4*. lB>7^/- UNITED STATES OF AMERICA *" . . FOUNDED 1836 WASHINGTON, D. C, GPO 16—67244-1 3,:, . *-. I u A *. \ » / * EVERY MAN HIS OWN DOCTOR; OB, A TREA TISE ON THE PREVENTION AND CURE OF DISEASES, 3 .. REGIMEN AND SIMPLE MEDICINES. By WILLIAM BUCHAN, M. D. XO WHICH IS ADDED, A TREATISE ON THE MATERIA MEDICA; IN WHICH THE MEDICINAL QUALITIES OF INDIGENOUS PLANTS ARE GIVEN AND ADAPTED TO COMMON PRACTICE. WITH AN APPENDIX, Containing a Complete Treatise on the Art of Farriery ; with Dircc- tions to the Purchasers of Horses ; and Practical Receipts for the Cure of Distempers incident to Horses, Cattle, Sheep, and Swine—To all of which arc added, A Choice Collection of Receipts, useful in every branch of Domestic Life—Making in all a Complete Family Directory. NEW-HAVEN: PUBLISHED BY NATHAN WHITING. 1S16. District of Connecticut, .?.?. **■■**#*#* "RE IT REMEMBERED, That on the thirteenth * L. S. # -t^ ^ay of April, in the fortieth year of the indr-pendence- ?#■**###* °f tne United States of America, Nathan Whiting, of the said district, hath deposited in this office the title of a book, the right whereof he claims as Proprietor, in the words follow- ing, viz. '« Every Man his own Doctor; or, a Treatise on the Prevention u and Cure of Diseases, by Regimen and Simple Medicines. By Wil- " Ham Buchan, M. D. To which is added, a Treatise on the Materia " Medica; in which the Medicinal Qualities of Indigenous Plants are " given and adapted to Common Practice. With an Appendix, Cou- " taining a Complete Treatise on the Art of Farriery; With Directions " to the Purchasers of Horses; and Practical Receipts for the Cure of " Distempers incident to Horses, Cattle, Sheep, and Swine—To all " of which are added, a Choice Collection of Receipts, useful iu " every branch of Domestic Life—Making in all a Complete Family " Directory." In Conformity to the Act of the Congress of the United States, en- titled, " An Act for the encouragement of learning, by securing the **r not very uecessary, it is omitted. " the most noble bowel next to the heart;" and, like the latter, it is in coustant action. At the time of inspiration it approaches towards a plane. Besides beiiig a muscle of inspiration, it assists in vomiting, and" the expulsion of the fVeces.j) From the exertion of this muscle likewise proceed sighing, yawuing, caughing, and laughing. It is effected by spasms, as in the hicknp, &c. It is both, a muscle of voluntary aad involuntary action. We may observe in this muscle strong characters of admirable contrivance. It separates posteriorly into two slips, between which the descending aorto passes. A little above this, and towards the left side, in the most fleshy part of the midriff, there is a direct opening for the passage of the esophagus o; gullet. There is also on the right side a large triaogular hole for the passage of the ascending cira. The gullet is composed both of longitudinal and circular fibres, but chic-fly circular, much more so than the intestines; because this has no foreign power to assist it, and because it is necessary that the food should make a shorter stay in the throat than in the bowels. The in- ner suiuce is a smooth membrane, veil supplied with mucilage, to sheath the org in, and render the passage of the aliment or food easy. * Cava is the large vein which conveys the refluent blood to the heart. t Abdomen, from abelo to hide, as its contents lie hidden. X Derived from the Greek, signifying the breast. !| This wore!_ v.ith chy mists is used to express the ingredients aa& setMing after distillation ?.::d infusion; here it means excrement. INTRODUCTION. 11 The stomach lies across the upper part of the abdomen, and is cov- '«rcd by the liver; when distended it presses ©u the spleen. It nearly Resembles in figure the pouch of a bag-pipe, its upper side being con- cave, and the lower convex. Its left end is the most capacious. On the left side is the entrance from the gullet; on the right is the open- ing, calleel pyloi vs, by which the chyle passes into the intestines, llei e is a circular valve, or sphincter-muscle, which prevents a regurgita- tion of the aliment. The stomach has circular and longitudinal fibres, and its inner membraue is covered with a strong viscid mucus. The liver, the largest gland in the body, is situated immeehately un- der the vaulted cavity of the midriff, chiefly on the right side, and t somewhat on the left over the stomach. Exteriorly, or anteriorly, it is convex, inwardly it is concave ; very thick in its superior part, and thin in its inferior. The upper side adheres to the midrifl": and it is fixed to this, and the sternutn, or breastbone, by a broad ligament. It is also tied to the navel by a ligamentous band, which is the umbili- cal vein of the unborn infant, degenerated into a ligament. Both these bands serve to suspend it, while laying on the back, from bearing too much on the subjacent cava ; otherwise it might press on this important returning vessel, stop the circulation, and put a period to life. Dogs, 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 or bowel which performs the secre- tion of the bile. The gall-bladder is situated under the gTeat lobe of die liver, a little fo the right. In a standing posture it lies forwards and downwards. Its bottom is raised bv a fulness, and depressed by the emptying ot the stomach. The use of the gall-bladder is to serre as a receptacle tor the bile. . The intestines are destined to receive the food from the stomach, and nfler exposing the useful part of it to the lactcalu, a set of extremely small vessels, to convey the remainder out of the body. The intesti- nal canal is usually five times the length of the individual; it iscuii- ously convoluted in the abdomen, and is extremely irritable. ^ Anato- mists have divided this canal, although one continued pipe, into six portions, three of which are termed the.w»aM intestines * and Uie three last, the great. In the small intestines there are numerous plaits to de- tain the food, and allow a larger surface for its absorption. 1 hese aie larger, and far more numerous near the stomach, where the lood is ~*The threelmaller are, the duodenum, (from its length being about that of the breadth of twelve fingers) fjunum, and ilhum,Trom the Greek signifying to turn about, because it makes many convolutions. The three larger are. the ceemm, or blind gut (so callee lromits be- ing perforated at one end only) the colon, signifying hollow, * -or* 'V«m tlte Greek, and the rcilum, or straight gut, 12 INTRODUCTION. thinner, than they are towards the other extremity. At the entrance of the illium into the colon, there are two very large valves, which prevent the regress of the faeces into the illiuin The cacum and colon, two of the intestines towards the lower extremity, besides having strong- er muscular coats than the small intestines, are furnished with three ligamentous bands, running lengthwise on their outside, dividing their surfaces into three portions nearly equal. Though appearing exter- nally like ligaments, they are composed, in their inner structure, of true raupcnlar fibres. The ligament-like bands, which in the csecum and colon are collec'rd into three portions, are spread equally over the surface of the rectum, or lower extremity of the intestines. Thi« is a wise precaution of Nature, that no part of it may be weaker than another, lest it should give way in the efforts for expelling the fxces. 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 loDg as broad, and almost 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 transversly under the s ach. Its shape resembles a dog's tongue. Along the whole 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 less viscid or slimy, and contains a larger proportion of the salts of the blood. It is probably intended for the solution of onr aliment. The kidneys are two oval bodies, situated in the lines, contiguous to the two last short ribs; the right under the liver, and the left under »he spleen. The structure of the kidneys is curiously fitted for secu- ring the urine, which is carried from each of them by caBals 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, run- ning for the space of an inch obliquely between its coats, and forming, ns it were, to themselves, two valves; «o that, upon the contraction of the bladder, the urine is directed along the urethra, which is its prop- er passage out of the body. Over the upper part of the abdomen is spread the omentum, or caul, consisting of two broad, thin, and transpareat membranes, joined togeth- er by cellular texture, in the cells of which a quantity of fat is deposi- ted. The uses of it are to interpose between the pcritenoum,* or li. * Signifying near to, stretching round, or about, as »most«um, rrri. carpinm, near to the bene, heart, &c. INTRODUCTION. 13 wing the intestines, and the stomach, to keep all these parts moist, warm slippery, and to prevent their adhesion. Last of all comes the peritonaeum, a strong membrane, which con- fines, as in an enclosure, the intestines and contents of the abdomen. Such, in a geueral view, are the contents of the cavities of the breast and belly, which perform, respectively, the vital motions, and those natural functions that are subservient to the support of our frame. But there remaius to be mentioned another essential cavity, with its de- pendent system, to the primary influence of which all the other parts of the body are 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 portions, namely, the cerebrum and cerebellum ;* 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 called aura, and the other pia, matter. It has also a third, called arachnota, from its fineness, as being similar to a spider's web. It contains some sinuses, which are nothiDg 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 diffuses through its substance, and on the membranes. The brain is the great elaboratory, where the animal spirits, or nervous influences which 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, how- ever, that from this source the nerves derive their origin. These are white, firm solid cords, which arise from the brain and spinal marrow, which is only an elongation of the brain, and are spread over every part of the body endowed 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 im.: terial 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, in the penetralia of the brain, has been as- signed as the sacred mansion of this immortal inhabitant. Human vision can discover no signs to confirm this opinion; but the man would be hlind, and utterly void of understanding, who could not trace through the whole of the animal system the most evident marks of Divioe Intel- ligence and wisdom: of intelligence which excites admiration, and of wisdom beyond conception. * Cerebellum, the little brain as it were; both are often called 1hue, when the brain is spoken of in small animals. 14 INTRODUCTION. The wonderful contrivance exhibited in the human frame is, if pos- sible, still more manifest from the curious formation of the eye and ears of which only a very imperfect idea could be conveyed by vma™* description. I shall therefore not attempt to delineate those admirable organs: nor need I mention the construction of the limbs; of the arms and legs; of the hands and feet; so nicely united with joints, and so happily supplied with muscles and tendons, with ligaments and nerves, that they are adapted to all the various purposes of convenience and utility in motion. I shall conclude this imperfect sketch of the human body with a brief account of digestioa, that important process in the animal econo- my, by means of which 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 actiop of the teeth and several mus- cles. This mastication is of greater moment than is generally imagin- ed; 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 down the gullet into the stomach, it there meets with an additional supply of juices, called the gastric juices, of a nature yet more effica- cious than the former, besides a small portion of bile. During its con- tinuance in the stomach, it experiences the effects of heat and muscu- lar action, from the coats of that organ, and the motion and warmth of the surrounding parts. It thence passes out gradually by the right ori- fice of the stomach, and there meets with an additional quantity of bile from the gall-bladder and liver, besides the pancreatic juice, or that of Jhe 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 St were, the whole mass, minutely mixing together the food, and the different juices, collected in the passage from the mouth. A fluid is now produced called chyle, which is separated UlQn? the grosser mate- rials, and taken up by a set of extremely small absorbent vessels calh.d tactcals. These have their origin, in the inner coat of the intestines, and, passing thence, discharge themselves into a duct named the recep- ^•'e °5 ^le. c''y'e» whence this fluid proceeds along the thoracic* duct, which terminates in the left subclavian! vein. In the passage from the intestines to the receptacle, there is a number of glands, which sepa- a number of valves, which open * From thorax the breast. ~ ' A team applied to any thing under the arm-pit or shoulder. INTRODUCTION. 15 enly forwards, and arc shut by any fluid pressing backwards. From the subclavian vein, the chyle is poured into the blood, and thence im- mediately thrown into the right auricle and ventricle* of the heart; from which, now mixed with the blood, it passes into the lungs. It undergees in that organ a considerable change from the act of respira- tion. From the lungs it proceeds through the pulmonary vein to the left auricle of the heart, and then into the left ventricle; whence, at last endowed with all the qualities of blood, it passes into the aorta, and is diffuseel universally through the frame; the wants of which it is fit- ted to supply by the addition of nourishing particles. Is it possible to contemplate this admirable mechanism without breaking forth in the exclamation of the Psalmist, that " we are wonderfully made ?" I may justly add, that considering the great variety of ways in which the hu- man body may be affected, both from without and within, with the ne- cessity for the perpetual motion of the vital powers, and the millions of vessels, invisible 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 would be impossible, were not the machine con- stantly sustained by the same Almighty and Beneficent Being who formed it. * Two muscular bags, one on each side, are termed its auricles. from the Latin, signifying ears. PART I. •________ OF THE GENERAL CAUSES OF DISEASES. CHAPTER I. Of Children. THE better to trace diseases from their original causes, we shall take a view of the common treatment of mankind in the state of in- fancy. In 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; but 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 recom- mend themselves by the appearance of extraordinary skill aod 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 wonder so many of them perish. Nothing can be more preposterous than a mother who thinks it be- low her to take care of her own child, or who is so ignoraut as not to 18 OF CHILDREN. know what is proper to be done for it. If we search Nature through- out, we cannot find a parallel to this. Every other aoimal 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. We mean not, however, to impose it as a task upon every mother to suckle her own child. This, whatever speculative writers may al- lege, is in some cases impracticable, atftl would inevitably prove des- tructive both to the mother and child. Women of delicate consti- £ tutions, subject to hysteric fits, or other nervous affections, make very bad nurses ,'~ and these complaints are now so common, that it is rare to find a woman of fashion free from them; such women therefore, sup- posing them willing, are often unable to suckle their own children. Almost eveiy mother would be in a condition to give suck, did man- kind live agreeably to Nature; but whoever cousiders 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 aud exercise, can neither have wholesome juices themselves, nor afford proper nourishment to an infant. Hence children who arc suckled by delicate women, either die young, or continue weak and sickly all their lives. When we say that mothers are not always in a condition to suckle their own children, we would not be understood as discouraging that practice. Every mother who can, ought certainly to perform so ten- der and agreeable an oflice. f 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 k abounds with milk, this is the easiest part of it. Numberless other of- * I have knowu au hysteric woman kill a child, by being seized with a fit in the night. t Many advantages would arise to society, as well as to individuals, from mothers suckling their own children. It would prevent the temp- tation which poor women are laid under of abandoning their children to suckle those of the rich for the sake of gain; by which means so- ciety loses many of its most useful members, and mothers become in some sense the murderers of their own offspring. I am sure I speak within the truth when I say, that not one in twenty of those children live, who are thus abandoned by their mothers. For this reason uo mother should be allowed to suckle another's child, till her own is cith- er dead, or fit to be wearied. 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 ure able to suckle two children" ia succession upon the same iiiilk. OF CHILDREN. IS fices are necessary for a child, which the mother ought at least to see done. ... i 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 ny being brought up under the mother's eye, not only secures her attec- tiou, but may reap all the advantages of a parent's care, though it fee suckled by another. How can a mother be better employed than in superintending the nursery ? This is at once the most delightful and im portant oflice t 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 id_ teacn- ingthe proper management of children to those whom Nature has de- signed for mothers. This, instead of being made the principal, is sel- dom 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 ihe duties belonging to that character ? However strange it may appear, it is certainly true, that many mothers, and those ol fashion too, are as ignorant, when they have brought a child into he world, of what is to be done for it, as the infant itselt. Indeed, tiie most ignorant of the sex are generally reckoned the most knowing in the business of nursing. Hence sensible people become the dupes oi i-morance and superstition; and the nursing of children, instead ot oe- ing conducted by reason, is the result of whim and caprice. Were the time that is generally spent by females in the acquisition of trifling accomplishments, employed in learning how to bring up heir children; how to dress them so as not to hurt, cramp, or confine their motions; how to feed them with wholesome and nourishing food; how to exercise their tender bodies, so as best to promote their growth and strength : were these made the objects of female instruction, mankind would derive the greatest advantages from it. But while the education of females implies little more than what relates to dress and public show, 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 opportuaity of informing themselves of the duties which they owe to their infant offspring. It is their province, * Tacitus, the celebrated Roman historian, complains greatly of the degeneracy of the Roman ladies in his time, with regard to the care of their offspring. He says that, in former times, the greatest women in Rome used to account it their ciiief glory to keep the house and attend their children; but that now the young infant was committed to the sole care of some poor Grecian wench, or other menial servant.—We are afraid, wherever luxury and rfiVmintKY prevail, there will be too rcucn ground for this complaint. :o OF CHILDREN. not only to form the body, but also to give the mind its most early bias. They have it very much in their power to make men healthy or vale- tudinary, useful in life, or the pests of society. But the mother is not the o::ly 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 ol the body or mind. It is a pity that the men should be so inattentive to this matlci. Their uegligence is oue reason why females know so little of it. Wo- men will ever be desirous to excel in such accomplishments as recom- mend them to the other sex. But men generally keep at such a dis- tance from even the smallest acquaintance with the affairs of the nurse- ry, that many would reckon it an affront, were they supposed to know any thing of them. Not so, however, with the kennel or the stables: a gentleman of the first rank is not ashamed to give directions concern- ing the management of his dogs or horses, yet would blush were he sur- prised in performing the same office for that being who derived its ex- istence from himself, who is the heir of his fortunes, and the future hope of his country. Nor have physicians themselves been sufficiently attentive to the management of children: this has been generally considered as the sole province of old women, while men of the first character in physic, have refused lo visit infants even when sick. Such conduct in the fac- ulty has not only caused this branch of medicine to be neglected, but has also encouraged the other sex to assume an absolute title to pre- scribe for children in the most dangerous diseases. The consequence is, that a physician is seldom called till the good women have exhaust- ed all their skill; when his attendance can only serve to divide the blame, and appease 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 of infants, they would not only be better qualified to treat them properly when sick, but like- wise to give useful elirections for their management when well. The diseases of children are by no means so difficult to be understood as many imagine. It is true, children canuot tell their complaints; but the causes of them maybe pretty certainly discovered by observing the symptoms, and putting proper questions to the nurses. Besides, the diseases of infants being less complicated, are easier cured than those of adults.* * The common opinion, that the diseases of infants are hard to dis- rover and difficult to cure, has deterred many physicians from paying that attention to them which thry deserve. 1 caD, however, frprfi 11. OF CHILDREN. 21 It is leally astonishing, that so little attention should in general be paid to the preservation of infants. What labour and expense are dai- ly bestowed to prop an old tottering carcase for a few years, while thousands of those who might be useful in life, perish without being re- garded ! Mankind are too apt to value things according to their pres- ent, not their future usefulness. Though this is of all others the most erroneous method of estimation; yet upon no other principle is it possi- ble to account for the general iudifferense with respect to the death of infants. Of Diseased Parents. Omb great source of the diseases of children is, the Unhealthiness of Parents. It would be as reasonable to expect a rich crop from a barren soil, as that strong and healthy children should be born of pa- rents whose constitutions have been worn out with intemperance and disease. An ingenious writer f observes, that on the constitution of mothers depends originally that of their offspring. No one ^ho believes this, will be surprised, on a view of the female world, to find diseases and death so frequent among children. A delicate female, brought up with- in doors, au utter stranger to exercise and open air, who lives on tea and other slops, may bring a child into the world, 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 of existence, its feeble frame, shaken with convulsions from every trivial cause, will be unable to perform the common functions of life, and prove a burden to society. If to the delicacy of mothers, we add the irregular lives of fathers, we shall see further cause to believe that children are often hurt by the constitution of their parents. A sickly frame may be originally indu- ced by hardships and intemperance, but chiefly by the latter. It is impossible that a course of vice should not spoil the best constitution: and did the evil terminate here, it would be a just punishment for the folly of the sufferers : but when once a disease is contracted and rivited in the habit, it is entailed on posterity. What a dreadful inheritance is the gout, the scurvy, or the king'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 fertunes, at the expense of inheriting 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 perience declare, that this opinion is without foundation; and that the diseases of infants arc neither so difficult to discover, nor so ill to cure3 as those of adults. t Rosseai.i. OF CHILDREN. 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 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 know that the gene- rous courser cannot be bred out of the foundered jade, nor the saga- cious spauiel out of the snarling cur. This is settled upon immutable laws. The man who marries a woman of a sickly constitution, and de- scended of unhealthy parents, whatever his views may be, cannot be said to act a prudent part. A diseased woman may prove fertile ; should this be the case, the family must become an infirmary : what prospect of happiness the father of such a family has, we shall leave any one to judge.f Such children as hare the misfortune to be borne of diseased parents, will require to be nursed with greater care than others. This is the only way to make amends for the defects of constitutioa; and it will often go a great length. A healthy nurse, wholesome air, and suffi- cient exercise, will do wonders. But when these are neglected, little is to be expected from any other quarter. The defects of constitutioa cannot be supplied by medicine. Those who inherit any family disease ought to be very circumspect in their manner of living. They should consider well the nature of such diseases, and guard agaiust 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 wholly eradicated. Thin 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, docs greater injury to his poster- ity, than the prodigal who squanders away the other. * The Lacedemonians condemned their king Archidamus for hav- ing married a weak puny woman; because, said they, instead of propagating a race of heroes, you will fill the throne with a progeny cf changelings. f 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 le- gislators ought to hay. a special regard. In some countries, diseased persons have actually been forbid to many. This is an evil of a com- plicated kind, a natural deformity, and political mischief; and there- fore requires a public consideration. OF CHILDREN. 23 Of the Clothing of Children. The n'othiug of an infant is so simple a matter, that it is surprising how many persons should err in it; yet many children lose their lives, and others are deformed, by inattention to this article. Nature knows no use of clothes to an infant, but to keep it warm. All that is necessary for this purpose, is to wrap it in a soft loose cov- ering. Were a mother left to the dictates of nature alone, she would certainly pursue this course. But the busiuess of dressing an infant has long been out of the hands cf mothers, and has at last become a se- cret which none but adepts pretend to understand. From the most eaily ages it has been thought necessary, that a wo- man in labour shoulel have some person to attend her. This in time became a business; and, as in all others, those who were employed iu it strove to outdo one another in the different branches of their profes- sion. The dressing of a child came of course to be considered as the midwife's province, who no doubt imagined, that the more dexterity she could show in this article, the more her skill would be admired. Her attempts were seconded by the vanity of parents, who, too often desirous of making a show 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: while these were often so tight, as not only to gall and wound 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 midwife. So far, however, are all her endeavours to mend the shape from being* successful, that they constantly operate the contrary way, and mankind become deformed in proportion to the means used to prevent it. How little deformity of body is to be found among uncivilized nations ? So little indeed, that it is vulgarly believed they put all their deformed child- jen to death. The truth is, they hardly know such a thing as a de- tormed child. Neither should we, if we followed their example. Savage nations never think of manacling their children. They allow them the full use of every organ, carry them abroad in the open air, wash their bodies daily in cold water, &c. By this management, thei* children become so strong and hardy, that by the time our puny in- i.uils get out of the nurte's arms, theirs are able to sliift for themselves.' * A friend of mine, who was eeteral years on the coast cf Africa, J4 OF CHILDREN. Among hruis animals no art is necessary to procure a fine shape. Though many of them are extremely delicate when they come into the world, yet we never find them grow crooked for want of swaddling bands. " Is Nature lers generous to the human kind ? No : but we take the business out of Nature's hands. Not only (he analogy of other animals, but the very feelings of in- fants tell us, they outfit to be kept easy and free from all pressure- They cannot indeed tell their complaints; but they can shew signs of pain . 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 will ap- pear in the strongest light. Nature, in 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 sur- rounded the fatus every where with 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. 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, which can never after be remedied. Hence it is, that so many people appear with high shoulders, crooked spines, and flat breasts, who were as well proportioned at their births as others, but had the misfortune to be squeezed out of shape by the application of stays arid bandages. Pressure, by obstructing the circulation, likewise prevents the equal distribution of nourishment to the different parts of the body, by which means the growth becomes unequal. One part grows too large, while another remains too small; and thus in time the whole frame becomes • iisproportionate and misshapen. To this we must add, that when a »!:':1.1 is cramped in its clothes, it naturally shrinks from the part that is. hurt; and by putting its body into unnatural postures, it becomes de- formed 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 deformed 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 impaired. Hence few people remarkably misshapen are tells me, that the natives neither put any cloths upon their children* nor apply to their bodies baudages of any kind, but lay them on a pal- let, and suffer them to tumble about at pleasure, yet they are all straight* and seldom have any disease. OF CHILDREN. 25 Atrong and healthy. The new motions which commence at the birth, as the circulation of the whole mass of blood through the lungs, respiration, the peristalic motion, Arc. afford another strong argument for keeping the body of an infant free from all pressure. These organs, not having been accustomed to move, are easily stopped ; but when 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 ban- dages. 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: how much more hurtful they must prove to the tender bodies of infants, we shall leave any one 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 pro- ceed from our own imprudent conduct. I have known a child sei- zed with convulsion fits soon after the midwife had done swaddling it, who, upon taking'ofl the rollers and bandages, was immediately relie- ved, 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 thaa pins, as these often gall and irritate their tender skins, and occasion dis- orders. Tins 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 ot their clothes, but also by the quantity. Every child has some degree of fever after the birth; and if it be 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-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 iucrease the fever to such a degree as will endanger the life of the infant. The danger of keepiag infants too hot will further appear, if we con- sider that, after they have been for some time in the siuiation before- mentioned, they are often sent into the country to be nursed in a cold house. Is it any wonder, if a child, from such a transition, catches a mortal cold, or contracts some other fatal disease 1 When an infant is kept too hot, its lungs, not being sufficiently expanded, are apt to re- main weak and flaccid for life; hence proceed coughs, consumptions and other diseases of the breast. * This is by no means inveighing against a thing that does not hap- pen. In many parts of Britain at this day, a roller eight or ten feet in length, is aopUe.i tightly round the child's body as soon as it is born. • 1 IS OF CHILD HEN. It would answer little purpose to specify the particular species of dress proper for an infant. These will always vary in tliffercut coun- tries, according to custom and the humour of parents. The great rule to be observed is, That a child have no more clothes than are necessa- ry to keep it warm, and that thy be quite easy for its body. Stays are the very*bane of iiih'its. A volume would not suffice to point out all the bael effects of this ridiculous piece of dress both on children and adults. The madness iu favour of stays seems however, to be somewhat abated; and it is to be hoped the world will, in time, become; w^e enough to know, that the human shape does uot solely de- pend upon M-hale-bone and bend leather.*1 1 shall only add with respect to the clothes of children, that they ought to be ke; t thoroughly clean. Children perspire more than ad- ults; and if their clothes be not frequently changed, they become very huff.f>d. Dirty clothes not only gall and fret the tender skins of infants, but likewise occasion ill smells; and what is worst, teud 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 supafiuous humours, which, if retained, could net fail to occasion diseases. No mother or nurse can h?tve any excuse fur allowing a child to be dirty. Poverty may oblige her to i;ivc it coarse clothes; but if she does uot keep them clean, it must be Oer owu fault. if the Food of Children. Nature not only points out the food proper for au infant, but actaai- 'y prepares it. lids however, is not sufficient to prevent some who ■iiink themselves wiser than Nature, from attempting to bring up theiv children without her provision. Nothing can shew the disposition which mankind have to deynrt from Nature more than their endeav- ■ 'i ;;:^- so bring up children without the breast. The mother's milk, * v that of a healthy nurse, is uncfiestiouably the best food for an infant. .'■"erthor art nor nature can afford a proper substitute f>r it. Children ::>ay seem to thrive for a few months without the breast; but when '* Stays made of bend leather are worn by all the women of lower station in tr.^ny 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. A^ reasoning would be totally lost upon such people, I shall beg leave just t» ask them, Why there are ten deformed women for one man? and like- wise to recommend to their perusal a short moral prcc:;»t, v.hich ivz bid a USiODlIiOJSJl IL'E lILtiK BODY. OF CHILDREN. 21 teething, the Fmal'-pox, and other diseases incident to childhood, come on, they generally perish. A child, soon after the birth, shews an inclination to suck; aEd there is no reason why it should not be gratified. It is true, the mother's milk does not always cnmc 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 ail die drugs in the apothecary'* shop, and at the same time prevents iuftammatious 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 beguiling 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 wish- 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 sv rups, 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 are seldom long af- ter the birth w ithout 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 wateT alone, with tlie addition of a little raw sugar. If this be given without any wines or spkeries, 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 natur- ally suggests the need of cordials. Accordingly wines are universally mixed with the first food of children. Nothing can be more fallacious than this way of reasoning, or more hurtful to infants than the conduct founded upon it. Children require very little food for some time after the birth; and what lirc-y receive should be thin, weak, light, and of a cooling 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 iafants 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 digest- ion, 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 -3 OF CHILDREN. 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 ; ami it may at all times be allowed as much plain bread as it will eat. The very chewing of bread will promote the cutting of the teeth, and the discharge of saliva, while by mixing with the nurse's milk in the stom- ach, it will afford an excellent nourishment. Children discover an ear- ly inclination to chew whatever is put into their hands. Parents ob- serve the inclination, but generally mistake the object. Instead of giv- ing the child something which may at once exercise its gums and af- ford it nourishment, they commonly put into its hands a piece of hard metal, or impenetrable coral. A crust of bread is the best gum stick. It not only answers the purpose better than any thing else, but has the additional properties of nouri&hing the child and carrying the saliva dow u to the stomach, which is too valuable a liquor to be lost. Bread, besides being used dry, may be mauy ways prepared into food for children. One of the best methods is to boil it iu water, af- terwards pouring the water off, and mixing with the bread a proper quantity of new milk unboiled. Milk is both more wholesome anel nourishing this way thau boiled, and is less apt to occasion costiveness. For a child further advanced, bread may be mixed iu veal or chicken broth, made into puddings or the like. Bread is a proper food for chil- dren at all limes, provided it be plain, made of wholesome grain, and well fermented ; but when enriched with fruits, sugars, or such things, it becomes very unwholesome. It is soon enough to allow children animal food when they have got teeth to eat it. They should never taste it till after they are weaned, and even then they ought to use it sparingly. Indeed, when children live wholly on vegetable Tood, 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 mixt- ure of animal and vegetable food as most proper for children. Few things prove more hurtful to infants than the common method of sweetening their foods It entices them to take more than they ought to do, which makes them grow fat and bloated. It is pretty certain, it' the fooil of children were quite plain, that they would never take more than enough. Their exeesses are entirely owing to nurses. If a child be gorged with food at all hours, and enticed to take it, by ma- king it swcot and agreeable to the palate, is it any wonder that such a child should iu time be induced to crave more food than it ought to hav, ? Children may be hurt by too little as well r.c too much food. After a child is weaned, it ought to be fed four c r five times a day; but should never be accustomed to eat iu the ni~ht; neither should it have too much at a time. Children thrive best with small quantities of food OF CHILDREN. 20 frequently given. This neither overloads tlic stomach nor hurts the digestion, 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 run into the opposite extreme, and ruined the consti- tutions of their children. But the error of pinching children in their food is more hurtfal than the other extreme. Nature had many ways of relieving 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, we are ready to acknowledge; but where one child is hurt by the quantity of its food, ten suffer from the enialily. This is the principal evil, and claims our strictest atten- tion. Many people imagine, that the food which they themselves love, can- not be bad for their children: but this notion is very absurd. Iu the more advauccd periods of life we often acquire an inclination for food, which wheu children we could not endure. Besides, there are many things that by habit may agree very well with the stomach of a grown person, which would be hurtful to a child; as high-seasoned, salt, and smoke-dried provisions, &c. It would also be improper to feed chil- dren with fat meat, strong broths, rich soups, or the like. All strong liquors are hurtful to children. Some parents teach their children to guzzle ale, and other fermented liquors, at every meal. Such a practice cannot fail to do mischief. These children seldom escape the violence of the small pox, measles, hooping-cough, or some inflam- matory 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 w»rm stimu- lants ; 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 eligestion, and sour and relax the stomach, by which means it becomes a proper nest for insects. Children indeed fchow a great inclination for fruit, and I am apt to believe, that if good ripe fruit were allowed them in proper quantity, it would have no bad < fleets. We never find a natural inclination wrong, if properly regu- lateel. Fruits are generally of a cooling nature, and correct the heat and acrimony of the humours. This is what most children require; ouly care should be taken lest they exceed. Indeed the best way 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 ef what is good.* * Children are always sickly in the fruit season, which may be thus accounted for. Two thirds of the fruit which comes to market in this country is teally unripe, aiid children not being in a conditio! to judge 30 OF CHILDREN. # Roots which contain a crude viscid juice should be sparingly given to children. They fill the body with gross humouis, and teud to pro- duce 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 vegeta- bles. Children had better ^at a smaller quantify of food which yields a wholesome nourishment, than be crammed with what their digestive powers are unable properly to assimilate. Batter ought likewise 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 iu most parts of Britain, wo would recommend honey. Honey is not only whole- some, but cooling, cleansing, and tends to sweeten the humours. Chil- dren 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 relaxei their solids, renders them weak, and disposes them to the rickets, scro- phula, and other glandular disorders. Relaxation is one of the most geueral causes of the diseases of children. Every thing therefore which tends to unbrace their solids, ought to be carefully avoided. We would not be understood by these observations as confiuing chil- dren to any particular kind of food. Their diet may be frequently va- ried, provided always that sufficient regard be had to simplicity. Of the Exercise ef Children. Of all the causes which conspire to render the life of man short and miserable, none have greater influence than the want of proper Exer- cise : Healthy parents, wholesome 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 necessary to the health, the growth, and the strength of children. The desire of exercise is coeval with 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 until man- for themselves, eat whatever they can lay their hands npon, which of- 'en proves little better than poison to their tender bowels. Servants, nnd others who have the care of children, should be strictly forbid to ^ve them any fruit without the knowledge of their parents. OF CHILDREN. M itfactures began to flourish, and people, attracted by the love of gain, left the country to follow sedentary employments in great towns. It is amongst these people that this disease chiefly prevails, and not only deforms but kills many of their offspring. The conduct of other youug animals shews the propriety of giving ex- ercise to children. Every other animal makes use of its organs of mo- tion as soon as it can, and many of them, even when uuder no neces- sity of moving in quest of food, cannot be restrained without force. This is evidently the case with the calf, the lamb, and most other young; animals. If these creatures Avere uot permitted to frisk about and take exercise, they Avould soon die or become diseased. The same inclina- tion appears very early in the human species; but as they are uot able to take exercise themselves, it is the business of their parents and nurses to asri-t them. Children may be exercised various ways. The best method, while 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 than%vinging 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 mauy 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 way, of swinging them in leading strings, fixed to their backs, has several bad consequences. It makes them throw their bodies forward, and press with their whole weight upou the stomach and breast; by this means the breathing is ob- structed, the breast flattened, and the bowels compressed ; which must hurt the digestion, and occasion consumptions of the lungs and oiher dis- eases. It is a common notion, that if children are set upon their feet too soou, their legs will become crooked. There is ie:is.j:i to believe, that the very reverse of this is true. Every member acquires strength iu pro- poriion as it is exercised. The limbs oi* children are weak indeed, but their bodies are proportion^!}- light; and had they skiil to direct thein.- stlves, they would soon be able to support their own weight. Whoever beard of u;jy other animal that became crooked by using its legs too soon ? Indeed, if a child is not permitted to make any use of its legs till .i considerable time after the birth, and be then set upon them with i:» whole weight at once, there may be some danger; but this proceeds "The nurse ought to be careful to keep the child in a proper position; as (let'jrndnv is of.on the consequence of inattention to this circumstance. Its situatioricught also to be frequently changed. 1 have known a child's !?£ bent i>'A ^ o&csHe,by the Kiirso carry•,•<■ itcous'xatJy c.-i one arm. 32 OF CHILDREN. entirely from the child's not having been acenstomed to use its tegs from the beginning. - Mothers of the poorer sort think they are great gainers by making their children lie or sit while they themselves work. In this they greatly mistake. By neglectins; 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 cat e. 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 power. Poverty often obliges them to neglect their offspring in ordet to procure the necessaries of life. When this is the case, it becomes the interest as well as the duty of the public tv assist them. Ten thou- sand times more benefit would accrue to the state, by enabling the poor to bring up their own 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 convinced of the necessity of exercise for the health of children. The body is composed of an infinite number of tubes, whose fluids cannot lie pushed on without 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. Na- ture has furnished both the vessels which carry the blood and lymph with numerous valves, in order that the action of every muscle might push forward their contents; but without action, this admirable contri- vance can have no effect. This part of the animal economy proves to a demonstration the necessity of exercise for the preservation of health. Arguments to show the importance of exercise might be drawn from every part of the animal economy; without exercise, the circulation of the blood cannot be properly carried e>n, nor the different secretions duly performed; without exercise, the fluids cannot be properly pre- pared, 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. But to point out the manner hi which these effects are proeluced, would lead us further into the economy of the human body, than most of those for Avhom this treatise is intended would be able to * If it were made the interest of the poor to keep their children alive, Ave should loose a cry few of them. A small premium given an- nually to each poor family, for every child they had alive at the year's end, would save more lives of infants than if the whole revenue of the nation were expended on hospitals far this purpose. This would make the poor esteem fertility a blessing; Avhcreas many of them think it the greatest curse that can befal them, and in place of Avishing their chidren to live, so far does poverty get the better of natural affection, that they are often very happy when they die. OF CHILDREN. 33 follow. We shall therefore only add, that, when exercise is neglected, »ione of the animal functions can be duly performed; and when that is the case, the Avhole constitution must go to wreck. 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 *i;>opy in life : and whoever neglects it, not only fails in his duty to his offspring, buttosociety. One very common error of parents, by which they hurt the consti- •j'.t'-ons 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 school-master 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 can- not fail to produce the worst effects upon the body; nor is the mind less injured. Early application Aveakens the faculties, and often, fixes iu the mind an aversion to books, Avhich continues for life.* But suppose this were the way to make children scholars, it cer- tainly ought not to be done at the expence of their constitutions. Our ancestors, who seldom went to school very young, Avere not less learned than Ave. But we imagine the boy's education will be quite marred, unless he be carried to school in his nurse's arms. No wonder if such rmt-bed plants seldom become either scholars or men! Not only the confinement of children in public schools, but their number, often proves hurtful. Children are much injured by being kept in crowds within doors; their breathing not only renders the place umvholesome, but if any one of them happens to be diseased, the rest catch the infection. A single child has been often known to communi- cate the bloody flux, the hooping cough, the itch, or other disease, to al- most every individual in a numerous school. But, if fashion must prevail, and infants are to be sent to school, wa would recommend it to teachers, as they value the interests of society, mi to confine them too long at a time, but allcAV them to run about and play at such active diversions as may promote their growth, and -;fie.i:gthen their constitutions. Were boys, instead of being Avhipped 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 would have many excellent effects. * It 11 undoubtedly the duty of parents to instruct their children, at ieast 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 lilial affecti;:::, of the want of which there are at present so many dcplo- iidjle instances. Though few fathers have time to instruct their chil- dren, vet nos: irotliPiv^havi., and surely thev cannot be better cm* ;Yu-d. 3d OF CHILDREN. It would be a great service to boys, if, at a proper age, they w«w- taught the military exercise. This Avould increase their strength, in- spire them with courage, and Avhen their country called for their as- sistance, would enable them to act in her defence, without being obli- ged to undergo a teelioiis and troublesome course of instructions, at a time Avhen they are less fit to learn new motions, gestures, &c* Au effeminate education will infallibly spoil the best natural constitu- tion ; and if boys are brought up in a more delicate manner than even girls ought to be, they will never be men. Nor is the common education of girls Isss 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 cousequenccs of obliging girls to sit too much. They are pretty Avell known, anJ are too often felt at a certain time of life. But supposing this critical period to be got over, greater dan- gers still await then Avhtn they come to be mothers. Women who haA'e been cany accustomed to a sedentary life, generally run great hazard in chi'd-bed; while those who have been used to romp about, and take sufficient exercise, are wddom in any danger. One hardly meets wish a girl who can at the same time boast of ear- ly performances by the needle, sirul a good constitution. Close and early confinement generally occasions indigestions, head-aches, pale complex- ions, pain of the stomach, loss of appetite, coughs, consumptions of the lun,<;s, anil deformity of body. The last of these indeed is not to be wondered at, considering the awkward postures in Avhich giils sit at many kinds of needle work, and the delicate flexible state of their bod- ies iu the early periods of life. Would mothers, instead of. having their daughters instructed in many trifling accomplishments, employ them in plain work and house-wifeiy, ami allow them sufficient fcxertise in the open air, they Avould both make them more healthy mothers, and more useful members of society. I am no enemy to genteel accomplishments, but would have them only con- sidered as secondary, and always disregarded Avhen they impair the health. Many people imagine it a great advantage for children to be early taught to earn their bread. This opiuion is certainly right, pro- vided they wore so employed as not to hurt their health or growth; but, when these suffer, society, instead of being benefited, is a real loser by their labour. There are few employments, except sedentary oLes, by which children can earn a livelihood; and if they be set to these too * 1 am happy to find that the funsters of academies now begin to put in practice this advice. EsM bath, because some nurses make a wrong use of it. Every child when in health, should at least have its extremities-daily Avashed in cold water. Tlu<; is a partial use of the cold l.dh, and is better than none. In winter this may suffice; but, in the warm season, if a child be rtlax^d, or seem to have a tendency to the rickets or scrophula, its whole body ought, to be frequently immersed in cold water. Care however must be taken not to (So this when the body is hot, or the storcae h full. The. child should be dipped ouly once at a time, should be taken out imme- diately, and have its skin well rubbed with a dry cloth. The bad EfJ'ecls of univholesomc Air upon Children. Few things prove more destructive to children than confined or un- wholesome air. This is one reason Avhy so few of those infants who are put into hospitals, or parish workhouses, live. These places are geuerally crowded with old,s:c! l:'| the vessel*, occasion asthmas, runtures, pleurisies, &c. AND THE STUDIOUS. Xl Those ^ho labour Avithout doors are often afflicted with intermitting "fevers or agues, occasioned by the freqtient Adcissitudes of heat and "old, poor living, bad water, sitting or lyiug on the damp ground, even- ing dews, night air, &c. to which they are frequently exposed. Such as bear heavy burdens, as porters, labourers, «fec. are obliged to draw in the air with much greater force, and also to keep their lungs dis- tended 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. Hippocrates men- tions au instance to this purpose, of a man, who, upon a Avager, carried au asa, but Avas'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 twice. Sometimes it proceeds from vanity or emulation. Hence it is, that the strongest men are most commor'y hurt by heavy burdens, hard labeur, or feats of activity, ft is rare to find one Avho boasts of strength with- out a rupture, a spitting of blood, or some other disease, Avhich he reaps as the fruit of his folly. One would imagine the daily instances we have of the fatal effects of carrying great weights, running, Avrestliug, and the like, would be sufficient to pre\'eut such practices. There are indeed some employments whjch 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 their strength to the utmost, nor Avork too longl . When the muscles are violently strained, frequent re3t is necessary, in order that thay may recover their tone; Avithout this, the strength and constitu- tion will soon be Avorn out, and a premature old age be induced. The erysipelas, or St. Anthony's fire, is a disease veTy incident to the laborious. It is occasioned by Atfhatever gives a Sudden check to the perspiration, as drinking cold Avater when the body is warm, Avet feet, keeping on wet clothes, sitting or lying on the damp ground, &c. It is impossible for > those who labour without doors ahvays to guard against these inconveniences; but it is known from'experience, that their ill consequences 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 likewise proceed from flatulent and indigestible food. Labourers gener- ally eat uofermented bread, made of peas, beans, rye, and other windy ingredients. They also devour great quantities of unripe fruits, baked, stewed, or raw, with various'kinds of roots and .herbs, upon which they ofteu drink sour milk, stale small beer, or the like. Such a mixture cannot fail to fill the bow els with Avind, and occasion diseases in those parts. Inflammation, whitloes, and other diseases of the extremeties, are like- wise common among those Arho labour without doors. These disease? it THE LABORIOUS, THE SEDENTARY, are. often attributed to venom, or some kind of poison ; but they gener- ally proceed either from sudden heat idler cold, or the contrary. When labourers, roilk-maios, &c. come from the field, cold or wet, they run to the fire, and often plunge their hands in Avarm water, by which me;»ns the blood and other humours in those parts are suddenly expanded, aiid„ the vessels not yielding so quickly, a strangulation happens, and an in- flammation or a mortification ensues. When such per: 01 s come home cold, they ought to keep at a distance from the fire for some time, to wash their hands iu cold water, and rub them well with a dry cloth. It sometimes happens, that people are so benumbed with cold, as to be quite deprived of the use of their limbs. In this case the only remedy is to rub the parts afl'ected with snow, or A«here it cannot be had, with cold water. If they bo held near the fire, or plunged iuto Avarm 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 euel of the summer and the beginning of autumn, are frequently occasioned by thi* ineat':(. When labourers leave off work, which they ought always to do daring the heat of the day, they should go home, or at least get un- der some cover where they may repose themselves in safety* Many people follow their employments 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 work, the more frequently they should eat. If the humours be not frequently replenished with fresh nourishment, they soon become putrid, and produce fevers of the very AVorst kind. Many peasants are extremely careless with respect to what they eat or drink, and often, through mere indolence, use miAvholesome food, when they might, for the same expence, have that which is Avholtscme. In some parts of Britain, the peasants are too careless even to take the trouble of dressing their own victuals. Such people would live upon one meal a-day, in indolence, rather than labeur, though it were to pro- cure them the greatest affluence. Fevers of a very bad kind are often occasioned among laboureis by poor living. When the body is not sufficiently nourished, the humours become vitiated, and the solids weak; from whence the most fatal con- sequences 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, when pinched in their food, are generally af- fected with diseases of the skin, which seldom fail to disappear ay hen they are put upon a good pasture. This shows how much a good state of the humours depeuds upon a sufficient qirantity of proper nourish- ment. Poverty not only occasions, but aggravates many of the diseases of 'lie laborious. Few of them haA'cmuch fere sight; and, if they had, it AND THE STUDIOUS. 45 is seldom iu their poAver to save any thing. They are glad to make a shift to live from day to day; and when any disease overtakes them, they are 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 wit- nesses 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 necessaries of life. Labourers are often hurt by a foolish emulation, which 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 away their lives iu this manner, deserve to be looked upon in no better light than self murderers. The office of a soldier, in time of war, may be ranked among the la- borious employments. Soldiers suffer many hardships from the in- clemency of seasons, long marches, bad provisions, hunger, watching, unwholesome climates, bad water, &c. These occasion fevers, fluxes, rheumatisms, and other fatal diseases, which generally do greater exe- cution than the sword, especially when campaigns are continued too late in the season. A few weeks of cold rainy weather will often prove more fatal than an engagement. Those who have the command of armies should take care that their soldiers be well clothed and well fed. They ought also to finish their campaigns in due season, and to provide their men Avith dry and well aired winter quarters. These rules, taking care, at the same time, to keep the sick at a proper distance from those in health, Avould tend great- ly to preserve the lives of the soldiery.* * It is indeed to be regretted, that soldiers suffer not less from indo- lence and intemperance in the time of peace, than from hardships in time of war. If men arc 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 obtained, 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 loAvered, public Avorks, 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 kiud might easily be conducted, so as not to depress the martial spirit, pro- vided the men Avere only to work four or five hours eveiy day, aBd al- Avays to Avork without doors; no soldier should be suffered to work too long, or to follow any sedentary employment. Sedentary employments render men weak and effeminate, quite unfit for the hardships of war; whereas Avorkiug for a few hours every day without doors, Avould in- ure them to the Aveather, brace their nerves, and increase their strength and courage. Au THE LABORIOUS, THE SEDENTARY, Sailors may also be numbered among the laborious. They underg* great hardships from the change of climate, the violence of the weath- er, hard labour, bad provisions, Arc. Sailors are of so great impor- tance that too much pnins cau never be bestowed in pointing out the mesns 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, without regard to the rlimatc, or their own constitutions, they plunge headlong into all man- ner of riot, and often persist till a fever puts an end to their lives. Thus intemperance, and not rti'• 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, Avhen on duty, cannot avoid sometimes getting Aret. When this happens, they should change tlfeir clothes as soon as they are re- lieved, and take every method to restore the perspiration. They should not iu this case, make too free with spirits or other strong li- quors, but should rather drink them diluted with warm Avater, and go immediately to bed, where a sound sleep and gentle sweat Avould 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 Ave cannot help thinking, that much might be done towards effecting so desirable an end, were due paius bestowed for that purpose. For example, various roots, greens, and fruits, might be kept a long time at sea, as onions, potatoes, cab- 1 ages, lemons, oranges, tamarinds, apples, &c. When fruits cannot be kept, the juices of them, either fresh or fermented, may. Writh these ?.ll the driak, and nd puddings made of peas or other vegetables, ought to be used plenti- fully. Ma:jy other things will readily occur to people conversant h AND THE STUDIOUS. 4* these Diallers, iphich Avould tend to preserve the health of tljat brave tuid useful set of men.* We have reason to believe if due attention were paid to the diet, air, cloathing, and above all things to the cleanlinessf of seafaring people, they Avould be the most healthy set of men in the Avorld; but when these are neglected, the very reverse will happen. The best medical antidote that Av'e can recommend to sailors or sol- diers on foreign coasts, especially Avhcre dampness prevails, is the Pe- ruvian bark. This will often prevent fevers, and other fatal diseases. About a drachm of it may be chewed 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 powdered, may be infused for two pr three days in an English qua^t of brandy, and half a wine glass of it may be taken twice or thrice a day, Avhen the stomach is empty. This has been found to be an excellent antidote against fluxes, putrid, intermitting, and other fevers, in unhealthy climates. It is not mate- rial iu Avhat form this medicine is taken. It may either be infused in Avater, Avine, or spirits, as recommended above, or made into an electu- ary with syrups of lemons, oranges, 6r the like. The Sedentary. Though nothing can be more contrary to the nature of man than a sedentary life, yet this class comprehends by far the greater pari of the species. Almost the Avhole'female Avorld, and iu manufacturing countries, the major part of the males, may be reckoned sedentary. J * The celebrated Captain Cook has shoivn how far, by proper care and attention, the diseases formerly so fatal to seamen may be prevent- ed. In a voyage of three years and eighteen days, during which he was exposed to eA'ery climate, from the 52 eieg. north, to the 71 t)cg. of south latitude, of one hundred ati.l eighteen men, composing the ship's comuauy, he lost only one, Avho died of a Ththisis Pulmonalis. The principal means he used were, to preserve a strict attention to cleanli- ness, to procure abundance of vegetable and fresh provisions, espe- cially good Avater, and to allow his people sufficient time for rest. t A regulation on board the United States' Navy, requiring every individual, at least once a week to ivash their feet clean, is worthy of general attention, as a me:\:i3 of preserving health. \ The appellation of sredentary has generally been given only to the studious? Ave can see no reason, however, for restricting it to tkci-, alone. Many artificers may, with as much propriety, be denominated sedentary as the studious, Avith this particular disadvantage, that they are often obliged to sit in very awkward postures, which the studlnu-, jiecd not do, unless they please. 43 THE LABORIOUS, THE SEDENTARY Agriculture, the first aud most healthful of all employments, is now followed by few who are able to carry on any other business. But those who imagine that the culture of the earth is not sufficient to em- ploy 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 ought a modern Briton, if he would be contented to live like a Roman. This shews what an immense increase of inhabitants Britain 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 neglected, Avhatever wealth may be imported from abroad, poverty and misery will abouud at home. Such is, aud ever will be, the fluctuating state of trade and manufactures, that thousands of people may be in full employment to-day and in beggary tomorrow. This can never hap- pen to those avIio cultivate the ground. They can eat the fruit of their labour, 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 twelve, he will soon become diseased. But it is not want 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 dozen tay!ors,*or stay-makers, for exam- ple, crowded into one small apartment, where there is hardly room for one person to breathe freely. In this situation they generally contin- ue for many hours at a time, often with the addition of several candle*, Avhich tend likewise to AVaste 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 to- gether, renders the air unwholesome. The danger from this qilirte: Avill be greatly increased, if any one of them happens to haATe bad lungs, or to be otherwise diseased. Those who sit near him, being forced to breathe the same air, can hardly fail to be infected. It would be a rare thing, however, to find a dozen of sedentary people all in good ' A person of observation in that line of life told me, that most tav- lors die of consumptions; Avhich he attributed chiefly to the unfavoura- ble postures in Avhich they sit, THE LABORIOUS, THE SEDENTARY, ulination for exercise; Ave shall, however, throw out a few hints w-iuV respect to the most likely means for preserving the health of this useful ■set of people, Avhich ?ouie of them, we hope, will be wise enough to. take. It has been already observed, that sedentary artificers are often hurt by their bending posture. They ought therefore to staud or sit as erect as the nature of their employments will permit. They should JikeAvise change their posture frequently, and should never sit loo long at a time, but leave off work, and Avalk, ride, run, or do auy thing that. will promote the vital functions. Sedentary artificers are generally allowed too little time for exer- cise; yet short as it is, they seldom employ it properly. A journey-. man taylor or weaver, for example, instead of walking abroad for ex- ercise and fresh air, at his hours of leisure, chuses often to spend therrj in a public house, or in playing at some sedentary game, by which he generally looses both his time and his money. The awkward postures in Avhich 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 taylors to sit round with liberty for their legs either to hang down, or rest upon a foot- board as they should chuse. A place might ljkeArise be cut out for each person, in such a manner that he might sit as conveniently for working as in the preseut mode of sitting cross-legged. All sedentary artificers ought to pay the most religious regard to cleanliness. Both their situation and occupations render this highly necessary. Nothing would contribute more to preserve their health, !ta:i 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 iieijjhbours. Sedentary people ought to avoid food that is windy or hard of di- gestion, aud should pay the strictest regard to sobriety. A person who ^vorks hard without doors will soon throw off a debauch; but one a?ho tits has by no means an equal chance. Hence it often happens, that sed« rrtrny people are sx-i.v-d with levers after hard drinking. When ruch persons feel their spirits low, instead of running to the tavern for relief, 'key should ride or walk in the field. This Avould remove the, complaint more effectually than strong liquor, and Avould never huii: the constitution. Instead of multiplying rules for preserving the health of the sedenta- ry, avc shall recommend to them the following general plan, viz. That every person who foHows a sedentary employment should cultivate »i piece: of ground with his own hands. This he might dig, plant, sow, f.nd weed at leisure hour?, so as to make it both an exercise and amuse- ment, Avhile H produced many of the necessaries of life. After work- ing aa hour in a garden, a man will return with more keenness to hi* employment within doors, than if he had been aU. the while idle* AND THE STUDIOUS. ll labouring the ground is every way conducive to health. It not on- ly gi v es exercise to every part of the body, but the very smell of the earth and fresh herbs revives and cheers the spirits, whilst the perpet- ual prospect of something coming to maturity, delights and entertain; the minet. We are so formed as to be always pleased with something in prospect, however distant or however trivial. Hence the happiness that most men feel iu 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 well ay herein true happiness consisted as we do. It may seem romantic to recommend gardening to manufacturers in great towns; but observation proves that the plan is very practicable. In the town of Sheffield, in Yorkshire, where the great iron manufac- ture is carried on, there is hardly a journeyman cutler who does not pos- sess a piece of ground, which he cultivates as a garden. This prac- tice has many salutary effects. It not only induces these people to take exercise without doors, but also to eat many greens, roots, expanded in those who do not take proper exercise; and where tin* is the case, obstructions and adhesions will ensue. Not only want of fcxercisc, but the posture in which studious persons generally sit, is Very hurtful to the lungs. Those who read or write much are ready to contract a habit of bending forwards, and .often press with their breast upon a table or bench. This posture cannot fail to hart the lungs. The functions of the heart may likewise by this means be injured* I remember to have seen a man opened, whose pericardium adhered to the breast-bone in such a manner as to obstruct the motion of the heart, aud occasion his death. The only probable cause that could be as- signed for this singular symptom was, that the man, whose business was writing, used constantly to sit in a bending posture, Avith his breast pressing upon the edge of a plain table. No person can enjoy health who does not properly digest his food. But intense thinking and inactivity uever fail to Aveaken the poAvers of digestion. Hence the humours.become crude and vitiated, the solids weak and relaxed, and the whole constitutioa goes to ruin. Long aad intense thinking often occasions grievous head- achs, which bring on virtigoes, apoplexies, palsies, and other fatal disorders. The best way 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 mediciue.. Those who read or write much are often afflicted with sore eyes. Studying by caudle-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 every night and morning in cold Avater, to which 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 in this way. Any person may observe, that sitting mtkes his legs sAvell, and that this goes off by exercise; Avhich clearly points out the method of prevention. Fevers, especially of the nervous kind, are often the effect of study. Nothing affects the nerves so much as intense thought. It in a man- ner unhinges the whole human frame, and not only hurts the vital mo- tions, hut disorders the mind itself. Hence a delirium, melancholy, and even madness, are often the effect of close application to study. In fine, there is no disease which can proceed either from a bad state of the humours, a defect of the usual secretions, or a debility of the nervous system, which may not be induced by intense thinking. But the most afflicting of all the diseases Avhich attack the studious is the hypochondriack. This disease seldom fails to be the companion of deep thought. It may rather be called a complication of malarlies Voau a single one. To what a wretched condition are the best of rueii «4 THE LABORIOUS, THE SEDENTARY, often reduced by it! Their strength and appetite fail; a perpetual gloortl hangs over their minds; they live in the constant dread of death, and are contiuually in search of relief from medicine; where, alas'. it ia not to be found. Those who labour under this disorder, though they are often made the subject of ridicule, justly claim our highest sympa- thy 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 member of society. He often neglects the most important duties of life, in 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 farthet men dive into profound researches, they generally deviate the more from common seuse, and too often loose sight of it altogether. Profound speculations, instead of making men wiser 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, is easily obtained; and the rest, like the forbidden fruit, serves ouly to increase his misery. Studious persons, iu order to relieve their minds, must not only dis- continue to read and write, but engage in some employment or diver- sion that will not so far occupy the thought as to make them forget the business of the closet. A solitary ride or walk, are so far from relax- ing the mind, that they rather encourage thought. Nothing can divert the mind Avhen 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 consequently relieve it. Learned men often contract a contempt for what they call trifling company. They are ashamed to be seen with any but philosophers. This however is no proof of their being philosophers themselves. No man deserves that name who is ashamed to unbend his mind, by asso- ciating with the cheerful and gay. Even the society of children will relieve the mind, and expel the gloom which 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 Dot only prevent the bad effects which attend confined air, but Avould cheer the spirits, and have a most happy influence both on the body and mind. It is said of Euripides the tragedian, that he used to retire to a dark cave to compose his tragedies, and of Demosthenes the Gre- cian orator, that he chose a place for a 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 Avhere the all cheering rays of the sun render the air wholesome, as in places where they never enter. AND THE STUDIOUS. 51 Those who read or write much should be very attentive to their po»- ture. They ought to sit and stand by turns, always keeping as nearly In an erect posture as possible. Those Avho dictate, may do it walk- ing. It has an excellent effect frequently to read or speak loud. This not only exercises the lungs, but almost the whole body. Hence stu- dious people are greatly benefited by delivering discourses in public. Public speakers, indeed, sometimes hurt themselves, by overacting their part; but that is their own- fault. The martyr to mere vociferation. merits not our sympathy. The morning has, by all medical writers, been reckoned the best time for study. It is so. But it is also the most proper season for ex- ercise, Avhile the stomach is empty, and the spirits refreshed with sleep. Studious people should therefore sometimes spend the morning in walk- ing, riding, or some manly diversions without doors. This would make them return to study with greater alacrity, and would be of more ser- vice than twice the time after their spirits are worn out with fatigue. It is not sufficient to take diversion, only when we can think no longer. Every studious 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, and inspire cheerfulness and good humour. 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 oue, and always proves destructive. Would such persons, when their spirits are low, get oa horseback, and ride ten or a dozen miles, they would find it a more ef- fectual remedy than any cordial medicine in the apothecary's shop, ov all the strong liquors in the world. The following is my plan, and I cannot recommend a better to oth» ers. When my mind is fatigued Avith study, or other serious business, 1 mount my horse, and ride ten or twelve miles into the country, where I spend a day, and sometimes, two with a cheerful friend; after which * " 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 grate- ful and gentle stimulus, it removes fatigue, restores the excitement o{ the mind, and invigorates the whole system. I am no advocate for the excessive use of tea. When taken loo 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 be i>eve it is, iu general, iunoxious, and, at all times, to be preferred to ardent spirits, as a cordial for studious rjen." x. e. »6 OF ALIMENT. I never fail to return to town with hcav vigour, and to pursue my stu- dies or business with fresh alacrity. It is much to be regretted, that learned men, Avhile in health, pay so little regard to these things! There is not any thing more common that to see a miserable object over-run with nervous diseases, bathing, Avalk- iDg, riding, and, in a word, doing every thing for health after it is gone j yet, if any one had recommended these things to him by Avay of pre- vention, the advice would, in all probability, have been treated with contempt, or, at least, with neglect. Such is the Aveakncss and folly of mankind, and such the want of foresight, even in those who ought to be wiser than others! With regard to the diet of the studious, we see no reason why they shoidd abstain from any kind of food that is wholesome, provided they use it in moderation. They ought, however, to be sparing in the use of every thing that is Avindy, rancid, or hard of digestion. Their sup- pers should always be 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, cor ever carried to the degree of excessive fatigue. They ought like- wise 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 general, riding on horseback, walking, Avorking in a gar- den, or playing at some active diversions, are the best. We would likewise recommend the use of the cold bath to the studi- ous. It will, 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 immedi- ately after a full meal. CHAPTER III. OF ALIMENT. UNWHOLESOME food, and irregularities of diet, occasion many diseases. There is no doubt but the whole constitutioa of body may be changed by diet alone. The fluids may be thereby attenuated or condensed, rendered mild or accrimonious, coagulated or viluted, to almost any degree. Nor are its effects upon the solids less OF ALIMENT. Jj7 considerable. They may be braced or relaxed, have their sensibility, motions, &c. greatly increased or diminished, by different kinds of ali- ment. 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 •nly; it is likewise of importance in the cure of diseases. Evt.y in- tention iu the cure of many diseases, may be answered by diet alone. Its effects 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 ob- tained. Our intention here is not to inquire minutely into the nature and prop- erties of the various kinds of aliment in use among mankiud; nor to show their effects upon the different constitutions of die human body; but to mark some of the most pernicious errors which people are apt to fall iuto, with respect both to the quantity and 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 ni- cety here is by no means necessary. The best rule is to. avoid all ex- tremes. Maukind Avere never intended to weigh and measure their food. Nature teaches every creature when it has enough; vand the calls of thirst and hunger are sufficient to inform them when more is necessary. Though moderation is the chief rule 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 sea- sons may either prevent the ripening of grain, or damage it afterwards. These, indeed, are acts of Providence, and we must submit to them; but surely no punishment can be too severe for those who suffer pro- visions 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 Avell as vegetable food, may be rendered unwholesome, by being kept too long. All animal substances have a constant ten- dency to putrefaction; and, when that has proceeded too far, they not only become offensive to the senses, but hurtful to health. Diseased animals, and such as die of themselves, ought never to be eaten. It is a common practice, however,,in some grazing countries, for servants * 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. 8 &£ OF ALIMENT. and poor people to eat such animals as die of any disease, or r.ie Rni- ed by accident. Poverty, indeed, may oblige people to do this; but they had better eat a smaller quantity of what is sound and wholesome; it would both afibrd a better nourishment, and be attended with less danger. The injunctions given to the JeAvs, not to eat fury creature Avhich died of itself, seemed to have a strict regard to health; and ought to be ob- served by Christians as Avelfas Jews. Animals never die themselves Avithout some previous disease; but how a diseased animal should be wholesome food, is inconceivable; even those which die by accident must be hurtful, as their blood is mixed with the flesh, and soon turns putrid. Animals which feed grossly, as tame ducks, hogs, &c. are neither so easily digested, nor afford such wholcscnie nourishment as others. No animal can be whole 3ome which does not take sufficient exercise. Most of our stalled*cattle are crammed with gross food, but not allow- ed exercise nor free air; by which means they indeed groAv fat, but their juices not being properly prepared or assimilated, remain crude, and occasion indigestions, gross humours, and oppression of the spirits, in those who feed upon them. Animals are often rendered unwholesome by being overheated. Ex- cessive heat causes a fever, exalts the animal salts, and ndxes the blood so intimately with the flesh, that it cannot he separaied. For thir. rea- son, butchers should be severely punished who over-drive their cattle. No person would chuse to eat the flesh of an animal which had died in a high fever; yet this is the case with all overdrove cattle; and the fever is often raised even to the degree ol madness. But this is uot the only Way by which butchers render meat unit hole- some. The abominable custom of filling the cellular membrane with air, in order to make them appear fat, is every day practised. 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 disgust a person ot any delicacy at every thing which comes from the shambles. Who can bear the thought of eating meat which has been blown up with air from the lungs of a dirty fellow, perhaps labouring under the very worst of diseases ? Butchers have likewise a method of filling thz cellular membranes of animals with blood. This makes the meet seem fatter, and likewise weigh more, but is notwithstanding a very pernicious custom, as it both renders the meet unwholesome and unfit for keeping. I seldom see a piece of meat fiom the shambles, where the blood is uot 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 arc killed for domestic use, and prop rly blooded. Veal seems to be most frequently spoilt in this Avay. Perhaps that may iu some meaeai-e be owing to the practice of carrying calves fi >-z OF ALIMENT. s.great distance to market, by which means their tender fiesh is bruis- ed, and many of their vessels burst. No people in the Avorld eat such quantities of animal foed as the Eng- lish, which is one reason Avhy they are so generally tainted with the scurvy, aud its numerous train of consequences, indigestion, lovr spirits, ■hypochoudriacism, &z. Animal food AYas surely designed for man, and •with a proper mixture of vegetables, it will be found the most whole- some ; but to gorge beef, mutton, pork, fish, and fo/vl, twice or thrice a day, is certainly too much. All who value health ought to be con- tented with making one meal of flesh in twenty-four hours, and this ought to consist of one kind only. The most obstinate scurvy ha? often been cured by a vegetable di- et; nay, milk alone will frequently do more in that disease than any medicine. Hence it is evident, that if vegetables and milk were more used in diet, we should have less scurvy, and likewise fewer putrid and inflammatory fevers. Fresh vegetables, indeed, came to be daily niose used in diet; this laudable practice Are hope will continue to gain 'ground. , Our aliment ought neither to be too moist nor too dry. Moist ali rnent relaxes the solids, and renders the body feeble. Thus Ave see females, who live much on tea and other watery diet, generally be- come Aveak and unable to digest solid food; hence proceed hysterics, and all their dreadful consequences. On the other hand, food that is too dry, renders the solids in a manner rigid,, and the humours viscid, which disposes the body to inflammatory fevers, scurvies, and the like. Much has been 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 now the uni- versal breakfast in this part of the world, but the morning is surely the most improper time of the ctay for drinking it. Most delicate persons, who, by the bye, are the greatest tea drinkers, cannot eat any thing iu the morning. If such persons, after fasting ten or twelve 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 oArn nature. By jumbling together a number of diffe- rent ingredients, in order to make a poignant sauce, or rich soup, the composition proves almost a poison. All high seasoning, pickles, &c. are only incentives to luxury, and never fail to hurt the stomach. It Avere well for mankind, if cookery, as an art, Avere entirely prohibit- ed. Plain roasting or boiling is all that the stomach requires.. These alone are sufficient for people iu health, and the sick have still less x?eed of a cook, 60 OF ALIMENT. The liquid part of our aliment likewise claims our attention. Wate? is not only the basis of most liquors, but also composes a great part ot our solid food. Good water must therefore be of the greatest impor- tance in diet. The best water is that which is most pure, and free from any mixture of foreign bodies. Water takes up parts of most bodies with which it comes into contact; by this means it is often impregoa* ted with metals or minerals of a hurtful or poisonous nature. Hence the inhabitants of s«me hilly countries have peculiar diseases,.which in all probability proceed from the water Thus the people Avho live near the Alps iu Switzerland, and the inhabitants of the Peak of Der- by in England, have large tumours or wen's on their necks. This dis- ease is generally imputed to the snow water ; but there is more reason to believe it is owing to the minerals in the mountains through at Inch the Avaters pass. When water is impregnated with foreign bodies, it generally appears by its weight, colour, taste, smell, heat, or some other sensible quality". Our business therefore is to choose such water, tor common use, as is lightest, and Avithout any particular colour, taste, or smell. In most places of-Britain the inhabitants have it in their poiver to make choice of their Avater, 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 die Avater that is nearest to them, without considering its qualities. Before wafer is brought into great towns, the strictest attention ought to be paid to its qualities, as many diseases may be occasioned or ag- gravated by bad water; and when orfceit has been procured at a great expence', people are unAvilling to give it up. The common methods of rendering water clear by filtration, or soft, by exposing it to to the sun and air, G2 OF ALIMENT. fine; well fermented, and made of wheat flower, or rather of Avrresft and rye mixed together. To specify the different kinds-of aliment, to explain their nature and properties, r,;id to point out their effects in different constitutions, would- far exceed the limits of our design. J nstead of a detail of this kind, 'which would nut be generally understood, and of course little attended to, we shall only mention the following easy rules with respect to the choice of aliment. Persons whose soiieis 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 j- highly nourishing, as fat meat, rich wines, strong ale, and .such like. Their food should consist chiefly of bread and other vege- table substances; and their drink ought to be water, whey or small beer. Fat people should not eat freely of oily nourishing diet. They ouglrt frequently to use horse-raddish, garlic, spices, or -such things as are heating and promote perspiration and urine. Their drink should be water, coffee, tea, or the like; and they ought to take much exercise and little sleep. Those who are too lean must follow an opposite course. Such as are troubled with acidities, or Avhose food is apt to sour oa the stomach, should live much on animal food; and those who are af- flicted with hot billious eructations, ought to use a diet consisting chief- ly of acid vegetables. People who are afflicted with the gout, low spirits, hypochondriac or hysteric disorders, ought to avoid all flatulent food, every thing that is viscid, or hard of digestion, all salted or smoke-dried provisions, and what- ever 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 tb 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 indi- gestible to a citizen; and the latter willlrve upon a diet on which the former would starve. Diet ought not to be too uniform1. 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 giving 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 OF ALIMENT. *. siiur, all austere and, astringent aliments; and those who are scorbutic should be sparing iu the use of salted provisions, &c. In the first period of life our food ought to be light, but nourishing, and frequently taken. Food that is tolid, with a sufficient degree of tenacity, is moskproper for the state of manhood. The diet suited to the last period of life, .when nature is upon the decline, approaches nearly to that of the first. It should be lighter and more succulent than that of vigorous age, and likewise more frequently taken. It is not only necessary for health that our diet be wholesome, but also that it be taken at regular periods. Some imagine that long fasting will atone for excess; but this,.instead of mending the matter, •generally makes it worse. Wheu the stomached intestines are over distended with food, they lotje their proper tone, and, by long fasting, they become weak, and inflated with wind. Thus, either gluttony or fasting des- trovs the powsrs of digestion. The frequent repetition of aliment is not only necessary for repair- in" the continual waste of our bodies, but likewise to keep the fluids eound and sweet. Our humours, even in the most healthy state, have a constant tendency to putrefaction, which can only be prevented by frequent supplies of fresh nourishment: when that is wanting too long, fhe putrefaction often proceeds so far as to occasion very dangerous le- vers. From hence we may learn the necessity of regular meals. Pso person can enjoy a good state of health, whose vessels are either fre- quently overcharged, or the humours long deprived of fresh supplies of chyle. a . . , ... Lon- fasting is extremely hurtful to young people; it not only viti- ates their humours, but prevents their growth. Nor is it less injurious to the aged. Most persons, hi the decline of life, are afflicted with wind- this complaint is not only increased, but even rendered dange- rous, and often fatal, by long fasting. Old people, when their stomachs are empty, are frequently seized with giddiness, head-achs, and taint- Bess. These complaints may generally be removed by a piece of bread and a glass of, wine, or taking any other solid food; which plainly points out the method of preventing them. '" It is more thau probable, that many of the sudden deaths, which happen iu the advanced periods of life, are occasioned by fasting too loo-, as it exhausts the spirits, and fills the bowels with wind : we would therefore advise people in the decline of life, never to allow their stom- achs to be too long empty. Many people take nothing but a few cups of tea and a little bread, from nine o'clock at night till two br three next afternoon. Such maybe 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 wind; all which might be prevented by a solid ■11*1^9 ic Fust It is a very common practice to eat a light breakfast and a heavy ^pper. This custom ought to be reversed. When people sup late. 64 OF ALIMENT. 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 v, ill be sure to find an appetite for his .break- fast, 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. repletiou. Many diseases, especially fevers, are the effect of a plethora, or too great fulluess 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 obstruct- ions and inflammations ensue. Hpnce so many people are seized with inflammatory and eruptive fevers, apoplexies, &c. after a feast or de- bauch. All great and sudden changes in diet are dangerous. What the stomach has been long accustomed to digest, though less wholesome, ■will agree better with it than food of a more salutary nature to which it has not been used. When therefore a change becomes necessary, it ought always to be made gradually; a sudden transition from a poor and low, to a rich and luxurious diet, or the contrary, might so dis- turb the functions of the body as to endanger health, or even to occa- sion death itself. When we recommend regularity in diet, we 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 ahvays , 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, we think the following uot unworthy attention. " Beef.—When this is the flesh of a bullock of middle age, it affords good and strong nouiishment, and is peculiarly well adapted to those who labour, or take much exercise. It Avill often sit easy upon the s|»machs that can digest no other kind of food; and its fat is almost as easily digested as that of veal. " real is a proper food for persons recovering from an indisposition, and may even be given to febrile patients in a very iveak state, but it affords less nourishment than the flesh of the same animal iu a state of maturity.. The fat of it is lighter than that of* any other animal, and shows the least disposition to putrescency. Veal is a very suitable food OF ALIMENT. 65 in costive 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 dry pasture, is an excellent meat. It is of a middle kind between the firmness of 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 digestion. The head of the sheep, especially Avhen 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 extreme- * ly suitable to delicate stomachs. " House-lamb, though much esteemed by many, possesses the bad qualities common to the flesh of all animals reared in an unnatural way. " Pork affords rich and substantial nourishment; and its juices are wholesome Avhen properly fed, and when the animal enjoys pure air and exercise. But the flesh of hogs reared in towns is both hard of digestion 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 stomach, it tends to harden the flesh, and of course, to make it more indigestible. " Smoakcd hams are a strong kind of meat, and rather fit for a rel- ish than for diet. It is the quality of all salted meat that the fibres be- come rigid, and therefore more difficult of digestion; and when to this is added smoakiog, 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 en weak stomachs. " The flesh of goats is hard and indigestible; but that of kids is y tender, as well as delicious, and affords good nourishment. " Venison, or the flesh of deer, and that of hares,, is of a nourislung-. _ uality; but is liable to one inconvenience; which is, that though much isposed to puf rescency 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 oatmeal, f a moderate degree of strength; for, if too weak it certainly relaxes the stomach. As it has an astringent taste, which seems not very con- sistent 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 im- pregnated with a sufficient quantitity of tea to coriect its oavh < molient ieedency, produces a relaxation unjustly imputed to Eome noxious qual- OF AIR. 71 ity of the plaut. But tea, like every other commodity, k liable to damage, and when this happens, it may produce effects not necessarily connected with its original qualities. " Coffee. It is allowed that coffee promotes digestion, and exhila- rates the animal spirits; besides which various other qualities are as- 'cribed to it, such as dispelling flatulency, removing dizziness of the head, attenuating viscid humours, increasing the circulation of the blood, and consequently perspiration; but if drank too strong it affects the nerves, occasious watchfulness, and tremor of the hands, though in some phlegmatic constitutions it is apt to produce sleep. Indeed it is to persons of that habit that coffee is well accomme'Kted; for to people of a thin and dry habit of body it seems to be injurious. Tur- key coffee is greatly preferable in flavour to that of the West- Indies. Drunk only in the quantity of one dish after dinner to pro- mote digestion, it answers best without either sugar or milk: but if ta- ken at other times it should have both, or in place of jthe latter rather cream, which not only improves the beverage but tends to mitigate the effect of coffee upon the nerves. " 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 addition of vanilla and other ingredients it is made too heating, and so much affects particular constitutions as to excite nervous symptoms, especially complaints of the head. CHAPTER IV. OF AIR. UNWHOLESOME air is a very common cause of diseases. Few are aware of the danger arising from it. People generally pay some attention to what 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 with 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 proves more generally hurtful to mankind; we shall therefore endeavour to point out ioine of these, and to 'how whence the danger chiefly arise?. *2 OF AIR. Air may become noxious many ways. Whatever greatly alter- its degree of heat, cold, moisture, Ax. renders it unwholesome ; for example, that which is too hot dissipates the watery parts of the blood, exalts the bile, and renders the whole Immours adu:;t ami thick. Hence proceed billious and inflammatory fevers, cholera morbus, A:c. Very cold air obstructs the perspiration, eonstringes the solids, and condenses the fluids. It occasions rheumatisms, coughs, and catarrhs, with other diseases of the throat and breast. Air that is too moist de- stroys the elasticity or spring of the solids, induces phlegmatic or lax constitutions, and disposes the body to agues, or intermitting fevers, dropsies, &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 iu crowded churches, assemblies, or any place wJiere the air is injured by breath- ing, 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 not only breathed repeatedly over, but is likewise loaded with sulphur, smoke, and other exhalations, besides the vapors continually arising from innumerable putrid substances, as dunghills, slaughter houses, &c. All possible care should be taken to keep the streets of large toivns open and wide, that the air may have a free current through them. They ought likewise to be kept very clean. Nothing tends more to pollute and contaminate the air of a city than dirty streets. It is very common in this country to have church-yards in the mid- dle of populous cities. Whether this be the effect of ancieut supersti- tion, or owing to the increase of such towns, is a matter of no conse- quence. Whatever gave rise to thi6 custom, it is a bad one. It is habit alone which reconciles us to these things; by means of which the most ridiculous, nay pernicious customs, often become sacred. Cer- tain it is, that thousands of putrid carcasses, so near the surface of the earth, in a place Avhere 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 carcasses must render it still Avorse. Churches are commonly old buildings with arched roofs. They are seldom open above once a week, are never ventilated by fires nor open A?indows, 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 * In mest eastern countries it Avas customary to bury the dead at some distance from any toATn. As this practice obtained among the Jews, the Greeks, and also the Romans, it is strange that this country should not have folloAved their example in a custom so truly laudable. OF AIR. 73 valetudinary.' These inconveniences might, in a great measure, be ob? viated, by prohibiting all persons from burying within churches, by keeping them cleau, and permitting a stream of fresh air to pass fre? quently through them, by opening opposite doors and AvindoAvs.* Wherever air stagnates long, it becomes uuAvbolesome. Hence the unhappy persons confined in jails not only contract malignant fevers themselvto, 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. These low dirty habitations are the very lurking places of bad air and contagious diseases. Such as live in them seldom enjoy good health ; and their childreu commonly, die young. Iu the choice of a house, those who have it in their pow- er ought always to pay the greatest attention to open free air. The various methods which luxury has invented to make* houses close and warm, contribute not a little to render then; 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, iustead ofbeing made up as soon as people rise out of them, ought to be turned down, and exposed to the fresh air from the open windows through the day. This would expell any noxious vapour, and could not fail to promote the health of the inhabitants, Iu hospitals, jails, ships, &c. where that cannot be conveniently done, ventilaters should be used. The method qf expelling foul and introdur cing 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 advan- tages, both to those in health and sickness. In all places, where num- bers of people are enwded together, ventilation becomes absolutely ne- cessary. . Air which stagnates in mines, wells, cellars, &c. is extremely nox- ious. 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 in opening cellars that have been long shut, or going down into deep wells or pits, especiallyif they have beeu kept close covered.t Many people who have splendid houses, chuse to sleep in small apartments. This conduct is very imprudent. A bed chamber ought * One cannot pass through a large church or cathedral, even in sum- mer, Avithout feeling quite chilly. t We have daily accounts of persons Avho lose their lives by going down into deep Arells anil other places where the air stagnates; all these acci- dents might be prevented by only letting down a lighted candle before them, and stopping when they percieve it go out; yet this precaution, simrde as it is, is seldom used. 10 ■u OF AIR. always to be well aired ; as it is generally occupied in the night o<3»y.-» when all doors and windows are shut. If a fire be kept in it, the dan- ger from a small room becomes still greater. Numbers have been sti- fled when asleep by a fire in a small apartment, Avlnch is always hurtful. Those who are olf.igcd, on account of business, to spend the day iq close towns, ought if possible, to sleep in the country. Breathing tree air ia the night will, in some measure, make up for the Avant ol it ^ through the dry. This practice would have a greater effect in pre- serving the health, of c'izens than is commonly imagined. Delicate persons ought, asnu'ch as possible, to aAroid the air of great towns. It is peculiarly hiirtfuf .to the asthmatic and consump- tive. Such persons should avoid cities as ih*y Avould the plague. 1'he hypochondriac are likt -rise ;. is to take them by turns, and to use that longest which is most suitable to the strength aud the constitution. Those kinds of exercise which gave action to most of the bodily organs, are ahvays to be preferred, as ivalking, running, riding, digging, rubbing furniture, and such like. i.- It is much to be regretted, that manly and active diversions are now so litde practised. Diversions make people take more exercise than they otherwise would 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. Sedeuta- , ry diversions are of no pther use but to consume time. Instead of re- • lieving 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 diversions which afford the best exercise are, hunting, shooting, playing at cricket, hand-ball, golff,* &c. These exercise the limbs, promote perspiration and the jjther secretions. They likewise strength- en the lungs, and gi\ e firmness and agility to the Avhdle body. ouch as caa, ought to spend two or three hours a-day on horse-back; those Avho cannot ride,-should employ the same time in walking. Ex- ercise should pever be continued too long. Over-fatigue prevents the benefit of exercise, and instead of strengthening the body tends to weak- en it. _____________________________________________________________\ * Golff is a diversion very common in North Britain. It is well cal- culated for exercising the body, and may always be taken in such mod- eration, as neither to over-heat nor fatigue. It has greatly the prefe- rence over cricket, tenuis, or aDy of those games which cannot be'pltry*- ed without violence. •f SLEEP AND CWTHING. 78 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 many who Avere fond of ex- ercise in the early p'art of life, become quite averse to it afterwards. This is the case of most hypochondriac and gouty people, which ren- ders their diseases in a great measure incurable. In some countries laws have been made, obliging every man, of what. ever rank, to learn some mechanical employment. Whether such laws were designed for the preservation of health, or the encouragement of manufacture, is a question of no importance. Certaiu it is, that if gen- tlemen were frequently to amuse and exercise themselves in this way, it might have many good effects. ' They w ould at least derive as much honour from a few iqasterly specimens of their own Arorkmanship, as from the character of having ruined most of their companions by'ga- ming or drinking;.' Besides men of leisure, by applying themselves to the mechanical arts, might improve them, to the great benefit of society. Indolence not only occasions diseases, and renders men useless to society, but promotes all manner of vice. To say a man is idle, id little better than to call him vicious. The mind, if not engaged in some useful pursuit, is constantly iu quest of idle pleasures, or impres- sed with the apprehension of some imaginary eyi!- From these sources proceed most of the miseries of mankind. Certainly man Avas never intended to be idle. Inactivity frustrates the very design of his crea- tion ; whereas an active life is the best guardian of virtue, and the greatest preservative of health. CHAPTER VI. OF SLEEP AND CLOTHING. SLE E P, as well as diet, ought to be duly regulated. Too little sleep weakens the nerves, exhausts the spirits, and occasions diseases; and too much renders the mind dull, the body gross, and disposes to apopl xies, 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, thaj another by eight or ten. 80 OF SLEES AND CLOTHING. Children may always be allowed to take as much sleep as they please g but for adults, six or seven hours is certainly sufficient, aud no one uu°ht to exceed eight. Those Avho lie a-bed more than tight hours may slumber, but they can hardly be said to sleep; silch generally toss and dream away the fore-part of the night, siuk to rest toAvards morning, and dose till noon. The best Avay to make sleep sound and refreshing is to rise betimes. The custom of laying a-bed for nine or ten hours, not only makes the sleep less refreshing, but relaxes the solids, and greatly weakens the constitution. Nature points out night as the proper season for sleep- Nothing more certainly destroys the constitution than night-watching. It is great pity that a practice so destructive to health should be so much in fashion. How quickly the want of rest iu due-season w ill blast the most blooming complexion, or rum the best constitution, is evident from the ihastly countenances of those Avho, as the phrase is, turn day into night, and night into day. To make sleep refreshing, the following things are requisite : First, to take sufficient exercise in the open air; to avoid strong tea or coffee; next, to eat a light supper; and lastly, to lie down with a mind as cheerful and serene as possible. It is certain that too much exercise will prevent sleep, as well as too little. We seldom hoAvever hear the active and laborious complain of restless nights. It is the indolent and slothful who generally have these complaints. Is it any wonder that a bed of doAvn should not be re- freshing 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 neglect the latter can never relish ..the* former. The labourer enjoys more true luxury in plain food and sound sleep, than is to be found iu sumptuous tables and downy pilloAVs, where exercise is wanting. That light suppers cause sound sleep, is true even to a proverb. Many persons, if they exceed the least at that meal, are sure to have uneasy nights; and, if they fall asleep, the load and oppression on their stomach and spirits occasion frightful dreams, broken and dis- turbed repose, the night-mare, Arc. Were the same persons to go to bed with a light supper, or sit up till that meal was pretty well digested, they would enjoy sound sleep, and rise refreshed and cheerful. There are indeed some people who cannot sleep, unless they have taken some solid food at night, but this does not imply the necessity of a heavy supper; besides, these are generally persons Avho have accustomed themselves to this method, and who do not take a sufficient quantity of solid food and exercise. Nothing more certainly disturbs our repose than anxiety. Whew the mind is not at ease, one seldom enjoys sound sleep. This greatest of human blessings flies the Avretched. and visits the happy, the" cheer- ful and the gay. This i. a sufficient reason Avhy every man should endeavour to be as easy in mind as possible when he gees to rest. Ma* OF SLEEP AND CLOTHING. 81 ny, by indulging grief and anxious thought, have banished sound sleep so long, that they could never afterwards enjoy it. Sleep, Avhen taken in the fore-part of the night, is generally reckon- ed 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 then 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 aud 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 in- habitant of Nova Zembla and the Island of Jamaica. It is not indeed necessary to observe an exact proportion between the quantity of clothes we wear, 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, while the blood is hot and the perspiration free, it is less necessary to cover the body with a great quantity of clothes; but in 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 wea- ring such as are better calculated for promoting tha discharge from the skin, as clothes made of cotton, flannel, &c. The clothing ought likewise to be suited to the season of the years. Clothing may be warm enough for summer, which is by no means suf- ficient for winter. The greatest caution, however, is necessary in ma- king 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 fre- quently cold weather even after the commencement of the summer months. It would likewise be prudent not to make the change all at once, but do it gradually; and indeed the changes of apparel in this * 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 is the only circumstance attending longevity to which I never knew an exception? U 82 OF SLEEP AND CLOTHING. climate ought to be very inconsiderable, 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 con- sidered clothes in this view ; accordingly their fashion and figure have bees continually varying, with very little regard either to health, the climate, or conveniency; a farthingale, for example, may be very ne- cessary in hot southern climates, but surely uothiug can be more ridic- ulous in the coltl rtgiotts of the north. Even the Immau shape is often attempted to be mended by dress, and those who know no better believe that mankind would be monstrous Avithout its assistance. AU attempts of this nature are highly perni- cious. The most destructive of them in this country is that of squeezr- jng the stomach aud boAvels into as narrow a compass as possible, to procure, Avhat is falsely called a fine shape 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 in- digestions, syncopes or fainting fits, coughs, consumptions of the lungs, and other complaints so common among females. The feet likewise often suffer by pressure. How a small foot came to be reckoned genteel, I Aril! uot pretend to say ; but certaiu 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 straight shoes. Corns are uot only very troublesome, but by rendering people unable to Avalk, they may likewise be consid- ered as the remote cause of other diseases J 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 person? * That colds kill moke than plagues, is an old observation: and, with regard to this country, it holds strictly true. Every person of discernment, 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 iu March or April, induce them to throw off their winter garments, without considering that our most penetrating colds generally happen in the rpring. t This madness seems to have pervaded the minds of mothers in ev- ery age and country. Terence, in his comedy of the Eunuch, ridi- cules the Roman matrors for attempting to mend the shape of their daughters. t We ofteu see persons, who are rendered quite lame by the nails of their toes having grown into the flesh, and frequently hear of mortifi- cations proceeding from this cause. All these, and many .other incon- veniences attending the feet, must be imputed solely to the use of th.ojr.tt 3&d straight shoes. OF SLEEP AND CLOTHING. s$ 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 iasttch 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 wilt uever walk well in this manner. It strains her joints, distorts her limbs, makes her sloop, 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 walk well. In fixing on the clothes, due care should be taken to avoid all tight bandages. Garters, buckles, &zc. Avhen drawn too tight, not only pre- vent the free motion and use of the parts about which they are bound, but likewise obstruct the circulation of the blood, Avhich prevents the equal nourishment and growth of these parts, and occasions various diseases. Tight bandages about the neck, as stocks, cravats, neckla- ces, vv( i 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 Avhole creation iu quest of luxuries, to his own destruction. An elegant Writer* of the last age, speaks thus of intemperance in diet: " For my part, when I behold a fashionable table set out in all its magnificence, I fancy that I Sec gouts aud dropsies, fevers and lethargies, with other innumerable distempers, lying in ambuscade among the dishes." 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 constitution ! Indeed these vices generally go hand in hand. Hence it is that we so often behold the votaries of Bacchus and Venus, even before they have arrived at the prime of life, worn out Avith diseases, and hastening with swift pace to an xitimely grave. Did men reflect on the painful diseases aad pre- mature deaths, which are daily occasioned by intemperance, it would be sufficient to make them shrink back with horror from the indulgence even of dnir darling pleasures. Intemperance does not hurt its votaries alone; the innocent too often feel the direful effects of it. Hoav many wretched orphans are to be seen embracing dung-hills, whose parents regardless of the future, spent in riot and debauch what might have served to bring up their off- spring in a decent manner ! How often do we behold the miserable mother, with her helpless infants, pining in want, Avhile the cruel father is indulging his insatiate appetites. Families are not only reduced to misery, but even extirpated by in- temperance. Nothing tends so much to prevent propagation, and short* en the lives of children as the intemperance of parents. The poor man who labors all day, and at night lies down contented with his hum- ble 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 their influence upon health, we shall only, by way of example, make a few observations on one particular species of that vice, vis.Xhe abuse of intoxicating liquors. * Addison. 6 r C F IN TEMPER AN L\ Ever}' act of intoxication puts nature to the expense of a fever m order to discharge the poisonous draught. When this is repeated al- most every day, it is easy to foresee the consequences. That constitu- tion must bestroug, indeed, which is able long to hold out under a daily fever ! but fevers occasioned by drinking do not alwajs go oil in a day ; they frequently eud in an inflammation of the breast, liver, of 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, Avhen u-rd to an excess, weaken the bowels aud spoil the digestion ; they destroy the poAver of the nerves, and occasion paralytir and convulsive disorders; they likeAviseheat and iaflame the blood, destroy its balsandc quality, render it unfit for circnlatiou, aud the nourishment of the body. Hence obstructions, atrophies, dropsies, and consumptions of the lungs. These are the common ways in which drunkaids make their exit. Diseases of this kiud, when brought on by hard drinking, seldom admit of a cure. Many people injure their health by drinking, Avhoseldom 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 constant- ly full and upon the stretch, the different digestions can neither be duly performed, nor the humours properly prepared. Hence most people of this character are afflicted with the gout, the gravel, ulcerous sores in the legs, Arc. If these disorders do not appear, they are seized with low spirits, hypochondriacal affections, and other symptoms of indi- gestion. Consumptions are noAV so common, that it is thought one-tenth of the inhabitants of great towns die of that disease. Hard drinking is uo 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, caunoj; fail to render the blood sizy and unfit for circulation; from whence proceed obstructions, and inflamma- tions of the lungs. There are feiv great ale drinkers who are not phthiscal; nor i6 that to be wondered at, considering the glutinous and almost indigestible nature of strong ale. Those avIio drink ardent spirits or strong wines, run still greater hazard ; these liquors heat and inflame the blood, and tear the tender vessels of the lungs to pieces; yet so great is the consumption of them in this country, that one would almost be induced to think that the in- habitants lived upon them.* * We may form some notion of the immense quantity of ardent spi- rits consumed in Great Britain from this circiimstance, that in the city of Edinburgh and its environs, besides the great quantity of foreign spi- rits duly entered, and the still greater quantity which is supposed to foe ^rp'ifrpl'd, it is computed that above two thousand private stills are OF INTEMPERANCE. 87 1 ••■ The habit of drinking proceeds frequently from misfortunes in Kfe. The miserable fly to it for relief It affords them indeed a temporary ease. But, alas ! this solace is short liv;ed ; aud Avhen it is over, the spirits sink as mtlch below their usual tone as they had before been raised above it. Hence a repetition of the dose becqmcs necessary, and every fresh dose makes way for another, till the unhappy wretch becomes a slave to the bottle, aud 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 i3 gone off. Hence it is that those who have the greatest flow of spirits while the-glass circulates freely, are of all others the most melancholy when sober, and often put an end to their own miserable existence iu a fit of spleen or ill humour. Drunkenness not only proves destructive to health, but likewise to the 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 iu silking so far below them. Were such as voluntarily deprive themselves of the use of reason, to continue ever after in that condition, it avouKI seem but a just punishment. Though this be not the consequence of oue act of intoxication, it seldom fails to succeed a course of it. By a habit of drinking, the greatest geuius is often re- duced to a mere idiot f Intoxication is peculiarly hurtful to young persons. It heats their, blood, impairs their strength, and obstructs their growth; besides the frequent use of strong liquors in the early part of life destroys any be- nefit that might arise from them afterwards. Those who make a prac- tice of drinking generous liquors when young, cannot expect to reap any benefit from them as a cordial in the decline of life. constantly employed in preparing a poisonous liquor called Molassis. 'The common people have got so universally into the habit of drinking this base spirit, that when a porter or labourer is seen reeling along the streets, they say, ht, has got jviolasseh. f It is amazing that our improvements iu arts, learning and politeness have not put the barbarous custom of drinking to excess out of fashion. It is indeed less common in South Britain than it was formerly; but *?t still prevails very much in the North, Avheiethis relic of Barbariiy is mistaken for hospitality. There no man is supposed to entertain his guests well, who does not make them drunk. Forcing people to drink is certainly the greatest piece of rudeness th-- any man can be guilty of. Manliness, complaisance, or mere good-nature, may induce amaa to take his glass, if urged to it, at a time wheu he might as Avell take poison. The custom of drinking to excess has lo;ig been out of fashion iu France; and, as it begins to lose ground among the politer part of the English, Ave hope it will soon be banished from every part ol" this island. Sft OF CLEANLINESS. Drunkenness is not only in itself a most abominable vice, but is au inducement to many others. There is hardly any crime so horrid that the drunkard will uot perpetrate for the love of liquor. We have known mothers sell their children's clotheB, the food that they should have eat, and afterwards even the infants themselves, in order to pur- chase the accursed draught. CHAPTER VIII. OF CLEANLINESS. THE want of cleanliness is a fault which admits of no excuse. Where watar can be had for nothing, it is surely in the power of every person to be clean. The continual discharge from our bo- dies by perspiration, renders frequent change of apparel necessary* Changing apparel greatly promotes the secretion from the skin, so ne- .eessary for health. When that matter which ought to be carried off by perspiratjon, is either retained in the body, or reabsorbed from dirty clothes, it must occasion diseases. Diseases of the skin are chiefly owning to Avant of cleanliness.* They may indeed be caught by infection, or brought on by poor living, un- wholesome food, &c. but they will seldom continue long Avhere cleanli- ness prevails. To the same cause must we impute the various kinds of vermin which infest the human body, houses, Ax. These may always be banished by cleanliness alone, and wherever they abound, we have reason to believe it is neglected. One common cause of putrid and malignant fevers is the want of cleanliness. These fevers commonly begin among the inhabitants of close, dirty houses, who breathe unwholesome air, take little exercise, and wear dirty clothes. There the infection is generally hatched* which often spreads far and wide, to the destruction of many. Hence cleanliness may be considered as an object of public attention. It is * Mr. Pot, in his surgical observations mentions a disease Avhich he calls the chimney sivecper's cancer, as it is almost peculiar to that un- happy set of people. 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 cer- tainly the most miserable wretches on the face of the earth: yet fof tlcaning chimneys, no such persons are oecessary. OF CLEANLINESS. 3* 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 re- moved 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 becomes of the utmost importance. It is well known that infectious diseases are communicated by tainted air. Every thing 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 kind, 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, be- ing frequently covered with ashes, dung, and nastiness of every kind. Even slaughter-houses, or killing shambles, are often to be seen iu • ie very centre of great towns. The putrid blood, excrements, &c. with which these places are generally covered, cannot fail to taint the air, and render it unwholesome. How easily might this be prevented by active magistrates who have it always in their power to make proper laws relative to things of this nature, and to enforce the observance of them. We are sorry to say, that the importance of general cleanliness dees 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 pretensions people may make to learning) politeness, or civilization, we -will venture to affirm, that while they neglect cleanliness, they are iu a state of barbarity.* The peasants in most countries seem to hold cleanliness in a sort of contempt. Were it not for the open situation of their houses, they would often feel the bad effects of this disposition. One seldom sees a farm-house without a dunghill before the door, and frequently the cat- tle and their masters lodge under the same roof. Peasants are likewise # In ancient Rome the greatest men did not think cleanliness an ob- ject unworthy of their attention. Pliny says, the Cloacab, or com- mon seAvers for the conveyance of filth and nastiness from the city, were the greatest of all the public works; and bestows higher encomi- ums upon Tarquinius, Agrippa, and others who made aud improved them, than on those who achieved the greatest conquests. How truly great does the emperor Trajan appear, Avhen giving di- rections to Pliny h'13 proconsul, concerning the making of a commen sewer for the health and convenience of a conquered city ! 12 i-* OF CLEANLINESS. e\treuitiv careless with respect to change of apparel, keeping tie is bouses, Ax. clean. This is merely the effect of indolence and a dirty deposition. Habit maj indeed render it less disagreeable to them, but fio habit can ever make it salutary to wear dh y clothes or breathe uu- >. Lo^sonie air. As many articles of diet come through the hands of peasants, every 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 aud best article of any kind to market, as butter, cheese, Arc. and- by punishing severely those who bring it dirty. The same method should be taken with butchers, ba- kers, brewers, and all who are employed in preparing the necessaries of life. In c.;rr:ps the strictest regard should be paid to cleanliness. By neg- ligence iu this matter, infectious diseases sue often spread amongst a \riiole army; and frequently more die of these thau by the sword. The Jews, during their encampments in the Avilderuess, received particular instructions with respect to cleanliness.* The rules enjoined them ought to be observed by all in the like situation. Indeed the Avhole system of laws delivered to that people has a manifest tendency ic promote cleanliness. Whoever considers the nature of their climate, the dis- eases to which they were liable, and their dirty disposition, will see the propriety of such laws. It is remarkable that, in. most eastern countries, cleanliness makes a great part of their religion. The Mahometan, as Avell as the Jewish religion enjoins various bathings, washings, and purifications—No doubt these might be designed to represent inward purity; but they Avere at the same time calculated for the preservation of health. ITovveA'er whimsical these washings may appear to some, few thirgs Avould tend more to prevent diseases than a proper attention to many of them* Were every peison, 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 down to meat, he would run less hazard either of catching the infection himself, or of commuuicating it to others. / Frequent Avashing notouly removes the filth and sores which adh'ic to the skin but likewise promotes the perspiration,braces the body and enlivens the spirits. How refreshed, how cheerful, and agreeable docs one i'&$ on being shaved, washed, and shifted; especially Avhen these of- fices have been neglected longer than usual! * Thcu shalt havTe a place also Avithout the camp, whither thou shalt go forth abroad; and thou shalt have a paddle upon thy weapon: aud it shall be when thou shalt ease thyself abroad, thou shalt dig therewith, and shall turn back, and cover that which coweth fieri t-hee, Ac Deti- Scronomy, chap xxii. \ ei. 12, 13. OF CLEANLINESS. 3! The eastern custom of washing the fuet, though less necessary in this ■country, is nevertheless a very agreeable piece of cleanliness, and con- tributes greatly to the preservation of health. The sweat and dirt with which these parts are frequently covered, cannot fail to obstruct the perspiration. This piece ol cleanliness would often prevent colds and fevers. Were people careful to bathe their feet and legs in luke warm water at night, after being exposed to cold or wet through the day, they would seldom experieuce 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 way to prevent them, is to take care that the whole company be cleanly in their clothes, bedding &c. When infectious dis- eases do break out, cleanliness i^ the most likely means to prevent the;.r spreading: it is likewise necessary to prevent their returning afterward?, or being conveyed toother places. Fortius purpose the clothes, bed- ding, &c. of the sick ought to be carefully washed, aud fumigated with brimstone. Infection will lodge a long time in dirty clothes, and after- wards break out in the most terrible manner. In places where great numbers of sick people are collected together, cleanliaess ought to be most religiously observed. The very 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 perfect health has a greater chance to become sick, than a sick person has to get well. Few things are more unaccountable than that neglect, or rather dread of cleauliuess, which appears among those who have the care of the sick.; they think it almost criminal to suffer any thing that is clean to come near a person in a fever; for example they would rather allow him to wallow iu all manner of filth, than change the least bit of his Unea. If cleanliness be necessary 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 neg- lected, the slightest disorders are often changed into the most malignant. The same mistaken care which prompted people to prevent the least admission of fresh air to the sick, seems to have indaced them to keep them dirty. Both these destructive prejudices will, avc hope be sooa eradicated. Cleanliness is certainly agreeable to our nature. We cannot help approving it in others, even though we should not practice it ouisehe?. It sooner attracts our regard than even finery itself, and often gains esteem where 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 *re of more importance to society than general clanliness. It crrght u» •2 OF INFECTION. be carefully cultivated every where; but in populous cities it should be almost revered.* CHAPTER IX. OF INFECTION. MANY diseases are infectious. Every person ought therefore, as far as he can, to avoid all communication with the diseased. The common practice of visiting the sick, though often well meant; has many ill consequences. Far be it from me to discourage any act of charity or benevolence, especially towards those in distress; but I cannot help blaming such as endanger their own or their neighbours' lives by a m'-staken friendship, or an impertinent curiosity. Ih". hoi;. e? of the sick, especially in the country, are generally croA.ded from morning till night with idle visitors. It is customary in sue! places, for servants and young people to wait upon the sick by turns and evei to sit up with them all night. It would be a miracle indeed should such always tscape. Experience teaches us the danger of this conduct. People often catch fevers^i this way, and communi- cate them to others, till at length they become epidemic. It would be thought highly improper for one who had not had the small-pox, to wait upon a patient in that disease; yet many other fevers are almost as infectious as the smallpox, and not less fatal. Some im- agine that fevers prove more fatal in villages than in great towns for want of proper medical assistance. This may sometimes be the ease; 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 not be done more effectually than by the common method of visiting the * As it is impossible to be thoroughly clean without a sufficient quan- tity of water, we would earnestly recommend it to the magistrates of great towns to be particularly attentive to this article. Most great towns in Britain are so situated as to be easily supplied with water; and those Sersons who will not make a proper use of it, after it is brought fo their and, certainly deserve to be severely punished. The streets of great towns, where water can be had, ought to be washed every day. This is the only effectual method for keeping them thoroughly clean; and, upon trial, we are persuaded it will be found the cheapest. Some of the most dreadful diseases incident to human nature, might in my opinion, be entirely eradicated by cleanliness. OF INFECTION. 91 sick. Such visitors not only endanger themselves and their connections, but likewise hart the sick. By crowding the house they render the air unwholesome, a.id by their private whispers and dismal countenances disturb the imagination of the patient, and depress his spirits. Per- sons wiio arc d», especially in fevers, ought to be kept as quiet as possi- ble :■. lit sight of strange faces, and every thing that disturbs the mind hurts them. The c-mmou practice in country places of inviting great numbers of people to fuuerais. and crowding them into the same apartment where the corpse lie&, is snotl e • way of spreading infection. The infection does o»;r ai..ayb d»e with »be patient. Every thing that comes into contact w;'a his body while alive, receives the contagion, and some of them, *'• cloth is, blankets &c. will retain it for a long time. Persons wbo die of iuiecuous disorders ought not to lie long unburied; aud peo- ple, should * «?op as much as possible at a distance from them. lc K-outd tend greatly to prevent the spreading of infectious diseases, if .hose i.i Health were kepi at a proper distance from the sick. The Jew is • Legislator, among many other wise institutions for preserving health, has been peculiarly attentive to the means of preventing infec- tion, or defilement as it is called, either from a diseased person or a d*ad boiy. Io many cases the diseased were to be separated from those L health; aad it was deemed a crime even to approach their limitations. If a person only touched a diseased or dead body, he was appointed to wash himself in water, and to keep for some time at a distance from society. Infoctious diseases are often communicated by clothes. It is ex- treme!)' da-^erous to wear apparel which has been worn by the disea- sed, uuless it has beeu well 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 lit- tle care is commonly 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 teuth part of the care taken to prevent the importation of diseases, that there is to prevent smuggling, it would be attended with many happy consequences. This might easily be done by appoint- ing a physician at every considerable sea-port, to inspect the ship'* company, passengers, &c. before they came ashore, and, if any fe- rer or other infectious disorders prevailed, to order the 6hip to per- form a snort quarantine) and to send the sick to some hospital or prop- VA OF INFECTION. Infection is often spread through cities, by jails, hospital*, &c These are frequently situated iu the very middle of populous towns ; and when infectious diseases break out iu 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 popu- lar cities. The Avholc atmosphere of a large town is one contaminated mass, abounding with various kinds of infection, and must be pernicious to health. The best advice that Ave can give to such as are obliged to Jive in large cities, is to chuse an open situation; to avoid narrow, dir- ty , s.rects; to keep their own houses and offices cleau ; and to be as imich abroad in the open air as their time will permit. It would tend greatly to prevent the spreading of infectious diseases, *.rere proper nur»es every where employed to take care of the sick. This might often save a family, or even a whole town, 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 who are afflicted with diseases of an infectious nature. S»ch as Avait\ipon 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 cleau, 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 washed their hands; otherwise, if the disease be infectious, they will in all probability carry the contagion along with them.* er place to be cured. He might likewise order all the clothes, bedding, «fcc. which had been used by the sick during the voyage, to be either destroyed, or thoroughly cleansed by fumigation, &c. before any of it was 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 tfie faculty themselves. Many physicians affect a familiar way of sitting upon the patient's bed-side, aud holding his arm for a considerable time. If the patient has the small-pox, or any other infectious disease, 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 being exposed to the open air, which is not sel- dom the case, is it any wonder that he should carry the disease along with lum i' Physicians not only endanger others, but also, themselves by ilik practict. And ladsed they sometimes suffer for tfceir want of eare. OF INJECTION. 8S 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 with the sick, except the necessary attendance. I mean not, however, by this caution, to deter those whose duty or office leads them to wait upon the sick, from such a laudable and necessary employment. Many things are iu the power of the magistrate which would tend to prevent the spreading of iufectiou; as the promoting of public cleanli- ness ; removing jails, hospitals, burying grounds, and other places where infection may be generated at a proper distance from great towns ;* widening the streets; pulling down useless walls, and taking all meth- ods to promote a free circulation of air through every part of the toAvn, &c. Public hospitals, or proper places of reception for the sick, pro- vided they were kept clean, well ventilated, aud placed in an open sit- uation, would likewise tend to prevent the spreading of iufection. Such places of reception would prevent the poor, Avhen sick, from being vis- ited by their idle or officious neighbours. They would likewise ren- der it unnecessary for sick servants to be kept in their master's houses. Masters had better pay for having their servants taken care of in aa hospital, than run the hazard of having an infectious disease diffused among a numerous family. Sick servants and poor people, when pla- ced 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 prevent- ing infection, may become the means of diffusing it. When they are placed in the middle of great towns; when numbers of patients are crowded together in 9mali apartments; when there is a constant com- munication kept up between the citizens and the patients; and when cleanliness and ventilation are neglected, they become nests for hatch- ing diseases, and every one who goes into them not only runs a risk of receiving infection himself, but likewise of communicating it to others. This however is not the fault of the hospitals, but of those Avho have the management cf them. It Avere to be wished, that they were both more numerous, and upon a more respectable footing, as that Avould 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 oat among the poor, and are by them communicated to-' the more eleanly, and the wealthy. Were proper attention paid to the first appearances of such disorders, and the patients early conveyance to an hospital, we should seldom see a putrid fever, which is almost as infectious as the plague, become epidemic. * The aneients Avould uot suffer even the temples of their gods: \r\ufz ;f <;-;ck resorted, to be built within the Avails of a city. 1» OF THE PASSIONS. CHAPTER X. OF THE PASSIONS. THE passions have great influence both in the cause apd cure of diseases. How the mind affects the body, will in all probrbiliiy 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 whatever injures the one disorders the other. Of Anger. The passion of anger ruffles the wind, distorts the countenance, hui<* ries on the circulation of the blood, and disorders the whole vital and animal functions. It often occasions fevers, and other acute diseases; and sometimes eveu sudden death. This passion is pecnlisriy hurtful t6 the delicate, and those of weak nerves. I have knoirn such perbonn frequently lose their lives by a violent fit of anger, and vtouM advise them to guard against the excess of this passion with the ut.nost 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 Lhews true greatness of mind more than to forgive injuries; it promotes the peace of society, and greatly conduces to our own ease, health, and felicity. Such as value health should avoid violent gusts of anger, &« they would the most deadly poison. Neither ought they to indulge resent* inent, but to endeavour at all times to keep their minds calm and se- rene. Nothing tends so much to the health of the body as a constant tranquility 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 disposes us to diseases, but often render those diseases fatal which an undaunted mind would 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 an- other. Many have lost their lives, and others have been rendered OF THE PASSIONS. 91 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 child bed. Many of those who die in that situation are impressed with a notion of their death a long time before it happens; and there is reason to believe that this im- pression is often the cause of it. The methods taken to impress the minds of women with the appre- hension of the great pain aud peril of child birth are very hurtful. Few women die in labour, though many lose their lives after it; which may be thus accounted for: A woman after delivery, finding herself Aveak and exhausted, immediately apprehends she is in danger; but this fear seldom fails to obstruct the necessary evacuations, upon which her recovery depends. Thus the sex often fall a sacrifice to their own im- aginations, when there would be no danger, did they apprehend none. It seldom happeus that two or three women in a great town die in child bed, but their death is followed by many others. Every woman of their acquaintance who is with child dreads the same fate, and the disease becomes epidemical by the mere force of imagination. This sh u!d induce pregnant women to despise fear, and by all means to avoid those tattling gossips who are continually buzzing in their ears the mis- fortunes of others. Every thing that may in the least alarm a pregnant or child bed womau, ought with the greatest care to be guarded against. Many women 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 who think themselves in dan- ger are very inquisitive; and if they come to know that the bell tolls for one who died iu the 6ame situation with themselves, what must be the consequence ? At any rate they are apt to suppose that this is the case, aud it will 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 which it is difficult to support the patieut's spirits, prevail, what must be the effect of a fu- neral peal sounding five or six times a-day in his ears: No doubt his imagination 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, Ave ought to keep the sick as much from hearing it as possible, and from every other 13 .48 OF THE PASSIONS. thing that may tend to alarm them. So/ar 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 ene- mies. All who wish 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 caU 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 physi- cian barbarous enough to boast, that he pronounced more sentences than all his majesty's judges. Would to God that such sentences we're not often equally fatal! it may indeed be alledged, that the doctor does not declare his opinion before the patient. So much the worse. A sensi- ble patient had belter hear what the doctor says, than learn it from the disconsolate looks, the Avatery eyes, and the broken whispers of those about him. It seldom happens, when the doctor gives an unfavourable opinion, that it can be concealed from the patieut. The very embar- rassment which the friends and attendants shew in disguising what be has said, is generally sufficient to discover the truth. Kind heaven has, for the wisest ends, concealed from mortals their fate; and we do not see what right any man has to announce the death of another, especially if such a declaration has a chance to kill him. Mankind are indeed very fond of prying into future events, and sel- dom fail to solicit the physician for his opinion. A doubtful answer, how- ever, or one that may tend rather to encourage the hopes of the sick, is surely the most proper. This conduct could neither hurt the patient nor the physician. Nothing tends more to destroy the credit of phys- ic thau those bold prognosticators, who, by the bye, are generally the moBt ignorant of the faculty.—The mistakes which daily happen in this way are so many standing proofs of human vanity, and the weak- ness of science. 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 town and coun- try should know, immediately after the doctor has made his first visit, that he has no hopes of his patient's recovery. Persons whose imper- tinent curiosity leads them to question tile physician, w ith regard to the fate of Ws patient, certainly deserves no other thau an evasive answer. The vanity of foretelling the fate of the sick is uot peculiar to the fac- ulty. Others follow their example, and those who think themselves wiser than their neighbours, often do much hurt in this way. Human- ity surely calls upon every one to comfort the sick, and not to add to their affliction by alarming their fear^. A friend, or even a physician, may often do more good by a mild and sympathizing behaviour than by OF THE PASSIONS. 99 medicine, and should never neglect to administer that greatest of all cordials, Hori;:. Of Grief. Grief is the most destructive of all the passions. Its effects are per- manent; and Avhen 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, Avhich preys upon the spir- its, and wastes the constitution. This passion ought not to be indulged* It may generally be conquered at the beginning; but when it has gain- ed strength, all attempts to remove it are vain. No person can prevent misfortunes iu life; but it shows true greatness of mind to bear them with serenity. Many persons make a merit of indulging 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 incon- sistent with reason, religion and" common sense. Changs of ideas is as necessary for health as change of posture. When the mind dwells long upon one subject, especially of a disagreea- ble nature, it hurts the whole functions of the body. Hence grief in- dulged 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 in excellent constitution has been ruined by a family mis- fortune, or any thing that occasions excessive grief. It is utterly impossible that any person of a dejected mind should en- joy health. Life indeed maybe dragged out for a few years; but whoever would live to a good old age, must be good humoured and cheer- ful. This indeed is not altogether in our own power; yet our temper of mind, as well as our actions, depend greatly upon ourselves. We can either associate with cheerful or melancholy companions, mingle in the amusements and offices in life, or sit still and brood over our ca- lamities as we choose. These, and many such things, are certainly in our power, and from these the mind generally takes its cast. The variety of sceues which present themselves to the senses, were certainly designed to prevent our attention from being too long fixed up- 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 in distress. Turn the attention frequently to new objects. Examine them for some time. When the mind begins to recoil, shift the scene. By this means a con- stant succession of new ideas may be kept up, till the disagreeable ones entirely disappear. Thus travelling, the 6tudy of any art or science, reading, or writing on such subjects as deeply engage the attention, will sooner expel grief than the most sprightly amusements. TOO OF THE PASSIONS. It has already been observed, that the body cannot be healthy unless 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 Avho pursue business with attention are hurt by grief, Instead therefore of abstracting ourselves from the world or business when misfortunes happen, we ought to engage in it with more than 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 mind 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 oth?r happy effects. Some persons, when overwhelmed with grief, betake themselves to drinking. This is making the care woise 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 becomes violent, it is less s-ubjret to the coutroul either of the under- standing or will, than any of the rest. Fear, anger, and several other passions, are necessary for the pmcivation of the individual, I ut love is necessaiy for the continuation of the species itself: it was therefore proper that this passion thculd be deeply rooted in the human breast. Though love be a strong pasrion. it is seldom so rapid in its pro- gress as several of the others. Few peisous f:dl desp.'iately in love all at once. We would tin reforc advise every one, before he tampers with th:s passion, to consider well the probability of his being able to obtain the object of his wishes. Wheu 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 another object which may engage his af- fections, and which it may be iu 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 vauity, or on purpose to show their conse- quence with the fair. This is perhaps the greatest piece of cruelty which any one can be guilty of. What we eagerly with lor Ave easily credit. Hence the too credulous fair are often betrayed into a situa* tion Avhich is truly deplorable, before they are able to discover that the pretended lover was only in jest. But thore is no jesting with this passion. When love has got to a certain height, it admits of no othe* OF THE PASSIONS. 101 cure but the possession of its object, which in this case ought always, if possible, to be obtained.* Of Religious Melancholy. Many persons of a religious turn of mind behave as if they thought it a crime 10 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 pre) s upon their mimIs. At length the fairest prospects vanish, every thing puts on a dismal appearance, and those very objects which ought to giv« delight, afford nothing but disgust.—Life itself becomt-s a burthen, and the un- happy 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 become the cause of those very evils which it was designed to cure. Nothing can be better calculated than True Religion, to raise aud sup- port the mind of its votaries under every affliction that can befall them. It teaches men that even the sufferings of this life are preparatory to the happiness of the next; and that all who persist iu a course of vir- tue 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 tranquillity of mind, which 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 wicked- nrts, but can never inspire them with that love of God, and real good- ness of heart, in which alone true religion consists. To conclude; the best way to counteract the violence of any passion, is to keep the mind closely engaged in some useful pursuit. * The conduct of parents with regard to the disposal of their children iu marriage is often very blameable. An advantageous match is the constant aim of parents; while their children often suffer a real mar- tyrdom betwixt their inclinations and duty. The first thing which pa- rents ought to consult in disposing of their children in marriage, is cer- tainly their inclinations. Were due regard always paid to these, there would be fewer unhappy couples, and parents would not have so oft- en cause to repent the severity of their conduct, after a ruined consti- tution, a lost character, or a distracted mind, has shown them their mistake. 102 OF THE COMMON EVACUATION*. CHAPTER XI. OF THE COMMON EVACUATIONS. fTHHE principal evacuations from the human body are those by stool, JL urine, and insensible perspiration. None of these can be long ob- structed without impairing the health. Whtu that which ought to be thrown off the bod) is long retained, it not only occasions a plethora, or too great fullness of the vessels, but acquires qualities which are hurtful to the health, as acrimony, putrescence, &c. Of the Evacuation by Stool. Few things conduce more to health than keeping the body regular. When the faccs lie too long in the bowels, they vitiate the humours; and when they are too soon discharged, the body is not sufficiently nour- ished. A medium is therefore to be desired, which can only be obtained by regularity iu diet, sleep, and exercise.—Whenever the body is not regular, there is reason to suspect a fault in one or other of these, Persons who 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 digestiou will be good, or their discharges regular. Irregularity in eating and drinking disturbs eve- ry 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 generally occasions looseness, and the latter costiveness; but both have a teudency 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 al- lowed, that one stool a day is sufficient for an adult, aud that less is hurtful. But this, like most general rules, admits of many exceptions. I have known persons in perfect health who did not go to stool above once a-week.# Such a degree of costiveness however is not safe; though the person Avho labours under it may for some time enjoy tole- rable health, yet at length it may occasion diseases. * Some persons have told me that they did net go to stool above once a month, OF THE COMMON EVACUATIONS. 103 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 unfavoura- ble to regular stools, but also the warmth. This, by promoting the perspiratiou, lessens all the other discharges. The method recommended for this purpose by Mr. Locke is like- wise very proper, vis. to solicit nature, by going regularly to stool every morning whether one has a call or not. Habits of this kind may be acquired, Avhich 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, weaken the bowels, hurt the digestion, and every dose makes vvay for another, till at length they become as necessary as daily bread. Those who are troubled with costiveuess ought rather, if possible, to remove it by diet than drugs. They should likewise go thinly cloathed, and avoid every thing of an astringent or of an heat- ing nature. The diet and other regimen uecessary 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 like- wise 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 astringent quality, as wheat-bread made of the finest flour, cheese, eggs, rice boiled in milk, &c. Their drink should be reel 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 perspiration, persous affected with it ought to keep their feet warm, to Avear flannel next their skin, and take every other method to promote the perspira- tion. Further directions with regard to the treatment of this complaint Avill 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 determined rules for judging of cither.* Dr. Cheyoe says, the urine ought to be equal * It has long been an observation among physicians, that the appear- ances of the urine, are very uucertaiu, and very little to be depended on. No one -will be surprised at this who considers how many Avays it may be affected, and consequently 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 causr s, are sufficient to induce a change either in the quantity or the appearance of the urine. Any one who attends to this will he astonished at the impudenee of those daring quarks Avho pre- 104 OF THE COMMON EVACUATIONS. to three-fourths of the liquid part of our aliment. But suppose any one were to take the trouble of measuring both, he would find that ey- ry thing which altered the degree of perspiration, would alter this proportion, and likewise that different kinds of aliment would afford very different quantities of mine. Though for these, and other reasons, no rule can be given for judging of the pn ci e quantity of urine which ought to be discharged, yet a person of common seise will seldom bs at a loss to know wheu it is iu ei her extreme. As a free discharge of urine not only prevents but actually cures many diseases, it ought by all means to be proii'o'ed; and cveiy thing that may obstruct it should be carefully avoided. Both the secretion and dischnnje of urine are lessened by a sedentary life, sleeping on beds that are too soft and warm, food of a dr) aud heating qualit), li. quors which are astrii gent and heating, as red port, claret, add such like. Those who have r< ason to suspect that their urine is in too small quantity, or who have any symptoms < f the gravely ought not only to avoid the-e things, but whatever else they find has a tendency to lessen the quantity of their urine. V\ hen the urine is too long retained, is is not only reabsorbed, or taken up again into the mass of fluids, but by stagnating in the bladder it becomes thicker, the more waery parts flying off first, and the more gross and earthly remaining behind By the constant tendency which these have to concrete, the formation of stones and gravel in the blad- der is promoted. Hence it comes to pass that indoleut and sedentary people are much more liable to these diseases, thau persons of a more active life. Many persons have lost 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 eften loses its power ef 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 n-Uure ought never to be postponed. Delicacy is doubtless a A'irtue, but thai cam ever be leckoncd true delicacy, which induces any one to risk his health or hazard his life. But the urine may be iu too great as well as too small a quantity. This may be occasioned by drinking large qua'itiths of weak and wa- tend to find out di^-a^s, ar;d prescribe to patients, from the bare in- spection of their urine. These imoostors, however, are very common all over Britain, and, by the amazing creduli'y of the populace, many of them amass considerable fortunes. Of all the medical prejudices which prevail in this country, that iy fivour 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 of them is able to distinguish the mine of a horse or any other animal, from that of a man. OF THE COMMON EVACUATIONS. 105 tery liquors, by the excessive use of alkaline salts, or any thing that stimulates the kidneys, dilutes the blood, &c. This disorder very soon weakens the body, and induces a consumption. It is difficult to cure, but may be mitigated by strengthening diet and .astringent medicines, such as are recommended under the article Diabetes, or excessive dis« charge of urine. Of the Perspiration. Tnseusible perspiration is generally reckoned the greatest of all the discharges from the human body. It is of so great importance to health, Cnat few diseases attack us while it goes properly on; but when it is obstructed, the Avhole frame is soon disordered. This discharge how- ever, being less perceptible than any of the rest, is consequently less at- tended to. Hence it is, that acute fevers, rheumatisms, agues, &c. oft- en proceed from obstructed perspiration, before we are aware of its having taken place. On examining patients, we find most of them impute their diseases either to violent colds which 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, cli- mates, constitutions, &c. we shall endeavour to point out the causes which most commonly obstruct it, and to show how far they may either be avoided, or have their influence counteracted by timely care. The want 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 weather, or state of the atmosphere. There is no place where such chauges 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 few 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.# * 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 morniug, August 14, 1783, the thermometer in the shade Avas down at fifty-three degrees, and a very few minutes ago it stood above eighty. No one who reflects on such great and sudden changes in the atmosphere, will be surprised to find colds, coughs, rheums, with other affections of the breast and boAvels, so common in this country. 105 OF THE COMMON EVACUATIONS. The best method of fortifying the body against the changes of the weather, is to be abroad every day. 1 hose who keep most withiu. doors are most l:able to catch colds. Such persons generally rcudes themselves so delicate as to feel even the :■ lightest changes in the at- mosphere, and by their pairs, coughs, and oppressions of the breast, difficult matter than most people would at first be ready to ima- gine. , A proper attention to the patient's age, sex, temper of mind, constitu- tion, and manner of life, will likewise greatly assist, both in the invests gatioa and treatment of diseases. 112 OF THE KNOWLEDGE In childhood the fibres are lax and soft, the nerves extremely irrita- ble, and the fluids thin; whereas in old age the fibres are rigid, the nerves become almost insensible, and many of the vessels impel viable. These and other peculiarities render the diseases of the young and aged very different, and 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 ia men, their 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 manner. A delicate person, for example, with weak nerves, who lives mostly within doors, must not be treated, under any disease, precisely in the same manner as one who is hardy and robust, and who is much expos d to the open air. The temper of mind ought to be carefully attended to in diseases. Fear, anxiety, and a fretful temper, both occasion and aggravate dis- eases. In vain do we apply medicines to the body to remove maladies which proceed from the mind. When it is effected, the best medicine is to soothe the passions, to divert the mind from auxious thought, and to keep the patient as easy and cheerful as possible. Attention ought likewise to be paid to the climate, or place where the patient lives, the air he breathes, his diet, &c. Such as live ia 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 entire strangers. Persons Avho feed grossly, and indulge in strong li- quors, are liable to diseases which do not affect the temperate and ab- stemious, &c. It has already been observed, that the different occupations and situ- ations in life dispose men to peculiar diseases. It is therefore necessary to inquire into the patient's occupation, manner of life, &c. This will not only assist us in finding out the disease, but will likewise direct us in the treatment of it. It would be very imprudent to treat the labo- rious and the sedentary precisely in the same manner, even supposing them to labour under the same disease. It will likewise be proper to inquire, whether 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 dietj manner of life, &c. The state of the patient's body and of the other evacuations, ought also to be inquired into; and likewise whether he can with ease perform all the vital and animal functions, as breathing digestion, &c. AND CURE OF DISEASES. 113 Lastly, it will be proper to inquire what diseases the patient has formerly been liable to, and what medicines were 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, \t is always the first thing to be attended to in the treatment of diseases. Those who know no better, imagine that every thing Avhich goes by the name of a medicine possesses some wonderful power or secret charm, and think, if the patient swallows enough of drugs, that he must do well. This mi.-lake has many ill consequences ; it makes people trust to drugs, and neglect their own endeavors ; besides it discourages all at- temp's to relieve the sick where medicines cannot be obtained. Medicines are no doubt useful in their places ; and when administer- ed with prudence, they may do much good; but w hen they are put in place of every thing else, or administered at random, Avhich is not sel- dom 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. Every disease weakens the digestive powers. The diet ought there- fore, in all cases, to be light and of easy digestion. It would be as prudent for a person with a broken leg to attempt to walk, as for one iu a fever to eat the same kiud of food, and in the same quantity, as when .he was iu perfect health. Even abstinence alone will often cure a fever, especially when it has been occasioned by excess in eating or drinking In all fevers attended with inflammation, as pleurisies, peripneumonies, &c. thin gruels Avheys, watery infusions of mucilaginous plants, roots, &c. are not only proper for the patient's food, but they are likewise the best medicines which can be administered. In fevers, of a slow, nervous, or putrid kind, where there are no symptoms of inflammation, and where the patient must be supported with cordials, that intention can always be more effectually answered by nourishing 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, Aviud, weak nerves, and other h) pochondriacal affections, generally find more ben- efit 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 obstinate malady, Avill sooner yield to a prop- er vegetable diet, thau to all the boasted antiscorbutic remedies of the shops. In consumptions, when the humours are vitiated, and the stomach 50 much weakened as to be unable to digest the solid fibre? of animals, or evcu to assimilate the juices of vegetables, a diet consisting chiefly 1j 3 M OF FEVERS IN GENERAL. of milk, will not only support the patient, but will often cure the dis- ease after every other medicine has failed. Nor is an attention to other thi(n."s of less importance than to diet. The strange infatuation which has long induce I people to shut up the sick from all communication with the external air has done great n*is- chief. Not only in fevers, but many other din ases, the patient wili re- ceive more benefit from having the fresh air piudently admitted into his chamber, than from ail the medicines which can be giv< ;i him. Exercise may likewise in man) cases b. considered as a medicine. Sailing, or riding on horseback for exaiop'i, will be of more service in the cure of consumptions, glandular obstructions, «.Vc. than any med- icine yet known. Iu diseases which proceed from a iclaxed state of the solids, the cold bath, and other parts of the g) ninaslic regimen, will. be found equally beneficial. Few things are of greater importance in the cure of diseases than cleanliness. When a patient is suffered to lie in dirty clothes, what- ever perspires from his body is a^ain reabsorbed, or taken up into it, which serves to nourish the disease and increase the danger. Many diseases may be cured by cleanliness alone; most of them may be mitigated by it, and in all of them it is highly necessary both for the patieut ar-d those avIio attend him. Many other observations, were it necessary, 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 proper regimen is neglected. For this reason, in the treat- ment of diseases, Ave have always given the first place to regimen. Those who are ignorant of medicine may confine themselves to it only* For others who have more knowledge, we have recommended some of the most simple but approved forms of medicine in eveiy difc ->se. Theee however are never to be administered but by people of bettet- "jnderstanding.; nor even by them without tho greatest precaution. CHAPTER XIIL OF FEVERS IN GENERAL. A S more than ocs half of mankind is said to perish by fevrrs. it i, uLjL of importance to be acquainted with their causes. The most general crises of fevers are, infection, errors in did, unnholfsome air, -iolrnt emotions of tlie mind, excess or suppression of usual evacna- Jum, external or internal injur: s, and extreme degrees of heat or cdtL OF FEVERS IN GENERAL. 11$ Xs most of these have already been trea cd of at considerable length, and their effects shewn, weshall not now resume the consideration of t!i!»m, but shall only recommend it to all, as they would wish to avoid fvers and other fatal diseases, to pay the most punctual attention to these ai tides. 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 a In a) s a combination of several different symptoms. The distin- guishing symptoms < i fever are, increased heat, frequency of pulse, loss of appetite, gcnt>ai debility, pain in ihe liead, aud a difficulty in per- forming some of the vital or animal functions. The symptoms usual- ly attendant on fevers are, nausea, thirst, anxiety, delirium, weariness, wasting of the flesh, Avant of sleep, or the sleep disturbed and not re- freshing. WIipu the fever comes on gradually, the patient generally complains first of languor or listlessoess, soreness of the flesh, or the bones, as the country people exp;*ss it, heavijess of the head, loss of appetite, sick- ness, with clamminess of the mouth ; after some time come on excessive bent, violent thirst, restlessness, &c. When the fever attacks suddenly, it always begins with an uneasy sensation of excessive cold, accompanied with debility and loss ot ap petite ; frequently the cold is attended with shivering, oppression about the heart, and sickrws* at stomach, or vomiting. Fevers are divided into continual, remitting, intermitting, and such as are attended wi h cutaneous eruption or topical inflammation as the email pox, erysipelas, repeated vomits. Our design is not to enter into a critical inquiry i ito the ua'ure and immediate causes of fevers, but to mark their most obvious symptoms, and to point out the proper treatment of the patient v.i h respect to his diet, drink, air, &c. in the different stages of the disease. In these ar- ticles the inclination of the patieut 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. Wluv is so likely to abate the heat, attenuate the humours, remove spasms and obstructions, pro- mote perspiration, increase the quantity of urine, and in short produce every salutary effect in an indent or inflammatory fever, as drinking plentifully of water, thin gruel, or any other wok liquor, of Avhich water is the basis l The nec< ssity of diluting liquors is pointed out by the dry tong'ue, the parched skin, ai:d the burning heat, as well as by the unquenchable thirst of the patient. Many cooling liquors, which are extremely grateful to patients in a fever, may be prepared from fruits, as decoctions of tamarinds, apple tea, orange Avhej, and the like. Mucilaginous liquors might also be prepared from marsh mallow roots, linseed, limetree buds, aud other mild vegetables. ,The«e liquors, especially when acidulated, are high- ly agreeable to the patient, and should never be denied him. At the beginning of a fever the patient generally complains of great lassitude or Avenriness, and has no inclination to move. This evidently shews the propriety of keeping him ea: y, and if possible in bed. Ly- ing iu bed relaxes the spasms, abates the violence of the circulation, and gives nature an opportunity of exciting ail her force to overcome the disease. The bed alone would often re move a fever at the begin- ning; but when the patient struggles Avith the disease, vinstead of dri- ving it.off, he onl) fixes it the deeper, and renders it mbre 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 homeiu- duees them to travel with the fever upon them, which conduct seldom fails to rerider it fatal. In fevers the mind as well as the body should be kept easy. Ccm- pany is seldom agreeable to the sick. Indeed every thing that disturbs the imagination, increases the disease; for which reason every pcreos. OF FEVERS IN GENERAL. 117 la a fever ought to be kept perfectly quiet, and neither allowed to see nor hear any thing that may in the least affect or discompose his mind. Though the patient in a fever has (lie greatest inclination for chink, 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 bo iu small quantity, light, and of easy digestion. It ought to be chiefly of the vegetable kind, as panada, roamed 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, this is the read) way to raise one. Stuf- fing the patient with s-veetmeats 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 am ^ It uot only removes his anxiety, but cools the blood, revives the spirits, and proves every way beneficial. Many patients are in a manner sti- lled to death in fevers for want of fresh air; yet such is the unarcounta- ble infatuation of most people, that the moment they think a person iu a fever, they imagine he should be kept in a close chamber, intn 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 warmth ought never to be greater than is agreeable to one in perfect health. Nothing spoils the air of a sick person's chamber, or hurts the pa- tient more, than a number of people breathing in it. When the blood is inflamed, or the humours in a putrid state, air that has been breath- ed repeatedly will greatly increase the disease. Such air not only lo- ses its spring, and becomes unfit for the purpose of respiration, but ac- quires a noxious quality, which renders it in a manner poisonous to the sick. In fevers, when the patient's spirits are low and depressed, he is not ouly to be supported with cordials, but every method should.be taken to cheer and comfort his mind. Many, fiom a mistaken zeal, Avhen they think a person in danger, instead of solacing his mind with the hopes and consolations of religion, fright him with the views ol hell and damnation, it would be unsuitable here to dwell upon the improprie- ty and dangerous consequences of this conduct; it often hurts the body, and there is reason to believe seldom benefits the soul. Among common people, the very name of a fever generally suggests the necessity of bleeding. This notion seems to have taken its rise from most fevers in this country having been formerly of au inflamma- US OF FEVERS IN GENERAL. tory nature; but true inflammatory fevers are now seldom to be met With. Sf dtntary occupations, aud a different manner of living, have so changed the state of di. eases iu Britain, that there is now hardly one fever in ten whore the lancet is necessary. In most low, nervous, and putrid fevers, which are hoav so common, bleeding is really hurtful, as it weakens the patient, sinks his spirits, Arc. We would recommend this geueral rule, never to bleed at the beginning of a fever, unless there be evident signs of inflammation. Bleeding is au exec lent medicine when necessary, but should never be waut<-nly performed. It is likewise a common notion, that sweating is always necessary in the beginning of a fever. VI hen the fever proceeds from an obsti ucted perspiration, this notion is not ill founded. If the patient only lies in bed, bathes his feet and legs in warm water, and dri:■!■> freely of warm water gruel, or any other weak diluting liquor, he will seldom fail to perspire freely. The warmth of the bed, and the diluting drink, will relax the universal spasm, which generally affects the skin at the begin- ning of a fever; it will open the pores, and promote the perspiration, by means of which the fiver 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. w liich fire his blond, increase the spasms, and renelcr the disease more dangerous. In all fevers a proper attention should be paid to the patient's long- ings. 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 what they eagerly desire, though it may net seem alto- gether proper. What the patient longs for, his stomach will generally digest; ami such things have sometimes a very happy effect. When a patient is recovering from a fever, great care is necessary to prevent a relapse. Many persons, by too soon imagining them?elves well, have lost their lives, or contracted other disease s of an obstinate nature. As the body after a fever is weak and delicate, it is necessa- ry 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; agree- able company will also have: a good effect. The diet must be light but nourishing. It should be taken firquently, but in small quantities. It is dangerous., c.t such a time, to eat as much as the stomach may crave. OF INTERMITTING FEVERS, OR AGUES. 119 CHAPTER XIV. OF INTERMITTING FEVERS, OR AGUES. INTERMITTING fevers afford the best opportunity both of ob- serving the nature of a fever, and also the effects of medicine. No person can be at a loss to distinguish au intermitting fever from any other, and the proper medicine for it is now almost universally known. The several kinds of intermitting fevers take their names from the period in which the fit returns, as quotidian, tertian, quartan, &c. C vUSES.—Agues are occasioned by effluvia from putrid stagna- ting water. This"is evident from their abounding in rainy seasons, and being most frequent in countries where the soil is marshy, as in Hol- land, the feas of Cambridgeshire, 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, laying upon the damp ground, watching, fatigue, depressing passions, and the like. When the inhabitants of a high country remove to a low one, they are gene- rally sei/.ed with intermitting.fevers, and to such the disease is most apt to prove fatal. In a word, whatever relaxes the solids, diminishes the perspiration, or obstructs the circulation in the capillary or small ves- sels, disposes the body to a»ues. SYMPTOMS.—An intermitting fever generally begins with a pain 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 becomes moist, and a profuse swvat breaks out, avInch generally termi- nates the fit or paroxysm. Sometimes indeed the disease comes on sud- denly, when the person thinks himself in perfect health; but it is more commonly preceded by listlessness, loss of appetite, aud the symptoms mentioned above. REGIMEN.—While the fit continues, the patient ought to drink freely of water gruel, orange whey, weak camomile tea; or, if his spi- rits be low, small wine-whey, sharpened with the juice of lemon. All hu drink should be warm, as that will a«sist in bringi'ig on the sweat, and consequently shorten the paroxysm.* '•' Dr. Lynd says, that twenty or twenty-five drops of laudanum put into a cup of the* patient's drink, and given about halfan hour after the comment me.it of the hot fit, promotes the sweat, shortens the fit, relieves the head, and tends greatly to remove the disease. 120 OF INTERMITTING FEVERS, OR AGUES. Between the paroxysms the patient must be supported with food thai is nourishing, but iigut and easy of digestion, as veal or chicken broths, sago, gruel with a little wine, light puddings, and such like. His driuk may bo small negus, acidulated with the juice of lemons or oranges, and sometimes a little weak punch. He may likewise drink infusions of bitter herbs, as camomile, wormwood, or water-tresoil, and may now and then take a glass of small wine, in which gentian root, centuary, or some oth'jr 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 be- tAveen the fits as he can bear. If he be able to go abroad, riding on horseback, or in a carriage, will be of great service. But if he can- not bear that kiud of exercise, he ouglit 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 when the disease is mild, in an open and dry country, there is seldom any danger from allowing it to take its course; but when the patient's strength seems to decline, or the paroxysms are so violent that his life is in danger, medicine ought immediately to be ad- ministered. This however should never be done till the disease be properly formed, that is to say, till the patient has had several fits of shakiug and sweating. MEDICINE.—The first thing to be done in the cure of an inter- mitting fever, is to cleanse the stomach aud bowels. This not only renders the application of other medicines more safe, but likewise more efficacious. In this disease, the stomach is generally loaded with 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 medicine. A dose of ipecacuanha will generally answer this purpose very well. A scruple or half a dram 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 two or three hours before the return of the fit, and may be repeated at the distance of two or three days. Vomits uot only cleanse the stom- ach, but increase the perspiration, and all the other secretions, which render them of such importance, that they often cure intermitting fe« vers, without the assistance of any other medicine. Purging medicines are likewise useful and often necessary in inter- mitting 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 OF INTERMITTING FEVERS, OR AGUES. 121 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 intermit- ting fever, when excessive heat, a delirium, &c. give reason to suspect an inflammation; but as the blood is seldom in an inflammatory state in intermitting fevers, this operation is rarely necessary. When fre- quently repeated, 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 preparation of the bark seems to answer better than the most sim- ple form in which it can be given, viz. in powder. Two ounces of the best Peruvian bark, finely powdered, may be di- vided into twenty-four doses. These may either be made into bolusses 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 returns every day, one of the above doses may be taken every two hours during the interval of the fits. By this method the patient will be able to take five or six doses between each parox- ysm. In a tertian or third day ague it will be sufficient to take aldose 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, and take one every hour, &c. For a young person 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 The above quantity of bark will frequently cure an ague ; the pa- 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 rea- son 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 * It has lately been observed, that the red bark is more powerful than that which has for some time been ia common use. Its superior efficacy seems to arise from its being of a more perfect growth than the quill bark, and consequently more fully impregnated with the medical properties of the plant. | In intermitting fevers of an obstinate nature, I have found it ne- cessary to throw in the bark much faster. Indeed the benefits arising from this medicine depend chiefly 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 taken in the course of some wee ks. 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. 16 122 OF INTERMITTING FEVUiiS, OR AGUES. medicine long enough. They are generally directed to take it till the fits are topped, then to leave it off. and begin again at some distance ef time ; by which means the dise-tse gathers strength arid often re- turns Avith as much violence as bcfoic. A relapse may aiwavs- he prevented by the patient's continuing to h:\r. do.-rs of the medicine for some time after the symptoms disappear, 'fins is both the most si-we and effectual melhrvl of cure. An ounce of gentian root, calamus aromaticus, and orange peel, of each half an ounce, with three or four handsful of camomile-flowers, and an handful of coriander 3eed, all bruised together in a mortar, may be use d in form of infusion ir: le a About half an handful of these in- gredients may be put into a tea-pot, and an Euglii-.h pint of boiling wa- ll r poured on them. A cup of this infusion drank three or four times a day will greatly promote the cure. Such patients as cannot drink the.' Avater infusion, may put two hanci.-ful of the same ingredients into a bottle of white wine, aud take a gla.-s ef it twice or thrice a day. If patients drink freely ef the above, or any other proper infusion of bit- ter?, a smaller quantity of bark than isgeuerally used will be sufficient to cu:e an ague * Those who cannot swallow the bark in substance, may take it in de- coction or infusion. An ounce of bark in powder ma> he infused in a bottle of white wine for four or five days, frequently shaking the bottle,' afterwards let the powder sul sideband pour eff the clear liquor. A wine glass may be drank three or four times a day, or oftener, as there is occasion. If a decoction be more agreeable, an ounce ol" the bark, and two drams of snake-root bruk-ed, with an equal quantity of suit of wormwood, may be boiled in a quart of water, to an English pint To. the ^tailed liquors may be added an equal quantity of red wine, and 'a glass of it taken frequently. In obstinate agues, the bark will be found much more efficacious when ss ittcd by brandy, or other warm cordials, than taken alone. 'l his i h.ivc had frequently occasion to observe in a country where iiiW niiUteiit fevers weje cudemical. The bark seldom succeeded un- h;s ass-Itted by snake root, ginger, canella, alba, or some other warm aromatic. When the fits are frequent and \ioletit, in which case the * fiiere L reason to believe, that sundry of our own plants or barks, which are very bitter and astringent, would succeed in the cure of in- tfn.intent fevers, especially when assisted by aromatic?. Eut as the PentiUiii baik has been long approved in the cure of this disease, and Is im-.v to be obtained at a very n.-ar.onable into, it is of h -s import- ance to sc.ich ai'cr new medicine*. We cannot however omit taking notice, that the Peruvian baik is very often adulterated, and that it re- q-tiitfc.co'i,id..iable skill to distingui.-h between the gniuiue and the fake. This ought to make people very cautious of Avhoni they r^- cLaseit. OF INTERMITTING FEVERS, OR AGUES. 12* fever often approaches towards an inflammatory nature, it avill be safer to keep out the aromatics, and to add salt of tartar in their stead. But in an obstinate tertian or quartan, in the end of autumn or beginning of winter, uarm and cordial med cims are ab.ol.itely necessary.* As autumnal and winter agues generally prove much more obstinate than those which attack the patient in spring or summer, it will be ne- cessary to continue the use of medicines longer in the former than in the latter A person who is seizfd with au intermitting (ever in the beginning; of whiter, ought frequently, if the season proves rain), to take a little medicine, although the dise-se may seem to be cured, to prevent a relapse, till the return of the warm season. He ought like- wise to take care not to be much abroad, iu wet weather, especially in cold easterly winds. When agues are not properly cured, they often degenerate into ob- stinate chronical diseases, as the dropsy, jaundice, ckc. For this rea- son all possible care should be taken to have them radically cured, be- fore the constitution has been too much weakened. Though nothing is more rational than the method of treating inter- mitting fevers, yet by some strange infatuation, more charms and whim- sical remedies arc 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 amazing with what readiness their preten- sions 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 last- iug cure, is gradually to assist Nature in removing the cause of the dis- order. Some indeed try bold, or rather fool hardy experiments to cure agues, as drinking great quantities of strong liquors, jumping into a river, taking arsenic, f a physician. 124 OF INTERMITTING FEVERS, OR AGUES. Many dirty things are extolled for the cure of intermitting fevers, as spiders, cobwebs, snuffiugs of candles, &c. Though these may some- times succeed, yet their veiy nastiness is sufficient to set them aside, especially when cleanly medicines will answer the purpose better. The only medicine that can be depended upon for thoroughly curing an in- termitting fever, is die Peruvian bark. It may always be used with safety: and 1 can houestly declare, that in all my practice I never knew it to fail, when combined with the medicines mentioned above, and duly persisted in. Where agues are endemical, even children are often afflicted with that disease. Such patients are very difficult to cure, as thry can sel- dom be prevailed upon to take the bark, or any other disagreeable medicine One method of rendering this medicine more palatable, is to make it into a mixture with distilled waters and syrup, aud after- wards to give it an agreeable sharpness with the elixir or spirit ol vit- riol. This both improves the medicine, and takes off the nauseous state. In cases where the bark cannot be administered, the saline mix- ture may be given with advantage to children. Wine-whey is a very proper drink for a child in an ague; to half an English pint of which may be put a tea spoonful of the spirit of hart- shorn. Exercise is likewise of considerable service; and when the dis- ease proves too obstinate, the child ought, if possible, to be removed to a warm dry air. The food ouglit to be nourishing, and sometimes a little generous wine should be allowed. To children, aud such as cannot swallow the bark, or when the stomach will not bear it, it may be given by clyster. Half an ounce of the extract of bark, dissolved in four ounces of warm water, with the addition of half an ounce of sweet oil, and six or eight drops of lauda- num, is the form recommended by Dr. Lind for an adult, and this to be re- peated every foarth hour, orofiener, as the occasion shall require. For childieu the quantity of extract aud laudanum must be proportionably lessened. Children have been cured ol agues by making them wear a waistcoat Avith powdered bark quilted between the folds of it; by bathing thein frequently in a strong decoction of the bark, and by rub- bing the spine 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 common, and because few patients in an ague apply to physicians un- less in extremeties. There are, however, many cases in which the disease is very irregular, being complicated with other diseases, or at- tended with symptoms which are both very dangerous and very diffi- cult to understand. All these Ave have purposed) passed over, as they Avould only bewilder the generality of readers. When the disease is very irregular, or the symptoms dangerous, the patient ought immedi- ately to apply to n ph)sician, and strictly to follow his advice. OF AN ACUTE CONTINUAL FEVER. 125 To prevent agues, people must endeavour to avoid the'r causes. These have been already pointed out in the beginning of this section: we shall therefore only add one preventative medicine, which may be of use to such as are obliged to five in low marshy countries, or who are liable to frequent attacks of this disease. Take an ounce of the best Peruvian bark; Virginian snake-root, and orange peel, of each half an ounce: bruise them all together, and infuse 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 wine glass of it twice or thrice a day. This indeed is recommending a dram ; but the bitter 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 wine; and such as can bring themselves to chew the bark, will find that meth- od succeed very Avell. Gentian root or calamus aromaticus, may also be chewed by turns for the purpose. All bitters seem to be antidotes to agues, especially those that are warm and astringent. T CHAPTER XV. OF AN ACUTE CONTINUAL FEVER. niS 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 sea- sons of the year; but is most frequent in the spri ig and beginning of CAUSES —\n ardent fever may be occasioned by any thing that overheats the body, or produces plethora, as violent exercise, sleeping in the sun, drinking strong liquors, eating spicenes; a full diet, with little exercise, &c. It may likewise be occasioned by whatever ob- structs the perspiration, as lying on the damp ground, drinking cold li- quor when the body is hot, night watching, or the like. SYMPTOMS.__A rigour or chilliness generally ushers in this le- ver, 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, pain? in the back, loins, etc To these succeed difficulty of breathing, sickness, with an inclination to vomit. The patient complains of great 528 OF AN ACUTE CONTINUAL FEVER. thirst, has no appetite for solid food, is restless, and his tongue generally appears black ami rough. A delirium, excessive restlessness, great oppres i.>ti of the breast, with laborious respiration, starting of the lentious, hickup, cold clam- my sweats, an involuntary discharge of urine, are very dangerous symptoms. As this disenre is always attended with danger, the best medical as- sistance ought to he piocured as «-oon as possible. A ph) sician may be of use at the beginning, but his skill is often of no iivail afterwards. Nothing can be more unaccountable than the conduct ol those who have it iu their power, ot the beginning of a fever, to procure the best medi- cal assistance, yet put it off tiil things come to an extremity. When the disease, by delay or wrong treatment, has become incurable, and has exhausted the ; tr< ngth of the patient, it is in vain to hope for relief from medicine. Physicians may indeed assist Nature; but their at- tempts must ever prove fruitless, when she is no logger able to co-ope- rate with their endeavours. REGIMEN—From the symptoms of this disease, it is evident, that the blood and other humours require to be attenuated; that the perspiration, urine, saliva, aud all the other secretions, are in too small quantity; that the vessels are rigid, and the heal of the whole bod) too great: all these clearly point out the necessity of a ve^imen calculated to dilute the blood, correct the acrimony of the humours, alia) the ex- cessive heat, remove the spasmodic structure of the vessels, and pro- mote the secretions. These important purposes may be greatly promoted by drinking plen- tifully of diluting liquors; as water-gruel, or oatmeai-tea, clear whey, barley-water, balm-tea, apple tea, &e These ma) be sharpened with juice of orange, jelly of currants, raspberries, and such like: orange- whey 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, or a few spoonsful of vinegar, will have the same effect —Two or three spoonsr ful of white Avine may occasionally b« added to the liquor when boiling* If the patient be costive, au ounce of tamarinds, with two ounces of ctoned rairins of the sun, and a couple of figs, may be boiled in three English pints of water to a quart. This makes a very pleasant drink, and may be used at discretion. The common pectoral decoction is likewise a very proper drink in this disease. A tea cup full of it may be taken every two hours, or ofteuer, if the patient's heat and thirst be very great. The above liquids must all be drank a little warm. They may be used in smaller quantities at the beginning of a fever, but more freely - .forwards, in order to assist in carrying off the disease by promoting the different excretions. Wre have mentioned a variety of drink?, that *he patient may have it in his power to choose those which are mo*fc v OF AN ACUTE CONTINUAL FEVER. 127 agrreable, and that, when tired of one, he may have recourse to another. The patient's diet must be very spare and light. All sorts of flesh- meats ail eve.i chicken broths, are to be avoided. He may be allow- ed groat, -n-uel, pauado. or light bread boiled in water; to which may be adieu a fow gntiiw of common salt, and a little sugar, which will render it more p il (table. He may eat roasted ap.des with a little su- gar, toHsted broad with jelly of currants, boiled prunes, &c. it will gre-;\lly relieve the patient, especiall) in an hot season, to have fresh air .'Veqiuvitlv let into his chain'ier. i'his, however, must ahvays b;: done in such a manner as not to eiclanger his catching cold. It U too common in fevers to load the patient with bed-clothes, under the pretencp .'making him sweat, or defending him from the cold. This cu-tom has many ill effects It increases the heat of the body, 1 digues 'he pntieut, aud retards, instead of promoting '.he perspiration. Sitting upright in 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 : and if the patient is inclined to sweat, 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 weather is hot. The patient's mouth should be often washed with a mixture of wa- ter and honey, to which a little vinegar may be added, or with a de- coction of figs in barley-water. His feet and hands cught likewise fre- quently to be bathed in hike-warm water; especially if the head is af- fected. The patient should be kept as quiet ?nd easy as possible. Compa- ny, noise, and every thing that disturbs the mind, is hurtful.—Even too much liqht, oranv thing that affects the tersr-s, ought to be avoid- ed. His attendants should be few as possible, and (hey ought not to be too often changed. His inclinations orght rather to be soothed than routrar!h-:ed; even the promise of what he craves v.ill ofon satisfy him as much as 'ts reality. MEDICINE.—In this and all other fivers, nttc-Vl with a hard, full, quick pal-e, bleeding h of the greatest importance. This opera- tion ought ai w !-> s to be performed as soon as the symptom" cf an inflam- matory fever appear. The quantity of blood to be taken away, how- ever, mttst be in proportion to the strength of the p-.diont and the vio- lence ol" tiio disea.-v. If after the first bleeding the fever should in- crease, and the pulce become more frequent and hard, there will be a necessity for repeating it a second, and perhaps a third, oreveu a fourth time, which may be done at the distance of twelve, eighteen, or twenty- four hours iVoni each other, as the symptoms require. If the pulse con- 128 OF AN ACUTE CONTINUAL FEVER. tinues 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 dul- cified or sweet spirit of nitre may be made into a draught, with an ounce of rose water, two ounces of common water, and half an ounce of sim- ple 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 in 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 weak camo- mile tea, or luke-warm Avater to drink. II the body is bouud, a clyster of milk and water, with a little salt, and a spoonful of sweet oil or fresh butter in it, ought daily to be ad- ministered. 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 soit, the tongue moister, aud the urine begins to let fall a reddish sedi- ment, there is reason to expect a favorable issue to the disease. But if, instead of these symptoms, the patient's spirits grow languid, his pulse sinks, and his breathing becomes difficult: with a stupor, trem- bling of the nerves, starting of the tendons, &c, there is reason to fear that the consequences will be fatal. In this case blistering plasters must be applied to the head, ancles, inside of the legs or thighs, as there may be occasion; poultices of wheat-bread, mustard, and vine- gar, may likewise be applied to the soles of the feet, and the patient must be supported with cordials, as strong wine-whey, negus, sago-^ru- el, with wine in it, and such like. A proper regimen is not only necessary during the fever, but like- wise 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, compauy, &c. are carefully to be avoided. The mind ought likewise to be kept easy, and the patient should not at- tempt to pursue study, or any business that requires intense thinking. It the digestion is bad, or the patient is seized at times with feverish heats, an infusion of Peruvian bark iu cold water will be of use It will strengthen the stomach, and help to subdue the remains of the lever. When the patient's strength is pretty well recovered, he ou°ht to take some gentle laxative. An ounce of tamarinds and a dram of «.eua 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 OF THE PLEURISY. 129 strained, and a teacupfull drank every hour till it operates. This" dose may be repeated 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. CHAPTER XVI, OF THE PLEURISY. THE true pleurisy is an inflammation of that membrane called the plana, which lines the inside of the breast. It is distinguished 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 work without doors, and are of a sanguine constitution. It is most frequent in the spring season. CAUSES—The pleurisy may be occasioned by whatever obstructs the perspiration; as cold northerly winds; drinking cold liquors when the body is hot; sleeping without 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 stri- king in of an eruption, as the itch, the measles, or the small-pox. Those who have been accustomed to bleed at a certain seasou of the year are apt, if they neglect it, to be seized with a pleurisy. Keeping the body too Avarm by means of fire, clothes, &c. renders it more liable to this disease. A pleurisy may likewise be occasioned by violent exercise, as running, Avrestling, 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 (he pleura, &c SYMPTOMS.—This, like most other fevers, generally begins with chilliness and shivering, which are followed by heat, thirst, and rest- lessness. To these succeeds a violent pricking pain in one of the sides among the ribs. Sometimes the pain extends towards the back-bone, sometimes towards the forepart of the breast, and at other times to- 130 OF THE PLEURISY, wards the shoulder blades. The pain is generally most violent wheu the patient draws his bieath. The pulse hi this disease is commonly quick and hard, the urine high coloured ;. and if blood be let, it is covered with a tough crust, or buffy coat The patient's spittle is at first thin, but afterwards it becomes grosser, and is often streaked w ith blood. REGIMEN.—Nature generally endeavours to carry off this dis- ease by a critical discharge of blood from some part of the tody, by expectoration, sweat, loose stools, thick urine or the like We oi'»,ht, therefore, to second her intentions by lessening the force of 'he circula- tion, relaxing the vessels, diluting the humours, and promoting expec- toration. 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 na- ture. His drink may be whey, or an infusion of pectoral and balsam- ic vegetables. Barley water, with 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, which must af- terwards be strained. The decoction of figs, raisins, and barley, re- commended iu the preceding disease, is here likewise very proper. These and other diluting liquors are not to be drank in large quanti- ties 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 aud drink should be taken a little warm. The patient should be kept quiet, coeJ, and every way easy, as di- rected under the foregoing disease. His feet and hands ought daily to be bathed in hike-warm water ; and he may sometimes sit up iu bed for a short spiice, in order to relieve liis head. MEDICIXE.—Almost every person knows, when a fever is atten- ded with a violent pain of the side, and a quick hard pulse, that bleed- ing is neoes-sary. Wheu these symptoms come on, the soonFr this op- eration is performed the better; and the quantity at first miut be pret- ty b-erge, provided 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 repeated small bleedings. A man may lose twelve or four- teen ounces of blood as soon as it is certainly known that he is seized with a pleurisy. For a younger person, or one of a delicate constitu- tion, the quantity must be less. If, after die first bleeding, the stitch with the other violent symptoms i-'iould still continue, it will be necessary, at the elistance of twelve or eighteen hours, to let eight or nine ounces more. If the symptoms do aot then abate, 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 OF THE PLEURISY. 13i pulse becomes softer, or the patient begins to spit freely, bleeding ougbj uoi to be repeated. This operation is seldom necessary after the tiiitd or f'rtirih day of the fever, aud ought not then to be performed, unless is the most urgent circumstances. The blood may be many ways attenuated without bleeding.—-There are likewise many things that may be done to ease the paiu of the side without this operation, as fomenting, blistering, &c. Fomentations may be made by boiling a handful of the flowers of elder, camomile, aud common mallows, or any other soft vegetable in a proper quantity of water. The herbs ma) be either put into a flannel bag, and applied warm to the side, or flannels may be dippedin the decoction, afterwards wrung out auel applied to the part affected, with as much Avarmth as the patient can easily bear. As the clothes grow cool, they must be ch.inged, and grc.-.t carevu.ken that the patient do not catch cold. A bladder ma) be fillet! with warm milk and water, and applied to the side, if the above method of fomenting be found inconvenient. Fomen- tations 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 little 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 part affected, or by cupping, which is both a more certain aud 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 cab- bage leaves applied warm to the side in a pleurisy. These not only re- lax the parts, but likewise draw off a little moisture, and may prevent the necessity 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 ouly 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-plas- ter is on, the patient may drink freely of the Arabic emulsion. If the patient is costive, a clyster of thin water gruel, or of barley water, in which a handful of mallows, or any other emolient vegetable has been boiled, may be daily administered. This will not only empty the bowels, but have the effect of a warm fomentation applied to the inferior viscera, which will help to make a derivation from theJbreasU The expectoration may be prompted by sharp, oily, and mucilagin- ous medicines. For this purpose au ounce of the oxymel, or the vine- gar 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 emulsion may toe administered ; or, in place cf it, two ounces of the oil of sweet aim- 132 OF THE PLEURISY. onds, or oil of olives, and two ounces of syrup of violets may be mixed with as much sugar candy powdered, as will make au electuary of the consistence of honey. The patient may take a tea-spoonful of this fre- quently, when the cough is troublesome. Should oily medicines prove nauseous, which i- sometimes the case, two table spoonsful of the solu- tion 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 posses very little water, some small doses of purified nitre and camphire will be of use. Two drams of the former may be rubbed with five or six grains of the latter in a mortar, aud the whole divided iuiosix doses, one of which may be taken every five or six hours, iu a little of" the patient's ordinary drink. We shall only mention oue medicine more, which some reckon almost a specific in the pleurisy, vis. the decoction of the seneka rattle snake- root. After bleeding aud other evacuations have been premised, the patient may take two, three, or four table-spoonsful of this decoction, according as his stomach will bear it, three or four times a-day. If it should occasion vomiting, tAvo or three ounces of simple cinnamon-water may be mixed with the quantity of decoction here directed, or it may be taken in smaller closes. As this medicine promotes 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 choose; and likewise, that when one cannot be obtained, they may make use of another. Different medi- cines 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 pro- per to try another. What is called the crisis or height of the fever, is sometimes attend- ed with very alarming symptoms, as difficulty of breathing, an irregu- lar pulse, convulsive motions, &c. These are apt to frighten the at- tendants, and iuduce them to c!o improper things, as bleeding the pa- tient, giving him strong stimulating medicines, 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 peculiar- ly necessary. If the patient's strength how( ver be much exhausted by the disease, it will be necessary at urns time to support him with fre- quent small draughts of wine-whey, negus, or the like. When the pain and fever are goDe, it will be proper, after the pa- tient 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 fchculd be buttermilk, whey, and other things of a cleansing nature. OF A PERIPNEUMONY. 133 Of the Bastard Pleurisy. That species of pleurisy which is called the bastard or spurious, gen- erally goes off by keeping warm for a few days, drinking plenty of di- luting 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 bleeding, with cupping, and scarifications of the part affected. These together with the use of nitrous and other cooling medicines, seldom fail to effect a cure. Of the Paraphrenias. The paraphrenias, or inflammation of the diaphragm, is so nearly con- nected with the pleurisy, and resembles it so much in the manner of treatment, that it is scarce necessary to consider it as a separate dis- ease. It is attended with a very acute fever, and an extreme pain in the part affected, which is generally augmented by coughing, sneezing, drawing in the breath, taking food, going to stool, making water, &c. Hence ihe patient breathes quick, and draws 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 involuntary grin, is no uncommon symptom of this disease. Every method must be taken to prevent a suppuration, as it is im- possible to save the patient's life when this happens. The regimen and medicine are in all respects the same as in the pleurisy. We shall on- ly add, that in this disease, emollient clysters are peculiarly useful, as they relax the bowels, and by that means make a derivation from the part affected. CHAPTER XVII. OF A PERIPNEUMONY, OR INFLAMMATION OF THE LUNGS. AS this disease affects an organ which is absolutely necessary to life, it must always be attended with danger. Persons who abound vrith thick blood, whose fibres are tense and rigid, who feed upon gross aliment, and drink strong viscid liquors, are most liable to a peripneumony. It is generally fatal to those who have a flat breast, 134 OF A PERIPNEUMONY. or narrow chest, and to such as are afflicted with an asthma, especial- ly in the decline of life. Sometimes the inflammation reaches to one kibe of the lungs only, at other times the whole of the organ is affect- ed; in which case the disease can hardly fail to prove fatal. When the disease proceeds from a viscid pituitous matter obstruct- ing the vessel* of the lungs, it is callecf a spurious or bastard /.eripnai' mony. When it arises from a thin acrid defluctioo ou the lungs, it is denominated a catarrhal peripneutnony. &c. CAUSES.—An inflammation of the lungs, is sometimes a primary disease, and sometimes it is the consequence of other diseases, as a quinsey, a pleurisy, ceed. If the patient's strength and spirits flag, he must be supported by strong broths, jellies, and such like. Some recommend shell fish in this disorder, aud with some reason, as they are nourishing and rest©- * Sheffield, OF CONSUMPTIONS. m wttive.* All the food and drink ought however to be taken in small quantities, lest an overcharge of fresh chyle should oppress the lungs, and too much accelerate the circulation of the blood. The patient's mind ought to be kept as easy and cheerful as possi- ble. Consumptions are often occasioned, and always aggravated, by a melancholy cast of mind; for which reason music, cheerful company, and every thing that inspires mirths are highly beneficial. The patieql ought seldom to be left alone, as brooding over his calamities is sure to render him worse. MEDICINE.-r-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 vio* lent 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 following medicines. Take fresh squills, gum-ammoniac, and powdered cardamum seeds, of each a quarter of an ounce; beat thera 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 mod-. erate size, and four or five of them taken twice or thrice a-day, ac.^ cording as the patient's stomach will bear them. The lac ammoniacum, or milk of gum ammoniac, as it is called, is likewise 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 letnon juice, fine honey, and syr- np o( poppies, may likewise be used. Four ounces of each of theae may be simmered together in a sauce-pan, over a gentle fire, and a ta- ble-spoonful of it taken at any time when the cough is troublesome. It is common in this stage of the disease to load the patient's stomaclfc with oily and balsamic medicines. These, instead of removing the cause of the disease, tend rather to increase it by heating the blood» while they pall the appetite, relax the solids, and prove every way hurtful to the patient. Whatever is used for removing the cough, be-. aides riding 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 patieut's thirst and to cool the blood. The vegeta- ble acids, as apples, oranges, lemons, &c. appear to be the most prop- er. I have known patients suck the juice of several lemons every day with manifest advantage, and would for this reason recommend acid vegetables to be takeu in as great quantity as the stomach will bear. * I have often known persons of a consumptive habit, where the symp- toms were not violent, reap great benefit from theuse of oysters.. They generally eat them raw, and drink the juice along with them. 142 OF CONSUMPTIONS. For the patient's di inft, we would recommend infusions of the bitter plants, as ground-ivy, the lesser centaury, camomile flowers, or water- tresoil. 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 ordinary drink, infusions or decoctions of the vulnerary roots, v plants, &c. There are many other mucilaginous plants and seeds, of a healing aud agglutinating nature, from which decoctions or infusions may be prepared with the same intention; as the others, the quince-seed, colts- foot, linseed, sarsaparilla, &c. It is not necessary to mention the dif- ferent ways in which these may be prepared. Simple infusion or boil* iug 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 bene- fit is to be expected from trifling doses of this medicine. I never knew it of any service, unless where three or four ounces at least were used daily for a considerable time. In this way I have seen it produce very happy effects, and would recommend it wherever there is a discharge of blood from the lungs. WThen the spitting up of gross matter, oppression of the breast, and the hectic symptoms, shew that an imposthume 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 in powder may be divided into eighteen or twenty doses, of which one may be taken every three hours through the clay, in a little syrup, or a cup of horehound tea. If the bark should happen to purge, it may be made into an electua- ry, with the conserve of roses, thus: Take old conserve of roses a quar- ter of a pound, Peruvian bark a quarter of an ounce, syrup of orange or lemon, as much as will make it of the consistence of honey. This quantity will serve the patient four or five days, and may be repeated as there is occasion. Such as cannot take the bark in substance, may infuse it in cold wa- ter. This seems to be the best menstrum for extracting the virtues of that drug. Half an ounce of bark in powder may be infused for twenty- four hours in half an English pint of water. Afterwards let it be pass- ed through a fine strainer, and an ordinary tea-cupful of it taken three ©r four times a-c'ay. We would not recommend the bark while there are any symptoms of an inflammation of the breast; but when it is certainly known that matter is collected there, it is one of the best medicines which can be used. Few patients indeed have resolution enough to give the bark a OF CONSUMPTIONS. 143 fair trial at this period of the disease, otherwise we have reason to be- lieve that some benefit might be reaped from it. When it is evident that there is au 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 inwardly, by drawing in the steams of warm water,or vinegar, with his breath, coughing, laughing, or bawl- ing aloud, &c. When it happens to burst within the lungs, the matter may be discharged by the mouth. Sometimes indeed the bursting of the vomica 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 should 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 ot a cure. The diet at this time ought to be light, but restorative, as chicken-broths, sago-gruel, rice-milk, &c. 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 a surgeon, it is not ne- cessary here to describe it. We shall only add, that it is not so dread- ful as people are apt to imagine, and that it is the only chance the pa- tient 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 diffi- culty of breathing. It is attended with indigestion, Aveakness, aud want of appetite, &c. Those Avho are of a fretful temper, who indulge in spirituous liquors, or who breathe on unwholesome air, are most liable to this disease. We would chiefly recommend, for the cure of a nervous consump- tion, a light and nourishing diet, plenty of exercise iu free open air, and the use of such bitters as brace and strengthen the stomach; as the Peruvian bark, gentian root, camomile, borehound, &c. These may be infused in water or wine, and a glass of it drank frequently. It will greatly assist the digestion, and promote the cure of this dis- ease, to take twice a-day twenty or thirty drops of the elixir of vitriol in a glass of wine or water. The chalybeate wine is likewise an ex- cellent medicine iu this case. It strengthens the solids, and powerfully assists Nature in the preparation of good blood. Agreeable amusements, cheerful company, ^nd riding about, are how - ever preferable to all medicines in this disease. For which reason, Avhen the patient can afford it, we would recommend a long journey of pleas- ure; as the most likely means to restore his health. 144 OF THE NERVOUS FEVER. What is called a symptomatic consumption, cannot be cured without first removing the disease by which it is occasioned. Thus, when a consumption proceeds from the scrophula, or king's evil, from the etur- vy, the asthma, the venereal disease, &c a due attention must be paid to the malady from whence it arises, and the regimen and medicine di- rected accordingly. When excessive evacuations of any kind occasion a consumption, they must not ouly 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, thej* ought immediately to wean the child, or provide another nurse, otlih erwise they cannot expect a cure. Before we quit this subject we would earnestly recommend it to all, as they wish to avoid consumptions, to take as much exercise, Avithout doors, as they can, to avoid unwholesome air, and to study sobriety. Consumptions owe 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 stiong liquors.—These liquors, when toq freely used, not only hurt the digestiou, aud spoil the appetite, but beat and inflame the blood, and set the whole constitution on fire. CHAPTER XIX. OF THE SLOW OR NERVOUS FEVER. NERVOUS fevers have increased greatly of late years in this isl- and, 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, who neglect exercise, eat little solid food, study hard, or indulge in spirituous liquors. CAUSES.—Nervous fevers may be occasioned by whatever 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, &c. They may likewise be occasion- ed by damp confined, or unwholesome air. Hence they are very com- mon in rainy seasons, and prove most fatal to those who live in dirty low houses, crowded streets, hospitals, jails, or such like places. OF THE NERVOUS FEVER. I4j Persons whose constitutions have been broken by excessive venery, frequent salivations, too free an use of purgative medicines, or any oth- er 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 strict- ure of the solids, may likewise occasion nervous fevers. We shall on- ly add, frequent and great irregularities 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. SYMPTOMS.—Low spirits, want of appetite, weakness, weariuess after motion, watchfulness, deep sighiug, and dejection of mind, are generally the forerunners of this disease. These are succeeded by a quick low pulse, a dry tongue without any considerable thirst, chilli- ness and flushing in turns, &c. After some time the patient complains of a giddiness and p.dn of the head, has a nausea, with retchings and vomiting; the pulse is qui.k, and sometimes intermitting; the urine pale, resembling dead small beer, and the breathing is difficult, with oppressions of the breast, aud slight alienations of fie mind. If towards the uinth, tenth, or twelfth day, the tongue becomes more moist, with a pleutiful spitting, a gentle purging, or a moisture upon the skin; or if a suppuration happens iu one or both ears, or large pus- tules break out about the lips and nose, there is reason to hope for a favourable crisis. But if there is an excessive looseness or wasting sweats, with fre- quent fainting fits; if the tongue, when put out, trembles excessively, and the extremities feel cold, with a fluttering or slow creeping pulse; if there is a starting of the tendons, an almost total loss of sight and hearing, and an involuntary discharge by stool and urine, there is great reason to fear that death is approaching. REGIMEN.—It is very necessary in this disease to keep the pa- tient cool and quiet. The least motion would fatigue bim, and will be apt to occasion weariness, and even faintings. His mind ought not on- ly to be kept easy, but soothed and comforted with the hopes of a spee- dy recovery. Nothing is more hurtful in low fevers of this kind than presenting to the patient's imagination gloomy or frightful ideas. These of themselves often occasion nervous fevers, and it is not to be doubted but they will likewise 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, panado, or whatever food he takes, must be mixed with wine according as the symptoms may require. Pretty strong wine- whey, or small negus sharpened with the juice of orange or lemon, will be proper for his ordinary drink. Mustard-whey is likewise a very 19 140 OF THE NERVOUS FEVER. proper drink in this fever, and may be rendered an excellent cordial medicine by the addition of a proper quantity of while 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 medicines, while it is free from many of their bad qualities. I say good wine; for however common this article of luxu- ry 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 patieuts 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, and negus, a bottle or two of strong wine every day. Good old sound claret is the best, and may be made into negus, or giveu'by itself, as circumstances may require. In a word, the great aim in this elisease is to support the patient's strength, by giving him frequently small quantities of the above, or other drinks c - a warm and cordial nature. He is not however to be overheated either with liquor or clothes; and his food ought to be light, and given in small quantities. MEDICINE.—Wheu 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 ipeoacuanha in fine powder, or a few spoonsful of the vomiting julep, will generally answer this purpose very well. This may be repeated auy time before the third or fourth day, if the above symptoms continue. Vomits uot only clean the stomach, but by the general shock which they give, promote the perspiration, aud have many other excellent effects in slow fevers* where there are no signs of inflammation, and nature wants rousiug. Sueh 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 pre- vent them from going to either extreme. Thus, in fevers of the inflate matory kind, where the force of the circulation is too great, or the blood dense, and the fibres too rigid, bleeding and ether evacuations are necessary. But in nervous fevers, where nature flags, where the blood is vipid and poor, and the solids relaxed, the lancet must be spa- red, and wine, with other cordials, plentifully administered. It is the more necessary to caution people against bleeding in this disease, as there is generally at the beginning an universal stricture up- on the vessels, and sometimes an oppression and difficulty of breathing, v.hich 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 feeliugs ia this respect, so far as to insist upon being bled, when it was evideut from the consequences that the operation was improper. Though bleeding is generally improper iu this disease, yet blistering is highly necessary. Blistering plasters may be applied at all times ei OF THE NERVOUS FEVER. 147 the fever with great advantage. If the patient is delirious he ought to be blistered ou 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 bo- dy, and by that means keep up a continual succession of them till he be out of danger. I have been more sensible of tire advantage of blistering in this than in any other disease. Blistering plasters not only stimulate the solids to action, but likewise 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 ol stupor has come on, in which last case it will always be proper to blister the heat!. 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 spoon- ful of common salt, if the above does not operate. Should a violent looseness come on, it may be checked by small quantities of Venice treacle, or giving the patient for his ordinary drink the white decoctiou. A miliary eruption sometimes breaks out about the ninth or tenth day. As eruptions are often critical, great care should be taken uot 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 the patient should be supported by gentle cordials, 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 breath- ing 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, we shall mention one or two of the forms of medicine which are commonly prescribed in it.* Tn desperate cases, Avhere the hickup and starting of the tendons have already come on, we have sometimes seen extraordinary effects from doses of musk frequently repeated. Musk is doubtless an antispas- modic, and may be given to the quantity of a scruple three or four * When the patient is low, ten grains of Virginian snake-root, and the same quantity of contraerva-root, Avith five grains of Russian cas* tor, all iu fine powder, may be made into a bolus with a little of the cordial confection of syrup of saffron. One of these may be taken ev- ery four or five hours. The following powder may be used with the same intention : Take wild Valerian 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, three or four times a-day. 143 PUTRID OR SPOTTED FEVER. 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, with three grains of camphire, and six grains of salt of hartshorn, may be made into a bolus with a little syrup, aud giv- en as above. 'f the fever should happen to intermit, which it frequently does to- wards the decline, or if the patient's strength should be wasted 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 in fine powder, may be given four or five times a-day in a glass of red port or claret. Should the bark in substance not sit easy ou the stomach, an ounce of it in powder may be infused in a bottle of Lisbon or Rhenish wine 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 symptoms of inflammation, without any regard to the remission or in- termission of the fever. How far future observation may tend to es- tablish this practice, we will not pretend to say; but we have reason to believe that the bark is a very universal febrifuge, aud that it may be administered with advantage in most fevers Avhere bleeding is uot necessary, or where there are uo symptoms of topical inflammation. CHAPTER XX. OF THE MALIGNANT, PUTRID OR SPOTTED FEVER. THIS may be called the pestilential fever of Europe, as in many of its symptoms it bears a great resemblance to that dreadful disease the plague. Persons of a lax habit, a melancholy disposition, and those whose vigour has been wasted by long fasting, watching, hard labour, excessive venery, frequent salivations, neral 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, and should have fiesh air frequently let into his chamber; whatever comes from him should be immeeliately removed, his linen should be frequent- ly changed, and those iu health ought to avoid all unnecessary com- munication with him. Any one who is apprehensive of having caught the infection, ought immediately to take a vomit, and to Avork it off by drinking plentifully of camomile tea. This may be repeated in a day or two, if the appro-- liensions still continue, or any unfavourable symptoms appear. The person ought likewise to take an infusion of the bark and camo- mile flowers for his ordinary drink ; and before he goes to bed he may drink a pint of pretty strong negus, or a few glasses of generous wine. I have been frequently obliged to follow this course Avhen malignant fevers orevailed, and have likewise recommended it to others with constant success. People generally fly to bleeding and purging as antidotes against in- fection ; but these are so far from securing them, that they often, by debilitating the body, increase the danger. Those who wait upon the sick in putrid fevers, ought always to have a piece of spuoge or a handkerchief dipt in vinegar, or juice of lemon, to smell to while near the patient. They ought likewise to wash their hands, and, if possible, to change their clothes, before they go into com- pany. * The late Sir John Pringle expressed a concern lest these cautions should prevent people from attending their friends or relations when afflicted with putriel feveia. I told him I meant only to dicourage unnecessary attendance, and mentioned a number of instances where putrid fevers had proved fatal to persons, who were rather hurtful thau beneficial to the sick. This sagacious physician agreed with me, in thinking that a good doctor and a careful nurse Avere the only ne- cessary attendants; and that all others not only cnelangered themselves, but, generally, by their solicitude and ill-directed care, hurt the sick, OF THE MILIARY FEVER. US CHAPTER XXI. OF THE MILIARY FEVER. THIS fever takes its name from the small pustules or bladders which appear on the skin, resembling in shape and size, the seeds of mil- let. The pustules are either red or white, and sometimes both are mixed together. The whole body is sometimes covered with pustules; but they are generally more numerous where the sweat is most abundant, as on the breast, the back, &c. A gentle sweat, or moisture on the skin, great- ly 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 ofleoer only a symptom of some other malady, as the small pox, measles, ardent, pu- trid, or nervous fever, &c. In all these cases it is generally the effect of too hot a regimen or medicines. The miliary fever chiefly attacks the idle and phlegmatic, or per- sons 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 than men, especially the delicate and the indolent, who neg- lecting exercise, keep continually within doors, and live upon weak and watery diet. Such females are extremely liable to be seized with this disease in childbed, and often lose their lives by it. ... CAUSES.—The mili-ry fever is sometimes occasioned by violent passions or affections of the mind; as excessive grief, anxiety, thought- fulness, &c. It may likeAvise be occasioned by excessive watching, great evacuations, a weak wateiy diet, rainy seasons, eating too fre- quently of cold, crude, unripe fruits, as plumbs, cherries, cucumbers, melons, &c. Impure waters, or provisions which have been spoiled by rainy seasons, long keeping, &c. may likewise cause miliary fevers. They may also be occasioned by the stoppage of any customary evac- uation, as issues, setons, ulcers, tlie bleeding piles in men, or the men- struel flux in women, &c. m This disease in child-bed women is sometimes the effect ot great costiveness during pregnancy; it may likewise be occasioned by their excessive use of green trash, and other unwholesome things, in which pregnant women are too apt to indulge. But its most genera cause « indolence. Such women as lead a sedentary life, especially during pregnancy, and at the same time live grossly, cau hardly escape this disease in child-bed. Hence it proves extremely fatal to women ot fashion, and likewise to those women in manufacturing towns, who, »o 1*6 OF THE MILIARY FEVER. order to assist their husbands, sit close within doors for almost the Arhole of their time. But among women Avho are active and laborious, who Uve in the couotiy, aud take sufficient exercise without doors, this disease is very little known. SYMPTOMS.—When this is a primary disease, it makes its at- tack, like most other eruptive fevers, with a slight shivering, which is succeeded by heat, loss of strength, faintishness, sighing, a low quick pulse, difficulty of breathing, with great auxiety 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 child-bed-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 while colour begin to ap- pear. Upon this the symptoms generally abate, the pulse becomes more full and soft, the skin grows moister, aud the sweat, as the dis- ease advances, 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, which 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, when the eruption is critical; but, when symptomatica!, they may appear at any time of the disease. Sometimes the pustules appear and vanish by turns. When 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 childbed-women the pustules are commonly at first filled with clear water, afterwards 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 suddeu disappearing of the pustules, and to pro- mote their maturation. For this purpose the patient mufct be kept in *uch temperature, as neither to push out the eruption loo fast, uor 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 mach covered Avith clothes Above all, the mind is to be kept easy and cheerful. Nothing so cer- tainly makes an eruption go in as fear. The food must be weak chicken broth with bread, panado, sa- go, or groat-gruel, &c. to a gill of which may be added a spoonful or two of wine, as the patient'* strength requires, with a few grains of salt and a little sugar. Good apples roasted or boiled, with other ripe fruit* of an opening cooling nature may be eaten. OF THE MILIARY FEVER. 157 The drink may be suited to the state of the patient's strength and spirits. If these be pretty high, the driuk ought to be weak; as water- gruel, balm-tea, or the decoction mentioned below.* When the patient's spirits are low, and the eruption does not rise suffi- ciently, his drink must be a little more generous; as wine-whey or small negus; sharpened with the juice of orange or lemon, and made strouger or weaker as circumstances may require. Sometimes the miliary fever approaches toward a putrid nature, in which case the patient's strength must be supported with generous cordi- als, joiued 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.! MEDICI XE.—If the food and drink be properly regulated, there will be little occasion for medicine in this disease. Should the erup- tion however not rise, or die spirits flag, it will not only be necessary to support ihe patient Avith cordials, but likewise to apply blistering-plas- ters. The most proper cordial, iu this case, is good wine, which may either be taken in the patient's food or drink ; aud if there be signs of putrescence, the bark and acids may be mixed with wine, as directed in the putrid fever. * 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 decoction add a little white sugar, and let the patient take it for his ordinary drink. f In the Commkrcium Literaru'm for the year 1735 we have the history of an eftidemical Miliary Fever, which raged at Stras- burg in the months of November, December, and January; from which we learn the necessity of a temperate regimen in this malady, and like- wise that physicians are not always the first who discover the proper treatment of dissases. ** This fever made terrible havoc even among men of robust constitutions, and all medicine proved in vain. They were seized in an instant with a shivering, yawning, stretching, and pains in the back, succeeded by a most intense heat; at the same time there Avas a great loss of strength and appetite. On the seventh or 9th day the miliary eruptions appeared, or spots like flea-bites, with great anxiety, a delirium restlessness and tossing in bed. Bleeding was fatal. While matters Avere in this unhappy situation, a midwife of her own ac- cord, 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, the grievous symp- toms vanished, and the patient was restored to his senses, and snatched from the jaws of death." This practice Avas imitated by others with the like happy effect. 153 OF THE REMITTING FEFF.R. Some recommend blistering through the whole course of this disease; and where Nature flags, aud the eruption comes and goes, it may be necessary to keep up a stimulus, by a continual succession of small blis- tering-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 weakens 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 childbed women, by plentiful bleeding, and other evacuations, as if it were highly inflammatory. But this practice is generally very un- safe. Patients in this situation bear evacuations very ill. And indeed the disease seems often to be more of a putrid than of au inflammatory nature. Though this fever is often occasioned in childbed-women by too hot a regimen, yet it would be dangerous to leave that off all of a sud- ellow fever. 2. Calomel ta- ken iu such small doses as gently to affect the gums. Several other controverted 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 ha's excited it iu 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 iu warm weather. 3. Fatigue from amusements; such as fishing, gunning, dancing, and from unusual labour or exercise. 4. Intemperance in eating and drink- ing. 5. Partaking of new alimeuts and drinks. 6. Violent emotions or passions of the mind. 7. The entire cessation of moderate labour. 8. The continuance of hard labour. These are the principal means of prevention which have been enumerated as necessary. The Regi- men to be observed after an attack, consists in the following: The pa- tient should abstain from animal food; the diet should consist of gruel, panado, sago, chicken'broth, and other spoon meats; he should use cool diluting drinks, such as barley-water, toa8t and water, lemonade, ap- ple tea, tamarind water, hop tea, anel also small quantities of ripe fruits, which teud to keep the bowels soluble. The chamber of the sick should be spacious and airy, and frequently ventilated through i\Hi day : vinegar, sprinkled on hot bricks, should be introduced into the apartment frequently, and impregnated with aromatic herbs repeat- edly sprinkled over the floor, bed clothes, &c. The passions of the mind ouglit also to be regularly attended to, aud the excrements should not be suffered to remain a moment iu the apartment. These circum- stances are of. infinite importance, as well to'the sick, as to those who frequent them. MEDICINE.—Here a particular necessity compels us to be minute in our observations. This publication Avas originally, and is hoav intended, as an assistant and guide to Families, and to such as arc out of the reach of Physicians. Happily for mankind, where this disease prevails, there are generally a sufficient number of eminent Physicians. Need we observe the importance of an early application to au 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 js to subdue it by the most speedy means in our power. The second i6 to prevent the putrescent state that follows so rapidly after the febrile stage, or to oppose its progress when 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 perfoimed within the first twenty-four hours from an siltack, or at most within thirty-six. Some practitioners have pointed ontthe exact quantity of blood to be dmvn, but as an implicit attention to that rule may subject us to error, we decline the insertion. In gra- OF THE YELLOW FEVER. let etal, when the use of the laucet is indicated, one or more bleedings may be admitted, with a view to alleviate the violent pains of the head, eyes, &c. provided it be performed within the time prescribed. In order to moderate the violent determination to the head, the feet should be bath- ed iu warm water, and an opening clyster administered immediately. As obstinate costiveness generally prevails, and the »'omach is seldom long capable to retain the common purgatives, We ought to improve the time to advantage. It may be here observed that if perspiration can, be promoted soon after the attack, it may be a means to subdue the fe- ver: with this view, if i here be no inclination to vomit, and the skin is dry and parched, the following may be administered to advantage, during the first twenty-four hours. Take antimonial powder, and cal- omel, of each one scruple, syrup enough to make a mass, of which eight pills may be made. Four of these may be taken immediately, and two more repeated every second or third hour after, till they ei- ther procure a due discharge, or free perspiration. Should however the first dose occasion a retching or vomiting, we should immediately desist and resort to the other means hereafter laid down. If the^pre- scription operates plentifully by sweat and by stool, the patient will in afl probability recover, as by this means the fever is often prevented from forming itself. Should the stomach not retain the foregoing, forty grains of jalap and twenty of calomel, or twenty of calomel with the like quantity of Crab's-eyes or magnesia, may be rubbed together, aud divided into ten poAvders; one of these may be given every two hours, in a little cold tea, or they may be formed into ten pills, one of which to be taken at the same periods, and continued during the whole of the febrile stage, or untill the gums are affected. When this fortunate circumstance takes place, the medicine must be suspend- ed, and nourishment with a little wine given. 2. As bark in substance will rarely remain on the stomach, decoctions are to be preferred, and as in this stage it is uecessary, to exert every effort to resist a ten- dency to putrefaction, four table spoonsful of the decoction of bark may be given every two hours. If the stomach should reject it, or whether it does or not, we ought not to neglect repeated clysters of it, acidula- ted with vinegar or lime juice, at least every two hours, nor would it be amiss to rub the body with Aduegar or lime-juice, as often as practi- cable. Some have recommended olive or sweet oil for this purpose also. Sometimes the strained juice of wood sorrel given internally aud by way of clyster, has been attended with good effects in restraining the putrid tendency, and in one instance has been known to check the black vomit. Hops, being possessed -ig'-great astiseptic properties, an infusion of them may be taken in modfca'o draughts, at proper inter- vals. In case of vomiting, a blister applied to the epigastric regiou, particularly the pit of (he stomach, is almost alon". to be relied on. In this fever, an inflammation of the stomach and viscera are almost always present, and the tendency to putrescence is so gieat as to exclude th« 108 OF THE COW-POX. remedies usually applied in other cases attended with vomiting. H^re it is essentially and absolutely necessary to avoid all heating medicine. Wherefore, if the gums are not already affected, frictions of strong mer- curial ointment, particularly over the hypochondriac and epigastric re- gions, may be used; and if by this meaus the gums can be affected, a cure may be lookeq* for. From what has been said we may collect, that the general plan of treatment for this Hydra-disease, consists of such remedies, as tend to subdue the inflammatory diathesis already pointed out.—Bleeding, ■warm bathing, and purgatives, appear to be the most approved, to which may be added blistering aud the mercurial friction. Among the pur- gatives, calomel appears to claim the preference, and when timely and prudently administered, seldom fails to prove successful. Hence we are again induced, earnestly to advise timely application to a Profes- sional Character. We shall now conclude with some remarks on the treatment of con- Talescents. They should avoid every thing which may tend to bring on a relapse; among these may be reckoned a too early exposure to im- proper 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 iu the fever, it must now be used more sparingly. Bark in substance or decoction, should be continued in moderate doses, untill the debilitated system is invigorated, the digestive faculty repaired and strengthened, and the patient returns to his usual mode of living. CHAPTER XXIV, OF THE COW POX, AND ITS INOCULATION. THE method of inoculating for the small-pox has been retained, as having hitherto been successfully practised during a number of years; but by a fortunate discovery it is now found, that the infection may be introduced in a manner equally successful, and the disease ren- dered still less considerable thac by the former kind of inoculation. This is done by inoculating Avith flatter either taken from a cow affect-^ ed with the disease, qr from some person who had received the infect- ion originally derived from that aaimal. It may be proper here to give a general account of the manner in which so surprising a discovery has been made. • OF THE COW-POX. 169 In several parts of England, where cows are kept for the purposes of the dairy, a peculiar eruptive disease lias been occasionally observ- ed among the h«d, and which affects in particular the udders and teats of those ani nals. It has therefore pretty generally obtained the name of the cow pox ('vaccinia or vacciola.) Till within these last two years the kuowledgeof this distemper has been chiefly cod lined to the people employed iu the dairies, and to far- riers and cow-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 wherever the existence of this disease was kn.ivvi. the fact w.»s likewise iscertainetl,that the disorder is communi- cated by the touch to the milkers who handle the teats of the diseased cows, aud from them again is often spread through a numerous herd: 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 indis- position, often severe, but never fatal, which runs a regular course; and that the person who has once undergone the disease so communica- ted, is ever after secure against the infection of the smallpox, either iu the natural way by contagion, or by inoculation. All these circumstances, however though known, as we are told, from time immemorial in certain parts of the kingdom, still remained in obscurity till within these three years, when Dr. Jenner, of Berkley, iu Gloucestershire, conceived the important idea of employing the cow- pox to annihilate the small pox, and published several interesting par- ticulars concerning this disease which works have now made it known to the publick in general. It appears, from observations made by those who are most conver- sant with cows, that several causes may produce sores upon the udder and 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, and other such exter- nal irritations, will often occasion small white blisters on the parts; which never extended 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, Avhile 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 practiced at 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 sup- ply the udder are kept for an unusual length of time in a state of great distention, which terminates frequently in a violent inflammation of those parts, succeeded by large eruptions upon the teats and udder fhat sometimes leave deep and troublesome sores. The matter discharged I-flB OF'THE COW-POX. ■from these ulcers will communicate a di.-order, like the other, into thr hands of the milkers, when the skin is broken in auy part; and ofua produces foul and extensive ulcers, which s.-mietbnes occasion pustules on the arms and shoulders, and prove tedious and difficult of cure. The-genuine cow-pox, however, is a dirt-net disease from those which have been just mentioned. It generally makes its appearance in the ^ori-g and shows Use'.f in irregular pustules on the teats or nip- ples ci'i'iir: udder. They are at fii-st of a palish blie,or rather a livid colour, at id contain a thin, watery, and sharp fluid. The surround- ing parts are inflamed and hardened- These pustidi??, it seems are very apt to degenerate into deep corroding ulcers, which a:; the cow- doctors term it, tat into Ute flesh, and constantly, discharge a matter, which commonly increase in thickness, and hardens at i;^i into a scab. Now and then the cow becomes evidently i;;.-v if posed, loses her appe- tite, and gives lets milk than n.-ual -r but it oi'Un happous, that the disor- der, though severe, i3 en'iieiv local. It appears that the cow-pox never proves fata! to cows, nor is itin- f.euous in the us»u S master cf contagious distempers, hut can only be corv.rr,it:::ccte.l to thrfin or to the human species by actually touching the m ;tter v.'hleh proceeds f.-om the tores. Hence, the cows which are u-< i;i milk .; .v.pe the disease entirely, though constantly in the ?v;nc fi.LI witii those that are highly j•.»fueled ; and it seems to be only from the circumstance oi" the miiker handling the teats of the sound cows, nftcr touching ths diseased, that the cow-cox ever spreads among the kenk V.'o are informed that the cow-pox is familiar to the inhabitants of Hie hundred of C rLley in Gloucestershire It has likewise been dis- covered in various parts of the counties of Wilts, Somersets, Bucking- ham, Devon, and Hants; in a few pk:ccs of Suffolk and Norfolk* wi.ere it is sometimes, called the pap pax; and iu Leicestershire and Staffordshire. Nor is it una; quoit in the very large milk-forms con- tignexis 'o the me-tropolis or: the iMiddlescx side. It is here observed generally to attack first some cow newly introduced to the herd, and t.;; supposed to originate i.i a sudden chang;: from a poor to a very rich and partly unnatural diet which it is the practice to use, in order to I'ring the yield of milk to is highest point. According to Dr. Je.uncr, the origin of the cow-pox is ascribed to a derivation from the ri.si?:*•- The horse is well known to be subject to an ir.fiammation aud swelling iu die heel. c?;!led the urease, from which ^discharged a A-ery sharp matter, capable of producing irritation and ulcers in r.::y other auimal to the surface of which it is applied- It is supposed that tiffs matter is conveyed to the cow by the men servants- ci the farm, who in several of the dairy counties, assist in milking One of these, having dressed the horse, goes immediately to his occu- pation of milking; aud having upon his hand some particles of the dis- fcaige ftotattc grease, he, cf course, applies it to the udder of the co*53 OF THE COW-POX. Ul where, if the animal be in a state for receiving the infection, it pro- duces that specific change in those parts which gives rise to the dis- ease of the cow-pox. The origin here ascribed to this disorder is principally founded on the circumstance, that Avhenver the cow pox appears, ihc grease is generally found to have preceded it; and the opinion of the propaga- tion of the disease from the horse to the cow is likewise current in some of the dairy couuties where the disease is known. But this opin- ion 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 with- out success, to introduce the disease iu the nipple of the cow by direct inoculation of the recent matter of the grease from the horse's heel. The cousequeuce of this experiment, when it took any effect, was a slight inflammation, and the production of a small pustule or pimple, but which disappeared in a few days, without exciting the speckic dis- ease of 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 admitted that a certain predisposition in the constitution of the cow to receive the diseack is also requisite for its production. It is remarked, that the matter discharged from the sores in the horse's heel is likew ise found to occasion, at times, very troublesome ul- cers ou the hands of the men that dress them, attended with a very con- siderable degree of indisposition; both of which appear to be fojl as severe as in the genuine cow-pox, and in many points to resemble this latter disorder. But the perscu who has been infected by the horse is not rendered thereby 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 in which they are produ- ced, are found by experience to possess the power of infecting the hu- man species, when any part of the body, where the skin is broken, or naturally thin, comes into actual contact with the matter which they dis- charge. Hence it is, that with the milkers, the hands are the parts that acquire this disorder accidentally, and it there exhibits the follow- ing appearances : 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 suppura- tion. The pustule is quite circular, depressed in the middle, and of a blueish colour, and is surrounded with a considerable redness. The blue colour Avhich the pustule almost invariably assumes, Avhen the dis- order is communicated directly from the cow, is one of the most cha- racteristic marks by which the cow-pox may be distinguished from other diseases Avhich the milkers arc likewise liable to receive from the coav. The matter of the pustule is at first thin and colourless; but, as the.disorder advances, it becomes^eilower and more purulent. laa 172 OF THE COW-POt. few days from the first eruption, a tendernc?* and swelling of the glands in the arm pit come on, and soon after the whole constitution becomes disordered, the pulse is increased in quickmss. shivering succeed, with a sense of weariness, and pains about the loins, vomiting, head-ach, and sometimes a slight degree of delirium. These s)mptoms 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; reemhling, in this respect, the ulcers on the nipple of the cow, from which the) 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 spontaneously, as in the small-pox. It often happens, however, that pusiules are form- ed in various parts which accidently come in contact with the diseased hands, as on the nostrils, lips, and other parts of the face where the skin is thin; or sometimes ou the forehead, when the milker leans with that part upon the udder of an infected cow. From thin account it appears, that the cow-pox as it affect the milkers, or what may be termed the casual cow pox in the hunum species, is often a severe disorder, some- times confining the patient to his bed during the period of fever, and generally leaving troublesome sores, but it has ueA 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 where all the serv- ants of the dairy take the infection from the coavs, those of them who have previously undergone the small pox are often the only persons among them able to go through the usual work. Thirdly—The cow-pox, in its genuine state, when it has been ac- companied with general fever, and has run its regular course, ever ai- OF THE COW-POX. 173 ter preserves the person who has been infected with it from receiving the infection of the small-pox. This assertion is, however, to be taken with exactly the same limitations as that of reinfection with the small- pox preventing a second attack of the same disease No previous in- fection will eatirely counteract the local effect on the arm, produced by the insertion of variolous matter in common inoculation: this may in a few cases go so far as to induce a degree of general fever, slight indeed, but prvh.ps equal to that of the mildest indisposition caused by a first infection with this disorder. By the inoculation of either disease, how- ever, the small-pox is equally aud completely di«aimed of its virulence against any subsequent attack, which is the circumstance that so much distinguishes and so strongly recommends this operation. Fourthly.—A comparison of the two diseases in respect of the mild- ness of their symptoms, aud the hazard to life which they may occasion, will show a very great advantage in favour of the cow-pox. Compa- red with the natural small pox, the natural or casual cow-pox is both milder and infiuitely more safe; no instance having ever been known of a fatal event in the cow-pox, so far as it effects the people employed in the dairies. When both diseases are introduced by artificial inocu- lation, they are each rendered much less severe; and here too the su- periority of the cow- pox as a safer and milder disease is extremely evi- dent. Fifthly.—The cow-ppx, even in its most virulent state, is not commu- nicable by the air, nor by any other of the ordinary means of conta- gion, 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 ascertained, whether in all cases an insertion of specific infectious 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 respect 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-po\ not being communicated by the 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 mothers whilst 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 superiority ; since, by adopting this dis- ease instead of the small-pox, all the dread and all the mischief occa- sioned bj the coutagion of the latter are entirely removed. The inoculated cow-pox appears to have almost as great a superiori- ty 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 would be highly requisite in communicating the latter becomes less so where the disorder is to be introduced by inoculation; 174 OF THE COW-POX. and still less where the cow-pox is substituted in the room of the ether. Wi.h rcg.-i'd to the method of performing inoculation in tne Cow pox. Dr. Woodville, whose industry, judgment, and accuracy, appear to great advantage in his observations on ibis subject, advices "that the lancet should be held nearly at aright angle Avith the skin, in order that the infectious fluid may gravitate to the point of the instrument, which, in this directiou, should be nnde to >c:atch th.. orMiele repeatedly, un- til it reach the true skin and beconie tinged with blood." The act of inoculation having been performed, the. first proof of is success is a small inflamed spot at the part where the puncture has been made, which is very distinguishable about the third day. This continues to increase in size, becomes hard, and a small circular tu- mour is formed, rising a little above the fkia. About the sixth day the centre of the tumour shows a discoloured speck, owing to the form- ation of a sma!l quantity of fluid; and this contiuues to increase, and the pustule or pimple to fill, till about the tenth day. At er the eighth diy, wheu the pustule is fully formed, the effects tr\ the constitution begin to show themselves ; the general indisposition * be'ug commonly preceded by pain at the pustule aud in the arm pit, followed by hearl-ach. some shivering, loss of appetite, pain in the limbs mid a fevM-eh increase of the pulse. These continue, with more or less violence, for one or two days, and always abate of their own ac- cord, without leaving any unpleasant consequence behind thera. Durii'g, or a little af'er the general indisposition, the pustule in the arm, which had been advancing iu a regular manner, becomes sur- rounded with a broad circular inflamed margin, and this is a sign that the body tn general is affected. After this period, the fluid in the pustule gradually dries up, tlie surronnding redness becomes fainter, and in a day or two vanishes imperceptibly; whilst the pustule no 2ouger increases iu extent, but on its surface a hard thick seal) of a fcrowu colour is formed, which if not pulled off, remains for nearly a fortnight; till at length it foils off, leaving the skin beneath perfectly sound aud uninjured. It is a circumstance of great importance iu favour of thi-j method of inoculation, that though some attention in choosing the natter for 5n0culation, and performing this slight operation in such a manner as to Insure success, be requisite, very little medical treatment is necessary iu order to conduct the patient through it with perfect safety. In most cases it is attended with so little fever as scarcely to be detected ■fey an attentive observer. To conclude this account of the cow-pox with a repetition of the circumstances which give.; 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 they had passed through the cow pox, amounting to upwards of four ivMred, But one was affected with .the smail-po7, though purposely OF THE MEASLES. 175 and repeatedly exposed to the infection of the disease; and what is not less extraordinary, nearly a fourth part of this number were so slight- ly affected with the cow-pox, that it neither produced any perceptible indisposition, nor pustules. From the beginning of the world, the cow, has, in all countries, beea esteemed a valuable animal. Besides cultivating the gronud which her species performs, she supplies us «.rith au aliment of her own preparing, the most wholesome as well as nourishing in nature; but never before was it known, except, as appears in some particular districts in Eng- land, that even from a disease to Avhich she is liable, she can likewise be further useful in preserving us from one of the most fatal calamities. tibat ever infested human kind. CHAPTER XXV. OF THE MEASLES. THE measles appeared iu 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 Avorld, are both infectious, aud sel- dom attack the same person more than once. The measles are most common iu the spring season, and generally disappear in summer. The disease itself, when properly managed, seldom proves fatal; but its con- sequences are often very troublesome. CAUSE.—This disease, like the small-pox, proceeds from infection, and ia more or less dangerous according to the constitution of the pa- tient, the season of the year, climate, &c. SYMPTOMS.—The me-isles, like other fevers, are preceded by alternate fits of heat and cold, with sickness and loss of appetite. The tongue is white, but generally mo;,t. There is a riiort cough, heavi- ness of the head ami eyes, drowsiness, and a running at the nose. Some- times indeed tin- couji does not come before :!:e eruption has appear- ed. There is an inflammation and heat in the eyes, accompanied with a defiuxion of sirup rheum, and great acuteness of sensation, so that they cannot bear the light without pain. The eye-lids frequently swell so as to occasion blindness. The patient generally complains of his throat; and a vomiting or looseness often precedes the eruption. The stools in chil.ireu are commonly greenish ; they complain of an itchin* of the skiu, and are remarkably peevish. Bleeding at the nose is com- mon, both before and in dit- progress cf the di=e??-. 170 OF THE MEASLES. About the fourth day, small spots resembling flea-bites, appear, first upon the face, then upon the breast, and afterwards on the extremi- ties: these may be distinguished 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 rath- er 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; so that by the ninth day they^ entirely disappear The fever, however, and difficulty of breathing, often continue, and especially if the patient has been kept upon too hot a regimen. Petechiae, 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 dauger. Such as die of the measles, generally expire about the ninth day from the invasion, and are commonly carried off by a peripneumony, or inflammation of the lungs. i The most favourable symptoms are a moderate looseness, a moist skin, and a plentiful discharge of urine. When the eruption suddenly falls in, and the patient is seized with a delirium, he is in the greatest danger. If the measles turn too soon of a pale colour, it is an unfavourable symptom, as are also great weak- ness, vomiting, restlessness, and difficulty of swallowing. Purple or black spots appearing among the measles are very unfavourable. When a continual cough, with hoarseness, succeeds the disease, there is rea- son to suspect an approaching consumption of the lungs. Our busiuess in this disease is to assist nature, by proper cordials, in throwing out the eruption, if her efforts be too languid; but when 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, aud difficulty of breathing. REGIMEN.—The cool regimen is necessary here as Avell as in the smallpox. 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 likewise, though a good drink in the small-pox, is here improper. The most suitable liquors are decoctions of liquorice, with marsh-mallow roots aud sarsaparilla, infusions of linseed, or of the flowers of elder, balm tea, clarified Avbey, barley-water, and such like. These, if the patient is costive, may be sweetened with honey; or, if that should disagree with the stomach, a little manna may occasionally be added to them. MEDICINE.—The measles being an inflammatory disease, with- out any critical discharge of matter, as in the small-pox, bleeding is commonly necessary, especially Avhen the fever runs high, with difficul- OF THE MEASLES. 177 ty 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 in lukewarm water, both tends to abate the violence of the fever, and to promote the eruption. The patient is often greatly relieved by vomiting. Wheu there is a tendeucy this Avay, it ouglit to be promoted by drinking luke-warm wa- ter, or weak camomile tea. "When the cough is very troublesome, with dryness of the throat, and difficulty of breathing, the patient may hold his head over the steam of warm water, and draw the steam into his lungs. He may likewise lick a little spermaceti and sugar candy pounded together; or take now and then a spoonful of the oil of sweet almonds, w ith 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 new vigour, and there appears great danger of suffocation, the patient must be bled according to his streugth, and blistering-plasters applied, with a view to prevent the load from being thrown on the luigs, 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 which we have recommended when the small- pox recede. The patient must be supported with 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 sharpened with spirits of vitriol; and if the putrid symptoms increase, the Peruvian bark must be administered in the same manner as direct- ed 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 syrup of poppies is sufficient. A tea-spoonful or two may be occasionally given according to the pa- tient'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 au 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 cat or drink. Their food for some time ought to be light, and in small * I do not kuow any disease wherein bleeding is more necessary than in' the measles, especially when the fever runs high : in this case I have always found it relieve the patient. 23 178 OF THE SCARLET FEVER. quantities, and their drink diluting, and rather of an opening nature, &z butter miik, whey, and such like. They ought also to beware of ex- pesiug theneelvcs too soon to the cold air, least a suffocating catarrh, an asthma, or a consumption of the lungs, should ensue. Should a cough, witii difficulty of breathing, and other symptoms of a consumption, remain after the measles, small quantities of blood may be frequently let at proper intervals, as the patient's strength and con- stitution Avill permit. He ought likewise to drink asses milk, to re- move 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 aud vegetables; aud lastly, if these do not succeed, let him remove to a warmer climate.* OF THE SCARLET FEVER. THE scarlet fever is so called from the colour of the patient's skin, which appears as if it were tinged with reel 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, without any violent sickness. Afterwards the skin is covered with red spots, which are broader, more florid, and less uniform than the measles. They continue two or three days, and then disappear; after which the cuti- cle, or scarf-skin falls off. There is seldom any occasion for medicine in this disease. The pa- tient ought however to keep within doors, to abstain from flesh, strong liquors, and cordials, and to drink freely of cool and. diluting liquors. If *■ 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 communi- c 'cd the disease by the blood. Others have tried this method, and have not found it succeed. Some think the disease would be more cer- tainly communicated by rubbing the skin of the patient who has the measles with cottou, and afterwards applying the cotton to a wound as in the small-pox; while others recommend a bit of flannel which had bef n applied to the patient's skin all the time of the disease, to be after- wards 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 small-pox, may be communicated various ways; the most probable, how ever, is either from 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, dint such patients as have been inoculated, had the disease very mild- ly; we therefore wish the practice were more geueral, as the measles have of late become very fatal. OF THE BILIOUS FEVER. 17K tim fever runs high, the body must be kept gently open by emohent clysters, or smalldoses of nitre and rhubarb. A scruple of the form- er* with five grains of the latter, may be taken thrice a-day, or oftener, if necessary. . . Children and young persous are sometimes seized at the beginning of this disease with a kind of stupor aud epileptic fits. In this case the feet and legs should be bathed in warm water, a large blistering-plast- er applied to the neck, and a dose of the syrup of poppies given eve- ry night till the patient recovers* , ... Tf • The scarlet fever however is not always of so mild a nature, it is sometimes attended with putrid or malignant symptoms, in which case it is always dangerous. Iu the malignant scarlet fever the patient is uot only affected with coldness and shivering, but with languor, sick- ness, and great oppression; to these succeed excessive heat, nausea, and vomiting, wi-h a soreness 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 erup- tion appears, it brings no relief: on the contrary, the symptoms gener- allv erow worse, and 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 Droves fatal. The only medicines that can be depended ou in this case, are cordials and antiseptics, as the Peruvian bark, wme, 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 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 ?s denominated bilious. In .Britain the bilious fever general- Iv makes its appearance about the end of summer, and ceases towards !LS^ff whiter. It is most frequent andJatal m£«™ trips psneciallv where the soil is marshy, and when great rains are succUdgd by Litry heat, Persons who work without doors^ieiu t I^fhe^yea; 1774, during winter, a very bad species of this fever orevailed in Edinburgh. It raged chiefly among young people The Son was generally accompanied with a quinsey, and the inflamma- S^iST^e7- blended with others;rf ■ P*^*^» » render the treatment of the disease very diflkuU Many^of the pa tients, towards the decline of the fever, were afflicted wit large sweu logs of the submaxillary glands, and not a lew had a supination m on* •r both ears. 180 OF THE ERYSIPELAS, camps, or who 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, aud to put the patient upon the cool dilu- ting regimen recommended in the inflammatory fever. The saline draught may likewise be frequently administered, aud the patient's body kept open by clysters or mild purgatives. But if the fever should remit or intermit, bleeding will seldom be necessary. Iu 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 ac- companv tins fever, it must be treated in the manner recommended un- der the article Dysentery. When there is a burning heat, and the patient does uot sweat, that evacuation may be promoted by giving him, three or four times a-day, a table-spoonful of Mindererus' spirit, mixed in a cup of his ordinary drink. 1 f the bilious fever be attended with the nervous, malignant, or pu- trid symptoms, which is sometimes the case, the patient must be treated in the same manner as directed under 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 ev* ery kind of flatulent aliment. CHAPTER XXVI. OF THE ERYSIPELAS, OR ST. ANTHONYS FIRE. THIS disease which in some part6 of Britain is called the rose, at- tacks persons at any period of life, but is most common between the age of thirty and forty. Persons of a sanguine or plethoric habit are most liable to it. It often attacks young people, and pregnant wo- men; 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 li- able to be attacked by an erysipelas, but it most frequently seizes the OR ST. ANTHONYS FIRE. 181 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 passious or affections of the mind; as fear, angtr, &c. 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 loug in a warm bath, or by any thing that overheats the blood. If any of the natural evacuatious be obstructed, or in too small quantity, it may cause an erysipelas. The same effect will follow from the stoppage of artificial evacuations; as issues, setons, or the like SYMPTOMS—The erysipelas attacks with shivering, thirst, 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 email pustules appear; at which time the fever generally abates. When the er) sipelas 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 it attacks the face, it swells, appears red, and the skin is cov- ered Avith small pustules filled with clear water. One or both eyes are generally closed with the swelling; and there is a difficulty of breath- ing. 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 swells and becomes exceed- ingly 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 for- med. 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 iu scales, the danger is over. When the erysipelas is large, deep, and affects a very sensible part of the body, the danger is great. 1 f the red colour changes into a liv- id or black, it will end in a mortification. Sometimes the inflamma- tion cannot be discussed, but comes to a suppuration; in which case fistulas, a gaugreue, or mortification, often ensue. * The country people in many parts of Britain call this disease a blast, aud imagine it proceeds from foul air, or ill wind, as they term it. The truth is they often lie down to rest when warm and fatigued, upon the damp ground, where they fall asleep, and lie so long as to catch cold, Avhich occasions the erysipelas. This disease may indeed proceed from other 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. 182 OF THE ERYSIPELAS, Such as die of this disease are commonly carried off by the fever, which is attended with difficulty of breathing, and sometimes w i'h a de- lirium and great droAvshess. They ge.iertily die about the seventh or eighth d..y. REGIMEN.—Jn the erysipelas the patient must neither be kept too hot nor cold, as either of thete extremes Avill tend to make it re- treat, which is always to be guarded agiitist. When the disease is mii.i, it will be sufficient to keep the patient within doors, without con- fining him to his bed, and to promote the perspiration by diluting li- quor s en the body. Jf clysters and milk purgatives foil to have this effect, stronger ones must be given. Blistering-plasters must likewise be ap- pliecfto the neck, or behind the ears, and sharp cataplasms laid to me soles of the feet. When the inflammation cannot be discussed, and Lie 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. Wheu the black, 1 vid, or blue colour of tie part shows a tendency to mortification, the Peruvian bark must be administered. It may be taken along with acids, as recommended in the =mall pox. or in any other form more agreeable to the patient. It must not however be tri- fled with, as the patient's life is at stake. A drachm may be given ev- ery two hours, if the symptoms be threatening, and cloth.3 dipped in warm camphorated spirits of wine, or the tfocture of myrrh and aloes, may be applied to the part, and frequently renewed. It may likewise be proper iu this case to apply poultices of the bark, or to foment the part affected with a strong decoction of it. In what is commonly called the scorbutic erysipelas, which contin- ues for a considerable time, it will only be necessary to give gentle lax- atives, and such things as purify the blood and promote the perspira- tion Thus, after the inflammation has been checked by opening med- icines, the decoction of woods may be drank, after which a course ot bitters will be proper. Such as are liable to frequent attacks of the erysipelas ous.it care- fully to .ruard against all violent passions, to abstain from stror* 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 friut*, herbs, and roots, as are of a cooling quality, and their drink ought to be small beer, whey, buttermilk, and such like.—Thej should never suffer themselves to be long costive. If that cannot be prevented by smtaJ ble diet, it will be proper to take frequently a gentle dose cf rhubarb, cream of tartar, the lenitive electuary, or some other mild purgative. 184 OF THE PHREN1TIS, CHAPTER XXVII. OFTHEPHREMTIS, OR INFLAMMATION OF THE BRAIN. THIS is sometimes a primary disease, but oftener only a symptom of some other malady ; as the inflammatory, eruptive, or spotted fever, &c. It is very common, however, as a primary disease in warm climates, and is most incident to persons about the prime or vigour of life. The passionate, the studious, and those whose nervous system 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, auger, grief, or anxiety. It is often occasioned by the stoppage of usual evacuations; as the bleeding piles in men* the custo- mary discharges of Avomeu, &c. Such as imprudently expose them- selves to the heat of the sun, especially by sleeping without doors, in a hot season, with their heads uncovered, are often suddenly seized with an inflammation of the brain, so as to awake quite delirious. When repellents are imprudently used iu an erysipelas, an inflammation of the brain is sometimes the consequence. It may likewise be occasion- ed by external injuries, as blows or bruises upon the head, &c. SYMPTOMS.—The symptoms which usually proceed a true in- flamraation'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 dry- ness of the skin, costiveness, a retention of urine, a small dropping of blood from the nose, singing of the ears, and extreme sensibility of the nervous 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 sometimes 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 arteries of the neck and temples. Though the tongue is ofteu black a^el 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 im- pression on it; and sometimes from a sullen silence, the patient becomes all of a sudden quite outrageous. A constant trembling and starting of the tendons is an unfavourable symptom, as are also a suppression of urine; a total want of sleep; a OR INFLAMMATION OF THE BRAIN. ■ 133 constant 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 'he intestines, or of the throat, &c. it is owing to a trans- lation of the disease from these parts to the brain, and generally provres fatal. This shows the necessity of proper evacuations, and the dan- ger of repellents iu all inflammatory diseases. The favourable symptoms are, a free perspiration, a copious dis- charge of blood from the nose, the bleeding piles, a plentiful discharge of untie, 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 few days, it requires the most speedy applications. When it is prolonged, or improperly treated, it sometimes ends iu madness, or a kind of stupidity which continues for life. In the cure, two things are chiefly to be attended to, viz. to lesseu the quantity of blood in the brain, and to retard the circulation towards the head. REGIMEN.—The patient ought to be kept very quiet.—Compa- ny, noise, and every thing that affects the senses, or disturbs the ima- gination, increase's 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 too hot nor cold. It is not how ever necessa- ry ttf exclude the company of an agreeable friend, as this has a tenden- cy to soothe and quiet the mind. Neither ought the patient to be kept too much iu 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 eve- ry 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 denied them, but rather put off.Avith the promise of having them as soon as they can be obtain- ed, or by some other excuse. A little of any thing that the mind is sot upon, though not quite proper, will hurt the patient less than a posi- tive refusal. In a Avord, whatever he was fond of, or used to be delight- ed with, when in health, may here be tried ; as pleasing stories, soft music, or whatever has a tendency to soothe the passions and compose the mind. Boerhaave proposes several mechanical experiments for this purpose; as the soft noise of Avater distilling by drops into a bason, and the patient tryii,g to reckon them, &c. Any uniform sound, if low and continued, lias a tendency to procure sleep, and consequently 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, preserves, &c. The drink small, diluting, and cooling; as whey, barley water, or de- 24 186 OF THE PHRENITIS, &c. coetions of barley and tamarinds, which latter not only render the li- quor more palatable, but likewise more beneficial as they are of an open- iug nature. MEDICINE—In an inflammation of the brain, nothing more cer- tainly relieves the patieut than a free discharge of blood from the nose. Wheu this comes of its own accord, it is by no means to be stopped but rather promoted, by applying cloths clipped in warm water to the part. When bleeding at the nose does not happen spontaneously, it may be provoked, by putting a straw or any other sharp body up the nostril. Bleeding in the temporal arteries greatly relieves the head; but as this operation cannot always be performed, we would recommend in its stead, bleediug iu the jugular veins. When the patient's pulse and spirits are so low that he cannot bear bleeding with the lancet, leeches may be applied to the temples. These uot only draw off the blood more gradually, but by beiug applied nearer to the part affected, gen- erally give more immediate relief". A discharge of blood from the haemorhoidal veins is likewise of great service, and ought by ail means to be promoted. If the patient has been subject to the bleeding piles, and that discharge has been stopped, every method must be tried to restore it; as the application of leeches to the parts, sitting over the steams of warm water, sharp clysters, or suppositories 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, setous, 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 mix- ed with his drink. Two or three drachms, or more, if the case be dangerous, may be used in the space of twenty-four hours. The head should be shaved and frequently rubbed with vinegar and rose water. Cloths dipped in this mixture may likewise be applied to die temples. The feet ought frequently to be bathed in lukewarm wa- ter, and soft poultices of bread aud milk may be kept constantly ap- plied to them. if the disease proves obstinate, and does not yield to these medicines, it will be uecessary to apply a blistering plaster to the Avhole head. OF THE OPHTHALMIA, &c. 1ST CHAPTER XXVIII. OF THE OPHTHALMIA, OR INFLAMMATION OF THE EYES. THIS disease may be occasioned by external injuries; as Moats, burns, bruises, and the like. It may likewise proceed from dust, quick-lime, or other substances, getting into the eyes. It is often caused by the stoppage ol* 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, &c. Long exposure to the night air, e pe- cially in cold northerly winds, or Avhatever suddenly checks the perspi- ration, especially after the body has been much heated, is very apt to rause an inflammation in the eyes. Viewing shoav or other white bod- ies for a long time, or looking stedfastly at the sun, a clear fire, or any bright object, will likewise occasion this malady. A sudden transition from darkness to very bright light will often have the eame 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 likewise very hurtful to the eyes. The acrid fumes of metals, and of several kinds of fuel, are also pernicious. Sometimes an inflammation of the eyes proceeds from a venereal taint, and often from a scrophulous or gouty habit. It may likewise be occasioned by hairs in the eyelids turning inward and hurting the eyes. Sometimes the disease is epidemic, especially after wet seasons; and I have frequently known it prove iufectious, partic- ularly 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 persons who are not accustomed to such situations. In children it often proceeds from imprudently drying up of scabbed heads, a run- ning behind the ears, or any other discharge of that kind. Inflamma- tions of the eyes often succeed the small-pox or measles, especially in children of a scrophulous habit. SYMPTOMS.—An inflammation of the eyes is attended with acute pain, heat, redness, and swelling. The patient is not able to bear the light, and sometimes he feels a pricking pain, as if his eyes were pier- ced with a thorn. Sometimes he imagines his eyes are full of motes, or thinks he sees flies dancing before him. The eyes are filled with a scalding rheum, which rushes forth in great quantities, Avhenever the patient attempts to look up. The pulse is generally quick and hard, with some degree of fever. When the disease is violent, the neigh« 188 OF THE OPHTHALMIA, bouring parts swell, and there is a throbbing or pulsation in the tempo- ral arteries, &c. A slight inflammation of the eyes, especially from on external cause, is easily cured; but when the disease is violent, a;'d 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 Avhen the disease is ac- companied wiih a violent pain of the head, mid continues long, the pa- tient is in danger of losiug his sight. REGIMEN.—The diet, unless in scrophulous cases, can hardly be too spare, especially at the beginning. 'The patient must abstain from every thing of a heating nature His food should consist chiefly of mild vegetables, Aveak broths, aud gruels. His driuk may be bar- lcy-water, balm-tea, common whey, and 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. Ha should not look at a candle, the fire or any luminous object; and ought to avoid all smoke, as the fumes of tobacco, or any thing that may cause coughing, sneezing, or vomiting. He should be kept quiet, avoid* ing all violent efforts, either of body or mind, and encouraging sleep as much as possible. MEDICINE.—This is one of those diseases wherein great huit 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 e) e-waters and ointments, with other external ap- plications, which do mischief twenty times for once they do good. Peo? pie 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 violeut inflammation of the eyes, is always necessary. This should be performed as near the part affected as possible. An adult may lose ten or twelve ounpes 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 iu the neck, the samt 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 Avater. 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 falts, and cream of tartar, every second or third day, or a decoction of tamarinds with senna. If these be not agreeable, gentle doses of rhubarb and nitre, a little of thu lenitive electuary, or any other mild purgative, will an- OR INFLAMMATION OF THE EYES. 189 swer the same end. The patient at the same time must drink freely of water-gruel, tea, whey, or any other Aveak diluting liquor. He ought likewise to take at bed-time, a large draught of very weak wine-Avhey, in order to promote perspiration. His feet and legs must frequently be bathed iu lukewarm water, and his head shaved twice or thrice a-week, aud afterwards washed in cold Avater. 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 neceKbary to continue the discharge for several weeks. When the disease has been of long standing, I have seen very extra- ordinary effects from a seton in the neck, or between the shoulders, especially the latter. It should be put upwards and downwards, or in the directiou of the spine, aud in the middle between the shoulder blades. It may be dressed tAvice a-day with yellow basilicon. I have known patients, 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 trou- blesome than between the shoulders; besides, it leaves a disagreeable mark; and does not discharge 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 with luke warm 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 poppies, 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 with 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 im- mersed 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 strengthener of the eyes as any of the most celebrated collyriums. When an inflammation of the eyes proceeds from a scrophulous hab- it, it generally proves very obstinate. In this case the patient's diet must not be too Ioav, and he may be allowed to driuk small negas, or now and then a glass of wine. The most proper medicine is the Pe- ruvian bark, which may either be given in substance, or prepared in the following manner. Take an ounce of the bark in powder, with two drachms of WinterV bark, and boil them in an English quart of water to a pint; when it has 180 OF THE QtilNSEY, boiled nearly long enough, add half an ounce of liquorice-root sliced. Let the liquor be strained. Two, three, or four table-spoonsful, ac- cording to the age of the patient, may be taken three or four times a- day. It is impossible to say how long this medicine should be contin- ued, as the cure is sooner performed in some than in others; but in gen- eral it requires a considerable time to produce any lasting effects. Dr. Cheyne says, " That jEthiop's mineral never fails in obstinate inflammations of the eyes, even scrophulous ones, if given in a sufficient dose, and duly persisted in/' There is no doubt but this and other preparations of mercury may be of singular service in ophthalmias of long continuance, but they ought ahvays to be administered with the greatest caution, or by persons of skill in physic. It will be proper frequently to look into the eyes, to see if any hairs be turned inwards, or pressing upon them.* These ought to be re- moved by pluckfog them out with a pair of small pincers. Those who are liable to frequent returns of this disease, ought con- stantly to have an issue on one or both arms. Bleeding or purging in the spring snd autumn, will be very beneficial to such persons. They ought likewise to live with the greatest regularity, avoiding strong li- quors, and every thiag of a heating quality. Above all, let them avoid the night air, and late studies. 'i"*.'.1' CHAPTER XXIX. OF THE QUINSEY, OR INFLAMMATION OF THE THROAT. THIS disease is very common in Britain, and is frequently attend- ed with great danger. It prevails in the winter and spring, and is most fatal to young people of a sanguine temperameot. CAUSES.—In general it proceeds from the same causes as other inflammatory disorders, viz. an obstructed perspiration, or whatever heats or inflames the blood. An inflammation of the throat is often oc- casioned by omitting some part of the covering usually worn about the * Any foreign body lodged in the eye may be expeditiously removed by passing a small hair pencil between the eye-lid, and the ball of the eye. Tn some places the peasants do this very effectually, by using their tongue ia the same manner. OR INFLAMMATION OF THE THROAT. 191 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 adjacent. It may likeAvise proceed from the neg- lect of bleeding, purging or any customary evacuation. Singiug, speaking loud aud long, or whatever strains the throat, may likewise cause an inflammation of that orgau. I have often known the quiusey prove fatal to jovial companions, who after sitting long in a warm room, drinking warm liquors, and siuging with vehemence, Avere so im- prudent as to go abroad in the cold night air. Sitting with wet feet, or keeping on wet clothes, are very apt to occasion this malady. It is likewise frequently occasioned by continuing long in a moist place, sit- ting uear an open window, sleeping in a damp bed, sitting in a room that has been newly plastered, 6ic. 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 lately washed. Acrid or irritating food may likewise inflame the throat, and occa- sion a quinsey. It may also proceed from bones, pins, or other sharp substances sticking in the throat, or from the caustic fumes of metals or minerals, as arsenic, antimony, &c. taken in by the breath. This dis- ease is sometimes epidemic and infectious. SYMPTOMS.—The inflammation of the throat is evident from in- spection, the parts appearing red aud swelled; besides the patient com- plains of pain 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 swelling anrl inflammation increase, the breathing and swallow- ing become more difficult; the pain affects the ears; the eyes gener- ally appear red; and the face sw ells. The patient is often obliged to keep himself iu an erect posture, being in danger of suffocation; there is a constant uausea, or inclination to vomit, and 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, with straitness of the breast, and anxiety, the danger is great. Though the pain in swallowing be very great, yet while the patient breathes easy, there is not so much danger. An external swelling is no unfavourable symptom ; but if it snddenly falls, aud the disease affects the breast, the clanger is very great. AVheu a quinsey is the consequence of some other disease, which has already Aveakeued the patient, his situation is dangerous. A frothing at the mouth, with a swelled tongue, a pale, ghastly countenance, and coldness of the extremities are fatal symptoms. RKGl MEN.—The regimen in this disease is in all respects the same as iu the pleurisy, or peripueumony. The food must be light, and in amall quantity, and the drink plentiful, Areak and diluting, mixed Avilh acids. 192 OF THE QUINSEY, It is highly necessary that the patient be kept easy and quiet. Vi- olent affections of the mind, or great efforts of the body, may prove fa- tal. He should not even attempt to speak but in a low voice. Such a degree of warmth as to promote a constant gentle sweat, is proper. When the patient is in bed, his head ought to be raised a little higher than usual. It is peculiarly necessary that the neck be kept warm ; for Avhich purpose several folds of soft flannel may be wrapt round it. That alone will often remove a slight complaint of the throat, especially if applied jn due time. We cannot here omit observing the propriety of a custom which prevails among the peasants of Scotland: When they feel an 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 applied with particular ceremonies; the custom however, is undoubtedly a good one, aud should never be neglected. When the throat has been thus wrapt up all night, it must not be ex- posed to the cold air through the day, but a handkerchief or a piece of flannel kept about it till the inflammation be removed. The jelly of black currants is a medicine very much in esteem for complaints of the throat; and indeed it is of some use. It should be almost constantly kept in the mouth, and swallowed down 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, or of mulberries, may be used in its stead. Gargles for the throat are very beneficial. They may be made of sage-tea, with a little vinegar and honey, or by adding to half a pint of the pectoral decoction, two or three spoonsful of honey, and the same quantity of currant-jelly. This may be used three or four times a-day; and if the patient be troubled with tough viscid phlegm, the gargle may be rendered more sharp and cleansing, by adding to it a tea-spoonful of the spirit 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 wa- ter, and to use a spare diet, with diluting liquors, at the beginning of this disease, it Avould seldom proceed to a great height, or be attended with any danger; but when these precautions are neglected, and the disease becomes violent, more powerful medicines are necessary. MEDICINE.—An inflammation of the throat being a most acute and dangerous distemper, which sometimes takes off the patient very suddenly, it will be proper, as soon as the symptoms appear, to bleed in the aim, or rather in the jugular vein, and to repeat the operation if circumstances require. OR INFLAMMATION OF THE THROAT. 193 The body should likewise be kept gently open. This may either be done by giving the patient for his ordinary drink a decoction of figs and tamarinds, or small doses of rheubarb and 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 salprunel, or purified nitre, held in the mouth, and swallowed 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 pro- moting the discharge of urine, &c. The throat ought likewise to be rubbed twice or thrice a-day with a little of the volatile liniment. This seldom fails to produce some good effects. At the same time the neck ought to be carefully covered with wool or flannel, to prevent the cold from penetrating the skin, as this application renders it very tender. Many other external applica- tions are recommended in this disease, as a swallow's nest, poultices made of the fungus called Jew's ears, album Graecum, &c. But as Ave do not look upon any of these to be preferable to a common poultice of bread and milk, we shall take no further notice of them. . Some recommend the gum-guaiacum as a specific in this disease. Half a drachm of the gum in 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 the 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 runniug by the application of issue ointment, till the inflammation is gone; otherwise, upon their drying up', the patient will be in danger of a relapse. When the patient has beon treated as above, a suppuration seldom happens. This however is sometimes the case, in spite of all endeav- ours to prevent it. When the inflammation and swelling continue, and it is evident that a suppuration Avill ensue, it ought to be promoted by drawing the steam of Avarm water into the throat through a tunnel, or the like. Soft poultices ought likewise to be applied outwardly, and the patient may keep a roasted fig constantly in his mouth. It sometimes happens, before the tumour breaks, that the SAvelling is so great, as entirely to prevent any thing from getting down into the stomach. In this case the patient must inevitably perish, unless he can be supported in some other way. This can only be done by nourish- ing clysters of broth, or gruel with milk, &c. Patients have often been supported by these for several days, till the tumour has broke; and afterwards they have recovered. * Dr. Home. 25 194 OF THE QUINSEY, *Cr. Not only the sw:dlowi:ig, but the breathing, is often prevented fry the tumour. In this cise nothing can save the patient's life but open- ing the trachea, or wind-pipe. As that has been often done with suc- cess, no person, in such desperate circumstances, ought to hesitate a moment about the operation ; but as it can only be performed by a sur- geon, 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 stimu- late the glands, as a decoction of figs with vinegar and honey ; to which may be added a little mustard, or a small quautity of spirits. But this gargle is never to be used where there are signs of au inflammation. This species of angina has various names among the common people, as the pap of the throat, the falling dowu of the almonds of the ears, &c. Accordingly, to remove it, they lift the patient up by the hair of the head, and thrust their fingers under his jaws, &c. all which practices are at best useless, and 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 like- Avise to beware of catching cold, and should abstain from aliment or med- icines of an astringent or stimulating nature. Violent exercise, by increasing the motion and force of the 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 who would avoid this disease ought therefore, after speaking loud, singing, running, drinking warm liquor, or doing any thing that may strain the throat, or increase the circulation of the blood towards it, to take care to cool gradually, aud to wrap some additional covering about their necks. 1 have often known perrons who had been subject to sore throats, en- »'iely freed from that complaint by only wearing a ribband, or bit of fianne 1, constantly round their necks, or by wearing thicker shoes, a flannel waistcoat or the like. These may seem trifling, but they have great effect. There is danger indeed in leaving them offafter persons hr.ve been accustomed to them ; but surely the inconvenience of using such things for life, is not to be compared with the clanger which may aueiid the neglect of them. Sometimes, after an in'Iammalim. the glands of the throat continue PAveiled, and become hard and callous-. This complaint is not easily removed, and is often rendered dangerous by the too frequent applica- tion of strong stimulating and styptic medicines. The best method is to keep it warm, and to gargle it twice a-day with a decoction of fi^s, t'tarpened a little with the elixir or spirit of vitriol; OF THE MALIGNANT QUINSEY. 195 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 than adults, females thau males, and the delicate than those who are hardy and robust. It pre- vails chiefly in autumn, aud is most frequent after a long course of damp or sultry weather. CAUSES.—This is evidently a contagious distemper, and is gener- ally communicated by infection. Whole families, aud even entire vil- lages, often receive the infection from one person. This ought to put people upon their guard against going near such patients as labour un- der the disorder; as by that means they endanger not only their owu lives, but likewise those of their friends aud connexions. Whatever tends to produce putrid or malignant fevers, may likewise occasion the putrid ulcerous sore throat, as unwholesome air, damaged provisions, iieglect of cleanliness, &c. SYMPTOMS.—It begins with alternate fits of shivering and heat. The pulse is quick, but low and unequal, aud generally continues so through the whole course of the disease. The patient complains great- ly of weakness and oppression of the breast ; his spirits are low, aud he is apt to faint away when set upright; he is troubled with a nausea, and often with a vomiting or purging. The two latter are most com- mon in children. The eyes appear red and watery, and the face swells. The urine is at first pale and crude; but, as the disease ad- vances, it turns more of a yellowish colour. The tongue is white, and generally moist, which distinguishes this from an inflammatory disease. Upon looking into the throat, it appears swelled, and ot a florid red colour. Pale or ash-coloured spots however are here and there inter- spersed, 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 die neck, arms, breast, and fing- ers, about the second or third day, is a common symptom cf thL dis- ease. Wheu it appears, the purging and vomiting generally cease. There is often a slight degree of delirium, aud the face frequently appears bloated, aud the inside of the nostrils red and inflamed.—The patieut complains of a disagreeable putrid fmell, and his breath is very offensive. The putrid ulcerous sore throat may be distinguished from the in- flammatory, by the vomiting and looseness with which it is generally ushered in; the foul ulcers iu the throat covered with a white or livid coat; and by the excessive Avcakness of the patient; with other symp- toms of a putrid fever. 188 OF THE MALIGNANT QUINSEY. Unfavourable symptoms are, an obstinate purging, extreme weakness, dimness of the sight; a livid or black colour of the spots, aud frequent shiverings, with a weak fluttering pulse. If the eruption upon the skin suddenly disappears, or becomes of a livid colour with a discharge of blood from the nose or mouth, the danger is very great. If a gentle sweat break out about the third or fourth day, and con- tinue with a slow, firm, and equal pulse; if the sloughs cas' off in a kiudly manner, and appear clean and florid at the bottom ; and il the breathing be soft and free, with a lively colour of the eyes, there is rea- son to hope for a salutary crisis. REGIMEN.—The' patient must be kept quiet, and for the most part in bed, as he will be apt to faint when taken out of it. His food must be nourishing and restorative; as sago gruel with red wine, jel- lies, strong broths, Arc. His drink ought 10 be generous, and of an an- tiseptic quality: as red Avine, negus, while-whine whey, and such like. MEDICINE—The medicine in this kind of quiusey is entirely different from that which is proper in the inflammatory. All evacua- tions, as bleeding, purging, &c. which weaken the patient must be avoid- ed. Cooling medicines, as nitre aud cream of tartar, are likewise hurt- ful. 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 flowers, or car- duus btncdietu.i, in order to cleanse the stomach. If these are not suf- ficient, 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 au infusion of sage and rose leaves, to a gill of which may be added a spoonful or two of honey; and as much vinegar as will make it agreeably acid ; but when the symptoms are urgent, the 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 contra) erva-root; let it boil for some time, and after- wards strain the liquor; to which add two ounces of white wine vine- gar, an ounce 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 be injected with a syringe to clean the throat, before the pa- tient takes any meat or drink. This method is peculiarly necessary for children who cannot use a gargle. It w ill be of great benefit if the patient frequently receives into his month, through au inverted funnel, thesteanis of warm vinegar myrrh, and honey. But when the putrid symptoms run high, and the disease is attended with danger, the only medicine that can be depended upon is the Peru- vian bark. It may be taken in uibstauce, if the patient's stomach will N-:ar U. If not, au ounce of bark grossly powdered, with two drachm* OF COLDS AND COUGHS. 107 of Virginian snake-root, may be boiled in an English pint and a half, of water to half a pint; to which a,tea-spoonful of the elixir of vitriol may be added, and an ordinary tea-cuplid of it taken every three or four hours. Blistering-plasters are very beneficial in this disease, es- p> rialiy 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 tv lent two table spoonsful of the saline julep every hour. Tea made of "lint and a little cinnamon will be very proper for his ordina- ry 01 ii.k. especially if an equal quantity of red wine be mixed with it. In ca^e: of a violent looseness, the size of a nutmeg of diascordium, or the japsuic coufection, may be taken two Or three times a-day, or ofteuer if necessarv. If a discharge of blood from the nose happens, the steams of warm vinegar may be received up the nostrils frequently ; and the drink njust be sharpened with spirits of vitriol, or tiricuire of roses. In case of a stranguary, the body must be fomented with Avarm wa- ter, and emollient clysters given three or four limes a-day. After the violence of the disease is over, the body should still be kept open with mild purgatives; as manna, senna, rhubard, or the like. If great weakness and dejection of spirits, or night-sweats, with oth- er symptoms of a consumption, should ensue, we would advise the pa- tient to continue the use of the Peruvian bark, with the elixer of vitri- ol, 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. CHAPTER XXX; OF COLDS AND COUGHS. IT has already been observed, that colds are the effect of an obstruc- ted perspiration; the common causes of which we have likewise en- deavoured to point out, and sh ill not here repeat them. Neither sfodl 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 lever, which onl) differs in degree from some of those that have already been treated of. No age, sex, or constitution, is exempted from this disease; neither is it in the power of any medicine or regimen to prevent it. The ia- 198 OF COLDS AND COUGHS. liabitants of every climate are liable to catch cold, nor can even the greatest circumspection defend them at all times from its attacks. In- deed, if the human bcdy could be kept constantly in an uniform degree of warmth, such a thing as catching cold would be impossible; but as that cannot be effected by any means, the per.-piration must be liable to many changes. Such changes, however, when small, do not affect the health; but, when great, they must prove hurtful. When oppression of the breast, a stuffing of the nose, unusual weari- ness, pain of ihe head, ;gh,which affects the patient for some days before the com- ing on of the fit. This cough is generally removed by a paroxysm of the gout, Avhich should therefore be promoted, by keeping the extrem- ities warm, drinking warm liquors, and bathing the feet and leg* fre- quently 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- wholesome air, and have too little exercise, are most liable to this dis- ease, 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 per- OR CHIN COUGH. 233 •spiration, or relaxes the solids, disposes to this disease; consequently its •cure must depend upou cleansing aud strengthening the stomach, bra- cing the solids, aud at the same time promoting perspiration, and the different secretions. 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 allow- ed sago-gruel, and if the fover be not high, a little boiled chicken, or other while meats. The drink may be hyssop, or penny-royal tea, sweeteued with honey or sugar-candy, small wine-whey : or if the pa- tieutbe weak, he m ttructiug matter, and to draw off the urine; but as this instrument •can only be managed with safety by persons skilled in surgery, we shall >ay nothing further of its use. A bougie may be used by any cautious hand, and will often succeed better than the catheter. We would chiefly recommend, in all obstructions of urine, foment- ations and evacuations. Bleeding, as far as the patient's strength will permit, is necessary, especially where thore are symptoms of topical inflammation. Bleeding in this case uot 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. These may either con- sist of warm water alone, or of decoctions of mild vegetables; as mal- lows, camomile-flowers, &c. Cloths dipped in these may either be ap- plied 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 being a bad method. These continue longer warm than ctoths dipped in the decoctiou, 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 emollient clysters, or gentle infusions of senna and manna. Clysters in this case ■ot only open the body, but answer the purpose of an internal fomenta- tion, and greatly assist in removing the spasms of die bladder and parts adjacent. The food must be light, and taken in small quantities. The drink may be weak broth, or decoctions and infusions of mucilaginous ve- getables, as marsh-mallow roots, lime-tree buds, &c. A tea-spoonful t»f the sweet spirits of nitre, or a drachm of Castile soap, may be fre- quently 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 temper- ate. Their diet should be light, and their liquor diluting- They should avoid all acids and austere wines, should take sufficient exer- eise, lie hard, and avoid study and sedentary 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 in the bladder for some time, it accumulates fresh matter, at at length becomes too large to pass •ff with the urine. Iu this case the patient is said to have the stone. CAUSES.—The stone and gravel may be occasioned by high liv- ing j ^ke use of strong astringent wines; a sedentary life; lying too OF THE GRAVEL AND STONE. hot, soft, or too much on the back; the constant use of water impreg- nated with earthy or stony particles; aliments of an astringeut or windy nature &c. It may likewise proceed from an hereditary dis- positic i Prisons in the decline of life, and thos'- who have been much afflic'd with the gout or rheumatism, are most liable to it. SYMPTOMS.—Small stones or gravel in the kidneys occasion pain in the loin; sickness; vomiting; and sometimes bloody urine. When the stone descends into Abe ureter, and is too large to pass along with ea.se, all the above symptoms are increased; the pain extends towitni.- the bladder; the thigh and fog of the affected side are benumb- ed ; the t«'Sticks are drawn upwards; aud the urine is obstructed. A stone ia the bladder is known from a pain, at the time, as well as before and after makfog water; from the urine coming away by drops Or st>' irng tiidoenly, ivheri it W3S running in a full stream; by a vi- ot'tif , in in the neck of the bladder upon motion, especially on horse- back, u: in a carriage on a rough road; from a white, thick, copious, stinking, mucous sediment in the urine; from an itching on the top of the p> :iis ; fr->m moody urine; from an inclination to go to stool during tiie dncharge of ur.nc ; fiom die patient's passing his urine more easily when I) ing than in an erect posture; from a kind of convulsive motion occasioned by the sharp pain in discharging the last drops of the urine; smd lastly, from sounding or searching with the catheter. REGIMEN.—Persons afflicted with 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, pota- toes, carrots, and radishes, may be 6afely eaten. Onions, leeks, and cellery are. in this case, reckoned medicinal The most proper drinks, are whey, butter-milk, milk and water, barley water ; decoctious or infusions of the roots of marsh-mellows, parsley, liquorice, or of other mild mucilaginous vegetables, as linseed, lime-tree buds or leaves, &c. If the patient has been accustomed to generous liquors, he may drink gin and water not too strong. Gentle exercise is proper; btit 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 stoues after riding on horseback, er in a carriage; but those who foive a stone in the bladder are seldom able to bear these kinds of ex- ercise. W here there is an 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 pre- vented from increasing; but if the same course which occasioned the disease is persisted in, it must be aggravated. OF THE GRAVEL AND STONE. 22* MEDICINE.—In what is called a fit of the ginvel, which is con> 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 thia case has been fully pointed out under the articles, inflammation of the kidneys and bladder, to which Ave refer. Dr. Whyte advises patients Avho are subject to frequent fits of gravel in the kidneys> but have do stone in the bladder, to drink every morning, two or three hours before breakfast, an English pint of oyster or 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 Ali- cant soap, and oyster or cockle-shell lime-water, to be taken in the fol- lowing manner : The patient must swallow every day, in any form that is least disagreeable, an ounce of the internal part of Alicant soap, and driuk 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 fasting in the morning early*, the second at noon; ami the third at peven in the evening; drinking above each dose a large draught of the lime-Avater; the remainder of which he may take any time betwixt diuoer 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 former, and three drachms of the' latter, may be taken daily. This quantity, however, he may increase by degrees, and ought to perse- vere in the use of these medicines, especially if he finds any abate- ment of his complaints, 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 lie can easily bear it, heighten its dissolving power still more by pour- ing it a second time on fresh caleined shells. The caustic alkali, or soap-lees is the medicine chiefly in Vogue at present for the stone. It is of a very acrid nature, and ought therefore to be given iu some gelatinous or mucilaginous liquor; as veal broth, new milk, linseed tea, a solution of gum-arabic, or a decoction of marsh-mallow roots. The patient must begin with small doses of the lees, as thirty or forty drops, and increased by degrees, as far as the stomach can bear it.* * The caustic alkali may be prepared by mixing two part6 of quick- 230 INVOLUNTARY DISCHARGES, &c. Though the soap-lees and lime-water are the most powerful meHi«- eines which have hitherto been discovered for the stone; yet there are some things of a more simple nature, which iu certain cases are found to be beneficial, and therefore deserve a trial. Au infusion of the seeds of daucus sylvestris or wHd carrot, sweetened with honey, has been found to give considerable ease in cases where the stomach could not bear any thing of au 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 "i earthy matter in flakes. Hooey is likewise found to be of considerable ser- % ice, and may be taken in gruel, or in any other form that is more agreeable. The only other medicine which we shall mention is the uva 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-wa- ter ; 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, with great safety and good effect. CHAPTER XXXIV. OF INVOLUNTARY DISCHARGES OF BLOOD. SPONTANEOUS or involuntary discharges of blood often hap- pen from various parts of the body. These, liowever, are so far from being always dangerous, that they often prove salutary. Whew such discharges 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, unless' they be so great as to endanger the patient's life. Most people, afraid of the smallest discharge ef blood from any part of the body, fly immediately to the use of styptic and astringent medi- cines, by which means an inflammation of the brain, or some other fa- tal disease, is occasioned, which, had the discharge been allowed to go on, might have been prevented. lime with one of pot-ashes, and suffering thera to stand till the lixivium be formed, Avhich must be carefully filtrated before it be used. If th« solution does not happen readily, a small quantity of water may ba added to the mixture. INVOLUNTARY DISCHARGES, &c. m Periodical discharges of blood, from whatevsr part of the body they proceed, must not be stopped. They are always the efforts of Nature lo relieve herself; and fatal diseases have often been the consequent of obstructing them. It may indeed be sometimes necessary to check the violence of suoh discharges; but even this requires the greatest caution. Instances might be giveu where the stopping of a small peri- odical 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 hxmop- toe, or discharge of blood from the lungs. After the middle period of 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 quite opposite causes. Sometimes they are owing to a particular con- stitution of the body, as a sanguine temperament, a laxity of the ves- sels, a plethoric habit, &c. At other times they proceed from a de- termination of the blood towards one particular part, as the head, the hemorrhoidal veins, &c. They may likewise proceed from an in- flammatory disposition of the blood, in which case there is generally some degree of fever: this likewise happens when the flux is occa- sioned by an obstructed perspiration, or a stricture upon the skin, the bowels, or any particular part of the system. But a dissolved state of the blood will likewise occasion haemorrha- ges. Thus, in putrid fevers, the dysentary, the scurvy, the malig- nant small pox, &c. there are often very great discharges of blood from different parts of the body. They may likewise be brought on by too liberal au use of medicine, which tends to dissolve the blood, as can- tharides, the volatile alkaline salts, &c. 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 1 have known them sometimes occasion an haemorrhage in the brain. Violent efforts of the body, by overstraining or heating the vessels, may have the same effect, especially when the body is long kept in an unnatural posture, as hanging the head very low, &c. The cure of an luemorrhage must be adapted to its cause. When it proceeds from too much blood, or a tendeucy to inflammation, bleed- ing, 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 vegetable diet, to avoid all strong liquors, and food that is of an acrid, hot, or stimulating quality. The body should be kept cool, aud the mind easy. When an hoemorrhage is owing to a putrid or dissolved state of the blood, the patient ought to live chiefly upon acrid fruits with milk and 832 OF BLEEDING AT THE NOSE., vegetables of a nourish .-".g nature, as sago, 6alop, &c. His drink inay be wine Muted wih water, and sharpened with the juice of lemon, vinegar, or spirits of vitriol. The best mecicine iu this case is the Peruvian baik, which may be taken according to the urgency of tlm symptoms. Wnen a flux of blood is the effect of acrid food, or of strong stimu- lating mediciues, the cure is to be effected by soft mucilaginous diet. The patient may likewise take frequently about the bulk of a nut- meg 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 ot an haemorrhage, it may be removed by drinking warm diluting liquors, lying a-bed, bathing the extremities in warm water, &c. 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 of the temporal arteries, heaviness in the head, dimness of the sight, heat and itching of the nostrils, &c. To persons who abound with blood this discharge is very salutary. It often cures a vertigo, the head ache, a phrenzy, and even an epi- lepsy. In fevers, where there is a great determination of blood to- wards the head, it is of the utmost service. It is likewise beneficial io inflammations of the liver and spleen, and often in the gout and rheuma- tism. In all diseases where bleeding is necessary, a spontaneous dis- charge of blood from the nose is of much more service than the same quantity let with the lancet. In a discharge of blood from the nose, the great point is to deter- mine whether it ought to be stopped or not. It i3 a common practice to stop the bleeding, Avithout considering whether it be a disease, os 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 ou, 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, especial!) if the symptoms of ple- thora, 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, find 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 tp grow cold, the lips pale, OF BLEEDING AT THE NOSE. 2a3 $r the patient complains of being sick or faint, it must immediately L~ stopped. For this purpose the patient should be set nearly upright, with his head reclining a little, and his legs immersed in water abou< the warmth of new milk/ His bauds ought likewise to be put in lukewarm wa- ter, and his garters may be tied a little tighter than u.*ual. 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 sto(>, and removed entirely as soon as it gives over. Sometimes dry lint put up the nostrils will stop the bleedmg. When this does not succeed, dossils 01 lint dipped iu strong -pirns of wine, may be put up the nostrils, or if that cannot be had, they may be dipped in brandy. Blue vitriol dissolved in water may likewise be used for this purpose, or a tent dipped iu the white of an e»g 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 au ounce of Glauber's salt, and the same quantity of manna, dissolved in four or five ouuees of barley-water. This may be takeu at a. draught, and repeated, if it does not operate, in a few hours. Ten or twelve grains of nitre may be taken in a glass of cold water aud 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, Arith twenty or thirty drops of the weak spirit of vitriol, may be taken every hour. When these things cannot be had, the patient may drink water, with a little common salt in it, or equal parts of water aud vinegar.* If the genitals be immersed for some time in cold water, it wib gen- erally stop a bleeding at the nose. I have not known this fail. Sotnetimes 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 it he falls asleep, which he is very ready to do after losing a great quantity gf blood. , ,, j *.• 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 nostrils, and bringing them out at the mouth, then fastening pieces of sponge, or small rolls of liuen cloth to the extremities; afterwards * 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 fron say other part. *34 OF THE BLEEDING AND BLIND PILES). drawing them back, and tying them on the outside with a. sufficient degree of tightness. After the blecdi.ig is stopped, the patient ought to be kept as easy and quiet as possible. He should not pick his nose, nor take away the tents or closed bJood, till they fall off of their own accord, aud should not lie with his head low. Those who are affected Arith frequent bleeding at the nose ought to bathe their feet often in warm water, ami to keep them warm aud dry. They ought to wear nothing tight about their necks, to keep their body as much in an erect posture as possible, and ucver to view any object obliquely. If they have too much blood, a vegetable diet, with now and then a cooling purge, is the srdest 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 stiong broths aud jellies, sago-gruel, will wine and sugar, efce. lufy.-iotis of the Peru- vian bark in wine ought like wise to be taken and pcTsistedin for a con- siderable time. OF THE BLEEDINCx AND BLIND PILES. A DISCHARGE of blood from the hemorrhoidal vessels is called the bleeding piles. When the ve-sds only swell, and di.-ehaige no blood, but are exceeding painful, the disease is called the blind piles. Persons of a loose spungy fibie, of a bulky size, who live high, and lead a sedeutary, inactive life, are me.st subject to this disease. It is often owing to an hereditary dig^orition. Where this is the case, it attacks persons more early in life than when U is accidental. Men are more linble to it than women, especially those of a sanguine plethoric, or scorbutic habit, or of a melancholy disposition. The piles may be occasioned by au 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, or any thfog that occasions hard or difficult stools. Anger, grief, or other violent passions, will likewise occasion the piles. I have often known them brought on by sitting on the damp ground. A pair of thin breeches will exejte the disorder in a person Avho is subject to it, and sometimes even in those who never had it be- fore. Pregnant women are often afflicted ,widi the piles A ffox of blood from the anus, \a not alwaj s to be treated as a dis- ease, it is even more salutary than bleeding at the nose, and often prevents or cirries off diseases. It is peculiarly beneficial in the gout, rheumatism, asthma, and hypochondrical complaints, and often proves critical in colics, and iuflammatoiy fevers. In the managemnt cf the patient, regard must be had to his habit of body, his age, strength, and manner of living. A discharge which might be excessive and prove inrtfql to one, may be very moderate OF THE BLEEDING AND BLIND PILES. 233 a'udcven salutary to another. That only is to be esteemed dangerous, which continues too long, and is iu such a quantity as to waste die pa- tient's strength, hurt the digestion, uuirition, and other functious neces- sary to life. When this is the case, the discharge must be checked by a proper regimeu, aud astringent medicine?. The DIET must be cool but nourishing, consisting chiefly of bread, milk, cooling vegetables, and broths. The drink ni.iy be chalybeate water, orange-whey, decoc- tions or infusions of the astringeut and mucilagfoous plants, as the tor- mentil root, bistort, the marsh-mallow-roots, &c. Old couseive of roses is a very good medicine in this case. It may be mixed iu new milk, and may be takeu iu the quantity of an ounce three or four times a-day. This medicine is in no great repute, owing to its being 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 iu violent haemorrhages, especial- ly when assisted by the tincture of roses ; a tea spoonful of which may be takeu about an hour after every dose of the conserve. The Peruvian bark is likewise propeT iu this case, both as a strength- ener and astringent. Half a drachm of it may be taken iu a glass of red wine, sharpened with a few drops of the elixir of vitriol, three or four times a-day. The bleeding piles are sometimes periodical, and return regularly once a mouth, or once in three weeks. In this case they are always to be considered as a salutary discharge, aud by no means to be stop- ped. Some have entirely ruined their health by stopping a period- ical discharge of blood from the hsemorrhoidal Veins. In the blind piles bleeding is generally cf use. The diet must be li^ht and thin, and the driuk cool and diluting. It is likewise neces- sary that the body be kept gently open. This may be done bv small doses of the flour of brimstone and cream of tartar. These may be mixed in equal quantities, aud a tea-spoonful taken two or three times a-day, or ofteuer if necessary. Or au ounce of the flour of brimstone, and half au ouuee of purified nitre ra iy be mixed with three or four ounces of the lenitive electuary, aud a tea-spoonful of it takeu three or four times a day. Emollient clysters are here likewise beneficial; but there is some- times such an astriction 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 and swelled, but discharge nothing, the patient must sit over the steams of warm water. He may likewise apply a linen cloth dipped in warm spirits of wine to the part, or poultices made of bread and milk, or of leeks fried with 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 will Six upon the pilts themselves, so much the belter. When leeches will 53c SPITTING OF BLOOD. not fix, the piles may be opened with a lancet. The operation h very e. effects from these, worth mentioning. Their pnaJple use is to keep he part moist, which may be done as Avell by a soft poultice or an emollient cataplasm- V» hen the paid however is very greai, a liniment made of two ounces of emollient oint- ment, ;uid half an ounce of liquid laudanum, beat up with the yolk of feu egg, raaj be applied. SPITTING OF BLOOD. WE menu here to treat of that discharge of blood from the lung! only win eh is called an hozmoptoe or spitting of blood. Persons of i slender mi'.e, and a lav fibre, who have long necks and strait breasts are m-^t ifoble to this di- :^se. It is most common in the spring, and generally at.uks people before they are at the prime or middle pe- riod of life. It "e- ;i common observation, that those who have beerl subject to bleeding m the nose when young, are afterwards most liable to an foemoptoe. CAUSblS.—An hremoptoe may proceed from excess of blOod from a peculiar weakness of the lungs, or a bad conformation of the breast; I. is often occasioned by excessive drinking, running, wrestling, sing- ing, or spt aking aloud. Such as have weak lungs ought to avoid r.U violent exertions of that organ, as they value life. They should fkewl.t: guard against violent passions, excessive drinking aud every th'ng hal occasions a rapid circulation of the blood. this disease may likewise proceed from wounds of the lungs. These may ouher be received from without, cr they may be occasion- id bv li .iv ;rop. - ;* he spirits of vitriol; or he may take frequently a cup of the tincture of v- ~*. Bathing the feet and legs in lukewarm Avater 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 of laudanum may be given in a cup of barley-Water twice a day, and continued foe some time, provided 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 iu. It may be taken to the quantity of three or four ounces a-day; ' and, if the patient be troubled with a cough, it should be made into an electuary Avith 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 Avater three or four times a-day. Those who 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 diem beware of vigo Vous 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 very dangerous, and requires particular attention. "V omitiog ot blood is generally preceded by pain of the stomach, sickuess, aud nausea; and is accompanied with great anxiety, and fre. que-ut fainting-fits. This disease is sometimes periodical; in which case it is less dan- gerous. It often proceeds from an obstruction of the menses in avo- men; and sometimes from the stoppage of the hafimorrhoidal flux in men. It may be occasioned by any thing that grea'ly stimulates or wounds the stomach, as strong vomits or purges, acrid poison, sharp er hard substauces taken into the stomach, &c. It is often the effect of obstruction in the liver, the spleen, or some of the other viscera. It may likewi-e proceed from external violence, as blows, bruises, or from any of the causes which produce inflammation. In hysteric 'women, v'omitting of blood is a very common, but by no means a dan- gerous symptom. A great part of the danger in this disease arises from th« extravasa- OF BLOODY URINE. :-i» led bic^i lodging in the boAvels, and becoming putrid, by which means, it dysentery or putrid haver may be occasioned. The best way of preventing this, is to keep the body gently open, by frequently exhibit- ing emollient clysters. Purges must uot be given till the discharge is'stopt, otherwise they will irritate the stomach, aud increase the dis- order. All the food and driuk must be of a mild cooling nature, and taken in small quantities. Even drinking cold Avater has sometimes proved a remedy, but it will succeed the better when sharpened with the weak spirits of vitriol. When there are signs of an inflammation, bleeding may be necessary; but the pari, nt's weakness will seklom permit it. Opiates may be of use ; but they must be given in very. smell doses, as four or five drops of liquid laudanum twice or thrice a-day. After the discharge is over, as the patient is generally troubled with-gripes occasioned by the acrimony of the blood lodged in the iutestines, gentle purges will be necessary. 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 ero- ded. It is more or less dangerous according to the different circum- stances which attend it. Wheu pure blood is voided suddenly Avithout 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 ptoceeds from the bladder. When bloody urine is occasioned by a rough stone descending from the kidneys to the bladder, which wounds the ureters, it is attended with a sharp pain in the back, and difficulty of making water. If the coats of the bladder are hurt by a stone and the bloody urine follows, it is attend- ed with the most acute pain, and a previous stoppage of urine. Bloody urine may likewise be occasioned by falls, blows, the lift- ing 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 cautharides. Blood)- urine is always attended with some degree of danger; but it is peculiarly so when mixed with purulent matter, as this shews au ulcer somewhere in the urinary passages. Sometimes this discharge proceeds from excess of blood, in which case it is rather to be consid- ered as a salutary evacuation than a disease. If the discharge howev- er be very great, it may waste the patient's strength, and occasioa an ij! habit of body, a dropsy or a consumption. The treatment of this disorder must b« varied according to the dif- ferent catu'-vs from which it proceeds. 44Q OF THE DYSENTERY, OR BLOODY FLUX. When it is owing to a stone in the bladder, the cure depends upafl an operation, a description of which would be foreign to our pur- pose. If it be attended with a plethora, and symptoms of inflammation, bleeding will be uecessary. The body must likewise be kept open by emollient clysters, or cooling purgative medicines ; as cream of tar- tar, rhubari), manna; or small doses of lenitive electuary. When bloody 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 Puruvian bark and acids, as has already been shewn. Whin 'here is reason to suspect an ulcer in the kidneys or bladder, the pat if-it's diet must be cool, and his drink of a soft healing balsa- mic qualify, as decoctions of marsh-mallow roots with liquorice, so- lutions of gum-arabic, tin without extracting it; and, as a spoilt tooth never becomes touivd 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 medical profession —The operation however p not without danger, and ought always to be performed with care. A person unacquainted with the structure of the parts will be in din- 250 OF THE EAR-ACHE. ger of hurting the janr-bone, or of drawing a sound tooth instead of ^ rotten one* When the tooth-ache returns periodically, and the pain chiefly af- fects the gums, it may be cured by the baric. Some preteud to have found great benefit in the tooth-ache, from the application of an artificial magnet to the affected tooth. We shall not attempt to account for its mode of operation; but, if it be found to answer, though only in particular cases, it certainly deserves a trial, as it is attended "with uo expense, and cannot do any harm. Electri- city has likewise been recommended, and particular instruments have been invented for sending a shock through the affected tooth. Persons who have returns of the tooth-ache 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 ache. The best method of doing this is to wash them daily with salt and water, a decoction ofthe bark, or with cold water alone. All brushing and scraping of the teeth is dangerous, and, unless it be per- formed with great care, does mischief. ; OF THE EAR-ACHE. THIS disorder chiefly affects the membrane which lines the inner cavity r jugular vci.i, or cuppiug iu the neck will be proper. The ear may likewise be fomented with steams of warm water; or flannel uag? fil- led with boiled mallows aud camorai'e-flowers may »be appfodicit warm; or bladders filled with warm miifc and water. An exceeding good me nod of fomenting the ear, is to apply it close to the inoudi of a jug filled with warm water, or a strong decoctiou of camomile- flowers. 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 tinies a chYv. His drink may be whey, or a decoction of bailey and liquorice, with figs or raisins. The parts behind the ear ought frequently to be rubbed with camphorated oil, or a little of the Volatile' liniment. Wheu the inflammation cannot be discussed^ a poultice of bread and milk, or roasted onions, may be applfod to the ear, and frequently re- newed, till the abscess breaks,.or can be opened. Afterwards the humours may be diverted from the part by genile laxative blisters, or issues ; but the discharge must uot be suddenly dried up L.y any ex- ternal application. PAIN OF THE STOMACH, Sic. THIS may proceed from various causes, as indigestion; wiodfc the acrimony of the bile ; sharp, acrid, or poisouous substances taken into the stomach, Sic. it may likewise be occasioned by worms; the stoppage of customary evacnalious; a translation 0J gouiy matter to the stomach, the boArels, s of age, Avho used to lie for whole houis at if dead. She at last expired, and upon opining her body, a number of the tires or long round worms, were found iu her guts, which were considerably, inflamed; and what anatomists call an intus susccptio, or involving of one part of the gut with another, had taken place iu no less than four different parte of the intestinal canal.* * MEDICINE.—Though numberless medicines are extolled for ex- pelling and killing worn^.f yet no disease more frequently baffles the physician's skill. In general, the most proper medicines for their ex- pulsion are strong purgatives; and to prevent their breeding, stomach bitters, with now and then a full glass of good wine. • * That worms exist in the human body, there can be no doubt; aud that they must sometimes be considered as a disease, is equally cer- tain ; but this is not the case so often as people imagine. The idea that worms occasion many diseases, gives an opportunity to the profess- ed worm doctors of imposing ou the credulity of mankind, and do- ing much mischief. They find worms in every case, and liberally throw in their s^.fdwtes. which generally consist of strong drastic pur- ges. 1 have known these given iu dtlicate constitutions to the des- truction of the patient, where there was not the least s) mptom of worms. f A medical writer of the present age has enumerated upwards of f-fty British piauts, all celebrated for killing and expelling warns; OF WORMS. 23 J The best purge for an adult is j lap and calomel. Five and twen- ty or thirty grains of the former with six or seven of the latter, mix- ed in syrup, may be taken early in the morniug for a dose. It will be proper that the patient keep the house all day, a.id drink nothing cold. The dose may be repeated once or twice a week for a fortnight-or tiiree 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 who do not choose to take calomel, may make use of the bitter purgatives; as aloes, hiera picra, liucture of senna, and rhu- barb, &c. Oily medicines are sometimes found beneficial for expelling worms. An ounce of salad oil and a fable-spoonful of common salt may be taken in a glass, of red port wine thrice a-day, or oftcner, if the stom- ach wil} bear it. But the more common form of using oil is in clys- ters Oily clysters sweetened with sugar or honey, are very effica- cious in bringing away .the short round worms called ascarides, and likewise the tires. The Harrowgate water is an excellent medicine for expelling worms, especially the ascarides. As this water is impregnated wbh 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 ef sulphur in very large doses, and with great success. It should be made into an electuary with hooey or treacle, and taken in such quan- tity as to purge the patient. Where Harrowgate water, cannot be obtained, sea-water may be used, which is far from being a contemptible medicine in this case. If sea-water cannot he 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 in the morniug. But worms though expelled, will soon breed again, if the stoma.h remains weak aqd relaxed; to prevent which we would recommend the Peruvian bark Half a drachm of bark in powder may be taken in a grass of red port wine three or four times a-day, after the above medi- cines have been used. Lime-water is likewise good for this purpose, or a table-spoonful of the chalybeate wine taken twice or thrice a-day. Infusions or decoctions of bitter herbs may likewise be drank ; as the iufusion of tansy, water trefoil, camomile flowers, tops of wormwood,' the lesser centaury, &c. For a child of four or five years old, six grains of rhubarb, five of jallap, and two of calomel, may be mixed in a spoonful of syrup or honey, and given in the morning. The child should ke< p the house all day, and take nothing cold. This dose may be repeated twice a-week for three or four wepks. -On the intermediate days the child may take a scruple of poAvdered tin and ten grains of aethiops mineral pQ OF WORMS. iu a spoonful of treacle twice a-day. This dose must be increased or diminished according to the ag« of the patient. Bisset says, the great bastard black hellebore, or bear's foot, is a most powerful vermifuge for the long round worm. lie orders the decoction of about a drachm of the green leaves, or about fifteen grains ot the dried 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 su«ar, is almost the only medicine he has used for round worms for three years past. Before pressing out the juice he moistens the bruised leaves with vinegar, Avhich corrects the medicine. The dose is a tea-spoonful at bed time, and one or tAVo next morning. I have frequently known those big bellies^ which in children are commonly 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, aud may be used various ways. We might here mention many, other plants, both for external and internal use, as the cabbage bark, &c. but think the powder of tin with sethiops mineral, and the purges of rhubarb and calomel, are more to be depended on. Ball's purging vermifuge powder 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 Aveight of all the other in- gredients. These must be well mixed together, and reduced to a fine powder. The elore for a child is from ten grains to twenty, once or twice a week. An aelult may take a drachm for a dose.* Parents who Avould preserve their children from worms ought to al- low them plenty of exercise in the open air; to take care that their food l;e avhob some and sufficiently solid; and as far as possible, to prevent their eating raw herbs, roots, or green trashy fruits. It will not be amiss to allow a child avIio is subject to worms, a glass of red wine after meals; as every thing that braces and strengthens the stom- ach is good botii for preventing and expelling these vermin.f * A powder for the tape-worm resembling this, was long kept a se- cret on the .continent, it was lately purchased by the French king. f We think it necessary here to warn people of their danger who buy cakes powders and other Avorm medicines, at random, from quacks, and give them to their children Avithout proper care. The principle ingredients in most of these medicines is mercury, which is never to be trifled with. I lately saw a shocking instance of the dan- ger of this conduct. A giil Avho had taken a dose cf worm powder, bought of a travelling quack, went out, and, perhaps, was so imprudent as to driuk cold water during its operation. She immediately swelled, and died on the following day with all the symptoms of hav:<>i; beea poisoned. OF THE JAUNDICE. 2*7 CHAPTER XXXVII. OF THE JAUNDICE. T':US disease is first observable in the white of the eye, which appears yellow. Afterwards the whole skin puts-on a yellow appeal ance. The urine too is of a saffron hue, aud dies a white cloth of the same colour. There is likewise a species of this disease called die Black Jaundice. CAUSES —The intermediate cause of the jaundice is an obstruc- tion of the bile. The remote or occasional causes are, the bites of poisonous animals, as the viper, mad dog, &c. the bilious or hys- teric colic; violent passions, as grief, anger, &c Stroug purges or vomits will likewise occasion the jaundice. Sometimes it proceeds from obstinate agues, or from that disease being prematurely stopped by astringent medicines. In infants it is often occasioned bv the me- conium uot being sufficiently purged off. ' Pregnant women are very subject to it. It is likewise a symptom in several kinds of fever. Catching cold, or the stoppage of customary evacuations, as the men- ses, the Weeding piles, issues, Sic. will occasion the jaundice. SYMPTOMS.—The patient at first complains of excessive wea- riness, 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 cla) colour, and the urine, as was observed above, is yellow. The breathing is difficult, and the patient complains of an unusual load or oppression ou his breast. There is a heat in his nostrils, a bitter* taste tin the mouth, loathing of food, sickness of the stopiach, vomiting, Hatulency, aud other symptoms of indigestion- If the patient be young, and the disease complicated with no other malady, it is seldom dangerous ; but in old people, where it continues !o;ig, returns frequently, or is complicated with the dropsy or hypo- chondriac symptoms, it generally proves fatal. The black jaundice is more dangerous than the yellow. REGIMEN.—The diet should be cool, light, and diluting, con- sisting chiefly of ripe fruits and mild vegetables; as apples boiled or roasted, slewed prunes, preserved plums, boiled spinnage, &c. Veal or chicken broth, with light bread, are likewise very proper. Many have been cured by living almost wholly for some days on raw eggs. t'he drink should be butter milk, whey sweetened with honey, or decoctions of coo! opening vegetables; or marsh-mallow roots with h> r.ucice, Sic, 53 '&* OF THE JAUNDICE. The patient should take as much exercise as he can bear, either otf 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 iuflariimation. Patients have been often cured of this disease by a long journey, after medicines had proved ineffect- ual. Amusements are likewise of great use in the jaundice. The disease is often occasioned by a sedentary life, joined to a dull melancholy disposition - Whatever therefore tends to promote the circulation, and to cheer the spirits, must have a good effect; as dancing, laughing, singing, &c. r MEDICINE.—If the patient be young, of a full sanguine habit, and complains of pain in the right side about the region of the liver, bleeding will be necessary. After this a vomit must be administered, and if the disease proves obstinate, it may be repeated once or twice. No medicines are more beneficial in the jaundice than vomits, espe- citily Avherc it is not attended with inflammation. Haifa drachm of ipecacuanha in powder will be a sufficient dose for an adult. It may be wrought off with Aveak camomile-tea, or luke-Avarm Avater. The body must likewise be kept open by taking a sufficient quantity ofcastile soap, or the pills for the jaundice recommended in the Ap- pendix. Fomenting the parts about the region of the stomach and liver, and rubbing thetn with a warm hand or flesh-brush, are likewise benefi- cial ; but it is still more so for the patient to sit in a bath of warm wa- ter up to the breast. He ought ,to do this frequently, and should continue in it as fottg as his strength wil| permit. • Many dirty tlmigs are recommended for the cure of the jaundice ; as lice, millepedes, dec'. But these do more harm than good, as peo- ple trust to them, and neglect more valuable medicines; besides they are seldom taken insufficient quantity to produce auy effects. People always expect that such things should act as charms, and consequent- ly seldom persist in the use of them. Vomits, purges, fomentations, aud exercise, will seldom fail to cure the jaundice when it is a simple disease; and when complicated with the dropsy, a scirrhus liver, or other chronic complaints, it is hardly to be cured by any means., Numberless 1'ritish herbs are extolled for the cure of this disease. The author of the Medicina Britannica mentions near a hundred, all famous for curing the jaundice. The fact is, the disease often goes off of its own accord; iu Which case the last medicine is always'said to have performed the cure. I have sometimes, however, seeu consider- able benefit in a very obstinate jaundice, from a decoction of hemp- seed. Four ounces of the seed may be boiled in two English quarts of ale, and sweetened with coarse sugar. The dose is half an Eng- lish pint every morning. It may be continued for eight or nine dajs. I have likewise known Harrowgate sulphur water cure a jaundice Of the dropsy. fc59 A At ry long standing. It should be used for some weeks, and the patient must both drink and bathe. The soluble tartar is a very proper medicine in the jaundice. A drachm of it may be taken every night and morning iu 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 possible, and to avoid all heating and astringent aliments. CHAPTER XXXVIIL OF THE DROPSY. f •■ THE dropsy is a preternatural swelliug of the whole body, or some part of it, occasioned by a collection of Avatery humour. It is dis- tinguished by different names, according to the part affected, as the anasarca, or collection of water under the skin; the ascites, or collec- tion 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 ofteu owing to an hereditary disposition. 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. Hence it is justly reckoned among the diseases of the seden- tary. It often proceeds from excessive evacuations, as frequent aud copious bleeding, strong purges often repeated, frequent salivations, &c. The sudden stoppage of customary or necessary evacuations, as the menses, tfce haemorrhoids, fluxes of the belly, &c. may likewise cause a dropsy. I have known the dropsy occasioned by drinking large quantities of cold, weak, watery liquor, when the body Avas heated by violent exer- cise. A low, damp, or marshy situation is likewise a frequent cause of it. Heuce it is a common disease iu moist, flat, fenny countries. It may also be brought on by a long use of poor watery diet, or of vis- cous aliment that is hard of digestiou. It is often the effect of other diseases, as the jaundice, a schirrhus of the liver, a violent ague of long continuance, a diarheea, dyseutery, au empyema, or a consumption of the lun coming on of the fit; he then becomes easier, the part begins to swell, appears red, and is covered with a little moisture. £04 OF THE GOUT. Towards morning he drops asleep, and generally falls into a geutl< breathing s.veat. This terminates the fust paroxysm, a number of vluch constitutes a fit of the gout; which is longer or shorter, accor- lifog to the patient's age, strength, the season of the year, aud the dis- position of the body to this disease. Th patient is always worje towards night, and easier in the morn- i.ig The p.ro\ysi>>"however generally grow milder every day, till lu leu';'.h the disease is carried off by perspiration, urine and the other i valuations. Iu some patients this happens in a few days; in others f requires weeks; and in some, mouths, to finish the fit. Those whom age and 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 for advanced. REG .MEN —As there are no medicines a et known that will cure the g-Jiit, we shall confine our observations chiefly to regimeu, both in Stud out cf the fit In the tit, if the patient be young atul strong, lus diet ought to be thin and cooling, and his drink of a diluting nature; but where the constitution is weak, and the patient has been accustomed to live high, t.iis is no: a pi o;>er time to retrench. In this case he must keep nearly to hi* usual diet, and should take frequently a cup of strong negus, or u glass of generous wine. Wine Avhey is a yery proper driuk in this vase, as it promotes the perspiration without greatly heating the pa- tient. It will answer this purpose better if a tea-spoonful of sat vola- tile oleosum, or spirits of hartshorn, be put into a cup of it twice a day. It will likewise be proper to give at bedtime a tea-spoonful of the vola- tile tincture of gu.ri.icum iu a large draught of warm wine-whey. This vill greatly promote perspiration through the night. As the mojt sde aud efficacious method of discharging the gouty matter, is by per-^iration, this ought to be kept up by all means, es*ie- cially in the affected part. For this purpose the leg and foot should be wrapt in soft flannel, fur, or wool. The last is most readily ol> i ti.ied, and stems to answer the purpose belter than any thing else. The people of Lancashire look upon wool as a kind of specific iu the jgjut. They wrap a great quantity of it about the leg and foot af- fected, aud cover it with a skin of soft dressed leather. This they buffer to continue for eight or ten days, and sometimes for a fortnight or three weeks, or longer, if the pain dens not cease. I never knew any external application answer so well iu the gout. I have often seen it applied Avhen th«. swelling aud inflammation were very great, with violent pain, and have found all these symptoms relieved by it in a I'm dtiys. The wool which they use is generally greased, and card- ed or combed. They choose the softest which can be had, and sel- dom or never remove it till the fit be entirely gone off. The patient ought likewise to be kept quiet and easy during the (if. Every thing that affects the mind disturbs the paroxysm, and tends to OF THE GOUT. £35, 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 disease, 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 Nature's method of removing somethiug that mi«hi prove destruc- tive-to the body, and all that we can do, with safety, is to promote her intentions, aud to assist her in expelling the enemy in her own v. ay. Evacuations by bleeding, stool, &c. are likewise to be used with cau- tion, they do not remove the cause of the disease, and sometimes by a eakening the patient, prolong the fit; but where the constitution is able to bear it, it will be of use to keep the body gently open 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 found which will do this with safety to the patient. In pain we eagerly grasp at any thfog that promises immediate ease, and even hazard life itself for a tempo- rary relief. This is the true reason why so many infallible remedies have been proposed for the gout, and Avhy such numbers have lost their lives by the use of them. It would 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 extremities. The latter is as much an effort of nature to free herself from an offend- ing cause as the former, and ought equally to be promoted. When the pain however is very great, and the patient is restless, thirty or forty drops of laudanum, more or less, according to the vio- lence of the symptoms, may be taken at bed time. This will ease the pain, procure 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 Aveak infusion of stomachic bitters in smalt mah or ale, as the Peruvian bark, with cinnamon. Virginia snake-root, and orange-peel. The diet at this time should be light but nourish- ing, and gentle exercise ought to be taken on horseback or in a car- riage. 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 return, less severe. This, however, is not to be attempted by med- icine. 1 have frequently known the gout kept off for several vears by the Peruvian bark and other astringent medicines ; but in all the cases where 1 had occasion to see this tried the persons died sudden- ly, and, to all appearance, for want of a regular fit of the gout. One would be apt, from hence, to conclude, that a fit of the goaf to some constitutions, in the decline of life, is rather salutary than hurt- foi. 34 280 OF THE GOUT. Though it nr.y be dangerous to stop a fit of the gout by medicine yet if the constitution can be so changed by diet and exercise, as t< lessen or totally to prevent its return, there certainly cau be no dan- ger in following seed a course. It is well known that the whole habit may be so altered by a proper regimen, as quite to eradicate this dis- ease ; 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 follows : In the first place, universal temperance. In the next place sufficient exercise* By this Ave do not mean sauntering about in an indolent manner, but labour, sweat and toil. These only can renrler 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. All strong liquors, especially gener- ous wines and sour punch, are 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 of gentian and camomile floAvers, or a decoction of burdock root, &c. Any of these, or an infusion of any Avholesome bitter that is more agreeable to the patient, may be drank for two or three weeks in March and Octo- ber, twice a day. An issue or perpetual blister has a great tendency to prevent the gout. If these were more generally used in the decline of life, tliey would not only often prevent the gout, but also other chron» ic maladies. Such as can afford to go to Bath, will find great benefit from bathing and drinking the water. It.both promotes digestion and iuvigorates the habit. Though there is little room for mprlicinc during a regular fit of the gout, yet when it leaves the extremities, and falls on some of the inter- nal parts, proper applications to recal and fix it, become absolutely ne- cessary. When the gout affects the head, the pain of the joints ceases and the swelling disappears, while either severe head-ache, drowsi- ness, trembling, giddiness, convulsions, or delirium come on. Whe n it seizes the lungs, great oppression, with cough and difficulty of breath- ing, ensue. If it attacks the stomach, extreme sickness, vomiting, anx- iety, pain in the epigrastric 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 water,* and acrid cataplasms applied to the soles. Blistering plasters * S.ime make a secret of curing the gout by muscular i-xkrcisk, 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, miy expect to reap solid aud permanent advantage. OF THE RHEUMATISM. 261 ^ught likewise to be applied to the ancles or calves of the legs. Bleed- iug iu the feet or ancles is also necessary, and warm stomachic purges. The patient ought to keep in bed for the most part, if there be any signs of inflammation, and should be very careful not to catch cold. If it attacks the stomach with a sense of cold, the most warm cordi- als are necessary ; as strong wine boiled up with cinnamon or other spices; cinnamon-water; peppermint-water; and even braudy or rum.* The patient should keep his bed, ami endeavour to promote a sweat, by drinking warm liquors; and if he should be troubled with a nausea, or inclination to vomit, lie may drink camomile-tea, or any thing that will make him vomit freely. When the gout attacks the kidneys, and imitates gravel-pains, the patient ought to drink freely of a decoction of marsh-mallows, and to have the parts fomented with Warm water. An emollient clyster ought likewise 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 decoction. Persons who have had the gout should be very attentive to any complaints 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 diverted from its regular course, to the great danger of the pa- tient's life. Those who never had the gout, but who, from their constitution or manner of living, have reasou to expect it, ought likewise to be very circumspect Avith regard to its first approach.. If the disease, by Avrong conduct or improper medicines, be diverted from its regular course, the miserable patient has a chance to be ever after tormented with head-aches, coughs, pains of the stomach and intestines; aud to fall at last a victim to its attack upon some of the more noble paits.f OF THE RHEUMATISM. THIS disease has often a resemblance to the gout. It generally at- tacks the joints with exquisite pain, and is sometimes attended with in- flammation and swelling. It is most common iu the spring, and towards the end of autumn. It is usually distinguished into acute and chron- ic ; or thejrheurnatism with Cr w ithout a fever. * ./Ether is found to be an efficacious remedy iu this case. t 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 tiling else during the time. This practice is already general!; adopted id France.—a. e. 2GP OF THE RHEUMATISM. CAUSES.—The causes of a rheumatism are frequently the sams as tho e of an iul: immator) fever, viz. an obstructed perspiration, the imm uk-rate use of strong liquors, and the like. Sudden chauges of the weather and all quick transitions from heat to cold, are very apt to ocri-.rijii the rheumatism. The most extraordinary case of a rheuma- tism that I ever saw. where almost even joint of the body was distor- ted, was a man who used to work one paf t of the day by fire, and the other part of it in water. Very obstinate rheumatisms have likewise been brought ou by persons uot accustomed to it, allowing their feet to con'.nue long wet. The same effects are often produced by wet clothes, d- i) beits, sitting or lying on the damp ground, travelling in Ike Tiie • ■■'■t'.matism may likewise be occasioned by excessive evacua- tions ...• • ••toppage of customary discharges. It is often the effect of :-';j ...; .. i u ,ASe,<, which vitiate the humours; as the scurvy, the lues ->ex;r. . •>t::tina'.e cvafnmia! agues. 'Sic. j'h - rhi ■ctmatism prevails in cold, damp, marshy countries. It is •".0; common among the poorer sort of peasants, who are ill clothed, ; !.»■# d imp houses, and eat coarse and unwholesome food, which :■• . .- hi. httle nourishment, and is not easily digested. ^ i MPTOMS.—The acute rheumatism commonly begins Avith wea- viiwss, siiivering, a quick pe.lse, r:^lessness, thirst, and other s) mp- t; ms of lever. Afte. wards the patient complains of flying pains, which are increased by the least motion. These at length fix in the joints, Avhirh u-e often affected with swelling and inflammation. If blood be It in tlus disease, it has generally the same appearance as in the pleurisy. In thii. kiud of rheumatism the. treatmerJ of the patient is uearly the 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 likewise 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, aud in small quantity, consisting chiefly of roasted apples, groat- gruel, or weak chicken broth. After the feverish symptoms have aba- ted, if lb' pain still continues, the patient must keep his bed, and take such things as promote perspiration, as ,;vine whey, with spiritus Kin- dt rtri. Sic He may likewise take, for a few nights, at bed-time, in a cup of wine-whey, a drachm of the cream of tartar, and half a drachm of gum guaiacuni iu powder.' Warm bathing, after proper evacuations, has often an exceeding 'good effect. The patient may either be put into a bath of warm watci or have cloths Anung out of it applied to the parts affected. Great care 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 genfcroliy confined to some particular part oi OF THE RHEUMATISM. 269 the body, as the shoulders, the back, or the loins. There is seldom^ any inflammation or swelling in this case. Persons iu the tlecline of life are most subject to the chronic rheumatism. Iu such patients it often proves extremely obstinate and sometimes incurab'e. In this kind of rheumatism the regimen should be nearly the same as in the acute. Cool aud diluting diet, consisting chiefly of vegeta- ble substances, as stewed prunes, coddled apples, currants or goose- berries boiled in milk, is most proper. Arbuthnot sa)s, -If there be a specific iu aliment for the rheumatism, it is certainly whey ;" and adds, that he " knew a person sibject to this disease, who could never be'cured by any other method but a diet of whey and bread " He likewise s'ays, that "cream of tartar in Avater-gruel, taken for several days, will e*se the rheumatic pains considerably." This I have often experienced, but found it always more efficacious when joined with gum guaiacum, as already directed. In this case the patient may take the dose formerly mentioned, twice a da) and likewise a tea- spoonful of the volatile tincture Of gum guaiacum, at bed time in wine- Avhey. 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 10 be omitted for a few days, ahd repeated again. At the same time leeches, or a blistering plaster may be applied to the part affected. What I have generally found answer better than either of these, in ob- stinate fixed "rheumatic pains, is the warm plaster. I have likewise known a plaster of Burgundy pitch Avorn for some time on the part af- fected, give great relief in rheumatic pains. My ingenious friend, Dr. Alexander, of Edinburgh, says, he has frequently cured very obstinate rheumatic pains,'by rubbing the part affected, with tincture of cantha- rides. When the common 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. Though this disease may not seem to yield to medicines for some time, yet they ought still to be persisted in. Persons who are subject to frequent returns of the rheumatism, will often find their account iu using medicines, whether they be immediately affected with the dis- ease 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 Avarm baths of Buxton or Matlock in Derbyshire. These have, often, to my knowledge, cured very obstinate rheumatisms, and are always safe cither in or out of the fit. When the rheumatism is complicated Avith 'scorbutic complaints, which is not seldom the case, the Harrowgate wa- ters, and those of Moffat, are proper. They should both be drank and «sed as a warm bath. i7o OF THE SCURVY. There are several of our own domestic plauts which may be uscM ■with advantage in the rheumatism. One of die best is the white mus tard. A table spoonful of the seed of this plant may be taken twice or thrice a-day, in a glavs of water or small wine. The water trefoil is likewise of great use iu this complaint. It may be infused in wine or ale, or drank in foi in of tea. The ground h), camomile, and several other bitters, are also beneficial, and may be used in the same manner. No benefit however is to be expected from these unless they be taken for a, considerable time. Excellent medicines are often despised in this disease, because they do not perform au immediate cure; whereas nothing would be. more certain than their effect, Avere they duly per- sisted in. Want of perseverance in the use of mediciues, is one reason why chronic diseases are so seldom cured. Cold bathing, especially iu salt-water, often cures the rheumatism. We would alsu recommend riding on horseback, and wearing flannel next the skiu. Issues are likewise very proper, especially in chronic cases. If the pain affects the shoulders, an issue may be made iu the arm; but if it affects the loins, it should be put into the leg or thigh. Persous afflicted with the scurvy are very subject to rheumatic com- plaints. The best mediciues in this case are bitters and mild purga- tives. These may either be taken separately or together, as the pa- tient inclines. An ounce of Peruvian bark, arid half an ounce of rhu- barb in powder, may be infused in a bottle of wine; and one, two or three wineglasses of it taken daily, as shall be found necessary for keeping the body gently open. In cases where the bark itself proves sufficiently purgative, the rhubarb may be omitted. Such as arc 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 miike frequent Use of the flesh brush. CHAPTER XL. Of THE SCURVY. npIllS disease prevails chiefly iu cold northerncountiies, especially J_ in low damp situations, near large marshes, or great quantities of stagnating Avater. Sedentary people, of a dull melancholy disposition, arc most subject to it. It proves often fatal to sailors on long voya- ges, particularly in ship6 that are not properly veutilalcd, have many ptople on board, or where cleanliness is neglected. OF THE SCURFY. 271 H is not necessary to mention the different species into which this disease has been divided, as they differ from one another chiefly in rlcree. What is called the land scurvy, however, is seldom attended with those highly putrid s) mptoms 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 rroi?f air; oy the long use of salted or smoke dried provisions, or any kind ot food that is hard of digestion, and affords little nourishment. It may also pro- ceed from the suppression of customary evacuations; as the manes, hemorrhoidal flux &c. It is sometimes owing to an hereditaiy taint, in which case a very small cause will excite the latent disorder. Grief, fe-.i\ and other depressing passions, have a great tendency both to ex- cite and aggravate this disease. The same observation bolls with re- gard to neglect of cleanliness; bad clothing ; the want of proper ex- ercise; confined air; unwholesome food; or any disease which greatly 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 of the gums, which are apt to bleed ou the slightest touch ; a stink- ing breath ; frequent bleeding at the nose; crackling of the: joints; dif- ficulty 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 h generally of a pale or leaden colour. As the disease ad- vances, other symptoms come on; as rottenness of the teeth, haemorr- hages or discharges of blood from different parts of the body, foul ob- stinate ulcers, pains in various parts, especially about the breast, dry scaly eruptions all over the body, &c. At last a wastiug or hectic fe- ver comes on, and the miserable patient is often carried off by a dys- entery, a diarrhcoa, a dropsy, the palsy, fainting fits, or a mortification of some of the bowels. CURE.—We know no way ol curing this disease but by pursuing a plan directly opposite to that which brings it on. It proceeds from a vitiated state of the humours, occasioned by errors in diet, air, or ex- ercise ; and this cannot be removed but by a proper attention to these important articles If the patient has been obliged to breathe a cold, damp, or confined air, he should be removed, as soon as possible to a dry, open, and moderated 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 this disease, than constant cheerfulness and good humour. 272 OF THE SCURVY. But this, a'as! is. seldom the lot of persons afflicted with the scurvy ( tliey are generally surly, peevish and morose. When the scurvy has been brought on by a long use of salted pro- visions, ihe p.-oper medicine is a diet consisting chiefly of fresh vegeta- bles ; as oranges, apples, lemons, limes, tamarinds, Avater-cresses, scur- vy-grass, brook lime, gooseberries, and many other vegetables, may be kept a long time by pickling, pre- serving, &c. and when these fail, the chymical acids, recommended above, which will keep for any length of time, may be used. We havs reason to behove, if ships were well ventilated, had got store of fruits, greens, cyder, Sic. laid in, and if proper regard were paid to cleanli- ness and warmth, that sailors would be ihe most healthy people in the world, and would seldom suffer either from the scurvy or putrid fe- vers, which are so fatal to that useful 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 thera, when it is too late to ward* off the blow. It must indeed be owned, that many of them have it not in their pow- er 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 en- gage in a long voyage without having these articles secured. I have often seen very extraordinary effects in the land scurvy from a milk diet. Tiiis preparation of nature is a mixture of animal and vegetable properties, which of all others is the most fit for restoring a decayed constitution, aud removing that particular acrimony of the hu- mours, which seems to constitute the very essence of the scurvy, and manv other diseases. But people despise this vfholesome and nour- ishing food, because it is cheap, and devour with greediness, flesh and fermented liquors, while milk is only deemed fit for the hogs. The most proper drink iu the scurtfy, 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 in 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 may be used for the same purpose, or decoctions of any of the OF THE SCURVY. 2?a uYtid mucilaginous vegetables: as sarsaparilla, marsh-mallow roots, i.c. Infusions of the bitter plants, as ground ivy, the lesser centaury marsh-trefoil, Sic. are likewise beneficial. I have s\ne parts of Britain express the juice of the last mentioned plant, and drink it with good effect in those foul scorbutic eruptions, Avith which they arc ofteu troubled in the spring season. Harrowgate water is certainly an excellent medicine in the land scur- vy. I have often seen patients who had been reduced to the most de- plorable condition by this disease, greatly relieved by drinking the sul- phur water, and bathing iu it. The chalybeate-water may also be used with advantage, especially with a view to brace the stomach af- ter drinking the sulphur-water, which though it sharpens the appetite, never fails 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. Wheu the disease affects the gums only, this practice, if contiuued for some time, will generally carry it off. We would however recommend the bitter or- ange as greatly preferable to lemon, it seems to be as good a medicine, aud is not near so hurtful to the stomach. Perhaps our own 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 spinuage, lettuce, parsley, celery, endive, radish, dandelion, Sic. It is amazing to see how soon fresh vegetables in the spring, cure the brute animals of any scab or foulness which is upon their skins. It is reasonable to suppose that their effects would be as great upon the human species, were they used in proper quantities for a sufficient length of time, I have seen good effects in scorbutic complaints of very loug stand- ing, from the use of a decoction of the roots of water clock. 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 piat to a whole pint of the decoction every d^i) . But in all the cases where I have seen it prove beneficial, it was made much strong- er, and drank in larger quantities. The safest Avay, hoAvever, 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 ma- ny months, ami have been told of otheis who had used it for Several years, before they were sensible of any benefit, but who nevertheless were cured by it at length. The leprosy, which was so common in the country long ago, seems to have been near a-kiu to the scurvy. Perhaps its appearing so sel- dom now, may be owing to the inhabitants of Britain eating more ve- getable food tlnn formerly, living more upon tea and other diluting di- c!. using le.-s salted meat, being more cleanly, better lodged and cloth. 274 OF THE SCROPHULA, ed, &c. For the cure of this disease Ave would recommend the saraa 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 sub ject to it, It is one of those diseases which may be removed by prop- er regimen, but seldom yields to medicine. The inhabitants of cold, damp, marshy countries, are most liable to the scrophula. CASES.—This disease may proceed from au hereditary taint, from a scrophulous nurse Sic Children who have the misfortune to be born of sickly parents, whose constitutions have been greatly inju- red by the pox, or other chronic diseases, are apt to be affected with the scrophula. It may likewise proceed from such diseases as weak- en the habit or vitiate the humours, as the small pox, measles, &c. External injuries, as blows, bruises, and the like, sometimes produce scrophulous ulcers; but we have reason to believe, when this happens, that there has been a predisposition in the habit to this disease. Iu short, Avhatever tends to vitiate the humours 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 cleanliuess, &c. Noth- ing tends more to produce fhis disease in children, than allowing them to continue long wet.* SYMPTOMS.—At first small knots appear under the chin, or, be- hind the ears, which gradually increase in number and size, till they form one large hard tumour. This often continues for along time with- out breaking, aud when it does break, it only discharges a thin sanies, or watery humour. O'her parts of the body are likewise liable to its' attack, as the arm pits, groins, feet, hands, eyes, breasts, &c. Nor are the internal parts exempt from it. It often affects the lungs, liver, or spleen; and I have frequently seen the glands of the mysentery greatly enlarged by It. Those obstinate ulcers which break out upon the feet and hands with swelling, and little or no reduess, are of the scrophulous kind. They seldom discharge good matter, and are exceedingly difficult to cure. The white swellings of the joints seem likewise to be of this kind. They are with difficulty brought to a suppuration, and when opened, they only discharge a thin ichor. There is not a more general symptom of the scrophula than a swelling of the upper lip and nose. REGIMEN.—As this disease proceeds, in a great measure, from relaxation, the diet ought to be generous and nourishing, but at the * The scrophula, as well as the rickets, is found to prevail iu large manufacUirirg towns; where people live gross, and lead sedentary li-.ec, OR KINGS EVIL. 2?a same time light and easy of digestion : as well fermented bread, nu\de of sound grain, the flesh aud broth of young auimals, with now and then a glass of generous wine, or good ale. The air ought to be open, dry and uot too cold, and the patient should take as m.ich exercise as he can bear. This is of the utmost importance. Children who have sufficient exercise, are seldom troubled with the scrophula MEDICINE—The vulgar are remarkably credulous with re- gard to the cure of the scrophula; many of them believing in the vir- tue of the royal touch, that of the seventh son, &c. The truth is, we know but little either of the nature aud cure of this disease, aud where reason or medicines fail, superstition always comes in their place. Hence it is, that in diseases which are most difficult to understand, we generally hear of the greatest number of miraculous cures being per- formed. Here, however, 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, who is really the physician. In the same Avay the insignificant nostrums of quacks and old women, 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 proceeds 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 given in gross habits, and in such quantity as to procure one, or at most two stools every day. Bathing in the salt-water has likewise a very good effect, especially in the warm season. I have often known a course of bathing iu salt- water, and drinking it in such quantities as to keep the body gently open, cure a scrophula, after many other medicines had been tried in vain. When salt water cannot 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, aud drinking the salt water, we would recom- mend the Peruvian bark. The cold bath may be used in summer aud the bark iu winter. To an adult half a drachm of the bark in powder may be given in a glass of red wine, four or five times a-day. Chil- dren, and such as cannot take it in substance, may use the decoction, made in the following manner: Boil au ounce of the Peruvian bark, and a drachm of Winter's bark, both grossly powdered, in an English quart of water to a pint: towards the end, half an ounce ol sliced liquorice-root, and a handful of raisins may be added, which will both render the decoction less disagreeable, Had make it take up more of the bark. The liquor must be strained, 27rj OF THE ITCH. and two, three, or four table-spoonsful, according to the age of the pi* tient, givn three times a-dtj . The .Vloffat and Harrowgate waters, especially the latter, are like- wise very proper medicines in the scrophula. They ought not, how- ever, 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. Th ^eml'./k may sometimes be used with advantage in the scrophula. S:>!ne lay it down as a general rule, that the sea-water is most propel1 before there are any suppuration or symptoms of tabes ; the Peruvian birk, when there are running sores, and a degree of hectic fever; and thrt hemlock in old inveterate cases, approaching to the scirrhus or cancerous state. Either the extract, or the fresh juice of this plant miy be used. The dose must be small at first and increased gradual- ly as far a* the stomach is able to bear it. External applications are of little use. Before the tumour breaks nothing ouglit to be applied to it, unless a piece of flannel, or something to keep ii warm. After it breaks, the sore may be dressed with some digestive ointment. What I have always found to answer best, was the yellow basilicon mixed with about a sixth or eighth part of its weight of red precipitate of mercury. The sore may be dressed with this twice a day; and if it be very fungous, and does not digest well, a large proportion of the precipitate may be added. Medicines which 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 well; but if he does not recover at Ibis time, in all probability he never will. There is no malady which parents are so apt to communicate to their offspring as the scrophula, for which 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. OF THE ITCH. THOUGH this disease is commonly communicated by infection, ye? it seldom prevails where clue regard is paid to cleanliness, fresh air and ■wholesome diet. It generally appears in form of small watery pus- tules, first about the Wrists or between the fingers; afterwards it affects the arms, legs, thighs, be ad- ministered, and if there be occasion, it may be repeated two or three times. The patient's feet and legs ought to be immersed iu warm wa- ter, 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 fomen- tations, or bladders filled with warm milk and water, may be applied to the put affected ; and warm cataplasms to the soles of the feet. The patient must drink freely of diluting liquors, and may take a tea-spoon- ful of the tincture of castor and of saffron mixed together, in a cup of valerian tea, twice or thrice a-day. Sometimes a vomit has a very good effect, and snatches the patient, as it were, from the jaws of death. This however will be more safe after other evacuations have been pre- mised. A very strong infusion of roasted coffee is said to give ease in asthmatic paroxysms. In the moist asthma, such things as promote expectoration or spit- ting, ought to be used; as the syrup of squills, gum ammoniac, and such like. A commou 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 asafoeti- da and gum ammoniac, at bed time.* For the convulsive or nervous asthma, antispasmodics and bracers are the most proper medicines. The patient may tnke a tea-spoonful of the paregoric elixir twice a-day. The Peruvian bark is sometimes * After copious evacuations, large doses of aether have been found very efficacious in removing a fit of the asthma. I have likewise, known the following mixture produce very happy effects; 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 this, two table-spoonsful may be taken every three hours. QF THE APOPLEXY. 281 found to be of use in this case. It may be taken in substance, or infu- sed in wine. 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 likewise known cow's milk drank warm in the morning, 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, aud should never be allow- ed to dry up. We shall here, ouce 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 tliey will often prolong the patient's life. CHAPTER XLII. OF THE APOPLEXY. r*|lHE apoplexy is a sudden loss of sense and motion, during which X. tin; patient is to all appearauce dead; the heart and lungs howev- er still continue to move. Though this disease proves often fatal, yet it may be sometimes removed by proper care. It chiefly attacks sed- entary persons of a gross habit, Avho use a rich and plentiful diet, and indulge in strong liquors. People in the decline of life are most subject to the apoplexy. It prevails most in winter, especially in rainy seas- ons, and very low states of the barometer. CAUSES.—The immediate cause of an apoplexy is a compression of the brain, occasioned by an excess of blood, or a collection of Ava- tiry humours. The former is called a sanguine, and the latter a se- rous apoplexy. It may be occasioned by any thing that increases the circulation towards the brain, or prevents the return of the blood from the head; as intense study; violent passions,f viewing objects for a long time obliquely; wearing any thing too tight about the neck; a rich and luxurious diet; suppression of urine; suffering the body to cool suddenly after having been greatly heated ; continuing long in a Avarm i 1 knew a woman, who in a violent fit of anger Avas seized with a :anguine apoplexy. She at first complained of extreme pain, " as if dag*:■■■.- Iiid bee:; thrust through her head," as she expressed it. Af- !(iwards she became comatose, her pulse sunk very low, and Avas ex- ceeding slow. B) bleeding, blistering and other evacuations, she ak.s kept alive for about a fortnight. When her head was opened, alarge quantity of exit-»vasatcd bipod was found in the left ventricle ofthf ''V.tin. 31* 282 OF THE APOPLEXY. or cold bath ; the excessive use of spiceries, or high seasoned food ; excess of vencry ; the sudden striking in of any eruption ; Miff' ring issues, setons. Sic. suddenly to dry up, or the stoppage of any custo- mary evacuation; a mercurial salivation pushed too far, or suddenly checked by cold; wounds or bruises on the head; long exposure to excessive cold ; poisonous exhalations, &c. SYMPTOMS, and method of cure.—The usual forerunners of an apoplexy are giddines, pain and swimming of the bead ; loss of memo- ry ; drowsiness, noise in the ear, the night mare, a spontaneous flux of tsars, 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, a id openii'i; mediciues. Iu the sanguine apoplexy, if the patient does not dm 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 ex- crements 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 tile 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 clown. His clothes ought to be loosened, es- pecially 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 die lower extremities will be retarded. As soon as the pa- tient is placed in a proper posture, he should be bled freeiy in the neck or arm, and if there be occasion the operation may be repeated in two or three hours. A laxative clyster, with plenty of sweet oil, or fresh butter, and a spoonful or two of common salt in it, may be admin- istered every two hours; and blistering-plasters applied between the shoulders, and to the calves of the legs. . A3 soon as the symptoms are a little abated, and the patient is able to swallow, he ought to drink freely of some diluting opening liquor, as a decoction of tamarinds and liquorice, cream tartar whey, or com- mon whey with cream of tartar dissolved in it. Or he may take anv cooling purge, as Glauber's salts, manna dissolved in an infusion of sen- na, or the like. All spirits and other strong liquors are to be avoided. Even volatile salts held at the nose do mischief. Vomits, for the same reason, ought not to be given, or any thing that may increase the mo- tion of the blood towards the head. I i the serous apoplexy, the symptoms are nearly the same, only the pulse is not so strong, the couutenance is less florid, and the breathing less difficult. Bleeding is not so necessary here as in the former case*. It may, however, generally be performed once with safety e.nd ad- vantage, but should not be repeated. The patient should be placed if: OF COSTIVENESS, etc 2S3 r.e same posture as directed above, and should have blistering plasters applied, and receive opening clysters iu the same manner. Purges here are likewise necessary, and the patient may drink strong balm- tea. If he be inclined to sweat, it ought to be promoted by drinking small wiue-whey, or an infusion of carduus benedictus. A plentiful sweat kept up for some considerable time, has often carried off a se- rous apoplexy. When apoplectic symptoms proceed from opium, or other narcotic substances taken into the stomach, vomits are necessary. The patient is generally relieved as soon as he has discharged the poison iu this way. Persons of an apopleptic make, or those Avho have been attacked by it, ought to use a very spare and slender diet, avoiding all strong li- quors, spiceries, and high-seasoned food. They ought likewise to guard against all violent passions, and to avoid the extremes of heat and cold. The head should be shaved, and daily Avashed with cold water. The feet ought to be kept warm, and never suffered to continue long wet. The body must be kept open either by food or medicine, and a little blood may be let every 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 setous; great care however, must be taken, not to suffer them to dry up, without opening others in their stead. Apopleptic persons ought ucver to go to rest with a full stomach, or to lie with their heads low, vr to wear any thing too tight about their necks. CHAPTER XLIII. OF COSTIVENESS, AND OTHER AFFECTIONS OF THE STOMACH AND BOWELS. WE do not here mean to treat of those astrictions of the bowels, Avhich are the symptoms of disease, as of the cholic, the iliac passion, &c. but only to take notice cf that infrequency of stools which sometimes happens, and which in some particular constitutions may oc- casion diseases. Costiveness may proceed from drinking rough red wines, or other astringent liquors; too much exercise, especially on horseback. It may likewise proceed from a long use of cold insipid food, Avhich does not sufficiently stimulate the intestines. Sometimes it is owing to the bile uot descending to the intestines, as in the jaundice; and at other limes it proceeds from diseases of the intestines themselves, as a pals}*, spasms, torpor, tumours, a cold dry state of the intestines, Sec. 284 OF COSTIVENESS, Sic Excessive costiveness is apt to occasion pains of the head, vomiting colics, and other complaints of the bowels. It is peculiarly hurtful to hypochoudriac aud hysteric persons, as it generates wind and other grievous symptoms. Some people however, cm bear costiveness to a great degree. I know persons whoenjoy pretty good health, yet do not go to stool above once a Aveek, and others not above once a fortnight. Indeed I have beard of some who do not go above once a month. Person who are generally costive, Fhould 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 spiunage, leeks, and other soft pot herbs, are likewise proper. Hye-bread, or that which is made of a mixture of Avheat and rye to- gether, ouglit to be eaten. No person troubled with costiveness, should eat white bread alone, especially that which is made of fine Hour. The best bread for keeping the body soluble, is what in some parts of England they call mcslin. It ic made of a mixture of wheat and rye, and is very agreeable to those who are accustomed to it. Costiveness is increased by keeping the body too warm, and by ev- ery thing that promotes the perspiration; as wearing flannel, I)ing too long a-bed, &c. Intense thought, and a sedentary life, are likewise hurtful. A:l the secretion aud excretions are promoted by moderate exercise without doors, and by a gay, cheerful, sprightly temper of mind. The drink should be of an opening quality. All ardent spirits-, austere arid astringent wines, as port, claret, Sic. ought to be avoided. Malt liquor that is fine, and of a moderate strength, is very proper. Butter-milk, whey, and other watery liquors, are likewise proper, and may be drank in turns, as the patient's inclination directs. Those who are troubled with costiveness, ouglit if possible to rem- edy it by diet, as the constant use of medicines for that purpose is at- tended with many inconveniences, and often with bad consequences.* '* 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 the internal parts of animals, as the liver, heart, midriff &c. He likewise recommends the expressed oils of mild vegetables, as olives, almonds, pastaches, and the fruits them- selves ; all oily and mild fruits, as figs; decoctions of mealy vegeta- bles ; the se lubricate the intestiues; some sanonaceous substances which stimulate gently, as honey, hydromeL or boiled hooey and water, un- *jfintd sugar, Sic. The doctor observes, that such lenitive substancrs are proper for persons of dry atrabilarian constitutions, who are subject to astriction of the belly, aud the -piles, and will operate when stronger medicinal substances are sometimes ineffectual; but that such lenitive diet hurts those whose bowels are weak aud lax. He likewue observes, that ?1? WANT OF APPETITE. 265 I never knew any one get into a habit of takiug medicine for keeping the body open, Avho couid foave it off. In time the custom becomes necessary, aud generally ends in a total relaxation,of the bowels, indi- gestion, loss of appetite, Avastbig of the strength, aud 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 uot near so injurious to the "stomach as aloes, jalap, or the oth- er drastic purgatives so much in use. Infusions of senna and manna may likewise be taken, or half an ounce of soluble tartar dissolved 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; anrtiety ; or any of the depressing passions; excessive heat; the use of strong broths, fat meats, or any thing that palls the appetite, oris hard of digestion; the immoderate use of strong liquors, tea, tobacco, opium, &c. 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 diges- tion ; 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 retch- ings show that the stomach is loaded with crudities a vomit will be of service. 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 trine. Though genile evacua- tions be necessary, yet strong purges and vomits are to be avoided, as they Aveaken the stomach and hurt digestion. Elixir of vitriol is an excellent medicine in most cases of indigest- ion, weakness of the stomach, or want of appetite. From twenty to thirty drops of it may be taken tAvice or thrice a-day in a glass cf wine or water. 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-spoons- ful of it taken in wine and Avater, as above. The chalybeate waters, if drank in moderation, are generally of considerable service in this case. The salt-water has likeAvise good ef- watery substances are lenitive, andthateven common water, Avhey, sour milk, and butter-milk have that effect; that new milk, especially asses milk, stimulates still more when it sonrs on the stomach; aud that Avhey turned sour, will purge strongly :—That most garden fruits are like- wise laxative; and that some of them, as grapes, will throw such as take them immoderately, into a cholera morbus, or incurable diarrhoea. 5S6 OF THE HEART-BURN. fects; but it must not be used too freely. The wafers of Harrowgate, Scarborough, Moffot, aud most other spas iu Britain, may be used w ith advantage. We would advise all who are afflicted with indigestion and want of appetite, to repair to these places of public rendezvous. The very clnnge of air, and the cheerful company, will be of service., not to mention the exercise, amusements, f use, aud * very thing that promotes digestiou. When bilious humours occasion the heart-burn, a tea-spoonful of the 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 drachm of brandy or rum may be taken. If acidity or sourness of the stomach occasions the heartburn, ab- sorbents are the proper medicines. In this case an ounce of powdered chalk, half an ounce of fine sugar, and a quarter of au ounce of gum-ara- bic, may be mixed in a quart of water, aud a tea-cupful of it taken as t- Ken as is necessary. Such as do not choose chalk may take a tea- spoonful ot prepared oyster shells, ov of the powder called crabs-eyes, in a glass of cinnamon or peppermint-water. But the safest and best absorbent is magnesia alba. This not only acts as an absorbent, but likewise as a purgative; whereas chalk and other absorbents of that kiud are apt to lie in the intestines, and occasion obstructions. This lewder 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 iw.iy be taken in a much greater quantity when there is occasion. These things are nojrits, but prevents the person from taking proper exercise, by which 288 OF NERVOUS DISEASES. means the digestion is impaired, the nourishment prevented, the soiiek relaxed, and the whole mass of humours vitiated. Grief and disap- pointment likewise produce the same effects. 1 have known more ner vous patients who dated the commencement of their disorders from the loss of a husband, a favourite child, or from some disappointment in life, than from any other cause. Iu a word, whatever weakens the body, or depresses the spirits, may occasion uervous disorders, as un- wholesome air, Avant of sleep, great fatigue, disagreeable apprehensions, anxiety, vexation, Sic. SYMPTOMS.—We shall only mention some of the most general symptoms of these disorders, as it would be both an useless and an endless task to enumerate the Ariiole. 'I hey generally begin with win- dy inflations or distentions of the stomach and intestines; the appetite and digestion are usually bad; yet s'wneu.'iies there is an uncommon craving for food, and a quick digestion. The food often turns sour on the stomach ; and the patient is troubled with vomiting of clear water, tough phlegm, or a blackish coloured liquor resembling the grounds of coffee. Excrutiating pains are often felt about the navel, a.tended with a rumbling or murmuring noise in the bowels. The body is some- times loose, but more commonly bound, which occasions a retention of wind aud great uneasiness. The urine is sometimes in small quantity, at other times very copi- ous and quite clear. There is a great straightness of the breast, with difficulty of breathing; violent palpitations of the heart; sudden flush- iugs of heat in various parts of the body; at other times a sen^e of cold as if Avater were poured on them ; flying pains in the arms and limbs, pains in the back and bejly, resembling those occasioned by the grav- el ; the pulse very variable, sometimes uncommonly slow, and at other times very quick; yawuing, the hickup, frequent sighing, and a sense of suffocation, as if from a ball or lump in the throat; alternate fits of crying aud convulsive laughing; the sleep is unsound, and seldom re- freshing ; and the patient is often troubled with the night-mare. As the disease increases, the patient is molested Avith head-aches, cramps, and fixed pains in various parts of the body; the eyes are clouded, and often affected Avith pain and dryness; there is a noise in the ears, aud often a dullness of hearing; in short the whole animal functions are impaired. The mind is disturbed on the most trivial oc- casions, aud is hurried into the most perverse commotions, inquietude, terror, sadness, anger, diffideoce, Sic. The patient is apt to entertain Avild imaginations, and extravagant fancies; the memory becomes Aveak, ami the judgment fails. Nothing is more characteristic of this disease than a constant dread ef death. This renders those unhappy persons who labor under it, peevish, fickle, impatient, and apt to run from one physician to anoth- er ; which is one reason why they seldom reap any benefit from med- icine, as they have not sufficient resolution to persist iu any one course uF NERVOUS DISEASES. 289 (ill it has 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 iaitgh 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 .--isy digestion. Fat meats and heavy sauces are hurtful. All excess should b ■ carefully avoided. They ought never to eat movn at ;•• time than they cau easily digest; but if they feel themselves we k and faint be- tween meats, they ought to eat a bit of bread, and drink a glas« of vine. Heavy suppers are to be avoided. Though wine in exce.-s enfteb'-a the body, and impairs the faculties of the mind, yet taken in modera- tion it strengthens the stomach, and promotes digestion Wine and wa- ter is a very proper drink at meals; but if wine sours on th^ stom- ach, or the patient is much troubled with wind, brandy and water will answer better. Every thing that is windy or foird of digestion must be avoided. All weak and warm liquors ar* hurtf.tl, as tea, coffee, punch, &c. People may find a temporary relief in the use of these, but they always increase the malady as they weaken the stomachy 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 aggravate the malaely, aud prove certain poisons at last. These cautions are the more necessary; 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 medicioes. Riding on horseback is generally esteemed the best, as it gives motion to the whole body Avithout fatiguing it. I have known son,e patients, how- ever, with whom walking agreed better, and others who were most benefited by riding in a carriage. Every one ought to use that Avhich he finds most beneficial. Long sea-voyages have an excellent effect; and to those avLo have sufficient resolution, we would by all means recommend this course. Even change Of place, and the sight of new objects, by diverting the mind, have a great tendency to remove these complaints. For this reasou a long journey, or a voy- age, is of much more advantage than riding short journies near home. A cool aiid dry air is proper, as it braces and invigorates th. whole body. Few things tend more to relax and eueivate than hot air, espe- cially that which is renderd so by great fires or stoves iu small apart- ments. But when the stomach or bowels are weak, the body ought to be well guarded agtinst cold, especially in winter, by wearing a thin flannel waistcoat next the skin. This will keep up an equal perspira- tion, and defend the alimentary canal from many impressions to which it would otherwise be subject, upon every sudden change from warm to cold weather. Rubbing the body frequently wtith a flesh-brush, or a co; re linneu cloth, is likewise beneficial, as it promotes the circuhv J7 : 200 OF NERVOUS DISEASES. tion, perspiration, Sic. Persons who have weak nerves ought to rise earl), and take exercise before breakfast, as lying too long a-bed can- not fail to relax the solids. They ought likewise to be diverted, and to be kept as easy aud cheerful as possible. There is not any thing which hurts the nervous system, or weakens the digestive powers more than fear, grief or anxiety. MEDICINES.—Though 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 mediciues. When the patient is costiv^ he ought to take a little rhubarb, or some other mild purgative, and should uever 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 ancl rhubarb in brandy, answer very well. This may be made of any strength, and taken in such quautity as tjie patient finds necessary. When digestion is bad, or the stomach relaxed and weak, the follow- ing infusion of Peruvian bark and other bitters may be used with ad- vantage. Take of Peruvian bark an ounce, gentian-root, orange-peel, and co- riander seed, of each half an ounce, let these ingredients be all bruised in a mortar, 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 ta- ken 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 extra- ordinary effects; but when the liver or other viscera are obstructed, or otherwise unsound, the cold bath is improper. It is therefore to be used with very great caution. The most proper seasons for it are sum- mer 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 pa- tient be Aveakeued by it, or feels chilly for a long time after coming out, it is improper. In patients afflicted Avith 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 expells the wind, strengthens the stomach, and pro- motes digestion. Opiates are generally extolled in these maladies; but as they only palliate the symptoms and generally afterwards increase the disease, Ave would advise people to be extremely sparing in the use of them, lest habit render them at last absolutely necessary. It Avould be an easy matter to enumerate many medicines Avhich have been extolled for relieving nervous disorders; but whoever Avishes for a thorough cure, must expect it from regimen alone ; we shall there- OF MELANCHOLY. 291 fore omit mentioning more medicines, and again recommend the strict- est attention to diet, air, exercise, and amusement. OF MELANCHOLY. MELANCHOLY is that state of alienation or Aveakness of mind, which renders people incapable of enjoying the pleasures, or perform- ing the duties of life. It is a degree of insanity, and ofteu terminates in absolute madness. CAUSES—It may proceed from an hereditary disposition; in- tense thinking, especially where the mind, is long occupied by one ob- ject ; violent passions or affections of the mind, as love, fear, joy, grief, pride, and such like. It may also be occasioned by excessive venery, narcotic or stupefactive poisons; a sedentary life ; solitude; the suppression of customary evacuations; acute fevers or other dis- eases. Violent auger will change melancholy into madness; and ex- cessive cold, especially of the lower extremities, will force the blood into the brain, and produce all the symptoms of madness. It may like- wise proceed from the use cf aliment 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 tht* brain itself. To all Avhich Ave may add gloomy and mistaken notions of religion. SYMPTOMS.—When persons begin to be melancholy, tliey are timorous; watchful; fond of solitude; fretful; fickle ; captious and inquisitive; solicitous about trifles; sometimes niggardly, and at other times prodigal. , The body is generally bound, the urine thin, and iu small quantity; the stomach and boAvels inflated Avith wind; the complexion pale; the pulse slow and weak. 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 their bodies were made of glass or other brittle substances, and were afraid to move lest they should be broken to pieces The unhappy pa- tient, in this case, unless carefully watched, is apt to put an end to his own miserable life. When the di; ease is owing to an obstruction of customary evacua- tions, or any bodily disorder, it is easier cured than when it proceeds from affections of the mind, or an hereditary taint. A discharge of blood from the nose, Iooseuess, scabby eruptions, the bleeding piles, or the menses, sometimes carry off this disease. REGIMEN.—The diet should consist chiefly of vegetables of a cooling and opening quality. Animal food, especially salted or smoke- dried fish or flesh, ought to be avoided. All kinds of shell fish are bad. Aliments prepared with onions, garlic, or any thing that gene- rates thick blood, are likewise improper. All kinds of fruits that are Avholesome may be eaten with advantage. Boerhaave gives an instance ©f a patient who, by a long use of whey, water, and garden fruit, re- 102 OF MELANCHOLY. covered, after having ev. cualcd a great quantity of black coloured mat^r. S'.'.'.ing liquors of ev^ry kind ought to be avoided as poison. The most ;>roj-er driuk .3 rater, whey, or very smill beer. Tea and cof- fee are improper If honey agrees with the prtient, it may be eaten freely, or his drink may be sweetened with it. Infusions of balm-leaves, penny ro)al. the roots of wild valerian, or the flowers of the lime tree, may be.i'.rmik ueely, either by ihemsefres, or sweetened whh honey, as die patient shall riioose. Tiie patient ought to take as much exercise as he can bear. This helps 10 dissolve the viscid humours, it removes obstructions, promotes the o.'rspiraiio.i. and all th» other secretions. Every kind of madness is aiu-nded with a diminished perspiration ; all means ought therefore to he used to promote that necessary and salutary discharge. Nothing can have a more direct tendency toiucrease the disease than confining the patieui to a close apartment. Were he forced to ride or walk a certain number of miles every day, it would tend greatly to. alleviate hi? disorder; but it would have still a better effect, if he were obliged to labour ou a piece of ground. By digging, hoeing, planting, sowing, &c both the body and mind Avould be exercised A long journey, or a voyage, especially towards a warmer climate, with agreeable com- panions, have often 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 medicines. MEDICINE.—In the cure of this disease particular attention must be paid to the miud. When the.patient is in a low state, his mind ought to be soothed and diverted with a- variety of amusements, as enter- taining stories, pastimes,, music, &c. This seems to have been the method of curing melancholy among the Jews, as we learn from the story of Ring Saul; and it is a very rational one. Nothing can remove diseases of the 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 are agreeable to him. People in this state are apt to conceive unaccountable aversions to particular per- sons; and the very sight of such persons is sufficient to distract their minds, aud throw them into the utmost perturbation. When the patieut's strength is high, or the pulse admits of it, evacua- tions are necessary. In this case he miiot 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. Jt may be taken iu the dose of half an ounce, dissolved in water-gruel, every day, for several weeks, or even for months, if necessary. More or less may be given according as it operates. Vomits have likewise a .good effect; but they must be pretty strong, otherwise they will not op- erate. OF THE PALSY. 29^ Whatever increases the evacuation of urine or promotes perspira- tion, has a tendency to remove this disease. Both these secretions may be promoted by the use of nitre and vinegar. Half a drachm of purified nitre may be given three, or four times a day. iu any manner that is most agreeable to the patient; aud an ou-'oe and a-i half of dis- tilled vinegar may be daily mixed with his drink. Dr Locker seems to think vinegar the best medicine that can be glv.in in this disease. Camphire and musk have likewise been used iu his cast: with ad- vantage. Ten or twelve grains of camphire ma) be rubbed in a mor- tar, with 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 siomach iu this form, it may be made into pills with gum-asafcctida and Russian castor, and taken in the quantity above directed. If musk is to be adminis- tered, a scruple or twenty-five grains of it may be made into a bolus with a little honey or common syrup, and takeu twice or thrice a-day. We do not niean that all these medicines should be administered at once ; but which ever of them is given, must be duly persisted in, and where one fails another may be tried. As it is very difficult to induce patients in this disease to take medi- cines, we shall mention a feAV outward applications which sometimes do good; die principal of these are issues, setons, and warm bathing. Is- sues may be made in any part cf the body, but they generally have the best effect near the spine. The discharge from these may be greatly promoted by dressing them with the mild blistering ciutment, and keep- ing what are commonly called the orrice pease in 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 diminution of sense or motion, or of both, 5n oue or more parts of the body. Of all the affections called nervous, this is the most suddenly fatal. It is more or less dangerous, according to the importance 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 shows that the disease proceeds from the brain. When the part affected feels cold, is ipsensible, or wastes away, or Avhen 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 pow er upon any particular muscle or part of the body. The occasional and predisposing causes are va- rious, as drunkenness ; wounds of the brain, or spinal marrow; pres- sure upon the brain, or nerves; very cold or damp air, the suppres- sion of customary evacuations; sudden fear; Avant of exercise; or £04 OF THE PALSY. whatever greatly relaxes the system, as drinking much tea,* or coffee. The palsy may likewise proceed from wounds of the nerves themselves, from the poisonous fumes of metals or minerals, as mercury, lead, arsenic. In young persons of a full habit, the palsy must be treated'in the same manner 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 relaxa- tion 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 vegetables, as mustard, horse radish, &c._ The drink may be generous wine, mustard, whe), or brandy and water. Friction with the flesh-brush or a warm hand, is extremely proper, es- pecially on the parts affected. Blistering-plasters may likewise be ap- plied to the affected parts with advantage. When this cannot be done, they may be rubbed with the volatile liniment, or the nerve ointment of the Edinburgh Dispensatory. One of the best cxKrn;d applica- tions Is electricity. The shocks or rather vibrations, ihcidd be re- ceived on the part affected, aud they ought daily to be repeated lor several weeks. Vomits are very beneficial in this kindof palsy, and ought frequent- ly to be administered. Cc oh'die srr.iff, or any thing that makes the patient sneeze, is likewise o'use Some pretend to have found great benefit from rubbing the pails affected with rttiks; be this, foes not teem to be any way preferable to blistering. Ii the 'o.igne is affected, the patient may gargle his mouth frequently wi'h brandy ami r.iua.ard; or he may hold a bit of sugar in 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 nny either be taken iu an infusion Avilh sage leaves, or half a drachm of it in po»rdcr may be giveu in a jdass of wine three or four times a day. If the patient cannot use the Valerian, h& may take of sat volatiU eltosum, compound spirits of la- Aender, and tincture of castor epxh half an ounce; mix these together, r.nd take forty or fifty drops in a glass of wine, three or four times i day. A table-spoonful of mustard-set d taken frequently i. a very f r»od medicine. The patient ought likeAvise to chew cinnamon, bark, fdtiser, or other Avarm spiceiies. * Many people imagine that tea has no tendency to hurt the nerves, and that drinking the same quautity of warm water would be equally pernicious. This however seems to be a mistake. Many persons c'ri:ik three or four cups of warm milk and Avater daily, Avithout feeling ;-ly bad consequences; yet the same quantity of tea will make their binds shike for twenty-four hours. That tea affects the nerves, is like- vise evident from its preventing sleep, occasioning giddiuess, dimness di tkc rigjit, sickness, &c. OF THE EPILEPSY, &o>. 2»5> 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 eext the skin; and if possible, should remove into a wanner climate. OF THE EPILEPSY, OR FALLING SICKNESS. THE epilepsy is a sudden deprivation of all the senses, Avherein the patient falls suddenly down, and is affected with violent convulsive mo- tions. Children, especially those who are delicately brought up, are most subject to it. It more frequently attacks men than women, and is very difficult to cure. When the epilepsy attacks children, there is reason to hope it may go off in the time of puberty. When it attacks any person after twenty years of age, the cure is difficult; but when after forty, a cure is hardly to be expected. If the fit continues only for a short space, and returns seldom, there ia reason to hope ; but if it continues long, and returns frequently, the. prospect is bad. It is a very unfavorable symptom when the patient is seized with the fits in his sleep. CAUSES.—The epilepsy is sometimes hereditary. It may like- wise proceed from blows, bruises, or wounds on the head; a collection of water, blood, or serous humours in the brain ; a polypus; tumours or concretions within the skull; excessive drinking; intense study; excess of venery ; worms; teething; suppression of customary evacua- tions ; too great emptiness or repletion; violent passions or affections of the mind, as fear, joy, &c. hysteric affections; contagion received jnto the body, as the infection of the small-poxi measles, &c. SYMPTOMS.—Au epileptic fit is generally preceded by unusual weariness; pain of the head ; dullness; giddiness; noise in the ears; dimness of sight; palpitation of the heart; disturbed sleep; difficult breathing; the bowels are inflated with wind; the urine is in great quantity, but thin; the complexion is pale; the extremities are cold; aud the patient often feels, as it were, a stream of cold air ascending towards the 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 tw isted various ways ; he often discharges his seed, urine, and fasces involun- tarily; and is quite destitute of all sense and reason. After the fit is over, his senses gradually return, and he complains of a kind of stu- por, weariness, aud pain of the head; but has no remembrance of what happened to him 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 difficult)' of investigating its causes, and its strange symptoms, was formerly attributed to the wrath of the gods, or the agency of evil spirits. Iu modem times it has often, by the vul- 296 OF THE EPILEPSY, Sic. gar, been imputed to witchcraft or fascination. It depends howcvfty, as much upon natural causes as auy other milady; and its cure may often be affected by persisting in the use of proper means. REGIMEN.—Epileptic patieuts, ought, if possible, to breathe a pure and free air. Their diet should be light but nourish^?. They ought to drink nothing strong, to avoid swine's flesh, water-fowl, and likewise all windy and oily vegetables, as cabbage, nuts, &c. They ought to keep themselves cheerful, carefully gu tiding against all vio- lent passions, as auger, fear, excessive joy and the like. Exercise is likewise of great use; but the patient must be careful to avoid all extremes either of heat or cold, all daugetous situations, as standing upon precipices, riding, deep waters, and such like. MEDICINE —The intentions of cure must vary according to the cause of the d-sease. If the patient be of a sanguine temperament, and there je reason to fear an obstruction in the brain, bleeding and other evacuations will 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. Is- sues or setous in this case have often a very good effect. Wheu there is reason to believe that the disease proceeds from worms, proper med- icines must be used to kill, or carry off these vermin. Wtien the dis- ease proceed.-) from teething, the body should be kept open by emolli- ent clysters, the feet frequently bathed in warm water, and if the fits prove obstinate, a blistering-pi aster 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 wrong formation of the brain, a cure is not to be expected. When it is owing to a de- bility, or too great an irritability of the nervous system, such medi- cines as tend to brace and strengthen the nerves may be used, as the Peruvian bark, and steel; or theantiepileptic electuaries,recommend- ed by Fuller and Mead. The flowers of ziuc have of late been highly extolled for the cure of the epilepsy. Though this medicine will not be found to answer the expectations which have been raised concerning it, yet in obstinate ep- ileptic cases it deserves a trial. The dose is from one to three or four grains, which may be taken either in pills or a bolus, as the patient in- clines. 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 can bear it. I have known this medicine, when duly pei&istcd iu, prove beneficial. Musk has sometimes been found to succeed in the. epilepsy. Ten 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. Sometimes the epilepsy has been cured by electricity. OF THE HICKUP. 297 Convulsion fits proceed from the same cause, and must be treated in tb: line 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 with strauge motions and gesticulations, which by the common people a.-c. generally believed to be the effects of witchcraft. This disease may be cured by repeated bleedings and purges; and afterwards using the medicines prescribed above for the epilepsy, vis. the Peruvian bark and snake-root, &c Chalybeate waters are found to be beneficial in this case. The cold bath is likewise of singular service, and ought never to be neglected Avhen the patient can bear it. OF THE HICKUP. THE hickup is a spasmodic or convulsive affection of the stom- ach 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 schirrous tumours of the stomach, intestines, bladder, midriff, or the rest of the viscera. In gangrenes, acute anil malignant fevers, a hickup is often the forerunner of death. When the hickup proceeds from the use of aliment that is flatulent, or hard of digestion, a draught of generous wine, or a drachm 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 recom- mended. When it proceeds from an inflammation of the stomach, &c. it is very dangerous. In this case the cooling regimen ought to be strictly observed. The patient must be bled, and take frequently a few drops of the spirits of nitre in a cup of wine. His stomach should likewise be fomented with cloths dipped in warm water, or have blad- ders filled with warm milk aud water applied to it, When the hickup proceeds from a gaugrene or mortification, the Peruvian bark, Avith other antiseptics, are the only medicines which have a chance to succeed. When it is a primary disease, and pro- ceeds from a foul stomach, loaded either with a pituitous or a bilious humour, a gentle vomit and purge, if the patient be able to bear them, Avill be of service. If it arises from flatulencies, the carminitive medi- ciues 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 prin- cipal of these is musk; fifteen or twenty grains of which may be made into a bolus, and repeated occasionally. Opiates are likewise of ser- vice ; but they must be used with caution. A bit of sugar dipped in c (impound spirits of fovender, or the volatile aromatic tincture, may be taken frequently. External applications are sometimes also benefi- cial ; as the stomach plaster, or a cataplasm of the Venice treacle of 35 y% CRAMP OE THE STOMACH. the Edinburgh or Louden dispensatory, applied to the region of thj 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, opi- um, Avinc, and other cordial and antispasmodic medicines, but always returned. Nothing however gave the patient so much ease as brisk small beer. By drinking freely of this, the hickup was often kept off for several days, which was more than could be done by the most pow- erful medicines. The patient was at length seized Avith a vomiting of blood, which soon put an end to his life. Upon opening the body, a large schirrous tumour was found near the pylorus or right orifice of the stomach. The hickup may be removed by taking vinegar; or by a few drops of the oil of vitriol taken in water. CRAMP OF THE STOMACH. THIS disease often seizes people suddenly, is very dangerous, and requires immediate assistance. It is most incident to persons in the de- cline of life, especially the nervous, gouty, hysteric, and hypochon- driac. If the patient has any inclination to vomit, he ought to take some draughts of warm water, 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 way of adntinistering it is in a clyster. Sixty or seventy d-ops of liquid laudanum may be giv- en in a clyster of warm water. This is much more certaiu than lau- danum given by the mouth, which is often vomited, and in some cases iucreases the pain aud sjnsms in the stomach. If the pains and cramps return with great violence, after the effects of the anodyue clysters are over, another, with an equal or larger quantity of opium, may be given ; and every four or five hours a bo- lus, with ten or twelve grains of Musk, aud half a drachm of the Ven- ice treacle. In the mean time the stomach ought to be fomented with cloths dip- ped in warm water, or bladders filled with warm milk and water shouhl be applied to it. I have often seen these produce the most happy ef- fects. The anodyne balsam may also be rubbed ou the part affected; and an anti-hysteric plaster Ayorn upon it for some time after the cramps are removed, to prevent their return. Iu very violent and lasting p:tins of the stomach, some blood ou!' a whole school of young ladies in Holland, who were all cured by being told, that the first Avho was seized should be burnt to death. But tbi* me'hod of cure, to my knowledge, will not always succeed. J Avould therefore advise, that young ladies who are subject to hysteric fits should not be sent to boardfog schools, as tlie disease may be caught b> ia:it?ti' t. I have known madnc.-s itself brought on by sympathy. 29 306 OF HYPOCHONDRIAC AFFECTIONS. ac patients are subject. Castor has in some cases been found to pro- cure sleep where opium failed; for which reason, Dr. Whytt-advises, that they should be joined together. He likewise recommends theau- ti hysteric plaster to be applied to the abdomen.* Hysteric women are often afflicted with cramps, in various parts of the bod)-, which are most apt to seize them in bed, or when asleep. The most efficacious medicines in this case are opium, blistering- plasters, and warm bathing or fomentations. When the cramp or spasm is very violent, opium is the remedy most to be depended on. In milder eases, immersing the feet and legs in warm water, or apply. ing a blistering-plaster to the part affected, will often be s-uili. ieut to remove the complaint. In patients whose nerves are uiicoriuiruly delicate and sensible, it will be better to omit the blistering pi.>s,er, an t to attempt the cure by opiates, musk, camphire aud the warm bath. Cramps are often prevented or cured by compression. Thus cramps iu the legs are prevented, and sometimes removed, by tight bandages; and when convulsions arise from a flatulent distention of the intestines, or from spasms beginning in them, they ma)- be often lessened or cured by making a pretty strong compression upon the abdom'n by means of a broad belt. A roll of brimstone held in the hand is frequently used as a remedy for crampo Though litis seems to owe its effects chiefly to imagination, yet, as it sometimes sue-.-ceils, it merits a trial.f Wheu spasms or convulsive motions arise from shaip humours in the stomach or intestiues, no lasting relief can be procured till these are either corrected or expelled The Peruvian bark has sometimes cured periodic convulsions after other medicines had failed. OP HYPOCHONDRIAC AFFECTIONS. THIS disease generally attacks the indolent, the luxurious, the un- fortunate, and the studious. It becomes daily more common in this country, owing no doubt to the increase of luxury and sedentary em- ployments. It has so near a resemblance to the immediately preceding, that many authors consider them as the same disease, and treat them accordingly. They req lire however, a very different regimen; and the symptoms of the latter, though less violent, are more permanent than those of ihe former. * Though antispasmodics and anodynes are universally recommend- ed in this disease, yet all the extraordinary cures that I ever knew in hysteric cases, were performed by means of tonic and corroborating medicines. f Some persons afflicted with cramps pretend to reap great benefit from small bundles of rosemary tied all night about their feet, ancle-;, aad knees. OF HYPOCHONDRIAC AFFECTIONS. 30* Men of a melancholy temperament, whose minds are capable of great attention, aud whose passions are not easily moved, are in the advan- ced periods of life, most liable to this disease. It is usually brought on by long and serious attentiou to abstruse subjects, grief, the sup- pression of customary evacuations, excess of veuery, the repulsion of cutaneous eruptions, long continued evacuations, obstruction in some of the viscera, as the liver, spleen, &c Hypochondriac persons ought uever to fast long, and their food should be solid and nourishing. All ascesent 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 bt drank. Cheerfulness aud serenity of mind are by all means to be cultivated. Etercise of every kiud is useful. The cold ba'h is likeAvise benefi- ci-d; aud where ii does not agree with the patient, frictions witii vhe flesh-brush or a coa;se cloth m:iy be tried. II the patient has it iu his power, he ought to travel either by sea or bind. A voyage or a long journey, especially towards a warmer climate, will be of more service thau any medicine. The general iiitentiotis of cure in this disease, are to strengthen the alimentary canal, and to promote the secretions, f best intentions will be best answered by the different preparations of iron and the Peruvi- an bark, which, after proper evacuations, may be taken iu the same manner as directed in the preceding disease. If the patient be costive, it will be necessary to make use of some gentle opening mediciues, as pills competed of equal parts of aloes, rhubarb, and asafcetida, with as much ot die eiixii piopvieutis as is necessary to form the ingredients into pills. Two, tin ee. or tour of these may be taken as often as it shall be found needful, to keep the body gently open. Such as cannot bear the asafcetida, may substitute Span- ish soap in its place. Though a cheerful glass may have good effects in this disease, yet all manner of excess is hurtful. Inteuse study, and every thing that de- presses the spirits, are likewise pernicious. Though the geueral symptoms aud treatment of nervous disorders were pointed out id the beginning of this chapter, yet, for the benefit of the unhappy persons afflicted with those obstiucte and complicated maladies, I have treated several of their capital symptoms under dis- tinct or separate heads. These however are not to be considered as different diseases, but as various modifications ot" 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 mer- it particular attentiou, which the nature of my plan will not permit me to treat of at full length. I shall therefore omit them altogether, aud conclude this chapter with a few general remarks on the most obvious weans of preventing or avoiding nervous disorders 30ft OF HYPOCHONDRIAC AFFECTIONS. In all persons afflicted with nervous disorders, there is a great deli' •cacy. «:id sens'biliy of the whole nervous system, and an uncommon degree of •» eakness of the organs of digestion. These may be either na'urd or acquired. When owing to a defect in the constitution, they ar- hardly to be removed; list maybe mitigated by proper care. Whej induced by diseases, as long or repeated fevers, profuse haetnorr- hag. s or the like, they prove also very obstinate, aud will yield only to a course of regimen calculated to restore a.iH invigorate the habit. But nervous affections arise more frequently from causes, which it . is iu » great measure in our own power to avoid, than from diseases, or an original fault in the constitution, &c. Excessive grief, intense study, improper diet, and neglect of exercise, are the great sources of this extensive class of diseases. Ii. has b< en already observed., that grief indulged destroys the appe- tite and digestion, depresses the spirits, and induces an universal relax- ation and d entity of the whole system Instances of tills are daily to be 'een The loss of a near relation, or any other misfortune in life, is *f 1'n -nffioieat to occasion the most complicated series of nervous symptom . Such misfortunes indeed are not to be avoided, but surely their efrei^. by a vigorous and proper exertion of the mind, might be rendered iess kurtfjl. For directions in this matter, we must refer the reader to the nrticle Grief, in the chapter on the passions. The effects of intense study are pretty similar to those occasioned by grief. It preys upon the auirual spirits, and destroys the appetite and digestion. To prevent these effects, studious persons ought accor- ding to the Poet, to toy with their books* They should never study too long at a time; nor attend long to one particular subject, especial- ly if it be of a serious nature. They oHght likewise to be attentive to their posture, and should take care frequently to unbend their minds by music, diversions, or going into agreeable company. With regard to diet, 1 shall only observe, that nervous diseases may be induced either by excess or inanition. Both of these extremes huit digestion, and vitiate the humours. When nature is oppressed with fresh loads of food, before she has had time to digest and assimi- late the former meal, her powers are weakened, and the vessels are fil- led with crude humours. On the other hand, w hen the food is not suf- ficiently nourishing, or is taken too seldom, the bowels are inflated with wind, and the humours, for Avant 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 train of consequen- ces. But the most general cause of nervous disorders, is indolence—The active and laborious are seldom troubled with them. They are reser- * Armstrong on Health. Tetanus, or locked jak. 309 ^ed for the children of ease aud affluence, who generally feel their keenest force. All we sh.til say to such persons, is, that the means of prevention :.nd cure are both in their owu power. If the constitution of hum-iu nature be w:li, that man must either labour or suffer diseas ;s, surely no individual has any ri«;ht to expect an exemption from the general rule- Those however who are willing to take exercise, but whose occupa- tions coufuf .hem to the hor.se, and perhaps to an unfavourable post- ure, really deserve our pity. We have in a former part of the book, endeavoured to lay down rules for their conduct; and -hall only add, that where these cannot be complied widi, their place may, in some measure, be supplied by the use of bracing and strengthening medi- cine^ as the Peruvian bark, with other bitters; the preparations of •ted; the elixir of vitriol, Sic. OF THE TETANUS, OR THE LOCKED JAW. UNDER this term may be comprehended the spasmodic affections, «al! ;. emproslhotonos, opisthotonos, and trismus, being one disease, dif- fering o, iy in the degree of its violence. Wheu the body aud head are bete- id forwards, it is called empiosthotonos, when they are car- ric : Ore is. wards, and immovably fixed, it bears the appellation of opist- hotonos; aie.' when the body is sustained ia an erect position, by tine mu-cle ou the fore aod back part of the trunk acting with equal strength, the disea.-c is called tetanus.—When the muscles of the jaw become m re paitienlarly affected, it is called trismus, or the locked jaw. The ;e spasmodic complaints affect both sexes, aud :o age is exemp- ted from thrir violence. They affect the male oftener than the female, and more particularly those people who inhabit warm climate?, and ever) climate at the Avarm season of the year. Sometimes they occur in winter, independent of wounds. CAUSES.—Wounds in any part of the body are sometimes suc- ceeded by this disease. But more particularly from these in tendons, where a trifling injury will not unfrequently produce this complaint, - when it is least expected. Whereas, at other times, a Avound of con- siderable magnitude, under apparently similar circumstances, will have no such effect; and, even after operations in teudenous parts, it is by- no means a frequent occurrence; when at other times, a simple frac- ture of the leg will produce it in all its force. Cold, when accompa- nied with moisture, will produce this disease; particularly when tha body is exposed while asleep on a damp pavement, or in a damp cel- lar, immediately after being heated and fatigued by exercise. Chil- dren are frequently siezed with this disease in a short time after de- livery. SYMPTOMS.-—This disease, if it is from the effects of cold, gen- erally comes on of a sudden. But when from a wound, ft. gradually « 810 TETANUS, OR LOCKED JAW'. approaches about the tenth, fourteenth, or twentieth days after the ac- cident. It oficu comes 0:1 at a time when tne wound gives, bui little uneasiness, and is nearly healed. Tiie patient first complains of an uneasy sensation at die lower part of the breast bone, with .1 stiffness in the .lack p.irt of the neck au;l muscles of the lower jaw, wlfoh in-, crease with a painful sensation at the root of the tongue, aud a 'light difficulty i:) f-vdhwi:-.-: But mo appearance of swelling cau be ob- served i.i the throat. The iir.i. cles of the back now become rigid. This rigidi'y in a siort time ex'enis to those of the neck, attended with a pain in the direction of the spine of the back. At length the head. nerk. and back bovte are forcibly bent backwards. The body become-, fixed in that position. The muscles of the jaw are now vio- leii'i) affected, ait>.oZ d with an impossibility of swallow fog. b en liquids are ih own forcibly back through the nose. These .'-ympio;; s g Niera'!) take plate on the second or third day. a he-i the: body is ire- qu'.id) siezed wi'.l: vioeni ccrr/nlaive spawns; if. > the p mn hi die lower pat of the breastbone increase, wiiich riioots :iiiougii to* • hicIs the ba a. The muscles of the !::nb" now become rigid, and the body i? so mil' h best backwards as to rest c.i the bok: part -t (he head :uid heels. As the disease tvh'rvicos, the eonvu. iv." spasms bec.-me more violent. At length tetaiius h : -.-o.focod, ft'.m the nuisch-s on the fore and back part of the trunk, acting aith an "qital degree cf vigom, sus- taining the body in an erect position. Tie puis-., is goner-dry t(, q,;cnt wi;h the 0 her symptoms of fever particularly when the disease is the con-Cc'uence of cold. The bowels arege:i< rally costive, attended with a retraction of the belly. The urine is discharged with difficulty, and sometimes a suppression of that evacuation take" :iace.— The tace ap- pears p:tie, expies-ive of great anxiety and dis'r. ss The patient is seldom, if ever, delirious, nl'hough he slumbi-ss but liule, from AVhich be fre-quentl)' awakes on a sudden, with violent spasms. At length the muM-uhu-system becomes more generally affected, and one univer- sal convulsion closes the miserable exislan< <• of the patient. MKDICTNE.—In our attempt to cut-' i.W disease, the indications are nearly the same, when produced l.em cold or the consequence of a wound, except when the wound is wiltiout swelling and inflamma- tion It should then be dilated and dressed, vviih lint dipped in warm bssi'icon. or any other stimulating application. Afu.r this two, three, or even four grains of opium should be given thnc or four times a-day Recording to the urgency of the symptoms, and tendency to induce sic o; for astonishing qu-mtities of this medicine may be given with- out having the ieasi tendency lo mnkethe patient slumber. This reme- dy should be administered early, as well as large quantities of Madeira Avinp, before the swallowing becomes interrupted; and the s)stern KiicJd be charged with mercuiy with as much expedition as possible. for this purpose two or three drachms of mercurial ointment must be % DISORDERS OF THE SENSES. 311 rubbed info the inside of the legs, thighs and arms, morning and even- ni;»g, and likewise into the muscles more particularly aifected with spai-nis. To co operate with those mediciues. the cold bath must be u-ed, or cold water thro>vi o>rer the body. The bowels should be kept op -n with eafoi.itl, castor-oil, and clysters. All those remedies must be used at an early period of the complaint, so as to make as formida- ble au atuick asipotsible on this very formidable disease, which too frequently terminates in the death of the patient, in spite of every ef- fort to save him. When it is about to take place in infants, the bowels must be opened with calomel or castor oil. But where it has actually taken place, lit- tle can be done. However, a similar plan may be used with that re- commended in grown persons. * CHAPTER XLV. DISORDERS OF THE SENSES. WE do not mean to treat of the nature of our sensations, or to give a minute description of the various organs by which they are performed; but to point out some of the diseases to Avhich these organs are most liable, aud to show how they may be 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 which the diseases are more difficult to cure. Though more iguoraut persons pretend to cure these than any other class of diseases; yet a very superficial acquaintance with the structure of the eye, aud the nature of vision, will be sufficient to convince any one of the danger of trusting to them. These diseases often exceed the skill of the most learned physician; hence we may easily infer the danger of trusting them to ignorant quacks, who, Avithout doubt, put out more eyes than they cure. But, though the diseases of the eye can seldom be cured, they might often, by due care, be prevented; and, even where the sight is totally lost, many things might be done, which are generally neglected, to render the unhappy person both more useful to himself and society* * 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 iguorauce, 3*S OF THE EYE. The eyes are hurt by viewing bright or luminous objects; keeping the head toe long in a hanging posture: violent head-aches; excessive venery ; the long use of bitters; the effluvia from acrid or volatile sub- stances; various diseases; as tlie small pox, measles, X.c. but above all from night watohing, ami candle-light studies. Long fasting is likewise hurtful to the eyes, anel freqtient heats and colds are no less pernicious. The eyes are often hurt by the stoppage of customary evacuations; ns morning sweats; sweatiug of the feet, the menses in women; and the bleeding piles in men.—All kinds of excess are likewise hurtful to the wight, particularly the immoderate use of ardent spirits and other stiong liquors. In all diseases of the eyes, especially those attended with inflamma- tion, the cool regimen ought lobe obserVed. The patient must abstuia from all spirituous liquors. The smoke of tobacco, smoky roomb, the vapours of onions and garlic, and all vivid lights and gluing colours, are carefully to be avoided. The driuk may be water, whey, or small beer; and the alimeut must be light and of easy digestion. Eor 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 ol" the body. It will likewise be of use to keep the body gently open, and either to bleed or purge every spring and fall. All excess and night s;tidies are to be avoided. Such as do not choose a seton or au issue, will reap benefit from wearing a small Bur- gundy-pitch plaster between the shoulders. A gulta serena or amaurosis is an abolition of the sight without any apparent cause or fault in the eyes. When it is owing to a decay or wasting of the optic nerve, it does not admit of a cure; but when it proceeds from a compression of the nerves by redundant humours, these may in some measure be drained off, and the patient relieved. Eor this purpose, 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 hack part of the head, will like- wise be of use. A running at tire nose may be promoted by volatile f-dts, stimulating powders, Sic. But the most likely means for reliev- ing the patient are issues or blisters kept ©pen for a long time on the or to beg. This is both cruelty atid want of economy. There are many employments of which blind persons are very capable, as knit- ting, carding, turning a wheel, teaching languages, Sic. Nor are in- -tances wantiug of persons who have arrived at the highest pitch of learning, without having the feast idea of light. Witness the late fa- mous Nicholas Sanderson of Cambridge, and'my worthy friend Dr. Thomas lllackfock of Edinburgh. The former Avas one of the first mathematicians of his age, and the latter, besides being a good poet and philosopher, is master of ali the learned languages, and a very conside- rable adept iu the libera! «rts. SF THE EYE. 313 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 answer the purpose better, twelve grains of corro- sive 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 of the decoction of sarsaparilta after it. A cataract is an obstruction of the pupil, by the interposition of some opaque substauce which either diminishes or totally extinguishes the sight. It is generally an opacity of chrystalline humour. In a re- cent 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 resolved a recent cataract by giving the pa- tient frequent purges with calomel, keeping a poultice of fresh hem- lock constantly upon the eye and a perpetual blister on the neck.* 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 admit of no cure. The incon- veniences arising from them may however be, in some measure, reme- died by the help 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 exposed to the light. They may likewise acquire* it by imitation from a squinting nurse or play-fellow, &c. 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 ophthalmi- as. They are very difficult to cure, and often occasion total blindness. It 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 occasione 'by a stroke, a fall, retching, vomiting, violeut coughing, &c. I have frequently known it happen to * iiilhen 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 goc:- off without medicine. Should it prove obstinate, the patient may be bled, and have his eyes fomented with a decoction of cumphry * In both these cases electricity merits a trial, 40 314 OF THE EAR. roots and elder flowers. A soft poultice may be applied to the eyei; and the body should be kept open by gentle purgative::. The watery or weeping eye is generally occasioned by a relaxation or weakness of the glandular parts of that organ. These may be bra- ced and strengthened by bathing the eye with brandy and water, Hun- gary-water, rose water, with Avhite vitriol dissolved in it, &c. Medi- cines which make a revulsion are likewise proper; as mild purgatives, perpetual blisters ou the neck, bathing the feet frequently iu luke-warm Arater, &c. Wheu this disease proceeds from an obstruction of the lachrymal duct, or natural passage of the tears, it is called ajistula lachrymalis, aud 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 ex- cessive noise; violent colds in the head; fevers; hard wax, or other substances 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 in the decline of life. Sometimes it is owing to au original fault in the structure or formation of the ear it- self. 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 * A weeping or watery eye is often the mark of a scrophulous habit. t Though those who have the misfortune to be born deaf are gener- ally suffered to continue dumb, aud consequently are in a great meas- ure lost to society, yet npthihg is more certaiu thau that such persons may be taught not only to read aud write, but also to speak and to un- derstand what others say to them. Teaching the dumb to speak will appear paradoxical to those who do not consider that the formation of sounds is merely mechanical, and may be taught without the assistance of the ear. This is not only capable of demonstration, but it is actual- ly reduced to practice by the ingenious Mr. Thomas Braid wood of Edinburgh. This gentleman has, by the mere force of genius aud ap- plication, brought the teaching of dumb persons to such a degree of perfection, that his scholars are generally more forward in their edu- cation thau thoseof the same age who enjoy all their faculties. They uot only read anil write with the utmost readiness, but likewise speak, and are capable of holding conversation with any person in the light. What a pity any of the human species should remain in a state of idi- otism, who arc capable of being rendered as useful and intelligent as others! We mention this not only from humanity to those who have ihe misfortune to be born deaf, but also in justice to Mr. Braid wood, ffhose success has far exceeded all forui?r attempts his Avay; and OF THE EAR. 315 When deafness is I lie effect of wounds or ulcers of the ears, 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, especially iu the night; he should likewise take some gentle purges, and keep his feet warm, and bathe them frequently in lukewarm 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 opodeldoch, or tincture of asafcetida, may be mixed together, and a few drops of it put iuto the ear every nigfit at bed-time, stopping them afterwards Avith a little wool or cotton. Some instead of oil, put a small slice of the fat of bacou into each ear, which is said to answer the purpose very well. When the ears abound with moisture, it may be draiued offby 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 wine, to be dropped into the ear ; others equal parts of Hungary-water, and spirit of lavender. Etmuller extols amber aud musk; and Brookes says, he has often known hardness of hearing cured, by putting a graiu or two of musk iuto 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 require a very delicate touch. For this reason what we would chiefly recom- mend in deafness, is, to keep the head warm. From whatever cause the disorder proceeds, this is always 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.f iudeed it exceeds imagination itself so far, that no person who has not seen aud examined his pupils, can believe what they are capable of.— As this gentleman, however willing, is only able to teach a few, and as the far greater part of those who are born deaf cannot afford to attend him, it would be an act of great humanity, 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 sal ammoniac in water would produce the same effect. f An obstinate deafness has been cured by electricity. 316 OF THE TASTE AND SMELt OF THE TASTE AND SMELL. THOUGH these senses are not of so great importance toman in £ state of society, as the sight and hearing; yet, as the loss of them ia attended-wit!i some inconveniency they deserve our notice. They are »eldom to be restored when lost; which Ought to make us very at- tentive to their preservation, by carefully avoiding whatever may in the least prove injurious to them. As there ia a very great affinity betweeu the oigans of tasting aud smelling, whatever 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 with any degree of nicety. Man, in a state of nature, may perhaps have these faculties as acute as any other animal. Theseuse of smelling may be diminished or destroyed by diseases; as, the moisture, dryness, inflammation or suppuration of that mem- brane which lines the inside of the nose, commonly called the olfactory membrane; the compression of the nerves which supply this mem- brane, or some fault in the brain itself at their origin. A defect or too great a degree of solidity, of the small spungy bones of the upper jaw, the caverns of the. forehead, &c. may likewise impair the sense of smell- ing. It may also be injured by a collection of foetid matter in those caverns, which keeps constantly exhaling from them. Few things are more hurtful to the sense of smelling, than taking great quantities of snuff. When the hose 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 with fine flour; camphire dissolved in oil of almonds, &c. The vapours of amber; frankin- cense, gum mastic, and benjamin, may likewise be received into the nose and mouth. For moisteninjr the mucus when it is too dry, some recommend snuff made of the leaves of marjoram, mixed with the oil of amber, marjoram and aniseed; or a sternutatory of calcined white vitriol; twelve grains of which may be mixed with two ounces of marjoram-water, and filtrated. The steam or vapour of vinegar upon, hot iron rectived up the nostrils is likewise of use for softening the mucus, opening obstructions, &c. If there is au ulcer in the nose, it ought to be dressed with some emollient ointment, to which if the pain be very great, a little lauda- num may be added. If it be a venereal ulcer, it is not to be cured without mercury. In that case, the solution 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 areceived up the nostrils. OF THE TOUCH. 317 If there be reason to suspect that the nerves which supply the organs ef smelling are inert, or want stimulating, volatile salts, strong snuffs, and other things which occasion sneezing, may be applied to the nose. The forehead may likewise be annointed with balsam ol Peru, to which may be added a little of the oil of amber. The taste may be diminished by crusts, filth, mucus, aphthae, pelicle^ warts, &c. covering the tongue; it may be depraved by a fault of the saliva, which being discharged into the mouth, gives the same sensa- tions as if the food which the person takes had read) a bad tayte; or it m;.y be entirely destroyed by injuries done to the nerves of the tongue and palate. Pew things prove more hurtful either to the sense of tast- ing or smelling than obstinate colds, especially those Avhich affect the- head. When the taste is diminished by filth, mucus, &c the tongue ought to be scraped and frequently washed with a mixture of water, vinegar, and honey or some other detergent. When the saliva is vitiated, which seldom happens unless iu fevers or other diseases, the curing of the dis- order is the cure of this symptom. To relieve it however iu the mean time, the following things may be of use; if there be a bitter taste, it may be taken away by vomits, purges, and other things which evacuate bile. What is called a nidorous taste, arising from putrid humours, ia corrected by the juice of citrons, oranges, and other acids. A salt taste is cured by plentiful dilution with watery liquors. An acid taste is destroyed by absorbents, and alkaliue salts, as powder of oyster- shells, salt of wormwood, &c. When the sensibility of the nerves which supply the organs of taste is diminished, the chewing of horse-radish, or other stimulating sub- stance, 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 or- gans of touching; as pressure, extreme cold, &c. It may likewise be hurt by too great a degree of sensibility, when the nerve is not sufficient- ly covered 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 gteueral 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 sys- tem, may be used. For this purpose, the spirit of hartshorn, sal vota- tile oleosum, horse-radish, &c. may be taken inwardly; the disordered parts, at the same time, be frequently rubbed with fresh nettles or spi- 31& OF A SCIRRHUS AND CANCER. lit of sal ammoniac. Blistering plasters and sinapisms applied to the parts will likewise be of use, as also warm bathing, especially in the natural hot ball's. CHAPTER XLVI. OF A SCIRRHUS AND CANCER. \ SCIRRHUS is a hard indolent tumour usually seated in some _l\_ of the glands; as the breasts, the arm-pits, Sic. If the tumour becomes large, unequal, of a livid, blackish, or leaden colour, aud is attended with violent pain, it gets the name of an occult cancer. When the skin -s broken, and a sanies or ichorous matter of an abomi- nable foetid smell is discharged from the sore, it is called an open or ulcerated cancer. Persons after the age of forty-five, particularly v. omen, and those who lead an indolent sedentary life, are most subject to this disease. CAUSES.—This disease is often owing 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 nnfortunate, the choleric, and those persons who devote themselves to a religious life in convents or monasteries, are often afflicted with it. It may aftr> be occasioned by the long continued use of food that is too haul of digesiioti, or of an acrid nature; by barrenness; indolence; celibacy; cold; blows; friction; pressure; or the like. Women of- ten suffer from the last cf these by means of their stays/which squeeze and compress their breasts so as to occasion «;rcat mischief. Sometimes the disease is owing to an hereditary disposition. SYMPTOMS.—This disorder seems often very trifling at the be- ginning. A hard tumour about the size, of a hazle-nut, or perhaps smaller, is generally the first symptom. This will often continue for a k'ii;r li.ne nil.out scemins: to increase or giving the patient great uu- CAsforss; 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 robts or limbs. It thenigets the name of cancer, from a fancied resemblance between dicsa limbs a.id the daws of a crab. The colour of the skin begins to ch in*.", which is first red, afterwards purple, then bluish, livid, and at last black. The patient complains of heat, with a burning, gnawing, shooting p»iu The tumour is very hard, rough, and unequal, with* OF A SCIRRHUS AND CANCER. 31 § protuberance or rising iuthe middle; its size increases daily, and the neighbouring veins become thick, knotty, and of a blockish colour. The skin at length gives way, and a thin sharp ichor begins to flow which corrodes the neighbouring parts till it forms a large unsightly ulcer More occult cancers arise, and communicate with the neigh- bouring glands. The pain aod stench beconie intolerable; the appe- tite fails; the strength is exhausted by a continual hectic fever; at last a violent haemorrhage, or discharge of blood, from some part of the body, with fointings, or convulsion fits, generally put an end to the miserable patient's life. REGIMEN.—The diet ought to be light, but nourishing.—All strong liquors, and high seasoned or salted provisions, are to be avoid- ed. The patient may take as much exercise as he can easily bear; and should use every method to divert thought, and amuse his fancy. All kinds of external injury are carefully to be guarded against, par- ticularly of the affected part, Avhich 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 fof those diseases for which no certain remedy is yet known. Its progress however may sometimes be retard- ed, and some of its most disagreeable symptoms mitigated, by proper applications. One misfortune attending the disease is, that the unhap- py patient 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 certain height, it generally sets all medicine at defiance. Wrhen 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 Avith a little of the mercurial ointment, aud kept Avarm with fur or flannel. The food must be light and a pint of the decoction of woods or sarsaparilla may be drank doily. I have sometimes discussed hard tumours, Avhich had the appearance 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 beltei'. It can answer no pur- pose to extirpate a cancer after the constitution is ruined, or the whole mass of humours are corrupted by it. This, however, is the common way, Avhich makes the operation so seldom succeed. Few people will submit to the extirpation till death stares them in the face; whereas, if it Avere done early, the patient's life Avould 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 uot submit to the operation, such medicines as will mitigate #r relieve the most urgent symptoms, may be used. Dr. Home says, 320 OF A SCIRRHUS AND CANCER. that half a grain of the corrosive sublimate of mercury, dissolved in a proper quantity of brandy, and taken night and morning, will often be of service in cancer of the face and nose He likewise recommends an infusion of me solanum or night shade, in cancers of the breasts. But the medicine most iu repute at present for this disease is hem- lock. Dr S ork, pbysfeian at Vienna, has of late recommended the extract of this plant ;e very efficacious in cancers of every kind. The Doctor says, he has-given some hundred weights of it without ever hurting anyr bodv, and often with manifest advantage. He advises the patient however to begin with very small doses, as two or three grains, and to increase the dose gradually fill some gooel effect be perceived, and there to rest without further increase—From two or three grains at first, the Doctor s lys he hns increased the dose to two, three, or four drachms a-day, and finds that such doses may be continued for several weeks without any bad consequences. The regimen which the Doctor recommends during the use of the medicine^ is to avoid farinaceous substances not fermented, and too acrid aromatics. He says, good wine will not be hurtful to those Avho 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 larjje doses without any apparent benefit; nevertheless the patient 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 Ave are far from thiuking he hemlock merits those extravagant enco- miums which the Doctor has bestowed 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 manner. Dr. Nicholson of Berwick, says, he gradually increased the dose of the powder from a few grains to half a drachm, a.id g^ve near four drachms of it in the day with remarkably good effects. The hemlock may also be used externally either as a poultice or fometita. tion. The sore may likewise be kept cleau 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 ueglected. The best application for this purpose seems to be the car- rot 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 cataplasm. This must be*applied to the sore, aud renewed twice a day. It generally cleans the sore, eases the pain, and takef OF A SCIRRHUS AND CANCER. 321 away the disagreeable smell, which are objects of no small importance in such a dreadful disorder.* Wort, or an infusion of malt, has been recommended not only as a proper drink, but as a powerful medicine in this disease. It must be frequently 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 hab- it, which must always be a work of time. Setons or issues in the neigh- bourhood of the cancer have sometimes good effects.f 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 ease the patienYs agony, and render life more tolerable while it continues. To avoid this dreadful disorder, people ought to use wholesome food; to take sufficient exercise in the open air; to be as easy and cheerful as possible; and carefully to guard against all blows, bruises, a.id every kind of pressure upon the breasts, or other glandular parts.:}; v Londou Medical Essays. | In a cancer which had set all medicines, and even surgery, at de- fiance, I lately saw remarkable effects from an obstinate perseverance in a course of antiseptics. I ordered the deep ulcers to be washed to the bottom by means of a syringe, twice or thrice a-day, either with an infusion of die bark, or a decoction 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 wash- ed, were likewise sprinkled with the same powder. When the patient began this course, her deatfewas daily expected. She continued 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, a°d died iu a few weeks. This course Avas not expected to cure the cancer, but to prolong the patient's life, which it evidently did almost to a miracle. \ A9 hemlock is the principal medicine recommended in this disease, Are Avould have given some directions for the gathering and preparing of that plant; but as its different preparations are% now kept in the shops, Ave think it much safer for people to get them there, with prop- .'•• directions for using them. 41 &2* OF POISONS. CHAPTER XLVII. OF POISONS. ETERT person ought, in some measure, to be acquainted with the nature and cure of poisons. They are generally taken una- wares, and their effects are often so sudden and violent, as not to admit of delay, or allow time to procure the assistance of physicians. Hap- pily indeed no great degree of medical knowledge is here necessary ; the remedies for most poisons being generally at hand, or easily obtain- ed, and nothing but common prudence needful iu the application of them • The vulgar notion that every poison is cured by some counter poi- son, 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 discharg- ing 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 shows plakily what ouglit to be done. Indeed common sense dictates to every one, that, if any thing has been taken into the stomach which endangers life, it ought immedi- ately to be discharged. Were this, duly regarded, the danger arising from poisons might generally be avoided. The method of prevention is obvious, and the means are in the hanrls of every one. We shall not take up the reader's time Avith a detail of the ridic- ulous notionswhich have prevailed among ignorant people in dinerent ages with regard to poisons; neither sliali we mention the boasted anti- dotes Avhich have been recommended either for preventing or obvi- ating their effects; but shall content ourselves with pointing out the poisons mrst common in tljis country, and the means of avoiding their dangerous consequences. Poisons either belong to the mineral, the vegetable, or the animal kingdom. Mineral poisons are commonly of an acrid or corrosive quality; as arsenic, cobalt, the conosive sublimate of mercury, Sic. Those of the vegetable kind are generally of a narcotic or stupcT factive quality; as poppy, hemlock, henbane, berries of the deadly nightshade, Sic. Poisonous animals communicate their infection either by the bite or sting. This poison is very different from the former, at id only produ,- pes its effects when received into the body by a wound. OF POISONS. 32ri MINERAL POISONS.—Arsenic is the most common of this class; and, as the whole of them are pretty similar both iu their effects aud method of cure, what is said with respect to it will be applicable to every other species of corrosive poison. When a person has taken arsenic, he soon perceives a burning heat, and a violent pricking pain in his stomach and bowels, with an intoler- able thirst, and an inclination to vomit. The tongue and throat feel rough and dry ; and, if proper means be not soon administered, the patient is seized with great anxiety, hickuping, huntings, and coldness of the extremities. To these succeed black vomits, foetid stools, with a mortification of the stomach and intestines, which are the immediate forerunners of death. On the first appearance of these symptoms the patient should driuk large quantities of new milk and salad oil till he vomits; or he may drink warm water mixed with oil. Fat broths are likewise proper, provided they can be got ready in time. Where no oil is to be had fresh butter may be melted aud mixed with the milk or water. These things are to be drauk as long as the inclination to vomit con- tinues. Some have drauk eight or teu English quarts before the vom- iting ceased; and it.is never safe to leave off drinking while one par- ticle of the poison remains in the stomach. These oily or fat substances not only provoke vomiting, but likewise blunt the acrimony of the poison, and prevents its wounding 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 cf the oxymel, or vinegar of squills may be mixed with the water which he drinks. Vomiting may likewise be excited by tickling the inside of the 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 tormentiug pains are felt in the lower belly, and there is reason to fear that the poison has got down to the intestines, clysters of milk and oil must be very frequently thrown up; and the patient must drink emollient decoctions of barley, oat-meal, marsh-mallows, and such like. He must likewise take an infusion of senna and manna, a solution of Glauber's salts, or some other purgative. 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 abstain from flesh and all strong liquors, and to live upon milk, broth, gruel, light puddings, and other spoon-meats of easy digestion. His drink should be barley-water, linseed-tea, or infusions of any of the wild mucilaginous vegetables. VEGETABLE POISONS, besides heat and pain of the stomach, commonly occasion some degree of giddiness, and often a kind of stu- pidity or folly. Persons who have taken these poisons mast be treated ■*n the same manner as for the mineral or corrosive. 324 DISEASES OF WOMEN. Though the vegetable poisons, when allowed to remain in the stoi,> ach, often prov'e fatal, yet the danger is generally over as soou as tliey are discharged. Not being of .-in h a caustic or corrosive nature, they are less apt to wound or inflame the bowels than the mineral substances; no time, however, ought to be lost in having them discharged. Opium, oefog frequently taken by mistake, merits particular atten- tion, it is used as a medicine both in a solid and liquid form, vvhicfi latter commonly goes by the name of laudauum. It is indeed a valua- ble medicine when taken in proper quantity; but as an over dose proves a sircrig poison, we shall point out its common effects, together with the method of cure. Ah over-dose of opium generally occasions great drowsiness, with stupor aud other apoplectic symptoms. Sometimes the person has so great an inclination to sleep, that it is almost impossible to keep him awake. Every method must however be tried for this purpose. He should be tossed, shaked aud moved about. Sharp blistering-plasters should be applied to his legs or arms, and stimulating medicines, as salts of hartshorn, Sic. held under lis 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 of strong vomits, drinking plenty of warm Avater with oil, Sic " Mead, besides vomits, in this case, recommends acid medicines with lixivial salts. He says, that he has often given salt of Worm-wood mix- ed with juice of lemon in repeated doses with great success. If the body should remain weak and languid after the poison has been extracted, nourishing diet and cordials will be proper; but when there is reason to fear that the stomach or bowels are inflamed, the greatest circumspection is necessary both tvith regard to food andi medicine. CHAPTER XLVIII. DISEASES OF WOMEN. WOMEN in all civilized nations, have the management of domes'-* tic 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 eirried.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 'he fresh aud ruddy looks of a milkmaid, with the pale complexion Of OF THE MENSTRUAL DISCHARGE, 325 those females whose whole time is spent within doors. Though IN ;■.- turc has made an evident distinction between the male and legale with regard to bodily strength and vigour, yet she certainly never mean!, either that the one should be always without, or the other ahvays with- in doors. The confinement of females, besides hurting their figure aud com- plexion, relaxes their solids, Areakens their minds, and disorders all the functions of the body. Hence proceed obstructions, indigestion, flat- ulence, abortions, and the whole train of nervous disorders. These not only unfit women for 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 wanting, the former is rarely to be found. I have always observed that women Avho were chiefly employed without doors, in the different branches of husbandry, gardening and Ifte like, were almost as hardy as their husbands, and that their chil- dren were likewise healthy. But as the bad effects of confinement and inactivity upon both sexes have been already shown, we shall proceed to point out those circumstances in the structure and design of females, which subject them to peculiar diseases; the chief of which are their monthly evacuations, pregnancy aud child bearing. These indeed cannot properly be called diseases, but, from the delicacy of the sex, and their being often improperly managed in such situations, they be- some the source of numerous calamities. OF THE MENSTRUAL DISCHARGE. FEMALES generally begin to menstruate about the age of fifteen, ■md leave it off about fifty, Avhich renders these two periods the most critical of their lives. About the first appearance of this discharge,^ the constitution undergoes a very considerable change, generally in- deed for the better, though sometimes for the worse. The greatest care is now necessary, as the future health and happiness of the female depends in a great measure upon her conduct at 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 manage- ment of themselves at this critical period of their lives. False modes- ty, 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 matron might have prevented. Nor is care less necessary in the subsequent returns of this discharge. Taking improper food, violent affections of the mind, or catching cold at this period, is often sufficient to ruin the health, or to render the fe- Wtale ever after mcapableOl procreation. 326 OF THE MENSTRUAL DISCHARGE. If a girl about this time of life be confined to the house, kept con- stantly sitting, and nei'he.r allowed to romp ;«bout, nor employed in any active business, Avbicn give* exerci-o to the Whole body, she become* weak, relaxed, and puny; her blood not being duly prepared, she looks pale and wa:i ; her health, spirits, aud vigour decline, and she rinks into a valetudinarian foi life. Such is the fate of numbers of those unhappy female*, who either fioui too much indulgence, or their «,wn u-utow circum-i-ii^cs-, are, at this crficai period, deni-'l the benefit of exercise aud free iiir. A lazy indolent dispo^'fon proves likewise very hurtful to girl? at C'i« period. Onesekiom m< "ts with compUmts from obstructions among the more active and mdusirious part of the sex; whereas the indolent aud lazy are sel-lo:. U-ee from them. These are in a manner eaten up by the chlorosis, v <:rce.-t icivms?, and other diseases of this na- ture. We wOuld therefore recommend it to all who wish to escape these calamities, to avoid indolence aod inactivity, ;ib lb -«r greatest enemies, and to be as much abroad in the open ai'- a? possibfo. A 'other thing which proves v ;y hurlfui to {.iris about this period of life, is imwholesome food Fond of -ill manner of irarii, they often indulge! in it, till their whole humours are quite vitiated. Hence en- sue indigestions, want of appetite, and a numerous train of evils. If the fluids be not duly prepared, it is utterly impossible that the secre- tions should go property on. Accordingly Ave find that such girls as lead au indolent life, and eat great quantities of trash, are not oujy sub- ject to obstructions of the menses, but likewise to glandular obstruct- ions; as the scrophufo. or king's evil, &c. A dull disposition is al»o very hurtful to girls at this period. It is a rare thing to see a sprigh'ly girl who does uot enjoy good health, while the grave, moping, uiela icholy creature, proves the very prey of vapours and hysterics. Youth is the season for mirth and cheerful- ness. Let it therefore be indulged. It is au absolute duty. To lay in a stock of health in time of youth, is as necessary a piece of pru- dence, as to make provision agabist the decays of old age.—While therefore, wise Nature prompts the happy youth to join in sprightly amusements, let not the severe dictates of hoary age forbid the useful impulse, nor damp, Avith serious gloom, the season destined to mirth and innocent festivity. Another thing very hurtful to females about this period of life, is straight clothes. They are fond of a fine shape, and foolishly imagine that this can be acquired by lacing themselves tight.—Hence, by squee- zing the stomach and bowels, they hurt the digestion, and occasion many incurable maladies. This error h? not indeed so common as it has been ; but. as fashions cha:ige, it may come about again : we there- fore think it uot improper to mention it. I know many females, who, to this day, feel the direful effects of that wretched custom which pre- vailed some years ago, of squeezing every girl iuto as small a size ia OF THE MENSTRUAL DISCHARGE. Ihe middle as possible. Human invention could not possibly have de- vised a pi icuce more destructive to health After a fem.de has arrived at that period of life when the menses usually begin to flow, and they do not appear, but, on me f^JJ* her health and ,pi.its begin to declfoe, we would advise, instead of shutting the poor girl up in the houre, and dosing her with steel, asalcB, tida, and other nauseous drugs, tc place her in a situation wnere she can enjoy the bencfu of fresh air and agreeable company. 1 here let her eat wholesome fori, take biiificieut exercise, and amuse herself iq the most agreeable manner ; and we have little reason to fear, but Ha- ture .mis .^sistco will do her proper work,—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 L.-..-1 ib, approach; as a sense of heat, weight, and dull pau. in the loins; distention and hardness of the breasts; head-ache ;lo,s of appe- tite; lasritude; paleness of the countenance; and sometimes a slight degree ot fever. When these symptoms appear about the age at which the menstrual flux usually begins, everything 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, &c. ' After the menses have once begun to flow, the greatest careshould be taken to avoid every thing that may tend to obstruct them. Females ought to be exceeding cautious of what they eat or drink at the time they are out of order! Every thing that is cold, or apt to sour on the stomach, ought to be avoided; as fruit, butter-milk, aud suchlike. 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 disa- gree with individuals at this time, we would recommend it to every female to be very attentive to what disagrees with herself, and care fully to avoid it. . __ f , ' Cold is extremely hurtful at this particular period More ot the sex date their diseases from colds, caught while they are ought of or- der, than from all other causes. This ought surely to put them upon the r guard, and to make them very circumspect in their conduct a such times. A degree of cold that will not in the least hurt ihem «t another time, will at this period be sufficient entirely to rum their he Jtb ^ThTgrea^t attention ought likewise tote pdd to the mine! which should be kept as easy aud cheerful as possible^ Every padof\he.an- imal economy is influenced by the passions, but none ™re £ ™J this. Anger, fear, grief, and other affections of me mind of. n occasion obstructions of the menstrual flux, which prove absolute y incurabe From whatever cause this flux is obstructed, except in the state ol pregnancy, proper means should be used to restore it. For tln» pur- 528 OF THE MENSTRUAL DISCHARGE. pose we would recommend sufficient exercise in a dry, open, and rati*. er cool air ; wholesome diet, and. if the -body be weak aud languid, generous liquors ; also cheerful company aud all manuer of amusements. If these fail recourse must be had to medicine. When obstructions proceed from a weak relaxed state of the solids, bucIi medicines as tend to promote digestion, to brace the solidn, and assist the body in preparing good blood, ought to be used. The principle of these are irou aud the Peruvian bark, with other bitter aud astringent 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 iu the dose of half a drachm, mixed with a little honey or treacle, three or four times a-day. The bark and otherJsitters may either be taken in substance or infusion, as is most agreeable to the patieut. When obstructions proceed from a viscid state of the blood ; or from women of a gross or full habit, evacuatious, and such medicines as at- tenuate the humours are necessary. The patient in this case ought to be bled, to bathe her feet frequently in warm water, to take now aud 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 die tincture of black hellebore may also be taken twice a-day iu a cup of warm water. When obstructions proceed from affections of the mind, as grief, fear, anger, &c. every method should be taken to amuse and divert the patient. And that she may the more readily forget the cause of her affliction, she ought, if possible, to be removed from the place where it happened. A phange of place, by presenting the mind with a variety of new objects, has often a very happy iuflueuce in relieving it from the deepest distress. A soothing, kind, and affable behaviour to females in this situation, is also of the first importance- An obstruction of the memes is often the effect of other maladies. When this is the case, instead of giving medicines to force that discharge, Avhich might be dangerous, we ought by all means to endeavour to re- store the patient's health and strength. When that is effected, the other will return of course. But the menstrual flux may be too great as we il as too small. When this happens, the patient becomes weak, the colour pale, the appetite and digestion are bad, and edematous 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. If may proceed from a sedentary life; a full diet, consisting chiefly of salted, hii-'i-seasoned, or acrid food, the use of .-.pirituous liquors; ex- cessive fatigue; relaxation; a dissolved state of the blood ; violent passions of the mind, Sic, OF THE MENSTRUAL DISCHARGE. 320 The treatment of this diseass must be varied according to its cause. When it is occasioned by any error in the patient's regimen, an oppo- site course to that which induced the disorder must be pursued, and such medicines taken as have a tendency to restrain the flux, and coun- teract the mnrbid affections of the system from whence it proceeds. To restrain the flux, the patient should be kept quiet and easy both lu body and mind. If it be very violent, she ought to lie in bed, with her head low; 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, stionger astringents may be used, as Japan earth, alum, elixir of vitriol, the Peruvian bark, Sic* The uterine flux may offend in quality as well as in quantity. What is usually called the flour albus, or whites, is a very common disease, and proves extremely hurtful to delicate women. This dis- charge, 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 appetite, 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 weak and watery diet. To remove this disease, the patient must take as much exercise as phe can bear without fatigue. Her food should be solid and nourish- ing, but of easy diges'ton; and her drink rather generous, as red port or claret mixed with Pyrmont, Bristol, or lime-water. Tea and cof- fee are to be avoided. I have often known strong broths have an ex- ceeding 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, Ave know none preferable to the Peruvian bark, which in tint- case ought always to be taken in substance. Iu warm weather the cold bath will be of considerable service. That period of life at which the menses cease to flow, is likewise very critic al to the sex. The stoppage of any customary evacuation, how- ever small, is sufficient to disorder the Avhole frame, and often to des- troy life itself. Hence it comes to pass, that so many women either 'i------------------------------------------------------------------------------------------■*" ——— * 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- Fpoonsful of the tincture of roses three or four limes 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 poAvder, with ten drops of the elixir of vitriol may be taken in a glass of red jrioe, four times a-day. 42 a?« OF PREGNANCY. fall into chronic disorders, or die about this time.—Such of them, how:- cvvr, as survive it, without contracting any chronic disease, often be- come more healthy and hardy than they were before, aud enjoy strength and vigour to a very great age. If the mensi* 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, aud to ke?p the boely open. This may be done by taking, once or twice a-wcek, a little rhubarb, or au infusion of hiera picra in wine or branely. It often happens that women of a gross habit, at this period of life, have ulcerous sores break out about their ancles, or iu other parts of the body. Such ulcers ought to'be considered as critical, and should either be suffered to coutinue open, or have artificial drains substituted in their stead. Women who will have such sores dried up, are often soon after canied 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 at- tended with a variety of complaints which merit attentiou, and which sometimes require the assistance of medicine. Some women 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, and are frequently indisposed during the whole time of pregnancy. Few fatal diseases, however, happen during that period; and hardly any except abortion, that can be called dangerous. We shall there- fore pay particular attention to it, as it proves generally fatal to the child, ami sometimes to the mother. Pregnant Avonien are often afflicted with the heart-burn.—The meth- od of treating this complaint has been already pointed out. They are likewise, in the more early periods of pregnancy, often harrassed with sickness aad vomiting, especially iu the morning. The method of re- lieving these complaints has also been shown. Both the head ache and toothache are very troublesome symptoms of pregnancy. The for- mer may generally be removed by keeping the boely gently open, by the use of prunes, figs, roasted apples, anel such like. When the pain is very violent, bleeding may be necessary. For the treatment of the latter, we must refer to that article. Several other complaints incident to pregnant women might be mentioned, as a cough aud difficulty of breathing, suppression and incontinency of urine, &c. but as all of these have been taken notice of before, it is needless to repeat them. Every pregnant woman is more or feas in danger of abortion- This should be gu rd'jd against with the greatest care, as it uot only Aveak- ens the constitution, but renders the woman liable to the same raisfor OF PREGNANCY. 331 Ktne afterwards.* Abortion may happen at any period of pregnancy, but it is most common iu the second or third mouth.—Sometimes, how- ever, it happens in the fourth or fifth. It'it happens within the first month it is usually called a false conception; if after the seventh month, the child may often be kept alive by proper care. The common causes of abortion are, the eleath of the child; Aveak- 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 bel- ly; falls; fevers; disagreeable smells; excess of blood; indolence; high living, or the contrary ; violent passions or affections of the mind, as fear, grief, &c. TH signs of approaching abortion are, pain in the loins, or about the bottom of the belly; a dull heavy pain iu the insiele of the thigh; a slight degree of coldness, or shivering; sickness, palpitation of the heart; the breasts become flat and soft; the belly foils; and there is a discharge of blood or watery humours from the ivomb. To prevent abortion, Ave would advise women of a weak or relaxed habit to use solid food, avoiding great quantities of tea, and other weak and 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 nature, consist- ing principally of vegetable substances. Every woman with child ought to be kept cheerful and easy iu her mind. Her appetites, eveu though depraved, ought to be indulged as far as prudence will permit. When any signs of abortion appear, the woman ought to be laid ia bed on a mattress, with her head low. She should be kept qui- et, and her mind, soothed and comfortid. 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. Ifshe be able to bear it, she should lose at least half a pound of blood from the arm. Her drink ought to be bailey water sharpened with juice of lemon; or she m.iy take half a drachm of powdered * Every mother avIio procures au abortion does it at the hazard of her life; yet there are not a few who run this risk merely to prevent the trouble of bearing and bringing up children. It is surely a most unnatural crime, aud cannot, even in the most abandoned, be viewed Avithout horror; but in the decent matron, it is still more unpardonable. Those Avretches who daily advertise their assistance to women in this business, deserve, in my opiuion, the most severe^of all human punh!.« -meots. 332 01? CHILD-BIRTH. nitre, in a cup of water-gruel, every five or six hours. If the womaft fie seized with a violent looseness, siie ought to drink the decoction of calci. d hartshorn prepared. If she be affected with vomiting, let her take freq ie itiy two table spoousful .»f the saline mixture. In general, opia.^ u. of service; bui they shed .1 always be given with caution. Sanguine robust women, who are liable to miscarry at a certain time of prcguancy, ought always to be bled a few days before .that pe- riod arrives. By this means, aud observing the regimen afeve pre- scribed, they might often escape that misfortune. Though we recommend due care for preventing ab©rtion, we would not be uifoerstood as restraining pregnant women from their usual exer- cises. This would generally operate a quite contrary way. Want of exercise uot only relaxes the body, but induces a plethora, or too great a fulness of the vessels, Avhich are the two principal causes of abortion. There are, however, some women of so delicate a texture, that it is necessary 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 necessa* ry precautions in this state. This is peculiarly the case with young wives. They think, when the labour-pains are ended, the danger is over; but in truth it may only then be said to be begun. Nature, if left to herself, Avill seldom fail to expel ihefeetus; but proper care aud management are certainly necessary for the recovery of the mother. No doubt mischief may be done by too much as well as by too little caie. Hence females who have the greatest number of attendants in child-bed generally recover worst. But this is not peculiar to the state of child-bed. Excessive care always defeats its own intention, and is genera;ly more dangerous than none at all.* * 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 till they are reduced to the necessity of doing it for bread. Hence not one in an hundred of them have any education, or proper know ledge ef their business. It is true, that Nature, if left to herself, will generally expel the foetus; but it is equally tree, that most women in child bed require to be managed with skill and atten- tion, and that they are often hurt by the superstitious prejudices of ig- norant and officious midwives. The mischief done in this way is much greater than U generally imagined ; most of which might be prevented by allowing no Avoman to practice midwifery, but tuch as are properly qualified. Were due attention paid to this, it would uot only be the OF CHILD-BIRTH. 333 inuring actual labour, nothing of a heating nature ought to be given. The woman may now arid then take a little panada, and her driuk ought to be toast and water, or thin groat gruel. Spirits, wiues, cordi- al waters, aud other things which are giveu with a view to strengthen the mother, and promote the birth, for the most part, tend only to in- * crease 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 be administered; and the patient should sit over the steams of warm water. The passage ought to be gently rubbed with a little soft pomatum or fresh butter, and cloths wrung out of v arm water applied over the belly. Jf nature seems to sink, and the woman is great- ly exhausted with fatigue, a draught of generous wine, or some other cordial, mcy be given, but not otherwise. These directions are suffi- cient i:i natural labours; and in all preternatural cases, a skilful sur- geon, or man-midwife, ouglit to be called as soon as possible. After delivery, the woman ought to be kept as quiet and easy as pocs tile.* Her food shouhl be light and thin, as gruel, panada, &c. and her drink weak and diluting. To this rule, however, there are many exceptions i have known several women, whose spirits could not be supported in child-bed without solid food and generous liquors; to such, a glass of wiue and a bit of chicken must be allowed. Sometimes an excessive haemorrhage or flooding happens after de- livery. In this case the patient should belaid with her head low, kept cool, and be in all respects treated as for an excessive flux of the menses. If the flooding proves violent, linen cloths, which have been wrung out of a mixture of equal parts of viuegar anil water, or red wine, should be applied to the belly, the loins, and the thighs : these must be changed as they grow dry; and may be discontinued as soon as the flooding abates.f means of saving many lives, but would prevent the necessity of em- ploying men in this indelicate and disagreeable branch of medicine, which is, on many other accounts, more proper for the other sex. * We cannot help taking notice of that ridiculous custom which still prevails in some parts of the country, of collecting a number of women together upon such occasions. These, instead of being useful, serve Only to crowd die house, and obstruct the necessary attendants. Be- sides they hurt the patient with their noise: and often, by their un- timely and impertinent advice, do much mischief. t In a violent flooding after delivery, 1 have seen very good effects from the folloAving mixture : Take of penny-royal water, simple cinna- mon-water, and syrup of poppies, each two ounces, elixir of vitriol a drachm. Mix, aod take two table-spoonsful every two hours, or oftetf- fcr, if necessary. OF CHILD-BIRTH. If there l"> violent pai rafter delivery, the patient ought to difok pleutifu'ly of warm diluting liquors, as gnul. or tea with a little saf- fron in it; and to take srn ill broths with carrawav-seeds, or a bit of an orange peel ia them ; an ounce of the oil of sweet almonds may like- wise be frequently taken in a cup of any of the above liquors; auel if the p.itient b> restfe.-s, a spoonful of the syrup of poppies, may now and then be mixed with a cup of her drink. If she be hot or fever- ish, one of the foil :u ing powefers may be taken iu a cup of her usual dri'ik every five or six hours.J Au inflammation of the woi.ib is a d ::igerous and not unfrequent dis- ease after eldiv.TV. It is known by'pains in the lower part of" the bel- ly, which are greatly increased upon touching ; by the tendon or tight- ness of the par's; great weakness; c!i v.v*e of countenance; a constant fever, with a weak and harel puhe: a blight ddirium or raving; some- times incesfant vomiting; a hickup ; a discharge of reddish, stinking, sharp water from the womb; au inclina^foci to go frequently to stool; a heat, and sometimes totd suppression of urine. This must be treated like other inflammatory disorders, by bleeding and plentiful diluti.m. The driuk may be Ihin gruel or barley-water; in a cup of wHvch half a drachm of nitre may be dissolved, and taken three or four times a-day. Clysters of warm miik and water must be frequently administered; aud the belly should be fomented by cloths wrung out of warm water, or by applying bladders filled with warm milk and water to it. A suppression of the lochia or usual discharge s 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- tiful dilution, gentle evacuations, and fomentations of the parts affected. In the milk fever, the breasts may be embrocated with a little Avarm linseed-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 uot allowing children to suck for the first two or three days, is contrary to Nature, and com- mon sense, aud is very hurtful both to the mother and child. Every mother who has milk in her breasts, ought either to suckle tier own child, or to have her breasts frequently drawn, at least for the | Take of crabs' claws prepared half an ounce, purified nitre two drachms, saffron powelered half a drachm; rub them together in a mor- Mr, and divide the whole into eight or nine dotes. When the patient is tow spirited, or troubled with hysterical com- phinis, she ought to take frequently twelve or fifteen drops of the tinct* vie of p^fu ,: la in r. cup of penny-royal tea. OF CHILD-BIRTH. 33* first month. This would prevent many of the diseases which prove fatal to women in child bed. When an inflammation happgns in the breast, attended with redness, hardness, and .oth..r symptoms of suppuration, the safest application is a f j'tice of bread auel milk, softened with oil or fresh butter. This, may be renewed Urict. a day, tiill the tumour b^ either discussed or bio :ght to sfippur.itioi'.. The use of repellents, in this case, is very da.'gorous; they often occasion fevers,anil sometimes cancers; where- as u suj'piuitiotj is seldom amended with any danger, and has often the rno^t s.tiuary effec's. When the nipples are fretted or ch-ipt, they may be anointed with a mixture of oil and bees wax, or a little powdered gum arabic may be sprinkled on thera. I h.ive seen Hur-gary water applied to the nipples have a very good effect. Should the complaint prove obstinate, a pooling purge may be given, which generally removes it. The- miliary fever, is a elisease 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 ob eives, that this fever of child bed women might generally be prevented, if they, during their pregnancy, Avere regular in their diet, used moderate exercise, took now and then a gen- tle laxative of manna, rhubarb, or cream of tartar; not forgetting to bleed in the first month*, and to avoid all sharp air. When the labour is coming <>u, it is uot to be hastened with forcing medicines, which in- flame the blood and humours, or put them into unnatural commotions. Care should be taken after the birth, that the natural excretions pro- ceed regularly; and if the pulse be quick, a little nitrous poAvder, or some other cooling medicines, should be administered. The most fatal disorder consequent upon delivery is the puerperal, or child-bed fever. It generally nukes 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 stomach, 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 patieut is frequently troubled with a tenes- mus, or constant 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, and becomes sus- ceptible of pain from the slightest touch. When the fever has contin- ued for a few days, the symptoms of inflammation usually subside, and the disease acquires a more putrid form. At this period, if not soon- £36 OF CHILD-BIRTH. er, a bilious or putrid looseness* of an obstinate and dangerous nature, comes on, aod accompanies the disease through all its mture progress. There is not any disease that requires to be treated witii nure skill and attention than this; consequently the best assistance midit to be obtained as soon as possible. In women of plethoric cotijiitutions, bleeding will generally be proper at the beginning ; it ought however to be used with caution, and noi to be repeated unless wliere the signs of inflammation rise high; in which case it wiii also be necessary to apply a blistering plaster to the region of the womb. During the rigour, or cold fit, proper means should be used to abate its violence and shorten its duration. For this purpose the p.iife.g; may drink frcly of warm diluting liquors, and, if low, may take now and then a cup of Wme-whey; warm applications to the extremities, as heated bricks, bottles or bladders filled with warm water, and sach like, may also be used with advantage. Emollient clysters of milkfand 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 intestines, and also by acting as a kindly fomentation to the womb ami parts adjacent. Great care however is requisite in giving thera, on account of the ten- derness of the parts in the pelvis at this time* To evacuate the offending bile from the stomach, a vomit is gener- ally given. But as this is apt to increase the irritability of the stom- ach, already too great, it will be safer to omit it, and to give in its stead a gentle laxative, which will both tend to cool the body, and to procure a free discharge of the bile.* The medicine which I have always found to succeed best in this. disease, is the saline draught. This, if frequently repeated, will 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 weaken 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 arabie has been dissolved. Should these fail, recourse must be had to Co- lumbo-root, or some other strong astringent. Though in general the food ought to be light, and the drink diluting, yet when the disease has been long protracted, aod the patient is great- * Mid wives ought to be very cautious in administering vomits or purges to women in childbed. I have known a woman who Avas re-; covering extremely well, thrown into the most imminent danger by a strong purge which was given her by au officious midwife. OF BARRENNESS. 33f ly spent by evacuations, it will be necessary to support her with nour- ishing diet and generous cordials. It was observed that this fever, after continuing for some time, often acquires a putrid form. In this case the Peruvian bark must be giv- en, either by itself, or joined with cordials, as circumstances may re- quire. As the bark in substance will be apt to purge, it may be given iu 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 spirituous cinnamon-water, two ounces of common water, and ten drops of laudanum, may be made into a draught, aud given every second, third, or fourth hour, as shall be found necessary. When the stomach will not bear any kind of nourishment, the pa- tient may be supported for some time by clysters of beaf-tea, or chick- en water. To avoid this fever, every woman in child-bed ought to be kept perfectly easy; her food should be light and simple, aud 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 not 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 becom- ing acrid, and its being absorbed iu 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 conclude our observations on child-bed women by recom- mending it to them, above all things, to beware of cold.—Poor women, Avhose circumstances oblige them to quit their bed too soon, often con- tract diseases 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 Avomen run the greatest hazard from too much heat. They* are generally kept in a sort of bagnio for the first eight or ten days, and then dressed out to see company. The danger of this conduct must be obvious to every one. The superstitious custom of obliging women to keep the house till they go to church, is likewise a very common cause of catching cold. All churches are damp, and most of them cold; consequently they are the very worst places to which a woman can go to mak*e her first visit, after having been confined in a Avarm room for a month. i OF BARRENNESS. BARRENNESS may be very properly reckoned among the dis- masts v\ females, as few married women who have not children enjoy a, 43 338 OF BARRENNESS. good state of health. It may proceed from various causes, as higb living, grief, relaxation, &c. but it is chiefly owing to an obstruction or irregularity of the menstrual flux. It is very certain that high living vitiates the humours, and prevents fecundity. We seldom find a barren woman among the labouring poor, while nothing is more common among the rich and affluent. The in- habitants of every countiy are prolific in 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 aud vegetable diet, have conceived and brought forth children, though they never had auy 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 vassals and dependants, the blessing of a numerous and healthy offspring, while they pine in sorrow for the want of even a sin gle heir to their extensive domains. Affluence begets indolence, which uot only vitiates the humours, but induces a general relaxation of the solids; a slate highly unfavoura- ble to procreation. To remove this, we would recommend the follow- ing course; First, sufficient exercise in the open air; secondly, a diet consisting chiefly of milk and vegetables; * thirdly, the use of astrin- gent meelicines, as steel, alum, dragon's blood, elixir of vitriol, and the Spaw or Tuubridge waters, Peruvian bark, Sic.; 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 the mind the per- son ought to be kept as easy and cheerful as possible; all elisagreeable objects are to be avoided, and every method taken to amuse and en- tertain the fancy. * Dr. Cheyne avers, that want of children is oftener the foujt of the male than of the female, and strongly recommends a milk and vegeta- ble d.et to the former as well as the lattei ; adding, that t^s friend Dr. Taylor whom he calls the Milk-doctor of Croydon, had brought sun- dry opulent families in his neighbourhood, who had continued some years after marriage without progeny, to have seATcral fine children, by keeping both parents for a considerable time, to a milk and vegeta- ble diet. 1 DISEASES OF CHILDREN. 339 CHAPTER XLIX. DISEASES OF CHILDREN. MISERABLE indeed is the lot of man in the state of infancy! He comes into the world more helpless thau any other animal, and stands much longer in need of the protection and care of his pa- rents; but, alas! this care is not always bestowed upon him; and wtten it is, he often suffers as much from improper management as he would have done from neglect. Hence the officious care of parents, nurses, and midwives, becomes one of the most fruitful sources of the disorders of infants.* It must be obvious to every attentive person, that the hist diseases of children arise chiefly from their bowels. Noi ib mis in the least to be wondered at, as they are in a manner poisoned with indigestible dru«s and improper diet as soon as they come into the world. Every thing that the stomacii cannot digest nay be considered as a po.sou; and unless it cau be thrown up, or voided by siool, it must occasion sickness, gripes, spasmodic affections of the bowels, or what the good women call inward fits, and at last convulrious and death. As these symptoms evidently arise from somewhat that irritates the intestines, doubtless the proper method of cure must be to expel it as soon as possible. The most safe and effectual method of doing this u by gentle vomits. Five or six grains of the poweler ot ipecacuanha may be mixed in two table-spoonsful of water, and sweetened with a little *u"ar. A tea-spoonful of this may be given to the in.aut every quarter of an hour till it operates; or, what will more certainly answer the purpose, a grain of emetic tartar may be dissolved in three ounces of water, sweetened with a little syrup; and given as above. Those who are willing to use the emetic tartar, may give six or seven drops * Of the officious and ill judged care of midwives, we shall adduce only one instance, viz the common practice ot torturing infante, by squeezing their breasts, to draw off the milk, as they call it. Though a small quantity of moisture is generally found m the breasts of infants, vet, as they are certainly uot intended to give suck, this ought uever to be draw., off. I have seen this cruel operation bring on hardness inflammation and suppuration of the ^st; but never knew any ill consequences from its being omitted. When the breasts are hard, the only application that we Avould recommend, is a soft pouUice, or a lit- tle of the 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. 340 OF THE MEtdNlVM. of the antimonial wine, in a tea-spoonful of water or thin gruel. Small doses of the ipecacuanha vrine will be found more gentle than any of the above, aud ough' to be preferred. These medicines will not only cleanse the stomach, but will general- ly likewise open the body. Should this however not happen, aud if the child be costive, some gentle purge will be uecessaiy : for this pur- pose, some manua aud pulp of cassia may be dissolved in boiling wa- ter, and giveu in small quantities till it operates; or, what will answer rather better, a few grains of magnesia alba may be mixed in any kind of food that is given to the child, and continued till it has the de- sired effect. If these mediciues be properly administered, and the child's belly aud limbs frequently rubbed with a warm hand before the fire, they will seldom fail to relieve those affections of the stomacii and boweli from which infants suffer so much. These general directions include most of what can be done for re- lieving the internal disorders of infants. They will likewise go a con- siderable way in alleviating those which appear externally, as the rash, gum, orfdlon, Sic These, 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, ami will seldom, if administered with 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 blackish coloured matter of the consistence of syrup, commonly called the meconium This is generally passed soon after the birth, by the mere effort of nature; in which case it is not necessary to give the in- fant any ki id of medicine But if it should be retained, or not suffi- ciently carried off, a little manna or magnesia alba may be given as mentioned above; or, if these should not be at baud, a common spoon- ful of whey, sweetened with a little honey, or raw sugar, will answer the purpose. The most proper medicine for expelling the meconium is the mo- ther's milk, which is always at first of a purgative quality. Were children allowed to suck as soon as they shoAv au inclination for the breast, they would seldom have occasion for medicines to discharge the meconium ; but even Avhere this is not allowed, they cught never to have daubs of syrup, oil, and other indigestible stuff, crammed down their throats. THE APHTHJE, OR THRUSH. THE aphthae are little whitish ulcers affecting the whole inside of 4he mouth, tongue, throat, and stomach of infants. Sometimes they OF ACIDITIES. 311 teach through the whole intestinal canal; in which case they are very dangerous, and often put au end to the infant's life. If the aphthae are of a pale colour, pellucid, few in number, soft, superficial, and fall easily off, they are not dangerous; but if opake, yellow, brown, black, thick, or running together, they ought 10 be dreaded. It is generally thought that the aphthae owe their origin to acid hu- mours ; we have reasou however to believe, that they are more fre- quently owing to too hot a regimen both of the mother and child. It is a rare thing to find a child who is not dosed with wine, punch, cin- namon-waters, or some other hot and inflaming liquors, almost as soon as it is born. It is well known that these will occasion inflammatory disorders even in adults; is it any wonder then that they should heat and inflame the tender bodies of infants, aud set as it were the whole constitution in a blaze ? The most proper medicines for the aphtha? are vomits, such as have: been already recommended, and gentle laxatives. Five grams of rhubarb, anel 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 may be repeated as often as is found uecessaiy to keep the body open. It is common in this case to administer calomel; but as that medicine sometimes occasious gripes, it ought always to be given to infants with caution. Many things have been recommended for gargling the mouth and throat in this disease ; but it is not easy to apply these in very young children; we 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 au ounce, borax a drachm, burnt alum half a drachm, rose water two drachms; mix them together. A very proper application in this case, is a solution of ten or twelve grains of white vitriol in dght ounces of barley-water. These may be applied with the finger, or by means of a bit cf soft rag tied to the 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 Avay disordered. Hence most diseases of children are accompanied with evident signs of acidity, as green stools, gripes, &c. These ap- pearances have induced many to believe, that all the diseases of chil- dren were owing to an acid abounding in the stomach and bowels ; but whoever considers the matter attentively, will find that these symptoms of acidity are oftener the effect than the cause of their dis- eases. 542 GALLING AND EXCORIA TION. Nature evidently intended that the food of children should be aces» cent; ami unless the body be disordered or the digestion hurt, from some other cause, we will venture to say, that the acescent q iality of their food is seldom injurious to them Acidi'y, ho.vever, is often a symptom of disorelers in chiliiren, aud. as v is some limes a troublesome one, we shall pokit out the method of relieving it. Wheu gree;i stools, gripes, purging* sour smells. Sic show that the bowel- abound with ;s deemed not unworthy attentio a—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 to prove of importance to the health and ease of the Europeans in India ; and will tend to the extirpation of that cruel malady, the uinc.avorm ; and the remedy is as simple as it is effica- cious. It consists in nothing more than a frequent embrocation, or friction of the parts where the eruption prevails, with common mush- y?oin keiS'urt. This remedy, sin pie as it appears, has nevTer been 44 SA& OF ERUPTIONS. The most obstinate of all the eruptions incident to children, are h.s tinea capitis, or scabbed head, unci chilblains. The scabbed head is often exceeding difficult to cure, and sometimes indeed the cure prove* worse than the disease. I have frequently kuowu children seized with internal disorders, of which they died soon after their scabbed heads had been healed by the application of drying mediciues.* The cute ought always first to be attempted by keeping the head very clean, cutting off the hair, combing and brushing away the scabs, Sic. If this is not sufficient, let the head be shav ed once a week, washed daily with soap suds, and gently anointed with a liniment made of train 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 sprinkled Avith a little burnt alum. While these things are doing, the patient must be confineel 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, especially 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. known to fail in removing the ring-worm, itch, or any other cutaneous eruption, niter 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 so- lution or essence of this fungus is proved, by this discovery, to bear such enmity to the minute insect which is the occult cause of this dis- order, that it immediately perforates the cuticle, and totally extirmi- nates the infection. The experiment is easy, and a trial is recom- mended to those afflicted with ring-worms, tettcrSj or eruptions of any kind." ' a. it. * I sometime ago saw a very striking instance of the clanger of sub- stituting drying medicines in the place of cleanliness and wholesome food, iu the Foundling Hospital at Ackworth, where the children were grievously afflicted with scabbed heads, and other cutaneous disorders. Upon inquiry it was found, that very little attention was paid either to the propriety or soundness of their provisions, aoel that cleanliness was totally neglected; accordingly it was advised, that they shouhl have more wholesome food, and be kept thoroughly clean.—This advice, however, was not followed. It was too troublesome to the servants, su- perinteudants, &c. The business was to be done by medicine ; which was accordingly attempted, but had nearly proved fatal to the whole house. Fevers, and other internal disordeis immediately appeared, and at length a putrid dysentery, which proveel so infectious, that it carried off a great many of the children, and spread over a consider- able part of the neighbouring country. OF THE CROUP, OR HIVES. 34? fcliHblains commonly attack children in cold weather. They are generally occasioned by the feet or hands being kept long wet or cold, aid afterwards sueldenly heated. When children are cold, instead of taking exercise to warm themselves gradually, they run to the fire. This occasions a sudden rarefaction of the humours, and an infraction of the vessels; which being often repeated, the vessels are at last over- distended, and forced to give way. To prevent it, violent cold and sudden heat must be equally avoid- ed. When the parts begin to look red and swell, the patient ought to be purged, auel to have the affected parts frequently rubbed Avith mus- tard and brandy, or something of a warming nature. They ought like- wise to be covered with flannel, and kept warm and dry. some apply warm ashes between cloths, to the swelled parts, which frequently help to reduce them. When there is a sore, it must be dressed with Tur- ner's cerate, the ointment of tutty, the plaster of cerus, or some other drying oiutment. These sores are indeed troublesome, but seldom dan- gerous. They generally heal as soon as the warm weather sets iu. OF THE CROUP, OR HIVES. CHILDREN are often seized very suddenly with this disease, which, if not quickly relieved, proves mortal. It is known by various names in different parts of Britain. On the east coast of Scotland it is called the croup. On the west 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, aud in America, the hives. It seems to be a species of asthma attended with very acute aud violent catarrhal symptoms. This disease generally prevails in cold and wet seasons. It is most common upon the sea-coast, and iu low marshy countries.—Children of a gross and lax habit are most liable to it. I have sometimes knowu it hereditary. It generally attacks children in the night, after having been much exposed to damp cold easterly Avinds through the clay. Damp houses, wet feet, thin shoes, wet clothes, or any thing that ob- structs the perspiration, may occasion the croup. It is attended with a frequent pulse, quick and laborious breathing, which is performed with a peculiar kind of croaking noise, that may be heard at a considerable distance. The voice is sharp and shrill, and the face is geuerally much flushed, though sometimes it is of a liv- id colour. When a child is seized with the above symptoms, his feet should be immediately put into warm water. He ought likewise to be bled,* and to have a laxative clyster administered as soon as possible. He should * In this disease bleeding is not always proper; but in very full halt- its it certainly must be of use. 343 OF THE CROUP, OR HIVES. be made to breathe over the steams of warm water and vinegar; or ar« emollient decoction, and emollient cataplasms or fomentations may be applied round his neck. lithe symptoms do not abate, a blisteriog- plastermust be applied round the ueck, or between the shoulders, and the chilel ma) take frequently a table spoonful of the following julep : Take peouy-royal water three ounces, syrup of althca aud of poppies, each one ounce, mix them together. Asafcetida is found to have a good effect iu this 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 Miudercrus' spirit, and three ounces of penny royal water. A table spoonful of this mixture may be given* every hour, or ofteuer, 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.* To prevent a return of the disorder, all those things which occasion it must carefully be avoided; as wet feet, cold, damp, easterly winds, &c. Children who have hael frequent returns of this disease, or whose constitutions seem to dispose them to it, ought to have their diet prop- erly regulated; all food that is viscid or hard of digestion, aud 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 plas- ter, worn continually between the shoulders for several years, have a very happy effect in preventing the return of this dreadful disorder. * I Avas lately favoured with a letter from Dr. William Turnbull iu London, a physician of great experience, aud who, fiom his former sit- uation on the northeast coast of England, hael 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 Doc- tor's sentiments differ very little from my own, this misfortune is the less to be regretted. The Doctor indeeel 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, va- lerian root, salt of hartshorn, and musk, adapted to the age. strength, <&c, of die patient; after which he advises two spoonsful of the follow- ing decoction: Take of 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 the whole •be simmered over a gentle fire, and aftemardr- strained, for use. OF TEETHING. :M9 OF TEETHING. Dr. Arbuthnot observes, that above a tenli part of infants die in teething, by symptoms proceeding from the irritation of the tender ner- vous parts of the jaws, occasioning inflammations, fevers, convulsions, gangrenes, Sic These symptoms are in a great measure owing to the great delicacy and exquisite sensibility of the nervous system at this time of life, which is too often increased by an effenv>iate education. Hence it comes to pass, that children who are delicately brought up, always suffer most iu teething, and often tall by convulsive disorders. About the sixth or seventh momh the teeth geuerally begin to make their appearance ; first, the incisorcs, or fore-teeth ; next, the canini, or dog-teeth ; and lastly, the molares, or grinders. About the seventh year, there comes a new set; and about the twentieth, the two inner grinders, called dentes sapicntcc, the teeth of wisdom. Children about the time of cutting their teeth, slaver much, and have generally a looseness. When the teething is difficult, especial- ly when the dog-teeth begin to make their Avay through the gums, the child has startings in his sleep, tumours of the gums, watchings, gripes, green stools, the thrush, fever, difficult breathing and convul- sions. Difficult teething requires nearly the same treatment as an inflam- matory disease. If the body be bound, it must be opened either by emollient 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 limetree flowers; to which about a third or fourth part of milk may be added. If the fever be high, bleeding will be necessary; but this in very young children ought always to be sparingly performed. It is an evac- uation which they bear the worst of any. Purging, vomiting, or sweat- ing, agree much better with them, and are generally more beneficial- Harris, however, observes, that when an inflammation appears, the physician will labour in Vain, if the cure be not begun with applying a leech under each ear. If the child be seized with convulsion fits, a blistering-plaster may be applied between the shoulders, or one behind each ear. Sydenham says, that in fevers occasioned by teething, he never found any remedy so effectual 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 often prescribed this medicine with success, but always found a laiger dose necessary. It may be given from five drops to fifteen or twenty, according to the age of the child, and when costive- ness does not forbid it, three or four drops of laudanum may be added 10 each dose. 350 OF THE RICKETS. In Scotland, it is very common, ivhen children are culling their teelrt* to put a small Burgundy pitch plaster between their shoulelers. Thii generally eases the tickling cough which attends teething, aid is by no means au useless application. When the teeth are cut Avith difficulty, it ought to be kept on luring the whole time of teething. It may be enlarged as occasion requires, and ought to be renewed at least once a fortnight. Several thirds have been recommended for rubbing the gums, as oils, mucilages, &c. but from these, much is not to be expected. If any thing of this kind is to be teed, we would recommend a little fine honey, which may be rubbed on with the finger three or four times a-di). Children are generally at this time elisposed to chew whatever they get into their hands. For this reason they ought never to be without somewhat that will yield a little to the pressure of their gum*, as a crust of bread, a wax candle, a bit of liquorice-root, or such like. With regard to cutting the gums, we have selelom known it of any great benefit. In obalfouie cases, however, ;i ought to be rieel. 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 intro- duced into the mouth; but a lancet, iu a skilful hand, 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 whdesome, and that their nerves be braced by sufficient exercise without doors, the use of the cold bath, &c. Were these things duly regarded, they would have a much better effect than teething necklaces, or other nonsensical amu- l«ts Avorn for that purpose. OF THE RICKETS. THIS disease generally attacks children between the age of nine snonths 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 which 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, who neglect exercise, and live upon weak wa- tery diet, can neither be expected to bring forth strong and healthy child- ren, or to be able to nurse them after the> are brought forth. Accord- ingly we find, that the children of such women generally die of the rickets, the scrophula, consumptions, or such like diseases. Children begotten by men in the decline of life, who are subject to the gout, the gravel or other chronic disease, or who have been often afflicted with the venereal disease in the.ir youth, are likewise very liable to tht rickets. OF THE RICKETS. 3o4 Any disorder that Avcakens the constitution, or relaxes the habit of children, as thri small-pox, measles, teething, the hooping-cough, Sic. disposes them to this disease It may likewise be occasioneel by im- proper eliet, as food that is either too weak auel watery, or so viscid that ihc stomach cannot eligest it. Bad nursing ia the chid" cause of this disease. When the nurse is either di-eased, or has uot enough of milk to nourish the child, it cau- uot thrive. But children suffer oftener by want of care in nurses than want ol" fooel. Allowing an infant to lie or sit too much, or not keeping it thoroughly clean in its clothe;', has the most pernicious effects. The want of free air is likewise very hurtful to children in this res- pect. When a nurse lives in a close small house, where the air is damp and ctidi.K el, and b- too iuelolent 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 auel flabby ; its strength is diminished ; it loses its Avonted cheerfuluess, looks more grave and composed than is natural for its age, and does not choose to be moved. The head and belly become too large, in proportion to the other parts; the face appears full, and the complexion florid. Afterwards the bones begin to be affected, especially in the more soft and spungy parts. Hence the wrists ami ancles become thicker than usual; the spine or back-bone puts ou an unnatural shape; the breast is likewise ofteu deformed; and the bones of the arms and legs groAv crooked. All these symp- toms vary according to the violence of the disease. The pulse is gene- rally quick, but feeble; the appetite and digestion for the most part bail; the tee'.h come slowly and with difficulty, and they often rot and fall out afterwards. Rickety children generally have great acuteness of mind, aid an understanding above their years. Whether this is ow- ing to their being more in the company of adults than other children, or to the preternatural enlargement of the brain, is not material. REGIMEN.—As this elisease is always atteuded with evident signs of weakness and relaxation, our chid" aim in the cure must be to brace and strengthen the solids; and to promote digestion and the due preparation of the fluid.-.. These important ends will be best answered by wholesome r> mrishing diet, suited to the age and strength of the pa- tient, open dry air, and sufficient exercise. If the child has a bad nurse, who eitlier 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 sweat- ing is apt to we.d-: en it, and too great a degree of cold has the same ef- fect. The limbs should be rubbed frequently with a warm hand, and ihe child kept as cheerful as possible. 352 OF CONVULSIONS. The diet ought to be dry and nourishing, as good bread, roasied flesh, any part where this would be inconvenient, the vinegar may be ap- 46 *ftS OF BURNS AND SCALDS. plied by means of linnen rags dipped in it. In slight injuries, the vitj. egar, if early and assiduously applied, will of itself soon effect a cure; but should any degree of pain return, the immersiou or fomentation must be repeated. In recent burns or scalds, attended with large blisters, excoriations, or loss of subt-tauce, the vinegar ought to be applied till the; pain near- ly ceases, which generally happens within eight hours. Many practi- tioners recommend spirits of turpentine instead of vinegar; or lime-wa- ter and linseed oil. The vinegar need not be employed longer than twelve hours, except on the outside of the sores, which, while they continue to be swelled or inflamed, should be fomented for a minute or two before they are dressed. For dressing the sores which arise from burns or scalds, one of the best applications is a poultice of bread, water, and sweet oil, This shouhl be removed in six hours, when the sores are to be covered with chalk finely powdered, till it has absorbed the matter, aud appears quite dry. A fresh poultice must be laid over the whole, which, 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 ce- rate thickly spread, may be used as a substitute iu 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 contain be pressed out with a linnen cloth, that the vinegar may act more closely upon the burnt flesh, which in this case it does effica- ciously. In severe cases, and in cold weather, the vinegar shouhl bo nearly blooel-Avarm. If the patient will not suffer the vinegar to be applied immediately to the surface, on account of the pain it excites, a linnen rag soaked in sweet oil may be previously laid on the part, covering the whole with cloths dipped in vinegar; and these applications are to be occasionally repeated till the pain anel inflammation be entirely removeel; after which the parts should be dressed, or, if the burning be very deep, with a mixture of that and yellow basilicum. When the burn or scald is violent, or has produced a high degree of inflammation, so that there is reason to be apprehensive of a gan- grene, the same method of cure becomes necessary as in other violent inflammations. The patient, iu this case, must be put upon a low diet, and drink plentifully of weak diluting liquors. He must likewise be bled, and his body be kept open. But if the burnt parts should be- come livid or black, with other symptoms of mortification, it will be necessary to apply to them camphorated spirits of wine, tincture of myrrh, and other antiseptics or correctors of putrefaction, mixed with a decoction of the Peruvian bark. In this case, the bark must like OF BURNS AND SCALDS. 363 wise be taken internally; the patient at the same time using a more generous diet, with wine, spiceries, Sic, When burns are occasioned by (he explosion of gun powder, some of the grains of the powder are apt to be forced into the skin. At first they proeluce much irritation; and, if they be not removed, they com- monly leave marks which ren.-ain during life. They should therefore be picked out as soon as possible after the accident; and to prevent inflammation, as well as to dissolve any powder which may remain, the parts 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 artifi- cers employed in any business exposing workmen to very bad scalds. This is allowed to be an excellent remedy. But, as the soap would take some time in dissolving, aud the solution some time in cooling, Dr. Underwood recommends a mixture of six ouuces of oil to ten of water, with two drachms of the ley of kali, or pot-ash. This quanti- ty may be sufficient for a burn on the band or foot, which is to be im- mersed, aud kept about half an hour in the liquor, which will remove the injury, if recourse to it immediately be had; but must be repeat- ed, as the pain may require, if the scald or burn be of s«me 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 prac- tice. A middle-aged man, of a good constitution, fell into a large ves- sel full of boiling water, and miserably scalded about one half of his body. As his clothes were on, the burning in some parts Avas 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 water and oil, which is a very proper application for recent burnings. On the third day, when I first saw him, his fever was high, and his body costive, for which he was bled, and had an emollient clyster adminis- tered. Poultices of bread and milk, softened with fresh butter, were likewise applied to the affected parts, to abate the heat aud inflamma- tion. 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 administered once a-day. WThen the inflammation began to abate, the parts were dressed with a digestive composed of brown cerate aud yellow basilicutn. Where any black spots appeared, they were slightly scarified, and touched with the tincture of myrrh, and to prevent their spreading, the Peru- vian bark was administered. By this course, the man Avas so well in three weeks as to be able to attend to his business. The most useful application, we are told, with which 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, allowing them to remain until the whole of the salt is liquified; which S6M OF BRUISES. must be then drained off, and kept in bottles, properly labelled, ready for immediate use. OF BRUISES. BRUISE3 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 anv elefinition of a disease so universally known; we shall therefore proceed to point out the method of treating it. In slight bruise? it will be sufficient to bathe the part with warm vin- egar, to which a liitle brandy or rum may occasionally be added, and to keep cloths wet with this mixture constantly applied to it. This is more propei than ru'-bi-ig it with brandy, spirits of wine, or other ar- dent spirits, which are commonly Used in such cases. Iu some puis of the country the peasants apply to a recent bruise a catapla.-m of fresh cow dung. I have often seen this cataplasm appli- Cel to viol, nt contusions occasioned by blows, falls, bruises, and such like, and never knew it foil 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 dri >k weak and of au opening nature : as whey sweeten- ed with honey, decoctions of tamarind?, barley, cream-tartar whey, anel such like. The bruised part must be bathed with vinegar anel wa er, as directed above ; and a poultice made by boiling crumbs of bread, elder flowers, and camomile flowers, in equal quantities of vinegar and water applied to it. This poultice is peculiarly proper when a wound is joined to the 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 of en ensues a great loss of substance, Avhich produces an ulcerous sore very difficult to cure If the heme be effected, the sore will not heal before au exfoliation takes place ; that is, before the dis- eased part of the bone separates, and comes out through the wound. This is often a very slow operation, and may even require several years to be completed. Hence it happens, that these sores are fre- quently mistaken for the king's evil, and treated as such though in fact thev proceed solely from the injury Which the solid parts received from the blow. Patients in this situation are pestered with different advices. Every one who sees them proposes a new remedy, till the sore is so much irritated with various and opposite applications, that it isoften at length rendered absolutely incurable. The best method of managing such sores is, to take care that the patient's constitution docs not suffer by confinement or improper medicine, and to apply nothing to then, be- sides simple ointment spread upon soft liut, over which a poultice q( OF ULCERS. 385 breael and milk, with boiled camomile flowers, or the like, may be put to nourish the part, and keep it soft and warm. Nature, thus assisted, wilt generally in time operate a cure, by throwing off the diseaseil parts of the bone, after which the sore soon heals. OF ULCERS. ULCERS may be the consequence of wounels, bruises, or impos- thumes improperl) treated ; they may likewise proceeei from au 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; anel persons who neglect exercise, and live grossly, are most liable to them. They mia;ht 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 Avound by its discharging a thin watery humour, Avhich is oflea so acrid as to inflame and corrode the skin; by the hardness and perpenelicular situation of its sides or edges; by the time of its duration, &c. 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 fron a bad habit of boely, should be suffered to coutinue 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. Ulters which are the effect of malignant fevers, or other acute diseas- es, may generally be healed with safety after the health has been res- tored for some time. The cure ought not however to be attempted too soon, nor at any time without the use of purging medicines and a proper regimen. When wounds or bruises have, by wrong treatment, degenerated into ulcers, if the constitution be good, they may general- ly be healed with safety. When ulcers either accompany chrouic dis- eases, or come in their stead, they must be cautiously healed. If an ulcer conduces to the patient's health, from whatever cause it pro- ceeds, it ought not to be healed; but if, on the contrary, it wastes the strength aud consumes the patient by a slow fever, it should be healeel as soon as possible. We Avould earnestly recommend a strict attention to these particu- lars to all who have the misfortune to labour under this disorder, par- ticularly those iu the decline of life ; as we have frequently known people throw away their lives by the want of it, while they Avere ex- tolliig anel generously rewarding those whom they ought to have look- ed uiou as their executioners. Tae most proper regimen for promoting the cure of ulcers, is to avoid all spices, salted and high seasoneel food, all stroug liquors, and to Sessci the usual quantity of flesh meat. The body ought to be kept gent- 56*6 OF ULCERS. ly open by a diet consisting chiefly of cooling laxative vegetables, and by driuking buttermilk, whey sweetened with honey, or the like. The patient ought to be kept cheerful, aud should take as much exer- cise as he can easily bear. When the bottom and sides of an ulcer seem hard and callous, they may be spriukled twice a-day with a liitle red precipitate of mercury, and afterwards dressed with the yellow basilicum ointment. Some- times it will be necessary to have the edges of the ulcer searified 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 aud gravd. My late learned and ingenious friend Dr. Whytt strongly recom- mends the use of the solution of corrosive sublimate of mercury iu bran- dy, for the cure of obstinate ill-conditioned ulcers I have frequently found this medicine, wheu given according to the Doctor's directions, prove very successful. This dose is a table-spoonful night and morn- ing ; at the same time washing the sore twice or thrice a-day with it. In a letter Avhich I had from the Doctor a little before his death, lie informed me, " That he observed washing the sore thrice a day with the solution ot a tripple 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 corrosive application, or they must be entirely cut away by the knife; but as this operatiou requires the hand of au expert surgeon, therej is no occasion to describe it. Ulcers about the anus are most apt to be- come fistulous, and are very difficult to cure. Some indeed prettnd to have found Ward's fistula paste very successful in this complaint. It is not a dangerous medicine, and being easily procured, it may de- serve a trial; but as these ulcers generally proceed from an ill hibit ©f body, they will seldom yield to any thing except a long course; of regimen, assisted by medicines which are calculated to correct that particular habit, and to induce an almost total change in the constitu- tion. * In ulcers of the lower limbs great benefit is often received from tight rollers, or wearing a laced stocking, as this prevents the flux ef humours to the sores, and disposes them to heal. •F DISLOCA TIONS, &*. 3 ? i CHAPTER LI. OF DISLOCATIONS. WHEN a bone is moved out of its place or articulation, so as tc impede its proper functions, it is said to be luxat.dor disloca- ted. As this often happens to persons in situations where no m: dical assistance can be obtaiued, by which means limbs, and even lives, are frequently lost, we shall endeavour to point out the method of reducing the most common luxations, and those which require immediate assist- ance. Any person of common sense anel resolution, who is present when a dislocation happens, may often be of more service to the pa- tient, than the most expert surgeon can alter the swelling and inflam- mation 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 wait- ing 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 extention alone, which must always be greater or less according to the strength of the muscles which move the joint, the age, robustness, and other circum- stances of the patient. When the bone has been out of its place for a considerable time, aud a swelling or inflammation has come on. it will be necessary to bleed the patient, and, after fomenting the part, to ap- ply soft poultices with vinegar to it for some time before the reduction is attempted. All that is uecessary after the reduction, is to apply cloths dipped in vinegar or camphorated spirits of wine to the part, and to keep it perfectly easy. Many bad consequences proceed from the neglect of this rule. A dislocation seldom happens without the tendons and lig- aments of the joint being (stretched aud sometimes torn. When these are kept easy till they recover their strength and tone, all goes on very well ; but if the injury be increased by too frequent an exer- tion of the parts, no wonder if they be found weak and diseased ever after. DISLOCATION OF THE JAW. THE lower jaw may be luxated by yawning, blows, falls, chewing hard substances, or the like. It is easily known from the patient's being 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 thrown toward one side, and the patient is neither able to speak distinctly, nor to swallow witbeut considerable difficulty. 305 DISLOCATION OF THE NECK. The usual metnod of reducing a dislocated jaw is to set the patient upon a low stool, so as an a.-sistanl may hold the head firm by pressing it against his breast. The operator is then to thrust his two thumbs, being first wrapped up with linnen cloths that tliey may not slip as far back into the patient's raouih as he can, while his fingers are applied to the jaw ex'ernally. After he has got firm hold of the jaw, he is to press it strongly downwards and backwards by Avhich means the elap- sed heads ot the jaw may be easily pushed iuto their former cav« ilies. The peasants in some parts of the country have a peculiar way of performing tbi** operation. One of them puts a handkerchief uuder 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, and therefore recom- mend the former. DISLOCATION OF THE NECK. TFIE neck may be dislocated by falls, violent blows, or the like. In this case, if the patient receives no assistance, he soon dies, which makes people imagine the neck wa6 broken; it is however, for the most part only partially dislocated, anel may be reduced by almost any person who has resolution enough to attempt it. A-complete disloca- tion of the neck is instantaneous death When the neGk is dislocated, the patient is immediately deprived of all sense anel motion; his neck sivells, his countenance appears bloat- ed ; his chin lies upon his breast, and his face is generally turned to- wards one side. To reduce this dislocation, the unhappy person should immediately be laid upon his back on the ground, anel, 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 mus; pull the head with con- siderable force, gently tAristing it at the same time, if the face be turned to one side, till he perceives that the joint is replaced, which may bt known from the noise which the bones generally make when going in, the patient's beginning to breathe, aud the head continuing in its natu- ral posture. This is one of those operations which is more easy to perform than describe. 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 res^ for some days, till the parts recover their proper tone. DISLOCATION OF THE RIBS, &c. 36$ DISLOCATION OF THE RIBS. AS 'he articulation of the ribs with the back bone i= very strong, they are not often dislocated. It does ftiwever sometimes happen, which is a sufficient reason for our taking notice of it. When a rib is dislocated either upwards or downwards, in order to replace it, the patient should be laiil upon hU belly on a table, and the operator must endeavour to push the head of the b'»ne into its proper pla'-e. div.id this method not succeed, the arm of die eii-onlered side ma) be .sus- pended over a gate or la Ider, and, while the rib- are thus ^tietolied asunder, the heads of such as are out of place may be thrust into iheir former situation. Those dislocations wherein the heads of the ribs are forced inwrards, are both more dangerous ami the most difficult to n duce. a6 neither the hand uorany iusir.iniuit can be applied internally to direct me lux- ated heads of the ribs. Almost the only thing that can tie done is, to lay the patient upon his belly over a ca.-k, or some gibbous body, and to move the fore pare of the rib inwa-el towards the back, some- times shaking 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 va- rious directions; it happens however most frequently downwards, but very seldom directly upwards. From the na'.ire 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 hu- merus may be know by a depression or cavity on the top of the shoul- der, and an inability to move the arm. When the disloca ion is downward or forward, the arm is elongated, and a ball or lump is perceiveel under the arm pit; but when it is backward, there appears a protuberance bdiind the shoulder, and the arm is throwu forwards toAvards the breast. The usiirtl method of reducing dislocations of the shoulder is to peat the patient upon a low stool, and to cause an assists;.', to hold his body so ?!iat it m ly not give way to die extension, while another lays hold of the: arm a iittle above the elboiv, and gradually extends it. The operator thou puts a napkin under the patient's ?rra, and eposes it to be tied behind his own neck; by this, while a sufficient extension js made, he lifts up the head of the bore, and with his hands directs it into its propt r place. There are various machines invented for focili* tiling this operation, but the hand of an expert surgeon is always more eafe. In young and delicate patients, I have generally found it a very •:.:) nutter to reduce the shoulder, by extending the arm with one 4f 370 DISLOCATION OF THE ELBOW, &c. hand, and thrusting in the head of the bone with the other. In ma- king the extension, the arm ought always to be a little bent. DISLOCA TION OF THE ELBOW. THE bones of the fore arm may be dislocated in any direction. Wrheu this is the case, a protuberance may be observed on that side of the arm towards which the bone is pushed, from which, and the pa- tient's inability to bend his arm, a dislocation of this joint may easily be knowu Two a- istants are generally necessary for reducing a dislocation of the elbow ; one of them must lay hole! of the arm above, and the other below th. ji»int, 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 manner as those of the elbow ; viz by making an extension in different directions, aud thrusting the head of the bone iuto its place. DISLOCATION OF THE THIGH. When the thigh-bone is dislocated forward and downward, the knee and foot are turneel out, and the leg is longer than the other, but when it is displaced backward, it is usually pushed upward at the same time, by which means the limb is shortened, aud the foot is turned in- wards. When the thigh-bone is displaced forward and downward, the pa- tient, in order to have it reekiced, must be laid upon his back and made fast by bandages, or held by assistants, while by others an extension is made by means of slings fixed about the bottom of the thigh a little above the knee. While the extension is made, the operator must push the head of the bone outward, till it gets into the socket. If the dis- location be outward, the patient must be laid upon his face, and, during the extention, the head of the bone must be pushed inward. Dislocations of the knees, ancles, and tecs, are reduced much in the same manner as those d the upper extremities, viz. by making an ex- tention in opposite directions, while the operator replaces the bones. In many cases, however, the extention alone is sufficient, anel the bone Avill slip into its place merely by pulling the limb with sufficient force. It is not hereby meant, that force alone is sufficient for the reduction of dislocations. Skill and address w ill often succed better than force. I have known a dislocation of the thigh reduced by one man, after all the force that could be used by six had proved ineffectual. OF BROKEN BONES. CHAPETR LII. OF BROKEN BONES, &c. THERE is, in most villages, some person who pretendslo the art of reducing fractures. Though in general such persons are very iguorant, yet some of them are very successful; which eviden-ly proves, that a small degree of learning, with a sufficient share of com- mon sense and a mechanical head, will enable a man to be useful in th'13 way. We would, however, advise people never to employ such operators, when an expert aud skillful surgeon can be had; but when this is impracticable, they must be employed; we shall therefore re- commend 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 shouhl likewise be kept quiet and cool, and his boely open by emollient clysters; or, if these cannot be conveniently administered, by food that is of an open- ing quality ; as steweel prunes, apples boiled in milk, boiled spinuage, and the like. It ought however to be here remarked, that persons who have been accustomed to live high, are not all of a sudden to be reduced to a very low diet. This might have fatal effects. There is often a necessity for indulging even bad habits, in some measure, where the nature of the disease might require a different treatment. It will generally be necessary 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 on- ly be performed soon after the accident happens, but if the patient be very feverish, it may be repeated next day. Wheu several of the ribs are broken, bleeding is peculiarly necessary. If any of the" large bones which support the body are broken, the patient must keep his bed for several weeks. It is by no means ne- cessary, however that he should lie all that time, as is customary upon his back. This situation sinks the spirits, galls and frets the patient's skin, and renders him very uneasy. After the second week he may be gently raised up, and may sit several hours, supported by a bed chair, or the like, which will greatly relieve him. Great care, however, must be taken in raising him up and laying him down, that he make no exertious himself, otherwise the action of the muscles may pull the bone out of its place.* * Various pieces of machinery have been contrived for counteract- ing the force of the muscles, and retaining the fragments of broken iwnes; but as descriptions of these without drawings would be of little 872 OF BROKEN BONES. it is of great importance to keep the patient dry and clean while in this situation. 11) neglecting this he is often so galled and excoriated, that he is forced to keep slutting places for ease. I have known a fractured .high bone, afu-r it had ia en kept straight for above a fort- nignt, displaced by ids means, and continue bent for life, in spite of al! f!.a could be Jon". It '.ab been customary when a bone wa0. broken, to keep the limb fo:1 five or six ;v<-e'vs coidnualt) upon the sic ch. But this is a bad posture. I :s bo.n uneasy to the p dent, aid ud'uvourade it the cure. Thr be t situation i- to keep the limb a li-.ile bent. This is the pos- ture into wh's.Mi every animal puts his limbs when it goes to rest, and in which it vest muscles are upon the stretch, li is easily effected, by •either h\ ing the pa but upon his side, or making the bed so as to fa- vour ids po-iifton of the l.mb Bo ie-seiiers ousjh: careiully to examine whether the bone be not sheltered or broken into severd pieces Iu this ca.e it will sometimes be nexes^rv to have the limb immediately taken off, otherwise a gan- grene or mortification may ensue. The horror which attends the very ide.i of an (imputation, often occasions its being delayed in such cases till loo late. 1 have known this principle operate so strongly, that a limb where the bones were shattered into more than twenty pieces* was not amputated before the thud 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 in all respects as a common wound. All that art can do towards 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 wantiigaltogether. A great many of the bad consequences which succeed to fractured bones are owing to tight bandages. This is one of the ways in which excess of art, or rather the abuse of it, does more mischief than Avould be occasioned by thje want of it. Some of the most sudden cures of broken bones which were ever known, happened where no bandages were applied at all. Some method however must be taken to keep the member steady; but this may be done many Ava) s without bracing it with a tight ban- dage. use I shall refer the reader to a cheap and useful performance " ou the nature and cure of fractures,"'' lately published by my ingenious friend Mr. Aitken, surgeon iu Edinburgh; wherein that gentleman has uot 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 fro» one place to another. OF STRAINS. 378 The best method of retention is by two or more splints made of leather or pasteboard. These, if moistened before they be applied, soon -isMi'iie the shipe of die iuchuftd member, and are sufficient, by th> assistance 01 a very slight bau.iaue, lor all the purposes of reten- tion I tie . audage which we wotdd recommeud, is that made with twelve or ei.,iiueii mils. 1. is mucii easier applied and taken off than rollers, aud answers all the purpo^s of retention equally well. The spiiiHs Mioi.d dw.iys be as lon^ as the limb, with holes cut for the an- cie- '.rile'* lie IVa. ture is in th.deg. In fiae-ures ol the ribs, where a bandage cannot be properly used, an adnesive jjfob « r ma) be applied over the part. The patient in this case o«i;h to keep himself quite easy, avoiding every thing that may occasion sneeziig, i.>ughiug, coughing, or the like. He ought to keep his body 01 a straight posture, and should take care that his stomach be constantly dis.ended, by taking frequently some light food, and drink- ing free I > of weak watery liquors The most proper external application for a fracture is oxycrate or a mixture of vinegar aud water. The bandages should be wetwidi fchks ai every dressiug. OF STRAINS. STRAINS are often attended with worse consequences than bro- ken bones. The reason is obvious; they are generally neglected. Whei. a none is broken, die patient is obliged to keep the member ea- sy, becaus he cannot make use of it; but when a joint is only strain- ed, the person finding be can still make a shift to move it, is sorry to lose his time for so trilling an ailment. In this way he deceives him- self, and converts into an incurable malady what miglit have been re- moved by only keeping the part easy for a few clays. Couutry 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 io produce a disease than remove one. Wrapping a garter, or some other bandage, pretty tight about the strained part, is likewise of u.e. It helps to restore the proper tone of the vessles and prevents the action of the parts from increasing the disease. It should not hoAvever be applied too tight. I have fre- quently known bleeding near the affected part have a very good ef- fect ; 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 com- plaint * * A great many external applications are recommended for strains, some of which do good, and others hurt. The following are such as ■say be used with the greatest safety, viz. poultices made of stale beer 574 OF RUPTURES. CHILDREN" and old people are most liable to this disease. Ia the former it is generally occasioned by excessive crying, coughing, vomiting or the like. In the latter it is commonly the e ftfect ot blows or vioUn- exertions of the s'rength, as leaping, carrying great weights, Sic. In both a relaxed habit, indolence, anel an oily or very moist di- et, dispose the body to this disease. . A mature sui.ieiimes proves fatal before it is discovered. When- ever sickness, vomiting, aud obstinate costiveness give reason to sus- pect an obstruction of the bowels, all those places where ruptures usual- ly happen ought carefully to be examined. The prolusion ot a very small part of the gut will "occasion all these symptoms, aud if not return- ed in due time, Avill prove fatal. On the first appearance of a rupture in an infant, it ought to be laid upon its back, with its head very low. While in this posture, if the gut eloes not return of itself, it may easily be|put up by gentle pressure. After it is returned, a piece of sticking plaster may be applied over the part, and a proper truss or bandage.must be constantly worn for a considerable time. The method of making and applying these rupture bandages for children is pretty well known. The child must, as far as possible, be kept from crying, and from all violent exertions, till the rupture is quite healed. Iu adults, when the gut has been forced down with great violence, or happens from any cause to be inflamed, there is often great difficulty in returning it, and sometimes the thing is quite impracticable without an operation; a description of which is foreign to our purpose. As I have been fortunate enough, however, always to succeed in my at- tempts to return the gut, without having recourse to any other means than what are in the power of every man, I shall briefly mention ths method which I generally pursue. After the patient has been bled, he'must be laid upon his back with his head very low, and. his breach raised high with pillows. In this situation flannel cloths wrung out of a decoction of mallows and camo- mile floweis, or if these are not at hand, of warm water, must be appli- ed for a considerable time. A cl)ster 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 pressure. If the tumour be very hard, considerable force will be ne- cessary : 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, or vinegar and oat-meal, camphorated spirits of wine, Mindererus's spirit, volatile linament, volatile aromatic spirit diluted with a double quantity of water, and the common fomentation, with the addition of V-andy or spirit of wine. OF CASUALTIES. S7fi 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 conveyed than described. Should these endeavours prove in- effectual, clysters of the smoke of tobacco may be tried. These have been often known 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. 1 have once and again succeeded by persevering in my endeavours, after enfneut surgeons had declared the reduction of the gut impracticable without an operation.* An adult, after the gut has been returned, must wear a steel ban- dage. 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 quite easy. No person who has had a rupture after he arrived at man's estate should ever be without one of these bandages. Persons who have a rupture ought carefully to avoid all violent ex- ercise, carrying great Aveights, leaping, running and the like. They should likewise avoid windy aliment and strong liquors; and should carefully guard against catching cold. CHAPTER LIIL OF CASUALTIES. IT is certain that life, when to all appearance lost, may often, by due care, be restored. Accidents frequently prove fatal, merely because 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 * I would here beg leave to recommend it to every practitioner, when his patient complains of pain in the belly with obstinate costive- Bess, to examine the groins and every place where a rupture may hap- pen, in order that it may be immediately reduced. By neglecting this, many perish who Avere not suspected to have had ruptures till af- ter they Avere dead. I have known this happen where half a dozen of the faculty were in attendance. 876 OF CASUALTIES. life, is evidently destroyed. The action of these organs may be so fa* impaired as even to b: for some rime imperceptible, wi.eu lite is t>) no means gone. In this case:, however, if the fluids be stored to g ow cold, it will be impossible to put them agd.i in "-*""* eve" ,»0USh the solids shouhl recover their power of acting. fhu*. wlien the mo- tion of the lungs have been stopt by unwholesome vapour, ihe action ot the heart by a stroke on the breast, or the fo actions of the main by a blow on the head, if the person be suffered to. grow cold, he wilt in all probability continue so; but, if the body be kept warm as soon as ihe injured part has recovered its power of acting, die fluids will again be- gin to move, and all the vital functions will be restored. It is a horrid custom immediately to conrign over to death every person who has the misfortune, by a fall, a blow, or the like to be de- prived of the appearance of life. The unhappy person, instead ot be- ing carried iuto a warm house, and laid by the fire, or put to a warm bed, is generally hurried away to church, or a barn or some other cold damp house, where, after a fruitless atten.pt has been made >o bleed ium, perhaps by one who knew nothing of the matter, he is given over for dead, anel no further notice takeu of him. I'll is conduct seems to be the result of ignorance, supported by an ancient superstbious notion which forbids the body of any person killed by aeddeut to be laid in an house that is inhabited. What the ground of this superstition may be, Ave shall not pretend to inquire; but sun!) die condu. t foi-n.ied upon it is contrary to all the principles of reason, Humanity, ami cotm mon seuse. When a person seems to be suddenly deprived of life, our first bu? siness is to inquire into the cause. We ought can fully to observe whether any substance be loelged in the windpipe or gullet; anel ii'itiat is the case, attempts m.ist be nude to remove it. Whe> uuwhdes-.wie air is the cause, the patient ought immediately to be removed out of it. If the circulation be suddenly stoppeel from any cause whatever, except mere weakness, the. patient should be bled. If the blood does not flow, he may be immersed in warm water, or rubbed with warm cloths, Sic. to promote the circulation. When the cause cauuot be suddenly removed, our great aim must be to keep up the vital warmth, by rubbing the patient with hot cloths, Or salt, aud covering his boely With warm sand., ashes or the like. I should now proceed to treat more fully of those accidents, Avhich 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 his observations as seem to be the most important, aud adding such of jny own as have occured in the course of practice. SUBSTANCES BETWEEN MOUTH &STOMACH. 371 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 taught to chew their food well, and to put nothing iuto their moutli9 which it would be dangerous for them to swallow. But chil- dren are not^the only persons guilty of this piece of imprudence. I know many adults who put pins, nails, and other sharp pointed sub- stances into their mouths upon every occasion, and some who even sleep with the former there all night. This conduct is exceedingly injudicious, as a fit of coughing, or twenty other accidents, may force over the substance before the peiaon is aware.* When any substance is retained in the gullet, there are two ways of removing it, viz.. either by extracting it, or pushing it doAvn. The sa- fest and most certain Ayay is to extract it; but this is not always the easiest; it may therefore be more eligible sometimes to thrust it down, especially when the obstructing body is of such a nature, that there is no danger from its reception into the stomach. The substances which may be pushed doAvn without elanger, are all common nourishing ones, as bread, flesh, fruits, and (he like. All indigestible bodies, as cork, wood, bones, pieces of metal, and such like, ought if possible to be ex- tracted, especially if these bodies be sharp pointed, as pins, needles, fishbones, bits of glass, &c. When such substances have not passed in too deep, we shouhl en- deavour to extract them with our fingers, which method often suc- ceeds. When they are loAver, we must make use of nippers, or a 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 de- scended far into the gullet. If the fingers and nippers fail, or cannot be duly applied, crotchets, a kind of hooks, must be employed. These may be made at once, by bending a piece of pretty strong iron Avire at one end, it must be intro- duced in the flat 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 kiud of handle to it; which has this further use, that it may be secu- red by a string tied to it, a circumstance not to be omitted in any in- strument employed on such occasions, to avoid suc(i ill accieleuts as have sometimes ensued from these instruments slipping out of the ope- lator'shaud. After the crotchet has passed below the substance that obstructs the passage, it is drawn up again, and hooks up the body * A woman in one of the hospitals of this city lately discharged a great number of pins, Avhich she had swallowed iu the course of her business through an ulcer in her side. 4^ 878 SUBSTANCES BETWEEN MOUTH & STOMACH. 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 iu such cases, seizing them about their middle part, crooks and thus disengages them ; or, if they are very brittle 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 kinel of rings, made either of wire, wool, or silk, ma) be used. A piece of fine wire of a proper length may be bent iuto a circle, about the middle, of about an inch diameter, and tlu lo:g in bent 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 conducted about the obstructing body, and so to extract it. More flexible rings may be made of wool, thread, si:k, or small pack-thread, which may be waxeel for their greater strength arid consistence. One of these is to be tied fast to a handle of iron wiit?.t tied to a thread, ai-d drawing it quickly up again. This is saftf SUBSTANCES BETWEEN MOUTH& STOMACII. 37» 'than swallowing a sponge, and will often answer the purpose equally well. WThen all these methods prove unsuccessful, there remains one more, which is, to make the patient vomit; but this can scarcely be of any service, unless when such obstructing bodies are simply engaged iu, and uot hooked or stuck into the sides of the gullet, as in this case vomiting might sometimes occasion further mischief It die patient can swallow, vomiting may be excited by taking half a diachm 01 two scruples of ipecacuauha in powder made into a draught. 11" he is uot able to swallow, au attempt may be made to excite vomitiug, by tick- ling his throat with a feather ; aud, if that should not succeed, a cl)ster of tobacco may be administered. It is made by boiling au ounce ot to- bacco in a sufficient quantity of water; this has often been found to succeed, Avhen other attempts to excite vomiting had failed. Wheu the obstructing body is of such a nature that it may with safe- ty be pushed downwards, this may be ati mpted by means of a wax- candle oiled, and a little heated, so as to make it flexible ; or a piece cf whale-bone, Avire, or flexible wood, with a sponge fasteued to one end. i • • .1 Should it be impossible to extract even those bodies which it is dan- gerous to admit into the stomach, we must then prefer the least of two evils, and rather run the hazard of pushiug them down than suffer the patient to perish iu a few minutes; and we ouglit to scruple this resolu- tion the less, as a great many instances have happened, where the swal- lowing of such hurtful and indigestible substances have been followed by no disorder. Whenever it is manifest that all endeavours, either to extract or push down the substance, must prove ineffectual, they should be dis- continued ; because the inflammation occasioned by persisting in them. might be as dangerous as the obstruction itself. Some have died m consequence of the inflammation, even after the body which caused the obstruction hael been entirely removed. While the means recommended above are making use ot, the pa- tient should often swallow, or, if he cannot, he should frequently re- celve by injection through a crooked tube or pipe tbat may reach down to the gullet, some emollient liquor, as warm milk and water, barley-water, or a decoction of mallows. Injections of this kiud not only soften and sooth the irritated parts, but, wheu thrown iu with force, are often more successful iu loosening the obstruction thau all attempts with instruments. When, after all our endeavours, we are obliged to leave the ob- structing body iu the part, Ihe patient must be treated as it he bad au inflammatory disease. He should be bled, kept upon a low diet, and have his whole neck surrounded with emollient poultices. 1 he like treatment must also be used, if there be any reason to suspect au inflammation of the passage?, though the obstructing body be re, moved*. 830 OF DROWNED PERSONS. A proper degree of agitation has sometimes loosened the inhering body more effectually than instruments. Thus a blow on the back has often forced up a substance which stuck in the gullet ; but this is still more pioper and efficacious wheu the substance gets iuto the wind- pipe. 11 this case vomiting and sneezing are likewise: to be excited. Pins which stuck iu the gullet have been frequently discharged by riding ou horseback, or in a carriage. When any indigestible substance has been forced down into the stomach, the patient should use a very mild aud smooth diet, consist- ing chiefly of fruits and fariuaccous substances, as puddings, pottage, and soups. He should avoid all heating and irritating things, as wine, punch, pepper, and such like ; aud his drink should be milk aud wa- ter, barley-water, or whey. When the gullet is so strongly and fully closed, that the patient can receive no food by the mouth, he must be nourished by clysters of soup, jelly, anel the like. When the patient is in danger of being immediately suffocated, and all hope of freeing the passage is vanished, so that death seems at hand, if respiration be not restored ; the operation of bronckotomy, or opening the wind-pipe, must be directly performed. As this opera- tion is neither difficult to an expert surgeon, nor very painful to the p*itic?iit, aud is often the only method which can be taken to preserve life in these emergencies,Ve thought proper to mention it, though it should only be attempted by persons skilled in surgery. OF DROWNED PERSONS. WHEN a person has remained above a quarter of an hour under water, 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, we should never loo soou re.sigu the unhappy object to his fate, but try eveiy method for his relief, as there are many Avell attested proofs of the recovery of persous to life and health who had been taken out of the water ap- parently dead,, and who remained a considerable time without exhibit- ing any signs ef life. The first thing to be done, after the body is taken out of the waterj is to convey it as soon as possible to some convenient place where the necessary 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 head downwards, or the like. If an adult body, it ought to be laid on a bed, or on straw with the head a little rdsed, and carried on a cart or men's shoulders, and kept in as natural and easy a position as possible. A small body may be carried In the arms. Iu attempting to recover persons apparently drowned, the principal Ir^rttiou to be pursued is, to restore the natural warmth, upon which OF DROWNED PERSONS. 331 all the vital functions depend; and to excite these functions by the ap- plication of stimulants, uot only to the skin, but likewije to the lungs, intestines, «fec. Though cold was by no means the cause of the person's death, yet it will prove au effectual obstacle to bis .recovery. For this reason, stripping him of his wet clothes, his body must be stiongly rubbed for a considerable time with coarse linen cloths, as warm as they can be made ; and as soon as a well-heated bed can be got ready, he may be laid in it, and the rubbing should be continued. Warm cloths ouglit likewise to be frequently applied to the stomach and bowels, and hot bricks, or bottles of warm-water, to the soles of his feet, aud to the palms of his hands. Strong volatile spirits should be frequently applied to the nose ; and the spine of the back aud pit of the stomach may be rubbed with Avarm brandy or spirit of wine. 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 nostrils at the same lime. When it can be perceived by trie iking of the chest or belly that the lungs are filled with air, the person ought to de- sist from blowing, and should press the breast aud belly so as to expell the air again; and this operation may be repeated for some time, al- ternately inflating and depressing the lungs so as to imitate natural res- piration. If the lungs cannot be inflated iu this maimer, 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 wooden 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 iuto 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, however, to spend time in describing this opera- tion, as it should not be attempted unless by persons skilled in surgery. To stimulate the intestines, the fume of tobacco may be thrown up in form of clyster. There are various piece- of apparatus contrived for this purpose which may be used when at hand ; but where these cannot be obtained, the business may be e'one by a common tobacco pipe. The bowl of the pipe must be tilled with tobacco well kindled, and, after the small tube has been introduced into the fundament, the sraoak may be forced up by blowing through a piece of paper full of holes wrapped round the mouth of the pipe, or by bloAring through an empty pipe, the mouth of Avhich is applied close to that of the other. This may also be done in the following manner : A common clyster- pipe with a bag mounted upon it may be introduced into the funda- 3E2 OF DROWNED PERSONS. meat, and the moutli of the bag may be applied round the small end of a tobacco-pipe, in the bowl of which te'ia<:co is to be kindled, and the smoke blown up as directed above, ahouid it bt i.>u..d impracti- cable to throw up the smoke of tobacco, clysters ol warm waier, with the aeldition of a little salt and some wine or spirits, niay be lie- qtienlly adm niste red. This may be done by a common clyster bag aud pipe; but, as it ought to be iluowu well up, a pretiy lavBe syringe wih aus«er the purp ;sc better. While thee things are doing, some of the attendants o.igln to be preparing a warm bath, into which the person should be put, if me above endeaA7ours prove ineffectual. \Vhere there aie no coi:\ciueiices for using the warm bath, the body may be covered with warm salt, s.ud, ashes, grains, or such like. Tissot mentions an instance of . gi.i »vuo Avas restored to life, after she had been taken out of iho water, skill- ed, bloated, and to all appearauce dead, by laying her naked body upon hot ashes, covering her with others equally hot, p ituug a bon- net round her head, and a s'ookfog round hei neck, siuit'.d with die same, and heaving coverings over all After she hud regained odf an hour in this situation, her pulse returned, she recovered speetli, aud cried out, I freeze; I freeze ; a little cherry-brand) was given her, and she remained buriecl as it were under the ashes lor eigiit hours; afterwards she was taken out, without any other conip:aim except that of lassitude or weariness, which went off iu a few days. Tin; Doctor mentions likewise an instance of a man wtio was restored to life, after he had remained six hours uuder water, by the heat of a dung- hill. Till the patient shows some signs of life, anel is able to swallow, it would be useless aud even daugt ions to pour liquors into his mouth* His lips however, aid tongue, may be friqtienti) Avet with a f alhcr dipt in waim brandy or other strong spirits; anel, as soon as he is re- covered the power of swallowing, a little warm wine, or some other cordial, ought every now anel then to be administered. Some recommend a vomit after the patient is a little re-animated ; but if he can be made to puke without the sickening draught, it will be more safe; this may generally be none by tickling the throat aud fauces with an oiled lea'her, or some other soft substance, which will not injure the parts. Tissot in this case recommends the oxy mel of squills, a table-spoonful of which, diluted with water, may be giveu every quarter of an hour, till the patient has taken five or six doses. W here that medicine is not at hand, a strong infusion of sage1, camo- mile flowers, or carduus benedictus, sweetened with honey, or some warm water, with the addition 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 ia tltis situation are not expedient. OF NOXIOUS VAPOURS. sw We are by no means to discontinue our assistance as soon as the par tients eti c iver some tokens of life, since they sometimes expire after these t'"u-t a,»:>earances of recovering. The warm and stimulating ap- plications are sill; to be continued, and small quantities of some cordial liquor ought frequently to be administereei. Lastl), thougfy the person should be manifestly re animated, there sometimes remaiis an oppres- sion, a cough, and levevisiiness, which effectually constitute a disease. In this case it will i>e necessary to bleed the p-.iticnt in the arm, and to cause him to drink plentifully of barley-water, elder-flower-tea, or any other soft pectoral infusions. Such persons as have the misfortune to be deprived of the appear- ances of life, by a fall a blow, suffocation, or the like, must be treated nearly in the same manner as those who have been for some time under water 1 once attended a patient who 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 ded, aid proper methods taken to keep up the vital warmth, recovered, and iu a few days was perfectly well. Dr. Alexander gives an instance to the same purpose in the Edinburgh Physical and Literary Essays, of a man who was to all appearance killed by a blow on the breast, but recovered upon being immersed for sometime iu warm water. These, and other instances of a similar na- ture, which might be adduced, amount toq full proof of this fact, that many of those unhappy pesons who lose their lives by falls, blows, and other accidents, might be saved by.the use of proper means duly per- sisted in. OF NOXIOUS VAPOURS. AIR may be many ways rendered noxious, or even destructive to animals. This may either happen from its vivifying principles being destroyed, or from subtle exhalations with which it is impregnated. Thus air 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 with coal fires. Some indeed suppose the danger here proceeds from the sulphurious oil contained in the coal, which is set at liberty and diffused all over the chamber; while others imagine it is oAving to the air of the room being charged with phlogiston. Be this as it may, it is a situation carefully to be^avoided. Indeed it is dangerous to sleep iu a small apartment Avith a fire of any kind. I lately saw four persons atIio had been suffocated by sleeping in an apartment where a small fire of coal had been left burning. The vapour Avhich exhales from wine, cider, beer, or other liquors in the state of fermentation, contains something poisonous, Avhich 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 i;. a^state of fomentation, especially if they have been de^e shut up for 884 OF NOXIOUS VAPOURS. some time. There have been many instances of persons stiuck dead; on entering such places, and of others who have with difficulty escaped, Wheu subterraneous caves, that have been very long shut, are opened or when eleep wells are cleaned, which have not been emptied for seve- ral years, the vapours arising from them proeluce the same effects as those mentioned above. Far this reason no person ought to venture into a well, pit, cellar, or any place that is damp, and has been long shut up, till the air has been sufficiently purified, by burning gunpow- der in it. It is easy to know, 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 thei;; continue to burn, people may safely venture in; but where they are suddenly extinguished, no one ouglit to enter till the air has been first purified by fire. N The offeusive smell of lamps and of candles, especially when their flames are extinguished, operate like other vapours, though with less violence, and less suddenly7. There have however been instances of people killed by the fumes of lamps, which hael been extinguished in a close chamber, and persons of weak delicate breasts generally find themselves quickly oppressed 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 uneasiuess, a little water a°d vinegar, or lemonaele, drank hot, affords them relief. But when they are so far poisoneel as to have lost their feeling and understanding, the following means must be used for their recovery. The patient should be exposed to a very pure, fresh, and open air, and volatile salts, or other stimulating substances, held to his nose. He should next be bleel in the arm, or if that does not succeed, in the neck. His legs ought to be put iuto warm water, anel well rubbed. As soon as he can swallow, some lemonade, or water, anel vinegar with the addi- tion of a little nitre, may be given him. Nor are 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 ouuces ; or in their stead, half an ounce of Venice turpentine dissolved in the yolk of an egg. Should these things not be at hand, ;wo or three large spoonsful of common salt may be put into the clyster. The same means, if necessary, which were recommended in the former part of this chapter, may be used to re- store the circulation, Avarmth, &c. Mr. Tossach, surgeon at Alloa, relates the case of a man suffoca- ted by the steam of burning coal, whom he recovered bv blowing his breath into the patient's mouth, bleeding him in the arm and causing him to be well rubbed and tossed about. And Dr. Fiewen, of Sussex, mentions the case of a, ou :i« man who wasstupified by the sr.iuki: of sea EFFECTS OF EXTREME COLD. 383 «oal, but was recovered by being plunged into cold water, and after* wartls laid in a warm 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 neighboring lake. EFFECTS OF EX TREME 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 circu- lation in the ex' remities, and forcing too great a proportion of blood to-' warels the brain ; 60 that the patient dies of a kiud of apoplexy, prece- ded by great sleepiness. The traveller, in this situation, who finds,' himself begiu to grow drowsy, should redouble his efforts to extricate himself from the imminent danger he is exposed to. This sleep winch he might consieler as some alleviation of his sufferings, would, if indul- ged prove his last. Such violent effects of cold are happily not very common in this country; it frequently happens, however, that the hands or feet of travellers are so benumbed or frozen, as to be in danger of a mortifi- cation, 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 observation show that this is a most dange- rous and imprudent practice. Every peasant knoAVs, if frozen meat, fruits, or roots of any kind be brought near the fire, or put iuto warm water, they will be destroyeel by rottenness or a kind of mortification; aud that the only way to re- cover them, is to immerse them for some time in very cold water. The same observation holds with 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 rubbed with snow, till they re- cover their natural warmth and sensibility; after which the person may be removed into au apartment a little warmer, and may drink some cups of tea, or an infusion of elder flowers sweetened with hon- ey. Every person must have observed, when his hands Avere even but slightly effected with cold, that the best way to warm them was by washing them in cold Avater, and continuing to rub them Avell for some time. When a person has been so long exposed to the cold, that all ap- pearances of life are gone, it will be necessary to rub him all over with snow or cold water; or, what will answer better, if it can he obtained, to immerse him iu a bath of the very coldest Avater. There is the I -<«;es! encouragement to persist in the use of these means, as we are a.-sured tint persons who had remained in the snow, or had been eg* 49 386 EFFECTS OF EXTREME HEAT, &c. posed to the freezing air during five or six successive days, and wfra had discovered no marks of life for several hours, have nevertheless been revived. I have always thought that the whitloes, kibes, chilblains, and othet '. inflammations of the extremities which are so common among the peas- ants in the cold season, were chiefly occasioned by their sudden transi- tions from cold to heat. After they have been exposeel to an extreme " degree of cold, they immediately apply their hands and feet to the fire, or, if they hare occasion plunge them into warm water, by which means, if a mortification does not happen, au inflammation seldom fails to ensue. Most of the ill consequences from this quarter might be easily avoided, by only observing the precautions meutioned above. EFFECTS OF EXTREME HEAT. THE effects of extreme heat, though not so common in this country, are no less fatal and much more sudden than those of cohi. Iu hot coun- tries people frequently drop down dead iu the streets, exhausted with heat and fatigue. Iu this case, if any warm cordial can be poured into the mouth, it ought to be clone. If this cannot be effected, they may be thrown up in form of a clyster. Volatile spirits and other things of a stimulating uature, may be applied to the skin, which shouhl be well rubbed with coarse cloths, whipped with nettles, or other stim- ulating things. Some of the ancient physicians are said to have resto- red to life persons apparently dead by beating them with rods. CHAPTER LIV. OF FAINTING FITS, AND OTHER CASES WHICH REQUIRE IMMEDIATE ASSISTANCE. STRONG and healthy persons, Avho abound with blood, are often seized with sudden fainting fits, after violent exercise, drinking freely ef warm or strong liquors, exposure to great heat, intense ap- plication to study, or the like. In such cases the patient should be maele to smell to some vinegar. His temples, forehead anil wrists, ought at the same time to be bathed with vinegar mixed with an equal quantity of warm water; and two or tlnee spoonsful of vinegar, with four or five times as much water, may, if he can swalloAV, be poured into hi* mouth. If the fainting p-oves obstinate, or degenerates into a syncope, that is, an abolition of feeling and understanding, the patient must be bled. After the bleeding, a clyster will be proper, and then he should be. OF FAINTING FITS, &c. 381 kept easy anel quiet, only giving him every half hour a cup or two of au infusion of any mild vegetable, with the addition of a little sugar and vinegar. . < When swoonings, which arise from this eause occur trequen ly in the same person, he should, iu order to escape them, confine himself to a light diet, consisting chiefly of bread, fruits, and other vegeta- bles. "His elrink ought to be water or small beer, and he should sleep but moelerately, and take much exercise. But fainting fits proceeel much oftener from a defect than an excess of blood. Hence they are very ready to happen after great evacua- tions of any kind, obstinate watching, want of appetite, or such like. In these, an almost directly opposite course to that mentioned above, must be pursued. The patient should be laid in bed, with his head low, and being co- vered, should have his legs, thighs, arras, and his whole body rubbed strongly with flannels. Hungary-water, volatile salts, or strong smell- ing herbs, as rue, mint, or rosemary, may be held to his nose. His mouth may be wet with a little rum or brandy ; auel if he can swal- low, some hot wine, mixed with sugar and cinnamon, which is an ex- cellent 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 patient is recovered a little, he should take some strong soup or broth, or a little bread or biscuit soaked in hot spiced wine. To preveut the return of the fits, he ought to take often, but in small quantities, some light yet strengthening nourishment, as pana- da, made with soup instead of water, new laid eggs lightly poached, chocolate, light roast meats, jellies, and such like. Those fainting fits, which are the effect of bleeding, or of the vio- lent operation of purges, belong to this class. Such as happen after artificial bleeding, are seldom dangerous, generally terminating as soon as the patient is laid upon the bed; indeed persons subject to tins kind should always be bled lying, in order to preveut it. Should tlie fainting however continue longer than usual, volatile spirits may De held to the nose, aud rubbed on the temples, &c. When fainting is the effect of teo strong or acrid purges or vomits, the patient must be treated in all respects as if he had takeu poison. He should be made to drink plentifully of milk, warm water, anel oil, barley water, or such like emmollient clysters will likewise be proper, and the patient's strength should afterwards be recruited, by giving him generous cordials, and anodyne medicines. Faintings are often occasioned by indigestion. This may either proceed from the quantity or quality of the food. When the former of these is the cause, the cure will be best performed by vomiting, which may be promoted by causing the patient to drink a Area* mlu- sioa of camomile flowers, carduus benedictus, or the like, wneu me *38 OF FAINTING FITS, &t. disorder proceeds from the nature of the food, the patient as in the case of weakness must be revived by strong smells, Sic after which he should be made to swallow a large quantity of light waim fluid, Avhichmay serve to drown, as it were, the offending matter, to soften it- acrimony, and either to effect a discharge of it by vomiting, or .force it down iuto the intestines. Even disagreeable smells will sometimes occasion SAVoonings, espe- '.cially in people- of weak uerv» s When this happens, the patient should be carried fo the open air, have stimulating things held to his nose, .and those substances which are disagreeable to him ouglit immediately to be removed. But we have already taken notice of swoonings which arise from nervous disorders, aud fehall therefore say no more ,Upnn that heael. , i aiutiug-fits often happen in the progress of eliseases. In the be- ginning of putrid diseases they generally denote au oppression at the stomach, or a mass of corrupted humours, aod they cease after evac- jiati r-s drb< r by v mil or stool. When they occur at the beginning pi" malifiant fevers, they iudicate great danger. Iu each of these ca.-ts, vinegar used both externally aid internally is the best remedy during the paroxysm, and plenty, of lemon juice anel water after it, Swoonings which happen iu diseases accompauied with great evacua- tii-os. muft be treated like those which are owing to weakness, and the evacuations ought to be restrained. Wheu they happen towards the end of a violent fit of an intermitting fever, or at that of each exa- cerbation of a coutinual fever, the patient must be supported by small draughts of wine and water. Dedicate and h)sttric women are very liable to swooning or fainting fits after delivery. These might be often prevented by generous cor- dials, anel the admission of fresh air. When they are occasioned by < « es-sive flooeling, it ought by all means to be restrained. They are generally the effect of mere weakness or exhaustion. Dr. Engltman, relates the case of a won>au '■ in child-bed, who, after having been happily delivered, suddenly fainted and lay upwards of a quarter of au hour apparently dead. A ph)sician 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 her's, blew in as much breath as she possibly could, and io a ver) short time the exhausted woman awaked as out of a profound sleep ; when pioj er things being given her, she soon recovered. " '1 he' maid being asked how she came to think of this expedient, said she had seen it practised at Altenburgh, by midwives, upon child- ren, with the happiest effect." We mention this chiefly that other midwives may be induced to fol- low to laueial.le an example. Many children are born without any figns ol life, and others expire soon after their birth, who might with- out all doubt, by proper care, be restored to life. OF INTOXICATION. 3L3 b rom whatever cause fainting-fits proceed, fresh air is always of the greatest importance to the patient. By not attending to this circum- stance, people often kill their friends when they are endeavouring 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 breath- ing exhausts the air, and increases the danger. There is not the least doubt but this practice, which is very common among the lower sort of people, often proves fatal, especially to the delicate and such per-' tons as fall iuto fainting-fits from mere exhaustion or the violence of some disease. No more persous ought ever to be admitted inaMlie room where the patient lies in a swoon than are absolutely neceasary for his assistance, anel the windows of the apartment should always be~ opened, as least as far as to admit a stream of fresh air. Persons subject to frequent swoonings, or fainting fits, should neglect' no means to remove the cause of them, as their consequences are al- ways injurious to the constitution. Every fainting fit leaves the person in dejection and weakness; the secretions are thereby suspended, the humours disposed to stagnation, coagulations and obstructions are formed, and if the motion of the blood be totally intercepted, or very consielerably checked, polypuses are sometimes formed in the heart or larger vessels. The only kind of swoonings not to be dreaded are those which some time mark the crisis in fevers; yet eveu 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 any over dose of ardent spirits. Sometinies, by destroying tlse nervous energy, they put an end to life at once; but in general their effects are more slow, and iu many respects similar to those of opium. Other kinds of intoxicating liquors may prove fatal when taken to excess, as well as ardent spirits; but they may general- ly be discharged by vomiting, which ought always to be excited when the stomach is overcharged with liquor. More of those unhappy persons, who die intoxicated, lose their lives from an inability to conduct themselves, than from the destructive qual- ity of the liquor. Unable to walk, tliey tumble down, and lie ia some awkward posture, which obstructs the circulation or breathing, anel often continue in this situation till they die. No drunken person shouhl be left by himself, till his clothes have been loosened, and his body laid in such a posture as is most favourable for continuing the vital motions, discharging the contents of the stomach, &c. The best pf; vre for dis- charging the contents of the stomach is to lay the person on his belly; when asleep he may be laid on his side, with his head a little raised, and particular care must be taken that his neck be no way bent, twist- ed, or have any thing too light about it. G30 OF INTOXICATION. The excessive degree of thirst occasioned by drinking strang liquors, often induces people to quench it by taking what is hurtful. I have known 1 fatal consequences even from drinking freely of milk after a debauch of wine or sour punch; these acid liquors, together with the heat of the stom- ped, having coagulated the milk in such a manner that it could never be digested. The safest drink after a debauch is water with 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 flowers, or lukewarm water and oil; but in this condition vomiting may generally ' be excited by only tickling the throat with the finger or a feather. Insteael of giving a detail of all the different symptoms of intoxica- tion Avhich delicate danger, and proposing a general plan of treatment . for persons in this situation, 1 shall briefly relate the history of a case Avhich lately fell under my own observation, wherein most of those symptoms usually reckoned dangerous concurred, and where the treat- ment was successful. A young man, about fifteen years of age, had, for a hire drank ten 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 send for me. 1 found him still sleeping, his countenance ghastly, and his skin covered with a cold clammy sweat. Almost the only signs of life remaining were, a deep laborious breathing, and a convulsive motion or agitation of his bowels. I tried to rouse him, but in vain, by pinching, shaking, applying volatile spirits, and other stimulating things to his nose, Sic A few ounces of blood were likewise taken from his arm, and a mixture of vinegar aud water Avas poured into his mouth ; but, as he could not swallow, very little of this got into the stomach. None of these things having the least effect, and the danger seeming to increase, I ordered - his legs to be put into warm water, and a sharp clyster to be immedi- ately administered. This gave him a stool, and was the first thing that relieved him. It Avas afterwards repeated with the same happy effect, aud seemed to be the chief cause of his recovery. He then began to show some signs of life, took drink when it was offered him, and came gradually to his senses. He continued, however, for seve- i al clays weak and feverish, and complained much of a soreness in his bowels, which gradually went oft", by means of a slender diet, aud cool mucilaginous liquors. This )oung man would probably have been suffered to die without any assistance being called, had not a neighbour a few clays be fore, who had been aelvised to drink a bottle of spirits, to cure him ol ai aj*ue, expired under very similar circumstances. 3CU OF SUFFOCATION AND STRANGLING. THESE may sometimes 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, arp very liable to suffocating fits from the former of these caus- es. Such ouglit as soon as they are attacked, to be bied, to receive an emollient clyster, and to take frequently a cup of diluting liquor with a little nitre in it. They should likewise receive the steams of hot vinegar into their lungs by breathing. Nervous and asthmatic persous are most subject to spasmodic affec- tions of the lungs. In this case the patient's legs should be immersed in warm water, and the steams of vinegar applied as above. Warm diluting liquors should likewise be drank; to a cup of which a tea- spoonful of the psrygoric elixir may occasionally be added. Burnt paper, feathers, or leather, may be 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 infant when in bed should always be laid so that it can- not tumble clown with its head under the bed-clothes; aud when in a cradle, its face ought never to be covered. A small degree of atten- tion to these two simple rules would save the lives of many infants, and prevent others from being rendered weak and sickly all their days by the injuries done to their lungs. Instead of laying down a plan for the recovery of iufants who are suffocated, or overlaid, 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, aud contains almost every thing that can be done on such occasions. A nurse having had the misfortune to over-lay a child, he was call-. eel in aud found the infant without any signs of life; no pulsation in the arteries, no respiration, the face livid, the eyes open, dull, auel tarn- ished, the nose full of snivel, the mouth gaping, in short, it was almost cold. Whilst some linnen clothes and a parcel of ashes Avere warming, he had the boy unswathed, and laid him in a warm bed, and on the right side. Hethen was rubbed all over wiih fine linnen, for fear of fretting his tender and delicate skin. As soon as the ashes had re- ceived their due degree of heat, Mr. Janin buried him in them, ex- cept the face, placed him on the side opposite to that on which he had been at first laid, and covered him vvith a blanket. He had a bottle * These accidents are not always the effects of carelessness. I have known an infant overlaid by its mother being seized in the night with au hysterick fit. This ought to serve as a caution against employing hysteric women as nurses, and should likewise teach such women ne- ver to lay au infant in the same bed with themselves, but in a small ad- jacent one. S92 OF PERSONS WHO EXPIRE of cau de luce in his pocket, Avhich he presented to his nose from tfnne to time; and between whiles some puffs of tobacco were blown up his nostrils: to these succeeded the blowing into his mouth, and squeezing -tight his nose. Animal heat began thus to be excited gradually ; the pulsations of (he temporal artery were soon felt, the breathing became .more freqient 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 happened to him. Though the pulsations, of the arteries were by this time very well reestablished, and it was hot weather, yet Mr. Janin thought it advisable to leave his little pa- tient three quarters of an hour longer under the ashes. He was after- wards taken out, cleaned and dresseel 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 twenty-nine minutes hanging, aod 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, mou1h, 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 windpipe, and air blown strong I v through a canula into the lungs. About twenty minutes after this, the bhod at the artery began to run down 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 aud nodg mindssuperioi to local prejudices, are capable of distinguishing diseares with accuracy, and of forming a souuel judg- ment respecting the genuine effects of medicines. vViihout a pr..;>er discrimination with regard to the diseases aid the coiHtituii j>n of the jnient, the most powerful medicine is more likely to do harm than good. Every one knows that the same physician who, by cold bathing, cured Augustus, by an imprndent use of the same m diciue, killed his heir. This induced the Roman senate to make laws for regulating the baths, and preventing the numerous evils which arose from au imprudent and promiscuous u.-e of those elegant and fash- ionable pieces of luxury. But as uo such laws exist in this country, every one docs that which is right in his own eyes, and of course many must do wrong ! People are apt to imagine that the simple element of water can do no hurt, anel that they may plunge into it at 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 never could be wholly eradicated. Nor are examples want- ing, either in aucieut 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 iu 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 autiquity: indeed it must have been coeval with man himself. The necessity of water for the purpose of cleanliness, and the pleasure arising from its application to the body in hot countries, must very early have recommended it to the human species. Even the example of oth- er auimals was sufficient to give the hint to man. By instinct many of them are fed to apply colel water in this manner; and some, wheu de-* prived 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, aud to guard peo- ple against an improper use of it. The cold bath recommends itself in a variety of cases, and is pe- eullarly beneficial to the inhabitants of populous cities, who indulge in idleness, and lead secfeutary lives. In persons of this description the action of the solids is always too weak, which induces a languid circu- lation, a crude indigested mass of humours, and obstructions in the Capillary vessels and glandular system. Cold water, from its gravity fcs Avell as its tonic powers, is well calculated either to obviate or re- lecre these symptoms. It accelerates the motion of the blood, pro* OF COLD BA THING, 351 motes the different secretions, aud gives permanent vigour to the sol- iels. But all these important purposes will be more essentially answer- ed by the application of salt water. This ouglit not only to be pre- fened on account of its superior gravity, but likewise fer its greater power of stimulating the skin, which promotes the perspiration, and prevents the patient from catching cold. It is necessary, however, to observe, that cold bathing is more like- ly to prevent, than to remove obstructions of the glandular or lympha- tic system. Indeed, when 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, anil hurry the unhappy patient into an untimely grave. It is tlieretore of the utmost importance, previous to the patient's entering upon the use of the cold bath, to determine whether or not he labours under any obstinate obstructions ot the lungs or other viscera; and where this is the case cold bathing ought strict- ly to be prohibited.* In what is called a plethoric state, or too great a fullness of the body, it is likewise dangerous to use the cold bath, without due preparation. In this case there is great danger of bursting a blood vessel, or occa- sioning an inflammation of the brain or some of the viscera. This pre- caution is the more necesssary to citizens, as most of them live full, and are of a gross habit. Yet what is very remarkable, these people re- sort in crowds every season to the sea side, and plunge in the water witho.it the least consideration. No doubt they often escape with im- punity ; but does this give a sanction to the practice ? Persons of this description ought by no means to bathe, unless the body has been pre- viously prepared by suitable evacuations. Another class of patients who stand peculiarly in need of the bra- cing qualities of cold water, is the nervons. 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. Nervous people have often weak bowels, and may, as well as others, be subject to congestions and obstructions of the viscera; and in this case they will not be able to bear the effects ef cold water. For thera, anel indeed for all delicate people, the best plan would be to accustom themselves to it by the most pleasing and gentle degrees. They ought * The late celebrated Dr. Smollet has indeed said, that if he were persuaded he had an ulcer in the lungs, he would jump into the cold bath; but here the Doctor evidently sho'.vs more courage than discre- tion ; 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 inew it so in the latter. Indeed all the phthisical patients I ever saw, who have tried the cold bath, were evidently hurt by it. 398 OF COLD BATHING. to begin with the temperate bath, and gradually use it cooler, till at length the cold proves quite agreeable. Nature revolts agaiust all great transitions; and those Avhodo violence to her dictates, have often cause to repent of their temerity. WThcrever cold bathing is practised, there ought likewise to be tepid baths for the purpose mentioned above. Indeed it is the practice of some countries to throw cold water over the patient as soon as he comes out of the warm bath; but though this may not injure a Russian pea- sant, we dare not recommend it to the inhabitants of this country. The ancient Greeks and Romans, Ave are told, when covered with sweat aod dust, used to plunge iuto the rivers, without receiving the smallest injury. Though they might often escape danger from this imprudent conduct, yet it was certainly contrary to souud reason. I have 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 feast, ought to be taken, as may excite a gentle glow all over the body, but by no means so as to over- heat it. To young people, and particularly to children, cold bathing is of the first 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. Were infants early accustomed to the cold bath, it would seldom disagree with them ; and we should see fewer instances of the scrophula, rickets, and other diseases which prove fatal to many, and make others miserable for life. Sometimes indeed, these disorders render infants incapable of bearing the shock of cold water; but this is owing to their not hav- ing been early and regularly accustomed to it. It is however neces- sary here to caution young men against too frequent bathing ; as I have known many fatal consequences result from the daily practice of plung- ing 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 circum- stance, there is reason to believe, that violent head-aches, and other complaints, which frequently proceed from cold bathing, might be of- ten prevented. * The celebrated Galen says, that immersion in cold water is fit on- ly for the young of lions anel bears; and recommends warm bathing, as conducive to the growth and streugth of infants. How egregiously do the greatest men err whenever they lose sight of facts, and substitute neasoniug in physic in place of observation and experience. OF DRINKING MINERAL WATERS. 39§ The cold bath, when too long continued in, not only occasions an ex- cessive flux of humours towards the head, but chills the blood, cramps tiie muscles, relaxes the nerves, and wholly defeats the intention of bathing. H.mce, by not adverting to this circumstance, expert swim- ers are often injured, and sometimes even lose their lives. All the ben- eficial purposes of cold bathing are answered by one immersion, at a time; and the patient ought to be rubbed dry trie moment he comes out of the water, and should continue to take exercise for some time after. When cold bathing occasions chillness, loss of appetite, listlessness, pain of the breast or bowels, a prostration of strength, or violent head aches, 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 errors into which, from mere inattention, they are apt to fall, and thereby not only endanger their own lives, bat bring an excellent medicine into disrepute. OF DRINKING THE 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 water is indeed the most inoffensive of all liquors, and constitutes a principal part of the food of every animal. But this element is often impreg- uated with substances of a very active and penetrating nature; and of such an insidious quality, that, while they promote certain secretions, and even alleviate some disagreeable symptoms, they weaken the pow- ers of life, undermine the constitution, and lay the foundation of worse diseases than those which they were employed to remove. Of this every practitioner must have seen instances; and physicians of emi- nence have more than once declared that they have known more dis- eases occasioned than removed by the use of mineral Avaters. Tlris 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 this country, we shall be enabled to form an idea of ike danger 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 are chiefly confined. The waters most iu use for medical purposes in Britain, are those impregnated with salts, sulphur, iron, and mephitic air, d.:,er sepa- rately, or variously combined. Of these the most powerful is the sa line sulphurous water of Harrowgate, of which I have had more occa- sion to observe the pernicious consequences, when improperly used, than of auy other. To this, therefore, the following remaik; will more 4oa " OF DRINKING MINERAL WATERS. immediately relate, though they will be found applicable to all the purging waters in the kiugdora which are strong enough to merit at- tention.* 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 frosi the manner of using them, the quantity taken, trie regiraeu pursued, or using thera in cases where they are uot proper. A very hurtful prejudice still prevails in this country, that all dis- eases 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 thousaads, aud will in all probability, destroy many more before it can be whol- ly eradicated. Purging is often useful in acute diseases, and in chrodeal cases may pave the way for the operation of other medi- cines ; but it will seldom perforin a cure; and by exhausting the strength of the patient, will often leave him in a vrorse condition than it found him. That this is frequently the case with regard to the more active mineral waters, every person conversant in these ma Iters, will readily allow. Strong stimulants applied to the stomach and bowels for a length of time, must tend to weaken and destroy their energy ; aud what stimu- lants are more active than salt and sulphur, especially when these substances are intimately combined, and carried through the system, by the penetrating medium of water ? Those bowels must be strong indeed, which can withstand the daily operation of such active princi- ples for months together, aud not be injured. This however is th% plan pursued by most of those who drink the purging mineral Avaters, 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 quantity 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 eraelicating his disorder, he is of en in fact undermining the powers of life, aud ruining his constitution. In- * The greatest class of mineral waters in this country is the chaly- beate. Iu many-[parts of Britain these are to be found in almost every field; but those chiefly in use. for medical purposes, are the pursiing chalybeates, as the waters of Scarborough, Cheltenham, Thorp Arch, Nevil Holt, &c. Of those which do not purge, the waters of Tun- bridge stand in the highest repute. The Saline purging waters, as those of Acton, Epson, Kilburn, Sic. are aNo in very general extern; Lu'. the fountains most frequented by the sick in this countr,., aie those I Avhich the minerals impart a certain degree of heat, as Bath, IfeLio' Buxton, Sic. OF DRINKING MINERAL WATERS, deed nothiig can do this so effectually as weakening the powers of digestion by the improper application of strong stimulants. The very essence of health depends on the digestive organs performing their due functions, and the most tedious maladies are all connected with indi- gestion. Drinking the water in too great quantity, not only injures the bow- «Is and occasions indigestiou, but generally defeats the intention for Avhich it is taken. The diseases for the cure of which mineral waters are chiefly celebrated, are mostly of the chronic kind; aud it is well knowu that such diseases can only be cured by the slow operation of dternatives, or such medicines as act by inducing a gradual change iu the lnbit. This requires length of time, and never can be effected by mediciues which run off by stool, and operate chiefly ou the first pa.^Fges. Those who wish for the cure of any obstinate malady from the min- eral waters, ought to take them in such a manner as hardly to produce any effect whatever on the bowels. With this view a half-pint glass may be drank at bed time, * and the same quantity an hour before breakfast, dinner, and supper. The dose, however, must vary accor- ding to circumstances. Even the quantity mentioned above will purge some persons, while others will drink twice as much without being in the least moved by it. Its operation em the bowels is the only stand- ard for using the water as an alternative. No more ought to be taken than barely to move the body; nor is it always necessary to cany it this length, provided the water goes off' by the other eraunctories, and does not occasion a dullness, or flatulency in the stomacfeor bowels. When the water is intended to purge, the quantity mentioned above may be all taken before breakfast. I would not only caution patients who drink the purging mineral waters over night, to avoiel heavy suppers, but also from eating heavy meals at any time. The stimulous of water, impregnated with s lis, seems to create a false appetite. I have seen a delicate person, af- t r drinking the Harrowgate waters of a morning, eat a bieakfast s.iflicieut to have served two pfoughmeu, devour a plentiful dinner of flesh and fish, aud, to crown all, eat such a supper as might have satisfied an hungry porter. '* When I speak of drinking a glass of the water ov^er night, I must beg leave to caution those who follow this plan against eating heavy *'ipuers. The late Dr. Daultry of York, who was the fir-t that brought the Harrowgate waters into repute, used to advise his patients t» elriiik a glass before they went to bed ; the consequence of which vas, that having eat a flerii supper, aid the water operating in the n'.ght, tlit-y were often tormeoltdwbh gripes-aud obliged to call for medical asri^taucc. 51 402 OF DRINKING MINERAL WATERS. All this, indeed, the stomach seemed to crave ; but this craving had better remain not quite satisfied, thau that the stomach should be loadeel with what exceeds its powers. To starve patients was never my plan ; but 1 am clearly of opinion, that in the use ol all purging mineral waters, a light and rather diluting diet is the most proper; and tint no person, during such a course, ought to eat to the full ex- tent to what his appetite craves. To promote the operation of mineral waters, anel 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 kiuds of exercise are those connected with amusement. Every thing that tenels to exhiler- ate the spirits, not only promotes the operation of the waters, but acts as a ineelirine. All who resort to the mineral waters ought there- fore to leave every care behind, to mix wiih the company and to in ike themselves as cheerful and happy as possible. From this conduct, assisted by the free and wholesome air of those fashiona- ble places of resort, aud also the regular and early hours which aie usually kept, the patieut often receives more benefit thau from iniug the waters. But the greatest errors in drinking the purging mineral waters arise from their being used iu cases where they arc absolutely improper, and adveise to the nature of the disease. When people hear of a wou- derfol cure having been performed by some mineral water, they im- mediately conclude that it will cure every thing, and according- ly swallow it down, when they might as well take poison. Pa- tients ought to be well informed, before they begin to drink the more active kinds of mineral waters, of the propriety of the course, aud should never persist iu using them when they aie found to aggravate the disorder. In all cth'g where purging is indicated, the saline mineral waters will be found to fulfil this intention better than any other medicine. This operalion, if taken in proper quautity, is generally milel ; and they are neither found to irritate the nerves, nor debilitate the patient so much as the other purgatives. As a purgative, these waters are chiefly recommended in diseases of the feist passages, accompanied with, or proceeding from, inactiv- ity of the stomach and bowels, acidity, indigestion, vitiated bile, worms, putrid sores, the piles and[ jaundice. In most cases of this kiud they are the best medicines that can be aehniuiaered. But when used with this view, it is suffjdeut to take them twice, or at most three times a week, so as to move the body three or lour times ; und it will be proper to continue this couise for some weeks. But the operalion of the more active mineral waters is not confined to the- bowels. They often promote the discharge of the urine, and not infrequently increase the p. ;>diaikm. This shews that they are OBSERVATIONS CONCERNING DIET, &c, 403 capable of penetrating into every part of the body, and of stimulating the whole system. Hence arises their efficacy in removing the most obstinate of all disorders, obstructions of the glandular and tymphatrc system. Uuder this class is compreliendeel the scrophula or King's evil, indolent tumours, obstructions of the liver, spleen, kidnies, ajel mesenteric glands. When these great purposes are to be effected, the waters must be used in the gradual manner mentioned above, and per- sisted in for a length of time. It will be proper however now aud then to discontinue their 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, bloches, foul ulcers, Sic Though these may seem superficial, yet they are often the most obstinate which the physician has to encounter, aud not unfrequently set his skill at defiance; but they ivill sometimes yield to the application of mineral waters for a sufficient length of time, and in most cases of this kind these Avaters deserve a trial. The saline sulphureous waters such as those of Moffat in Scotland, and Harrowgate iu England, are ihe most likely to succeed in diseases of the skin; but for this purpose it will be necessary not only to driuk the waters, but likeAvise to use them externally. To enumerate more particularly the qualities of the different mine- ral waters, to specify those diseases in which they are respectively in- dicated, and to point out their proper nioeles of application, would be an useful, and by no means a disagreeable employment; but as the lim- its prescribed to these remarks will not allow me to treat the subject at more length, I shall conclude by observing, that whenever the min- eral waters are founel to exhaust the strength, depress the spirits, take away the appetite, excite fevers, distend the bowels, or occasion a cough, they ouglit to be discontinued. CHAPTER LVI. OBSERVATIONS CONCERNING 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 country, are owing to their mode of living. The vegetable productions they consume, fall considerably short of the proportion which they ought to bear to the animal part of their food. The constant use of bread, and animal substances, excites an unnatural ihirst, and leads to the immoderate use of beer and other stimulating 464 OBSERVATIONS CONCERNING DIET, 6c. liquors, which generate disease aod reduce the lower orcfors of people to a state of indi-enee To teach the poor man how to live cheaper and better, is the design of the following pages. Though the common people of tins country live at a greater expensr than any where else, it does not follow that they live better. They aie strong it-deed, 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 anel death iu foreign cliinrs, than the inhabitants of any other country. It is certainly proper that a 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 rm>nomy in living, be deemed trivial, In a country where the riches depend ou the cheapness of labour. It is a'dedged that the English are so much attached to their own modes of living, that no argument will induce them to make the small- est change. Habits are indeed obstinate things, especially those which relate to diet; but there are proofs that the English t»re not inflexible even in this matter. The mode of living among the lower 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 reason provided due care were taken to instruct them. But here the people may be tiui) said *■'to perish for want of knowledge." No means have been used to give them proper instruction. Hurtful cus- toms 11:-v;-• been suffered to prevail, till they have struck such deep roots that it Avill not be an easy matter to eradicate them. The diffi- culty, however, is cot insurmountable. A lew experiments of refoim wotild have the effect to render it as agreeable as it is salutary. Aeluits have many old prejudices to overcome, but the case is differ- ent in regard to children. They may be taught to use any kind of food, and what they use when youug tiiey will love when old. If I can introduce a different method of feeding children, my purpose will be auswcreel This aloue will, in time, effect a total change in the general moele of living. J in late distress of the poor has called forth m?.ny publications in- tended for their relief. Most of them, however, were adapted only for the paiticnlar occasion, ard not calculated to prevent the return of like ew.<. The following observations, it is hoped, will have a more permanent effect. They are intended to recommend a plan of living, which will reneler the people less dependent on bread and animal food (or their subsistence, and consequently not so liable to suffer from a scarcity or e'earth of either of there articles in future. Particular attention has been paid to the substitutes for bread, as the Bcarcit} of this article proves peculiarly distressing to the poor. K will appear from the following pages, that bread is by no means so GENERAL OBSERVATIONS ON ALIMENT. 4j5 rr.uch a necessary of life as generally imagined, and that its place may, in many instances, be supplied by a variety of other farinaceous Hibstaurc*. GENERAL OBSERVATIONS ON ALIMENT. NO creature eats such a variety of foot! ?s man. Intended for an ^habitant of every climate, he devours the productions of them all; and if they do not suite his palate, or agree with his stomach, he calls in the aid of cookery, an art peculiar to himself; by which many things that, in a crude state, would'prove hurtful, or even poisonous, are ren- dered whohsome and salutary. . The obvious division of food is into animal and vegetable. To siy that man was intended by nature for using either the one or the other alone, would be absurd. His structure aud appetite prove that he was formed for both. Judgment, however, is requisite iu adjust- ing thedue proportions ofeacb,soas to avoid the inconveniences, arising from an extreme on cither hand. Though animal food is more nourishing than vegetable, it is not safe to live on that alone. Experience hf:s shewn that a diet consisting solely of animal food, excites thirst, and nausea, occasions putres- cence in the stomacii and bowels, anel finally brings ou violent gri- ping pains with cholera and dysentery. Animal food is less adapted to the sedentary than the laborious, and least of all to the studious, whose diet, ought to consist chiefly ot veg- etables. Indulging in animal food renders men dull, and unfit for the pursuits of science, especially when it is accompanied witii the free use of strong liquors. t The plethoric, or persons of a full habit, should eat sparingly of animal food. It yields far more blood thau vegetables taken in the same quantitv, and of course may induce inflammatory disorders. It acts as a stimulus to the whole system, by which means the circula- tion of the blood is greatly accelerated. # I am inclined to think, that consumptions, so common in England, are in part owing to the great use of animal food. Though the fhthisis Pulmonalis properly speaking, is not an inflammatory dis- ease, yet it generally begins with symptoms of inflammation, aud is often accompanied with them through its whole progress. But the disease most common to this country is the scurvy. One fends 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 devour- ed by the natives. As a proof that scurvy arises from this cause, we are in possession of no remedy for that disease equal to the free *rse •f fresh vegetables. OF BREAD. F>> the uuintcrnrVe,1 u«=e of animal food a putrid diathesis is indu- ced in the system, which predisposes to a variety of disorders. I am fully convinced that many of those obstinate complaints for which wc are at a loss to account, and 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 disposition of the English is almost proverbial. Were I to assign a cause, it would be, their living so much on animal food. There is no doubt but this induces a ferodty of temper unknown to men whose food is chie.'ly taken from the vegetable kingdom. Though these anel similar consequeuces 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 of the aliment ought nevertheless to consist of vegetable substances. There is a continual tendency in animal food, as well as in the human body itself, to putrefaction, which can only be counteracted by the free us* 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 cir- cumstances, as the heat of the weather, the warmth of the climate, and the like. The vegetable part, however, where nothing forbids, ought certainly to preponderate, and 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 affords bears but a small proportion to the quantity of vegetable matter he consumes. 1 am no enemy to good fruit, as an article of diet; but the greater part of Avhat is used in this country, by the lower orders ol" the pcopfe, in mere trash. Fruit should be eaten in the early part of the day, wheu the stomach is not loaded with food, aud it never ought to b« «ateu raw till it be thoroughly ripe. OF BREAD. BREAD, or something resembling it, makes a part of the diet of nil nations. Hence it is emphatically denominated ihe staff of life. It may, however, be used too freely. The late Dr. Eothergiil was of opinion, and I perfectly agree with him, that most people eat more bread thau is conducive to their health. I do not mean to insinuate that bread is unwholesome, but that the best things may prove hurtful when taken to excess. A surfeit of bread is more dangerous than of any other food. Omnis repletio mala repktio panis pessima. The French consume vast quantities of bread ; but its bail effects are pre- vented by their copious use of soups and fruits, which have little or »t» share in the diet of the common people of England. OF BREAD. 407 One important use of bread is to form a mass fit for filling up the alimentary canal, and carrying the nutritious juices aloug that passage iu such a state as to render them fit to be acted upon by the lacteal absorbents, which take up the nourishment aud convey it to the blood. In this light bread may be considered as a soil from whence the nourishment is drawn. I do not say that bread contains uo noui- ishment, but that its use, as an article of diet, does not solely depend on the quantity of uutriment its contains, but in some measure, on its fitness as a vehicle for conveying the nutritious particles through the intestinal tubes. Hence it follows, that the finest bread is not ahvays the best adapteel for ausweriug the purposes of nutrition. The richest food will uot nourish an animal, unless the alimentary canal is sufficiently distended. A dog has been fed on the richest broth, yet couhl not be kept alive ; while another, which had ouly the meat boiled to chip and water, throve very well. This shews the folly of attempting to nourish men ou alimentary powders and oth- er concentrated food. The great art therefore of preparing food, is to blend the nutritive part of the aliment with a sufficient quaulity of some light farinaceous substance, iu 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 aelaptcd to the narrow circumstances of the lower orders of the people, as it is burthened with loo heavy additional charges, in passing through the hands of both the miller aid the baker. Besides, the former often grinds down extraneous matter with the wheat, and the latter as fre- quently bakes it up with the adelition of lime, chalk, alum, aud other pernicious substauces. Since the articles of diet have become branch- es of manufacture, the publick neither know what they eat or what tiiey drink. People imagine, as the finest flour contains the greatest quantity of nourishment, that it must therefore be the most proper for making into bread; but this by no means follows. The finest flour comes the near- est to starch, which though it may occasionally prove a good medicine, makes bad bread. Household bread, which is made by grinding down the whole graiu, aud only separating the coarser brau, is without doubt the most wholesome. The b?st household bread I ever remember to have eat, Avas in the sounty of York, it was what they called meslin bread, anel consisted of wheat aud rye giound together. I am not quite Certain as to the proportion; but I think there might be two parts of the former to out-. of the latter. This bread, when well fermented, eats light, is of a pleas- ant taste, and soluble to the bowe!*- After using it for *omc years, I 408 OF BREAD. found that bread made entirely of flour was neither so agreeable to the palate, nor so conducive to health. Bread is often spoiled to please the eye. The artificially whitened, drying, stuffing breael, though made of the heart of the wheat, is in reality the worst of any ; yet this is the bread which most people pre- fer, aud the poorer sort will eat no other. All the different kinds of grain are occasionally made into breael, some giving preference to one and some to another, according to e ar- ly custom anel prejudice. The people of South Britain generally prefer bread made of the finest wheat flour, while those of the north- ern counties eat a mixture of flour and oatoieal, or ryemtal, and many give ihe pre. ference to bread made of oatmeal alone. The com- mou people of Scotland also eat. a mixed bread, but more frequently bread of oatmeal only. In Germany the common bread is made of rye, aud the American labourer thinks no bread so strengthening at that which is made* ot Indian corn; nor eio I much doubt but (he Laplander thinks his bread, made of the bones of fishes, is the best of any. Breael made of different kinds of giaiu is more wholesome thau what is made of one only, as their qualities serve to correct one an- other. Eor example, wheat flour, especially the finer kind, being of a starchy nature, is apt to occasion constipation. Bread made of ryemeal, oil the other hand, proves often too slippery for the bowels. A due proportion of these makes the best bread. For the more active and 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, and to use his own language, they lie longer on his stomach than bread nude of wheat flour only. Barley bread passes too quickly through the alimentary canal to afford time for conveying the proper nourishment; but bread made of barley mixed with peas is very nourishing. When potatoes, or boiled grain, are used, bread ceases to be a bccessary 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, aud 1 fouud no inconvenience wliatever from the change. Nay, some told me, that for a considerable time they had left off the use of hread altogether, without experiencing any change iu the slate of their health. A great part of the bread consumed in this country is by children. St i> always ready, and when children call for food, a piece of bread is put into their hanels, to save the trouble of diesring any o her kiud of victuals. Of mauy children this is the principal food, but it is for from being the most proper. Children are often troubled wiih aci dies of ilte stomach aud bowels; a;d it is well kujvvj thai OF BREAD. fog bread mixed with wafer, and kept in a degree of heat equal to that of the human stomach, soon turns sour. During the late scarcity, many of the laboui-iug men, and even ar- tificers, could not earn as much money as Avas sufficient to keep their families in the article of breael only. It is certain, however, that on a different plan, such families might have lived very comfortably. Ma- ny 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 se- lection of the articles of diet. The English labourer lives chiefly on bread, which being ac- companied with other dry, and often salt food, fire3 his blood, and excites an unquenchable thirst, so that his perpetual cry is for drink. But the greatest consumption of bread is occasioned by tea. It h said that the subjects of Great Britain consume a greater quantity of that herb, than the whole inhabitants of all the other nations of this quarter of the globe. The poorest woman in Eugland must have her tea, and the children generally share it with her. As tea contains no nourishment, either for young or old, there must of course be bread and butter to eat along with it. The quartern loaf will not go far a- mong a family of hungry children, and if we adel the cost of tea, sugar, butter, anel milk, the expense of one meal will be more than would be sufficient to fill their bellies with Avholesome food three times a day. There is reason to believe that one half the bread consumed iu Eng- lanel is used to tea, without one hearty meal ever being made of it. The higher ranks use tea as a luxury, while the lower orders make a eliet of it. I had lately occasion to see a striking instance of this in .7 family that was represented to me as iu distress for want of bread I sent them a Utile money, and was informed that they ran away with it directly to the tea shop. To a heavy, sluggish, phlegmatic man, a moelerale use of tea may not prove pernicious; but where there is a debilitated stomach and an irritability of fibre, it never fails to do much hurt. With many it has the effect to prevent sleep. Tea will induce a total change of constitution in the people of this country. Indeed it has gojje a great way towards effectfog that evil t heady. A debility and consequent irritability of fibre, are become so common, that not only women but even men, are affected with them. That class of diseases which, for want of a better name, we call ner- vous, has made almost a complete conquest of the one sex, aud is ma- I ing hasty strides towards van<|iii*hiug 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 shun t,:a as the most deadly poison. No ma:i can love a woman eaten up with vapours, or washed down with diseases arising from relaxation 410 OF BOILED GRAIN. 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 tbiuk it could not be better employed than in Avritiug 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 substance's should always assume the name and form of bread. jVLany of them are more wholesome, and not less agreeable in other forms. Bread is o'e:t used merely to save the trouble of cookery ; aud being portable, is the most convenient article of diet for carrying a- broad. 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 L the most wholesome. Simple boiling pre- cludes all adulteration, aud 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 breael. It may either be eaten alone or with milk. In the East it is used with meat, in the same manner as we do bread. The people of this country believe that rice proves injurious to the eyes, but this seems to be without foundation; it has no such effect on those who make it the principal part of their food. r-.fany other kinds of grain will, when boiled, make good substitutes for breael. Even those which make a harsh and unpleasant sort of bread, are often rendered very palatable by boiling. This is the case with all the leguminous class of plants, as peas, beans, &c. Even oats and burley are more agreeable, as well as more wholesome, wheu boiled, than made into bread. All allow that peas and beans boiled, wheu young, are a great lux- ury. But when old, they are equally wholesome, and. when proper- ly cooked, by no means unpleasant. There are few who do uot rel- ish peas pudding, aod 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 whoever eats this broth will find idle occasiou for bread. Peas and beans contain an equal quantity of sugar with wheat, oats, or bttrley, aud at the same time a greater proportion of oil, cpuse- OF BOILED GRAIN. 411 m'lently are more nourishing. This fact is confirmed by daily expe- rience. On those farms where 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 dimiuutiou 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 Avhen crops of that kind are duly alternated with crops of wheat, barley, or oats, the fertility ot the soil may be maintained without rest or manure, for many years together ; whereas, if the latter be raised on the same soil foi sever- al years successively, they render it barren, so that, without rest or manure, its fertility cannot be preserved. The people in England are but little accustomed to the use of boil- ed grain, though in many countries it is eaten as a iuxury. Boiled barley is a great favorite with the Dutch, and is eaten with milk, but- ter, or molasses. It is the principal food of the Dutch sailors, Avho in general, are both healthy and robust, Barfey is one of the best ingredients in soup. Count Rum ford says it possesses the quality of tithing, or thickening soups, in a superior degree to any other grain. We have reason, however, to believe, that grits, or coarse oatmeal, will answer that purpose still better. Oatmeal is frequently made into bread ; but it is a much more wholesome, as well as agreeable food, Avhen made into hasty pudding, and eaten with milk. The peasants in many parts of Britain make two meals a day of it, Avhile their children almost Avholly subsist on it ; and it is well known that both old and young afIio are thus fed, are healthy aud robust. The opinion of oatmeal being heating, aud occasioning skin dis- eases, is wholly Avithout foundation. Bread made of oatmeal, Avhen not leavened, will sometimes occasion the heart burn ; but this is no proof of its heating quality. Unleavened bread,.of Avheat or any other grain, produces the same effect on a debilitated stomach. Oat- meal thoroughly boiled seldom gives the heart-burn. Persons who are fed on oatmeal bread, or hasty pudding, arc not more subject to diseases of the skin than those who live on wheatmea). Cutaneous disorders proceed more from the want of cleanliness, than from any particular aliment. The Erench, 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, and sick people of every description, which shows that they are inconsist- ent with themselves, in alledging that the blooel is fired by the use of oatmeal. A lieutenant of the army, residing at a country village within a few wales of Edinburgh, with a wife and tea children, having no othec ;« 412 OF BOILED GRAIN. come than his half pay, led the whole of his children with hasty piick ding and buttermilk only, from a conviction that it was the most whole- some; and full diet that fejl within the reach of his narrow circumstan- ces, f hey grew apace, and it was the universal remark of the ueigh- bonhood. that they were as uprightly, healthy, an l robust as othei chilelren, and at the same sime perfectly free from all skin diseases. Chiforen are seldom well, unless when their bodies are gently open. But this is more likely to be ihe case when fed on oatmeal and milk, thau when their bellies are crammed with a stareh) substance made of the finest flour; yet this in England is the common food of chil- dren. I have s:^en an infant stuffed four or five times a day with this kind of food. There needs no conjurer to tell the consequences. A late Author, a man of learning, but the dupe of prejudice, has by a ridiculous definition, endeavoured to represent oats as proper food for horses only. I Avish the horses in England elevoured a smaller quantity of thai grain, and the people more. Few things would have a gienter tendency to lessen the' expense of living. The oats in North Britain are of a superior quality, anel I hope the people will long have the sense to use them as an article of diet. lnelian corn is likewise saiel to make the best food when boiled. Count Rumford observes, that of all things it make s the best pudding, and that he has made a hearty meal of it, sauce included, for five far- things. What makes good puddings. will make good dumplings, ami these will, at any time, supply the place of breael. The Count also rcmniks, that the negroes in America prefer Indian corn to rice; and that the Bavarian peasants prefer it to wheat; that it might be im- ported from North America at about four or five shillings per bushel; that when mrde into flour, it Avoulel cost oily one penny farthing per pound; and that it is highly nutritious, and the cheapest food known. During the late scarcity a large quantity of this graiu was imported; but such is the aversion ot the common people of this country to every Sort of food to Avhich they are not accustomed, that tliey refused to pur- chase it, and the merchants were very great loosers by the importation. On the same principle the Geimaus, till within a few years, could not be induced to eat potatoes, though now they are become extremely lond cf them. The American, the Italian, and the German, all cook Indian cora the sumo way as the INorth Briton does his oat meal, by making it info liast) pudding. It may be eaten in a variety of ways. Seme cat it wiih a sauce composed of butter aod brown sugar, or butter and mo- lasses. Others eat it with milk only. In either way it makes a good, .cheap anel wholesome diet, by no means disagreeable to those wlioare ^accustomed to it. , 1 he only other grain we shall mention as best when boiled, is buck- wheat: It is of a very mucilaginous nature, and of course highly nutri- Wouj. Jn fevcral parts of Europe, it constitutes a principle part of the OP BUTTER. 413 food of the fower people. In former times it was eaten in Russia, not by the lower classes only, even tfie nobility made use of it. Boiled. and then buttered, it was so great a favfourite of the great Czar Peter, that he is said to have seldom supped on any thing else. OF BUTTER. 1T 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, miy be used too freely, and in this country, I am convinced that is the case. To weak stomachs it is hurtful, even in small quantities, and when used freely, it proves prejudicial to the strongest. Butter, like other things of an oily nature, has a constant lendency to turn rancid. This process, by the heat of the stomach, is greatly accelerated, insomuch that many peopfe, soon after eating butter, com- plain of its rising in their stomachs, in a state highly disagreeable. Oils of evevy kind are with diflicul'y mixed with watery fluids. This is the reason why butter floats on the stomach, aud rises iu such an unpleasant manner. Persons afflxted with bile should use butter very sparingly. Some Sceptical authors doubt Avhether or not aliment of any kioel lias au ef. feet on the bile. Onethiug, however, is certain, that many patients af. flicted Avith complaints which were supposed to be occasioned by bile, have been completely cured by a total abstinence frotfl 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 cholera morbus and the like. Nor an such complaint? be cured, till the ranciel matter is totally evacuated by vomiting and purging. But supposing butter did not possess the quality of becorning 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 appe.ite. The free use of butter, and other oi'y substances, not only tends to relax the stomach, and impede its action, but to induce a debility of the solids, which paves the way to many maladies. In a country Avhere two thirds of the inhabitants lead sedentary lives, a debility of fibre must predominate. Whatever increases that debility ought to be avoided. Children, without exception, are disposed to diseases arising from relaxation. Butter of course, ought to be giA en to them with a sparing hand. But i* this the case ? By no m >a.,s. Bread and butter constitute a great part of the food of chiiirer, and I *m convinced that the gross 'humours with which they are frequently troubled, are partly owing to A\A OF BUTTER. this food. As children abound with moisture, bread alone is, generally speaking, bei'x-v for them than breael and butter. I have been astonished to see the quantities of butter eaten by grors womeu who lead sedentary lives Their tea bread is generally contri- ved so as to suck up butter like a sponge. What quantities of crum- pets anel muffin? they will devour iu a morning,' soaked with this oil; and afterwards complain of indigestion, Avheu they have eaten what would oveil'Md the storruch of a ploughman. Dr. i'othergill is ol opinion, that butter produces the nervous or sick heael-ache, so common amoug the women of this country. As a proof of this, it is often cured by au emetic. Oils, in certain quantises, excite nausea, and even vomiting. They must of course prove unfriendly to digestion. A Dutch sailor, we arc told, can digest ham oil. So may an English sailor; 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 aud fish of almost cvr.y description, is certainly wrrong. The flesh eaten in this country is generally fat enough Avithout the addition of butter, and the more oily kinds of fish, as sabnoii or herrings, are lighter oa the stomach, and more easily digested when eaten Avithout it. Butter is rather a gross food, aid fitter for the athletic and labori- ous, than the sedentary and delicate. It is less hurtful Avhen eaten fresh than salted. Salt butter certainly tends to induce skiu diseases, and I am iuclined 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 iu England. What I mean is to mix it with au equal quantity of hone/, and keep it for use. In this Avay it may be given to children with greater freedom. In North Britain this raethod of mixing butter with honey is well known, and from theoommon proverb, I take the castom to be very ancient. Butter, in itself, ia not so hurtful, as when combined with certain other things. For example: bread made with butter is almost indigestible, and pastries of every kind are little better: yet many people almost live upon pastry, and it is universally given to ehihlren. It is little better, how- ever, than poison, and never fails to disorder their stomaclis. The fond mother cannot pass a pastry shop, without treating her darling boy Avith some of the dainties, and then wonders how lie got the cough, *r cholic. I have known a man seemingly in perfect health, who by eating a. penny-worth of pastry, as he passed alcug 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 dng bak*d with batter. OF BROTHS AND SOUPS. 4U ^ Every thing that proves very injurious to health ought, as far as pos- sible, to be prohibited, by laying a high duty up, .;.. \ V.y ou pastry would be serving the public in more respects thau one. It would save many lives, and fesseti some tax on necessaries. Cheese, as a eliet> is likewise injurious to health. It should never be oaten but as a dessert, it occasions ccnwipHiioa, fiiec the blood, and excites a constant cravhg for drink. It is very improper for the sedentary, and hardly to be digested, even by the athletic. If men will live on dry bread, poor cheese, salt butter, broiled ba- con, aud such like parching food^ they will find their way to the ale-. house, the bane of the lower orders, aud the source of half the beg- gary iu the nation. OF BROTHS AND SOUPS. THESE may likewise be considered as substitutes for bread. If properly maele they will serve uotli for bread aud drink. Though broth is a dish of the greatest antiquity, aud may be considered as ex- tremely delicious, yet it is not.a favourite in this country, nere 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 can, get. The ody difference is, the foreigner makes hh broth in a pot, aud 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 ; whe e «? in any other eountry in Europe, that quantity of animal food, wheu 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 heen devised by the humane for relieving the distresses of the poor, a better and more ex'eurive charily cauuot be devised than that of instructing them in a new mode of cookery. The same author adds that the result of his experiments ou ihh sub- ject had exceeded his most sanguine expectations, and that each day gave him fresh proofs of the excellency of his plan for teaching the poor and neady to find themselves in a wholesome and palatable diet, a' the cheapest rate, iu which little or no breael was required He concludes; by asserting that there is scarce a place in this kingdom where twenty persons may not have a wholesome, hearty, and palatable meal for three shillings. The writer who has paid most attention to the improvement of cod: • ery for the benefit of the poor, is Count lifimford. In his economic; 1 and philosophical essays, he has given such a variety of* forms for ma- king wholttfume, cheap aud nourishing soups, stews, and other ddes for common use, that little more seems necessary to be said on the sub- J"ect. I shall only obreivc that the mode cf liv"; g on broths, soups, liisfy-iuidding, and such like, so warmly and justly rccoraraci iu! by 41-3 OF BROTHS AND SOUPS. the Count, has b-e.i practised in the northern parts of this kingdom, from time immemorial. There the food of the common people is hasty pudding with milk for breakfast and supper, and broth, with ve- getables and meat for dinner. The poorer sort often make broth with- out meat; but th.iy all use vegetables in great abundance, and some- times they supply the place of meat with butter. As the hasty-pudding and milk make a complete meal, no bread is necessary either at sup- per or breakfast; neir is much required at dinner, as the broth is maelo thick with barley, cabbage, and a variety of other vegetables or pot- herbs. Cabbage is a favoinbe ingredient in the Scotchman's broth. It is seldom made without this article, which is not eaten so early as in Engl. d. It is there suffered to grow to maturity, and when that is the case there is no plant more productive. This the Germans know Avell, and make: it into sour croul, one of the best antidotes against the seurvy with whie h we are acquainted. It would be i t wool 1 v s.irface, feeling like velvet. The flowers appear in August, fro.n the* bosom of the leaves on fruit stalks in a kind ol pamde, and are of a white or pale flesh colour. EA'ery part of the nrni'sh mallow,and especially the root, upon boiling, yields a copious mucilage; on account of which, it is frequently employ- ed in emollient cataplasms, and by way of infusion. In humid as' una, hoarseness, dysenteries, and likewise in nephritic and calculous complaints, it is of eminent service; as by lubricating aid relaxing the v« ssels, it procures a more easy passage to the st.ignant muds. It is with equal advantage applied externally, for softening and maturing lard tumors, mid when chewed, it is smd to afford n-iief in difficult teething. An ointment and syrup are made from the idiots of this plant. Andromeda Mariana. " A decoction of the Andromeda Mariana has been " found i'sdu.1 as a wash in a disagreeable ulceration of '■ the feet, which is not uncommon among the slaves, Sic. in the " Mint >eri'. st-Vs." This complaint is very common, particular- ly ai, > ig the ivrroes, aid the poorer sort of white people, in Carol a, Georgia, Sic. It is called "toe-itch," and " ground- itci;" u is a '«;>)'] of ulcerous excoriation between the toes, sowutmi • --ri-.id-ng ms higii as the instep, and is attended Avith nv>st inul.iv*.d-.* .♦.(;'.1:17. It is, probably, in a great measure, tfe- co'iseq-i'.m v y inattention to cleanliness. Is it occasioned by >.'-(.(• 'hii- ms.vts ? >o.ne persons, with whom I have convers- ed m the s'li'i-.-.t, are <>•' opinion, that it is owing to the great warmth odhe waters to the southwanl, in which the inhabit- ants are ace istom.d to wa le a great deal. The disease is some^ times seen in Pennsylvania. MATERIA MEDIO A. 421 The brown powder which is attached to the foot-stalks of the leaves of the Andromeda, is consielerably errhine. The powder about the seeds, in the seed-vessels of the same vegetable, pos- sesses a similar quality. Whether this powder may he advanta- geously employed in practice, 1 cannot say. Anethum Fceniculum. Fozniculum di''c^. Sweet fennel. The root aud seeds. This is a perennial plant, of which there are fom- varieties. One of these, the common fennel, is indigenous on chalky clifi's in England. The sweet fennel, the variety of which is officinal, grows wild in Italy, hut is also cultivated in gardens. Ji is smaller in all its parts than the common, except the seeds, which are considerably larger. The seeds of* the two sorts differ likewise in shape and colour. Those of the common are roundish, ob- long, flattish on one side, and protuberant on the other, of a dark, almost blackish colour; those of the sweet are longer, narrower, not so flat, generally crooked, and of a whit'sli or pale yellowish colour. The seeds of both the fennels lire, e an aro- matic smell, and a moderately warm pungent taste: those of the fceniculum dulce are in flavour most agreeable, and have also a considerable degree of sweetness. The seeds yield an excellent aromatic oil, which is carminative, resolvent, and diuretic, Avith- out heating the body. Anethum Graveolens. Dill. The see's. Dill is an annual umbelliferous plant, cultivated in guldens, as well for culinary as medical use. The seeds are of a pale yel- lowish colour, iu shape nearly oval, convex on one side, and flat on the other. Their taste is moelerately warm and pungent; their smell aromatic, but not of the most agreeable kind. The seeds are recommended as a carminative in flatulent coi.es. These seeds, with those of cummin, possess qualities and vir- tues similar to those of the anise and caraway, and are useel for similar purposes, but are scarcely entitled to a place in the ma- teria medica. Cummin however affords au oil peculiarly grate- ful to wild pigeons, and is frequently resorted to by the people in the country as a lure for those birds to the stand of the gunner. Antiiemis Nobilis. Chamomile. The floAvers- Chamomile is a perennial plant, indigenous to the south of England, but cultivated in gardens for the purposes of medicine* The flowers have a strong, not ungrateful aromatic smell, and a A-^ry bitter nauseous taste. Their active constituents aie bitter. ■122 MATERIA MED1CA, extractive, and essential oil. To the latter is to be ascribed., ilielV antiseptic, carminatiAe, cordial,and diaphoretic effects: to iue forme;', their iidlueuce in promoting digestion. Chamomile iiov-crs are a very common and excellent remedy, which is often used with advantage in spasmodic diseases, in hysteria, in spas- modic and flatulent colics, in suppression of the menstrual dis- diu:ie, in the vomiting of puerperal women, in after pains, iu gout, in inte-anittents, arid typhus. Erom its stimulating and somewhat unpleasant essential oil, chamomile is also capable of exciting A'omiting; and a strong infusion of the flowers is often used to promote the action of other emetics. In substance, it has been frequently given as a remedy in intermittent fever, in a dose of a drachm, or more, three or four times in the day. Chamomile flowers are applied as a discutient anel emollient, iu the form of clyster or fomentation, in colic, dysentery, strangu- lated hernia, Sic. ♦ Abbutus Uva-Ursi. Bearberry. Bear's Whortleberry. The leaves. The uva-ursi is a low shrub, somewhat resembling the myrtle. The leaves have a bitterish, astringent taste; and their astringent qualities are so considerable, that in certain places, particularly the provinces of Russia, they are used for tanning leather. A watery infusion of the leaves, immediately strikes a very black colour Avith chaKbeates. Dr. de Haen of Vienna,has bestowed very high encomiums on the uva-ursi, against ulcerations of the kidneys, bladder, and urinary passages. He represents it as capable of curing almost every case of that kind; and even asserts, that in cases of calculus, much benefit is derived from its use; patients after the employment of it, passing their urine without pain. It has not however answered the expectations, which, on these grounds, other practitioners formed of it. $ut in many affections of the urinary organs, it has proved to be a remedy of considerable use; and it has been particularly ser- viceable in alleviating dyspeptic symptoms in nephritic and cal- culous cases. From its astringency, uva-ursi has been employed in menorrhagia, and other fluxes, but more particularly in cys- tirrhoea, calculus, diabetes, and ulcerations of the urinary organs, in some of which affections, its efficacy is greater than has of late been allowed. Professor Barton of Philadelphia, from long experience of its efficacy, is high in its commendation, in cases of nephritis depending on gout, and has found it serviceable in old gonorrhoea. It is sometimes exhibited in the form of decoc- tion, but most frequently in that of powder, from a scruple to a drachm for a dose, repeated tAvice or thrice in a day. In tlie NeAv-England states, and in New-York and New-Jersey, MATERIA MEDIC A. 4-3 the uva-ursi, a low ever-green shrub, is found in great abundance trailing 011 the gro.md in dry, sandy sods, in woods, and on nio.mtains. The inhabitants, to whom it is known by the name of wild cranberry, have recourse to it with much confidence as a rcmeely, under various circumstances attending affections of the urinary organs. More lately it has been recommendeel in phthisis, and it is probable deserving of trial. For medicinal use the green leaves alone should be selected and picked from the twigs, and dried by a moderate exposure to heat. Arctium Lappa. Burdock. The root and se^ls,. This is a common plant about way-sides, sufficiently known from its scaly heads, or burs, which stick to the clothes. It bears purplish blossoms in July and August. The seeds have a bit- terish siibacrid taste : they are recommended as very effica- cious diuretics, g.veu either in the form of emulsion, or in pow- der, to the quantity of a drachm. The roots are esteemed ape- rient, diuretic, anel sudorific ; and are said to act without irrita- tion, so as to be safely used in acute disorders. Decoctions of them have of late been employed in rheumatic, gouty, and ve- nereal disorders, and are by some preferred to sarsaparilla. Angemone Mexicajja. Prickly Poppy. This abounds Avith a milky glutinous juice, turning in the air, into fine bright yelloAv, and hot distinguishable from gamboge ; said to be efficacious, in small doses, in dropsies, jaundice, and cutaneous eruptions ; deemed to be very detersive, and used in diseases of the eyes, the infusion is sudorific and resolutive ; the seeds are a stronger narcotic than opium, and frequently administered in the sugar colonies in diarrhaeas and dysenteries. In the West Indies it is called the yellow thistle. This appears to be a hardy annual, and without doubt can be cultivated ea- sily in the United States. Aristolochia Serpentaria. Virginia Snake Root. The root. A perennial medicinal plant, and a native production of the United States exclusively. The root consists of a number of small strings or fibres, matted together, issuing from one head, of a light brown colour, having a slightly aromatic smell and a pungent bitterish taste. This root is a warm stimulant, both diaphoretic, and diuretic, and esteemed one of the principal remedies in indignant fevers to support the powers of the sys- tem. It increases the pulse very perceptibly, and is improper rl24 MATERIA MED1CA. Avlicnevvr bleeding is required. It is given iu substance in do- ses of from twenty to thirty grains, and in infusion to a drachm or more, or it may lie administered in tincture, its active matter being entirely extracted by proof spirit. By decoction, its pow- ers are entirely destroyed. This root promotes the efficacy of cinchona in the cure of intermittents, and remittents, and is a remedy of considerable power in dyspepsia. Combined with calamus aromaticus, and infused in spirits, or water, it forms the common morning dram in aguish situations. Externally, it is used as a gargle, in putrid sore throat. Artemisia Absinthium. Common Wormwood. The leaves anil flowering heads. The absinthium or common wormwood, is a perennial herb, growing wild on the road sides, and is cultivated in gardens.— It floAvers in August; the smell of the leaves is strong and disa- greeable ; their taste intensely bitter. The active constituents of this plant, are bitter extractive and essential oil. It is used in stomacii complaints, and is of great service to hypochondri- acs. It is also employed in intermittent fevers, in cachectic and hydropic affections, in jaundice, anel against worms. Ac- cording to Dr. Withering, an infusion of the leaves is a good stomachic, and, with the addition of fixed alkaline salts, proves a powerful diuretic in some dropsical cases. Their ashes produce a purer alkali, than most other vegeta- bles. The essential oil, is used both externally and internally, for destroying worms. The herb, being an excellent antiseptic, is often employed in fomentations, to resist putrefaction ; and if the plant be macerated in boiling water, and repeatedly ap- plied to a bruise, by way of cataplasm, it will not only speedi- ly remove the pain, but also prevent the swelling and discoloura- tion of the part. Arum triphyllum. Indian Turnip. The root. The acrimony of the recent root of this plant is well known. By drying, much of this is lost. It has been very beneficial in asii una, especially in old people; in croup and whooping-cough. The recent root boiled in lard, to the consistence of ointment, li:sbeen fonr.d useful in tinea capitis. The dried root boiled n: milk, in die proportion of one root to a hdf pint, has been advantageous!/ employed in consumption. Some acrimony should be pereepibie to the tongue and throat in its exhibition. It never affects the general circulation, says Dr. Mease, but acts sdely on the parts just named; to the glands of which it is a powerful stimufes, causing a copious secretion of mucus. A line MATERIA MEDICA. 425 sago has been prepared from the roots, in the proportion of one part to tour of the root, freed from its exterior coat. As ARC M CaxADEN.-E. We have several species of the genus Asarum, or Asarabacca. I am best acquainteel with the Asarum Canadense, Avhich is well known by the name of Wild Ginger*. In \ irginia, it is called Coltsfoot. Both the root and leaves may be used. The ex- pressed juice of the fresh leaves is a powerful emetic. Asclepias decumbens. Decumbent swalloio^ivort. Pleurisy root. Butteijiy-weed. The root. This species of swallow-wort is one of our most beautiful peren- nial plants, flourishing best inalightsane'v soil, by the way side, under fences, anel near old stumps in rye fields, &c It abounds in the southern state s, but with us is not so frequently found.— There are sometimes fifteen or twenty, or more stalks, the size of a pipe stem, proceeding from one root, rising from one to two feet in height, and spreading to a considerable extent, gen- erally in a decumbent position. The stalks are round and wool- ly, of a reddish brown colour on the sun side ; the leaves stand irregularly, and are spear, or tongue shaped, Avith a short foot stalk, and covered with a fine down on the under surface. The umbels are compact at the extremities of the branches, and formed like the common silk Aveed, but differing from it in the colour of the flowers, being of a bright orange colour, while those of the silk weed are of a pale purple hue. The flowers appear in July and August, and are distinguished by their size and bril- liancy from all the flowers of tie field. These are succeeded by long slender pods, containing the seeds, which have a deli- cate kind of silk attached to them. This is probe bly the only variety of asclepias that is destitute of a milky juice. The- root is spindle, or carrot shaped, of a light brownish colour on tie outer surface, white, coarse and striated within. The root of this plant is a valuable addition to our Materia Mediea, having been found to possess medicinal virtues of no inconsiderable im- portance. It has been long celebrated in Virginia aud the Carolinas, as a remedy in pleurisy, and in pneumonic affections in general. It is said to display a remarkable power of affect- ing the skin, inducing general and plentiful perspiration witiout heating the body. In the form of decoction it often induces a diaphoresis when other medicines have failed tei produce that effect. We have the testimony of Professor Barton in favor of the great efficacy of this medicine in pulmonic affections. He 426 MATERIA MEDICA. corroborates the account publisiied by Mr. Thompson Mason, of Virginia, whose experience of its virtues in pleurisy has been so extensive as to establish its reputation. After the use of an antimonial emetic and the loss of some blood, he gives his pa- tients about a half a drachm of the root finely powdered iu a cup of Avarm water, and repeats the dose every two hours until the patient is perfectly recovered, which happens frequently in three days. Mr. Mason asserts that by those simple means he has cured hundreds, and never failed in a single instance.---- The powdered root frequently acts as a mild purgative, but it is particdarly valuable for its virtues as an expectorant, diapho- retic, and febrifuge, and in this respect its efficacy is amply confirmed by the testimony of Dr. Benjamin Parker, of Brad- ford, Massachusetts, from his own obse-nation during an exten- sive practice for many years in Virginia. From the successful emyloyment of the pleurisy root for twenty-five years, this res- pectable physician has imbibed such confidence, that he extols it as -lossessing the peculiar, and almost specific quality of act- ing on the organs of respiration, powerfully promoting suppres- sed expectoration, and thereby relieving the breathing of pleu- ritic patients in the most advanced stage of the disease ; and in pneumonic fevers, recent colds, catarrhs and diseases of the breast in general, this remedy has in his hands proved equally efficacious. He directs it to be given in the form of strong in- fusion, a tea-cup full every two or three hours. By many fami- lies in the country this root has long been esteemed as a do- mestic medicine, resorted to for the relief of pains of the stom- ach from'flatulcnce and indigestion, hence the vulgar name of wind root, by Avhich it is known in some parts of the country, and from its colour it is by some called white root. It is said tin: t by a perseverance for several Aveeks in the use of about one drachm of the powdered root every day, the lost tone of the stomach and digestive powers has been restored. Asclepias Svriaca. Dr. Cutler describes another species, asclepias syriaca, or common silk weed, often called also milkweed, from its abund- ance of milky juice. The leaves are spear or tongue shaped, larger than the preceding, and in August its aggregate, reddish, or purple blossoms, are exhibited at the extremites of the branches, ami axil he of the leaves. The seeds are contained in large oblong«pods, anel are crowded with down extremely fine and-soft, resembling silk, which has occasioned the name of silk weed. This substance has been mixed with cotton and spun into candle wicks. The stalk of this species is from three to six feet high, the lenvev large, standing on short foot stalks. MATERIA MEDIf A. 42! \ milky juice exudes from the stems or leaves when broken.— The root, as soon as it penetrates the earth, shoots off horizon- tally, and often sends out other stalks. The large roots are cortical and ligneous. It abounds near fences on the road side in all parts of the country. Dr. Abijah Richardson of Medway, Massachusetts, has been induced to try the effects of this species. He gave the cortical part of the root in powder, one drachm in a day, in divided do- ses, and also in strong infusion. An asthmatic patient Avas much benefitted by its use. In one case of typhus fever with catarr- hal affection of the throat and bronchia-, it rendered the expec- toration more copious, and the-matter thicker and more digest- ed. In both cases it had an anodyne effect, the patients were relieved from pain, from dyspnoea and cough, and expectora- tion became easier and sleep more refreshing. Avena sativa. Oats. The seeds. When deprived of their husks and formed into groats, oats are converted into an excellent dish for the infirm and diseased. When ground into meal, and boiled in Avater, they afford a thick and nourishing mucilage, which, with the addition of a few cur- rants, is very wholesome, and products a mildly laxative effect. \u infusion of the husks in water, allowed to remain until it becomes acidulous, is boiled down to a jelly, which is called sowins. In these forms, oats are nutritious and easy of diges- tion. . . . ... Gruels or decoctions, of groats or oatmeal, cither plain, acidi- fied or sAveelened, form an excellent drink in febrile diseases, diarrhoea, dysentery, &c. and from their demulcent properties, prove useful in inflammatory disorders, coughs, hoarseness. roughness, and exulceration of the inures. Cassia Marilandica. Amerwem Sennei. The leaves. This plant is abundant in America, and known by Hie name ©f senna, is of the same genus with the senna ol the shops, and possesses nearly the same virtues as the eastern species. It is used as a purgative, in different parts of the United States, and, from the high price of foreign senna, deserves to be attended to. It is easily cultivated from the seeds, and ought to be generally introduced into our gardens. Chenopodi. m anthelmintics. Jerusalem Oak. The herb and seeds. This plant, a native of Buenos Ayres, and of various parts of the United Stales, is said to bean excellent vermifuge. The 12S M \ ! trill \ MEDICA. whole plant has a powerful smell, of which it is very retentive ; the taste s bitter, with a good deal of aromatic acrimony. The Avhole plant ma v be empjencd. Sometimes the ex| re ssed juice is used in tiic dose of a table sp mnfid, for a child of two or three years old : mare commonly, however, the seeds, emphat- ically ceiled toorms,*e-i, are reduced to a fine poweer, and made into'an electiarv with syrup. Of th.s, the dose for a child two or three years old, is a table s;>emifnl early in the morning.— The patient .is to be kept without nourishment for some hours; after supper anotlier dose is to be administered. It is • MATERIA MEDICA. ornament of our woods. These are succeeded by oblong drupe* or berries of a rich glossy crimson colour which ripen in Sep- tember. They haAe a very bitter taste, and an infusion of them in rum or brandy is much esteemed as an agreeable morn- ing bitter. The bark both of the stem and root, is considerably astringent, and has long been employed in intermittent fevers. And as possessing properties closely allied to the Peruvian bark, this and the following article will be found excellent substitutes. Cornus Sericea, Or American red-rod cornel. Called also red Avillovv j swamp dogwood ; blue berried dogwood. It grows in a moist soil by the sides of creeks and rivers and in swamps, seldom attaining in height more than six or eight feet. In general a considerable number of stems arise from the rame root and are Aery straight. The bark of the young shoots is very smooth, shining, and of a rich dark red colour. The branches are placed opposite, as are also the leaves which a good deal resemble the cornus flo- rida. The flowers are produced in clusters or cymes at the ex- tremity of every branch, and give to this shrub a very elegant appearance, being of a whitish colour in June and July. They are succeeded by succulent drupes or berries, which are of a blue colour inclining to green when ripe. Both these American species of cornel are found by experi- ments instituted by Dr. John M. Walker to possess the same ingredients with cinchona. The bark of cornus sericea forms a beautiful tincture with proof spirit, wbich has been useful in the latter stages of diarrhoea unaccompained with fever. This and the powdered bark of both species are well deserving a place in the apothecaries' shops, as valuable additions to our Materia Medica. It is asserted by Dr. Walker that in what- ever form of disease the tinchona has been decidedly servicea- ble, the corni will be found equally so. They are like cinchona bark, bitter anel astringent in the mouth, tonic and febrifuge in the stomach; and their chemical analysis affords results per- fectly analogous. Thirty-five grains of powdered bark of dog- wood is considered equal to thirty of cinchona. Professor Bar- ton adds his decided testimony relative to the efficacy of dog- wood as a valuable substitute for the Peruvian bark in the cure of intermittent fevers. This article as a remedy has attracted the attention of medi- cnl practitioners of the United States, many of whorn have vouched for their tonic and astringent powers, as being little if any inferior to those of cinchona officinalis. If therefore our native productions are adequate tp our exigencies let expensive exotics he rejected. MATERIA MEDICA. 431 Dai ci.s Cauota- Wild Carrot. The seeds. The seeds of wild carrot have a moderately Avarm pimcent taste, and an agreeable aromatic smell. They are carminative, and are said to be diuretic The roots of the cultivated variety, common carrot, contains much mucilaginous anel saccharine mat- ter, and are therefore highly nutritions and emollient. When beaten to a pulp, they form an excellent application to cance- rous and other ill-conditioned ulcers, allaying the paiu, check- ing the suppuration and foetid smell, and softening the callous edges. A marmalade of carrots, on account of their strong antiseptic qualities, has been successfully used for preventing and curing the sea-scurvy. An infusion of these roots has also been found to afford considerable relief to persons afflicted with the stone and worms, but especially the tape Avorm. Draconitim Fcetidum. Linn. Skunk Cabbage. The root and seeds. This singular plant abounds in the swamps and meadows throughout New-England, and is found native in North Ameri- ca only. The vulgar name by Avhich it is here generally known is taken from its very rank and disagreeable smell, nearly re- sembling that of a skunk, or pole cat, and from its leaves re- sembling those of the cabbage. The roots and seeds when fresh, impart to the mouth a sensation of pungency and acri- mony. This valuable domestic article is found to be Avell deserving of a place in our Materia Medica, and may be ranked high in the class of antispasmodic. The roots dried and powdered have proved'of excellent use in asthmatic cases, and often afford- ed relief in this distressing disease when other means are inef- fectual. • It should be exhibited during the paroxysm, and re- peated as circumstances may require, in doses of thirty or for- ty grains. It will be proper to persevere in the use of it for some time after the paroxysm has gone off, or till the patient is perfectly recovered, which is said to have been the method pursued by the Indians for the cure of this disease. The Rev. Dr. Cutler has announced his opinion of its efficacy as experi- enced in his own particular case after other remedies had dis- appointed his expectations. The antispasmodic powers oflhe skunk cabbage root have been displayed when prescribed in oth- er diseases. In one of the most violent hysteric cases I ever met Avith, says a correspondent, where the usual atispasmodics and even musk had failed, two tea-spoonsful of the powdered root in spirits and water procured immediate relief, and on repealing the trials Avith the same patient, it afforded more hist- 431! MATERIA MEDICA. ing benefit than any other medicine. In those snasnis frequent- ly a flee tin ir the abdominal muscles in parturition, he adds, it produces the desired effect in doses of one tea-spewnful repeat- ed occasionally. In numerous other instances of spasmodic affection, and also in chrome- an ' acute rheumatism, this root either iu powder or decoction has evinced its efficacy, and per- formed important cures, as attested by good authority, in con- firmation of my own experieuce. Two instances have been sta- led in which this medic.ne has been supposed to be remarka- bly efficacious in the case of dropsy ; two tea-spoonsful Of the powdered root being taken every morning successively till the cure Avas effected. The seeds of this plant are said by some to afford more relief in ast'unatic cases than the root. A caution is suggested by Dr. Cutler, that in collecting the roots, poke root which some people call skunk weed, be not mistaken for this plant, as the consequence might be fatal. There is an obvious distinction ; the hellebore has a stalk, but the skunk cabbage has none ; anel the roots of the latter are much larger than those of the former. Erigeron Philadelphicum. The Erigeron Philadelphicum, or Philadelphia Flea-Bane is one of the most common plants in many parts of the Uniteei States. A decoction or infusion of the plant has been used in Philadel- phia by several persons, for gouty and gravelly complaints, and some of them have informed me, that they have been much benefited by the use of the plant*. It operates powerfully as a diuretic, and also as a sudorific. This Erigeron is known in Pennsylvania by the name of Skevish, Avhich I suspect is a cor- ruption of the word Scabious. But it must be confessed, that the genera Scabiosa (Scabious) and Erigeron are sufficiently re- mote from each other. 1 have never employed the Erigeron Philadelphicum', in prac- tice : but 1 am led to believe, that there is some foundation for the assertions which 1 have noticed, because I find that the same plant is mentioned by Father Loureiro, as one of the remedies that are employed by the pleople of Cochinchina; and he speaks of it as an active einmeiiagoguet. Eupatoriv/m perfoliatum. Thorough Wort. The leaves and , flowei s. This is a native annual plant, flourishing abundantly in wet meadows and other moist places. The stalk is hairy and rises * See Elements of Botany, &c 1'urt Third, p. 123. f Flora Cochinchinensis, &c. Tom. II. p. 500. Ulyssiponse : 1790. MATERIA MED1CA. 433 Lrom two to four feet, perforating the leaves at each joint, from which it is sometimes called thorough stalk, or stem. The flow- ers arc Avhite and appear in July and August, forming a corym- bus at the termination of the branches. The leaves at e.ich joint are horizontal, serrated and rough, from three to four inch- es long, and about one inch broad at their base, gradually les- sening to a very acute point, of a dark green, and covered with short hairs. Thorough Avort certainly possesses active proper- ties, and deserves the attention of American physicians. I: acts powerfully as a sudorific and emetic, and sometimes as a pur- gative, and has been successfully employed in intermittents and other fevers, either in decoction or the leaves in powder. Eve- ry part of the plant maybe advantageously employed, though the flowers appear most active. A watery infusion of the leaves is a powerful and not disagreeable bitter, and the flowers are deemed superior in this respect to those of camomile, and ought to be kept in the shops. The dried leaves in powder, or made into pills with lenitive electuary, giveu in doses of twelve or fif- teen grains, are of excellent effect as a mild laxative, obviating costiveness Avithout inducing debility or heat; correcting bile and promoting perspiration. This plant is frequently employ- ed in the country as a drench in diseases of cattle. There are several species in the United States. Frasera Carolinexsis, Walth. ~> Columbo of Marietta. Frasera Waltheri, Mich. $ ^ie root- It is a production of high land, a rich and loamy soil that is- eovered with white oak, white thorn, and tufts of prairie grass. It flowers in July. The root as soon as it enters the earth shoots out in a horizontal direction ; is spindle shaped ; and when well grown is from eighteen to thirty inches in length, and two in diameter at the turn. Near the surface of the earth the root is wrinkled ; its colour in the young plant is a light yellow; and is solid and brittle. After the stalk is grown the root be- comes softer aud less bitter. The proper time for collecting it seems to be in the spring of the third year. Dr. Hildreth asserts that from the experiments he has made with American colum- bo, he is induced to believe it fully equal, if not superior to the imported. It is in common use there, and has in one instance, in the heat of summer, put a stop to a Avide spreading gangrene.-, on one of the lower extremeties, by internal use and external application, Avhen bark and other remedies had failed. The columbo plant is undoubtedly to be estimated as a valua- ble acquisition to our Materia Medica. The root, however, is found on examination to be of a lighter colour, and to possess Tte.«* of the bitter principle than the imported r«ot. 55 454 MATERIA JV1EDICA- dALEGA VlRUIN'lANA. The Galega \ irgiuiana, or a irginia-Goats-rue, is one the moj>( beautiful of the known North-American plants of the class of Diadelphia. It is Arery common in many parts of Pennsylvania, New-Jersey, &c In Jersey, it is called Cat-gut, from the re- semblance of some of its roots to the article of this name. A decoction of the roots is reputed a powerful anthelmintic* 1 have never used it. It may be observed, in this place, that, notwithstanding the general character of the class of Diadelphia,, there are in this class some very active and even deleterious vegetables. It is somewhat in favour of the anthelmintic pow- er of the Galega Yirginiana, that some West-India species of the same genus are said to intoxicate and poison fish. Gaultheria procumbens. The Gaultheria procumbens, Avhich we call Mountain-tea*, i? spread very extensively over the more barren, mountainous parts of the United States. It belongs to the same class as the plants just mentioned. I have made use of a strong infusion of this plant, which is evidently possessed of a stimulant and ano- dyne quality, I am told it has been found au useful medicine iu cases of asthma. But I have not learned to Avhat particular forms of this disease it is best adapted, nor in what manner it operates. Geranium maculatum, or Crane's Bill. The plant and roots. This is a common plant near Philadelphia, and in many oth- er parts of the United States. It is commonly known by the English name of " Croufuot," and flowers in the spring. It is a powerful astringent, and will stop very violent bleedings, if ap- plied to the- wounded vessel. A decoction of this plant has al- s\ on some trials, manifested great efficacy in restraining inter- nal luemorrhagy. The root boiled in milk is a common domes- tic remedy for the bowel complaints of children. Gei.u rivals. Common Avcns, or Herb-bennet. The root. Avens. Throat root. Cureall. The blossoms are purplish. In boggy meadows. May.— The root is powerfully astringent. A decoction of it has been • it is also called Berried-tea, Grouse-berry, and Deer-berries. If I do not mistake, this is one of the principal articles, in Ihe materia medi- ca of some of our Indian tribes. In ihe language of some of the Indian?. of Canada, it is cailecl PoUovi. MATERIA MEDICA. 455 used, with good success, as a gargle, and a. drink, in inflamed and ulcerated sore throats, and cankers. It is said, that the powdered root will cure tertain agues, and that it is much used by the Canadians for that purpose. Glycyrrhiza glabra. Liquorice. The root and extract. Liquorice is a perennial plant, and a native of the south of Europe, but is cultivated in considerable quantities, for medici- nal purposes. The root of this plant has a sweet agreeable taste. This sweetness is extracted by water, by infusion or de- coction ; and, by evaporation, a dark coloured extract, of the same s veet taste, is obtained, consisting principally of saccha- rine and mucilaginous matter. Liquorice root is a pleasant de- mulcent, whicii is frequently added to infusions of linseed or althaea. There is no doubt of its gentle deterging qualities, Avhich ren- der it an excellent medicine in coughs, hoarseness, asthma, &c. for lubricating the throat, softening acrimonious humours, and affording relief to the organs of respiration. But with this in- tention it ought to be taken as a diet drink in consielerable por- tions by way of infusion. This plant is found in the state of Vermont, and on the borders of the Ohio river. Hamamelis Virginica. Witch-liazel. The bark. This singular shrub does not commonly bloom until its leaves are destroyed by frost, when its numerous blossoms make a gay and agreeable appearance ; and continue until tlm* weather be- comes very cold, often until snow falls. The gerinen endures the severity of our winters uninjured; for the fruit does not ripen until the next September, the time of its blossoming again, when ripe fruits and blossoms will be found on the same tree. The Indians considered this tree as a valuable article in their Materia Medica. They applied the bark, which is sedative and disculient, to painful tunmrs aud external inflammations. A cataplasm of the inner rind of the bark, rs found to be very efficacious in re- moving painful inflammations of the eyes. The bark chewed in the mouth is, at first, somewhat bitter, very sensibly astringent, and then leaves a pungent, sweetish taste, which will remain for a considerable time. The specific qualities of this tree seem, by no means to be accurately ascertained. It is probably possessed •f very valuable properties. Cutler. Helemum Autimxale. This is an extremely common plant in many parts of the Un- ion, growing generally along the margins of rivers, and flowering 436 MATERIA MEDIC A from the hitter part cf the summer through the ..utnmn. 1 he leaves and flowers of this plant possess the sternutative- quality m an eminent degree: but it is strongest in the floweis. aid espe- cially in the florets of the disk. A very small quantity of these florets reduced to a powder between the fingers, or otherwise, gives a strong and durable impression, when applied to the nose. Sudi, indeed, is the degree anel durability of impression, without at the same time, anv of the violent and dangerous stimulus, which is the consequence of the application of the juices and oth- er preparations of certain species of Euphorbia, of Veratrnm al- bum. &c., that I do not hesitate to consider the Helenium autum- nale (or Sneezo-weed, as it is called in some parts of Virginia, Sic.) as a valuable addition to the list of our useful medicine's. It may be employed either by itself, or combined with other vege- table matters;'or along with sulphat of mercury, as a mercurial errhine. The good and important effects of these mercurial err- Irines, and even of the simple vegetable errhines, are frequently so obvious, that it is to be regretted that they are not more fre- quently resorted to by physicians, in cases of amaurosis, or gutta serena; in cases of deafness, especially perhaps when the aflect- ion depends upon a morbid state of the eustachian tube ; in cases of rheumatic congestions of the jaws, &c. In all these cases the errhine medicines have often been employed with much advan- tage by physicians: and it is a fact that they sometimes give re- lief Avhen other measures, more generally applied, have been ap- plied in vain. Helleeorus trifolius. Golden-thread. Mouth Root. The root. Golden-thread is a very small plant found in wet swampy situa- tions. The stems are erect and naked. The leaves grow by threes at the termination of the stems and are circular and scol- loped. The white solitary blossoms appear in May. The roots appear singular, being thread shaped, running, and of a bright yellow colour. They possess a considerable degree of astrin- gency and bitterness, and have long been employed by the peo- ple in the country as a remedy in apthas and cankerous sores in the mouths of children Avith considerable benefit. Frenn the bitter property possessed by these roots they are supposed by some to be useful as a stomachic bitter. Heuchera Americana. The Heuchera Americana is the next astringent. This is sometimes called American Sanicle. It is more commonly call- ed Alum-root. The root is a very intense astringent, it is tire MATERIA MEDfCA. 437 basis of a powder, which has lately acquired some reputation in the cure of a cancer. I suppose all its virtue, m this case, depends upon its astringency. I may here observe, that the disease ef cancer is not confined to civilized nations. It is knoAvn among our Indians. I am informed that the Cheerake cure it with a plant, which is thought to be the Hydrastis Canadens s, one of our fine native dyes. I do not believe that Heuchera has cured genuine cancer ; but it seems certain, that it has proved very beneficial in some obstinate ulcers, which have been mistaken for cancer. In such cases, the astringent medicines are too much neglected. Humulus Llpulus. Tlie common Jwp. The flowers. Tins perennial plant is a very strong bitter accompanied with a degree of aromatic flavour and some astringency ; these are ex- tracted by water by infusion ; by decoetion the aromatic flavour is lost. Along with its bitterness it has a narcotic power : of this the popular remedy? sometimes successful, of a pillow of hops to procirc sleep in the delirium of lever and in mania, is a proof. It accord;ndy, Avhen given internally in a full dose, reduces the fre- quency oi lie pulse and procures sleep. It has been employed as au anodyne, either in substance, in the dose of three grains, or under the form of infusion or tincture.A cataplasm or ointment, prepared from it, has been also used as an anodyne application to cancerous sores. Hydrastis Canadensis. This is a very common vegetable in various parts of the Uni- ted States; particularly in the rich soil adjacent to the Ohio and its branches, in the Avestern parts of Pennsylvania and Virginia; and in Kentucky. The root of this plant is a very- powerful bitter: perhaps not less so than that of the Zanthor- hiza. To the taste, hoAvever, it is unquestionably more pungent than the Zanthorhiza. When held between the lips, it even ex- cites a very considerable sense of pungent heat. The dried root has a strong and virose smell, very similar to that of the Zanthorhiza, but stronger. The infusion in hot water, smells very like the infusion of Zanthorhiza. The two infusions taste a good deal alike. Hyssopus officinalis. Hyssop. The herb. The leaves of hyssop have an aromatic smell, and a warm pungent taste ; they are particularly recommended in humoral asthmas, coughs, and other disorders of the breast and kings ; being supposed wonderfully to promote expectoration. Accor- 4JS MVfERIA MEDK4A- dinMo Kav, these leaves are of great service when applied uv cataplasms"to bruises, the pain of which they speedily mitigate, and at the same time disperse every mark or spot from the part afl'ected. Inula Helexium. Elecampane. The root. This is a very large downy perennial plant, sometimes found wild in moist rich soils. The root, especially Avhen dry, has an agreeable aromatic smell ; its taste, on first chewing, is glutinous anel somewhat rancid, quickly succeeded by an aromatic bitter- ness and pungency. The ancients entertained a high opinion of elecampane, which is recommended for promoting expectoration hi humoral asthma and coughs; liberally taken, it is said to ex- cite urine, and loosen the belly. In some parts of Germany, large quantities of this root are candieel, and used as a stomachic, for strengthening the tone of the viscera in general, and for attenuating viscid humors. Its dose is from twenty to sixty grains powdered ; and in this form it has been found, by experience, to possess considerable efficacy. Juglans Cinerea. Butternut. . White Wdlnut. The unripe fruit. and the inner bark. This tree is generally known throughout the United States, and is now introduced into the Materia Medica of the Massa- chusetts Pharmacopceia. During the American war, the ex- tract made from the inner bark of this tree, attracted the at- tention of Dr. Rush, and other medical men in our military hospital; and, being frequently administered to patients under the operation of inoculated small pox, it Avas proved to be au excellent substitute for jalap or other cathartics. It is now es- teemed as a valuable purgative, in doses from ten to thirty grains, not occasioning heat or irritation; and is greatly com- mended in cases of dysentery. Conjoined Avith calomel it is rendered more active and efficacious, especially in bilious hab- its. As this extract is often very carelessly prepared by the country people, it ought to be prepared by the apothecaries, or practitioners themselves ; and as a domestic medicine of consid- erable importance, it sltould be adopted by every physician.— The bark of the root of this tree will excite abhster; and the bark and shells of the nuts dye a good brown colour. A ele- eoction of the inner bark is advantageously employed as a ca- thartic in the disease of horses, called the yellow water. The exl'",»•! slioud be made from the bark in the'month of May ftl June. MATERIA MEDIC A. 439 Ji'Nipervp communis. Juniper. The berries and leaves. This is an evergreen shrub growing on dry barren commons and hilly grounds in different parts of the United Stales as in Europe. If planted in a good soil it aviII attain the height of fifteen or sixteen feet, and produce numerous branches . It is remarkable that no grass will grow beneath this shrub. This tree hvs three spreading pointed leaves coming out together, that are longer than the berry. The Avood is of a reddish celour, very hard and durable. Gum sandarach, more commonly cal- led pounce, is the product of this tree. The flowers are borne upon a conical catkin, the scales of of which serve the purpose of a calyx. The be.ies of the Juniper require two years be- fore they ripen, when they change from a green, or a blackish purple, 'to a bluish black colour. Juniper berries possess a stiong not disagreeable smell, and a warm pungent sweet taste, Avhich if they be long chewed, or previously bruised, is follow- ed by a bitterish one. Their predominant constituents are, an essential oil, and a sweet mucilaginous matter. To the oil, they are indebted for their stimulatiug,carminative, diaphoretic, and diuretic properties. They are most commonly used in the form of infusion, to which a little gin is added, as a diuretic drink in dropsy. The essential oil may be separated by distillation. It possesses the same properties in a higher degree, and imparts them to ardent spirits. The peculiar flavour, and Avell-known diuretic effects of Hol- land gin, are owing-to the oil of juniper. Juniperus Virginiana. Common Red Cedar Tree. The leaves. The red cedar tree is a native of the United States, and grows to the height of fifteen or twenty feet. Its berries are smaller than those of the true juniper. In"Virginia and Carolina the berries are distilled into brandy. The leaves of this tree are now broudit into notice by the investigation of Dr. Aaron Dexter. Professor of Chemistry, and Materia Medica, in the University at Cambridge. He has found this to be the oidy species of ju- niper in the United States, whose leaves agree in their proper- tics with those of the savine, directed by Dr. Crowther, as the basis of the savine ointment. Ju Lactcca sativa. Common Garden Lettuce. The herb. This plant, so valuable as an article of diet, abounds with a milky juice, which possesses all the characteristic properties ot the opium of the shops, and ma«y be procured from it m sufficient *dO MATERIA MEDICA. quantity, to repay any labour bestowed on it for this purpose- The laudanum made from the opium of the lettuce increases the pulse in force and frequency, anel produces generally the same effects as result from similar doses of common laudanum. It has been used with advantage in allaying the pain of chronic rheumatism, and colic; in checking the frequent stools accom- panying diarrhoea; in allaying cough, &c &c.; and doubtless the "plant may be advantageously cultivated for medioal pur- poses, especially as the opium is procured after the period in which the plant is useful for the table. Laurus Benzoin. During the late American war, necessity drove the inhabit- ants, in many parts of'the United States, to seek for a substi- tute for senne of the spices to which they had been accustom- ed. They used the dried and powdered berries of the Laurus Benzoin, which we call SpiceAvood, and Wild-Alspice-bush, and found them a tolerable substitute for alspice*. A watery infusion of the twigs and leaves of the Laurus Ben- zoin, is often given to children, with a view to destroy and dis- lodge worms, and is deemed an efficacious medicine in thut case. Laurus Sassafras. Sassctfras. The wood, root, and its bark. This tree is a native of North America, and is cultivated ia Jamaica. The wood, root, and its bark are used; they have a moderately fragrant smell, and a sweetish aromatic taste. Sas- safras is a warm aperient and strengthening medicine; it has often been successfully given in the form of infusion and decoc- tion, for improving the tone of the stomach and bowels, in per- sons whose humors were in a vitiated state. The essential oil is highly stimulating and heating, and must be given only in very small doses,being a sudorific and diuretic remedy. The bark is useful in intermittents; and the oil is said to be efficacious, appli- ed externally to wens. Lavandula Spica. Lavender. The flowering spikes. Lavender is a well known small, shrubby, perennial plant, a native of the south of Europe, but frequently cultivated in our • " A decoction of the small twijrs makes an agreeable drink in slow •' fevers and is much use-d by the.- country people- It is said 0 442 materia medic-a. constitutions wheu affected Avith nervous and hysterical agita. tions. An infusion of this plant is a common domestic medi- cine, taken at bed time, it composes and procures refreshing sleep in a manner similar to valerian, Avhen it could riot be ob- tained by the operation of opium. Linum usitatissimum. Common Flax. The seeds and their fixed oil. Linseed contains about one fifth of mucilage, and one sixth of fixed oil. It is therefore considered as emollient and demul- cent. The entire seeds are only used in cataplasms. The mu- cilage resales wholly in the skin, and is separated by infusion or decoction. The infusion is used as a pectoral drink, and in arelor urinre, nephritic pains, and during the exhibition of cor- rosive sublimate., Flaxseed syrup is made.by adding to two pints of the mucilage one pint of honey ; Avhile simmering away by a gentle heat observe to take off the scum as it rises. This is highly useful in all kinds of coughs, and other diseases of the breast and lungs. The oil is separated by expression. It is one of the cheapest fixed oils; but is generally rancid or nau- seous, and unfit for internal use. These seeds, Avhen reduced to powelcr and properly blended with hot \Arater, form one of the most convenient and useful of cataplasms. The cake which remains after expression of the oil, contains Ihe farinaceous and mucilaginous part of the seed, and is used in fattening cattle, under the name of oil cake. Liquidamd ar asplenipolium. The Liquidambar asplenifolium* of Linnauis is Avell knoAvn by the name- of Sweet-Fern. It lias often been found useful in diar- rhoea. Other virtues have been ascribed to it.f Colden was informed, that the Indians chew the root of this vegetable, with a view to stop haemorrhages in recent Avouuds. Th,s effect of the Sweet-Fern may, perhaps, meet with some credit from those who have Avitncssecl the Avonderful powers of small doses of the preparations of lead, in diminishing and stop- ping, almost immediately after their reception into the stomach, haemorrhages from the uterus, intestines, Sic. • Comptonia asplei.ifolia of Aiton. f See Sehoepf's Materia Medica, &c. p. 14?. MATERIA MEDICA. 443 Liriodendron Tulipipera. Tulip bearing Prplar. fulip tret. The bark of the root. A native and Avell known tree in the edited Slates, called al- so American poplar, >vhite Avood, and in some parts of New*. England improperly called cypress tree. It attains to a very large size, rising as high as any forest tree, and makes a noble and beautiful appearance when in flower, about the middle of May. This tree is remarkable for the shape of its leaves, hav- ing the middle lobe of the three truncate, or cut transversely at the end. The flowers are large and bed shaped; calyx of three leaves, six petals to the corolla, marked with green, yellow, and reel spots ; and many lance shaped seeds, lying one over anoth- er, and forming a sort of cone. The bark of the root has long been employed by medical men in the United States, as a to- nic, and when joined with various proportions of prinos virfkib- latus, and cornus fiorida, has afforded a remedy of equal eflica- cy with Peruvian bark. It is a strong bitter, and considerably aromatic and antiseptic, and has been found particularly bene- ficial in the last stage of dysentery. The powdered root com- bined with steel dust is an excellent remedy in relation to the stomach. According to Dr. Km ton, the bark is used in some parts in gout and rheumatism. A decoction of it is said to he a common remedy in Virginia for botts in horses. Lobelia cardinalis. ' The Cheerake use a decoction of the root of the beautiful Lo- belia Cardinalis, or Cardr.ial-Fiov.vr, as a remedy agadst worms. I have already mentioned the diuretic quality of another spe- cies of this genus, the Lobelia siphijiii.a. Malva sylvkstris. Common MaWnv. The leaves and floAvers. This is an annual plant, growing iu hedges, foot paths, and among rubbish. The whole plant abounds with mucilage.— The leaves were formerly often used in food, to prevent costive- ness. At present, decoctions of the plant are sometimes pre- scribed in dysenteries and urinary complaints; though it is chief- ly employed in emollient cataplasms, clysters, and fomentations. Marrubium vulgare. White, Horehound. The leaves. This is a perennial plant, which grows wild on road sides, and among rubbish. The leaves have a very strong, not disagreea- ble smell, and a roughish, very bitter taste. * It is reputed to be 444 MATERIA MEDIC A. both attenuant and resolvent; an infusion of the leaves in water; i»weetened with honey, is recommended in asthamtic and phthisi- cal complaints, as well as in most otlier diseases of the breast and lungs. They promote the fluid secretions in general, ami liberallv taken, loosen the belly. Dr. Withering observes that'it was a favourite- medicine with the ancients in obstructions of the viscera. He says, that it is the principal ingredient in the negro Ca>sar's remedy for veg- etable^ poisons. That a young man avIio hael occasion to take mercurial medicines, was thrown into a salivation which con- tinued for more than a year. Every method that was tried to remove it, rather increased the complaint. At length Liima?us prescribed an infusion of this plant, and the patient got well in a short time. Melissa officinalis. Balm. The leaves. Balm is much cultivated in our gardens on account of its pleaiij ant aromatic smell, resembling that of the lemon, and its fra- grant though roughish taste. It is principally employed in the form of a watery infusion, which is drunk in the manner of tea ; and in acute fevers, Avhen acidulated with the juice of lemon, it is an usefd diluent. Mentha viridis. Spearmint. The herb. Spearmint is perennial and grows on the banks of rivers, and in Avatery situations ; and flowers in the months of July and Au- gust. The leaves have a Avarm, reuighish, somewhat bitterish taste ; and a strong, not unpleasant, aromatic smell.. Their virtues are stomachic and carminative. Mentha piperita. Peppermint. The herb. Of the different mints, this is the one which has the greatest degree of pungency. The leaves have a strong, rather disa- greeable smell, and an intensely pungent aromatic taste, resem- bling that of pepper; and accompanied with a peculiar sensa- tion of coldness. They afford an essential oil, rich in the aro- matic quality of the herb- It also contains a small portion of camphor. Peppermint is used as a stimulant and carminative, to obviate nausea or griping, or to relieve the symptoms resulting from flatulence, and very frequently to cover the taste and odour of other medicines. It is also an excellent stomachic, of great use in flatulent colics, languors, and hysteric cases, and in vomiting. It is used under the forms of the watery infusion, the distilled MATERIA MEDIC A. 445 water, and the essential oil. This last being dissolved in a e!ue proportion of rectified spirit of wine, and coloured Avith green grass, forms the essence of peppermint of the shops; a fashiona- ble and pleasant carminative, which, when taken on sugar, im- parts a glowing taste, sinking into the toneue, and extending its effects through the whole system, instantly communicating a glowing Avarmth. Mvrica ceripera. Dwarf Cundleberry Myrtle. Baybe.mj. The bark of the root. There are in the United States several species of this plant, from which myrtle wax is obtained in abundance. The dwarf cundleberry myrtle, commonly called in the New England States, bayberry, is a plant which possesses considerable medi- cinal virtues. The bark of the root is much employed by com- mon people in jaundice, from obstructions to the flow of bile.— This medicine has been employed by the aborigines as a mild emetic. According to Dr. James Mann, of Wrentham, who lias used the bark in powder, its strength is eejual to ipecacuanha.— A more particular acquaintance with its medicinal properties Ought to be attempted by practical experiments. Orobanche Virginiana. The Orobanche Virginiana, or Virginian Broom-rape, is a very common plant in many parts of North-America. Michaux says that it groAvs from Canada to Georgia. It is generally, if not always, found under the shade of the American Beach-tree fFagus ferruginea)f. Hence one of its names, in Pennsylvania, viz. " Beach-drops." But it is much more generally known by the name of Cancer-root-f Panax quinquefolium. The celebrated Ginseng, or Panax quinquefolium, may, with propriety, be thrown into the class of stimulants^. I find it dif- ficult to speak of this plant with any degree of certainty. Ifk were not a native of our woods, it is probable that we should im- port it, as we do the teas of China and Japan, at a high price. • Michaux entirely restricts its habitation to the root of the Beach " In radice Fagi nee aliat plants.'* Flora, &c. Tom. 11. p. 26. f See Elements of Botany, &c Part Third, p. 80. $ The Ginseng is by no means a powerful stimulant. It is not very kappily arranged in the class of Medicamenta Stimuluntia, or Incitanlia. The Indians make use of a tea prepared of the leaves as well as the re>ot of this plant. But I cannot learn, that they so highly esteem the Ginseng as their Tartar brethren in Asia do. <4G ■MATERIA MEDIC A. Phytolacca ueoanoba. American Nigltfshadt. Gargst. Thf leaves, berries, and root. This is one of the most common North American plants, weH known in New-England by the name of cunicum, skoke, or coakum. In the southern states it is called pokeweed. It has a thick, fleshy, perennial root as large as parsnips. From r .s rise many purplish herbaceous stalks, about an inch thiek, and six or seven feet long ; which brcdc into many branches irregu- lar! v set Avith large, oval, sharp pointed leaves, supported on snort foot stalks. These are, at first, of a fresh green colour, but as thev grow old they turn reddish. At the joints anel di- visions of the branches, come forth long bunches of small bluish coloured flowers, consisting of five eoneive petals each, sur- rounding ten stamina and ten stiles. These are succeeded by round depressed berries, having ten cells, each of which con- tains a single smooth seed. The young stems when boiled are as good as asparagus, but when old they are to be used with caution, being a plant of great activity, operating both as an emetic and cathartic. A tincture of the ripe berries in brandy or Avine, is a popular remedy for rheumatism and similar affec- tions ; and it may be given with safety and advantage in all ca- ses where guaiacum is proper. The extract of the .juice of the ripe berries has been employed in some cases of scrofula; and cancerous ulcers have been greatly benefitted by its application* The juice of the leaves, hoAvever, is said to be more effectual. Dr. Shultz in his ingenious inaugural dissertation on this sub- ject, observes, that " scabies and herpes have been often remov- ed by it. In these cases, a solution of the extract in water is generally substituted where the expressed juicTe cannot be* had. In rheumatisms, the whole substance of this plant has at differ- ent times been of essential service ; although the berries have generally been preferred. In those rheumatic affections which sometimes occur to syphilitic patients, its virtue far exceeels that of opium ; and it seems more a aluable than guaiacum, especial- ly Avhen combined Avith mercury. Ci For medicinal purposes, the leaves should be gathered about July, when the foot stalks begin to assume a reddish colour, dri- ed iu the shade, and powdered for use. An extract may easily be obtained from the leaves Avhen gathered at this period, by gently evaporating their expressed juice to a proper consist tence." A tincture may be made by dissolving either the extract or the leaves, in their green or dry state, in common brandy, or in the spirit distilled from the, berries. An ointment is also made by powdering the dried leaves, and mixing them Avell Avith hog's lard, or simple cerate; or by boQ'L MATERIA MEI>M*A. 417 ing some hog's lard and bees wax with fresh leaves, and strain- ing tlu; mass. The proper tune for gathering the berries in this climate is in October, when they become soft and ripe, and are of a blackish colour. The root is to lie gathered about November or December, when the stalks of the plant are perfectly dead, and to facili- tate drying, it should previously be divided into small pieces.— Au extract may be made from the root in the same manner as from the leaves or berries. It is affirmed by a physician of reputation and experience, that the leaves of phytolacca decaudra have been found an ad- mirable remedy in lurmorrhois. A strong infusion is given in- ternally, aud if it does not speedily relieve, the same infusion is to be injected into the rectum. This method Avill in general ef- fect a perfect cure. According to the experience of Drs. Jones and Kollock, of Savannah, this plant may be relied on as an effectual remedy for syphilis in its various stages, even Avithout the aid of mercu- ry ; and they employ it Avith much confidence, both internally and externally iu rheumatisms, and in cutaneous eruptions.— One ounce of the dried root infused in a pint of wine, aud giv- en to the quantity of two spoonsful, operates kindly r.s an emet- ic. The roots are sometimes applied to the hands aud feet of patients in ardent fevers. Many country people use the extract with great confidence in its efficacy in discussing indolent tu- mors, and in healing various kinds of ulcers. It is found to ope- rate as a mild vegitable caustic, cleansing and healing foul ulcers better than most other remedies of that class. In three cases of apparent fistula lachrymalis, it is reputed to have performed cures, by being applied to the tumors twice a day for two or three Aveeks. This root has also been employed in compounds as an article of dying. Pimpinella Anisum. Anise. The seeds. Anise is an annual umbelliferous plant, growing naturally ha 6rete, Syria, and other places of the East. The seeds of anise have an aromatic odour, and a warm taste with a share of SAveetness. They afford by distillation with wa- ter, a considerable quantity of an essential oil, having a strong flavour, and a sweet taste without pungency. Anise* is used as a good carminative in dyspepsia, and in the flatulence to which children are subject. A drachm or two of the seeds may be? taken, ox a few drops ef the eft" rubbed wifi sngar. 448 MATERIA MEDICA. Plantaoo major. Plantain. The leaves- Great plantain is perennial, common in fields and by the road sides, flowering from June to August. The country people ap- ply the bruised leaves of this vegetable to slight wounds, and inflamed sores and swellings with a favourable effect. It has been recorded in a Virginia gazette, 1802, that a gentleman was bitten above the knee by a venomous spider. In a few min- utes he observed a pain shooting upwards from the spot, which presently reached his heart. A quantity of plantain leaf was immediately procured, and the juice being bruised out was swal- lowed largely, by which the progress of the poison was stopt, and finally a cure was effected. Some oil was also swallowed, but the plantain leaf had the entire credit of his recovery, and but for this remedy, he sdd he could not have survived an hour longer. Podophyllum peltatum. May apple. Mandrake. The root. This plant is very common throughout North America. The fruit is esculent, and by many, thought delicious. The leaves are poisonous. The root is an excellent purgative in doses of twenty grains. It is most advantageously used in combination with calomel, or crystals of tartar. The root, also, often ope- rates as anthelmintic, and as such, it is used by the Che>rokee and other Southern Indians. The best time of gathering the May apple, for medical pur- poses, is m autumn, when the leaAes have turned yellow, and are about falling off. The Indians dry it in the shade, and poAvder it for use. Polygala Senega. Seneka. Rattle Snake Root. The root. Seneka is a perennial plant, which abounds in nearly all the United States, particularly m Virginia and Pennsylvania. This root is usually about the thickness of the little finger, variously bent, and contorted, and appears as if composed of joints* whence it is supposed to resemble the tail of the animal whose name it bears ; a kind of membranous margin runs on each side, the whole length of the root. This root was first introduced into use in 1739, by Dr. Ten- nent, of Virginia, who Avrote a pamphlet on the subject, and highly extolled it as a remedy for many complaints, and par- ticularly, as a specific for the cure of the bite of the rattle-snake. It is an active stimulus, and increases the force of the circula- tion, especially of the pulmonary vessels. It has therefore beeii found useful in typhoid inflammation of the lungs, but it is apt to MATERIA MEDtCA. 449 disorder the stomach, and to induce diarrhcea. Some have HkeAvise employed this root in hydropic cases, and not without success. There are examples of its occasioning a plentiful discharge by stool, urine, and perspiration; and by this means removing the disease, after the common diuretics and hydragogues had failed. It sometimes induces salivation, and it possesses diuretic, em- etic, cathartic, expectorant, and diaphoretic powers. Dr. Arch- er, of Maryland, discovered the great utility of seneka snake-root, as a remedy for that fatal disease, the croup, and speaks with confidence as to the general good effects produced by it. The decoction of the root is the manner in which he generally gives it; the strength must be determined by the physician; it must he so strong, as to act sensibly on his own mouth and throat, in exciting coughing, &c for in this disease, the larynx (mouth of the wind pipe) in a manner loses its natural sensibility. Half an ounce of the root of seneka, brdsed, and simmered in a close ves- sel, in half a pint of water, until reduced to four ounces, will, probably, in most cases be sufficiently strong. A tea spoonful of this to be given every hour or half hour, as the urgency of the symptoms shall demand ; and during these intervals, a feAV drops occasionally, to keep up a sensible action of the medicine, in the mouth and throat, until it act as an emetic and cathartic; then repeated in small quantities, and so frequently as to keep up a constant stimulus in the same. By these means, in the course of two, four, six, or eight hours, a membrane is often times dis- charged by the mouth, one, two, and often three inches in length ; sometimes it is SAvallowed and voided by stool. Patients Avho use the medicine should not be permitted to drink any thing whatever, for some minutes after each dose. The reason must be obvious to all. The powder has lately been used bv Drs. Archer and Son, in doses of four or five grains, mixed vvith a little water, with effects equally as pleasing as the decoc- tion, and more so, unless the latter have been carefully prepared. It should be remarked that this powerful stimulant cannot with safety be exhibited during the inflammatory stage of croup. It is in the third or last stage only, it has been found extremely use- ful in exciting the vessels of ihe traci.ee aud lungs to a powerful excretion. • , Seneka has been usefully employed ia the cochne ofpleuns.es and catarrhs, to promote expectoration. In suppressed coughs of aged persons, and in asthma, it is doubtless useid.; a gentle and constant stimulus on the throat should bv ke:u up m tnese diseases. It has also been exhibited u, r. powerful remeity m cases of female obstructions. Dr. Chapman ol Ph.iae,.:\.\a? lias found it of great utility in obstinate ammiorriuen wheu giv.-n m decoction prepared by adding rn ounce of t!;«> root to a pmt of 57 45ti MATERIA MEDIC A boiling water, which is slowly reduced by simmering to the quan- tity of one third. Four ounces of the decoction is to be taken during the day, increasing it when the menstrual effort is expect- ed, as far as the stomach will dlow. If this cxeite nausea, he acids aroinatics. To prevent disgust, it is omitted a week or two in the intervals of the menstrual periods. The poly gala san- gumea, a new species discovered at Savannah, has been used as a substitute for the polygala seneka. Prinos Verticillatus. Winter Berry. Black Alder. The bark and berries. This is a very common shrub in many parts of the United State's, and grows in the greatest perfection in swamps and mar- shy places. The bark is manifestly astringent. It is likewise considerably bitter, and pungent. The berries, which are of a fine red colour, greatly partake of the bitter quality : and, if infused in wine or brandy, might be ad- vantageously employ eel in cases whov hitter tinctures are exhib- ited. The burk has been used as a substitute for the Peruvian bark, in intermittents and otlier diseases, both in substance and decoction. It is supposed to be chiefly useful in cases of great debility unaccompanied with fever, as a corroborant in anasar- cous and otlier dropsies, and as a tonic in cases of incipient spha- celus or gangrene. It is both given internally, and employed ex- ternally as a wash. On many occasions, it appears to be more useful than the Peruvian bark. Professor Barton says, it ouglit to have a place in the shops, and in the pharmacopoeia of this country, when such a desideratum shall be supplied. Dr. Mease observes, (Philadelphia Medical Museum, vol. 2.) it is useful in mortification, united with the root of sassafras, in decoction, &c. Care must be taken to distinguish our prinos from the swamp al- der or candle aider. Prixus Virginiana. Wild Cherry Tree. The bark of the tree and root. The common wild cherry tree is often found in vvoods and hedges and is associated Avith the trees of the forest, growing to the height of forty or more feet and of a very large size. The gmn which exudes from the tree is said to be equal to gum ara- ble. This tree produces in Autumn a small bitter cherry, black wdn quite ripe, which serves for food for birds who frequently • become intoxicated from eating thorn. They a'.so are infused in brandy by the country people on account of the pleasant aromatic flaA-our which they impart to the liquor. The bark of the wild cherry tree is powerfully tonic, and has been freejuently substi- MATERIA MEDICA. 451 tuted for the Peruvian bark, Avith great success. It is slightly narcotic, and commonly produces a drowsiness in those who take it. From the experiments of Mr. C. Morris of Virginia, (Inaug. Diss. 1812, Phila.) it appeared that the bark of the root was more powerful than the bark of the trunk. It has been very useful in dyspepsia and in consumption of the lungs. The Indians it is said, use the bark in the cure of syphilis. Very excellent effects have been produced by washing ill conditioned ulcers with a de- coction of the bark, and the same has proved anthelmintic. ri be leaves of the tree are poisnous to certain animals. While tins valuable tree abounels in the United States, we act unwisely, says Dr. Mease, in sending thousands of dollars out of the country for flio Peruvian bark. Pyrola umbellata. Of the Pyrola umbellata I have made no mention in the first part of this work. It is a very common North-American plant, and is sometimes called Ground-Holly, but is much better known (at least in New-Jersey and in Pennsylvania) by the name of Pippsisseva*, which is one of its Indian appellations. In the sex- ual system of Linnaeus, it belongs to the same class and order (Decandria monogynia) as the Uva Ursi. It also belongs to the same natural assemblage of plants as the last mentioned vegeta- ble, viz.: the order Bicornes of Linmeus, and the order Eneas of Mr. de Jussieu. The two plants are, unquestionably, nearly allied to each other in respect to their botanical affinity, as well as in their medical properties. The pyrola is considerably astringent, and the quantity of as- tringency appears to be nearly the same in the leaves and in the stems. Hitherto, it has not greatly excited the attention of physicians. But I think it is worthy of their notice. A res- pectable physician, in East-Jersey, informed me, that he had employed this plant, with manifest advantage, in the same cases in which Uva Ursi has been found so useful. This looks yery probable: for it would seem, from many facts, that the lithon- triptic powers of the Uva Ursi, are, in no small degree, owing to the astringent quality of this plant: and, "perhaps, upon the « whole (as an eminent practitionert has observed,) we shall «find it no better than other vegetable astringents: some of « which have long been used by the country people, m gravelly • Perhaps, Phipsseaxoa. | Dr. Withering. See A Systematic Arrangement of British Plants, &c. Vol. n. p- 391. London i 1801. 462 MATERIA MED1CA. " coniddnls, md with very great advantage : uiough hitherto " unnoticed l>v the regular practitioners.* ' The Pvrola, as 1 am informed by my pupil Dr. John S. Mitch- ell, has been used, with good eddi, in some case.; ofintermit- tents. In one case, its diuretic operation was evident. -The " urine discharged was almost black. It appeared as if a lev " drops of a solution of the sulphat of iron had been put into an " 'astringent infusion." This was a solitary occurrence, and one which I am unable to explain. For more ample information concerning this vegetable, I beg leave to refer the reader to Dr. Miuddds Inaugural Essay on the Arbutus Via Ursi, and the Pyrola umhllala and maexdata of Limuc-ns'. Prefixed to this dissertation, there is a good figure of the Pyrola umbellata. The bruisd leaves of this plant, Avhen externally applied, sometimes induce redness, vesication and desquamation of the skin. But this is by no means a constant operation of the veg- etable ; and therefore, it does not seem particularly worthy of our attention, in this point of view. Quercus alba. Oak. The bark. White oak bark exceeds in astringency the Peruvian bark and falls but little, if any short of it, in its tonic powers. Hence, we have a valuable domestic substitute for Peruvian bark, which is successfully employed in hamiorrhagies, alvine fluxes, and other preternatural or immoderate secretions. On account of the great difficulty in reducing it to a sufficiently .fine powder, it is most commonly given in decoction. Ranunculus bulbosus anu sceleratus. The Ranunculus sceleratus, or Celery-leaved Crowfoot, is a very acrid plant- If it be bruised, and laid upon any part of the body, it will, in a few hours time, raise a blister. This plant is a native of Europe and of America. The Ranuncu- lus bulbosus, called Bdbous Crowfoot, and Butter-cups, possesses the s.niie properties. This plant grows very plentifully in our meadows and fields; but I believe it is not a native. • I cannot forbear mentioning in this place (at the risk, perhaps, of exposing myself to the ridicule of the mere theorist,) that the nuclei, or kernels, of the common American Hazlenut (Coryleis Americana) have been found very useful in affording relief to several persons labouring under nephritic, and perhaps calculous affections. 1 mention this fact on the respectable authority of my frind, Dr. Frederick Kuhn, of Lan- caster, in Pennsylvania. Do these kernels act solely by virtue of their astringent quality ? i Philadelphia : 1803. MATERIA MEDIC A. 453 The Ranunculus bulbosus. Every part of this s/ecies of Ra- nunculus is endued with an acrid quality. But it is especially Ihe bdbous-like root which has frequently been used as a sub- stitute for cantharides. Where the foreign and native species of blistering-flies cannot readily he procured, this Ranunculus ought not to be neglected. 1 have employed it, and am dispon- ed to think, that it gives a more durable irritation to the part to which it is applied, than the anima 1 blisters which I have mentioned. If this suspicion be well founded, it will noi be de- nied, that there are cases in which the Ranunculus ought even to be preferredio those blisters. Among otlier such cases, I may mention vertigo, and affections of the stomach, boili originating in a misplaced or irregular gout. I must not omit to add, that the roots of the Ranunculus, that are collected iu the fall, may be very well preserved through the winter, by burying them in some fine, siliceous sand. When thus preserved, they retain, vith very little diminution, their active irritating quality. Rhus Copallixcm. Narrow leaved Sumach. The berries. Narrow leaved Sumach, grows naturally in most parts of the United States ; rising to the height of six feet in a slaty gravelly soil. The berries are very acid, and are sprinkled with a gray- ish pounce, of an agreeable acid taste. Rhus Glabrum. Pennsylvanian Sumach. The berries. Rhus glabrum, smooth Pennsylvanian sumach, common or upland sumach, rising to the height of eight or ten feet. The leaves are feathered, sawed, lanced, naked on both sides, and change to a beautiful red in autumn: it flowers in July. The seeds are arranged like the flowers, are red, and covered Avith a white powder of an agreeable acid taste. The two species above described are considerably astringent. An infusion of the berries sweetened with honey is sometimes used for a gargle in sore throats, and for cleansing the mouth in putrid fevers. They are also recommended as useful in several of the arts. The leaves or berries are found a valuable substi- tute for nut gcdls in dyeing or making ink, they give a deep and permanent$lack. The plants in aU their parts may be us- ed as a succedaneum for oak bark in tanniug, especially the white glove leather. Rhus Typhinum. Virginian Sumach. Stag's Horn. Vinegar Plant. The berries. This plant grows naturally in almost every part of the United States. In Virginia and Pennsylvania, it rises to the height ot 4J4 MATERIA MEDICA. ; welve or fifteen feet, with a trunk of six or eight inches iu diam- eter. The young branches are covered with a soft velvet-like down, and from their resemblance to the horn of a stag, the common people have given it the appellation of stag's horn. The flowers are produced in close tufts at the end of the branch- es, and are succeeded by seeds inclosed in purple, woolly, succu- lent covers; so that the branches are of a beautiful colour in autumn. This plant resembles in its properties the rhus copallinum and glabrum. Ribes rubrum. Currant tree. The fruit. The fruit of the red, and white currants of our gardens are greatly esteemed for their pleasant and nutritive qualities. In fevers, the juice of currants, when mixed with an equal quan- ity of sugar, and made into a jelly, is cooling and grateful to the stomach; being in a slight degree astringent and antiseptic. Currant wim, with the addition of water, is an excellent beverage during the heat of summer. Various receipts are given for mak- ing this liquor in the Dom. Encyclopedia. Ribes nigrum. Black Currant is found growing, naturally, near Kennebeck river, and it is also cultivated in gardens. This fruit is reputed to be very wholesome, and their juice is frequently boiled down into an extract or syrup with sugar, in which state it is called rob, and much esteemed in sore throats of the inflammatory kind.—The fruit is often put into rum or brandy instead of black cherries. An infusion of the young roots is useful in fevers of the eruptive kind; and in the dysenteric fevers of cattle. Rosa Gallica. Red Rose. The petals. The Gallica, French or common red rose, has large, spreading, half double, deep red flowers. It has not the fragrance of the damask rose, but the beautiful colour of its petals, and their pleas- ant astringency, have rendered them officinal. It must however be remarked, that their odour is increased by drying, while that of the damask and moss roses is almost destroyed. Rosa Damascena. Damask Rose. The petals. This is justly termed the queen of flowers, and both its elegance and fragrance have rendered it the favourite ornament ef every MATERIA MEDICA. 45a garden. It is sometimes called Dutch hundred leaved rose- The damasu rose yields on distillation, a small portion of buty- rous oil, together with a water, which possesses the odour and taste of the roses, and are generally esteemed for the agreeable flavour they impart to culinary preparations, and also to cordials. A valuable perfume is obtained from the flowers by distillation, called ottar or essence of roses. The true ottar of roses is sold in the East Indies, at the exorbitant price of twenty guineeis and upwards per ounce. It is doubtless the most elegant perfume in vegetable nature ; as a single drop imparts its fragrance through- out the room or dwelling, and suppresses other less agreeable odours. Rumex aquaticus. Water Dock. The toot and leaves. It grows in peat marshes, wet ditches, pools, at the side of rivers, and in shallow water. It flowers in July and August, and is succeeded by large seeds. This plant affords a medicine of considerable efficacy, when applied externally, as a wash for spongy, putrid gums; its roots when pulverized have been found excellent for cleaning the teeth. These roots are of a bitter, astringent taste, and have often been employed for the cure of scorbutic and cutaneous disorders, whether administered inter- nally, or applied externally in ointments, cataplasms, lotions, or fomentations. Decoctions of the leaves are, likewise, an effica- cious laxative, and have been taken with advantage in rheumatic pains, and chronical diseases occasioned by costiveness, or by visceral obstructions. The dose usually given, is a decoction of half an ounce of the fresh roots, or from one to two drachms of them, in a dry state. The Indians, says Dr. Cutler, used the root of water dock with great success in cleansing foul ulcers. It is said, they endeav- oured to keep it a secret from the Europeans. Dr. Withering says, he saw an ill conditioned ulcer in the mouth, which had destroyed the palate, cured by waslung the moutli with a decoction of this root, and drinking a small quan- tity of the same decoction daily. Rumex acutus. Narrow Dock. ~) Tfae roots. Rumex crispus. Curled Dock. $ These grow about barn yards and in cultivated fields, flowe ring in July. The roots of both species are somewhat cathartic. The seeds are said to have been given with advantage in dysen- tery. The fresh roots bruised and made into an ointment or decoction cure the itch. Some instances have occurred among the country people, of ill conditioned ulcers, and hard tumors 4oo MATERIA MEDINA. apparently of a caiuerous nature, having been entirely removed by the application of the bruised roots of dock or a decoction of the same. Ruta graveolens. Rue. The herb. This is a small shrubby plant met with in gardens, where i; flowers in June and holds its green leaves through the winter. It has a strong ungrateful smell, and a bitterish, penetrating taste; the leaves when in full vigour, are extremely acrid, insomuch as to inflame and blister the skin if much handled. Former writers on Materia Medica have entertained a very high opinion of the medicinal virtues of this plant, and it is still retained in the Mas- sachusetts and other Pharmacopoeias. It has been considered as powerfully stimulating, attenuating, and detergent, and hence, in cold phlegmatic habits it quickens the circulations, dissolves tenacious juices, opens obstructions of the excretory glands, and promotes the fluid secretions. Boerhaave is extravagant in his praises of the essential oil and distilled water of rue, for their efficacy in promoting sweat and perspiration, and for the cure of the hysteric passion and of epilepsies, and for expelling poison. In modern practice, rue is not regarded as possessing much power as a remedy. Salix alba. White Willow. The bark, and the bark of the root. The species or varieties of the willow, which have been noticed by botanical writers, are very numerous; and it is probable that the bark of all of them possesses properties in many respects similar. In 1763, Mr. Stone, an English clergyman, presented a paper to the Royal Society, on the beneficial effects of the salix alba, or white willow, in intermittent fevers; and Dr. Cullen, on this authority, and from the sensible qualities it possesses, re- commends it, in his Materia Medica, as a substitute for the cinchona. Mr. Stone gathered the bark in summer, when it was full of sap; dried it by a gentle heat, and gave a drachm of it powdered every four hours, betwixt the fits. In a few obstinate cases he mixed it with one-fifth part of the cinchona. Some: judicious physicians here, says Dr. Cutler, made trial of the bark of white willow, and recommended it as a valuable substitute for the Peruvian bark. They have used principally the bark of the root. Salvia officinalis. Sage. The leaves. The leaves of the sage have a peculiar aromatic smell, and a warm aromatic iasic, with some dejiee of bitterness and astrin- gency. MATERIA MEDICA. 4o? In its effects, sage agrees with other aromatics. It is stimulant, carminative, and tonic. In cold, phlegmatic habits, it ex- cites appetite, and proves serviceable in debilities of the ner- vous system. The best preparation for these purposes, is an infusion of the dry leaves, drank as tea ; or a tincture, or extract, made with rectified spirit, taken in proper doses; these contain the whole virtues of the sage ; the distilled water and essential oil, only its warmth and aromatic quality, without any of its roughness or bitterness. Aqueous infusions of thedeaves, with the addition of a little lemon juice, prove an useful diluting drink in febrile disorders, feeing sufficiently agreeable to the palate. SlLENE VIRGINICA. The Silene Virginica, or Ground-Pink, as it is called in some parts of our country, is another native anthelmintic. A decoc- tion of the root is used, and is said to have been found a very efficacious remedy*. Scutellaria lateriflora. Blue Scull-cap. Hooded Willow Herb. The plant. The Scutellaria is perennial, of Avhich there are numerous species indigenous to the United States. , The plant is found in great abundance on the banks of rivers and the borders of ponds ; flowering in July or August. The stem is square, branched, and attains the height of from one to three feet. The leaves are opposite, narrow pointed, on long foot stalks. The racemes are axillary and latent, bearing small violet coloured blossoms, intermixed with small leaves. The calyx is hooded, or helmet-formed, from whence originated the generic name of Scull-cap or Scutellaria. It is now introduced here on account of its recently reputed efficacy as an antidote agdnst the effects ef canine madness. Should this plant ultimately prove a success- ful remedy for a disease so truly deplorable in its nature, and destructive in its consequences, no encomiums can surpass its merits even if recorded in letters of gold. The remedy was for many years a secret, in the possession of a family by the name of Lewis, in West Chester county, and in 1809 it was promulga- ted by Mr. R. Bowne, of New York. T» the publication of Mr. B. [Med. Repos. Kcxade 3. Vol. 2. No. 3.] was annexed an ac- • From the information of my friend, the late learned Dr .^rr.es ra-een- Way, of Virginia.—This species of SUene, or C^tch-ity, prows abundantly in many parts of the United Slates, as in Pennsylvania, V;rgnua, &c-.&c. Some of our Indians have told me, that it is a poisonous pinat. Jlus^s highlv probable, if it be a fact, that it is a very efficacious unUcininiic. 58 458 MATERIA MEDICA curate engraving of this species of Scutellaria, jet in his descrip- tion he erroneously attached to it a specific name belonging to a different species, the Scutellaria Galericulata. This last spe- cies is to be distinguished by its axillary flowers in pairs, on pe- dicles from the ala> of the leaves, and pendulous. With regard to the anti-rabid virtues of Scutellaria, it is to he observed, that subsequent to its promulgation, it has been in- vestigated and tested by practical experiment, so far as oppor- tunity and the nature of the subject permit. A mass of evi- dence in favour of its efticacv may be found in a production entitled " Observations on Hydrophobia," lately published by the compiler of this work. As, however, it is still doubtful, and yet desirable to have the fact clearly ascertained how far this plant is entitled to the character of a specific preventive of hydro- phobia, every human person must consider himsedf warranted in resorting to the use of it ou any occasion which may offer, either of alleviating the misery and distress of mankind, or of arresting the devastation among the brute creation. Tiiis remedy is to be given in the form of strong infusion of thoi leaves every morning, fasting, and to be continued for sev- eral weeks. Eor cattle it may bo mixed vvith their food or drink. Sin Aprs alba. White Mustard. £ rp: Sinapis nigra. Black or common Mustard,. ^ These plants are both annual, both grow wild in England, and possess similar virtues. They produce small round compressed seeds, which have an acrid bitterish taste, and a pungent smell when reduced to powder. The common mustard has blackish seeds, and is more pungent than the white. They impart their taste and smell in perfection to aqueous liquors, while rectified spirit extracts extremely little of either. The whole of the pungency arises with water in distillation. Committed to the press, they yield a considerable quantity of a soft insipid oil, perfectly void of acrimony ; the cake left after the expression, is more pungent than the mustard itself. The imported mustard, so common at tables, and which is generally preferred to our own, is the pulverized seed of the black species ; the difference consists only in the preparation of the powder. The seeds unbruised are frequently given in palsies and chro- nic rheumatisms, and are found beneficial. They may be tak- en in the quantity of a table spoonful or more, and will gently relax the bowels. Rheumatic pains iu the stomach are often relieved by taking them in brandy. The powdered seeds, with crumbs of bread and vinegar, are made into cataplasms, and applied to the soles of the feet in fevers, when stimulants an- MATERIA MEDICA. 45« necessary. They are also topically applied in fixed rheumatic and sciatic pains. Dr. Withering says, wherever we want a strong stimulus, that acts upon the nervous system without ex- citing much heat, we know none preferable to the mustard seed. An infusion of the seed, given in large quantities, vomits ; but in smaller doses, operates as an aperient and diuretic. Mustard whey, with wine, is used as a drink m fevers. Its acrimony is said to consist in an essential oil. Mustard whey is made by boiling one and half ounce of the bruised seeds in a pint of milk, and as much water, till the curd be perfectly separated. This is perhaps the most elegant form in which mustard can be exhibited. A little sugar may be ad- ded, and an ordinary tea-cupful given four or five times a day in cases of low nervous fever, greatly warms and invigorates the habit, and promotes the different secretions. Solanum nuLCAMAR.v. Bitter Sweet. Vt'oody Night Shade. The twigs. This plant grows wild in moist hedges ; has woody, brittle stalks, and climbs on the bushes. But if there be no shrubs in their vicinity, the shoots creep along the ground, and frequently strike new roots. It flowers in the months of June and July.— The taste of the twigs and roots, as the name of the plant ex- presses it, is both bitter and sweet ; the bitterness being first perceived, and the sweetness afterwards. The dulcamara was formerly much esteemed as a powerful medicine. It is generally said to occasion some considerable evacuation by sweat, urine, or stool, particularly the latter. It has been recommended as a discutieut and resolvent medicine ; and it has been said to have been attended vvith good effects in obstinate cutaneous diseases of the herpetic kind. It has also been used, and sometimes with advantage, in cases of rheu- matism, jaundice, and obstructed menstruation. The twigs are principally employed under the form of wate- ry infusion, incloses of two leacnpsful, morning and evening. Dr. Hill has found it very efficacious in the asthma. Sophora Tinctoria. Linn. ~) Wild Indigo. Indigo Weed. Podalvria Tinctoria. Mich. $ The root and plant. This vegetable is indigenous, and supposed to be exclusively American. It is perennial, growing in great abundance in al- most every barren pasture and in woods. The stalk rises to two feet or more, sending off numerous branches. The leaves are small, termite, inversely heart shaped, and sessile. Iu July and August all its branches display, butterfly shaped, golden 4.60 MATERIA MEDICA. coloured blossoms, which render the plant very conspicuous,— The seed vessels are inflated, containing numerous seeds. The root is ligneous, rough, and irregular in shape, of a dark brown colour externally, and sending off many long slender branches. Its taste is unpleasant, subacrid, and nauseous, very similar to that of ipecacuanha. The particular medical properties of indigo weed are yet to be ascertained ; that it possesses great activity is unquestionably tree; these who in the spi ing season have; made the young shoots a substitute for asparagus experienced its drastic evacuating powers. In the hands of some physicians it is found to operate in a large dose, with much severity as an emetic and cathartic But a weak decoction of the root has frequently been given with the effect only of a mild laxative.— A decoction of the bark of the root has, it is said, been made known by au empiric experienced in its use, as a remedy in scarlatina anginosa, and its employment has been extended in a few instances to typhus or putrid (over with such good effect as to encourage further trials. An experienced physician considers it as an excellent antiseptic and febrifuge, preferring it in some fevers to Peruvian bark. As an external application, its anti- septic qualities ought to be more extensively known. In the form of fomentation or cataplasm, it has proved eminently bene- ficial when applied to phagedenic and gangrenous ulcers, espe- cially if the decoction be administered internally at the same time. A liniment prepared by simmering the cortical part of the root in cream, has been found an efficacious application to sore nipples and ulcerated breasts. A violet or pale blue colour has been prepared from the leaves and small branches of this plant and used as a substitute for indigo. The leaves turn black whew dried. Spigelia Marilandica. Carolina Pink. The root. This plant is perennial, and grows wild in most of our south- ern states. The roots are celebrated as an anthelmintic, par- ticularly for the expulsion of lumbrici from the alimentary ca- nal. Every part is possessed of the anthelmintic property, though the root is most active. It is commonly administered in the form of infusion ; an emetic is generally premised, and its purgative effect assisted by some suitable addition, as senna or jalap. By some the powdered root is directed in doses of ten or fifteen grains; while others prescribe it in drachm closes. But it shod.! be observed that according to the late Dr. Lining of Charleston, when exhibited in large doses, and without prop- er precautions, it sometimes produces very singular and dis- tressing effects upon the nervous system, such as vertigo, pains MATERIA MEDICA. 461, over the eyes, and dilated pupil. As a vermifuge, spigelia has acquired a Superior confidence, and it often affords relief and effects a cure, in cases where no worms are discharged. It is supposed by Dr. Barton, that it will be found highly useful in some febrile diseases of children, unaccompanied by worms, es- pecially in the insidious remittent which so frequently lays the foundation of dropsy of the brain. Spirjea TRrFOLi.vr-A, Indian Physic. Ipecacuan, Sfc The root. This shrub grows plentifully in the United States, and is one of the feAv active plants of the class icosandria. The root, the part employed, consists, like that of the officinal Ipecacuan of a bark, and woody part. The active power seems to reside ex- clusively in the bar' . It is a safe and efficacious emetic in do- ses of about thirty grain,';. It also seems to possess a tonic pow- er, and has accordingly been thought peculiarly beneficial iu intermittent fevers. It is sometimes very injudiciously employ- ed by the country people, insomuch that they are obliged to apply for medical aid, to remove the debility induced by the large doses of the root which they employ. Another species, it is said, grows in Kentucky, which is still more valuable us an emetic, than the one under notice. Statice Limoniu-u. Marsh Rvtemary. Lavender Thrift. See Leivmder. The root. This is Avell knoVvn iu the New England States. It is indi- genous and pelennial? growing on the sea shore, in salt marsh- es ; and the fissures or cliffs of rocks near the sea coast: it is in flower from July to September. The stem is naked, branched, and about a foot high. The radical leaves are long, pointed, and grow on foot stalks. The flowers are blue, and grow on long spikes on the tops of the branches. The roots of this plant are powerfully astringent. A decoction of them is given and used as a gargle Avith success in Cankers and ulcerated sore throats. We learn from an authentic source, that the late Dr. Mews, of Providence, held the root of this plant in high estima- tion in cases of aphthous states of fever accompanying dysente- ry, ulcerous sore throats, or scarlatina anginosa. He valued it as the greatest ahtiseptic he was acquainted with, and said he could administer it in cases where the bark was inadmissible. Dr. William Baylies, of Dighton, in ,a communication to the Massachusetts Medical Society, makes favourable mention of, this root from his experience in the ulcerated sore throat, as it appeared in that town in 1785 and 1786. This in a large dose Operate* as a vemit; in a smaller, proves a powerful ex- 402 MATERIA MEDICA. peclorant; and from its sensible qualities, one would suppose it to possess considerable antiseptic powers. I am well assured it was the basis of a medicine used by a physician in Providence, with very great success in this complaint. It is undoubtedly of great efficacy, and deserves a more thorough investigation." Tanacetoi vulgare. Common Tansy. The leaves and seeds. Tansy is an idigenous perennial growing by road sides and the borders of fields, and is also cultivated in gardens. Its yel- low blossoms appear in August. This plant possesses a warm bitter taste; it is deobstruent, not ungrateful to the palate, and some have had a favourable opinion of it in hysteric disorders. The leaves and seeds have been of considerable esteem as an- thelmintics, and are given in doses of from one scruple to one drachm. The leaves are frequently used to give colour and fla- vour to pudding. And if fresh meat be rubbed with the plant, it will be effectually preserved from the attacks of the flesh fly. TRIOSTEUM PERFOLIATUM. Among the more mild, I may mention the Triosteum perfo- liatum, sometimes called Bastard-Ipecacuanha. This, when giv- ' en in very large doses, sometimes proves emetic; hence the vulgar name. But I find it a good cathartic. Cortex, or bark, of the root is employed. I give it in doses of twenty and thirty grains. On some occasions, it has seemed to operate as a diu- retic. But this may have been only an accidental circumstance. Rhubarb sometimes produces the same effect, as has been ob- served by C. Piso. Tussilago Farfara. Coltsfoot. The leaves and flowers. This grows wild in moist situations, producing yellow flowers in February and March : these soon fall off, and are succeeded by large, roundish leaves, hairy underneath ; their taste is her- baceous, somewhat glutinous and subacrid. It is recommended in coughs, phthisis, and other disorders of the breast and lungs, and some use it in scrofula. It is chiefly directed to be taken with milk, and upon this, probably, more than on the tussilago itself, any benefit derived from it in practice is to be explained- Ulmus fulva. American Elm. The inner bark. It rises to the height of thirty feet, with a pretty strong trunks div iding into many brauches, and covered with a light coloured MATERIA MEDICA. 463 v.xnigh bark. The leaves are oblong, oval, and sharp pointed, unequally sawed on their edges, unequal at the base, very rough on their upper surface, and hairy underneath. The flowers are produced thick upon the branches, upon short, collected foot stalks, and are succeeded by oval, compressed membraneous seed vessels, vvith entire margins, containing one oval compres- sed seed. The inner bark by infusion or gentle boiling in water affords a great quantity of insipid mucous substance, that is ap- plicable to a variety of important uses. Dr. Mitchell says it has been beneficially administered in catarrhs, pleurisies, * and quinsies ; it has been applied as a poultice to tumours, and as a liniment to chops and festers. [Letter to Dr. North, Amer. Museum, vol. 7th.] ' The surgeons of our revolutionary army, and also those of general Wayne's army, who defeated the Indians in August 1794, experienced the most happy effects from the application of poultices of the elm bark to gun shot wounds, which were soon brought to a good suppuration, and to a disposition to heal. It was applied as the first remedy. When tendency to mortifica- tion was evident, this bark bruised, and boiled in water, produ- ced the most suprising good effects. After repeated compara- tive experiments with other emollient applications, as milk and bread, and linseed poultice, its superiority was firmly established. In old ill-conditioned ulcers, anel in fresh burns, equal benefit was derived from it. The infusion of the bark was used with ad- vantage as a diet drink, in pleurisy, and catarrh, and also in diarrlima and dysentery. Many of the above facts relative to the medicinal qualities of the red elm, were communicated, says the editor of the Domestic Encyclopaedia, by Dr. Joseph Strong, of Philadelphia, who served as surgeon in the western army ; and adds, as a proof of the nutriment which it affords, that a sol- dier who lost his way supported himself for ten days upon this mucilage and sassafras. The editor of the above mentioned work, (vol. 2d, p. 448) proceeds to observe, that the red elm tree may be considered as a highly valuable addition to our stock of medicines, exclusively American, and ought to be care- fully searched for by the medical gentlemen in the country, and preserved from the indiscriminate axe. The inner bark of the slippery elm, or its mucilage, has been found by recent experience to he singularly beneficial when applied to chilblains, cutaneous eruptions, and various kinds of sores and ulcers; and there is much reason to believe, that its in- ternal use in dysentery, consumption, &c. may be attended with greater advantage than is generally imagined. This tree cer- tainly may be recommended to the particular regard of medical practitioners as a new, and domestic article of our Materia Medica, whose medicinal virtues will probably be found to merit a large share of confidence; 464 MATERIA MEDICA. UrticA dioica. Common Nettle. The plant. This is a Avell known perennial weed. The leaves of the fresh plant stimulate, inflame, and raise blisters on the part of the skin which they touch. Hence, Avhen a powerful rubefacient is required, stinging Avith nettles has been recommended. It has been said, sometimes to have succeeded in restoring sense and motion to paralytic limbs. M. Zannetini, in Italy, asserts, that the flowers and seeds of the common nettle, may, with efficacy be substituted for the Peruvian bark, iu all febrile affections, es- pecially in tertian and quartan agues. 1 operates more^speedi- ly than the bark ; and in large doses, induces a lethargic sleep , the portion to he given should never exceed one drachm, and should be administered in wine, two or three times in twenty- four hours. The same cautions thst are necessary in the use of Peruvian bark, are likewise to be observed in taking the seeds and flowers of the nettle. Viola odorata. March Violet. The recent flower. This plant is perennial, and found wild under hedges, and ia shady places; but shops are generally supplied from gardens. Its flowers are so remarkable for their delightful odour, and their peculiar richness of colour, that they have given a name to both. They impart their colour and flavour to aqueous liquors; a syrup made by this infusion has long maintained a place in the shops, and is said to be an agreeable and useful laxative for children ; but is chiefly valued as a delicate test of the presence of uncombined acids or alkalies, the former changing its blue te a red, and the latter to a green colour. Veratrum virioe. A species of Veratrum, or Helonias, nearly allied to the Vera- trum album of the old continent, is a pretty common plant in many parts of the United States, and seems to possess the si; me sternutative and other active properties, that the foreign plant does. The American plant, to which I allude, is the Veratrum viride of Aiton: the Helonias viridis of some later botanists.---- A COMPLETE TREATISE ON THE ART of FARRIERY, WHEREIN ARE FULLY EXPLAINED THE NATURE AND STRUCTURE OP THAT USEFUL CREATURE, A HORSE : WITH THE DISEASES AND ACCIDENTS HE IS LIABLE TO j AND THE METHODS OF CURE. LIKEWISE, RDLES FOR BREEDING AND TRAINING OF COLTS : PRACTICAL RECEIPTS FOR THE CURE OF COMMON DISTEMPERS INCIDENT TO OXEN, COWS, CALVES, SHEEP, LAMBS, HOGS, &C. TO WHICH IS PREFIXED TEN MINUTES ADVICE TO THE PURCHASERS OF HORSES. NEW-HAVEN: PUBLISHED BY NATHAN WHITINC. 1816. *KTH HTCHATmS, riUNTF.K........MTTU.T.-RTOWV. PREFACE. THE following Treatise Avas compiled with intent to guard the unwary from deception in the purchase, as Avell as to refresh the memory of gentlemen better acquainted with the requisite qualifications, of that noble animal the Horse. The remarks are drawn from long, and, in some instances, dear-bought experience, in the snares which jockies and grooms in general lay before those avIio are under the necessity of deal- ing with them. Having premised thus much, it may not be thought improper, by Avay of introduction, to observe, That a large shin bone, that is long from the knee to the pastern, in a foal shews a tall horse. Double the space in a foal, newly foaled, betwixt his knee and withers, will, in general, he the height of him when a complete horse. Foals that are of stirring spirits, wanton of disposition, active in leaping, running, and chasing, ever leading the way, and striving for mastery, always prove horses of excellent mettle : and those of the contrary disposition most commonly jades. Before I enter on my particular observations, it may not be unnecessary to give one general rule, which experience has proved to me a good one, that is, no foot, no horse. A horse's ability, and continuance in goodness, is known by his hoof^- PREFACE If they are strong, smooth, hard, deep, tough, upright, and hollow, that horse cannot be a very bad one ; for they are the foundation of his building, and give a fortitude to all the rest j and if otherwise, he cannot be remarkably good or lasting. Without further preface, I shall therefore proceed to the fol- lowing particular remarks and observations. T A P L 1 N I M P R OVE I), OR ADVICE TO THE PURCHASERS OF HORSES, Nothing is more true than the common observation, that in the art of horsemanship, the most difficult part is that of giving proper directions for the purchasing a horse free of fault and blemish. The deceptions in this branch of traffic being looked on in a less fraudulent light than they seem to deserve, and of consequence are more frequently practised. It shall, therefore be my business in the following brief remarks, to shew, in the best manner I am able, the imperfections which, from either na- ture or mischance, every horse is liable to. In the Stable.} See the horse you are about to purchase in the stable, without any person being in the stdl with him ; and if he has any complaint in his legs he will soon show it, by altering the situation of them, taking up one and setting down the other ; and this denotes his being foundered or overworked. On ordering him out let no one be the last in the stable but yourself; you should also, if possible, be the first in, lest the owner, or some of his quick emissaries, take an opportunity to fig him ; a practice common among dealers, in order to make the tail shew as if carried very high, when, in reality, the day after, he will in appearance be five pounds worse. The Eyes.] This is the proper time to examine his eyes, which may be done in a dark stable with a candle, or rather in the day time when he is led from the stall; cause the man who leads him to stop at the stable door just as his head peeps out, and all his body is still within. If the white of the eye appears red- dish at the bottom, or of a colour like a withered leaf, I would not advise you to purchase him. A moon-eyed horse is known by his weeping and keeping his eyes almost shut at the begin- ning of the distemper : as the moon changes, he gradually re- covers his sight, and in a fortnight or three weeks sees as well 6 . ADVICE TO THE as before he had the disorder. Dealers, when they have such a horse to sell, at the time of his Aveeping, always tell you that he has cot a bit of straw or hay in his eye, or that he has re- cdved some blow ; they also take care to wipe away the hu- mour, to prevent its being seen ; but a man should trust only himself in buying of horses, and above all be very exact in ex- amining the" eyes : in this he must have regard to time and place where he makes the examination. Bad eyes may appear toocI in winter, Avhen snow is upon the ground ; and often good ones appear bad, according to the position of the horse. Nev- er examine a horse's eyes by the side of a white wall, where the dealers always choose to shew one that is moon-eyed. The moon-eyed horse has always one eye bigger than the other, and above his lids you may generally discover wrinkles or circles. If you obseiwe a fleshy excrescence that proceeds from the corner of the eye, and covers a part of the pupil, and is in ,shape almost like the beard of an oyster, though seemingly a matter of no great consequence, yet it is Avhat I call a Witlow in the eye, and if suffered to grow, it draws away apart of the nourishment of the eye, and sometimes occasions a total pri- vation of sight. On the contrary, if the eyes are round, big, black, and shining; if the black of