made  use of for that purpose,
 uot only abridged its duration,  but  precluded his  power of enjoying it.
 Though he  w as buried at the age of twenty-one, he might be 6aid to
 have  died  in his cradle;  for life has been Avell defined, not to consist in
 merely breathing—but in making a proper use of our organs, or senses,
 our faculties, and of  all those parts of the human frame which contribute
to the consciousness, of our existence.   That he never attained to Uiis
state of bein?, will fully appear from the folloAving narrative.
  Edward Watkinson was the only son of a country clergymen,  of amia-
ble mann is and sound learning, but of a recluse turn of mind.   The
 moth  r was a daughter of a Loudon tradesman,  and had been educated
 with extreme delicacy.   She naturally pursued  the same line of  con- 
76
BANEFUL EFFECTS OF
duct towards her own clriU;  and'Iter fond husband wa;> too much under
the influence of the like fatal Aveakness.  Many  a child in spoiled by
the indulgence of one parent: in Uie case now before us. both concurred
to produce that enervating effect.
   For seme time after his birth, master Neddy w;s  reckoned a prom-
ising boy.   When I first saw hun, he  was about eighteen years of age :
but, to judge  by his look, one would have supposed him to  be at least
eighty.  His face was long, pail,  and deeply iurroived with wrinkles—
his eyes Avere sunk in tlieir sockets—his teeth quite decayed—his nose
and chin almost touched each, other—his breast narrow and prominent—
hisbody twisted—his legs like spindles—his hands and fingers approach-
ing nearly to the form of birds claws—in  short, his  whole figure exhibi-
 ted the truly pitiable appearance of a veiy old man,  sinking under the
 Weight of  years and infirmities into the grave.
    It Avas  a Midsummer I  paid my first visit.  I then found him wrap-
 ped up iu  clothing sufficient for the rigours of a Lapland Avinter, and so
 closely muffled that one could hardly see the tip of his note.  He Avore
 several pair of stockings: his gloves  were double, and  reached his el-
 bows;  and, to compleat the absurdity of his dress, he was tightly laced
 in stays.   Though armed in this manner  at all points, he seldom pee-
 ped out of doors except in the dog days, and then ventured  no farther
 than the church, which was only forty paces from his father's  house.  1
 believe this Avas the most distant excursion he ever made;  and the ex-
 traordinary attempt Avas always accompanied with  peculiar  care, and
 many additional preservatives from cold.
    The eye of his parents might be truly said to watch over him not
  only by day, but by night also, as  he slept in tlie same bed with them, ha-
  ving never been permitted to lie  alone, lest he should throw the clothes
  off, or feel the want of any immediate assistance.   It did  not once oc-
  cur to his father  or mother, that all the inconveniences  which they so
  much dreaded, could not be half so injurious as the relaxing atmosphere
  of a warm bed, surrounded by close curtains, and impregnated  with the
  noxious effluvia fiom their lungs and bodies.
     His food and his drink were of tlie weakest quality, always  adminis-
  tered warm, and by woiglit and measure.  When I recommended a more
  nourishing diet, and a little generous wine, I  was told  that the  strongest
  tiring master  Neddy had ever taken was chicken water, and that they
  chmt not venture on wine or animal foodfor fear of a fever.  Thus was
  the poor lad reduced  almost  to a skeleton, through the silry  appre-
  hension of a disease, of which he was not susceptible.  Nature was m
  him too weak to spread a hectic flush even for a moment over his counte-
  nance, which had acquired the colour of a par-boiled chicken.  All his
  vital  powers were languid;  and even his speech resembled the squeak-
  iug of a bird, more than the voice of  a man.
     When I spoke of exercise, I was told he took a  walk every  fine day
  in the hall, and that  was deemed  sufficient for one of his delicate consti-
   tution.  I mentioned a horse-the mother was frightened at the vrry
  name  of so dangerous an animal.  On telling her, that I owed the firm-
  ness and vigour of my own constitution to riding every day, she began to
  biak  there might be something specific in it; and she therefore consented
   to the purchase of a little horse.  But tame as the creature was^t  dxl
   not quiet the mother's alarms.  Master Nedthj, though placed upon the 
PARENTAL  TENDERNESS.               77
poney's back, was not entrusted with  the reins.  These were  given iu
charge to a maid-servant, who  led the horse round the orchard, while
the cautious rider fastened both hands on the pommel of the saddle;  and
the father walking on one side, and the mother on the other, held  hinr
fast by the legs, lest he might be brought  to the ground by any sudden
start of his high mettled racer.   This exhibition was too ridiculous not
to excite the laughter of  the neighbours : which soon put an end to mas-
ter Neddy's equestrian exercise.
   The timidity of a youth, thus brought up is more easily conceived
than described.   Fearful of every thing, he would run from the most in-
offensive animal, as if he had been pursued by a lion or a tiger.   Ilia
Aveakness in this respect being known to the village boys, it was  a com-
mon practice witli them, whenever they saw him peeping through his la-
ther's gate, to frighten him into the house by calling to the pigs to bite
him.   This sportive alarm had the same effect as the sudden rush  of a
mad bullock.
   With such excessive Aveakness both of mind and body, master Neddy
had some good points about him.   His parents represented him as a per-
fect model of morality ;  aid I had no right to doubt the truth of their
representation, though  I did not give  him quite so much  credit on
that score, because he did not possess sufficient  force  of constitution
to be capable of any kind of vice.  But I viewed,  with mixed emotions
of admiration and pity,  some proofs of learning and abilities which he.
left behind him.  I was the more surprised, as tlie incessant care bestow-
ed on his person seemed to leave Very little time for any mental acquire-
ments.
   Improper food, tight or oppressive  clothing and Avantof fresh air and
exercise, have in their turn proved destructive to thousands. Thi6 young
man fell a victim to them all;  and it would have been a Miracle indeed,
had he survived their combined influence.  He died without a groan, or
any mark of disease except premature old age, the machine being fairly
Avorn out before lie completed his tAtenty-fiVst year.   His death proved fa-
tal to both his parents, whose lives were closely bound up in that of the
lad.
   The father had perceived his own error, but not before it was too late.,
On reading my inaugural dissertation, which was then publishedin Latin.
under tlie title already mentioned, be sent for me, and begged I would en-
deavour to save his son.  The youth, ales! Avas far beyond  the reach
of my most zealous efforts: I could only Avitness the certainty of his fate.
Medicine was of as little use  to him as consolation to his afflicted pa-
rents.   The bitterness of their grief was increased by self-reproach :
and friendship exerted her soothing voice  in vain.  The  father on his
death-bed conjured me to translate my dissertation  into English, as ho
thought it might be of infinite service to mankind.   My compliance with
his request gave rise to the " Domestic Medicine,"  of which that essay
on the means of preserving the lives of children,  constitutes the  first,
and in my opinion, the best chapter.
   The above  relation may to some appear romantic; but did I suppose.
any one capable of questioning my veracity, I could name  several per-
son* of the first respectability, who know, that, so far from being heigh-
tened, it falls short of the truth.   Indeed I might go farther, and assert.
from my own too frequent observation, that a master Neddy is not so sis- 
78
BANEFUL  EFFECTS OF
gular a phenomenon in many other families, and Uiat the evils of paren-
tal folly are much oftener entailed upou favourite heirs, than the powci
of fully enjoying the estates ay Inch descend to them.
  But it is ia the female world, more especially, that maternal  fondncsu
spreads its fatal ravages.   Girls remain longer than boys under the im-
mediate and almost exclusive care of their mothers; and  when the lat-
ter are  more guided by love than  reason, by the impulses of  a tender
heart instead of the dictates of an enlightened mind, the former are doom-
ed to weakness and misery. I shall not offend my  fair  readers by  a re-
petition of the remarks already made on the acquired defects aud  infir-
mities of too many of  our young Avomen;  nor shall I attempt to describe:
the longtraiu  and almost endless variety of nervous diseases, from which
so feAVof them are exempt: I shall uoavconfine myself to a   single in-
stance of the effects of extreme delicacy in the education of a  daughter
 as the counterpart of  my story of a son cut off by the like means.
   Isabella Wilson was in early life a very promising child, and the ob-
ject of her mother's idolatry.   This good Avoman had no idea that health
 and beauty Avere more likely to be  destroyed than improved or preser-
 ved by excessive care.   In the choice of  diet, clothes, exercise, &.c. the
 delicacy of her sweet girl Avas always the ruling idea.   It is easy, in-
 deed, to render the human frame more  delicate; but to  make it more ro-
 bust, requires a very different mode of proceeding.  As the child did not
 seem afflicted with auy particular complaint, the doting mother exulted
 at the happy  effects of her own  management, and never  thought that
 the taper form, the fine limbs, and the languishing softness, which she so
 much admired, were the sure symptoms of  debility and of latent disease.
   Isabella's meutal  improvement, in  which she surpassed many  other
 young girls of her age at the same  school,  was no  less flattering to her
 mistaken parents.   But she had scarcely  attained her fourteenth year
 before the fond illusion vanished, and the regular functions of both  mind
 and body were suspended by  a fit of the most extraordinary nature.  I
 cannot avoid making one remark here, which may be of great  practical
 utility.   It is, that fits, though they go by different names, and are as-
 cribed to a great variety of causes, may all be ranked under the general
 appellation of nervous affections, and are almost always the consequence
 of bad nursing or injudicious  treatment in childhood.  Few  children,
 properly nursed, have fits; and of  those who are  improperly  managed,
 few escape them.  Poor Bell Wilson was one of the unfortunate class.
   On my being sent for to attend this young woman, who was then six-
 teen, I was informed that  she had been subject  to fits for about three
 year's, and had taken a great deal  of medicine by the advice of several
 of the faculty, but  without having experienced any  benefit.   Though
 the person who gave  roe this account made use of the word fits,  I soon
 found that, strictly speaking,  it was only one fit, that assumed two  differ-
 ent forms or  states, which followed one  another in constant succession
 during the whole of the above period.       •   ,.,.„_.„  „
   In order to give a precise idea of this singular kind of  fit, I shall call
 its first  state  active, and the  second passive.  During the  former, the
 young  woman made use   of the most  violent  exertions,  springing up
 throwing her arms about, and striking them  against every thing  winch
 came within her reach.  At the same time, she uttered a sort ot  noise, 
PARENTAL  TENDERNESS.
7&
consisting of three notes,  which was more like the cry of some wild
beast than any thing human.
  An universal  spasm succeeded those strange agitations,  and  every
limb became as still'and inflexible as  if it had been suddenly petrified.
Her whole appearance Avas that of a sta ue made of Parian marble.—In
this state of rigidity she continued sometimes for one hour, sometimes two
and often three or four, but the moment it iras over, she  began Avith ihe
cry and motion above described.
  The active convulsion never lasted so long as the  rigid state; but it
was the o.ily time at Avhich any thing could be got down her throat.  As
she would  not admit substances of the least solidity into her mouth, the
little nutriment Avhich she received was always given in a fluid form, and
chiefly consisted of small-beer, or wine  aud water.—Her evacuations,
either by stool or urine, were of course very  trifling, and she was whol-
ly insensible of both.   Notwithstanding the thiuuess of her diet, she
did not appear emaciated or ghastiy;  on the  contrary, she was tolera-
bly well iu fle&h, and her countenance,  though  quite  void  of colour,
was  rather pleasing.   Her figure was exquisitely fine,  the disease did
not seem to have prevented her growth in height, though ii had in strength,
and in bulk or expansion ; she was very slender, but as tall as most young
women of  the same age.—Such were the moot striking peculiarities of
her situation ivhen I paid  my first visit.
  As all the voluntary motions were suspended, and  the involuntary
alone took place, I thought by excitiug the former I might suppress the
latter, which had so  long agitated the system.   But  before I had re-
course to  stim'ulauts,  I was  induced, by  the  tone of confidence with
which I had often heard anodynes aud antispasmodics spoken of by pro-
fessional men of eminence, to try them first; but the experiment, though
fairly made and duly persevered in, was not attended Avith the least suc-
cess.   And here I must observe, that, after forty  years farther practice,
I have never found the effect of antispasmodics in such cases to corres-
pond with  the high reputation which they long retained  in the medical
world.   I knoAv it has been the usual method, when the actions of the
system appeared to be inverted,  to employ this class of medicines,  in
order to restore  regularity and to take off the  supposed spasm.   I am
far from being inclined to question  the veracity  of the favourable re-
ports made by others of the iseue of their experiments, I candidly  state
the resuli  of my own,  ivhich  has wholly destroyed my reliance on that
mode of  proceeding.
  After the failure of the above attempts, in  which I was more guid-
ed by the  example of  others than by the dictates of my own mind, I
resolved to try  the effect of irritation on the  most sensible parts, which
were often rebbed with sether, and other volatile  spirits.  I  prescribed
at the  same lime the  internal use of tonics, particularly chary bested
Avine, and  the compound  tincture of bark.*   Appearances soon became
favourable; but as the change  for the better  Avas  alow, the parents were
persuaded  by somebody to try the cold bath;  aud this rash  step proved
almost fatal to my hopes and to their fondest wishes.
——^—--———--------------—       '                          ——+m
  •  I have  here omitted the detail of doses and effects, usually given in medi-
cal cases, as I am not  writing instructions for the treatment  of diseases, hut
cautions to mothers concerning1 the nursing of their chjliiren.
                                 79 
80                 BANEFUL  EFFECTS  OT
  The reader should be informed, that the astonishing singularity of th*
girl's disorder had filled the minds of the country people all around Avith
the  wildest and most  superstitious conjectures.   The general opinion
was, that the complaint must be owing to evil spirits, and that the  girl
was  certainly possessed.  Some were  for putting  her into Avater, where
they Avere sure she would sAvim.   Others said that, if she was laid  upon
the fire, she would undoubtedly fly  up the chimney.  One bold captain
of horse, a man of more resolution than intellect, declared his reaeliuess
to expel the foul fiend  by shooting the girl, if the parents wpuld give him
leave.   Her mother, who was not deficient in natural good seuse, though
in the education of her daughter she had suffered her fondness to get the
better of her understanding, paid no regard to such absurd and ridicu-
lous proposals ;  but she yielded to the importunities of a friend, who bad
described to her with great earnestness and plausibility the wonderful ef-
fects of the cold bath.
   A single immersion  convinced the parents of their dangerous error*
All  the symptoms were aggravated in the most  alarming manner,   The
duration of the  rigid state of the body Avas extended from a few hours to
eleven  days.  She would then have been buried, had I not positively
forbidden her mother, Avhatever might happen, not to have her interred,
till I should give my assent.  At the time of this last attack, I was upon
u journey to a distant  part of the country.  On my return home  I was
told that my patient was dead;  but that her burial  had been delayed till I
should  see her.  When I called, I found her  to all appearance  what
the people had described her, a lifeless corpse.  On examining the  body,
however, I thought I perceived some degree of  warmth about the region
of the  heart.   This confirmed me in my previous desigu to make  every
attempt to restore animation.   It was  a considerable time before any
symptoms of life appeared :  at length,  the girl set up her old cry, and
began to throw her arms about as usual.
   After  having so far succeeded, the parents  implicitly followed my
 farther directions, and did not throw any new obstacle in the way of a
 cure.   I again had  recourse to the tonics before mentioned, with such
 nourishment as the girl could be brought  to swallow.   The violence of
 the convulsive  motions gradually abated, and the duration of the rigid
 state of  the fit grew  shorter  and shorter;  till, in about  six months,
 the whole ceased,  and the regular  aud  natural actions of the system
 returned.
   The state of this  girl's  mind, as well  as of her  body, on her reco-
 very, was as extraordinary as her disease.  It is common to all persons
 who fall into fits, to have no remembrance of  what happens during  the
 paroxysm. This young woman not only was insensible of every occurrence
 »nd of the progress of time during her long fit, but her malady had com-
 pletely blotted  out all recollection  of every event before that period, and
 even the traces of alT  knowledge winch she had acquired from the moment
 of her  bfrth till her illness.   I have indeed known a single fit of tiven-
 ty-four hours' duration to destroy the powers  ofthe mind,  and produce
 absolute idiotisra; but that was not the case here.   The mental faculties.
 after a total suspension for four years, were not  destroyed, but reduced to
 an  infant state; and though void of all knowledge, were as capable of ac-
 quiring it as ever.
   It was just thesame with regard  to speech.   And to the proper man- 
PARENTAL
TENDERNESS.
81
agcment of the legs and arms, of ivhich she knew as Uttle at the time of
her recovery as at Uie iustaut of her birth.  Nothing could be more cu-
rious than  to hear her  lisping for some months the namby  pamby  of a
child, and  to trace her progress in the imitation of sounds and the  use
of language.   As soon  as she could converse,  she was told how long she
had been ill,  she cried, but could not believe  it.—When some books
which she had written at school, were shown to her she thought it impos-
sible they could be her's and was positive that the whole must be a mock-
ery.   Iu the course of time, she yielded to the concurrent testimony of
•others  ; but she remained unconcious of any former state of existence.
   Her new attempts to Avalk Avere as  aukward as her attempts to speak;
and she required nearly as much  time to recover the perfect use of her
legs as of her tongue.  Even after she had acquired a considerable  degree
of strength,  she Avanted expertness in her motions, and Avas obliged to
be led about by the arms  like a baby.—Whenever I called  to see her, I
made a point of taking her into the  garden to Avalk with me; but it Avas
with great difficulty that I could prevent her from falling.  We often la-
ment the Aveakness of infancy;  yet Avere we to come full grown into the
world,  we should  not only be as long in learning to walk as infants are,
but our first essays would  be  infinitely more dangerous.
   It is unnecesaiy to trace any farther the steps by which this young W0r
man advanced to the full re-establishment of her health, and to the perfect
use of  all  her mental  and corporeal faculties.—These great ends were
gained by a mode of treatment the very reverse of the enervating plan,
which had been the cause of her long sufferings, but Avhich, happily for
her, wras not afterwards  resumed.   I  shall leave tender parents to make
their own reflections on this case, and shall now only urge it as a fur-
ther caution against the too hasty interment of persons who may seem to
expire in a fit.  Unequivocal proofs of death should always be  waited
for, and every adviseable  means of resuscitation persevered in, when Ave
consider how long appearances may be deceitful, and Iioav unexpectedly
the latent sparks of life may be rekindled.
   Besides the uncommon  instance of this young  woman's  re-animation,
as it may be called, I have  heard of a young lady  in Holland,  who
was restored to her desponding friends, after she had been for  nine  days
apparently in  a state of death.   The  day before her proposed interment,
her doctor  called to take his final leave of her; but fancying that he per-
ceived some vital symptom, he reneived his before hopeless efforts,  and
had the happiness to succeed.  This girl's case differed from that of my
patient in one very remarkable particular:  I am told that, in her seeming-
ly inanimate state, she Avas all the while perfectly conscious of being alive,
though  she could  not stir, nor speak, and that her only terror ivas lest
glie should be buried alive. 
82              ,,  OF  IMFLOYMENTS
                   f     CHAP.  VII.


    OF  EMPLOYMENTS  UNFAVOURABLE  TO  THE

        GROWTH  AND HEALTH OF  CHILDREN.


        THOUGH my remarks on air and exercise render it less ne-
cessary to be vey  minute in my detail of  occupations which preclude
the full enjoyment of those essential requisites, yet some little illustration
in a few instances may have its use.   The children of the rich aud of
the poor are  alike sacrificed to the mistaken views of their parents, the
former by confinement  at  home or at school,  for the sake  of  some
trifling attainments, and the latter, by  premature endeavours to get a
livelihood.   There is, however, a very  material difference  betAveen
both,  as the error in  one case, arising from  fashion or caprice, is infi-
nitely less pardonable  than the  otlier,  which is too often occasioned by
want.
-   It is strange the mothers in the higher ranks of life,  A?ho must  have
felt or frequently observed  the debilitating effects of fashionable modes
of education, should perrist in making their own daughters sit for hours
together at a tambour frame, or at the needle in learning fancy works,
which can never be of the least service, but must do their health and
their form irreparable  injury.   The very postures, in  which they arc
thus employed,  not only tend to distort their pliant limbs and bodies,
 but to impede the action of the principal organs of life,  which require
above all things an expanded chest for the easy  performance of their
respective functions.  I cannot too often repeat that personal deformities,
pale complexions, head-aches,  pains of the stomach,  loss of appetite, in-
digestion, consumptions, and  numberless otlier enemies  of youth and
beauty,  are  the sure consequence of long  coutinuance in a sitting or in-
clining attitude.   What so  many young ladies suffer at a  critical time of
life and the still greater dauger Avhich often awaits them when they bu-
come  wives  aud mothers, are  chiefly owing  to the same cause,—early
confinement in sedentary pursuits; and the  want of frequent exercise in
the open air.                                              ,       f
   To fetter the active motions of children, as soon as they get the use ol
their limbs, is a barbarous opposition to nature : and to do so, under a
p-eteice of improvement, is an insult upon common sense.  It may, in-
deed, be the way to train up enervated puppets, but never to  form ac-
complished men or woman.   I always behold, with much heart-felt con-
cern  poor little creatures often  or twelve years of  age,  and sometimes
younger, who are exhibited by their silly parents as prodigies of learning,
or distinguished for their  extraordinary proficiency  in languages,  in
 elocution? in music, in drawing, or  even in some fnvobus  acquire-
ment    The strength of the mind as  well  as of the body is exhaust-
 ed, and the natural growth of both is checked by such untimely exertions.
 I am not for discouraging the early introduction of youth into  the sweet
 society of the Muses and the Graces; but I  would have them  pay their
 court also to the Goddess of Health, and spend a considerable  part o> 
UNFAVOURABLE  TO CHILDREN.          83
tlieir time, during the above period at least, in her enlivening sports and
gambols.
  It would be foreign to myr immediate purpose to say any  thing farther
of the literary pursuits of boys,  than that more frequent  intervals be-
tween the hours ot study thau are now usual, should be allowed for re-
creation and active exercises.   But a much greater reform is wanted in
female education, the ivholc of which appears to be upon a wrong basis.
I leave to others the moral part of this business, and shall only take a
medical vieAV of the subject.   It  grieves me to see health impaired by a
close application to objects of very little consequence Avhile the most im-
portant qualifications are disregarded.   Every girl should be brought up
with a vieiv of  being a wife and mother; or, whatever her  other accom-
plishments may be, she will prove totally unfit for the discharge of those
duties, on A\hich the affections of her husband, the well-being of her pro-
geny, and her own  happiness, must  depend.   If she herself is languid
aud indolent, how can she hope to bring forth active and vigorous chil-
dren;  and if she knows  nothing of the proper  management  of them,
must she not  have recourse to hirelings,  and trust entirely to their care,
to their skill, and to their fidelity, iuthe  dearest concerns of life?
  It h,  common to see  women, who are supposed to have had a Aery
genteel education, to ignorant,  wheii they come to have children, of
» veiy thing tvith ivhich a mother ought to be acquainted, that the infant
itself is as wise in these matters as its parent.   Had the time spent bv
such females in the acquisition of what can never  be of any  service tc
tliem, bed employeel under the eye of  a sagacious matron in learning
domestic virtues and the art of rearing children, they would have secur-
ed the attachment of their husbands, made tiieir sons and daughters useful
members of society, and been themselves au example and an ornament to
fhe ;•(■?£.
  If a young nn;i be intended for the army or navy, be is sent to the
academy to be instructed in those branches of science which are deemed
necessary for his makiug a figure in the proposed department.  But a
young woman, avIio has got a more  difficult part to act, has no :.uch op-
portunity afforded* her.  She is supposed to require no previous course
of training,—to need no assistance but that of nature, to fit  her for the
discharge of her duties when she  comes to be a mother.   Did she live in
a state of nature?, that idea would not be far wrong, but, in society, every
thing is artificial, and must be learned as an art.
  Tlie art in question,  however, can neither be learned from books, nor
from conversation.   These may have their use, but they will not make
an accomplished nurse.   Indeed, nothing can form this first of characters
but practice; and if such practice is not acquired under some experienced
matron, it will cost many fives to learn it any where else. A mother may
blunder on, as most of them do, till she has  killed a number of children,
before she i* capable of rearing one.   At last,  perhaps, she succeeds—
It is  in this  ivay we find manyr wealth)' citizens, who have had seve-
ral  children, yet die Avithout any, or leave only one to enjoy their ample
fortune.
  All practical things are  the most difficult to learn, because they can
or I«.- be learned from observation and experiment.   Thus I have known a
girl, A\'i!)-e mother had eighteen children, take one of them and bring it
up by tfcfthai'd, merely from Uie force of example and imitation.   Had 
54
OF  EMPLOYMENTS
this girl studied the art under the ablest medical  instructor, en- read Uie
best books that ever were written on the subject,she could not have done
what she effected with the utmost ease, because she had so often wen it
succeed under her  mother's management.
   The inference is very  plain : that acquirements ot little value, or
merely ornamental, ought not to  be assiduously  cultivated  at the exr
pe ise of health, or to the neglect of things of the first importance ; and
that a neat part ofthe time inconsiderately spent by young ladies iu fan-
cy works, and in learning to draw, to paint, or to play upon some musical
instrument;  of which tliey will never feel the want, or which at best
 will afford them only a momentary gratification,  had much better be em-
 ployed in  practical lessons on the duties  of Avives  and mothers, which
 they will be soon called upon to discharge, and their ignorance of which
 will cost them many an aching heart.
    As to the other evil before hinted at, which is owing to poverty,  and
 which consists in putting young children  to sedentary or unwholesome
 employments, in order to get their bread, it is a matter  of the most pain-
 ful consideration, when viewed either by the eye of humanity or ot poli-
 cy    Tlie source of the sweetest pleasures is thus embittered to the pa-
 rent- and society loses the  valuable services of the man, through the
 feeble, untimely, and exhausting efforts of the child. In vain do  we look
 for the full grown fruits of autumn, after a too early expansion ot tl,(
 buds of spring; and we never see a colt, if put too soon to hard labour,
 turn out a  strong and active horse.
    When I touched upon this subject in the first chapter of my   Do-
  mestic Medicine," I thought I could not urge a stronger proof of my as,
  sertion, that the constitutions of children were ruined by such premature
  endeavours to earn a livelihood, than the immense number of  rickety,
  scrophulous, aud diminutive creatures, \hat warm in all our manufac-
  iurin* towns.  There theinfants suffer severely in the very first s age ol
  life for want of proper exercise and proper nursing, while the distressed
  mothers are busy at other work.   The next step almost as soon as they
   eel the use of their legs and arms, is to employ them  in some of the >.ub-
   ordinate or preparatory parts of the manufactures, which are the more
   Sriousto growth and health for requiring constant  confinement rather
   ban act  ve exertion.  Very few of those poor objects attain to maturity,
    id fewer still to manly vigour.   Most of them die very young  and the
   ves ST weak and sickly all their lives, so that incapacity  of labour at
   an^adv^nced age is the sure consequence of the sorry  earnings  of child-

   H°But there is  another set of  devoted beings more  pitiable  still than
   thoseTv,Si I have now described-1 mean the children ha are bound
   loD^nticcato chimney-sweepers.   If any creature can exist ,n a state of
   Sito^caneasroriB a juster object of commiseration than  a  boy
   who is forced to clean chimneys in this country, I an. very much mis-
   taken   Half naked in the most bitter cold, he creeps along the streets
   bv br'eak ofday-the ice cutting through his feet-his legs bent-and
   hfs bX twisted In this state, he is compelled to work his way up those
   *£S£^VB***-any of which  are almost too^-for iica
   to climb   In  order to subdue the terror w Inch he  must feel in his Urst
   attempts  his savage master often lights up some wet straw in the fire-
   plac^vhich  leavls the poor creature no alternative but that of certain 
UNFAVOURABLE  TO  CHILDREN.            &5
suffocation, or  of instantly getting to the top.   I have Avitnessed still
«*reater  cruelty : 1 have more than  once seen a boy, Avhen the chimney
was all in a blaze, forced down the veut, like a bundle of wet rags, to ex-
tinguish the flame.
   On the  very day (the  twenty-second of last October) when I was
come to this part  of my subject, an indictment  for cruelty to a  young
chimney-sweeper happened to be tried  at the  Westminister  sessions.
The wretched sufferer had been decoyed  into the house of a woman who
carried on this  horrid business, but avIio promised to employ him only as
au errauel-boy.   He had not been long there, however, before he was
put to learn the trade, as it is called.  Some domestic lessons were deem-
ed  necessary  to prepare him for public  exhibition.  The child not be-
ing able to climb with the readiness expected, used to be stripped naked
by the  foreman, and Avhipped round  the room with birch rods.  His
boely, legs, aud arms were severely bruised by Uie beatings he had receiv-
ed.  This Avas not all. Theuigh his knees and elboAvshael been rendered
sore by repeated trials, yet when the poor creature could not mount quick
enough, his cruel instructor used to goad him (vvliile in the chimney) ia
the legs and thighs,  by a needle put into  the end of a stick.
   It also came out in the course of the evidence, that unfortunate chil-
dren  of this sort are taught to climb by  being taken to the porch of St.
 George's church,  where, at the risk of tlieir lives, they are obliged to
 mount the perpendicular wall.   I  am always happy to see justice tem-
 pered with mercy, especially when the punishment is at Uie discretion of
 the judge or magistrate ; but after a culprit had been fully convic»ed of
those attrocious acts, I could not help thinking that lenity towards  him
was carried too for in sentencing him only to six months'  imprisonment.
 I am still more grieved to think, that any business which requires such
 dreadful modes of training, should be  tolerated.
    Perhaps i shall be told, that boys so  trained are necessary.  I deny
 the assertion.  Cliimneys are kept clean, without such cruel and danger-
 ous means, not only in many countries  on the continent, but even in some
 parts of our own inland, where the bouses are much higher than in Lon-
 don.   In North Britain, for iustance,  a bunch of furze or of broom an-
 swers the purpose, and does the business cheaper and better.   One  mau
 stands at the top aud another at the bottom of the chimney, when a rope
 is let down by means of a ball; and the bunch of furze or broom, being
 ■properly fastened on, is pulled up and down till the chimney is quite clean-
 eel.   The litti  trouble andexpeuse attending the operation arc the strong-
 est'iiiritements to repeat itso often as to preclude the possibility of chimneys
 ever taking fire.  Is this the case in London, though  hundreds of lives
 are every year sacrificed to the most barbarous method of preventing  dau*
 «-er?  How vain shall we find the lwasts that  are made of mighty im-
 provements, in the  metropolis of the British empire, if we fairty consid-
 er that it U at least  a century behind the meanest village in Uie kingdom;
 in almost every thing that regards the  preservation of human  life!
    I have often heard the plea of necessity urged to justify doing wrong,
 but uc a ev more absurdly than in the employment of boys to clean chim-
  neys.   Experience cleerly proves that it can be much better done without
  them; and shall we,  in perverseoppositiou to reasouand humanity, continue
  a practice which is  equally forbidden by both ? The abolition of the slave-.
 frade ha" of Lite yaars become a ve ry popular topk amoag us : aud th^ 
86                 OF  EMPLOYMENTS,  &l0«

cause of the poor Africans has been pleaded with lips of fire in our sen-  .
ate.   But Avhileour pride bflatteredby the idea of relieving slave* abroad,
we make a set of our fellow-subjects at home inliuitely greater slaves, and
far more miserable !  This is something like the fashionable chimera of
universal philanthropy, which pretends to be alive to the sufferings ofthe
distant Hottentots, but in reality steels the  heart  against spectacles ol
much keener wretchedness in our own streets.
   My late worthy friend,  Jonas Hanway, who literally ncnl about, do-
in<r eood,  used all his influence to ameliorate die condition of those un-
happy creatures : which, iu a certain degree, he elfected.  But there
are some  customs, that  can be thoroughly mended,  only by being com-
pletely abolished.  While boys are forced up chimneys, thy must be mis-
erable  whatever laws are made for their relief.  A law prohibiting the
practice  altogether, would be at once laying the axe to the root of u>
tree ; and the evil admits of no  otlier remedy.
   Had Mr. Hanway taken up  the  matter upon  this ground, he had
snirit and perseverance sufficient to  have carried it  through, a id to have
Attained  an act of parliament for the effectual relief ef the most wretch-
 eel bein-s on the face of the earth.  He confined his benevolent  exertions
 to a  partial alleviation of their miseries, because it had never occurred
 to him, that the climbing boys, as he calls them, where wholly unueces| a-
 rv   What a pity he did not carry  his views a little farther, as, in that
 case, he certainly would have not remained satisfied with any thing short
■ of their total emancipation from such cruel and useless bondage •
    The situation of those children of misery is now become more hopeless
 in consequence of the death of  Lady Montague who used to make such
 of themes could go to her house, happy for at least one day in the long
 and lin-rin- year. 1 often wished to see he* well known talents everted
 ta&ffirthcy could not have  had an abler of a better advocate.

 The M»62"    f h       and the legislature might have been m-
 S^lS^^tlS^ iu suppressing an employment atonce so
   .  .  *;..« onri en dp*radin» to tlie human species.
 *£S2S^^«r eooughin  both houses of P?—*
  ,afe up Subject, wiUiout any other appeal to their feehugs than a

  ^n^hfIre SSd be necessary to finish the -ta**!**




   TV  LwXvhich those poor creatures, if  they live long enough,
   the disorders, with whicntnosev                       deformed  and

   are •^""XiS.Wf. coSpienceof  h/ving theirv"
   stunted m their powbb„t,^       ^  ^               d

   clogged,  and the surlace n  »K       .  (h       subjec, t0 v;mous
   a coat of  dirt composed of soot, sweat, <*c ruey        r-
   maladies unknown *J*££j%»«■     ^^ „,,,,„ is ca.led

   h/thTSrfthe^^  but which the K«e ^-Jf^
   3y oaiuedtheCfe-^

   KKSJSS:  »   -t ie^n, "lekructi. in i,s even,  EsUr- 
©F  ACCIDENTS.
87
pation by the knife, on its first appearance, and the immediate removal of
the part affected, he: looks upon as the only chance of putting a stop to,
or preventing the fatal issue of the disease.  His reflection on the  sub-
ject  does equal honour to his  heart  and to his  understanding.  "  The
fate of these people," says he, " seems singularly hard.   In their early
infancy, they are most frequently treated  with  great brutality, and al-
most starved  with cold and hunger.   They are thrust up narrow, and
sometimes hot chimneys;  where  they  are bruised,  burned, and almost
suffocated ; anel when they get to puberty, they  become  peculiarly lia-
ble to a most noisome, painful, aud fatal disease."
                         CHAP. VIII.

                       OF ACCIDENTS.

      CylllLDREN are not  only lamed and maimed, but they  often
lose their lives by accidents,  owing  to the carlessuerS  or inconsiderate
neglect of nurses aud mothers.  A child should never be left alone  in  a
place of tlanger, or in  any situation where  he may, through his own want
of experience, be exposed to the destructive elements of fire and water.
We daily hear of children  that hi a e been  burned to death,  in conse-
quence of their clothes having caught fire ; and even grown people often
lose  their lives by similar accidents.
   Afflicting events of this kind often take place even under the mother's
eye ; auel, Avhat is surprising, their  frequency does uot prepare womeu
for the most effectual methoel of extinguishing the fire.   Distracted  by
the frightful scene, and the cries of the sufferer, they rush to tear off the
burning clothes.   But, before this can be  effecteel, the mischief is done.
The attempt, therefore shoulel never be maele.  The  clothing instead of
being torn off, ought to be pressed close to the body, and  whatever is  at
hand wrapped over it, so as  to exclude the air, upon which the blaze will
go out.  It is  the action of the air that keeps it alive, anel  increases its
vehemence.  A carpet, a table-cloth, a blanket, any close wrapper, will
instantly extinguish it.   Ladies, whose dress is  so very liable  to  catch
fire, should in such a case  have recourse to these means,  and be their
oavii preservers, instead of ruuning out of the room, fanning the flame,
and uselessly screaming for help,  which comes too late to save them from
 trture s and from death.
   Our newspapers frequently contain accounts of  persons, who, by run-
ning about, not only accelerate their own destruction, but frighten others
into an absolute incapacity of affording them any  assistance.  A case
nearly of this sort very lately fell under my  observa-'ion.   A beautiful
woman, with her clothes in  a blaze, had be:en suffered to run out into ihe
street before any body ventured to approach her.   A  hackney-coach-
man, seeing her in this situation, jumpeel  off  his  box, and wrapping  his
coat  rouuel her, extinguMie'd  the flinies.  Though her life was  saved,
no remedy could be found for the cruel ravages of the fire  on her per-
son.   She lo-i the use of some  of her limbs, -ml Avas most shockingly dis-
figured.   Few people are ignorant of what ought to be done to extinguish 
88
OF ACCIDEN 1 S.
flame: but presence of mind or courage is wanting in the moment of Mid-
den danger, and the consequeuce s  are. of course eleplorable.  I admire
the practical philosophy of the good women in North  Britain,  who arc
employed in  spinning fiax, or tow as they call it.   Whenever ihe flax
round the distaff catches fire by accielent, they immediately wrap their
apron about it and it is  out iu an instant.  Bin where  the fire a Herts an
animated being, especially a darling child, I am afraid few mothers would
have the resolution to act in the same manner.  Nor is this the case with
mothers only.   I have  known a father stand by, and see  his darling daugh-
ter burned to death, without any immediate and rational effort tor her re-
lief : the powers both of  his mind anel body were suspended by  the shock;
 and "he remained like a statue at the very  crisis of the alarming  catastro-
 phe.  Nay, I have known  children carried into the street, that the air
 might extinguish the flame.
    It must be evident enough, from what I have said of  excessive care in
 the treatment of childreu, that I would not have mothers or nurses over-
 solicitous about trifles.   But v. here exposure to danger may be attended
 with irreparable mischief,  it cannot be too  cautiously guarded against.
 I would therefore  have the upper garments of children, when they can
 run about, made of woollen  materials, which do not so readily catch
 fire as manufactures  of flax  and cotton.   I would  also have children
 taught very  early to dread the  fire; and I think that the best way of in.-
 me sin- tlieir minds with the  danger  of coming too near  it,  is to suffer
 them to burn  their fingers slightly, yet  so  as to give them  some pam.
 This would have more effect than a thousand admonitions.
    When children are  cold, they are very apt to get  close to the fire:
 by which means they not only run the risk ot being burned, but of indu-
 cing whitloes or other inflammatory disorders of the extremiti s.   In
 Se cases, however,  I would not have the preventive care  of the nur-
   es or parents carried  too  far.  The actual experience: of  he tingling
  effect wu operate more powerfully than any which can be said to young
  neoDle to make them avoid it: when they have once felt he  smart, a tew
  words to^mind them of  the cause will be  quite sufficient : and they
  wifl easily  acquire the habit  of rubbing their lianda and running about
  rather than going to the fire to warm themselves, after having been out

  intTbehaVle'always been glad  to find those semi-circular irons, called
       /  Lerl „n round fire-places in nurseries, and m  all  the apart-
  'T^Shtehchi^            Ogives me still greater pleasure to

  Twire"                * ^^««^£


  Wei?as gTddy bo^s and givls, may-be exposed, when  .landing or sitting
rendered her lesscapableof asristingthe0^^°up  ,   breast-milk
shock on herself was seriously alarming, it dneti up 
OF ACCIDENTS.
89
and produced a fever, the violence of which left little hopes of her reco-
very for three weeks;  she was then seized with a convulsion fit,. Avliich
came on critically, like that which oftou precedes the eruption of the small
pox in infants, aud is far from being an unfavourable symptom.  Her fit
proved equally salutary; it abated the force of the fever, and she grew
better eveiy day after.   This laely was attended by my excellent friend
the late Dr. John Gregory and myself, avIio had both despaired of her
recovery.
   The accidents from scalding are still more  numerous.   Children are
in continual danger where victuals  are cooking: and among the lower
and middle ranks, the kitchen is the nursery.   One of the finest boys I
ever saw, lost his life in this manner.  He Avas dancing round the kitch-
en, when  a pot full of food for some  domestic animals, which had been
just taken off the fire, stood  in his  way: he fell backwards, aud was so
scalded, that in spite of all my best endeavours,  he died.
   Nothing hot should ever be left within a child's reach;  otherwise he
will very probably pull it over him : in which case, before the clothes
can be got off, he may be scalded to death.  Children are  also apt to
carry every tiling to the mouth; and a veiy smaU quantity of any liquid
boiling hot, will occasion death, if taken into the  stomach.  A melancho-
ly proof of this occurred uot long since.  A child put the spout of a tea-
kettle to its mouth, and drank a little of the boiling water, which proved
almost instantly fatal.  Numberless instances have come to my know-
leelge, of children having pulled off  the table dishes full of hot victuals,
with which they were scalded in a terrible manner.   Indeed, victuals, or
auy thick substances, iu a burning hot state, are  much worse than fluids
as they adhere more closely  to the  skin.
   Perhaps there is not a more painful death, than Uiat which is the con-
sequence of scaleling or burning.   When  instantaneous, it is nothing;
but when lingering, it is dreadful beyond  imagination.   We can only
form sonic imperfect idea of it from the intense pain occasioned by scalds
or burns, though not of deadly effect.  I once had a patient,  about oue
half of whose skin was scaleled, by foiling into  a boiler. Though this man
recovered,yet so great was his agony, that, every time he was  dressed,
he used to beg and pray to be put to death.
   Accidents by cold water, though not so frequent in early life as these
 occasioned by fire,  ought nevertheless to be guarded against with due
 precaution.   Children, who have no idea that these elements are hostile
 to life  are often dead before they know their danger.  Wells and pieces
 of water near houses  are  frequently left open, or without  auy fence
 round them, as if they were designed for traps to allure Uie unwary to
 desti uction.   Is it not we 11 known that young people are fond of looking
 into the water, especially when they cau see tbeirown image or likeness?
 And, is it an uncommon thing for them, when viewing themselves in the
 watery mirror, to tumble in, and to be drowned ?   Even to this day I
 shudder  at the recollection of a draw-well iu my father s garden, without
 the least  railing to keep children at a proper distance.  A thousand times
 in playful mood, have I sported on the margin of the abyss, and cannot
 now  conceive how I escaped a fatal slip.   It is  a weak  security against
 the danger of open  wells, or ponds, or pits, or the like cavities, to tell a
 child to take care.   The effect of such a silly piece of advice is well ex- 
90                     OF  ACCIDENTS.
posed in Gat's fable of the old hen and the young cock, of which the
moral is—
          " Restrain your child —you'll soon believe
          " The text which says we sprung from Eve "
   But it is not o.ity in y ards, aud  gardens that the least slip may some-
times be fatal 10 children; they are often exposed to almost  > much
danger  whvuin doors, by falls in various situations.   I  shall first   'ention
the tia.k and winding 6tair cases,  which remain in  all old houses, espe-
cially iu that part of L'.mdon ivhich is called the city.  Children mint be
en luedivith  a degree of precaution far bcAond their years, to avoid tum-
bling upon those stairs ; and f they do make a feW step, they often roll
from the top to  the  bot.om.  As,  from  the usual lightness of a child, a
leg or an a m is selelom broken by such an accident, little notice is taken
of it at the time; but although it may not seem to do much  hurt for the
present, it often lays the foundation of future maladies.  The fine or-
ganization or structure of the brain may receive a dangerous shock; and
there is reason to believe that the hydroscephalus internus, is sometimes
the consequence of bruises, or blows, or other injuries done to the head.
I lost a most promising boy, through an affection of his brain, which I
thought was owing to a fall from a kitcheu-elresser.
   All children have an inclination to climb, aud to get  upon stools, chairs,
tables, &c.   A fall from one of these is more dangerous than  mothers and
nurses are apt to imagine.  A child's head is large, and, being specifically
heavier than the body, is the part most liable to strike  the ground, and
thus to cmse a concussion of the brain, which may be attended  with fa-
tal consequences.   All the furniture of a nursery  should be loiv, so  as
to preclude at once  the desire of climbing and the danger of falling. The
 tables should also be made without corners, as the se sharp projections of-
 ten do  mischief.  I have already  declared myself a Avarm advocate lor
 indulging the. restless  activity of children, on which their growth and
 health very  much depe .d;  but, till they acquire reason and  experience
 to guide them, it is the business of their parents to take care, that they
 move about, and always remain in a sphere  of perfect safety.
   For the same reason, nurses shouid never  leave any eleadly weapon
 within the reach of ch'Idren.  Knives aud sharp instruments, with which
 they may cut or wound themselves, are very improper  play-things. Yet
 I remember to have read iu some newspaper a curious  story, of several
 lives having been saved by a knife in  the  hand of an  infant.   It hap-
 pened  near one of those extensive woods on the continent, whence  hun-
 gry wolves often sally forth in quest of prey.  The wife of a peasant, who
 lived in a cottage at no great distance, Avas gone out upon some  business ;
 leaviu^ an infant in the cradle, under  the care  of  three or  four more of
 her young family,  one of whom gave a knife to the baby to amuse it.—
 During the mother's absence, a Avolf, impelled by hunger, ruriied into the
 cottage, and made its first snap at the infant's arm, which, being extend-
 ed with the kiifein a playful manner, it eutered the throat of  the rave-
 nous animal, and proved its death.  As the women in  our happy island
 have  no occasion to arm their children against such enemies, I do not
 suppis? that they lrill be tempted, by  the desire of hearing their infants
 cried up as  heroes, to intrust them with weapons, which are far more
 likely  to hurt thau to defend them.
    ;But to return to more serious and necessary precautions: I must take 
OF  ACCIDENTS.                       91
notice of some fatal accidents which frequently occur, though they may
be cosily guarded against.   We daily hear of childreu falling from win-
dows and beiug killcel: this must be owing to the want of proper preser-
vatives ; a feiv bars fixed across the windows of the nursery, or of any
high apartments where children are suffered to play about, would prevent
Hich disasters.  Yet easy as the remedy is, we finel it too often neglected.
How frequently have I  seen, Avith mnch  alarm, childreu hanging  out of
windows in a state of imminent  danger, and no regard paid to them by
any person within 1   this is peculiarly the case with the children  of the
poor in London, who commonly live in the upper stories, and seldom or
never have their  windows secured by bars.   To keep such windows con-
stantly shut would  exclude the fresh  air,  so necessary to health, and
even to existence : while, on the other hand, having them open, Avithout
the guard or defence here  recommended, is  exposing the giddy and
thoughtless to certain mischief.   On the least noise in the street, a child
is apt to run to the window, and, leaning forward in eager gaze, is often
dashed agaiust the pavement.
   In my  former remarks  on hanging cots, my chief aim was to shew
hoAv much safer and more conducive to sleep their gentle motion was than
the a iedent  and elangerous rocking of a cradle.   I have now an observa-
tion of greater exteut to make on beds in general, which is, that they of-
ten prove fatal to chilelreu,  instead of being places of easy and secure re-
pose.   It is too customary for mothers and nurses to take infants into bed
with them for the whole night.   This is always relaxing, and sometimes
attended with the mclancholly effect of suffocation. Either in France or in
Holland, I am not noiv  positive which, there is a prohibitory law against
putting any child  to sleep in the same  bed with  its  mother  or  nurse.
Though we have no such law in England,  maternal care ought to  supply
the want of it, especially as it is not an extraordinary, or a very uncom-
 mon thing to hear of a child's  being smothered by the accidental  rolling
or pressure of a grown person during sleep.
   The use of turn up bedsteads is uot less  noxious or dangerous.—They
 exclude the air from the bed-clothes all day, and rendu- them frouzy and
unAvholesome.  Children may also be inadvertently killed in them.  The
 servant, or perhaps the mother, turns  up the bed in a hurry, without ex-
 amining whether the child is  in it or not : the infant incapable  of ma-
king any noise in this situat on, is smothered before the mistake is found
 out;  and tears Hoav  in vain to remedy what a little caution might haA'e
 prevented,  or what could never have happened in a proper bed.
    Children suffocated in this manner, as Avell as those accidentally over-
 laid, might be sometimes restored to life. Yet I do not recollect any instan-
 ces, except the one mentioned in my  "  Domestic Medicine,"  of its hav-
 ing been done; though it must be as practicable as in cases of droAvning,
 of fits, anel  various o'her casualties, attended with a suspension of seem-
 in" extinction of all the vital powers.   It is not my business, however, to
 sucjrest the use of very precarious restoratives, when the  means  cf pre-
 vention are so easv and certain.
    f should never have done, Avere I to engage in a particular description
 of nl  'I'e dangers 'o which children are exposed in  our streets, partly
 tb .in  b the unit of a good medical police, and partly through the negli-
 gence of  'heir parr ts.   The importance and the necessity of the former,
J may take some other opportunity to enlarge upon; my present wish is, 
92                  OF  HOSPITALS,  &.C.
to excite the attention of mothers to the perils which await tin ii  chil-
dren at almost every corner, when they are suffered to ri'ii about  by
themselves, or  intrusted to  young people who  have neither sufficient
strength nor experience to protect ibem.  It always gives  me great un-
easiness to see infants dandled by girls who are hardly able to hold them
up, or led about by others  Avhose giddiness is more  likely  to plunge
them into danger than to  keep them out of it.   A: least half the acci-
dents that befal children,  both within doors anel without, are owing to
Uie folly,  the cruelty, I had almost saiel the murderous crim'.nality of
leaving one child to the care of another, who,  though a little oleler, is
not less in want of a mother's or a nurse's vigilance.
   Let me ask any parent of  common sense and  tender feelings, whether
it can be  fairly  considered as much short of murder,  to let a little girl
of s veil  or eight years of age take an infaut out in her arms, or lead a-
bout younger children than herself, in a city, were carts aud  carriages
of every  description are  rattling along—where horses are galloping—
bullocks  furiously driven—and crowds of people constantly ru hing with
thoughtless impetuosity ?  Is it a wonder,  tlieu, to hear every day of
children run over,  their legs or arms broken, their brains dashed out, or
their bodies crushed to atoms,  in the midst of those dangers to which
they are  so inconsiderately exposed ?   Though the immediate authors
of such disasters deserve in  most cases to be hanged, yet I do not know
how  any jury could  conscientiously  acquit  the negligent parent of
 some participation in the crime.
   Let me therefore conjure mothers, in particular, never to permit their
youn<* children to go afoneinto the streets, and  never to rely upon  one
 child's protection'of another.  It is  also a mother's duty to make her
 children, as soon as they are capable of it, aware  of danger, anel  to in-
 s>'ruct them how to  avoid  the numberless enemies  that beset them on all
 side*  and too  often prove  fatal  to infant life.  A good police  would
 certainly *o a great way towards the prevention of many of those disas-
 ters whicirso frequently occur in our streets,  but no laws can ever be
 made that will supercede the mother's care and attention in watching over
 the health and safety of her children.
                          CHAP.  IX.

OF FOUNDLING  HOSPITALS, AND OTHER CHARITABLE INSTITUTIONS FOR
          THE  REARING OF POOR OR DESERTED CHILDREN.

      THE proper qualifications and indispensable duties of mothers
having to far engaged our attention, I am uot without hopes that the re-
marks which have been madeon those important subjects will be of some
service  in the middling and higher ranks of  life.  But it gives me  pain
to think, that there are great numbers of poor women, who do uot  want
so much to be taught,  as to be enabled to discharge their duty.  Ihey
would ivillingly devote all their  tinie aud care to the  nuising of  heu
children; Imt the want of common necessaries forces them to be otiie,-
wise employed.  They see tlieir infants laugukh; but the dread of fa- 
OF HOSPITALS,  &C.
93
mine is an object of still keener ccncern.   They are not dead to the im-
pulses of natural affection; but its warm emotions in their  he arts are
soon chilleel by distress.   It is poverty, whose icy  hanel congeals tlie
streams of maternal comfort,  and whose withering breath blasts some of
the bii.e' tbuds of human life.
   Vanity is more gratified than  reison, by the  acknowledgment that
there is not any country iu the known world ivhich is so much distinguish-
ed as Englanel for its charitable institutions.  How mortifying is it to
add,  that there is not any  country in Avhich charity is  so much abused
and perverted !  When I look at such a building as the FoundlingHos-
pital, much more like a palace than a nursery for poor  children; when
I  consider the vast sums laiel out in raioing that structure, and the still
greater sums Avhich have since been expended and continue to be expen-
ded upon the most  pompous auel useless parts of the establishment;—I
cannot help crying out with Rochkfoucault, that virtue or charily would
never go so far, if pride did not  keep her company.
   It is much to be lamented,  that the plans for the relief both of the old
and the young, in eveiy pitiable situation, which at different times have
been encouraged by the people of Ei gland, thcu'd all be connected with
superb builelings, profitable jobs, and a train of offices anel employments
which prey upon the funds, and render their use to the public very small,
in comparison to what it might otherwise haA'e been.  This gross misappli-
cation—this waste of charitable contributions, is net the only thing to be
found fault with in the management of the Fouudling Hospital.   Never
did any institution hold out fairer claims to the  support of the benevo-
lent and  humane, and never  w as any  more  liberally  patronised; yet,
from ignorance anel inexperience, instead of preserving  the lives of chil-
dren, it has too frequently  accelerated their death.
   The first suggestion of a FouPMiing Hospital was certainly very plau-
sible; its professed object ivas to rescue from misery aud destruction the
innocent victims that would otherwise be doomed to both by the  deser-
tion of their parents.   Thus  many valuable lives would be saved to so-
ciety, and such a resource Avoulel be opened  to u;dbrtuuate  mothers, as
would remove, or  considerably weaken* any temptation to the commis-
sion of the most unnatural acts.   The prude, the bigot, aud the canting
hypocrite, might, indeed, condemn such a supposed encouragement to the
illicit union of the sexes;  but humanity can never look upon the preser-
vation of a human being as a crime.
   An undertaking, therefore, of  so specious a tendency, could not fail to
meet  Avith the  most generous  support.   Independently of  all private
contributions, sixty thousand pounds  a year out of the public money
were for  several years appropriated by parliament to so laudable a pur-
pose.  A palace, as I before observed, instead of a nursery, 60on reareel
its head.   The doors were thrown open for  the  admission of deserted
children  from all parts, not to be nursed and educated there, but to be
sent down to tlie distant, counties and in their conveyance numbers of the
poor infants perished.  I am  not here miking a  vague or an imaginary
c a I.'illation;  I am statiug what foil uneler my  own notice, when I was
physician to a Airy considerable; branch of the Foundling Hospital.   I
have elseivhere described the  mortality which was occasioned by the im-
proper use o'i medicines among those who had survived tiie  fatigues of
the journey.   I have also  explained the very easy means I made use of 
94
OF HOSPITALS,  &C.
to put a stop to such afflicting ravages, while the children and their nur-
ses were under  my inspection and control.  But all my remonstrances
against having them dragged away from those uurses too soon, crowded
into hospitals, confined iu schools, or put out to  unhealthy employment?,
were unavailing.   1 was told that the established rules auel customs of
the hospital could not be deviated from, though their evident effect was
to destroy health, and to enfeeble the miuds as  well as the bodies of the
unfortunate victims.
   I have often viewed with indignation the fallacious reports of the num-
bers of childreu said  to be brdUght up and provided for  at such place s.
I am very confide  t,  Uiat were  au accurate list made out of those  who
perished through unseasonable removals, improper treatment, bad nursing,
diseases occasioned by too early confinement in  schools, as ivell as  by
infection in  hospitals, and,  lastly, through what I call murderous occu-
pations, it Avould appear that not one in ten of the iufants received there,
ever lived to become a useful member of society.
   But, besides the evils here hinted at, there is a fundamental error  iu
the plan itself, not only of the Founelling Hospital, but of all parochial
 and other charitable institutions for the maintenance and eelucatiou of poor
childreu.   Every scheme which tends to separate the parent from the
child, whatever imposing appearance it may wear, is a bad one, aud will
eventually be found to do mischief.   It is flying in the face of nature, a
thing that never can be  done with impunity: it is rending  asunder the
first and the strongest bonds of society—parental and filial  affection :  it
is perversely attempting to blunt and destroy the finest feeling of the heart,
motherly love, without  which the human species could not long exist.
All nature points out the mother for  the  uurse of every  thing that is
brought forth  alive; nor can her place be supplied by any institution.
Those who make the experiment will soon be convinced of their teme-
rity and folly.
   A few years ago, I  met with a letter addressed to Lord  Filzwilliam,
then viceroy of Ireland, on the  subject of the protestant charity schools
in that country.  As the author's  sentiments agree with mine in many
points, and particularly Avith respect to the pernicious  effects of  sepa-
rating' children from  their  parents for the sake  of  education,  I shall
here&give them in his own words.  Some people  may think the  lan-
guage too strong; but the nature of the subject required the most poiu-
ted energy.
   " My Lord, I  do request that you will  take the trouble ot reading  the
account of this inveterately illiberal institution in any common almanac;
and every Une will, I think, carry its own  reprobation to au ingenuous
mind.  The children, as it is regulated in their unnatural system, are all
placed in schools remote from their former abodes; or, in  other words,
they are torn from all the  sweet associations that attend the interesting
idea of home.  This is, indeed,  a charity which thrives on the extinction
of  all the other charities of life;  and the feelings of nature must be erad-
icated, before they can become nurslings of the state.  They are banish-
ed from their  vicinage to a remote quarter of the kingdom, where all  the
traces and ties of kindred  are lost  and  cut off; all habitudes of  the
heart smothered in the  cradle;  and,  when sent into the  ivorld,  thry
know not the spot which gave them birth,  the  mother  that bore  them,
nor the blood that flows in their  veins.   I think of the speech ol Logan 
FOR POOR CHILDREN.
95
the Indian chief, when all his kindred were murelered— There remains
not a drop ojinyblocd in the veins of any living creature."
  The writer here takes occasion to direct his remarks to the heart, as
well as to the head ;—to exert all bis powers of pathetic, as well a* ar-
gumentative eloquence.  " It  is," says he, " a cold, cheerless, and for-
lorn feeling of this nature, which must freeze the young blood, aud,  pla-
cing the mind in a state of sullen insulation, makes its  reactiou upon so-
ciety rather dangerous thau beneficial.   The ties of kindred operate  as
a sort of external conscience upon the conduct of  meu, deterring them
from the commission of great crimes, for fear ofthe disgrace which would
be reflected on their relations.   There is a family pride, a domesUc  hon-
our, anion* the  very poorest and loivest  of the community,  that guards
and sanctions, and is a sort of God for the little household.  Even the
the highest have such workings of nature.  Lady Macbeth exclaims,
had lie not resembled my father when he slept, I had done vt.   The ima-
gined countenance  of her father  was the only conscience  left, and came
between her and murder.   But  charter school  policy makes a sort of
massacre of all  those domestic molalities which operate upon character
 and conduct, without being able to put a higher  and nobler  principle ot
 action in their place; and thus, I fear, the same policy has bred up many
 victims for  the  laws, while they only thought of making proselytes to

 l'  Though  the subject is here  considered only in a  moral light,  yet I
 could not resist  the temptation to make a short extract from such a mas-
 terly  letter; and I do  not  think  that auy  of  my readers will  be
 displeased at the perusal  of it.   But I  have still   less occasion to  make
 any   apology,  for  stating the  author's opinion of  the mo t effectual
 means of remedying the evil,  as the leading feature of his plan  of
 reform  exactly corresponds  with what I recommended  above thirty
 years ago.  I  was  then  lamenting that poverty often  obliged moth-
 on to neglect their offspring, in order to procure the necessaries of life.
 I observed, that,  iu such cases, it  became the interest as we  as  the
 duty of the public  to assist them ;  but I  contended that ten thousand
 rimes more benefit  would accrue, to the state,  by  enabling the poor to
 bri" up uSr own children,  than from all  the hospitals that ever
 could be erected with that view.  In a subsequent edition of those re-
 marks  I added, that, if it were made the interest of the  poor to keep
  She  ^cldldren  alive, we  should lose  but very  few of them;  and  that a
   m'  1 premium given annually to each poor family for every child they
  tad .Kvc at the year's  end. would  save more infant lives than if the
  whole revenue of  the crown were expended on hospitals for that purpose.
    It gave me  great pleasure to find, that the writer just now quoted  had
  reasonediTthe same manner on the hundreds of thousands which  had
  heelexpended, merely, he says, to create foundlingsr; the  tenth part of
  S&y employed, would have been  of infinitely more service
  to society  The  proper mode of employing charitable contributions,
  he dunks, should consist chiefly in giving premiums to  such parents"
    ave shewn most zeal and capacity in educating their children.   Thus,
    otwi^1 standing the different points of view in which  we examine the
   abule  of so important a part of public charities,  the very means which
   I advised for saving the lives, and promoting the bodily health  of .n- 
96
OF HOSPITALS, &C.
fants, appear to him the most conducive abo to the intellectual anel moral
improvement.'
  The prejudices iu favour of old institutions must be strong, indeed,
Avhen they can resist the clearest evidence of  fncts, anel the plain  de-
ductions of fair argument.  Yt-t, in  the  question before us,  how  the
public, or the state, may most effectually contribute to the  nursing anel
rearing of poor infants, one would suppose that no appeal  to pat ex-
perience, nor  any great depth of reasoning, were necessary  t.> demon-
strate the impropriety of separating children  from their parents.  IN a-
fure* forms the chain that binds them ;  anel, if possible, it should never be
broken.   I have shewn how the lives of the mother  and the child •.•ve
entwined, not only dining pregnancy, but after  delivery.   To part them
is to endanger the health and  existence of both.  They are equally ne-
cessary to each other's Avell-being;  and the longer they are kept togeth-
er,  the more sensible they become of the duties they owe to one another,
which, when faithfully discharged,  teid  greatly to  increase  the sum of
human happiness.
   But hoAv are avc to expect that any regard will be paid to this doctrine
by narrow-minded unfeeling overseers of the poor, who make a greater
merit of saving a shilling to their parish, than of saving fifty lives to the
community ?  We now and then hear of  such  persons being dragged i,'
to our courts  of justice, to answer for their cruelty to pregnant Avomen ;
but  no account is kept, and of course no cognizance can be taken, ofthe
immense number  of infants that are torn  in our parochial  receptacles,
from the  arms of their distressed mothers, and are  consigneel to  an un-
timely death, or to certain debility and protracted wretchedness.  Even
the  sIioav of  humanity in some of those places, serves only to  excite our
 stronger indignation.  It is a cobAved, through which the  penetrating
 eye can easily see Avritten up in letters of blood  children murdered here
 under the sanction of  charity.
   Are we not always shocked at reading or hearing any  accounts of the
 barbarous policy that prevails in China, where avaricious as well as dis-
tressed parents are encouraged by the permission  of the law, and by the
 force of example, to destroy their female children in order to  avoid the
 expense of rearing them ?  Anel is there a father or a mother in  Great-
 Britain, who would not join in a general outcry against an act of parlia-
 ment for the immediate drowning  of all infants taken to parish work-
 houses ?   Yet, humanity itself must acknowledge that fostant death 1, in-
 finitely preferable to a lingering existence in a state of pain, of misery,
 of continual suffering and disease.   1 do not, therefore, hesitate to assert,
 that such policy as that of the Chinese, or such an act ol parliament as 1
 have now mentioned,  would, in reality,  be an act of mercy, contrasted
 with thp present most barbarous, most inhuman, and  most detestable me-
 thod of taking carb, as it is fohely called, of poor infants thrown upon the

 ^Srothin" was left undone by the late Jonas  Hanway to probe this sore
 to the bottom.   He spared neither time, pains, nor expense,  to procure
 the fullest information on the subject, before he published his   F ea  or
 mercy to the children of the poor."   He there states, as the result of hw
 inquiries and calculations, that not more than one in seventy of the chil-
 dren consigned to the parish,  ever attained to mature age; and that even
 that one, seldom became an  useful member of the community.   Among 
JFOR  POOR  CHILDREN.                 97
 many  instances of the most horrid  nature, he takes notice of a memo-
 randum  he met AviUi in the books of a certain parish, where the names
 of particular nurses were inserted, AviUi the remark of tlieir being " ex-
 cellent killing nurses."—Tins testimonial of their expertness in murder,
 was deemed b) the overseers, who bad tried them, the strongest recom-
 mendation to constant employment.
   Let it not be supposed, that I mean to involve all overseers of the poor
 in one general charge of infanticide.  1  knoiv several of them  to be
 very amiable and tender-hearted men, who would do every thing in
 tlieir power to promote the ends of true charity and the real interests of
 humanity, were they not  tied down  by the  established rules of their
 office.   That part of the institution which relates to the nursing and
 rearing of children, being radically wrong, the most zealous exertions of
 any individual, during his short continuance in office, will operate but as
 a temporary palliative of  an evil in its own nature incurable.   It is not
 a partial reform, but a total change of system, that can in such cases be
 productive of any good effect.
   The supporters of Founelling Hospitals may imagine, Uiat a justifica-
 tion of their plan is implied even in my censures of parochial establish-
 ments for poor children.  They may say, that the laudable end of their
 charity is not to separate  infants from their mothers, but to provide for
 those from  whom cruel and  unnatural mothers  have separated  them-
 selves.   I before paid the just tribute of applause to the spirit of such
 an institution, and to its professed objects; but I lamented the abuses
 Avhich bad arisen out of it, or rather, which were  inseparably connected
 Arith the execution of the scheme.  Its obvious tendency and its actual
 effect  have been to create foundlings,— to encourage  the  desertion of
 young children, Avhoni many of their parents Avould never have consign-
 ed to a receptacle of that  sort,  but from cruel  necessity, and from a
 A'ain hope that due care would be taken of the poor creatures.   I  have
 shewn the  exteut of that  care, the dreadful sweep of mortality which
 accompanied it, and its consequent insufficiency to promote the desired
 end.
   I  would not however have Foundling  Hospitals entirely  abolished.
 I would cneleavour,  in the first place,  to  render them less  necessary,
 by a method whic'i I  shall fully explain in the uext  chapter, and of
 Avhich the great  object Aiill be to take aivay from poor  mothers all
 temptation  to abandon their children.   But  as  some women may  be
 prompted, by other motives Uiau that of want, to  destroy  their young,
 let there be a receptacle ever open for the rescue of such  victims, and
 for the prevention of such unnatural crimes.  If ray plan for the relief of
 jioverty, above hinted at,  be carried into full effect, the number of foun-
 dlings of the latter description will always be small, aud will not require
 any very expensive establishment. There will be  no occasion for shoAvy
 buildings—no room for lucrative jobs, offices, or appointments.   Two or
 three trustees, Avithout salary or emolument, and actuated solely by hu-
 mane and chariinbfo motives, will be sufficient to receive the money, and
 to lay it out according to well-regulated and maturely considered instruc-
 tions.  The pi  sent abuses are  very  great and flagrant; but the reform
 is very easy, if it be zealously undertaken and persevered in by men of
talci's and virtue.  I take; it for granted that such persons will also pos-
sess dignity of mind enough  iod;-spi>e» the wretched suggestions of igae^ 
98               PLAN  FOR  PRESERVING
ranee, of prejudice, of envy, malignity, sordid interest, and disappointed
vanity.
  The foregoing remarks are  purposely  confined to some of our most
popular establishments for the nursing and rearing of childreu. It would
lead me too far to  enter  into a detail of all the schemes ivhich have as
sumed the like name of charitable institutions in the neighbourhood  of
Loidon alone.   The  former have at least the merit of having beeu well
inteneled ; but most of the latter are founded in fraud, and have ho oth-
er aim but to enrich some artful projector, at the expense of public credu-
lity.  This is an inexhaustible fuud for any mau who can invent a quack
medicine, a neiv mode  of faith, or the plan of some specious charity.
We have seen footman in the first department, coal-heavers in the se-
cond, and swindlers in the third, driving their chariots with  rival splen-
dor and  success.  But the victims of the last description are most to be
pitied, because  they  are poor, inuocent, aud helpless children ; while
the dupes ofthe two first, being people of mature years and experience,
cannot lay claim  to any compassion for sufferiug not only their purses,
but th^ir very souls and bodies, to be  sported with by ignorant and au-
 dacious  impostors.
                           CHAP.  X.

SKETCH OF A PLAN  FOR THE  PRESERVATION AND
       IMPROVEMENT  OF THE HUMAN SPECIES.

       ^£RE this  subject to be discussed Avith a degree of extent
suited to  its importance, it Avould require a large volume.  But I mean
to touch only ou a few of the principal points, merely with the hope of
exciting more  general attention to a matter, which, though of the high-
est concern, has  hitherto been  very slightly considered!   I  shall  not
dwell upon  truths Avhich are olmous to almost every  person of com-
mon understanding, that the resources and stability of a state depends up-
on the number, vigour, and industry of its subjects;  and, on the contraiy
that where little value is set on the increase of population, on the growth,
health, or life  of man, the political fabric, however showy,  stands on a
rotten foundation, and must sooner or liter sink iuto an abyss dug out ol
its own inhumanity.  It is enough to meutiou these truths, in order to se-
cure the ready assent of all thinking people ; but  the practical inferen-
 ces to be drawn from them may admit of  a great diversity  of opinions.
 The plan which I am about to propose, whether  approved ot, or  not,
 may be productive of  one eood effect at least, that of exercising the in-
 genuity of  others, and perhaps of conducting public and private charity
 to more useful purposes than those to which they are now applied
    I hope I need not go  over the ground  again,  or repeat my termer
 arguments, to  prove that there is not any law  of natuie  so clear, so
 forcible,  or  so sacred  as that which ordains every mother to be the nurse
 of her own young.   The well-being of both, as I before observed, de-
 pe<^ on the faithful discharge of this duty.  Every attempt lo^ divert
 the breast-milk from its proper channels,  endangers the mother s tile;
 and it is beyond the power of wealth to procure, or of art to dcA ise, any 
THE  HUMAN  SPECIES.
m
nutriment so congenial to the constitution of the infant, as the very  jui-
ces of which it is composed, and which have so long sustained  it in the
womb.   It is equally impossible to supply the  tender care and  unweari-
ed attention of a parent; anel  the rich, Avho trust to hirelings, find by
Avoeful e'xperie nee, that half their children perish in early life.   Is  it a
wonder, then,  that a far greater mortality should await the poor infants
thrown upou the parish, or consigned to au hospital, where no individual
is interested in their preservation?   I have faithfully stated, as a  mat-
ter which came  within the sphere of my oavu knowledge, that nine out of
ten of the descried foundlings died before they attained to maturity; and
it appears from  Mr. Hanway's unquestionable account,  that sixty-nine
out of seventy of the poor parish children perish iu the  same  untimely
manner.   Can it therefore be called charity to persevere iu  measures
which are so destructive  to the population  of the countiy ?
   I before suggested what appeared to me the best substitute for'a Found-
ling Hospital, confiued in its objects to  the preservation  01 such child-
ren as might otherwise perhh by neglect, and of such  as  may  be depri-
ved of their mothers at an early age by the "hand of fate."   Poor or-
phans and deserted infants being in the same predicament, though  from
different causes, must be reared  by strangers.  The only expedient in
these unavoidable deviations from natuie, is to  place the children under
the care of nurses of unexceptionable character, iu a healthy part of the
country, anel not to take them away till of age to be put  apprentices.
This very circumstance  will prompt every nurse to use her best endea-
vours to rear  a  child Avho is to stay with her, if  he thrives and does well
till be is fourteen years of age.   It is the only chance of making a stran-
ger acepiire in time a materuul affection for her  nursling.  It is also the
only chance of a poor child's acquiring a good  constitution, and that kind
of early education which is best suited to rural employmerts.
   But, for the relief of poor Avomen, Avho iu pregnancy may be exposed
to numberless afflictions, and who, after delivery, may often be forced to
part with their children, I would not recommend either  hospitals or pa-
rish  work-houses.  These  receptacles are little better  than  half-way
bouses, or conductors to Uie grave. In their room,  I would have a fund
established to afford ineligent mothers eArery necessary  comfort and as-
sistance at their own habitations,  during pregnancy as well as in child-
bed, and afterwards to enable them to nurse aud bring up  their infants
themselves.   By these means more lives Avould be preserved than by all
the charitable institutions now existing in this country, without cos'ing
one  half of the  money,  or  alienating the hearts of children from  their
parents.
   It is  impossible, Avithout  heart-felt sorroiv, to think of  the immense
numbers of fine children that are lost for Avaut  of a little timely aid to
ivothcivi.  How many  of these- poor women pine with their offspring in
obscurity, and in un:r,;tiliiu>; struggles for their support!  The dread of
ill treatment of  diseases, ed' death, and fVhat  is still more  terrible to a
delicate miud) the dread of shame, keeps  them from Avork-houses and
ho-p:faK   Tlieir groans are unheard—their wants  unpitied—and they
pas-; like silent shadows to the gnve!
   IL v.  manv others, no lets tender!;. ■Utaehecl to their young, are driven
bv exir.'-me distress to leave them to the very uncertain  care of others,
aud to hire out their breasts, aud .heir own distracted attention,  to a straa- 
100
PLAN  FOR  PRESERVING
ger!  When a mother abandons her child, to suckle that of another wo-
man, one of the infants is almost sure to die; and it frequently happen:.
that both share the same fate.
   There is a third class of truly pitiable objects, though too often re-
garded with cruel indifference and contempt;  I mean the poor women
Avhora we daily see begging with two, tiiree or more childi. n, and entire-
ly deoendant on so precarious a resource for a morsel of bread.  While
these can h% under hedges, and get scraps of food they ma a live; but
should  a severe Avinter  overtake them, when  they must cling to the
rock for shelter, they  will all be lost.  It is not unlikely that man) of
those poor infants may be the issue of men who have fought for their
country,  and that they were turned out of house and harbour lest they
should become troublesome to the parish.
   Can public or private charity be better employed than  in preserving
so many lives to the state ?  Anel how are they to be prese i veil ?   Not
by tearing the poor children from the arms of their mothers, and sending
tliem to hospitals and work-houses, to be put under the care of " cxcJ-
lent killing nurses;"—but by enabling the mothers to nurse them agreea-
bly to the designs of nature, and thus rendering fertility, not what know
is, a curse to the poor, but the source of the sweetest pleasures, and the:
greatest of all blessings.  A very small part of the vast sums collected in
this kingdom by taxes, under the title of poor rates, and  by voluntary
contributions, ivoujd be fully sufficient for the proposed fund; and I am
persuaded that the wisdom and humanity of parliament anel of govern-
 ment could not be better exerted,  than in preparing aud carrying into
 effect either this, or some other more advisable plan, for saving the lives
 of such an incalculable  number of devoted victims.
    Vanity, as I before observed, has a very great share in the erection
 and support of  alms-houses; or the rich and the truly humaue would rea-
 dily discover in the hints now given, a much more useful as well as a
 more charitable method of employing their superfluous wealth.   I hope,
 however, that  the  conscious pleasure of doing real  good, will induce
 many ladies, blessed with affluence, to assist poor women to nurse and
 rear their children  in their own little huts or habitations, though not in-
 scribed on the outside with any vain compliment to the pride of a pat-
 roness or a founder. Is not the sight of a rising family, who are indebted
 to you for health, and even for existence, a thousand times more gratifying
 to the human heart, than the silly ostentation or parade of a public clia-

 "'it* would imply a very unbecoming doubt of the good sense anel na-
 tural feelings of my readers, to dwell any longer on this head; but many
 of them may think the other part of my plan, expressed m the title o
 the present chapter, anel having  for its  avowed object the improvem.d
 af £> human species, a little romantic,   Yet IIflatter mysell t>aI  hall
 be able to prove, that there is nothing of fanciful  or impracticable theo-
 ry in the suggestion; anel that the improvement, as well as the preserva-
 tion of the human  species, may be effectually promoted  by the same
 means-well-timed assistance, and proper encouragement to mothers
    In the first chapter of this work I  threw out some hints on the pi opci
 choice of wives and or husbands,  with a view to the pocreation ot a
 healthy and vigorous issue; and  I lamented that the impulses of natural
 inclination  w?p too  often checked  iu civilized society by the mem.-. 
THE  HUMAN  SPECIES.
101
pas to as of aA'arice and false pride.   I aho took notice of cases in Avhich
marriage hud  been forbidden by tin: legislators  of different countries.
But though it would be difficult to frame, and to enforce any complete
system of  laws for  regulating the union of the sexes; and Uiougb  such
legal restraints on marriagejs Avould  be  incompatible with the  liberty of
individuals in a free government like  ours,  yet it is in the power of
every state to encourage die rearing of  fine  children, by gi anting to
every mother a premium annually, iu proportion  to the  age'and number
of the healthy children she brought up.  The prospect of a liberal and
honourable reward at the end of every year, would encourage mothers
to exert all their skill, and use every endeavour  to rear a  numerous and
healthy offspring.   It would excite  a general emulation among mothers;
and the object of the virtuous struggle  would be, who should have  the
finest children.   The name of  Cornelia, that  famous Roman mother,
would  no  longer stand alone on the records of maternal affaglion:   But
English Avomen, Avhen requested to shew their jewels or thelrphrightest or-
naments, would throw open the nursery, and exhibit  a lovely family to
the spectator's admiring gaze.
   Let it not be frivolously objected, that  a fond mother cannot want, or
cannot feel a  stronger stimulus, than uatural affection, to make her take
care of her child.   Poor women are forccel by keen distress to neglect
tlieir infants in order to earn a  bit of bread.   They require therefore
present supplies, and the assurance of a future reward; not merely  to in-
duce them, but iu fact to enable them to bestoiv more time and attention
upon this one important object.  Again, then, I must assert, that a part of
the public money, as well as of  private charitable contributions, cannot
be applied to  a better purpose, than to the establishment of a fund for tho
support and encouragement of such mothers.    The good effects of this
plan would for  exceed any present conjecture or calculation.^ The po-
pulation of the country would increase  with almost inconceivable rapidi-
ty.  Instcaelof  punfoese, deformity, diseases, and early deaths, the ri-
sing generatio-i would be distinguished from their health,  beauty and vi-
gour ;  and we should see a stout and hardy race spring up, to repay with
usury, in valuable services to the state, the sums expended in minting
and rearing  them.  I do not knoiv any one  institution upon earth, in
which humanity and  enlightened policy would  be  found more happily
uni'ed.
   The effects of premiums have been proved in a  variety of other in-
stances, such as the culture of vegetables, the growth of flax, of  hemp,
of potatoes, the  planting of trees, and the improvement of the breed of
 cattle.   Is it not a matter of just surprise that no attention of this sort
should ever  have been paiel to the  personal or  bodily improvement of
the human species?   We knoAv that the most teneler plaut is not more
 susceptible of any shape or form than infant man.   AVe know that bis
 strength and  figure are  certainly as improveable as diote of any other
 animal, were proper methods pursued for the accomplishment of such de-
 sirable purposes.  Yet the breed of men is alone neglected, while  every
 effort  of  ingenuity is called forth,  and the  resources of  wealth arc ex-
 hausted, in experiments to improve the breed of sheep, of horses, and of
 oxen!                                            , .    i •
   I never met with more than one man who took up tins subject on a se-
 rious ground.   His plan  av;>s a good cne  had  he  possessed sufficient 
102          PLAN  FOR  PRESERVING,  CCC.
means to carry it into execution.  He proposed to purchase a snudl isl-
and, and to plaut it with as many people of both sexes as it would very
comfortably maintain.  Of these, he meant to supcriuU-iid the diet, oc-
cupations, marriages, and the  management of tlieir  children,  wbh  a
vie* to try how  far the breed might be improved.  It was a speculation
Avorthy of an enlarged miuel.  Were every person of landed property in
the kingdom, of this gentleman's w-ay of thinking, and could our country
squires  in particular be induced to pay half as  much attention to the
breed of men, as to that of dogs,  horses, aud cattle,  the progress of the
humau species to perfection would become  mere rapid, and more aston-
ishing, than the degeneracy so often complained of in every successive age.
   Nor would this progressive  improvement of man be confined to the
body only; it would extend itself also to the mind.  Every thing great
or good in future life, must be the effect of early impressions;  anel by
whom are »lhose impressions to be made but by mothers;  who are meist
interested in  i!:c consequences?   Their instructions and example will
have a  lasting influence, and of course, will go farther to form the morals,
than all the clocmcnce of the pulpit, the efforts of  schoolmasters, or the
corrective power of the civil magistrate, who may, indeed, punish crimes,
buUannol implant the seeds of virtue.  If these are not sown in child-
hood, they will  never take deep root; and where they are uot  found to
grow, every vice will spring up with baneful luxuriance.
   In this view cf  tlie subject I could easily find a thousand arguments
to enforce the political importance of  the plan which I have suggested :
but I undertook  only to shew that perfect health and growth, that per-
sonal beauty and vigour, were most likely to be the fruits of the well-di-
rected and well-encouraged care of mothers in the nursing and  rearing
of their children.  Other authors have enlarged  on the culture ot the
heart and the understanding, the  first  and  chief part of which they al
acknowledge to be the incontestible province of mothers.   The  eloquent
writer whom I have repeatedly quoted, and who has taken some pains to
illustrate this point, argues with great justness, that if the early part ol ed-
ucation, which  concerns us most, had been designee  for  lathers, tlie
 Author of  natuie  would doubtless have  furnished them with milk
 for the  nourishment of their children.   It  is  in concurrence with
 his opinion,  that  I  have addressed  tins  little book  of instruction*
 to females; and as  he has very  beautifully compared infant man to a
 shrub exposed to  numberless injuries m thelngh way of life, I shall join
 him in calling on  the tender and provident mother, to preserve the rising
 shrub from the shocks of human prejudice.   I shall say to her  almoaLi..
 his words, Cultivate, water the young plant before it die; so shall its fruit
 be hereafter delicious to your task.  Erect an early fence round the dis-
 position qf your clM: otliers may delineate Us extent; but it remains with
you only to raise the barrier. 
APPENDIX.
     WHEN I first turned my attention to the nursing and management
of children, the late Dr. Cadogan's pamphlet on that subject fell into my
hands.  1 perused it Avith great pleasure, but soon lost it : and though I
have been in quest of it for above forty years, I never could set my eyes
upon it till within these feiv days ; wliich makes  me conclude that it is
out of print.   That so  valuable a fragment may not be lost; 1 shall msert
the principal part of it  in this Appendix ; and I hope it will render the
book more extensively useful, and at the same time, tend to corroborate
my sentiments  concerning mothers.
  " In my opinion," says the ingenious writer whom I am noiv quo-
ting, " the business of nursing  has been too long  fatally left to the man-
agement of women, who caunot be supposed to have proper knoivledge
to fit them for  such a task, notwithstanding they look upon it to be their
oAvn province.  What I mean is, a  philosophic knowledge of nature, to
be acquired only  by learned observation  aud experience, and Avhich
therefore the unlearned  must be uicapable of.   They may presume upon
the examples and transmitted  customs of tlieir great grandmothers, avIio
were taught by the physicians, of their unenlightened days ; when phy-
sicians, as appears by late discoveries, ivere mistaken in many things, be-
ing led away by hypothetical  reasonings to entertain very wild conceits,
in which they  were greatly bewildered themselves, and misled others to
believe I knoAv not Avhat strange unaccountable powers iu certain herbs,,
roots, and drugs; anel also in some superstitious practices and ceremonies;
for all which notions their being no foundation in nature, they ought to be
looked upon  as the  effects of ignorance, or the artifices of designing
quacks, who  found tlieir account by pretending to great knowledge in
these occult qualities, and imposing upon the credulous.   The art of phy-
sic has been much improved within this last century :  by observing and
following nature more closely, many useful discoveries have been made,
which help us to account for things  in a natural way, that before  seemed
mysterious and magical, and which have consequently made the practice
of it more conformable to reason and good sense.  This being the case,
there is great room to fear, that those nurses, who yet retain many of these
traditional prejudices, are capitally mistaken in the management  of chil-
dren  in general, and, fancying that nature has left a great deal to  their
skill and contrivance, ofteu do much harm where they intend to do good;
Of this I shall endeavour to convince them, by shewing how I think chil-
dren may be clothed, fed, and managed, with much less trouble to their
nurses and infinitely greater  ease, comfort, and safety, to the little ones;
      ' ^     #    *     *******
   "  When a  man takes upon  him to contradict received opinious and
prejudices sanctified by time,  H ,is expected  he should  bring  vafid 
104
APPENDIX.
proof of Avhat he advances.  The truth of what I say, that the  treat-
ment of children in general is wroug, unreasonable and unnatural, will
in a great measure appear, if we but consider what a puny valetudinary
race most of our people of condition are, chiefly owing to bad nursing,
and bad habits contracted early.  But let any one who woulel be fully
convinced of  this matter,  look  over the Bills of Mortality.   There he
may observe, that almost half the number of those who fill up that black
list, die under five years  of age: so that half the people that come into
the world,  go out of it again before they become of the least use to it, or
themselves.  To me this seems to deserve serious consideration; and yet I
cannot find that any one man of sense and public spirit has ever attend-
ed to it all: notwithstanding  the maxim in  every one's mouth,  that a
multitude of inhabitants is tlie greatest  strength and best support of a
commonwealth.  The misconduct,  to Avhich I must  impute a  great part
of the calamity, is too common  and obvious to engage the idle and spe-
culative, who are to be caught only by very refined researches; and the
busy part of mankind,  Avhere their immediate interest is not concerned,
will ahvays overlook Avhat they see daily : it may be thought  a natural
evil, and  so is  submitted to Avithout examination.  But this is by no
means the case; and where it is entirely owing to mismanagement, and
possibly may admit of a remedy',  it is ridiculous to charge  it upon na-
ture, and suppose that infants are  more subject to disease and death,
than grown persons;  on the contrary, they bear pain and disease much
better, fevers especially (as is plain in the case of the  small-pox, gene-
rally most favourable to children),  and for the  same reason that  a twig
 is less hurt by a storm than an oak.  In all the other productions of na-
ture, we see the greatest  vigour and luxuriauce of health, the  nearer
they are to the egg or the bud; they are indeed most sensible  of injury,
and it is injury only that destroys them.   When was there a lamb,  a bird,
or a tree that died because it was young? These are under the immedi-
ate nursing of unerring nature,  and they thrive accordingly.   Ought it
not therefore to be the care of every nurse and every parent, not only
to protect their nurslings from injury, but to be well assured  that their
own officious services be not the greatest the helpless creatures  can suffer.
   " In the lower class  of mankind, especially  in  the country, disease
and mortality are not so frequent, either among the adults or their child-
ren.   Health and posterity are the portion of the poor, I mean the la-
borious.  The want  of superfluity confines them more within the limits
of nature: hence they enjoy  blessings they feel not, and are ignorant of
their cause.   The  mother, Avho has only a  few rags to  cover her child
loosely  and little more than her own breast to  feed it,  sees  it healthy
and'strong, and veiy soon able to shift  for itself; while the puny insect,
the heir anel hope of a rich family, lies languishing under a load of finery
that overpowers his limbs, abhorring and  rejecting  the  dainties he is
crammed with, till he dies a victim to the mistaken care and  tenderness
of his fond mother.  In the course of my practice,  I have had frequent
occasion to be fully satisfied of this;  and have often heard a mother anxi-
ously say, the child has not been well ever since  it has done puleing and
crying.  These complaints, though not  attended to, point very plaiuly
to their cause.   Is it uot very  evident when a child rids its stomacli
several times in a  day, that it has been overloaded ?  When it  cries,.
from the incumbrance aud confinement of its clothes,  that it is hurt by 
APPENDIX.                        105
them ? While the natural strength lasts,  (as every child is  born with
more health and strength than is generally imagined,) it cries at or re-
jects the  superfluous load, and thrives apace ;  that is, grows very fat,
bloated,  and distended beyond measure, like a house-lamb.  But in time,
the same oppressive cause continuing, the natural powers are overcome,
being no longer able to throw off the unequal weight;  the child, now not
able to cry any  more,  languishes and is quiet.  The  misfortune is,
these complaints are not understood; it is swaddled and crammed on, till,
after gripes, purging, &c. it sinks  under both burdens into a convulsion-
fit, aud escapes any farther  torture.  This would be the case with the
lamb,  were it not killed when full fat.
   " That the present mode of nursing is Avrong, one would think need*
ed no other proof than the frequent miscarriages attending it, the death'
of many, and ill-health of those that survive ****.   What I am going
to complain of is, that children iu general are over-clothed  and over-
fed ; and fed and clothed improperly.   To these causes I impute almost
all their diseases.  But to be a Uttle more explicit.  The first great mis-
take is, that Uiey think  a new-born infant cannot be kept too  warm :
from  this prejudice  they  load and  bind it with  flannels,  wrappers,
swathes, stays, &c. which altogether are almost equal  to its own weight;
by which means a healthy child in a month's time is made so tender and
chilly, it cannot bear the external  air; and if, by any  accident of a door
or a window left carelessly open too long,  a refreshing breeze be admit-
ted into  the suffocating atmosphere  of the lying-in  bed-chamber, the
child and mother sometimes  catch irrecoverable colds: but,  what is
worse  than this, at the end a month, if things go on apparently well, this
hot-bed plant is sent out into the country to be  reared in a leaky house,
that lets iu wind and rain at every quarter.  Is it any wonder the child
never thrives afterwards ?  The truth is,  a new-born infant cannot well
be too cool anel loose in its dress: it wants less clothing than a grown per-
son in proportion, because it is naturally warmer, as appears by the ther-
mometer, and would therefore  bare the cold of a  winters night niuch
better than any adult person whatever.   There are many instances, both
ancient and modern,  of infants exposed  and deserted, that  have lived
several days ;  as it was the practice in ancient times, m many parts ot
the world  to expose all whom the parents did  not care to be encumber-
 ed with • that*were deformed or born under evil stare;  not  to mention
 the many foundlings picked up in London streets.  These instances may
 «.erve to shew, that nature has made  children  able to bear  even great
 hardships, before they are made weak and sickly by their mistaken nur-
 ses  But, besides the mischief arising from the  weight and heat of these
 swaddling-clothes, they are put on so tight, anel the child is so cramped
 by them, Uiat its bowels have not room, nor tlie limbs  any liberty, to ret
 and exert themselves in the  free easy manner  they ought    This is a
 very hurtful circumstance; for limbs that are uot used will never be
 ahw and such tender bodies cannot bear much pressure: the circula-
 tion restrained by the compression of any  one part must  produce unna-
  ul a  swellings in some  other, especially  as the fibres of infanta are so
 easily distended.   To which, doubtless, are owing the many distortion*
 !ind deformities we meet with every where; chiefly among women, who
 Miff.-r more in  this particular than the men.
      If n.uvcs were  capable of making just observations, they might see 
106                        APPENDIX.

and take notice of that particular happiness, w-hich a child shews by all
its powers of expression, wheu it is nearly undressed.  How pleased,  how
delighted it is with this  new1 liberty, avIicu  indulged for a few minutes
with the free use of its legs and arms !   But this  is not to last long : it
is waddled up as before, notwithstanding its cries and complaints.
   " I  would recommend the following  dress:  a little flannel  waistcoat,
without sleeves, made to fit the body, and tie loosely behind ; to which
there should be a petticoat  sewed, and  over this a kind of gown of the
Bame material, or any otlier that is light, thin, and  flimsy.  The petti-
coat should not be quite so long as the child, the gown a few inches Ion-
ser;  with oue cap only on  the bead, which may be made  double, if it be
 thought not warm enough.   What I mean is, that Uie whole coiffure
 should be so contrived, that it. might be put on at once, and neither bind nor
 press  the head at all: the linen  as usual.   This I think would be abun-
 dantly sufficient for the day ; laying aside all  those swathes, bandages,
 stays, and contrivances, that are  most ridiculously used to close and
 keep the head in its place, and  support the body.  As  if nature, exact
 nature, had  produced her chief work, a human creature, so carelessly
 unfinished as to want those idle aids to make it perfect.  Shoes and
 stockings  are very needless incumbrances, besides that  they keep the
 legs  ivet aud nasty if they  are not  changed eveiy hour,  and  often
 cramp and hurt the feet: a child would stand firmer, and learn to
 walk much sooner, without them.   I think they cannot be necessary till
 it runs out in the dirt.  There should be a thin flannel shirt for the night
 which ought to be every Avay quite lose.  Children in this simple, plea-
 sant drees, which may be readily  put  on  and off without teazing them,
  would find themselves perfectly easy and happy,  enjoying the free use of
  their limbs and  faculties, which they would very soon begin to employ
  when thus left at liberty.  I would have them put into it as soon as they
  are born, anel continued in it till they  are three years old; when it may
  be changed for  any other  more genteel and fashionable: though 1  could
  wish it  was not the custom  to wear stays at all; not because I see no
  beauty in the sugar-loaf shape, but that I am apprehensive it is often pro-
  cured at the expense ofthe health and strength ofthe body.  There is an
  odd notion enough entertained about change, and the keeping of children
  clean.  Some imagine  that clean linen and fresh clothes draiv, and rob
  them of their nourishing juices; I cannot see that they do any thing more
  than imbibe a little of that moisture which their bodies exhale.  Were it,
  as is supposed, it would be of service to them;  since they are always too
  abundantly supplied,  and  therefore I think they cannot be changed too
  often, and woulel  have them clean every day; as it  would free them
  from stinks and sournesses, which are not only offensive, but very preju-
  dicial to  the tender state of infancy.
     " The feeding of children properly, is of much  greater importance to
   them than their clothing.   We ought to take gieat care to be right in
   this material article, and Uiat nothing be given them but what is  whole
   some and good for them,  and in such quantity as  the body  calls  for to-
   wards its support and groivth; not a grain more.—Let us consider what
   nature directs in  the case : if we follow nature, instead of loading or
   driving it,  we  cannot err.   In the business of uursing, as well as  physic
   art  is ever destructive, if it does not exactly copy  this original.  When
   a child is first born, there seems  to be no provision at all made  for rt$ 
APPENDIX.                         107
for the mother's milk, as it is now managed, seldom comes till the third
day; so that  accordiug to this  appearance of nature, a child would be
left a day and  a half, or two days,  without any food.  Were  this really
the case, it Avould be a sufficient proof that it Avanted none;  as indeed
it eloes not immediately; for it is born full of  blooel, full of excrement,
its appetites not awake, nor  it senses opened; aud requires some inter-
mediate time of abstinence anel rest to compose and recover the struggle
of the birth, and the change of circulation (the blood  running iuto new
channels) which always put it into a little fever.   However extraordina-
ry this might appear,  I am  sure it would  be  better that the  child was
not fed even all that time, than as  it generally is fed, for it ivould sleep
the greatest part of tlie time, and, Avhen the milk Avas ready for it, would
be very hungry, and suck with more eagerness; which is often necessary
 for  it seldom comes  freely  at first.  But let me endeavour to reconcile
this difficulty, that a child should  be  born thus apparently unprovided
for : Isay apparently,  for in reality it is not so.  Nature neither inten-
ded that a child should be kept so long fasting, nor that we should feed it
 for her.   Her design is  broke in  upon,  and a difficulty  raised that is
 wdiolly owing te> mistaken management—The child, as soon as it is born,
 is taken from the mother, and not suffered to suck till the  milk comes of
 itself; but is either fed with  strange and improper things, or put to suck
 some other woman, whose milk flowing in  a full stream, overpowers the
 new born-infant, that has not yet learned to swallow, and sets it a coughing,
 or gives it a hickup: the  mother is left to  struggle with the load of her
 milk, unassisted by the  sucking of the child.  Thus two great evils are
 produced, the one a pre juelice to the child's health, the other  the danger
 of the mother's life; at least the retarding her recovery,  by  causing
 Avhat is called a milk  fever; which has been thought to be natural, but
 bo for from it, that it is entirely owing to this  misconduct.  1 am confi-
 dent from  experience,  that there would be no fever at all, were things
 managed rightly;  were the  child kept without  food of any kind till it
 Avas hungry,  which it is  impossible it should be just after the birth, and
 then applied to the mother's breast: it would suck with strength  enough,
 after a lew repeated  trials, to  make the milk flow gradually,  in due pro-
 portion to the child's unexercised faculty  of swallowing, and the call of
 its stomach.   Thus the child would not only provide for itself the best of
  nourishment,  but, by opening a free passage for  it,  would take oil' the
  mother's load, as it iucreaseel, before  it could oppress or hurt her ; and
  therefore effectually prevent the  fever,  which is caused only  by the
  painful distension of the lacteal a essels of  the  breasts, when the milk is
  injudiciously suffered  to accumulate.  Here let me elescribe a case of
  pure nature, in order  to illustrate this material point yet farther.  When
  a healthy young woman lies in of  her first child, before the  operations
  of  nature have been perverted by any absurd practices, her labour would
  be strong, anel, as I have chosen to instance in the case of a first child,
  perhaps difficult; but  in a few minutes after her delivery, she and her
  child, if it be not injured, would fall iu a sweet sleep of six or seven
  hours : the mother, if no poisonous opiate has been unnecessarily given
  her, Avould  awake refreshed, the child hungry.  A little thin broth with
  bread, or some such light food, should be them given her;  and soon  after
  the: child be put to suck.   In one' hour or two the milk would infallibly
  floAv; and, if  nothing else be given it. the  child would grow stroDg, and 
108                        APPENDIX.
she recover perfectly in a few days.  This is the constant course of un-
tiire, which is very little attended to, and never followed.   The geueral
practice is, as soon as a child is boru, to cram a dab of butter and sugar
down its throat, a little oil, panada, caudle, or some such unwholesome
mess.  Sqthat they set out Avrong, anel the child stands a fair chance of
being made sick from the first hour.   It is the custom of some to give a
little roast pig to an  infant, which, it seems, is to cure it of all the moth-
er's longings.  Much nonsense has been propagated, and believed, about
women's longings, without any foundation in truth aud nature.  I wish
these matters Avere a little more inquired into  for the honour  of the sex
to Avliich many imperfections of this kind are  imputed, which I am sure
it does not lie under.
   w Hence I  may be asked, Avhat is to be done Avith a child  born sick,
that, instead of sleeping, cries incessantly from the birth,  anel is hardly
to be  quieted by any means ?  Let good care be taken that it is not hurt,
by the dressing, or rather let it not be dressed at all, but wrapped up in a
loose  flannel.   If, notwithstanding this precaution, it still continues cry-
ing:  instead of feeding it, for it is certainly a preposterous thing to think
of feeding a child because it is sick, though possibly this  may stop  its
mouth for a little while, let it be  applied to the mother's breast, perhaps
it may bring the milk immediately,  which would be the best mediciue
for it in such a case ; or the nipple in its mouth  may quiet it, though it
does not bring it.—And it is certainly better it should be quieted without
food  than with it, which must necessarily make it worse.  Sometimes in-
deed the child may be so very ill, that it  will uot even attempt to  suck.
In such a case, which  I think can happen but rarely, let  the  physic I
shall recommend a little farther on, where children are unavoidably to b«
dry-nursed,  be given, a little every hour,  till it takes effect, still attempt-
ing to bring  it to suck the mother's milk, which is the best physic or
food  it can take.
   « When a child sucks its own mother,  which, with a very lew excep-
 tions, would be best for every child and every mother, nature has provi-
dedit with such wholesome and suitable nourishment, supposing her a
temperate woman that makes some use of her  limbs,  it can hardly do
amiss   The mother would likewise, in most hysterical nervous cases,
establish her own health by it, though she were weak and sickly before,
 as well  as that of her offspring.   For these reasons I  could wish, that
 every woman that is able, whose fountains are not greatly disturbed or
 tainted  would give suck to her child.   I  am very sure that forcing back
tlie milk, which most young women must have in great abundance, may
be of fatal consequence: sometimes it endangers life, and otten lays the
foundation of many incurable diseases.   The reasons that are given for
 this practice are very  frivolous, and drawn from false premises; that
some women are too weak to bear such a drain  which would  rob them
of their own nourishment.  This is a very mistaken notion; for the first
 general cause of mqst people's diseases is, not want of  nourishment, as is
 here imagined, but too great  fulness and redundancy of humours; good
 at first, but being more than the body can employ or consume, they stag-
 nate, degenerate! and   the Avhole mass becomes  corrupt, and  produces
 many diseases. This is confirmed by the general practice of physwisus,
 who  make holes in the skin, perpetual  blisters, isues, &c  to  et out the
 superfluity.   I would therefore leave it to be considered, wuctliu tlie 
APPENDIX.                       109
throAving  back  such a  load of humour,  as a woman's  first milk be
uiost likely to menel  her  constitution, or make her complaint irremedia-
ble.   The mother's first  milk is purgative, and cleanses the chilel of its
long-hoareled excrement; no child, therefore, can be deprived of it with-
out manifest injury.   By degrees it changes its property,  becomes  less
purgative aud more nourishing; and is the best and  only food Uie child
likes, or ought to have  for some time.  If I could prevail,  no child
should ever be crammed with any unnatural  mixture, till  the  provision
of nature was ready for it;  nor afterwards fed  with any ungenial alien
diet whatever, at least for the first three months: for it is not  well able
to digest  anel  assimilate other  aliments sooner.   I have  seen very
healthy fine children, that never ate or drank any thing whatever but the
mother's milk for the first ten or twelve months.  Nature seems to direct
this, by giving them no teeth till about that time.  There is usually milk
enough with the first child; sometimes more than  it can take:  it  is
poureel forth from an exuberant, overflowing urn, by  a bountiful hand
that never provides sparingly.  The call of nature  should be waited for
to feed it  Avith any thing more substantial, and the appetite ever precede
the food; not only with regard  to Uie daily meals, but those  changes of
diet, which opening, increasing life  requires.  But  this is never  done  in
either case, which is one of the greatest mistakes of all nurses.  Thus far
nature, if she be not interrupted,  will do the whole business perfectly
well; and there seems to be nothing left for a nurse to do, but  to keep
the child  cleau and sweet, and to tumble and toss it about a  good deab,
play with it, and keep it in good humour.
   " When the child requires more solid  sustenance, we  are to  inquire
what, and how much is  most proper to give it.   We may be  well assu-
red there is a great mistake either in the quantity or quality of children's
food, or both, as it is usually given them;  because they are made sick by
it;  for to this mistake I cannot help imputing nine in ten of all their dis-
 eases.  As to the quantity, there is a most ridiculous error in the common
 practice; for it is generally supposed, that, whenever a child cries, it
wants victuals; and  it is accordingly fed ten,  twelve, or more times, iu
 a day and night.   This is so obvious a misapprehension,  that I  am sur-
 prised it should ever prevail.  If a child's wants and motions  be  dili-
 gently and judiciously attended to, it will be found that it never cries
 but from pain: noiv the first sensations of hunger are  not attended  with
 pain: accordingly  a child (I mean this of a very young  one) that is
 hungry, will make a hundred other signs of its want, before  it  will cry
 for food.  If it be healthy and quite easy in its dress, it will hardly ever'
 cry at all.   Indeed these signs and motions I speak of are but rarely to
 be observed; because it seldom happens that children are ever suffered
 to be hungry.  In a few days, very few,  whom I have had the  pleasure
 to see reasonably nursed, that were not fed above two cr three  times in
 four and twentyhours,  and yet were perfectly healthy, active, and hap-
 py, I have seeu these signals, which were as intelligible as if they had
 spoken.
    k' There are many faults in the quality of their  food :  it is not simple
 enough.   Their paps, panadas, gruels, Arc.  are generally enriched with
 sugar, spice, and sometimes a drop of wine,  neither of which the v ought
 ever to taste.   Our bodies never want them : they are what luxury only
 has introduced, to the dcutractioa of the health of mankind.  It is  not 
HO                        APPENDIX.
enough that their food be simple, it should be also light.  Several  peo-
ple I find, are mistaken in their notions of what is light; aud fancy that
most kinds of pastry, puddings, cu-tarels, &c. are light, that is, light  of
digestion.  But there is nothing heavier iu this sense than unfermented
flour and eggs boiled hard, which are the chief ingredients of those pre-
parations.  What I mean by light, to give the best idea f can oHt, is any
substance that is easily separated, and soluble  in warm  water.  Good
bread  is the lightest thing I know; the power of due fermentation,  iu
which consists the whole art of  making it, break and attenuates the tena-
cious particles of the flour so as to give it these qualities I meution, and
make it the fittest food for young children.  Cow's milk is also simple and
light, and very good for them : but it is injudiciously prepared; it should
not be boiled ; for boiling alters the taste and property of it, destroys its
sweetness auel makes it thicker, heavier and less fit to mix and assimilate
Avith the blood.  But the chief objection is, that their food is wholly veg-
etable, the bad  consequence of which is, that  it will turn sour in their
stomachs.  The first and gener.d cause of all the diseases of infants  is
manifestly this acescent quality of  all their  food.  If any of these veg-
etable preparations I have named, be kept in a degree of heat equal to
that of a child's stomach, it will become sour as vinegar in a few hours
time.   These things are therefore very improper to  feed a child wholly
 with.   Some part of its diet should be contrived to have a contrary ten-
dency ; such as we find only in flesh, which is the direct opposite to acid
and tends to putrefaction.   Iu a due mixture of these tw o extremes, cor-
recting each other, consists that salubrity of  aliment  our nature seems to
require.   As we are partly carnivorous animals, a child ought not to be
fed wholly upon vegetables.  The mother's milk, Avhen it is  perfectly
good, seems to be this true mixture of  the animal  and vegetable proper-
ties that agrees  best with the constitution of a child, readily passes into
good blood, requiring but  a gentle exertion of the powers of circulation
to break and subdue its  particles, and make them smooth and round, and
easily divisible.   I would advise therefore, that  one half of  au infant's
diet, be thin light broths, with a little bread or rice boiled in them; which
last is not so acescent as any other kind of meal or flour.  These broths
should be made with the flesh of full-grown animals,  because their juices
are more elaborate; especially if they have never been confined to be fat-
ted.   The juices of a young ox, taken from the plough, make the finest
flavoured and most wholesome soup.  I believe it is  for the same reason,
the flesh of all wild animals  has a  higher taste than that of tame, sagina-
teel ones,  and is therefore most agreeable to the palate of the  luxurious;
but this is to be understood of those creatures that feed on corn or herbage.
The other part of children's diet may  be a little toasted bread and water
boiled almost dry, and then mixed with  fresh milk  not boiled.*   This,
without sugar, spice, or any other pretended amendment  whatever, w ould
be perfectly light and wholesome, of sufficient nourishment, something like
milk from the cow, ivith the additional strength and spirit of breael in it.
   * The London bakers are  suspected of putting alum in their bread, which
would  be very pernicious to infants.  Therefore rusks,  or the biscuits called
tops-and-bottoms, or rice, mav be used instead of it.  These will not turn sour
•o soon as common bread ; which quality is undoubtedly an objection to using
much of it, especially when children are weakly.  The safest and best method
in my opinion is, not to feed them at all; at least till they are six or eight months
old.  The finest children  I ever saw lived wholly upon sucking till alter that
age. 
APPENDIX.
Ill
Twice a-day, and not oftener, a sucking child should be fed at first; once
with the broth, and once Avith the milk thus prepared.   As to the quantity
at each time, its appetite must be the measure of that.   Its hunger should
be satisfied, but no more; for children will always eat with some eager-
ness full as much as  they ought: therefore it must be very  wrong to go
beyond that, and  stuff them till they spew,  as the common method is.
They should not be  laid on their backs to be  feel, but held iu a sitting
posture, that swallowing may be easier to  them, aud that they may the
more readily discover when they have had enough.  When they come to
be about ten or twelve months old, aud their appetite and digestion grows
strong,  they may be  fed three  times a-day;  Avhich  I  think they ought
never to exceed their  whole lives  after.  By  night  1 would not have
them fed or suckled at all, that they might at least be hungry in a morning.
It is this night-feeding that makes them so over-fat anel bloated.  If they
be not used to it at first, and, perhaps, awaked on purpose, they will never
seek it; and if they are uot disturbed from the birth, in a week's time
they Avill get into a  habit of sleeping all or most part of  the night  very
quietly, awaking possibly once or twice for a few minutes, when they are
wet, anel ought to  be changed.   Their meals, and, in my opinion, their
sucking too, ought to be at stated times, anel the same every day ; that the
stomach may  have intervals  to digest, and the appetite return.  The
child would soon be quite easy and satisfied in  the habit; much more so
than Avhen taught to e xpect food at all times, and at every little fit of cry-
ing  or uneasiness.   Let this method be observed about a twelve month,
when, anel not before, they may be Aveaned ; not all at once,  but by in-
sensible elegrees, that they may neither feel, nor fret at, the want of the
breast.  This  might be  veiy easily managed,  if they were suffered to
suck only at certain times.  Were this plau of nursing literally pursued,
the children kept clean and sweet, tumbled and tossed about  a good deal,
and carried out every day in all weathers, I am confielent, that, in six or
eight months time, most children would become healthy and strong, Avould
be able to sit upon the ground without support, to divert themselves an
hour at a time, to the great relief of their  nui'ses ; would readily find the
use  of  their legs, and very soon shift for themselves.
   " If  it be asked, Avhether I mean this of children in general, and that
weakly ones, born of  unhealthy parents, should be  treated in the same
manner, I answer, that it is uot so common for children to inherit the dis-
eases of their parents, as is generally imagined :  there is much  vulgar  er-
ror in this opinion; for people that are very unhealthy  seldom  have chil-
dren, especially if the bad health le on the female side; and it  is gen-
erally late in life Avhen chronic diseases take place in most men, when
the  business   of  love is  pretty  well  over :  certainly children can
have  no title to those infirmities  which their parents have  acquired
by  inelolence and  intemperance  long after  their  birth.   It  is  not
common  for people to complain of ails  they think heredUaiA, till they
are grownup: that is, till they have  contributed to them by their own
irregularities  and excesses, and then are glad to throw their own faults
back upon their parents, and lament a bad constitution when they have
spoiled a verv good one.   It is vny seldom that  childreu are troubled
with family distempers.  Indeed, Avhen we find  them affected with scro-
phulou-« 1 A-enereal complaints,  Ave may  reao: ably conclude  the  taint
loJiavcbccn transmitted to them; but the'-e cases are very rnrc, in compa-
                                   71 
JU2
APPENDIX".
rison of the many others that are falsely, and without the least foundation,
imputed to parents: when the real cause is either  in the complainauts
themselves, or bad nursing, that has fixed them early in bad habits.  In
one sense, raaiiy diseases may be said to be hereditary, perhaps all those
of malformation, by which I mean not only deformity and distortion, but
all those cases Avhere the fibres and  vessels of one part are weaker in
proportion than the rest; so that upon any strain  of the body whether
of debauch or too violent exercise, the  weak part fails first, and disor-
ders the  whole.   Thus complaints may be produced similar to those of
the parent, owing in some measure to  the similitude of parts, which pos-
sibly is iuherited like  the  features of the  face; but yet these diseases
might never have appeareel, but for the immediate acting cause, the vio-
lence done the body.   Most distempers have two causes :  the one, a par-
ticular state of the solids and fluids of the body, w hich dispose it to re-
ceive certain infections and impulses; the other, the infection or impulse
itself.  Now what I contend lor is,  that though this predisponent state
or habit of body be heritable, yet the diseases  incident to these wretched
heirs may be avoided by preventing  the active cause: ivhich  may be
done in many cases by a due attention to the non-naturals, as they arc
called; iu plainer words, by a  temperate, active  life;  in children, by
good nursing.  Therefore, I conclude, that, instead of indulging and en-
feebling yet more by the common  methods, children so  unhappily born
what I am recommending,  together with the wholesome milk of a heal-
thy nurse, is the best,  the only means to remedy the evil, and  t v  which
alone they may by degrees be made  healthy aud strong.  And thus, in
a genera'ion or two of reasonable temperate persous, every taiut  and in-
firmity Avhatever, the king's evil and madness not excepted, wouid be to-
 tally Avorn out.
   " The plain natural plan I have laid elownis never followed, because
most mothers, of any condition, either cannot, or will not unelera.e the
troublesome task of suckliug their  own chilelren;  which is troublesome
only for want of proper method:  were it rightly  managed, there would
be too much pleasure in it, to every  woman that can  prevail  upon
 herself to give up a little of the beauty of her breast  to feed her off-
 spring;  though this Is a  mistaken notion, for  the breasts are not spoil-
 ed  by given suck, but by growing  fat.  There  would  be no  fear of
 offeneling the husband's ears Avith  the noise of the squalling brat   The
 child, was it nurseel in this way, would be always quiet, in good humour,
 ever playing, laughing, or sleeping.  In  my opinion, a man of sense can-
 not  have a  prettier  rattle (for rattles he must  have of one kind or
 other) than  such  a youug child.  I am  quite  at a loss to account for the
 «eneral  practice of seueling infants out of doors,  to be suckled  or dry-
 nur.ed by another woman,  who has not so much understanding, nor can
 have so much affection for it, as the parents;  anel how it  comes to
 pass, that  people of good sense and easy  circumstances will not give
 themselves the pains to Avatch over the health and welfare of their chil-
 dren, but are so careless as to give them up to the common methods, with-
 out considering how near it is to an equal chance that they are destroyed
 by them.  The aucient custom of exposing them to wild beasts, or drown-
 ing them, would certainly be a much quicker  and more humane way of
 dispatching them.   There are some, however, who wish to have children
 and to preserve them, but are mistaken in their cares about  them.  To 
APPENDIX.                       113
such only 1 would address  myself, and earnestly recommend it to every
father to have his- child nursed unde  his oivn eye; to make us.e of his
own reason and sense, in superintending and directi g the managemeut of
it; nor suffer it to be made one of the mysteries of Uie Bona Dea,  from
which the  men are to be excluded.   I would advise every mother that
cau, for her own sake as well as her child's to suckle it: if she be a  heal-
thy woman, it will confirm her health;  if weakly, in most cases it will
restore here.   It need be  no confinement to her, or abridgment of her
time :  four times in four-and twenty -hours will be often enough to give it
suck; letting it have as much as it will suck out of both breasts at each
time.   11 may be feel anel dressed by some handy reasonable servant, that
will submit to be  directed; whom,  likeivise, it may  sleep with.   No
other woman's milk can be so good for her child; and dry-nursing I look
upon to be the most unnatural and dangerous method of all; and, accord-
ing to my  observation, not one in three survives it.  To \< eed a  child
iu this artificial manner, requires more knowledge of nature and the ani-
mal economy, than the best nurse was ever mistress of, as well as more-
care and attention than is generally bestowed on children:  the skill of a
good physician woulel be necessaiy to manage it rightly."  *  *   *   *
    The doctor is here leel to state his opinion as to the p»ecautions neces-
 sary to be taken in Uie choice of hired nurses, and his reasous why the
 childreu entrusted to their care should be treated somewhat differently
 from those who are nursed in a more natural way, and suck their own mo-
 thers.   He does  not deem it enough that hired nurses sliould be clean
 and  healthy: he looks  ujion their age as  a material  consideration.
 •' those," he says, " between  twenty and thirty are certainly of the best
 age; because they will have more milk than the very young, and more
 anel better than the old.   But what," he thinks, " of the utmost conse-
 quence is, that regard should be had to the time of their  lying-in, and
 those procured, if possible, who have not been brought to bed above two
 or thee months."   He justly observes,  that "nature  intending a child
 sl'-oulel suck about a twelve-month, the milk seldom continues good much
 loriger;" and he adds, with a still greater degree of evidence, " that if a
 new-bom infant be deprived of its own mother's milk, it ought undoubt-
 edly to have what is most like it: the newer it'is, the more suitable in all
 respects to its teuder nature."  ******
    Alter censuring a very common practice  with poor women, who, if
 they can get nurse-children, will suckle two or three of them successive-
 ly with the same  milk, he proceeds thus: " A uurse ought to have great
 rejrard to her diet:  it is not enough  that she be sober and temperate j
 heY food should consist of a proper mixture of flesh and vegetables : she
 should eat one hearty meal of unsalted flesh-meat eveiy elay, with a good
 deal of garden-stuff, and a little bread. Thin broth or milk Avould be best
 for her breakfast aud supper.    Her drink should be small-beer,  or
 milk and  water;  but  on no  account should  she ever touch a drop  of
 wine or strong drink, much less  any kind of spirituous liquors: giving
 ale or brandy to a nurse' is, in effect,  giving it to the child ;  and it is easy
 to conclude what would be the consequence."  *"•*****
    Thh equally caneliel and  judicious Avriter  does  uot enter upon his
  promiieel  description of  the  treatment proper for  children put out to
 nurse, without again reminding his  readers, that the plan,  which  he
 irnuld lay down, could he prevail, would be that of nature, excluding ar. 
114
APPENDIX.
and foreign aid entirely.   ".But," he aelds, « when this is broke in upou.
a little adventitious skill becomes indispensably  necessary; that, if we
are not perfectly right in folloiving closely  the design of nature, we may
co-operate  a little, and not be totally  wrong  in counteracting it, as is
often  the  case.  What  I mean is, that  every  child, not alloweel the
mother's first milk, Avhether it be dry-nursed or  suckled by another Avo-
man, should be purged in a day or two after the birth, and this purging
continued for some time;  not by regular doses of physic that may ope-
rate all  at once, but  some lenient  laxatives should  be contrived, and
given two or three times a-day, so as to keep the child's boely open for
the  first nine  days,  or   a night ; lessening  the quantity insensibly,
till it be  left off.   It should be so managed, that  the operation  of the ar-
tificial physic may resemble that of the  natural.  This is so material,
that, for want of it, most children in the first month break out in pim-
ples all  over: the nurses  call it red-gum,  anel look upon it to be a natu-
ral thing, and that the children will be unhealthy who have it  not.  So
indeed they will be in all likelihood : and it is better that these foulnesses,
which become acrid and hot by remaining too long in the body, shoulel
be discharged through the skin, than not  at all: or that  they  should be
lodged in the blood, or fall upon the vitals, to   lay  the  foundation of
numberless future evils;  but it  is  chiefly owing to  the neglect of this
method  at first.  A child  that sueks its own mother, unless it be greatly
over fed, or kept too hot, will never be troubled with this humour at all."
   The  following is the form of the  gentle purgative which the Doctor
recommends to such infants as have been deprived of the salutary opera-
tion of their mother's milk :
   " Take  manna,  pulp of cassia,  of each half  an ounce : dissolve them
m about three  ounces of thin broth.  Let the child take two spoonsful
three times a-day, varying the quantity according to the effect; which,
at first,  ought  to  be three or four stools  in four-and-twenty hours."
   Among other rules for  the conduct  of  hired nurses, this experienced
physician particularly  enjoins such Avomen " to keep the children awake
by day, as long as they are disposed to be so,  and to amuse anel keep
them in good humour all they can ; not to  lull and rock them to sleep, or
to continue their sleep too long; Avhich is only done to save  their own
time and trouble, to the great detriment of the children's health, spirits,
and understanding."   *****   Here he refers to his former ob-
servations  on the changes to be gradually made in the diet of children,
Avhen they come to require more solid sustenance thau breast-milk;  aud
he takes occasion to introduce the following  remarks :
   " A child  may be allowed any kind of  mellow fruit, either raw, stew-
ed, or baked, roots of all sorts, anel all the produce ofthe kitchen-garelen.
I am sure  all these things are wholesome  and good for them, and every
one else, notwithstanding  the idle notion of their, being windy,  which
they are only  to  very debauched stomachs; and  so is milk: but no
man's blood wants the cleansing, refreshing power of milk, more than
his, whose stomach, used to inflammatory  things  of high relish, will not
bear the first chill of it.   To children, all this kind of  food, taken in
moderation, is perfectly  grateful aud  salutary.   Some may think that
they carry into the stomach the eggs of future  worms : but  of this I am
not very apprehensive; for I believe there are  few things we eat or elrmk
that do not convey them.   But then  they  can  never be hatched in  a
healthy  ioride, where all  the juices are  sweet  and good, and every 
APPENDIX.                      115
 gland performs its office: the  gall,  in particular, would destroy them;
 bullock's gall has been found to be a good and safe vermifuge.  It is my
 opinion, we Bwallow  the eggs  of many  little animals, that are never
 brought to life within us, except where they find a fit nest or lodgment in
 the acid phlegm or vitiated  humours of the stomach and bowels.  Were
 these totally discharged every  day, and the food of yesterday employed
 in nourishment,  cnel the superfluity thrown off to the last  grain, no
 worms coulel ever breed or harbour in our vitals.  As  soon as the chil-
 dren have any teeth, at six or eight months, they may by degrees be used
 to a little flesh-meat; ivhich they are always very fond  of, much more
 so at first, than of any confectionary or pastry Avares, with ivhich  they
 should never debauch their taste."
  I have elsewhere enlarged on Uie fatal effects of these palatable poisonsj
 and I  am not without hopes that tender and  rational  mothers will pay
 some little  attention to my warnings.   A reform in this article alone—
 the total disuse of pastry in  the diet of young  children—will go a  great
 way towards preventing many of the worst complaints to which they are
 subject.
   From the above remarks on the proper food of iufants, the Doctor
 makes a very natural transition to the consideration of their  diseases.  He
 begins with exposing the absurdity of popular errors and popular preju-
 dices with retpect to teething.   " Breeding teeth,'' he says, " has beeu
 thought to be, and is fatal to  many children; but I am confident this
 is not from nature, for it is no disease, or  we could not be Avell  in health
 till one or  two-and-twenty,  or  later.  Teeth are breeding the  greatest
 part of that time;  anel it is my opinion, the last teeth give more pain
 than the first, as Uie bones and  gums they are to pierce are grown  more
 firm and hard.   But, whatever fever, fits or other dangerous symptoms
 seem to attend this operation of  nature, healthy children have sometimes
 bred their teeth Avithout any such bad attendants; Avhich ought to  in-
 cline us to suspect the evil not to be natural, but rather the effect of too
 great a fulness, or the corrupt humours of  the body put in agitation by the
 stimulating pain the tooth causes in breaking its way out. This, I believe,
 never happens without some pain, and possibly a little fever ; but if the
 blood and juices  be perfectly sweet and good, and there be not too great a
 redundancy of them, both will  be but slight, and pa?s off imperceptibly,
 without  any bad consequeuce  whatever,   The chief intention of the
 method I am recommending is, to preserve the humours of the body in
 this state;  and therefore, if it succeeds,  children so managed Avill breed
 their teeth with less pain and danger then are commonly observed to at-
 tend this work of nature."
  In  support  of this opinion, T can  state from  my  own  experience
 Uiat  I have never known cutting  the teeth, as it is called, attended with
 any pain, of an alarming nature, except in cases of previous disease, mis-
 management or bad nursing.  Fevers, convulsion-fits, and other dange-
 rous symptoms, are always, upon such occasions, the consequences of an
 extreme fulness of the habit,  a vitiated state of the blood aud juices,
 some constitutional weakness,or a gieat irritability of the nervous sys-
 tem.    The use also of corals, anel the; like  hard substances, by  render-
 ing  the gums callous, must  oppose additional resistance to the  bursting
tooth, and greatly increase Uie acuteness  of tiie pain.   But  the  doctor's
text requires no comment,   t shall therefore resume my quotation  from
his valuable pamphlet. 
116
APPENDIX.
  " As I have  said,*' continues he, " that the first and general cause of
most of the diseases founts are liable to, is the acid corruption  of then
food,  it may not be am'ss just to mention a.i easy and certain remedy,
or rather preventive, if g ven timely, at the first appearance of prtelom-
iuatiug acid; which is very obvious, tie m the crude white or green stools,
gripes and purgings occasioned by it.   The common method when the*e
symptoms appea , i;> to give the pearl-julep, crabs  eyes and the testace-
ous powders; which, though they do absorb the acidities, have this incon-
venience in their effect,  that they are apt to lodge in the body, and bring
on a costiveness very detrimental to infants, aud therefore require a litile
manna,  or some gentle purge, to be given frequently to carry them off.
Instead of these. I would recommend a certain fine insipid powder, caded,
magnesia alba, which, at the same time it corrects and  sweetens  all
sournesses rather more effectually than Uie  testaceous powders,  is like-
wise  a lenient  purgative, and keeps the body  gently o  en.   This is the
only alkaline pu^ge I know of,  and which our dispensatories have long
wanted.  I have taken it myself and given it to others, for  the  heart-
burn, and find it to be the best  and most effectual remedy  for that com-
plaint.   It may be given to children from one to two drams a-day, a little
at a time in all their  food, till the acidities be quite overcome, and the
concomitant symptoms disappear entirely.   I have often given it with
good and great effect, even  when the  children have been far gone in
d seases first brought on by prevailing acid.
   " It is ahvays easier to prevent diseases  than  to  cure them; aud as
neither childreu, nor indeed  grown persons,  are ever seized with chronic
diseases suddenly,  the progress of decaying  health being perceptibly
gradual,  it is no difficult matter for a physician of common skill to ob-
serve the first step towards illness, anel to foretell the consequence, in all
those Avhose habit of life is well knoAvn to him.  But to parents and nur-
ses in general, these observations may not occur.  I  will therefore point
out a few certain signs anel symptoms, by which they may be assured,
that a child's health is decaying,  even before it appears to  be sick.  If
these are neglected, the evil increases,  grows from  bad to worse, and
more violent aud apparent complaints will follow, and perhaps end in in-
curable diseases, which, a timely remedy, or a slight change in the  diet
and manner of life, had infallibly prevented.  The first tendency to dis-
ease may be observed in a child's breath.   It is  not enough the breath
be not offensive: it sliould be sweet and fragrant  like a nosegay of fresh
flowers, or a  pail of new milk  from  a  young cow  that feeds upon the
eweetest grass of the spring;  and  this as well at first waking in the morn-
ing, as all day long.   It is  also so with children that are in perfect deli-
cate health.  As soon, therefore as a child's breath is found to be either
hot, or strong or sour, we may be assured that  digestion and surfeit have
fouled and disturbed the blood,  and noiv is the time to apply a proper
remedy, and  prevent  a train of impending evils.   Let the child be re-
strained in its food, eat less, live upon milk or thin broth for a elay or two;
be carried, or walk  if it is able, a little  more than usual, in the open air.
Let a little of this powder,  or any o'her proper physic, be given;  not
that I would advise physic to be made familiar; but one dose administered
now, would prevent the necessity of n gieat mauy that might afterwards
be prescribed with much less good effect.
   " If this first symptom of approaching illness be overlooked, the child 
APPENDIX.
117
who, if it'was healthy, Avould lie quiet as a log all night, will have  dis-
turbed sleep, restless,  terrifying dreams; will be talking,starting,kicking,
and tumbling about; or smiling and laughing, as is  common with very
young children when they are griped; and the nurses say they see and
converse wi h angels.  After this will follow loss of appetite and com-
plexion, check of growth, decay of strength, cough, consumption, or else
colics, gripes, worms, fits, &c. diseases that require all the skill of a good
physician;  and happy for them, if the utmost he can  employ will restore
them to any degree of lasting health.
   "There is one thing more which I forgot to mention in its proper place
and therefore, I must take notice of it here;  that is, the degree of ex-
ercise proper lor  children.   This is of more consequence than all the
rest; for, without it, all our care in feeding and clothing wUl not succeed
to our wishes: but when by due degrees a child is brought to bear agood
deal of exercise without fatigue, it is inconceivabie how much impropri-
ety and absurdity in both these articles it will  endure unhurt.  A child,
therefore, should be pushed forwarels, and taught to  walk  as soon as pos-
sible.   A healthy child a year old will be able  to  walk alone.   This
we may call the sera of their  eleliverance: for this  great difficulty sur-
mounted, they geuerally do well, by getting out of the nurse's hands to
shift for themselves.   And here I must endeavour to correct a great mis-
take, which is that most people think it  wrong  to put weakly children up-
on their legs, especially if  they are the least bent or crooked ; but who-
ever will venture the experiment will surely fiud, that crooked legs will
grow in time strong and straight by frequent ivalking, while disuse  will
make  them worse and  worse every  day.  As they grow daily more
 and more able,  let  their walks  be gradually increased,  till 'hey  can
 Avalk two miles on a s'retch without weariness; which they will be veiy
 ivell able to do before they are three years old, if they are accustomed
 to it every day.   To lead them such a walk, should be imposed as an
 indispe  sible task upon  their  maids, for to them it  will be the  highest
 pleasure;  so far from a burthen to them, that if they perform the daily
 duty, they  will, from the impulse of their own active vi-our, be found
 running, leaping, and plaj ing,  all  day long.   Thus, a dull  he^Ay child
 may be made playful an I sprightly,  a  weakly one healthy and  strong,
 and confirmed in good habits- and perpetual health.
   " There are some o her little  niceties  that,  Avere they observed in
 the nursing of eh'ti dren, would be of some use to them; such as mak-
 ing them lie straight in the bed.   I do not mean extended  like  a
 corpse, but that  their limbs  may be free and easy.  I have sometimes
 seen children a year or two old lie doubled up in bed as in the Avomb, es-
 pecially in cold weather;  and from the constraint of their posture, fall
 into profuse sweats.  Ties will be prevented if they are laid straight;
 and sleep relaxfog all the muscles of the body, the knees will naturally
 be Lent a little.  They sliould be taught  to'use  both hands alike; for
 employing one more than Uie other will not only  make the hand and
 arm so used, but also that side of the body bigger than the other.  This
 is sometimes the  can-e of crookedness.   It would  likewise uot be amiss
 to forward their speaking plain  distinct words to them, instead  of the
 nambypamby style, and giving them back their own broken inarticulate
 attempts;  by which means, I believe, some children scarcely speak in-
 telligibly at seven years.of age,  X think they cannot be made reasonable -
 creatures too soon. 
118                       APPENDIX.
  As this essay Avas written in ths form of a letter, the Doctor concludes
it with an apology to the geutlemau to whom it Avas addressed,  for the
loose manner in which the thoughts were laid before him.  The writer
very candidly confesses that he had  " neither time nor patience to think
of form and order, or supporting them by affected demonstrations taken
from mechanical  principles  and powers.  ''All I have endeavoured,"
says he, " is to be intelligible and useful: anel therefore I have avoided,
as much as possible, all terms of art; together with learned quotations,
as often produced out of  vanity, and to sheiv deep  reading, as for the
sake of proof. ******   I shall  only add by way of persuasive to
those avIio may be inclined to make trial of the  method 1 recommend,
that I  am a farther, aud have already practised it  with Uie most desira-
ble success."
   In a postscript to the tenth edition of this pamphlet, dated July 17th,
 J 769, the author expresses himself in the following manner :
   "It is now  above twenty years since I Avrote the foregoing essay; and
though I have made a feiv alterations, it was only to explain those passa-
ges  that contained any apparent difficulty or obscurity : 1 have never
yet  found cause to alter  essentially any one opinion delivered in it.   I
have,  through the whole, industriously laboured at the greatest plainness
and simplicity;  aud yet my meaning  has been much mistaken.   Some
have very strangely expected to find in it the general  cure of children's
diseases, though it be  professedly Avritten only to prevent them, by es-
tablishing  good health;  a very different  thing (whatever people  may'
think) from the cure of diseases.  Sick or weak children, whether such
by nature, or made such by bad nursing, cannot perhaps be brought im-
mediately into thehaoUs here recommended, but must first be cured of
their maladies by a skilful physician; who, if he be also an honest man,
will introduce these, or similar habits of management, to continue them
in health and strength.  But in treating their  diseases, as  well  as  in
nursing them, I am very sure many capital errors are committed.   I ob-
ject greatly in particular to the frequent use of antimonial and mercurial
medicines; which, though they give sometimes a little temporary relief,
by discharging crude and phlegmatic humours, killing worms, &c.  I am
 very confident a  repeated use of them  breaks the blood, relaxes the fi-
 bres, and is every Avay destructive to the constitution of children.   Pre-
 sent relief seems  to be  all that is desired, and therefore all that is intend-
 ed by medication: the slow, but permamenl  effects of goerd habits fevr
 have patience to  expect.  Others have neglected essentials, to lay stress
 only upon trifles.   A lady  of great sway among her acquaintance told
 me  long ago, with an air of  reproach, that she had nursed her child ac-
 cording to my book, and it died.   I asked, if she had suckled it her-
 self?   No.—Had it sucked any other  wonnn ?—It was dry-nursed.—
 Then, madam, you cannot  impute  your misfortune to my  advice, for
 you have taken a method quite contrary to it in the most capital point.
 Oh  ! but, according to my direction, it had never worn stockings.   Ma-
 dam, children may die Avhether they do or do not Avear stockings."   A
 stronger illustration could not be given of the folly of attending only to
 trifles, and acting diametrically opposite to the dictates of reason and ex-
 pei ieuce in matters of the greatest moment.
FINIS. 
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